Molecular survey of head lice (Pediculus humanus capitis) infestation among disadvantaged children in Klang Valley, Malaysia

@#Ectoparasitic infestations including pediculosis capitis are common in people of disadvantaged communities as they live in overcrowded institutions, a condition that often favourable for disease transmission. In this study, we evaluated the prevalence of head lice infestation among disadvantaged children aged between five to 14 years-old living in five poor conditions located across the Klang Valley, Malaysia. Of total 335 children examined, 14% were positively infected with head lice. Molecular analysis using the universal cytochrome c oxidase subunit I (COI) barcoding gene on total of 167 head lice collected in this study indicated they are belonging to the A and C clades; confirming the global distribution of clade A and expansion of clade C in Southeast Asia, which is reported for the first time in Malaysia.

Bite envenomation by Latrodectus geometricus (Araneae: Theridiidae) spiders in Malaysia

@#We report two confirmed human bite cases by Lactrodectus geometricus, also known as the brown widow spider. These are the first reported bite envenomation incidents by L. geometricus in Malaysia. The incidents occurred in Tawau, Sabah and Paka, Terengganu. Both men were bitten on their ear while putting on motorcycle helmets. The spiders appeared to have nested in the helmets. The dead specimens were collected and sent to the Invertebrate and Vertebrate Neurobiology Laboratory, Department of Parasitology, Universiti Malaya for identification. The species identity was confirmed by DNA barcoding.

A Retrospective Review of 25 cases of Lethal Fetal Anomalies

Introduction: To review the gestational age at diagnosis, method of diagnosis, pregnancy outcome and maternal complications of prenatally diagnosed lethal foetal anomalies. Methods: Retrospective review of 25 women who had aborted or delivered foetuses with lethal anomalies in a tertiary hospital in 2011 based on patient medical records. Results: There were a total of 10,088 deliveries, in which 25 (0.24%) women were found to have conceived foetuses with lethal anomalies. All of them were diagnosed by prenatal ultrasound and only 7 (28.0%) had both prenatal ultrasound and genetic study done. The women’s mean age was 29.9 years old. The mean gestational age at diagnosis of lethal foetal anomalies was 25.5 weeks (SD=12.5) and mean gestational age at termination of pregnancy (TOP) or delivery was 28.5 weeks (SD=12.5). Seven (28%) women had early counseling and TOP at the gestation of < 22 weeks. Beyond 22 weeks of gestation, eight (32%) women had TOP and ten (40%) women had spontaneous delivery. Twenty (80%) women delivered or aborted vaginally, three (12%) women with assisted breech delivery and two (8%) women with abdominal delivery which were performed due to transverse foetal lie in labour and a failed induction, leading to emergency hysterotomy complicated by hysterectomy due to intraoperative finding of ruptured uterus. Overall, the associated post-partum adverse events included post-partum haemorrhage (12%), retained placenta (12%), blood transfusion (8%), uterine rupture (4%) and endometritis (4%). Mean duration of hospital stay was 6.6 days (SD 3.7 days). Conclusion: Late diagnosis of lethal foetal anomalies leads to various maternal morbidities, in this case series , which could have been prevented if they were diagnosed and terminated at early trimester. A new direction is needed in our local practice.

Equine piroplasmosis in Kelantan, Malaysia: Clinicohemato-biochemical alterations in subclinically and clinically infected equids

Equine piroplasmosis (EP) is global disease of equids affect the international movement of horses and their industry. This work was conducted on a random collection of blood samples from a total of 306 equids (horses and ponies) comprising both clinically healthy (n=276) and clinically suspected animals (n=30) for EP from 53 stables in eight districts at Kelantan, Malaysia. Competitive-inhibition enzyme linked immunosorbent test (cELISA) was applied to detect the antibodies for Theileria equi and Babesia caballi and their titers in the serum. Hemato-biochemical parameters were analyzed from blood and serum samples from clinical and subclinical cases in comparison to healthy animals (n=25) a control group. The overall prevalence of EP infections (T. equi, B. caballi and both infections) in subclinical and clinical infected equids was 70.26 and 9.80 per cent, respectively. The subclinical infection in equids was statistically higher than that of clinical infection (P<0.05). Higher titration of T. equi antibodies in clinical infected cases ranged from 1/160 to 1/1280 in (n=27), whereas in B. caballi the titres ranged from 1/160 to 1/640 (n=26). Manifestation in clinical cases was the acute onset of the disease, with significant Hemato-biochemical changes. Whereas, equids with subclinical infection appeared healthy with absence of clinical signs and non-significant Hemato-biochemical alterations were seen as compared to clinical cases and healthy control groups.

The Effect of Diet Control on the Leptin Levels in Diabetic Pregnant Women

Leptin is an adipokine that has strong correlation with the body mass index (BMI). Gestational diabetes mellitus (GDM) is a common medical complication associated with pregnancy. Leptin may lose its correlation with the body mass index (BMI) during diabetes due to hormonal rearrangement. Diet control is the first line management in GDM. Leptin reported to increase in pregnancy and further increases in diabetic patients during GDM screening. There is paucity in the reports concerning Leptin levels in GDM patients on diet control. The present study was aimed to evaluate the changes in maternal leptin in pregnancy complicated by GDM on diet control compared to the normal pregnancy in the 3rd trimesters by comparing the means and to find the correlation of Leptin with the body mass index in both groups. Methods: The study included 2 groups: normal pregnancy (n = 40) and pregnancy with GDM under diet control (n = 60) both groups are at 38-40 weeks of gestation. Leptin concentration in serum was measured in both groups and statistically tested using student t test. The BMI were measured and correlated with the Leptin level in test groups. Results: the results indicated that Leptin will nearly triple in the third trimester (38±30 ng/ml) of pregnancy compared to the standard normal non-pregnant. Leptin level was significantly lower in diabetic women on diet control (28±16 ng/ ml) when compared with the non-diabetics (38±30 ng/ml). The hormone has no correlation with the age of the patients but have a positive correlation with the body mass index before and during pregnancy in both groups. Conclusion: Leptin is increasing in pregnancy as part of the physiological changes. Dieting can decrease Leptin level in diabetics’ pregnant women. Diet can restore the hormonal dysregulation of Leptin. Assessment of Leptin level might be used as an indicator for good diet control during pregnancy.

Vancomycin resistance and biofilm formation among methicillin resistant coagulase negative staphylococci isolated from conjunctivitis

Fifteen isolates of methicillin resistant coagulase negative staphylococci [MRCONS] recovered from fifteen cases of bacterial conjunctivitis were tested for their susceptibilities to ten antibiotics, by disc diffusion method, the extent of their susceptibilities to vancomycin by agar dilution method and, their capability for producing biofilm. Multiple antibiotic resistance teas clearly recognized among all MRCONS and one strain teas found resistant to all antibiotics. Six out of the 15 strains [40%] exhibited intermediate resistance to vancomycin [8-16 microg/ml] and one isolate [6.7%] recovered from adult age group was fully resistant to vancomycin [32 microg/ml]. Biofilm production teas expressed by 11 out of the 15 strains. These constituted seven isolates of VRCONS [100%] and four isolates out of MRCONS [50%]. The association between biofilm formation and antibiotic resistance reflects clinical significance of these isolates and the need for determination of antibiotic susceptibility directly against biofilm-associated organisms

Effect of salicylates on gentamicin ototoxicity in humans

Reports showed a protective effect of salicylates, when given in low doses, against Gentamicin-induced ototoxicity in animals. The aim of the present study was to test this contention in humans. The study included 30 patients recruited from the chest department. Fifteen patients served as control and took Gentamicin, for 10 to 14 days. The study group included 15 patients taking the same dosage of Gentamicin in addition to aceryl salicylic acid. Audiologic evaluation was done in the form of pure tone audiometry, transient-evoked and distortion product [DP] oto-acoustic emission. The evaluation was done before the start of therapy and immediately after its cessation. In the study group, salicylates resulted in significant protection of outer hair cells against gentamicin-induced ototoxicity, which was manifested by the following: 1-Improved reproducibility of the transient emissions, although levels of emission decreased. 2-Increased DP peak levels. 3-Improved DP thresholds. 4-Increased DP levels-at-thresholds. The study recommended the use of salicylates as an adjuvant to Gentamicin to reduce the latter's ototoxic effects

Metastatic involvement of the eighth cranial nerve: a temporal bone study

A total of 251 temporal bones belonging to 130 patients who had malignant disease were revised for evidence of metastatic involvement of the VIIIth nerve within the internal auditory meatus. Twenty-one bones from 14 cases, were recovered, found positive for secondary implication of the VIIIth nerve and included in the study. The pathologic findings of 21 temporal bones with metastatic involvement of the VIIIth nerve are reported and correlated with the clinical history, autopsy findings and pathologic changes in the inner ear. It was concluded that a generalized insight has been developed regarding the magnitude of metastatic [secondary] involvement of the VIIIth cranial nerve which may be more prevalent than realized. Diagnosis of VIIIth nerve involvement by metastatic disease may contribute clues to the prognostic evaluation of the patient's status. Five pattern of implicating the VIIIth nerve by metastatic malignancies within the internal auditory canal are recognized and reported

Toxic labyrinthine reaction: a human temporal bone study

The study material included 240 temporal bones with various pathological conditions involving the middle ear, internal auditory meatus and otic capsule in addition to 40 normal temporal bones to serve as controls. The bones were examined for histomorphologic changes in the inner ear and its fluid content. A significant correlation has been shown between the intralabyrinthine eosinophillic reaction and many of the pathological categories included in the study. It was concluded that speculation were inferred relating the toxic labyrinthine reaction to the immune mechanisms of the inner ear, to the development of secondary endolymphatic hydrops and to the modalities of hearing loss in otitic and meningitic conditions. The pathogenesis of intralabyrinthine eosinophilic exudate was hypothesized and pathophysiology of the consequent hearing loss was discussed

Histomorphometric mapping of melanocytes in the inner ear: a study of human temporal bones

The inner ear in 100 human temporal bones of various age groups was mapped out for ten different locations on each bone, using semiquantitative histomorphometric measures to assess the distribution of pigmentary cells in the labyrinth in the various age groups. The mean pigmentary intensity of the various inner ear location in the various age groups was assessed and tabulated. It was concluded that possible functional correlations to the different pigmentary distributions are suggested. A chronological alteration in pigmentary pattern was shown and was related to the development of the inner ear and to the developmental period during which hearing function is established. Pigment was detected in the subepithelial space of the round window niche and is explained by the migratory ability of the melanocyte