Browse publications by year: 2020

  1. Fulltext Teaching Epidemiology and Biostatistics: a peer-led teaching module for postgraduate psychiatry student
    Pang,Nicholas Tze Ping, Koh,Eugene Boon Yau, Sandi James, Mohd Amiruddin Mohd Kassim
    Borneo Epidemiology Journal, 2020;1(2):157-162.
    MyJurnal
    Background and Objective: Biostatistics and epidemiology have been integral subjects in any postgraduate courses, including medical specialties Master programs. Both are widely accepted as among the difficult and confusing subjects, which worsen by lack of adequate exposure and often, time constraints. Hence, peer-led learning approach was proposed as a viable option to the traditional lecturer-driven learning style
    Method: The peer-led approach intends to promote targeted learning and conceptual understanding, instead of widely sweeping learning, which is rather directionless and could cause information overload
    Discussion: Students were divided into two groups, namely humanities-inclined group and science inclined group. Different pedagogical methods to address the different groups were discussed.
    Conclusion: This approach helps to make the learning more palatable, boosting knowledge retention and fostering camaraderie spirit among colleagues
    MeSH terms: Biometry; Humans; Humanities; Learning; Medicine; Students; Biostatistics
  2. Fulltext Mitigation measures during elections and it’s impacts on COVID-19 Pandemic: Sabah State (Malaysia), New Zealand and the United States
    Syaza Zainudin, Mohd Amiruddin Mohd Kassim, Nor Nadia Mohamad Ridza
    Borneo Epidemiology Journal, 2020;1(2):145-156.
    MyJurnal
    Background and Objective: Countries all over the world respect the election process as one of the fundamental steps in forming a government. However, the exponential spread of COVID-19 has been deeply alarming, with a high number of positive cases and total deaths, forcing World Health Organization to declare it as a pandemic on 11thMarch 2020. During these unprecedented events, governments have had a tough decision to balance between the constitutional obligation to hold an election and the safety of the people. As such, electoral commissions have implemented numerous approaches to allow election to proceed in a safe and controlled setting during the pandemic.
    Methods: The preventative measures and standard operating procedures in the Sabah state of Malaysia, NewZealand and the United States elections are discussed, as well as COVID-19 post-election situation in respective countries. Innovative approaches and election flexibilities shall be considered to allow voting in the safest way possible, following the new normal.
    Discussion:Nevertheless, countries need to evaluate its strength of public health response when deciding to hold elections due to potential devastating outbreaks following elections despite measures taken.
    Conclusion: The election is a fundamental process in a democracy. Countries are required to be flexible and innovative in their approach to hold a safe election. Nevertheless, it may be prudent for countries with fewer resources and poor pandemic control to postpone election as a rise in cases will be catastrophic, putting many lives at risk.
    MeSH terms: Democracy; Disease Outbreaks; Government; Humans; Malaysia; Politics; Public Health; Reference Standards; United States; World Health Organization; Pandemics
  3. Fulltext Indonesian version of the fear of COVID-19 scale: validity and reliability
    Mohd Amiruddin Mohd Kassim, Friska Ayu, Assis Kamu, Pang,Nicholas Tze Ping, Ho,Chong Mun, Hafid Algristian, et al.
    Borneo Epidemiology Journal, 2020;1(2):124-135.
    MyJurnal
    Background and Objective: The Fear of COVID-19 Scale (FCV-19S) is a seven-item uni-dimensional scale assessing the severity of COVID-19 concerns. A translation and validation of the FCV-19S in Bahasa Indonesia language was expedited in view of the worrying trends of COVID-19 in Indonesia as well as its psychological squeal.
    Methods:Formal WHO forward and backward translation sequences were applied in translating the English FCV-19S into Bahasa Indonesia. Indonesian university participants were recruited viaconvenience sampling online using snowball methods. The reliability and validity of the Indonesian FCV-19S was psychometrically evaluated by applying confirmatory factor analysis and Rasch analysis in relation to sociodemographic variables and response to the depression, anxiety, and stress components of the Indonesian version of DASS-21. The sample consisted of 434 Indonesian participants.
    Results:The Cronbach α value for the Indonesia FCV-19-I was 0.819 indicated very good internal reliability. The results of the confirmatory factor analysis showed that the uni-dimensional factor structure of the FCV19S fitted well with the data. The FCV-19-I was significantly correlated with anxiety (r=0.705, p
    MeSH terms: Anxiety; Anxiety Disorders; Depression; Factor Analysis, Statistical; Fear; Humans; Indonesia; Language; Psychometrics; Translating; Translations; Universities; World Health Organization; Reproducibility of Results
  4. Fulltext Early experience in surgical treatment of adolescence idiopathic scoliosis: a report of four cases
    Muhammad Wafiuddin Ahmad, Ed Simor Khan, Rajandra Kumar, Zamzuri Zakaria, Ahmad Faiza, Haidar Nusuruddin, et al.
    Borneo Journal of Medical Sciences, 2020;14(1):39-47.
    MyJurnal
    Adolescent idiopathic scoliosis (AIS) is the most common spinal deformity among teenager. For those indicated, early surgical intervention allows better surgical correction due to flexibility of the spine during teenage years, hence good functional outcome and better cosmetic can be expected. In this case report, there is the management of four patients surgically using the posterior spinal instrumentation and fusion. Pre-operatively patients were examined at IIUM Medical Centre spine clinic, all necessary investigations were carried out. A thorough explanation was done to patient and parents regarding procedure, risk and benefit. All patients were treated using the same surgical technique. Neuromonitoring was used throughout the whole surgery until skin closure. All patients were hospitalized around one week. Post-operatively patients were followed up at two weeks, six weeks, three months, and every six months thereafter. It is important for clinicians to identify patients with AIS as early detection and timely treatment will change the natural history of curve progression. Surgical intervention when necessary will be easier and with less risk of complications when surgery was carried out during teenage years as the spine is more flexible and the deformity is less severe.
    MeSH terms: Adolescent; Humans; Kyphosis; Parents; Scoliosis; Spine; Neurosurgical Procedures
  5. Fulltext Sonographic measurement of the thickness of subcutaneous tissue and hepatic echo-intensity attenuation rate in nonalcoholic fatty liver disease
    Abdul Sattar Arif Khammas, Hasyma Abu Hassan
    Borneo Journal of Medical Sciences, 2020;14(1):29-38.
    MyJurnal
    The most common cause of the chronic liver disease is non-alcoholic fatty liver disease (NAFLD). This study was designed to compare a mean subcutaneous tissue thickness (SCTT) and hepatic echo-intensity attenuation rate (HEIAR) among NAFLD grades. Sonography was carried out on 628 consecutive subjects. The distance between the skin surface and the liver capsule was measured and was labelled the SCTT. Also, the ultrasound of HEIAR was retrospectively quantified on an image archiving. HEIAR was calculated as the difference between mean intensity of echo for two regions of interest (ROIs) in near- and far-fields divided by the distance between these two ROIs multiply by frequency of the probe. Of the 628, 235 subjects were diagnosed with NAFLD. The age range was 45 – 75 years with mean 54.5 ± 6.7 years. There was a significant difference of mean SCTT among NAFLD grades (p
    MeSH terms: Aged; Humans; Middle Aged; Retrospective Studies; Ultrasonography; Non-alcoholic Fatty Liver Disease
  6. Fulltext Prevalence of obesity and correlated hypertension and hyperglycaemia status among participants of a health screening programme in inanam sub-district, Kota Kinabalu, Sabah, Malaysia
    Khairul Anwar Zarkasi, Vennila Gopal, Sadia Choudhury Shimmi, Anne Lolita Miranda, Wan Salman Wan Saudi, Caroline Sunggip, et al.
    Borneo Journal of Medical Sciences, 2020;14(1):19-27.
    MyJurnal
    Obesity is a known risk factor for non-communicable diseases, including hypertension and diabetes mellitus, with Malaysia having the highest prevalence of obesity among Southeast Asian countries. Additionally, the delivery of medical services to the rural communities remains challenging despite efforts to increase accessibilities to the healthcare facilities. Therefore, regular health screening programmes specifically aiming at these communities are necessary for early diagnosis and intervention to prevent complications while improving the patients’ quality of life. A health screening programme was conducted in a sub-district of Kota Kinabalu, Sabah, Malaysia, where 50 participants were examined for general obesity based on body mass index (BMI) together with central obesity according to waist circumference (WC) and waist-to-hip ratio (WHR). Bioelectrical impedance analysis was performed to estimate body fat percentage (fat%) and body fat mass, along with the measurement of systolic blood pressure (SBP), diastolic blood pressure (DBP), and capillary blood glucose. The median age of the participants was 39.50 years. The prevalence of general obesity, central obesity based on WC and WHR, hypertension, and hyperglycaemia was 28%, 78%, 74%, 24%, and 20%, respectively. Both fat% and fat mass had positive correlations to the BMI (fat%: r = 0.656, p = 0.001; fat mass: r = 0.868, p = 0.001) and WC (fat%: r = 0.505, p = 0.001; fat mass: r = 0.761, p = 0.001). DBP had positive correlations with the BMI (r = 0.390, p = 0.005), WC (r = 0.467, p = 0.001), and WHR (r = 0.331, p = 0.019), while SBP had a positive correlation only with WC (r = 0.341, p = 0.015). Conversely, capillary blood glucose had no significant correlation with either BMI, WC, or WHR. The higher prevalence of central obesity among participants of the health screening program compared to the national level should raise concern among the healthcare providers regarding the future risk for hypertension and hyperglycaemia in this community
    MeSH terms: Adult; Blood Pressure; Delivery of Health Care; Diabetes Mellitus; Glucose; Humans; Hyperglycemia; Hypertension; Malaysia; Obesity; Body Mass Index; Prevalence; Electric Impedance; Waist-Hip Ratio; Waist Circumference
  7. Assessment of Antiviral combination therapy with Cephalosporin antibiotic for prevention of severe Influenza-A (H1N1)pdm09 infection associated secondary bacterial infection and other complications
    Ishaqui AA, Khan AH, Syed Sulaiman SA, Alsultan M, Khan I
    Pak J Pharm Sci, 2020 Jul;33(4(Supplementary)):1763-1770.
    PMID: 33612459
    Secondary bacterial infection is considered as a major complication associated with severe Influenza-A (H1N1)pdm09 infection responsible for the mortalities and morbidities worldwide. Use of antibiotics in viral Influenza infection is still debatable. All the confirmed diagnosed hospitalized Influenza-A (H1N1)pdm09 infection patients fulfilling inclusion/exclusion criteria during the study period were divided into two groups based on drug therapy for initial 72 hours. Group-1 included those patients who received oral oseltamivir alone while Group-2 included patients who were initiated on oseltamivir in combination with empiric cephalosporin antibiotic within 6-8 hours after hospitalization. The patients of both groups were assessed for incidences of various complication associated with Influenza-A (H1N1)pdm09 infection. A total of 227 and 116 patients were enrolled for Group-1 and Group-2 respectively. The incidences of secondary bacterial infections were significantly less (P<0.05). Moreover, length of stay in hospitalization, need of ICU admission, multiple organ failure and need of respiratory support were also significantly less (P<0.05) for Group-2 patients. Majority of patients that suffered complications were unvaccinated and aged more than 50 years with multiple comorbidities. Among cephalosporins, cefuroxime was found to be least effective in prevention of Influenza associated complications. Early initiation of empiric antibiotic therapy in combination with oseltamivir can prevent complications associated with Influenza-A (H1N1)pdm09 infection especially in elderly and unvaccinated high risk patients. Different combinations of antibiotics and antiviral medications need to be analysed for the prevention of severe Influenza infection complications.
    MeSH terms: Aged; Anti-Bacterial Agents; Antiviral Agents; Bacterial Infections; Cefuroxime; Cephalosporins; Hospitalization; Humans; Influenza, Human; Intensive Care Units; Length of Stay; Middle Aged; Multiple Organ Failure; Incidence; Influenza A Virus, H1N1 Subtype; Oseltamivir; Coinfection
  8. Fulltext Fortification of Rice Noodles with Vitamin A: Quality, Sensory Evaluation, and Enhancement of Vitamin A Intakes
    Malahayati N, Muhammad K, Bakar J, Karim R
    J Nutr Sci Vitaminol (Tokyo), 2020;66(Supplement):S179-S183.
    PMID: 33612590 DOI: 10.3177/jnsv.66.S179
    Vitamin A deficiency is common in many countries where rice is the staple food. Food fortification is an important strategy to address this problem. As rice noodle is the second principal form of rice products widely consumed in Asia, rice noodles could be a potential vehicle for fortification of vitamin A. In this study, rice noodles were prepared from 0, 300, 600, 1,050, and 1,500 μg of vitamin A per 100 g of rice flour. Samples were analyzed for quality, sensory evaluation, and enhancement of vitamin A intakes. Increasing level of vitamin A fortification did not influence quality and sensory properties of the rice noodles, except for the ash content, color, and appearance of the noodles. Rice noodle that was fortified with the highest level of vitamin A was found to be the darkest in color. However, this sample received scores higher than 6 (like slightly) for appearance. Furthermore, sample fortified with the highest level of vitamin A produced rice noodles with the highest level of vitamin A retention suggesting that noodles were good vehicle for vitamin A fortification. Fortification of rice flour with 1,500 μg of vitamin A produced rice noodles with 24.88% of the RDI for vitamin A per serving and provided an effective means of enhancing vitamin A intake.
    MeSH terms: Flour/analysis; Food, Fortified/analysis; Nutritional Status; Oryza*; Vitamin A
  9. Fulltext Development of a Photographic Food Atlas as a Portion Size Estimation Kit for Malaysian
    Wong LS, Wong JE
    J Nutr Sci Vitaminol (Tokyo), 2020;66(Supplement):S184-S189.
    PMID: 33612592 DOI: 10.3177/jnsv.66.S184
    A photographic food atlas is a series of photographs showing different quantities of different foods. It serves as a portion size estimation aid (PSEA). In Malaysia, the existing food atlases, which display foods in exchanges and standard portion sizes, may not be representative of the actual sizes of the portions of food consumed by the local population. This paper aims to describe the development of a food atlas, namely the 'MY Food Album', and assess its usability as a PSEA. Thirty four participants (aged 31.6±20.9 y) served themselves, in a laboratory setting, what they considered to be typical, small, medium, and large portions of 23 amorphus food items. All food portions were weighed to obtain the mean and standard deviation of the range of food portion sizes to be displayed in the food atlas. Using standard camera and lighting settings, various local foods were photographed at an angle of 45º. A total of 393 food items were categorized into 14 food groups and presented as serial (n=101), guide (n=213) and range (n=79) photographs. The usability of MY Food Album was evaluated by six nutritionists and dietitians using an adapted questionnaire. The food atlas was perceived to be useful to aid in the quantification of food during dietary assessment. It was suggested that the function, dimension and application of fiducial markers be introduced in the food atlas to facilitate its use in size estimation. While MY Food Album was well-accepted as a PSEA, futher validation is required to evaluate the effectiveness of this newly developed food atlas in portion size estimation.
    MeSH terms: Energy Intake*; Diet Surveys; Food; Humans; Photography; Surveys and Questionnaires; Portion Size*
  10. Fulltext The Relationship of Health and Nutrition Claims towards Purchasing Choices among Consumers in Shah Alam, Selangor
    Shammakh M, Ali RT, Shaari T
    J Nutr Sci Vitaminol (Tokyo), 2020;66(Supplement):S222-S225.
    PMID: 33612599 DOI: 10.3177/jnsv.66.S222
    Consumers nowadays have more awareness for healthy foods and demanded healthier food choices to avoid health-related problems; therefore, industries had included health and nutrition claims on their products. Health and nutrition claims usually influence consumers' food choice decision. Products with health claim resulted in higher perception of healthiness and nutritional value of the product, even if the product was not considered as a healthy choice. The aim of this study was to assess whether the health and nutrition claims had led to a healthier perception or better evaluation of the product among consumers.

    METHODS: A cross-sectional survey was conducted using an online questionnaire on 385 respondents collected through convenience sampling. The survey consisted of four parts: socio-demographic background, health awareness, understanding and usage of health and nutrition claims, and purchase intention measured through the use of a mock packaging. Data collected were analyzed using SPSS version 22.

    RESULTS: Most of the respondents aged 18-30 (81.0%) and almost half of them were Malay (45.7%) with bachelor/master or PhD qualification (60.0%). The distribution of household income for all categories was almost similar (18.2-20.8%). There was a significant statistical relationship between health awareness and purchase intention among respondents (r=0.391, p<0.01).

    CONCLUSIONS: Health and nutrition claims influenced consumer's perceptions and purchase intention, especially for those who were more concerned about their health, thus, more focus on policy regarding claims is needed.

    MeSH terms: Choice Behavior*; Consumer Behavior; Cross-Sectional Studies; Food Labeling*; Food Preferences; Nutritive Value
  11. Fulltext Association between Food Habits and Nutritional Status of Secondary School Students in Kuala Lumpur, Malaysia: Baseline Findings from Nuteen Project
    Vaidehi U, Shashikala S, Mirnalini K
    J Nutr Sci Vitaminol (Tokyo), 2020;66(Supplement):S256-S261.
    PMID: 33612607 DOI: 10.3177/jnsv.66.S256
    Dietary habits and choice of food influences nutritional status of adolescence. Malnutrition have been associated with adolescents' dietary habits that may predispose to chronic disease during their adulthood. The aim of this study is to determine the association between food habit and nutritional status of adolescents. In the baseline study, a total of 924 students from 10 secondary schools were randomly selected from a total of 62 secondary schools in Kuala Lumpur. The students were assessed on various dietary components including food habits using a structured questionnaire as well as for anthropometry measurements. All data were analyzed using SPSS 23. The prevalence of obesity was significantly higher among males compared to females (16.4% vs. 8.4%, X2=25.42, p<0.001). Food habit exhibits an inversed association with z-score of body mass index for age (β=-0.107, 95% CI=-0.053, -0.013), especially via food habits such as often eat dinner (r=-0.102, p=0.002), often have breakfast before school (r=-0.100, p=0.002), often eat cake or dessert at meal (r=-0.110, p=0.001), often drink eight glasses of water (r=0.132, p<0.001), often eat food from school canteen (r=-0.071, p=0.031) and often bring own snack from home (r=-0.112, p=0.001). This study suggested that the type of food and timing of meal should be considered to prevent obesity among adolescents.
    MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Feeding Behavior*; Female; Humans; Malaysia/epidemiology; Male; Nutritional Status*; Surveys and Questionnaires; Schools; Students; Body Mass Index
  12. Fulltext Associations of Knowledge, Attitude and Practices of Food Label on Cardiovascular Diseases (CVD) Risk amongst University Students in Selangor, Malaysia
    Evelyn H, Aziz AF, Sariman S
    J Nutr Sci Vitaminol (Tokyo), 2020;66(Supplement):S275-S282.
    PMID: 33612610 DOI: 10.3177/jnsv.66.S275
    Cardiovascular diseases (CVD) deaths were on the rise in developing countries. In Malaysia, the accelerating economic transition has been accompanied by high prevalence of CVD risk factors which accounts for 35% of total deaths in 2016. This increasing trend involving not only the elderly but also the young adults. Food label reading is reported to be the key to help individual adopt healthy food choice and dietary habits. Hence, the aim of this study is to determine the associations of knowledge, attitude and practices (KAP) of food label on CVD risk amongst university students. A cross sectional study was conducted on 389 university students aged 19 to 35 y old in Selangor. Information on socio-demographic profile, nutrition knowledge, attitude, and practice of food label were collected using self-administrated questionnaires. Anthropometric data of participants were measured using standardize methodology and blood pressure was measured using Omron blood pressure monitor. The data were tested using Chi-Square test. Average age of the respondents were 23 y. Majority of the respondents had no CVD risk (41%) while (59%) had increased CVD risks. There was a significant association between CVD risk factors (BMI, waist circumference, systolic blood pressure (SBP), and diastolic blood pressure (DBP) with knowledge and attitude of using food label (p<0.05). The practice of food label usage showed no significant association (p>0.05) with all CVD risk factors. Considering the importance of understanding and usage of food label in the management of chronic diseases, these findings provide useful information to incorporate nutrition education on food labelling in preventing CVD risks.
    MeSH terms: Aged; Cross-Sectional Studies; Food Labeling; Humans; Health Knowledge, Attitudes, Practice; Malaysia/epidemiology; Risk Factors; Students; Universities; Young Adult
  13. Sub-lethal concentrations of artemisinin alter pH of the digestive vacuole of the malaria parasite, Plasmodium falciparum
    Ibrahim N, Roslee A, Azlan M, Abu-Bakar N
    Trop Biomed, 2020 Mar 01;37(1):1-14.
    PMID: 33612713
    An appropriate pH maintenance within a membrane-enclosed organelle is vital for the occurrence of biological processes. Artemisinin (ART), a potent antimalarial drug has been reported to target the digestive vacuole (DV) of Plasmodium falciparum, which might alter the pH of the organelle, thereby impairing the hemoglobin degradation and subsequent heme detoxification. Hence, a flow cytometry-based technique using fluorescein isothiocyanate-dextran (FITC-dextran) as a ratiometric pH probe was employed to measure the pH of the DV of the malaria parasite treated with ART. Based on the pH calibration curve generated, the steady-state pH of the acidic DV of the non-treated parasites was 5.42 ± 0.11, indicating that FITC-dextran is suitable for detection of physiological pH of the organelle. The alteration of the DV pH occurred when the parasites were treated with ART even at the sub-lethal concentrations (15 and 30 nM) used. The similar effect was shown by the parasites treated with a standard proton pump inhibitor, concanamycin A. This suggests that ART might have altered the DV pH at lower levels than the level needed to kill the parasite. This study has important implications in designing new ART treatment strategies and in generating new endoperoxide-based antimalarial drugs pertaining to the interruption of the pH regulation of the malaria parasite's DV.
    MeSH terms: Antimalarials/pharmacology*; Erythrocytes/parasitology; Flow Cytometry; Humans; Hydrogen-Ion Concentration; Phagosomes/drug effects; Phagosomes/chemistry*; Plasmodium falciparum/drug effects*; Artemisinins/pharmacology*
  14. Evaluation of the in vitro antileishmanial activities of bioactive guided fractionations of two medicinal plants
    Al Nasr IS
    Trop Biomed, 2020 Mar 01;37(1):15-23.
    PMID: 33612714
    The organisms of the genus Leishmania are flagellated protozoan parasites and are the causative agents of leishmaniasis. This disease is a major health problem, especially in tropical countries. Currently, cutaneous leishmaniasis is treated by chemotherapy using pentavalent antimonials, but these drugs have serious organo-toxicity, drug resistance on several occasions, and low efficiency in controlling the infection. The present work is carried out to evaluate the in vitro antileishmanial activity of methanolic extracts and phytochemical fractions of two plants ethnobotanically used against leishmaniasis and skin infection, Calotropis procera and Rhazya stricta leaves against Leishmania major promastigote and amastigote stages and cytotoxicity against the Vero cell line. The leaves of C. procera and R. stricta were extracted with methanol and fractionated by petroleum ether, chloroform, ethyl acetate, n-butanol, and water. The methanolic extracts of the leaves of C. procera and R. stricta exhibited antileishmanial activity against L. major promastigotes with IC50 values of 66.8 and 42.4 µg mL-1, respectively. While their CC50 2.3 and 298 µg mL-1 and their SI 0.03 and 7.03 respectively. However, the fractionations of the methanolic extract of C. procera leaves revealed antiparasitic activity against both L. major promastigote and amastigote stages in vitro, which significantly increased with polarity with the exception of n-butanol. Hence the best activity was revealed by the water fraction (IC50 of 26.3 and 29.0 µg mL-1) for the two stages. In conclusion, further phytochemical investigation should be performed for the C. procera water extract in terms of antileishmanial active ingredient isolation that may enhance the possibility of avoiding toxic substances and overcome the low SI (1.1 and 1.01).
    MeSH terms: Animals; Antiprotozoal Agents/isolation & purification; Antiprotozoal Agents/pharmacology*; Cercopithecus aethiops; Plant Extracts/pharmacology; Plants, Medicinal/chemistry; Vero Cells; Leishmania major/drug effects*; Plant Leaves/chemistry; Apocynaceae/chemistry*; Calotropis/chemistry*; Phytochemicals/isolation & purification; Phytochemicals/pharmacology
  15. First case report of paragonimiasis in a Malaysian man
    Ponnampalavanar S, Kukreja A, Amir A, Mahmud R
    Trop Biomed, 2020 Mar 01;37(1):24-28.
    PMID: 33612715
    Paragonimiasis is an infection caused by Paragonimus, a lung fluke and is acquired by eating raw or undercooked crustaceans containing the infective metacercariae. Herein, we report a case of paragonimiasis in a Malaysian man who presented with incidental findings from chest radiographs. Examination of his biopsied lung tissue and sputum specimen revealed Paragonimus sp. eggs, whereas stool examination showed the presence of Giardia cysts. Patient was succesfully treated with praziquantel and metronidazole respectively.
    MeSH terms: Animals; Food Contamination; Giardiasis/drug therapy; Humans; Lung/parasitology; Malaysia; Male; Metronidazole/therapeutic use; Middle Aged; Paragonimiasis/diagnosis*; Paragonimiasis/drug therapy; Paragonimus; Praziquantel/therapeutic use*; Sputum/parasitology; Incidental Findings
  16. Progression of malaria induced pathogenicity during chloroquine therapy
    Zaid OI, Abd Majid R, Sidek HM, Noor SM, Abd Rachman-Isnadi MF, Bello RO, et al.
    Trop Biomed, 2020 Mar 01;37(1):29-49.
    PMID: 33612716
    Treatment Failure with chloroquine is one of the challenges that faced the dedicated efforts to eradicate malaria This study aims at investigating the impact of treatment failure with chloroquine on the progression of the disease-induced histo-pathogenic and immunogenic outcomes. To achieve this, Rane's protocol with modifications was applied on a model of Plasmodium berghei ANKA infected ICR mice to determine the dose response curve of chloroquine and to screen the treatment impact on the disease progression. Chloroquine was given at 1, 5, 10, 15 and 20 mg/kg once the parasitemia reached to 20-30% (the experimental initiation point). During the subsequent days, the mice were monitored for changes in the clinical signs, hematology parameters and the progress of the parasitemia until the parasitemia reached to 60-70% (the experimental termination point) or up to 10 days after chloroquine administration in case of achieving a complete eradication of the parasite. At the end, the mice were exsanguinated and their blood and organs were collected for the biochemistry and the histology study. A complete eradication of the parasite was achieved at 20 mg/kg while recrudescence was observed at the lower doses. At 1 mg/kg, the parasite growth was comparable to that of the positive control. The histo-pathogenic and immunogenic changes were stronger in the groups that experienced recrudescence (at 5 and 10 mg/kg). All in all, the study highlights the possibility of having a worsened clinical condition when chloroquine is given at its sub-therapeutic doses during malaria treatment.
    MeSH terms: Animals; Antimalarials/administration & dosage*; Antimalarials/therapeutic use; Chloroquine/administration & dosage*; Chloroquine/therapeutic use; Malaria/drug therapy*; Mice, Inbred ICR; Plasmodium berghei/drug effects; Treatment Failure; Disease Progression; Parasitemia/drug therapy
  17. Parasitological and molecular detection of human fascioliasis in a young man from Guizhou, China
    Chen MX, Zhang RL, Xu XN, Yu Q, Huang DN, Liu W, et al.
    Trop Biomed, 2020 Mar 01;37(1):50-57.
    PMID: 33612717
    A 24-year-old man born in Guizhou province was diagnosed with obstructive jaundice and bile duct stones in 2013. Four living trematodes were found during laparotomy and cholecystectomy. Based on the morphology and molecular genetics analysis of internal transcribed spacer and pcox1 genes of the flatworm specimens, the trematodes from the patient were confirmed to be Fasciola hepatica. This report provided the clinical and molecular diagnosis information on human fascioliasis, which is an emerging sanitary problem still ignored in China. Human fascioliasis constantly occurs due to climatic changes and frequency of human travel. Therefore, it deserves more attention from physicians working in both developing and developed countries.
    MeSH terms: Animals; China; Cholecystectomy; Fasciola hepatica/genetics; Fasciola hepatica/isolation & purification*; Fascioliasis/diagnosis*; Humans; Male; Phylogeny; Jaundice, Obstructive/surgery; Young Adult
  18. Serotyping of dengue virus in 2016-17 outbreak in Kudat, Sabah, Malaysia
    Aung TS, Gintarong T, Balingi DB, Emran A, Thein TT, Chua TH
    Trop Biomed, 2020 Mar 01;37(1):58-65.
    PMID: 33612718
    An outbreak of dengue in Kudat, northern Sabah in 2016-2017 provided an opportunity to investigate the circulating serotypes of dengue viruses of cases at Hospital Kudat. Between September 2016 and December 2017, a total of 156 dengue positive sera (tested positive by either NS1 antigen, or IgM and IgG antibody rapid test) were collected from dengue patients who had acute fever and showed signs and symptoms suggestive of dengue. RNA was extracted from the sera using QIAamp RNA Blood Mini Kit, and molecular amplification was performed using one-step RT-PCR kit, followed by nested PCR using HotStart Taq master mix kit with the primers of the dengue C-prM gene. There were 81 (52%) male and 75 (48%) female cases. The age group with the highest number of cases was the 10-19 years old, while the youngest infected was 8 months old and the oldest was 83 years old. RT-PCR results showed 88 sera dengue positive, 48 infected with a single serotype while another 40 with multiple serotypes. All four DENV serotypes were co-circulating during the outbreak period and DENV-1 was predominant. Molecular analysis also indicated 69.2%, 50.0%, 51.9% and 48.9% respectively of the NS1, IgM, IgG and IgM and IgG positive sera were RT-PCR positive for dengue. High number of cases were seen in December 2016, February and May 2017. The dengue outbreak might be related to switching of predominant serotype from DENV 4 to DENV 1.
    MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Dengue/epidemiology*; Dengue/virology; Dengue Virus/classification*; Disease Outbreaks; Female; Humans; Infant; Malaysia; Male; Middle Aged; Serotyping; Young Adult
  19. Does the morbidity management and disability prevention (MMDP) clinic serve the filarial lymphedema (FLE) patients' preeminent expectation?
    De Britto RLJ, Vijayalakshmi G, Boopathi K, Kamaraj P, Supriya VK, Yuvaraj J
    Trop Biomed, 2020 Mar 01;37(1):66-74.
    PMID: 33612719
    Advocacy and training on "Home care" for filarial lymphoedma (FLE) patients are provided through morbidity management and disability prevention (MMDP) clinic commonly known as filariasis clinic and clinical improvement is assessed by follow-up visits. While the physicians aim at reducing the recurrent ADL (coined as ADLA in 1997) episodes, the patients expect reduction in LE volume. The objective of the present study was to know whether the MMDP clinic serves the primary expectation of the FLE patients. LE patients who attended the clinic for at least four follow-up consultations and had LE volume measurements at three points of time during the one year period of observation were considered for analysis. Clinical assessment was done for LE grading and LE volume was measured by water displacement volumetry. Sixty-three patients who fulfilled the follow up criteria were included. It was observed that the median LE volume was 914ml (IQR 269 - 1935) at first visit of the observation period which reduced to 645ml (IQR 215- 1666) and 752ml (IQR 215 - 1720) at first and second follow-up visits respectively. Over all, in short span of one year, 21 of the 63 patients (33.3%) who visited MMDP clinic at least four times in a year were benefitted through the MMDP advocacy and the National filariasis control programme need to emphasise on the importance of follow up visits to FLE patients.
    MeSH terms: Adult; Ambulatory Care; Elephantiasis, Filarial/therapy*; Female; Humans; India; Male; Middle Aged; Morbidity; Patient Satisfaction*; Outcome Assessment (Health Care)*; Disease Management
  20. Immunohistochemical evaluation of interleukin-23 and cyclooxygenase-2 in the muscles of mice infected with Trichinella spiralis
    El-Aswad BEW, Ammar AI, Mahmoud SF, Soliman SS, Abd El-Atty AF
    Trop Biomed, 2020 Mar 01;37(1):75-88.
    PMID: 33612720
    The course of Trichinella (T.) spiralis infection includes intestinal and muscle phases. The aims of this work were to evaluate IL-23 and cyclooxygenase-2 (COX-2) by immunohistochemistry in the muscles of T. spiralis infected mice in a time-course study and to correlate their level with the serum levels of IL-23, IFN-γ, IL-4 and IL-10 cytokines. The mice were divided into an un-infected control group (UC) (10 mice) and 5 infected mouse groups (each 10 mice/group. Each mouse was infected with 200 T. spiralis larvae) and sacrificed on days 7, 14, 21, 28 and 35 post-infection (dpi). IL-23 showed weak expression (+1) on the 21st dpi, then it became moderately expressed (+2) on the 28th dpi and on day 35 pi, the immunoreactivity was strong (+3). COX-2 expressed weakly on 14 dpi, while the other mouse groups (21, 28 and 35) showed strong (+3) expression. IL-23 serum concentrations increased gradually in a significant pattern, in comparison to that of UC mice, from the 21st dpi to the end of the experiment. IFN-γ increased gradually and was significantly higher than those of UC mice from the 7th dpi, reached its maximum level on the 21st dpi, after which it decreased non-significantly. IL-4 up-regulated significantly in all infected groups in comparison to UC mice achieving its highest level on the 21st dpi and decreased after that. IL-10 increased significantly on the 7th dpi, but dropped at the 14th dpi, then reached its peak on the 21st dpi, and decreased again on the 28th and 35th dpi. In conclusion, T. spiralis infection caused increased expression of IL-23 and COX-2 in the muscle of infected mice, the effect being strongest on the 35th day. Also, the infection induced a mixed Th1/Th2 profile with a predominance of Th2 at the early muscle phase, after which the immune repose became mainly Th2.
    MeSH terms: Animals; Immunohistochemistry; Muscles/parasitology*; Trichinellosis/immunology*; Cytokines/blood; Trichinella spiralis; Mice; Cyclooxygenase 2/immunology*; Interleukin-23/immunology*; Th1-Th2 Balance
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