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Fulltext Gangrenous small bowel obstruction secondary to congenital internal herniation: a case report

Tan YL, Alhagi MV

Med J Malaysia, 2012 Feb;67(1):118-20.
PMID: 22582563 MyJurnal

Congenital internal herniation is a rare condition presenting as recurrent abdominal pain or acute intestinal obstruction. In cases in which bowel incarceration or strangulation develop, rapid progression to bowel ischemia, necrosis or perforation is inevitable. Mortality in such cases has been reported to be as high as 50%. Despite advances in imaging modalities, arriving at a pre-operative diagnosis of a congenital internal herniation remains a challenge. We report such a case where imaging was unsuccessful in determining the cause of intestinal obstruction in a 3 year old child. Congenital internal herniation may result in disastrous consequences if not addressed in a timely fashion due to its rarity. Hence a high index of clinical suspicion is needed to avoid missing this diagnosis in a child presenting with recurrent abdominal pain or acute intestinal obstruction.
Fulltext From 18S to 28S rRNA Gene: An Improved Targeted Sarcocystidae PCR Amplification, Species Identification with Long DNA Sequences

Lee FCH, Muthu V

Am J Trop Med Hyg, 2021 02 22;104(4):1388-1393.
PMID: 33617472 DOI: 10.4269/ajtmh.20-0767

Sarcocystosis outbreaks in Tioman and Pangkor islands of Malaysia between 2011 and 2014 have raised the need to improve Sarcocystis species detection from environmental samples. In-house works found that published primers amplifying the 18S rRNA gene of Sarcocystis either could not produce the target from environmental samples or produced Sarcocystis DNA sequence that was insufficient for species identification. Using the primer pair of 18S S5 F (published) and 28S R6 R (new), this study improved the PCR amplification of Sarcocystidae to overcome these two difficulties. The PCR product spanned from the 18S to 28S rRNA genes, providing more information for species identification. The long DNA sequence allowed comparison between the "Ident" and "Query Cover" sorting in GenBank identity matching. This revealed the ambiguity in identity matching caused by different lengths of reference DNA sequences, which is seldom discussed in the literature. Using the disparity index test, a measurement of homogeneity in nucleotide substitution pattern, it is shown that the internal transcribed spacer (ITS)1-5.8S-ITS2 and 28S genes are better than the 18S gene in indicating nucleotide variations, implying better potentials for species identification. The example given by the handful of Sarcocystidae long DNA sequences reported herein calls for the need to report DNA sequence from the 18S to the 28S rRNA genes for species identification, especially among emerging pathogens. DNA sequence reporting should include the hypervariable 5.8S and ITS2 regions where applicable, and not be limited to single gene, per the current general trend.
Fulltext Influence of low-level gelling agents on the dissolution and in-vitro nutrient release study of coconut water-based hydrogel

Seow EK, Muthu V, Che Muhamed AM, Ooi CH, Singh R, Mat Easa A, et al.

J Food Sci Technol, 2022 Feb;59(2):589-596.
PMID: 35153308 DOI: 10.1007/s13197-021-05045-0

The purpose of this study was to evaluate the controlled-release properties of nutrients from coconut water-based hydrogel. Hydrogels were prepared at varying proportions of gellan and xanthan gums such that the total weight of the gelling agents for all 11 formulations was 1% (w/w) in coconut water. The formulation of the hydrogel was selected using gravimetric analysis by evaluating the dissolution weight of the hydrogel in simulated gastric fluid and simulated intestinal fluid. Interestingly, hydrogel with 0.7% gellan gum and 0.3% xanthan gum showed the most tolerance towards simulated gastric and intestinal fluids over a 1-h period. The in-vitro release study was performed in simulated gastric fluid and followed by simulated intestinal fluid for about 2 h. The trend of release profile showed that the hydrogel had the ability to sustain the nutrients release over a period of 1 h. After 75 min, the release trend was static indicated the nutrients was released from the hydrogel. In conclusion, a coconut water-based hydrogel formulated with 0.7% of gellan and 0.3% of xanthan gum has demonstrated its controlled-release property as evidenced by its effectiveness in the sustained release of nutrients over a period of 1 h.
Fulltext Assessing the national antibiotic surveillance data to identify burden for melioidosis in Malaysia

Arushothy R, Mohd Ali MR, Zambri HF, Muthu V, Hashim R, Chieng S, et al.

IJID Reg, 2024 Mar;10:94-99.
PMID: 38179416 DOI: 10.1016/j.ijregi.2023.11.014

OBJECTIVES: A leading cause of morbidity and mortality in Southeast Asia, the epidemiological data on melioidosis disease occurrence and mortality in Malaysia is not comprehensive. The aim of this study is to determine the burden of melioidosis and assess the National Surveillance for Antibiotic Resistance (NSAR) data as a potential tool melioidosis surveilance in Malaysia.
METHODS: We performed a retrospective analysis on the B. pseudomallei reposited data submitted to the NSAR network between January 2014 and December 2020. The data were screened for information on patient demographics and specimen types. Additional patient comorbidities and outcomes were drawn from parallel surveillance for bacteremic melioidosis.
RESULTS: The average annual incidence rate of melioidosis between 2014-2020 was 3.41 per 100,000 population and was significantly different between states (P <0.001). The highest incidence was observed in Pahang at 11.33 per 100,000 population. Individuals of Malay ethnicity, from the states of Pahang, Johor, Perak, and Negeri Sembilan aged 40-49, who were diabetic and working in agriculture-related sectors had a higher risk of succumbing to the infection.
CONCLUSION: Assessing the NSAR data proved to be a useful tool for the determination of the incidence and socio-demographic risk factors attributed to melioidosis in Malaysia.