Helminthiasis among Indian Preschoolers from Urban Areas in Penang

Helminthiasis is a common parasitic condition particularly among children in rural areas in developing countries where poor hygiene standard is practiced. The study aimed to determine the prevalence of helminthiasis among Indian preschoolers in urban areas in Penang and its associated factors. A total of 194 urban Indian preschoolers aged 4 to 6 years old were selected randomly from 11 kindergartens in the state of Penang for this cross sectional study. Data collection was carried out in 2 phases. First, microscopic stool examinations were done to examine the presence of helminths. Second, self administered questionnaires which inquired about human, environment and socioeconomic factors were completed by the parents/guardians. The overall prevalence of helminthiasis was 7.2% and the most frequently encountered infective agent was Ascaris lumbricoides (57.1%) and followed by the tapeworms (42.86%). The logistic regression indicated that habitual thumb sucking (AOR= 5.6. 95%CI: 1.73-18.39) and families owning domestic pets (AOR= 3.2; 95%CI: 1.03-10.14) were the significant contributing factors to helminthiasis among the Indian pre-schoolers in urban Penang. Although the prevalence of helminth infection among the urban Indian preschoolers is lower than rural area, it is still a public health concern. Children habitual thumb sucking and rearing domestic pets at home were the significant contributing factors in helminthiasis. Prevention strategy should focus on health education and promotion among adults and children, awareness on domestic animal hygiene and maintaining good environmental sanitation. Multi agency collaboration is clearly essential, especially between state health, education and veterinary departments in curbing this disease.

Syphilis in pregnancy

Syphilis in pregnancy remains an important medical condition due to its consequences. We present two cases of young pregnant women who were diagnosed syphilis during their antenatal visit. The first case was a 29-year-old Malay lady diagnosed with syphilis during the first trimester of pregnancy, while the second case was a 21-year-old Chinese lady diagnosed with syphilis during the third trimester of pregnancy. The diagnosis and management of the syphilis in pregnancy are discussed

Anti-cyclic citrullinated peptide antibody is a good indicator for the diagnosis of rheumatoid arthritis

Anti-cyclic citrullinated peptide [CCP] antibody has recently been used in the classification of rheumatoid arthritis [RA]. This antibody is more specific than rheumatoid factor [RF] for the diagnosis of RA. The study objectives were to determine the sensitivity, specificity, positive and negative predictive values of anti-CCP in RA diagnosis. Eighty RA patients and 80 non-RA individuals were included in the study. Blood was collected from both arms of study subjects and tested for anti-CCP and RF antibodies. Relevant clinical information and laboratory profiles of the RA patients were evaluated using patients' medical records and Integrated Laboratory Management System [ILMS], respectively. The sensitivity and specificity of anti-CCP were 35% and 100% respectively. The positive and negative predictive values were 100% and 61%, respectively. Positive anti-CCP was found significantly associated with multiple joint pain [p < 0.001] and hand's joints pain [p=0.01], symmetrical joints involvement [p=0.015] and high CRP value [p < 0.001]. Anti-CCP was also found to have positive association with RF [p < 0.001]. Anti-CCP is highly specific for the diagnosis of RA. High positive predictive value should be taken into consideration for effective treatment

Case series of syphilis and HIV co-infections

Syphilis and HIV co-infection are indeed dangerous combinations. The present communication describes three different cases of syphilis and HIV co-infection in young men. The first case is a 25-year-old medical graduate with a primary and secondary syphilis lesions at time of presentation. The second case is a 24-year-old government officer with right eye posterior uveitis where the serology tests for syphilis were reactive. His HIV tests were also positive. The final case is a 25-year-old homosexual who was admitted to the medical ward because of Mycobacterium tuberculosis infection. The HIV and syphilis serology tests were noted to be positive