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Mild homozygous high a2-type beta thalassaemia

Ganesan J, Gill SS, Lie-Injo LE

Med J Malaysia, 1974 Jun;28(4):229-33.
PMID: 4278391
Human infection with rat lungworm Angiostrongylus cantonensis (Chen, 1935) in West Malaysia

Bisseru B, Gill SS, Lucas JK

Med J Malaya, 1972 Mar;26(3):164-7.
PMID: 5064003
Human infection with rat lungworm Angiostrongylus cantonensis (Chen, 1935) in West Malaysia

Bisseru TB, Gill SS, Lucas JK

Med J Malaysia, 1972 Mar;26(3):164-167.
PMID: 35158514

No abstract available.
Dubin-Sprinz disease

Dutt AK, Gill SS, Kutty MK, Omar-Ahmad U

Med J Malaya, 1968 Sep;23(1):2-4.
PMID: 4237552
Fulltext Neonatal tetanus: the current context of cases in Tawau, Sabah, Malaysia

Kok HC, Muhammad Anuar AS, Choo MY, Gill SS

Malaysian Journal of Paediatrics and Child Health, 2016;22(101):0-0.
MyJurnal

Objective: To study the demographic, clinical features, management and outcome of neonatal tetanus treated at Tawau Hospital.
Method: A retrospective study of neonatal tetanus admitted to a district hospital in Sabah was conducted.
Results: In 2015, the hospital handled 18 cases of babies with neonatal tetanus in the Tawau Hospital. This implies an occurrence of 1.5 cases per month. All the mothers were non-citizens and did not have any proper antenatal follow up. All the tetanus babies required invasive mechanical ventilation with a median of 20 days (range, 5 to 32 days). The survival rate was 94.4%.
Conclusion: Despite the promotion of maternal and childhood vaccination along with hygienic practices of delivery, neonatal tetanus still remains a threat to babies born in Sabah.
Isolation and Identification of novel toxins from a new mosquitocidal isolate from Malaysia, Bacillus thuringiensis subsp. jegathesan

Kawalek MD, Benjamin S, Lee HL, Gill SS

Appl Environ Microbiol, 1995 Aug;61(8):2965-9.
PMID: 7487029

A new mosquitocidal Bacillus thuringiensis subsp., jegathesan, has recently been isolated from Malaysia. Parasporal crystal inclusions were purified from this strain and bioassayed against fourth-instar larvae of Culex quinquefasciatus, Aedes aegypti, Aedes togoi, Aedes albopictus, Anopheles maculatus, and Mansonia uniformis. The 50% lethal concentration of crystal inclusions for each species was 0.34, 8.08, 0.34, 17.59, 3.91, and 120 ng/ml, respectively. These values show that parasporal inclusions from this new subspecies have mosquitocidal toxicity comparable to that of inclusions isolated from B. thuringiensis subsp. israelensis. Solubilized and chymotrypsin-activated parasporal inclusions possessed low-level hemolytic activity. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis revealed that the crystals were composed of polypeptides of 77, 74, 72, 68, 55, 38, 35, 27, and 23 kDa. Analysis by Western blotting (immunoblotting) with polyclonal antisera raised against toxins purified from B. thuringiensis subsp. israelensis reveals that proteins in parasporal inclusions of subsp. jegathesan are distinct, because little cross-reactivity was shown. Analysis of the plasmid content of B. thuringiensis subsp. jegathesan indicates that the genes for toxin production may be located on 105- to 120-kb plasmids. Cry- clones that have been cured of these plasmids are nontoxic. Southern blot analysis of plasmid and chromosomal DNA from subsp. jegathesan showed little or low homology to the genes coding for CryIVA, CryIVB, and CryIVD from B. thuringiensis subsp. israelensis.
Fulltext The cry toxin operon of Clostridium bifermentans subsp. malaysia is highly toxic to Aedes Larval Mosquitoes

Qureshi N, Chawla S, Likitvivatanavong S, Lee HL, Gill SS

Appl Environ Microbiol, 2014 Sep;80(18):5689-97.
PMID: 25002432 DOI: 10.1128/AEM.01139-14

The management and control of mosquito vectors of human disease currently rely primarily on chemical insecticides. However, larvicidal treatments can be effective, and if based on biological insecticides, they can also ameliorate the risk posed to human health by chemical insecticides. The aerobic bacteria Bacillus thuringiensis and Lysinibacillus sphaericus have been used for vector control for a number of decades. But a more cost-effective use would be an anaerobic bacterium because of the ease with which these can be cultured. More recently, the anaerobic bacterium Clostridium bifermentans subsp. malaysia has been reported to have high mosquitocidal activity, and a number of proteins were identified as potentially mosquitocidal. However, the cloned proteins showed no mosquitocidal activity. We show here that four toxins encoded by the Cry operon, Cry16A, Cry17A, Cbm17.1, and Cbm17.2, are all required for toxicity, and these toxins collectively show remarkable selectivity for Aedes rather than Anopheles mosquitoes, even though C. bifermentans subsp. malaysia is more toxic to Anopheles. Hence, toxins that target Anopheles are different from those expressed by the Cry operon.
Fulltext A neurotoxin that specifically targets Anopheles mosquitoes

Contreras E, Masuyer G, Qureshi N, Chawla S, Dhillon HS, Lee HL, et al.

Nat Commun, 2019 06 28;10(1):2869.
PMID: 31253776 DOI: 10.1038/s41467-019-10732-w

Clostridial neurotoxins, including tetanus and botulinum neurotoxins, generally target vertebrates. We show here that this family of toxins has a much broader host spectrum, by identifying PMP1, a clostridial-like neurotoxin that selectively targets anopheline mosquitoes. Isolation of PMP1 from Paraclostridium bifermentans strains collected in anopheline endemic areas on two continents indicates it is widely distributed. The toxin likely evolved from an ancestral form that targets the nervous system of similar organisms, using a common mechanism that disrupts SNARE-mediated exocytosis. It cleaves the mosquito syntaxin and employs a unique receptor recognition strategy. Our research has an important impact on the study of the evolution of clostridial neurotoxins and provides the basis for the use of P. bifermentans strains and PMP1 as innovative, environmentally friendly approaches to reduce malaria through anopheline control.
Frequency of significant steatosis and compensated advanced chronic liver disease among adults with chronic liver disease

Shahrani S, Gill SS, Sooi CY, Skantha R, Kumar CVC, Limun MF, et al.

J Gastroenterol Hepatol, 2023 Oct;38(10):1818-1822.
PMID: 37587719 DOI: 10.1111/jgh.16313

BACKGROUND: With changes in the epidemiology and treatment of chronic liver disease (CLD), the impact of various etiologies of liver disease on steatosis and advanced fibrosis are uncertain.
METHODS: A retrospective study was conducted among liver disease patients of various etiologies undergoing transient elastography (TE) over a 9-year duration.
RESULTS: Data for 2886 patients were analyzed and had the following demographics: The median age was 60 (IQR: 45-69) years, 51% were males, and ethnicity was predominantly Chinese (52.5%), followed by Malays (34%) and Indians (12.3%). The median CAP score was 272 (IQR: 219-319) dB/m and the median liver stiffness measurement (LSM) score was 6.5 (IQR: 4.9-9.7) kPa. Hepatic steatosis occurred across the spectrum of etiologies of CLD. Among patients with steatosis, the most common etiologies were nonalcoholic fatty liver disease (NAFLD) at 62% and chronic hepatitis B (CHB) at 26.3%. TE findings suggestive of cACLD (10.1-15 kPa) and highly suggestive of cACLD (>15 kPa) were observed in 11.3% and 12.4% of patients, respectively. NAFLD was found to be the most common etiology for cases with suggestive of cACLD (47.2%) and highly suggestive of cACLD (41.5%).
CONCLUSION: Hepatic steatosis is common in CLD, regardless of etiology. Compared with other etiologies, NAFLD is now the leading cause of cACLD.
Fulltext Clinical features and mutational analysis of X-linked agammaglobulinemia patients in Malaysia

Chear CT, Ismail IH, Chan KC, Noh LM, Kassim A, Latiff AHA, et al.

Front Immunol, 2023;14:1252765.
PMID: 37809070 DOI: 10.3389/fimmu.2023.1252765

BACKGROUND: Bruton's tyrosine kinase (BTK) is a cytoplasmic protein involved in the B cell development. X-linked agammaglobulinemia (XLA) is caused by mutation in the BTK gene, which results in very low or absent B cells. Affected males have markedly reduced immunoglobulin levels, which render them susceptible to recurrent and severe bacterial infections. Methods: Patients suspected with X-linked agammaglobulinemia were enrolled during the period of 2010-2018. Clinical summary, and immunological profiles of these patients were recorded. Peripheral blood samples were collected for monocyte BTK protein expression detection and BTK genetic analysis. The medical records between January 2020 and June 2023 were reviewed to investigate COVID-19 in XLA.
RESULTS: Twenty-two patients (from 16 unrelated families) were molecularly diagnosed as XLA. Genetic testing revealed fifteen distinct mutations, including four splicing mutations, four missense mutations, three nonsense mutations, three short deletions, and one large indel mutation. These mutations scattered throughout the BTK gene and mostly affected the kinase domain. All mutations including five novel mutations were predicted to be pathogenic or deleterious by in silico prediction tools. Genetic testing confirmed that eleven mothers and seven sisters were carriers for the disease, while three mutations were de novo. Flow cytometric analysis showed that thirteen patients had minimal BTK expression (0-15%) while eight patients had reduced BTK expression (16-64%). One patient was not tested for monocyte BTK expression due to insufficient sample. Pneumonia (n=13) was the most common manifestation, while Pseudomonas aeruginosa was the most frequently isolated pathogen from the patients (n=4). Mild or asymptomatic COVID-19 was reported in four patients.
CONCLUSION: This report provides the first overview of demographic, clinical, immunological and genetic data of XLA in Malaysia. The combination of flow cytometric assessment and BTK genetic analysis provides a definitive diagnosis for XLA patients, especially with atypical clinical presentation. In addition, it may also allow carrier detection and assist in genetic counselling and prenatal diagnosis.