Displaying publications 81 - 100 of 232 in total

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  1. Fulltext PCR-based construction and transformation of CodY gene deletion construct in Streptococcus Pneumoniae
    Aisyah Mohamed Rehan, Mohammad Izwan Enche Othman, Nor Munirah Mohd Amin, Intan Azura Shahdan, Hanani Ahmad Yusof@Hanafi
    International Medical Journal Malaysia, 2017;16(11):7-7.
    MyJurnal
    Streptococcus pneumoniae (S. pneumoniae) is a gram-positive diplococci belonging to the genus Streptococcus and it is a well-studied pathogenic bacterium. Pneumococcal diseases such as otitis media, pneumonia, sepsis and meningitis caused by pathogenic strains of S. pneumoniae still brought significant mortality and morbidity worldwide. The pathogenicity of S. pneumoniae is exerted by various virulence factors and one of it is the enzyme hyaluronate lyase. Hyaluronate lyase plays a major role in
    the invasive capability of S. pneumoniae. Its mechanism of action and crystallographic
    structure have been determinedbut its regulatory mechanism is still poorly understood.
    Drawing connections between the nutritional behaviour and invasive property of S.
    pneumoniae, CodY regulator is hypothesized as a potential hyaluronate lyase regulator.
    This work was aimed to construct CodY deficient mutant of S. pneumoniae to form
    foundational work for the study of CodY regulatory effect on hyaluronate lyase.
    Matched MeSH terms: Sepsis
  2. Fulltext Plasma Cystatin C and estimates of Glomerular filtration rate using Cystatin C independently diagnose acute kidney injury in critically ill patients with Sepsis
    Azrina Md Ralib, Iqbalmunawwir Ab Rashid, Nur Aisyah Ishak, Suhaila Nanyan, Nur Fariza Ramly, Mohd Basri Mat Nor
    International Medical Journal Malaysia, 2017;16(11):8-8.
    MyJurnal
    Plasma Cystatin C (CysC) is as an early functional marker for acute kidney
    injury. Estimates of glomerular filtration rate using CysC (eGFRCysC) has been used in
    some clinical setting. We evaluated the utility of CysC and eGFRCysC in diagnosing acute
    kidney injury (AKI) and predicting death in critically ill patients with sepsis. (Copied from article).
    Matched MeSH terms: Sepsis
  3. Fulltext A Case of a Large Sub-retinal Abscess Secondary to Klebsiella pneumoniae Endophthalmitis in a Pyelonephritis Patient
    Mohd-Ilham I, Zulkifli M, Yaakub M, Muda R, Shatriah I
    Cureus, 2019 May 14;11(5):e4656.
    PMID: 31316877 DOI: 10.7759/cureus.4656
    Endogenous endophthalmitis is an ocular emergency, with severe sight-threatening complications. We report a case of unilateral endogenous Klebsiella pneumonia endophthalmitis with a large sub-retinal abscess in a 39-year-old lady that developed four days after presentation with sepsis secondary to urinary tract infections and pyelonephritis. Despite immediate treatment with intravenous (IV) and intravitreal antibiotics, her eye condition deteriorated. A pars plana vitrectomy was performed, and the sub-retinal abscess was removed, followed by silicone oil tamponade. Subsequently, she regained her vision to 6/36 with complete regression of the intraocular inflammation and sub-retinal abscess.
    Matched MeSH terms: Sepsis
  4. An Audit on Overnight Transfusion Practice in A Teaching Hospital in Malaysia
    Tang YL, Yousuf R, Wan Nawawi WM, Rahman IL, Zainal Abidin J, Rechard Nathan VR, et al.
    Malays J Pathol, 2019 Aug;41(2):161-167.
    PMID: 31427551
    INTRODUCTION: Overnight transfusion (OT) is the blood transfusion taking place from 9pm to 8am. During this period, patients are exposed to increased risk of errors. This cross-sectional study aims to determine the incidence and practice of OT in Universiti Kebangsaan Malaysia Medical Centre.

    MATERIALS & METHODS: Data from all OT in June and mid-July 2017 were collected from recipients' cards, transfusion request forms and patient's case files, regarding discipline involved, indications, time intervals from request of blood transfusion to the completion of OT on patients, monitoring of patients and adverse reactions.

    RESULTS: A total of 1285 transfusion cases were identified during the study period. 216 (16.8%) cases were OT while the 1069 (83.2%) cases were non-OT. Surgery discipline has the highest (30.1%) OT. The indications of OT were acute clinical need: 82.9%, less acute clinical need: 13.9% and no clinical need: 3.2%. A huge delay (average: 5 hours 40 minutes) in starting transfusion after grouping and crossmatching (GXM) completion was noted. Besides, 25.9% cases took <4 hours to complete OT; 83.4% cases did not have proper transfusion monitoring and three transfusion reactions were reported.

    DISCUSSION: Although most of the OT cases had appropriate clinical indications, the transfusion can be commenced earlier at day time rather than overnight. Cases without absolute indication should avoid OT. The poor monitoring of patient during OT had posed risks to patients' life if an adverse transfusion reaction happened. The major reason for OTs was a huge delay in starting transfusion after the GXM completion. The contravention of 4-hour infusion rule increased the patients' risk of developing bacterial sepsis. The practice of OT should be discouraged wherever possible except for clinically indicated cases.

    Matched MeSH terms: Sepsis
  5. Fulltext Melioidosis: Cases Notified to Kota Kinabalu District Health Office Year 2017
    Rosfina Ghazali
    Borneo Journal of Medical Sciences, 2018;12(101):29-0.
    MyJurnal
    Melioidosis is a tropical infectious disease cause by gram-negative bacterium, Burkholderia pseudomallei. It is predominantly in tropical climate especially Southeast Asia and Northern Australia. This disease is associated with significant mortality due to early onset of sepsis.
    Matched MeSH terms: Sepsis
  6. Fulltext Systemic lupus erythematosus and melioidosis
    Che Rahim MJ, Mohammad N, Kamaruddin MI, Wan Ghazali WS
    BMJ Case Rep, 2019 Jul 01;12(7).
    PMID: 31266760 DOI: 10.1136/bcr-2019-229974
    We reported a case of a young female patient presented with sepsis and diagnosed with melioidosis and systemic lupus erythematosus (SLE) within the same admission. She presented with 1-week history of productive cough, progressive dyspnoea together with prolonged fever, arthralgia, rashes and oral ulcers. She had septicemic shock, respiratory failure requiring intubation and ventilation in intensive care unit and subsequently developed acute renal failure requiring haemodialysis. Antibiotics and immunosuppressive treatment including low-dose intravenous cyclophosphamide were commenced. She had a remarkable recovery and was discharged after 6 weeks. There was no evidence of active SLE or relapse of melioidosis during clinic follow-ups.
    Matched MeSH terms: Sepsis/complications*; Sepsis/diagnosis*; Sepsis/drug therapy
  7. Fulltext Shock in the neonate
    Davendralingam Sinniah, Thiruselvi Subramaniam, Myint Myint Soe-Hsiao
    International e-Journal of Science, Medicine & Education, 2013;7(2):17-28.
    MyJurnal
    Shock is a clinical challenge to neonatal intensivists and pediatricians alike. It occurs in critically ill babies for many reasons, but the main cause is sepsis that kills more than a million newborn globally every year. This article is designed to help young doctors and trainees have a better understanding of shock in the neonatal period and its management. The paper reviews the basic pathophysiology, risk factors, clinical investigation, management, supportive care, and complications in the common types of shock seen in neonates. Treatment is governed largely by the underlying cause, with the ultimate goal of achieving adequate tissue perfusion with delivery of oxygen and substrates to the cells, and removal of toxic metabolic waste products. Intervention needs to be anticipatory and urgent to prevent progression to uncompensated and irreversible shock respectively. Early recognition and urgent effective management are crucial to successful outcomes.
    Matched MeSH terms: Sepsis
  8. The control of haemorrhagic septicaemia in West Malaysia
    Thomas J
    Trop Anim Health Prod, 1972;4(2):95-101.
    PMID: 4671395
    Matched MeSH terms: Sepsis/drug therapy; Sepsis/prevention & control; Sepsis/veterinary
  9. Fulltext Perianal Mucinous Adenocarcinoma Diagnosed by Histological Study of Anorectal Abscess with Fistula
    Jee SL, Amin-Tai H, Fathi NQ, Jabar MF
    ACG Case Rep J, 2018;5:e21.
    PMID: 29577055 DOI: 10.14309/crj.2018.21
    Perianal mucinous adenocarcinoma (PMA) is an oncologic rarity that poses a diagnostic and therapeutic dilemma for treating clinicians because there are few reported cases and an absence of definitive guidelines. We report a patient who had been treated with local surgery for recurrent perianal abscess with fistula for 3 years. Biopsy of the indurated tissue overlying his surgical scars revealed PMA. Neoadjuvant concurrent chemoradiotherapy followed by abdominoperineal resection was planned to address the locally advanced disease and ongoing sepsis. Our case is unique in that the fistula preceded carcinoma by only 3 years instead of the typical 10 years.
    Matched MeSH terms: Sepsis
  10. Fulltext Vibrio vulnificus: An Environmental and Clinical Burden
    Heng SP, Letchumanan V, Deng CY, Ab Mutalib NS, Khan TM, Chuah LH, et al.
    Front Microbiol, 2017;8:997.
    PMID: 28620366 DOI: 10.3389/fmicb.2017.00997
    Vibrio vulnificus is a Gram negative, rod shaped bacterium that belongs to the family Vibrionaceae. It is a deadly, opportunistic human pathogen which is responsible for the majority of seafood-associated deaths worldwide. V. vulnificus infection can be fatal as it may cause severe wound infections potentially requiring amputation or lead to sepsis in susceptible individuals. Treatment is increasingly challenging as V. vulnificus has begun to develop resistance against certain antibiotics due to their indiscriminate use. This article aims to provide insight into the antibiotic resistance of V. vulnificus in different parts of the world as well as an overall review of its clinical manifestations, treatment, and prevention. Understanding the organism's antibiotic resistance profile is vital in order to select appropriate treatment and initiate appropriate prevention measures to treat and control V. vulnificus infections, which should eventually help lower the mortality rate associated with this pathogen worldwide.
    Matched MeSH terms: Sepsis
  11. Fulltext The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections
    Sartelli M, Chichom-Mefire A, Labricciosa FM, Hardcastle T, Abu-Zidan FM, Adesunkanmi AK, et al.
    World J Emerg Surg, 2017;12:29.
    PMID: 28702076 DOI: 10.1186/s13017-017-0141-6
    Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs. The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.
    Matched MeSH terms: Sepsis
  12. The treatment of wounds
    Cameron JAP
    Journal of the Malaya Branch of the British Medical Association, 1939;3:297-304.
    Matched MeSH terms: Sepsis
  13. The role of nutritional support in acute pancreatitis: a review and proposal of a clinical pathway for management
    Ramanujam TM
    JUMMEC, 1999;4:81-87.
    The aim of this review is to critically analyse the available literature and to propose a rational, safe and cost-effective clinical pathway to provide nutritional support in acute pancreatitis. This pathway is proposed based on assessment of peer reviewed literature and existing generally accepted knowledge. Acute pancreatitis is a heterogeneous disease and the outcome is variable. The role of nutritional support is controversial. Acute mild pancreatitis (80%) usually does not require nutritional support unless the pre-existing nutritional is poor or complications occur. Contrary to this acute severe pancreatitis is associated with severe catabolism and a high complication rate. Nutritional depletion rapidly occurs. It is logical to support the nutrition once the patient is haemodynamically stable. Although enteral nutrition should be administered whenever feasible, it is not always possible or advisable. Aggressive, hypercaloric parenteral nutrition administered via central venous line is not recommended. A combination of initial peripheral parenteral nutrition with fat in appropriate amount, and gradually switching over to enteral feedings is safer and cost-effective. It also avoids central line associated sepsis. The roles of newer specific therapeutic diets to enhance the immune status in patients with acute pancreatitis are not well established. KEYWORDS: Acute pancreatitis, Enteral nutrition, Parenteral nutrition, Immunonutrition.
    Matched MeSH terms: Sepsis
  14. Fulltext Complete Genome Sequence of Pasteurella multocida Serotype A Strain PMTB2.1 Isolated from Buffaloes That Died of Septicemia in Malaysia
    Jabeen S, Yong YH, Abdullah FJF, Zakaria Z, Mat Isa N, Tan YC, et al.
    Genome Announc, 2017 Nov 02;5(44).
    PMID: 29097462 DOI: 10.1128/genomeA.01190-17
    Pasteurella multocida causes pneumonic pasteurellosis and hemorrhagic septicemia (HS) in large ruminants. In this study, we determined the complete genome sequence of P. multocida strain PMTB2.1 capsular serotype A isolated from buffaloes that died of septicemia.
    Matched MeSH terms: Sepsis
  15. Fulltext Clinical Utility and Measurement of Procalcitonin
    Samsudin I, Vasikaran SD
    Clin Biochem Rev, 2017 Apr;38(2):59-68.
    PMID: 29332972
    Procalcitonin (PCT), regarded as a biomarker specific for bacterial infections, is used in a variety of clinical settings including primary care, emergency department and intensive care. PCT measurement aids in the diagnosis of sepsis and to guide and monitor antibiotic therapy. This article gives a brief overview of PCT and its use in guiding antibiotic therapy in various clinical settings, as well as its limitations. PCT performance in comparison with other biomarkers of infection in particular CRP is also reviewed. Owing to its greater availability, CRP has been widely used as a biomarker of infection and sepsis. PCT is often reported to be more superior to CRP, being more specific for sepsis and bacterial infection. PCT starts to rise earlier and returns to normal concentration more rapidly than CRP, allowing for an earlier diagnosis and better monitoring of disease progression.
    Matched MeSH terms: Sepsis
  16. Fulltext Delayed Bowel Perforation after Routine Distal Loopogram Prior to Ileostomy Closure
    Poh KS, Hoh SY, Aziz R, Chong SS, Roslani AC
    Open Med (Wars), 2020;15:261-265.
    PMID: 32292822 DOI: 10.1515/med-2020-0037
    Ultra-low anterior resection for low rectal cancer is usually done with a covering ileostomy as a safety measure to reduce the consequences of distal anastomotic failure. In many centres, distal loopogram is performed routinely, prior to the closure of the loop ileostomy, to assess the integrity of anastomosis. Distal loopogram is generally considered a safe procedure with very low complication rates, especially when water-soluble contrast is used. We report two cases of delayed bowel perforation which led to severe sepsis and generalized peritonitis after distal loopogram prior to ileostomy closure. Our cases highlight the potential dangers of distal loopogram. Therefore, the routine usage of this procedure should be scrutinized and the patient needs to be properly counselled prior to the procedure.
    Matched MeSH terms: Sepsis
  17. Appropriate Antibiotic Administration in Critically Ill Patients with Pneumonia
    Khan RA, Bakry MM, Islahudin F
    Indian J Pharm Sci, 2015 7 17;77(3):299-305.
    PMID: 26180275
    Inappropriate initial antibiotics for pneumonia infection are usually linked to extended intensive care unit stay and are associated with an increased risk of mortality. This study evaluates the impact of inappropriate initial antibiotics on the length of intensive care unit stay, risk of mortality and the co-predictors that influences these outcomes. This retrospective study was conducted in an intensive care unit of a teaching hospital. The types of pneumonia investigated were hospital-acquired pneumonia and ventilator-associated pneumonia. Three different time points were defined as the initiation of appropriate antibiotics at 24 h, between 24 to 48 h and at more than 48 h after obtaining a culture. Patients had either hospital-acquired pneumonia (59.1%) or ventilator-associated pneumonia (40.9%). The length of intensive care unit stay ranged from 1 to 52 days (mean; 9.78±10.02 days). Patients who received appropriate antibiotic agent at 24 h had a significantly shorter length of intensive care unit stay (5.62 d, P<0.001). The co-predictors that contributed to an extended intensive care unit stay were the time of availability of susceptibility results and concomitant diseases, namely cancer and sepsis. The only predictor of intensive care unit death was cancer. The results support the need for early appropriate initial antibiotic therapy in hospital-acquired pneumonia and ventilator-associated pneumonia infections.
    Matched MeSH terms: Sepsis
  18. Late onset group b beta-hemolytic streptococcus infection in a neonate manifesting as a urinary tract infection: a rare clinical presentation
    Zurina Z, Rohani A, Neela V, Norlijah O
    Southeast Asian J Trop Med Public Health, 2012 Nov;43(6):1470-3.
    PMID: 23413711
    Group B beta-hemolytic streptococcus (GBS) sepsis is a serious bacterial infection in neonates, with significant morbidity and mortality. We report here a neonate with late onset GBS infection manifesting as a urinary tract infection (UTI) in an infant presenting with prolonged neonatal jaundice. The pathogenesis of this late onset is postulated.
    Matched MeSH terms: Sepsis/diagnosis*; Sepsis/drug therapy; Sepsis/microbiology
  19. Fulltext Value of Shock Index in prognosticating the short-term outcome of death for patients presenting with severe sepsis and septic shock in the emergency department
    Yussof SJM, Zakaria MI, Mohamed FL, Bujang MA, Lakshmanan S, Asaari AH
    Med J Malaysia, 2012 Aug;67(4):406-11.
    PMID: 23082451
    INTRODUCTION: The importance of early recognition and treatment of sepsis and its effects on short-term survival outcome have long been recognized. Having reliable indicators and markers that would help prognosticate the survival of these patients is invaluable and would subsequently assist in the course of effective dynamic triaging and goal directed management.
    STUDY OBJECTIVES: To determine the prognosticative value of Shock Index (SI), taken upon arrival to the emergency department and after 2 hours of resuscitation on the shortterm outcome of severe sepsis and septic shock patients.
    METHODOLOGY: This is a retrospective observational study involving 50 patients admitted to the University of Malaya Medical Centre between June 2009 and June 2010 who have been diagnosed with either severe sepsis or septic shock. Patients were identified retrospectively from the details recorded in the registration book of the resuscitation room. 50 patients were selected for this pilot study. The population comprised 19 males (38%) and 31 females (62%). The median (min, max) age was 54.5 (17.0, 84.0) years. The number of severe sepsis and septic shock cases were 31 (62%), and 19 (38%) respectively. There were 17 (34%) cases of pneumonias, 13 (26%) cases of urological sepsis, 8 (16%) cases of gastro intestinal tract related infections and 12 (24%) cases of other infections. There were a total of 23 (46%) survivors and 27 (54%) deaths. The value of the shock index is defined as systolic blood pressure divided by heart rate was calculated. Shock Index on presentation to ED (SI 1) and after 2 hours of resuscitation in the ED (SI 2). The median, minimum and maximum variables were tested using Mann-Whitney U and Chi square analysis. The significant parameters were re-evaluated for sensitivity, specificity and cut-off points. ROC curves and AUC values were generated among these variables to assess prognostic utility for outcome.
    RESULTS: Amongst all 7 variables tested, 2 were tested to be significant (p: < 0.05). From the sensitivity, specificity and ROC analysis, the best predictor for death was (SI 2) with a sensitivity of 80.8%, specificity of 79.2%, AUC value of 0.8894 [CI 95 0.8052, 0.9736] at a cut-off point of > or = 1.0.
    CONCLUSION: (SI 2) may potentially be utilized as a reliable predictor for death in patients presenting with septic shock and severe sepsis in an emergency department. This parameters should be further analyzed in a larger scale prospective study to determine its validity.
    Matched MeSH terms: Sepsis/physiopathology*
  20. Fulltext Spectrum of infections in splenectomised thalassaemia patients
    Zarina AL, Norazlin KN, Hamidah A, Aziz DA, Zulkifli SZ, Jamal R
    Med J Malaysia, 2010 Dec;65(4):283-5.
    PMID: 21901946
    Splenectomised thalassaemia patients are at risk of developing sepsis. As the infection may be life-threatening, treatment should be sought and given promptly. A retrospective study was performed amongst our thalassaemia major patients who were splenectomised. The vaccination status of each patient and the types of infections seen were reviewed to obtain a local perspective. In our cohort of 49 splenectomised patients, 25 patients required hospitalization for the treatment of infection. There were a total of 40 febrile episodes within this hospitalised group of which 27.5% were microbiologically documented infection with bacteraemia. The predominant causative organisms were gram negative rods and three patients succumbed to overwhelming septicaemic shock as a result of delayed presentation. Sixty percent of the febrile episodes were clinically documented infection and comprised mainly upper respiratory tract infections. Based on the spectrum of infections seen, there is a need to improve the patients' awareness level so that early treatment is sought. There is also a need to re-address the approach towards vaccination in this immunocompromised group of patients by administering a booster pneumococcal and influenza vaccination in an attempt to reduce morbidity.
    Matched MeSH terms: Sepsis/epidemiology*
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