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Mediastinal melioidosis masquerading as malignancy of the lung

Kho SS, Ho YF, Chan SK, Tie ST

Lancet, 2021 03 13;397(10278):e8.
PMID: 33714391 DOI: 10.1016/S0140-6736(21)00200-2
Matched MeSH terms: Fever/etiology
Fulltext A novel de novo NLRC4 mutation reinforces the likely pathogenicity of specific LRR domain mutation

Chear CT, Nallusamy R, Canna SW, Chan KC, Baharin MF, Hishamshah M, et al.

Clin Immunol, 2020 02;211:108328.
PMID: 31870725 DOI: 10.1016/j.clim.2019.108328

Autoinflammatory disorders are characterized by dysregulated innate immune response, resulting in recurrent uncontrolled systemic inflammation and fever. Gain-of-function mutations in NLRC4 have been described to cause a range of autoinflammatory disorders. We report a twelve-year-old Malay girl with recurrent fever, skin erythema, and inflammatory arthritis. Whole exome sequencing and subsequent bidirectional Sanger sequencing identified a heterozygous missense mutation in NLRC4 (NM_001199138: c.1970A > T). This variant was predicted to be damaging in silico, was absent in public and local databases and occurred in a highly conserved residue in the leucine-rich repeat (LRR) domain. Cytokine analysis showed extremely high serum IL-18 and IL-18/CXCL9 ratio, consistent with other NLRC4-MAS patients. In summary, we identified the first patient with a novel de novo heterozygous NLRC4 gene mutation contributing to autoinflammatory disease in Malaysia. Our findings reinforce the likely pathogenicity of specific LRR domain mutations in NLRC4 and expand the clinical spectrum of NLRC4 mutations.

Matched MeSH terms: Fever/genetics
Admission Clinicopathological Factors Associated with Prolonged Hospital Stay Among Hospitalized Patients with Dengue Viral Infections

Willeam Peter SS, Hassan SS, Khei Tan VP, Ngim CF, Azreen Adnan NA, Pong LY, et al.

Vector Borne Zoonotic Dis, 2019 07;19(7):549-552.
PMID: 30668248 DOI: 10.1089/vbz.2018.2379

Background:
There is an escalation of frequency and magnitude of dengue epidemics in Malaysia, with a concomitant increase in patient hospitalization. Prolonged hospitalization (PH) due to dengue virus (DENV) infections causes considerable socioeconomic burden. Early identification of patients needing PH could optimize resource consumption and reduce health care costs. This study aims to identify clinicopathological factors present on admission that are associated with PH among patients with DENV infections.
Methods:
This study was conducted in a tertiary referral hospital in Southern Malaysia. Relevant clinical and laboratory data upon admission were retrieved from medical records of 253 consecutive DENV nonstructural protein 1 (NS1) antigen and PCR-positive hospitalized patients. The DENV serotype present in each patient was determined. Patients were stratified based on duration of hospital stay (<4 vs. ≥4 days). Data were analyzed using IBM® SPSS® 25.0. Multivariate logistic regression was performed to examine the association between PH and admission parameters.
Results:
Of 253 DENV hospitalized patients, 95 (37.5%) had PH (≥4 days). The mean duration of hospital stay was 3.43 ± 2.085 days (median = 3 days, interquartile range = 7 days). Diabetes mellitus (adjusted odds ratio [AOR] = 6.261, 95% confidence interval [CI] = 2.130-18.406, p = 0.001), DENV-2 serotype (AOR = 2.581, 95% CI = 1.179-5.650, p = 0.018), duration of fever ≤4 days (AOR = 2.423, 95% CI = 0.872-6.734, p = 0.09), and a shorter preadmission fever duration (AOR = 0.679, 95% CI = 0.481-0.957, p = 0.027) were independently associated with PH. However, PH was not found to be associated with symptoms on admission, secondary DENV infections or platelet count, hematocrit, or liver enzyme levels on admission.
Conclusions:
Early identification of these factors at presentation may alert clinicians to anticipate and recognize challenges in treating such patients, leading to more focused management plans that may shorten the duration of hospitalization.

Matched MeSH terms: Fever*
Induction and characterization of heat shock proteins of Salmonella typhi and their reactivity with sera from patients with typhoid fever

Tang SW, Abubakar S, Devi S, Puthucheary S, Pang T

Infect Immun, 1997 Jul;65(7):2983-6.
PMID: 9199477

The heat shock protein (HSP) response of Salmonella typhi following exposure to elevated growth temperatures was studied. Three major proteins with molecular sizes of 58, 68, and 88 kDa were abundantly expressed when S. typhi cells were shifted from 37 to 45 degrees C and to 55 degrees C. These proteins were also constitutively expressed at 37 degrees C. Western blotting and immunoprecipitation studies with anti-HSP monoclonal antibodies revealed that the 58- and 68-kDa proteins were analogous to the GroEL and DnaK proteins, respectively, of Escherichia coli. These HSPs are also abundantly present in the outer membrane fraction of disrupted cells and, to a lesser extent, in the cytosol. Immunoblotting experiments with sera from patients with a culture-positive diagnosis of typhoid fever showed the presence of antibodies to these HSPs. Nine of twelve sera reacted with the 58-, 68-, and 88-kDa proteins, while three sera reacted only with the 68- and 88-kDa proteins. All 10 sera from healthy individuals showed no binding to these HSPs. In light of the well-documented roles of HSPs in the pathogenesis of microbial infections and as immunodominant antigens, these findings may be relevant for a better understanding of disease processes and for the future development of diagnostic and preventive strategies.

Matched MeSH terms: Typhoid Fever/immunology*
Haemolytic anaemia precipitated by dengue fever

Abdullah NH, Mohammad N, Ramli M, Wan Ghazali WS

BMJ Case Rep, 2019 Aug 28;12(8).
PMID: 31466966 DOI: 10.1136/bcr-2018-226760

We reported a case of a woman with no past medical illness who presented with a few days' history of fever, myalgia, arthralgia, hypochromic microcytic anaemia and thrombocytopaenia and who was nonstructural protein 1 antigen (NS1Ag)-positive. Haemolytic anaemia including full blood picture work-up revealed high reticulocyte count and haemolysis with positive direct Coombs test. She was started on prednisolone and was discharged well.

Matched MeSH terms: Fever/diagnosis
Fulltext Living environment and health of under-five children in urban slums of a coastal region in South India

Roja VR, Narayanan P, Sekaran VC, Ajith Kumar MG

Ghana Med J, 2020 Dec;54(4):238-244.
PMID: 33883772 DOI: 10.4314/gmj.v54i4.6

Objective: The primary objective of the study was to determine the association between the living environment and morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums in southern India.
Methods: This study included 224 mothers of under-five children living in urban slums of Udupi Taluk, Karnataka. A total of 17 urban slums were selected randomly using random cluster sampling.
Results: Undernutrition was high among children of illiterate mothers (63.8%), and the children of working mothers were affected by more morbidity (96.6%) as compared with housewives. Morbidity was also found to be high among children belonging to families with low incomes (66.1%) and low socio-economic backgrounds (93.1%). Safe drinking water, water supply, sanitation, hygiene, age of the child, mother's and father's education, mother's occupation and age, number of children in the family, use of mosquito nets, type of household, and family income were significantly associated with child morbidity, nutritional status, immunization status, and personal hygiene of under-five children living in urban slums.
Conclusion: Overall, in our study, family characteristics including parental education, occupation and income were significantly associated with outcomes among under-five children. The availability of safe drinking water and sanitation, and the use of mosquito nets to prevent vector-borne diseases are basic needs that need to be urgently met to improve child health.
Funding: Self-funded.

Matched MeSH terms: Fever/epidemiology
Fulltext Penicilliosis in lupus patients presenting with unresolved fever: a report of 2 cases and literature review

Chong YB, Tan LP, Robinson S, Lim SK, Ng KP, Keng TC, et al.

Trop Biomed, 2012 Jun;29(2):270-6.
PMID: 22735849 MyJurnal

Penicilliosis is a rare occurrence among non human immunodeficiency virus (HIV) infected patients. We report here two cases of Penicillium marneffei infection in patients with systemic lupus erythematosus (SLE). Both patients had a recent flare of lupus and were on immunosuppressive drugs when they presented with prolonged fever without an obvious foci of infection, unresponsive to broad-spectrum antibiotics. They were leucopaenic upon admission, with rapid deterioration during the course of the illness. Diagnosis of penicilliosis via fungal isolation from blood culture was delayed resulting in the late initiation of antifungal agents. While both patients ultimately recovered, the delay in diagnosis led to a prolonged hospital stay with increased morbidity. Clinicians should be aware of this uncommon but emerging fungal pathogen in SLE patients and maintain a high index of suspicion in diagnosing this potentially fatal but treatable disease.

Matched MeSH terms: Fever/microbiology*
Clinical and laboratory presentation of malaria: an analysis of one thousand subjects with malaria parasitaemia

O'Holohan DR

J Trop Med Hyg, 1976 Sep;79(9):191-6.
PMID: 794512

In the context of this study the ethnic origin of the patients revealed no noteworthy difference in the clinical reaction to the parasite; neither did age or sex of the patients. Any minor differences whcih appeared in length of history before seeking treatment and frequency of repeat attacks were more a reflection of the cultural pattern of response to illness (i.e. resort to traditional medicines) and the distance between the patient's home and the doctor rather than any altered response on the part of the host to the parasite. However, the fact that about 35 per cent of all the episodes had a history of eight or more days (about 10 per cent more than 30 days) suggest that more "malaria consciousness" is called for in what is after all an endemic malaria area. The value (and necessity) of repeated examination of the blood to detect the parasite is confirmed but it is also encouraging to note that in 84% of cases a single careful examination of the blood revealed the parasite. Since in 49% of our malaria episodes the patient was afebrile when the parasite was discovered, it is obvious that in outpatient practice especially blood should be examined when the patient presents for treatment, irrespective of the presence or absence of pyrexia. As always, a prerequisite to the diagnosis of malaria is an awareness of its possible presence.

Matched MeSH terms: Fever/etiology
Fulltext Pyrethroid resistance in the dengue vector Aedes aegypti in Southeast Asia: present situation and prospects for management

Amelia-Yap ZH, Chen CD, Sofian-Azirun M, Low VL

Parasit Vectors, 2018 Jun 04;11(1):332.
PMID: 29866193 DOI: 10.1186/s13071-018-2899-0

Human arboviral diseases transmitted by Aedes aegypti such as dengue, Zika, chikungunya and yellow fever remain global public health threats to date. Of these diseases, dengue fever is particularly prevalent in Southeast Asia. Relentless vector control efforts are performed to curtail disease transmissions through which pyrethroid insecticides are broadly used as the first line of defense to control Ae. aegypti, especially in the course of disease outbreaks. Here, we compile the largest contemporary database for susceptibility profiles and underlying mechanisms involved in Ae. aegypti resistant to pyrethroids in Southeast Asia. The extensive use of pyrethroids inevitably elicit different levels of resistance to numerous populations despite the presence of geographical isolation. The most common mechanisms of pyrethroid resistance that have been identified in Ae. aegypti includes mutations in the voltage sensitive sodium channel gene (Vssc gene) and metabolic-mediated insecticide resistance. Aedes aegypti develops resistance to pyrethroids by acquisition of one or several amino acid substitution(s) in this Vssc gene. Enzymes involved in metabolic-mediated detoxification (i.e. monooxygenases, glutathione-S-transferases and esterases) have been reported to be related to pyrethroid resistance but many specific contributory enzymes are not completely studied. An inadequate amount of data from some countries indicates an urgent need for further study to fill the knowledge gaps. Perspectives and future research needs are also discussed.

Matched MeSH terms: Chikungunya Fever/transmission*
Fulltext Persistent ductus arteriosus in Malaysian patients

Krishnan M, Snelling MR

Br Heart J, 1971 Sep;33(5):699-701.
PMID: 5115012 DOI: 10.1136/hrt.33.5.699
Matched MeSH terms: Fever/etiology
Suspected new wave of muscular sarcocystosis in travellers returning from Tioman Island, Malaysia, May 2014

Tappe D, Stich A, Langeheinecke A, von Sonnenburg F, Muntau B, Schäfer J, et al.

Euro Surveill, 2014 May 29;19(21).
PMID: 24906376

In May 2014, six patients presented in Germany with a Sarcocystis-associated febrile myositis syndrome after returning from Tioman Island, Malaysia. During two earlier waves of infections, in 2011 and 2012, about 100 travellers returning to various European countries from the island were affected. While the first two waves were associated with travel to Tioman Island mostly during the summer months, this current series of infections is associated with travel in early spring, possibly indicating an upcoming new epidemic.

Matched MeSH terms: Fever/etiology
Fulltext Computed tomography of focal splenic lesions in patients presenting with fever

Joazlina ZY, Wastie ML, Ariffin N

Singapore Med J, 2006 Jan;47(1):37-41.
PMID: 16397719

INTRODUCTION: There is an awareness of the increased incidence of splenic abscess in Southeast Asia giving rise to unexplained fever. This study looks at the role of computed tomography (CT) in evaluating focal splenic lesions in patients presenting with fever.
METHODS: 37 patients presenting with fever of unknown origin underwent CT and this study retrospectively analyses the findings in these patients. 13 patients also had associated abdominal pain. Patients with conditions at high risk for splenic infection include: diabetes mellitus in ten patients, leukaemia in seven patients, human immunodeficiency virus infection in five patients, intravenous drug abuse in six patients, and steroid therapy in two patients. No risk factors could be identified in seven patients.
RESULTS: Splenic abscess was diagnosed in 28 patients. A range of infecting organisms was isolated but the most frequent were Staphylococcus aureus (eight), tuberculosis (four), Streptococcus (four), fungal (four) and melioidosis (four). No infecting organism could be identified in ten cases though in patients with leukaemia with multiple low attenuation areas, the cause was presumed to be fungal. Six patients were diagnosed to have splenic infarcts though differentiation from splenic abscess could be difficult; these patients were treated for an abscess and all had endocarditis. Three patients were subsequently diagnosed with lymphoma. Percutaneous abscess drainage was performed in five patients and splenectomy was carried out in six patients.
CONCLUSION: CT proved to be very useful as it not only revealed the size and extent of any splenic abnormality but it assisted with guidance for percutaneous drainage, determined the site for biopsy, and provided follow-up after treatment.

Matched MeSH terms: Fever of Unknown Origin/etiology
Molecular analysis of environmental and human isolates of Salmonella typhi

Thong KL, Cordano AM, Yassin RM, Pang T

Appl Environ Microbiol, 1996 Jan;62(1):271-4.
PMID: 8572705

Molecular characterization of a total of 54 isolates of Salmonella typhi from Santiago, Chile, was performed by pulsed-field gel electrophoresis (PFGE) after digestion of chromosomal DNA with three restriction endonucleases: XbaI (5'-TCTAGA-3'), AvrII (5'-CCTAGG-3'), and SpeI (5'-ACTAGT-3'). Thirteen of the 54 isolates were obtained from environmental sources (sewage and river water), and the rest were isolates from clinical cases of typhoid fever. Considerable genetic diversity was detected among the human isolates obtained in 1994, as evidenced by the presence of 14 to 19 different PFGE patterns among 20 human isolates, with F (coefficient of similarity) values ranging from 0.69 to 1.0 (XbaI), 0.61 to 1.0 (AvrII), and 0.70 to 1.0 (SpeI). A total of eight phage types were detected among these 20 isolates, with 50% possessing the E1 or 46 phage type. There was no correlation between PFGE pattern and phage types. Similar diversity was seen among 21 isolates obtained in 1983, with 17 to 19 PFGE patterns detected and F values of 0.56 to 1.0 (XbaI), 0.55 to 1.0 (AvrII), and 0.67 to 1.0 (SpeI). Comparison of these two groups of human isolates obtained 11 years apart indicated that certain molecular types of S. typhi are shared and are able to persist for considerable periods. A similar degree of genetic diversity was also detected among the environmental isolates of S. typhi, for which 10 to 12 different PFGE patterns were detected among the 13 isolates analyzed, with F values ranging from 0.56 to 1.0 (XbaI), 0.52 to 1.0 (AvrII), and 0.69 to 1.0 (SpeI). Certain molecular types present among the environmental isolates of S. typhi were also found among the human isolates from the same time period, providing evidence for the epidemiological link between environmental reservoirs and human infection.

Matched MeSH terms: Typhoid Fever/microbiology
Notes from the field: acute muscular sarcocystosis among returning travelers - Tioman Island, Malaysia, 2011

Centers for Disease Control and Prevention (CDC)

MMWR Morb Mortal Wkly Rep, 2012 Jan 20;61(2):37-8.
PMID: 22258418

GeoSentinel (the surveillance program of the International Society of Travel Medicine and CDC) has identified 32 cases of suspected acute muscular sarcocystosis in travelers returning from Tioman Island off the east coast of peninsular Malaysia. All the patients traveled to Tioman Island during the summer of 2011. Within days or weeks of returning home, all experienced fever and muscle pain, often severe and prolonged. All had peripheral eosinophilia, and most had elevated serum creatinine phosphokinase levels. Most were tested for acute trichinosis and toxoplasmosis by serology, and all of these tests were negative. Approximately half of the patients were identified in Germany; others were reported elsewhere in Europe, and in North America and Asia. Muscle biopsy from two patients demonstrated organisms consistent with sarcocystosis, one from a group of five ill travelers and one from a group of three.

Matched MeSH terms: Fever/etiology
Molecular analysis of isolates of Salmonella typhi obtained from patients with fatal and nonfatal typhoid fever

Thong KL, Passey M, Clegg A, Combs BG, Yassin RM, Pang T

J Clin Microbiol, 1996 Apr;34(4):1029-33.
PMID: 8815078

Molecular characterization of a total of 52 human isolates of Salmonella typhi from Papua New Guinea was performed by using pulsed-field gel electrophoresis (PFGE) after digestion of chromosomal DNA with three restriction endonucleases, XbaI (5'-TCTAGA-3'), AvrII (5'-CCTAGG-3'), and SpeI (5'-ACTAGT-3'). Of the 52 isolates tested, 11 were obtained from patients with fatal typhoid fever and 41 were obtained from patients with nonfatal disease. The 52 isolates showed limited genetic diversity as evidenced by only three different PFGE patterns detected following digestion with XbaI (patterns X1 to X3; F [coefficient of similarity] = 0.86 to 1.0), four patterns detected following digestion with AvrII (patterns A1 to A4; F =0.78 to 1.0), and two patterns detected following digestion with SpeI (patterns S1 and S2; F = 0.97 to 1.0). Of the 52 isolates, 37 were phage typed, and all belonged to phage type D2. All 11 isolates obtained from patients with fatal typhoid fever were identical (F = 1.0) and possessed the PFGE pattern combination X1S1A1, whereas the 41 isolates from patients with nonfatal typhoid fever had various PFGE pattern combinations, the most common being X2S1A2 (39%), X1S1A1 (24%), and X1S1A2 (15%). Thus, all the isolates from patients with the fatal disease had the X1 and A1 patterns, whereas the majority of the isolates from patients with nonfatal typhoid fever possessed the X2 and A2 patterns. The data suggest that there is an association among strains of S. typhi between genotype, as assessed by PFGE patterns, and the capability to cause fatal illness. Analysis of blood and fecal isolates of S. typhi from the same patient also indicated that some genetic changes occur in vivo during the course of infection.

Matched MeSH terms: Typhoid Fever/microbiology*
Fulltext Genome sequence and comparative pathogenomics analysis of a Salmonella enterica Serovar Typhi strain associated with a typhoid carrier in Malaysia

Yap KP, Gan HM, Teh CS, Baddam R, Chai LC, Kumar N, et al.

J Bacteriol, 2012 Nov;194(21):5970-1.
PMID: 23045488 DOI: 10.1128/JB.01416-12

Salmonella enterica serovar Typhi is a human pathogen that causes typhoid fever predominantly in developing countries. In this article, we describe the whole genome sequence of the S. Typhi strain CR0044 isolated from a typhoid fever carrier in Kelantan, Malaysia. These data will further enhance the understanding of its host persistence and adaptive mechanism.

Matched MeSH terms: Typhoid Fever/microbiology
Fulltext MOSQUITO-BORNE HAEMORRHAGIC FEVER IN MALAYA

RUDNICK A, TAN EE, LUCAS JK, OMAR MB

Br Med J, 1965 May 15;1(5445):1269-72.
PMID: 14278815
Matched MeSH terms: Hemorrhagic Fever with Renal Syndrome*
Clinical prognostic factors and survival outcome in renal cell carcinoma patients--a malaysian single centre perspective

Yap NY, Ng KL, Ong TA, Pailoor J, Gobe GC, Ooi CC, et al.

Asian Pac J Cancer Prev, 2013;14(12):7497-500.
PMID: 24460324

BACKGROUND: This study concerns clinical characteristics and survival of renal cell carcinoma (RCC) patients in University Malaya Medical Centre (UMMC), as well as the prognostic significance of presenting symptoms.
MATERIALS AND METHODS: The clinical characteristics, presenting symptoms and survival of RCC patients (n=151) treated at UMMC from 2003-2012 were analysed. Symptoms evaluated were macrohaematuria, flank pain, palpable abdominal mass, fever, lethargy, loss of weight, anaemia, elevated ALP, hypoalbuminemia and thrombocytosis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic significance of these presenting symptoms. Kaplan Meier and log rank tests were employed for survival analysis.
RESULTS: The 2002 TNM staging was a prognostic factor (p<0.001) but Fuhrman grading was not significantly correlated with survival (p=0.088). At presentation, 76.8% of the patients were symptomatic. Generally, symptomatic tumours had a worse survival prognosis compared to asymptomatic cases (p=0.009; HR 4.74). All symptoms significantly affect disease specific survival except frank haematuria and loin pain on univariate Cox regression analysis. On multivariate analysis adjusted for stage, only clinically palpable abdominal mass remained statistically significant (p=0.027). The mean tumour size of palpable abdominal masses, 9.5±4.3cm, was larger than non palpable masses, 5.3±2.7cm (p<0.001).
CONCLUSIONS: This is the first report which includes survival information of RCC patients from Malaysia. Here the TNM stage and a palpable abdominal mass were independent predictors for survival. Further investigations using a multicentre cohort to analyse mortality and survival rates may aid in improving management of these patients.

Matched MeSH terms: Fever/diagnosis*; Fever/mortality
Continuous infusion vs. bolus dosing: implications for beta-lactam antibiotics

Mohd Hafiz AA, Staatz CE, Kirkpatrick CM, Lipman J, Roberts JA

Minerva Anestesiol, 2012 Jan;78(1):94-104.
PMID: 21730935

Beta-lactam antibiotics display time-dependant pharmacodynamics whereby constant antibiotic concentrations rather than high peak concentrations are most likely to result in effective treatment of infections caused by susceptible bacteria. Continuous administration has been suggested as an alternative strategy, to conventional intermittent dosing, to optimise beta-lactam pharmacokinetic/pharmacodynamic (PK/PD) properties. With the availability of emerging data, we elected to systematically investigate the published literature describing the comparative PK/PD and clinical outcomes of beta-lactam antibiotics administered by continuous or intermittent infusion. We found that the studies have been performed in various patient populations including critically ill, cancer and cystic fibrosis patients. Available in vitro PK/PD data conclusively support the administration of beta-lactams via continuous infusion for maximizing bacterial killing from consistent attainment of pharmacodynamic end-points. In addition, clinical outcome data supports equivalence, even with the use of a lower dose by continuous infusion. However, the present clinical data is limited with small sample sizes common with insufficient power to detect advantages in favour of either dosing strategy. With abundant positive pre-clinical data as well as document in vivo PK/PD advantages, large multi-centre trials are needed to describe whether continuous administration of beta-lactams is truly more effective than intermittent dosing.

Matched MeSH terms: Fever/drug therapy; Fever/etiology
Antinociceptive, anti-inflammatory, and antipyretic properties of an aqueous extract of Dicranopteris linearis leaves in experimental animal models

Zakaria ZA, Ghani ZD, Nor RN, Gopalan HK, Sulaiman MR, Jais AM, et al.

J Nat Med, 2008 Apr;62(2):179-87.
PMID: 18404320 DOI: 10.1007/s11418-007-0224-x

This study was performed out to establish the antinociceptive, anti-inflammatory, and antipyretic properties of an aqueous extract of Dicranopteris linearis leaves in experimental animals. The antinociceptive activity was measured using the abdominal constriction, hot plate, and formalin tests. The anti-inflammatory and antipyretic activities were measured using the carrageenan-induced paw edema and brewer's yeast-induced pyrexia tests, respectively. The extract, obtained after 72 h soaking of the air-dried leaves in distilled water and then prepared in the doses of 13.2, 66.0, 132.0, and 660.0 mg/kg, was administered subcutaneously 30 min before subjecting the animals to the assays mentioned above. Generally, the extract, at all doses used, was found to have significant (P < 0.05) concentration-independent antinociceptive, anti-inflammatory, and anti-pyretic activity. In conclusion, the aqueous extract of D. linearis has antinociceptive, anti-inflammatory, and antipyretic activity, supporting previous claims of its traditional use by the Malays to treat various ailments, particularly fever.

Matched MeSH terms: Fever/drug therapy; Fever/etiology

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