A neglected tropical disease, melioidosis is known to have variability in clinical presentations. Here, we described clinical features that should alert the physicians on the possibility of melioidosis. In this review of 86 cases from 2001 to 2011, the common presentations of melioidosis in the Emergency Department (ED), Hospital Universiti Sains Malaysia were; male gender (79.1 %), in working age group (47.8 ± 15.2 year-old), worked in contact with soil (73.3 %), presented with fever (91.9 %), in rainy season (55.8 %), have underlying diabetes mellitus (79.1 %), have leukocytosis (67.4 %) and high blood glucose (62.8 %) during presentation. In 34.9 % of cases, the antimicrobials were initiated at the ED and only 10.5 % include antimelioid drugs. Thirty-one patients (36.0 %) died due to melioidosis and 51.6 % of this were within 48 h of admission. Despite high mortality rate, the clinical awareness on the possibility of melioidosis among emergency physicians is still low and need to be strengthened.
Suicidal feelings and a sense of hopelessness have been regarded as part of the ageing process more so in the context of being elderly and having physical difficulties. As older adults are the fastest growing population in the world, suicides among this population is also expected to increase. The authors retrospectively reviewed all cases recorded by the National Suicide Registry Malaysia (NSRM) for the year 2009. Suicide in victims 65 years and older totaled 23 in number and accounted for 7.1% of all suicides. All the cases were autopsied. The case records were retrospectively analyzed with respect to age, gender, ethnicity and method of death. Comparisons were also made between males and females, levels of education, presence of stressor and life events antecedent to suicide. The ages of these suicide victims ranged from 65 to 94 years. Men comprised almost 70% of the cases. The average age of the victim was 73 years. Hanging was the most common method of suicide, accounting for 56.5% of the cases. Other methods included jumping from height (13.1%), exposure to unspecified chemicals (13.1% ), jumping/lying before moving object (4.3%), exposure to pesticides (4.3%) and injuring oneself using sharp object (4.3%). Death of a loved one, legal problems, financial problems and physical illness were the stressors identified contributing to the suicide act.
The lack of information on ground truth gas dispersion and experiment verification information has impeded the development of mobile olfaction systems, especially for real-world conditions. In this paper, an integrated testbed for mobile gas sensing experiments is presented. The integrated 3 m × 6 m testbed was built to provide real-time ground truth information for mobile olfaction system development. The testbed consists of a 72-gas-sensor array, namely Large Gas Sensor Array (LGSA), a localization system based on cameras and a wireless communication backbone for robot communication and integration into the testbed system. Furthermore, the data collected from the testbed may be streamed into a simulation environment to expedite development. Calibration results using ethanol have shown that using a large number of gas sensor in the LGSA is feasible and can produce coherent signals when exposed to the same concentrations. The results have shown that the testbed was able to capture the time varying characteristics and the variability of gas plume in a 2 h experiment thus providing time dependent ground truth concentration maps. The authors have demonstrated the ability of the mobile olfaction testbed to monitor, verify and thus, provide insight to gas distribution mapping experiment.
Chronic kidney disease is an emerging problem in the majority Muslim countries. Despite the uncertainties of the risks involved, some Muslim patients undergoing chronic haemodialysis choose to observe intermittent fasting during the month of Ramadan. This study aims to investigate the effect of Ramadan fasting in haemodialysis patients residing in a tropical climate country.
Currently, dengue fever is considered as the main health problem in several parts (Mekkah, Jeddah, Jazan and Najran) of Kingdom of Saudi Arabia (KSA) with dramatically increase in the number of cases reported every year. This is associated with obvious ineffectiveness in the recent control and management programs for the mosquito vector (Aedes aegypti). Here, we suggested promoting the health education and public awareness among Saudi people to improve the control of dengue mosquito vector. Several suggestions and recommendations were highlighted here to ensure effectiveness in the future control and management programs of dengue mosquito vector in KSA.
Common purslane (Portulaca oleracea), also known as pigweed, fatweed, pusle, and little hogweed, is an annual succulent herb in the family Portulacaceae that is found in most corners of the globe. From the ancient ages purslane has been treated as a major weed of vegetables as well as other crops. However, worldwide researchers and nutritionists have studied this plant as a potential vegetable crop for humans as well as animals. Purslane is a nutritious vegetable with high antioxidant properties and recently has been recognized as the richest source of α-linolenic acid, essential omega-3 and 6 fatty acids, ascorbic acid, glutathione, α-tocopherol and β-carotene. The lack of vegetable sources of ω-3 fatty acids has resulted in a growing level of attention to introduce purslane as a new cultivated vegetable. In the rapid-revolutionizing worldwide atmosphere, the ability to produce improved planting material appropriate to diverse and varying rising conditions is a supreme precedence. Though various published reports on morphological, physiological, nutritional and medicinal aspects of purslane are available, research on the genetic improvement of this promising vegetable crop are scant. Now it is necessary to conduct research for the genetic improvement of this plant. Genetic improvement of purslane is also a real scientific challenge. Scientific modernization of conventional breeding with the advent of advance biotechnological and molecular approaches such as tissue culture, protoplast fusion, genetic transformation, somatic hybridization, marker-assisted selection, qualitative trait locus mapping, genomics, informatics and various statistical representation have opened up new opportunities of revising the relationship between genetic diversity, agronomic performance and response to breeding for varietal improvement. This review is an attempt to amalgamate the assorted scientific information on purslane propagation, cultivation, varietal improvement, nutrient analyses, medicinal uses and to describe prospective research especially for genetic improvement of this crop.
Mitochondrial cytochrome oxidase subunit I (COI) gene was utilized to assess the population genetics of the commercially important black scar oyster, Crassostrea iredalei among 11 populations throughout the west and east coasts Peninsular Malaysia and Sabah (Malaysian Borneo). Overall, populations of C. iredalei demonstrated low nucleotide diversity π (0.000-0.004) and low-to-high haplotype diversity h (0.000-0.795) levels. Genetic structuring was detected between the Peninsular Malaysia and Sabah populations as revealed by the FST analysis. However, the COI gene analyses showed minimal and non-significant (p > 0.05) population differentiation within the east and west coasts Peninsular Malaysia and Sabah regions. This was attributed to both high larval dispersal along the east and west coasts and human-driven spat translocation between the two coastlines due to C. iredalei cultivation practices. Phylogeographic relationships inferences were also conducted to further support these hypotheses. The neutrality and mismatch distribution analyses suggested that C. iredalei had experienced a/several bottleneck event(s), followed by population expansion. The molecular information obtained from this study could be incorporated in a pragmatic aquaculture management strategy of wild broodstock and the hatchery lines of C. iredalei in Malaysia.
The influence of hydraulic retention time (HRT, 24, 12, and 6h) on the physical characteristics of granules and performance of a sequencing batch reactor (SBR) treating rubber wastewater was investigated. Results showed larger granular sludge formation at HRT of 6h with a mean size of 2.0±0.1mm, sludge volume index of 20.1mLg(-1), settling velocity of 61mh(-1), density of 78.2gL(-1) and integrity coefficient of 9.54. Scanning electron microscope analyses revealed different morphology of microorganisms and structural features of granules when operated at various HRT. The results also demonstrated that up to 98.4% COD reduction was achieved when the reactor was operated at low HRT (6h). Around 92.7% and 89.5% removal efficiency was noted for ammonia and total nitrogen in the granular SBR system during the treatment of rubber wastewater.
The structure of a novel psychrophilic β-mannanase enzyme from Glaciozyma antarctica PI12 yeast has been modelled and analysed in detail. To our knowledge, this is the first attempt to model a psychrophilic β-mannanase from yeast. To this end, a 3D structure of the enzyme was first predicted using a threading method because of the low sequence identity (<30%) using MODELLER9v12 and simulated using GROMACS at varying low temperatures for structure refinement. Comparisons with mesophilic and thermophilic mannanases revealed that the psychrophilic mannanase contains longer loops and shorter helices, increases in the number of aromatic and hydrophobic residues, reductions in the number of hydrogen bonds and salt bridges and numerous amino acid substitutions on the surface that increased the flexibility and its efficiency for catalytic reactions at low temperatures.
Nutritional or dietary factors have drawn attention due to their potential as an effective chemopreventive agent, which is considered a more rational strategy in cancer treatment. This study was designed to evaluate the effect of IP₆ extracted from rice bran on azoxymethane- (AOM-) induced colorectal cancer (CRC) in rats. Initially, male Sprague Dawley rats were divided into 5 groups, with 6 rats in each group. The rats received two intraperitoneal (i.p.) injections of AOM in saline (15 mg/kg body weight) over a 2-week period to induce CRC. IP₆ was given in three concentrations, 0.2% (w/v), 0.5% (w/v), and 1.0% (w/v), via drinking water for 16 weeks. The deregulation of the Wnt/β-catenin signaling pathway and the expression of cyclooxygenase (COX)-2 have been implicated in colorectal tumorigenesis. β-Catenin and COX-2 expressions were analysed using the quantitative RT-PCR and Western blotting. Herein, we reported that the administration of IP₆ markedly suppressed the incidence of tumors when compared to the control. Interestingly, the administration of IP₆ had also markedly decreased β-catenin and COX-2 in colon tumors. Thus, the downregulation of β-catenin and COX-2 could play a role in inhibiting the CRC development induced by IP₆ and thereby act as a potent anticancer agent.
Children are the vulnerable group in the agricultural community due to their early exposure to pesticides through the dynamic interplay between genetic predisposition, environment, and host-related factors. This study aims to identify the possible association between the depression in blood cholinesterase level and genotoxic effect among farm children. The results of micronuclei assay and comet assay showed that the reduced blood cholinesterase level from organophosphate pesticide exposure is significantly associated with an increase in chromosome breakage and DNA strand breaks. These genotoxicity end points suggest that farm children's cells experience early DNA damage that may lead to uncontrolled cell proliferation during their adulthood. Thus, farm children who grow up near pesticide-treated farmland have a higher probability of developing cancer than children with minimal or zero exposure to pesticides.
We describe two example pilot efforts to help define new thermoluminescent dosimeter media. The first concerns ZnS:Mn nanophosphors, prepared by chemical precipitation using zinc and sodium sulfate, doped with manganese sulfate at concentrations varying from 1 to 3mol. The second concerns chemical vapor deposited diamond, produced as a thin film or as amorphous carbon on a single-crystal silicon substrate, each deposited under the same conditions, use being made of the hot filament-chemical vapor deposition (HFCVD) technique. The gas concentrations used were 1% CH4 in 99% H2 and 25% CH4 in 75% H2. Characterization of formations used FESEM, XRD and EDX. The nanophosphors consisted of particles of sizes in the range 85-150nm, the thermoluminescence (TL)-based radiation detection medium giving rise to a single peaked glow curve of maximum yield at a temperature of 250°C at a heating rate of 5°C/s. The TL response increased linearly with radiation dose, ZnS doped to 2mol of Mn being found the most sensitive. Regarding chemical vapor deposited (CVD) carbon, inappreciable TL was found for the resultant ball-like amorphous carbon films, graphite, and the silicon substrate, whereas CVD diamond films showed a promising degree of linearity with dose. For both the ZnS and diamond samples, TL signal fading was appreciable, being some 40% per day for ZnS and>50% per day for CVD films even under storage in the dark at room temperature, making it apparent that there is need to adjust parameters such as the size of nanoparticles.
This study aimed to identify candidate proteins which may serve as potential biological markers for cervical cancer using 2D-DIGE. Serum samples of controls, patients with cervical intraepithelial neoplasia grade 3 (CIN 3), squamous cell carcinoma of early (SCC I and II) and late (SCC III and IV) stage were subjected to 2D-DIGE. Differentially expressed spots were identified by tandem mass spectrometry. Validation of candidate proteins in serum and tissue samples were then performed by ELISA and immunohistochemistry (IHC) analysis respectively. A total of 20 differentially expressed proteins were identified. These proteins were found to play key roles in the apoptosis pathway, complement system, various types of transportation such as hormones, fatty acids, lipid, vitamin E and drug transportation, coagulation cascade, regulation of iron and immunologic response. Based on their functional relevancy to the progression of various cancers, 4 proteins namely the complement factor H, CD5-like antigen, gelsolin and ceruloplasmin were chosen for further validation using ELISA. Biological network analysis showed that ceruloplasmin and gelsolin are closely interacted with the oncogene NF-κb. These two proteins were further validated using the IHC. Gelsolin and ceruloplasmin may serve as potential predictive biomarkers for the progression of high grade lesions.
The status report on metal pollution in tropical estuaries and coastal waters is important to understand potential environmental health hazards. Detailed baseline measurements were made on physicochemical parameters (pH, temperature, redox potential, electrical conductivity, salinity, dissolved oxygen, total dissolved solid), major ions (Na, Ca, Mg, K, HCO3, Cl, SO4 and NO3) and metals concentrations ((27)Al, (75)As, (138)Ba, (9)Be, (111)Cd, (59)Co, (63)Cu, (52)Cr, (57)Fe, (55)Mn, (60)Ni, (208)Pb, (80)Se, (66)Zn) at estuaries and coastal waters along the Straits of Malacca. Principal component analysis (PCA) was employed to reveal potential pollution sources. Seven principal components were extracted with relation to pollution contribution from minerals-related parameters, natural and anthropogenic sources. The output from this study will generate a profound understanding on the metal pollution status and pollution risk of the estuaries and coastal system.
INTRODUCTION: Coagulase-negative staphylococci (CoNS) are a group of micro-organisms that are increasingly implicated as a cause of significant infection and the leading cause of bloodstream infection (BSI). One important predictor of true BSI is the isolation of CoNS from multiple blood cultures, presuming that the isolates represent the same species. Thus the objective of this study was to determine the significance of repeated CoNS isolated from blood cultures.
METHODOLOGY: This was a prospective laboratory study which was initiated in June 2007 and lasted until July 2008. CoNS isolates were obtained from patients who had two positive blood cultures within a 14-day interval. CoNS were identified to the species level using an API-Staph, and antibiotics susceptibility testing was performed according to Clinical and Laboratory Standards Institute specifications. Strain relatedness was confirmed using pulsed-field gel electrophoresis.
RESULTS: During the study period, 202 CoNS-positive samples were isolated from 101 patients. The most common species isolated was Staphylococcus epidermidis (59.0%), and 83.2% of the patients isolated the same species of CoNS from repeated blood cultures. Among the isolates of the same species, only 40.7% had the same antibiogram. CoNS with the same species and antibiogram had 93.3% probability of belonging to the same strain. Most (65.5%) of the patients were treated with antibiotics, primarily from the glycopeptides group.
CONCLUSION: Speciation and antibiogram of CoNS from repeated blood cultures are adequate in determining the significance of repeated CoNS isolated from blood cultures.
INTRODUCTION: Anterior cruciate ligament (ACL) injuries are common among Malaysian military patients but has not been studied closely. The purpose of this study was to assess the type of activities leading to the ACL injury and the outcome of reconstructive ACL surgery at one year follow up.
METHODS: From the registry record, military patients who had undergone ACL reconstruction in two Malaysian military hospitals were identified. Their medical records were reviewed. The activities that they performed when the ACL injury occurred were identified. After ACL reconstruction, the patients' ability to resume previous duty at one year follow up was evaluated.
RESULTS: From 111 patients, 82% of the ACL injuries were due to sporting activities whereas military activities and road traffic accident accounted for 14% and 4% respectively. Out of 69 patients with isolated ACL injury who were followed up at one year, all except two were able to resume their previous duty.
CONCLUSIONS: Among the military patients who underwent ACL reconstruction, ACL injury was mainly due to sporting activity. ACL reconstruction showed good outcome at one year follow up.
Solid variant of papillary thyroid carcinoma (PTC) is a rare, poorly characterised variant and predominantly reported in children with a history of radiation exposure. This variant has a high propensity for extra-thyroidal extension and cervical lymph node metastases. A 14-year-old Malay girl who had no history of radiation exposure, presented with multiple cervical lymphadenopathy and it was clinically suspicious for tuberculosis or lymphoma. An incisional biopsy revealed a metastatic PTC. The patient underwent total thyroidectomy with bilateral lateral neck dissection and histopathology report was solid variant of PTC. Whole-body I(131) scan was performed which revealed an intense tracer uptake in the neck. She was planned for radioactive iodine ablation and now on regular follow-up for monitoring of possible tumour metastasis.
The trapezium shape of the talar dome limits the use of 2-dimensional plain radiography for morphometric assessment because only 2 of the 4 required parameters can be measured. We used computed tomography data to measure the 4 morphologic parameters of the trochlea tali: anterior width, posterior width, trochlea tali length, and angle of trapezium shape. A total of 99 subjects underwent computed tomography scanning, and the left and right talus bones were both virtually modeled in 3 dimensions. The 4 morphologic parameters were measured 3 times each to obtain the intraclass correlation, and analysis of variance was used to check for any significant differences between the repeated measurements. The average intraclass correlation coefficient for the measurements for 2 to 3 trials was 0.94 ± 0.04. Statistical analyses were performed on the data from all 198 talus bones using SAS software, comparing male and female and left and right bones. All 4 morphometric values were greater in the male group. No significant differences were found between the left and right talus bones. A strong positive correlation was observed between the trochlea tali length and the anterior width. The angle of trapezium shape showed no correlation with the other 3 parameters. The measurements were compared with the dimensions of the current talar components of 4 total ankle arthroplasty implants. However, most of them did not perfectly match the trapezium shape of the talus from our population. We successfully analyzed the trapezium shape of the trochlea tali using reliable virtual 3-dimensional measurements. Compared with other published reports, our study showed a relatively smaller dimension of the trochlea tali than the European counterparts.