MyMedR

Nor GM

Med J Malaysia, 1989 Dec;44(4):344-7.

PMID: 2520046

Ludwig's angina is a potentially lethal oro-facial cellulitis due to oro-dental infection. The aetiology and management of a case of Ludwig's angina are briefly discussed.

Matched MeSH terms: Anti-Bacterial Agents

Pyogenic meningitis in hospitalized children in Kelantan, Malaysia

Choo KE, Ariffin WA, Ahmad T, Lim WL, Gururaj AK

Ann Trop Paediatr, 1990 Mar;10(1):89-98.

PMID: 1694651

A 2.5-year retrospective study of pyogenic meningitis in hospitalized children in Kelantan was carried out with regard to aetiology, clinical features, investigation, treatment and outcome. There were 58 children with 43 cases (74.1%) occurring below the age of 1 year. Frequent presenting symptoms included fever (98.3%), fits (77.6%), anorexia (39.7%), vomiting (34.5%) and drowsiness (12.1%). On admission, 37 (63.7%) had neck stiffness, 10 (17.2%) had Kernig's sign and 32 (55.2%) had coma. CSF cultures were positive for Haemophilus influenzae in 29 (50%), Streptococcus pneumonia in 13 (22.4%) and Neisseria meningitidis in 3 (5.2%). The antibiotic sensitivity profiles showed that the three main organisms were 100% sensitive to Chloramphenicol, Streptococcus pneumoniae was 100% sensitive to penicillin, Neisseria meningitidis was 100% sensitive to penicillin and ampicillin, and Haemophilus influenzae was 90% sensitive to penicillin and ampicillin. The total hospital mortality was 18.9%. All but two of the eleven deaths occurred in children younger than 1 year. Nineteen of the 35 (54.3%) survivors attended for at least one follow-up after discharge from hospital. Of these 19 children, 47.4% had neurological sequelae.

Matched MeSH terms: Anti-Bacterial Agents

Fulltext Fatal Steven Johnson syndrome in a child

Krishnan R

Med J Malaysia, 1990 Sep;45(3):267.

PMID: 2152093

Matched MeSH terms: Anti-Bacterial Agents/adverse effects*

Fulltext Empyema thoracis and lung abscess

Yaacob I, Ariffin Z

Singapore Med J, 1991 Feb;32(1):63-6.

PMID: 2017709

The case histories of 22 patients with lung abscess and empyema presenting to Hospital University Sains Malaysia (HUSM) between 1984 and 1989 are reviewed. The presenting features of both lung abscess and empyema were similar. The commonest predisposing factor was pneumonia, and the commonest organism isolated was Staphylococcus aureus but in the majority of cases, no causal organisms were identified. All the patients were treated with antibiotics and in addition, closed chest tube drainage was performed initially in all patients with empyema. Three patients with empyema required additional surgical drainage procedures. Death occurred in one patient with empyema and in one patient with lung abscess. The features, aetiology, treatment and outcome of thoracic empyema and lung abscess are discussed.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use

Pig-bel but no pig: enteritis necroticans acquired in Australia

Watson DA, Andrew JH, Banting S, Mackay JR, Stillwell RG, Merrett M

Med J Aust, 1991 Jul 01;155(1):47-50.

PMID: 2067439

OBJECTIVE: To report a case of enteritis necroticans acquired in Australia, and to review the history, epidemiology, pathogenesis, clinical features, management and prevention of this disease.

CLINICAL FEATURES: A 44-year-old diabetic and alcoholic restaurateur of Chinese-Malay origin, who had been living in Australia for over 20 years, was admitted to hospital with bloody diarrhoea which progressed to fulminant toxaemia and circulatory collapse, and ultimately required laparotomy. Typical pathological features and the isolation of Clostridium perfringens type C from faeces confirmed the diagnosis of enteritis necroticans.

INTERVENTION AND OUTCOME: He was treated initially with ampicillin, gentamicin, metronidazole and chloramphenicol, and later with penicillin and metronidazole, and he required large volumes of intravenously administered fluid and blood for his toxaemic, hypotensive state. Laparotomy was performed as a life-saving procedure. Despite a lengthy convalescence, the patient recovered.

CONCLUSIONS: Enteritis necroticans is a rare disease in developed countries, however it is likely to be underdiagnosed. Clinicians are encouraged to be on the alert for signs of severity that may indicate the need for laparotomy in a predisposed individual with features of this condition.

Matched MeSH terms: Anti-Bacterial Agents

Use of gas liquid chromatography as an adjunct to conventional bacteriological methods in the diagnosis of anaerobic cerebral abscess

Pit S, Jamal F, Cheah FK, Abbas MA

Ann Saudi Med, 1991 Jul;11(4):424-8.

PMID: 17590760

Forty cases of cerebral abscesses were studied prospectively to establish the microbial agents implicated in these cases. Chronic otitis media (14 patients, 35%), congenital heart disease (five patients, 12.5%),a and meningitis (five patients, 12.5%) were among the important predisposing factors. Streptococcus (14 patients, 35%) was the most common causative pre-isolated, the predominant species being Streptococcus milleri (11 patients, 27.5%). Other organisms isolated included Proteus mirabilis in six patients (15%) and Staphylococcus aureus in five patients (12.5%). Anaerobes (12 patients, 30%), predominantly Bacteroides sp. (eight patients, 20%), played an important role in these cases, the majority of which were isolated in mixed cultures. Gas-liquid chromatographic analysis of pus detected the presence of anaerobes in another 11 cases of cerebral abscess, in which cultures of anaerobes were negative. Therefore, gas-liquid chromotography is useful as an adjunct to conventional bacteriological methods in providing a rapid and sensitive means of detecting anaerobes in pus obtained especially from patients who had received antibiotic therapy prior to hospitalization.

Matched MeSH terms: Anti-Bacterial Agents

The patterns and transmissibility of antibiotic resistance among clinical strains of Pseudomonas aeruginosa

Palillo ES, Salleh MA

Microbiol. Immunol., 1992;36(11):1195-200.

PMID: 1491621

Four hundred and ninety-eight predominantly pyocin-type 10 clinical strains of Pseudomonas aeruginosa were analyzed for resistance to carbenicillin, cefoperazone, cefotaxime, ceftazidime, gentamicin, amikacin and netilmicin. Based on NCCLS-recommended MIC breakpoints, 245 strains were found to be resistant, of which 41.6% were resistant to carbenicillin, 38% to gentamicin, 37.8% to netilmicin, 26.3% to cefoperazone, 17.9% to cefotaxime, 0.6% to amikacin and none to ceftazidime. Quadruple resistance to carbenicillin, cefoperazone, gentamicin and netilmicin was the most frequent pattern observed. Resistance to older antibiotics (kanamycin, streptomycin and tetracycline) and to mercuric chloride were also common. Conjugation experiments suggested that self-transmissible and non-transmissible plasmids occurred in at least 66 strains.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology

Fulltext Melioidosis in a splenectomized boy with beta-thalassemia major

Hoe TS, Deng CT, Khuzaiah R

Southeast Asian J. Trop. Med. Public Health, 1993 Sep;24(3):601-2.

PMID: 8160075

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use

Occurrence of Vibrio cholerae 01 strains in Southeast Asia resistant to vibriostatic compound 0/129

Mahalingam S, Cheong YM, Kan SK, Pang T

Southeast Asian J. Trop. Med. Public Health, 1993 Dec;24(4):779-80.

PMID: 7939959

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*

A stepwise approach to the management of chronic obstructive pulmonary disease

Liam CK

Family Physician, 1993;5:46-53.

Smoking cessation helps patients with COPD more than any specific medical treatment. By commencing treatment early, the main symptoms of COPD, i.e. cough, dyspnoea, and excessive mucus production, can be relieved and premature mortality from respiratory failure can, in many cases, be prevented. An anticholinergic aerosol offers the greatest bronchodilator benefit with the least side-effects to a patient with COPD. After maximising the dosage of an anticholinergic agent, either an inhaled beta2-agonist or oral theophylline may be added for additional bronchodilator effects. Corticosteroids may be beneficial in a subset of the patients. Selected patients with exercise limitation despite optimal medical therapy may gain from an increased sense of well-being enrolled in a supervised exercise rehabilitation progromrne. Long-term domiciliary oxygen therapy improves survival for patients who are chronically hypoxaemic. Antibiotics are reserved for acute exacerbations. The role of alpha-1-antitrypsin replacement and lung transplantation is still investigational.

Matched MeSH terms: Anti-Bacterial Agents

Comprehension of antibiotic instructions in an outpatient Malaysian practice

Hassan Y, Abd Aziz N, Sarriff A, Darwis Y, Ibrahim P

Hosp Pharm, 1994 Jan;29(1):48-50, 53.

PMID: 10131493

Patients may not comply with antibiotic instructions because they do not understand them. The aim of this study was to assess outpatients' ability to comprehend their antibiotic prescription labels. Two hundred and five subjects on oral antibiotic regimens from an outpatient clinic and pharmacy of a district hospital were selected in this survey. All patients were interviewed by trained clinical pharmacy students. They were asked to read the labels and then how they would take their antibiotics. The results show that 119 (58.1%) patients could interpret the label. Forty-nine (23.9%) patients knew the name of antibiotics and interpreted the directions of use correctly. One hundred sixteen (56.6%) subjects were able to recall the auxiliary information. However, only 44 (21.4%) patients were able to comprehend complete antibiotic instruction. This study demonstrates that a significant proportion of patients could not interpret the labeling instruction. The comprehension level of patients was low and significantly associated (P < 0.05) with the ability of patient to read the label contents. These observations illustrate the need for physicians and pharmacists to provide antibiotic instructions and review these instructions with the patient.

Study site: outpatient clinic and pharmacy of a district hospita

Matched MeSH terms: Anti-Bacterial Agents/administration & dosage*

Fulltext Neonatal meningitis due to non-encapsulated Haemophilus influenzae in a set of twins--a case report

Lim CT, Parasakthi N, Puthucheary SD

Singapore Med J, 1994 Feb;35(1):104-5.

PMID: 8009266

A set of twins born to a 24-year-old primigravida had evidence of sepsis 24 to 60 hours after birth and were treated empirically with penicillin and gentamicin. A non-encapsulated H. influenzae biotype IV strain was isolated from the blood cultures of both and from the CSF of twin II. The isolates were beta-lactamase positive and hence showed resistance to ampicillin and therapy was changed to chloramphenicol only. Twin II recovered but Twin I developed a brain abscess in the left occipital region which resolved with extended antibiotic treatment. Although ampicillin-resistant H. influenzae have been reported in Malaysia, invasive disease by such strains are rare.

Matched MeSH terms: Anti-Bacterial Agents

Multiple and multigeneric anthelmintic resistance on a sheep farm in Malaysia

Sivaraj S, Dorny P, Vercruysse J, Pandey VS

Vet Parasitol, 1994 Oct;55(1-2):159-65.

PMID: 7886917

The anthelmintic efficacy of benzimidazoles, levamisole, closantel, ivermectin and moxidectin was evaluated on an institutional farm in Malaysia using faecal egg count reduction tests, controlled slaughter trials and an in vitro egg hatch assay. The results of this study indicated simultaneous resistance of Haemonchus contortus against benzimidazoles and ivermectin and of Trichostrongylus colubriformis against benzimidazoles and levaminsole on the same farm. Moxidectin was effective against the ivermectin resistant H. contortus.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use

Fulltext Chronic granulomatous disease--a report in two Malay families

Mohd Noh L, Noah RM, Wu LL, Nasuruddin BA, Junaidah E, Ooi CP, et al.

Singapore Med J, 1994 Oct;35(5):505-8.

PMID: 7701372

Chronic granulomatous disease (CGD) is a very rare disease whose defect lies in an abnormal intracellular killing resulting in recurrent abscesses, lymphadenitis and granuloma formation. We describe 2 Malay male infants with CGD whom we believe to be the first report of this disorder in Malays. Both children presented with recurrent abscesses, pneumoniae and hepatosplenomegaly; lymphadenopathy was also present in one of the patients. The organisms isolated were catalase positive bacteria. Both neutrophil chemiluminescence (against fungal and bacterial antigens, phorbol myristate acetate) and intracellular killing assays were severely depressed. Recognition of CGD is important as great strides have been made in the treatment of this disease which include gamma interferon therapy besides the conventional prophylactic antibacterial therapy.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use

Fulltext Campylobacter enteritis in children: clinical and laboratory findings in 137 cases

Puthucheary SD, Parasakthi N, Liew ST, Chee YW

Singapore Med J, 1994 Oct;35(5):453-6.

PMID: 7701360

One hundred and thirty-seven children with Campylobacter diarrhoea were reviewed. The predominant species was C. jejuni. Ninety-five percent of the children were below 5 years of age with 61% of these being 2-12 months old. A slight male preponderance was noted. About half the cases presented with fever and bloody diarrhoea; vomiting was seen in 28% and abdominal colic in only 8%. Moderate to severe diarrhoea was present in 48% of the children. Thirty-seven percent had a history of recent or concurrent illness. Other bacterial enteropathogens together with Campylobacter were isolated in 15% of the children. Erythromycin, the most useful drug, when indicated for Campylobacter infections, had an MIC90 of 2 mg/l with 96.2% of the strains being sensitive.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology

Fulltext The use of surgical antibiotic prophylaxis in seven Malaysian hospitals

Lim VK, Cheong YM, Suleiman AB

Southeast Asian J. Trop. Med. Public Health, 1994 Dec;25(4):698-701.

PMID: 7667716

A survey on the use of antibiotics in surgical prophylaxis was carried out in seven Malaysian hospitals. Details of antibiotic prescriptions were obtained through questionnaires completed by the prescriber. A total of 430 such prescriptions was analysed. A large number of different antibiotic regimens were used for a variety of surgical procedures. The majority of prescriptions (70%) were issued for procedures where such prophylaxis was probably not necessary. Antibiotics were also often prescribed for durations that were longer than necessary. There is an urgent need to educate surgeons and standardize surgical prophylactic regimens in order to reduce cost and combat the emergence of antibiotic resistance.

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use*

Fulltext Antibiotic resistance

Lim VK

Med J Malaysia, 1994 Dec;49(4):315-6.

PMID: 7674965

Matched MeSH terms: Anti-Bacterial Agents/therapeutic use

Concentrations of thiocyanate and hypothiocyanite in the saliva of young adults

Jalil RA

J Nihon Univ Sch Dent, 1994 Dec;36(4):254-60.

PMID: 7869127

The study was conducted to determine thiocyanate (SCN-) and hypothiocyanite (OSCN-) concentrations in resting (RWS) and stimulated whole saliva (SWS) and stimulated parotid saliva (SPS) of 20 healthy young adults aged 21-29 y. Samples of saliva were collected at 12:30, immediately before lunch. Resting saliva was collected by expectoration, and stimulated saliva was collected during the uniform chewing of paraffin wax. Parotid secretion was collected using a modified Carlsson-Crittenden cup (Carlsson et al., Am, J. Physiol., 26, 169-177, 1910). SCN- concentration was determined by the ferric nitrate method (Betts et al., J. Am. Chem. Soc., 75, 5721-5727, 1953) whilst OSCN- was assayed using 2-mercaptoethanol as a reducing agent (Pruitt et al., Caries Res., 16, 315-323, 1982). In RWS, SWS and SPS, the mean SCN- concentrations (in mM) were 1.48 +/- 0.59(S.D.), 0.90 +/- 0.56(S.D.) and 1.24 +/- 0.65(S.D.) whilst the mean OSCN- concentrations (in microM) were 31.21 +/- 13.54(S.D.), 24.90 +/- 12.61 and 30.19 +/- 23.35(S.D.) in the respective salivas. The presence of OSCN- in the secretion collected from the parotid gland supported previous findings by Tenovuo and Pruitt (Tenovuo et al., J. Oral Path, ol. 13, 573-584, 1984), who suggested an endogenous glandular (eukaryotic) source of hydrogen peroxide (H2O2), since parotid saliva from healthy glands is devoid of bacteria and leukocytes.

Matched MeSH terms: Anti-Bacterial Agents/analysis

Fulltext Antimicrobial resistance pattern of bacteria isolated from patients seen by private practitioners in the Klang Valley

Cheong YM, Fairuz A, Jegathesan M

Singapore Med J, 1995 Feb;36(1):43-6.

PMID: 7570134

Data on bacterial resistance in patients seen by general practitioners are usually not readily available. The objective of this paper is to present the antimicrobial resistance pattern of bacteria isolated from patients seen by private practitioners in the Klang Valley. A total of 18 clinics participated in this study. From mid August 1991 to end of June 1993, 2,823 specimens were received. Throat swabs and urine specimens constituted 56% of all the specimens. A large proportion of the specimens (55%) yielded no growth or just normal flora. The common bacteria encountered were Staphylococcus aureus (18.4%), Escherichia coli (16.2%), Klebsiella spp (13.7%) and Neisseria gonorrhoeae (9.3%). The S. aureus strains were mainly isolated from wound, pus and ear swabs. Not one out of the 218 strains tested was resistant to methicillin. In vitro susceptibility tests showed that 91% were resistant to penicillin while 23% were resistant to tetracycline and 13% to erythromycin. Eighty-two percent of the E. coli were isolated from urine. It was also the most common isolate from urine. Fifty percent of these strains were resistant to ampicillin, 33% to cotrimoxazole, 17% to cephalothin, 21% to ampicillin-sulbactam, 18% to amoxycillin-clavulanic acid while only 2.3% were resistant to nalidixic acid and nitrofurantoin and none to cefuroxime. Generally the gram negative bacilli encountered in general practice are less resistant to the third generation cephalosporins and aminoglycosides when compared to the hospital strains.

Matched MeSH terms: Anti-Bacterial Agents/pharmacology*

Antimicrobial activity of Cassia alata from Malaysia

Ibrahim D, Osman H

J Ethnopharmacol, 1995 Mar;45(3):151-6.

PMID: 7623478

Ethanolic extract of Cassia alata leaves was investigated for its antimicrobial activities on several microorganisms including bacteria, yeast, dermatophytic fungi and non-dermatophytic fungi. In vitro, the extract exhibited high activity against various species of dermatophytic fungi but low activity against non-dermatophytic fungi. However, bacterial and yeast species showed resistance against in vitro treatment with the extract. The minimum inhibitory concentration (MIC) values of the extract revealed that Trichophyton mentagorphytes var. interdigitale, Trichophyton mentagrophytes var. mentagorophytes, Trichophyton rubrum and Microsporum gypseum had the MIC of 125 mg/ml, whereas Microsporum canis had the MIC of 62.5 mg/ml. The inhibition can be observed on the macroconidia of Microsporum gypseum which resulted in structural degeneration beyond repair. The mechanism of inhibition can be related to the cell leakage as observed by irregular, wrinkle shape and loss in rigidity of the macroconidia.

Matched MeSH terms: Anti-Bacterial Agents

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