First molecular detection of porcine circovirus type 4 (PCV4) in Malaysia

Porcine circovirus type 4 (PCV4) is the newest member in the porcine circovirus family, first reported in 2020. To date, the presence of PCV4 has only been reported in China, South Korea and most recently in Thailand. Detection of PCV4 have been reported in various production stages of pigs from piglets, finishers to sows; associated with a myriad of clinical manifestations including porcine dermatitis and nephropathy syndrome (PDNS), postweaning multisystemic wasting syndrome (PMWS), respiratory, enteric and neurological diseases. While successful virus isolation and culture has yet to be reported, pathogenicity of PCV4 has been demonstrated through infectious clone studies. The objective of this study is to investigate the presence of PCV4 in Malaysian porcine population to update the epidemiology of porcine circoviruses in Malaysia. A total of 49 samples from commercial intensive pig farms, abattoir and wild boar population were subjected to conventional polymerase chain reaction assay to detect PCV4 capsid (cap) genome. Resulting cap nucleotide sequences were analyzed for maximum likelihood phylogeny relationship. Results revealed that PCV4 is present in Peninsular Malaysia at a molecular prevalence of 4.08% (2 / 49 samples). Both PCV4 positive samples originated from clinically healthy finishers. Malaysian PCV4 strains were classified as genotype PCV4b, and were found to be phylogenetically distinct from the China, South Korea and Thailand strains. With this latest update of the novel PCV4 in Malaysia, it is clear that more attention needs to be given to the investigation of novel porcine circoviruses (PCV) and management of PCV diseases.

Psidium guajava L. An Incalculable but Underexplored Food Crop: Its Phytochemistry, Ethnopharmacology, and Industrial Applications

Psidium guajava L. (guava) is a small tree known for its fruit flavor that is cultivated almost around the globe in tropical areas. Its fruit is amazingly rich in antioxidants, vitamin C, potassium, and dietary fiber. In different parts of the world, this plant holds a special place with respect to fruit and nutritional items. Pharmacological research has shown that this plant has more potential than just a fruit source; it also has beneficial effects against a variety of chronic diseases due to its rich nutritional and phytochemical profile. The primary goal of this document is to provide an updated overview of Psidium guajava L. and its bioactive secondary metabolites, as well as their availability for further study, with a focus on the health benefits and potential industrial applications. There have been several studies conducted on Psidium guajava L. in relation to its use in the pharmaceutical industry. However, its clinical efficacy and applications are still debatable. Therefore, in this review a detailed study with respect to phytochemistry of the plant through modern instruments such as GC and LC-MS has been discussed. The biological activities of secondary metabolites isolated from this plant have been extensively discussed. In order to perform long-term clinical trials to learn more about their effectiveness as drugs and applications for various health benefits, a structure activity relationship has been established. Based on the literature, it is concluded that this plant has a wide variety of biopharmaceutical applications. As a whole, this article calls for long-term clinical trials to obtain a greater understanding of how it can be used to treat different diseases.

COVID-19 infection, hospitalisation and mortality rates in people with severe mental illness: findings from two UK cohort studies

Introduction

Recent systematic reviews have highlighted that people with Severe Mental Illness (SMI) have higher risks of infection, hospitalisation and death from COVID-19, although the full extent of these disparities are not yet established.

Objectives

Utilising electronic health records, we investigated COVID-19 related infection, hospitalisation and mortality among people with schizophrenia/psychosis, bipolar disorder (BD) and/or major depressive disorder (MDD) in two large UK samples: the UK Biobank (UKB) cohort study and GP-registered patients in Greater Manchester (GM).

Methods

We sampled 447,296 adults with and without SMI from UKB (inc. schizophrenia/psychosis=1,925, BD=1,483 and MDD=41,448, non-SMI=402,440) and 1,152,831 adults from GM (inc. schizophrenia/psychosis =46,859, BD=3,461, recurrent MDD=134,661, non-SMI = 922,264). Primary care, hospital and death records were linked to identify COVID-19 related outcomes. Logistic regression models were used to estimate unadjusted and adjusted Odds Ratios (ORs) to compare differences in COVID-19 outcomes by diagnosis, controlling for sociodemographic factors and comorbidities.

Results

We will report the findings of unadjusted and adjusted analyses, comparing ORs for people with and without SMI, by diagnosis. Findings will be compared between the two datasets, with attention to the demographic and clinical profiles of each sample. We will consider the role of demographic characteristics and comorbidities in attenuating outcomes.

Conclusions

Emerging evidence suggests that people with SMI have higher risks of COVID-19 infection, hospitalisation and mortality. Based on two large datasets utilising EHRs, we present findings from the UK on COVID-19 outcomes among people with SMI, a country that has been severely affected by COVID-19.

Disclosure

No significant relationships.

Risk Factors for Acute Brucellosis in Patients on the Day of Admission at Selected Hospitals of Abbottabad, Pakistan

Brucellosis is a neglected zoonotic disease of ruminants. It causes severe health problems in humans and significant economic loss. Only a limited number of studies have been conducted in Pakistan to determine the prevalence of human brucellosis and related risk factors. The objectives of the current cross-sectional study were to determine the prevalence of anti-Brucella antibodies in sera collected from symptomatic patients at three hospitals of Abbottabad using a commercial slide agglutination test (SAT) and to determine risk factors for brucellosis for these patients. Five hundred blood samples were collected. A questionnaire was filled in for each patient to obtain information on age, gender, living area, brucellosis associated symptoms, associated risk factors, pregnancy and abortion history. A total of 13.6% (n = 68) patients were found to be SAT positive and in 83.3% (n = 57) of these samples Brucella DNA was detected by genus specific RT-PCR for BCSP-31 gene. Statistical analysis was performed to determine odd ratios, risk ratios, 95% confidence intervals, and p-values. The prevalence of brucellosis by SAT was reported to be higher in women (14.6%, n = 44) than in men (12.1%, n = 24). The age group 25–50 years was found to be at higher risk for brucellosis (14.5%, n = 50) “animal contact” was reported as the main risk factor followed by “consumption of raw animal products.” Out of 131 pregnant women and 21 patients had abortion, the seropositivity of Brucellosis was 9.9% and 23.8%, respectively. The present study reports a striking prevalence of brucellosis among patients including pregnant women at three hospitals of Abbottabad. These findings may foster strategies for controlling human brucellosis at household level, raising of awareness about brucellosis in hospital and family doctors, and finally in setting up an eradication program in the dairy industry.

Serosurvey and Risk Factors Associated with Brucella Infection in High Risk Occupations from District Lahore and Kasur of Punjab, Pakistan

Brucellosis is a neglected zoonotic disease, and occupations with a high risk of infection exist. Limited information is available on brucellosis for these employees at high risk in Pakistan. A total of 459 persons with high-risk occupations, i.e., 211 abattoir workers, 63 milkers, 52 dung cake makers, 44 veterinarians, 44 shepherds, and 45 veterinary students of the districts Kasur and Lahore, Pakistan, were tested in this study. Blood samples and information on place of residence, gender, age, urbanicity, type of occupation, socioeconomic status, contact with animals, consumption of raw milk, contact to women who had a miscarriage, contact to aborted animal fetus or abortion material, pregnancy, miscarriage history, or intrauterine fetal death were collected. Serum samples were examined using Rose Bengal tests for anti-Brucella antibodies and seropositive samples were subjected to genus-specific qPCR for the detection of DNA. Data were analyzed using chi-squared and binary regression. Twenty (4.35%) persons were seropositive for anti-Brucella antibodies. Out of these, 18 (90%) were tested positive by Brucella genus-specific qPCR. Positive sera were more often found in Lahore district (8.3%) than in Kasur district (3.1%). Persons older than 36 years were more often seropositive. Persons involved in the handing of milk and in contact with animals were more often seropositive. Contact with women who had had a miscarriage was also a significant factor for seropositivity for brucellosis. Place of residence, gender, age, urbanicity, and contact with animals were identified as potential risk factors in the present study. The present study confirmed that brucellosis is an occupation hazard for abattoir workers, milkers, dung cake makers, and veterinarians in the districts of Lahore and Kasur of Punjab, Pakistan. The study shows the need for strategies for safety at work to minimize the risk of infection. Raising awareness for the prevention and use of proper personal protection equipment during the slaughtering and treatment of animal is highly needed.

Perineal hernia mesh repair: a fixation with glue, sutures and tacks. How to do it

Introduction: Many different approaches for the repair of a perineal hernia (PH) after abdomino-perineal rectum amputation (APR) have been described throughout the years. Literature shows us that the use of a mesh had the best results with relatively low rates of recurrence compared to primary suture. Yet there is still no consensus on the best technique for fixation of the mesh in the perineal cavity. Methods: We want to introduce an addition to the surgical repair technique, using laparoscopic glue to ensure a solid fixation of the mesh. This is to prevent small bowel from sliding into the perineal area due to the high abdominal pressure when standing and to avoid the difficulties and risks of laparoscopical suturing in this area. Results: This use of glue for fixation of the mesh has been successful in the three cases described, with no recurrence after one-year follow-up. Conclusion: A recurrent PH can be prevented by a solid fixation of the mesh using the technique of a glued mesh repair. This technique shows to be easy, fast and without recurrence.

Toxoplasma gondii infection in native village chickens (Gallus domesticus) in Selangor and Melaka, Malaysia

Toxoplasmosis is a worldwide zoonosis caused by the protozoa Toxoplasma gondii which affects human and animals. Village chickens (Gallus domesticus) most commonly known as Ayam Kampung or free-range chickens, have been suggested to play a role in the epidemiology of toxoplasmosis. This study determines the presence of T. gondii in the village chicken populations in two states of Malaysia. A total of 50 serum samples from the chickens from Selangor (n=20) and Melaka (n=30) were collected and analysed using commercial serological kits. T. gondii antigen was detected in 20% (Selangor 30%; Melaka 13%) samples using ELISA test and anti-T. gondii antibody was detected in all positive ELISA samples using the indirect haemagglutination test (IHAT). Histopathological examination revealed tissue changes such as inflammation and degeneration in brain and liver of seropositive chickens. This is the first report of T. gondii infection in the village chickens in Malaysia.

Molecular detection of Leptospira sp. in cattle and goats in Kelantan, Malaysia after a massive flood using multiplex polymerase chain reaction

Flood is a potential driver in spreading waterborne diseases including leptospirosis, which is a zoonotic disease caused by pathogenic bacteria of the genus Leptospira. In the case of leptospirosis, cattle and goats can be incidental hosts and potential carriers of leptospirosis. Traditionally, serology such as microscopic agglutination test (MAT) and isolation of the organisms have been commonly used as the diagnostic approaches in diagnosing leptospirosis. However, nowadays, various molecular techniques have been developed for specific detection of Leptospira sp. such as, polymerase chain reaction (PCR), which is sensitive, specific and rapid in detecting the species. This study detected Leptospira sp. directly from the blood and urine of the animals such as, cattle, goats and sheep in Kelantan after a massive flood by using multiplex PCR (mPCR). From the results collected in the study, four blood samples (0.63%; 4/635) were found to be positive with Leptospira sp. and one urine sample (3.23%; 1/31) was detected as positive with Leptospira sp. The blood and urine samples that were detected to be positive with Leptospira sp. were collected from cattle and goats exposed to the flood. However, no Leptospira sp. was detected from the sheep in this study. Multiplex PCR (mPCR) was successfully used to detect the presence of Leptospira sp. in animals. Apart from that, it is also suggested that flood has a significant role in transmitting the disease to animals.

Case-control investigation on the risk factors of melioidosis in small ruminant farms in Peninsular Malaysia

AIMS

Epidemiology of melioidosis is poorly understood because its occurrence is influenced by complex interaction of environmental, climatic, physicochemical and host factors. We investigated the potential risk factors for the exposure to Burkholderia pseudomallei in small ruminants' farms in Peninsular Malaysia.

METHODS AND RESULTS

Melioidosis-positive (n = 33) and negative (n = 27) farms were selected and visited for interviews and environmental samples collection. The characteristics and putative disease risk factors were compared between the case and the control farms using Chi-square test and logistic regression analysis. The multivariable logistic regression analysis showed that the odds of melioidosis were significantly higher in farms that had bush clearing around farms (odds ratio (OR) = 6.61, 95% confidence interval (CI) = 1.12-38.84, P = 0.037), in farms with B. pseudomallei present in the soil (OR = 6.23, 95% CI = 1.03-37.68, P = 0.046), in farms that have other animal species present (OR = 7.96, 95% CI = 1.14-55.99, P = 0.037) and in farms that had flooding or waterlogging conditions (OR = 11.95, 95% CI = 1.39-102.6, P = 0.024) when compared to the odds of the disease in farms that did not have the above conditions. The odds of the disease in farms that treated their soils with lime were significantly lower (OR = 0.028, 95% CI = 0.003-0.29, P = 0.003) compared to the odds in those that did not.

CONCLUSIONS

The risk factors for the exposure to B. pseudomallei highlighted above may have contributed to the occurrence of melioidosis in animals in the study farms.

SIGNIFICANCE AND IMPACT OF THE STUDY

Information from the study may be helpful in planning control measures against melioidosis and have improved understanding of the epidemiology of the disease in livestock farms.

Nasal Bubble CPAP: One Year Experience in a Neonatal Unit of a Tertiary Health Facility in Northwestern Nigeria

AIMS AND OBJECTIVES

Nasal bubble continuous positive airway pressure (NBCPAP) respiratory support, though decades old, is beginning to gain popularity in developing countries including Nigeria. We reviewed neonates who benefitted from NBCPAP, to describe the demographics and outcome of NBCPAP respiratory support in newborns admitted to the neonatal unit of Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, over a one year period.

MATERIALS AND METHODS

The study is a descriptive observational review of all neonates who required NBCPAP respiratory support in the neonatal unit of ABUTH Zaria. Data was extracted from a specifically designed proforma used to obtain information on each neonate throughout the period of admission.

RESULTS

Twenty babies received NBCPAP respiratory support during the period of study. Seventeen (85%) of the neonates were successfully weaned off CPAP while three (15%) failed CPAP. Three neonates developed complications with two having CPAP belly syndrome and the third had facial swelling which resolved spontaneously after 6 hours. Overall, seven (41%) of the neonates who were successfully weaned off CPAP were discharged home.

CONCLUSION

MajorityofnewbornswhorequirerespiratorysupportwillbenefitfromNBCPAP therefore, this method of respiratory support should be popularized and neonatal units in the country should be supported to efficiently offer the service.

The prevalence and distribution of Brucella melitensis in goats in Malaysia from 2000 to 2009

A study was conducted to describe the prevalence and distribution of zoonotic Brucella melitensis in goats in Peninsular Malaysia. Using serosurveillance data of the last decade (2000-2009) involving 119,799 goats and 3555 farms, the seroprevalence of brucellosis among goats was 0.91% (95% CI=0.86-0.96) and among farms was 7.09% (95% CI=6.27-7.98). The odds of brucellosis was significantly (P<0.05) higher in the later part of the decade, in larger herd size and among the states located in the peninsula as compared to eastern Malaysia. The infection was detected throughout Malaysia but at generally low seroprevalences with states like Perlis that border neighbouring countries having higher seroprevalence of brucellosis than other non-border states.

Outcome of Extremely Low Birth Weight Babies in Zaria; A Ten-Year Review

BACKGROUND

Survival among extremely low birth weight (ELBW) babies (birth weight below 1000grams) in resource limited settings is still very low. The study aimed to determine the correlation between materno-foetal factors and outcome in this category of neonates.

STUDY DESIGN

A retrospective study in which patients' records admitted into the Neonatal Unit of Ahmadu Bello University Teaching Hospital between January 2005 and December 2014 were retrieved. Information on neonates weighing < 1000 g were extracted and analyzed. Survival at discharge was the primary outcome.

RESULTS

The overall survival rate of extremely low birth weight babies was 18%. Mortality in ELBW neonates weighing less than 750g was 100%. Factors that were significantly predictive of survival were birth weight, parity and duration of hospital stay with p-values of 0.014, 0.039 and 0.025 respectively

CONCLUSION

The survival rate of ELBW babies remains low in our resource constrained setting. Focus should be on preventing preterm deliveries and as well equipping newborn care providers and newborn units with the necessary skills and materials respectively to enable implementation of evidence based interventions to improve newborn survival.

Emerging Zoonoses in Domesticated Livestock of Southeast Asia

Southeast Asia, identified as one of the hotspot for emerging and reemerging diseases is an area of emerging market with doubling population size within the next few years. The livestock industry is growing rapidly to cater for the population need via intensification and various diversification methods. This article discusses a few relevant emerging and emerging zoonoses within the past two decades and highlights the impact of these diseases to the animal industry and public health in the region.

Active infection and morphometric study of Trypanosoma evansi among horses in Peninsula Malaysia

Apart from occasional reports of clinical disease affecting horses, there is no information about Trypanosoma evansi in horses in Peninsula Malaysia. Thus, a cross-sectional study was conducted in eight states in Peninsula Malaysia to determine the active presence of T. evansi in horses. A total of 527 blood samples were obtained and examined by haematocrit centrifugation technique (HCT), Giemsa-stained thin blood smear (GSS), morphometric measurements, polymerase chain reaction (PCR) and cloning of PCR products. The results showed an overall parasitological prevalence of 0.57% (3/527, CI: 1.6-0.19%) with both HCT and GSS. Morphometric study revealed the mean total length of the trypanosomes including the free flagellum was 27.94 ± 2.63 μm. PCR successfully amplified a trypanosome specific 257 bp in 1.14% of samples (6/527, CI: 2.4-0.52%) and was confirmed by nucleotide sequences. The mean packed cell volume (PCV) for the positive cases detected by HCT was lower (23% ± 7.00) compared to the positive cases detected by PCR alone in the state of Terengganu (35% ± 4.73). In conclusion, this study showed T. evansi infection occurred in low frequency in horses in Peninsula Malaysia, and anaemia coincided with parasitaemic animals. PCR is considered as a sensitive diagnostic tool when parasitaemia is undetectable. The slight lengthier mean of parasite and anaemia may indicate a virulent strain of T. evansi circulating throughout the country. Thus, it's highly recommended to shed light on host-parasite relationship for better epidemiological understanding.

Genetic Diversity In Mango (Mangifera Indica L.) Through Multivariate Analysis

The genetic divergence was assessed in 60 mango genotypes through D2- statistics and principal component analysis. The genotypes under study were grouped into eight clusters and the diversity was influenced by the morphological characters, not by the geographical distribution of the genotypes. The clustering pattern revealed that the genotypes collected from the same region did not fall in the single cluster. The maximum inter cluster distance was noticed between cluster II and cluster VIII, and the lowest between clusters VII and cluster VIII. From the cluster means, cluster I was high yielding and ranked first in terms of number of secondary branches per inflorescence, percent fruit set per inflorescence, and yield per plant. Cluster VIII had only one genotype which produced the highest percentage of flowering shoots, % perfect flowers, number of fruits per plant, and %TSS. The genotypes of cluster VII produced the biggest sized fruits. The first nine characters of the principal component axes with eigen values above unity accounted for 88.3% of the total variation among the fifteen characters. Weight of harvested fruits per plant (0.990 and 0.181), number of fruits per plant (0.101 and 0.607) and individual fruit weight (0.027 and 0.107) for both the vectors were positive across two axes indicating the important components of genetic divergence. The genotypes belonging to clusters I, VII and VIII with high to moderate genetic distances might be recommended for use in crossing programs to produce new recombinants with desired traits. Bangladesh J. Agril. Res. 38(2): 343-353, June 2013 DOI: http://dx.doi.org/10.3329/bjar.v38i2.15895

Identification and management of prisoners with severe psychiatric illness by specialist mental health services

BACKGROUND

The prevalence of mental disorders among prisoners is considerably higher than in the general population. This is an important public health issue as the vast majority of prisoners stay in custody for less than 9 months and, when not in prison, offenders' lifestyles are frequently chaotic, characterized by social exclusion, instability and unemployment. Multi-disciplinary mental health inreach services were introduced to target care towards prisoners with severe mental illness (SMI) in a similar way to that provided by Community Mental Health Teams outside prison. The aim was to establish the proportion of prisoners with SMI who were assessed and managed by prison mental health inreach services. Method A two-phase prevalence survey in six prisons in England measured SMI upon reception into custody. Case-note review established the proportion of those with SMI subsequently assessed and treated by inreach services.

RESULTS

Of 3492 prisoners screened, 23% had SMI. Inreach teams assessed only 25% of these unwell prisoners, and accepted just 13% onto their caseloads.

CONCLUSIONS

Inreach teams identified and managed only a small proportion of prisoners with SMI. Prison-based services need to improve screening procedures and develop effective care pathways to ensure access to appropriate services. Improved identification of mental illness is needed in both the community and the Criminal Justice System to better engage with socially transient individuals who have chaotic lifestyles and complex needs.

Characterization and risk factors of vancomycin-resistant Enterococci (VRE) among animal-affiliated workers in Malaysia

AIMS

This study determined the risk factors and characteristics of vancomycin-resistant Enterococci (VRE) among individuals working with animals in Malaysia.

METHODS AND RESULTS

Targeted cross-sectional studies accompanied with laboratory analysis for the identification and characterization of resistance and virulence genes and with genotype of VRE were performed. VRE were detected in 9·4% (95% CI: 6·46-13·12) of the sampled populations. Enterococcus faecium, Enterococcus faecalis and Enterococcus gallinarum were isolated, and vanA was detected in 70% of the isolates. Enterococcus faecalis with vanB was obtained from one foreign poultry worker. At least one virulence gene was detected in >50% of Ent. faecium and Ent. faecalis isolates. The esp and gelE genes were common among Ent. faecium (58·3%) and Ent. faecalis (78%), respectively. The VRE species showed diverse RAPD profiles with some clustering of strains based on the individual's background. However, the risk factors found to be significantly associated with the prevalence of VRE were age (OR: 5·39, 95% CI: 1·98-14·61) and previous hospitalization (OR: 4·06, 95% CI: 1·33-12·35).

CONCLUSION

VRE species isolated from individuals in this study have high level of vancomycin resistance, were genetically diverse and possessed the virulence traits. Age of individuals and history of hospitalization rather than occupational background determined VRE colonization.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides comprehensive findings on the epidemiological and molecular features of VRE among healthy individuals working with animals.

Phenotypic and genotypic characterization of methicillin-resistant Staphylococcus aureus (MRSA) isolated from dogs and cats at University Veterinary Hospital, Universiti Putra Malaysia

Methicillin-resistant Staphylococcus aureus (MRSA) is known to cause nosocomial infections and is now becoming an emerging problem in veterinary medicine. The objective of the study was to determine the presence of MRSA in 100 cats and dogs sampled between November 2007 and April 2008 at the University Veterinary Hospital, Universiti Putra Malaysia. MRSA was detected in 8% of pets sampled. Ten percent (5/50) and 6% (3/50) of the isolates were from dogs and cats, respectively. All MRSA isolates possessed the mecA gene and were found to be resistant to at least three antimicrobials with a minimum of Oxacillin MIC of 8 μg/mL. One isolate (CT04) had an extremely high MIC of >256 μg/mL. The MLST type ST59 found in this study have been reported earlier from Singapore and other countries as a strain from animal and community-associated MRSA respectively. Pulsed-field gel electrophoresis revealed five pulsotypes. Two isolates from cats (CT27 and CT33) and three isolates from dogs (DG16, DG20, and DG49) were respectively assigned to pulsotypes B and D. The study suggests that cats and dogs in Malaysia are potential reservoirs for MRSA.

Lungworm of cattle in Malaysia

Bovine lungworm Dictyocaulus viviparus is highly endemic in temperate regions. However, the occurrence of the lungworm has not been reported in any South East Asian country. The main aim of the present study was to detect the presence of lungworm in cattle in peninsular Malaysia and to examine the morphology of the parasite. A cross-sectional study was carried out in which 602 animals from four large scale government cattle farms and one dairy smallholder farm were sampled. In addition, 283 lungs from 11 abattoirs around the country were examined. Faecal samples were examined using the Baermann technique while post-mortem examination was performed on the lungs. Approximately 5% of faecal samples and 1% of lungs were positive for lungworm. Based on the morphology of adult lungworm, eggs and first stage larvae, Malaysian bovine lungworms were D. viviparus.

Ectoparasite fauna of rodents and shrews from four habitats in Kuala Lumpur and the states of Selangor and Negeri Sembilan, Malaysia and its public health significance

A total of 204 rodents comprising 14 host species from four different habitats were examined. Nine rodent species were trapped from the forest and another five species were trapped from the coastal, rice field and urban habitats. Rattus rattus diardii (67%) was the predominant rodent species examined. Fifty six (47.3%) rodents and shrews were found to be infested with at least one of the 20 species of ectoparasite recovered. Mites belonging to the family Trombiculidae were the predominant ectoparasite species recovered. Ticks belonging to the family Ixodidae were recovered mainly from the forest dwelling rodents. Polyplax spinulosa and Hoplopleura pacifica were the common lice species found infesting the urban rodents. Xenopsylla cheopis was the only flea species recovered. The following ecto-parasites have been incriminated as important vectors or as mechanical carriers for the transmission of zoonotic diseases: Ixodes granulatus, Dermacentor sp. Haemaphysalis sp., Amblyomma sp. Ascoschoengastia indica, Leptotrombidium deliense, Ornithonyssus bacoti, Laelaps nuttalli, H. pacifica, P. spinulosa and Xenopsylla cheopis. Urban and forest rodents were significantly higher in ecto-parasitic infestation, compared to rats from the other two habitats. However, there was no significant statistical association between male and female rodents infested with ectoparasites.

Characterization of vancomycin-resistant Enterococcus isolates from broilers in Selangor, Malaysia

Vancomycin-resistant Enterococcus (VRE) is an emerging nosocomial pathogen in humans. The use of antibiotics in human therapy and in the production of food animals has been incriminated in the emergence of this organism. The present study describes the distribution of VRE species, the vancomycin-resistant genes detected, the vancomycin resistance pattern observed, and the genetic diversity of the isolates found in live broiler chickens in Malaysia. Overall 140 VRE were isolated with species comprising Enterococcus faecalis (48%), Enterococcus faecium (25.7%), Enterococcus gallinarum (12.1%), Enterococcus casseliflavus (1.4%) and other Enterococcus species (12.8%). Vancomycin resistance gene vanA and intrinsic genes vanC1 and vanC2/3 were detected in the study population. VanA was detected in 15 (63.9%) of E. faecium, 23 (22.4%) of E. faecalis and in 3 (17.6%) E. gallinarum isolates. E-test was conducted on randomly selected 41 of the isolates and the minimum inhibition concentration (MIC) of vancomycin for five (11.9%) of tested isolates is more than 256 μg/ml. Genotypic analysis using random amplified polymorphic DNA (RAPD) showed genetic diversity within the Enterococcus species.

Gangrene of the limb complicating Salmonella typhi septicaemia in a Nigerian child

We report an unusual case of lower limb gangrene in a pubertal boy following a typical clinical presentation of septicaemia due to Salmonella typhi. After an initial response to presumed appropriate antibiotic and supportive therapy, the patient developed tissue ischaemia in both feet. There were no clinical or laboratory evidence suggestive of DIC or coagulopathy. Following conservative management which included oral administration of vitamin C, there was gradual regression of ischaemic changes, progressive healing and recovery of function of the left foot while the condition of the right foot deteriorated with extensive tissue necrosis and dry gangrene that extended to the distal one third of the foot. This necessitated surgical disarticulation of the metatarsophalangeal joints two months after admission. This report is to alert clinicians about this rare complication of a common curable disease with a view to anticipating the possibility of it occurring as well as considering appropriate preventive measures.

Endo-parasite fauna of rodents caught in five wet markets in Kuala Lumpur and its potential zoonotic implications

Rodents were collected from five wet markets (Chow Kit, Dato Keramat, Setapak, Jinjang and Kepong) in Kuala Lumpur, Federal Territory between March to April 2006. Ninety seven rats were trapped using wire traps measuring 29 x 22 x 50 cm baited with fruits, coconuts, dried fish or sweet potatoes. A total of 17 different species of parasites were identified from three species of rats out of which 11 (65%) were identified to be zoonotic. The helminths identified from the urban rats were nematodes- Capillaria hepatica, Gongylonema neoplasticum, Heterakis spumosa, Heterakis sp., Masterphorus muris, Nippostrongylus brasiliensis, Physolaptera sp., Pterogodermatis sp., Rictularia tani and Syphacia muris; cestodes- Hymenolepis nana, Hymenolepis diminuta, Hymenolepis sabnema, Hymenolepis sp., Raillietina sp. and Taenia taeniaeformis, and acanthocephalan- Moniliformis moniliformis. The following parasites are of potential medical importance: C. hepatica, G. neoplasticum, R. tani, S. muris, H. diminuta, H. nana, Raillietina sp. and T. taeniaeformis.

First report of bovine lungworm disease in South-East Asia

This paper presents investigation of lungworm disease outbreaks that is based on retrospective examination of cases recorded between 1994 and 2000 on a government beef cattle breeding centre in the state of Pahang, peninsular Malaysia. The breed of cattle on the centre was Nelore and the mean population over a 7-year period (from 1994 to 2000) was 1612. All animals were allowed to graze on pasture and mixed grazing was practiced on the farm. The routine de-worming programme was performed using levamisole and ivermectin from 1994 to 1998 and abamectin in 1999 and 2000 on 1 to 3-month-old calves and an annual dose given to the adult cattle. Nelore was introduced into the farm in 1991, three years before the first outbreak from Brazil where Dictyocaulus viviparus infection had been reported. No lungworm infection had been observed in the farm prior to the animal introduction. Within the 7-year period, 36 fatalities occurred and the annual mortality rate due to lungworm infection was 0.31%. The highest rate was recorded in 1997. Among the total 36 deaths, about 75% of deaths occurred in calves aged between 6 months and 12 months, 67% were males and 33% were female cattle. The highest number of deaths (19%) occurred in the month of November. In conclusion, D. viviparus infection may have been introduced into a tropical climate along with consignments of cattle from lungworm endemic areas resulting in fatal disease outbreaks for a few years following the animal's initial introduction.

Time course of intraoperative cytokine levels in liver transplant recipients

We evaluated the levels of several cytokines (interleukin [IL]-2, IL-4, IL-6, IL-10, tumor necrosis factor [TNF]-alpha, and interferon [IFN]-gamma) in plasma samples obtained before surgical intervention (T0) and during intraoperative liver transplantation: after induction of anesthesia (I-1), 15 minutes of anhepatic phase (I-2), 5 minutes before reperfusion (I-3), 10 minutes after reperfusion (I-4), 20 minutes after reperfusion (I-5), 60 minutes after reperfusion (I-6), and 1 hour after liver transplantation (I-7). Cytokine levels were determined using a technique which combines ELISA technique and flow cytometry. The study was approved by the local clinical research (ethics) committee. Written informed consent was obtained from patients' relatives. Twenty patients (14 men, 6 women) aged 23 to 61 years, recipients of a liver transplantation were studied. The cytokine IL-2 plasma values were maintained during the whole study period, with a slight increase at 15 minutes of anhepatic phase (I-2). IL-4 showed a peak value 20 minutes after reperfusion (I-5). IL-6 increased its plasma value starting at 15 minutes of anhepatic phase (I-2), maintaining high concentrations during the whole intraoperative period. IL-10 increased progressively, reaching a maximum 1 hour after transplantation (I-7). TNF-alpha reached maximum plasma levels 20 minutes after reperfusion (I-5), whereas IFN-gamma showed a peak at 15 minutes of anhepatic phase (I-2). Our results indicate that the anhepatic phase (I-2) is the earliest phase during which proinflammatory and anti-inflammatory cytokines, such as IL-6 and IL-10, respectively, are involved during liver transplantation. We conclude that IL-6 is the first cytokine involved in the inflammatory response during liver transplantation.

Early postoperative response of cytokines in liver transplant recipients

We evaluated the early postoperative response of several cytokines (IL-2, IL-4, IL-6, IL-10, TNF-alpha, IFN-gamma) prior to liver transplantation (T(0)) as well as 1, 6, and 12 hours and 1, 2, 3, 5, and 7 days afterward. Cytokine concentrations were correlated with serum levels of bilirubin as a predictor of postoperative complications. Cytokine levels were determined in plasma samples from 16 liver transplant recipients (13 men, 3 women) aged 43 to 61 years. IL-6 and IL-10 reached their maximum concentrations 1 hour after transplantation. Each increase in IL-6 correlated to a rise in IL-10. IL-2, IL-4, TNF-alpha, and IFN-gamma had a particular time-course for each patient studied. Bilirubin fell to almost normal values but not in cases of postoperative complications, where IL-6 showed values four times higher compared to those of liver transplant recipients who did not show postoperative complications. IL-6 and IL-10 plasma concentrations and serum bilirubin level might be useful as a predictive factor of postoperative complications in liver transplant recipients.

Condemnation of lungs in abattoirs in peninsular Malaysia due to parasitic infection from 1998-2004

A study on causes of lung condemnation in 25 abattoirs from peninsular Malaysia for a period of seven years (1998-2004) was conducted by examining the records at the Department of Veterinary Services headquarters in Kuala Lumpur. A total of 5.3% of lungs from 233,417 cattle and buffaloes were condemned from 1998 to 2004. The main cause of condemnation was congestion (2.98%). The percentage of lungs that were condemned due to parasitic infection among the total population slaughtered was low (0.11%). Parasitic infection contributed to 2.1% of all lungs condemned. It was also found that the prevalence of parasitic infection in the lungs was generally much higher in buffaloes than in cattle.

Time course of antioxidant enzyme activities in liver transplant recipients

Reactive oxygen species (ROS) play a central role in ischemia-reperfusion injury after organ transplantation. They are degraded by endogenous radical scavengers such as antioxidant enzymes. The purpose of this study was to evaluate the temporal variations of antioxidant enzyme activities in liver transplant recipients. The study was performed in 13 liver transplant patients (11 men and 2 women). Blood samples were obtained pre- and postsurgical intervention: before transplant (T(0)), and 1, 6, 12, 24, 48, and 72 hours, as well as 5 and 7 days thereafter. We determined total and specific superoxide dismutase (SOD) activity, catalase (CAT), glutathione peroxidase (GPX), and glutathione reductase (GR) activities as well as malondialdehyde (MDA) and low-density lipoproteins (LDL). The results showed increased SOD and mainly GPX activities after liver transplantation, which correlated with MDA levels. Total SOD activity was mainly represented by Mn-SOD (75%) and Cu,Zn-SOD (25%), whereas Fe-SOD was not detected. In conclusion, the enhanced antioxidant enzyme activities reported in this study indicated a control of oxidative stress generated in liver transplantation. In this sense, although MDA levels showed an enormeous increase at 1 hour after transplantation, the lipid peroxidation was compensated for by GPX activity.

Immediate replacement removable partial dentures with cobalt-chromium frameworks: rationale, technology and a case report

The advantages of removable partial dentures with cobalt-chromium frameworks over those made entirely of acrylic resin, in oral health and hygiene, are well documented. However, in cases where teeth are to be extracted for fitting the removable partial denture, a difficulty arises because of the need to test the fit of the removable partial denture framework. The advent of two modern technologies-- laser welding and metal bonding agents -- make it possible to test the fit of the major part of the framework prior to adding additional metal components to support artificial teeth. A case is described in which the four lower incisors were extracted. The main part of the framework was constructed and its fit tested. A second casting was laser-welded to the lingual plate of the first casting to support the artificial incisor teeth. This technique avoids the need to make an acrylic resin temporary denture but incurs the cost of the additional technical work and so the advantages may be considered to be economically neutral.

Evaluation of a new enzyme immunoassay for the detection of Helicobacter pylori in stool specimens

H. pylori infects the gastric mucosa and causes many digestive disorders such as peptic ulcer, chronic gastritis and gastric cancer. H. pylori infection relates neither to functional health status, nor to intensity of dyspepsia. There is evidence that in most patients with H. pylori positive functional dyspepsia do not improve with eradication of the organism.This study evaluated the diagnostic accuracy of HpSA by determining the sensitivity and specificity of the stool antigen test in predicting successful eradication during and after anti microbial therapy. The work was conducted on patients who underwent upper gastrointestinal endoscopy at Al-Azhar University hospitals. Fifty patients (34 male & 16 female) with dyspepsia were selected, the exclusion criteria included use of antibiotics and proton pump inhibitors up to one month before the study. All cases were submitted to, full history, general and local examination and upper gastrointestinal endoscopy. Biopsies were taken from the antrum and body of the stomach for rapid urease test and histopathology. Stool samples were taken to detect H. pylori stool antigen. Positive patients received eradication treatment for one month and H. pylori status was re-determined by rapid urease test, histological examination and HpSA test one month later. H. pylori was detected by rapid urease test in 29 (58%) dyspeptic patient by histology in 26(52%) dyspeptic patient, while H. pylori was detected by HpSA immunoassay in 16 (32%) dyspeptic patient. The sensitivity and specificity of HpSA were 57.7% and 95.8% respectively. After successful eradication of H. pylori, reassessment by rapid urease test and histology revealed curative rate of 86.2% and 84.6% respectively, while HpSA immunoassay revealed curative rate 75%. Based on these results, the HpSA immunoassay gave sensitivity (75%) and specificity (100%). The H. pylori stool test represents an accurate and novel non-invasive concept for diagnosis of infection and can be used for daily routine in clinical practice. HpSA is a promising non-invasive test for diagnosis of H. pylori infection but may be hampered by low patient acceptability. So, HpSA is a valuable test in the pre-and post eradication assessment of infection. HpSA can be profitably employed in the primary diagnosis of H. pylori infection. This non invasive test could be very useful in investigating dyspeptic young patients. Also, it could be used profitably in epidemiological studies to determine the prevalence of H. pylori infection in the asymptomatic subjects in different communities.

Eclampsia, a major cause of maternal and perinatal mortality: a prospective analysis at a tertiary care hospital of Peshawar

OBJECTIVE

To observe pregnancy outcome in eclamptics and to explore the avoidable factors contributing to the adverse outcome.

SETTING

Department of Obstetrics and Gynaecology, Hayatabad Medical Complex, Peshawar.

METHOD

This prospective cross-sectional observational study (from 1st Jan 2001 to 31st Mar 2002) included all the patients admitted to the unit with eclampsia. A Sociodemographic and clinical data was collected along with the results of investigations to categorize the complications and data was analyzed using various statistical tests.

MAIN OUTCOME MEASURES

Maternal and Perinatal morbidity and mortality.

RESULTS

During the study period 71 patients developed eclampsia (frequency: 1.2%). Majority were unbooked (86%), primigravida (69%), < or = 25 years of age (63%), referred from other health facilities (66.2%) and had some delay in seeking medical help (60%). Thirty five percent of patients developed major complications and 16.9% of them died (48% of overall maternal mortality). Mortality was frequent in Afghani women (OR 7.71 p value 0.002) and in women who sought medical help more than 6 hrs after developing seizures (OR 14.6 P value 0.0004). Perinatal mortality was 41.6% having prematurity the main risk factor (OR 13.33 p value 0.0000068).

CONCLUSION

To decrease the adverse outcome associated with eclampsia a community-based approach is needed to improve community health education, socioeconomic status and prenatal care. Delivery of proper health care system and emergency obstetrical care facilities are vital for prevention, early detection, proper management and hence to save the mothers and their babies from such a dreadful disease.

Farm-management and milking practices associated with the presence of Listeria monocytogenes in New York state dairy herds

Knowledge of the relationship between dairy herd management and milking practices with the occurrence of Listeria monocytogenes on dairy farms might assist in the development of intervention strategies aimed at eliminating this organism at the pre-harvest dairy-food-production level. This paper represents a first step towards that goal. We carried out a cross-sectional study to identify farm factors that were associated with isolation of L. monocytogenes from on-farm in-line milk-filters. Data on these factors were collected by personal interview of the farm owners or managers. Logistic regression was used to evaluate the significance of association of each factor while simultaneously controlling for the presence of other factors. A systematic approach was developed in which the bivariable association of the hypothesized factors initially was evaluated. All significant factors were then jointly evaluated in a multivariable logistic model. Farms that used a bucket system had significantly higher odds of L. monocytogenes as compared to farms that used a round-the-barn pipeline milking system (OR=0.35,P=0.05) or milking parlor (OR=0.21,P=0.01). There was a significant association between pre-milking teat disinfection (OR=0.26,P=0.001) and pre-milking examination of abnormal appearance of milk (OR=0.4,P=0.01) against the occurrence of L. monocytogenes. We also found a significant association between the use of E. coli J5 vaccine (OR=3.3,P=0.03) and how long dry-cow therapy had been used on farm (OR=0.34,P=0.04).

A cross-sectional study on the prevalence of Listeria monocytogenes and Salmonella in New York dairy herds

As part of our long-term objective of assessing risk for Listeria monocytogenes and Salmonella spp. in dairy herds, we carried out a cross-sectional study to determine the prevalence of the two organisms. The study population consisted of a sample of dairy herds enrolled in the Quality Milk Promotion Services at Cornell during the period of April 1998 to March 1999. The sample was stratified by geographical region to assure representation. Four hundred and four dairy farms were enrolled in the study. In-line milk filters were collected from each farm for bacteriological examination of L. monocytogenes and Salmonella spp. Four hypothesized risk factors were evaluated for their association with the likelihood of the presence of each of the two organisms using logistic regression analysis. Listeria monocytogenes was isolated from 51 (12.6%) of the milk filters. We found region-specific differences in the rate of farms with positive milk filters for this pathogen. Salmonella spp. were isolated from 6 (1.5%) milk filters. One isolate was confirmed as Salmonella enterica Serotype Typhimurium DT 104. There was no significant association between any of the hypothetical risk factors and the likelihood of Salmonella spp. isolation. Our study demonstrated that both L. monocytogenes and Salmonella spp. were prevalent in milk filters in New York dairy herds and that Salmonella was isolated at a significantly lower rate then L. monocytogenes.

Colchicine-induced heritable modification of chiasma frequency and distribution in perennial ryegrass (Lolium perenne)

One-week-old seedlings of inbred lines of perennial ryegrass (Lolium perenne L.) were given a 3-h period of treatment with 0.2% colchicine, and this treatment was found to have heritable effects on chromosome behaviour at meiosis. The mean pollen mother cell chiasma frequency was reduced, and there was a corresponding increase in the number of univalents per cell and also changes in cell and bivalent variances. Patterns of chiasma distribution within bivalents were also modified. The effects were seen in the generation in which the treatment was given and they were also observed in the following sexual generation.

A pre-search estimation algorithm for MEDLINE strategies with qualifiers

Inexperienced users of online medical databases often have difficulty formulating their queries. Systems designed to assist them usually do not estimate how effective the initial search strategy will be before performing an actual search. Consequently, the search may find an overwhelming number of citations, or retrieve nothing at all. We have developed an estimation algorithm to predict the outcome of a MEDLINE search. The portion of the algorithm described here estimates retrieval for strategies containing qualifiers. In test searches, the estimate reduced the trial-and-error of strategy formulation. However, the accuracy of the estimate fell short of expectations. Our results show that pre-search estimation for strategies with qualifiers cannot be performed effectively with only the occurrence data that is presently available. They further imply that automated search intermediaries can benefit from medical knowledge which expresses the relationships that exist between terms.

Representation of nursing terminology in the UMLS Metathesaurus: a pilot study

To see whether the National Library of Medicine's Metathesaurus (tm) includes terminology relevant to clinical nursing practice, two widely used nursing vocabularies were matched against the Meta. The two nursing vocabularies are 1) the North American Nursing Diagnosis List of Approved Diagnoses; and 2) the Omaha System, a vocabulary of problems and interventions developed by the Omaha Visiting Nurses Association. First, the terms were scanned against Meta in their "native" form, with phrases and combinations intact. This produced a relatively low percentage of exact matches (12%). Next, the terms were separated into "core concepts" and "modifiers" and the analysis was repeated. The percentage of exact matches to terms in Meta increased to 32%. However, the semantic types of the split terms often were not equivalent to the semantic types of the phrases from which the split terms were derived; also, in some cases, terms returned as exact matches had different meanings in Meta. Automatic scanning for lexical matches is a helpful first step in searching for vocabulary representation in Meta, but term-by-term search for context, semantic type and definition is essential. However, it seems clear that representation of nursing terminology in the Metathesaurus needs to be expanded.

Q & A: a query formulation assistant

Inexperienced users of online medical databases often do not know how to formulate their queries for effective searches. Previous attempts to help them have provided some standard procedures for query formulation, but depend on the user to enter the concepts of a query properly so that the correct search strategy will be formed. Intelligent assistance specific to a particular query often is not given. Several systems do refine the initial strategy based on relevance feedback, but usually do not make an effort to determine how well-formed a query is before actually performing the search. As part of the Interactive Query Workstation (IQW), we have developed an expert system, Questions and Answers (Q&A), that assists in formulating an initial strategy given concepts entered by the user and that determines if the strategy is well-formed, refining it when necessary.

Casebook: a system for tracking clinical encounters

Casebook is a clinically oriented database, written in MUMPS, and designed for recording the clinical encounters of medical students at Harvard Medical School. Its main goals are to 1) increase student use of computer technology, 2) help faculty evaluate the diversity of clinical experiences on their service, 3) provide data to the faculty on the "typical" experience of medical students on their service to aid in the evaluation of the curriculum and, 4) provide report-generation capabilities for the students to improve dialog with their preceptors. Students are able to enter information on "Problems" and "Procedures" selecting from a pop-up menu of medical terms or by entering free text. Casebook is currently in use in the Medicine, OB/GYN, Pediatric and Ambulatory rotations. At sites where the faculty take an active interest in the use of Casebook students perceive it to be valuable and subsequently use it more frequently. It is currently being expanded for use by medical students in their second, third, and fourth years of school.

Plant Regeneration from Seedling Derived Explants through Callus of Eggplant (Solanum melongena L)

Different concentrations and combinations of hormones were used in MS medium to observe callus induction and then plant regeneration using stem, leaf and root explants. The rate of callus formation varied in different treatments used. The highest amount of callus (48.66%) was produced on MS medium containing 2.0 mg/l BAP and 0.5 mg/l NAA from stem after 8.2 days. The highest fresh weight of callus was 1.12, 0.5 and 0.48 g from stem, leaf and root, respectively. The highest percentage of regeneration (23.28%) was recorded in MS media containing 2.0 mg/l BAP + 0.5 mg/l NAA from stem after 38.8 days. However, 11.94% leaf the regeneration was obtained by 2.0 mg/l BAP + 0.5 mg/l NAA after 46.2 days. It was also found that 2.0 mg/l BAP + 0.5 mg/l NAA was the best stem regeneration. The protocol in the study might be useful for the production of disease free and healthy plant materials and also it would be useful for genetic transformation of eggplant using biotechnological approach. Keywords: 6-Benzyl amino purine (BAP); α-Naphthalene acetic acid (NAA); Solanum melongena; regeneration. DOI: 10.3329/agric.v8i2.7583 The Agriculturists 8(2): 98-107 (2010)