MyMedR

First case of Acanthamoeba keratitis in Malaysia

Kamel AG, Norazah A

Trans R Soc Trop Med Hyg, 1995 11 1;89(6):652.

Fulltext Sensitivity of Acanthamoeba cyst to antimicrobial agents

Noradilah, S. A., Mohamed Kamel, A. G., Anisah, N., Noraina, A. R., Yusof, S.

Malaysian Journal of Medicine and Health Sciences, 2010;6(1):111-117.

MyJurnal

Introduction: Acanthamoeba is an ubiquitous free-living protozoa which causes serious ocular problems. Acanthamoeba keratitis is becoming more prevalent amongst contact lens wearers. The disease can cause loss of vision and blindness if not treated properly. The objective of this research is to study the sensitivity of six Acanthamoeba spp. isolates, of which three were from the clinical isolates (HKL 95, HTH 40 and HS 6) and the remaining three from environmental isolates (TTT 9, TL 3 and SMAL 8) to antimicrobial agents. Methods: The antimicrobial agents chosen for this purpose were polyhexamethylene biguanide (PHMB) and chlorhexidine. Serial dilutions were perfomed for polyhexamethylene biguanide and chlorhexidine. Cyst suspensions from the chosen isolates were exposed to PHMB and chlorhexidine respectively. After 48 hours incubation time at 30°C, each mixture was filtered and filtration membrane was put onto non-nutrient agar laid with Escherichia coli. The agar plates were incubated for three days at 30°C and examined daily until day 14 to detect the presence of Acanthamoeba trophozoites under the inverted microscope. The presence of trophozoites indicated the ineffectiveness of the antimicrobial agents. Results: Both of the antimicrobial agents tested were found to be effective against Acanthamoeba cysts from all the test strains. Polyhexamethylene biguanide gave a minimum cysticidal concentration (MCC) mean value of 2.848 μg/mL while chlorhexidine showed
MCC mean value at a concentration of 3.988 μg/mL. Conlusion: It can be concluded that the Acanthamoeba cysts were sensitive to polyhexamethylene biguanide and chlorhexidine.

Fulltext Laboratory acquired murine typhus--a case report

Norazah A, Mazlah A, Cheong YM, Kamel AG

Med J Malaysia, 1995 Jun;50(2):177-9.

PMID: 7565191

A 34-year-old laboratory worker developed murine typhus after an accidental splashing of Rickettsia typhi over her right eye and lips. Indirect immunoperoxidase test showed a four-fold increase in titre to Rickettsia typhi. She responded well to doxycycline.

Fulltext Effectiveness of Propamidine Isethionate and Ciprofloxacin Towards Clinical Isolates of Acanthamoeba spp. in Malaysia

SHAHIRAH, S., MOHAMED KAMEL, A. G., MAZLAN, M., NUR HAZIQAH, O., NUR EMILIA, O., NUR ATHIKAH, J., et al.

Buletin Sains Kesihatan, 2021;5(1):1-6.

MyJurnal

Acanthamoeba is a free-living amoeba and opportunistic protozoa that causes infection to humans. One of its primary infections is Acanthamoeba keratitis that occurs mostly amongst contact lens users. There are some difficulties in providing effective treatment to the patients as the cysts of Acanthamoeba spp. are very resistant towards most of the antimicrobial agents. Thus, study was conducted to determine the effectiveness of antimicrobial agents comprising 0.1% propamidine isethionate (Brolene®) and 0.3% ciprofloxacin (Ciloxan®) towards two clinical isolates of Acanthamoeba spp. (HUKM 74 and HS 72). Besides that, the minimum cysticidal concentration (MCC) of the tested antimicrobial agents were also determined. Propamidine isethionate and ciprofloxacin showed cysticidal activities at therapeutic dosage against both Acanthamoeba spp. isolates. The minimum cysticidal concentration for propamidine isethionate was between 62.5-125 µg/ml while for ciprofloxacin was 375 µg/ml. Both the clinical isolates of Acanthamoeba belonged to group II (Polyphagids).

Streptococcal impetigo among aboriginal children in Malaysia

Norazah A, Normaznah Y, Kamel AG, Rohani MY

Southeast Asian J Trop Med Public Health, 1995 Dec;26(4):803-4.

PMID: 9139400

Fulltext In-vitro activity of quinupristin/dalfopristin, levofloxacin and moxifloxacin against fusidic acid and rifampicin-resistant strains of methicillin-resistant Staphylococcus aureus (MRSA) from Malaysian hospitals

Norazah A, Lim VKE, Rohani MY, Kamel AGM

Med J Malaysia, 2005 Oct;60(4):411-5.

PMID: 16570701

The in-vitro susceptibility of quinupristin/dalfopristin, levofloxacin and moxifloxacin against methicillin-resistant Staphylococcus aureus (MRSA) strains, which are also resistant to fusidic acid and rifampicin were carried out to determine whether these antibiotics can be used as an alternative treatment for multiply resistant MRSA strains. The minimum inhibitory concentrations (MIC) of these antibiotics were determined by E-test. Quinupristin/dalfopristin had good activity (MIC90 = 1 mg/L) against these strains while most of the strains showed intermediate resistance to moxifloxacin with MIC90 = 2 mg/L). However, more than 90% of these strains were resistant to levofloxacin with the MICs that ranged from 8 mg/L to 16 mg/L with the majority inhibited at 8 mg/L.

Fulltext Staphylococcus aureus carriage in selected communities and their antibiotic susceptibility patterns

Norazah A, Lim VKE, Munirah SN, Kamel AGM

Med J Malaysia, 2003 Jun;58(2):255-61.

PMID: 14569746

The carriage and antibiotic susceptibility patterns of Staphylococcus aureus in the community were determined. Nasal, throat and axillary swabs were taken from 100 healthy adults and 90 disabled nursing home inmates. Antibiotic disc susceptibility testing was conducted following the NCCLS method. Staphylococcus aureus carriage was noted in 29% of healthy adults and 47.7% of nursing home inmates. Out of 79 strains, resistance to antibiotics were as follows; penicillin (92.4%), genetamicin (2.5%), tetracycline (6.3%), fusidic acid (11.3%), erythromycin (3.8%), pefloxacin (5.1%), mupirocin (3.8%), amikacin (3.8%), ciprofloxacin (2.5%) and chloramphenicol (2.5%). Methicillin-resistant Staphylococcus aureus was not isolated. Multiple colonizations and multi-antibiotic resistant Staphylococcus aureus were shown to occur in healthy individuals without risk factors and not previously hospitalized.

Fulltext Over-the-Counter Herbal Weight Loss Supplements in Egypt: Label Claim, Microbiological and Pharmaceutical Quality, and Safety Assessments

Ahmed N, Nounou MI, Abouelfetouh A, El-Kamel A

Med Princ Pract, 2019;28(2):167-177.

PMID: 30517949 DOI: 10.1159/000495986

OBJECTIVES: Nutraceuticals are advertised and sold with the label claim of being natural and safe herbal products. Due to the absence of clear regulations and guidelines for safety assessments of these products, nutraceuticals are commonly adulterated in order to increase sales. The objective of the current study was to design a comprehensive evaluation system to assess the safety, efficacy, authenticity according to label claim, and pharmaceutical quality of herbal slimming products in between 2015 and 2017.

METHODS: We designed a comprehensive assessment system to evaluate the safety, authenticity according to label claim, and pharmaceutical quality of slimming nutraceuticals. Six different popular products were evaluated (Zotreem Plus®, Zotreem Extra®, Malaysian Super Slim®, AB Slim®, Chinese Super Slim®, and Metabolites®). The pharmaceutical evaluation included analyzing the samples via high-performance liquid chromatography to determine any possible adulterants. Additionally, the products' physical properties were assessed via pharmacopeial tests. Finally, a microbial evaluation and a cross-sectional observational retrospective prevalence study were conducted to assess the products' safety and efficacy. -Results: The tested products were found to be adulterated with unreported active pharmaceutical ingredients such as sibutramine, sildenafil, phenolphthalein, and orlistat. Furthermore, they contained heterogeneous amounts of adulterants and exhibited an unsatisfactory pharmaceutical and microbial quality. Finally, the observational survey conducted on users showed that high percentages of participants suffered from common side effects such as depression, diarrhea, and hypertension.

CONCLUSIONS: These products threaten the health of consumers. There is a need to raise awareness of the lethal consequences of illegal nutraceuticals.

Mupirocin resistance among Malaysian isolates of methicillin-resistant Staphylococcus aureus

Norazah A, Koh YT, Ghani Kamel A, Alias R, Lim VK

Int J Antimicrob Agents, 2001 May;17(5):411-4.

PMID: 11337230

Four hundred methicillin-resistant Staphylococcus aureus strains (MRSA) from different geographical areas in Malaysia were tested for mupirocin susceptibility using minimum inhibitory concentration (MIC) determination. The majority of these strains (98.75%) were susceptible to mupirocin with MICs of < or = 4 mg/l. Fifty-percent of these strains had MICs of 0.125 mg/l or less while 90% of the strains had MICs of 1 mg/l or less. Mupirocin resistance was detected in five strains (1.25%) and one of these (0.25%) had an MIC of 64 mg/l and the other four strains (1%), high-level resistance with MICs > 512 mg/l. Even though the rate of mupirocin resistance in MRSA is still low in Malaysia, its presence calls for a strict policy on mupirocin usage in Malaysian hospitals.

Fulltext A case of trauma related Acanthamoeba keratitis

Kamel AG, Faridah H, Yusof S, Norazah A, Nakisah MA

Trop Biomed, 2004 Dec;21(2):135-8.

PMID: 16493405 MyJurnal

Acanthamoeba is an uncommon cause of keratitis but one of the most severe because of the prolonged and painful course of the disease and poor visual outcome. Although contact lens use is the principal risk factor, about 10% of cases occur following trauma and exposure to contaminated soil or water. Two cases of Acanthamoeba keratitis involving women contact lens wearers have previously been reported in Malaysia but this is the first time, a non contact lens related Acanthamoeba keratitis is reported. The case involved a 28 year old Indonesian male construction worker who had a trauma of the right eye during work. His eye was struck by sand and dust particles after which he quickly washed with water from an open tank at the construction site. He experienced pain, redness, glaring and blurring of vision of the right eye three days later. The diagnosis was missed at initial presentation but culture of the corneal scraping had proven Acanthamoeba as the aetiological agent. The history and clinical findings of this trauma related Acanthamoeba keratitis are briefly discussed.

Fulltext Isolation of Acanthamoeba sp. from conjunctival sac of healthy individuals using swab

Anisah N, Amal H, Kamel AG, Yusof S, Noraina AR, Norhayati M

Trop Biomed, 2005 Jun;22(1):11-4.

PMID: 16880749 MyJurnal

Is Acanthamoeba sp. normally found in the eyes? A study was carried out to establish the possibility of Acanthamoeba sp. as a part of the normal conjunctival flora. Conjunctiva swabbing were carried out in 286 healthy Orang Asli school children using sterile cotton swab. The swab was then inoculated onto non-nutrient agar (NN-A). Heat killed Escherichia coli that was used as food source for the growth of the amoebae was pipetted onto and away from the smear. The plates were incubated at 30 degrees C and examined daily using an inverted microscope for 14 days. Morphology of the trophozoites and cysts of the amoebae were used as the taxonomic criteria for identification. Positive-controls and negative-controls were done to check for the consistency of the technique used and monitoring of contamination respectively. None of the conjunctiva swab cultured was positive for Acanthamoeba sp. This finding may indicate that Acanthamoeba sp. is not part of normal conjunctival flora or conjunctiva swab is an insensitive technique to isolate the organism. However, a more extensive research is needed to investigate these possibilities.

Fulltext DNA fingerprinting of methicillin-resistant Staphylococcus aureus by pulsed-field gel electrophoresis (PFGE): comparison of strains from 2 Malaysian hospitals

Norazah A, Liew SM, Kamel AG, Koh YT, Lim VK

Singapore Med J, 2001 Jan;42(1):15-9.

PMID: 11361232

To determine and compare the pulsed-field gel electrophoresis (PFGE) patterns of endemic MRSA strains in 2 major Malaysian hospitals and to compare the PFGE patterns with antibiotypes of the strains studied.

DNA fingerprinting of septicemic and localized Burkholderia pseudomallei isolates from Malaysian patients

Azura MN, Norazah A, Kamel AG, Zorin SA

Southeast Asian J Trop Med Public Health, 2011 Jan;42(1):114-21.

PMID: 21323173

We have analysed DNA fingerprinting patterns by pulsed-field gel electrophoresis (PFGE) of 52 unrelated Burkholderia pseudomallei strains isolated from septicemic and localized infections from Malaysian subjects. A total of 38 PFGE types were observed among 36 septicemic and 16 localized strains with no predominant pattern. Type 25 was seen in 2 epidemiologically related strains, suggesting human to human transmission. Twelve PFGE types were shared among 26 strains (21 septicemic and 5 localized) showing close genetic relatedness with coefficient of similarity of 0.81 to 1.0. The other 26 strains (15 septicemic and 11 localized) were unrelated as shown by the similarity coefficient of < 0.8. This study showed that our B. pseudomallei strains in Malaysia were mainly heterogenous with no predominant type both in septicemic or localized strains.

Fulltext Enteropathogenic Escherichia coli in raw and cooked food

Norazah A, Rahizan I, Zainuldin T, Rohani MY, Kamel AG

Southeast Asian J Trop Med Public Health, 1998 Mar;29(1):91-3.

PMID: 9740276

A total of 402 Escherichia coli isolates were obtained from a variety of food samples and screened for enteropathogenic E. coli (EPEC). Screening was carried out using 15 specific monovalent antisera from Murex Diagnostic Limited. A total of 19 E. coli isolates were serotyped as EPEC. The EPEC strains were shown to belong to 8 serotypes. Eight out of 19 EPEC strains belonged to serotype 018C:K77 (B21). Seventeen out of 19 of the EPEC strains were isolated from cooked food. The presence of E. coli in cooked food is an indicator of fecal contamination and a sign of unhygienic food handling. The presence of EPEC in food could be a potential source of food-borne outbreak. Hygiene training for every food-handler is a necessity.

Fulltext Indirect hemagglutination antibodies against Burkholderia pseudomallei in normal blood donors and suspected cases of melioidosis in Malaysia

Norazah A, Rohani MY, Chang PT, Kamel AG

Southeast Asian J Trop Med Public Health, 1996 Jun;27(2):263-6.

PMID: 9279987

Interpretation of the indirect hemagglutination test (IHA) for melioidosis in endemic areas is difficult because of the presence of antibodies in apparently healthy individuals. Fifty-three out of 200 healthy blood donors in Malaysia showed positive antibody titers (> or = 1 : 40) against Burkholderia pseudomallei. Seven percent had an IHA titer of 1 : 40, 11% had an IHA titer of 1 : 80 while 8.5% had a titer > or = 1 : 160. Out of 258 sera sent for melioidosis serology, 7% of the patients had an IHA titer of 1 : 40, 9% had an IHA titer of 1 : 80 while 20% had an IHA titer of > or = 1 : 160. If a titer of > or = 1 : 80 is taken as cut off point for positivity, 29% of the patients had positive melioidosis serology. Increasing the positivity threshold may jeopardize the sensitivity of the test. A more specific and sensitive test is needed.

Fulltext Cryptosporidiosis among HIV positive intravenous drug users in Malaysia

Kamel AG, Maning N, Arulmainathan S, Murad S, Nasuruddin A, Lai KP

Southeast Asian J Trop Med Public Health, 1994 Dec;25(4):650-3.

PMID: 7667707

A study conducted at the Tampin Drug Rehabilitation Center in Malaysia established a high prevalence (23%) of asymptomatic carriers of Cryptosporidium among exposed HIV positive intravenous drug users (IVDUs). A majority of them were young adults and among the ethnic groups, the Malay HIV positive inmates had the highest prevalence of Cryptosporidium infection.

Fulltext Chitosan-Urea Nanocomposite for Improved Fertilizer Applications: The Effect on the Soil Enzymatic Activities and Microflora Dynamics in N Cycle of Potatoes (Solanum tuberosum L.)

Kondal R, Kalia A, Krejcar O, Kuca K, Sharma SP, Luthra K, et al.

Polymers (Basel), 2021 Aug 27;13(17).

PMID: 34502927 DOI: 10.3390/polym13172887

The impact of polymer-based slow-release urea formulations on soil microbial N dynamics in potatoes has been sparingly deciphered. The present study investigated the effect of a biodegradable nano-polymer urea formulation on soil enzymatic activities and microflora involved in the N cycling of potato (Solanum tuberosum L.). The nano-chitosan-urea composite (NCUC) treatment significantly increased the soil dehydrogenase activity, organic carbon content and available potassium compared to the conventional urea (CU) treatment. The soil ammonical nitrogen (NH4+-N) and nitrate nitrogen (NO3--N) contents and urease activity were significantly decreased in the NCUC-amended soil. The slow urea hydrolysis rate led to low concentrations of NH4+-N and NO3--N in the tested potato soil. Furthermore, these results corroborate the low count of ammonia oxidizer and nitrate reducer populations. Quantitative PCR (q-PCR) studies revealed that the relative abundance of eubacterial (AOB) and archaeal ammonia-oxidizing (AOA) populations was reduced in the NCUC-treated soil compared to CU. The abundance of AOA was particularly lower than AOB, probably due to the more neutral and alkaline conditions of the tested soil. Our results suggest that the biodegradable polymer urea composite had a significant effect on the microbiota associated with soil N dynamics. Therefore, the developed NCUC could be used as a slow N-release fertilizer for enhanced growth and crop yields of potato.

The screening of extracts from Goniothalamus scortechinii, Aralidium pinnatifidum and Andrographis paniculata for anti-malarial activity using the lactate dehydrogenase assay

Siti Najila MJ, Noor Rain A, Mohamad Kamel AG, Syed Zahir SI, Khozirah S, Lokman Hakim S, et al.

J Ethnopharmacol, 2002 Oct;82(2-3):239-42.

PMID: 12242001

Goniothalamus scortechinii, Andrographis paniculata and Aralidium pinnatifidum were selected for the study based on their ethnomedicinal values. They were screened for anti-malarial activity towards Plasmodium falciparum in vitro using the lactate dehydrogenase (LDH) assay. The crude extract of G. scortechinii exhibited the most potent schizonticidal activity compared to the other extracts. It is effective against both the chloroquine resistant isolate, Gombak A and the sensitive strain, D10 of Plasmodium falciparum. Furthermore a better IC(50) value was obtained against the resistant strain, (9 microg/ml) compared to the sensitive strain, 40 microg/ml. When the crude extract was fractionated into 3 fractions, the chloroform fraction yielded the best activity, exhibiting equipotency against both strains of parasite used; IC(50) of 23.53 microg/ml against Gombak A and 21.06 microg/ml against D10.

A major methicillin-resistant Staphylococcus aureus clone predominates in Malaysian hospitals

Norazah A, Lim VK, Rohani MY, Alfizah H, Koh YT, Kamel AG

Epidemiol Infect, 2003 Jun;130(3):407-11.

PMID: 12825724

This study was conducted to determine the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) in Malaysian hospitals. A total of 264 MRSA isolates from eight hospitals were subjected to typing by pulsed-field gel electrophoresis (PFGE) of SmaI restricted DNA. Antibiotic disk susceptibility testing was also carried out to determine their resistance patterns. Thirty-one PFGE pattern types were identified. Three major pattern types A, ZC and K were found with type A the predominant profile in c. 80% of strains and present in all hospitals. Unlike type A, other DNA pattern types were unique to the hospitals in which they were isolated. PFGE type A also consisted of strains that were multiply antibiotic resistant. The presence of a single predominant PFGE type in Malaysian hospitals is an important finding which suggests that inter-hospital spread of MRSA had occurred frequently and regularly.

Fulltext Detection of Vibrio cholerae 01 from aquatic environment in Sarawak

Norazah A, Zainuldin MT, Kamel AGM, Kamaliah MN, Taha AM

Med J Malaysia, 2001 Mar;56(1):4-9.

PMID: 11503295

The detection of Vibrio cholerae 01 from the aquatic environment of Daro and Bintulu in Sarawak was carried out following an outbreak of cholera. Conventional culture methods and detection of ctx gene by polymerase chain reaction technique were carried out on 80 water samples. Only one sample was positive by culture methods while 8 were positive by PCR. DNA finger printing by pulsed-field gel electrophoresis showed that the clinical isolates in Daro and Bintulu were genetically identical while the environmental isolate was closely related. Recovery of Vibrio cholerae by culture method is poor and newer methods of detection should be developed.

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