Displaying publications 1 - 20 of 225 in total

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  1. Nor-Anuar A, Ujang Z, van Loosdrecht MC, de Kreuk MK, Olsson G
    Water Sci Technol, 2012;65(2):309-16.
    PMID: 22233910 DOI: 10.2166/wst.2012.837
    Aerobic granular sludge has a number of advantages over conventional activated sludge flocs, such as cohesive and strong matrix, fast settling characteristic, high biomass retention and ability to withstand high organic loadings, all aspects leading towards a compact reactor system. Still there are very few studies on the strength of aerobic granules. A procedure that has been used previously for anaerobic granular sludge strength analysis was adapted and used in this study. A new coefficient was introduced, called a stability coefficient (S), to quantify the strength of the aerobic granules. Indicators were also developed based on the strength analysis results, in order to categorize aerobic granules into three levels of strength, i.e. very strong (very stable), strong (stable) and not strong (not stable). The results indicated that aerobic granules grown on acetate were stronger (high density: >150 g T SSL(-1) and low S value: 5%) than granules developed on sewage as influent. A lower value of S indicates a higher stability of the granules.
  2. Nor Anuar A, Ujang Z, van Loosdrecht MC, de Kreuk MK
    Water Sci Technol, 2007;56(7):55-63.
    PMID: 17951868
    Aerobic granular sludge (AGS) technology has been extensively studied recently to improve sludge settling and behaviour in activated sludge systems. The main advantage is that aerobic granular sludge (AGS) can settle very fast in a reactor or clarifier because AGS is compact and has strong structure. It also has good settleability and a high capacity for biomass retention. Several experimental works have been conducted in this study to observe the settling behaviours of AGS. The study thus has two aims: (1) to compare the settling profile of AGS with other sludge flocs and (2) to observe the influence of mechanical mixing and design of the reactor to the settleability of AGS. The first experimental outcome shows that AGS settles after less than 5 min in a depth of 0.4 m compared to other sludge flocs (from sequencing batch reactor, conventional activated sludge and extended aeration) which takes more than 30 min. This study also shows that the turbulence from the mixing mechanism and shear in the reactor provides an insignificant effect on the AGS settling velocity.
  3. Rahmah N, Anuar AK, Ariff RH, Zurainee MN, A'shikin AN, Fadzillah A, et al.
    Trop Med Int Health, 1998 Mar;3(3):184-8.
    PMID: 9593356
    OBJECTIVE: To evaluate the usefulness of antifilarial IgG4 antibody assay in detecting B. malayi infection in a filaria endemic area in Malaysia.

    METHODS: A sandwich ELISA using B. malayi soluble antigen was employed to detect antifilarial IgG4 antibodies in serum samples of 330 individuals who comprised 88 healthy individuals from nonendemic areas, 15 B. malayi microfilaraemic cases, 22 individuals with soil-transmitted helminthiases, 9 elephantiasis cases and 196 residents from a B. malayi-endemic area. An O.D. value of > 0.420 at serum dilution of 1:400 was used as the cut-off point. This cut-off point was obtained by taking the mean optical density (0.252 + 4 S.E.) of 36 negative sera which had O.D. values greater than 0.1 at serum dilution of 1:400.

    RESULTS: All 15 microfilaraemic persons were positive for antifilarial IgG4 antibody. Non-endemic normals, soil-transmitted helminth infected persons and chronic elephantiasis cases were negative for antifilarial IgG4 antibody. Of the 196 individuals from the filaria endemic area, 37 (18.8%) demonstrated presence of antifilarial IgG4 antibodies; and only eight individuals (4.1%) were positive for microfilariae. All eight microfilaraemic individuals were also positive for antifilarial IgG4 antibodies.

    CONCLUSION: Antifilarial IgG4-ELISA could detect 4.6 times more positive cases than the microfilaria detection method. With appropriate cut-off values that eliminate cross-reactivities, this serological tool is very useful for Brugia malayi prevalence surveys and diagnosis.

  4. Anuar AS, Tay ST
    Trop Biomed, 2014 Dec;31(4):802-12.
    PMID: 25776607 MyJurnal
    Klebsiella pneumoniae is a healthcare-associated bacterial pathogen which causes severe diseases in immunocompromised individuals. Concanavalin A (conA), a lectin which recognizes proteins with mannose or glucose residues, has been reported to agglutinate K. pneumoniae and hence, is postulated to have therapeutical potential for K. pneumoniae-induced liver infection. This study investigated the conA binding properties of a large collection of clinical isolates of K. pneumoniae. ConA agglutination reaction was demonstrated by 94 (51.4%) of 183 K. pneumoniae isolates using a microtiter plate assay. The conA agglutination reactions were inhibited in the presence of 2.5 mg/ml D-mannose and 2.5 mg/ml glucose, and following pretreatment of the bacterial suspension with protease and heating at 80ºC. Majority of the positive isolates originated from respiratory specimens. Isolation of conA-binding proteins from K. pneumoniae ATCC 700603 strain was performed using conA affinity column and the conA binding property of the eluted proteins was confirmed by western blotting analysis using conA-HRP conjugates. Proteins with molecular weights ranging from 35 to 60 kDa were eluted from the conA affinity column, of which four were identified as outer membrane protein precursor A (37 kDa), outer membrane protein precursor C (40 kDa), enolase (45 kDa) and chaperonin (60 kDa) using mass spectrometry analysis. Several conA binding proteins (including 45 and 60 kDa) were found to be immunogenic when reacted with rabbit anti-Klebsiella antibody. The function and interplay of the conA binding proteins in bacterium-host cell relationship merits further investigation.
  5. Rahmah N, Taniawati S, Shenoy RK, Lim BH, Kumaraswami V, Anuar AK, et al.
    Trans R Soc Trop Med Hyg, 2002 1 31;95(6):601-4.
    PMID: 11816429
    A total of 753 serum samples from 6 institutions in 3 countries (Malaysia, Indonesia and India) were used to evaluate an immunochromatographic rapid dipstick test, Brugia Rapid, for diagnosis of Brugia malayi infection. The samples comprised sera from 207 microfilaria-positive individuals and 546 individuals from filaria non-endemic areas. The latter consisted of 70 individuals with soil-transmitted helminth infections, 68 with other helminth infections, 238 with protozoan infections, 12 with bacterial and viral infections and 158 healthy individuals. The dipstick is prepared with a goat anti-mouse antibody control line and a B. malayi recombinant-antigen test line. First, the dipstick is dipped into a well containing diluted patient serum, thus allowing specific anti-filarial antibody in the serum to react with the recombinant antigen. Then the dipstick is placed into an adjacent well containing reconstituted anti-human IgG4-gold. After 10 min, development of 2 red-purplish lines denotes a positive result and one line indicates a negative reaction. The overall results of the evaluation showed 97% sensitivity, 99% specificity, 97% positive predictive value and 99% negative predictive value. Brugia Rapid is thus a promising diagnostic tool for detection of B. malayi infection, and would be especially useful for the brugian filariasis elimination programme.
  6. Rahmah N, Lim BH, Khairul Anuar A, Shenoy RK, Kumaraswami V, Lokman Hakim S, et al.
    Trans R Soc Trop Med Hyg, 2001 8 9;95(3):280-4.
    PMID: 11490997
    An IgG4 ELISA based on a novel recombinant antigen was evaluated for detection of Brugia malayi infection, using 2487 sera from various institutions: 2031 samples from Universiti Sains Malaysia, 276 blinded sera from 2 other institutions in Malaysia, 140 blinded sera from India and 40 blinded sera from Thailand. These sera were from various groups of individuals, i.e., microfilaraemics, chronic patients, endemic normals, non-endemic normals and individuals with other parasitic and bacterial infections. Based on a cut-off optical density reading of 0.300, the IgG4 ELISA demonstrated specificity rates of 95.6-100%, sensitivity rates of 96-100%, positive predictive values of 75-100% and negative predictive values of 98.9-100%. These evaluation studies demonstrated the high specificity and sensitivity of this test for the detection of active B. malayi infection. Thus, the IgG4 ELISA would be very useful as a tool in diagnosis and in elimination programmes for brugian filariasis.
  7. Rahmah N, Ashikin AN, Anuar AK, Ariff RH, Abdullah B, Chan GT, et al.
    Trans R Soc Trop Med Hyg, 1998 12 16;92(4):404-6.
    PMID: 9850392
    A polymerase chain reaction assay based on the enzyme-linked immunosorbent assay (PCR-ELISA) has been developed to detect Brugia malayi infection in an area of low endemicity in Malaysia. Blood samples from 239 subjects were tested: 192 amicrofilaraemic individuals, 14 microfilaraemic persons and 3 chronic elephantiasis cases from endemic areas and 30 city-dwellers (non-endemic controls). PCR products were examined by ELISA and Southern hybridization. In the PCR-ELISA, digoxigenin-labelled PCR products were hybridized to a biotin-labelled probe. This was followed by incubation in streptavidin-coated microtitre wells and detection using anti-digoxigenin-peroxidase and ABTS [2,2'-azinobis(3-ethylbenzthiazoline-6-sulphonic acid)]. All microfilaraemic samples were positive by PCR-ELISA and Southern hybridization and all samples from non-endemic subjects and chronic elephantiasis patients were negative. The PCR-ELISA detected 12 times as many B. malayi infections as did thick blood film examination. Nineteen of the 194 samples from the endemic area gave positive results by both PCR-ELISA and Southern hybridization, and an additional 5 samples were positive by PCR-ELISA only. The PCR-ELISA was specific and sensitive, detected more infections, and was more reproducible than Southern hybridization.
  8. Raj SM, Sein KT, Anuar AK, Mustaffa BE
    Trans R Soc Trop Med Hyg, 1996 11 1;90(6):666-9.
    PMID: 9015510
    Intestinal permeability of 246 early primary schoolchildren at 2 schools (106 of whom were infected with intestinal helminths) was assessed by using the lactulose/mannitol differential absorption test. The ratio of the urinary recoveries of lactulose and mannitol was determined after oral administration of a standard solution of the 2 sugars. Assessment of intestinal permeability was repeated on 100 infected children after treatment and on a cohort of 68 uninfected children. Infected and uninfected groups were compared with respect to baseline lactulose/mannitol ratio (L/M1) and change in lactulose/mannitol ratio between assessments (delta L/M). The correlations between baseline intensity of infection and L/M1, and between fall in intensity and delta L/M, were evaluated. Based on a crude index of socioeconomic status, each child was assigned to one of 3 socioeconomic groups; all but 3 children belonged to either groups 2 or 3. Trichuris trichiura and Ascaris lumbricoides were the 2 predominant infections; the hookworm infection rate was relatively low. The results suggested that helminthiasis exerted only a marginal effect on intestinal permeability, the impact of which in children from lower socioeconomic backgrounds was negligible in comparison with the cumulative effects of other factors.
  9. Raj SM, Sein KT, Anuar AK, Mustaffa BE
    Trans R Soc Trop Med Hyg, 1997 3 1;91(2):131-2.
    PMID: 9196748
    Stool examination of 249 early primary schoolchildren at 2 schools in north-eastern peninsular Malaysia revealed that 73 were infected with Ascaris lumbricoides, 103 with Trichuris trichiura, and 18 with hookworms. Infected children were treated with a single dose of 400 mg of albendazole. The school attendance records during a 60 d period before treatment and 2 consecutive 60 d periods after treatment were examined. The absenteeism rate did not improve more among infected children after treatment than it did among the uninfected control children. The correlation between worm intensity and the number of lost school-days was poor. There was no evidence that intestinal helminthiasis caused school absenteeism among this group of children.
  10. Samedani B, Juraimi AS, Rafii MY, Anuar AR, Sheikh Awadz SA, Anwar MP
    ScientificWorldJournal, 2013;2013:695404.
    PMID: 24260020 DOI: 10.1155/2013/695404
    This study investigated the allelopathic effect of Axonopus compressus litter on Asystasia gangetica and Pennisetum polystachion. In experiment 1 the bioassays with 0, 10, 30, and 50 g L⁻¹ of aqueous A. compressus litter leachate were conducted. Experiment 2 was carried out by incorporating 0, 10, 20, 30, 40, and 50 g L⁻¹ of A. compressus litter leachate into soil. In experiment 3, the fate of A. compressus litter leachate phenolics in the soil was investigated. A. compressus leachates did not affect the germination percentage of A. gangetica and P. polystachion, but delayed germination of A. gangetica seeds and decreased seed germination time of P. polystachion. A. compressus litter leachates affected weeds hypocotyl length. Hypocotyl length reductions of 18 and 31% were observed at the highest concentration (50 g L⁻¹) compared to the control in A. gangetica and P. polystachion, respectively. When concentration of A. compressus litter leachate-amended soil increased A. gangetica and P. polystachion seedling shoot length, root length, seedling weight and chlorophyll concentration were not affected. The 5-week decomposition study of A. compressus showed that the phenolic compounds in A. compressus litter abruptly decreased about 52% after two weeks and remained steady until the end of the incubation.
  11. Samedani B, Juraimi AS, Anwar MP, Rafii MY, Sheikh Awadz SH, Anuar AR
    ScientificWorldJournal, 2013;2013:308646.
    PMID: 24163618 DOI: 10.1155/2013/308646
    Axonopus compressus is one of the native soft grass species in oil palm in Malaysia which can be used as a cover crop. The competitive ability of A. compressus to overcome A. gangetica was studied using multiple-density, multiple-proportion replacements series under a glasshouse and full sunlight conditions in a poly bag for 10 weeks. A. compressus produced more dry weight and leaf area when competing against A. gangetica than in monoculture at both densities in the full sunlight and at high density in the shade. Moreover, the relative yield and relative crowding coefficients also indicated A. compressus is a stronger competitor than A. gangetica at both densities in the full sunlight and high density in the shade. It seemed that A. gangetica plants in the shade did not compete with each other and were more competitive against A. compressus as could influence A. compressus height in the shade. It is concluded that although suppression of A. gangetica by A. compressus occurred under full sunlight, irrespective of plant density, this ability reduced under shade as A. compressus density decreased. The result suggests that A. compressus in high density could be considered as a candidate for cover crops under oil palm canopy.
  12. Gikonyo EW, Zaharah AR, Hanafi MM, Anuar AR
    ScientificWorldJournal, 2011;11:1421-41.
    PMID: 21805012 DOI: 10.1100/tsw.2011.131
    Soil phosphorus (P) release capability could be assessed through the degree of P saturation (DPS). Our main objective was to determine DPS and, hence, P threshold DPS values of an Ultisol treated with triple superphosphate (TSP), Gafsa phosphate rocks (GPR), or Christmas Island phosphate rocks (CIPR), plus or minus manure. P release was determined by the iron oxide-impregnated paper strip (strip P), while DPS was determined from ammonium oxalate-extractable aluminum (Al), iron (Fe), and P. Soils were sampled from a closed incubation study involving soils treated with TSP, GPR, and CIPR at 0-400 mg P kg-1, and a field study where soils were fertilized with the same P sources at 100-300 kg P ha-1 plus or minus manure. The DPS was significantly influenced by P source x P rate, P source x manure (incubated soils), and by P source x P rate x time (field-sampled soils). Incubated soil results indicated that both initial P and total strip P were related to DPS by exponential functions: initial strip P = 1.38exp0.18DPS, R2 = 0.82** and total strip P = 8.01exp0.13DPS, R2 = 0.65**. Initial strip P was linearly related to total P; total P = 2.45, initial P + 8.41, R2 = 0.85**. The threshold DPS value established was about 22% (incubated soil). Field soils had lower DPS values <12% and strip P was related to initial DPS and average DPS in exponential functions: strip P = 2.6exp0.44DPS, R2 = 0.77** and strip P = 1.1DPS2 ¨C 2.4DPS + 6.2, R2 = 0.58**, respectively. The threshold values were both approximately equal to 8% and P release was 11-14 mg P kg-1. Results are evident that DPS can be used to predict P release, but the threshold values are environmentally sensitive; hence, recommendations should be based on field trials.
  13. Ahmed OH, Hussin A, Ahmad HM, Rahim AA, Majid NM
    ScientificWorldJournal, 2008 Apr 20;8:394-9.
    PMID: 18454247 DOI: 10.1100/tsw.2008.68
    Ammonia loss significantly reduces the urea-N use efficiency in crop production. Efforts to reduce this problem are mostly laboratory oriented. This paper reports the effects of urea amended with triple superphosphate (TSP) and zeolite (Clinoptilolite) on soil pH, nitrate, exchangeable ammonium, dry matter production, N uptake, fresh cob production, and urea-N uptake efficiency in maize (Zea mays) cultivation on an acid soil in actual field conditions. Urea-amended TSP and zeolite treatments and urea only (urea without additives) did not have long-term effect on soil pH and accumulation of soil exchangeable ammonium and nitrate. Treatments with higher amounts of TSP and zeolite significantly increased the dry matter (stem and leaf) production of Swan (test crop). All the treatments had no significant effect on urea-N concentration in the leaf and stem of the test crop. In terms of urea-N uptake in the leaf and stem tissues of Swan, only the treatment with the highest amount of TSP and zeolite significantly increased urea-N uptake in the leaf of the test crop. Irrespective of treatment, fresh cob production was statistically not different. However, all the treatments with additives improved urea-N uptake efficiency compared to urea without additives or amendment. This suggests that urea amended with TSP and zeolite has a potential of reducing ammonia loss from surface-applied urea.
  14. Ahmed OH, Ahmad HM, Musa HM, Rahim AA, Rastan SO
    ScientificWorldJournal, 2005 Jan 21;5:42-9.
    PMID: 15674449
    In Malaysia, pineapples are grown on peat soils, but most K fertilizer recommendations do not take into account K loss through leaching. The objective of this study was to determine applied K use efficiency under a conventionally recommended fertilization regime in pineapple cultivation with residues removal. Results showed that K recovery from applied K fertilizer in pineapple cultivation on tropical peat soil was low, estimated at 28%. At a depth of 0-10 cm, there was a sharp decrease of soil total K, exchangeable K, and soil solution K days after planting (DAP) for plots with K fertilizer. This decline continued until the end of the study. Soil total, exchangeable, and solution K at the end of the study were generally lower than prior values before the study. There was no significant accumulation of K at depths of 10-25 and 25-45 cm. However, K concentrations throughout the study period were generally lower or equal to their initial status in the soil indicating leaching of the applied K and partly explained the low K recovery. Potassium losses through leaching in pineapple cultivation on tropical peat soils need to be considered in fertilizer recommendations for efficient recovery of applied K.
  15. Ahmed OH, Husni MH, Anuar AR, Hanafi MM
    ScientificWorldJournal, 2004 Nov 20;4:1007-13.
    PMID: 15578124
    Due to the 1997/98 haze problem in South-East Asia and the increasing need for sustainable food production and development, the usual management of crop residues (including pineapple wastes) through burning is prohibited. As a result, the need for alternative uses of pineapple wastes in pineapple production has been emphasized. This study investigated an environmentally friendly means of recycling pineapple leaves for agricultural use. Pineapple leaves were shredded and composted in a composting drum for 30 days. Part of the shredded leaves was ashed in a muffle furnace for 4 h. Humic acid (HA), K-fulvate, and K in HA and compost were analyzed using standard procedures. An ash to water ratio of 1:7 was used to extract 0.1 molar (M) KOH from the shredded leaves. The 0.1 M KOH contained 50% K and was able to extract 20% HA from the composted pineapple leaves. Percent K in the fulvate using 0.1 M KOH was 43. Besides serving as a foliar spray (supplement soil application K fertilizers), source of K for freshwater fish (e.g., tilapia), the HA produced can be used as a soil conditioner. Studies show that between 0.05-0.01 g of HA per kg soil retards runoff by 36% in sandy and sandy loam soils. The K-fulvate can be used as a fluid fertilizer. In addition, the pH of 2 of the K-fulvate suggests it could be used to dissolve phosphate rocks, particularly those in the arid regions where high soil pH does not facilitate the dissolution of these important rocks that serve as one of the sources of phosphorus fertilizer in agriculture.
  16. Nissapatorn V, Kuppusamy I, Josephine FP, Jamaiah I, Rohela M, Khairul Anuar A
    PMID: 17547073
    A total of 136 patients, 67 HIV, 69 diabetes mellitus (DM) with or without (+/-) end-stage renal disease (ESRD), were registered for tuberculosis treatment at the National Tuberculosis Center (NTBC) from May to December, 2003. Ages ranged from 21-78 years (median 57.7 years) in TB/DM patients, and 21-62 (mean 37.6 +/- 8.3 years) in TB/HIV patients. TB was significantly found in younger and single HIV patients, but in older and married DM patients (p<0.05). Male patients in both groups were strongly associated with TB, while females more commonly had TB with DM (p<0.05). The majority of these patients were Malays, unemployed, and resided in Kuala Lumpur territory; however, no statistically significant difference was found between the 2 groups. Smoking, IVDUs and hepatitis C virus (HCV) infection were more significantly found in TB/HIV patients and further analysis showed that pulmonary TB was strongly associated with HCV infection in these patients (p<0.05). Pulmonary TB (62; 89.9%) was the most common type found in both groups and was a markedly more common disease location in TB/DM patients, while extrapulmonary TB (21; 31.3%) and miliary TB (14; 21%) were significantly higher in TB/HIV patients. Cough with or without sputum, fever and loss of appetite and/or weight were common clinical presentations in both groups. Nevertheless, fever (54; 80.6%) and lymphadenopathy (17; 25.4%) were significantly related to TB/HIV patients (p<0.05). Interestingly, the presence of BCG vaccination and positive tuberculin skin test were stronger in TB/HIV (27; 40.3%) and TB/DM (20; 29%) patients, respectively (p<0.05). Overall, regular 6-, 9- and 12-months' anti-tubercular therapy (ATT) were routine practice, and EHRZ+B6 was the most common regimen used. The highest percentage of patients with treatment success were in both groups with 6 months' ATT; however, a significantly higher percentage was found in TB/DM (24; 34.8%) than TB/HIV (13; 19.4%) (p<0.05). A success rate of 15 (21.7%) was noted for TB/DM patients with 9 months' ATT, which was similar to both groups with the 12-month regimen. A higher percentage failure rate (lost to follow-up) was seen in TB/HIV (19; 28.4%) patients. Nine patients were reported to have anti-tubercular-drug side-effects, such as drug-induced hepatitis, blurred vision, and skin rash. No cases of drug resistance or death were notified among these patients.
  17. Nissapatorn V, Lim YA, Jamaiah I, Agnes LS, Amyliana K, Wen CC, et al.
    PMID: 16438180
    A total of 1,885 blood and stool samples of four main protozoan parasitic infections were retrospectively reviewed from January, 2000 to April, 2004. Eleven of the 1,350 stool samples were shown positive for Cryptosporidium and Giardia infections; one of the 5 cases was clinically diagnosed as gastrointestinal cryptosporidiosis, while 6 cases were giardiasis. In patients with giardiasis, children were among the high-risk groups, making up 66.7% of these patients. The common presenting signs and symptoms were: diarrhea (83.3%), loss of appetite (83.3%), lethargy (83.3%), fever (66.7%), nausea/vomiting (50.0%), abdominal pain (16.7%), dehydration (16.7%) and rigor and chills (16.7%). Metronidazole was the drug of choice and was given to all symptomatic patients (83.3%). For the blood samples, 28 of the 92 peripheral smears for Plasmodium spp infection were diagnosed as malaria. The age range was from 4 to 57, with a median of 32.5 years. The sex ratio (M:F) was 3.6:1, while the age group of 30-44 years was the most commonly affected in both sexes. The majority of patients were foreigners (60.7%) and non-professional (39%). Plasmodium vivax (71%) infection was the most common pathogen found in these patients, along with a history of traveling to an endemic area of malaria (31%). The predominant presenting signs and symptoms were: fever (27%), rigor and chills (24%), nausea/vomiting (15%) and headache (8%). Chloroquine and primaquine was the most common anti-malarial regimen used (78.6%) in these patients. The seroprevalence of toxoplasmosis in different groups was 258/443 (58%): seropositive for IgG 143 (32.3%); IgM 67 (15%); and IgG + IgM 48 (10.8%). The age range was from 1 to 85, with a mean of 34 (+/- SD 16.6) years. The predominant age group was 21 to 40 years (126; 28.4%). The sex ratio (M:F) was 1.2:1. Subjects were predominantly male (142; 32%) and the Malay (117; 26.4%). Of these, 32 cases were clinically diagnosed with ocular toxoplasmosis. The range of age was from 10 to 56 years with a mean of 30.5 (+/- SD 12.05) years. The sex ratio (M:F) was 1:1.7. The majority were in the age group of 21 to 40 years, female (20; 62.5%), and Malay (17; 53%). They were also single (16; 50%), unemployed (12; 37%), and resided outside Kuala Lumpur (21; 65.6%). The more common clinical presentations were blurring of vision (25; 78%), floaters (10; 31%) and pain in the eye (7; 22%). We found that funduscopic examination (100%) and seropositivity for anti-Toxoplasma antibodies (93.7%) were the main reasons for investigation. Choroidoretinitis was the most common clinical diagnosis (69%), while clindamycin was the most frequently used antimicrobial in all cases. Among HIV-infected patients, 10 cases were diagnosed as AIDS-related toxoplasmic encephalitis (TE) (9 were active and 1 had relapse TE). In addition, 1 case was confirmed as congenital toxoplasmosis.
  18. Nissapatorn V, Kuppusamy I, Jamaiah I, Fong MY, Rohela M, Anuar AK
    PMID: 16438212
    This retrospective and descriptive study was a report on the clinical situation of tuberculosis in diabetic patients, with 1,651 patients recruited. The mean age of TBDM patients was significantly higher than that of non-diabetic patients (p<0.05). Moreover, TBDM patients had a higher ratio of male to female than the other group. The significant proportion of TB appeared to increase steadily with age in diabetic patients compared to non-diabetic ones (p<0.05). However, they showed similarities in terms of sex, race, marital status, present address, and occupation. A higher percentage of pulmonary tuberculosis (91.4%) was shown in the TBDM group. We found that both groups had no differences in the radiological findings, with opacity or cavity of the upper lobe involvement being 89% and 91% in TBDM and non-diabetic groups, respectively. TBDM patients were shown to have more treatment success (33.3%), particularly the pulmonary type of tuberculosis in the longer duration ( 9 months). Further findings demonstrated that a lower proportion of the TBDM group defaulted in their treatment (19.8%) and experienced resistance to anti-tubercular therapy (1.4%) compared to non-diabetics.
  19. Nissapatorn V, Kuppusamy I, Sim BL, Quek KF, Khairul Anuar A
    PMID: 16295550
    This retrospective study was conducted at the National Tuberculosis Center (NTBC) where 252 HIV-positive patients coexisting with tuberculosis (TB/HIV) were examined. We found that patients with pulmonary (PTB) and extrapulmonary tuberculosis (EPT) had similar mean age. A higher sex ratio between male to female (10.7:1) was observed in patients with PTB. The other characteristics of patients with pulmonary and extrapulmonary tuberculosis were not statistically different from each other. Cough (88%) and hemoptysis were the most common presenting symptoms, significantly related to patients with PTB. Lymphadenopathy (33.5%) was the most common sign in patients with EPT. The majority of patients with pulmonary and extrapulmonary tuberculosis had CD4 cell counts of less than 200 cells/mm3 (range 0-1,179 with a median of 57 cells/mm3). Lung (89%) and miliary (55.6%) forms were the most frequent disease locations in patients with PTB and EPT, respectively. A higher percentage of patients with PTB (42%) were treated successfully with short-course (6 months) therapy, whereas in patients with EPT (43%) needed a longer period (9 months) for successful treatment. Of the patients who defaulted treatment, a higher proportion (87%) had PTB. No MDR-TB or relapse cases were found in this study.
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