The purpose of this study is to review the literature on microsporidiosis in various high-risk groups among the Malaysian population, i.e., HIV/AIDS, cancer, hospitalised patients and Orang Asli, and to update information with regards to microsporidia prevalence, diagnosis and association of the disease with gastrointestinal symptoms in Malaysia. Hospitalised patients showed the highest prevalence (28.3%) of microsporidiosis compared to other risk groups. This review did not find any direct correlations between gastrointestinal symptoms and microsporidiosis. Since microsporidiosis is an emerging threat to the high-risk groups, greater awareness should be instilled among clinicians to consider microsporidiosis in their differential diagnosis if no other causes can be defined.
Microscopy-based technique has been widely used in the detection of Blastocystis sp. This study was conducted to compare
the techniques used for screening of Blastocystis sp., namely in vitro cultivation of stool specimens in Jones’ medium (IVC)
followed by Wheatley Trichrome staining and direct examination of stool samples preserved with polyvinyl alcohol (PVA)
followed by Wheatley Trichrome staining with single-round polymerase chain reaction (PCR) as the reference technique.
The study was performed on 466 stool samples obtained from the aboriginal community in Pahang, Malaysia. IVC showed
higher detection rate of Blastocystis sp. (35.6%) than PVA (20.0%). Single-round PCR detected Blastocystis sp. in 41.0%
of the stool specimens. The sensitivity and specificity of PVA and IVC in comparison to the reference technique were 75.3%
(95% CI: 65.2-83.6) and 68.5% (CI: 63.7-73.3) and 88.6% (CI: 82.7-93.0) and 86.3% (CI: 81.9-90.0), respectively. The
agreement between the reference technique and PVA showed statistically significant fair agreement by Cohen Kappa
statistics of (K=0.318, p<0.001), meanwhile statistically significant substantial agreement was observed between PCR
and IVC by Cohen Kappa (K=0.727, p<0.001). Therefore, in vitro cultivation in Jones’ medium followed by Wheatley
Trichrome staining of stool specimens should be used as a screening technique in the detection of Blastocystis sp. infections.
Tujuan kajian ini adalah untuk mengenal pasti punca insidens tinggi infeksi Acanthamoeba di kalangan pemakai kanta sentuh di Kuala Lumpur. Satu ratus tujuh puluh empat sampel diambil dari 66 subjek pemakai kanta sentuh lembut jenis pakaibuang dan mereka juga disoal dengan menggunakan borang kaji selidik. Kesemua pemakai kanta sentuh menggunakan pelbagai jenis larutan disinfeksi atau larutan pelbagai guna untuk membersih dan mendisinfeksi kanta sentuh. Swab diambil dari kanta sentuh yang masih dipakai, bekas kanta sentuh dan juga larutan disinfeksi yang sedang digunakan. Daripada swab ini proses pengkulturan yang lengkap dilakukan untuk pemencilan Acanthamoeba spp. Pemencilan Acanthamoeba spp. daripada 14 sampel daripada 7 subjek telah berjaya dilakukan. Hasil pemencilan yang tinggi adalah daripada bekas kanta sentuh (13.5%) dan kanta sentuh subjek (10.6%). Walau bagaimanapun tiada sebarang pemencilan didapati daripada larutan disinfeksi. Punca infeksi Acanthamoeba adalah dari bekas simpanan kanta sentuh dan kanta sentuh yang dipakai. Kaji selidik menunjukkan peratusan tidak komplain yang tinggi di kalangan pemakai kanta sentuh kerana ramai menggunakan air paip untuk mencuci kanta sentuh dan bekasnya.
Keratitis Acanthamoeba merupakan sejenis inflamasi kornea yang dikaitkan dengan penggunaan kanta sentuh. la disebabkan oleh Acanthamoeba spp., ameba hidup bebas yang tersebar luas di pelbagai persekitaran manusia. Kontaminasi Acanthamoeba spp. pada bekas penyimpanan kanta sentuh merupakan faktor kehadiran ameba pada kanta seterusnya menjangkiti mata. Kajian ini bertujuan untuk melihat kehadiran Acanthamoeba spp. pada bekas penyimpanan kanta sentuh pengguna asimptomatik. Seramai 90 orang pengguna kanta sentuh asimptomatik terlibat dalam kajian ini. Sampel diambil secara swab pada bekas kanta sentuh dan dikulturkan ke atas agar bukan nutrien yang dilapisi Escherichia coli. Plat agar diperiksa setiap hart bagi mengesan kehadiran ameba. Kultur positif seterusnya disahkan di bawah 'Image Analysis with Video TesT 4.0'. Acanthamoeba spp. didapati positif pada lapan daripada 90 sampel (8. 7%) dan kesemua strain adalah kumpulan II (polyphagids). Penemuan ini membuktikan Acanthamoeba spp. boleh Nadir pada bekas penyimpanan kanta sentuh pengguna asimptomatik dan boleh menjadi risiko jangkitan keratitis Acanthamoeba.
Cat flea bite in humans results in extremely pruritic skin lesions. It has been reported to occur among those living in domiciliary accommodation. However, nosocomial infestation with cat flea has not been reported. We hereby report a case of nosocomial infestation of cat flea in a hospital facility. Identification of the parasite, its appropriate eradication, and adequate medical management of the patients resulted in a satisfactory outcome.
The art of talking to patients and their relatives does not come naturally to most of us and the ability to put oneself in the patients’ predicament is difficult particularly for the young doctors. To identify the communication abilities of the young doctors, a cross sectional study was carried out on 32 house officers who graduated from UKM in 2004 during their house jobs at different hospitals in Malaysia. A standardized questionnaire was used to collect the data. Fifty nine percent respondents claimed that they had communicated very well with patients while 69% with support staff and 88% with peers. On the other hand 38% and 41% of the respondents claimed they communicated very well with their superiors and families of patients. Only 22% of the graduates’ skills of communication in breaking bad news were very well, while 50% and 81% were very well in counselling patients and taking consent for procedures. Curriculum planners need to emphasize the importance ofdeveloping good communication skills in all aspects for the future doctors.