Infections in hospitalized lupus nephritis patients: characteristics, risk factors, and outcomes.

Background There are limited studies documenting infection epidemiology in lupus nephritis (LN) patients. We aimed to study infection incidences and risk characteristics and ascertain possible predictors of infective outcomes in a multiethnic Asian population. Methods This retrospective study from 2006 to 2012 included newly diagnosed LN patients. We collected admissions, immunosuppression, and infection data until end-stage renal failure, death, last follow-up, or the year 2015. The infection incidence rates were evaluated and a generalized linear latent and mixed models (GLLAMM) analysis was carried out to evaluate potential predictors of infection. Results Our cohort of 101 patients consisted of mainly Chinese (75.2%), females (78.2%), and a median age of 38 years (IQR 26-49). The median time of follow-up was 72.8 months (IQR 49.5-94.0). Six out of 14 patient deaths were infection related. Seventy-eight out of 200 admissions, with a total of 102 episodes of infection, occurred in 46 patients. The incidence of infection rates leading to admissions was 10.3 per 100 person-years and the incidence of infection episodes rates was 17.6 per 100 person-years. Cytomegalovirus (CMV) was the most common organism identified. Univariate GLLAMM analysis showed Malay compared to Chinese ethnicity (HR 2.833 (95% CI 1.088-7.373)), use of oral cyclophosphamide (HR 6.618 (95% CI 1.015-43.154)) and rituximab (HR 3.967 (95% CI 1.157-13.603)) as predictors of infection-related admissions. Malay ethnicity and rituximab remained significant in the multivariate GLLAMM analysis. Conclusions Our study highlights substantial infection incidences in patients with LN and its contribution to deaths.

Soil-Transmitted Helminths in Malaysia landscape: an aborigines study.

Soil-transmitted helminths (STH) is a group of parasitic nematodes, including Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus, which can cause gastrointestinal disorders in humans. STH is prevalent among neglected communities in both developing and developed countries. This present study aims to determine the current prevalence of STH infections in Aboriginal population after mass delivering of antihelminthic drugs was proposed by WHO in 2005 and a health education learning package (HELP) was initiated in Malaysia in 2012. A total of 235 human fecal samples were collected and a pre-tested questionnaire was given to gather information about the socio-demographic of the Aborigine communities living in Kedah and Selangor, Malaysia. The samples were screened by a direct-fecal smear and confirmed by formalin-ether sedimentation methods. From human faeces, 81.7% was found to be infected with one or more STH species. T. trichiura was the most commonly detected (76.6%), followed by hookworms (26.4%) and A. lumbricoides (19.1%). Triple infections were found in 6.4% of the studied population. Univariate analysis showed that individuals with age group, male, presence of indoor toilet, family size with <7 members and bad living habits (i.e., without antihelminthic drugs) were significantly associated with STH infections. The analysis further showed that walking barefoot was the significant contributing factor to hookworm infections. The high prevalence of human STH infections is alarming. Thus, the urgency in implementing health education related behavioral practice and hygiene to reduce disease burden in these rural communities are a crucial need.

Soil-Transmitted Helminths in Malaysia landscape: an aborigines study

Soil-transmitted helminths (STH) is a group of parasitic nematodes, including Trichuris trichiura, Ascaris lumbricoides, Ancylostoma duodenale and Necator americanus, which can cause gastrointestinal disorders in humans. STH is prevalent among neglected communities in both developing and developed countries. This present study aims to determine the current prevalence of STH infections in Aboriginal population after mass delivering of antihelminthic drugs was proposed by WHO in 2005 and a health education learning package (HELP) was initiated in Malaysia in 2012. A total of 235 human fecal samples were collected and a pre-tested questionnaire was given to gather information about the socio-demographic of the Aborigine communities living in Kedah and Selangor, Malaysia. The samples were screened by a direct-fecal smear and confirmed by formalin-ether sedimentation methods. From human faeces, 81.7% was found to be infected with one or more STH species. T. trichiura was the most commonly detected (76.6%), followed by hookworms (26.4%) and A. lumbricoides (19.1%). Triple infections were found in 6.4% of the studied population. Univariate analysis showed that individuals with age group, male, presence of indoor toilet, family size with <7 members and bad living habits (i.e., without antihelminthic drugs) were significantly associated with STH infections. The analysis further showed that walking barefoot was the significant contributing factor to hookworm infections. The high prevalence of human STH infections is alarming. Thus, the urgency in implementing health education related behavioral practice and hygiene to reduce disease burden in these rural communities are a crucial need.

Postauricular cutaneous mastoid fistula.

Postauricular cutaneous mastoid fistula is a rare condition. The cutaneous mastoid fistula is a very rare complication of chronic suppurative otitis media. The fistula tracts are typically difficult to manage because of the surrounding necrotic skin edges. We describe an unusual case of a postauricular cutaneous mastoid fistula and outline the surgical technique used for closure.