A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic

@#Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic.

The Effects Of Dietary Sodoium Nitrite Supplementation On Jejunal Mucosa And Possible Protective Effect Of Vitamin A In Albino Rats

Nitrate (NO3-) and nitrite (NO2-) are naturally-occurring oxidation products of nitrogen which widely used in thefood industry. The goal of this study was to illustrate the histopathological effects of sub-lethal dose of sodiumnitrite on jejunal mucosa and the possible protective effect of vitamin A. Thirty adult male Albino rats weredivided into 3 groups as follows: Group I (control) received distilled water, Group II (Nitrite-treated) whichreceived intra-gastric daily dose of 50 mg/kg NaNO2 and Group III (Nitrite & vit-A treated group) which receivedintra-gastric daily dose of 50 mg/kg NaNO2 +10,000 I.U/ rat vitamin A. Animals were sacrificed 8 weeks aftertreatment. Blood samples were collected and examined. Specimens from jejunal mucosa of rats were collectedfor the optical and electron microscope study. The blood samples showed significant reduction in all blood cellscounting and albumin level with elevated methemoglobin level in the nitrite treated group. Light microscopicexamination revealed that; Sodium nitrite cause jejunal mucosa damage represented by abnormal shape andlength of jejunal mucosa villi, necrosis with marked loss of covering epithelium and excessive cellular infiltrationin its core of lamina. PAS stained sections exhibited weak or negative PAS reaction of goblet cells of brush borderof villi and crypts. The entrocytes and goblet cells showed ultrastructural changes. Vitamin A administrationresulted in marked regression of the previously mentioned jejunal mucosal effects. Results of the current studyrevealed that diatry supplemtation of nitrite cause multible jejunal mucosal injury but the co-administration ofVitamin A greatly reduce the toxic effects of nitrite supplementation on jejunal mucosa

Morphological and molecular characterization of Acanthamoeba isolated from contact lens paraphernalia in Malaysia: Highlighting the pathogenic potential of T4 genotype

Objective: To determine the morphological and molecular characterization of Acanthamoeba isolates from contact lens paraphernalia in Malaysia and to investigate their pathogenic potential based on the physiological tolerance. Methods: One hundred and eighty contact lens wearers donated their contact lens, lens storage cases and lens solutions between 2018 and 2019. The samples were inoculated onto 1.5% non-nutrient agar plates for 14 d. Polymerase chain reaction (PCR) was performed and the amplified PCR products were sequenced and compared with the published sequences in GenBank. The pathogenic potential of positive isolates was further tested using temperature-tolerance and osmo-tolerance assays. Acanthamoeba species were categorized into three distinct morphological groups established by Pussard and Pons. Results: Acanthamoeba was successfully isolated from 14 (7.8%) culture-positive samples in which 11 belong to morphological group II and 3 belong to morphological group III, respectively. The sequencing of 18S ribosomal RNA gene led to the identification of the T4 genotype in all the isolated strains. In vitro assays revealed that 9 (64.3%) Acanthamoeba isolates were able to grow at 42 °C and 1 M mannitol and were thus considered to be highly pathogenic. Conclusions: To the best of our knowledge, this is the first report identifying the Acanthamoeba genotype and their pathogenic potential among contact lens wearers in Malaysia. The potentially pathogenic T4 genotype isolated in this study is the most predominant genotype responsible for human ocular infection worldwide. Hence, increasing attention should be aimed at the prevention of contamination by Acanthamoeba and the disinfection of contact lens paraphernalia.

Giardiasis Amongst The Orang Asli School Children At Pos Titom, Pahang, Malaysia / Jurnal Sains Kesihatan Malaysia

Giardia intestinalis is among the protozoa that is commonly found in the human fecal samples throughout the world. Theprevalence of infection is higher among people living in developing countries than developed countries. One hundredand eleven Orang Asli children at Pos Titom, Pahang participated in this study. The prevalence study was conducted inaccordance to gender, age groups and the diagnostic techniques employed. Fecal samples were collected and examinedfor the presence of G. intestinalis using three diagnostic techniques ie; the direct fecal smear, formalin-ether concentrationand the trichrome staining technique. The overall prevalence of G. intestinalis infection among Orang Asli children at PosTitom was 23.42%. The infection was higher among females (25%) as compared to males (21.57%) eventhough it wasnot statistically significant (p > 0.05). In terms of age groups, no positive case was observed among preschoolers whoseage were below seven-years while the school aged children (7 to 12-years old) showed 24.53% infection. The trichromestaining technique was the most sensitive with a detection rate of 22.52% followed by the formalin-ether concentrationtechnique with a detection of 19.82% whilst the direct smear technique only detected 12.61% of cases. The prevalenceof giardiasis amongst the Orang Asli children at Pos Titom, Pahang was still high despite various efforts made andimprovements in basic infrastructural facilities undertaken for their community. The health care status and personalhygiene of Orang Asli children remains poor and needs to be further improved.

Identification of Gram Positive and Negative Bacteria Microflora Isolated from Hot Water Spring in Bentong, Pahang / Jurnal Sains Kesihatan Malaysia

A study on the isolation and identification of bacterial flora from hot spring was carried out from Bentong hot springwater, Pahang. In general, many of the bacteria identified from the hot spring were from Bacillus sp. due to its abilityto adapt to high temperature mainly by forming endospore. The objective of this study was to identify bacteria otherthan Bacillus sp. that were able to survive this hot spring. Three hot spring pools were identified as A, B and C. Thetemperatures were ranging from 36°C to 52°C and their pH values were between 7.88-8.65. The result shows thattwo species of Gram positive cocci and three species of Gram negatives were isolated. The two Gram positives wereStreptococcus sp. and Staphylococcus sp. The three species of Gram negative rods were identified as Pseudomonas sp.,Klebsiella sp. and Proteus sp. In conclusion, non-sporulating species of bacteria other than Bacillus sp. have adaptedto survive in hot spring

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.

Infant acute myocarditis mimicking acute myocardial infarction

Myocarditis is an inflammatory disease of the myocardium with heterogeneous clinical manifestations and progression. In clinical practice, although there are many methods of diagnosis of acute myocarditis, the diagnosis remains an embarrassing dilemma for clinicians. The authors report the case of 9-month-old infant who was brought to the Pediatric Emergency Department with sudden onset dyspnea. Examination disclosed heart failure and resuscitation was undertaken. The electrocardiogram showed an ST segment elevation in the anterolateral leads with a mirror image. Cardiac enzyme tests revealed a significant elevation of troponin and creatine phosphokinase levels. A diagnosis of acute myocardial infarction was made, and heparin therapy was prescribed. The infant died on the third day after admission with cardiogenic shock. The autopsy showed dilatation of the ventricles and massive edema of the lungs. Histological examinations of myocardium samples revealed the presence of a marked lymphocytic infiltrate dissociating myocardiocytes. Death was attributed to acute myocarditis. The authors call attention to the difficulties of differential diagnosis between acute myocarditis and acute myocardial infarction especially in children, and to the important therapeutic implications of a correct diagnosis.

Does intrauterine injection of low-molecular-weight heparin improve the clinical pregnancy rate in intracytoplasmic sperm injection? / 대한생식의학회지

OBJECTIVE: Heparin can modulate proteins, and influence processes involved in implantation and trophoblastic development. This study aimed to assess the improvement of clinical pregnancy and implantation rates after local intrauterine injection of low-molecular-weight heparin (LMWH) in patients undergoing intracytoplasmic sperm injection (ICSI). METHODS: A randomised case/control design was followed in women scheduled for ICSI. The study arm was injected with intrauterine LMWH during mock embryo transfer immediately following the ovum pickup procedure, while the control arm was given an intrauterine injection with a similar volume of tissue culture media. Side effects, the clinical pregnancy rate, and the implantation rate were recorded. RESULTS: The pregnancy rate was acceptable (33.9%) in the LMWH arm with no significant reported side effects, confirming the safety of the intervention. No statistically significant differences were found in the clinical pregnancy and implantation rates between both groups (p=0.182 and p=0.096, respectively). The odds ratio of being pregnant after intrauterine injection with LMWH compared to the control group was 0.572 (95% confidence interval [CI], 0.27−1.22), while the risk ratio was 0.717 (95% CI, 0.46−1.13; p=0.146). No statistical significance was found between the two groups in other factors affecting implantation, such as day of transfer (p=0.726), number of embryos transferred (p=0.362), or embryo quality. CONCLUSION: Intrauterine injection of LMWH is a safe intervention, but the dose used in this study failed to improve the outcome of ICSI. Based on its safety, further research involving modification of the dosage and/or the timing of administration could result in improved ICSI success rates.

comparative study of open, laparoscopic and robotic partial nephrectomy in obese patients

Partial nephrectomy is a standard intervention for the treatment of small renal tumors. Our study compares the outcomes of three different partial nephrectomy methods [open, laparoscopic and robotic assisted] in obese [>/=30 Kg/m[2]] patients with renal tumors. Between 2005-2011, 66 obese patients had partial nephrectomy. Patients were divided into three groups according to intervention received: Open [n = 21], laparoscopic [n = 31] and robotic [n = 14]. The outcome variables of blood loss, length of hospital stay, and complications were assessed. Mean blood loss in the laparoscopic group [100 mls] was significantly less than open group [300 mls] and no difference between laparoscopic and robotic groups [150 mls]. We observed a shorter median hospital stay in the laparoscopic group [two days] than open group [four days] and no difference between laparoscopic and robotic groups [three days]. Three patients in the laparoscopic group had complications: Two grade II and one with grade III [based on Clavien-Dindo classification]. Tumor location, pathology, grade, stage, patient gender, age, preoperative creatinine and postoperative creatinine were not different among the groups [P > 0.05]. The mean tumor size in the laparoscopic group [2.70 cms] was significantly smaller than that of the open group [4.22 cm] [P; < 0.05], but not statistically different from that of the robotic group [2.99 cm]. Our study demonstrates that in obese patients, both laparoscopic and robotic partial nephrectomy are associated with less blood loss than open partial nephrectomy. Second, the length of the hospital stay was not related to the type of utilized intervention

Myelo-Enhancement by Astragalus Membranaceus in Male Albino Rats with Chemotherapy Myelo-Suppression. Histological and Immunohistochemical Study

BACKGROUND AND OBJECTIVES: Myelo-suppression is the most common toxicity encountered in the oncology clinic today. This study was planned to investigate the possible protective and therapeutic role of the traditional Chinese Medicinal Herb; Astragalus Membranaceus (AM), on chemotherapy-induced myelosuppression. METHODS AND RESULTS: This study was carried out on thirty six adult male albino rats. They were divided into: Group I Control Group (n=6) received a vehicle of phosphate buffered saline (PBS) solution. Group II (n=12) were injected I.P. with cyclophosphamide (CY) for 3 days (gIIa n =6) and continued for one more week to receive AM orally (gIIb n=6). Group III (n=6) received CY I.P. together with AM orally for 3 days. Group IV (n=12) received AM orally for one week (gIVa n=6) and continued for extra three days receiving CY I.P. with AM orally (gIVb n=6). Blood samples were analysed for Total Leucocytic Count and Lymphocytic Count. Counting of CD34 +ve cells in bone marrow was performed by flowcytometry. Bone marrow sections were subjected to H&E stain as well as immunohistochemical staining for anti- CD20 antibody. The mean area % of cellular bone marrow regions occupied by developing haemopoietic cells, mean area of fat cells and mean number of CD20 immunopositive B lymphocytes in the bone marrow were measured by histomorphometric studies and statistically compared. AM proved to have a myelo-protective and myelo-therapeutic capacity, evidenced at both laboratory and morphological levels. CONCLUSIONS: The greatest myelo-potentiating effect of AM was achieved when supplied before and together with CY therapy.

Enhancement of Neural Stem Cells after Induction of Depression in Male Albino Rats (A histological & Immunohistochemical Study)

BACKGROUND AND OBJECTIVES: Depression is one of the most prevalent psychiatric disorders. Endogenous neural stem cells (NSCs) could replace damaged Hippocampal neurons in depression. This work was planned to evaluate Rhodiola rosea (Rr) extract possible role in stimulation of NSCs proliferation and in depression improvement. METHODS AND RESULTS: Thirty adult male albino rats were divided into three groups; control, untreated depressed model and Rr model. After depression induction by chronic mild stress, rats received Rr extract 1.5 g/kg/day for three weeks. The sucrose preference test (SP) was done before, after depression induction and 3 weeks after supplementation of Rr. The brain was removed and processed for H&E and immunohistochemical staining for caspase 3, glial fibrillary acid protein (GFAP) and proliferating cell nuclear antigen (PCNA). Rr group revealed improved sucrose preference, increased undamaged neurons and decreased dark neurons. Moreover, Caspase 3 +ve cells were not detected, GFAP +ve cells increased and PCNA +ve cells were detected only in Rr group. CONCLUSIONS: This work points to the role of Rr in depression improvement and in stimulation of NSCs proliferation.

Prevalence Study of Candidiasis by Conventional Pap Smear at Sarawak General Hospital, Malaysia / Jurnal Sains Kesihatan Malaysia

This study was conducted to determine the prevalence of candidiasis among women of 20 to 59 years of age at Sarawak General Hospital by examining the conventional Pap smear. The prevalence of this infection was studied among the five main ethnic groups comprising of Iban, Chinese, Malay, Bidayuh and Orang Ulu. Microscopic screening of 300 conventional Pap smears which had been processed and stained with the Papanicolaou staining method was conducted. Based on the information provided in the Pap smear screening form, the clinical manifestations were observed which may provide some indications on the type of infection. The details of the clinical manifestations were very important because in an infection or inflammation, Pap smears would usually demonstrate the cyto-morphological changes of the epithelial cells. The age factor among the different ethnics also plays important role in the assessment of the infection frequency. Candida sp. was detected in 12.7% of the specimens. The infection occurred in all ethnic groups as well as in all age groups. All cases presented with clinical signs and symptoms. The results of this study revealed the importance of undergoing Pap smear screening for candidiasis detection besides screening for the early detection of cervical cancer

Different Clinical Outcomes of Entamoeba histolytica in Malaysia: Does Genetic Diversity Exist?

The present study was conducted to investigate the clinical outcomes of Entamoeba histolytica infection in symptomatic and asymptomatic Orang Asli (aborigine) communities in Malaysia. Examination was performed on 500 stool samples obtained from Orang Asli communities in 3 different states using formalin-ether concentration, trichrome staining, and single-round PCR techniques. Out of 500 stool samples, single infection of E. histolytica, Entamoeba dispar, and Entamoeba moshkovskii was identified in 3.2%, 13.4%, and 1%, respectively. In addition, 10 samples had mixed infections with E. histolytica and E. dispar. Six samples containing E. dispar were also positive for E. moshkovskii, and only 2 samples had E. histolytica in association with E. dispar and E. moshkovskii. Seventeen E. histolytica-positive samples were from symptomatic subjects, whereas the remaining 11 samples came from asymptomatic subjects. These findings suggest a predominant distribution of pathogenic potential of E. histolytica strains in this community. Therefore, further studies on genotyping of E. histolytica is required, to find out association between E. histolytica genotype and the outcome of the infection.

The Effect of In Vivo Mobilization of Bone Marrow Stem Cells on the Pancreas of Diabetic Albino Rats (A Histological & Immunohistochemical Study)

BACKGROUND AND OBJECTIVES: The rapidly increasing number of diabetic patients across the world drew the attention to develop more effective therapeutic approaches. Recent investigations on newly differentiated insulin producing cells (IPCs) revealed that they could be derived from embryonic, adult mesenchymal and hematopoietic stem cells. This work was planned to evaluate the role of StemEnhance (Aphanizomenon flos-aquae [AFA] plant extract) in mobilizing naturally occurring bone marrow stem cells as well as in improving streptozotocin-induced diabetic rats. METHODS AND RESULTS: Twenty adult male albino rats were divided into four groups namely the control, the diabetic, the positive control-StemEnhance and the diabetic-StemEnhance groups. After diabetes induction by streptozotocin (STZ), rats received StemEnhance for four weeks. The mean number of blood CD34 immunopositive cells was measured by flowcytometry and random blood sugar was measured weekly. The pancreas was removed from the sacrificed rats and processed for staining with H&E and immunohistochemical staining for CD34+ve and insulin +ve cells. CD34+ve cells increased in the blood after introduction of StemEnhance. CD34+ve cells were observed in the pancreas and the insulin producing cells in the islets of Langerhans were increased from the second to the fourth week of treatment. Blood glucose level improved but it was still higher than the control level after four weeks of StemEnhance treatment. CONCLUSIONS: This work points to the significant role of StemEnhance in stem cell mobilization and the improvement of diabetes mellitus.

IMPROVING THE TOLERANCE OF Vicia faba AGAINST ENVIRONMENTAL SALINITY RESULTED FROM THE IRRIGATION WITH SEA WATER BY USING KNO3 AND (NH4)2SO4 AS CHEMICAL OSMOREGULATORS / Mejoramiento de la tolerancia de Vicia faba a salinidad ocasionada por irrigación con agua de mar usando KNO3 AND (NH4)2SO4 como osmoreguladores químicos

The familiar solutes, Na+, K+, Ca2+, Mg2+, Cl-, PO4(3-), SO4(2-), soluble carbohydrates, amino acids and soluble proteins, which play a role in osmotic adjustment were estimated to investigate the role of potassium nitrate and ammonium sulphate as osmoregulators and their effects on the solutes composition. Vicia faba L. was cultivated and irrigated with 5, 10, 15 and 20 % (v:v) sea water. The plants were divided to three groups. The first was irrigated with sea water only. The second was treated with 5 mM KNO3 while the third was treated with 5mM (NH4)2SO4. The plants were left to grow until flowering stage. The results indicated that the non treated group increased the soluble carbohydrates in the roots to avoid the influx of sodium. The treatment with KNO3 decreased the sodicity (SAR) while (NH4)2SO4 treatment decreased the SK:Na value in the shoots at higher salinity. The availability of nitrogen as nitrate or ammonium ions enhances the accumulation of soluble carbohydrates in shoots. The plants of all groups were depended on Ca2+, as compatible solute more than Na+, and K+.

Los solutos Na+, K+, Ca2+, Mg2+, Cl-, PO4(3-), SO4(2-), carbohidratos y proteínas solubles, así como amino ácidos son importantes en ajuste osmótico y fueron estimados para determinar el papel de nitrato de potasio y sulfato de amonio como osmoreguladores y su efecto en la composición de solutos. Vicia faba L. fue cultivada e irrigada con 5, 10, 15 y 20 % (v:v) de agua de mar permitiendo crecimiento hasta el estado de floración. Las plantas fueron divididas en tres grupos. El primero fue irrigado con agua de mar solamente. El segundo fue tratado con 5 mM KNO3, mientras que el tercer grupo fue expuesto a 5mM (NH4)2SO4. Los resultados indican que las plantas del primer grupo (no tratado) incrementan carbohidratos solubles en sus raíces para evitar influjo de sodio. El tratamiento con KNO3 disminuye riqueza de sodio (SAR) mientras que la exposición a (NH4)2SO4 diminuye la de SK:Na en brotes a salinidad alta. La disponibilidad de nitrato o iones amonio aumenta acumulación en las raíces de carbohidratos solubles. Las plantas de todos los grupos dependen de Ca2+ como soluto compatible más que de Na+ o K+.

The Effectiveness of Gentamicin against Acanthamoeba Cysts in Vitro

Acanthamoeba is a free-living protozoa which causes serious ocular problem. Acanthamoeba keratitis is becoming more prevalent amongst contact lens wearers and it can cause loss of vision and blindness if not treated properly. The objective of this research is to determine the effectiveness of gentamicin against six Acanthamoeba spp. isolates, of which three were clinical isolates (HS 6, HKL 95, HTH 73) and three environmental isolates (SMAL 7, SMAL 8, TTT 9). Cyst suspension from the chosen isolates were exposed to gentamicin. After 48 hours of incubation at temperature of 30°C and 37ºC, each mixture was filtered and filtration membrane was put onto non-nutrient agar laid with Escherichia coli. The agar plates were incubated for three days at 30oC and 37oC and the plates were examined daily until day 14 to look for the presence of Acanthamoeba trophozoites under inverted microscope. The presence of trophozoites indicated the ineffectiveness of gentamicin. Gentamicin was found to be effective against Acanthamoeba cysts from all the test strains at both incubation temperatures. The minimum cysticidal concentration (MCC) mean value of gentamicin was 0.193 mg/mL at 30oC and 0.229 mg/mL at 37oC. So, we concluded that gentamicin has cysticidal potential towards Acanthamoeba.

Identification of Bacterial Flora other than Bacillus sp. from Bentong Hot Spring in Pahang, Malaysia / Jurnal Sains Kesihatan Malaysia

A study on the isolation and identification of bacterial flora from hot spring was carried out using water from Bentong hot spring in Pahang. In general most of the bacteria identified from the hot springs were from Bacillus sp. This was due to its ability to adapt to high temperature mainly by forming endospore. The objective of this study was to identify bacteria other than Bacillus that were able to survive in hot springs. Three hot spring pools were identified (A,B and C) with temperatures ranging from 36°C to 52°C and pH values between 7.88-8.65. This study has succesfully isolated two species of Gram positive cocci and three species of Gram negative bacilli. The two Gram positives were Streptococcus sp. and Staphylococcus sp. The three species of Gram negative rods were unidentified and were denoted as X, XI and XII.

Prevalence of Bacterial Vaginosis from Examination of Conventional Pap Smears at Sarawak / Jurnal Sains Kesihatan Malaysia

This study was conducted to determine the prevalence of bacterial vaginosis among women of age 20 to 59 years at Sarawak General Hospital by examining the conventional Pap smear. The prevalence of this infection was studied among the five main ethnic groups comprising the Iban, Chinese, Malay, Bidayuh and Orang Ulu. Microscopic screening of 300 conventional Pap smears which had been processed and stained with the Papanicolaou staining method was conducted. Based on the information provided in the Pap smear screening form, the clinical manifestations were observed which may provide some indications on the type of infection. The details of the clinical manifestations were very important because in an infection or inflammation, Pap smears would usually demonstrate changes on the cyto-morphology of the epithelial cells. The age factor among the different ethnics also played important role in the assessment of the infection frequency. Bacterial vaginosis was detected in 79.7% (239/300) of cases. The infection occurred in all ethnic groups and the infections were more frequently seen among the 20 to 39 years age group. Majority of the cases (93.9%) presented with clinical signs and symptoms. The results of this study revealed the importance of undergoing a Pap smear screening for bacterial vaginosis detection besides screening for the early detection of cervical cancer

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.

Prevalence Study of Trichomonas vaginalis by Conventional Pap Smear at Sarawak General Hospital, Malaysia / Jurnal Sains Kesihatan Malaysia

This study was conducted to determine the prevalence of Trichomonas vaginalis among women of age 20 to 59 years at Sarawak General Hospital by examining the conventional Pap smear. The prevalence of this infection was studied among the five main ethnic groups comprising the Iban, Chinese, Malay, Bidayuh and Orang Ulu. Microscopic screening of 300 conventional Pap smears which had been processed and stained with the Papanicolaou staining method was conducted. Based on the information provided in the Pap smear screening form, the clinical manifestations were observed which may provide some indications on the kind of infection. The details of the clinical manifestations were very important because in an infection or inflammation, Pap smears would usually demonstrate changes on the cyto-morphology of the epithelial cells. The age factor among the different ethnics also played important role in the assessment of the infection frequency. Trichomonas vaginalis was detected in 7.7% (23/300) of the specimens. This infection occurred in all ethnic groups and the infections were more frequently seen among 20 to 29 years age group. All the cases presented with clinical signs and symptoms. The results of this study revealed the importance of undergoing Pap smear screening for Trichomonas vaginalis infection detection besides screening for the early detection of cervical cancer.