ABSTRACT
@#Most poultry farms in Malaysia preferred rearing chickens either for eggs or/and meat than turkeys. This is due to several challenges such as parasitic load and heat stress in rearing turkey. Blastocystis is one of the most common protozoan parasites infecting poultry. As no study was conducted on Blastocystis infection in turkey in Malaysia, this study aims to determine the current status, the morphological characteristics and subtyping of Blastocystis from turkey reared either in closed house or free-range system in Penang, Malaysia. It was found that the prevalence of Blastocystis sp. infection in turkeys were moderately high with 41.6% (25/60) in the closed house and 45.0% (45/100) in free-range system as infection was higher in the female turkeys with no gastrointestinal signs and symptoms. Vacuolar form was the most common form found in the in vitro culture ranged between 5 to 20 μm in diameter with a rough surface coat and undulating cell surface viewed under the scanning electron microscope. Meanwhile, the ultrastructure of the cells from turkey isolates were varies with partially expanded electron-opaque vacuoles to electron-dense in fully distended vacuoles. Interestingly, sequence analysis for 30 positive Blastocystis isolates from turkeys revealed one subtypes with three alleles namely, ST7 allele 99 (73.4%, n=22), ST7 allele 100 (23.3%, n=7) and ST7 allele 101 (3.3%, n=1). Findings from this study added to our understanding on Blastocystis infection in turkey production.
ABSTRACT
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.
ABSTRACT
Tuberculous (TB) biliary stricture with calcified liver nodules rendering obstructive jaundice is a rare clinical phenomenon. Recently, we encountered a young patient with obstructive jaundice who was investigated in a general hospital. He was sent to our hospital for subsequent management after undergoing a series of investigations and biliary stenting. The radiological imagings performed revealed multiple calcified lesions in the liver with proximal bile duct strictures. Blood investigations, tumor markers and tuberculous work up were not remarkable. Subsequently, he underwent laparotomy and biliary reconstruction. Postoperatively, he was discharged well. Histopathological examination of the hepatoduodenal nodes showed chronic infections and granulomatous lymphadenitis, suspicious of a mycobacterium infection.
ABSTRACT
Majority of doctors show no interest in research although research is now a requirement and is being done in every field of medicine. The objective of this survey was to describe the involvement in research activities among doctors in Penang and Seberang Jaya hospitals in Penang. A self-administered questionnaire was used. A total of 302 doctors participated in the survey. The differences in age (p=<0.001), years since graduation (p=0.001), occupation (p=<0.001), post graduate qualification (p=0.001) and career focus (p=0.005) were statistically significant for the involvement in research activities. Respondents who had additional training in statistics (OR 2.86 95% CI 1.76; 4.67), who read journals regularly (OR 3.79 95% CI 2.29; 6.27), who were confident in interpreting medical literature (OR 3.08 95% CI 1.84;5.17), interested in a career in research (OR 7.35 95% CI 4.26;12.68) and who had knowledge in the use of statistical packages (OR 11.10 95% CI 6.29;19.60) were more likely to be involved in research. By hierarchy, having knowledge in statistical packages (aOR 11.57 95% CI 5.49; 24.42), interested in a career in research (aOR 8.54 95% CI 3.99; 18.28) and having a post graduate qualification (aOR 1.48 95% CI 1.01;2.16) were significant associated factors. It is imperative that doctors be given ample opportunity to attend research methodology training programmes to increase their participation in research activities.
ABSTRACT
Background: Hypertension is estimated to cause 4.5% of the global disease burden. The prevalence of hypertension in Malaysia is 32.2%. Objective: To determine the prevalence of hypertension and its associated risk factors in two rural communities in Penang, Malaysia. Methods: This cross sectional study was conducted among all consenting residents aged 18 years and above from two villages in Penang. Besides the baseline demographic information, blood pressure was measured using a manual sphygmomanometer according to the American Heart Association Guidelines. Results: 50 out of 168 people were hypertensive, giving a prevalence rate of 29.8%. 50.0% of those found with hypertension were undiagnosed and 48.0% of those who were diagnosed with hypertension had uncontrolled blood pressure. Logistic regression analysis showed that age, history of alcohol consumption and BMI were found to be independently associated with hypertension. Conclusions: Age, education level, alcohol consumption and BMI are important risk factors associated with the prevalence of hypertension among the villagers. These risk factors are comparable to those reported in National Health and Morbidity Survery 2006 in Malaysia.
ABSTRACT
A mucous cyst is a benign, self limiting mucous containing cyst of the salivary glands commonly occuring in the oral cavity. Mucocele may develop following the obstruction of the salivary flow from secretory apparatus of the salivary gland. Mucoceles commonly occur on the lower lip but may occur in other locations too. The objective of the study was to determine the factors associated with mucocele in patients attending the dental clinic of Penang Hospital from January 2000 to December 2005. This is a retrospective record review analysis of all the total 35 cases treated during this period, comprising of 20 males (57.1%) and 15 females (42.9%) with Malays as the largest group of patients treated and, mainly students had seek treatment. Mucocele was frequently treated in patients aged 21 to 24 year old. The site of the mucocele was the lower lip and all of the cases were treated surgically. The size of the mucocele ranged from 0.5 to 5 centimetres with 1.0 cm as the most common size. Most of the patients gave a history of spontaneous development (71.4%), followed by lip biting (25.7%) and trauma (2.9%). Lip biting was more common among students (55.6%) as compared to others. There were only two recorded cases of recurrence.
ABSTRACT
Introduction: To review the sputum bacteriology and its in-vitro antibiotic susceptibility in patients hospitalized with community-acquired pneumonia (CAP) in a state tertiary-referral Hospital (Penang hospital, Malaysia) in order to determine the most appropriate empiric antibiotics. Methods : From September 2006 to May 2007, 68 immunocompetent adult patients [mean age: 52 years (range 16-89); 69% male] admitted to respiratory wards for CAP with positive sputum isolates within 48 hours of admission were retrospectively identified and reviewed. Results: 62 isolates were Gram(-) bacilli (91%) & 6 were Gram(+) cocci (9%). The two commonest pathogens isolated were Pseudomonas aeruginosa (n=20) and Klebsiella pneumoniae (n=19) together constituted 57% of all positive isolates. Among the Pseudomonas isolates, 84.2% were fully sensitive to cefoperazone and cefoperazon/sulbactam; 95% to ceftazidime, cefepime, piperacillin/tazobactam, ciprofloxacin and amikacin, and 100% to gentamycin, netilmycin, imipenem and meropenem. Among the Klebsiella isolates, 5.3% were fully sensitive to ampicillin; 84.2% to amoxicillin, ampicllin/sulbactam, cefuroxime and ceftriazone; 89.5% to piperacillin/ tazobactam; 93.3% to cefoperazon/sulbactam and 100% sensitive to ceftazidime, cefepime, ciprofloxacin, all aminoglycosides and carbopenems. Conclusion : In view of the high prevalence of respiratory Pseudomonas aeruginosa, ampicillin/ sulbactam, currently the most prescribed antibiotic to treat CAP in our respiratory wards, may not be the most appropriate empiric choice. Higher generation cephalosporins with or without beta-lactamase inhibitors, ciprofloxacin or carbapenem may be the more appropriate choices. The lack of information on patients’ premorbidities such as recent hospitalization and prior antibiotic exposure, limits the interpretation of our findings and may have biased our results towards higher rates of Gram negative organisms.