The present study was aimed to identify the gene of drug resistance betalactamase producing bacteria and clinical features of the infected patients at Hospital University Kebangsaan Malaysia. Blood samples from the patients were collected, processed and betalactamase producing drug resistance bacteria were identified by antibiotic sensitivity testing. Genes of the drug resistance bacteria were detected and characterized by polymerase chain reaction. A total of 34 isolates of drug resistance Betalactamase producing E. coli and Klebsiella spp. were isolated from 2,502 patients. Most common drug resistance gene TEM was found in 50% of the isolates. 11% was found positive for both TEM and SHV. Next 11% of the isolates expressed only SHV genes. Clinical features of the patients were recorded from where the bacteria isolated. Regarding community affiliations 70.5% of the infected patients were Malay 17.6% were Indian and 11.7% were Chinese. Majority of the patients has an underlying pre-morbid condition as reflected by their diagnosis. Better infection control and hygiene in hospitals, plus controlled and prudent use of antibiotics, is required to minimize the impact of drug resistance betalactamase producing bacteria and the spread of infections.
Irritable bowel syndrome (IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients' quality of life. The epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psycho-social factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including: (1) large proportion of the population living in rural areas; (2) rapid development and associated lifestyle changes in urban areas; and (3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
An experiment was conducted to evaluate the efficacy of porcine follicle stimulating hormone (pFSH) dosage based on body weight (BW) on ovarian responses of crossbred does. Thirty donor does were divided into 3 groups getting pFSH dosages of 3, 5, and 8 mg pFSH per kg BW, respectively, and were named as pFSH-3, pFSH-5 and pFSH-8, respectively. Estrus was synchronized by inserting a controlled internal drug release (CIDR) device and a single injection of prostaglandin F2α (PGF2α). The pFSH treatments were administered twice a day through 6 decreasing dosages (25, 25, 15, 15, 10, and 10% of total pFSH amount; decreasing daily). Ovarian responses were evaluated on Day 7 after CIDR removal. After CIDR removal, estrus was observed 3 times in a day and pFSH treatments were initiated at 2 days before the CIDR removal. All does in pFSH-5 and pFSH-8 showed estrus signs while half of the does in pFSH-3 showed estrus signs. No differences (p>0.05) were observed on the corpus luteum and total ovarian stimulation among the treatment groups, while total and transferable embryos were higher (p<0.05) in pFSH-5 (7.00 and 6.71) than pFSH-3 (3.00 and 2.80) and pFSH-8 (2.00 and 1.50), respectively. In conclusion, 5 mg pFSH per kg BW dosage gave a higher number of embryos than 3 and 8 mg pFSH per kg BW dosages. The results indicated that the dosage of pFSH based on BW is an important consideration for superovulation in goats.
Bush bean, long bean, mung bean, and winged bean plants were grown with N fertilizer at rates of 0, 2, 4, and 6 g N m(-2) preceding rice planting. Concurrently, rice was grown with N fertilizer at rates of 0, 4, 8, and 12 g N m(-2). No chemical fertilizer was used in the 2nd year of crop to estimate the nitrogen agronomic efficiency (NAE), nitrogen recovery efficiency (NRE), N uptake, and rice yield when legume crops were grown in rotation with rice. Rice after winged bean grown with N at the rate of 4 g N m(-2) achieved significantly higher NRE, NAE, and N uptake in both years. Rice after winged bean grown without N fertilizer produced 13-23% higher grain yield than rice after fallow rotation with 8 g N m(-2). The results revealed that rice after winged bean without fertilizer and rice after long bean with N fertilizer at the rate of 4 g N m(-2) can produce rice yield equivalent to that of rice after fallow with N fertilizer at rates of 8 g N m(-2). The NAE, NRE, and harvest index values for rice after winged bean or other legume crop rotation indicated a positive response for rice production without deteriorating soil fertility.
OBJECTIVES: To determine the prevalence of aspirin resistance and associated risk factors based on biochemical parameters using whole blood multiple electrode aggregometry.
METHODS: The study was conducted at the outpatients cardiology clinic of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from August 2011 to February 2012. Subjects on aspirin therapy were divided into two groups; first-ever coronary event and recurrent coronary event. Aspirin resistance was measured by a Multiplate(®) platelet analyser.
RESULTS: A total of 74 patients (63 male, 11 female), with a mean age of 57.93 ± 74.1years were enrolled in the study. The patients were divided into two groups -first-ever coronary event group (n=52) and recurrent coronary event group (n=22). Aspirin resistance was observed in 12 out of 74 (16%) of the study patients, which consisted of 11 patients from the first-ever coronary event group and one patient from the recurrent coronary event group. There were significant correlations between aspirin resistance and age (r = -0.627; p = 0.029), total cholesterol (r = 0.608; p = 0.036) and LDL (r = 0.694; p = 0.012). LDL was the main predictor for area under the curve (AUC) for aspirin resistance. However, there was no association between aspirin resistance and cardiovascular events in both groups in this study.
CONCLUSIONS: Aspirin resistance was observed in 16% of the study population. LDL was the major predictor of aspirin resistance. No association was found in the study between aspirin resistance with recurrent coronary events.
KEYWORDS: Aspirin resistance; Multiplate® platelet analyser; aspirin responsiveness; first-ever coronary event; recurrent coronary event
Burkholderia pseudomallei is an free-living gram-negative bacterium causing melioidosis and is endemic in Southeast Asia. A 56-year-old diabetic construction worker with a 1-month history of abdominal pain and 1-day history of high-grade fever was found to have a left non-dissecting infrarenal mycotic aortic aneurysm by abdominal computerized tomography scan. Bacteriological examination of his blood yielded Burkholderia pseudomallei. The patient was treated with right axillo-bifemoral bypass with excision of aneurysm and high-dose intravenous ceftazidime for two weeks, followed by oral trimethoprim/sulfamethoxazole and oral doxycycline for a minimum of five months.
Syphilis and HIV co-infection are indeed dangerous combinations. The present communication describes three different cases of syphilis and HIV co-infection in young men. The first case is a 25-year-old medical graduate with a primary and secondary syphilis lesions at time of presentation. The second case is a 24-year-old government officer with right eye posterior uveitis where the serology tests for syphilis were reactive. His HIV tests were also positive. The final case is a 25-year-old homosexual who was admitted to the medical ward because of Mycobacterium tuberculosis infection. The HIV and syphilis serology tests were noted to be positive.
Objectives: Anti-cyclic citrullinated peptide (CCP) antibody has recently been used in the classification
of rheumatoid arthritis (RA). This antibody is more specific than rheumatoid factor (RF) for the diagnosis of RA. The study objectives were to determine the sensitivity, specificity, positive and negative predictive values of anti-CCP in RA diagnosis.
Methodology: Eighty RA patients and 80 non-RA individuals were included in the study. Blood was collected from both arms of study subjects and tested for anti-CCP and RF antibodies. Relevant clinical information and laboratory profiles of the RA patients were evaluated using patients’ medical records and Integrated Laboratory Management System (ILMS), respectively.
Results: The sensitivity and specificity of anti-CCP were 35% and 100% respectively. The positive and
negative predictive values were 100% and 61%, respectively. Positive anti-CCP was found significantly
associated with multiple joint pain (p < 0.001) and hand’s joints pain (p=0.01), symmetrical joints
involvement (p=0.015) and high CRP value (p < 0.001). Anti-CCP was also found to have positive association with RF (p < 0.001).
Conclusion: Anti-CCP is highly specific for the diagnosis of RA. High positive predictive value should be taken into consideration for effective treatment.
KEY WORD: Rheumatoid arthritis, anti-CCP, Rheumatoid factor, Sensitivity, Specificity, Positive predictive value, Negative predictive value.
Study site: Rheumatology Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Helicobacter pylori strains secrete a vacuolating cytotoxin (VacA), plays an important role for the development of peptic ulcer disease and gastro-duodenal diseases. vacA gene is responsible to regulate the activity of the vacuolating cytotoxin. The objective of this study was molecular detection of vacA gene and observes the vacuolating activity on human gastric adenocarcinoma (AGS) cells.
Selected physiological and biochemical parameters were monitored at the vegetative and reproductive growth stages in potted Bougainvillea plants treated with five different concentrations of TRIA. Advanced flowering, flower bud number, and blooming rate increased significantly with 0.5 and 1.0 mg/L TRIA treatments. Similarly, photosynthetic rate, pigment content, quantum yield, and stomatal conductance increased significantly with 2.5, 1.0, and 5.0 mg/L TRIA treatments. Higher levels of N, P, and K, as well as increased total soluble solids (TSS) and higher sugar and protein contents, were recorded in treated plants. Furthermore, 46% more flowers, a 1.5-fold increase in bract weight, increased longevity, and 40% less leaf abscission were recorded following 2.5 mg/L TRIA treatment. Phenol and flavonoid contents, sucrose phosphate synthase (SPS), and antioxidant activities were also markedly increased with 2.5 and 1.0 mg/L TRIA treatments. However, ethylene production was significantly lower in the treated plants. Positive correlations were observed between leaf TSS and flowering time and flower number, between leaf sugar content and bract weight, and between net photosynthesis and bract growth and dry matter production. It can be concluded that the foliar spray of TRIA stimulates growth, enhances flowering, and improves the quality of potted Bougainvillea plants.
This study describes the synthesis of Al(2)O(3)/SiC/ZrO(2) functionally graded material (FGM) in bio-implants (artificial joints) by electrophoretic deposition (EPD). A suitable suspension that was based on 2-butanone was applied for the EPD of Al(2)O(3)/SiC/ZrO(2), and a pressureless sintering process was applied as a presintering. Hot isostatic pressing (HIP) was used to densify the deposit, with beneficial mechanical properties after 2 h at 1800 °C in Ar atmosphere. The maximum hardness in the outer layer (90 vol.% Al(2)O(3)+10 vol.% SiC) and maximum fracture toughness in the core layer (75 vol.% Al(2)O(3)+10 vol.% SiC + 15 vol.% ZrO(2)) composite were 20.8±0.3 GPa and 8±0.1 MPa m(1/2), respectively. The results, when compared with results from Al(2)O(3)/ZrO(2) FGM, showed that SiC increased the compressive stresses in the outer layers, while the inner layers were under a residual tensile stress.
Published data on oxalate poisoning in domestic animals are reviewed, with a focus on tolerance and performance. Oxalic acid is one of a number of anti-nutrients found in forage. It can bind with dietary calcium (Ca) or magnesium (Mg) to form insoluble Ca or Mg oxalate, which then may lead to low serum Ca or Mg levels as well as to renal failure because of precipitation of these salts in the kidneys. Dietary oxalate plays an important role in the formation of Ca oxalate, and a high dietary intake of Ca may decrease oxalate absorption and its subsequent urinary excretion. Oxalate-rich plants can be supplemented with other plants as forage for domestic animals, which may help to reduce the overall intake of oxalate-rich plants. Non-ruminants appear to be more sensitive to oxalate than ruminants because in the latter, rumen bacteria help to degrade oxalate. If ruminants are slowly exposed to a diet high in oxalate, the population of oxalate-degrading bacteria in the rumen increases sufficiently to prevent oxalate poisoning. However, if large quantities of oxalate-rich plants are eaten, the rumen is overwhelmed and unable to metabolize the oxalate and oxalate-poisoning results. Based on published data, we consider that <2.0% soluble oxalate would be an appropriate level to avoid oxalate poisoning in ruminants, although blood Ca level may decrease. In the case of non-ruminants, <0.5% soluble oxalate may be acceptable. However, these proposed safe levels of soluble oxalate should be regarded as preliminary. Further studies, especially long-term studies, are needed to validate and improve the recommended safe levels in animals. This review will encourage further research on the relationships between dietary oxalate, other dietary factors and renal failure in domestic animals.
Despite established country's tobacco control law, cigarette smoking by the young people and the magnitude of nicotine dependence among the students is alarming in Bangladesh. This study was aimed to determine the prevalence of smoking and factors influencing it among the secondary school students. A two-stage cluster sampling was used for selection of schools with probability proportional to enrollment size followed by stratified random sampling of government and private schools. The 70-item questionnaire included 'core GYTS' (Global Youth Tobacco Survey) and other additional questions were used to collect relevant information. Analysis showed that the prevalence of smoking was 12.3% among boys and 4.5% among girls, respectively. The mean age at initiation of smoking was 10.8 years with standard deviation of 2.7 years. Logistic regression analysis revealed that boys are 2.282 times likely to smoked than girls and it was 1.786 times higher among the students aged 16 years and above than their younger counterparts. Smoking by teachers appeared to be the strong predictor for students smoking behaviour (OR 2.206, 95% CI: 1.576, 3.088) followed by peer influence (OR 1.988, 95% CI: 1.178, 3.356). Effective smoking prevention program should to be taken to reduce smoking behaviour. The school curricula had less impact in preventing smoking except teacher's smoking behaviour.
To determine the efficacy of cell culture, immunoflourescence Assay (IFA) and real time polymerase chain reaction (rRT-PCR) in relation to diagnosis of influenza and Respiratory Syncytial Virus (RSV).
The growth response, metal tolerance and phytoaccumulation properties of water spinach (Ipomoea aquatica) and okra (Abelmoschus esculentus) were assessed under different contaminated spiked metals: control, 50 mg Pb/kg soil, 50 mg Zn/kg soil and 50 mg Cu/kg soil. The availability of Pb, Zn and Cu metals in both soil and plants were detected using flame atomic absorption spectrometry. The concentration and accumulation of heavy metals from soil to roots and shoots (edible parts) were evaluated in terms of translocation factor, accumulation factor and tolerance index. Okra recorded the highest accumulation of Pb (80.20 mg/kg) in its root followed by Zn in roots (35.70 mg/kg) and shoots (34.80 mg/kg) of water spinach, respectively. Different accumulation trends were observed with, Pb > Zn > Cu in okra and Zn > Pb > Cu in water spinach. Significant differences (p
Twelve Jermasia kids were individually housed in pens to study the effects of soywaste on growth performance and carcass characteristics and to compare such effects with commercial pellet. Kids were divided into a pellet group and a soywaste group, including six kids (3 males and 3 females) in each group. Pellet or soywaste was offered to kids at a rate of 2.0 % dry matter (DM) of body weight/day in addition to Napier grass ad libitum. In last 10 days of experiment, kids were housed in metabolism crates for faeces collection. At the end of the experiment, three males from each group were slaughtered. Kids fed soywaste diet consumed more grass and neutral detergent fibre (NDF) than those fed pellet. The same trend was found for the digestibilities of DM, organic matter (OM) and NDF. Conversely, kids fed soywaste diet consumed less soywaste supplement than kids fed pellet. No treatment effects were observed on total intakes of DM, OM and crude protein (CP) including CP digestibility. Similarly, no effects were found on carcass and non-carcass components, except for lean, lean to fat ratio and kidney weight which were higher for kids fed soywaste diet. Results indicate that soywaste is effective as a feed for growing kids.
The native distribution of the small labyrinth fish species Pseudosphromenus cupanus includes southern India and Sri Lanka. According to literature it has a range including also Pakistan, Bangladesh, Myanmar, Malaysia, and Indonesia (Sumatra) but there are no voucher specimens or reliable observations from those areas. The distribution record of P. cupanus was inflated partly by including P. dayi as a synonym. Pseudosphronemus dayi is native to the Western Ghats in India, but the origin of the aquarium importation in 1907 was reported as both Cochin (=Kochi) and Malacca (=Malaysia), the latter locality obviously in error. The basis for the Sumatra record is an obviously mislabeled sample of P. dayi from Pulau Weh close to Sumatra. The basis for reporting the species from Pakistan, Myanmar or Bangladesh could not be located. Misidentified museum specimens from Myanmar and Pakistan identified as P. cupanus were never published on. Pseudosphromenus cupanus has been considered recently to be extinct in Bangladesh, but in fact it never occurred there.
Antimicrobial resistance in Acinetobacter baumannii is a growing public health concern and an important pathogen in nosocomial infections. We investigated the genes involved in resistance to carbapenems and cephalosporins in clinical A. baumannii isolates from a tertiary medical centre in Malaysia. A. baumannii was isolated from 167 clinical specimens and identified by sequencing of the 16S rRNA and rpoB genes. The MIC for imipenem, meropenem, ceftazidime and cefepime were determined by the E-test method. The presence of carbapenemase and cephalosporinase genes was investigated by PCR. The isolates were predominantly nonsusceptible to carbapenems and cephalosporins (>70 %) with high MIC values. ISAba1 was detected in all carbapenem-nonsusceptible A. baumannii harbouring the blaOXA-23-like gene. The presence of blaOXA-51-like and ISAba1 upstream of blaOXA-51 was not associated with nonsusceptibility to carbapenems. A. baumannii isolates harbouring ISAba1-blaADC (85.8 %) were significantly associated with nonsusceptibility to cephalosporins (P<0.0001). However, ISAba1-blaADC was not detected in a minority (<10 %) of the isolates which were nonsusceptible to cephalosporins. The acquired OXA-23 enzymes were responsible for nonsusceptibility to carbapenems in our clinical A. baumannii isolates and warrant continuous surveillance to prevent further dissemination of this antibiotic resistance gene. The presence of ISAba1 upstream of the blaADC was a determinant for cephalosporin resistance. However, the absence of this ISAba1-blaADC in some of the isolates may suggest other resistance mechanisms and need further investigation.
Three different types of low cost soil amendments, namely, EDTA, elemental S and N-fertilizer, were investigated with Vetiver grass, Vetiveria zizanioides (Linn.) Nash growing under highly mixed Cd-Pb contamination conditions. A significant increase (p
Objective: Voluntary HIV testing is one of the key strategies in the HIV/AIDS prevention and control program. New National Strategic Plan for 2016-2030 in Malaysia, adapt three zeros viz. 'zero new infections of HIV/AIDS, zero discrimination and zero AIDS-related deaths'. This study aimed to determine the predictors of voluntary HIV testing in Sarawak. Materials and methods: A cross-sectional study was conducted with a total of 900 respondents (450 males and 450 females) from the state of Sarawak, aged 18 years and above, who were selected by gender-stratified multistage cluster sampling. Data were obtained by face-to-face interview using a pretested questionnaire. Binary logistic regression analysis was done to determine the potential predictors for voluntary HIV testing. Results: The prevalence of HIV testing was higher among female respondents (26%) compared to male respondents (14.2%), and the difference was statistically significant (p < 0.001). Binary logistic regression analysis revealed that household income more than MYR 1501 (p = 0.009), not living with a partner (p < 0.001) and discussion on HIV/AIDS (p = 0.019) appeared to be predictors for the male respondents, while, ethnicity was statistically significant for female respondents (p < 0.001). Conclusion: The utilisation of HIV testing was low in both males and females. Thus, the finding of this study could be considered when designing HIV education and screening program in Sarawak.