Displaying publications 1 - 20 of 47 in total

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  1. Zamri-Saad M, Kamarudin MI
    Asian Pac J Trop Med, 2016 12;9(12):1136-1140.
    PMID: 27955740 DOI: 10.1016/j.apjtm.2016.11.007
    Brucellosis is a zoonotic disease characterized by reproductive failure in animals and undulent fever in humans. In cattle, it is caused by Brucella abortus while in goats by Brucella melitensis, the main cause of brucellosis in humans. Brucellosis in livestock has been associated with importation of animals from breeder herd of unknown disease status. The prevalence of bovine brucellosis Brucella abortus in 2014 ranged between 1% and 2% in Thailand and Indonesia, and 4%-5% in Malaysia and Myanmar. Prevalence of goat brucellosis Brucella melitensis is approximately 1% in Malaysia and Thailand. 'Test-and-slaughter' is the general policy against brucellosis adopted by most ASEAN countries to eradicate the disease. Under this program, the Rose Bengal Plate Test (RBPT) is used as the screening test to identify infected farm/herd while the complement fixation test (CFT) is the confirmatory test. The test-and-slaughter eradication strategy that was implemented since 1979 had managed to keep the prevalence rate to less than 5%, from 3.3% in 1979, 0.23% in 1988, 1% in 1998 and 5% in 2016. The test-and-slaughter program seemed effective in reducing the prevalence of brucellosis but was unable to eradicate the disease due to several factors, which include failure to locate and identify the remaining affected animals and to control their movement, importation of breeder animals from non-brucellosis free countries and lack of participation by the farmers following unreliable test results. To support the eradication policy, research activities since 1980s have suggested combinations of serological tests to improve diagnosis while surveillance should be focused on hotspots areas. The prevalence can be further reduced by strictly sourcing breeder animals from brucella-free areas or countries.
  2. Zain RM, Ibrahim N, Ismail S, Suppiah J, Mat Rahim NA, Thayan R
    Asian Pac J Trop Med, 2017 Jan;10(1):75-78.
    PMID: 28107870 DOI: 10.1016/j.apjtm.2016.12.005
    OBJECTIVE: To determine drug resistance mutations and the HIV-1 subtypes among antiretroviral treatment naive HIV-1 patients in Peninsular Malaysia.

    METHODS: A total of 45 samples from four hospitals that provide HIV viral load services were subjected to the amplification of the protease and two third of reverse transcriptase regions of the pol gene by RT-PCR and Sanger sequencing. Drug resistance mutation (DRM) interpretation reports the presence of mutations related to protease inhibitors (PIs), Nucleoside reverse-transcriptase inhibitors (NRTI) and Non-nucleoside reverse-transcriptase inhibitors (NNRTI) based on analysis using Stanford HIV database program.

    RESULTS: DRMs were identified in 35% of patients, among which 46.7% of them showed minor resistance to protease inhibitor with A71V and L10l were the commonest DRMs detected. About 21.4% and 50.0% of patients had mutations to NRTIs and NNRTIs, respectively. CRF01_AE was found to be the predominant HIV-1 subtype.

    CONCLUSIONS: These findings have served as an initial crucial data in determining the prevalence of transmitted HIV-1 drug resistance for the country. However, more samples from various parts of the country need to be accumulated and analyzed to provide overall HIV-1 drug resistance in the country.

  3. Zaid OI, Abd Majid R, Sabariah MN, Hasidah MS, Al-Zihiry K, Yam MF, et al.
    Asian Pac J Trop Med, 2015 Jul;8(7):507-12.
    PMID: 26276279 DOI: 10.1016/j.apjtm.2015.06.007
    OBJECTIVE: To explore whether its antiplasmodium effect of andrographolide is attributed to its plausible effect on the plasma membrane of both Plasmodium falciparum infected and non-infected RBCs.

    METHODS: Anti-plasmodium effect of andrographolide against Plasmodium falciparum strains was screened using the conventional malaria drug sensitivity assay. The drug was incubated with uninfected RBCs to monitor its effect on their morphology, integrity and osmotic fragility. It was incubated with the plasmodium infected RBCs to monitor its effect on the parasite induced permeation pathways. Its effect on the potential of merozoites to invade new RBCs was tested using merozoite invasion assay.

    RESULTS: It showed that at andrographolide was innocuous to RBCs at concentrations approach its therapeutic level against plasmodia. Nevertheless, this inertness was dwindled at higher concentrations.

    CONCLUSIONS: In spite of its success to inhibit plasmodium induced permeation pathway and the potential of merozoites to invade new RBCs, its anti-plasmodium effect can't be attributed to these functions as they were attained at concentrations higher than what is required to eradicate the parasite. Consequently, other mechanisms may be associated with its claimed actions.

  4. Zahari A, Ablat A, Sivasothy Y, Mohamad J, Choudhary MI, Awang K
    Asian Pac J Trop Med, 2016 Apr;9(4):328-332.
    PMID: 27086149 DOI: 10.1016/j.apjtm.2016.03.008
    OBJECTIVE: To study antiplasmodial and antioxidant activities of the isolation of alkaloids from the active dichloromethane extract of Alseodaphne corneri.

    METHODS: Phytochemical studies of the crude extract led to the isolation of six alkaloids using recycle high performance liquid chromatography and preparative thin layer chromatography. The antiplasmodial activity of the isolated compounds was evaluated using the histidine-rich protein II assay. The isolated alkaloids were also tested for their antioxidant activity using three different assays; DPPH, ferric reducing ability of plasma and metal chelating assays.

    RESULTS: Malaria infection caused the formation of free radicals which subsequently led to oxidative stress and apoptosis. The antioxidant properties of the alkaloids under investigation revealed that in addition to the antiplasmodial activity, the alkaloids could also prevent oxidative stress. (+)-laurotetanine and (+)-norstephasubine exhibited strong antiplasmodial activities with IC50 values of 0.189 and 0.116 μM, respectively.

    CONCLUSIONS: Interestingly, the two most potent compounds that exhibit antiplasmodial activity also exhibit good antioxidant activities. The crude dichloromethane extract and the isolated compounds exert substantial antiplasmodial and antioxidative activities which in turn suppress oxidative stress and cause less damage to the host.

  5. Yusoff NA, Yam MF, Beh HK, Abdul Razak KN, Widyawati T, Mahmud R, et al.
    Asian Pac J Trop Med, 2015 Aug;8(8):595-605.
    PMID: 26321511 DOI: 10.1016/j.apjtm.2015.07.015
    OBJECTIVES: To study the antidiabetic and antioxidant activities of nipa palm vinegar (NPV) used in traditional Malay medicine for treating diabetes.

    METHODS: NPV was extracted using liquid-liquid extraction method and the obtained samples were subjected to antidiabetic studies using normal and streptozotocin-induced diabetic rat models whereas antidoxidant activities were investigated via in vitro antioxidant tests namely 2,2-diphenyl-1-picrylhydrazyl and 2,2'-azinobis-3-ethylbenzothiozoline-6-sulfonic acid free radicals scavenging activities and the reducing power assay.

    RESULTS: Single administration of NPV and its extracts were not effective in both normal and diabetic rats. In intraperitoneal glucose tolerance test, NPV and its aqueous extract showed significant blood glucose lowering effect. In the sub-acute study, compared with the diabetic control, aqueous extract of NPV showed the most notable blood glucose lowering effect (56.6%) and a significant improvement in serum insulin levels (79.8%, P 

  6. Yu KX, Wong CL, Ahmad R, Jantan I
    Asian Pac J Trop Med, 2015 Dec;8(12):1006-1012.
    PMID: 26706671 DOI: 10.1016/j.apjtm.2015.11.011
    OBJECTIVE: To investigate the larvicidal activity, inhibition effect on development, histopathological alteration and morphological aberration induced by the extracts derived from seaweeds Bryopsis pennata (B. pennata), Sargassum binderi (S. binderi) and Padina australis in Aedes aegypti (Ae. aegypti) larvae and to characterize the phytochemical components of the three seaweeds.

    METHODS: Larvicidal activity of the seaweeds towards the larvae of Ae. aegypti was determined according to WHO. The inhibition effect of seaweeds was assessed by determining the mortality, adult emergence rate, larval and pupa duration of the treated larvae. Histopathological effect on midgut epithelium of larvae and morphological aberration induced by the methanol extracts were examined. Phytochemical analysis was done to determine the presence of alkaloids, saponins, steroids and terpenoids in the seaweeds.

    RESULTS: Chloroform partition of B. pennata extract exhibited the strongest larvicidal activity (LC50 = 82.55 μg/mL), followed by methanol extract of B. pennata (LC50 = 160.07 μg/mL) and chloroform partition of S. binderi extract (LC50 = 192.43 μg/mL). The methanol extract of S. binderi exhibited the strongest effect on prolongation of larval period (1.5-fold longer as compared to control) and resulted in strongest inhibition effect in adult emergence (98.67%). The histopathological study showed that larvae treated with seaweed extracts had cytopathological alteration of the midgut epithelium. The morphological observation revealed that the anal papillae and terminal spiracles of larvae were the common sites of aberrations.

    CONCLUSIONS: The study provided information on various effects of seaweed extracts on Ae. aegypti. Further investigation on identifying the active compounds and their mechanisms of action is recommended.

  7. Wesam RK, Ghanya AN, Mizaton HH, Ilham M, Aishah A
    Asian Pac J Trop Med, 2013 Oct;6(10):811-6.
    PMID: 23870471 DOI: 10.1016/S1995-7645(13)60143-1
    OBJECTIVE: To investigate the cytotoxicity and the genotoxicity of standardized aqueous of dry leaves of Erythroxylum cuneatum (E. cuneatum) in human HepG2 and WRL68 cells.

    METHODS: The cytotoxicity of E. cuneatum extract was evaluated by both MTS and LDH assays. Genotoxicity study on E. cuneatum extract was assessed by the single cell gel electrophoresis (comet assay). The protective effect of E. cuneatum against menadione-induced cytotoxicity was also investigated.

    RESULTS: Results from this study showed that E. cuneatum extract exhibited cytotoxic activities towards the cells with IC50 value of (125±12) and (125±14) μg/mL for HepG2 and WRL68 cells respectively, after 72 h incubation period as determined by MTS assay. LDH leakage was detected at (251±19) and (199.5±12.0) μg/mL for HepG2 and WRL68 respectively. Genotoxicity study results showed that treatment with E. cuneatum up to 1 mg/mL did not cause obvious DNA damage in WRL68 and HepG2 cells. Addition of E. cunaetum did not show significant protection towards menadione in WRL68 and HepG2 Cells.

    CONCLUSIONS: E. cuneatum standardized aqueous extract might be developed in order to establish new pharmacological possibilities for its application.

  8. Taher M, Susanti D, Rezali MF, Zohri FS, Ichwan SJ, Alkhamaiseh SI, et al.
    Asian Pac J Trop Med, 2012 Feb;5(2):136-41.
    PMID: 22221758 DOI: 10.1016/S1995-7645(12)60012-1
    OBJECTIVE: To study the chemical constituents of stembark of Garcinia malaccensis (G. malaccensis) together with apoptotic, antimicrobial and antioxidant activities.

    METHODS: Purification and structure elucidation were carried out by chromatographic and spectroscopic techniques, respectively. MTT and trypan blue exclusion methods were performed to study the cytotoxic activity. Antibacterial activity was conducted by disc diffusion and microdilution methods, whereas antioxidant activities were done by ferric thiocyanate method and DPPH radical scavenging.

    RESULTS: The phytochemical study led to the isolation of α,β-mangostin and cycloart-24-en-3β-ol. α-Mangostin exhibited cytotoxic activity against HSC-3 cells with an IC(50) of 0.33 μM. β- and α-mangostin showed activity against K562 cells with IC(50) of 0.40 μM and 0.48 μM, respectively. α-Mangostin was active against Gram-positive bacteria, Staphylococcus aureus (S. aureus) and Bacillus anthracis (B. anthracis) with inhibition zone and MIC value of (19 mm; 0.025 mg/mL) and (20 mm; 0.013 mg/mL), respectively. In antioxidant assay, α-mangostin exhibited activity as an inhibitor of lipid peroxidation.

    CONCLUSIONS: G. malaccensis presence α- and β-mangostin and cycloart-24-en-3β-ol. β-Mangostin was found very active against HSC-3 cells and K562. The results suggest that mangostins derivatives have the potential to inhibit the growth of cancer cells by inducing apoptosis. In addition, α-and β-mangostin was found inhibit the growth of Gram-positive pathogenic bacteria and also showed the activity as an inhibitor of lipid peroxidation.

  9. Suppiah J, Saraswathy TS, Amry K, Yusof A, Saat Z
    Asian Pac J Trop Med, 2016 Mar;9(3):252-5.
    PMID: 26972396 DOI: 10.1016/j.apjtm.2016.01.037
    OBJECTIVE: To identify the circulating serotypes of human echovirus in Malaysia from 2002 to 2013.

    METHODS: A total of 31 retrospective samples from non-polio acute flacid paralysis, hand-food-and-mouth disease, viral meningitis and enterovirus cases were subjected to amplification of partial VP1 gene by RT-PCR.

    RESULTS: Sequencing and phylogenetic analysis of the partial sequences identified presence of human echovirus and human coxsackie viruses. It was found that echovirus 11 was the commonly circulating serotype followed by echovirus 6, echovirus 7, echovirus 3, echovirus 9, echovirus 30 and echovirus 1 in decreasing order. Additionally two types of human coxsackie virus isolates were detected which were coxsackie A24 and B3.

    CONCLUSIONS: From the findings, there is a possibility that echovirus 11 is the predominant serotype among Malaysian patients with echovirus infection. However, a larger sample size will yield a more confident result to support this evidence.

  10. Shahfiza N, Osman H, Hock TT, Shaari K, Abdel-Hamid AH
    Asian Pac J Trop Med, 2015 Jun;8(6):451-6.
    PMID: 26194829 DOI: 10.1016/j.apjtm.2015.05.012
    OBJECTIVE: To determine the metabolic response associate with dengue infection based on human gender metabolic differences by means of (1)H NMR-spectrometry.

    METHODS: The mid-stream urine collected from both male and female patients diagnosed with dengue fever at Penang General Hospital and fourty-three healthy individuals were analyzed with (1)H NMR spectroscopy, followed by chemometric multivariate analysis. NMR signals which highlighted in the OPLS-DA S-plot were further selected and identified using Human Metabolome Database, Chenomx Profiler.

    RESULTS: The results pointed out that NMR urine profiling was able to capture human gender metabolic differences that are important for the distinction of classes of individuals of similar physiological conditions; infected with dengue. Distinct differences between dengue infected patients versus healthy individuals and subtle differences in male versus female infected with dengue were found to be related to the metabolism of amino acid and tricarboxylic acid intermediates cycle.

    CONCLUSIONS: The (1)H NMR metabolomic investigation combined with appropriate algorithms and pattern recognition procedures, gave an evidence for the existence of distinct metabolic differentiation of individuals, according to their gender, modulates with the infection risk.

  11. Sasidharan S, Lachumy SJ, Ravichandran M, Latha LY, Gegu SR
    Asian Pac J Trop Med, 2011 Jan;4(1):72-5.
    PMID: 21771421 DOI: 10.1016/S1995-7645(11)60037-0
    OBJECTIVE: To study the epidemiology of Helicobacter pylori (H. pylori) infection according to age group.

    METHODS: H. pylori infection data among 1 965 consecutive patients referred to the Endoscopy Unit collected at Sungai Petani Hospital for oesophagogastro-duodenoscopy (OGD). The patients were divided into 9 age groups (10-19, 20-29, 30-39, 40-49, 50-59, 60-69, 70-79, 80-89 and 90-99 years). In addition these groups were further divided into three minor group namely young adults (10-39), older adults (40-69) and geriatric groups (70-99).

    RESULTS: Overall prevalence of infection of H. pylori was analyzed and found that the prevalence increase with age (P<0.05). When the patients divided by ethnic and gender group with age, prevalence rate among young adults and older adults significantly higher (P<0.05) compared to geriatric groups across all races and gender (P<0.05). Furthermore, significantly higher number of males were infected compared to female (P<0.05) but such trend was only observed among older adult groups. In addition, there is a significant differences in H. pylori infection prevalence rates among ethnic groups (highest in Indians adults, followed Chinese and low in Malays, P<0.05).

    CONCLUSIONS: The overall prevalence of H. pylori did increase with age group across ethnicity and gender, in Northern Peninsular Malaysia.

  12. Saraswathy Subramaniam TS, Thayan R, Yusof MA, Suppiah J, Tg Abd Rashid TR, Zawawi ZM, et al.
    Asian Pac J Trop Med, 2016 Feb;9(2):201-3.
    PMID: 26919957 DOI: 10.1016/j.apjtm.2016.01.016
    An efficient public health preparedness and response plan for infectious disease management is important in recent times when emerging and exotic diseases that hitherto were not common have surfaced in countries with potential to spread outside borders. Stewardship from a reference laboratory is important to take the lead for the laboratory network, to proactively set up disease surveillance, provide referral diagnostic services, on-going training and mentorship and to ensure coordination of an effective laboratory response. In Malaysia, the Institute for Medical Research has provided the stewardship for the Ministry of Health's laboratory network that comprises of hospital pathology, public health and university laboratories. In this paper we share our experiences in recent infectious disease outbreak investigations as a reference laboratory within the Ministry of Health infectious disease surveillance network.
  13. Salehuddin AR, Haslan H, Mamikutty N, Zaidun NH, Azmi MF, Senin MM, et al.
    Asian Pac J Trop Med, 2017 Mar;10(3):211-219.
    PMID: 28442104 DOI: 10.1016/j.apjtm.2017.03.002
    Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. Previously, this rare virus was limited to sporadic cases in Africa and Asia until its emergence in Brazil, South America in 2015, where it rapidly spread throughout the world. Recently, a high number of cases were reported in Singapore and other Southeast Asia countries. A combination of factors explains the current Zika virus outbreak although it is highly likely that the changes in the climate and high frequency of travelling contribute to the spread of Aedes vector carrying the Zika virus mainly to the tropical climate countries such as the Southeast Asia. The Zika virus is known to cause mild clinical symptoms similar to those of dengue and chikungunya and transmitted by different species of Aedes mosquitoes. However, neurological complications such as Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a serious concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Therefore, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.
  14. Sahu PS, Lim YAL, Mahmud R, Somanath SD, Tan CT, Ramachandran CP
    Asian Pac J Trop Med, 2017 Apr;10(4):332-340.
    PMID: 28552103 DOI: 10.1016/j.apjtm.2017.03.024
    Seizures due to neurocysticercosis (NCC) is a neglected human-to-human transmitted disorder and an emerging problem worldwide. A substantial portion of recent onset seizures is known to be attributed to NCC in Taenia solium (T. solium) endemic areas where populations which neither raise pigs nor eat pig meat are also at risk. High prevalence of NCC causing epilepsy has been reported in the underdeveloped areas of Southeast Asia (SEA) however, only fragmentary information on its incidence is available in countries like Malaysia. In Malaysia T. solium infection was previously thought to be infrequent due to Muslim population majority and the religious prohibition of consuming pork, but it is not totally absent. There is an evident lack of knowledge and awareness of the actual burden, routes of transmission, and the impact of NCC in this region. The problem is assumed to be more prevalent particularly in cities because of the frequent inflow of possibly T. solium infected individuals or carriers among those who migrate from neighboring endemic countries to Malaysia. The issue of imported cases that are likely to be emerging in Malaysia is highlighted here. An accurate quantification of regional burdens of epilepsy due to NCC in Malaysia is warranted considering the disease emergence in its neighboring countries. It is suggested that the importance of NCC be recognized through quantification of its burden, and also to collect epidemiological data for its subsequent elimination in line of World Health Organization's mission for control of cysticercosis as a neglected tropical disease. In this review the need as well as a strategy for neuro-care center screening of epilepsy cases, and various issues with possible explanations are discussed. It is also proposed that NCC be declared as a reportable disease which is one of the eradicable public health problems in SEA.
  15. Saad S, Taher M, Susanti D, Qaralleh H, Rahim NA
    Asian Pac J Trop Med, 2011 Jul;4(7):523-5.
    PMID: 21803301 DOI: 10.1016/S1995-7645(11)60138-7
    OBJECTIVE: To investigate the antimicrobial activities of n-hexane, ethyl acetate and methanol extracts of the leaves of Lumnitzera littorea (L. littorea) against six human pathogenic microbes.

    METHODS: The antimicrobial activity was evaluated using disc diffusion and microdilution methods.

    RESULTS: The antimicrobial activities of the crude extracts were increased with increasing the concentration. It is clear that n-hexane extract was the most effective extract. Additionally, Gram positive Bacillus cereus (B. cereus) appear to be the most sensitive strain while Pseudomonas aeruginosa (P. aeruginosa) and the yeast strains (Candida albicans (C. albicans) and Cryptococcus neoformans (C. neoformans)) appear to be resistance to the tested concentrations since no inhibition zone was observed. The inhibition of microbial growth at concentration as low as 0.04 mg/mL indicated the potent antimicrobial activity of L. littorea extracts.

    CONCLUSIONS: The obtained results are considered sufficient for further study to isolate the compounds responsible for the activity and suggesting the possibility of finding potent antibacterial agents from L. littorea extracts.

  16. Rajoo Y, Mahmud R, Xiang NR, Omar SF, Kumar G, Lim YA, et al.
    Asian Pac J Trop Med, 2015 Apr;8(4):334-6.
    PMID: 25975509 DOI: 10.1016/S1995-7645(14)60341-2
    We report a case of a patient with Schistosoma mansoni infection who presented with liver cirrhosis and splenomegaly. She was diagnosed by a serological test and Kato-Katz thick smear stool examination. The patient was a 52-year-old woman from Sudan who came to Malaysia for a week to visit her sons. The patient lives in the middle of Rabak region, Sudan, a highly endemic area for schistosomiasis where her daily routine includes rearing of cows and farming. The site of toilet and sources of drinking water are canals and wells; both infested with snails. Patient had a long history of exposure and coming into contact with water from these canals and wells.
  17. Piaru SP, Mahmud R, Abdul Majid AM, Mahmoud Nassar ZD
    Asian Pac J Trop Med, 2012 Apr;5(4):294-8.
    PMID: 22449521 DOI: 10.1016/S1995-7645(12)60042-X
    OBJECTIVE: Toinvestigate the anti-angiogenic activity and antioxidant properties of Myristica fragrans (M. fragrans) (nutmeg) and Morinda citrifolia (M. citrifolia)(mengkudu) oils.

    METHODS: The nutmeg and megkudu essential oils were obtained by steam distillation. The antioxidant activities of both essential oils were determined by beta-carotene/linoleic acid bleaching assay and reducing power while the anti-angiogenic activity was investigated using rat aortic ring assay using various concentrations.

    RESULTS: The results showed that nutmeg oil has higher antioxidant activity than mengkudu oil. The nutmeg oil effectively inhibited the oxidation of linoleic acid with (88.68±0.1)% while the inhibition percentage of oxidation of linoleic acid of the mengkudu oil is (69.44±0.4)%. The nutmeg oil and mengkudu oil showed reducing power with an EC(50) value of 181.4 μg/mL and 3 043.0 μg/mL, respectively. The antiangiogenic activity of nutmeg oil showed significant antiangiogenic activity with IC(50) of 77.64 μg/mL comparing to mengkudu oil which exhibits IC(50) of 109.30 μg/mL.

    CONCLUSIONS: Bioactive compound(s) will be isolated from the nutmeg essential oil to be developed as antiangiogenic drugs.

  18. Pang EL, Loh HS
    Asian Pac J Trop Med, 2016 Apr;9(4):395-401.
    PMID: 27086160 DOI: 10.1016/j.apjtm.2016.03.004
    Prevalence of dengue transmission has been alarmed by an estimate of 390 million infections per annum. Urban encroachment, ecological disruption and poor sanitation are all contributory factors of increased epidemiology. Complication however arises from the fact that dengue virus inherently exists as four different serotypes. Secondary infection is often manifested in the more severe form, such that antibody-dependent enhancement (ADE) could aggravate ailment by allowing pre-existing antibodies to form complexes with infecting viruses as means of intrusion. Consequently, increased viraemic titter and suppression of antiviral response are observed. Deep concerns are thus expressed in regards to escalating trend of hospitalisation and mortality rates. In Malaysia, situation is exacerbated by improper clinical management and pending vector control operations. As a preparedness strategy against the potential deadly dengue pandemic, the call for development of a durable and cost-effective dengue vaccine against all infecting serotypes is intensified. Even though several vaccine candidates are currently being evaluated in clinical trials, uncertainties in regards to serotypes interference, incomplete protection and dose adequacy have been raised. Instead of sole reliance on outsourcing, production of local vaccine should be considered in coherent to government's efforts to combat against dengue.
  19. Pang EL, Loh HS
    Asian Pac J Trop Med, 2017 Mar;10(3):220-228.
    PMID: 28442105 DOI: 10.1016/j.apjtm.2017.03.003
    Dengue has been ranked as one of the top emerging diseases in Asia and Latin America. Current epidemiological data may not even reflect the true burden of disease due to under-reported figures. Vector control programmes have failed to contain the disease and worst of all, no specific treatment is available at the moment. Thereby, this pushes the demand for a dengue vaccine as a long-term protective approach. Despite there are numerous vaccine candidates ahead, they could be held back by different aspects in promoting vaccine implementation. Particularly for developing nations, logistics and cost are the major hurdles that need to be addressed in order to provide a quick yet affordable medical relief. As an alternative, plant-based vaccine production system is able to offer an attractive prospect given to its advantages of biocontainment warranty, low operation cost, rapid scalability and logistics flexibility. Researches that have embarked on this scope are laid out and reviewed in terms of the feasibility of plant system to serve as a biofactory for dengue vaccine.
  20. Ng KF, Tan KK, Ngui R, Lim YA, Amir A, Rajoo Y, et al.
    Asian Pac J Trop Med, 2015 Oct;8(10):878-80.
    PMID: 26522307 DOI: 10.1016/j.apjtm.2015.09.018
    We reported a case of amoebic liver abscess (ALA) in a 6-year-old Malaysian boy who presented with fever, lethargy, diarrhoea and right hypochondriac pain. On admission he was diagnosed with perforated acute appendicitis and a laparotomy was done. After surgery he developed acute respiratory distress. Ultrasonography, chest X-Ray and CT scan revealed two ALAs in the posterior segment of right lobe of liver, pleural effusion and collapsed consolidation of lungs bilaterally. Percutaneous liver abscesses drainage was done and intravenous Metronidazole was started. PCR carried out on the pus from the abscess was positive for Entamoeba histolytica. Patient however succumbed to the infection one week after admission.
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