Chikungunya is an infection caused by chikungunya virus which at present has spread to new countries and con- tinents. Chikungunya is associated with self-limiting and non-fatal infection in the past. However, in recent times, increased severity of the disease has been reported resulting in health and economic burden. The threat and bur- den of chikungunya would grow in future in the absence of specific antiviral or vaccine to control or eliminate the infection. This review discusses chikungunya in general including transmission of its etiological agent and clinical manifestations of the disease. Subsequently, management and treatment of chikungunya virus will be reviewed with particular emphasis on natural products or their active compounds with potential anti-chikungunya virus activities.
Introduction: Exposure of PM2.5 and PM10 released from combustion of biomass activity caused respiratory health among children. Objective: This study aims to determine the association between exposure of PM2.5 and PM10 with DNA damage in primary school children living nearby palm oil combustion activity at Semenyih. Methods: A cross sectional comparative study were conducted among Malay primary school children in school A located 2.7km from palm oil activity (N=82) and school B located about 40km away from the palm oil area (N=85). A standardized ques- tionnaire were distributed to respondent’s parents. Concentrations of PM2.5 and PM10 were measured by using Dust Trak DRX Aerosol Monitor Model 8534 and Escort LC Personal Sampling Pump. Measurement of indoor and outdoor air pollutants were conducted in schools and home. Buccal cells were collected, which then followed by micronu- cleus assay. Results: Concentration of PM10 and PM2.5 at home of studied group were significantly higher compared to comparative group with p value (p=0.007) and (p=0.018) respectively. PM10 and PM2.5 of studied schools were significantly higher compared to comparative schools with p value (p=0.014) and (p=0.04) respectively. MN fre- quencies of studied group were significantly higher compared to comparative group (p=0.001). Significant difference of respiratory symptoms were found between two groups which are cough, phlegm, wheezing and chest tightness (p=0.001). There were significant correlation between PM10 with MN frequency of studied group and comparative group with r= 0.562; p=0.001. Conclusion: This study indicated that the exposure of PM10 and PM2.5 would increase the risk of having respiratory health symptoms and might induce the micronuclei formation among children who lived near palm oil activity area.
Introduction: Cholera epidemics can produce devastating public health outcomes. Cholera distribution is influenced by temperature, precipitation, elevation, distance to the coastline and oceanic environmental factors such as sea surface temperature, sea surface height and ocean chlorophyll concentration. The purpose of this study is to describe the spatial epidemiology of cholera in the four districts of Sabah. Methods: This is a retrospective review of 4 years (2011 to 2014) data from the districts of Kota Kinabalu, Penampang, Putatan and Papar, Sabah. All reported cases of cholera from those areas are included. Coordinates for locations of the cases are based on home addresses. SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: Cholera showed several clustering of cases, such as in 2011 and 2014 in Kota Kinabalu. In the year 2011 and 2013, Penampang and Papar districts had the nearest neighbour index of less than 1, but p value was not significant, meaning the pattern did not appear to be significant. Nearest neighbour hierarchical clustering analysis further revealed cholera had 7 clusters, of those 6 were first order and 1 was a second order cluster. Conclusion: Cholera shows disease clustering which could mean it is due to its common point source or localised human to human transmission. Using GIS as a tool may help in surveillance and control of cholera infections.
Introduction: Food poisoning usually occurs with the consumption of contaminated food. Some related factors are unsafe water supply, poor sanitation, unhygienic waste disposal and unhygienic practices or poor personal hygiene by food handlers. The purpose of this study is to describe the spatial epidemiology of food poisoning cases in the four districts of Sabah. Methods: This review consists of all food poisoning cases reported from 2011 to 2014 from Kota Kinabalu, Penampang, Putatan and Papar, Sabah. The coordinates used for locations of cases are based on home addresses. Tools such as SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: A total of 1,787 cases of food poisoning were reported during this review period. In 2011, only Kota Kinabalu and Pa-par illustrated significant food poisoning clusters. Meanwhile, in the year 2012 to 2014, Kota Kinabalu, Penampang and Putatan had clustering of cases. Analysis of nearest neighbour hierarchical clustering analysis showed 32 food poisoning clusters. There were 4 food poisoning points at 500 meters radius around a market place, 2 food poisoning points near a sewage plant and 1 food poisoning point near a water treatment plant. No cases were near a municipal landfill. For rivers and coastline, there were 37 points of food poisoning cases in the proximity of 500 meters. Con-clusion: Food poisoning usually occurs in clusters with possible associated environmental factors.
Introduction: Zika virus infection is caused by flavivirus virus and spread by Aedes mosquitoes. Since first report-ed in 1947, it spread to various countries especially in the equatorial region including Malaysia. The infection is non-fatal to an adult. However, the major risk of its infection is towards unborn baby when the mother is infected. The vertical transmission to the foetus possess various risks include the teratogenic effect that may lead to elective abortion. Thus, the objectives of this review are to discover about Zika virus and its effect on pregnant women and to evaluate Islamic perspective about elective abortion of Zika virus-infected women. Methods: This review was done through reviewing evidence from the journals, books and reports. The data were reviewed thematically according to the objectives. Results: Studies shown that Zika virus may cause miscarriage, preterm birth, microcephaly and other malformation known as Congenital Zika syndrome. This leads to a demand for elective abortion which raised Islamic ethical issue if it is permissible. In Islam, abortion is extremely prohibited once the foetus reached 120-day of con-ception unless it causes harm to the mother’s life. But, if the foetus age is less than 120-day, abortion is permissible when the pregnancy affects the mother’s health. Abortion due to foetal microcephaly and congenital malformation is prohibited. Conclusion: Effort must be taken to prevent the spread of Zika virus to reduce the need for an elective abortion through an education Muslim community regarding elective abortion.
Introduction: The study is introducing a laboratory technique to sustain the longevity of Heterotrigona itama sting- less bees collected from the farm in order to facilitate future health research on Kelulut honey. Methods: The worker bees were held in laboratory at 26 ± 2 oC, 57 ± 8 % relative humidity (RH) and 12:12 hours (light:dark period) in a cup covered with meshed cloth and installed with an inverted-wick system consists of a drinking straw with the bottom end loosely plugged with cotton wool. The artificial diet was pipetted into the straw to wet the cotton wool. The bees were divided into five diet groups, namely a) unfed - control, b) distilled water, c) purified tap water, d) non-carbonated isotonic drink or e) 5% honey solution. Feeding activity and survival of worker bees were observed daily. Results: The worker bees are seen to frequent and lick the cotton wool wetted with artificial diets. Comparison between the artificial diets, Kaplan-Meier statistical analysis showed that the 5% honey solution and non-carbonated isotonic drink have significantly (P < 0.05) extended the longevity of the worker bees with 50% survival probability at least 8 days. When the similar holding and feeding technique used for the bees from commercial farms, the 50% survival probability was extended to 14 days. Conclusion: The inverted-wick system with the use of 5% honey solu- tion or isotonic drink as the artificial diet is capable to hold the H. itama worker bees at least for a week with survival above 50% for laboratory experiments.
Introduction: Laryngectomy patients undergo voice rehabilitation that requires implantation of trachea-oesophagal speech valves (TESV). Usually, laryngeal cancer patients require insertion of these devices post-operatively to im-prove their quality of life. Implantation of TESV dates back to 1979 by pioneering work of Blom and Singer. There are cases of aspiration of TESV wearer reported, and obstruction of the TESV causes leakage through the valve and is suggested as a main reason for replacement of the device. The dysfunctional failure may be caused by microbial colonization on the valve or physical malfunction and requires immediate replacement is desirable. The aim of this study is to identify the microbial community members of selected TESVs using both culture-independent techniques (Next-generation sequencing) to analyse the microbiota, including unculturable species, and routine microbiology techniques (culture-dependent method) and to obtain representative isolates that can form the basis for experiments to enable increased understanding of the community. Methods: Biofilms were harvested from 16 explanted speech valves from patients visiting the ENT clinic in Freeman Hospital, Newcastle, UK. Routine microbiology techniques (culture-dependent method) including ChromeID® plates and Matrix-Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) Mass Spectrometry were used for identification of TESV microbiome. Sequencing of the samples was performed at MR DNA (www.mrdnalab.com, USA) on a MiSeq following the manufacturer’s guidelines in order to determine the bacteria and candida composition in the biofilm community. Results: The most frequently isolated fungal species was C. albicans, which was cultured from 11 out of 16 TESVs (79%), followed by five TESVs with C. tropicalis (36%), three TESVs had C. glabrata (21%) and only one TESV contained S. cerevisiae (7%). Interestingly no biofilm communities contained more than two fungal species and 2 TESVs (12%) possessed only bacterial species. There were only 16 species of bacteria cultured and identified by MALDI-TOF MS. This was far lower than the 91 species that were detected by NGS. Species from the genus Lactobacillus were found in 10 of 16 TESVs (63%), the highest frequency of any bacterial genus isolated from TESVs followed by S. aureus found in eight TESVs of 16. S. epidermidis was identified in two TESVs (13%), Streptococcus spp., K. oxytoca and O. anthropi were both identified in five different TESVs, while the gut bacterium E. faecium was found in four TESVs. Only one TESV contained E. coli. Conclusion: TESV biofilm composition was dominated by Candida spp. and occasionally contained other types of eukaryote such as Saccharomycetes. It was not uncommon for more than one Candida species to be present. The biofilms also harboured a mixture of bacteria, with lactic acid producers (Lactobacillus sp. and Streptococcus sp.) normally accompanying Candida sp. in the biofilm.
Introduction: Doctors are known to deal with high occupational stress, causing increased risk of depression, anxi- ety and stress.Nevertheless, the prevalence and associatedfactors of depression, anxiety and stress among registered doctorsworking in 24 public hospitals in Sabah, Malaysia are not known yet. Methods: This cross-sectional study was conducted using convenient sampling from September-October 2018. The data of 21-item Depression Anxiety Stress Scale (DASS-21) was collected via online link anonymously. Results: Among 314 doctors, majority of them were females (62.1%), mean age 29 (SD 2.72), non-Sabahan (82.8%), Malays (46.8%), not married (78.3%) and medical officers (93.6%). Prevalence of severe/extremely severe anxiety symptoms was 27.4%,depression (22.9%) and stress (18.5%). Doctors perceiving themselves to be depressed, anxious and/or stressed were more likely to develop the corresponding symptoms. Females and Chinese were twice more likely to report anxiety symptoms. Being married had protective effect against depressive symptoms, while working in same hospital for longer time had a significant but weak protective effect against anxiety and stress symptoms. Conclusions: Mental health issue among doctors is substantial and need to be addressed effectively for the benefit of their life, patients and country.
Maternal obesity is significantly associated with less intention to breastfeed, low breastfeeding self-efficacy, and poor breastfeeding outcomes. This cross sectional study investigates the determinants of breastfeeding self-efficacy among overweight and obese pregnant mothers using self-administered validated questionnaires. There were 44.9% of overweight and obese from 200 recruited mothers. They had low breastfeeding self-efficacy and less intended to breastfeed as compared to normal-weight mothers. Past breastfeeding experience and exclusive breastfeeding inten- tion are predictors of breastfeeding self-efficacy among overweight and obese pregnant mothers. Effective strategies should be conducted targeting this population with regards to low self-efficacy and intention to breastfeed.
Automated microbial detection system (AMDs) are design to detect early growth of bacterial and fungal. We herein report a rare case of false positive blood culture by AMDs in Plasmodium falciparum infection. A 41-year-old pre- viously healthy lady, with recent history of travelling to Lagos, Nigeria had presented to the casualty with history of fever and lethargy for three days. There was no malaria prophylaxis taken prior to the travelling history. Peripheral blood smear confirmed the presence of young trophozoite of Plasmodium falciparum with parasitemia of 7%. Con- current blood culture sent was positive, however all subcultures were negative for any growth. She was treated with intravenous artesunate however succumbed to death on the day of admission due to severe falciparum infection complicated with multiorgan failure and shock. The aim of this report is to highlight, the circumstances that can trigger the false positive AMDs detection and the possible underlying mechanism.
Despite pulmonary cryptococcosis showing good response to antifungal treatment, making accurate diagnosis in a timely manner remains a challenge. Tissue for fungal culture is less sensitive, nonspecific, and time-consuming to allow for prompt diagnosis. We herein report a case of 31-year-old woman with no known medical illness but presented with history of cough and haemoptysis for two months. The chest X-ray and bronchoscopy revealed left lung mass. While tuberculosis showed negative result and no growth observed in the tissue culture, the histopathological examination (HPE) finding was suggestive of fungal infection. The formalin-fixed paraffin-embedded (FFPE) tissue was sent for molecular testing, which revealed Cryptococcus neoformans. This report emphasises on the advantages and limitations of polymerase chain reaction (PCR) as an alternative method to confirm the diagnosis in cases of culture-negative fungal infection.
Introduction: Tobacco smoking is a major public health concern worldwide as it is one of the major risk factors for non-communicable diseases leading to burden of adverse health effects in their later life. According to Global Adult Tobacco Survey Malaysia (2011), 43.9% of men, 1.0% of women, and 23.1% overall currently smoked tobacco. It is important to prevent smoking uptake and promote smoking cessation to reduce the impact of tobacco smoking. The constant monitoring of the magnitude of smoking and its influencing factors is crucial for effective planning of anti-smoking programs. This study aimed to determine the prevalence of smoking and its associated factors among male villagers in Kampung Barambangon, Kudat, Sabah. Methods: A cross-sectional study was conducted among male villagers aged 15 years and above in Kampung Barambangon, Kudat District, Sabah State. Non probability convenience sampling was employed. The study period was from March to April, 2019. Data collection was done by using pretested self-administered questionnaire and a total of 97 villagers were participated in the study. Chi-square test was used for statistical analysis. Results: The study revealed that the prevalence of smokers among male residents in Kampung Barambangon was 50.5% (95% CI: 48.6–52.1%). It was found that there were significant associations between smoking status and positive attitude towards smoking (p-value 0.001), having siblings who smoked (p value 0.001), having high percentage of friends who smoked (p-value 0.009) and high educational level (p-value 0.005). Conclusion: The prevalence of male smokers in Kampung Barambangon was higher than the national prevalence. The findings may help in understanding the magnitude of the smoking problem and its associated factors which can be used for effective tobacco control and intervention programs.
In this study, we report an extremely rare case of liposarcoma which arises primarily in mediastinum. The patient appeared to have progressive dyspnoea and prolonged cough for a duration of one year. Chest radiograph and Computed Tomography (CT) of the thorax revealed a large right mediastinal mass with fatty component. It was confirmed to be primary liposarcoma on histopathological examination.
We report a case of a fatal gunshot injury to the chest which illustrates the compatibility of the Postmortem Multislice Computed Tomography (PMCT) features with that of conventional forensic autopsy findings. This case demonstrates that the PMCT has high potential to enhance the investigation and performance of conventional forensic autopsy.
Introduction: Determination of learning needs is central for holistic patient education, to sustain behavior changes and to control patient’s risk factor. However, patients often sense that their learning needs are unmet and informa- tion provided was too general. Thus, this study aimed to determine the perceived learning needs and their level of importance among Coronary Artery Disease (CAD) patients. Methods: The current investigation is a descriptive, cross-sectional study for which all CAD patients were selected using the cencus method. The data was collected us- ing Cardiac Patients Learning Needs Inventory. The questionnaire was delivered to 140 CAD patients who had their follow-up in a cardiology clinic. The instrument is reliable with a Cronbach’s alpha coefficient of 0.96. The study design followed STROBE cross-sectional design process guideline. Results: Participants’ mean age was 58.96 ± 9.42 years. More than half of the participants were males (62.9%), employed (52.0%) and had attained secondary level education (69.3%). Around two-thirds (60.7%) of the patients perceived to have high learning needs. Gender and highest educational achievement were significantly associated with perceived learning needs. The most significant perceived learning needs were medication information, risk factors for CAD, information on diet, physical activity, anatomy and physiology, and other related information. Conclusion: This study has identified the important domains of learning needs among CAD patients. Findings from the present study will provide important input for future cardi- ac educational strategies to reduce the rate of hospital readmission and death.
Introduction: This article aims to describe the effect of an intervention to promote the practice of voluntary Islamic fasting and its barriers among a group of overweight and obese Muslim women working in the public sector in Malaysia. Materials and methods: In this quasi-experimental study, an intervention to encourage voluntary fasting was delivered in a half day seminar, supported by relevant booklets prepared. A self-administered questionnaire was used to capture data on voluntary fasting practices and its perceived barriers before and four months after the intervention. Data was analysed using Mc Nemar test to compare the proportion before and after the intervention. Significant level was set at p
Background: Lack of awareness, poor knowledge and attitude regarding cancer have been identified as possible reasons accounting for the late presentation which lead to the poor survival of cancer patients in Malaysia. Method: A cross sectional study was conducted in three traditional Malay villages in Negeri Sembilan among adult males. Those who were already diagnosed with prostate cancer or Non malaysians were excluded from the study. Data was collected using self-administered questionnaires which consist of several sections namely socio-demographic, awareness about prostate cancer, sources of information, family history of prostate cancer, lifestyle associated with risk of cancer, knowledge and attitude towards prostate cancer. Data was analysed using SPSS version 22.0. Chisquare test was used to determine associations. Level of significance was set at p
Introduction: The causes of obesity is caloric intake that, over time, is greater than the caloric expenditure. Factors that are associated with this energy imbalance include genetic predisposition, behavioural dynamics, hormonal disturbances, and environmental circumstances. Results: Food Intake: Increased portion sizes, the energy density of today’s commonly eaten foods, and the trend in consuming meals outside the home contribute to the increase in calorie consumption. Satiety helps determine food intake and is partially determined by the volume and weight of the food consumed. Foods that are high in calorie content for a given volume, such as highly processed, low-fiber foods, can lead to excessive calorie intake. Many factors contribute to overeating, including stress, boredom, nutritional insufficiencies, emotional lability, access to food, and the changing of our diet to one that is highly processed. Movement and Physical Activity: In a recent review, Denham et al. (2013) summarized the ability of physical activity to influence epigenetic modifications of histones or DNA in the brain, skeletal muscle, and peripheral blood. Aerobic exercise over many weeks was the primary variable studied that led to activity-induced benefits. Several of the studies found benefits with 30 minutes of daily moderate activity. Yoga is an effective type of movement activity for improving weight and mental well-being. Sleep: There is an association between too little or too much sleep and overweight and obesity. In a survey of more than 54,000 U.S. adults age 45 years or older, sleeping too little (≤6 hours) and sleeping too much (≥10 hours) were significantly associated with obesity. Sleep deprivation is associated with elevated ghrelin, elevated cortisol, elevated insulin, decreased leptin, and increased hunger (Patel and Hu, 2008). Psychosocial Stress: In addition to the negative influences of physiological stress from poor nutrition, insufficient appropriate activity, and inadequate sleep, psychosocial stress can also contribute to excess weight. Psychosocial stress can arise from a wide variety of environmental stressors, such as change in routine, difficult decisions, depression, chronic health issues, lack of access to health care, economic challenges, inadequate social support, abusive relationships, illiteracy, job dissatisfaction, poor adjustment to life-cycle transitions such as retirement, and legal problems. This type of stress is often associated with weight gain, elevated BMI, and poor food choices. Increased cortisol levels can lead to weight gain around the abdominal region (central adiposity). Conclusion: It is important to screen for emotional stress with patients, identify how this stress may be negatively impacting their weight, and help them incorporate stress reduction programs to achieve their weight loss goals.
Introduction: Vibrio cholerae is a motile, Gram-negative curved rod belonging to the Vibrionaceae family. It is the causative agent of cholera. The acute diarrheal disease cholera causes about 120 000 casualties annually and has a significant effect on the health of young kids between the ages of 1 and 5. The main cause of death is due to resistance to antibiotics. As a result, new drug targets need to be identified immediately. The study’s goal is to identify Vibrio Cholerae’s putative drug target through an integrated approach to genomics and proteomics. Methods: Through this study, 2241 core protein sequence of Vibrio Cholerae were retrieved from the Panx tool. The sequence decreased to 173 druggable sequences by undergoing different phases of the process such as determining the non-homolo- gous sequence against human proteome by using the BlastP tool, identifying the essential genes by using the DEG database, and determining the sequence of virulent proteins by using Virulent prediction tool. Results: 11 potential drug targets were identified through molecular weight, and sub-cellular localization analysis. Conclusion: Through pan-genome analysis, we can able to find potential drug targets. This study also helps to identify the potential drug targets against Vibrio cholerae and to increase the efforts of drug and vaccine developments.
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.