Displaying publications 121 - 140 of 347 in total

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  1. Fulltext Challenges experienced by induced lactation women in Malaysia: An exploratory qualitative study
    Che Abdul Rahim N, Sulaiman Z, Ismail TAT
    PLoS One, 2024;19(1):e0291758.
    PMID: 38277383 DOI: 10.1371/journal.pone.0291758
    BACKGROUND: Induction of lactation occurs when breast milk is produced in a human (woman), without going through the process of pregnancy and delivery. Efforts to produce milk by women who had never been pregnant and give birth are not easy. According to the many who have attempted it, it is far more arduous a task than initiating postpartum lactation, but it is possible and worth the effort.

    RESEARCH AIM: This study aimed to explore and understand the challenges for women during induced lactation in Malaysia.

    METHODS: This qualitative study was done in 2017 and utilized in-depth interview among women who induced lactation in five states based on five regions in Malaysia [Central Region (Selangor), Northern Region (Penang), Southern Region (Johor), East Coast Region (Kelantan), Malaysia Borneo (Sabah)]. All interviews were consented, audio-recorded then transcribed verbatim, followed by identification of main themes.

    RESULTS: Data saturation was achieved after interviewing a total of 23 induced lactation women. Data synthesized using thematic analysis revealed six themes describing the main challenges during the induction process were (1) health condition, (2) work commitment, (3) overexertion, (4) not eligible to take leave, (5) inability to follow the treatment plan, and (6) difficulty attaching the adopted baby to initiate breastfeeding during induced lactation process.

    CONCLUSIONS: The challenges faced by women during the process of induced lactation were complex and the induced lactation process requires considerable dedication and determination. The findings of this research will help other women and their spouses/partners comprehend the challenges, obstacles, and support that are needed along the induced lactation process. The Government and other stakeholders have roles in more efforts and programs to help these mothers breastfeed their adoptive child and make them feel more accomplished as women and mothers.

    Matched MeSH terms: Milk, Human
  2. Discordance in exclusive breastfeeding between maternal recall and deuterium dose-to-mother technique during the first 6 months of infants: A multi-country study in Asia
    Winichagoon P, Pongcharoen T, Fadjarwati T, Winarno E, Karim NA, Purevsuren E, et al.
    Eur J Clin Nutr, 2024 Feb;78(2):135-140.
    PMID: 37838807 DOI: 10.1038/s41430-023-01353-0
    PURPOSE: This study aimed to assess the agreement in EBF between maternal recall and the dose-to-mother (DTM) technique.

    METHODS: Indonesia, Malaysia, Mongolia, Pakistan, Sri Lanka, Thailand, and Vietnam participated in the study. A total of 207 and 118 mother-infant pairs were assessed at 3 and 6 months of child's age. Using a standardized questionnaire, mothers were asked to recall child feeding during the previous 24 h, at 3 and 6 months. Those recalled to be EBF proceeded to be assessed using DTM technique. Non-milk oral intake (NMOI) cutoff of 86.6 g/d was used to classify EBF.

    RESULTS: According to DTM, 66% of infants were EBF at 3 months, while only 22% were EBF at 6 months. At 3 months, the overall % agreement between maternal recall and DTM method was 68%, kappa 0.06 (95% CI: 0.07-0.20), and at 6 months, the % agreement was only 21%, kappa -0.031 (95% CI -0.168 to 0.107). Human milk intakes were similar at 3 months and 6 months when expressed as g/d, but decreased when expressed as g/kg/d, with a large variation within and between countries; Pakistan being the lowest.

    CONCLUSION: This study showed there were declining levels of EBF from 3 to 6 months in the participating countries from Asia and the agreement between maternal recall and DTM technique to classify EBF was low. To ensure that the DTM technique can be more widely used in evaluating breastfeeding promotion programs, consensus on the appropriate NMOI cutoff and simplification of the DTM protocol is necessary.

    Matched MeSH terms: Milk, Human
  3. Fulltext Clinical effects of thai herbal compress: a systematic review and meta-analysis
    Dhippayom T, Kongkaew C, Chaiyakunapruk N, Dilokthornsakul P, Sruamsiri R, Saokaew S, et al.
    Evid Based Complement Alternat Med, 2015;2015:942378.
    PMID: 25861373 DOI: 10.1155/2015/942378
    Objective. To determine the clinical effects of Thai herbal compress. Methods. International and Thai databases were searched from inception through September 2014. Comparative clinical studies investigating herbal compress for any indications were included. Outcomes of interest included level of pain, difficulties in performing activities, and time from delivery to milk secretion. Mean changes of the outcomes from baseline were compared between herbal compress and comparators by calculating mean difference. Results. A total of 13 studies which involved 778 patients were selected from 369 articles identified. The overall effects of Thai herbal compress on reducing osteoarthritis (OA) and muscle pain were not different from those of nonsteroidal anti-inflammatory drugs, knee exercise, and hot compress. However, the reduction of OA pain in the herbal compress group tended to be higher than that of any comparators (weighted mean difference 0.419; 95% CI -0.004, 0.842) with moderate heterogeneity (I (2) = 58.3%, P = 0.048). When compared with usual care, herbal compress provided significantly less time from delivery to milk secretion in postpartum mothers (mean difference -394.425 minutes; 95% CI -620.084, -168.766). Conclusion. Thai herbal compress may be considered as an alternative for osteoarthritis and muscle pain and could also be used as a treatment of choice to induce lactation.
    Matched MeSH terms: Milk
  4. Fulltext Maternal serum and breast milk vitamin D levels: findings from the Universiti Sains Malaysia Pregnancy Cohort Study
    Jan Mohamed HJ, Rowan A, Fong B, Loy SL
    PLoS One, 2014;9(7):e100705.
    PMID: 24992199 DOI: 10.1371/journal.pone.0100705
    Vitamin D deficiency has become a global health issue in pregnant women. This study aimed to assess the adequacy of maternal vitamin D status by measuring maternal serum and breast milk 25-hydroxyvitamin D [25(OH)D] levels and to determine the association between maternal serum and milk 25(OH)D levels.
    Matched MeSH terms: Milk, Human/metabolism*
  5. Fulltext Probiotic potential of Lactobacillus strains with antimicrobial activity against some human pathogenic strains
    Shokryazdan P, Sieo CC, Kalavathy R, Liang JB, Alitheen NB, Faseleh Jahromi M, et al.
    Biomed Res Int, 2014;2014:927268.
    PMID: 25105147 DOI: 10.1155/2014/927268
    The objective of this study was to isolate, identify, and characterize some lactic acid bacterial strains from human milk, infant feces, and fermented grapes and dates, as potential probiotics with antimicrobial activity against some human pathogenic strains. One hundred and forty bacterial strains were isolated and, after initial identification and a preliminary screening for acid and bile tolerance, nine of the best isolates were selected and further identified using 16 S rRNA gene sequences. The nine selected isolates were then characterized in vitro for their probiotic characteristics and their antimicrobial activities against some human pathogens. Results showed that all nine isolates belonged to the genus Lactobacillus. They were able to tolerate pH 3 for 3 h, 0.3% bile salts for 4 h, and 1.9 mg/mL pancreatic enzymes for 3 h. They exhibited good ability to attach to intestinal epithelial cells and were not resistant to the tested antibiotics. They also showed good antimicrobial activities against the tested pathogenic strains of humans, and most of them exhibited stronger antimicrobial activity than the reference strain L. casei Shirota. Thus, the nine Lactobacillus strains could be considered as potential antimicrobial probiotic strains against human pathogens and should be further studied for their human health benefits.
    Matched MeSH terms: Milk, Human/microbiology
  6. 'A better alternative': why women use peer-to-peer shared milk
    Gribble KD
    Breastfeed Rev, 2014 Mar;22(1):11-21.
    PMID: 24804519
    The process by which women came to use internet-facilitated peer-to-peer shared milk was explored via a written questionnaire administered to 41 peer milk recipients from five countries. Respondents were universally unable to provide some or all of the milk their infants required. Twenty-nine dyads had a medical condition that could have affected their ability to breastfeed. Many respondents had had great difficulty in finding health workers who could assist them with their breastfeeding challenges. Before obtaining peer-shared milk, respondents had tried to increase their own milk supply, used infant formula or sought donor milk from personal contacts. Health workers dealing with breastfeeding women require greater training in the recognition and treatment of conditions that adversely affect breastfeeding including a physiological incapacity to fully breastfeed. Peer-to-peer milk recipients appear to be very satisfied with the solution milk sharing provides to their problem of being unable to fully breastfeed their infants.
    Matched MeSH terms: Milk Banks*
  7. International perspectives on donor milk in and beyond the NICU
    Grøvslien A, Torng HH, Moro GE, Simpson J, Barnett D
    J Hum Lact, 2013 Aug;29(3):310-2.
    PMID: 23855030 DOI: 10.1177/0890334413487509
    Matched MeSH terms: Milk Banks/organization & administration*
  8. Genetic characterization of Arcobacter isolates from various sources
    Shah AH, Saleha AA, Zunita Z, Cheah YK, Murugaiyah M, Korejo NA
    Vet Microbiol, 2012 Dec 7;160(3-4):355-61.
    PMID: 22739058 DOI: 10.1016/j.vetmic.2012.05.037
    Arcobacter is getting more attention due to its detection from wide host-range and foods of animal origin. The objective of this study was to determine the prevalence of Arcobacter spp. in various sources at farm level and beef retailed in markets in Malaysia and to assess the genetic relatedness among them. A total of 273 samples from dairy cattle including cattle (n=120), floor (n=30), water (n=18) and milk (n=105) as well as 148 beef samples collected from retail markets were studied. The overall prevalence of Arcobacter in various sources was 15% (63/421). However, source-wise detection rate of Arcobacter spp. was recorded as 26.66% (8/30) in floor, 26.3% (39/148) in beef, 11.11% (2/18) in water, 7.6% (8/105) in milk and 6.66% (8/120) in cattle. Arcobacter butzleri was the frequently isolated species however, a total of 75%, 66.7%, 53.8%, 50% and 12.5%% samples from floor, milk, beef, water and cattle, respectively, were carrying more than one species simultaneously. One (12.5%) cattle and beef sample (2.5%) found to be carrying one Arcobacter spp., A. skirrowii, only. Typing of Arcobacter isolates was done though pulsed field gel electrophoresis (PFGE) after digested with Eag1 restriction endonuclease (RE). Digestion of genomic DNA of Arcobacter from various sources yielded 12 major clusters (≥ 50% similarity) which included 29 different band patterns. A number of closely related A. butzleri isolates were found from beef samples which indicate cross contamination of common type of Arcobacter. Fecal shedding of Arcobacter by healthy animals can contaminate water and milk which may act as source of infection in humans.
    Matched MeSH terms: Milk/microbiology
  9. Fulltext Determination of polycyclic aromatic hydrocarbons in fresh milk by hollow fiber liquid-phase microextraction-gas chromatography mass spectrometry
    Sanagi MM, Loh SH, Wan Ibrahim WA, Hasan MN, Aboul Enein HY
    J Chromatogr Sci, 2013 Feb;51(2):112-6.
    PMID: 22776739 DOI: 10.1093/chromsci/bms113
    In this work, a two-phase hollow fiber liquid-phase microextraction (HF-LPME) method combined with gas chromatography-mass spectrometry (GC-MS) is developed to provide a rapid, selective and sensitive analytical method to determine polycyclic aromatic hydrocarbons (PAHs) in fresh milk. The standard addition method is used to construct calibration curves and to determine the residue levels for the target analytes, fluorene, phenanthrene, fluoranthene, pyrene and benzo[a]pyrene, thus eliminating sample pre-treatment steps such as pH adjustment. The HF-LPME method shows dynamic linearity from 5 to 500 µg/L for all target analytes with R(2) ranging from 0.9978 to 0.9999. Under optimized conditions, the established detection limits range from 0.07 to 1.4 µg/L based on a signal-to-noise ratio of 3:1. Average relative recoveries for the determination of PAHs studied at 100 µg/L spiking levels are in the range of 85 to 110%. The relative recoveries are slightly higher than those obtained by conventional solvent extraction, which requires saponification steps for fluorene and phenanthrene, which are more volatile and heat sensitive. The HF-LPME method proves to be simple and rapid, and requires minimal amounts of organic solvent that supports green analysis.
    Matched MeSH terms: Milk/chemistry*
  10. Bioconversion of isoflavones and the probiotic properties of the electroporated parent and subsequent three subcultures of Lactobacillus fermentum BT 8219 in biotin-soymilk
    Ewe JA, Wan-Abdullah WN, Alias AK, Liong MT
    J Microbiol Biotechnol, 2012 Jul;22(7):947-59.
    PMID: 22580314
    This study was aimed at an evaluation of the potential inheritance of electroporation effects on Lactobacillus fermentum BT 8219 through to three subsequent subcultures, based on their growth, isoflavone bioconversion activities, and probiotic properties, in biotin-supplemented soymilk. Electroporation was seen to cause cell death immediately after treatment, followed by higher growth than the control during fermentation in biotin-soymilk (P<0.05). This was associated with enhanced intracellular and extracellular beta-glucosidase specific activity, leading to increased bioconversion of isoflavone glucosides to aglycones (P<0.05). The growing characteristics, enzyme, and isoflavone bioconversion activities of the first, second, and third subcultures of treated cells in biotin-soymilk were similar to the control (P>0.05). Electroporation affected the probiotic properties of parent L. fermentum BT 8219, by reducing its tolerance towards acid (pH 2) and bile, lowering its inhibitory activities against selected pathogens, and reducing its ability for adhesion, when compared with the control (P<0.05). The first, second, and third subcultures of the treated cells showed comparable traits with that of the control (P>0.05), with the exception of their bile tolerance ability, which was inherited to the treated cells of the first and second subcultures (P<0.05). Our results suggest that electroporation could be used to increase the bioactivity of biotin-soymilk via fermentation with probiotic L. fermentum BT 8219, with a view towards the development of functional foods.
    Matched MeSH terms: Soy Milk/metabolism
  11. Fulltext Mixed biopolymer systems based on starch
    Abd Elgadir M, Akanda MJ, Ferdosh S, Mehrnoush A, Karim AA, Noda T, et al.
    Molecules, 2012 Jan 09;17(1):584-97.
    PMID: 22231495 DOI: 10.3390/molecules17010584
    A binary mixture of starch-starch or starch with other biopolymers such as protein and non-starch polysaccharides could provide a new approach in producing starch-based food products. In the context of food processing, a specific adjustment in the rheological properties plays an important role in regulating production processing and optimizing the applicability, stability, and sensory of the final food products. This review examines various biopolymer mixtures based on starch and the influence of their interaction on physicochemical and rheological properties of the starch-based foods. It is evident that the physicochemical and rheological characteristics of the biopolymers mixture are highly dependent on the type of starch and other biopolymers that make them up mixing ratios, mixing procedure and presence of other food ingredients in the mixture. Understanding these properties will lead to improve the formulation of starch-based foods and minimize the need to resort to chemically modified starch.
    Matched MeSH terms: Milk Proteins/chemistry
  12. Apparent bioavailability of isoflavones in urinary excretions of postmenopausal Malay women consuming tempeh compared with milk
    Haron H, Ismail A, Shahar S, Azlan A, Peng LS
    Int J Food Sci Nutr, 2011 Sep;62(6):642-50.
    PMID: 21574819 DOI: 10.3109/09637486.2011.570742
    Quantitation of isoflavones in humans is important to establish the benefits of these compounds to the populations. Urinary isoflavones are frequently used as a biomarker of isoflavone bioavailability from food or supplement since urine contains 100-fold higher concentrations of isoflavones. The objective of the present study was to determine and compare the urinary excretions of daidzein (DA), genistein (GE) and equol (EQ) in postmenopausal Malay women following the consumption of tempeh and milk in a calcium absorption study and to test the hypothesis that the excretion of isoflavones following consumption of tempeh maybe higher compared with milk. The amounts of DA (47.06 ± 4.18 μmol/h), GE (33.27 ± 3.71 μmol/h) and EQ (24.35 ± 4.34 μmol/h) excreted in urine following tempeh consumption were significantly higher (P < 0.05) compared with those in milk (3.51 ± 0.62 μmol/h DA, 2.79 ± 0.35 μmol/h GE and 0 μmol/h EQ). Almost all studied postmenopausal Malay women were able to excrete EQ following consumption of 240 g tempeh but only one subject can be classified as an equol producer. We concluded that most postmenopausal Malay women excreted DA, GE and EQ in their urine following tempeh consumption and the amount of the excreted isoflavones were higher compared with those in milk. However, further studies are needed to determine whether longer periods of time are required to capture EQ producers.
    Matched MeSH terms: Milk*
  13. Effect of ultrasound on the growth of probiotics and bioconversion of isoflavones in prebiotic-supplemented soymilk
    Yeo SK, Liong MT
    J Agric Food Chem, 2011 Feb 9;59(3):885-97.
    PMID: 21235273 DOI: 10.1021/jf103974d
    The objective of the present study was to evaluate the effects of ultrasound on the growth of probiotics and bioconversion of isoflavones in prebiotic-soymilk. Previous studies have shown that ultrasound elevated microbial enzymatic activity and growth by altering cellular membranes. The growth of probiotics was significantly decreased (P < 0.05) immediately after ultrasound treatment, attributed to membrane permeabilization, cell lysis, and membrane lipid peroxidation upon ultrasound treatment. The ultrasound treatment also caused alteration at the acyl chain, polar head, and interface region of the probiotic membrane phospholipid bilayers. The cells treated with ultrasound showed recovery from injury with subsequent increase in growth upon fermentation in soymilk (P < 0.05). Ultrasound treatment at 100 W for 2 and 3 min also enhanced (P < 0.05) the intracellular and extracellular β-glucosidase activity of probiotics, leading to increased (P < 0.05) bioconversion of glucosides to aglycones in the prebiotic-soymilk. Our present study illustrated that ultrasound treatment could produce bioactive synbiotic-soymilk with increased concentrations of bioactive aglycones.
    Matched MeSH terms: Soy Milk/chemistry*
  14. Antibiotics for mastitis in breastfeeding women
    Jahanfar S, Ng CJ, Teng CL
    Cochrane Database Syst Rev, 2009 Jan 21.
    PMID: 19160255 DOI: 10.1002/14651858.CD005458.pub2
    BACKGROUND: Mastitis can be caused by ineffective positioning of the baby at the breast or restricted feeding. Infective mastitis is commonly caused by Staphylococcus Aureus. Incidence of mastitis in breastfeeding women may reach 33%. Effective milk removal, pain medication and antibiotic therapy have been the mainstays of treatment.

    OBJECTIVES: This review aims to examine the effectiveness of antibiotic therapies in relieving symptoms for breastfeeding women with mastitis with or without laboratory investigation.

    SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (December 2007), the Cochrane Central Register of Clinical Trials (The Cochrane Library 2007, Issue 4), MEDLINE (1996 to 2007) and EMBASE (January 1985 to 2007). We contacted investigators and other content experts known to us for unpublished trials and scanned the reference lists of retrieved articles

    SELECTION CRITERIA: Randomized and quasi-randomized clinical trials comparing the effectiveness of various types of antibiotic therapies or antibiotic therapy versus alternative therapies for the treatment of mastitis were selected.

    DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. When in dispute, we consulted a third author.

    MAIN RESULTS: Two trials met the inclusion criteria. One small trial (n = 25) compared amoxicillin with cephradine and found no significant difference between the two antibiotics in terms of symptom relief and abscess formation. Another, older study compared breast emptying alone as "supportive therapy" versus antibiotic therapy plus supportive therapy, and no therapy. The findings of the latter study suggested faster clearance of symptoms for women using antibiotics, although the study design was problematic.

    AUTHORS' CONCLUSIONS: There is insufficient evidence to confirm or refute the effectiveness of antibiotic therapy for the treatment of lactational mastitis. There is an urgent need to conduct high-quality, double-blinded randomized clinical trials to determine whether antibiotics should be used in this common postpartum condition.
    Matched MeSH terms: Milk, Human/metabolism
  15. Constraint analysis to improve integrated dairy production systems in developing countries: the importance of participatory rural appraisal
    Devendra C
    Trop Anim Health Prod, 2007 Dec;39(8):549-56.
    PMID: 18265864
    The paper describes the rationale and importance of the approaches and methodologies of Participatory Rural Appraisal (PRA) to enable constraint analysis, to understand the complexities of farming systems and to improve integrated dairy productivity. Implicit in this objective is Farming Systems Research (FSR), which focused on cropping systems in the 1970's, with the subsequent addition of animal components. The methodology for FSR involves the following sequential components: site selection, site description and characterization (diagnosis), planning of on-farm research, on-farm testing and validation of alternatives, diffusion of results, and impact assessment. PRA is the development of FSR, which involves the active participation of farmers to identify constraints and plan appropriate solutions. In the Coordinated Research Project (CRP), the approach was adapted to 10 different country situations and led to Economic Opportunity Surveys (EOS) and Diagnostic Surveillance Studies (DSS), allowing the planning and implantation of integrated interventions to improve dairy productivity.
    Matched MeSH terms: Milk/metabolism*
  16. Bacteria in expressed breastmilk from mothers of premature infants and maternal hygienic status
    Dahaban NM, Romli MF, Roslan NR, Kong SS, Cheah FC
    Breastfeed Med, 2013 Aug;8(4):422-3.
    PMID: 23398139 DOI: 10.1089/bfm.2012.0109
    Matched MeSH terms: Milk, Human/microbiology*
  17. Fulltext Effect of added carbohydrates on glycemic and insulin responses to children’s milk products
    Brand-Miller J, Atkinson F, Rowan A
    Nutrients, 2013 Jan;5(1):23-31.
    PMID: 23306187 DOI: 10.3390/nu5010023
    Powdered milk products for children (Growing Up Milk Powders or GUMPs) containing added carbohydrates such as glucose and sucrose are now well established in parts of Asia. We surveyed GUMPs in Malaysia and Indonesia to determine the content of added carbohydrates. The ingredient lists and nutrition information panels were used to calculate the percentage of declared carbohydrates contributed by added carbohydrates and a subset of seven products was tested for their glycemic index (GI) and insulin responses in healthy adults. The glycemic load for each product was calculated. In total, 58 products (n = 24 in Malaysia and n = 34 in Indonesia) were surveyed. Added carbohydrate content (excluding fibre) ranged from 0 to 21.5 g per serve. Milk powders without added sources of carbohydrate had similar GI values to standard liquid whole milk. Products containing maltodextrins, corn or glucose syrups increased the GI by more than 2-fold, and glycemic load (GL) by 7-fold compared to milk powders with no added carbohydrates. Insulin responses were significantly but not strongly correlated with glucose responses (r = 0.32, p < 0.006). Children's milk powders containing higher levels of added carbohydrate ingredients elicit higher glucose and insulin responses than liquid or powdered whole milk.
    Matched MeSH terms: Milk/chemistry*
  18. Simultaneous determination of three organophosphorus pesticides in different food commodities by gas chromatography with mass spectrometry
    Vijaya Bhaskar Reddy A, Yusop Z, Jaafar J, Bin Aris A, Abdul Majid Z, Umar K, et al.
    J Sep Sci, 2016 Jun;39(12):2276-83.
    PMID: 27095506 DOI: 10.1002/jssc.201600155
    A sensitive and selective gas chromatography with mass spectrometry method was developed for the simultaneous determination of three organophosphorus pesticides, namely, chlorpyrifos, malathion, and diazinon in three different food commodities (milk, apples, and drinking water) employing solid-phase extraction for sample pretreatment. Pesticide extraction from different sample matrices was carried out on Chromabond C18 cartridges using 3.0 mL of methanol and 3.0 mL of a mixture of dichloromethane/acetonitrile (1:1 v/v) as the eluting solvent. Analysis was carried out by gas chromatography coupled with mass spectrometry using selected-ion monitoring mode. Good linear relationships were obtained in the range of 0.1-50 μg/L for chlorpyrifos, and 0.05-50 μg/L for both malathion and diazinon pesticides. Good repeatability and recoveries were obtained in the range of 78.54-86.73% for three pesticides under the optimized experimental conditions. The limit of detection ranged from 0.02 to 0.03 μg/L, and the limit of quantification ranged from 0.05 to 0.1 μg/L for all three pesticides. Finally, the developed method was successfully applied for the determination of three targeted pesticides in milk, apples, and drinking water samples each in triplicate. No pesticide was found in apple and milk samples, but chlorpyrifos was found in one drinking water sample below the quantification level.
    Matched MeSH terms: Milk/chemistry
  19. Outbreak of Human Brucellosis from Consumption of Raw Goats' Milk in Penang, Malaysia
    Leong KN, Chow TS, Wong PS, Hamzah SH, Ahmad N, Ch'ng CC
    Am J Trop Med Hyg, 2015 Sep;93(3):539-41.
    PMID: 26055742 DOI: 10.4269/ajtmh.15-0246
    We report the largest outbreak of brucellosis in Penang, Malaysia. Brucellosis is not endemic in this region. The index case was a 45-year-old goat farm owner presented with 3 weeks of fever, headache, severe lethargy, poor appetite, and excessive sweating. He claimed to have consumed unpasteurized goat's milk that he had also sold to the public. Tests were negative for tropical diseases (i.e., dengue fever, malaria, leptospirosis and scrub typhus) and blood culture showed no growth. Based on epidemiological clues, Brucella serology was ordered and returned positive. Over a period of 1 year, 79 patients who had consumed milk bought from the same farm were diagnosed with brucellosis. Two of these patients were workers on the farm. Four laboratory staff had also contracted the disease presumably through handling of the blood samples. The mean duration from onset of symptoms to diagnosis was 53 days with a maximum duration of 210 days. A combination treatment of rifampin and doxycycline for 6 weeks was the first line of treatment in 90.5% of patients. One-third of the patients had sequelae after recovering and 21% had a relapse. We highlight the importance of Brucellosis as a differential diagnosis when a patient has unexplained chronic fever.
    Matched MeSH terms: Milk/microbiology*
  20. Fulltext A pilot study to determine the short-term effects of milk with differing glycaemic properties on sleep among toddlers: a randomised controlled trial
    Misra S, Khor GL, Mitchell P, Haque S, Benton D
    BMC Pediatr, 2015;15:79.
    PMID: 26174581 DOI: 10.1186/s12887-015-0393-9
    BACKGROUND: Sleep is important for children as it directly impacts their mental and physical development. Sleep is not only influenced by the timing but also the macronutrient (carbohydrate and protein) content of meals. Glycaemic index (GI) and glycaemic load (GL) describe the quality of carbohydrates in a food and the burden of these foods on the body's blood glucose response. Diets with a high GI/GL may increase the risk of developing obesity and type 2 diabetes mellitus in adulthood. The present study is piloted to evaluate the short-term impact of milk products with differing glycaemic properties on the sleep patterns of toddlers.
    METHODS: Toddlers were recruited from various day care centres. Informed consent was obtained from both the mothers and the centres. A double-blind randomised controlled trial with a between-subjects design was adopted. The toddlers were randomised to either one of two types of milk with a differing GI ("Low" = 23 and "High = 65") for a period of 3.5 days. There were no other dietary restrictions imposed except that the enrolled child did not consume any other milk during the study period. The sleep patterns were recorded using a Phillips Actiwatch-2, which was worn on the wrist for 24 h over 4 days. The parameters used to measure the sleep pattern were sleep-onset latency (SOL), total sleep time (TST), wake after sleep onset (WASO) and sleep efficiency (SE).
    RESULTS: A total of 56 toddlers completed the study. The toddlers had a mean age of 19.9 +/- 4.3 months. There were no significant differences (p > 0.05) between the two GI groups for SOL, TST, WASO and SE at the end of the feeding period.
    CONCLUSIONS: Sleep patterns of toddlers on low-GI milk did not differ from those with high-GI milk consumed over a short period. Future studies should consider the glycaemic effects of other foods, along with milk with differing GI, consumed for a longer feeding duration.
    TRIAL REGISTRATION: ClinicalTrial.gov NCT01589003.
    Matched MeSH terms: Milk/chemistry*
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