Occurrence of The Pathogenic Amoeba Naegleria fowleri, Pathogenesis, Diagnosis, and Treatment Options

@#Naegleria fowleri is the causative agent of primary amoebic meningoencephalitis (PAM) that infects the central nervous system (CNS). The amoeba is present ubiquitously. The infection is rare but has a high mortality rate. The pathogenic amoeba reaches the host through the nasal passage and migrates along the olfactory nerves to reach the human brain and cause severe destruction of the CNS. As Malaysia has a large population that practising ablutions in daily routine, the risk of infection increases. Two mechanisms associated with the infection include contact-dependent and contact-independent. Signs and symptoms vary from early stage to later stage of infection. CSF and brain biopsy are the common specimens collected used to diagnose the PAM infection and usually detect and identify by PCR method. As for treatment, the CDC of United States America has recommended the usage of miltefosine that provides promising in vitro therapy against N. fowleri. This review will discuss more on the occurrence of N. fowleri, pathogenicity, diagnostic tools, and pharmacotherapy approach against N. fowleri infection.

Qualitative Phytochemical Analysis and Antimicrobial Activity of Piper sarmentosum Leaves Extract against Selected Pathogens / Jurnal Sains Kesihatan Malaysia

@#The controversial usage of antiseptic in treating wound infections had become a huge issue over the years due to its minimal effectiveness and high toxicity level that are harmful to humans. Hence, numerous studies had been carried out to determine other possible approaches including herbal remedies. The alarming situation had led us to study on Piper sarmentosum and its antimicrobial activity against selected pathogens. In present study, methanol extract of Piper sarmentosum leaves were prepared to investigate the presence of phytochemical compounds. The in vitro antimicrobial activity of crude methanolic extract was evaluated using disc diffusion and microdilution broth methods. The study demonstrated the antimicrobial activity of leaves extract against Staphylococcus aureus (7 mm) and Escherichia coli (6.5 mm). However, no zone of inhibition was observed against Pseudomonas aeruginosa. Meanwhile, the MIC values for Staphylococcus aureus was 6.25 mg/mL whilst Escherichia coli was 12.5 mg/mL. In addition, the phytochemical screening results revealed that the extract contained glycosides, flavonoids, terpenoids, alkaloids, and phenolics. In conclusion, methanolic extract of Piper sarmentosum leaves has the potential as a new, effective alternative towards current drugs that are available for skin-associated infection. The findings from this study are crucial in providing latest information of the plant’s additional values that can be incorporated as a baseline for current and future studies as well as in investigating other possible plants that are beneficial for health purposes, particularly for combating skin-associated infection.

Parasitic Infections Among Renal Transplant Recipients in Kuala Lumpur Hospital / Jurnal Sains Kesihatan Malaysia

@#One hundred seventy-one patients suffering from chronic renal diseases at Kuala Lumpur Hospital participated in a crosssectionalstudy with purposive sampling to ascertain prevalence rates of Cryptosporidium parvum (C. parvum), Giardiaintestinalis (G. intestinalis), Blastocystis hominis (B. hominis) and Strongyloides stercoralis (S. stercoralis). The patientswere divided into 2 groups: post-transplant group (138 patients) and pre-transplant group (33 patients). In this study, theparasite infection is linked to the aspects of race, gender, renal patient’s group and the postrenal transplantation period.Immunofluorescence staining was performed on fecal slides for the detection of C. parvum oocysts and G. intestinalis cysts.Sand charcoal culture technique was also used to detect the presence of S. strongyloides in fecal samples. The findingsshowed that the prevalence of C. parvum, G. intestinalis dan B. hominis among post-transplant patients was 18.1%,10.9% and 22.5%, respectively but none of the pretransplant patient was infected. Meanwhile, both patient groups werefree of S. stercoralis infection. Furthermore, there was no significant association between post-transplantation periodand pattern in prevalence of the studied parasites, however, it was noted that the prevalence rates of C. parvum and G.intestinalis had declined after 6 months post transplantation.

Technology Advancement Enabling the Link of Gut Microbiota with Obesity and Metabolic Disorder / Jurnal Sains Kesihatan Malaysia

Obesity is a growing epidemic due to an accelerated phase of industrialization and urbanization with the overfed people now outnumbered the underfed. It is the major public health problem with a lot of research interest as it is associated with many complicated chronic disorders such as type-2 diabetes, cardiovascular diseases (CVD) and cancers. A global estimation of 2.8 million deaths per year is due to obesity and there are tremendous on-going efforts to identify hosts and environmental factors that infl uence the cause and pathogenesis of obesity. Concerted efforts from different research groups had successfully shown that obese subjects have altered composition of gut microbiota and transplantation of this microbiota infl uences body weight in the germ-free recipient mice. The advancement of technology had made possible the study of gut microbiota which was unculturable for better understanding of their impact to human health. Rapid deep sequencing of DNA at reasonable cost through various options of platforms followed by data analysis using robust bioinformatic tools are an important way of analysing the gut microbiome. Here we review the role of gut microbiota which modulates host’s metabolic functions and gene expression, facilitating the extraction and storage of energy from the ingested dietary substances and leading to body-weight gain. We will discuss on the different techniques used, focusing on the high-defi nition technologies for the determination of the composition, function and ecology of gut microbiota. This allows the appropriate selection of platform which becomes the key for success of subsequent research.

Trichuriasis among Orang Asli Children at Pos Lenjang, Pahang, Malaysia / Jurnal Sains Kesihatan Malaysia

A cross-sectional study was conducted in February 2006 to determine the prevalence of Trichuris trichiura infection among Orang Asli (Aborigine) children at Pos Lenjang, Pahang. A total of 71 faecal samples were collected from the children (40 girls and 31 boys) aged between 1-12 years. The samples were examined for the presence of Trichuris trichiura ova using direct smear and formalin-ether concentration techniques. The result revealed that the overall prevalence of Trichuris trichiura infection was 43.7%. The infection was higher in males (51.6%) compared to females (37.5%), though not statistically significant (p > 0.05). According to age group, the school-aged children had higher prevalence of infection (56.8%) than preschool children (29.4%) (p < 0.05). Low socioeconomic status, large family size, poor environmental sanitation and poor personal hygiene are possible contributing factors that increase the prevalence of infection among the Orang Asli children at Pos Lenjang. In 31 samples positive for Trichuris trichiura, a detection rate of 100% was obtained using formalin-ether concentration, compared to 25.8% with direct smear technique. Thus, it is recommended that both techniques be performed in routine faecal examination for a more accurate diagnosis.

Giardiasis Among Orang Asli Children at Pos Lenjang, Pahang / Jurnal Sains Kesihatan Malaysia

Giardia intestinalis is a cosmopolitan parasite and the infection is widely distributed worldwide especially in the developing countries with poor sanitation and lack of potable water. Seventy one Orang Asli children from Pos Lenjang, Pahang participated in this study and stool specimens were collected and examined for G. intestinalis using three diagnostic techniques ie; Direct fecal smear, Formalin-ether concentration and Trichrome staining. The prevalence of G. intestinalis infection among the Orang Asli children in Pos Lenjang, Pahang was as high as 43.7%. According to gender, the prevalence was almost similar between the female and male children with 45.0% and 41.9%, respectively. The infection was more prevalent in school going children (48.6%) as compared to the pre-school children (38.2%).

Entamoeba histolytica Infection Among Aborigines at Pos Lenjang, Pahang / Jurnal Sains Kesihatan Malaysia

Entamoeba histolytica infection is widespread worldwide and higher prevalence is usually seen among the indigenous under priviledged people living in the tropics and subtropics. Seventy one Orang Asli children from Pos Lenjang, Pahang participated in this study and were grouped according to age and gender. Faecal samples were collected and examined for the presence of Entamoeba histolytica using 3 different diagnostic techniques namely the direct faecal smear, formalin ether concentration and trichrome staining.The prevalence of Entamoeba histolytica infection among the Orang Asli children at Pos Lenjang, Pahang was high at 22.5%. According to gender, female children showed higher prevalence (32.5%) compared to male at only 9.7%. Infection was also apparently higher among the school going children at 32.4% compared to preschool children (11.8%). The high prevalence of Entamoeba histolytica infection amongst the Orang Asli children at Pos Lenjang is related to several factors including low socioeconomic status, lack of basic amenities, culture, and poor knowledge on healthy life practice.