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  1. Antimycobacterial activity: synthesis of novel 3-(substituted phenyl)-6,7-dimethoxy-3a,4-dihydro-3H-indeno[1,2-c]isoxazole analogues
    Ali MA, Ismail R, Choon TS, Pandian S, Hassan Ansari MZ
    J Enzyme Inhib Med Chem, 2011 Aug;26(4):598-602.
    PMID: 21714764 DOI: 10.3109/14756366.2010.529805
    In this study, a series of novel 3-(substituted phenyl)-6,7-dimethoxy-3a,4-dihydro-3H-indeno[1,2-c]isoxazole analogues were synthesized and evaluated for antimycobacterial activity against Mycobacterium tuberculosis (MTB) H(37)Rv and isoniazid resistant M. tuberculosis (INHR-MTB). All the newly synthesized compounds were showing moderate to high inhibitory activities. The compound 6,7-dimethoxy-3-(4-chloro phenyl)-4H-indeno[1,2-c]isoxazole (4b) was found to be the most promising compound, active against MTB H(37)Rv and INHR-MTB with minimum inhibitory concentrations of 0.22 and 0.34 μM.
  2. Fulltext A qualitative exploration of Malaysian cancer patients' perspectives on cancer and its treatment
    Farooqui M, Hassali MA, Shatar AK, Shafie AA, Seang TB, Farooqui MA
    BMC Public Health, 2011;11:525.
    PMID: 21718547 DOI: 10.1186/1471-2458-11-525
    BACKGROUND: Cancer patients' knowledge about cancer and experiences with its treatment play an important role in long-term adherence in their disease management. This study aimed to explore cancer patients' knowledge about cancer, their perceptions of conventional therapies and the factors that contribute to medication adherence in the Malaysian population.
    METHODS: A qualitative research approach was adopted to gain a better understanding of the current perceptions and knowledge held by cancer patients. Twenty patients were interviewed using a semi-structured interview guide. A saturation point was reached after the 18th interview, and no new information emerged with the subsequent 2 interviews. All interviews were transcribed verbatim and analysed by means of a standard content analysis framework.
    RESULTS: The majority of patients related the cause of their cancer to be God's will. Participants perceived conventional therapies as effective due to their scientific methods of preparations. A fear of side effects was main reasons given for delay in seeking treatment; however, perceptions were reported to change after receiving treatment when effective management to reduce the risk of side effects had been experienced.
    CONCLUSIONS: This study provides basic information about cancer patients' perceptions towards cancer and its treatment. These findings can help in the design of educational programs to enhance awareness and acceptances of cancer screening. Priorities for future research should focus on patients who refused the conventional therapies at any stage.
  3. Fulltext Melanocytoma of the optic nerve head - a diagnostic dilemma
    Mohmad Z, Kah TA, Yong KC, Abdul Halim WH, Kong Yong T
    Clin Pract, 2011 Jul 01;1(3):e60.
    PMID: 24765321 DOI: 10.4081/cp.2011.e60
    The clinical features, autofluorescence, B-scan ultrasonography, optical coherence tomography and fluorescein angiography of the lesion were described. Multiple investigation modalities are needed to confirm the benign nature of the lesion. Careful evaluation and follow-up is crucial to avoid misdiagnosis and erroneous management.
  4. Fulltext Seroepidemiology of toxoplasmosis in renal patients
    Nissapatorn V, Leong TH, Lee R, Init-Ithoi, Ibrahim J, Yen TS
    Southeast Asian J Trop Med Public Health, 2011 Mar;42(2):237-47.
    PMID: 21710842
    Toxoplasmosis is an important parasitic disease in immunosuppressed patients. This prospective study was conducted to determine the seroprevalence, associated risk factors and the incidence of clinically confirmed toxoplasmosis among renal patients at the University of Malaya Medical Center, Kuala Lumpur, Malaysia. We interviewed 247 renal patients, each of whom answered an epidemiological questionnaire, and collected blood samples for measurement of anti-Toxoplasma IgG and IgM antibodies by ELISA. Overall seroprevalence of latent toxoplasmosis was observed in 126 (51%) renal patients. Race (Malays), marital status (married) and primary level of education, were all factors associated with a greater chance of Toxoplasma infection. A case of clinically confirned toxoplasmosis was diagnosed in a renal transplant recipient as a result of immunosuppression. Based on the findings obtained, this preliminary study shows a high prevalence of latent toxoplasmosis in renal patients. Risk factors may have significantly contributed to Toxoplasma acquisition in these patients. We recommend further studies be carried out to monitor for trends in toxoplasmosis among immunosuppressed patients.
  5. Fulltext Genetic structure of the snakehead murrel, Channa striata (channidae) based on the cytochrome c oxidase subunit I gene: Influence of historical and geomorphological factors
    Jamsari AF, Jamaluddin JA, Pau TM, Siti-Azizah MN
    Genet Mol Biol, 2011 01;34(1):152-60.
    PMID: 21637559 DOI: 10.1590/S1415-47572011000100026
    Nucleotide sequences of a partial cytochrome c oxidase subunit I gene were used to assess the manner in which historical processes and geomorphological effects may have influenced genetic structuring and phylogeographic patterns in Channa striata. Assaying was based on individuals from twelve populations in four river systems, which were separated into two regions, the eastern and western, of the biodiversely rich state of Perak in central Peninsular Malaysia. In 238 specimens, a total of 368-bp sequences with ten polymorphic sites and eleven unique haplotypes were detected. Data on all the twelve populations revealed incomplete divergence due to past historical coalescence and the short period of separation. Nevertheless, SAMOVA and F(ST) revealed geographical structuring existed to a certain extent in both regions. For the eastern region, the data also showed that the upstream populations were genetically significantly different compared to the mid- and downstream ones. It is inferred that physical barriers and historical processes played a dominant role in structuring the genetic dispersal of the species. A further inference is that the Grik, Tanjung Rambutan and Sungkai are potential candidates for conservation and aquaculture programmes since they contained most of the total diversity in this area.
  6. Fulltext Genetic characterization of porcine circovirus 2 found in Malaysia
    Jaganathan S, Toung OP, Yee PL, Yew TD, Yoon CP, Keong LB
    Virol J, 2011;8:437.
    PMID: 21914166 DOI: 10.1186/1743-422X-8-437
    Porcine circovirus type 2 is the primary etiological agent associated with a group of complex multi-factorial diseases classified as Porcine Circovirus Associated Diseases (PCVAD). Sporadic cases reported in Malaysia in 2007 caused major economic losses to the 2.2 billion Malaysian ringgit (MYR) (approximately 0.7 billion US dollar) swine industry. The objective of the present study was to determine the association between the presence of PCV2 and occurrences of PCVAD.
  7. Fulltext Branch retinal vein occlusion associated with quetiapine fumarate
    Yong KC, Kah TA, Ghee YT, Siang LC, Bastion ML
    BMC Ophthalmol, 2011;11:24.
    PMID: 21867521 DOI: 10.1186/1471-2415-11-24
    To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate.
  8. Fulltext Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization
    Geok Chin T, Masir N, Noor Hussin H, Mohd Sidik S, Boon Cheok L, Yean T
    Malays J Pathol, 2011 Jun;33(1):47-51.
    PMID: 21874752 MyJurnal
    Myeloid sarcoma (MS) is a rare extramedullary myeloid tumour. It has been reported in various sites, including lymph node, bone, skin, soft tissue, various organs and the CNS. It may precede or occur concurrently with acute myeloid leukemia. Urinary bladder involvement is extremely uncommon. We report a 70-year-old female who had MS of the urinary bladder, presented with frank and persistent hematuria associated with lower abdominal pain. She subsequently had tumour seeding in the abdominal skin via percutaneous suprapubic catheter. Tumours from both the urinary bladder and skin showed immature cells that were immunoreactive toward LCA (focal), MPO (strong), CD99 (weak) and CD117 (weak). Summary of cases in the literature is presented. The potential of its misdiagnosis and the useful markers for the diagnosis of MS are discussed.
  9. Mitragynine inhibits the COX-2 mRNA expression and prostaglandin E₂ production induced by lipopolysaccharide in RAW264.7 macrophage cells
    Utar Z, Majid MI, Adenan MI, Jamil MF, Lan TM
    J Ethnopharmacol, 2011 Jun 14;136(1):75-82.
    PMID: 21513785 DOI: 10.1016/j.jep.2011.04.011
    ETHNOPHARMACOLOGICAL RELEVANCE: [corrected] Mitragyna speciosa Korth (Rubiaceae) is one of the medicinal plants used traditionally to treat various types of diseases especially in Thailand and Malaysia. Its anti-inflammatory and analgesic properties in its crude form are well documented. In this study, the cellular mechanism involved in the anti-inflammatory effects of mitragynine, the major bioactive constituent, was investigated.

    MATERIALS AND METHODS: The effects of mitragynine on the mRNA and protein expression of COX-1 and COX-2 and the production of prostaglandin E(2) (PGE(2)) were investigated in LPS-treated RAW264.7 macrophage cells. Quantitative RT-PCR was used to assess the mRNA expression of COX-1 and COX-2. Protein expression of COX-1 and COX-2 were assessed using Western blot analysis and the level of PGE(2) production was quantified using Parameter™ PGE(2) Assay (R&D Systems).

    RESULTS: Mitragynine produced a significant inhibition on the mRNA expression of COX-2 induced by LPS, in a dose dependent manner and this was followed by the reduction of PGE(2) production. On the other hand, the effects of mitragynine on COX-1 mRNA expression were found to be insignificant as compared to the control cells. However, the effect of mitragynine on COX-1 protein expression is dependent on concentration, with higher concentration of mitragynine producing a further reduction of COX-1 expression in LPS-treated cells.

    CONCLUSIONS: These findings suggest that mitragynine suppressed PGE(2) production by inhibiting COX-2 expression in LPS-stimulated RAW264.7 macrophage cells. Mitragynine may be useful for the treatment of inflammatory conditions.

  10. A transgressive brown rice mediates favourable glycaemic and insulin responses
    Karupaiah T, Aik CK, Heen TC, Subramaniam S, Bhuiyan AR, Fasahat P, et al.
    J Sci Food Agric, 2011 Aug 30;91(11):1951-6.
    PMID: 21480266 DOI: 10.1002/jsfa.4395
    BACKGROUND: We evaluated glycaemic response of a brown rice variant (BR) developed by cross-breeding. Subjects (n = 9) consumed 50 g carbohydrate equivalents of BR, white rice (WR) and the polished brown rice (PR) in comparison to 50 g glucose reference (GLU) in a cross-over design. Plasma glucose and insulin at 0, 15, 45, 60, 90, 120 and 180 min were measured and incremental area under the curve (IAUC) and indices for glucose (GI) and insulin (II) calculated.
    RESULTS: BR compared to PR or WR produced the lowest postprandial glycaemia (GI: 51 vs 79 vs 86) and insulinaemia (II: 39 vs 63 vs 68) irrespective of amylose content (19 vs 23 vs 26.5%). Only BR was significantly different from GLU for both plasma glucose (P = 0.012) and insulin (P = 0.013) as well as IAUC(glu) (P = 0.045) and IAUC(ins) (P = 0.031). Glycaemic and insulinaemic responses correlated positively (r = 0.550, P < 0.001). Linear trends for IAUC(glu) and IAUC(ins) indicated a greater secretion of insulin tied in with a greater glycaemic response for WR (r(2) = 0.848), moderate for PR (r(2) = 0.302) and weakest for BR (r(2) = 0.122).
    CONCLUSION: The brown rice variant had the lowest GI and II values but these advantages were lost with polishing.
  11. Histomorphometric changes in the perirenal adipocytes of adrenalectomized rats treated with dexamethasone
    Ahmad F, Soelaiman IN, Ramli ES, Hooi TM, Suhaimi FH
    Clinics (Sao Paulo), 2011;66(5):849-53.
    PMID: 21789391
    INTRODUCTION: Prolonged steroid treatment administered to any patient can cause visceral obesity, which is associated with metabolic disease and Cushing's syndrome. Glucocorticoids have a profound negative effect on adipose tissue mass, giving rise to obesity, which in turn is regulated by the 11β-hydroxysteroid dehydrogenase type 1 enzyme. Adrenalectomized rats treated with dexamethasone exhibited an increase in visceral fat deposition but not in body weight.

    OBJECTIVES: The main aim of this study was to determine the effect of dexamethasone on the histomorphometric characteristics of perirenal adipocytes of adrenalectomized, dexamethasone-treated rats (ADR+Dexa) and the association of dexamethasone treatment with the expression and activity of 11 β-hydroxysteroid dehydrogenase type 1 (11 β-hydroxysteroid dehydrogenase type 1).

    METHODS: A total of 20 male Sprague Dawley rats were divided into 3 groups: a baseline control group (n = 6), a sham-operated group (n = 7) and an adrenalectomized group (n=7). The adrenalectomized group was given intramuscular dexamethasone (ADR+Dexa) 2 weeks post adrenalectomy, and the rats from the sham-operated group were administered intramuscular vehicle (olive oil).

    RESULTS: Treatment with 120 μg/kg intramuscular dexamethasone for 8 weeks resulted in a significant decrease in the diameter of the perirenal adipocytes (p<0.05) and a significant increase in the number of perirenal adipocytes (p<0.05). There was minimal weight gain but pronounced fat deposition in the dexamethasone-treated rats. These changes in the perirenal adipocytes were associated with high expression and dehydrogenase activity of 11β-hydroxysteroid dehydrogenase type 1.

    CONCLUSIONS: In conclusion, dexamethasone increased the deposition of perirenal fat by hyperplasia, which causes increases in the expression and dehydrogenase activity of 11 β-hydroxysteroid dehydrogenase type 1 in adrenalectomized rats.

  12. Development of a dry reagent-based triplex PCR for the detection of toxigenic and non-toxigenic Vibrio cholerae
    Chua AL, Elina HT, Lim BH, Yean CY, Ravichandran M, Lalitha P
    J Med Microbiol, 2011 Apr;60(Pt 4):481-485.
    PMID: 21183596 DOI: 10.1099/jmm.0.027433-0
    Vibrio cholerae has caused severe outbreaks of cholera worldwide with thousands of recorded deaths annually. Molecular diagnosis for cholera has become increasingly important for rapid detection of cholera as the conventional methods are time-consuming and labour intensive. However, traditional PCR tests still require cold-chain transportation and storage as well as trained personnel to perform, which makes them user-unfriendly. The aim of this study was to develop a thermostabilized triplex PCR test for cholera which is in a ready-to-use form and requires no cold chain. The PCR test specifically detects both toxigenic and non-toxigenic strains of V. cholerae based on the cholera toxin A (ctxA) and outer-membrane lipoprotein (lolB) genes. The thermostabilized triplex PCR also incorporates an internal amplification control that helps to check for PCR inhibitors in samples. PCR reagents and the specific primers were lyophilized into a pellet form in the presence of trehalose, which acts as an enzyme stabilizer. The triplex PCR was validated with 174 bacteria-spiked stool specimens and was found to be 100 % sensitive and specific. The stability of the thermostabilized PCR was evaluated using the Q10 method and it was found to be stable for approximately 7 months at 24 °C. The limit of detection of the thermostabilized triplex PCR assay was 2×10(4) c.f.u. at the bacterial cell level and 100 pg DNA at the genomic DNA level, comparable to conventional PCR methods. In conclusion, a rapid thermostabilized triplex PCR assay was developed for detecting toxigenic and non-toxigenic V. cholerae which requires minimal pipetting steps and is cold chain-free.
  13. Fulltext In vitro effects of plantago major extract on urolithiasis
    Aziz SA, See TL, Khuay LY, Osman K, Abu Bakar MA
    Malays J Med Sci, 2005 Jul;12(2):22-6.
    PMID: 22605954
    The study was carried out to determine the in vitro effect of Plantago major extract on calcium oxalate crystals and to compare the effects of Plantago major extract with clinically used drugs like allopurinol and potassium citrate (positive controls). Modified Schneider slide gel method was used for the in vitro study and the crystals formed were measured by Image Analyser system KS 300, 3.0 Carl Zeiss. The concentrations of Plantago major extract used were from 100ppm to 350ppm. Plantago major extract at concentrations in the range of (100ppm-350ppm) significantly inhibited the size of calcium oxate crystals (dihydrate variety) against negative control (p<0.05) and against positive controls (p<0.05). However the inhibition concentration 50 (IC(50)) values on the size of calcium oxalate crystal for the extract, potassium citrate and allopurinol were 300ppm, 350ppm and 450ppm respectively. Extract of Plantago major also has inhibition effect on the number of crystals but it was not significant. In conclusion extract of Plantago major was better than allopurinol and potassium citrate in inhibiting the size of the calcium oxalate crystal in-vitro.
  14. Genotyping of hepatitis B virus in Malaysia based on the nucleotide sequence of preS and S genes
    Ong HT, Duraisamy G, Kee Peng N, Wen Siang T, Seow HF
    Microbes Infect., 2005 Mar;7(3):494-500.
    PMID: 15792534
    Hepatitis B virus (HBV) has been classified into eight genotypes, designated A-H. These genotypes are known to have distinct geographic distributions. The clinical importance of genotype-related differences in the pathogenicity of HBV has been revealed recently. In Malaysia, the current distribution of HBV remains unclear. The aim of this study was to determine the genotypes and subtypes of HBV by using PCR, followed by DNA sequencing, as well as to analyse the mutations in the immunodominant region of preS and S proteins. The S gene sequence was determined from HBV DNA of four apparently healthy blood donors' sera and three sera from asymptomatic chronic hepatitis B carriers. Of this batch of sera, the preS gene sequence was obtained from HBV DNA from three out of the four blood donors and two out of the three chronic carriers. Due to insufficient sera, we had to resort to using sera from another blood donor to make up for the sixth DNA sequence of the preS gene. Based on the comparative analysis of the preS sequences with the reported sequences in the GenBank database, HBV DNA from two normal carriers was classified as genotype C. Genotype B was assigned to HBV from one blood donor and two hepatitis B chronic carriers, whereas HBV of one chronic carrier was of genotype D. Based on the S gene sequences, HBV from three blood donors was of genotype C, that of one blood donor and one chronic carrier was of genotype B, and the remaining, of genotype D. In the five cases where both preS and S gene sequences were determined, the genotypes assigned based on either the preS or S gene sequences were in concordance. The nature of the deduced amino acid (aa) sequences at positions 125, 127, 134, 143, 159, 161 and 168 of the S gene enabled the classification of these sequences into subtypes, namely, adrq+, adw2 and ayw2. The clustering of our DNA sequences into genotype groups corresponded to their respective subtype, that is, adw2 in genotype B, adrq in genotype C and ayw in genotype D. Analysis of the point mutations revealed that five of the sequences contained aa substitutions at immunodominant epitopes involved in B or/and T cell recognition. In conclusion, despite the low numbers of samples studied, due to budget constraints, these data are still worthwhile reporting, as it is important for the control of HBV infections. In addition, the genotype and mutational data obtained in this study may be useful for designing new treatment regimes for HBV patients.
  15. Fulltext High-risk human papillomavirus in the oral cavity of women with cervical cancer, and their children
    Saini R, Khim TP, Rahman SA, Ismail M, Tang TH
    Virol J, 2010;7:131.
    PMID: 20550718 DOI: 10.1186/1743-422X-7-131
    Association of High-risk Human Papillomavirus (HR-HPV) with oral cancer has been established recently. Detecting these viruses in oral cavity is important to prevent oral lesions related to them. The purpose of this study was to evaluate the prevalence of HR-HPV in the oral cavity of women with cervical cancer, and their children. A total of 70 women, previously diagnosed with cervical cancer, and 46 children of these women, born by vaginal delivery only, were selected for this study. Buccal swabs were collected from their oral cavity and HPV detection was carried out using Hybrid Capture 2 high-risk HPV (HC2 HR-HPV) detection system.
  16. Discovering potential, transforming life
    Van Rostenberghe H, Yusoff MS, Jie TY, Shamsuddin S, Ibrahim WP
    Med Educ, 2010 May;44(5):504-5.
    PMID: 20518994 DOI: 10.1111/j.1365-2923.2010.03647.x
  17. Fermentation of Metroxylon sagu resistant starch type III by Lactobacillus sp. and Bifidobacterium bifidum
    Siew-Wai L, Zi-Ni T, Karim AA, Hani NM, Rosma A
    J Agric Food Chem, 2010 Feb 24;58(4):2274-8.
    PMID: 20121195 DOI: 10.1021/jf903820s
    The in vitro fermentability of sago (Metroxylon sagu) resistant starch type III (RS(3)) by selected probiotic bacteria was investigated. Sago RS(3) with 12% RS content was prepared by enzymatic debranching of native sago starch with pullulanase enzyme, followed by autoclaving, cooling, and annealing. The fermentation of sago RS(3) by L. acidophilus FTCC 0291, L. bulgaricus FTCC 0411, L. casei FTCC 0442, and B. bifidum BB12 was investigated by observing the bacterial growth, carbohydrate consumption profiles, pH changes, and total short chain fatty acids (SCFA) produced in the fermentation media. Comparisons were made with commercial fructo-oligosaccharide (FOS), Hi-maize 1043, and Hi-maize 240. Submerged fermentations were conducted in 30 mL glass vials for 24 h at 37 degrees C in an oven without shaking. The results indicated that fermentation of sago RS(3) significantly (P < 0.05) yielded the highest count of Lactobacillus sp. accompanied by the largest reduction in pH of the medium. Sago RS(3) was significantly the most consumed substrate compared to FOS and Hi-maizes.
  18. Fulltext SMART GROW - Low-cost automated hydroponic system for urban farming
    Shin KKY, Ping TP, Ling MGB, Chee Jiun C, Bolhassan NAB
    HardwareX, 2024 Mar;17:e00498.
    PMID: 38130490 DOI: 10.1016/j.ohx.2023.e00498
    Urban farming has gained popularity in recent years, as more people have become interested in locally grown food and reducing their carbon footprint. Smart hydroponic systems can be an important tool for urban farming as they allow for precise control over plant growth and require less space and resources than traditional farming methods. Urban areas often lack access to land suitable for farming, making hydroponic systems a viable option for growing crops in limited space. Readily available hydroponic systems in the market are costly and not cost effective, thus hydroponic systems are usually only installed in larger scale farming. The challenge here is to connect multiple low-cost sensors to microcontrollers and to any store-bought hydroponic set. This paper describes the development of smart Internet of Things (IoT) hydroponic system integrated with an Android mobile application for small scale urban farming. The new set up of IoT hydroponic set, coined as SMART GROW, is used to monitor and control various aspects of the system based on the basic parameters important in growing a healthy plant. The challenges faced during this build were irregular reading of the analog sensor when connected to a single board microcontroller (ESP32). This issue was resolved. SMART GROW currently is capable of monitoring basic parameters such as pH, EC and water level and can cater to additional sensors for monitoring other parameters if required. SMART GROW can easily be replicated and built at home and customized to the needs of the plant's requirement. SMART GROW is versatile as it can be used to grow a wide variety of plants, including herbs, vegetables, and fruits, and offers several benefits over traditional soil-based growing methods such as automated regulation of the water level.
  19. Long-Term Air Pollution Characteristics and Multi-scale Meteorological Factor Variability Analysis of Mega-mountain Cities in the Chengdu-Chongqing Economic Circle
    Li X, Abdullah LC, Sobri S, Md Said MS, Hussain SA, Aun TP, et al.
    Water Air Soil Pollut, 2023;234(5):328.
    PMID: 37200574 DOI: 10.1007/s11270-023-06279-8
    Currently, air quality has become central to global environmental policymaking. As a typical mountain megacity in the Cheng-Yu region, the air pollution in Chongqing is unique and sensitive. This study aims to comprehensively investigate the long-term annual, seasonal, and monthly variation characteristics of six major pollutants and seven meteorological parameters. The emission distribution of major pollutants is also discussed. The relationship between pollutants and the multi-scale meteorological conditions was explored. The results indicate that particulate matter (PM), SO2 and NO2 showed a "U-shaped" variation, while O3 showed an "inverted U-shaped" seasonal variation. Industrial emissions accounted for 81.84%, 58% and 80.10% of the total SO2, NOx and dust pollution emissions, respectively. The correlation between PM2.5 and PM10 was strong (R = 0.98). In addition, PM only showed a significant negative correlation with O3. On the contrary, PM showed a significant positive correlation with other gaseous pollutants (SO2, NO2, CO). O3 is only negatively correlated with relative humidity and atmospheric pressure. These findings provide an accurate and effective countermeasure for the coordinated management of air pollution in Cheng-Yu region and the formulation of the regional carbon peaking roadmap. Furthermore, it can improve the prediction accuracy of air pollution under multi-scale meteorological factors, promote effective emission reduction paths and policies in the region, and provide references for related epidemiological research.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11270-023-06279-8.

  20. Fulltext Pediatric brain abscess with fatal outcome caused by hypervirulent Klebsiella pneumoniae, serotype K2-ST65
    En ETS, Ismail N, Nasir NSM, Ismadi YKM, Zuraina NMNN, Hassan SA
    J Infect Public Health, 2023 Jul;16(7):1089-1092.
    PMID: 37224619 DOI: 10.1016/j.jiph.2023.05.015
    Hypervirulent Klebsiella pneumoniae (hvKp) is an emerging pathotype in addition to classical Klebsiella pneumoniae, with its ability to cause life-threatening, community-acquired metastatic infections even in healthy individuals. We presented a case of cerebral abscess preceded by otitis media in a 10-year-old child caused by hvKp. The isolates from blood pus aspirate were later identified as K. pneumoniae capsular serotype K2 and closely related to sequence type (ST65), with multiple hypervirulent genes detected (rmpA, rmpA2, iucA and peg344). She succumbed to death despite surgical drainage and susceptible antibiotic therapy. Clinicians should be cognizant of the rising incidence of hvKp infections in pediatric populations.
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