Presence of SARS-CoV-2-like coronaviruses in bats from east coast Malaysia

@#Most of the public health importance coronaviruses, such as Severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV-2 are likely originated from bats and spread to humans through intermediate hosts; civet cats, dromedary camel and Malayan pangolin, respectively. SARS-CoV-2-like coronaviruses were detected in Thailand, which is neighbouring with Kelantan in East Coast Malaysia. To date, there is no report on the presence of public health concerns (SARS-CoV, SARS-CoV-2 and MERS-CoV) coronaviruses in bats from Malaysia. This study was aimed to elucidate the presence of these coronaviruses in bat samples from East Coast, Malaysia. A total of hundred seventy oropharyngeal swab samples were collected from three states of East Coast Malaysia. Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was conducted based on partial 3’ Untranslated region (3’UTR) or ORF10 gene and the products were sequenced. The sequences were compared with all coronavirus sequences from the National Center for Biotechnology Information-GenBank (NCBI-GenBank) using NCBI-Basic Local Alignment Search Tool (NCBI-BLAST) software. A phylogenetic tree was constructed to determine the genetic relationship among the detected coronaviruses with the reference coronaviruses from the NCBI-GenBank. Our results showed that SARSCoV-2-like viruses were present in 3% (5/170) of the bats from East Coast Malaysia that have 98-99% sequence identities and are genetically related to SARS-CoV-2 from humans. This finding indicates the presence of SARS-CoV-2-like viruses in bats from East Coast Malaysia that may become a public health concern in the future.

Sybr Green Real-Time PCR is a Useful Method in Screening for High Risk Human Papilloma Virus Types 16 and 18 in Neoplastic Cervical Cancer

Human papillomavirus (HPV) plays an important role in the pathogenesis of cervical cancer. HPV has been found in 99.7% of cervical cancers worldwide. In Malaysia, it is the second most common cancer among women in all major ethnic groups. The main purpose of this study was to establish the method of SyBrGreen Real-Time PCR and apply it for identification of multiple infections of the two high risk HPV subtypes. In this study, 57 positive samples for HPV 16 and HPV 18 were used to establish a simple and sensitive method to detect and identify HPV infection in the cervical neoplasia at different stages of the disease by using real-time ABICycler SyBrGreen 1 technology. The results showed 67 HPV genomes in 57 samples. HPV 16 genome was detected in 55/67 (82%) cases while HPV 18 was detected in 8/67 (12%) cases with 4 cases showing multiple infections of HPV 16 and HPV 18. HPV 16 was the most prevalent followed by HPV 18. Using SyBr Green Real-Time PCR techniques, the results showed that DNA melting curve for HPV 16 had a peak around 80.2ºC and Ct value of 20 cycles whereas the DNA melting curve for HPV 18 around 79.2ºC and Ct INTRODUCTION value of 22 cycles. In conclusion, a SyBr Green Real-Time PCR method has the potential for clinical usage in detection and identification of HPV infection in cervical neoplasia at different stages of the disease.

Tracheobronchial straight metallic pin aspiration in young Jordanian females

To define the clinical spectrum of tracheobronchial straight metallic pin aspiration in adults, assess predisposing conditions, evaluate the efficacy of bronchoscopy, and determine the outcome and complications at the largest 2 hospitals in Jordan. Retrospective analysis of 60 consecutive clinical cases from 2 referrAl based medical centers [32 patients at King Hussein Medical Center [KHMC] and 28 patients at Al Basheer Hospital]. Medical records of adult patients [>13 years of age] who presented with history of straight metallic pin aspiration over 6-year period [July 2000 and July 2006] were analyzed. Clinico-radiological features and location of the pins were studied. The flexible fiberoptic bronchoscopy [FFB] was used for foreign body [FB] identification and removal in all KHMC patients; video assisted rigid bronchoscope under general anesthesia was used at Al Basheer Hospital. All patients were females<28 years of age. Fifty-six patients [93%] presented within the first 24 hours after aspiration. Medical history was suggestive of FB aspiration in all patients. Chest x-rays demonstrated the radio opaque pins in all patients. At bronchoscopy, the intermediate bronchus was the most common site of FB lodgment [62%]. Ninety-two percent of patients were discharged on the same day of the procedure. Tracheobronchial straight metallic pins are relatively frequent FB in Jordanian young females and can occur in a very specific clinical setting. Removal of these FBs can usually be accomplished successfully by FFB

Clinical evaluation and diagnosis of hyperthyroidism revisited

Rationale: An attempt to help hyperthyroid patients to circumvent the cost of thyroid function tests, a relatively heavy financial burden for the average Iraqi citizen nowadays. To design a protocol for clinical diagnosis of hyperthyroidism utilizing the Wayne's Thyrotoxicosis Diagnostic Index [WTDI] as a base line. Design: Clinical comparison of hyperthyroid patients and euthyroid subjects. Setting: a. for patients, Hazim-Al-Hafidh Oncology and Nuclear Medicine Hospital, Mosul, b. for subjects, visitors of Ibn Seena Teaching Hospital, Mosul. The study was conducted during the period from December 1997 to August 1998. Participants: One hundred thyrotoxic patients diagnosed by hormonal assays and one hundred clinically euthyroid subjects of similar sex and age. Intervention: History and physical examination pertinent to hyperthyroidism for each patient and each subject including all components of the WTDI. Main outcome measures: Clinical data obtained from both patients and subjects were measured using sensitivity, specificity, and predictive values of each symptom and sign. The WTDI was utilized for assessing the clinical findings of each patient and subject Two symptoms and ten physical signs, including two new signs that were not part of WTDI - the velvety skin and the wide pulse pressure, attained confirmatory value in ruling - in the diagnosis of hyperthyroidism. Two symptoms and four signs did attain a confirmatory value in ruling - out the diagnosis when absent. Both hot hands and tachycardia reached rule - In and rule - out states. Ninety-five of the one hundred patients entered the thyrotoxicosis zone of the WTDI by attaining >/= 19 points. By offering two points and one point to the velvety skin and the wide pulse pressure respectively, all the 100 patients attained >/= 19 points. The highest score attained by any of the 100 subjects was 14 points; the mentioned addition would at most bring the highest score among subjects to 17 points; less than the diagnostic score of WTDI. Heat intolerance did not reach a ruling - in or ruling - out diagnostic value in our study though given the highest diagnostic value in WTDI. The reason[s] for such discrepancy was discussed. Koilonychia was noted in 29% of the patients and 8% of the subjects. WTDI with minor modification is worth to be adopted for the diagnosis of thyrotoxicosis and for follow up reassessment of patients during medical treatment particularly when a patient could not bear the cost of the thyroid function tests with the possible exception of some patients like pregnant women who may need a more elaborate evaluation