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Staphylococcal-scalded skin syndrome: evaluation, diagnosis, and management

Leung AKC, Barankin B, Leong KF

World J Pediatr, 2018 04;14(2):116-120.
PMID: 29508362 DOI: 10.1007/s12519-018-0150-x

BACKGROUND: Staphylococcal-scalded skin syndrome (SSSS), also known as Ritter disease, is a potentially life-threatening disorder and a pediatric emergency. Early diagnosis and treatment is imperative to reduce the morbidity and mortality of this condition. The purpose of this article is to familiarize physicians with the evaluation, diagnosis, and treatment of SSSS.
DATA SOURCES: A PubMed search was completed in Clinical Queries using the key terms "Staphylococcal scalded skin syndrome" and "Ritter disease".
RESULTS: SSSS is caused by toxigenic strains of Staphylococcus aureus. Hydrolysis of the amino-terminal extracellular domain of desmoglein 1 by staphylococcal exfoliative toxins results in disruption of keratinocytes adhesion and cleavage within the stratum granulosum which leads to bulla formation. The diagnosis is mainly clinical, based on the findings of tender erythroderma, bullae, and desquamation with a scalded appearance especially in friction zones, periorificial scabs/crusting, positive Nikolsky sign, and absence of mucosal involvement. Prompt empiric treatment with intravenous anti-staphylococcal antibiotic such as nafcillin, oxacillin, or flucloxacillin is essential until cultures are available to guide therapy. Clarithromycin or cefuroxime may be used should the patient have penicillin allergy. If the patient is not improving, critically ill, or in communities where the prevalence of methicillin-resistant S. aureus is high, vancomycin should be used.
CONCLUSION: A high index of suspicion is essential for an accurate diagnosis to be made and treatment promptly initiated.

Matched MeSH terms: Sex Distribution
Women--an endangered species

World Dev Forum, 1987 Nov 30;5(21):1-2.
PMID: 12269045

Throughout India and China, South Korea and Taiwan, Pakistan and Malaysia, the same sentiment recurs: "The birth of girl is an occasion for gloom, not cheer, for bitterness, not pleasure." In all these countries "patriarchal traditions and social stigmas" make females the unwanted sex, reports Asiaweek. The tragic result: prenatal gender tests are flourishing. And for many women, if the test indicates a female, they abort. In India, sex tests and abortions are legal, cheap and readily available. Some 1500 sex-tested girls are aborted annually in Bombay alone. In China, abortions are legal, but gender tests strictly forbidden. Says one official: We cannot afford to let people know what sex the fetus is because all the girls would be aborted." Yet the numbers of baby girls in China have been reduced--and illicit gender tests and female infanticide are considered partly to blame. In South Korea, gender tests have been banned and most abortions are illegal, but "clandestine tests" are available, and according to the government some 30,000 pregnancies are terminated annually. The number of aborted females is not known, but birth ratios have shown "an alarming swing towards males" in recent years. Can laws and education change the social attitudes against girls in these Asian countries? Indian activist Vibhuti Patel, a lobbyist for stronger controls over sex-testing, hopes so. She urges a "continuous campaign" to fight the "centuries-old values" that encourages gender tests. Says Patel: Nothing less than the very survival of women is at stake."

Matched MeSH terms: Sex Distribution*
Prevalence of musculoskeletal disorders among staffs in specialized healthcare centre

Ibrahim NI, Mohanadas D

Work, 2012;41 Suppl 1:2452-60.
PMID: 22317086 DOI: 10.3233/WOR-2012-0480-2452

This study was conducted to investigate pervasiveness of the musculoskeletal disorder (MSD) among staffs in a specialized healthcare centre. Sixty-eight staffs from three departments namely Cardiovascular Lab (CVL), Nuclear Radiology, and General Radiography were recruited in this study. A modified Nordic Musculoskeletal Questionnaire (NMQ) was distributed among study population. The result shows that the prevalence of MSD was highest in lower back (88.2%), neck (76.5%) and shoulder (60.3%) for the past 12 months followed by lower back and elbow (44.1%), and wrist (39.1%) correspondingly, for the past 7 days. Present results suggest that healthcare professionals - radiographers, patient assistants and nurses incurs MSD risks through work tasks as well as psychosocial factors. These include awkward posture during patient handling, workload, work stress and time pressure. Therefore, an ergonomics improvement on the job design and workspace are needed in order to reduce the MSD risks.

Matched MeSH terms: Sex Distribution
Tuberculosis of the spine-the Sabah experience. Epidemiology, treatment and results

Dharmalingam M

Tuberculosis (Edinb), 2004;84(1-2):24-8.
PMID: 14670343 DOI: 10.1016/j.tube.2003.08.008

A retrospective review of 33 patients with tuberculosis of the spine from January 2000 to April 2002 revealed that the mean age was 36.5 and peak incidence is in the second decade of life (27.3%). There were 24 males and 9 females. The majority of the lesions involved the thoracic spine (30.3%), followed by the lumbar spine (27.2%). Skip lesions was seen in 12.1% of cases. The erythrocyte sedimentation rate was normal in 9.1% of patients. Neurological involvement was seen in 51.5% of patients. Concomitant tuberculosis of the lung was 66.6%. The radical surgical debridement and grafting rate was 39.3%. The preferred surgical procedure was that of radical anterior debridement and fusion supplemented by anterior or posterior instrumentation if needed. Anti-tuberculous chemotherapy remained the mainstay of treatment. Surgery gives faster relief of pain and neurological recovery but is a major undertaking, and thus selection of patients is vital to avoid morbidity and mortality.

Matched MeSH terms: Sex Distribution
Epidemiology of tuberculosis and leprosy, Sabah, Malaysia

Dony JF, Ahmad J, Yap KT

Tuberculosis (Edinb), 2004;84(1-2):8-18.
PMID: 14670341 DOI: 10.1016/j.tube.2003.08.002

The objectives in this epidemiology review are to measure and report the extent of morbidity and mortality due to tuberculosis (TB), the proportion of new sputum smear positive cases in districts and the status of cohort analysis as of 1999. As for leprosy, the main objective is to determine morbidity and the treatment outcomes of Multiple Drug Therapy (MDT). Based on the results obtained, a comprehensive action plan for prevention, control and monitoring of tuberculosis and leprosy cases and patients is being produced and implemented throughout the state. The analysis concentrated on patients diagnosed at all out-patient units and admitted in all of the state's hospitals. The patient particulars were recorded using a standardized format based on TB and Leprosy Health Management Information System (TB HMIS). TB was the second highest by notification of communicable diseases in Malaysia in 2001. 29% or about one-third of the national TB cases are from Sabah. However, it has been noted that there was an average decline of 2.6% in annual notification since 10 years ago to date. There was also a reduction of 11.4% in 2001 as compared to annual notification in 2000. Immigrants contribute more than 24% in detection of new cases since 1990. Treatment success rate in term of completion of treatment to date is 82%. Mortality rate has steadily declined from 14 deaths to 7 deaths per 100,000 population. Leprosy in Sabah also contributes to 30% of the yearly total caseload of Malaysia and has the highest notification rate of 2 per every 100,000 population as compared to other states. The average registered leprosy cases over the past 5 years are 239 cases and the prevalence rate is 0.7/10,000 population. The state has successfully achieved its goal to decrease leprosy as per the World Health Organization (WHO) goal of yearly overall prevalence rate of less than 1 case for every 10,000 population. However, the districts of Kudat, Tawau, Lahad Datu, Kota Kinabalu and Semporna are still within the prevalence rate of more than one per 10,000 population. This review highlights some interesting findings which can be incorporated into the State and Districts action plans and strategies. It is also noted that in order to translate National Plans and Strategies into effective action at the community level, health workers need relevant up-to-date knowledge of the pattern of health and disease, and of their determinants, in each district. The Sabah Health Department continues to organize and support programs related to management and control of tuberculosis and leprosy to progressively reduce the incidence of these diseases in the community by breaking the chain of transmission of Mycobacterium tuberculosis and M. leprae, respectively.
Study site: outpatient clinics, inpatients, hospitals, Sabah, Malaysia

Matched MeSH terms: Sex Distribution
Fulltext Seroprevalence of toxocariasis among Orang Asli (Indigenous people) in Malaysia using two immunoassays

Romano N, Nor Azah MO, Rahmah N, Lim Y AL, Rohela M

Trop Biomed, 2010 Dec;27(3):585-94.
PMID: 21399601 MyJurnal

Toxocariasis is a zoonotic helminthic infection of humans caused by the dog roundworm (Toxocara canis) or cat roundworm (Toxocara cati). There are two main human syndromes: visceral larva migrans (VLM), which are characterized by symptoms associated with major organs and ocular larva migrans (OLM), in which pathological effects on the host are restricted to the eye and the optic nerve. The present study evaluated the seroprevalence of toxocariasis among the Orang Asli with an IgG4-ELISA using recombinant antigens (rTES-26, rTES-30 and rTES-120) and an IgG-ELISA commercial kit (Cypress Diagnostic, Belgium). A total of 188 serum samples were analyzed using IgG4-ELISA recombinant antigens while 83 were tested using IgG-ELISA. Overall, 9 out of 188 (4.8%) samples were positive with the former assay: rTES-26 (2.7%) and rTES-30 (2.1%); and 63 out of 83 (75.9%) were positive with the IgG-ELISA. In general, the seroprevalence of toxocariasis among males (9.5%) was higher compared to females (1%). Children below 12 years (6.3%) have higher seroprevalence rate compared to adults (1.2%). Out of 59 IgG positive samples, 56 (94.9%) were also positive with soil-transmitted helminth (STH) infections which may indicate high false positivity. None of the IgG4- ELISA positive samples were positive with STH infections. Of 9 positive samples with IgG4-ELISA, 7 were also positive with IgG-ELISA giving the probability of true cases. The present finding indicated that exposure to Toxocara infection is not unusual among Malaysian aborigines, and it affects both sexes and all age groups. As a prevention strategy, more effective public health programmes to promote better understanding on the consequences of toxocariasis among the Orang Asli communities are deemed necessary.

Matched MeSH terms: Sex Distribution
Fulltext Prevalence of scabies and head lice among children in a welfare home in Pulau Pinang, Malaysia

Muhammad Zayyid M, Saidatul Saadah R, Adil AR, Rohela M, Jamaiah I

Trop Biomed, 2010 Dec;27(3):442-6.
PMID: 21399584 MyJurnal

This is a survey of 120 children for scabies and head lice infestations in a welfare home in Pulau Pinang. Children from this welfare home (Rumah Kanak-Kanak Taman Bakti, Kepala Batas, Pulau Pinang) were randomly selected. Majority of them were Malays (72.5%) and the rest were Indians. The infestation rates were highest in the 10-12 years age group with 46% and 70% for scabies and head lice respectively. Head lice was more commonly seen in girls (65%) than boys (29%). Scabies was more commonly seen in boys (50%) than girls (16%). Overall prevalence rate for scabies was 31% and for head lice infestation was 49%.

Matched MeSH terms: Sex Distribution
Consequences of Elder Abuse and Neglect: A Systematic Review of Observational Studies

Yunus RM, Hairi NN, Choo WY

Trauma Violence Abuse, 2019 04;20(2):197-213.
PMID: 29333999 DOI: 10.1177/1524838017692798

This article presents the results of a systematic review of the consequences of elder abuse and neglect (EAN). A systematic search was conducted in seven electronic databases and three sources of gray literature up to January 8, 2016, supplemented by scanning of citation lists in relevant articles and contact with field experts. All observational studies investigating elder abuse as a risk factor for adverse health outcomes, mortality, and health-care utilization were included. Of 517 articles initially captured, 19 articles met our inclusion criteria and were analyzed. Two reviewers independently performed abstract screening, full-texts appraisal, and quality assessment using the Newcastle-Ottawa Scale. Across 19 studies, methodological heterogeneity was a prominent feature; seven definitions of EAN and nine measurement tools for abuse were employed. Summary of results reveals a wide range of EAN outcomes, from premature mortality to increased health-care consumption and various forms of physical and psychological symptoms. Higher risks of mortality emerged as the most credible outcome, while the majority of morbidity outcomes originated from cross-sectional studies. Our findings suggest that there is an underrepresentation of older adults from non-Western populations and developing countries, and there is a need for more population-based prospective studies in middle- and low-income regions. Evidence gathered from this review is crucial in upgrading current practices, formulating policies, and shaping the future direction of research.

Matched MeSH terms: Sex Distribution
Anaemia and iron deficiency anaemia among aboriginal schoolchildren in rural Peninsular Malaysia: an update on a continuing problem

Al-Mekhlafi MH, Surin J, Atiya AS, Ariffin WA, Mahdy AK, Abdullah HC

Trans R Soc Trop Med Hyg, 2008 Oct;102(10):1046-52.
PMID: 18617209 DOI: 10.1016/j.trstmh.2008.05.012

A cross-sectional study to determine the current prevalence of anaemia and iron deficiency anaemia (IDA) and to investigate the possible risk factors for IDA was carried out on 241 aboriginal schoolchildren (120 boys, 121 girls) aged 7-12 years and living in remote areas in Pos Betau, Pahang, Malaysia. Haemoglobin (Hb) level was measured and serum iron status was assessed by serum ferritin (SF), serum iron (SI) and total iron binding capacity measurements. Socioeconomic data were collected using pre-tested questionnaires. All children were screened for intestinal parasitic infections. Overall, 48.5% (95% CI 42.3-54.8) of children were anaemic (Hb<12 g/dl). The prevalence of IDA was 34% (95% CI 28.3-40.2), which accounted for 70.1% of the anaemia cases. The prevalence of IDA was significantly higher in females than males. Low levels of mothers' education and low household income were identified as risk factors for IDA. Severe trichuriasis also found to be associated with low SF and SI. Logistic regression confirmed low levels of mothers' education and gender as significant risk factors for IDA. Improvement of socioeconomic status and health education together with periodic mass deworming should be included in public health strategies for the control and prevention of anaemia and IDA in this population.

Matched MeSH terms: Sex Distribution
Epidemiology of adenovirus respiratory infections among hospitalized children in Seremban, Malaysia

Foong Ng K, Kee Tan K, Hong Ng B, Nair P, Ying Gan W

Trans R Soc Trop Med Hyg, 2015 Jul;109(7):433-9.
PMID: 26038572 DOI: 10.1093/trstmh/trv042

There is scarcity of data regarding epidemiology and clinical aspects of human adenovirus acute respiratory infection (ARI) among children in developing countries.

Matched MeSH terms: Sex Distribution
Hypercalcaemia in patients with newly diagnosed tuberculosis in Malaysia

Liam CK, Lim KH, Srinivas P, Poi PJ

Int J Tuberc Lung Dis, 1998 Oct;2(10):818-23.
PMID: 9783529

University Hospital, Kuala Lumpur, Malaysia.

Matched MeSH terms: Sex Distribution
Fulltext Prevalence and predictors of recent illness and injury among the Malaysian population

Paramesarvathy R, Amal NM, Gurpreet K, Tee GH, Karuthan C

Southeast Asian J. Trop. Med. Public Health, 2012 May;43(3):773-84.
PMID: 23077858

The World Health Organization (WHO) estimates that injury will be the second leading cause of morbidity of disease burden worldwide by the year 2020. We conducted a community-based survey to determine the prevalence of recent illness and injury, in Malaysia. The survey was a cross sectional population-based household survey conducted using face to face interviews. The information was on self-reported recent illness and injury (SRRII) over the previous 2 weeks. This study was conducted during April - August 2006 and as a part of the third National Health and Morbidity Survey of Malaysia. A total of 56,710 respondents were interviewed with a response rate of 98.2% (55,660/56,710). The overall prevalence of combined SRRII was 23.6%; for injuries the prevalence was 3.1%. The groups with the highest SRRII were children 0-5 years old (31.2%), males (24.3%), Indians (26.9%), those with secondary education level (22.9%), those earning RM 1,000/ month (25.0%) and rural dwellers (25.5%). Age, sex, ethnicity, and locality were significantly associated with SRRII while monthly household income and educational level were marginally associated. On multivariate analysis, age, gender, race, ethnicity, education, income and locality were significantly associated with SRRII. The most common reported recent illness was related to the respiratory system (42.0%). The information obtained from this survey is useful to policy makers in the Ministry of Health to review and strengthen existing health programs.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Sex Distribution
Fulltext Pneumocystis carinii (jirovecii) pneumonia (PCP): the most common opportunistic infection observed in HIV/AIDS cases at the University Malaya Medical Centre, Kuala Lumpur, Malaysia

Jamaiah I, Rohela M, Tok EL, Tan CL, Tan WH, Teo WS, et al.

Southeast Asian J. Trop. Med. Public Health, 2012 Jul;43(4):825-31.
PMID: 23077803

This retrospective study was conducted among 59 HIV/AIDS patients with opportunistic infections admitted to the University Malaya Medical Centre between 2000 and 2009. Fifty-five point nine percent of cases were Chinese, 25.4% were Malays, 11.9% were Indians and 6.8% were of unknown ethnic origin. The male:female ratio was 2.9:1 (44 males and 15 females). The highest prevalence (38.9%) occurred in the 30-39 year old age group. Men comprised 47.7% and women 53.3%; the majority of both were married. The majority of cases were Malaysians (89.8%) and the rest (10.2%) were immigrants. Most of the patients (18.6%) were non-laborers, followed by laborers (11.9%), the unemployed (5.1%) and housewives (3.4%). The most common risk factor was unprotected sexual activity (20.3%). The two most common HIV/AIDS related opportunistic infections were Pneumocystis carinii (jirovecii) pneumonia (PCP) (62.7%) and toxoplasmosis (28.8%). Seventy-two point nine percent of patients had a CD4 count <200 cells/microl and 5.1% had a CD4 count >500 cells/microl. Eleven point nine percent of cases died during study period. A low CD4 count had a greater association with opportunistic infections. Most of the patients presented with fever (44.1%), cough (42.4%) and shortness of breath (28.8%). Detection of the etiologic pathogens aids clinicians in choosing appropriate management strategies.

Matched MeSH terms: Sex Distribution
Fulltext Knowledge of sexual and reproductive health among adolescents attending school in Kelantan, Malaysia

Ab Rahman A, Ab Rahman R, Ibrahim MI, Salleh H, Ismail SB, Ali SH, et al.

Southeast Asian J. Trop. Med. Public Health, 2011 May;42(3):717-25.
PMID: 21706952

The objectives of this study were to describe the knowledge of sexual and reproductive health among adolescents attending school and to compare the levels of knowledge between males and females and between older and younger groups of adolescents. A cross-sectional study was conducted among 1,034 secondary school students using a self administered validated questionnaire. The items with the fewest correct responses included: whether one can get pregnant after a single act of sexual intercourse (30.4%), whether sexual intercourse causes sexually transmitted diseases (STDs) (12.4%) and whether washing the vagina after sexual intercourse prevents pregnancy (17.0%). Their main source of sexual information was friends (64.4%). An independent t-test revealed the mean knowledge score was significantly higher among females than males on items assessing whether the genitalia may be touched freely by family members, females having attained menarche may become pregnant if having sex, whether pregnancy will occur if there is penetration of the penis into the vagina, whether premarital sexual intercourse causes pregnancy and if there is a relationship between abandoned babies and premarital pregnancies. The mean knowledge score assessing whether pregnancy can be prevented using condoms was higher among males than females. The mean knowledge scores were significantly higher among form four and form five students than forms one, two and three students. Lack of knowledge regarding important aspects of sexual and reproductive health warrant the need to strengthen sexual and reproductive health education.

Matched MeSH terms: Sex Distribution
Fulltext Blood pressure control among diabetic hypertensives under cardiology follow-up at a regional hospital in rural Malaysia

Azarisman SM, Aszrin A, Marzuki AO, Fatnoon NN, Hilmi A, Hadzri MH, et al.

Southeast Asian J. Trop. Med. Public Health, 2010 Jul;41(4):973-81.
PMID: 21073073

Three hundred thirty-one consecutive patients presenting with hypertension to the outpatient medical clinic of Tengku Ampuan Afzan Hospital, Kuantan, Malaysia were screened and 150 patients with concurrent diabetes were enrolled into a cross-sectional study. The majority of patients were male (60.6%) with a mean age of 60.0 +/- 11.0 years. The mean systolic blood pressure (SBP) was 140.9 +/- 20.1 mmHg and the mean diastolic blood pressure (DBP) was 81.7 +/- 9.8 mmHg. Only 38.0% (57/150) of patients had blood pressures within recommended guidelines (130/80 mmHg). The mean blood pressure in this group was 123.7 +/- 8.5/76.4 +/- 5.6 mmHg. The majority of patients were on either 2 (41.3%) or 3 (31.3%) anti-hypertensives. Females had a significantly higher SBP 145.4 +/- 22.7 vs. 138.0 +/- 17.8 mmHg in males (p = 0.026). The level of blood pressure control in diabetics was unsatisfactory, especially in females and the elderly. A reassessment of priorities in the management of patients with concurrent hypertension and diabetes is therefore, urgently needed.

Study site: outpatient medical clinic of Tengku Ampuan Afzan Hospital,

Matched MeSH terms: Sex Distribution
Prevalence and associated factors of head lice infestation among primary schoolchildren in Kelantan, Malaysia

Bachok N, Nordin RB, Awang CW, Ibrahim NA, Naing L

Southeast Asian J. Trop. Med. Public Health, 2006 May;37(3):536-43.
PMID: 17120976

Head lice infestation contributes a significant morbidity among schoolchildren in Malaysia. A cross-sectional study was designed to determine the prevalence and associated factors of head lice infestation among primary schoolchildren in Kelantan, Malaysia. Six schools were randomly selected from three sub-districts of Kuala Krai, Kelantan. A total of 463 eleven-year-old pupils were screened by visual scalp examination and fine-toothed combing. Self-administered questionnaire was used to collect data on socio-demography and associated factors of head lice infestation. The prevalence of head lice infestation was 35.0% (95% Cl: 30.6, 39.3) with 11.9% inactive, 23.1% active, 18.2% light and 16.8% heavy infestations. The associated factors were girls; family income of RM247 or less; head lice infestation of family member and having four or more siblings. The high prevalence of head lice infestation in this study indicates the need for regular school health program that emphasis on the eradication of head lice. The significant associated factors identified in this study reconfirm the importance of controlling the transmissibility of head lice. Pupils and parents should be informed regarding factors that may facilitate the transmission of head lice.

Matched MeSH terms: Sex Distribution
Fulltext Seroprevalence of cysticercosis in a rural village of Ranau, Sabah, Malaysia

Noor Azian MY, Hakim SL, Sumiati A, Norhafizah M

Southeast Asian J. Trop. Med. Public Health, 2006 Jan;37(1):58-61.
PMID: 16771213

The objective of this study was to determine exposure to cysticercosis among a rural population in a selected village in Ranau, Sabah, Malaysia. A total of 135 serum samples were analyzed. The result showed that the seroprevalence of cysticercosis antibodies was 2.2%. There was no significant difference in the seroprevalence among age groups (p=0.307). Even though there was a slightly higher antibody titer in males compared to females, the difference was not significant (p=0.400). The results indicate evidence of exposure to cysticercosis in this rural population.

Matched MeSH terms: Sex Distribution
Parasitic infections in Malaysia: changing and challenges

Nissapatorn V, Lim YA, Jamaiah I, Agnes LS, Amyliana K, Wen CC, et al.

Southeast Asian J. Trop. Med. Public Health, 2005;36 Suppl 4:50-9.
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.

Matched MeSH terms: Sex Distribution
Fulltext Tuberculosis in diabetic patients: a clinical perspective

Nissapatorn V, Kuppusamy I, Jamaiah I, Fong MY, Rohela M, Anuar AK

Southeast Asian J. Trop. Med. Public Health, 2005;36 Suppl 4:213-20.
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.

Matched MeSH terms: Sex Distribution
Prevalence of snake bites in Kangar District Hospital, Perlis, west Malaysia: a retrospective study (January 1999-December 2000)

Jamaiah I, Rohela M, Roshalina R, Undan RC

Southeast Asian J. Trop. Med. Public Health, 2004 Dec;35(4):962-5.
PMID: 15916099

The records of 284 snake bite cases presenting to the Kangar District Hospital, Perlis, west Malaysia, from January 1999 till December 2000 were carefully reviewed. Data on prevalence and types of snake bites, were recorded. The majority of the cases were among Malays (60.2%), followed by Chinese (16.9%), Indians (13%), and others which include Thai nationals, army personnel from Sabah and Sarawak, and foreign tourists (9.8%). A higher incidence was found in males (60.2%) and most cases were seen in the age group of 10-19 years (33%). Snake bites were more common between 2 PM and 9 PM (47.6%) and from 7 AM to 2 PM (33.4%). The snakes were positively identified in 68 cases, of which 50 were common cobras (Naja naja) (73%), 16 were Malayan pit vipers (Agkistrodon rhodostoma) (24%) and two were sea-snakes (3%).

Matched MeSH terms: Sex Distribution

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