Human strongyloidiasis research requires a large supply of Strongyloides stercoralis.
This can be achieved through in vivo maintenance of Strongyloides stercoralis in Meriones
unguiculatus, but isolating a large quantity of Strongyloides stercoralis to establish the
colony from an infected patient is too difficult to achieve. Hence, Strongyloides ratti have
been used as a model in human strongyloidiasis research. This study describes a successful
establishment and maintenance of Strongyloides ratti infection in experimentally
immunosuppressed Wistar rats. Large quantities of filariform (iL3) larvae of Strongyloides
ratti for research related to human strongyloidiasis have been harvested following this
protocol. Molecular detection method based on PCR using species specific primers was used
to confirm the species of the harvested infective larvae (iL3). Additionally, the identification
of histopathological lesions confirmed the presence of infective larvae (iL3) in the liver and
lungs as a result of an increased parasite burden due to hyperinfection and disseminated
disease. This pathological presentation was found to be similar to that reported in
Strongyloides stercoralis-infected immunocompromised human subjects.
Human-landing catch (HLC) technique was undertaken in nine selected study sites
within Peninsular Malaysia to determine the biting cycle of Aedes, Armigeres, Culex, and
Mansonia mosquitoes. HLC was conducted 24 hours on three different nights in a duration of
one week at each study site. Aedes albopictus were found in all study sites with bimodal
biting cycle, whereas the biting peak of Aedes butleri was recorded between 1600 and 1900
hr. For Armigeres, five study sites demonstrated similar biting peak hour (1900 – 2000 hr) for
Ar. kesseli four study sites showed biting peak at 1800 – 1900 hr for Ar. subalbatus. Culex
quinquefasciatus was collected from all study sites except in Sungai Penchala with its biting
activity beginning from 1900 hr. Both Mansonia annulifera and Mansonia uniformis captured
in two different study sites showed similar biting peaks (1500 – 1600 hr). It is recommended
that vector control activities be carried out at dusk as almost all mosquito species captured
started their biting activities at that time.
A cross-sectional study was conducted to determine the prevalence of feline
bartonellosis and the associated clinicopathological findings in cats presented to the University
Veterinary Hospital, Selangor, Malaysia from 2013–2014. Out of 284 cats examined, Bartonella
DNA was detected in 48 (16.9%) cats using a specific polymerase chain reaction (PCR) assay
targeting the internal transcribed spacer of Bartonella species. Bartonella henselae strain
Houston was identified through BLAST analyses of randomly selected amplicons. Univariable
analysis showed significant association of feline bartonellosis with cats < 2 years of age (OR
1.37, 95% CI 0.982–1.927, p = 0.036) and those presenting with ocular discharge (OR 3.211,
95% CI 1.422–7.248, p = 0.003). Significant associations of neutrophilia (OR 2.244, 95% CI
1.131–4.452, p = 0.019) and monocytosis (OR 2.476, 95% CI 1.154–5.312, p = 0.017) with
bartonella infection in cats were observed. This study reports for the first time the prevalence
(approximately 17%) of feline bartonellosis in Malaysia and highlights several
clinicopathological factors associated with the disease.
Surveys are conducted at central zone of Shah Alam in determining the distribution
of dengue vector mosquito population. A minimum of 100 houses was randomly searched for
breeding at every 24 localities in central zone of Shah Alam. Number of buildings at central
zone of Shah Alam was obtained from the local authorities in order to calculate the sample
size. The positive and wet containers in each locality were recorded and the types of container
for positive containers were categorized accordingly. The numbers of larvae in each container
were collected. The pupal index (PI), house index (HI), container index (CI), and the Breteau
index were calculated for each locality. Plastic containers (CID 1) showed the highest number
of positive, while Seksyen 1 and Seksyen 14 showed the highest percentage of BI with 70%
and 80% respectively. This study would provide the information regarding Aedes mosquito
infestation and , highlighted the central region as the dengue fever was fluctuating in these
area. It can also help to create strategy to reduce the mosquito menace in our country with
more cost-effective mosquito larval control.
Blastocystis has been increasingly reported in water bodies. However, lack of
studies to determine the presence of Blastocystis in water used by the aborigines in Malaysia
has led to the birth of this research. This study was therefore aimed to determine the
occurrence of Blastocystis in water samples in aboriginal settlements in Pahang, Malaysia.
Water samples collected from seven sampling points of two rivers and other water sources in
the villages were subjected to filtration and cultivation followed by trichrome staining. The
trichrome stained slides were observed microscopically under 1000X magnification for the
presence of Blastocystis. River samples were also measured for physicochemical parameters.
From this study, 42.9% of the river water and 6.25% of other water samples were positive for
Blastocystis. All river samples showed presence of Escherichia coli and Enterobacter
aerogenes, indicating faecal contamination. Statistical analysis showed Blastocystis
occurrence in the river were significantly correlated conductivity, turbidity, chemical oxygen
demand (COD), total dissolved solid (TDS), concentration of sulfate and faecal coliforms.
The river water used by the aborigines is a probable source for Blastocystis transmission in
this community. Therefore, protection of the river from organic material and faecal
contaminations are highly required in order to control the contamination by Blastocystis.
Entero- and exfoliative toxin gene profiling of 237 methicillin-susceptible Staphylococcus aureus (MSSA) isolated
from Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were carried out via PCR amplification. Among
the tested toxin genes, sei was found to be the most prevalent (54.9%).
Nor Azian Abdul Murad, Sue-Mian, Then, Mohd Ridhwan Abdul Razak, Conjeevaram, Rajendrarao Thambidorai, Sri Noraima Othman, Rosniza Mohamad Hussain, et al.
Hirschsprung’s disease (HSCR) is a disorder associated with congenital absence of ganglion cells in the
gastrointestinal tract. Molecular analyses have identified variants in various genes including RET, GDNF,
EDN3 and EDNRB that are involved in the development, migration and survival of neural cells. Variants
in the receptor tyrosine kinase (RET) are most common and have been identified in 10-20% of sporadic
HSCR patients. The objective of this study was to screen for RET gene variants in Malaysian patients with
HSCR. Thirty-two patients with HSCR and 30 normal controls were recruited for this study. Mutations
were screened using the Polymerase Chain Reaction – Denaturing High Performance Liquid
Chromatography (PCR-dHPLC) approach. Mutations identified were then confirmed using Sanger
sequencing. We identified one novel rare variant in exon 4 (A268A c807 G>C) in one patient. We also
identified the common coding sequence variantsA45A (c135G>A), A432A (c1296A>G), L769L (c2307 T>G)
and the G691S in our cohort of patients. In conclusion, our Malaysian patients with HSCR diseases showed
the presence of similar RET gene common variants which have been described in other populations. We
have also identified a novel variant in exon 4 (A268A).
Precision medicine is mainly about genome-driven
clinical decision-making which is the use of genome
data from the patient to decide on tailoring the best
treatment for the patient. The completion of the human
genome project in 2003 has paved the way for a deeper
understanding of diseases at the molecular level. The
term genomics medicine has since emerged as
clinicians and researchers capitalized on the
knowledge of the genome to improve the management
of many diseases. In the past decade, the term
personalized or precision medicine was introduced to
represent the tailoring of treatment to each individual
based on a person’s unique genetic makeup,
environment and lifestyle [1]. The coining of the term
precision medicine, as opposed to the more common
term ‘personalised medicine’, was intended to
highlight the principle that subgroups of patients could
be defined, often by genomics, and given treatment in
more specific ways [2]. In simple terms, it means
giving the right treatment to the right patient at the
right time with the right outcome. The concept is not
entirely new as it has been applied before in the
practice of blood transfusion where each patient is
given the appropriate blood units based on their blood
groups. However, the emergence of genome data has
allowed a more comprehensive application of
personalized medicine to make it more precise. The
unravelling of the molecular events in certain diseases
like cancers has also led to the development of targeted
therapies. (Copied from article)
Leptospirosis is endemic in Malaysia with Leptospira species extensively isolated
from domestic and wild animals. Rats were found to be the principal maintenance hosts
followed by cattle, pigs, and dogs. The objectives of this study were to isolate and identify
Leptospira serovars circulating among swine from three different farms and also from stray
dogs and cats from Klang valley, Selangor, Malaysia. Urine and kidney samples collected from
150 stray dogs, 50 cats and 81 swine were inoculated into semi-solid Ellinghausen McCullough
Johnson and Harris (EMJH) media supplemented with additional 5-Fluorouracil. Dark field
microscopy revealed only one positive culture of Leptospira from dog and swine samples, but
all cat samples were negative. The PCR technique using published primers detected 11
positives in urine samples of dogs and 5 positives from swine. The microscopic agglutination
test (MAT) confirmed the presence of two serovars in both dog and swine populations namely,
L. interrogans serovar Canicola and L. interrogans serovar Pomona (MAT > 100), with Not
I-PFGE analyses separating these two serovars into distinct profiles. Despite the low
prevalence in stray dogs, the latter may play an important role in the contamination of the
environment. Swine can also pose a potential risk of infection to humans and other domestic
animals, especially those living close to swine farms. Thus improving hygiene and eradication
of rodents in swine farms are likely to reduce the risk of infection.
This study was carried out to investigate the Coagulase Negative Staphylococci
(CoNS) nasal carriage and the presence of methicillin resistant Coagulase Negative
Staphylococci (MR-CoNS) among health sciences students at Faculty of Medicine and Health
Sciences, Universiti Putra Malaysia. A total of 120 isolates of CoNS (62.5%) was isolated from
192 student volunteers. The mecA gene was detected in 15 isolates of CoNS (12.5%). Eight
out of the 15 isolates of mecA positive CoNS were resistant to cefoxitin in disc diffusion test
whereas the remaining seven isolates of mecA positive CoNS were susceptible to cefoxitin.
Analysis of questionnaires showed no significant association between CoNS nasal carriage
and the socio-demographic and risk factors except for the genders and history of cold
(P < 0.050). Generally, this finding showed a relatively low level of methicillin resistance
among CoNS nasal carriage from student volunteers.
This study investigated canine vector borne diseases (CVBDs) of zoonotic
significance in three major shelters in Peninsular Malaysia in order to highlight the
importance of shelter management in diseases prevention. Since crowded housing has
the potential to bring vectors and infected dogs into close proximity, the prevalence of
CVBDs infection is always higher in sheltered dogs in comparison to pet dogs. Serum
was collected from 90 adult dogs (30 from each shelter) from three shelters in different
regions of Peninsular Malaysia (Shelter A, B and C). The prevalence of Dirofilaria immitis,
Ehrlichia canis, E. ewingii, Anaplasma phagocytophilum, A. platys and Borrelia
burgdorferi in dogs residing in three shelters with different management protocols was
investigated by using rapid clinical test kits, SNAP® 4Dx® Plus (IDEXX Laboratories,
Westbrook, ME). The most common pathogen detected was Ehrlichia spp. (55.6%, 50
out of 90 dogs), followed by Anaplasma spp. (16.7%; 15 out of 90 dogs). Dirofilaria
immitis could only be detected in one of the shelters (10.0%; nine out of 90 dogs). No
evidence of B. burgdorferi was detected in all three shelters. Forty one out of 90 dogs
(45.6%) were infected with at least one pathogen meanwhile 14 out of 90 dogs (15.6%)
were infected with more than one pathogen. It is of crucial importance to practice
preventive measures during the admission of the new animals into the facilities.
Occasional treatment of the dogs (as practiced in Shelter B) was not effective when
compared to scheduled preventive measures. Future studies should emphasize the
isolation and additional molecular characterization of vector borne pathogens in Peninsular
Malaysia. In addition, studies that define the tick species that infest dogs in this region
would help to elucidate their role as vectors for disease transmission.
This study was conducted to determine the current prevalence of nematode
infections in small ruminants and the management of farms in Terengganu, Malaysia. A total
of 267 faecal samples from sheep and goats were collected and examined by the Modified
McMaster method, larval culture and third stage larva identification. Results revealed that
the worm egg count (WEC) for nematode infections ranged between 0–26,800 e.p.g. and the
distribution of the WEC was different between farms (χ2 (15) = 165.72, p
Fat embolism syndrome is manifested by the fat globule presence in the pulmonary and systemic circulation. A 34-year-old man was involved in a motor vehicle accident with a fracture of the left femur and avulsion fracture of the left posterior cruciate ligaments. He developed signs and symptoms that suggested an early diagnosis of fat embolism syndrome. Intravenous methylprednisolone administration was administered as part of the treatment. The role of methylprednisolone in a patient with fat embolism syndrome is controversial due to unproven effectiveness. In this case, fat embolism syndrome after a femur fracture was treated successfully with methylprednisolone.
Colonic lipomatosis is relatively a rare tumour of mesenchymal origin, composed of welldifferentiated adipocytes interlaced by fibrous tissues. A 59-year-old lady presented with right iliac fossa pain with positive rebound tenderness, Rovsing’s and obturator signs. Investigation revealed marked leucocytosis suggestive of an acute appendicitis. Diagnostic laparoscopy revealed an inflamed appendix with concomitant caecal mass suspecting of a malignancy. Laparoscopic right hemicolectomy was proceeded following oncologic resection. However, final histopathologic examination was consistent with caecal colonic lipomatosis with concomitant acute appendicitis. Hereby, dual pathologies can be elicited in an acute abdomen.
Both metformin and gliclazide have been used extensively in the management of type II diabetes mellitus. Metformin and gliclazide overdose can lead to severe hypoglycaemia refractory to intravenous (IV) dextrose rescue therapy. A 21-year-old man complained of vomiting and felt dizzy after four hours of taking 70 tablets of Metformin 500 mg and 40 tablets of Gliclazide 80 mg. He had major depressive disorder and wanted to commit suicide. He was given IV Dextrose 50% 50 cc immediately. Octreotide had been used successfully to reverse the refractory hypoglycaemia caused by gliclazide overdose. Unfortunately, he developed severe lactic acidosis with acute kidney injury. Dialysis had been done by continuous venovenous haemodiafiltrationa and intravenous sodium bicarbonate 8.4% infusion was given. However, the patient succumbed due to the severe lactic acidosis and kidney failure despite of urgent dialysis. Octreotide infusion helps in preventing refractory hypoglycaemia secondary to sulfonylurea overdose by inhibit calcium-mediated insulin release. Metformin overdose causes severe lactic acidosis due to conversion of glucose to lactate. Sodium bicarbonate therapy in metformin induced lactic acidosis is also controversial. Though sulfonylurea and metformin are the most commonly-prescribed anti-hypoglycaemic agents, thus during prescribing everyone has to be careful about the overdoses and side effects of these drugs.
Escherichia coli sequence type 131 (ST131) carries multiple drug resistance (MDR) genes as well as virulence genes. Drug resistant characteristics give a management problem to health care personnel. Four MDR Escherichia coli ST131 H30-Rx subclones were identified among 80 Uropathogenic E. coli (UPEC) isolates by using 4 allelic-specific Polymerase Chain Reactions (PCR) in two hospitals of Kota Kinabalu, Sabah, Malaysia. There is emergence of multidrug resistant E. coli in Kota Kinabalu.
The huge population of persuadable, active, healthy and young students is the potential as blood donors to meet safe blood donation. This study focused on the existing level of knowledge regarding voluntary blood donation among medical (Faculty of Medicine and Health Science) and nonmedical students with science background (Faculty of Engineering) at the Universiti Malaysia Sabah. Four hundred and fifty-five students consisting of medical (231) and nonmedical (224) were selected through stratified random sampling to participate in the study. Data was collected using validated structured questionnaire. Statistical analysis was performed by structural equation modelling using SPSS AMOS Graphics version 22 and SPSS version16. The results showed a significant (pp
Staphylococcus aureus food poisoning and Salmonellosis outbreaks have been
associated with two popular ready-to-eat items: sushi and sashimi. Thus this study aims to
determine the prevalence of S. aureus and S. enterica in sushi and sashimi in Malaysia. Sushi
(149) and sashimi (51) were collected from 14 retail outlets comprising supermarkets,
hypermarkets, restaurants and open-air night markets. Bacterial isolation was carried out
using Baird-Parker and CHROMagar Salmonella Plus selective media. The food pathogens
isolated from microbiological media were then confirmed by molecular analysis. The results
confirmed an overall S. aureus and S. enterica contamination of 42% (84/200) in the sushi and
sashimi samples. Regarding prevalence of the individual pathogens involved, S. aureus was
detected in 26% (52/200) and S. enterica in 16% (32/200) of the contaminated samples. This
study demonstrates a high occurrence rate of S. aureus and S. enterica in sushi and sashimi
foods in Malaysia, and warrants the necessity to monitor the microbiological process of RTE
foods to ensure food safety for consumers.
Taeniasis, endemic in Southeast Asia, is caused by Taenia saginata (for beef) or
Taenia solium and Taenia asiatica (for pork). T. solium also causes cysticercosis which can
affect various organs. Taeniasis and cysticercosis cases are rarely reported in Malaysia. We
report here two separate cases of beef taeniasis, and an interesting case of neurocysticercosis
in a Malay Muslim. The taeniasis cases involved a Malaysian Chinese and a native Sabahan.
Proglottids were recovered from them, and identification of the tapeworm done either from
the microscopic examination of the egg or using PCR-based molecular diagnosis. Upon
confirmation of taeniasis, both cases were given praziquantel and had been asymptomatic
since. The neurocysticercosis case involving a Muslim who presented with seizure, was
confirmed by histopathological examination of tissue sections taken from craniotomy excision
of the brain lesion. He was given one month course of albendazole 400 mg bid and
dexamethasone, and had been well and seizure free since. The two cases of taeniasis
documented here had acquired the disease through eating raw or undercooked contaminated
beef. For the neurocyticercosis case, it is suspected that he might have acquired the infection
in one of his travels through human to human transmission via contaminated food or water
consumption, given that Malaysia is not T. solium endemic area. Lastly praziquantel is an
effective drug for beef taeniasis, while a combination of albendazole and dexamethasone
work well for neurocysticercosis.
A total of 120 non-consecutive MRSA isolates were obtained from hospitalized
patients at Hospital Kuala Lumpur, Malaysia. All isolates were subjected to antimicrobial
susceptibility tests and genotyping based on staphylococcal cassette chromosome
mec(SCCmec), Staphylococcus aureus protein A typing (spa) and multilocus sequence typing
(MLST). Vast majority of MRSA isolates were resistant to more than three classes of antibiotics.
Five antibiotic resistance profiles were observed among the MRSA isolates. All isolates
tested were still susceptible to vancomycin. Genotyping revealed isolates are highly clonal,
where all MRSA belonged to the predominant Asian clone ST239 comprising 4 spa types. Spa
typing revealed four different spa types. Continuous monitoring and effective therapeutic
options for Asian MRSA clone is recommended.