Displaying publications 81 - 100 of 566 in total

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  1. Sam IC, Chua CL, Rovie-Ryan JJ, Fu JY, Tong C, Sitam FT, et al.
    Emerg Infect Dis, 2015 Sep;21(9):1683-5.
    PMID: 26291585 DOI: 10.3201/eid2109.150439
    Matched MeSH terms: Chikungunya Fever/epidemiology*; Chikungunya Fever/prevention & control; Chikungunya Fever/transmission
  2. Gupta V, Singla N, Bansal N, Kaistha N, Chander J
    Malays J Med Sci, 2013 Jul;20(4):71-5.
    PMID: 24043999
    BACKGROUND: The incidence of multidrug resistant enteric fever is increasing alarmingly. This study was planned to determine the rate of isolation of Salmonella spp. and to compare the isolates for their epidemiological parameters and antimicrobial susceptibility patterns at our center.

    METHODS: The study was conducted over a span of three years with a total of 8142, 8134, and 8114 blood culture samples processed for the years 2008, 2009, and 2010 respectively. The minimum inhibitory concentration (MIC) for ciprofloxacin and chloramphenicol was determined using an agar dilution method. The MIC for ciprofloxacin was also confirmed by Epsilon-test (E -test) strips.

    RESULTS: Of the total 302 Salmonella spp. isolated, 257 were Salmonella enterica serotype Typhi (85.1%) and 45 (14.9%) were S. enterica serotype Paratyphi A. The majority of the isolates recovered were from the pediatric age group (54.6%) and males (60.6%). Complete susceptibility was observed to chloramphenicol, cefotaxime, ceftriaxone, and azithromycin over the last two years (2009 and 2010), with an increase in resistance to nalidixic acid (100%) and ciprofloxacin (13.6%).

    CONCLUSION: In our study, we found augmentation of resistance to nalidixic acid and fluoroquinolones and complete sensitivity to ceftriaxone along with reemergence of chloramphenicol sensitivity for Salmonella isolates. This report emphasises the necessity of continuous surveillance of antibiograms of enteric fever isolates in an area.

    Matched MeSH terms: Typhoid Fever
  3. Wan Mansor, W.H., Hamizah, M.S., Wan Sulaili, W.S., Jeriah, I., Che Nok @ Nawi, I., Noraini, I., et al.
    MyJurnal
    On March 17, 2003 the Kelantan Health Department was notihed about a possible typhoid outbreak following a wedding party. An investigation was carried out to identiy the source and recommend control measures. Active case detection, yield investigation and case»control study were conducted. Cases were symptomatic attendees with a stool or blood culture positive for Salmonella
    typhii. Each control had a negative culture and denied symptoms. Of the more than 1 OOO guests, 477 experienced fever; 152 met the case definition. The party hostess was found to be an Salmonelb typhii carrier. Syrup prepared with untreated well water was identified as the most likely source for this outbreak, with an odds ratio 14.0 (95% C1: 2.9, 104.1). This was a common source
    outbreak of typhoid. We recommend that all food handlers at large parties be screened for typhoid and other foodborne diseases and samples of higherisk foods should be kept for few days after each event in case they are needed for testing.
    Matched MeSH terms: Typhoid Fever
  4. Guan HH, Yoshimura M, Chuankhayan P, Lin CC, Chen NC, Yang MC, et al.
    Sci Rep, 2015 Nov 13;5:16441.
    PMID: 26563565 DOI: 10.1038/srep16441
    ST50, an outer-membrane component of the multi-drug efflux system from Salmonella enterica serovar Typhi, is an obligatory diagnostic antigen for typhoid fever. ST50 is an excellent and unique diagnostic antigen with 95% specificity and 90% sensitivity and is used in the commercial diagnosis test kit (TYPHIDOT(TM)). The crystal structure of ST50 at a resolution of 2.98 Å reveals a trimer that forms an α-helical tunnel and a β-barrel transmembrane channel traversing the periplasmic space and outer membrane. Structural investigations suggest significant conformational variations in the extracellular loop regions, especially extracellular loop 2. This is the location of the most plausible antibody-binding domain that could be used to target the design of new antigenic epitopes for the development of better diagnostics or drugs for the treatment of typhoid fever. A molecule of the detergent n-octyl-β-D-glucoside is observed in the D-cage, which comprises three sets of Asp361 and Asp371 residues at the periplasmic entrance. These structural insights suggest a possible substrate transport mechanism in which the substrate first binds at the periplasmic entrance of ST50 and subsequently, via iris-like structural movements to open the periplasmic end, penetrates the periplasmic domain for efflux pumping of molecules, including poisonous metabolites or xenobiotics, for excretion outside the pathogen.
    Matched MeSH terms: Typhoid Fever/diagnosis; Typhoid Fever/microbiology*
  5. Lee ZS, Chin SY, Cheng CK
    Heliyon, 2019 Jun;5(6):e01792.
    PMID: 31245637 DOI: 10.1016/j.heliyon.2019.e01792
    This study evaluates the effects of subcritical hydrothermal treatment on palm oil mill effluent (POME) and its concomitant formations of solid hydrochar, liquid product and gaseous product. The reactions were carried out at temperatures ranged 493 K-533 K for 2 h. The highest reduction of chemical oxygen demand (COD) and biochemical oxygen demand (BOD) were 58.8% and 62.5%, respectively, at 533 K. In addition, the removal of total suspended solids (TSS) achieved up to 99%, with the pH of POME reaching 6 from the initial pH 4. The gas chromatography coupled with mass spectroscopy (GC-MS) analysis showed that the fresh POME contained n-Hexadecanoic acid as the dominant component, which gradually reduced in the liquid product in the reaction with increased temperature, in addition to the attenuation of carboxyl compounds and elevation of phenolic components. The gaseous products contained CO2, CO, H2, and C3 - C6 hydrocarbons. Traces of CH4 were only found at 533 K. CO2 is the dominant species, where the highest of 3.99 vol% per 500 mL working volume of POME recorded at 533 K. The solid hydrochars showed negligible morphological changes across the reaction temperature. The O/C atomic ratio of the hydrochar range from 0.157 to 0.379, while the H/C atomic ratio was in the range from 0.930 to 1.506. With the increase of treatment temperature, the higher heating value (HHV) of the hydrochar improved from 24.624 to 27.513 MJ kg-1. The characteristics of hydrochar make it a fuel source with immense potential. POME decomposed into water-soluble compounds, followed by deoxygenation (dehydration and decarboxylation) in producing hydrochar with lower oxygen content and higher aromatic compounds in the liquid product. Little gaseous hydrocarbons were produced due to subcritical hydrothermal gasification at low temperature.
    Matched MeSH terms: Fever
  6. Ng, Y.M., Cheng, J.T.
    JUMMEC, 2016;19(1):1-2.
    MyJurnal
    Typhoid fever is a systemic infection caused by Salmonella typhi, which may be associated with extra-intestinal
    complications. Neurological manifestations, particularly Parkinsonism, are rarely reported. We report a
    17-year-old patient with relapsed culture-proven Salmonella typhi infection who developed septic shock and
    subsequently Parkinsonism. Lumbar puncture revealed acellular cerebrospinal fluid with raised protein level.
    Magnetic resonance imaging revealed cerebral petechial haemorrhages resulted from small vessels vasculitis.
    His symptoms resolved spontaneously after 3 months.
    Matched MeSH terms: Typhoid Fever
  7. Cheong BM
    Med J Malaysia, 2008 Mar;63(1):77-8.
    PMID: 18935745 MyJurnal
    Typhoid fever being a systemic infection can present in a multitude of ways, involving various systems. Here we describe a case of typhoid fever presenting with acute cerebellar ataxia and marked thrombocytopenia. This atypical presentation is not common in typhoid fever and can lead to misdiagnosis as well as a delay in the initiation of appropriate therapy. Prompt clinical improvement and the return of platelet counts to normal were noted after the patient was started on IV Ceftriaxone.
    Matched MeSH terms: Typhoid Fever/complications*; Typhoid Fever/diagnosis
  8. Alice V, Cheong BM
    Med J Malaysia, 2016 02;71(1):41-3.
    PMID: 27130747
    A previously well 13-year-old boy presented with a short history of fever and altered mental status. His mother was admitted for dengue fever and there had been a recent dengue outbreak in their neighbourhood. He was diagnosed with dengue encephalitis as both his dengue non-structural protein 1 (NS-1) antigen and cerebrospinal fluid (CSF) dengue polymerase chain reaction (PCR) were positive. He did not have haemoconcentration, thrombocytopenia or any warning signs associated with severe dengue. He recovered fully with supportive treatment. This case highlights the importance of considering the diagnosis of dengue encephalitis in patients from dengue endemic areas presenting with an acute febrile illness and neurological symptoms.
    Matched MeSH terms: Fever
  9. Ng WW, Cheong BMK
    Med J Malaysia, 2021 03;76(2):261-263.
    PMID: 33742642
    A previously well 21-year-old girl presented to Hospital Teluk Intan, Perak, Malaysia with a short history of fever, vomiting and altered sensorium. She was diagnosed with dengue encephalitis as her dengue NS-1 antigen was positive and her cerebrospinal fluid (CSF) dengue polymerase chain reaction (PCR) was positive with serotype DENV-2. She also had severe hyponatremia due to Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) which caused an episode of seizure. She recovered well with supportive management. SIADH and dengue encephalitis should be considered as one of the differential diagnosis in patients presenting with fever and altered sensorium especially in dengue endemic countries like Malaysia.
    Matched MeSH terms: Fever
  10. Tan-Loh J, Cheong BMK
    Med J Malaysia, 2021 01;76(1):24-28.
    PMID: 33510104
    INTRODUCTION: COVID-19 is a highly transmissible respiratory virus that has affected millions of people worldwide in the span of months. The burden of disease among healthcare workers (HCW) has not been well studied despite reports of infectivity and transmission around the world. Two HCW in Hospital Teluk Intan (HTI) contracted COVID-19 while attending a social event. They were in close proximity with colleagues upon returning to work, resulting in the spread of infection among other HCW in HTI.

    OBJECTIVE: The objectives of this paper are to gain a better understanding of the key presenting symptoms of COVID-19 in HCWs in a district specialist hospital, to establish the proportion of symptomatic COVID-19 cases among HCWs and its severity and to determine the time taken from onset of symptoms or perceived exposure to diagnostic testing.

    METHODOLOGY: This is a retrospective descriptive analysis of clinical characteristics of subjects infected with COVID-19 among HCW in HTI. Their demography and clinical characteristics were recorded.

    RESULTS: There were 47 HCW in HTI who tested positive for COVID-19. The mean age of the patients was 37.5 years old. 7 patients (15.2%) had at least more than one comorbidity. Average duration of time from perceived close contact to onset of symptom was 4.5 days, while the mean duration of time from symptoms to first positive RT-PCR result was 3.4 days. Six patients (13.0%) were asymptomatic throughout, whereas 40 (87.0%) had at least one symptom prior to hospitalization. The most commonly reported symptoms were fever (65.2%), sore throat (39.1%) and cough (37.0%). In terms of severity of symptoms, the majority of patients experienced mild symptoms (Group 2, 52.2%). Two patients (4.3%) with multiple comorbidities had severe disease requiring ICU admission and mechanical ventilation. There were no mortalities, and the longest staying patient was hospitalized for 18 days. The high rates of infectivity among HCW in HTI can be attributed to working in close proximity while in the asymptomatic incubation phase, while no HCW directly involved in the care of COVID-19 positive patients were tested positive.

    CONCLUSION: We report that HCW share similar clinical characteristics of COVID-19 infection as those of non HCW patients in earlier studies. The infection can spread rapidly within healthcare settings via close contacts among infected HCWs. As such, we advocate distancing when working and usage of personal protective equipment when treating patients with respiratory illness to reduce transmission of COVID-19.

    Matched MeSH terms: Fever/virology
  11. Fadilah SA, Raymond AA, Leong CF, Cheong SK
    Med J Malaysia, 2006 Mar;61(1):91-3.
    PMID: 16708741
    Haemophagocytic syndrome (HPS) should be included in the differential diagnosis of pyrexia of unknown origin (PUO). The hallmark of HPS is the accumulation of activated macrophages that engulf haematopoietic cells in the reticuloendothelial system. We describe a patient with unexplained fever in which a final diagnosis of HPS was established in a bone marrow study.
    Matched MeSH terms: Fever of Unknown Origin/diagnosis*; Fever of Unknown Origin/physiopathology
  12. Cheong WH
    Med J Malaya, 1966 Jun;20(4):329-31.
    PMID: 4224347
    Matched MeSH terms: Yellow Fever/prevention & control
  13. Koay AS, Jegathesan M, Rohani MY, Cheong YM
    PMID: 9322288
    Strains of Salmonella typhi implicated in two separate cases of laboratory acquired infection from patients and the medical laboratory technologists who processed the patients' samples were analysed by pulsed-field gel electrophoresis. Although all four isolates were of bacteriophage type E1, PFGE was able to demonstrate that the strains responsible for the two laboratory acquired cases were not genetically related. The PFGE patterns of the isolates from the MLTs were found to be identical to those of the corresponding patients after digestion with restriction enzyme AvrII. This provided genetic as well as epidemiological evidence for the source of the laboratory acquired infections.
    Matched MeSH terms: Typhoid Fever/diagnosis; Typhoid Fever/microbiology; Typhoid Fever/epidemiology*
  14. Tong SF, Aziz NA, Chin GL
    Medicine & Health, 2006;1(1):25-30.
    MyJurnal
    A proportion of patients with acute viral fever with thrombocytopaenia does not necessary have dengue infection. Managing them indiscriminately as dengue infection may not be appropriate. The prevalence of this problem is not exactly known. The objective of this study is to determine the prevalence of acute non-dengue febrile thrombocytopaenia among adult patients presenting with acute non-specific febrile illness in an outpatient setting. This was a clinic-based cross sectional study. Consecutive patients presenting with non-specific febrile illness of less than two weeks were selected from the Primary Care Centre of Hospital Universiti Kebangsaan Malaysia (HUKM) and the Batu 9 Cheras Health Clinic. Full blood count was done on the day of visit and dengue serology was done on day five of illness for all patients enrolled. Seventy three patients participated in this study from May to November 2003. Among the patients, 35 (47.9%) were noted to have thrombocytopaenia. Fourteen (40%) patients with thrombocytopaenia were serologically negative. The prevalence of non-dengue febrile thrombocytopaenia was 19.2%. A significant number of patients with acute non-specific febrile illness with thrombocytopaenia were negative for dengue serology. These patients should be differentiated from those with acute febrile thrombocytopaenia, as they might differ in their natural history from those with dengue infection, and hence require different management strategies.

    Study site: Primary Care Centre of Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
    Matched MeSH terms: Fever
  15. Tan J. Y. S., R. Surendran, Mohd Noh Malehah, Shaila Kabir, Chong Y. Y. Eleen
    MyJurnal
    Introduction: Ascariasis is a parasitic infection, which commonly affects immunocompromised patients. Most pa-tients remained asymptomatic during the early larval migration stage and respond well with conventional anti-hel-minthic drugs. Previous literature had reported symptomatic Ascaris infection mimicking bacterial pneumonia and the typical eosinophilia found in Loeffler syndrome was absent in patients on corticosteroids. Thus, a high index of suspicion for ascariasis is needed for immunosuppressed patients presented with infection. We present here a case of severe ascariasis infection in a systemic lupus erythematosus patient. Case description: A 16-year-old boy presented with fever, generalized maculopapular rash associated with neutropenia and thrombocytopenia. He was treated initially as Dengue Fever initially. However his symptoms did not resolve at even day 14 of admission. On further assessment, we were convinced he has SLE based upon presence of malar rash, oral ulcers, urinary protein-uria, persistent leucopenia, thrombocytopenia with low complements and ANA positive. He was promptly started on IV hydrocortisone. He showed a good progress in the first few days. On day 5 of admission, he coughed out a round worm which later identified as Ascarisis lumbricoides. He was started on Albendazole. Unfortunately he developed hemoptysis and respiratory compromisation where he required intubation. Post intubation he went into cardiac arrest, which required CPR. Following that event, his condition further deteriorated with multi organ failure. He succumbed to his illness three days later. Conclusion: Immunocompromised patients are prone to opportunistic infections including parasitic infections. we present here a case of ascariasis in an SLE patient who unfortunately succumbed to the illness. Due to the variable clinical symptoms that mimic other infections, screening for parasitic infections needs to be considered especially if the patients do not respond to antibiotics and routine treatments.
    Matched MeSH terms: Fever
  16. Ismail R, Teh LK, Choo EK
    Ann Trop Paediatr, 1998 Jun;18(2):123-8.
    PMID: 9924573
    Despite concerns about adverse effects, chloramphenicol (CMC) continues to be used in certain situations and, due to its low therapeutic index and variable pharmacokinetics, therapeutic drug monitoring (TDM) is often recommended. At our centre, CMC finds applications in typhoid and meningitis and TDM is routinely performed. Elsewhere in Malaysia, however, CMC is used without TDM. We therefore decided to evaluate our TDM for CMC in relation to its roles in CMC therapy in children, who constitute most of our patients. Our objective was also to develop strategies to improve our TDM for CMC use. Data were collected from 168 children given CMC for various indications and monitored by the TDM service. Plasma CMC was determined by HPLC and used to adjust doses to maintain concentrations within a range of 10-25 micrograms/ml. Outcomes measured included daily temperatures and haematological indices. Daily doses and plasma CMC varied greatly. Doses averaged 40.5 mg/kg for neonates and 75.5 for older children. Average peak concentrations were therapeutic in 60% and trough in 42%. Average duration of fever was 6.3 days and it was unaffected by plasma CMC. Typhoid was eradicated in 97% but nine children with other diagnoses died. Side-effects were confined to mild reversible haematological abnormalities which developed in 11% of children at plasma concentrations which tended to be high. We conclude that CMC remains useful in children with typhoid. Its use for other indications, however, should be reviewed. Routine TDM for CMC is probably not warranted, at least until a clearer role is defined by well designed prospective studies.
    Matched MeSH terms: Typhoid Fever/blood; Typhoid Fever/drug therapy*
  17. Fathilah J, Choo MM
    Med J Malaysia, 2003 Aug;58(3):437-9.
    PMID: 14750386
    A patient with ocular syphilis is presented. She experienced deterioration in vision following the commencement of treatment due to a Jarisch-Herxheimer reaction. This is a transient febrile illness that can occur in patients after the first adequate dose of an anti-microbial drug to treat infectious diseases such as syphilis, Lyme disease and relapsing fever. However, a Jarisch-Herxheimer reaction occurring in a patient receiving treatment for ocular syphilis can be serious, resulting in the rapid loss of vision.
    Matched MeSH terms: Fever/chemically induced*
  18. Tan SF, Chong CP, Chooi WT
    MyJurnal
    An assessment on the use of acetaminophen (paracetamol) among consumers would
    provide guidance for implementing strategies to overcome the misuse of acetaminophencontaining
    products. This study aims to evaluate Malaysian consumers’ practices,
    perceptions and understanding regarding the use of acetaminophen. A semi-structured
    qualitative study utilising face-to-face interviews was conducted among 14 consumers
    aged 24 to 82 years old who live in Pulau Pinang, Malaysia. Transcripts of all the
    interviews were generated from audio tapes and were analysed for the issues and themes
    emerging from the text; the transcripts were independently coded and verified by experts.
    The consumers had a positive attitude towards the popularity, safety and efficacy of
    acetaminophen. The consumers predominantly used acetaminophen for pain and fever.
    Some consumers tended to increase the frequency and dosage of acetaminophen
    consumption if their condition persisted. Consumers had difficulty recognising the generic
    acetaminophen-containing products available in the market. Health literacy investigations
    have found that consumers have a lack of knowledge regarding the correct dosing
    regimen for acetaminophen in adults and children. The consumers were not aware of the
    precautions and toxicities of acetaminophen. To increase awareness of acetaminophen
    poisoning in Malaysia, the consumers suggested that educational tools regarding the
    proper use of acetaminophen are needed from the Ministry of Health and policy-makers.
    The information gained from this study emphasises the importance of educational
    interventions to educate the public on the proper use of acetaminophen in Malaysia.
    Matched MeSH terms: Fever
  19. Leong SW, Lim TS, Ismail A, Choong YS
    J. Mol. Recognit., 2018 05;31(5):e2695.
    PMID: 29230887 DOI: 10.1002/jmr.2695
    With the development of de novo binders for protein targets from non-related scaffolds, many possibilities for therapeutics and diagnostics have been created. In this study, we described the use of de novo design approach to create single-chain fragment variable (scFv) for Salmonella enterica subspecies enterica serovar Typhi TolC protein. Typhoid fever is a global health concern in developing and underdeveloped countries. Rapid typhoid diagnostics will improve disease management and therapy. In this work, molecular dynamics simulation was first performed on a homology model of TolC protein in POPE membrane bilayer to obtain the central structure that was subsequently used as the target for scFv design. Potential hotspot residues capable of anchoring the binders to the target were identified by docking "disembodied" amino acid residues against TolC surface. Next, scFv scaffolds were selected from Protein Data Bank to harbor the computed hotspot residues. The hotspot residues were then incorporated into the scFv scaffold complementarity determining regions. The designs recapitulated binding energy, shape complementarity, and interface surface area of natural protein-antibody interfaces. This approach has yielded 5 designs with high binding affinity against TolC that may be beneficial for the future development of antigen-based detection agents for typhoid diagnostics.
    Matched MeSH terms: Typhoid Fever/diagnosis
  20. Mustafa B, Hani AW, Chem YK, Mariam M, Khairul AH, Abdul Rasid K, et al.
    Med J Malaysia, 2010 Dec;65(4):291-6.
    PMID: 21901948
    Classical dengue fever is characterized by the clinical features of fever, headache, severe myalgia and occasionally rash, which can also be caused by a number of other viral and bacterial infections. Five hundred and fifty eight patients who fulfilled the criteria of clinical diagnosis of acute dengue from 4 government outpatient polyclinics were recruited in this prospective field study. Of the 558 patients, 190 patients were categorized as acute dengue fever, 86 as recent dengue and 282 as non-dengue febrile illnesses based on the results of a number of laboratory tests. Epidemiological features of febrile patients showed that the mean age of patients in the dengue fever group was significantly younger in comparison with patients in the non-dengue group. There was no significant difference between the two groups with respect to gender but there was significant ethnic difference with foreign workers representing a higher proportion in the dengue fever group. Patients with acute dengue fever were more likely to have patient-reported rash and a history of dengue in family or neighbourhood but less likely to have respiratory symptoms, sore-throat and jaundice in comparison to patients with non-dengue febrile illnesses. As with patients with dengue fever, patients in the recent dengue group were more likely to have history of patient-reported rash and a history of dengue contact and less likely to have respiratory symptoms in comparison to patients with non-dengue febrile illnesses. In contrast to patients with dengue fever, patients in the recent dengue group were more likely to have abdominal pain and jaundice in comparison to non-dengue febrile patients. The finding strongly suggests that a proportion of patients in the recent dengue group may actually represent a subset of patients with acute dengue fever at the late stage of illness.
    Study site: Klinik Kesihatan Seksyen 7, Shah Alam; Klinik Kesihatan Kelana Jaya, Petaling Jaya; Klinik Kesihatan Sg. Buloh; Klinik Kesihatan Jinjang, Selangor, Kuala Lumpur, Malaysia
    Matched MeSH terms: Fever/epidemiology*
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