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Fulltext Acanthamoeba in Southeast Asia - Overview and Challenges

Bunsuwansakul C, Mahboob T, Hounkong K, Laohaprapanon S, Chitapornpan S, Jawjit S, et al.

Korean J Parasitol, 2019 Aug;57(4):341-357.
PMID: 31533401 DOI: 10.3347/kjp.2019.57.4.341

Acanthamoeba, one of free-living amoebae (FLA), remains a high risk of direct contact with this protozoan parasite which is ubiquitous in nature and man-made environment. This pathogenic FLA can cause sight-threatening amoebic keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE) though these cases may not commonly be reported in our clinical settings. Acanthamoeba has been detected from different environmental sources namely; soil, water, hot-spring, swimming pool, air-conditioner, or contact lens storage cases. The identification of Acanthamoeba is based on morphological appearance and molecular techniques using PCR and DNA sequencing for clinico-epidemiological purposes. Recent treatments have long been ineffective against Acanthamoeba cyst, novel anti-Acanthamoeba agents have therefore been extensively investigated. There are efforts to utilize synthetic chemicals, lead compounds from medicinal plant extracts, and animal products to combat Acanthamoeba infection. Applied nanotechnology, an advanced technology, has shown to enhance the anti-Acanthamoeba activity in the encapsulated nanoparticles leading to new therapeutic options. This review attempts to provide an overview of the available data and studies on the occurrence of pathogenic Acanthamoeba among the Association of Southeast Asian Nations (ASEAN) members with the aim of identifying some potential contributing factors such as distribution, demographic profile of the patients, possible source of the parasite, mode of transmission and treatment. Further, this review attempts to provide future direction for prevention and control of the Acanthamoeba infection.

Matched MeSH terms: Amebiasis/diagnosis
Tumour lysis syndrome in a neonate with transient abnormal myelopoiesis

Mohammad Khuzaini A, Mohd Baharudin JA, Md Fauzi A, Zulkeflee HA, Abdul Halim H, Mazli SK, et al.

J Neonatal Perinatal Med, 2024;17(2):269-273.
PMID: 38728206 DOI: 10.3233/NPM-230146

BACKGROUND: Tumor lysis syndrome (TLS) is an oncological emergency associated with hematological malignancies or highly proliferative solid tumors, commonly after chemotherapy. It is rarely associated with transient abnormal myelopoiesis.
OBSERVATION: We report a rare case of a neonate with transient abnormal myelopoiesis and tumor lysis syndrome, complicated with concomitant heart failure due to an underlying atrioventricular septal defect. Hyperhydration was contraindicated due to heart failure. The patient was managed conservatively with full recovery.
CONCLUSION: Tumor lysis syndrome should be suspected in neonates with transient abnormal myelopoiesis with electrolyte abnormalities. Treatment options should be considered carefully for their risks and benefits.

Matched MeSH terms: Heart Septal Defects, Atrial/diagnosis
Bed Bug Infestation: An Updated Review

Leung AKC, Lam JM, Barankin B, Leong KF, Hon KL

Curr Pediatr Rev, 2024;20(2):137-149.
PMID: 37038684 DOI: 10.2174/1573396320666230406084801

In the past decade, there has been a global resurgence of bed bug infestations, especially in developed countries. Proper awareness and identification of bed bug infestations are essential to guide treatment and eradication. The purpose of this article is to familiarize physicians with bed bug bites so that they can effectively diagnose, treat, and address questions about bed bug bites and infestations. Bed bug bites are often painless. Typical reactions include pruritic, erythematous maculopapules occurring in clusters or in a linear or curvilinear distribution in exposed areas of the body. A small red punctum may be visualized at the center of the bite mark. Lesions that appear three in a row and papules on the upper eyelid associated with erythema and edema are highly suggestive of bites from bed bugs. Exaggerated local reactions such as vesicles, urticarial wheals, urticarial perilesional plaques, diffuse urticaria, bullae, and nodules may occur in previously sensitized individuals. Reactions to bed bug bites are self-limited. As such, treatment is mainly symptomatic. Topical pramoxine and oral antihistamines can be used to alleviate pruritus. Topical corticosteroids can be used for significant eruptions to control inflammation and pruritus, and to hasten resolution of the lesions. Integrated pest management, an approach for the eradication of bed bugs, includes monitoring devices (active monitors include the use of heat or carbon dioxide attractants and passive monitors include the use of sticky pads for trapping), and judicious use of nonchemical and chemical treatments known to be effective. Nonchemical interventions include keeping affected areas clean and free of clutter, vacuuming, washing linens with hot water, caulking wall holes and cracks where bugs can hide, proper disposal of highly infested items, and placement of bed bug traps/interceptors at the base of beds and furniture. Chemical interventions involve the use of insecticides such as synthetic pyrethroids, silicates, insect growth disruptors, carbamates, organophosphates, neonicotinoids, diethyl-meta-toluamide, chlorfenapyr, fipronil and plant essential oils. Insecticides should be used with caution to prevent over-exposure and toxicity (in particular, cardiovascular and neurologic toxicity), especially if there are young children around. It is important to note that multiple mechanisms of insecticide resistance exist and as such, chemical treatment should only be undertaken by trained professionals who understand the current literature on resistance. Both nonchemical and chemical technologies should be combined for optimal results. Bed bug infestations may cause diverse dermal reactions, stigmatization, poor self-esteem, emotional stress, anxiety, significant adverse effect on quality of life, and substantial socioeconomic burden to society. As such, their rapid detection and eradication are of paramount importance. Consultation with a professional exterminator is recommended to fully eradicate an infestation.

Matched MeSH terms: Ectoparasitic Infestations/diagnosis
Fulltext The relationship between hair cortisol concentration and autism diagnosis

Lin PI, John JR, Masi A, Ong LK, Mathew NE, Moni MA, et al.

J Psychiatr Res, 2024 Aug;176:68-76.
PMID: 38850580 DOI: 10.1016/j.jpsychires.2024.05.052

BACKGROUND: Autistic children are prone to experience heightened levels of distress and physiological reactivity to a range of sensory, social, and emotional stimuli. In line with this, multiple studies have demonstrated that autistic children have higher acute cortisol stress responses to adverse or threatening stimuli and altered cortisol awakening responses. However, few studies have examined whether this sensitivity may relate to heightened levels of chronic stress and persistently elevated hypothalamic-pituitary-adrenal (HPA) axis activity. The measurement of cortisol accumulation in hair is considered a non-invasive biomarker of chronic stress and has been associated with several childhood diseases. Here, we investigated whether hair cortisol concentration in a large sample of autistic children differed from non-autistic children, and after accounting for a range of child, parental and family-level characteristics.
METHODS: Hair cortisol concentration was measured in 307 autistic children and 282 non-autistic controls aged between 2 and 17 years recruited from four Australian states who participated in providing hair samples and demographic data to the Australian Autism Biobank. Independent samples t-test or one-way analysis of variance (ANOVA) were conducted to determine significant differences in the mean hair cortisol concentration (pg/mg) between potential covariates. Primary analysis included multivariable regression modelling of the collapsed sample to identify variables that were significantly associated with hair cortisol concentration after controlling for covariates. We also accounted for the potential interaction of multiple biological (e.g., age, sex, BMI) and psychosocial characteristics at the level of the child, the mother and the father, and the family unit.
RESULTS: Our findings suggest that the diagnosis of autism was not a significant predictor of chronic stress, as measured by hair cortisol concentration. However, findings of the multivariable regression analysis showed that key factors such as area of residence (Queensland vs Victorian state of residence) and decrease in child's age were significantly associated with higher hair cortisol concentration whereas lower family income was significantly associated with higher hair cortisol concentration.
CONCLUSION: To our knowledge, this is the first study to show that socioeconomic factors such as family annual income affect hair cortisol status in autistic children, indicating that the psychosocial environment may be a potential mediator for chronic stress in autistic children just as it has been demonstrated in non-autistic children.

Matched MeSH terms: Stress, Psychological/diagnosis
Fulltext ECG-based prediction algorithm for imminent malignant ventricular arrhythmias using decision tree

Mandala S, Cai Di T, Sunar MS, Adiwijaya

PLoS One, 2020;15(5):e0231635.
PMID: 32407335 DOI: 10.1371/journal.pone.0231635

Spontaneous prediction of malignant ventricular arrhythmia (MVA) is useful to avoid delay in rescue operations. Recently, researchers have developed several algorithms to predict MVA using various features derived from electrocardiogram (ECG). However, there are several unresolved issues regarding MVA prediction such as the effect of number of ECG features on a prediction remaining unclear, possibility that an alert for occurring MVA may arrive very late and uncertainty in the performance of the algorithm predicting MVA minutes before onset. To overcome the aforementioned problems, this research conducts an in-depth study on the number and types of ECG features that are implemented in a decision tree classifier. In addition, this research also investigates an algorithm's execution time before the occurrence of MVA to minimize delays in warnings for MVA. Lastly, this research aims to study both the sensitivity and specificity of an algorithm to reveal the performance of MVA prediction algorithms from time to time. To strengthen the results of analysis, several classifiers such as support vector machine and naive Bayes are also examined for the purpose of comparison study. There are three phases required to achieve the objectives. The first phase is literature review on existing relevant studies. The second phase deals with design and development of four modules for predicting MVA. Rigorous experiments are performed in the feature selection and classification modules. The results show that eight ECG features with decision tree classifier achieved good prediction performance in terms of execution time and sensitivity. In addition, the results show that the highest percentage for sensitivity and specificity is 95% and 90% respectively, in the fourth 5-minute interval (15.1 minutes-20 minutes) that preceded the onset of an arrhythmia event. Such results imply that the fourth 5-minute interval would be the best time to perform prediction.

Matched MeSH terms: Arrhythmias, Cardiac/diagnosis*
Fulltext Restoring private autism dataset from sanitized database using an optimized key produced from enhanced combined PSO-GWO framework

Rahman MM, Muniyandi RC, Sahran S, Usman OL, Moniruzzaman M

Sci Rep, 2024 Jul 09;14(1):15763.
PMID: 38982129 DOI: 10.1038/s41598-024-66603-y

The timely identification of autism spectrum disorder (ASD) in children is imperative to prevent potential challenges as they grow. When sharing data related to autism for an accurate diagnosis, safeguarding its security and privacy is a paramount concern to fend off unauthorized access, modification, or theft during transmission. Researchers have devised diverse security and privacy models or frameworks, most of which often leverage proprietary algorithms or adapt existing ones to address data leakage. However, conventional anonymization methods, although effective in the sanitization process, proved inadequate for the restoration process. Furthermore, despite numerous scholarly contributions aimed at refining the restoration process, the accuracy of restoration remains notably deficient. Based on the problems identified above, this paper presents a novel approach to data restoration for sanitized sensitive autism datasets with improved performance. In the prior study, we constructed an optimal key for the sanitization process utilizing the proposed Enhanced Combined PSO-GWO framework. This key was implemented to conceal sensitive autism data in the database, thus avoiding information leakage. In this research, the same key was employed during the data restoration process to enhance the accuracy of the original data recovery. Therefore, the study enhanced the restoration process for ASD data's security and privacy by utilizing an optimal key produced via the Enhanced Combined PSO-GWO framework. When compared to existing meta-heuristic algorithms, the simulation results from the autism data restoration experiments demonstrated highly competitive accuracies with 99.90%, 99.60%, 99.50%, 99.25%, and 99.70%, respectively. Among the four types of datasets used, this method outperforms other existing methods on the 30-month autism children dataset, mostly.

Matched MeSH terms: Autistic Disorder/diagnosis
Fulltext Diagnostic performance of two non-invasive biomarkers used individually and in sequential combination for cirrhosis associated with hepatitis C virus infection

Suan MAM, Chan HK, Sem X, Shilton S, Hassan MRA

Sci Rep, 2022 Nov 23;12(1):20153.
PMID: 36418369 DOI: 10.1038/s41598-022-24612-9

This cross-sectional study evaluated the performance of the Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) and the Fibrosis-4 (FIB-4) Index when they were used individually and in sequential combination to diagnose cirrhosis associated with hepatitis C virus infection. The final evaluation involved 906 people living with hepatitis C. The diagnostic performance of individual biomarkers at cut-off scores of 1.5 and 2.0 for the APRI and at 3.25 for the FIB-4 index was assessed. For the sequential combination method, the cirrhosis status of individuals with an APRI score between 1.0 and 1.5 were reassessed using the FIB-4. Transient elastography (TE) was used as the reference standard for diagnosing cirrhosis. The APRI, at a cut-off score of 1.5, showed a sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 44.9%, 97.6%, 91.1% and 76.3%, respectively. Increasing the cut-off score to 2.0 produced a much lower sensitivity (29.6%) and NPV (71.9%). The FIB-4, at a cut-off score of 3.25, yielded a sensitivity, specificity, PPV and NPV of 40.8%, 97.3%, 89.1% and 75.0%, respectively. The sequential combination method demonstrated a much more optimal diagnostic performance (50.2% sensitivity, 96.6% specificity, 89.0% PPV and 77.9% NPV). Overall, the APRI and FIB-4 Index performed better in diagnosing cirrhosis associated with hepatitis C when they were used in sequential combination.

Matched MeSH terms: Liver Cirrhosis/diagnosis
Acute labyrinthitis secondary to aural tick infestation

Shibghatullah AH, Abdullah MK, Pein CJ, Mohamad I

Southeast Asian J Trop Med Public Health, 2012 Jul;43(4):857-9.
PMID: 23077807

Aural tick usually menisfests as intolerable otalgia. The severity of pain makes the patient to seek early treatment. Other uncommon symptoms include inner ear dyfunctions such as vertigo and tinnitus. The diagnosis is established by clinical examinaion either by otoscopic evidence of the tick itself, or its fecal remnant. We report a case of patient with acute labyrinthitis features with concurent otoscopic findings of tick fecal material.

Matched MeSH terms: Tick Infestations/diagnosis*
Fulltext Serological evidence of hantavirus infections in Malaysia

Lam SK, Chua KB, Myshrall T, Devi S, Zainal D, Afifi SA, et al.

Southeast Asian J Trop Med Public Health, 2001 Dec;32(4):809-13.
PMID: 12041558

Hantaviruses are primarily rodent-borne and transmission is by inhalation of virus-contaminated aerosols of rodent excreta, especially urine and saliva. The genus Hantavirus, family Bunyaviridae, comprises at least 14 serotypes and the symptoms of clinical illness range from mild fever to severe hemorrhagic manifestations with renal complications. Many countries in Southeast Asia are unaware of the importance of hantavirus infections and give them low priority. Malaysia, like other countries in the region, has conducted very few studies on the epidemiology of hantaviruses - and even these were conducted in the 1980s. Using a more extensive range of hantavirus antigens, we conducted a seroprevalence study of rodents and humans and found further evidence of hantavirus infections. Moreover, the data from the antibody profiles strongly suggest the presence of different hantaviruses at the study sites.

Matched MeSH terms: Hantavirus Infections/diagnosis*
Fulltext Diagnosis of malaria by enzymatic detection of polymerase chain reaction products

Normaznah Y, Furuta T, Saniah K, Noor Rain A, Kojima S, Mak JW

Southeast Asian J Trop Med Public Health, 1997 Jun;28(2):432-3.
PMID: 9444035
Matched MeSH terms: Malaria/diagnosis*
False-positive widal test in nontyphoid Salmonella infections

Pang T, Pothocheary SD

Southeast Asian J Trop Med Public Health, 1989 Mar;20(1):163-4.
PMID: 2672364
Matched MeSH terms: Salmonella Infections/diagnosis*
A dot enzyme immunoassay for dengue 3 virus: comparison with the haemagglutination inhibition test

Cardosa MJ, Noor Sham S, Tio PH, Lim SS

Southeast Asian J Trop Med Public Health, 1988 Dec;19(4):591-4.
PMID: 3238470

A dot enzyme immunoassay (DEIA) was used to determine the levels of antibody to dengue 3 virus in the acute and convalescent sera of febrile patients with a clinical diagnosis of dengue fever or dengue haemorrhagic fever. The antibody titres were compared with titres determined by the haemagglutination inhibition (HI) test. The results of the study showed that, besides being more simple to perform, the DEIA is in order of magnitude more sensitive than the HI test. Furthermore, the data suggest that it is possible to use a single dilution as a cutoff point to predict with reasonable accuracy, if a patient has had a recent dengue infection. The DEIA test for antibodies to dengue virus is an appropriate technology highly suitable for rapid diagnosis and surveillance in developing countries.

Matched MeSH terms: Dengue/diagnosis*
Dirofilaria causing eye infection in a patient from Malaysia

Rohela M, Jamaiah I, Hui TT, Mak JW, Ithoi I, Amirah A

Southeast Asian J Trop Med Public Health, 2009 Sep;40(5):914-8.
PMID: 19842373

Human dirofilariasis caused by Dirofilaria immitis and Dirofilaria repens have been reported in Malaysia. This is the fourth reported case of dirofilariasis caused by D. repens. The patient was a Chinese male from Kuching Sarawak, Malaysia who presented with a one day history of redness and itchiness over the temporal aspect of his left eye. A worm was seen and later removed from beneath the conjunctiva under local anesthesia and based on the morphological characteristics, it was identified as an immature Dirofilaria repens.

Matched MeSH terms: Dirofilariasis/diagnosis*
Fulltext A second case of diphyllobothriasis in Malaysia

Rohela M, Jamaiah I, Goh KL, Nissapatorn V

Southeast Asian J Trop Med Public Health, 2006 Sep;37(5):896-8.
PMID: 17333730

Diphyllobothriasis was first reported in Malaysia in 2002. We are reporting a second case of diphyllobothriasis in Malaysia. The patient was a 37-year-old Chinese male seen at the outpatient clinic with a complaint of passing strands of white color flat worm in his stool. He had no other abdominal complaints. Laboratory and physical examinations were normal. Diphyllobothrium latum was confirmed by examination of the gravid proglottids passed out and the typical operculated eggs expelled from the ruptured proglottids. The patient had a history of eating raw fish. He was treated with a single dose of praziquantel.
Study site: Outpatient clinic, University Malaya Specialist Center (UMSC), Kuala Lumpur, Malaysia

Matched MeSH terms: Diphyllobothriasis/diagnosis*
Fulltext Thalassemia among blood donors at the Hospital Universiti Sains Malaysia

Rosline H, Ahmed SA, Al-Joudi FS, Rapiaah M, Naing NN, Adam NA

Southeast Asian J Trop Med Public Health, 2006 May;37(3):549-52.
PMID: 17120978

The aim of this study was to screen and identify the types of thalassemia among blood donors at the Hospital Universiti Sains Malaysia (HUSM). Thalassemia screening was performed by hemoglobin electrophoresis. A total number of 80 blood samples were obtained from donors at the Transfusion Medicine Unit, HUSM. The ethnic origins of the donors were Malays (n=73, 91.3%) and non-Malays (n=7, 8.75%). Males comprised 88.1% of the donors. Thalassemia was detected in 16.25% (n=13) of the blood donors. Of those with thalassemia, 46.2% (6/13) were anemic. Microcytosis and hypochromia were detected in 84.6% (n=l1) and 84.6% (n=l1) of these donors, respectively. The types of thalassemias detected were Hb E, 11.25% (n=9/80) and beta thalassemia trait, 5% (n=4/80). Among the thalassemias detected, the Hb E hemoglobinopathy was comprised of Hb E/ alpha-thalassemia (38.5%: n=5), Hb E /beta-thalassemia (23.1%: n=3), Hb E trait (7.6%: n=1) and beta-thalassemia (30.8%: n=4). In conclusion, screening for thalassemia trait should be included as part of a standard blood testing before blood donation. Further studies are required to look at the effects of donated thalassemic blood.

Matched MeSH terms: Thalassemia/diagnosis
Epidemiology of intussusception in Malaysia: a three-year review

Giak CL, Singh HS, Nallusamy R, Leong TY, Ng TL, Bock HL

Southeast Asian J Trop Med Public Health, 2008 Sep;39(5):848-55.
PMID: 19058579

This study aimed to document the baseline incidence and epidemiology of intussusception (IS) in Malaysia. This retrospective surveillance examined hospital discharge data from three hospitals in Malaysia to identify IS cases over a 3-year period (2000-2003) in children <5 years of age. Identification of definite cases of IS was done through a search of computerized hospital discharge records (ICD-9-CM code 560.0) followed by confirmation of diagnosis through medical record review. The definition of IS was based on the clinical guidelines from the IS Brighton Collaboration Working Group, version 2002. During the 3-year study period, there were 62 cases hospitalized due to IS, of which 74.2% were < 1 year of age. The incidences for hospitalization due to IS in children < 1 year old and < 5 years old averaged 17.8 and 4.8 per 100,000 person-years, respectively. No IS-associated deaths were recorded and all IS cases had a favorable outcome. No distinct seasonality with IS occurrence was observed.

Matched MeSH terms: Intussusception/diagnosis
Does automation play a role in coagulation studies in Southeast Asian countries

George E

Southeast Asian J Trop Med Public Health, 1979 Sep;10(3):319-20.
PMID: 515794
Matched MeSH terms: Blood Coagulation Disorders/diagnosis
Bleeding manifestations in snake bite

Devaraj T

Southeast Asian J Trop Med Public Health, 1979 Jun;10(2):255-7.
PMID: 524151

Bleeding following bites by the Malayan Pit Viper can either be local or systemic. Bleeding at the site of the bite is due to the local action of the venom as a vasculotoxin. Systemic bleeding occurs with severe poisoning and appears to be mainly dependent on platelet deficiency and the co-existing defibrination syndrome appears to play a minor role in the initiation of bleeding. Thus in the clinical situation non-clotting blood with no overt bleeding can continue up to weeks when specific antivenene is not given. Assessment of the severity of poisoning can easily be made at the bedside. Specific viper antivenene rapidly corrects the spontaneous bleeding and clotting defect of severe systemic poisoning but has no effect on local poisoning.

Matched MeSH terms: Snake Bites/diagnosis
Development of a dot enzyme immunoassay for dengue 3: a sensitive method for the detection of antidengue antibodies

Cardosa MJ, Hooi TP, Shaari NS

J Virol Methods, 1988 Oct;22(1):81-8.
PMID: 3058737

Partially purified DEN3 virus was used as antigen in a sensitive dot enzyme immunoassay (DEIA) for the detection of antibodies to flavivirus antigens. We describe here the method used to prepare and optimise the antigen-bearing nitrocellulose membranes and present the results obtained from screening 20 acute phase sera from patients shown to have had recent dengue infections by the haemagglutination inhibition (HI) test. Sixteen pairs of acute and convalescent sera from dengue-negative patients had no detectable antibody to dengue virus by HI. These were shown to have no antibody detectable by DEIA. Sera positive for dengue antibodies by HI had DEIA titers ranging from 10 to several thousand times greater than the titers detected by HI.

Matched MeSH terms: Dengue/diagnosis
Fulltext Plasmodium cynomolgi as Cause of Malaria in Tourist to Southeast Asia, 2018

Hartmeyer GN, Stensvold CR, Fabricius T, Marmolin ES, Hoegh SV, Nielsen HV, et al.

Emerg Infect Dis, 2019 10;25(10):1936-1939.
PMID: 31538931 DOI: 10.3201/eid2510.190448

We report human infection with simian Plasmodium cynomolgi in a tourist from Denmark who had visited forested areas in peninsular Malaysia and Thailand in August and September 2018. Because P. cynomolgi may go unnoticed by standard malaria diagnostics, this malaria species may be more common in humans than was previously thought.

Matched MeSH terms: Malaria/diagnosis

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