1
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Wong WHS, Leung DL, Yip KM, So HK, Rosa Duque JS, Lau YL. Effectiveness of inactivated COVID-19 vaccine CoronaVac in children aged less than 3 years old during Omicron wave in Hong Kong. Vaccine 2024; 42:2135-2137. [PMID: 38453618 DOI: 10.1016/j.vaccine.2024.02.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 02/05/2024] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
The COVID-19 pandemic has affected people of all ages worldwide. However, there is still no information on the vaccine effectiveness (VE) of inactivated COVID-19 vaccines in children aged less than 3 years old. This study highlighted that 2 doses of CoronaVac were effective in preventing COVID-19, with a VE of 83.1 %.
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Affiliation(s)
- W H S Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - D L Leung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - K M Yip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - H K So
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - J S Rosa Duque
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong SAR, China.
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2
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Noordin NR, Azhar A, Lau YL, Cheong FW, Fong MY. Multiplicity of infection of Plasmodium knowlesi in Malaysia: an application of Pkmsp-1 block IV. Trop Biomed 2023; 40:295-300. [PMID: 37897161 DOI: 10.47665/tb.40.3.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
In Malaysia presently, the main cause of human malaria is by the zoonotic monkey parasite Plasmodium knowlesi. A previous study has suggested that the P. knowlesi merozoite surface protein 1 (Pkmsp-1) block IV to be a suitable multiplicity of infection (MOI) genotyping marker for knowlesimalaria. This study therefore aimed to investigate the usefulness of Pkmsp-1 block IV in assessing the MOI of P. knowlesi in clinical isolates from Malaysia. Two allele-specific PCR primer pairs targeting the two allelic families of block IV (T1 and T2) were designed, and used to genotype P. knowlesi in 200 blood samples (100 from Peninsular Malaysia and 100 from Malaysian Borneo). Results showed that the mean MOI in Malaysian Borneo was slightly higher as compared to Peninsular Malaysia (1.58 and 1.40, respectively). Almost half of the total blood samples from Malaysian Borneo (52%) had polyclonal infections (i.e., more than one allele of any family type) as compared to Peninsular Malaysia (33%) samples. The T1 allelic family was more prevalent in Peninsular Malaysia (n=75) than in Malaysian Borneo (n=60). The T2 allelic family, however, was more prevalent in the Malaysian Borneo (n=87 vs n=53 respectively). This study shows that the single locus Pkmsp-1 block IV can serve as a simple alternative genetic marker for estimating knowlesi malaria MOI in a population. Future MOI studies should focus on macaque populations as macaques are the natural host of P. knowlesi.
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Affiliation(s)
- N R Noordin
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysi
| | - A Azhar
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysi
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysi
| | - F W Cheong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysi
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603, Kuala Lumpur, Malaysi
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3
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Tan JH, Cheong FW, Lau YL, Fong MY. Plasmodium knowlesi circumsporozoite protein: genetic characterisation and predicted antigenicity of the central repeat region. Trop Biomed 2023; 40:37-44. [PMID: 37356002 DOI: ttps:/doi.org/10.47665/tb.40.1.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Circumsporozoite protein (CSP) central repeat region is one of the main target regions of the RTS,S/AS01 vaccine for falciparum infection as it consists of immunodominant B cell epitopes. However, there is a lack of study for P. knowlesi CSP central repeat region. This study aims to characterise the CSP repeat motifs of P. knowlesi isolates in Peninsular Malaysia. CSP repeat motifs of 64 P. knowlesi isolates were identified using Rapid Automatic Detection and Alignment of Repeats (RADAR). Antigenicity of the repeat motifs and linear B cell epitopes were predicted using VaxiJen 2.0, BepiPred-2.0 and BCPred, respectively. A total of 35 dominant repeat motifs were identified. The repeat motif "AGQPQAQGDGANAGQPQAQGDGAN" has the highest repeat frequency (n=15) and antigenicity index of 1.7986. All the repeat regions were predicted as B cell epitopes. In silico approaches revealed that all repeat motifs were antigenic and consisted of B cell epitopes which could be designed as knowlesi malaria vaccine.
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Affiliation(s)
- J H Tan
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - F W Cheong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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4
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Azlan UW, Lau YL, Hamid MHA, Jelip J, Ooi CH, Mudin RN, Jaimin JJ, Fong MY. Genetic diversity of secreted protein with an altered thrombospondin repeat (SPATR) of Plasmodium knowlesi clinical isolates from Malaysia. Trop Biomed 2022; 39:504-510. [PMID: 36602208 DOI: 10.47665/tb.39.4.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Plasmodium knowlesi secreted protein with an altered thrombospondin repeat (PkSPATR) is an important protein that helps in the parasite's invasion into the host cell. This protein has been regarded as one of the potential vaccine candidates against P. knowlesi infection. This study investigates the genetic diversity and natural selection of PkSPATR gene of P. knowlesi clinical isolates from Malaysia. PCR amplification of the full length PkSPATR gene was performed on 60 blood samples of infected P. knowlesi patients from Peninsular Malaysia and Malaysian Borneo. The amplified PCR products were cloned and sequenced. Sequence analysis of PkSPATR from Malaysia showed higher nucleotide diversity (CDS p: 0.01462) than previously reported Plasmodium vivax PvSPATR (p = 0.0003). PkSPATR from Peninsular Malaysia was observed to have slightly higher diversity (CDS p: 0.01307) than those from Malaysian Borneo (CDS p: 0.01212). Natural selection analysis on PkSPATR indicated significant purifying selection. Multiple amino acid sequence alignment revealed 69 polymorphic sites. The phylogenetic tree and haplotype network did not show any distinct clustering of PkSPATR. The low genetic diversity level, natural selection and absence of clustering implied functional constrains of the PkSPATR protein.
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Affiliation(s)
- U W Azlan
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - M H A Hamid
- Vector Borne Disease Sector, Disease Control Division, Ministry of Health Malaysia, 62590 Putrajaya, Malaysia
| | - J Jelip
- Vector Borne Disease Sector, Disease Control Division, Ministry of Health Malaysia, 62590 Putrajaya, Malaysia
| | - C H Ooi
- Sarawak Health Department, Ministry of Health Malaysia, 93050 Kuching, Sarawak, Malaysia
| | - R N Mudin
- Sabah Health Department, Ministry of Health Malaysia, 88590 Kota Kinabalu, Sabah, Malaysia
| | - J J Jaimin
- Public Health Laboratory Kota Kinabalu, Ministry of Health Malaysia, 88850 Kota Kinabalu, Sabah, Malaysia
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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5
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Wong JSC, Wong TS, Chua GT, Wan C, Lau SH, Ho SCS, Rosa Duque JS, Wong ICK, To KKW, Tso WWY, Wong CS, Ho MHK, Kwok J, Chow CB, Tam PKH, Chan GCF, Leung WH, Lau YL, Ip P, Kwan MYW. COVID toe in an adolescent boy: a case report. Hong Kong Med J 2022; 28:175-177. [PMID: 35307653 DOI: 10.12809/hkmj219690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- J S C Wong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - T S Wong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - G T Chua
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - C Wan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - S H Lau
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - S C S Ho
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - J S Rosa Duque
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - I C K Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong.,Research Department of Practice and Policy, UCL School of Pharmacy, University College London, United Kingdom
| | - K K W To
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - W W Y Tso
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - C S Wong
- Dermatology Division, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - M H K Ho
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - J Kwok
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - C B Chow
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - P K H Tam
- Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong.,Dr Li Dak-Sum Research Centre, The University of Hong Kong-Karolinska Institutet Collaboration in Regenerative Medicine, The University of Hong Kong, Hong Kong
| | - G C F Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - W H Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - P Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - M Y W Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
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Chua GT, Wong JSC, Chung J, Lam I, Kwong J, Leung K, Law CY, Lam CW, Kwok J, Chu PWK, Au EYL, Lam CK, Mak D, Fong NC, Leung D, Wong WHS, Ho MHK, Tsao SSL, Wong CS, Yam JC, Tso WWY, To KKW, Tam PKH, Chan GCF, Leung WH, Yuen KY, Novelli V, Klein N, Levin M, Whitaker E, Lau YL, Ip P, Kwan MYW. Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2: a case report. Hong Kong Med J 2022; 28:76-78. [DOI: 10.12809/hkmj219689] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Gilbert T Chua
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Joshua SC Wong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Jaime Chung
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Ivan Lam
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Joyce Kwong
- Haematology Laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong
| | - Kate Leung
- Haematology Laboratory, Department of Pathology, Princess Margaret Hospital, Hong Kong
| | - CY Law
- Division of Chemical Pathology, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - CW Lam
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Janette Kwok
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Patrick WK Chu
- Division of Transplantation and Immunogenetics, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Elaine YL Au
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Crystal K Lam
- Division of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong
| | - Daniel Mak
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - NC Fong
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - Daniel Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Wilfred HS Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Marco HK Ho
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sabrina SL Tsao
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Christina S Wong
- Division of Dermatology, Department of Medicine, Queen Mary Hospital, Hong Kong
| | - Jason C Yam
- Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Hong Kong
| | - Winnie WY Tso
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Kelvin KW To
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Paul KH Tam
- Division of Paediatric Surgery, Department of Surgery, The University of Hong Kong, Hong Kong; Dr Li Dak-Sum Research Centre, The University of Hong Kong–Karolinska Institutet Collaboration in Regenerative Medicine, The University of Hong Kong, Hong Kong
| | - Godfrey CF Chan
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - WH Leung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - KY Yuen
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Vas Novelli
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children, London, United Kingdom; Institute of Child Health, University College London, London, United Kingdom
| | - Nigel Klein
- Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children, London, United Kingdom; Institute of Child Health, University College London, London, United Kingdom
| | - Michael Levin
- Section of Paediatrics, Imperial College London, London, United Kingdom
| | - Elizabeth Whitaker
- Paediatric Infectious Diseases Department, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - YL Lau
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Mike YW Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
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7
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Mokhtar AS, Sahimin N, Hanapi IRM, Lau YL, Zain SNM, AbuBakar S, Ya'çob Z. Molecular survey of head lice (Pediculus humanus capitis) infestation among disadvantaged children in Klang Valley, Malaysia. Trop Biomed 2021; 38:590-593. [PMID: 35001925 DOI: 10.47665/tb.38.4.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
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.
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Affiliation(s)
- A S Mokhtar
- Department of Microbiology, Faculty of Medicine, Manipal University College Malaysia, Jalan Batu Hampar, 75150 Bukit Baru, Melaka, Malaysia
| | - N Sahimin
- Higher Centre of Excellence (HICoE), Tropical Infectious Diseases Rese arch & Education Centre (TIDREC), Universiti Malaya, 5060 3 Kuala Lumpur, Malaysia
| | - I R M Hanapi
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Medical Microbiology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - S N M Zain
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - S AbuBakar
- Higher Centre of Excellence (HICoE), Tropical Infectious Diseases Rese arch & Education Centre (TIDREC), Universiti Malaya, 5060 3 Kuala Lumpur, Malaysia
| | - Z Ya'çob
- Higher Centre of Excellence (HICoE), Tropical Infectious Diseases Rese arch & Education Centre (TIDREC), Universiti Malaya, 5060 3 Kuala Lumpur, Malaysia
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Mohd Hanapi IR, Sahimin N, Lewis JW, Lau YL, Othman J, Tedong PA, Mohn Zain SN. Public health status of Myanmar refugees in South East Asia: A Malaysian case study. Trop Biomed 2021; 38:594-604. [PMID: 35001926 DOI: 10.47665/tb.38.4.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The United Nations High Commissioner for Refugees (UNHCR) reports over 80 million people are displaced worldwide with approximately 26.3 million categorized as refugees and over a million residing temporarily in South East Asia. Despite the lack of national legislative framework in place for refugees and asylum seekers (RAS), Malaysia hosts approximately 178,140 as registered with UNHCR and the majority originate from Myanmar. In this review, we examine refugees from South East Asia, particularly from Myanmar that have contributed to the largest influx of refugees to this region with a focus on their health status. The present study traces barriers to the health care of refugees in the country of asylum and also the challenges faced by these communities in accessing health services.
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Affiliation(s)
- I R Mohd Hanapi
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - N Sahimin
- Tropical Infectious Diseases Research and Education Cen tre (TIDREC), Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - J W Lewis
- School of Biological Sciences, Royal Holloway, University of London, TW20 OEX Egham, Surrey United Kingdom
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - J Othman
- Department of Language & Literacy Education, Faculty of Education, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - P A Tedong
- Department of Urban & Regional Planning, Faculty of Built Environment, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - S N Mohn Zain
- Institute of Biological Sciences, Faculty of Science, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
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9
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Cimpeanu O, Sim K, Lau Y, Dobson R, Marshall G, Padfield G, Wright G, Connelly D. Negative impact of socioeconomic deprivation on clinical outcomes after cryoablation for atrial fibrillation: 18-month study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Lower socioeconomic status has also been shown to associate with higher incidence of atrial fibrillation (AF), increased mortality and morbidity. However, the impact of socioeconomic deprivation on clinical outcomes post AF cryoablation has yet to be investigated.
Aim
To assess the impact of socioeconomic deprivation (as categorised by Scottish Index of Multiple Deprivation, SIMD) on the medical management and clinical outcomes of patients with AF post cryoablation.
Methods
A retrospective study of paroxysmal or persistent AF patients after cryoablation. Parameters included basic demographics, weight, past medical history (hypertension, heart failure, diabetes, stroke, myocardial infarction, sleep apnoea) and alcohol misuse. Medical treatment post ablation (Beta blocker, calcium channel blocker, flecainide, amiodarone, dronaderone, sotolol, anticoagulant use) were also recorded.
Socioeconomic deprivation index, as per SIMD was recorded (1 – most deprived and 10 – least deprived), and accordingly placed into quintile (SIMD 1–2,3–4,5–6,7–8, 9–10). Follow-up for 18 months.
Clinical outcome assessed was rate of readmission for symptomatic AF, rate of heart failure admission, stroke, bleeding diathesis and all-cause mortality.
Results
383 patients were identified: 78 from the lowest quintile (SIMD 1–2), 68 (SIMD 3–4), 64 (SIMD 5–6), 62 (SIMD 7–8), and 111 from the highest quintile (SIMD 9–10). No statistical difference exists between age, gender or weight. Lowest socioeconomic quintile has higher incidence of heart failure (p=0.006) and hypertension (p=0.005) but other past medical history was no different. No difference in incidence of alcohol misuse.
Medicine prescription was not different. Echo features: left ventricular function, atrial size and valvular dysfunction were not different between all groups.
18 months follow-up demonstrated that both readmission for symptomatic documented AF and recurrence of symptoms at 18 months were higher among patients of lowest socioeconomic quintile (Keplan Meier plot, p=0.014 and p=0.006 respectively). Stepwise multiple regression analysis also confirmed multiple socioeconomic deprivation as an independent predictor for more adverse clinical outcome (p=0.02).
Risk of symptom recurrence at 18 months in patients from the least deprived background is less than one third as compared to the ones from the most deprived background (Odd-ratio 0.32 (0.17 - 0.59))
Risk of readmission for AF in patients from the wealthiest socioeconomic group is also less than a third as compared to those of most deprived social group (Odd-ratio 0.31 (95% CI 0.15–0.61)).
Other clinical outcomes including risk of admissions for heart failure, stroke, bleeding diathesis and all-cause mortality was not statistically different across all groups.
Summary
After cryoablation, patients from the lowest socioeconomic group are more likely to experience symptoms recurrence and readmission for symptomatic AF
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- O Cimpeanu
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - K.Y.T Sim
- Queen Elizabeth University Hospital, Glasgow, United Kingdom
| | - Y Lau
- Golden Jubilee National Hospital, Glasgow, United Kingdom
| | - R Dobson
- Golden Jubilee National Hospital, Glasgow, United Kingdom
| | - G Marshall
- Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - G Padfield
- Forth Valley Royal Hospital, Larbert, United Kingdom
| | - G Wright
- Golden Jubilee National Hospital, Glasgow, United Kingdom
| | - D.T Connelly
- Golden Jubilee National Hospital, Glasgow, United Kingdom
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10
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Kwan MYW, Chua GT, Chow CB, Tsao SSL, To KKW, Yuen KY, Lau YL, Ip P. mRNA COVID vaccine and myocarditis in adolescents. Hong Kong Med J 2021; 27:326-327. [PMID: 34393110 DOI: 10.12809/hkmj215120] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- M Y W Kwan
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong
| | - G T Chua
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - C B Chow
- Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong.,Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - S S L Tsao
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - K K W To
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - K Y Yuen
- Department of Microbiology, Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - P Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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11
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Lai MY, Rafieqin N, Lee PYL, Amir Rawa MS, Dzul S, Yahaya N, Abdullah FH, Othman N, Jelip J, Ooi CH, Ibrahim J, Aung M, Abdullah AH, Laili Z, Lau YL. High incidence of Plasmodium knowlesi malaria compared to other human malaria species in several hospitals in Malaysia. Trop Biomed 2021; 38:248-253. [PMID: 34362867 DOI: 10.47665/tb.38.3.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Through the regional control programme, Malaysia has been successfully reducing the incidence of Plasmodium falciparum and Plasmodium vivax infections. However, the incidence of zoonotic malaria Plasmodium knowlesi infection is increasing and now has been the major cause of malaria in Malaysia especially Malaysian Borneo. The emergence of knowlesi infection has threatened the malaria elimination programme which the government aims to reduce the overall malaria infections by 2020. Unlike other benign human Plasmodium spp., P. knowlesi can cause fatal infections. The aim of this study was to determine the incidence and distribution of five human malaria parasites including P. knowlesi in Peninsular Malaysia and Malaysian Borneo. A total of 112 blood samples were collected from seven states and district hospitals in Peninsular Malaysia and Malaysian Borneo from year 2015 to 2016. The samples were examined by microscopy and further confirmed by nested PCR assay targeting 18S rRNA gene of Plasmodium spp. Following the nested PCR assays, a total of 54 (48.2%) samples were positive for P. knowlesi infections, 12 (10.7%) cases were positive for P. vivax infections, followed by 7 (6.3%) cases of P. falciparum and 4 (3.5%) cases of P. malariae. There were 3 cases (2.7%) of mixed infections (P. knowlesi/P. vivax). However, no cases were identified as P. ovale. A total of 32 (28.6%) cases were found as negative infections. LoopMediated Isothermal Amplification Assay (LAMP) was performed to confirm inconclusive results produced by microscopy and nested PCR. P. knowlesi showed the highest prevalence in Sarawak (n= 30), Sabah (n=13), Pulau Pinang (n=5) and Pahang (n=6). PCR and LAMP was not able to detect a large number of microscopy positive samples due to DNA degradation during storage and shipping. Among all the states involved in this study, the highest prevalence of P. knowlesi infection was found in Sabah and Sarawak.
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Affiliation(s)
- M Y Lai
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - N Rafieqin
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - P Y Lee Lee
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - M S Amir Rawa
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - S Dzul
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - N Yahaya
- Jabatan Kesihatan Negeri Pulau Pinang, 10590 Pulau Pinang, Malaysia
| | - F H Abdullah
- Pusat Penyelidikan Klinikal, Hospital Sultanah Nur Zahirah, 20400 Kuala Terengganu, Malaysia
| | - N Othman
- Microbiology Unit, Department of Pathology, Hospital Sultanah Nur Zahirah, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Malaysia
| | - J Jelip
- Ministry of Health Malaysia, 62590 Putrajaya, Malaysia
| | - C H Ooi
- Sarawak State Health Department, 03050 Kuching, Sarawak
| | - J Ibrahim
- Sarawak State Health Department, 03050 Kuching, Sarawak
| | - M Aung
- Hospital Kuala Lipis, 27200 Kuala Lipis, Pahang
| | | | - Z Laili
- Hospital Raja Permaisuri Bainun, 30450 Ipoh, Perak
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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12
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Ng YL, Fong MY, Lau YL. Genetic diversity of the full length apical membrane antigen-1 of Plasmodium knowlesi clinical isolates from Peninsular Malaysia. Trop Biomed 2021; 38:159-164. [PMID: 34172705 DOI: 10.47665/tb.38.2.052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The Plasmodium knowlesi apical membrane antigen-1 (PkAMA-1) plays an important role in the invasion of the parasite into its host erythrocyte, and it has been regarded as a potential vaccine candidate against human knowlesi malaria. This study investigates genetic diversity and natural selection of the full length PkAMA-1 of P. knowlesi clinical isolates from Peninsular Malaysia. Blood samples were collected from P. knowlesi malaria patients from Peninsular Malaysia. The PkAMA-1 gene was amplified from DNA samples using PCR, cloned into a plasmid vector and sequenced. Results showed that nucleotide diversity of the full length PkAMA-1 from Peninsular Malaysia isolates (π: 0.006) was almost similar to that of Sarawak (π: 0.005) and Sabah (π: 0.004) isolates reported in other studies. Deeper analysis revealed Domain I (π: 0.007) in the PkAMA-1 had the highest diversity as compared to Domain II (π: 0.004) and Domain III (π: 0.003). Z-test indicated negative (purifying) selection of the gene. Combined alignment analysis at the amino acid level for the Peninsular Malaysia and Sarawak PkAMA-1 sequences revealed 34 polymorphic sites. Thirty-one of these sites were dimorphic, and 3 were trimorphic. The amino acid sequences could be categorised into 31 haplotypes. In the haplotype network, PkAMA-1 from Peninsular Malaysia and Sarawak were separated into two groups.
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Affiliation(s)
- Y L Ng
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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13
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Wong KC, Lai MY, De Silva JR, Cheong FW, Fong MY, Lau YL. Experimental Study on Plasmodium knowlesi Normocyte Binding Protein Xa Region II (PkNBPXaII) for Erythrocyte Binding. Trop Biomed 2021; 38:143-148. [PMID: 34172703 DOI: 10.47665/tb.38.2.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Normocyte binding protein Xa (NBPXa) has been implied to play a significant role in parasite invasion of human erythrocytes. Previous phylogenetic studies have reported the existence of three types of NBPXa for Plasmodium knowlesi (PkNBPXa). PkNBPXa region II (PkNBPXaII) of type 1, type 2 and type 3 were expressed on mammalian cell surface and interacted with human and macaque (Macaca fascicularis) erythrocytes. The binding activities of PkNBPXaII towards human and macaque erythrocytes were evaluated using erythrocyte-binding assay (EBA). Three parameters were evaluated to achieve the optimal protein expression of PkNBPXaII and erythrocyte binding activity in EBA: types of mammalian cells, post transfection time and erythrocyte incubation time. COS-7, HEK-293, and CHO-K1 cells showed successful expression of PkNBPXaII, despite the protein expression is weak compared to the positive control. COS-7 was used in EBA. All three types of PkNBPXaII showed rosette formation with macaque erythrocytes but not with human erythrocytes. Future studies to enhance the PkNBPXaII expression on surface of mammalian cells is indeed needed in order to elucidate the specific role of PkNBPXaII in erythrocytes invasion.
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Affiliation(s)
- K C Wong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Lai
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - J R De Silva
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - F W Cheong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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14
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Lau Y, Cimpeanu O, Marshall GE, Padfield GJ, Wright GA, Connelly DT. Socioeconomic deprivation and 1 year clinical outcomes after cryablation for atrial fibrillation. Europace 2021. [DOI: 10.1093/europace/euab116.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Socioeconomic deprivation has previously been demonstrated to result in worse heart failure and myocardial infarction outcomes. Published studies shown lower socioeconomic group to associate with higher prevalence of atrial fibrillation (AF), increased mortality and morbidity. However, the impact of socioeconomic deprivation on clinical outcomes post AF cryoablation has yet to be investigated.
AIM
To assess the impact of socioeconomic deprivation (as categorised by Scottish Index of Multiple Deprivation, SIMD) on the medical management and clinical outcomes of patients with AF treated by cryoablation.
METHODS
A retrospective study of paroxysmal or persistent AF patients after cryoablation. The parameters included basic demographics, weight, past medical history (inclusive of hypertension, heart failure, diabetes, stroke or transient ischaemic attacks, prior myocardial infarction, obstructive sleep apnoea) and alcohol misuse. Medical treatment post AF ablation (Beta blocker, non-dihydropyridine calcium channel blocker, flecainide, amiodarone, dronaderone, sotolol, anticoagulant use) were also recorded.
Individual’s socioeconomic deprivation index, as described SIMD was also recorded (1 – most deprived and 10 – least deprived), and accordingly placed into quintile (SIMD 1-2,3-4,5-6,7-8, 9-10). Follow-up for 12 months.
Clinical outcome assessed was rate of readmission for symptomatic documented AF, rate of heart failure admission, stroke, bleeding diathesis and all-cause mortality.
RESULTS
312 patients were identified: 65 from the lowest quintile (SIMD 1-2), 57 from SIMD 3-4, 54 from SIMD 5-6, 52 from SIMD 7-8, and 84 from the highest quintile (SIMD 9-10). No statistical difference exists between age, gender or weight. Lowest socioeconomic quintile has higher incidence of heart failure (p =0.018) but other past medical history was no different. No difference in incidence of alcohol misuse.
Prescription rate/rhythm control agents and anticoagulant use post ablation was not statistically different between all groups.
12 months follow-up demonstrated readmission for symptomatic documented AF was statistically higher among patients of lowest socioeconomic quintile (Keplan Meier plot, p = 0.001). Stepwise multiple regression analysis also confirmed multiple socioeconomic deprivation as an independent predictor for more adverse clinical outcome (p = 0.02).
Risk of readmission for AF in patients from the wealthiest socioeconomic group is almost a quarter as compared to those of most deprived social group (Odd-ratio 0.273 (95% CI 0.122 – 0.607)).
Other clinical outcomes including risk of admissions for heart failure, stroke, bleeding diathesis and all-cause mortality was not statistically different across all groups.
Summary
After cryoablation for AF, patients from the lower socioeconomic group are still more likely to experience readmission for symptomatic AF at 12-month, despite similar post-procedure pharmaceutical agents utilised.
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Affiliation(s)
- Y Lau
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - O Cimpeanu
- Glasgow Royal Infirmary, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - GE Marshall
- Glasgow Royal Infirmary, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - GJ Padfield
- Forth Valley Royal Hospital, Larbert, United Kingdom of Great Britain & Northern Ireland
| | - GA Wright
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - DT Connelly
- Golden Jubilee National Hospital, Glasgow, United Kingdom of Great Britain & Northern Ireland
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15
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Affiliation(s)
- Y L Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong
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16
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Amir A, Lai MY, Sarip F, Omar H, Wan Ismail WH, Grover CS, Lau YL, Mahmud R. Enteral myiasis causing acute dysentery: A case report. Trop Biomed 2021; 38:142-144. [PMID: 33797537 DOI: 10.47665/tb.38.1.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Enteral myiasis or intestinal myiasis is acquired by ingesting food or water contaminated with dipteran fly eggs or larvae. Here, we describe a patient with intestinal myiasis presenting with acute dysentery caused by the larva of Hermetia illucens. The larva was identified morphologically, and its species confirmed through molecular analysis using polymerase chain reaction and sequencing based on mitochondrial cytochrome c oxidase subunit I gene (COI).
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Affiliation(s)
- A Amir
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.,Parasitology Diagnostic Unit, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia
| | - M Y Lai
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - F Sarip
- Parasitology Diagnostic Unit, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia
| | - H Omar
- Parasitology Diagnostic Unit, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia
| | - W H Wan Ismail
- Parasitology Diagnostic Unit, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia
| | - C S Grover
- Columbia Asia Hospital - Miri, Lot 1035 - 1039, Jalan Bulan Sabit, CDT 155, Jalan Bulan Sabit, 98009 Miri, Sarawak, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - R Mahmud
- Parasitology Diagnostic Unit, University Malaya Medical Centre, 59100, Kuala Lumpur, Malaysia
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17
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Mat Salleh NH, Abdul Rahman MF, Samsusah S, De Silva JR, Tan JH, Amir A, Lau YL. Complications of Sub-microscopic Plasmodium vivax Malaria among Orang Asli in Pos Lenjang, Kuala Lipis. Trop Biomed 2021; 38:33-35. [PMID: 33797521 DOI: 10.47665/tb.38.1.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In recent years, increasing cases of Plasmodium vivax complications had been reported all over the world. This former benign Plasmodium species is now recognized to be one of the human malaria parasites that can produce severe disease. In this article, we report two cases of sub-microscopic P. vivax malaria confirmed by PCR. Both patients were asymptomatic before treatment. They showed unusual presentations few days after initiation of antimalarial treatment. Both patients had subsequently completed antimalarial treatment and recovered completely.
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Affiliation(s)
- N H Mat Salleh
- Lipis District Health Office, 27200 Kuala Lipis, Pahang, Malaysia
| | - M F Abdul Rahman
- Lipis District Health Office, 27200 Kuala Lipis, Pahang, Malaysia
| | - S Samsusah
- Lipis District Health Office, 27200 Kuala Lipis, Pahang, Malaysia
| | - J R De Silva
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - J H Tan
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - A Amir
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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18
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Zen LPY, Lai MY, Lau YL. Elimination of contamination in loop-mediated isothermal amplification assay for detection of human malaria. Trop Biomed 2020; 37:1124-1128. [PMID: 33612764 DOI: 10.47665/tb.37.4.1124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The LAMP assay, amplifies the target DNA rapidly, with 10-fold greater sensitivity than conventional PCR. The greater sensitivity also comes with greater risks of contamination. To overcome this issue, the current project includes either uracil DNA glycosylase (UDG) or a mineral oil overlay in the LAMP assay. Our results indicated that UDG or a mineral oil overlay can effectively prevent carryover contamination in the LAMP assay for the detection of human malaria. By incorporating these preventative methods, contamination can be eliminated and LAMP can potentially be used in the field; and point of care diagnosis for human malaria.
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Affiliation(s)
- L P Y Zen
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Lai
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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19
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Rouhani-Rankouhi SZ, Kow KS, Liam CK, Lau YL. Seropositivity and risk factors of Toxocara canis infection in adult asthmatic patients. Trop Biomed 2020; 37:599-608. [PMID: 33612775 DOI: 10.47665/tb.37.3.599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This cross-sectional study involving 86 adult asthmatic patients aimed to determine the relationship between Toxocara seropositivity and severity of asthma in adult asthmatics and investigate the risk factors for Toxocara infection. In all cases, T. canis IgG level was measured using an anti-Toxocara IgG enzyme-linked immunosorbent assay kit. Total serum IgE and eosinophil count were also determined. The anti-Toxocara IgG seropositivity was 68.6% among asthmatic patients. There were no statistically significant associations between Toxocara seroprevalence and other risk factors, clinical symptoms of asthma and high level of total serum IgE and eosinophilia. Pet ownership could be an important risk factor for Toxocariasis. Having a pet at home and wheezing were significantly associated with Toxocara seropositivity in adult asthmatic patients.
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Affiliation(s)
- S Z Rouhani-Rankouhi
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - K S Kow
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - C K Liam
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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20
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De Silva JR, Ching XT, Lau YL. Investigative study on the role of the Toxo 5699 gene in the Toxoplasma gondii lytic cycle using the CRISPR/Cas9 system. Trop Biomed 2020; 37:324-332. [PMID: 33612802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The focus of the current study was to disrupt the Toxo 5699 gene via CRISPR/Cas9 to evaluate the effects of gene disruption on the parasite lytic cycle. In the present work, a single plasmid expressing both the guide RNA and Cas9 nuclease together with a selectable marker of human dihydrofolate reductase (DHFR) was introduced into Toxoplasma gondii. Targeted disruption of the Toxo 5699 gene was carried out via the CRISPR/Cas9 system and confirmed by PCR, sequencing, and immunofluorescence microscopy. Disrupted and nondisrupted control parasites were allowed to invade HS27 cell monolayers and plaques were counted. The average number of plaques from three replicates per group was obtained between the disrupted and non-disrupted T. gondii RH strain and was compared using a onetailed t-test. It was observed that there was a significant decrease in number and size of plaque formation in the Toxo 5699 gene disrupted parasite line. This is an indication that the Toxo 5699 gene may play a role in the lytic cycle of the parasite, particularly during the replication phase and thus would be a novel target for disruption or silencing. The Toxo 5699 gene presented in the current work is an important part of the T. gondii lytic cycle, therefore meriting further inquiry into its potential as a target for further genetic-silencing or disruption studies.
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Affiliation(s)
- J R De Silva
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - X T Ching
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia
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21
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Lau Y, Mackey W, Connelly D. P347Physician-led, weight loss advice prior to atrial fibrillation ablation, overall weight change and clinical outcomes. Europace 2020. [DOI: 10.1093/europace/euaa162.340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Randomised trial, controlled study and international guidelines have advocated weight loss in AF patients with obesity as a means of attaining better AF burden control and maintenance of sinus rhythm. However, previous study required patients to undertake a highly structured weight management programme, detailed counselling, meal plans and behaviour modification.
Aim
To assess if weight-loss can be attained through a 5-minute, target-driven, physician-led counselling amongst overweight/obese patients referred AF ablation, without the need for intensive weight management programme. Subsequently to assess this can lead to better clinical outcomes (reduction in AF recurrence and readmission).
Methods
All patients referred for AF ablation in a tertiary centre over a 6-month period were included. Baseline weight and BMI at initial encounter plus weight and BMI at day of AF ablation were recorded. Optional physician-led counselling was provided, with aim for target weight loss of <10% or reduction of 3 point in BMI.
Initial contact to AF ablation is 6 months.
Clinical outcomes such as symptomatic AF >3 months post AF ablation and readmission for symptomatic AF were recorded. Follow-up duration of 6 months post ablation.
Patients received counselling were designated Group 1, and those who did not were designated Group 2.
Outcomes
146 new AF referrals for ablation seen over the 6-month period. 105 (71.9%) are paroxysmal AF, 37 (25.3%) are persistent, 4 permanent AF.
Mean BMI 34.4 (+/- 5.1). Out of which, 76% have BMI > 30 (Obese), 47.6% possess BMI >35 (Morbidly obese), with 1 patient with BMI exceeding 50.
21.9% patients received physician-led counselling to lose weight. Basic demographics (age, gender), proportion of pAF and duration of AF, use of antiarrhythmic drugs were not statistically different between the two groups.
Among AF patients receiving weight-loss counselling (Group 1), they have higher mean weight and BMI, 108kg (+/- 14.3) and BMI 33.7 (+/-4.3), as compared to those who did not received counselling (Group 2), 87.5kg (+/- 16.2) and BMI 29.5 (+/-4.3).
At point of AF ablation, Group 1 has median weight loss of (-)4.5kg, mean reduction of BMI (-)2.0 points, while Group 2 has median weight gain of 3.6kg, increase of BMI 1.1 point. Overall statistically significant difference in weight change (p <0.001).
Composite clinical outcomes at 6 months post ablation comprising recurrence of AF and readmission for symptomatic AF were higher in Group 2 as compared to Group 1, 38% vs 13% (p = 0.03).
Summary
This small cohort study suggests that concise physician-led weight loss counselling (without dietician-led meal plan or extensive weight loss programme) provided to AF patients with increased BMI can lead to significant weight loss and lower BMI in the run-up to AF ablation. This is also associated with statistically significant reduction in recurrence of AF and hospital re-admission.
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Affiliation(s)
- Y Lau
- Glasgow Royal Infirmary, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - W Mackey
- Glasgow Royal Infirmary, Glasgow, United Kingdom of Great Britain & Northern Ireland
| | - D Connelly
- Glasgow Royal Infirmary, Glasgow, United Kingdom of Great Britain & Northern Ireland
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22
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Lam KT, Zheng J, Xiang Z, Liu YP, Lau YL, Tu WW. Antiviral activity of human γδ-T cells against enterovirus 71. Hong Kong Med J 2019; 25 Suppl 9:21-23. [PMID: 31889030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023] Open
Affiliation(s)
- K T Lam
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - J Zheng
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Z Xiang
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Y P Liu
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - W W Tu
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
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23
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Chua GT, Chong PC, Au EY, Cheong KN, Wong WH, Chan EY, Ho MH, Lau YL, Duque JSR. Skin prick testing a better predictor than blood testing for the diagnosis of peanut allergy in Chinese children. Asian Pac J Allergy Immunol 2019; 39:241-248. [PMID: 31310149 DOI: 10.12932/ap-110319-0519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Peanut allergy is common in Chinese children, yet the most predictive diagnostic cut-offs for skin prick test (SPT) and blood testing in this population are unclear. OBJECTIVES We aimed to determine the optimal cut-off values for whole-peanut SPT, specific IgE (sIgE) and component-resolved diagnostics (CRD) for Chinese children based on outcomes of open oral food challenges (OFC) to peanut. METHODS We recruited ethnic-Chinese patients 1-18 years old who were suspected of having peanut allergy based on a history of reactions after exposure or sensitization although peanut naïve. Considering the AUC value of 0.8, 80% power and 5% level of significance with two tails, 26 patients were needed. Sensitivities, specificities, positive and negative predictive values, and receiver operating characteristic curves (ROCs) and their area-under-curves (AUCs) for SPT, peanut sIgE, and CRD were compared. RESULTS Thirty-one subjects participated. Only SPT reached statistical significance (AUC 0.91, p = 0.0001), but not the other tests. Seven retrospective data were added to optimize the power. SPT remained to be the best predictor, followed by Ara h 2 sIgE (AUC 0.72, p = 0.02). An SPT wheal size of 3 mm and Ara h 2 sIgE of 0.14 kU(A)/L yielded the highest Youden's index. The specificity of SPT and Ara h 2 sIgE reached 94% at 6 mm and 0.74 kU(A)/L, respectively. Comparisons of ROCs revealed that SPT was significantly better than Ara h 2 sIgE (p = 0.03) and whole-peanut sIgE (AUC 0.61, p = 0.26). CONCLUSION In Chinese children, SPT appeared to be the best predictor for peanut allergy, followed by Ara h 2 sIgE.
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Affiliation(s)
- Gilbert T Chua
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Patrick Cy Chong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Elaine Yl Au
- Division of Clinical Immunology, Department of Pathology & Clinical Biochemistry, Queen Mary Hospital, Hong Kong, China
| | - K N Cheong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Wilfred Hs Wong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Eric Yt Chan
- Division of Clinical Immunology, Department of Pathology & Clinical Biochemistry, Queen Mary Hospital, Hong Kong, China
| | - Marco Hk Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Jaime S Rosa Duque
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Tay ST, Kho KL, Vythilingam I, Ooi CH, Lau YL. Investigation of possible rickettsial infection in patients with malaria. Trop Biomed 2019; 36:257-262. [PMID: 33597446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Rickettsioses are a common health problem in many geographical areas, including rural areas in Southeast Asia. Co-infection of rickettsioses and malaria has been reported in Africa, where common reservoir and vectors are available. In this study, blood samples of Malaysian patients microscopically positive (n=148) and negative (n=88) for malaria parasites (Plasmodium knowlesi, Plasmodium malariae, Plasmodium falciparum, and Plasmodium vivax) were screened for the presence of rickettsial DNA, using PCR assays targeting specific genes. A partial fragment of rickettsial ompB gene was successfully amplified and sequenced from a patient microscopically positive for Plasmodium spp. and PCR-positive for P. vivax. BLAST analysis of the ompB sequence demonstrated the highest sequence similarity (99.7% similarity, 408/409nt) with Rickettsia sp. RF2125 (Genbank accession no. JX183538) and 91.4% (374/409 nt) similarity with Rickettsia felis URRWXCal2 (Genbank accession no. CP000053). This study reports rickettsial infection in a malaria patient for the first time in the Southeast Asia region.
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Affiliation(s)
- S T Tay
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur
| | - K L Kho
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur
| | - I Vythilingam
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur
| | - C H Ooi
- Vector Borne Diseases Section, Sarawak Health Department, Ministry of Health Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur
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25
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Garon E, Ardizzoni A, Barlesi F, Cho B, De Marchi P, Goto Y, Lu S, Paz-Ares L, Spigel D, Thomas M, Cazorla Arratia P, Baum J, Lau Y, Zheng C, Yang J. P3.16-02 Phase III Study of Canakinumab (ACZ885) as Adjuvant Therapy in Patients with Surgically Resected NSCLC. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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26
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Yang WL, Lau YL, Lee PP, Chung BH, Yang J. Molecular diagnosis of severe combined immunodeficiency using whole-exome sequencing. Hong Kong Med J 2018; 24 Suppl 3:15-17. [PMID: 29937439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Affiliation(s)
- W L Yang
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - P Pw Lee
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - B Hy Chung
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
| | - J Yang
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong
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27
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Shairah D, Fong MY, Amirah A, Ponnampalavanar S, Cheong FW, Lau YL. Detection of mutated Plasmodium vivax Kelch Propeller Domain (PvK12) in Malaysian isolates. Trop Biomed 2018; 35:135-139. [PMID: 33601785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Malaysia is located near the borders of countries where artemisinin resistant Plasmodium falciparum (mutations in the P. falciparum Kelch propeller domain [PfK13]) have been reported. Plasmodium vivax Kelch propeller domain, PvK12, the ortholog of PfK13, could assess resistance towards artemisinin in vivax malaria. Polymorphisms in PvK12 gene were determined by PCR and sequencing was done in 300 clinical isolates collected in recent years (2012-2017) from hospitals within the country. Among 48 P. vivax samples, all were Sal-1 wild type alleles except for two isolates, a synonymous and nonsynonymous mutation respectively. The nonsynonymous (V552I) isolate was collected from an immigrant. P. vivax with mutated PvK12 is speculated to be an imported case and is likely to be circulating at very low frequency in Malaysia. An in-depth drug resistance surveillance among immigrants needs to be investigated to provide information that may be crucial for drug policy changes.
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Affiliation(s)
- D Shairah
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - A Amirah
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - S Ponnampalavanar
- Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - F W Cheong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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28
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Chua GT, Rosa Duque JS, Chong PCY, Lee PPW, Lau YL, Ho MHK. Paediatric case series of drug reaction with eosinophilia and systemic symptoms (DRESS): 12-year experience at a single referral centre in Hong Kong and the first reported use of infliximab. Eur Ann Allergy Clin Immunol 2017; 50:273-276. [PMID: 29384118 DOI: 10.23822/eurannaci.1764-1489.47] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Summary DRESS (drug reaction with eosinophilia and systemic symptoms) is a rare but potentially life-threatening disorder characterized by fever, skin eruption, haematological abnormalities and multi-organ dysfunction after drug exposure. The pathophysiology is thought to be related to interactions between culprit drugs, viral reactivation and T-lymphocytes activation. We report 4 paediatric patients with DRESS who were treated at our centre over the past 12 years. Most cases improved after corticosteroids. Other immunosuppressive medications were attempted in refractory cases with varied outcomes. Patient 3 was the first reported case that involved the use of infliximab, a TNF-α inhibitor, for DRESS. Although clinical efficacy was not observed for this one patient, a previous study demonstrated that patients with DRESS, disease progression and HHV-6 reactivation had elevated pre-treatment TNF- α and IL-6 levels. Further research is needed to explore the role of these cytokines in DRESS.
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Affiliation(s)
- G T Chua
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
| | - J S Rosa Duque
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
| | - P C Y Chong
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
| | - P P W Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
| | - M H K Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong
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Lau Y, Klainin-Yobas P, Htun TP, Wong SN, Tan KL, Ho-Lim ST, Chi C, Tsai C, Ong KW, Shorey S, Tam WSW. Electronic-based lifestyle interventions in overweight or obese perinatal women: a systematic review and meta-analysis. Obes Rev 2017; 18:1071-1087. [PMID: 28544551 DOI: 10.1111/obr.12557] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 03/21/2017] [Accepted: 03/27/2017] [Indexed: 12/30/2022]
Abstract
Electronic-based (e-based) lifestyle interventions provide potential and cost-effective delivery of remote interventions for overweight and obese perinatal women. To date, no meta-analysis has reported the efficacy of maternal and neonatal outcomes. Seven electronic databases were searched from inception up to July 13, 2016, including the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, EMBASE, ProQuest Dissertations and Theses, PsycINFO, PubMed and Scopus. Among the 1,145 studies retrieved, 14 randomized controlled trials were selected among 17 publications. The Cochrane risk of bias tool was used to appraise the quality assessment. The meta-analyses demonstrated a significant result for limiting gestational weight gain, losing postnatal weight in 1-2 months, increasing self-reported moderate and vigorous physical activity and reducing caloric intake using diet-related software. Our review shows that an e-based lifestyle intervention is an acceptable approach. The findings reveal the variability in intervention methods and provide limited conclusive evidence. Thus, future studies should examine the efficacy and essential components as well as the various approaches using optimal portions of in-person and phone sessions. Further evaluations comparing the effectiveness of different e-based lifestyle intervention approaches toward activity-related and diet-related outcomes are necessary.
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Affiliation(s)
- Y Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - P Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - T P Htun
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - S N Wong
- Medical Resource Team, National University of Singapore Libraries, National University of Singapore, Singapore
| | - K L Tan
- Department of Computer Science, National University of Singapore, Singapore
| | - S T Ho-Lim
- Department of Nursing, National University Hospital, Singapore
| | - C Chi
- Department of Obstetrics and Gynecology, National University Hospital, Singapore
| | - C Tsai
- Department of Rehabilitation, National University Hospital, Singapore
| | - K W Ong
- Dietetics, National University Hospital, Singapore
| | - S Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - W S W Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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30
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Ranjit P, Lau Y, Lip GYH, Blann AD. Development and validation of a new assay for assessing clot integrity. Vascul Pharmacol 2015; 71:102-7. [PMID: 25872165 DOI: 10.1016/j.vph.2015.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 01/29/2015] [Accepted: 02/20/2015] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Research and routine laboratory assessment of clot integrity can be time consuming, expensive, and cannot be batched as it is generally performed in real time. To address these issues, we developed and validated a micro-titre based assay to quantify thrombogenesis and fibrinolysis, the purpose being to assess patients at risk of cardiovascular events by virtue of hypercoagulability. In further validation, thrombogenesis results were compared to similar indices from the thrombelastograph (TEG). METHODS Our assay determines three indices of thrombogenesis (lag time to the start of thrombus formation (LT), rate of clot formation (RCF), and maximum clot density (MCD)) and two of fibrinolysis (rate of clot dissolution (RCD) and time for 50% of the clot to lyse (T50)). Plasma was tested fresh and again after being frozen at -70°C. Some samples were tested immediately, others after being left at room temperature for up to 24h. RESULTS The intra-assay coefficients of variation (CVs) of the three thrombogenesis measures (LT, RCF, MCD) and two fibrinolysis measures (RCD, T50) varied between 2.7 and 12.0% in fresh plasma and between 1.3% and 10.8% in frozen plasma respectively. Similarly, the inter-assay coefficients of variation of the thrombogenesis and fibrinolysis measures were 4.9-10.8% in fresh plasma and 2.2-6.5% in frozen plasma respectively. TEG assays intra- and inter assay CVs were around 25%. There were no significant differences in all plate assay indices up to 6h at room temperature. Certain plate assay thrombogenesis data were comparable to TEG indices after analysis by Pearson's correlation. The reagent processing cost per sample is £15 for TEG and £2 for the plate assays. CONCLUSION Our micro-titre based assay assessing plasma thrombogenesis and fibrinolysis has good intra- and inter-assay CVs, can assess plasma up to 6h after venepuncture, is more efficient (in terms of throughput) and is more economical than that of the TEG.
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Affiliation(s)
- P Ranjit
- University of Birmingham, Centre for Cardiovascular Sciences, Department of Medicine, City Hospital, Dudley Road, Birmingham B18 7QH, UK
| | - Y Lau
- University of Birmingham, Centre for Cardiovascular Sciences, Department of Medicine, City Hospital, Dudley Road, Birmingham B18 7QH, UK
| | - G Y H Lip
- University of Birmingham, Centre for Cardiovascular Sciences, Department of Medicine, City Hospital, Dudley Road, Birmingham B18 7QH, UK
| | - A D Blann
- University of Birmingham, Centre for Cardiovascular Sciences, Department of Medicine, City Hospital, Dudley Road, Birmingham B18 7QH, UK.
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Yang W, Lee PPW, Thong MK, Ramanujam TM, Shanmugam A, Koh MT, Chan KW, Ying D, Wang Y, Shen JJ, Yang J, Lau YL. Compound heterozygous mutations in TTC7A cause familial multiple intestinal atresias and severe combined immunodeficiency. Clin Genet 2015; 88:542-9. [PMID: 25534311 DOI: 10.1111/cge.12553] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/10/2014] [Accepted: 12/10/2014] [Indexed: 11/28/2022]
Abstract
Familial multiple intestinal atresias is an autosomal recessive disease with or without combined immunodeficiency. In the last year, several reports have described mutations in the gene TTC7A as causal to the disease in different populations. However, exact correlation between different genotypes and various phenotypes are not clear. In this study, we report identification of novel compound heterozygous mutations in TTC7A gene in a Malay girl with familial multiple intestinal atresias and severe combined immunodeficiency (MIA-SCID) by whole exome sequencing. We found two mutations in TTC7A: one that destroyed a putative splicing acceptor at the junction of intron 17/exon 18 and one that introduced a stop codon that would truncate the last two amino acids of the encoded protein. Reviewing the recent reports on TTC7A mutations reveals correlation between the position and nature of the mutations with patient survival and clinical manifestations. Examination of public databases also suggests carrier status for healthy individuals, making a case for population screening on this gene, especially in populations with suspected frequent founder mutations.
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Affiliation(s)
- W Yang
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - P P W Lee
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - M-K Thong
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - T M Ramanujam
- Division of Paediatric Surgery & Paediatric Urology, University of Malaya, Kuala Lumpur, Malaysia
| | - A Shanmugam
- Division of Paediatric Surgery & Paediatric Urology, University of Malaya, Kuala Lumpur, Malaysia
| | - M-T Koh
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K-W Chan
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - D Ying
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Y Wang
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - J J Shen
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - J Yang
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, Hong Kong
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Chan YT, Ho HK, Lai CKW, Lau CS, Lau YL, Lee TH, Leung TF, Wong GWK, Wu YY. Allergy in Hong Kong: an unmet need in service provision and training. Hong Kong Med J 2015; 21:52-60. [PMID: 25554794 DOI: 10.12809/hkmj144410] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Many children in Hong Kong have allergic diseases and epidemiological data support a rising trend. Only a minority of children will grow out of their allergic diseases, so the heavy clinical burden will persist into adulthood. In an otherwise high-quality health care landscape in Hong Kong, allergy services and training are a seriously unmet need. There is one allergy specialist for 1.5 million people, which is low not only compared with international figures, but also compared with most other specialties in Hong Kong. The ratio of paediatric and adult allergists per person is around 1:460 000 and 1:2.8 million, respectively, so there is a severe lack of adult allergists, while the paediatric allergists only spend a fraction of their time working with allergy. There are no allergists and no dedicated allergy services in adult medicine in public hospitals. Laboratory support for allergy and immunology is not comprehensive and there is only one laboratory in the public sector supervised by accredited immunologists. These findings clearly have profound implications for the profession and the community of Hong Kong and should be remedied without delay. Key recommendations are proposed that could help bridge the gaps, including the creation of two new pilot allergy centres in a hub-and-spoke model in the public sector. This could require recruitment of specialists from overseas to develop the process if there are no accredited allergy specialists in Hong Kong who could fulfil this role.
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Affiliation(s)
- Y T Chan
- Division of Clinical Immunology, Department of Pathology and Clinical Biochemistry, Queen Mary Hospital, Pokfulam, Hong Kong
| | - H K Ho
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | | | - C S Lau
- Division of Rheumatology and Clinical Immunology, Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Pokfulam, Hong Kong
| | - T H Lee
- Allergy Centre, Hong Kong Sanatorium and Hospital, Hong Kong
| | - T F Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Gary W K Wong
- Department of Paediatrics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Y Y Wu
- Private practice, Hong Kong
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Tu WW, Lau YL, Peiris JSM. Use of humanised mice to study antiviral activity of human γδ-T cells against influenza A viruses. Hong Kong Med J 2014; 20 Suppl 6:4-6. [PMID: 25482962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Affiliation(s)
- W W Tu
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong
| | - Y L Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong
| | - J S M Peiris
- Department of Microbiology, The University of Hong Kong
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Lau YL, Jamaiah I, Rohela M, Fong MY, Siti COS, Siti FA. Molecular detection of Entamoeba histolytica and Entamoeba dispar infection among wild rats in Kuala Lumpur, Malaysia. Trop Biomed 2014; 31:721-727. [PMID: 25776597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Entamoeba histolytica infection is the third-greatest parasitic disease responsible for death in the world. Wild rats harbouring E. histolytica can be the possible reservoir hosts for human amoebiasis. There were numerous studies on prevalence of intestinal parasites among wild rats in Malaysia but none has reported E. histolytica. Rats were captured from Sentul and Chow Kit areas, Kuala Lumpur, Malaysia. The preserved stool samples were used for microscopy examination and molecular analysis. Out of 137 samples collected, 12 were positive for E. histolytica / E. dispar / E. moshkovskii microscopically. Two E. histolytica (1.4%), 1 E. dispar (0.7%) and 6 mixed infections of E. histolytica and E. dispar (4.3%) were detected using PCR. This is the first report of molecular detection of E. histolytica/dispar infection among wild rats in Malaysia. This study provides useful information about the potential risks of zoonotic agents and the importance of developing control measures to prevent zoonotic transmission.
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Affiliation(s)
- Y L Lau
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - I Jamaiah
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Rohela
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - C O S Siti
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - F A Siti
- Department of Parasitology, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
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35
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Lau YL, Cheong FW, Chin LC, Mahmud R, Chen Y, Fong MY. Evaluation of codon optimized recombinant Plasmodium knowlesi merozoite surface protein-119 (pkMSP-119) expressed in Pichia pastoris. Trop Biomed 2014; 31:749-759. [PMID: 25776601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Malaria causes high global mortality and morbidity annually. Plasmodium knowlesi has been recognised as the fifth human Plasmodium sp. and its infection is widely distributed in Southeast Asia. Merozoite surface protein-119 (MSP-119) appears as a potential candidate for malaria blood stage vaccine as it could induce protective immunity. In this study, codon optimized P. knowlesi MSP-119 (pkMSP-119) was expressed and purified in yeast Pichia pastoris expression system. The purified recombinant protein was further evaluated using Western blot assay using knowlesi malaria, non-knowlesi human malaria, non-malarial parasitic infections and healthy serum samples (n = 50). The sensitivity of purified pkMSP-119 towards detection of knowlesi infection was as 28.6% (2/7). pkMSP-119 did not react with all non-malarial parasitic infections and healthy donor sera, yet reacted with some non-knowlesi human malaria sera, therefore lead to a specificity of 86.0% (37/43).
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Affiliation(s)
- Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - F W Cheong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - L C Chin
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - R Mahmud
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Y Chen
- Faculty of Dentistry Dean's Office, Faculty of Dentistry Building, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - M Y Fong
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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36
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Liew PS, Teh CSJ, Lau YL, Thong KL. A real-time loop-mediated isothermal amplification assay for rapid detection of Shigella species. Trop Biomed 2014; 31:709-720. [PMID: 25776596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Shigellosis is a foodborne illness caused by the genus Shigella and is an important global health issue. The development of effective techniques for rapid detection of this pathogen is essential for breaking the chain of transmission. Therefore, we have developed a novel loop-mediated isothermal amplification (LAMP) assay targeting the invasion plasmid antigen H (ipaH) gene to rapidly detect Shigella species. This assay could be performed in 90 min at an optimal temperature of 64ºC, with endpoint results visualized directly. Notably, the method was found to be more sensitive than conventional PCR. Indeed, the detection limit for the LAMP assay on pure bacterial cultures was 5.9 x 10(5) CFU/ml, while PCR displayed a limit of 5.9 x 10(7) CFU/ml. In spiked lettuce samples, the sensitivity of the LAMP assay was 3.6 x 10(4) CFU/g, whereas PCR was 3.6 x 10(5) CFU/g. Overall, the assay accurately identified 32 Shigella spp. with one enteroinvasive Escherichia coli displaying positive reaction while the remaining 32 non-Shigella strains tested were negative.
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Affiliation(s)
- P S Liew
- Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - C S J Teh
- Laboratory of Biomedical Science and Molecular Microbiology, Institute of Graduate Studies, University of Malaya
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya
| | - K L Thong
- Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Wu JT, Cowling BJ, Hung I, Lau YL, Peiris JSM. Infection attack rates during the epidemic of swine influenza A by tracking temporal changes in age-specific seroprevalence rates. Hong Kong Med J 2014; 20 Suppl 4:29-33. [PMID: 25224116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- J T Wu
- School of Public Health, The University of Hong Kong
| | - B J Cowling
- School of Public Health, The University of Hong Kong
| | - I Hung
- Department of Medicine, The University of Hong Kong
| | - Y L Lau
- Department of Pediatrics, The University of Hong Kong
| | - J S M Peiris
- Department of Microbiology, The University of Hong Kong
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Song BK, Pan MZ, Lau YL, Wan KL. Sequence analysis of the PIP5K locus in Eimeria maxima provides further evidence for eimerian genome plasticity and segmental organization. Genet Mol Res 2014; 13:5803-14. [PMID: 25117339 DOI: 10.4238/2014.july.29.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Commercial flocks infected by Eimeria species parasites, including Eimeria maxima, have an increased risk of developing clinical or subclinical coccidiosis; an intestinal enteritis associated with increased mortality rates in poultry. Currently, infection control is largely based on chemotherapy or live vaccines; however, drug resistance is common and vaccines are relatively expensive. The development of new cost-effective intervention measures will benefit from unraveling the complex genetic mechanisms that underlie host-parasite interactions, including the identification and characterization of genes encoding proteins such as phosphatidylinositol 4-phosphate 5-kinase (PIP5K). We previously identified a PIP5K coding sequence within the E. maxima genome. In this study, we analyzed two bacterial artificial chromosome clones presenting a ~145-kb E. maxima (Weybridge strain) genomic region spanning the PIP5K gene locus. Sequence analysis revealed that ~95% of the simple sequence repeats detected were located within regions comparable to the previously described feature-rich segments of the Eimeria tenella genome. Comparative sequence analysis with the orthologous E. maxima (Houghton strain) region revealed a moderate level of conserved synteny. Unique segmental organizations and telomere-like repeats were also observed in both genomes. A number of incomplete transposable elements were detected and further scrutiny of these elements in both orthologous segments revealed interesting nesting events, which may play a role in facilitating genome plasticity in E. maxima. The current analysis provides more detailed information about the genome organization of E. maxima and may help to reveal genotypic differences that are important for expression of traits related to pathogenicity and virulence.
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Affiliation(s)
- B K Song
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor DE, Malaysia
| | - M Z Pan
- School of Science, Monash University Malaysia, Bandar Sunway, Selangor DE, Malaysia
| | - Y L Lau
- Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - K L Wan
- Malaysia Genome Institute, Kajang, Selangor DE, Malaysia
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Lau YL, Tu W. Case-control study of Sichuan and Hong Kong children with melamine-associated renal stones: renal ultrasonography and urinary IL-8 and MCP-1 levels. Hong Kong Med J 2013; 19 Suppl 8:26-30. [PMID: 24473525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- Y L Lau
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong
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Anthony C, Mahmud R, Lau YL, Syedomar SF, Sri La Sri Ponnampalavanar S. Comparison of two nested PCR methods for the detection of human malaria. Trop Biomed 2013; 30:459-466. [PMID: 24189676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Battling malaria will be a persistent struggle without the proper means to diagnose the parasitic infection. However, the inherent limitations of microscopy, the conventional method of diagnosing malaria, affect the accuracy of diagnosis. The present study aimed to compare the accuracy of two different set of primers targeting the small subunit ribosomal RNA (ssRNA) and the dihydrofolate reductase-thymidylate synthase linker region (dhfr-ts) in detecting species specific malaria infections by nested PCR. The sensitivity and specificity of nested PCR assay using the two primers were calculated with reference to microscopy as the 'gold standard'. The results show that 18S rRNA primers had 91.9% sensitivity and 100% specificity in detecting human Plasmodium species as opposed to dhfr-ts primers which had 51.4% sensitivity and 100% specificity. The higher sensitivity of 18S rRNA primers suggests that it may be a better diagnostic tool for detecting human malaria.
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Affiliation(s)
- C Anthony
- Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Lee SL, Cheung YF, Wong HSW, Leung TH, Lam TH, Lau YL. Chronic health problems and health-related quality of life in Chinese children and adolescents: a population-based study in Hong Kong. BMJ Open 2013; 3:bmjopen-2012-001183. [PMID: 23293240 PMCID: PMC3549227 DOI: 10.1136/bmjopen-2012-001183] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE We examined the association of different chronic physical and mental conditions, individually or comorbidly on health-related quality of life (QoL) in Chinese children aged ≤14 years in Hong Kong. DESIGN Population-based cross-sectional survey. PARTICIPANTS Approximately 7500 Chinese children aged <14 years in Hong Kong. INTERVENTIONS Nil. PRIMARY AND SECONDARY OUTCOME MEASURES Various health concepts of validated Chinese version of Child Health Questionnaire (CHQ), a health-related QoL questionnaire in children. RESULT There was significant association of physical and mental health conditions, either individually or comorbidly, on the various concepts of CHQ. Children with mental health problems were apparently more affected than those with physical health problems. Chronic renal disease and congenital malformation were the physical health conditions associated with the lowest scores in CHQ concepts in children aged 5-10 years and aged 10-14 years, respectively. Behavioural problem was the mental health condition associated with the lowest score in CHQ concepts in both age groups. CONCLUSIONS Our study shows important information concerning the prevalence of different health conditions and its association, either individually or comorbidly on the QoL in a representative sample of Chinese children in HK.
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Affiliation(s)
- S L Lee
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Ang EY, Soh JY, Liew WK, Chan KW, Thoon KC, Chong CY, Lau YL, Lee BW. Reliability of acute illness dihydrorhodamine-123 testing for chronic granulomatous disease. Clin Lab 2013; 59:203-206. [PMID: 23505928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Dihydrorhodamine (DHR) flow cytometric analysis is used to evaluate granulocyte oxidative bursts and is the test of choice for the diagnosis of chronic granulomatous disease (CGD). We present the clinical and DHR test profiles of five subjects assessed during and after acute illness. METHODS This was a retrospective report of the findings of five out of a total of one hundred and seventeen patients, whose blood was sent to the laboratory for dihydrorhodamine-123 flow cytometry testing between January 2005 and December 2010. Using whole blood technique and stimulation using phorbol myristate acetate, the results of DHR were expressed as stimulation index and coefficient of variation of histograms of stimulated cells and compared with healthy controls. DHR tests were repeated when the patients had recovered and were clinically well. RESULTS These five patients showed abnormal DHR test results during their acute illness, with a stimulation index (SI) lower (p = 0.009) and coefficient of variation (CV) higher (p = 0.009) than controls. The DHR profiles repeated when patients had recovered showed normalization of tests with no significant difference for SI (p = 0.602) and CV (p = 0.917) compared to controls. Wilcoxon Signed Rank tests showed a significant improvement in SI (p = 0.043) and CV (p = 0.043) upon recovery. On follow up, all five patients were well, with no further severe or atypical infections. CONCLUSIONS DHR may be transiently abnormal during acute illness, and may therefore not be reliable when assessed during an acute illness. If these subjects had CGD, it would be of a hypomorphic variant that has not previously been described.
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Affiliation(s)
- E Y Ang
- University Children's Medical Institute, National University Health Systems, Singapore
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Badagliacca R, Reali M, Vizza C, Poscia R, Pezzuto B, Gambardella C, Papa S, Mezzapesa M, Nocioni M, Fedele F, Freed B, Bhave N, Tsang W, Gomberg-Maitland M, Mor-Avi V, Patel A, Lang RM, Liel-Cohen N, Yaacobi M, Guterman H, Jurzak P, Ternacle J, Gallet R, Bensaid A, Kloeckner M, Monin JL, Gueret P, Dubois-Rande JL, Lim P, Otsuka T, Suzuki M, Yoshikawa H, Hashimoto G, Ishikawa Y, Osaki T, Masai H, Ono T, Yamamoto M, Sugi K, Satendra M, Sargento L, Sousa C, Arsenio A, Lousada N, Palma Reis R, Wang S, Lam Y, Liu M, Fang F, Shang Q, Luo X, Wang J, Sun J, Sanderson J, Yu C, De Marchi S, Hopp E, Urheim S, Hervold A, Murbrach K, Massey R, Remme E, Hol P, Aakhus S, Bouzas Mosquera A, Peteiro J, Broullon F, Garcia NA, Rodriguez Garrido J, Martinez Ruiz D, Yanez Wonenburger J, Bouzas Zubeldia B, Fabregas Casal R, Castro Beiras A, Le Tourneau T, Sportouch C, Foucher C, Delasalle B, Rosso J, Neuder Y, Trochu J, Roncalli J, Lemarchand P, Manrique A, Sharif D, Sharif-Rasslan A, Shahla C, Khalil A, Rosenschein U, Monti L, Tramarin M, Calcagnino M, Lisignoli V, Nardi B, Balzarini L, Khalatbari A, Mills J, Chenzbraun A, Theron A, Morera P, Resseguier N, Thuny F, Riberi A, Giorgi R, Collart F, Habib G, Avierinos J, Liu D, Hu K, Niemann M, Herrmann S, Gaudron P, Voelker W, Ertl G, Bijnens B, Weidemann F, Lenders GD, Bosmans JM, Van Herck PL, Rodrigus IE, Claeys MJ, Vrints CJ, Paelinck BP, Veronesi F, Fusini L, Tamborini G, Gripari P, Maffessanti F, Mirea O, Alamanni F, Pepi M, Caiani E, Frikha Z, Zairi I, Saib W, Fennira S, Ben Moussa F, Kammoun S, Mrabet K, Ben Yaala A, Said L, Ghannouchi M, Carlomagno G, Ascione L, Sordelli C, Iengo R, Severino S, D'andrea A, Calabro' R, Caso P, Mizia M, Mizia-Stec K, Sikora-Puz A, Gieszczyk-Strozik K, Chmiel A, Haberka M, Hudziak D, Jasinski M, Gasior Z, Wos S, Biaggi P, Felix C, Gruner C, Hohlfeld S, Herzog B, Gaemperli O, Gruenenfelder J, Corti R, Tanner F, Bettex D, Kovalova S, Necas J, Dominguez Rodriguez F, Monivas V, Mingo S, Garcia-Lunar I, Garcia-Pavia P, Gonzalez-Mirelis J, Zegri I, Cavero M, Jeon HK, Lee D, Youn H, Shin H, Yoon J, Chung H, Choi E, Kim J, Min P, Lee B, Yoon Y, Hong B, Kwon H, Rim S, Petronilli V, Cimino S, De Luca L, Cicogna F, Arcari L, Francone M, Iacoboni C, Agati L, Halmai L, Atkinson P, Kardos A, Bogle R, Meimoun P, Flahaut G, Charles V, Villain Y, Clerc J, Germain A, Elmkies F, Zemir H, Luycx-Bore A, Kim K, Song J, Jeong H, Yoon H, Ahn Y, Jeong M, Cho J, Park J, Kang J, Tolba OA, El-Shanshory MR, El-Shitany NAEA, El-Hawary ES, Elkilany GN, Tolba OA, El-Shanshory MR, El-Shitany AEA, El-Hawary EES, Nagib Elkilany GE, Costanzo L, Buccheri S, Monte IP, Curatolo G, Crapanzano P, Di Pino L, Rodolico M, Blundo A, Leggio S, Tamburino C, Rees E, Hocking R, Dunstan F, Lewis M, Tunstall K, Rees DA, Halcox JP, Fraser AG, Rodrigues A, Guimaraes L, Guimaraes J, Monaco C, Cordovil A, Lira E, Vieira M, Fischer C, Nomura C, Morhy S, Bruno R, Cogo A, Sharma R, Bartesaghi M, Pomidori L, Basnyat B, Taddei S, Picano E, Sicari R, Pratali L, Satendra M, Sargento L, Sousa C, Lousada N, Palma Reis R, Zakhama L, Sioua S, Naffati S, Marouen A, Boussabah E, Kadour R, Thameur M, Benyoussef S, Vanoli D, Wiklund U, Henein M, Naslund U, Lindqvist P, Palinsky M, Petrovicova J, Pirscova M, Korpi K, Blafield H, Suomi H, Linden P, Valtonen M, Jarvinen V, Laine M, Loimaala A, Kaldararova M, Kantorova A, Vrsanska V, Tittel P, Hraska V, Masura J, Simkova I, Attenhofer Jost C, Zimmermann C, Greutmann M, Dave H, Valsangiacomo Buechel E, Pretre R, Mueller C, Seifert B, Kretschmar O, Weber R, Carro A, Teixido G, Rodriguez-Palomares J, Gutierrez L, Maldonado G, Paucca E, Gonzalez-Alujas T, Evangelista A, Al Akhfash A, Al Mesned D, Maan Hasson D, Al Harbi B M, Cruz C, Pinho T, Lebreiro A, Silva Cardoso J, Julia Maciel M, Kalimanovska-Ostric D, Nastasovic T, Deljanin-Ilic M, Milakovic B, Dostanic M, Stosic M, Lam YY, Fang F, Yu C, Bobbo M, Leonelli V, Piazza R, Leiballi E, Pecoraro R, Cinello M, Mimo R, Cervesato E, Nicolosi GL, Cruz C, Pinho T, Lebreiro A, Silva Cardoso J, Julia Maciel M, Moral Torres S, Evangelista A, Gonzalez-Alujas M, Rodriguez-Palomares J, Teixido G, Gutierrez L, Cuellar H, Carro A, Maldonado G, Garcia-Dorado D, Kocabay G, Dal Bianco L, Muraru D, Peluso D, Segafredo B, Iliceto S, Badano L, Schiano Lomoriello V, Santoro A, Esposito R, Ippolito R, De Palma D, Schiattarella P, Muscariello R, Galderisi M, Teixido Tura G, Redheuil A, Rodriguez-Palomares J, Gutierrez L, Sanchez V, Forteza A, Lima J, Garcia-Dorado D, Evangelista A, Moral Torres S, Evangelista A, Gonzalez-Alujas M, Rodriguez-Palomares J, Teixido G, Gutierrez L, Cuellar H, Carro A, Maldonado G, Garcia-Dorado D, Mihalcea D, Florescu M, Suran B, Enescu O, Mincu R, Patrascu N, Serbanoiu I, Margulescu A, Vinereanu D, Teixido Tura G, Rodriguez-Palomares J, Gutierrez L, Gonzalez-Alujas T, Carro A, Thomas M, Garcia-Dorado D, Evangelista A, Tosello F, Milan A, Magnino C, Leone D, Chiarlo M, Bruno G, Losano I, Burrello J, Fulcheri C, Veglio F, Styczynski G, Szmigielski CA, Kaczynska A, Kuch-Wocial A, Jansen R, Kracht P, Kluin J, Tietge W, Cramer M, Chamuleau S, Zito C, Tripepi S, Cusma-Piccione M, Di Bella G, Mohammed M, Oreto L, Manganaro R, D'angelo M, Pizzino F, Carerj S, Arapi S, Tsounis D, Matzraki V, Kaplanis I, Perpinia A, Varoudi M, Mpitsios G, Lazaros G, Karavidas A, Pyrgakis V, Mornos C, Ionac A, Cozma D, Mornos A, Dragulescu D, Petrescu L, Pescariu S, Lupinek P, Sramko M, Kubanek M, Kautznerova D, Tintera J, Lanska V, Kadrabulatova S, Pavlukova E, Tarasov D, Karpov R, Sveric K, Forkmann M, Richter U, Wunderlich C, Strasser R, Grapsa J, Dawson D, Zimbarra Cabrita I, Punjabi P, Nihoyannopoulos P, Kovacs A, Apor A, Nagy A, Vago H, Toth A, Becker D, Merkely B, Ranjbar S, Karvandi M, Hassantash S, Yoshikawa H, Suzuki M, Kusunose Y, Hashimoto G, Otsuka T, Nakamura M, Sugi K, De Knegt M, Biering-Sorensen T, Sogaard P, Sivertsen J, Jensen J, Mogelvang R, Montserrat S, Gabrielli L, Borras R, Bijnens B, Castella M, Berruezo A, Mont L, Brugada J, Sitges M, Tarr A, Stoebe S, Pfeiffer D, Hagendorff A, Ternacle J, Jurzak P, Gallet R, Champagne S, Teiger E, Monin JL, Gueret P, Dubois-Rande JL, Lim P, Monney P, Jeanrenaud X, Monivas Palomero V, Mingo Santos S, Garcia Lunar I, Beltran Correas P, Gonzalez Lopez E, Sanchez Garcia M, Gonzalez Mirelis J, Cavero Gibanel M, Gomez Bueno M, Segovia Cubero J, Haarman M, Van Den Bosch A, Domburg R, Mcghie J, Roos-Hesselink J, Geleijnse M, Yanikoglu A, Altekin E, Kucuk M, Karakas S, Ozel D, Yilmaz H, Demir I, Tsuruta H, Iwanaga S, Sato T, Miyoshi S, Nishiyama N, Aizawa Y, Tanimoto K, Murata M, Takatsuki S, Fukuda K, Carrilho-Ferreira P, Cortez-Dias N, Silva D, Jorge C, Goncalves S, Santos I, Sargento L, Marques P, Carpinteiro L, Sousa J, Schubert U, Kockova R, Tintera J, Kautznerova D, Cerna D, Sedlacek K, Kryze L, Sikula V, Segetova M, Kautzner J, Iwaki T, Dores H, Goncalves P, Sousa P, Carvalho M, Marques H, Machado F, Gaspar A, Aleixo A, Carmo M, Roquette J, Lagopati N, Sotiropoulos M, Baka I, Ploussi A, Lyra Georgosopoulou M, Miglioranza M, Gargani L, Sant'anna R, Rover M, Mantovani A, Kalil R, Sicari R, Picano E, Leiria T, Minarik T, Taborsky M, Fedorco M, Novak P, Ledakowicz-Polak A, Polak L, Zielinska M, Zhong L, Chin C, Lau Y, Sim L, Chua T, Tan B, Tan R. Poster session: Dobutamine stress echo. Eur Heart J Cardiovasc Imaging 2012. [DOI: 10.1093/ehjci/jes257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lee SL, Lam TH, Leung TH, Wong WHS, Schooling M, Leung GM, Lau YL. Foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. ScientificWorldJournal 2012; 2012:542983. [PMID: 22927783 PMCID: PMC3425811 DOI: 10.1100/2012/542983] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 04/14/2012] [Indexed: 11/23/2022] Open
Abstract
Objective. We examined the hypothesis that foetal exposure to maternal passive smoking is associated with childhood asthma, allergic rhinitis, and eczema. Methods. The study was a population-based cross-sectional survey of Hong Kong Chinese children aged ≤14 years carried out in 2005 to 2006. Results. Foetal exposure to maternal passive smoking was significantly associated with wheeze ever (OR 2.05; 95% CI 1.58–2.67), current wheeze (OR 2.06; 95% CI 1.48–2.86), allergic rhinitis ever (OR 1.22; 95% CI 1.09–1.37), and eczema ever (OR 1.61; 95% CI 1.38–1.87). Foetal exposure to maternal active smoking was significantly associated with asthma ever (OR 2.10; 95% CI 1.14–3.84), wheeze ever (OR 2.46; 95% CI 1.27–4.78), and current wheeze (OR 2.74; 95% CI 1.24–6.01) but not with allergic rhinitis ever (OR 1.01; 95% CI 0.70–1.46) or eczema ever (OR 1.38; 95% CI 0.87–2.18). The dose response relationship between wheeze ever and current wheeze with increasing exposure, from no exposure to maternal passive smoking and then to maternal active smoking, further supports causality. Conclusion. There is significant association between foetal exposure to maternal passive smoking and maternal active smoking with childhood asthma and related atopic illnesses. Further studies are warranted to explore the potential causal relationship.
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Affiliation(s)
- S L Lee
- Department of Paediatrics & Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Abstract
OBJECTIVES Impaired autonomic function is common in acute ischemic stroke. Previous limited studies have suggested that atherosclerosis may affect the distensibility of the carotid sinus and then impair the cardiovascular autonomic function. This study sought to investigate cardiovascular autonomic function in patients with ischemic stroke with carotid stenosis. METHODS Eighty-five patients with ischemic stroke (58 ones without carotid stenosis and 27 ones with carotid stenosis, average 6 months after stroke onset) and 37 elderly controls were recruited. All performed Ewing's battery autonomic function tests. RESULTS From Ewing's battery of autonomic function tests, atypical, definite, or severe autonomic dysfunction was identified in 69.0% patients without carotid stenosis and 88.9% with carotid stenosis, with significant difference between the two groups, and the prevalence of autonomic dysfunction in both groups was higher than that in controls (21.6%). Patients with carotid stenosis showed impairment of all parasympathetic tests (all P < 0.05) and one of the sympathetic tests [Mean fall in systolic blood pressure (BP) on standing: P = 0.051], and those without carotid stenosis only showed impairment in two parasympathetic tests (Valsalva ratio: P = 0.014; heart rate response to deep breathing: P < 0.001) in comparison with controls. Patients with carotid stenosis had significantly more impairment than those without carotid stenosis in some autonomic parameters (Valsalva ratio: P < 0.05; mean fall in systolic BP on standing: P < 0.05). CONCLUSIONS Cardiovascular autonomic function is impaired in patients with ischemic stroke, but patients with carotid stenosis show more severely impaired parasympathetic and sympathetic functions.
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Affiliation(s)
- L Xiong
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
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Lau YL, Peiris JSM, Law HKW. Role of dendritic cells in SARS coronavirus infection. Hong Kong Med J 2012; 18 Suppl 3:28-30. [PMID: 22865220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Affiliation(s)
- Y L Lau
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
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Thiruvengadam G, Init I, Fong MY, Lau YL. Optimization of the expression of surface antigen SAG1/2 of Toxoplasma gondii in the yeast Pichia pastoris. Trop Biomed 2011; 28:506-513. [PMID: 22433878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Surface antigens are the most abundant proteins found on the surface of the parasite Toxoplasma gondii. Surface antigen 1 (SAG1) and Surface antigen 2 (SAG2) remain the most important and extensively studied surface proteins. These antigens have been identified to play a role in host cell invasion, immune modulation, virulence attenuation. Recombinant SAG1/2 was cloned and expressed in yeast Pichia pastoris. We describe here optimization of critical parameters involved in high yield expression of the recombinant SAG1/2. Our results suggest that recombinant SAG1/2 were best expressed at 30ºC, pH 6 and 1% methanol as the carbon source by X33 Pichia cells. Additional optimizations included the downstream process such as ammonium sulphate precipitation and dialysis. The fusion protein was purified using Ni-NTA purification system with 80% recovery. The purified protein was 100% specific and sensitive in detection of toxoplasmosis.
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Affiliation(s)
- G Thiruvengadam
- School of Science, Monash University Sunway Campus, Bandar Sunway, 46150 Selangor, Malaysia
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Naidoo R, Jordaan N, Chan KW, Le Roux DM, Pienaar S, Nuttall J, Lau YL, Eley BS. A novel CYBB mutation with the first genetically confirmed case of chronic granulomatous disease in South Africa. S Afr Med J 2011; 101:768-769. [PMID: 22272860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2011] [Accepted: 08/03/2011] [Indexed: 05/31/2023] Open
Abstract
A case of a child with chronic granulomatous disease (CGD) presenting with recurrent mycobacterial infections and invasive Aspergillus fumigatus disease is described. Genetic analysis confirmed X-linked CGD with a novel mutation in exon 10 of the CYBB gene - the first South African report of genetically confirmed CGD.
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Affiliation(s)
- R Naidoo
- Paediatric Infectious Diseases Unit, Red Cross War Memorial Childrens's Hospital, Cape Town, South Africa.
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Lau YL. Asian network for molecular diagnosis of primary immunodeficiencies. BMC Proc 2011. [PMCID: PMC3019407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- YL Lau
- Department of Paediatrics & Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR
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