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Fulltext A new method of mark detection for software-based optical mark recognition

Loke SC, Kasmiran KA, Haron SA

PLoS One, 2018;13(11):e0206420.
PMID: 30412588 DOI: 10.1371/journal.pone.0206420

Software optical mark recognition (SOMR) is the process whereby information entered on a survey form or questionnaire is converted using specialized software into a machine-readable format. SOMR normally requires input fields to be completely darkened, have no internal labels, or be filled with a soft pencil, otherwise mark detection will be inaccurate. Forms can also have print and scan artefacts that further increase the error rate. This article presents a new method of mark detection that improves over existing techniques based on pixel counting and simple thresholding. Its main advantage is that it can be used under a variety of conditions and yet maintain a high level of accuracy that is sufficient for scientific applications. Field testing shows no software misclassification in 5695 samples filled by trained personnel, and only two misclassifications in 6000 samples filled by untrained respondents. Sensitivity, specificity, and accuracy were 99.73%, 99.98%, and 99.94% respectively, even in the presence of print and scan artefacts, which was superior to other methods tested. A separate direct comparison for mark detection showed a sensitivity, specificity, and accuracy respectively of 99.7%, 100.0%, 100.0% (new method), 96.3%, 96.0%, 96.1% (pixel counting), and 99.9%, 99.8%, 99.8% (simple thresholding) on clean forms, and 100.0%, 99.1%, 99.3% (new method), 98.4%, 95.6%, 96.2% (pixel counting), 100.0%, 38.3%, 51.4% (simple thresholding) on forms with print artefacts. This method is designed for bubble and box fields, while other types such as handwriting fields require separate error control measures.
Fulltext Bacteriology of diabetic foot lesions

Yoga R, Khairul A, Sunita K, Suresh C

Med J Malaysia, 2006 Feb;61 Suppl A:14-6.
PMID: 17042222

Infection plays a pivotal role in enhancing a diabetic foot at risk toward amputation. Effective antibiotic therapy against the offending pathogens is an important component of treatment of diabetic foot infections. Recognition of the pathogen is always difficult as the representative deep tissue sample for culture is surrounded by ulcer surface harbouring colonies of organisms frequently labelled as skin commensals. The emergent of resistant strains represents a compounding problem standing against efforts to prevent amputation. This study was undertaken to identify the pathogens associated with diabetic foot infection in terms of their frequency and sensitivity against certain commonly used antibiotics. Forty-four consecutive patients with open diabetic foot infections had wound swab taken for culture and sensitivity testing. Cultures positive were observed in 89% of the cases with Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeroginosa encountered in 20%, 14% and 14% of cases respectively. Mixed growths were isolated in 6% of cultures. All Staphylcoccus aureus isolates were resistant to Penicillin but 80% were sensitive to Erythromycin and Co-trimoxazole. Klebsiella pneumoniae isolates were sensitive to Methicillin and Gentamycin in 80% and 60% of cases respectively, and resistant to Ampicillin and Ceftazidime in 83% and 50% respectively. All Pseudomonas aeroginosa isolates were sensitive to Amikacin and Ciprofloxacin but 50% were resistant to Gentamycin. There was no single antibiotic possessing good coverage for all common organisms isolated from diabetic foot lesions. Staphylococcus aureus remains the predominant cause of diabetic foot infections followed by Klebsiela pneumonia and Pseudomonas aeroginosa. Most infections are monomicrobial. The emergence of multiresistant organisms is a worrying feature in diabetic foot infections.
Fulltext Neurocysticercosis an uncommon intra-cerebral infection in Malaysia

Arasu K, Khairul A, Waran V

Med J Malaysia, 2005 Oct;60(4):514-6.
PMID: 16570721

Neurocysticercosis, infection of the central nervous system (CNS) by larvae of the pork tapeworm Taenia solium, is the commonest neuroparasitic infection in humans. However in countries as in Malaysia it poses a diagnostic problem as the disease in not seen amongst the local population; however with the arrival of immigrant workers, a number of cases have recently been diagnosed. There were 3 cases of neurocysticercosis reported in our centre over the last 5 years.
Relationship standards and Malay Muslim couples' marital satisfaction

Nordin N, Halford WK, Barlow FK, Mastor KA

J Marital Fam Ther, 2023 Oct;49(4):825-841.
PMID: 37545186 DOI: 10.1111/jmft.12659

Relationship standards are beliefs about what is important in high-quality couple relationships. Clarifying standards cross-culturally informs theory about relationship quality and goals for culturally appropriate couple therapy. The current study assessed four standards (Couple Bond, Family Responsibility, Relationship Effort, and Religion) in n = 113 Malay Muslim couples, and the association of those standards with marital satisfaction. All four standards were strongly endorsed, Religion was the most strongly endorsed, and there were minimal sex differences. Separate actor-partner interdependence models showed actor effects of all four standards on own satisfaction for husbands and wives, partner effects of three of the four husbands' standards (not Relationship Effort) on wives' satisfaction, but no partner effects of female standards on male satisfaction. The findings underscore the importance of all four standards in Malay Muslim marriages and that attention to all these standards might need to be part of couple therapy with Malay couples.
Fulltext Custom-Made Articulating Spacer (CUMARS): The Resolution of Periosteal Reaction and Femur Remodelling in Periprosthetic Hip Infection

Wong R, Abbas AA, Ayob KA, Nasuruddin H, Selvaratnam V

Cureus, 2023 Jul;15(7):e41669.
PMID: 37575748 DOI: 10.7759/cureus.41669

Periprosthetic joint infection (PJI) is one of the most common complications after total hip arthroplasty (THA). Two-stage revision surgery is one of the treatment options for PJI, however, it has been associated with poor patient tolerance, reduced patient mobility, and periarticular tissue contracture leading to difficulty during second-stage reconstruction. The custom-made articulating spacer (CUMARS) was developed to provide an alternative that is better tolerated and to reduce the complexity of second-stage reconstruction. This study details the treatment of a patient with PJI post-THA with significant periosteal reaction using a CUMARS construct, which enabled immediate post-operative weight bearing, eventual eradication of infection, restoration of femoral bone stock, and avoidance of second-stage reconstruction.
Fulltext Seroprevalence of toxoplasmosis among AIDS patients in Hospital Kuala Lumpur, 2001

Nissapatorn V, Lee CK, Khairul AA

Singapore Med J, 2003 Apr;44(4):194-6.
PMID: 12952031

Four hundred and six AIDS patients were recruited in this retrospective study. The seroprevalence of toxoplasmosis among 406 AIDS patients was 208 (51.2%). Their age ranged from 17 to 74 years with a median of 35 years. The majority of patients were males 172 (82.6%), Malays 99 (47.5%), single 109 (52.4%), unemployed 99 (47.6%) and heterosexual with commercial sex workers (CSW) 97 (46.6%) as the risk marker to HIV infection. Thirty-one (14.9%) of 208 AIDS-related toxoplasmosis were diagnosed as active toxoplasmic encephalitis. The most common clinical manifestation was headache (67.7%). The CT scan findings showed most lesions to be multiple (87.5%), hypodense (66.7%), and in frontal region (41.7%). Twenty-two (71%) patients had chronic (latent) Toxoplasma infection as evidenced by seropositivity for anti-Toxoplasma (IgG) antibody. They were statistically significant in the association between CD4 count and toxoplasmic encephalitis (P = 0.019; OR = 2.6; 95% CI = 1.14-6.02). After the initial six weeks of anti-TE therapy, relapsing toxoplasmic encephalitis was detected in 9.7% in this study.
Fulltext Measles--an experience in Sandakan Hospital, Sabah, 1990

Khoo A, Ho CK, Ong TK, Khairul A

Singapore Med J, 1994 Dec;35(6):595-8.
PMID: 7761883

A descriptive study of 143 cases of clinically diagnosed measles in patients under the age of 12 years admitted to the Duchess of Kent Hospital, Sandakan, Sabah, during the year 1990 was carried out. The median age of the patients was one year and 13.3% of the cases were between the ages of 6 and 9 months. The male to female ratio was 1.3:1. The majority of the cases (85.3%) were not immunised against measles while 60.0% of the cases were malnourished. Most of the cases (86.0%) had at least one complication with 32.9% of the cases having more than one complications. The main complications were pneumonia (74.1%) and diarrhea (38.5%). Other complications were convulsions, otitis media and corneal ulceration/scarring. A case of pneumonia with mediastinal emphysema and subcutaneous emphysema was noted. The case fatality rate was 1.4% while blindness was the long term morbidity in 1.4% of the cases. Measles remains an important cause of morbidity in children in Sabah.
The strain among caregivers of children with disabilities at the community-based rehabilitation centres in Kudat division of Sabah, Malaysia

Khairul AY, Kannan TC, Erna FP

Med J Malaysia, 2024 Mar;79(Suppl 1):59-66.
PMID: 38555887

INTRODUCTION: The prevalence of children with disabilities (CWD) is increasing. CWD requires exceptional long-term attention, which often falls on the caregivers. Caring for a CWD affects caregivers in multiple ways, such as physical, social, personal, and financial aspects. Most of the CWD will be cared in Community-Based Rehabilitation (CBR) centres where the caregivers have to play a crucial role as they become partners in the respective service delivery. However, there is still insufficient information on the impact (strain) of a disabled child on the caregivers in the CBR centre in the Kudat division of Sabah, Malaysia specifically. Hence, this study aims to explore the strains among caregivers of CWD at the CBR centre in the Kudat.
MATERIALS AND METHODS: A cross-sectional study through a purposive sampling method was employed, involving 142 caregivers of CWD at the selected CBR centre. Four CBR centres were selected in this study, which were located in the Kudat division of Sabah. The Malay version of the Modified Caregiver Strain Index Questionnaire (M-CSI-M) was used in this study to obtain information about the caregiver's strain.
RESULTS: Findings from this study revealed that most caregivers experienced moderate strain (72.5%). Some of the leading causes of their strain were upsetting CWD's behaviour (10.6%), financial strain (9.2%), and overwhelmed (9.2%). In addition, there were significant differences between caregiver strain and their level of education, income, and the types of their child's disabilities (p ≤ 0.05).
CONCLUSION: The well-being of the caregivers may significantly impact the effectiveness of rehabilitation for CWD, as caregivers are vital interdisciplinary team members.
PERSONALITY TRAITS AND STRESS LEVELS AMONG SENIOR DENTAL STUDENTS: EVIDENCE FROM MALAYSIA AND SINGAPORE

Yusof ZYM, Hassan WNW, Razak IA, Hashim SMN, Tahir MKAM, Keng SB

Southeast Asian J. Trop. Med. Public Health, 2016 Nov;47(6):1353-65.
PMID: 29641164

This study aimed to evaluate the association between dental students’
personality traits and stress levels in relation to dental education programs among
senior dental students in University Malaya (UM) in Malaysia and National University
of Singapore (NUS). A cross-sectional survey using a self-administered
questionnaire was conducted on UM and NUS senior dental students. The questionnaire
comprised items on demographic background, the Big Five Inventory
Personality Traits (BFIPT) test and a modified Dental Environment Stress (DES)
scale. Rasch analysis was used to convert raw data to interval scores. Analyses
were done by t-test, Pearson correlation, and Hierarchical regression statistics.
The response rate was 100% (UM=132, NUS=76). Personality trait Agreeableness
(mean=0.30) was significantly more prevalent among UM than NUS students
(mean=0.15, p=0.016). In NUS, Neuroticism (mean=0.36) was significantly more
prevalent than in UM (mean=0.14, p=0.002). The DES mean score was higher
among NUS (mean=0.23) than UM students (mean=0.07). In UM, Neuroticism
was significantly correlated with stress levels (r=0.338, p<0.001). In NUS, these
were Neuroticism (r=0.278, p=0.015), Agreeableness (r=0.250, p=0.029) and Conscientiousness
(r=-0.242, p=0.035) personality traits. The correlation was strongest
for personality trait Neuroticism in both schools. Hierarchical regression analysis
showed that gender and Neuroticism were significant predictors for students’
stress levels (p<0.05) with the latter exerting a bigger effect size (R2=0.18) than
gender (R2=004). This study showed that gender and Neuroticism personality
trait were significant predictors for stress levels among selected groups of dental
students in Southeast Asia. Information on students’ personality may be useful in
new students’ intake, stress management counseling and future program reviews.
Fulltext A review of studies examining the association between genetic biomarkers (short tandem repeats and single-nucleotide polymorphisms) and risk of prostate cancer: the need for valid predictive biomarkers

Albujja MH, Vasudevan R, Alghamdi S, Pei CP, Bin Mohd Ghani KA, Ranneh Y, et al.

Prostate Int, 2020 Dec;8(4):135-145.
PMID: 33425790 DOI: 10.1016/j.prnil.2019.11.003

Prostate cancer (PCa) is a challenging polygenic disease because the genes that cause PCa remain largely elusive and are affected by several causal factors. Consequently, research continuously strives to identify a genetic marker which could be used as an indicator to predict the most vulnerable (i.e., predisposed) segments of the population to the disease or for the gene which may be directly responsible for PCa. To enhance the genetic etiology of PCa, this research sought to discover the key studies conducted in this field using data from the main journal publication search engines, as it was hoped that this could shed light on the main research findings from these studies, which in turn could assist in determining these genes or markers. From the research highlighted, the studies primarily used two kinds of markers: short tandem repeats or single-nucleotide polymorphisms. These markers were found to be quite prevalent in all the chromosomes within the research carried out. It also became apparent that the studies differed in both quantity and quality, as well as being conducted in a variety of societies. Links were also determined between the degree and strength of the relationship between these markers and the occurrence of the disease. From the studies identified, most recommended a larger and more diverse survey for the parameters which had not been studied before, as well as an increase in the size of the community (i.e., the population) being studied. This is an indication that work in this field is far from complete, and thus, current research remains committed toward finding genetic markers that can be used clinically for the diagnosis and screening of patients with PCa.
Fulltext The Role of N-Acetylcysteine Supplementation on the Oxidative Stress Levels, Genotoxicity and Lineage Commitment Potential of Ex Vivo Murine Haematopoietic Stem/Progenitor Cells

Hamid ZA, Tan HY, Chow PW, Harto KAW, Chan CY, Mohamed J

Sultan Qaboos Univ Med J, 2018 May;18(2):e130-e136.
PMID: 30210840 DOI: 10.18295/squmj.2018.18.02.002

Objectives: The ex vivo maintenance of haematopoietic stem/progenitor cells (HSPCs) is crucial to ensure a sufficient supply of functional cells for research or therapeutic applications. However, when exposed to reactive oxygen species (ROS) in a normoxic microenvironment, HSPCs exhibit genomic instability which may diminish their quantity and quality. This study aimed to investigate the role of N-acetylcysteine (NAC) supplementation on the oxidative stress levels, genotoxicity and lineage commitment potential of murine haematopoietic stem/progenitor cells (HSPCs).
Methods: This study was carried out at the Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia, between June 2016 and July 2017. Bone marrow cells were isolated from nine mice and cultured in a growth medium. Various concentrations of NAC between 0.125-2 μM were added to the culture for 48 hours; these cells were then compared to non-supplemented cells harvested from the remaining three mice as the control group. A trypan blue exclusion test was performed to determine cell viability, while intracellular ROS levels and genotoxicity were determined by hydroethidine staining and comet assay, respectively. The lineage commitment potential of erythroid, myeloid and pre-B-lymphoid progenitor cells was evaluated via colony-forming cell assay.
Results: NAC supplementation at 0.25, 0.5 and 2 μM significantly increased cell viability (P <0.050), while intracellular ROS levels significantly decreased at 0.25 and 0.5 μM (P <0.050). Moreover, DNA damage was significantly reduced at all NAC concentrations (P <0.050). Finally, the potential lineage commitment of the cells was not significantly affected by NAC supplementation (P >0.050).
Conclusion: The findings of this study indicate that NAC supplementation may potentially overcome the therapeutic limitations of ex vivo-maintained HSPCs.
Fulltext The prevalence and intensity of soil-transmitted helminthiasis among pre-school children in Orang Asli resettlement villages in Kelantan

Zulkifli A, Khairul AA, Atiya AS, Abdullah B, Yano A

Med J Malaysia, 1999 Dec;54(4):453-8.
PMID: 11072462

A study of the prevalence and intensity of soil-transmitted helminthiasis among pre-school children aged 0 to 7 years from an Orang Asli village resettlement scheme in Gua Musang, Kelantan was undertaken. The overall prevalence of soil transmitted helminthic (STH) infections was 56.0%. The predominant helminth found was Ascaris lumbricoides while the commonest type of infection was a mixed infection with Ascaris lumbricoides and Trichuris trichiura. The prevalence rates of Ascaris, Trichuris and hookworm infections were 47.5%, 33.9% and 6.2% respectively. The intensity of Ascaris infections were 64.5% light, 27.3% moderate and 8.3% heavy whilst the intensity of Trichuris infections were 80.5% light, 18.3% moderate and 1.2% heavy. However, the intensity of hookworm infections were 86.7% light, 13.3% moderate and no heavy infection. The prevalence of helminthiasis (STH) shows an-age dependent relationship, with the lowest prevalence in 0-< 1 year age group and highest in the 6-< 7 year age group.
Fulltext Lead poisoning in childhood

Nasir HM, Kassim MS, Malinee T, Khairul AM, Low BH

Med J Malaysia, 1993 Sep;48(3):361-3.
PMID: 8183154

We report here a case of lead poisoning in a 20 month old girl who presented with acute encephalopathy and status epilepticus. The major clues leading to the diagnosis were the occupational family history and dense lead lines on X-ray of the long bones. She showed evidence of neurological dysfunction in the initial phase, but she improved steadily, regaining her motor power partially and her vision, although some cognitive and language deficits were already evident. She will need long-term neurological assessment and evaluation to ascertain the extent of permanent brain damage.
Fulltext Epidemiological screening of lymphatic filariasis among immigrants using dipstick colloidal dye immunoassay

Wan Omar A, Sulaiman O, Yusof S, Ismail G, Fatmah MS, Rahmah N, et al.

Malays J Med Sci, 2001 Jul;8(2):19-24.
PMID: 22893756

We have recently reported that a dipstick colloidal dye immunoassay (DIA) that detect parasite antigens in human serum is sensitive and specific for the diagnosis of active infection of lymphatic filariasis. Rabbit polyclonal antibodies (RbBmCAg) labelled with a commercial dye, palanil navy blue was used to detect filarial antigenemia among Indonesian and Bangladeshi immigrant workers (N= 630) at oil palm estates at Hulu Trengganu District, Peninsular Malaysia. Microfilaremia with Brugia malayi were detected in 51 (8.10 %) individuals, of which 42 (6.67 %) were among the Indonesians and 9 (1.98 %) among the Bangladeshis. Microfilaremia with Wuchereria bancrofti were detected in 33 (5.24 %) individuals of which 15 (2.38 %) were among the Indonesians and 18 (2.86 %) among the Bangladeshis workers. The DIA detected 96 (15.24 %) antigenemic cases which comprise of all the microfilaremic cases and 15 (2.38 %) amicrofilaremic cases. The amicrofilaremic cases with filarial antigenemia consisted of 9 (1. 43 %) Indonesians and 6 (0.95%) Bangladeshis. We have used 6 ul of the RbBmCAg and diluted (1:10) patients' sera per dipstick which make the DIA reagent conservative. The DIA is a rapid test and can be read in approximate 2 hours.. Additionally, coloured dots developed in the DIA can be qualitatively assessed visually for intensity. The DIA does not require sophisticated equipment or radioactivity, and therefore suitable for field application.
Adsorption of methyl orange from aqueous solution onto calcined Lapindo volcanic mud

Jalil AA, Triwahyono S, Adam SH, Rahim ND, Aziz MA, Hairom NH, et al.

J Hazard Mater, 2010 Sep 15;181(1-3):755-62.
PMID: 20538408 DOI: 10.1016/j.jhazmat.2010.05.078

In this study, calcined Lapindo volcanic mud (LVM) was used as an adsorbent to remove an anionic dye, methyl orange (MO), from an aqueous solution by the batch adsorption technique. Various conditions were evaluated, including initial dye concentration, adsorbent dosage, contact time, solution pH, and temperature. The adsorption kinetics and equilibrium isotherms of the LVM were studied using pseudo-first-order and -second-order kinetic equations, as well as the Freundlich and Langmuir models. The experimental data obtained with LVM fits best to the Langmuir isotherm model and exhibited a maximum adsorption capacity (q(max)) of 333.3 mg g(-1); the data followed the second-order equation. The intraparticle diffusion studies revealed that the adsorption rates were not controlled only by the diffusion step. The thermodynamic parameters, such as the changes in enthalpy, entropy, and Gibbs free energy, showed that the adsorption is endothermic, random and spontaneous at high temperature. The results indicate that LVM adsorbs MO efficiently and could be utilized as a low-cost alternative adsorbent for the removal of anionic dyes in wastewater treatment.
Fulltext Culture, cross-role consistency, and adjustment: testing trait and cultural psychology perspectives

Church AT, Anderson-Harumi CA, del Prado AM, Curtis GJ, Tanaka-Matsumi J, Valdez Medina JL, et al.

J Pers Soc Psychol, 2008 Sep;95(3):739-55.
PMID: 18729706 DOI: 10.1037/0022-3514.95.3.739

Trait and cultural psychology perspectives on cross-role consistency and its relation to adjustment were examined in 2 individualistic cultures, the United States (N=231) and Australia (N=195), and 4 collectivistic cultures, Mexico (N=199), the Philippines (N=195), Malaysia (N=217), and Japan (N=180). Cross-role consistency in trait ratings was evident in all cultures, supporting trait perspectives. Cultural comparisons of mean consistency provided support for cultural psychology perspectives as applied to East Asian cultures (i.e., Japan) but not collectivistic cultures more generally. Some but not all of the hypothesized predictors of consistency were supported across cultures. Cross-role consistency predicted aspects of adjustment in all cultures, but prediction was most reliable in the U.S. sample and weakest in the Japanese sample. Alternative constructs proposed by cultural psychologists--personality coherence, social appraisal, and relationship harmony--predicted adjustment in all cultures but were not, as hypothesized, better predictors of adjustment in collectivistic cultures than in individualistic cultures.
Fulltext A comparative evaluation of dengue diagnostic tests based on single-acute serum samples for laboratory confirmation of acute dengue

Chua KB, Mustafa B, Abdul Wahab AH, Chem YK, Khairul AH, Kumarasamy V, et al.

Malays J Pathol, 2011 Jun;33(1):13-20.
PMID: 21874746

A prospective study was carried out to evaluate the sensitivity of dengue NS1 antigen-capture ELISA in comparison with dengue virus isolation, conventional RT-PCR and real-time RT-PCR for laboratory confirmation of acute dengue based on single-acute serum samples. Four primary healthcare centres were involved to recruit patients with clinical diagnosis of dengue illness. Patient's demographic, epidemiological and clinical information were collected on a standardized data entry form and 5 ml of venous blood was collected upon consent. In the laboratory, six types of laboratory tests were performed on each of the collected acute serum sample. Of the 558 acute serum samples collected from 558 patients with clinical diagnosis of dengue from mid-August 2006 to March 2009, 174 serum samples were tested positive by the dengue NS1 antigen-capture ELISA, 77 by virus isolation, 92 by RT-PCR and 112 by real-time RT-PCR. A total of 190 serum samples were tested positive by either one or a combination of the four methods whereas, only 59 serum samples were tested positive by all four methods. Thus, based on single-acute serum samples, 190 of the 558 patients (34.1%) were laboratory-confirmed acute dengue. The overall test sensitivity was 91.6%, 40.5%, 48.4% and 58.9% for dengue NS1 antigen-capture ELISA, virus isolation, conventional RT-PCR and real-time RT-PCR respectively. Statistically, dengue NS1 antigen-capture ELISA was the most sensitive and virus isolation was the least sensitive test for the laboratory confirmation of acute dengue based on single-acute serum specimens. Real-time RT-PCR was significantly more sensitive than the conventional RT-PCR.
Fulltext Epidemiological and clinical features of dengue versus other acute febrile illnesses amongst patients seen at government polyclinics

Mustafa B, Hani AW, Chem YK, Mariam M, Khairul AH, Abdul Rasid K, et al.

Med J Malaysia, 2010 Dec;65(4):291-6.
PMID: 21901948

Classical dengue fever is characterized by the clinical features of fever, headache, severe myalgia and occasionally rash, which can also be caused by a number of other viral and bacterial infections. Five hundred and fifty eight patients who fulfilled the criteria of clinical diagnosis of acute dengue from 4 government outpatient polyclinics were recruited in this prospective field study. Of the 558 patients, 190 patients were categorized as acute dengue fever, 86 as recent dengue and 282 as non-dengue febrile illnesses based on the results of a number of laboratory tests. Epidemiological features of febrile patients showed that the mean age of patients in the dengue fever group was significantly younger in comparison with patients in the non-dengue group. There was no significant difference between the two groups with respect to gender but there was significant ethnic difference with foreign workers representing a higher proportion in the dengue fever group. Patients with acute dengue fever were more likely to have patient-reported rash and a history of dengue in family or neighbourhood but less likely to have respiratory symptoms, sore-throat and jaundice in comparison to patients with non-dengue febrile illnesses. As with patients with dengue fever, patients in the recent dengue group were more likely to have history of patient-reported rash and a history of dengue contact and less likely to have respiratory symptoms in comparison to patients with non-dengue febrile illnesses. In contrast to patients with dengue fever, patients in the recent dengue group were more likely to have abdominal pain and jaundice in comparison to non-dengue febrile patients. The finding strongly suggests that a proportion of patients in the recent dengue group may actually represent a subset of patients with acute dengue fever at the late stage of illness.
Study site: Klinik Kesihatan Seksyen 7, Shah Alam; Klinik Kesihatan Kelana Jaya, Petaling Jaya; Klinik Kesihatan Sg. Buloh; Klinik Kesihatan Jinjang, Selangor, Kuala Lumpur, Malaysia
Fulltext A fatal case of chikungunya virus infection with liver involvement

Chua HH, Abdul Rashid K, Law WC, Hamizah A, Chem YK, Khairul AH, et al.

Med J Malaysia, 2010 Mar;65(1):83-4.
PMID: 21265260 MyJurnal

Recovery from chikungunya is previously considered universal and mortality due to the virus is rare and unusual. Findings from recent chikungunya outbreaks occurred in Reunion Island and India have since challenged the conventional view on the benign nature of the illness. Malaysia has experienced at least of 4 outbreaks of chikungunya since 1998. In the present on-going large outbreak due to chikungunya virus of Central/East African genotype, a previous healthy sixty six years gentleman without co-morbidity was noted to have severe systemic infection by the virus and involvement of his liver. He subsequently passed away due to cardiovascular collapse after 5 days of illness.
Fulltext Broad reactive monoclonal antibodies for rapid identification of enteroviruses show cross-reactivity with chikungunya virus infected cells

Khairul AH, Chem YK, Keniscope C, Rosli J, Hassan S, Mat J, et al.

Malays J Pathol, 2010 Jun;32(1):49-52.
PMID: 20614726 MyJurnal

In the past decade, enterovirus 71 (EV71) and chikungunya (CHIK) virus have re-emerged periodically causing serious public health problems in Malaysia, since their first emergence in 1997 and 1998 respectively. This study demonstrates that CHIK virus causes similar patterns of cytopathic effect in cultured Vero cells as some enteroviruses. They also show positive cross-reaction on direct immunofluorescence staining using monoclonal antibodies meant for typing enteroviruses. Without adequate clinical and epidemiological information for correlation, CHIK virus isolated from patients with acute febrile rash can be wrongly reported as untypeable enterovirus due to its cross-reactivity with commercial pan-enterovirus monoclonal antibodies. This is due to the diagnostic laboratory being unaware of such cross-reactions as it has not been reported previously. Final identification of the virus could be determined with specific antibodies or molecular typing using specific oligonucleotide primers for the CHIK virus.

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