The local Chow Kit market is the largest wet market in the city of Kuala Lumpur. It is very close to the biggest government hospital in the city centre. However, the level of cleanliness in this area is always questionable and a matter of concern. The aim of this study was to identify the prevalence of T. gondii oocyst in water samples used by hawkers in that market and tissue cysts in rats' brains captured from the same area. Water samples were taken to the parasitology laboratory at the National Universtiy of MalaysiaUniversity and a sugar flotation concentration method was used. Supernatant microscopical examination was then performed. A total of 752 slides were screened for the presence of T. gondii oocyst. A hundred rats wandering in the same area were also captured by the hawkers using mousetraps. After each animal was sacrificed, and an electric microtome was used to cut out serial sections 5 microm thick from the rat brains. The de-waxed tissue sections were stained by the progressive Haematoxylin and Eosin (H&E) stain for microscopical examination. A total of 1000 slides were screened under a light microscope to detect the presence of T. gondii brain cysts. All the water samples were found to be negative for T. gondii oocyst. Out of the 100 rats captured, three rats were found to possess T. gondii cysts in their brains. Water samples reflect minimal or no solid food contamination, while the 3% of positive brain cysts influence the researchers to broaden their investigations for future projects.
The authors report a case of a 6-week-old baby girl who was admitted to the paediatric ward due to a high fever for 2 days. The patient experienced three fits which took place while in the ward. A brain sonogram showed subdural heterogeneous collection consistent with focal empyema; however, no hydrocephalus or infarction was detected. An urgent Burr hole procedure was performed to remove the collected pus. Both blood and cerebrospinal fluid (CSF) culture grew Salmonella species which remain sensitive to some antibiotics. This strain was sent to the institute of medical research (IMR) for serotyping. The patient was treated with intravenous combination of ceftriaxone and ciprofloxacin for 3 weeks. One week later, IMR sent results that identified the strain as Salmonella enterica serotype Houtenae. Following antibiotic treatment, repeat ultrasound illustrated an improvement of the subdural empyema, and the gram stain of the CSF specimen failed to isolate bacteria.
Ocular parasitosis in human is more prevalent in geographical areas where environmental factors and poor sanitary conditions favor the parasitism between man and animals. Lesions in the eye can be due to damage directly caused by the infectious pathogen, indirect pathology caused by toxic products, or the immune response incited by infections or ectopic parasitism. The epidemiology of parasitic ocular diseases reflects the habitat of the causative parasites as well as the habits and health status of the patient. An ocular examination may provide clues to the underlying disease/infection, and an awareness of the possibilities of travel-related pathology may shed light on an ocular presentation. This paper is a comprehensive review of the parasitic diseases of the eye. The majority of the clinically important species of parasites involved in eye infection are reviewed in this paper. Parasites are discussed by the disease or infection they cause.
A 31-year-old Malaysian man was presented with an episode of seizures by the roadside, after having been recently diagnosed as HIV positive accompanied with miliary tuberculosis. On physical examination, he was oriented to person, but not to time or place. There was no neck stiffness or papilloedema. The other systemic examination was unremarkable. Chest examination revealed crepitations at the upper zone of the right lung. After diagnosis suspicion, the case was confirmed as toxoplasma encephalitis by MRI and serological tests. Patient was treated with trimethoprim/sulfamethoxazole 480-2400 mg/day with folinic acid supplement for 60 days. Two months later, a repeat brain MRI showed resolution of the cerebral lesions.
Absence of the distal crease of the fingers is usually associated with a flexion deformity. A single crease of one or more fingers is found in many syndromes. We present this report as a rare case of absence of interphalangeal crease of the right ring finger with restriction of flexion but without any other anomaly.
Current anti-gastric ulcer agents have side effects, despite the progression and expansion of advances in treatment. This study aimed to investigate the gastroprotective mechanisms of Pithecellobium jiringa ethanol extract against ethanol-induced gastric mucosal ulcers in rats. For this purpose, Sprague Dawley rats were randomly divided into five groups: Group 1 (normal control) rats were orally administered with vehicle (carboxymethyl cellulose), Group 2 (ulcer control) rats were also orally administered with vehicle. Group 3 (positive control) rats were orally administered with 20 mg/kg omeprazole, Groups 4 and 5 (experimental groups) received ethanol extract of Pithecellobium jiringa ethanol extract at a concentration of 250 and 500 mg/kg, respectively. Sixty minutes later, vehicle was given orally to the normal control group, and absolute ethanol was given orally to the ulcer control, positive control and experimental groups to generate gastric mucosal injury. The rats were sacrificed an hour later. The effect of oral administration of plant extract on ethanol-induced gastric mucosal injury was studied grossly and histology. The level of lipid peroxidation (malondialdehyde-MDA), superoxide dismutase (SOD) and gastric wall mucus were measured from gastric mucosal homogenate. The ulcer control group exhibited severe gastric mucosal injury, and this finding was also confirmed by histology of gastric mucosa which showed severe damage to the gastric mucosa with edema and leucocyte infiltration of the submucosal layer. Pre-treatment with plant extract significantly reduced the formation of ethanol-induced gastric lesions, and gastric wall mucus was significantly preserved. The study also indicated a significant increase in SOD activity in gastric mucosal homogenate, whereas a significant decrease in MDA was observed. Acute toxicity tests did not show any signs of toxicity and mortality up to 5 g/kg. The ulcer protective effect of this plant may possibly be due to its preservation of gastric wall mucus along with increased SOD activity and reduction of oxidative stress (MDA). The extract is non-toxic, even at relatively high concentrations.
Massive lower gastrointestinal bleeding due to trichuriasis and/or typhoid fever is rarely reported. We reported a case of a 29-year-old male presented with per rectal bleeding, diarrhea, generalized abdominal pain and fever for two weeks. After diagnosis suspicion, emergency exploratory laparotomy was performed, where resection of the ulcerated part of the caecum and terminal ileum was performed. Microscopically analysis, diagnosed heavy infestation with Trichuris trichiura. It was complicated with Salmonella typhi infection confirmed later from the blood culture result.
The age distribution, types of infection and clinical patterns of malaria were compared in patients admitted to an urban and a rural hospital. Analysis of the cases seen in urban setting characteristically indicated a relatively low transmission rate of the disease, whereas the mean inoculation rate in patients from the rural hospital was found to be at least twenty folds higher. Plasmodium vivax was the predominant causative species in the urban hospital (p = 0.01), infecting mostly adult (p = 0.001) males (p = 0.01). The geometric mean parasite count at 3432/microl among the urban patients was significantly higher than that in the rural patients at 1422/microl (p = 0.04). Coma and death were more common among the cases seen in the urban hospital (p = 0.003), while severe anemia was the significant complication in the rural setting. Overall, the provisional diagnosis of malaria was relatively low in the urban hospital (p = 0.02). The results from this study highlighted the need to define the extent of malaria in urban areas. This report attempts to identify the non-climatic determinants of the infection and, furthermore, to provide a more informed basis to describe the burden of the disease.