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Association between aflatoxin M1 excreted in human urine samples with the consumption of milk and dairy products

Mohd Redzwan S, Rosita J, Mohd Sokhini AM, Nurul Aqilah AR

Bull Environ Contam Toxicol, 2012 Dec;89(6):1115-9.
PMID: 23052590 DOI: 10.1007/s00128-012-0853-y

This study aimed to find the association between urinary aflatoxin M(1) level and milk and dairy products consumption. Of 160 morning urine samples collected, aflatoxin M(1) was detected in 61.3 % samples (n = 98) [mean ± SD = 0.0234 ± 0.0177 ng/mL; range = 0-0.0747 ng/mL]. Of these positive samples, 67.3 % (n = 66) had levels above the limit of detection. Respondents with intake of milk and dairy products above median (67.79 g/day) had significantly high level of AFM(1) compared to those with low intake. A significant and positive association (φ = 0.286) was found between milk and dairy products consumption and urinary aflatoxin M(1) level.
Factors influencing Malaysian public attitudes to agro-biotechnology

Amin L, Ahmad J, Jahi JM, Nor AR, Osman M, Mahadi NM

Public Underst Sci, 2011 Sep;20(5):674-89.
PMID: 22164706

Despite considerable research in advanced countries on public perceptions of and attitudes to modern biotechnology, limited effort has been geared towards developing a structural model of public attitudes to modern biotechnology. The purpose of this paper is to identify the relevant factors influencing public attitudes towards genetically modified (GM) soybean, and to analyze the relationship between all the attitudinal factors. A survey was carried out on 1,017 respondents from various stakeholder groups in the Klang Valley region. Results of the survey have confirmed that attitudes towards complex issues such as biotechnology should be seen as a multifaceted process. The most important factors predicting support for GM soybean are the specific application-linked perceptions about the benefits, acceptance of risk and moral concern while risk and familiarity are significant predictors of benefit and risk acceptance. Attitudes towards GM soybean are also predicted by several general classes of attitude.
Fulltext Evidence of geographical structuring in the Malaysian Snakehead, Channa striata based on partial segment of the CO1 gene

Siti-Balkhis AB, Jamsari AF, Hwai TS, Yasin Z, Siti-Azizah MN

Genet Mol Biol, 2011 Jul;34(3):520-3.
PMID: 21931528 DOI: 10.1590/S1415-47572011005000016

Channa striata, locally known as "haruan", is economically important in fisheries and aquaculture industries in several Asian countries. DNA sequencing, based on a partial segment of the Cytochrome oxidase c subunit 1 (CO1) gene, was used to determine genetic variation in C. striata samples from four different populations on the west coast of Peninsular Malaysia. The highest nucleotide and haplotype diversities were observed in the Linggi population (π = 0.0067, h = 0.835), and the lowest in the Timah Tasoh population (π = 0.0008, h = 0.286). Apart from Kajang-Linggi, which was insignificant, F(ST) values were significant (p < 0.05) in all pairwise-population comparisons. Consequently, it is inferred that genetic structuring C. striata populations in this region was largely shaped by a common origin, with secondary influences from geographical factors and isolation.
Identification of the major allergens of Indian scad (Decapterus russelli)

Misnan R, Murad S, Jones M, Taylor G, Rahman D, Arip M, et al.

Asian Pac J Allergy Immunol, 2008 Dec;26(4):191-8.
PMID: 19317337

The purpose of this study was to characterize major allergens of Indian scad (Decapterus russelli) which is among the most commonly consumed fish in Malaysia. Raw and cooked extracts of the fish were prepared. Protein profiles and IgE binding patterns were produced by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting using sera from subjects with fish allergy. The major allergens of the fish were then identified by two-dimensional electrophoresis (2-DE), followed by mass spectrometry of the peptide digests. The SDS-PAGE of the raw extract revealed 27 protein fractions over a wide molecular weight range, while the cooked extract demonstrated only six protein fractions. The 1-DE immunoblotting detected 14 IgE-binding proteins, with a molecular weight range from 90 to < 6.5 kDa. Three protein fractions with molecular weights of approximately 51, 46 and 12 kDa were identified as the major allergens of this fish. The approximately 12 kDa band was a heat-resistant protein while the approximately 51 and 46 kDa proteins were sensitive to heat. The 2-DE gel profile of the raw extract demonstrated > 100 distinct protein spots and immunoblotting detected at least 10 different major IgE reactive spots with molecular masses as expected and isoelectric point (pI) values ranging from 4.0 to 7.0. A comparison of the major allergenic spot sequences of the 12 kDa proteins with known protein sequences in databases revealed extensive similarity with fish parvalbumin. In conclusion, this study demonstrated that a parvalbumin which is similar to Gad c 1 is the major allergen of Indian scad. Interestingly, we also detected heat-sensitive proteins as major allergenic components in our fish allergy patients.
Alpha lipoic acid possess dual antioxidant and lipid lowering properties in atherosclerotic-induced New Zealand White rabbit

Zulkhairi A, Zaiton Z, Jamaluddin M, Sharida F, Mohd TH, Hasnah B, et al.

Biomed Pharmacother, 2008 Dec;62(10):716-22.
PMID: 18538528 DOI: 10.1016/j.biopha.2006.12.003

There is accumulating data demonstrated hypercholesterolemia and oxidative stress play an important role in the development of atherosclerosis. In the present study, a protective activity of alpha-lipoic acid; a metabolic antioxidant in hypercholesterolemic-induced animals was investigated. Eighteen adult male New Zealand White (NZW) rabbit were segregated into three groups labelled as group K, AT and ALA (n=6). While group K was fed with normal chow and acted as a control, the rest fed with 100 g/head/day with 1% high cholesterol diet to induce hypercholesterolemia. 4.2 mg/body weight of alpha lipoic acid was supplemented daily to the ALA group. Drinking water was given ad-libitum. The study was designed for 10 weeks. Blood sampling was taken from the ear lobe vein at the beginning of the study, week 5 and week 10 and plasma was prepared for lipid profile estimation and microsomal lipid peroxidation index indicated with malondialdehyde (MDA) formation. Animals were sacrificed at the end of the study and the aortas were excised for intimal lesion analysis. The results showed a significant reduction of lipid peroxidation index indicated with low MDA level (p<0.05) in ALA group compared to that of the AT group. The blood total cholesterol (TCHOL) and low density lipoprotein (LDL) levels were found to be significantly low in ALA group compared to that of the AT group (p<0.05). Histomorphometric intimal lesion analysis of the aorta showing less of atheromatous plaque formation in alpha lipoic acid supplemented group (p<0.05) compared to that of AT group. These findings suggested that apart from its antioxidant activity, alpha lipoic acid may also posses a lipid lowering effect indicated with low plasma TCHOL and LDL levels and reduced the athero-lesion formation in rabbits fed a high cholesterol diet.
Fulltext High white cell count at presentation in children with acute lymphoblastic leukaemia

Menon BS, Wan Maziah WM, Jackson N, Jamaluddin N, Narazah MY, Dasgupta A, et al.

Med J Malaysia, 1999 Jun;54(2):283-4.
PMID: 10972046
Vision impairment and cognitive function among urban-dwelling malaysians aged 55 years and over from the Malaysian Elders Longitudinal Research (MELoR) study

Effendi-Tenang I, Tan MP, Khaliddin N, Jamaluddin Ahmad M, Amir NN, Kamaruzzaman SB, et al.

Arch Gerontol Geriatr, 2020 06 26;90:104165.
PMID: 32650156 DOI: 10.1016/j.archger.2020.104165

INTRODUCTION: Published literature on vision impairment and cognitive function amongst older Malaysians remains scarce. This study investigates the association between vision impairment and cognitive function in an older Malaysian population.
METHODS: Subjects aged 55 years and above from the Malaysian Elders Longitudinal Research (MELoR) study with available information on vision and Montreal Cognitive Assessment (MoCA) scores were included. Data were obtained through a home-based interview and hospital-based health check by trained researchers. Visual acuity (VA) was assessed with logMAR score with vision impairment defined as VA 6/18 or worse in the better-seeing eye. Cognition was evaluated using the MoCA-Blind scoring procedure. Those with a MoCA-Blind score of <19/22 were considered to have cognitive impairment.
RESULTS: Data was available for 1144 participants, mean (SD) age = 68.57 (±7.23) years. Vision impairment was present in 143 (12.5 %) and 758 (66.3 %) had MoCA-Blind score of <19. Subjects with vision impairment were less likely to have a MoCA-Blind score of ≥19 (16.8 % vs 36.2 %, p < 0.001). Vision impairment was associated with poorer MoCA-Blind scores after adjustments for age, gender, and ethnicity (β = 2.064; 95 % CI, -1.282 to 3.320; P = 0.003). In those who had > 6 years of education attainment, vision impairment was associated with a significant reduction of cognitive function and remained so after adjustment for age and gender (β = 1.863; 95 % CI, 1.081-3.209; P = 0.025).
CONCLUSION: Our results suggest that vision impairment correlates with cognitive decline. Therefore, maintaining good vision is an important interventional strategy for preventing cognitive decline in older adults.
Fulltext Factors affecting nutritional status of children below 24 months in Pekan district, Pahang, Malaysia

Masroor N, Ab Rahman J, Han TM, Khattak MAK, Aye A

Malays J Nutr, 2014;20(2):197-207.
MyJurnal

Introduction: This study aimed to assess the nutritional status of children below 24 months in the district of Pekan, Pahang, and identify the contributing factors. Methods: Using a cross-sectional methodology, a total of 910 children was selected by random sampling from four public health clinics. Anthropometric measurements were taken and weight-for-age, height-for-age, and weight-for- height were calculated in Z scores. Immediate caregivers of children were interviewed by using a pretested validated questionnaire to assess their socio- economic, demographic, educational and occupational status. Results: Of the 910 children who participated in the study, the majority were Malay (70.1%), while the remaining comprised indigenous or Orang-Asli (OA) children. Prevalence of wasting, stunting and underweight were 28.7 %, 15.6 % and 19.0% respectively. There were more underweight males than females. Wasting was most common among children aged below 6 months. Stunting was more prevalent in children between 12 to 24 months. Obesity was seen in 7.3% of the sample. Maternal education, employment and socio-economic status had a significant influence on wasting and underweight. Children were vulnerable to stunting as age advanced, whereas prevalence of wasting tended to decrease. Conclusion: Malnutrition exists in significant proportions among children below 24 months in the Pekan district. This study identified low birth weight along with age, race, gender, large family size and socio-economic status as important risk factors of malnutrition.
Fulltext Humeral Supracondylar Fractures in Children: A Novel Technique of Lateral External Fixation and Kirschner Wiring

Kow RY, Zamri AR, Ruben JK, Jamaluddin S, Mohd-Nazir MT

Malays Orthop J, 2016 Jul;10(2):41-46.
PMID: 28435560 MyJurnal DOI: 10.5704/MOJ.1607.008

Introduction: Supracondylar fracture of the humerus is the most common fracture around the elbow in children. Pinning with Kirschner wires (K-wires) after open or closed reduction is generally accepted as the primary treatment modality. However, it comes with the risk of persistent instability and if the K-wire is not inserted properly, it may cause displacement and varus deformity. We present our two-year experience with a new technique of lateral external fixation and K-wiring of the humeral supracondylar fracture. Materials and Methods: A total of seven children with irreducible Gartland Type III supracondylar humeral fracture were treated with closed reduction and lateral external fixation and lateral Kirschner wiring. Patients with ipsilateral radial or ulnar fracture, open fracture and presence of neurovascular impairment pre-operatively were excluded. All the patients were followed up at one, three and six weeks and three and six months. The final outcomes were assessed based on Flynn's criteria. Results: All the patients achieved satisfactory outcomes in terms of cosmetic and functional aspects. All patients except one (85.5%) regained excellent and good cosmetic and functional status. One patient (14.3%) sustained pin site infection which resolved with oral antibiotic (Checketts- Otterburn grade 2). There was no neurological deficit involving the ulnar nerve and radial nerve. Conclusion: The introduction of lateral external fixation and lateral percutaneous pinning provide a promising alternative method for the treatment of humeral supracondylar fracture. This study demonstrates that it has satisfactory cosmetic and functional outcomes with no increased risk of complications compared to percutaneous pinning.
Fulltext Parental perception of children's weight status and sociodemographic factors associated with childhood obesity

Noor Shafina MN, Abdul Rasyid A, Anis Siham ZA, Nor Izwah MK, Jamaluddin M

Med J Malaysia, 2020 05;75(3):221-225.
PMID: 32467536

INTRODUCTION: The trend of childhood obesity is on the rise and hence leading towards the increase in obesity related complications. Early recognition of obesity in children and accurate parental perception of the status of the weight of their children is vital. Furthermore, identification of sociodemographic risk factors contributing to obesity is crucial in order to identify children who are in the risk group and thus prevent potential complications. This study is aimed to establish the parental perception of the status of the weight of their children. Secondly, the study also to identify the sociodemographic risk factors associated with obesity in children.

METHODS: This was a cross-sectional study involving 245 children from 5 to 12 years of age. Following informed consent, the children were classified into either normal (body mass index (BMI) >5th to <85th percentile), overweight (BMI >85th to <95th percentile) or obese (BMI >95th percentile) groups. Parents responded to questionnaires which assessed their perception and sociodemographic factors.

RESULTS: A total of 157 participants (64.1%) had normal BMI while 41(16.7%) were overweight and 47(19.2%) were obese. More parents of overweight and obese group had misperceptions of their children's weight status (p=0.001). Families with higher household income, children with higher birth weight, higher education of mothers and family history of obesity and type 2 diabetes had increased risk of higher BMI among their children (p=0.029, p=0.013, p=0.041 and p=0.001 respectively).

CONCLUSIONS: Most parents of either overweight or obese children had inaccurate perception of the status of weight of their children. Higher household income, birth weight and education level of the mothers as well as history of diabetes and obesity in the family are associated with increased risk of childhood obesity.
Fulltext Higher mortality rates for large- and medium-sized mammals on plantation roads compared to highways in Peninsular Malaysia

Jamhuri J, Edinoor MA, Kamarudin N, Lechner AM, Ashton-Butt A, Azhar B

Ecol Evol, 2020 Nov;10(21):12049-12058.
PMID: 33209269 DOI: 10.1002/ece3.6827

The fragmentation of forests by agricultural expansion, urbanization, and road networks is an ongoing global biodiversity crisis. In Southeast Asia and other tropical regions, wildlife populations are being isolated into pockets of natural habitat surrounded by road networks and monoculture plantations. Mortality from wildlife-vehicle collisions (WVCs) is contributing to a decline in many species of conservation priority in human-modified landscapes. This study is the first in Malaysia to investigate factors affecting the occurrence of WVCs. We assessed roadkill data gathered by the Department of Wildlife and National Parks on small-, medium-, and large-sized mammals in Peninsular Malaysia. We examined the relationship between wildlife road accidents and several environmental factors. We found a total of 605 roadkill animals, involving 21 species, which included three species classified as Endangered. Road type (plantation road or highway), year, and distance of the road from continuous and fragmented forests were significant in determining mammal mortality. Unexpectedly, the majority of road mortality occurred on palm oil plantation roads compared to highways. Mortality of small- and medium-sized mammals was greater at locations further from continuous forest than those closer to fragmented forests. Segmentation of continuous forest by roads should be avoided wherever possible to reduce the threat of roads on crossing wildlife.
Nipah virus infection in bats (order Chiroptera) in peninsular Malaysia

Yob JM, Field H, Rashdi AM, Morrissy C, van der Heide B, Rota P, et al.

Emerg Infect Dis, 2001 May-Jun;7(3):439-41.
PMID: 11384522

Nipah virus, family Paramyxoviridae, caused disease in pigs and humans in peninsular Malaysia in 1998-99. Because Nipah virus appears closely related to Hendra virus, wildlife surveillance focused primarily on pteropid bats (suborder Megachiroptera), a natural host of Hendra virus in Australia. We collected 324 bats from 14 species on peninsular Malaysia. Neutralizing antibodies to Nipah virus were demonstrated in five species, suggesting widespread infection in bat populations in peninsular Malaysia.
Fulltext Antioxidant effects of pineapple vinegar in reversing of paracetamol-induced liver damage in mice

Mohamad NE, Yeap SK, Lim KL, Yusof HM, Beh BK, Tan SW, et al.

Chin Med, 2015;10:3.
PMID: 25699088 DOI: 10.1186/s13020-015-0030-4

Pineapple (Ananas comosus) was demonstrated to be hepatoprotective. This study aims to investigate the reversing effects of pineapple vinegar on paracetamol-induced liver damage in murine model.
Fulltext Agricultural intensification, priming for persistence and the emergence of Nipah virus: a lethal bat-borne zoonosis

Pulliam JR, Epstein JH, Dushoff J, Rahman SA, Bunning M, Jamaluddin AA, et al.

J R Soc Interface, 2012 Jan 7;9(66):89-101.
PMID: 21632614 DOI: 10.1098/rsif.2011.0223

Emerging zoonoses threaten global health, yet the processes by which they emerge are complex and poorly understood. Nipah virus (NiV) is an important threat owing to its broad host and geographical range, high case fatality, potential for human-to-human transmission and lack of effective prevention or therapies. Here, we investigate the origin of the first identified outbreak of NiV encephalitis in Malaysia and Singapore. We analyse data on livestock production from the index site (a commercial pig farm in Malaysia) prior to and during the outbreak, on Malaysian agricultural production, and from surveys of NiV's wildlife reservoir (flying foxes). Our analyses suggest that repeated introduction of NiV from wildlife changed infection dynamics in pigs. Initial viral introduction produced an explosive epizootic that drove itself to extinction but primed the population for enzootic persistence upon reintroduction of the virus. The resultant within-farm persistence permitted regional spread and increased the number of human infections. This study refutes an earlier hypothesis that anomalous El Niño Southern Oscillation-related climatic conditions drove emergence and suggests that priming for persistence drove the emergence of a novel zoonotic pathogen. Thus, we provide empirical evidence for a causative mechanism previously proposed as a precursor to widespread infection with H5N1 avian influenza and other emerging pathogens.
Fulltext Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study

Chen CH, Shin SD, Sun JT, Jamaluddin SF, Tanaka H, Song KJ, et al.

PLoS Med, 2020 10;17(10):e1003360.
PMID: 33022018 DOI: 10.1371/journal.pmed.1003360

BACKGROUND: Whether rapid transportation can benefit patients with trauma remains controversial. We determined the association between prehospital time and outcome to explore the concept of the "golden hour" for injured patients.
METHODS AND FINDINGS: We conducted a retrospective cohort study of trauma patients transported from the scene to hospitals by emergency medical service (EMS) from January 1, 2016, to November 30, 2018, using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital time intervals were categorized into response time (RT), scene to hospital time (SH), and total prehospital time (TPT). The outcomes were 30-day mortality and functional status at hospital discharge. Multivariable logistic regression was used to investigate the association of prehospital time and outcomes to adjust for factors including age, sex, mechanism and type of injury, Injury Severity Score (ISS), Revised Trauma Score (RTS), and prehospital interventions. Overall, 24,365 patients from 4 countries (645 patients from Japan, 16,476 patients from Korea, 5,358 patients from Malaysia, and 1,886 patients from Taiwan) were included in the analysis. Among included patients, the median age was 45 years (lower quartile [Q1]-upper quartile [Q3]: 25-62), and 15,498 (63.6%) patients were male. Median (Q1-Q3) RT, SH, and TPT were 20 (Q1-Q3: 12-39), 21 (Q1-Q3: 16-29), and 47 (Q1-Q3: 32-60) minutes, respectively. In all, 280 patients (1.1%) died within 30 days after injury. Prehospital time intervals were not associated with 30-day mortality. The adjusted odds ratios (aORs) per 10 minutes of RT, SH, and TPT were 0.99 (95% CI 0.92-1.06, p = 0.740), 1.08 (95% CI 1.00-1.17, p = 0.065), and 1.03 (95% CI 0.98-1.09, p = 0.236), respectively. However, long prehospital time was detrimental to functional survival. The aORs of RT, SH, and TPT per 10-minute delay were 1.06 (95% CI 1.04-1.08, p < 0.001), 1.05 (95% CI 1.01-1.08, p = 0.007), and 1.06 (95% CI 1.04-1.08, p < 0.001), respectively. The key limitation of our study is the missing data inherent to the retrospective design. Another major limitation is the aggregate nature of the data from different countries and unaccounted confounders such as in-hospital management.
CONCLUSIONS: Longer prehospital time was not associated with an increased risk of 30-day mortality, but it may be associated with increased risk of poor functional outcomes in injured patients. This finding supports the concept of the "golden hour" for trauma patients during prehospital care in the countries studied.
Fulltext SARS-CoV-2 lineage B.6 was the major contributor to early pandemic transmission in Malaysia

Chong YM, Sam IC, Chong J, Kahar Bador M, Ponnampalavanar S, Syed Omar SF, et al.

PLoS Negl Trop Dis, 2020 11;14(11):e0008744.
PMID: 33253226 DOI: 10.1371/journal.pntd.0008744

Malaysia had 10,219 confirmed cases of COVID-19 as of September 20, 2020. About 33% were associated with a Tablighi Jamaat religious mass gathering held in Kuala Lumpur between February 27 and March 3, 2020, which drove community transmission during Malaysia's second wave. We analysed genome sequences of SARS-CoV-2 from Malaysia to better understand the molecular epidemiology and spread. We obtained 58 SARS-CoV-2 whole genome sequences from patients in Kuala Lumpur and performed phylogenetic analyses on these and a further 57 Malaysian sequences available in the GISAID database. Nine different SARS-CoV-2 lineages (A, B, B.1, B.1.1, B.1.1.1, B.1.36, B.2, B.3 and B.6) were detected in Malaysia. The B.6 lineage was first reported a week after the Tablighi mass gathering and became predominant (65.2%) despite being relatively rare (1.4%) globally. Direct epidemiological links between lineage B.6 viruses and the mass gathering were identified. Increases in reported total cases, Tablighi-associated cases, and community-acquired B.6 lineage strains were temporally linked. Non-B.6 lineages were mainly travel-associated and showed limited onward transmission. There were also temporally correlated increases in B.6 sequences in other Southeast Asian countries, India and Australia, linked to participants returning from this event. Over 95% of global B.6 sequences originated from Asia Pacific. We also report a nsp3-C6310A substitution found in 47.3% of global B.6 sequences which was associated with reduced sensitivity using a commercial diagnostic real-time PCR assay. Lineage B.6 became the predominant cause of community transmission in Malaysia after likely introduction during a religious mass gathering. This event also contributed to spikes of lineage B.6 in other countries in the Asia-Pacific. Mass gatherings can be significant causes of local and global spread of COVID-19. Shared genomic surveillance can be used to identify SARS-CoV-2 transmission chains to aid prevention and control, and to monitor diagnostic molecular assays. Clinical Trial Registration: COVID-19 paper.
Factors Associated With Suicidal Attempt Among School-Going Adolescents in Malaysia

Abdul Aziz FA, Abd Razak MA, Ahmad NA, Awaluddin SM, Lodz NA, Sooryanarayana R, et al.

Asia Pac J Public Health, 2019 11;31(8_suppl):73S-79S.
PMID: 31353928 DOI: 10.1177/1010539519862161

Various factors contribute to suicidal attempt. This study aims to determine the relationship between suicidal attempt and its associated factors among school-going adolescents in Malaysia. Data from the National Health and Morbidity 2017 survey were analyzed. This survey was implemented as a nationwide school-based survey targeting adolescents 13 to 17 years old. Descriptive and multiple logistic regression analysis was done using SPSS version 20. A total of 27 399 adolescents participated in this survey. The prevalence of suicidal attempt was 6.9% (95% confidence interval = 6.2-7.7). Multivariate analysis found that the odds of suicidal attempt among adolescent with depression is 4.3 (adjusted odds ratio = 4.3; 95% confidence interval = 3.9-4.8). Other significant factors are young adolescent, non-Malay ethnicities especially Indian, adolescent with parents living apart, and those without peer support and parental connectedness. A holistic approach for the planning of preventative strategies and public health policies should be made according to these risk factors.
Study name: National Health and Morbidity Survey (NHMS-2017)
Fulltext Knowledge, Perception, and Antibiotic Prescribing Practice in the Intensive Care Unit: Findings from the Malaysian Public Setting

Rozali MA, Abd Rahman NS, Sulaiman H, Abd Rahman AN, Atiya N, Wan Mat WR, et al.

J Pharm Bioallied Sci, 2020 Nov;12(Suppl 2):S804-S809.
PMID: 33828380 DOI: 10.4103/jpbs.JPBS_266_19

Introduction: Approach to managing infection in the intensive care unit (ICU) often varies between institutions and not many readily adapt to available local guidelines despite it was constructed to suite local clinical scenario. Malaysia already has two published guidelines on managing infection in the ICU but data on its compliance are largely unknown.
Objectives: A cross-sectional survey was carried out and sent to a total of 868 specialists working primarily in the ICU. The aim of this study was to explore knowledge, perception, and the antibiotic prescribing practice among specialists and advanced trainees in Malaysian ICU.
Materials and Methods: A cross-sectional survey was used, consisted of three sections: knowledge, perception, and antibiotic prescribing practice in ICU. Three case vignettes on hospital-acquired pneumonia (HAP), infected necrotizing pancreatitis (INP), and catheter-related bloodstream infection (CRBSI) were used to explore antibiotic prescribing practice.
Results: A total of 868 eligible subjects were approached with 104 responded to the survey. Three hundred eighty-nine antibiotics were chosen from seven different classes in the case vignettes. All respondents acknowledged the importance of pharmacokinetic/pharmacodynamic (PK/PD) in antibiotic optimization and majority (97.2%) perceived that current dosing is inadequate to achieve optimal PK/PD target in ICU patients. Majority (85.6%) believed that antibiotic dose should be streamlined to the organisms' minimum inhibitory concentration (MIC). In terms of knowledge, only 64.4% provided the correct correlations between antibiotics and their respective PK/PD targets. Compliance rates in terms of antibiotic choices were at 79.8%, 77.8%, and 27.9% for HAI, INP, and CRBSI, respectively.
Conclusion: Malaysian physicians are receptive to use PK/PD approach to optimize antibiotic dosing in ICU patients. Nonetheless, there are still gaps in the knowledge of antibiotic PK/PD as well as its application in the critically ill, especially for β-lactams.
Assessment on Hand Hygiene Knowledge and Practices Among Pre-school Children in Klang Valley

Tengku Jamaluddin TZM, Mohamed NA, Mohd Rani MD, Ismail Z, Ramli S, Faroque H, et al.

Glob Pediatr Health, 2020;7:2333794X20976369.
PMID: 33335950 DOI: 10.1177/2333794X20976369

Background. Pre-school children are at a higher risk to acquire infectious diseases such as hand, foot and mouth disease due to their immature immune system. Good hand hygiene prevents transmission of infectious diseases. This study aimed to determine the knowledge and practices of hand hygiene among pre-schoolers. Methods. In this prospective, multi-center study, the pre-schools were selected according to the selection criteria. A questionnaire consisting of socio-demographics, knowledge and practices of hand hygiene were administered via face-to-face interview during the pre- and post-intervention period. A total of 435 pre-schoolers aged 5 and 6 years old from 2 pre-schools within Klang Valley, School P (test group) and School C (control group) were involved in this study. The test group was provided with comprehensive hand hygiene education including video on proper handwashing technique during the 2 months intervention period, whereas the control group did not receive any form of intervention. The data were statistically analyzed using descriptive analysis and independent t-test. Results. Majority of pre-schoolers gained knowledge of handwashing from their parents. However, only 63% demonstrated good handwashing technique. Test group were significantly better (P
Fulltext Complete Genome Sequences of SARS-CoV-2 Strains Detected in Malaysia

Chong YM, Sam IC, Ponnampalavanar S, Syed Omar SF, Kamarulzaman A, Munusamy V, et al.

Microbiol Resour Announc, 2020 May 14;9(20).
PMID: 32409547 DOI: 10.1128/MRA.00383-20

We sequenced four severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from Malaysia during the second wave of infection and found unique mutations which suggest local evolution. Circulating Malaysian strains represent introductions from different countries, particularly during the first wave of infection. Genome sequencing is important for understanding local epidemiology.

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