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Hidden bugs in a newly opened hospital: the distribution of skin microbiota among healthcare workers in a newly opened teaching hospital

Kamala Nathan M, Jasni AS, Zakariah SZ, Tengku Jamaluddin TZM, Mohd Isa M, Ibrahim R

J Med Microbiol, 2023 Jul;72(7).
PMID: 37432079 DOI: 10.1099/jmm.0.001732

Background. Skin is a reservoir for millions of micro-organisms, all of which make up the skin microbiota. Hospitals have been identified as a favourable environment for transmitting micro-organisms and thus, it is important to know the distribution of skin microbiota among healthcare workers (HCWs), as such findings may provide baseline information for the distribution of skin microbiota in hospitals.Hypothesis. There is no significant association between the factors (age, gender, type of skin microenvironment, hand hygiene practices, usage of skin care products, current healthcare practices and previous workplace) and the distribution of the skin microbiota among HCWs.Aim. The study aims to identify type of skin microbiota and associated factors (age, gender, type of skin microenvironment, hand hygiene practices, use of skincare products, current healthcare practice, and previous workplace) that influence the growth of skin microbiota.Method. About 102 bacterial isolates were obtained from the skin of 63 healthcare workers in a newly opened teaching hospital, namely Hospital Pengajar Universiti Putra Malaysia (HPUPM). All isolated bacteria were subjected to phenotypic identification according to standard microbiological procedures.Results. The most common isolated skin microbiota were Gram-positive bacteria (84.3%), followed by Gram-negative bacteria (15.7%). A Chi-square test of independence was used to analyse the above factors and there was a significant association between the type of skin microenvironment and the distribution of skin microbiota (P=0.03) (type of skin microenvironment influences the distribution of skin microbiota).Conclusion. Coagulase-negative Staphylococcus spp. was the most common bacteria isolated from the skin of the healthcare workers. Even though coagulase-negative staphylococci (CoNS) are low pathogenic bacteria, but it may cause serious infection in high risk group of patients. Therefore, it is important to emphasize on the good hand hygiene practices and implement strict infection control measures to minimize the risk of HAI in newly opened hospitals.
[Double to avoid trouble? An experience of double Memokath(tm) 044TW stents insertion for multiple anterior urethral stricture in hospital universiti sains Malaysia]

Mohd Isa MF, Mohamed Ashraf Md MAM, Yusof MR, Faiz N G, Siti Rahmah H I Merican SRHIM

Urologiia, 2023 May.
PMID: 37401716

For the past two decades urethral stenting became more popular for treatment of urethral stricture. However, urethral stents still not widely used in view of good outcome from urethroplasty surgery. The MemokathTM stent is the most popular in this field. It is manufactured from a biocompatible alloy of nickel and titanium. Most of the studies have been limited to single stent insertion, and no studies done for double stents insertion. An 81-year-old man with history of multiple anterior urethral strictures since 2013. He underwent internal urethrotomy in the same year but failed and was on urinary catheter since then. The MemokathTM 044TW was the option due to patient has multiple comorbidities. The micturating cystourethrogram (MCUG) and ascending urethrogram showed multiple anterior urethral strictures. He underwent direct visual internal urethrotomy and two MemokathTM stents inserted in the whole length of urethral. However, one year after procedure, he had recurrent lower urinary tract symptoms and ultimately developed acute urinary retention (AUR). Patients stents were removed endoscopically. During endoscopic removal, he had encrustation of both stents that causing obstructive symptoms. He is under our follow-up with no recurrent urinary retention or urosepsis with satisfactory uroflowmetry. Stent encrustation is known to be a common late complication of urethral stents. Stent encrustation should be suspected if patient comes with obstructive symptoms. Endoscopic is shown to be the best method to detect the cause of obstructed stent.
Fulltext Ocular Ischemic Syndrome With Bilateral Carotid Artery Stenosis in a Patient With Chronic Tophaceous Gout

Mohammad Razali A, Mohamed Shafit MA, Md Saleh R, Mohmood A, Mohd Isa M

Cureus, 2023 Nov;15(11):e49270.
PMID: 38143638 DOI: 10.7759/cureus.49270

Ocular ischemic syndrome is a rare, blinding condition that usually presents rather late. This occurs mainly due to stenosis or occlusion of the carotid artery which supplies the ocular structures. Bilateral involvement may occur in one in five cases but may be asymmetrical. We report a case of a 72-year-old gentleman with bilateral ocular ischemic syndrome secondary to left common carotid artery total occlusion and severe right proximal internal carotid artery stenosis in a patient who is an active smoker with chronic tophaceous gout. His vision remained stable after a year of follow-up, with the main emphasis on optimizing his medical condition and smoking cessation.
Fulltext Nystagmus and Abducens Nerve Palsy as an Early Presentation of Non-alcoholic Wernicke Encephalopathy

Darussalam SH, Mohd Isa M, Md Saleh R, Mohmood A, Mohammad Razali A

Cureus, 2024 Jan;16(1):e52121.
PMID: 38344547 DOI: 10.7759/cureus.52121

Wernicke encephalopathy (WE) is a rare but life-threatening syndrome that is commonly associated with chronic alcoholism. It has also been found to be associated with malnutrition, prolonged parenteral nutrition, hemodialysis, hyperemesis gravidarum, gastroplasty, and AIDS. It usually presents as a clinical triad of confusion, ophthalmoplegia, and gait ataxia. Nystagmus is usually the most common and earliest ophthalmologic sign. We report a case of non-alcoholic WE in a patient who had prior bariatric surgery and was treated for malnutrition and sepsis, with nystagmus being the initial presentation. The MRI of the brain was normal. The diagnosis of WE was made clinically and was supported by the patient's symptomatic and clinical recovery following intravenous thiamine treatment. It is essential to highlight that a high level of suspicion is needed to diagnose non-alcoholic WE to allow the commencement of appropriate treatment and reduce morbidity and mortality rates related to this condition.
Fulltext Development of a hydrogen gas sensor using a double SAW resonator system at room temperature

Yunusa Z, Hamidon MN, Ismail A, Mohd Isa M, Yaacob MH, Rahmanian S, et al.

Sensors (Basel), 2015;15(3):4749-65.
PMID: 25730480 DOI: 10.3390/s150304749

A double SAW resonator system was developed as a novel method for gas sensing applications. The proposed system was investigated for hydrogen sensing. Commercial Surface Acoustic Wave (SAW) resonators with resonance frequencies of 433.92 MHz and 433.42 MHz were employed in the double SAW resonator system configuration. The advantages of using this configuration include its ability for remote measurements, and insensitivity to vibrations and other external disturbances. The sensitive layer is composed of functionalized multiwalled carbon nanotubes and polyaniline nanofibers which were deposited on pre-patterned platinum metal electrodes fabricated on a piezoelectric substrate. This was mounted into the DSAWR circuit and connected in parallel. The sensor response was measured as the difference between the resonance frequencies of the SAW resonators, which is a measure of the gas concentration. The sensor showed good response towards hydrogen with a minimum detection limit of 1%.
Fulltext Tear Samples for Protein Extraction: Comparative Analysis of Schirmer's Test Strip and Microcapillary Tube Methods

Tham ML, Mahmud A, Abdullah M, Md Saleh R, Mohammad Razali A, Cheah YK, et al.

Cureus, 2023 Dec;15(12):e50972.
PMID: 38259376 DOI: 10.7759/cureus.50972

INTRODUCTION: Tear sampling is an attractive option for collecting biological samples in ophthalmology clinics, as it offers a non-invasive alternative to other invasive techniques. However, there are many tear sampling methods still in consideration. This study explores the suitability of Schirmer's test strip and microcapillary tube as reliable and satisfactory methods for tear sampling.
METHODS: Tear samples were collected from eight healthy volunteers using the standard Schirmer's test strip method with or without anesthesia and microcapillary tubes. The total tear protein concentrations were analyzed via spectrophotometry and bicinchoninic acid (BCA) protein assay. The protein profile was determined by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The optimal wetting length of Schirmer's strip and suitable buffer solutions were compared. Discomfort levels reported by participants and the ease of execution for ophthalmologists were also evaluated.
RESULTS: Tear samples exhibited typical protein profiles as shown by SDS-PAGE. The mean total protein obtained from an optimum wetting length of 20 mm using Schirmer's strip without anesthesia in phosphate-buffered saline (PBS) yielded substantial quantities of protein as measured by nanophotometer (220.20 ± 67.43 µg) and the BCA protein assay (210.34 ± 59.46 µg). This method collected a significantly higher quantity of protein compared to the microcapillary tube method (p=0.004) which was much more difficult to standardize. The clinician found it harder to utilize microcapillary tubes, while participants experienced higher insecurity and less discomfort with the microcapillary tube method. PBS used during the tear protein extraction process eluted higher tear protein concentration than ammonium bicarbonate, although the difference was not statistically significant. Using anaesthesia did not ease the sampling procedure substantially and protein quantity was maintained.
CONCLUSION: Good quality and quantity of protein from tear samples were extracted with the optimized procedure. Schirmer's strip test in the absence of local anesthesia provided a standard, convenient, and non-invasive method for tear collection.
Correction: Tear Samples for Protein Extraction: Comparative Analysis of Schirmer's Test Strip and Microcapillary Tube Methods

Tham ML, Mahmud A, Abdullah M, Md Saleh R, Mohammad Razali A, Cheah YK, et al.

Cureus, 2024 May;16(5):c173.
PMID: 38736763 DOI: 10.7759/cureus.c173

[This corrects the article DOI: 10.7759/cureus.50972.].