MyMedR

Fulltext Underestimation of co-infections in COVID-19 due to non-discriminatory use of antibiotics

Chang CY, Chan KG

J Infect, 2020 Sep;81(3):e29-e30.

PMID: 32628960 DOI: 10.1016/j.jinf.2020.06.077

Fulltext A Fatal Case Of Persistent Burkholderia Pseudomallei Bacteraemia With Severe Pneumonia And Splenic Abscess

Chang CY, Lee HL

J Ayub Med Coll Abbottabad, 2023;35(2):331-333.

PMID: 37422833 DOI: 10.55519/JAMC-02-11131

Burkholderia pseudomallei is a Gram-negative bacterium that causes melioidosis. Melioidosis is a potentially fatal disease that is endemic in Southeast Asia and Northern Australia and is being increasingly recognized in other regions worldwide. Melioidosis can affect any organ system and present with a wide range of clinical manifestations including pneumonia, bone, skin/soft tissue, or central nervous system infections. In this report, we describe a diabetic farmer who succumbed to persistent B. pseudomallei bacteraemia with multiorgan involvement despite treatment with meropenem and ceftazidime.

Fulltext Left atrial myxoma causing near-total mitral valve obstruction

Chang CY, Chan EZ

Clin Case Rep, 2023 Jan;11(1):e6887.

PMID: 36698520 DOI: 10.1002/ccr3.6887

Cardiac myxomas are the most common primary cardiac tumors in adults, with the left atrium being the most frequently affected. Echocardiography is the diagnostic modality of choice. The most effective treatment for cardiac myxomas is surgical excision.

Fulltext Modulation of Host Biology by Pseudomonas aeruginosa Quorum Sensing Signal Molecules: Messengers or Traitors

Liu YC, Chan KG, Chang CY

Front Microbiol, 2015;6:1226.

PMID: 26617576 DOI: 10.3389/fmicb.2015.01226

Bacterial cells sense their population density and respond accordingly by producing various signal molecules to the surrounding environments thereby trigger a plethora of gene expression. This regulatory pathway is termed quorum sensing (QS). Plenty of bacterial virulence factors are controlled by QS or QS-mediated regulatory systems and QS signal molecules (QSSMs) play crucial roles in bacterial signaling transduction. Moreover, bacterial QSSMs were shown to interfere with host cell signaling and modulate host immune responses. QSSMs not only regulate the expression of bacterial virulence factors but themselves act in the modulation of host biology that can be potential therapeutic targets.

Fulltext Inhibiting N-acyl-homoserine lactone synthesis and quenching Pseudomonas quinolone quorum sensing to attenuate virulence

Chan KG, Liu YC, Chang CY

Front Microbiol, 2015;6:1173.

PMID: 26539190 DOI: 10.3389/fmicb.2015.01173

Bacteria sense their own population size, tune the expression of responding genes, and behave accordingly to environmental stimuli by secreting signaling molecules. This phenomenon is termed as quorum sensing (QS). By exogenously manipulating the signal transduction bacterial population behaviors could be controlled, which may be done through quorum quenching (QQ). QS related regulatory networks have been proven their involvement in regulating many virulence determinants in pathogenic bacteria in the course of infections. Interfering with QS signaling system could be a novel strategy against bacterial infections and therefore requires more understanding of their fundamental mechanisms. Here we review the development of studies specifically on the inhibition of production of N-acyl-homoserine lactone (AHL), a common proteobacterial QS signal. The opportunistic pathogen, Pseudomonas aeruginosa, equips the alkylquinolone (AQ)-mediated QS which also plays crucial roles in its pathogenicity. The studies in QQ targeting on AQ are also discussed.

Fulltext Invasive Aspergillus rhinosinusitis complicated with cerebral abscess

Wang VV, Chang CY, Radhakrishnan AP

Rev Soc Bras Med Trop, 2021;54:e02962021.

PMID: 34431947 DOI: 10.1590/0037-8682-0296-2021

Invasive Klebsiella pneumoniae Syndrome: A Case Report From Malaysia

Cheong XP, Lim LM, Chang CY

Cureus, 2024 Oct;16(10):e71814.

PMID: 39559649 DOI: 10.7759/cureus.71814

Invasive Klebsiella syndrome is a potentially life-threatening condition primarily caused by hypervirulent strains of Klebsiella pneumoniae. It is characterized by severe infections that metastasize to various organs, including the liver, lungs, eyes, and brain. We present a case of invasive K. pneumoniae syndrome in Malaysia, highlighting the aggressiveness of the disease. The case involves a 44-year-old woman with diabetes mellitus who developed cavitary pneumonia, pulmonary embolism, and pleural effusion, requiring prolonged antibiotic treatment and drainage. This case highlights the need for early diagnosis and extended antibiotic therapy to improve patient outcomes.

Fulltext Whole-Genome Sequencing Analysis of Quorum-Sensing Aeromonas hydrophila Strain M023 from Freshwater

Tan WS, Yin WF, Chang CY, Chan KG

Genome Announc, 2015;3(1).

PMID: 25700404 DOI: 10.1128/genomeA.01548-14

Aeromonas hydrophila is a well-known waterborne pathogen that recently was found to infect humans. Here, we report the draft genome of a freshwater isolate from a Malaysian waterfall, A. hydrophila strain M023, which portrays N-acylhomoserine lactone-dependent quorum sensing.

Fulltext Understanding the Quorum-Sensing Bacterium Pantoea stewartii Strain M009 with Whole-Genome Sequencing Analysis

Tan WS, Chang CY, Yin WF, Chan KG

Genome Announc, 2015;3(1).

PMID: 25635007 DOI: 10.1128/genomeA.01509-14

Pantoea stewartii is known to be the causative agent of Stewart's wilt, which usually affects sweet corn (Zea mays) with the corn flea beetle as the transmission vector. In this work, we present the whole-genome sequence of Pantoea stewartii strain M009, isolated from a Malaysian tropical rainforest waterfall.

Fulltext Modulation of obesity-induced inflammation by dietary fats: mechanisms and clinical evidence

Teng KT, Chang CY, Chang LF, Nesaretnam K

Nutr J, 2014;13:12.

PMID: 24476102 DOI: 10.1186/1475-2891-13-12

Obesity plays a pivotal role in the development of low-grade inflammation. Dietary fatty acids are important modulators of inflammatory responses. Saturated fatty acids (SFA) and n-6 polyunsaturated fatty acids (PUFA) have been reported to exert pro-inflammatory effects. n-3 PUFA in particular, possess anti-inflammatory properties. Numerous clinical studies have been conducted over decades to investigate the impact of dietary fatty acids on inflammatory response in obese individuals, however the findings remained uncertain. High fat meals have been reported to increase pro-inflammatory responses, however there is limited evidence to support the role of individual dietary fatty acids in a postprandial state. Evidence in chronic studies is contradictory, the effects of individual dietary fatty acids deserves further attention. Weight loss rather than n-3 PUFA supplementation may play a more prominent role in alleviating low grade inflammation. In this context, the present review provides an update on the mechanistic insight and the influence of dietary fats on low grade inflammation, based on clinical evidence from acute and chronic clinical studies in obese and overweight individuals.

Neck Abscess Caused By Morganella Morganii

Chang CY, Rajappan M, Zaid M, Ong E

J Ayub Med Coll Abbottabad, 2021 3 29;33(1):172.

PMID: 33774979

Fulltext Disseminated talaromycosis in an HIV-infected patient

Chang CY, Wahid AA, Ong ELC

Rev Soc Bras Med Trop, 2021 03 22;54:e0896-2020.

PMID: 33759937 DOI: 10.1590/0037-8682-0896-2020

Investigation of the Tiger Milk Medicinal Mushroom, Lignosus rhinocerotis (Agaricomycetes), as an Antiulcer Agent

Nyam KL, Chang CY, Tan CS, Ng ST

Int J Med Mushrooms, 2016;18(12):1093-1104.

PMID: 28094747 DOI: 10.1615/IntJMedMushrooms.v18.i12.40

The aim of this study was to determine the antiulcer activity of Lignosus rhinocerotis in rats. A total of 48 Sprague-Dawley rats were used in ethanol-induced, aspirin-induced, and water immersion-restraint stress-induced ulcer models. Rats were equally divided into 4 groups for each model and orally administered 5 mL/kg distilled water, 20 mg/kg omeprazole, as well as 250 and 500 mg/kg of L. rhinocerotis powder. L. rhinocerotis powder at both 250 and 500 mg/kg doses demonstrated significant (P < 0.05) protection against gastric ulceration in all the induced ulcer models. Histological studies revealed severe damage and hemorrhage of gastric mucosa in the negative control group for all ulcer-induced models. The study suggests that L. rhinocerotis powder possesses dose-dependent antiulcer activity in the gastric mucosa, as ascertained grossly and histologically, compared with the negative control groups.

Fulltext Spontaneous splenic rupture in Plasmodium knowlesi malaria

Chang CY, Pui WC, Kadir KA, Singh B

Malar J, 2018 Dec 04;17(1):448.

PMID: 30509259 DOI: 10.1186/s12936-018-2600-2

BACKGROUND: Plasmodium knowlesi, a malaria parasite typically found in long-tailed and pig-tailed macaques, is the most common cause of human malaria in Malaysian Borneo. Infections in humans result in a spectrum of disease, including fatal outcomes. Spontaneous splenic rupture is a rare, but severe complication of malaria and has not been reported previously for knowlesi malaria.

CASE PRESENTATION: A 46-year-old man presented with fever and acute surgical abdomen with concomitant P. knowlesi malaria infection at Kapit Hospital. He was in compensated shock upon arrival to the hospital. He had generalized abdominal tenderness, maximal at the epigastric region. Bedside focused abdominal ultrasonography revealed free fluid in the abdomen. He underwent emergency exploratory laparotomy in view of haemodynamic instability and worsening peritonism. Intraoperatively, haemoperitoneum and bleeding from the spleen was noted. Splenectomy was performed. Histopathological examination findings were suggestive of splenic rupture and presence of malarial pigment. Analysis of his blood sample by nested PCR assays confirmed P. knowlesi infection. The patient completed a course of anti-malarial treatment and recovered well post-operation.

CONCLUSIONS: Spontaneous splenic rupture is a rare complication of malaria. This is the first reported case of splenic rupture in P. knowlesi malaria infection. Detection of such a complication requires high index of clinical suspicion and is extremely challenging in hospitals with limited resources.

Fulltext Disseminated melioidosis in early pregnancy - an unproven cause of foetal loss

Chang CY, Lau NLJ, Currie BJ, Podin Y

BMC Infect Dis, 2020 Mar 06;20(1):201.

PMID: 32143598 DOI: 10.1186/s12879-020-4937-8

BACKGROUND: Melioidosis is a potentially life-threatening infection caused by the Gram-negative bacterium Burkholderia pseudomallei. Melioidosis is difficult to diagnose due to its diverse clinical manifestations, which often delays administration of appropriate antibiotic therapy.

CASE PRESENTATION: Melioidosis is uncommon in pregnancy but both spontaneous abortion and neonatal melioidosis have been reported. We report a case of bacteraemic melioidosis in a young woman with a subsequent spontaneous abortion, with B. pseudomallei cultured from a high vaginal swab as well as blood.

CONCLUSION: It remains unclear in this and previously reported cases as to whether the maternal melioidosis was sexually transmitted.

Fulltext Acute abdomen revealed Streptococcus gordonii infective endocarditis with systemic embolism

Chang CY, Gan YL, Radhakrishnan AP, Ong ELC

Oxf Med Case Reports, 2022 Jan;2022(1):omab145.

PMID: 35083058 DOI: 10.1093/omcr/omab145

Infective endocarditis can result in potentially fatal complications such as heart failure, systemic embolization, mycotic aneurysm and neurological complications. Staphylococci and streptococci are the most common causative agents of infective endocarditis, with Streptococcus gordonii being a rare cause. We present a case of infective endocarditis in a young patient who presented with an acute abdomen 2 months after being diagnosed with cerebrovascular accident. An abdominal computed tomography revealed superior mesenteric artery thrombosis, and infarct in the right kidney and spleen as a result of systemic septic embolism. Echocardiography showed numerous vegetations at the aortic and mitral valves. Infective endocarditis was diagnosed based on echocardiographic findings and positive blood cultures for S. gordonii. He was treated with intravenous benzylpenicillin and was also referred for surgical intervention.

Fulltext Impact of an Antimicrobial Stewardship Intervention on the Appropriateness of Carbapenem Use at a Tertiary Hospital in Malaysia

Chang CY, Devi Nath N, Lam K, Zaid M

Cureus, 2022 Nov;14(11):e31660.

PMID: 36540495 DOI: 10.7759/cureus.31660

Introduction Carbapenems are broad-spectrum antibiotics used to treat infections caused by multidrug-resistant organisms. The inappropriate use of carbapenem results in the development of antimicrobial resistance. The aim of this study was to determine the impact of an antimicrobial stewardship intervention on the appropriateness of carbapenem use. Method The study includes a baseline/pre-intervention audit, an intervention, and a post-intervention study to examine the impact of antimicrobial stewardship activities on carbapenem use. Audit and data collection were carried out by filling up an audit form. The indicator for this study will be the appropriateness of carbapenem use (appropriate, suboptimal, or inappropriate) pre- and post-intervention. Results The overall appropriateness of carbapenem prescription in the medical wards increased from 65% to 83.3% following the implementation of antimicrobial stewardship intervention. The most common indication of carbapenem usage in our study was hospital-acquired pneumonia/ventilator-associated pneumonia. Conclusion Antimicrobial stewardship intervention is effective in improving the appropriateness of carbapenem use. Tailored stewardship programs are required to better control carbapenem use and combat antimicrobial resistance.

Fulltext Necrotizing Pneumonia Due To Rhodococcus Hoagii In A Patient With Advanced Retroviral Disease

Gan YL, Chang CY, Yusoff YK, Radhakrishnan AP

J Ayub Med Coll Abbottabad, 2022;34(4):877-879.

PMID: 36566419 DOI: 10.55519/JAMC-04-10234

Rhodococcus hoagii is a well-known zoonotic disease, especially in foals. Its occurrence in humans is uncommon and usually occurs in immunocompromised patients. We present a case of Rhodococcus hoagii infection resulting in necrotizing pneumonia in a patient with advanced retroviral disease who had defaulted treatment. Effective treatment of Rhodococcus hoagii infection requires a combination of antibiotics. We also highlighted the importance of effective communication between clinicians and microbiologists so that prompt treatment can be initiated to improve patient outcomes.

Fulltext Dengue fever complicated by hemophagocytic lymphohistiocytosis: Report of 2 cases and bone marrow findings

Chang CY, Rajappan M, Zaid M, Ong ELC

Clin Case Rep, 2020 Dec;8(12):3427-3431.

PMID: 33363946 DOI: 10.1002/ccr3.3422

Hemophagocytic lymphohistiocytosis is a rare but severe complication of dengue infection which carries a high mortality. This report highlights the importance of early recognition of this condition as prompt appropriate treatment improves outcomes.

Fulltext Streptococcus sanguis brain abscess as an initial manifestation of pulmonary arteriovenous malformation

Chang CY, Chai CSY, Ong ELC

Clin Case Rep, 2020 Dec;8(12):2685-2688.

PMID: 33363805 DOI: 10.1002/ccr3.3272

Pulmonary arteriovenous malformation is a vascular anomaly that predisposes to complications of paradoxical embolization including stroke and brain abscess. Here, we present a case of brain abscess associated with pulmonary arteriovenous malformation.

Displaying publications 21 - 40 of 72 in total