Phylogenetic analysis of human metapneumovirus among children with acute respiratory infections in Kuala Lumpur, Malaysia.

Human metapneumovirus (HMPV) is a recently discovered cause of viral respiratory infections. We describe clinical and molecular epidemiology of HMPV cases diagnosed in children with respiratory infection at University of Malaya Medical Centre, Kuala Lumpur, Malaysia. The prevalence rate of HMPV between 2010 and 2012 was 1.1%, and HMPV contributed 6.5% of confirmed viral respiratory infections. The HMPV patients had a median age of 1.6 years, and a median hospital admission of 4 days. The most common clinical presentations were fever, rhinitis, pneumonia, vomiting/diarrhoea, and bronchiolitis. Based on the partial sequences of F fusion gene from 26 HMPV strains, 14 (54%) were subgenotype A2b, which was predominant in 2010; 11 (42%) were subgenotype B1, which was predominant in 2012; and 1 (4%) was subgenotype A2a. Knowledge of the circulating subgenotypes in Malaysia, and the displacement of predominant subgenotypes within 3 years, is useful data for future vaccine planning.

Prevalence of bronchial asthma among orang asli in peninsular malaysia.

A survey was carried out to determine the prevalence of bronchial asthma and their contributing risk factors among Orang Asli subgroups living in Malaysia using IUATLD questionnaire and spirometry without being discriminatory towards age or gender. Of the 1171 distributed questionnaires, 716 (61.1%) comprising of 62.7% Semai Pahang, 51.3% Temiar, 74.2% Mah Meri, 65.6% Semai Perak, 53.6% Temuan, 53.8% Semelai, 61.1% Jakun and 67.4% Orang Kuala subgroups completed their questionnaire and were included in the data analysis. Participants comprised 549 (76.7%) children and 167 (23.3%) adults, age between 1 to 83 years old, 304 (42.5%) males and 412 (57.5%) females. The overall prevalence of bronchial asthma was 1.4% of which 1.5% was children, 1.3% adults, 1.0% male and 1.7% female, respectively. Of the 8 subgroups surveyed, 5 out of 10 confirmed asthma cases were Semai Pahang, followed by 3 cases among Mah Meri, and one case each among Temuan and Semai Perak subgroups, respectively. This study also demonstrated that the prevalence of self-reported and confirmed bronchial asthma tend to be higher among those who had close contact with pets, smoking individuals and among those who had a family history of asthma.

Effects of food composition on the inactivation of foodborne microorganisms by chlorine dioxide.

Chlorine dioxide (ClO2) is a strong oxidizing agent that can be applied in solution as well as in the gaseous state. It has bactericidal, fungicidal and viricidal properties. Several food-related microorganisms, including Gram-negative and Gram-positive bacteria, yeasts, mould spores and Bacillus cereus spores were tested for their susceptibility to 0.08 mg/L gaseous ClO2 during 1 min at a relative humidity of 90%. In this screening, the resistance of the different groups of microorganisms towards gaseous ClO2 generally increased in the order Gram-negative bacteria, Gram-positive bacteria, yeasts and mould spores and Bacillus cereus spores. With this treatment, reductions of microbial numbers between 0.1 and 3.5 log cfu/cm2 could be achieved. The effects of the food components starch, fat, protein and NaCl on the antimicrobial activity of gaseous ClO2 were also evaluated. Soluble starch, corn oil, butter, whey protein isolate and NaCl were added in incremental concentrations to portions of an agar medium. Then, plates of the supplemented agars were inoculated with Leuconostoc mesenteroïdes at numbers of 4 log cfu/cm2 and subsequently treated with ClO2. Both soluble starch and NaCl did not have an effect on the antimicrobial efficiency of ClO2. However, butter, corn oil or whey protein in the agar almost eliminated the antimicrobial effect of ClO2. In corn oil-water emulsions treated with gaseous ClO2 the peroxide value increased significantly, indicating the formation of primary oxidation products. Similarly, a treatment with ClO2 increased the protein carbonyl content and induced the transformation of SH-groups to -S-S-groups in whey protein. The findings suggest that gaseous ClO2 will be a highly effective decontaminating agent for carbohydrate-rich foods, but that it would be less effective for the decontamination of high-protein and fatty foods.

Sensitization profiles of Malaysian and Singaporean subjects to allergens from Dermatophagoides pteronyssinus and Blomia tropicalis.

BACKGROUND: The house dust mites Dermatophagoides pteronyssinus (Der p) and Blomia tropicalis (Blo t) are the most common house dust mite species in Southeast Asia. To date, there have only been a few studies on the sensitization profile of the general populations in Southeast Asia to house dust mites. The aim of this study was to determine the profiles of Der p and Blo t sensitization among Singaporean and Malaysian subjects. METHODS: Enzyme-linked immunosorbent assay was used to detect specific IgE to Der p and Blo t mite crude extracts as well as purified Der p 1, Der p 2 and Blo t 5 allergens. Sera used were from 229 Singaporean subjects (124 with rhinitis, 105 without rhinitis) and 143 Malaysian subjects (94 adults and 49 children with asthma). RESULTS: The sensitization profile of rhinitis subjects to the dust mite allergens used in this study was as follows: Blo t extract positive: 91/124 (73%); Blo t 5 positive: 62/124 (50%); Der p extract positive: 61/124 (49%); Der p 1 positive: 53/124 (43%); Der p 2 positive: 45/124 (36%). The nonrhinitis subjects' sensitization profile was as follows: Blo t extract positive: 60/105 (57%); Blo t 5 positive: 24/105 (23%); Der p extract positive: 38/105 (36%); Der p 1 positive: 14/105 (13%); Der p 2 positive: 17/105 (16%). The study of Malaysian asthmatic adults showed that 39% of them were sensitized to Der p 1, 32% to Der p 2 and 37% to Blo t 5. Among the asthmatic children, sensitization to Blo t 5, Der p 1 and Der p 2 was 90, 57 and 39%, respectively. CONCLUSION: This study clearly revealed that dual sensitization to B. tropicalis and D. pteronyssinus is common in the general populations of Singapore and Malaysia. Sensitization to Blo t 5 is more prevalent than to Der p 1 and Der p 2.

Serum Eosinophilic Cationic Protein (ECP) in Asthmatic Malaysian Children.

Eosinophilic inflammation in the airways is important in the pathogenesis of childhood asthma. Serum eosinophilic cationic protein (ECP), a marker of eosinophil activation was measured in 20 asthmatic children and 19 non-asthmatic controls. There was no difference in the socio-demography, passive smoke exposure, urinary cotinine levels and family history of asthma between the 2 groups. The median serum ECP in asthmatic children was 27.0 mcg/L (IQ1 8.8, IQ3 59.0); which was higher than in non-asthmatic controls [5.9 mcg/L (IQ1 3.0, IQ3 11.9), p=0.002]. An elevated serum ECP level can be helpful as supportive evidence in the diagnosis of bronchial asthma in Malaysia children.

Successful treatment of Candida albicans endocarditis in a child with leukemia--a case report and review of the literature.

Candida species is now being increasingly recognised as an important cause of endocarditis especially in immunocompromised patients. A case of Candida albicans endocarditis in a child with acute lymphoblastic leukemia (ALL) is reported. The child did not have a central venous catheter at any time. Treatment consisted of intravenous amphotericin B and fluconazole for 3 weeks followed by oral fluconazole for 2 weeks. No surgical resection was necessary. We highlight here the importance of echocardiography in the management of prolonged febrile neutropenia and discuss the dilemma of continuing chemotherapy in such patients.

[Analgesics; the use of aspirin in dogs; effects of tablet type and food intake on plasma salicylate level]. / Pijnstillers; het gebruik van aspirine bij de hond; invloeden van tablettype en voeropname op de plasma-salicylaatconcentratie.

Administration of acetylsalicylic acid (aspirin) in the dog may cause gastric mucosal damage. Enteric-coated tablets protect the canine stomach during oral aspirin medication. A therapeutic plasma salicylate concentration can be attained using enteric-coated aspirin tablets at a dosage of 25 mg/kg TID. In a series 4 of experiments using adult beagle and large mixed breed dogs and two types enteric-coated tablets, the influence of food intake on the plasma salicylate concentration was studied. Tablets were administered with 8h intervals and food intake was either once daily or three time daily with 8h intervals. Plasma salicylate concentrations were also studied during fasting. It is concluded that, when using enteric-coated tablets, the plasma salicylate concentration in the dog after oral medication is strongly influenced by the aspirin dosage, the tablet type and the feeding pattern. Large enteric-coated tablets may accumulate in the stomach over several days and are not suitable for use in the dog. The gastric accumulation is caused by the enteric-coating of the large tablets and not by the aspirin medication.

Gastric retention of enteric-coated aspirin tablets in beagle dogs.

Administration of acetylsalicylic acid (ASA) in the dog may cause gastric mucosal damage. Enteric-coated tablets protect the canine stomach during oral ASA medication. A therapeutic plasma salicylate concentration can be attained using enteric-coated ASA tablets at a dose rate of 25 mg/kg body wt, administered every 8 h. Six beagle dogs were given enteric-coated ASA tablets (500 mg) orally, in a 5-day cross-over experiment on two different feeding regimens: i.e. feeding once daily (Group I) or 8 hourly (Group II). Results demonstrate that feeding regimen strongly influences the plasma salicylate concentration pattern. Subtherapeutic mean plasma salicylate concentrations were found in both groups. In Group II the standard deviation (SD) of the mean plasma salicylate concentration was larger than that of Group I. The minimal plasma salicylate concentration never reached detectable levels in Group II. In both groups large numbers of tablets were vomited. Gastric evacuation of the ASA tablets is comparable to indigestible solid particles; their removal was dependent on the interdigestive gastric motility. It is concluded that large enteric-coated ASA tablets are not suitable for therapeutic use in small dogs.

[Mesotherapy in abarticular rheumatism]. / Mesotherapie bij abarticulair reuma.

Mesotherapy is a method of treatment in which subcutaneous infiltrations are given loco dolenti at short intervals of time. In this way a mixture of readily available drugs is administered. There are many indications for mesotherapy, although most applications are found in the field of the osteo-articular affections. As yet there is no scientific explanation for the effect of this therapy. Studies on this subject are currently being performed.

[Sigmoid necrosis: a complication of total hip replacement]. / Sigmoïd necrose: een complicatie van total hip replacement (THR).

After total hip replacement on the left side, a patient developed sigmoid necrosis, apparently as a major complication. Extensive review of the recent literature related to complications of total hip replacement.

Radicular lesions in tuberculous meningitis. A clinicopathological study.

In the present work, the involvement of cranial and spinal nerve roots in tuberculous meningitis was studied. Cranial nerves of 11 cases and the spinal roots of three patients were examined by means of serial sections of the base of the brain, brainstem and spinal cord. Although entrapment of the nerves by the tenacious inflammatory exudate was prominent, vasculitis lesions of the cranial nerves and spinal roots were also frequently observed. The latter could be an additional cause of nerve palsies in tuberculous meningitis.