Chlamydia trachomatis and C. pneumoniae are members of the Chlamydiaceae family of obligate intracellular bacteria. The former causes diseases predominantly at the mucosal epithelial layer of the urogenital or eye, leading to pelvic inflammatory diseases or blindness; while the latter is a major causative agent for pulmonary infection. On top of these well-described diseases at the respective primary infection sites, Chlamydia are notoriously known to migrate and cause pathologies at remote sites of a host. One such example is the sexually acquired reactive arthritis that often occurs at few weeks after genital C. trachomatis infection. C. pneumoniae, on the other hand, has been implicated in an extensive list of chronic inflammatory diseases which include atherosclerosis, multiple sclerosis, Alzheimer's disease, asthma, and primary biliary cirrhosis. This review summarizes the Chlamydia infection associated diseases at the secondary sites of infection, and describes the potential mechanisms involved in the disease migration and pathogenesis.
Burkholderia cepacia complex (Bcc) are opportunistic pathogens implicated with nosocomial infections, and high rates of morbidity and mortality, especially in individuals with cystic fibrosis (CF). B. cepacia are naturally resistant to different classes of antibiotics, and can subvert the host innate immune responses by producing quorum sensing (QS) controlled virulence factors and biofilms. It still remains a conundrum as to how exactly the bacterium survives the intracellular environment within the host cells of CF patients and immunocompromised individuals although the bacterium can invade human lung epithelial cells, neutrophils, and murine macrophages. The mechanisms associated with intracellular survival in the airway epithelial cells and the role of QS and virulence factors in B. cepacia infections in cystic fibrosis remain largely unclear. The current review focuses on understanding the role of QS-controlled virulence factors and biofilms, and provides additional impetus to understanding the potentials of QS-inhibitory strategies against B. cepacia.
Orf disease is known to be enzootic among small ruminants in Asia, Africa, and some other parts of the world. The disease caused by orf virus is highly contagious among small ruminant species. Unfortunately, it has been neglected for decades because of the general belief that it only causes a self-limiting disease. On the other hand, in the past it has been reported to cause huge cumulative financial losses in livestock farming. Orf disease is characterized by localized proliferative and persistent skin nodule lesions that can be classified into three forms: generalized, labial and mammary or genitals. It can manifest as benign or malignant types. The later type of orf can remain persistent, often fatal and usually causes a serious outbreak among small ruminant population. Morbidity and mortality rates of orf are higher especially in newly infected kids and lambs. Application of antibiotics together with antipyretic and/or analgesic is highly recommended as a supportive disease management strategy for prevention of subsequent secondary microbial invasion. The presence of various exotic orf virus strains of different origin has been reported in many countries mostly due to poorly controlled cross-border virus transmission. There have been several efforts to develop orf virus vaccines and it was with variable success. The use of conventional vaccines to control orf is a debatable topic due to the concern of short term immunity development. Following re-infection in previously vaccinated animals, it is uncommon to observe the farms involved to experience rapid virus spread and disease outbreak. Meanwhile, cases of zoonosis from infected animals to animal handler are not uncommon. Despite failures to contain the spread of orf virus by the use of conventional vaccines, vaccination of animals with live orf virus is still considered as one of the best choice. The review herein described pertinent issues with regard to the development and use of potential effective vaccines as a control measure against orf virus infection.
Lactococcus lactis has progressed a long way since its discovery and initial use in dairy product fermentation, to its present biotechnological applications in genetic engineering for the production of various recombinant proteins and metabolites that transcends the heterologous species barrier. Key desirable features of this gram-positive lactic acid non-colonizing gut bacteria include its generally recognized as safe (GRAS) status, probiotic properties, the absence of inclusion bodies and endotoxins, surface display and extracellular secretion technology, and a diverse selection of cloning and inducible expression vectors. This have made L. lactis a desirable and promising host on par with other well established model bacterial or yeast systems such as Escherichia coli, Saccharomyces [corrected] cerevisiae and Bacillus subtilis. In this article, we review recent technological advancements, challenges, future prospects and current diversified examples on the use of L. lactis as a microbial cell factory. Additionally, we will also highlight latest medical-based applications involving whole-cell L. lactis as a live delivery vector for the administration of therapeutics against both communicable and non-communicable diseases.
Orbital cellulits is one of the life threatening event that should not be missed out and must be distinguished from preseptal cellulitis. It is an infective process involving ocular adnexal structures posterior to the orbital septum. High index of suspicion is the key to its diagnosis as even experienced physician can miss. Here, we present a case of a 15-year-old female who presented with progressive swelling over right forehead associated with high grade fever, headache and purulent discharge of the swelling. She was diagnosed with sepsis due to right forehead abscess and was treated with intravenous antibiotics followed with admission. However, she suddenly deteriorated in the ward which required intubation and thereby Intensive Care Unit (ICU) admission. Investigations revealed fluid collection at right retrobulbar space suggestive of an abscess where emergency drainage was carried out. Unfortunately, her condition worsened and patient succumbed at day-10 of admission, despite all efforts.
The primary target of severe acute respiratory syndrome coronavirus 2 is the respiratory system including the nose and lungs, however, it can also damage the kidneys, cardiovascular system and gastrointestinal system. Many recent reports suggested that severe acute respiratory syndrome coronavirus 2 infections can also affect the central nervous system as well as peripheral nervous system that lead to the several neurological complications. The virus can break the blood brain barrier and enters the brain via haematological route or directly by the angiotensin-converting enzyme 2 receptors present on endothelial cells of many cerebral tissues. The neurological complications are manifested by headache, dizziness, encephalopathy, encephalitis, cerebrovascular disease, anosmia, hypogeusia, muscle damage, etc. This review article described the possible routes and mechanism of nervous system infection and the range of neurological complications of COVID-19 that may help the medical practitioners and researchers to improve the clinical treatment and reduce the mortality rate among patients with viral diseases.
Marine sponges are sessile invertebrates that can be found in temperate, polar and tropical regions. They are known to be major contributors of bioactive compounds, which are discovered in and extracted from the marine environment. The compounds extracted from these sponges are known to exhibit various bioactivities, such as antimicrobial, antitumor and general cytotoxicity. For example, various compounds isolated from Theonella swinhoei have showcased various bioactivities, such as those that are antibacterial, antiviral and antifungal. In this review, we discuss bioactive compounds that have been identified from marine sponges that showcase the ability to act as antibacterial, antiviral, anti-malarial and antifungal agents against human pathogens and fish pathogens in the aquaculture industry. Moreover, the application of such compounds as antimicrobial agents in other veterinary commodities, such as poultry, cattle farming and domesticated cats, is discussed, along with a brief discussion regarding the mode of action of these compounds on the targeted sites in various pathogens. The bioactivity of the compounds discussed in this review is focused mainly on compounds that have been identified between 2000 and 2020 and includes the novel compounds discovered from 2018 to 2021.
This paper sheds light on infectious diseases and the status of malnutrition in Nepal, a Himalayan country located in South Asia. In spite of efforts by both Government and non-government sectors, infectious diseases are rampant in the countries constituting a major cause of morbidity and mortality, which in turn, impose a socio-economic and public health burden for the country. Intestinal parasitic infection has been implicated in the causation of malnutrition. Malnutrition associated with child mortality is more common among children aged less than five years. Nepalese women suffer from chronic malnutrition. People in rural areas are more affected by malnutrition than those in urban areas. This has been attributed to poverty, lack of education, and rampant infectious diseases.
The large population of human congestion in Makkah during Hajj would promote contagious diseases. Thus, the pilgrims require health care services that are efficient, effective, and high quality. The aim of this study is to determine the type of health-related problems among Malaysian pilgrims and to identify the health care services required by them during Hajj in Makkah. A cross-sectional study was conducted in which involved 379 Malaysian pilgrims in 2013/14234H. The survey was conducted after the pilgrims completed their Hajj ritual. A total of 400 sets of questionnaires were distributed at Abraj Janadriyah Hotel, which was occupied by more than 3000 Malaysian pilgrims. The response rate for this survey was 93%. Male respondents were constituted of 49.6% and female respondents were 50.4% with the mean age 52 years old. The underlying disease among Malaysian pilgrims during Hajj was respiratory disease (77.5%). The demands for health personnel (36.1%) and quality medication (34.7%) are among the important healthcare services required by the Malaysian pilgrims in Makkah. Respiratory disease is a common disease experienced by Malaysian pilgrims in Makkah. A certain types of services such as health personnel and quality medicine are strongly demanded by the Malaysian pilgrims to overcome their health problem during Hajj. This research provides a fundamental input to the health care providers, and also benefited the Hajj management authority to improve the quality of hajj management in future.
Rubella is an acute and contagious disease which is mainly characterized by fever, rash, and cervical lymphadenopathy. This contagious disease spreads easily through nasopharyngeal secretions, droplet or direct contact with patients. Meanwhile clinical features of scarlet fever include a sore throat, skin rash and strawberry tongue. A descriptive study was conducted to describe the epidemiological characteristic of diseases at a Training Camp in Mersing. Data obtained on demographic details, onset and time of fever and rash or contact with ill person 14 to 21 days prior to symptoms. Screening and interview conducted for all suspected cases of Rubella. 47.4% of the cases presented on 5th June 2012 followed by 15.8% on 11th June 2012 and 13.5% on 12th June 2012. Maculo papular rash was the predominant presenting symptom among students with acute infection in this outbreak (100%) followed by fever (36.8%). Measles specific IgM was not detected in the serum taken but rubella specific IgM was detected in 66.7% (6/19) of samples. 55% (11/20) were positive for ASOT. 4 trainees had Rubella and Scarlet Fever co-infection. It was found out that the outbreak occurred among 391 residents in the camp who shared common places for activities such as lecture, physical activity and meal. Rapid dissemination was due to overcrowded environment and close contact during common activities of the residents. Theoretically co-infection would be presented with severe clinical symptoms but not in this outbreak where all affected trainees only presented with mild fever and rashes.
The large population of human congestion in Makkah during Hajj would promote contagious diseases. Thus, the pilgrims require health care services that are efficient, effective, and high quality. The aim of this study is to determine the type of health-related problems among Malaysian pilgrims and to identify the health care services required by them during Hajj in Makkah. A cross-sectional study was conducted in which involved 379 Malaysian pilgrims in 2013/14234H. The survey was conducted after the pilgrims completed their Hajj ritual. A total of 400 sets of questionnaires were distributed at Abraj Janadriyah Hotel, which was occupied by more than 3000 Malaysian pilgrims. The response rate for this survey was 93%. Male respondents were constituted of 49.6% and female respondents were 50.4% with the mean age 52 years old. The underlying disease among Malaysian pilgrims during Hajj was respiratory disease (77.5%). The demands for health personnel (36.1%) and quality medication (34.7%) are among the important healthcare services required by the Malaysian pilgrims in Makkah. Respiratory disease is a common disease experienced by Malaysian pilgrims in Makkah. A certain types of services such as health personnel and quality medicine are strongly demanded by the Malaysian pilgrims to overcome their health problem during Hajj. This research provides a fundamental input to the health care providers, and also benefited the Hajj management authority to improve the quality of hajj management in future.
Vaccines, used appropriately and efficiently, have changed the landscape of infectious diseases. Poliomyelitis is almost completely eliminated globally. In many industrialised countries, there has been over 99 percent reduction in incidence of diphtheria, tetanus, measles, mumps, rubella, Haemophilus in-fluenzae b meningitis and over 97 percent reduction in whooping cough.',2Unlike anti-biotics, most vaccines have remained equally effective despite years of continuous usage.
Introduction: Under 5 mortality is a leading indicator of the level of child health and overall development of a coun-try. In Malaysia, progressive reduction has been observed from 1990 however since 2000 progress has been static. Further understanding about this trend is crucial. The objective of this study was to identify causes of mortality for better policy development in order to further reduce this rate. Methods: Analysis of mortality trends was done using data from Department of Statistics and causes of mortality using data collected through the Stillbirth and Under 5 Mortality Reporting System (SU5MR) in 2016. Results: The trend for Under 5 mortality rate between 2006 till 2016 is still plateaued and hovered between 8 to 9 per 1000 live births at the national level. High percentage of death is seen among the neonatal group (51%), followed by children 28 days to 1year (31%) and toddlers 1-4 years (18%). Percentage of preventable deaths increased with age i.e. 21% among neonates, 41% among children 28 days to 1year and 48% among toddlers. The leading causes of death are conditions from perinatal period (34.4%), congen-ital malformation (30%), injuries and external causes (6.4%), respiratory (5.6%) and certain infectious and parasitic disease (5.1%). Conclusion: To further reduce under -5 mortality focus needs to be on preventable deaths; to reduce neonatal deaths will require political commitment to ensure adequate resources; interagency collaboration is needed to reduce toddler mortality and family and community awareness on prevention of injury and infection.
Introduction: Poor hygiene practice is an important factor that lead to morbidity and mortality among young chil- dren which are common among the indigenous population due to the lack of access to health services and their unique beliefs and practices. This study aimed to identify the socio-demographic determinants of hygiene practices among the indigenous (known as Orang Asli in Malaysia) primary caregivers of children under the age of three in Malaysia. Methods: A cross-sectional study was conducted among 166 primary caregivers of Orang Asli children of below three years old in Kuala Langat District. Data was collected using a validated and pre-tested questionnaire via face-to-face interviews with individual respondents. The questionnaire consisted of two main sections: sociodemo- graphics and hygiene practice. Results: A majority of the Orang Asli primary caregivers had good hygiene practices (78.9%). The number of children under five years old living at home was significantly associated with hygiene prac- tice and it was the only significant determinant or predictor of good hygiene practice among the Orang Asli primary caregivers. Conclusion: The number of children under five years old living at home is an important factor to ensure good hygiene practices among the primary caregivers of Orang Asli children. This factor need to be taken into con- sideration in monitoring children health status by the health staff by emphasizing the importance of hygiene practice in the prevention of infectious diseases and malnutrition among Orang Asli children.
Ochrobactrum anthropi is a rare nosocomial pathogen that is manifesting itself mostly in immunocompromised patients and those with indwelling catheters. Identification of the microorganism is challenging and the ability to survive in aquatic surroundings have made it a clinically significant pathogen. Furthermore, the clinical picture of
O. anthropi infection, is not well described. It may manifest in any form of clinical infections though bacteremia is the most common mode of presentation reported in the limited literature. We report here two cases of O. anthropi bacteremia presenting in an immunocompetent and an immunocompromised host respectively with different clini- cal manifestation and response. In view of the highly variable presentation of O.anthropi, a high index of suspicion must be given to at risks patients to ensure the timely diagnosis and optimal clinical outcome.
Introduction: One of the biggest global health threats of the 21st century is climate change It is so catastrophic that the climate action has been given a platform as it is the 13th goal of the 17 United Nations Sustainable developmen-tal goals (SDG). This review seeks to understand the factors causing climate change, followed by understanding the impact it has on individual and population health. We also identify the strategies to control and prevent further cli-mate change. Methods: Reviews of local and international articles from the past ten years was conducted. The focus of the review was the causes, health effects as well as strategies. Data base used was Pro Quest. Results: This re-view identified that the main contributor to climate change are man-made activities such as fossil fuels combustion, livestock farming, and deforestation. This change in climate has many repercussions from mass migrations, increase communicable diseases as well as an increase in extreme weather events and natural disasters. All this eventually leads to the deterioration of individual and population health. Strengthening adaptivity to climate-related hazard, climate change integration into national policies, education, awareness-raising, impact reduction and early warning are actions that are present in Malaysia to manage this crisis. Conclusion: Climate change is occurring globally, and its presence can no longer be denied. Actions have been put forth, but only when its importance and impact is taken seriously will the positive changes be sustainable.
Introduction: Tuberculosis (TB) is one of the utmost serious infectious diseases worldwide. The emergence of multi- drug resistance demands the development of better or new putative drug targets for tuberculosis. Recent studies sug- gest Mycobacterium tuberculosis cytochrome P450 enzymes as promising drug targets and azole drugs as potential inhibitors. Methods: Various computational tools, like Expasy Protparam, Swiss model, RaptorX and Phyre2 were used to analyze 12 Mycobacterium tuberculosis P450 enzymes and determine their three-dimensional structure. The structural validation was done through a Ramachandran plot using RAMPAGE server. The docking of P450 enzymes with azole drugs was done with autodock ver 4.2.6. Results: Based on sub-cellular localization prediction using CEL- LO tool, P450 enzymes CYP123A1, CYP132A1, CYP135A1, CYP136A1, CYP140A1, and CYP143A1 were predicted to be in the cytoplasm. Through structure assessment by Ramachandran plot, the best homology modelled proteins were docked with azole drugs like clotrimazole, croconazole, econazole, fluconazole, itraconazole, itraconazole, ketaconazole and micronazole by using autodock. By docking method it is identified that ketaconazole drug has a high affinity towards most of the mycobacterium P450 enzymes followed by the itrconazole drug. CYP123A1 enzyme is preferable as a drug target due to high binding affinity towards ketoconazole followed by CYP135A1, CYP140A1 enzymes. Conclusion: This study would help in identifying putative novel drug targets in Mycobacterium tuberculosis, which can lead to promising candidates for the optimization and development of novel anti-mycobac- terial agents.
Protein kinases (PKs) are regulators of protein phosphorylation in many infectious diseases, including malaria. How- ever, the cellular functions of majority of PKs in Plasmodium falciparum remain unknown. The mechanisms involved in P. falciparum cell cycle progress are not fully understood. The activation of cyclin-dependent kinases (CDKs), which constitute a PK family that includes crucial regulators of cell cycle progression in eukaryotes, is strictly being coordinated by the interaction with specific cyclins at well-defined points within the cell cycle. These cyclin/CDK complexes are very well characterised in humans, but little is known in P. falciparum. This review expand our un- derstanding of the characteristic of CDKs and cyclins in P. falciparum, and paves the way for further investigations on the precise molecular role of these crucial regulatory proteins in mosquito and human. This represents a valuable step towards the elucidation of cell cycle control mechanisms in malaria parasites.
Military personnel who are deployed for peace-keeping missions are exposed to many hazards, including infectious diseases. One of the most common and fatal infectious disease is Malaria. Although well controlled in Malaysia, this deadly disease is still widely endemic in many other countries especially Africa. We would like to report the case of a military personnel who was infected with Malaria during a peace-keeping mission in Sudan and subsequently died after returning home. We hope that by reporting this case in depth, strategic actions can be taken to avoid similar unfortunate events in future.
Ludwig angina is a submandibular space cellulitis secondary to oral cavity infection. It is strongly associated with difficult intubation due to limitation in the mouth opening. The presentation of Ludwig angina varies according to the severity of the infection. The extreme presentations include upper airway obstruction and respiratory failure. We present a female teenager with right submandibular abscess as the consequence of Ludwig angina, who was planned for incision and drainage. Successful awake fibre optic intubation was performed as a method of induction due to trismus, deferring the need for tracheostomy.