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Siphoning diesel: a fatal mistake

Leong WC, Cheong BM

Med J Malaysia, 2017 10;72(5):314-315.
PMID: 29197890 MyJurnal

Diesel is commonly used as fuel for engines and is distilled from petroleum. Diesel has toxic potential and can affect multiple organs. Exposure can occur after ingestion, inhalation or through the dermal route. The practice of siphoning diesel using a rubber tubing and the mouth is common in rural communities. This can lead to accidental ingestion and aspiration. Here we report a case of a patient who accidentally ingested diesel during siphoning, which caused extensive erosion of the oral cavity and oesophagus leading to pneumomediastinum and severe chemical lung injury. The patient responded well initially to steroids and supportive care but required prolonged hospitalisation. He developed complications of nosocomial infection and succumbed 23 days after admission.

Matched MeSH terms: Pneumonia/chemically induced; Pneumonia/diagnosis; Pneumonia/drug therapy
Necrotising pneumonia: A pneumonia that may need surgical intervention

Ooi SY, Lee SW

Med J Malaysia, 2017 12;72(6):367-369.
PMID: 29308776 MyJurnal

Pneumonia is primarily a disease that is usually managed medically with antibiotics. However, in rare cases it may progress to necrotising pneumonia, which is an uncommon but severe complication of bacterial pneumonia. This case illustrates a typical case of necrotising pneumonia complicated with parenchymal and pleural complication such as empyema, pneumothorax with possible bronchopleural fistula. Early consultation with thoracic surgeon can be life-saving.

Matched MeSH terms: Pneumonia, Necrotizing/drug therapy*; Pneumonia, Necrotizing/physiopathology*; Pneumonia, Necrotizing/diagnostic imaging
Fulltext Modelling the Effectiveness of Epidemic Control Measures in Preventing the Transmission of COVID-19 in Malaysia

Gill BS, Jayaraj VJ, Singh S, Mohd Ghazali S, Cheong YL, Md Iderus NH, et al.

Int J Environ Res Public Health, 2020 Jul 30;17(15).
PMID: 32751669 DOI: 10.3390/ijerph17155509

Malaysia is currently facing an outbreak of COVID-19. We aim to present the first study in Malaysia to report the reproduction numbers and develop a mathematical model forecasting COVID-19 transmission by including isolation, quarantine, and movement control measures. We utilized a susceptible, exposed, infectious, and recovered (SEIR) model by incorporating isolation, quarantine, and movement control order (MCO) taken in Malaysia. The simulations were fitted into the Malaysian COVID-19 active case numbers, allowing approximation of parameters consisting of probability of transmission per contact (β), average number of contacts per day per case (ζ), and proportion of close-contact traced per day (q). The effective reproduction number (Rt) was also determined through this model. Our model calibration estimated that (β), (ζ), and (q) were 0.052, 25 persons, and 0.23, respectively. The (Rt) was estimated to be 1.68. MCO measures reduce the peak number of active COVID-19 cases by 99.1% and reduce (ζ) from 25 (pre-MCO) to 7 (during MCO). The flattening of the epidemic curve was also observed with the implementation of these control measures. We conclude that isolation, quarantine, and MCO measures are essential to break the transmission of COVID-19 in Malaysia.

Matched MeSH terms: Pneumonia, Viral/epidemiology; Pneumonia, Viral/prevention & control*; Pneumonia, Viral/virology
Fulltext Reproductive number of coronavirus: A systematic review and meta-analysis based on global level evidence

Billah MA, Miah MM, Khan MN

PLoS One, 2020;15(11):e0242128.
PMID: 33175914 DOI: 10.1371/journal.pone.0242128

BACKGROUND: The coronavirus (SARS-COV-2) is now a global concern because of its higher transmission capacity and associated adverse consequences including death. The reproductive number of coronavirus provides an estimate of the possible extent of the transmission. This study aims to provide a summary reproductive number of coronavirus based on available global level evidence.
METHODS: A total of three databases were searched on September 15, 2020: PubMed, Web of Science, and Science Direct. The searches were conducted using a pre-specified search strategy to record studies reported the reproductive number of coronavirus from its inception in December 2019. It includes keywords of coronavirus and its reproductive number, which were combined using the Boolean operators (AND, OR). Based on the included studies, we estimated a summary reproductive number by using the meta-analysis. We used narrative synthesis to explain the results of the studies where the reproductive number was reported, however, were not possible to include in the meta-analysis because of the lack of data (mostly due to confidence interval was not reported).
RESULTS: Total of 42 studies included in this review whereas 29 of them were included in the meta-analysis. The estimated summary reproductive number was 2.87 (95% CI, 2.39-3.44). We found evidence of very high heterogeneity (99.5%) of the reproductive number reported in the included studies. Our sub-group analysis was found the significant variations of reproductive number across the country for which it was estimated, method and model that were used to estimate the reproductive number, number of case that was considered to estimate the reproductive number, and the type of reproductive number that was estimated. The highest reproductive number was reported for the Diamond Princess Cruise Ship in Japan (14.8). In the country-level, the higher reproductive number was reported for France (R, 6.32, 95% CI, 5.72-6.99) following Germany (R, 6.07, 95% CI, 5.51-6.69) and Spain (R, 3.56, 95% CI, 1.62-7.82). The higher reproductive number was reported if it was estimated by using the Markov Chain Monte Carlo method (MCMC) method and the Epidemic curve model. We also reported significant heterogeneity of the type of reproductive number- a high-value reported if it was the time-dependent reproductive number.
CONCLUSION: The estimated summary reproductive number indicates an exponential increase of coronavirus infection in the coming days. Comprehensive policies and programs are important to reduce new infections as well as the associated adverse consequences including death.

Matched MeSH terms: Pneumonia, Viral/epidemiology*; Pneumonia, Viral/transmission; Pneumonia, Viral/virology
Fulltext Perceived Threat of COVID-19 Contagion and Frontline Paramedics' Agonistic Behaviour: Employing a Stressor-Strain-Outcome Perspective

Shahzad F, Du J, Khan I, Fateh A, Shahbaz M, Abbas A, et al.

Int J Environ Res Public Health, 2020 Jul 15;17(14).
PMID: 32679748 DOI: 10.3390/ijerph17145102

Historically, infectious diseases have been the leading cause of human psychosomatic strain and death tolls. This research investigated the recent threat of COVID-19 contagion, especially its impact among frontline paramedics treating patients with COVID-19, and their perception of self-infection, which ultimately increases their agonistic behaviour. Based on the stressor-strain-outcome paradigm, a research model was proposed and investigated using survey-based data through a structured questionnaire. The results found that the perceived threat of COVID-19 contagion (emotional and cognitive threat) was positively correlated with physiological anxiety, depression, and emotional exhaustion, which led toward agonistic behaviour. Further, perceived social support was a key moderator that negatively affected the relationships between agonistic behaviour and physiological anxiety, depression, and emotional exhaustion. These findings significantly contributed to the current literature concerning COVID-19 and pandemic-related effects on human behaviour. This study also theorized the concept of human agonistic behaviour, which has key implications for future researchers.

Matched MeSH terms: Pneumonia, Viral/psychology; Pneumonia, Viral/transmission*; Pneumonia, Viral/virology
Fulltext Application of deep learning technique to manage COVID-19 in routine clinical practice using CT images: Results of 10 convolutional neural networks

Ardakani AA, Kanafi AR, Acharya UR, Khadem N, Mohammadi A

Comput Biol Med, 2020 Jun;121:103795.
PMID: 32568676 DOI: 10.1016/j.compbiomed.2020.103795

Fast diagnostic methods can control and prevent the spread of pandemic diseases like coronavirus disease 2019 (COVID-19) and assist physicians to better manage patients in high workload conditions. Although a laboratory test is the current routine diagnostic tool, it is time-consuming, imposing a high cost and requiring a well-equipped laboratory for analysis. Computed tomography (CT) has thus far become a fast method to diagnose patients with COVID-19. However, the performance of radiologists in diagnosis of COVID-19 was moderate. Accordingly, additional investigations are needed to improve the performance in diagnosing COVID-19. In this study is suggested a rapid and valid method for COVID-19 diagnosis using an artificial intelligence technique based. 1020 CT slices from 108 patients with laboratory proven COVID-19 (the COVID-19 group) and 86 patients with other atypical and viral pneumonia diseases (the non-COVID-19 group) were included. Ten well-known convolutional neural networks were used to distinguish infection of COVID-19 from non-COVID-19 groups: AlexNet, VGG-16, VGG-19, SqueezeNet, GoogleNet, MobileNet-V2, ResNet-18, ResNet-50, ResNet-101, and Xception. Among all networks, the best performance was achieved by ResNet-101 and Xception. ResNet-101 could distinguish COVID-19 from non-COVID-19 cases with an AUC of 0.994 (sensitivity, 100%; specificity, 99.02%; accuracy, 99.51%). Xception achieved an AUC of 0.994 (sensitivity, 98.04%; specificity, 100%; accuracy, 99.02%). However, the performance of the radiologist was moderate with an AUC of 0.873 (sensitivity, 89.21%; specificity, 83.33%; accuracy, 86.27%). ResNet-101 can be considered as a high sensitivity model to characterize and diagnose COVID-19 infections, and can be used as an adjuvant tool in radiology departments.

Matched MeSH terms: Pneumonia/diagnosis; Pneumonia, Viral/diagnosis*
Fulltext Impact of complete lockdown on total infection and death rates: A hierarchical cluster analysis

Ghosal S, Bhattacharyya R, Majumder M

Diabetes Metab Syndr, 2020;14(4):707-711.
PMID: 32426062 DOI: 10.1016/j.dsx.2020.05.026

INTRODUCTION AND AIMS: Retarding the spread of SARS-CoV-2 infection by preventive strategies is the first line of management. Several countries have declared a stringent lockdown in order to enforce social distancing and prevent the spread of infection. This analysis was conducted in an attempt to understand the impact of lockdown on infection and death rates over a period of time in countries with declared lock-down.
MATERIAL AND METHODS: A validated database was used to generate data related to countries with declared lockdown. Simple regression analysis was conducted to assess the rate of change in infection and death rates. Subsequently, a k-means and hierarchical cluster analysis was done to identify the countries that performed similarly. Sweden and South Korea were included as counties without lockdown in a second-phase cluster analysis.
RESULTS: There was a significant 61% and 43% reduction in infection rates 1-week post lockdown in the overall and India cohorts, respectively, supporting its effectiveness. Countries with higher baseline infections and deaths (Spain, Germany, Italy, UK, and France-cluster 1) fared poorly compared to those who declared lockdown early on (Belgium, Austria, New Zealand, India, Hungary, Poland and Malaysia-cluster 2). Sweden and South Korea, countries without lock-down, fared as good as the countries in cluster 2.
CONCLUSION: Lockdown has proven to be an effective strategy is slowing down the SARS-CoV-2 disease progression (infection rate and death) exponentially. The success story of non-lock-down countries (Sweden and South Korea) need to be explored in detail, to identify the variables responsible for the positive results.

Matched MeSH terms: Pneumonia, Viral/mortality*; Pneumonia, Viral/epidemiology; Pneumonia, Viral/prevention & control*; Pneumonia, Viral/transmission
Fulltext Factors Associated with the Perception of Risk and Knowledge of Contracting the SARS-Cov-2 among Adults in Bangladesh: Analysis of Online Surveys

Abir T, Kalimullah NA, Osuagwu UL, Yazdani DMN, Mamun AA, Husain T, et al.

Int J Environ Res Public Health, 2020 Jul 21;17(14).
PMID: 32708161 DOI: 10.3390/ijerph17145252

This study investigated the perception and awareness of risk among adult participants in Bangladesh about Coronavirus Disease 2019 (COVID-19). During the lockdown era in Bangladesh at two different time points, from 26-31 March 2020 (early lockdown) and 11-16 May 2020 (late lockdown), two self-administered online surveys were conducted on 1005 respondents (322 and 683 participants, respectively) via social media. To examine risk perception and knowledge-related factors towards COVID-19, univariate and multiple linear regression models were employed. Scores of mean knowledge (8.4 vs. 8.1, p = 0.022) and perception of risk (11.2 vs. 10.6, p < 0.001) differed significantly between early and late lockdown. There was a significant decrease in perceived risk scores for contracting SARS-Cov-2 [β = -0.85, 95%CI: -1.31, -0.39], while knowledge about SARS-Cov-2 decreased insignificantly [β = -0.22, 95%CI: -0.46, 0.03] in late lockdown compared with early lockdown period. Self-quarantine was a common factor linked to increased perceived risks and knowledge of SARS-Cov-2 during the lockdown period. Any effort to increase public awareness and comprehension of SARS-Cov-2 in Bangladesh will then offer preference to males, who did not practice self-quarantine and are less worried about the propagation of this kind of virus.

Matched MeSH terms: Pneumonia, Viral/epidemiology; Pneumonia, Viral/psychology*; Pneumonia, Viral/transmission; Pneumonia, Viral/virology
Mycobacterium brisbanense species nova isolated from a patient with chronic cavitary lung infection

Poh ME, Liam CK, Ng KP, Tan R

Chest, 2014 Apr;145(4):858-860.
PMID: 24687707 DOI: 10.1378/chest.13-1952

We describe the first case, to our knowledge, of Mycobacterium brisbanense species nova with the type strain W6743T (=ATCC 49938T=DSM 44680T) isolated from the lungs of a man with a 6-month history of productive cough and intermittent fever presenting with acute hypoglycemia. A CT scan of the thorax revealed multiple small nodules and consolidation over both lungs with cavitation. Sputum culture repeatedly grew M brisbanense species nova, a novel species never before isolated in Malaysia. The case met the American Thoracic Society criteria for the diagnosis of nontuberculous mycobacterial infection. There was dramatic clinical and radiologic response to treatment with an empirical combination of rifampicin, ethambutol, and levofloxacin and subsequently clarithromycin and levofloxacin once sensitivity was known. This report is the first, to our knowledge, of the pathogen isolated in a patient with chronic cavitary lung infection since it was first identified from an antral sinus in Brisbane, Queensland, Australia, and the first time it is isolated from a human subject in Malaysia.

Matched MeSH terms: Pneumonia, Bacterial/microbiology*
Fulltext First detected human bocavirus in a Malaysian child with pneumonia and pre-existing asthma: a case report

Etemadi MR, Jalilian FA, Abd Wahab N, Jahanshiri F, Amini R, Othman N, et al.

Med J Malaysia, 2012 Aug;67(4):433-4.
PMID: 23082460 MyJurnal

Human bocavirus (HBoV) is a newly discovered parvovirus associated with respiratory disease in children. There are many reports worldwide on the endemicity of this virus. Since it is relatively new, detection in clinical laboratories is not routinely performed. We describe the first detection of HBoV in Malaysia in a 13-month-old boy with pneumonia and underlying asthma. The infective agent was confirmed by molecular methods.

Matched MeSH terms: Pneumonia, Viral/virology*
A discrimination method for the detection of pneumonia using chest radiograph

Noor NM, Rijal OM, Yunus A, Abu-Bakar SA

Comput Med Imaging Graph, 2010 Mar;34(2):160-6.
PMID: 19758785 DOI: 10.1016/j.compmedimag.2009.08.005

This paper presents a statistical method for the detection of lobar pneumonia when using digitized chest X-ray films. Each region of interest was represented by a vector of wavelet texture measures which is then multiplied by the orthogonal matrix Q(2). The first two elements of the transformed vectors were shown to have a bivariate normal distribution. Misclassification probabilities were estimated using probability ellipsoids and discriminant functions. The result of this study recommends the detection of pneumonia by constructing probability ellipsoids or discriminant function using maximum energy and maximum column sum energy texture measures where misclassification probabilities were less than 0.15.

Matched MeSH terms: Pneumonia/diagnosis*
Fulltext A 'target' skin lesion

Loh KY

Aust Fam Physician, 2008 Nov;37(11):946.
PMID: 19037470

A boy, 12 years of age, was being treated for pneumonia. The cold haemagglutination test was positive for Mycoplasma pneumoniae. He developed an isolated asymptomatic skin lesion on his lower limb which disappeared completely after 1 week.

Matched MeSH terms: Pneumonia, Mycoplasma/diagnosis
Critical care nurses' knowledge in preventing nosocomial pneumonia

Soh KL, Koziol-Mclain J, Wilson J, Soh KG

Aust J Adv Nurs, 2007 Mar-May;24(3):19-25.
PMID: 17518161

The purpose of this study was to identify knowledge deficits concerning nosocomial pneumonia (NP) prevention among critical care nurses. The study also determined whether NP knowledge was associated with nurse characteristics.

Matched MeSH terms: Pneumonia/prevention & control*
RSV and bronchiolitis

Van Rostenberghe HL, Kew ST, Hanifah MJ

Arch. Dis. Child. Fetal Neonatal Ed., 2006 Mar;91(2):F154.
PMID: 16492958
Matched MeSH terms: Pneumonia, Viral/epidemiology
Viral aetiology of lower respiratory tract infection in young Malaysian children

Chan PW, Goh AY, Chua KB, Kharullah NS, Hooi PS

J Paediatr Child Health, 1999 Jun;35(3):287-90.
PMID: 10404452

OBJECTIVE: To study the viral aetiology of lower respiratory tract infection (LRTI) in young Malaysian children.
METHODOLOGY: A retrospective review was performed of LRTI patients aged less than 24 months who were admitted to the University Malaya Medical Centre between 1982 and 1997. Respiratory viruses in their nasopharyngeal secretion were identified by indirect immunofluorescence, viral culture, or both.
RESULTS: A total of 5691 children were included in the study. The mean age was 8.6 +/- 6.6 months and the M:F ratio was 1.6:1. The most common diagnosis was pneumonia (52%) followed by bronchiolitis (45%) and croup (2%). Positive viral isolation rate was 22.0%. Respiratory syncytial virus (RSV) was the commonest virus isolated (84%), followed by parainfluenza virus (8%), influenza virus (6%) and adenovirus (2%). Patients with positive virus isolation were younger (7.8 +/- 6.2 vs 8.7 +/- 6.7 months, P = 0.0001) and were more likely to have bronchiolitis.
CONCLUSION: Young Malaysian children admitted with LRTI had a 22% viral isolation rate and RSV was the commonest virus isolated.

Matched MeSH terms: Pneumonia, Viral/epidemiology*
Fulltext Pulmonary involvement by Hodgkin's disease mimicking pneumonia

Liam CK, Wong KT, Lim YC

Med J Malaysia, 1997 Mar;52(1):84-6.
PMID: 10968059

A 24-year-old man who was initially thought to have nocardiosis of his mediastinal lymph node which progressed to involve his right lung, had to undergo a right pneumonectomy when he failed to respond to treatment with sulphadiazine. Histology of the right lung specimen and a subsequent axillary lymph node biopsy revealed that he actually had lymphocyte-depleted Hodgkin's disease.

Matched MeSH terms: Pneumonia/etiology*
The first isolate of Mycoplasma pneumoniae in Malaysia

Cheong YM, Jegathesan M, Singh M, Wong S, Ong L

Malays J Pathol, 1985 Aug;7:51-2.
PMID: 3939616
Matched MeSH terms: Pneumonia, Mycoplasma/diagnosis
Pneumococcal infection in hospitalized patients: a four-year study in Malaysia

Jamal F, Pit S, Isahak I, Abdullah N, Zainal Z, Abdullah R, et al.

Southeast Asian J. Trop. Med. Public Health, 1987 Mar;18(1):79-84.
PMID: 3660072

A total of 90 cases of pneumococcal infections were identified at a major referral hospital in Kuala Lumpur, Malaysia during a study period of four years. Pneumonia was the most common clinical presentation (41 cases) followed by meningitis (19 cases). Of 48 patients who were followed-up during the microbiology consultation round, 11 died, 9 were children below two years old. Capsular typing was carried out on 57 strains of Streptococcus pneumoniae isolated from blood and body fluids of 43 children and 14 adults. 38 strains isolated from pharyngeal specimens were also typed. Types 6A (11 strains), 6B (7 strains), 14 (8 strains) and 19A (8 strains) predominated in children. The strains from older patients comprised 3 isolates from cerebrospinal fluid (types 18B, 6B and 14), five from blood (4 strains, type 1 and 1 strain, type 4) and six from pus (1 strain, type 14, 3 strains type 23F and 2 strains type 34). The isolates from pharyngeal specimens belonged to capsular type similar to those implicated in infections. 90% of the types reported in this study are included in the 23 valent pneumococcal vaccines. Minimum inhibitory concentrations of penicillin, cefuroxime, chloramphenicol and rifampicin were determined for selected strains. 4.1% of isolates were resistant to penicillin (3/74), 4.5% to cefuroxime (2/44), 6.5% to chloramphenicol (3/46) and 14.6% to rifampicin (6/41).

Matched MeSH terms: Pneumonia/microbiology
Fulltext The acquired immune deficiency syndrome: a report of the first case in Malaysia

Goh KL, Chua CT, Chiew IS, Soo-Hoo TS

Med J Malaysia, 1987 Mar;42(1):58-60.
PMID: 3501533

The acquired immune deficiency syndrome (AIDS) requires no further introduction. Since 1981, when the AIDS was first recognized in the United States, much interest, anxiety and fear have been generated among people all over the world. It has spread inexorably in the United States, Europe and Africa such that the World Health Organization has warned of the beginning of a worldwide epidemic of AIDS. Asia has been relatively spared; nonetheless cases have been reported from Thailand, India, Taiwan, China and Japan.' Malaysia has anticipated the appearance of the disease; an AI DS task force under the auspices of the Ministry of Health was established in early 1986. However, it is only a year later that we now report the first case of AIDS in this country.

Matched MeSH terms: Pneumonia, Pneumocystis/diagnosis
Fulltext A University-Wide Preparedness Effort in the Alert Phase of COVID-19 Incorporating Community Mental Health and Task-Shifting Strategies: Experience from a Bornean Institute of Higher Learning

Mukhsam MH, Jeffree MS, Pang NTP, Syed Abdul Rahim SS, Omar A, Abdullah MS, et al.

Am J Trop Med Hyg, 2020 Sep;103(3):1201-1203.
PMID: 32705977 DOI: 10.4269/ajtmh.20-0458

The COVID-19 pandemic caught the world by surprise, causing millions of confirmed cases and hundreds of thousands of deaths. Hence, the Malaysian government announced a Movement Control Order at the start of the containment phase to flatten the epidemiological curve. Universiti Malaysia Sabah (UMS), a public university in Borneo, was accelerated into alert phase because of high risk of case importation from more than 400 China incoming undergraduates. Measures to mitigate the potential COVID-19 outbreaks in its population were taken by using conventional public health measures with special attention to task-shifting and widespread community mental health interventions. A Preparedness and Response Centre was established to overseer the mitigating measures happening inside the university. Measures taken included empowerment of frontline staff, strengthening of restrictions, strengthening university health center, vigorous contact tracing, widespread health education, maintaining cultural sensitivity, and establishment of early standard operating procedures and university continuity plans. Hence, UMS was able to ensure no importation of cases into its campus during both acute and containment phases at the nationwide level.

Matched MeSH terms: Pneumonia, Viral/prevention & control*

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