Displaying publications 901 - 920 of 1517 in total

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  1. Nazariah Harun, Ravivarma Rao Panirselvam, Yusni Yusuff
    MyJurnal
    Introduction: Children and adolescents requiring mental health services are increasing. This paper is a registry of new clients in the Child and Adolescent Mental Health (CAMH) outpatient clinic of Hospital Sultan Abdul Halim (HSAH), Sungai Petani, Kedah, Malaysia from January 2014 to December 2014.
    Objectives: We aimed to determine the trends of different types of mental disorders in first contact clients at an outpatient CAMH clinic in HSAH. Thereafter, we sought to compare the differences in demographics with types of illness and treatments modalities. Method: We reviewed electronic case records retrospectively for the study period from January 2014 to December 2014 and universal sampling was done.
    Results: During the study period, there were 160 new cases. The highest number of patients were from the primary school age group with a mean age of 9.98 years. The highest incidence was Attention Deficit Hyperactivity Disorder (23.8%), followed by Autism Spectrum Disorder (17.5%) and others at 15.6%. Out of those sampled, 61% were treated pharmacologically and 39% were receiving non-pharmacological treatment.
    Conclusions: There is a need to enhance and expand services to enable the client and family to obtain the necessary intervention. With improved screening and empowerment of the family, better outcomes could be achieved for the client.

    Study site: outpatient clinic of Hospital Sultan Abdul Halim (HSAH)
    Matched MeSH terms: Incidence
  2. Eskandari F, Abdullah KL, Zainal NZ, Wong LP
    Nurse Educ Pract, 2018 Sep;32:52-57.
    PMID: 30029085 DOI: 10.1016/j.nepr.2018.07.007
    The use of physical restraint exposes patients and staff to negative effects, including death. Therefore, teaching nursing staff to develop the improve knowledge, skills, and attitudes regarding physical restraint has become necessary. A quasi-experimental pre-post design was used to evaluate the effect of educational intervention on nurses' knowledge, attitude, intention, practice and incidence rate of physical restraint in 12 wards of a hospital using a self-reported questionnaire and a restraint order form in Malaysia. The educational intervention, which included a one-day session on minimising physical restraint use in hospital, was presented to 245 nurses. The results showed a significant increase in the mean knowledge, attitude sand practice score and a significant decrease in the mean intention score of nurses to use physical restraint after intervention. There was a statistically significant decrease in the incidence rate of physical restraint use in the wards of the hospital except geriatric-rehabilitation wards after intervention.
    Matched MeSH terms: Incidence
  3. Koh, S.P., Aziz, N., Sharifudin, S.A., Abdullah, R., Hamid, N.S.A., Sarip, J.
    Food Research, 2017;1(4):109-113.
    MyJurnal
    Foodborne illness is recognized as an emerging infectious disease. The incidence of foodborne
    infections is common and the majority cases are undiagnosed or unreported. Apart from some
    diarrhea or minor gastrointestinal problem, some foodborne pathogenic microbes may cause
    death, particularly to those people with weakened immune system. In this study, we have
    developed a new fermented papaya beverage using symbiotic culture of yeast and acetic acid
    bacteria under controlled biofermentation process. An in-vitro assessment of fermented papaya
    beverage against few foodborne pathogenic microorganism was conducted to determine
    its minimum bactericidal concentration (MBC>99). Three types of foodborne pathogen:
    Escherichia coli O157, Salmonella enterica serovar Typhimurium ATCC 53648, Salmonella
    enterica serovar Enteritidis (isolated from infectious chicken) were selected. From minimum
    bactericidal concentration (MBC>99) assay, both fermented papaya pulp and leaves beverages
    have shown 100% killing rate against three selected foodborne pathogenic microbes. Inversely,
    non-fermented papaya pulp and leaves beverages indicated no inhibition at all. In fact, further
    dilution of fermented papaya pulp and leaves beverages demonstrated different degree of
    MBC>99 and brix value, but the pH value remained less than 3.5. These findings indicated
    the combination of soluble solid compounds presents in both fermented papaya beverage and
    product acidity play an important role in the inhibition of pathogenic microorganisms. The
    preliminary promising results of this work have shown that the great potential of fermented
    papaya beverages as a preventive measure to reduce the incidence of foodborne illness.
    Matched MeSH terms: Incidence
  4. Ismail A, Razak IA, Ab-Murat N
    BMC Oral Health, 2018 07 27;18(1):126.
    PMID: 30053849 DOI: 10.1186/s12903-018-0589-0
    BACKGROUND: This study evaluated the impact of anticipatory guidance on the caries incidence of 2-3-year-old preschool children and their 4-6-year-old siblings, as well as on their mothers' oral health literacy, as compared to the conventional Ministry of Health (MOH) programme.

    METHODS: This quasi-experimental study was conducted at two government dental clinics in Batu Pahat District, Malaysia. The samples comprised of 478 mother-child-sibling trios (233 families in the intervention group, and 245 families in the control group). An oral health package named the Family Dental Wellness Programme (FDWP) was designed to provide dental examinations and oral health education through anticipatory guidance technique to the intervention group at six-month intervals over 3 years. The control group received the standard MOH oral health education activities. The impact of FDWP on net caries increment, caries prevented fraction, and mother's oral health literacy was assessed after 3 years of intervention.

    RESULTS: Children and siblings in the intervention group had a significantly lower net caries increment (0.24 ± SD0.8; 0.20 ± SD0.7) compared to the control group (0.75 ± SD1.2; 0.55 ± SD0.9). The caries prevented fraction for FDWP was 68% for the younger siblings and 63.6% for the older children. The 2-3-year-old children in the intervention group had a significantly lower incidence of white spot lesions than their counterpart (12% vs 25%, p 
    Matched MeSH terms: Incidence
  5. Raihan R, Azzeri A, H Shabaruddin F, Mohamed R
    Euroasian J Hepatogastroenterol, 2018 05 01;8(1):54-56.
    PMID: 29963463 DOI: 10.5005/jp-journals-10018-1259
    Hepatocellular carcinoma (HCC) is one of the leading causes of death globally. In Malaysia liver cancer is the eighth most common cause of cancer for both gender and fifth most common cause of cancer for males. Liver cancer is a cause of premature death in Malaysia: The trend from 1990 to 2010 was observed upward. Since 1990, the annual years of life lost (YLLs) from liver cancer have increased by 31.5%. Older persons are at higher risk and there is male predominance observed. Curative surgical resection, liver transplantation, and supportive symptomatic care, including percutaneous ethanol injection and radiofrequency ablation (RFA), and noncurative transarterial chemoembolization (TACE) are among available treatment facilities. Yet the survival rate is very poor as majority of patients present at very advanced stage. Hepatitis B virus (HBV) remained the leading cause of HCC in Malaysia. Several studies showed cryptogenic causes, which are mainly nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) among the predominant causes of HCC in Malaysia than hepatitis C virus (HCV), alcohol, or any other reason. This mainly correlates with the increasing incidence of diabetes and obesity in Malaysia. How to cite this article: Raihan R, Azzeri A, Shabaruddin FH, Mohamed R. Hepatocellular Carcinoma in Malaysia and Its Changing Trend. Euroasian J Hepato-Gastroenterol 2018;8(1):54-56.
    Matched MeSH terms: Incidence
  6. Sahilah, A.M., Rozeita, L., Umi Kalsum, M.S., Son, R.
    MyJurnal
    Ninety one leaf samples of Josapine pineapple cultivar (Kelantan, n=8; Pahang, n=20; Perak, n=11; Sabah, n=15; Johor, n=37) showing symptoms of heart rot disease were collected to determine the incidence of Erwinia chrysanthemi. Sixteen strains of E. chrysanthemi were isolated from 13 leaf samples from Pahang (n=4), Sabah (n=2) and Johor (n=7). All of the E. chrysanthemi strains displayed resistance to bacitracin with two strains showing resistance to sulfamethoxazole. None of the E. chrysanthemi strains were resistant toward ampicillin, carbenicillin, cephalothin, ceftriaxone, cefuroxime, gentamicin, kanamycin, nalidixic acid, penicillin G, streptomycin and tetracycline. All of the E. chrysanthemi strains were plasmidless. The dendrogram generated from the ERIC-PCR fingerprinting showed that the E. chrysanthemi strains formed 4 clusters and 7 single isolates at 80% similarity level. The restriction fragment length polymorphism (RFLP) analysis for 16 strains of E. chrysanthemi with HinfI and HaeIII endonuclease, 2 and 4 restriction profiles were obtained, respectively. The combinations of the four techniques were able to differentiate the 16 E. chrysanthemi strains into 14 genome types, suggesting a wide diversity of strains examined. ERICPCR fingerprinting method is found to be more discriminating and useful for the determination of the E. chrysanthemi strains relatedness.
    Matched MeSH terms: Incidence
  7. Wong HT, Chee KH, Chong AW
    Eur Arch Otorhinolaryngol, 2017 Jun;274(6):2601-2606.
    PMID: 28243782 DOI: 10.1007/s00405-017-4491-1
    Obstructive sleep apnea (OSA) is a growing health hazard in the United States and worldwide. OSA is now recognized as a disorder with systemic manifestations and its association with obesity and adverse cardiovascular consequences. There is increasing evidence that OSA may be associated with systemic hypertension and an increased incidence of stroke, heart failure, myocardial infarction, and arrhythmias. Less information is available about the association between OSA and pulmonary hypertension (PH). We therefore conduct this study to look at the prevalence of the pulmonary hypertension in obstructive sleep apnea patient and to identify risk factors leading to pulmonary hypertension among OSA patient. We studied and analyzed all OSA patient confirmed by polysomnograph in the year 2015. Twenty-five patients with OSA were included in this study with prevalence of pulmonary hypertension of 16%. Univariate analysis of various factors revealed a statistically significant association between having the lowest SpO2 of <70% and pulmonary hypertension (p = 0.016). There were no statistically significant associations between age, gender, smoking status, hypertension, body mass index (BMI), or apnea-hypopnea index (AHI) with occurrence of pulmonary hypertension. AHI is not a good predictor for pulmonary hypertension. The real value of using AHI to predict the health risk of OSA is doubtful. We recommend routine echocardiogram among OSA patient. The objective information in the echocardiogram provides evidence for counseling of patient with disease of OSA and hence hopefully can improve compliance of patient to treatment especially usage of CPAP.
    Matched MeSH terms: Incidence
  8. Wan Rohani WT, Mahfudzah A, Nazihah MY, Tan HL, Wan Syamimee WG, Amanda Jane PG, et al.
    Med J Malaysia, 2018 10;73(5):307-310.
    PMID: 30350810 MyJurnal
    INTRODUCTION: Gout is one of the most common inflammatory arthritis in Malaysia. It is due to persistent hyperuricemia that leads to the formation and deposition of intra- and periarticular monosodium urate crystals either due to excessive production or insufficient excretion of uric acid. Incidence and prevalence of gout is increasing worldwide, with a higher rate among men compared to women. Malay is the largest ethnic group in Malaysia, followed by Chinese and Indian. SLC2A9 is a renal urate transporter that controls renal uric acid excretion and genetic variants in SLC2A9 are associated with the risk of gout in several populations. This study aimed to test if the SLC2A9 variant (R265H, rs3733591) is also associated with gout among Malays in Malaysia.

    METHODOLOGY: A total of 89 patients with gouty arthritis and 100 normal subjects who consented and were recruited in this study. The serum urate and creatinine were measured. The SNP genotyping was performed using PCR-RFLP method for rs3733591 and BST 1236 was used as a restriction enzyme to cut the targeted amplicons.

    RESULT: SLC2A9 variant was associated with gout, p-value of 0.007, OR=4.713 [95%CI 1.530-14.513], however this association was not significant after adjustment for age and gender with p=0.465 (OR=1.950; 95%CI[0.325-11.718]).

    CONCLUSION: Our data suggest that the genetic variant of SLC2A9 may contribute to the susceptibility of gout among Malays in Malaysia.

    Matched MeSH terms: Incidence
  9. Bergin PS, Brockington A, Jayabal J, Scott S, Litchfield R, Roberts L, et al.
    Epilepsia, 2018 10;59 Suppl 2:144-149.
    PMID: 30159885 DOI: 10.1111/epi.14478
    The EpiNet project has been commenced to facilitate investigator-led collaborative research in epilepsy. A new Web-based data collection tool has been developed within EpiNet to record comprehensive data regarding status epilepticus and has been used for a study of status epilepticus in Auckland, New Zealand. All patients aged >4 weeks who presented to any of the five public hospitals and the major private hospital within Auckland city (population = 1.61 million) with an episode of status epilepticus between April 6, 2015 and April 5, 2016 were identified using multiple overlapping sources of information. For this study, status epilepticus was defined as any seizure exceeding 10 minutes in duration, or repeated seizures lasting >10 minutes without recovery between seizures. Patients who had either convulsive or nonconvulsive status epilepticus were included. Episodes of status epilepticus were classified according to the 2015 International League Against Epilepsy ILAE status epilepticus classification. A total of 477 episodes in 367 patients were considered as definite or probable status epilepticus; 285 episodes (62%) lasted >30 minutes, which is the duration that has previously been used for epidemiological studies of status epilepticus.
    Matched MeSH terms: Incidence
  10. Arulappen AL, Danial M, Sulaiman SAS
    Front Pharmacol, 2018;9:809.
    PMID: 30177879 DOI: 10.3389/fphar.2018.00809
    Adverse drug reaction (ADR) primarily caused by many drugs including antibiotics. At present, the incidence and pattern of ADR caused by antibiotics have remained as neglected area in Malaysia. This study was conducted to determine the incidence and analyze the pattern of ADR caused by antibiotics among patients in a tertiary care hospital. It is a 2-year retrospective observational study conducted at Hospital Pulau Pinang, Malaysia. All eligible patients who had antibiotic prescribed belonging to any age group either from outpatient or inpatient that had experienced ADR was included in this study. The outcomes were measured with the aid of Naranjo's and Hartwig's scales. The incidence of the ADRs among patients prescribed with antibiotics in Hospital Pulau Pinang is about 1.1%. Vancomycin and Trimethoprim/Sulfamethoxazole both are considered to be the major contributors to ADR incidences. The skin was the most affected organ by ADRs followed by gastrointestinal system. Most of the severe ADRs were caused by Penicillin. The causality relationship of all the severe reactions was mostly probable. General Medicine unit had reported the highest number of ADRs caused by antibiotics. The common manifestations of ADRs are acute kidney injury and exanthem. In addition, majority of the ADRs caused by antibiotics were reversible. A large multicenter study is suggested to confirm the present findings.

    Study site: Hospital Pulau Pinang
    Matched MeSH terms: Incidence
  11. Soliman A, Teoh SL, Ghafar N, Das S
    Mini Rev Med Chem, 2018 Oct 25.
    PMID: 30360709 DOI: 10.2174/1389557518666181025155204
    The incidence of diabetes mellitus (DM) is increasing worldwide. One of the main complications in DM is delayed wound healing which often requires amputation. Various drugs have been used to treat DM but they present with various complications and patients often do not comply with such treatment. This opens the door for complementary and alternative medicine. In the present review, we explore the molecular concept of wound healing occurring in different stages with special emphasis to DM. We also highlight potential herbal products such as NF3 (Chinese 2-Herb Formula), Zicao, Jing Wan Hong ointment, mixture of Adiantum capillus-veneris, Commiphora molmol, Aloe Vera, and henna, Aleo vera, Phenol-rich compound sweet gel, Jinchuang ointment, San-huang-sheng-fu (S) oil, Yi Bu A Jie extract, Astragali Radix (AR) and Rehmanniae Radix (RR), Yiqi Huayu, Tangzu yuyang ointment, Shengji Huayu recipe, Angelica sinensis, Lithospermun erythrorhison, Hippophae rhamnoides L., Curcuma longa, and Momordica charantia that could be effectively used to treat DM wounds. Future clinical trials are needed for designing potential drugs which may be effective in treating DM wounds.
    Matched MeSH terms: Incidence
  12. Wong MP, Zahari Z, Abdullah MS, Ramely R, Md Hashim MN, Zakaria Z, et al.
    J Vasc Nurs, 2018 Dec;36(4):173-180.
    PMID: 30458938 DOI: 10.1016/j.jvn.2018.07.001
    Surgical patients are at high risk for developing deep vein thrombosis (DVT). There are many reports concerning DVT, but little is known about silent deep vein thrombosis (sDVT). This study aimed to determine the incidence of sDVT. Secondary objective is to identify the associated factors for the use of DVT prophylaxis and Caprini risk scores among major surgery patients. This prospective observational study involved postoperative surgical patients who are at risk of developing sDVT. The Caprini risk-assessment scores were calculated, and each subject had a preoperative and postoperative compression ultrasound complemented by duplex venous ultrasonography of deep venous system. No patient from the study experienced sDVT. There were significant associations between Caprini risk score group (odds ratio, 8.16; 95% confidence interval [CI], 1.01-68.74; P = .016) and the use of central venous catheter (odds ratio, 6.34; 95% CI, 1.62-24.80; P = .008) with DVT prophylaxis. Interestingly, the use of central venous catheter resulted in more than four-point increment of Caprini risk scores (mean increment, 4.19; 95% CI, 3.16-5.21; P 
    Matched MeSH terms: Incidence
  13. Islam MJ, Saha SK, Das AK, Jahan MS, Pervin S, Karim CF, et al.
    Mymensingh Med J, 2019 Oct;28(4):935-939.
    PMID: 31599264
    Hepatocellular carcinoma (HCC) is an important reason of liver-related death globally. HCC is the fifth most common cancer, the third most common cause for cancer related death in the world and responsible for approximately one million deaths each year. The incidence of HCC is expected to increase in the next two decades, largely due to hepatitis C infection and secondary cirrhosis. We have reported a case of hepatocellular carcinoma in a 56-year-old man with peritoneal metastasis. Diagnostic imaging (Ultra sonogram & CT-Scan) shown: a large hypo density, irregular outline lesion noted in right lower liver, post contrast image shown patchy enhancement of the lesion. His serum Alpha-Feto Protein (AFP) level was very high with elevated serum alanine amino transaminase (ALT) enzyme and prothrombin time. Histopathological (microscopic) features are compatible with Hepatocellular carcinoma. His Hepatitis C viral DNA load e.g., core protein variants and genotype 1, have been reported. The patient was treated by surgical resection followed by conservative treatment includes sorafenib & interferon alpha. This case report aims to outlines the epidemiology of HCC in chronic HCV, risk factors and pathophysiology that contribute to this disease process, related pathophysiology of patient's clinical features, screening recommendations, and the available statistics on the impact of new direct-acting antiviral treatment on the development on HCC.
    Matched MeSH terms: Incidence
  14. Saeung A, Srisuka W, Aupalee K, Fukuda M, Otsuka Y, Taai K, et al.
    Acta Trop, 2020 Apr;204:105344.
    PMID: 31954685 DOI: 10.1016/j.actatropica.2020.105344
    Zoonotic onchocerciasis is a human infection caused by Onchocerca species of animal origins and transmitted by black fly vectors. The reported incidence of this disease has increased throughout the world. This study aims to clarify the vectorial roles of black fly species in zoonotic filarial transmission in Tak province, western Thailand. The integrated approach of morphological and DNA sequence-based analyses was used to identify species of both wild-caught female black flies and infective filarial larvae found in the infected black flies. All of 494 female black flies captured were identified as Simulium nigrogilvum, through scanning electron microscopy (SEM) and DNA sequence analyses based on the cytochrome c oxidase subunit I (COI) and subunit II (COII), and the fast-evolving nuclear elongation complex protein 1 (ECP1) genes. Four females of S. nigrogilvum harbored one to three third-stage larvae (infective larvae) in their thoraces, with an infection rate of 0.81% (4/494). All infective larvae were similar in morphology and size to one another, being identified as Onchocerca species type I (= O. sp. type A), a bovine filaria, originally reported from Japan, and also as O. sp. found in S. nodosum in Thailand, based on their body lengths and widths being 1,068-1,346 µm long by 25-28 µm wide, and morphological characters. Comparisons of cytochrome c oxidase subunit I (COI) and 12S rRNA sequences of mitochondrial DNA (mtDNA) and phylogenetic analyses with those of previous reports strongly supported that all larvae were O. sp. type I. This report is the first indicating the presence of O. sp. type I in Thailand and its vector being S. nigrogilvum.
    Matched MeSH terms: Incidence
  15. Sunil M, Hieu HQ, Arjan Singh RS, Ponnampalavanar S, Siew KSW, Loch A
    Ann Clin Microbiol Antimicrob, 2019 Dec 17;18(1):43.
    PMID: 31847847 DOI: 10.1186/s12941-019-0341-x
    BACKGROUND: Staphylococcus has replaced streptococcus as the most common cause of infective endocarditis (IE) in developed health care systems. The trend in developing countries is less clear.

    AIM: To examine the epidemiological trends of infective endocarditis in a developing nation.

    METHODS: Single-centre, retrospective study of patients admitted with IE to a tertiary hospital in Malaysia over a 12-year period.

    RESULTS: The analysis included 182 patients (n = 153 Duke's definite IE, n = 29 possible IE). The mean age was 51 years. Rheumatic heart disease was present in 42%, while 7.6% were immunocompromised. IE affected native valves in 171 (94%) cases. Health-care associated IE (HCAIE) was recorded in 68 (37.4%). IE admission rates increased from 25/100,000 admissions (2012) to 59/100,000 admissions (2017). At least one major complication on admission was detected in 59 (32.4%) patients. Left-sided IE was more common than right-sided IE [n = 159 (87.4%) vs. n = 18 (9.9%)]. Pathogens identified by blood culture were staphylococcus group [n = 58 (40.8%)], streptococcus group [n = 51 (35.9%)] and Enterococcus species [n = 13 (9.2%)]. staphylococcus infection was highest in the HCAIE group. In-hospital death occurred in 65 (35.7%) patients. In-hospital surgery was performed for 36 (19.8%) patients. At least one complication was documented in 163 (85.7%).

    CONCLUSION: Staphylococcus is the new etiologic champion, reflecting the transition of the healthcare system. Streptococcus is still an important culprit organism. The incidence rate of IE appears to be increasing. The rate of patients with underlying rheumatic heart disease is still high.

    Matched MeSH terms: Incidence
  16. Zulperi D, Sijam K
    Plant Dis, 2014 Feb;98(2):275.
    PMID: 30708756 DOI: 10.1094/PDIS-03-13-0321-PDN
    During March 2011 to June 2012, 50 banana plants of cultivar Musa × paradisiaca 'Horn' with Moko disease symptoms were randomly sampled in 12 different locations of 5 outbreak states in Peninsular Malaysia comprising Kedah, Selangor, Pahang, Negeri Sembilan, and Johor, with disease incidence exceeding 90% in some severely affected plantations. The disease symptoms observed in the infected plants included yellowing and wilting of the oldest leaves, which became necrotic, and eventually led to their dieback or collapse. The pulp of banana fruits also became discolored and exuded bacterial ooze. Vascular tissues in pseudostems were discolored. Fragments from symptomatic plant samples were excised and cultured on Kelman's-tetrazolium salt (TZC) medium. Twenty positive samples produced fluidal colonies that were either entirely white or white with pink centers after incubation for 24 to 48 h at 28°C on Kelman's-TZC medium and appeared as gram-negative rods after Gram staining. They were also positive for potassium hydroxide (KOH), Kovacs oxidase, and catalase tests, but negative for utilization of disaccharides and hexose alcohols, which are characteristics of biovar 1 Ralstonia solanacearum. For the pathogenicity test, 30 μl of 108 CFU/ml bacterial suspension of three selected virulent strains were injected into banana (Musa × paradisiaca 'Horn') leaves explants grown in plastic pots of 1,440 cm3 volume in a greenhouse, with temperature range from 26 to 35°C. Leaves that were infiltrated with sterile distilled water served as a negative control. Inoculations with all isolates were performed in three replications, as well as the uninoculated control leaves explants. The inoculated plants produced the same symptoms as observed on naturally diseased samples, whereas control plants remained asymptomatic. Strain cultures were re-isolated and possessed the morphological and biochemical characteristics as previously described. PCR amplification using race 2 R. solanacearum primers ISRso19-F (5'-TGGGAGAGGATGGCGGCTTT-3') and ISRso19-R (5'-TGACCCGCCTTTCGGTGTTT-3') (3) produced a 1,900-bp product from DNA of all bacterial strains. BLAST searches resulted that the sequences were 95 to 98% identical to published R. solanacearum strain race 2 insertion sequence ISRso19 (GenBank Accession No. AF450275). These genes were later deposited in GenBank (KC812051, KC812052, and KC812053). Phylotype-specific multiplex PCR (Pmx-PCR) and Musa-specific multiplex PCR (Mmx-PCR) were performed to identify the phylotype and sequevar of all isolates (4). Pmx-PCR showed that all isolates belonged to phylotype II, whereas Mmx-PCR showed that they belonged to phylotype II sequevar 4 displaying 351-bp amplicon. Although there were previously extensive studies on R. solanacearum associated with bacterial wilt disease of banana crops in Malaysia, none related to Moko disease has been reported (1,2). The result has a great importance to better understand and document R. solanacearum race 2 biovar 1, since banana has been identified as the second most important commercial fruit crop with a high economic value in Malaysia. References: (1) R. Khakvar et al. Plant Pathol. J. 7:162, 2008. (2) R. Khakvar et al. Am. J. Agri. Biol. Sci. 3:490, 2008. (3) Y. A. Lee and C. N. Khor. Plant Pathol. Bull. 12:57, 2003. (4) P. Prior et al. Pages 405-414 in: Bacterial Wilt Disease and the Ralstonia solanacearum Species Complex. The American Phytopathological Society, St. Paul, MN, 2005.
    Matched MeSH terms: Incidence
  17. Landoni G, Lomivorotov VV, Nigro Neto C, Monaco F, Pasyuga VV, Bradic N, et al.
    N Engl J Med, 2019 03 28;380(13):1214-1225.
    PMID: 30888743 DOI: 10.1056/NEJMoa1816476
    BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG).

    METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year.

    RESULTS: A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P = 0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction.

    CONCLUSIONS: Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. (Funded by the Italian Ministry of Health; MYRIAD ClinicalTrials.gov number, NCT02105610.).

    Matched MeSH terms: Incidence
  18. Nasehi A, Kadir JB, Abidin MAZ, Wong MY, Mahmodi F
    Plant Dis, 2012 Aug;96(8):1226.
    PMID: 30727066 DOI: 10.1094/PDIS-03-12-0223-PDN
    In June 2011, tomatoes (Solanum lycopersicum) in major growing areas of the Cameron Highlands and the Johor state in Malaysia were affected by a leaf spot disease. Disease incidence exceeded 80% in some severely infected regions. Symptoms on 50 observed plants initially appeared on leaves as small, brownish black specks, which later became grayish brown, angular lesions surrounded by a yellow border. As the lesions matured, the affected leaves dried up and became brittle and later developed cracks in the center of the lesions. A survey was performed in these growing areas and 27 isolates of the pathogen were isolated from the tomato leaves on potato carrot agar (PCA). The isolates were purified by the single spore technique and were transferred onto PCA and V8 agar media for conidiophore and conidia production under alternating light (8 hours per day) and darkness (16 hours per day) (4). Colonies on PCA and V8 agar exhibited grey mycelium and numerous conidia were formed at the terminal end of conidiophores. The conidiophores were up to 240 μm long. Conidia were oblong with 2 to 11 transverse and 1 to 6 longitudinal septa and were 24 to 69.6 μm long × 9.6 to 14.4 μm wide. The pathogen was identified as Stemphylium solani on the basis of morphological criteria (2). In addition, DNA was extracted and the internal transcribed spacer region (ITS) was amplified by universal primers ITS5 and ITS4 (1). The PCR product was purified by the commercial PCR purification kit and the purified PCR product sequenced. The resulting sequences were 100% identical to published S. solani sequences (GenBank Accestion Nos. AF203451 and HQ840713). The amplified ITS region was deposited with NCBI GenBank under Accession No. JQ657726. A representative isolate of the pathogen was inoculated on detached 45-day-old tomato leaves of Malaysian cultivar 152177-A for pathogenicity testing. One wounded and two nonwounded leaflets per leaf were used in this experiment. The leaves were wounded by applying pressure to leaf blades with the serrated edge of a forceps. A 20-μl drop of conidial suspension containing 105 conidia/ml was used to inoculate these leaves (3). The inoculated leaves were placed on moist filter paper in petri dishes and incubated for 48 h at 25°C. Control leaves were inoculated with sterilized distilled water. After 7 days, typical symptoms for S. solani similar to those observed in the farmers' fields developed on both wounded and nonwounded inoculated leaves, but not on noninoculated controls, and S. solani was consistently reisolated. To our knowledge, this is the first report of S. solani causing gray leaf spot of tomato in Malaysia. References: (1) M. P. S. Camara et al. Mycologia 94:660, 2002. (2) B. S. Kim et al. Plant Pathol. J. 15:348, 1999. (3) B. M. Pryor and T. J. Michailides. Phytopathology 92:406, 2002. (4) E. G. Simmons. CBS Biodiversity Series 6:775, 2007.
    Matched MeSH terms: Incidence
  19. Abu Hassan MR, Aziz N, Ismail N, Shafie Z, Mayala B, Donohue RE, et al.
    PLoS Negl Trop Dis, 2019 03;13(3):e0007243.
    PMID: 30883550 DOI: 10.1371/journal.pntd.0007243
    BACKGROUND: Melioidosis, a fatal infectious disease caused by Burkholderia pseudomallei, is increasingly diagnosed in tropical regions. However, data on risk factors and the geographic epidemiology of the disease are still limited. Previous studies have also largely been based on the analysis of case series data. Here, we undertook a more definitive hospital-based matched case-control study coupled with spatial analysis to identify demographic, socioeconomic and landscape risk factors for bacteremic melioidosis in the Kedah region of northern Malaysia.

    METHODOLOGY/PRINCIPAL FINDINGS: We obtained patient demographic and residential information and clinical presentation and medical history data from 254 confirmed melioidosis cases and 384 matched controls attending Hospital Sultanah Bahiyah (HSB), the main tertiary hospital of Alor Setar, the capital city of Kedah, during the period between 2005 and 2011. Crude and adjusted odds ratios employing conditional logistic regression analysis were used to assess if melioidosis in this region is related to risk factors connected with socio-demographics, various behavioural characteristics, and co-occurring diseases. Spatial clusters of cases were determined using a continuous Poisson model as deployed in SaTScan. A land cover map in conjunction with mapped case data was used to determine disease-land type associations using the Fisher's exact test deploying simulated p-values. Crude and adjusted odds ratios indicate that melioidosis in this region is related to gender (males), race, occupation (farming) and co-occurring chronic diseases, particularly diabetes. Spatial analyses of disease incidence, however, showed that disease risk and geographic clustering of cases are related strongly to land cover types, with risk of disease increasing non-linearly with the degree of human modification of the natural ecosystem.

    CONCLUSIONS/SIGNIFICANCE: These findings indicate that melioidosis represents a complex socio-ecological public health problem in Kedah, and that its control requires an understanding and modification of the coupled human and natural variables that govern disease transmission in endemic communities.

    Matched MeSH terms: Incidence
  20. Yahya MJ, Ismail PB, Nordin NB, Akim ABM, Binti Md Yusuf WS, Adam NLB, et al.
    J Nutr Metab, 2019;2019:8736215.
    PMID: 30719346 DOI: 10.1155/2019/8736215
    Type 2 diabetes mellitus (T2DM) is associated with a high incidence of nephropathy. The aim of this study was to investigate the association of a genetic polymorphism of carnosinase (CNDP1-D18S880 and -rs2346061), endothelial nitric oxide synthase (NOS3-rs1799983), and manganese superoxide dismutase (MnSOD-rs4880) genes with the development of diabetic nephropathy among Malaysian type 2 diabetic patients. A case-control association study was performed using 652 T2DM patients comprising 227 Malays (without nephropathy = 96 and nephropathy = 131), 203 Chinese (without nephropathy = 95 and nephropathy = 108), and 222 Indians (without nephropathy = 136 and nephropathy = 86). DNA sequencing was performed for the D18S880 of CNDP1, while the rest were tested using DNA Sequenom MassARRAY to identify the polymorphisms. DNA was extracted from the secondary blood samples taken from the T2DM patients. The alleles and genotypes were tested using four genetic models, and the best mode of inheritance was chosen based on the least p value. The rs2346061 of CNDP1 was significantly associated with diabetic nephropathy among the Indians only with OR = 1.94 and 95% CI = (1.76-3.20) and fitted best the multiplicative model, while D18S880 was associated among all the three major races with the Malays having the strongest association with OR = 2.46 and 95% CI = (1.48-4.10), Chinese with OR = 2.26 and 95% CI = (1.34-3.83), and Indians with OR = 1.77 and 95% CI = (1.18-2.65) in the genotypic multiplicative model. The best mode of inheritance for both MnSOD and NOS3 was the additive model. For MnSOD-rs4880, the Chinese had OR = 2.8 and 95% CI = (0.53-14.94), Indians had OR = 2.4 and 95% CI = (0.69-2.84), and Malays had OR = 2.16 and 95% CI = (0.54-8.65), while for NOS3-rs1799983, the Indians had the highest risk with OR = 3.16 and 95% CI = (0.52-17.56), followed by the Chinese with OR = 3.55 and 95% CI = (0.36-35.03) and the Malays with OR = 2.89 and 95% CI = (0.29-28.32). The four oxidative stress-related polymorphisms have significant effects on the development of nephropathy in type 2 diabetes patients. The genes may, therefore, be considered as risk factors for Malaysian subjects who are predisposed to T2DM nephropathy.
    Matched MeSH terms: Incidence
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