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Introduction: Majority of individuals who acquire Acanthamoeba keratitis are contact lens wearers. A number of disinfection solutions are completely ineffective against Acanthamoeba, especially in its cysts form. Acanthamoeba keratitis could be prevented by the adequate use of an effective disinfection system. Objectives: This study investigates the effectiveness of Oxysept® 1-Step lens disinfecting solution against 4 clinical isolates of Acanthamoeba sp., based on the soaking time recommended by the manufacturer and soaking times of 4 hours, 6 hours and 8 hours. Materials and Methods: Cyst suspensions were prepared using Acanthamoeba cysts grown on Non-Nutrient Agar (NNA) for 10 days at 30°C (± 2°C). Oxysept® 1-Step contact lens disinfecting solution was used to determine its effectiveness as anti-Acanthamoeba agent. Cyst suspensions of each isolate were tested based on the manufacturers' recommended soaking time, 4 hours, 6 hours and 8 hours respectively. After the soaking time, 100 pi cyst suspension of each isolate was cultured onto NNA plates seeded with E. coli at 30°C (± 2°C) and observed daily for 14 days under an inverted microscope to detect the presence of trophozoites. Results: Oxysept® 1- Step was successful at inactivating the cysts of all the Acanthamoeba spp. isolates tested within all the testing times. Oxysept® 1- Step showed high anti-Acanthamoeba activity. Conclusion: Contact lens disinfecting solutions using hydrogen peroxide systems are probably the best choice for contact lens wearers in preventing Acanthamoeba keratitis. [ABSTRACT FROM AUTHOR]

Giardia intestinalis is among the protozoa that is commonly found in the human fecal samples throughout the world. The prevalence of infection is higher among people living in developing countries than developed countries. One hundred and eleven Orang Asli children at Pos Titom, Pahang participated in this study. The prevalence study was conducted in accordance to gender, age groups and the diagnostic techniques employed. Fecal samples were collected and examined for the presence of G. intestinalis using three diagnostic techniques ie; the direct fecal smear, formalin-ether concentration and the trichrome staining technique. The overall prevalence of G. intestinalis infection among Orang Asli children at Pos Titom was 23.42%. The infection was higher among females (25%) as compared to males (21.57%) eventhough it was not statistically significant (p > 0.05). In terms of age groups, no positive case was observed among preschoolers whose age were below seven-years while the school aged children (7 to 12-years old) showed 24.53% infection. The trichrome staining technique was the most sensitive with a detection rate of 22.52% followed by the formalin-ether concentration technique with a detection of 19.82% whilst the direct smear technique only detected 12.61% of cases. The prevalence of giardiasis amongst the Orang Asli children at Pos Titom, Pahang was still high despite various efforts made and improvements in basic infrastructural facilities undertaken for their community. The health care status and personal hygiene of Orang Asli children remains poor and needs to be further improved. [ABSTRACT FROM AUTHOR]

Introduction: The association between Acanthamoeba keratitis and contact lens wear is now firmly established. Thus, the use of contact lens disinfecting solutions effective at killing Acanthamoeba organisms is important in preventing corneal infections. However the effectiveness of commercially available contact lens disinfecting solutions as anti-Acanthamoeba is doubtful. Objective: This study investigates the effectiveness of Meni Care Plus and Opti-Free® Express® against 4 clinical isolates of Acanthamoeba sp., to determine their efficacy based on the soaking times recommended by the manufacturers and soaking times of 4 hours, 6 hours and 8 hours. Materials and methods: Cyst suspensions were prepared using Acanthamoeba cysts grown on Non-Nutrient Agar (NNA) for 11 days at 30°C (± 2°C). Meni Care Plus and Opti-Free® Express® were tested to determine their effectiveness as anti-Acanthamoeba agents. Cyst suspensions of the isolates were exposed to each contact lens disinfecting solution based on the manufacturers' recommended soaking time, 4 hours, 6 hours and 8 hours respectively. After the soaking time, 100 pi cyst suspension of each isolate was cultured onto NNA plates seeded with E. coli at 30°C (± 2°C) and observed daily for 14 days under an inverted microscope to detect the presence of trophozoites. Results: Meni Care Plus was successful at inactivating cysts of two clinical isolates after soaking for 6 hours and 8 hours. Opti-Free® Express® was ineffective at inactivating the Acanthamoeba cysts within the testing times. Conclusion: Meni Care Plus displayed partial effectiveness as anti -Acanthamoeba. Most commercially available contact lens disinfecting solutions are ineffective as anti-Acanthamoeba agents. [ABSTRACT FROM AUTHOR]

Introduction: Acanthamoeba spp. are free-living protozoan parasites that can cause painful, severe ocular inflammation and sight-threatening keratitis. Acanthamoeba keratitis is a widespread infectious corneal disease that has been reported worldwide. Objective: This study investigates the effectiveness and the range of minimum cysticidal concentration (MCC) of four antimicrobial agents in therapeutic doses; 0.02% chlorhexidine, 0.1% propamidine isethionate (Brolene®), 0.3% ciprofloxacin and 0.3% gentamicin against 4 clinical isolates of Acanthamoeba. Four isolates of Acanthamoeba cysts being used were derived from clinical cases (HKL 95, HKL 109, HS 5 and HS 6). Materials and methods: Serial doubling dilutions of the antimicrobial agents were performed in microtiter plates. After exposure of the four Acanthamoeba isolate cysts to the four antimicrobial agents for 24 hours, the cysts were washed three times with PAS and centrifuged. The deposits (cysts) were cultured onto non-nutrient agar coated with heat-killed Escherichia coli. The excystment of trophozoites from cysts was observed and recorded microscopically for 14 days to determine the MCC value of each drug. Results: Results of this study showed that chlorhexidine, propamidine isethionate, ciprofloxacin and gentamicin successfully exhibited their cysticidal activities in therapeutic doses on all isolates. The values of MCC for chlorhexidine, propamidine isethionate, ciprofloxacin and gentamicin varied from 6.25 to 25 pg/ml, 125 to 250 pg/ml, 1500 to 3000 pg/mi and 1500 to 3000 pg/ml, respectively. Moreover, chlorhexidine, propamidine isethionate, ciprofloxacin and gentamicin were found to exhibit cysticidal activities with their mean MCC values of 17.2 ± 9.4 pg/ml, 156.3 ± 62.5 pg/ml, 2625 ± 750 pg/ml and 1875 ± 750 pg/ml, respectively. Conclusion: The in vitro sensitivity test can be used as a standard test to determine values of MCC of drugs on Acanthamoeba isolates and to study the susceptibility pattern of anti-Acanthamoeba drugs. Chlorhexidine and Propamidine isethionate exhibited the best anti-Acanthamoeba activity and are therefore highly recommended for use in the treatment of Acanthamoeba keratitis. [ABSTRACT FROM AUTHOR]

One hundred seventy-one patients suffering from chronic renal diseases at Kuala Lumpur Hospital participated in a crosssectional study with purposive sampling to ascertain prevalence rates of Cryptosporidium parvum (C. parvum), Giardia intestinalis (G. intestinalis), Blastocystis hominis (B. hominis) and Strongyloides stercoralis (S. stercoralis). The patients were divided into 2 groups: post-transplant group (138 patients) and pre-transplant group (33 patients). In this study, the parasite infection is linked to the aspects of race, gender, renal patient's group and the postrenal transplantation period. Immunofluorescence staining was performed on fecal slides for the detection of C. parvum oocysts and G. intestinalis cysts. Sand charcoal culture technique was also used to detect the presence of S. strongyloides in fecal samples. The findings showed that the prevalence of C. parvum, G. intestinalis dan B. hominis among post-transplant patients was 18.1%, 10.9% and 22.5%, respectively but none of the pretransplant patient was infected. Meanwhile, both patient groups were free of S. stercoralis infection. Furthermore, there was no significant association between post-transplantation period and pattern in prevalence of the studied parasites, however, it was noted that the prevalence rates of C. parvum and G. intestinalis had declined after 6 months post transplantation. [ABSTRACT FROM AUTHOR]

Introduction: Hookworm infestation is one of the most common intestinal parasitic infections which cause anemia and malnutrition, mainly affecting those with poor socioeconomic status. Hookworm infection is still widely prevalent among aborigines in Malaysia. Objective: This study was conducted to investigate the prevalence of hookworm infestation among the Orang Asli (aboriginal) children at Pos Lenjang, Pahang, Malaysia Materials & methods: Cross-sectional study was carried out among 71 volunteered aboriginal children aged between 1 to 12 years old (31 boys and 40 girls). The stool specimens were collected and screened for hookworm ova by the direct faecal smear method followed by formalin ether concentration technique. Results: The overall prevalence of hookworm infestation in this population is 14.1%. The highest infection rate was observed in school children aged between 7 - 12 years (24.3%) with males (19.4%) dominating over females (10%). The formalin ether concentration technique had shown a higher percentage of detection (90%) for hookworm ova as compared to the direct faecal smear (20%). Conclusion: Hookworm infestation among the aboriginal children at Pos Lenjang, Pahang still indicates a relatively low health standard of this indigenous community. Improving socioeconomic status, including enhanced access to quality health care and adequate sanitation has the potential to significantly reduce the prevalence and intensity of this infection. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the prevalence of candidiasis among women of 20 to 59 years of age at Sarawak General Hospital by examining the conventional Pap smear. The prevalence of this infection was studied among the five main ethnic groups comprising of Iban, Chinese, Malay, Bidayuh and Orang Ulu. Microscopic screening of 300 conventional Pap smears which had been processed and stained with the Papanicolaou staining method was conducted. Based on the information provided in the Pap smear screening form, the clinical manifestations were observed which may provide some indications on the type of infection. The details of the clinical manifestations were very important because in an infection or inflammation, Pap smears would usually demonstrate the cyto-morphological changes of the epithelial cells. The age factor among the different ethnics also plays important role in the assessment of the infection frequency. Candida sp. was detected in 12.7% of the specimens. The infection occurred in all ethnic groups as well as in all age groups. All cases presented with clinical signs and symptoms. The results of this study revealed the importance of undergoing Pap smear screening for candidiasis detection besides screening for the early detection of cervical cancer. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the prevalence of bacterial vaginosis among women of age 20 to 59 years at Sarawak General Hospital by examining the conventional Pap smear. The prevalence of this infection was studied among the five main ethnic groups comprising the Iban, Chinese, Malay, Bidayuh and Orang Ulu. Microscopic screening of 300 conventional Pap smears which had been processed and stained with the Papanicolaou staining method was conducted. Based on the information provided in the Pap smear screening form, the clinical manifestations were observed which may provide some indications on the type of infection. The details of the clinical manifestations were very important because in an infection or inflammation, Pap smears would usually demonstrate changes on the cyto-morphology of the epithelial cells. The age factor among the different ethnics also played important role in the assessment of the infection frequency. Bacterial vaginosis was detected in 79.7% (239/300) of cases. The infection occurred in all ethnic groups and the infections were more frequently seen among the 20 to 39 years age group. Majority of the cases (93.9%) presented with clinical signs and symptoms. The results of this study revealed the importance of undergoing a Pap smear screening for bacterial vaginosis detection besides screening for the early detection of cervical cancer. [ABSTRACT FROM AUTHOR]

Serotyping is not sufficient to differentiate between Salmonella species that cause paratyphoid fever from the strains that cause milder gastroenteritis as these organisms share the same serotype Salmonella Paratyphi B (S. Paratyphi B). Strains causing paratyphoid fever do not ferment d-tartrate and this key feature was used in this study to determine the prevalence of these strains among the collection of S. Paratyphi B strains isolated from patients in Malaysia. A total of 105 isolates of S. Paratyphi B were discriminated into d-tartrate positive (dT+) and d-tartrate negative (dT-) variants by two lead acetate test protocols and multiplex PCR. The lead acetate test protocol 1 differed from protocol 2 by a lower inoculum size and different incubation conditions while the multiplex PCR utilized 2 sets of primers targeting the ATG start codon of the gene STM3356. Lead acetate protocol 1 discriminated 97.1% of the isolates as S. Paratyphi B dT+ and 2.9% as dT- while test protocol 2 discriminated all the isolates as S. Paratyphi B dT+. The multiplex PCR test identified all 105 isolates as S. Paratyphi B dT+ strains. The concordance of the lead acetate test relative to that of multiplex PCR was 97.7% and 100% for protocol 1 and 2 respectively. This study showed that S. Paratyphi B dT+ is a common causative agent of gastroenteritis in Malaysia while paratyphoid fever appears to be relatively uncommon. Multiplex PCR was shown to be a simpler, more rapid and reliable method to discriminate S. Paratyphi B than the phenotypic lead acetate test. [ABSTRACT FROM AUTHOR]

Introduction: Acanthamoeba keratitis is known as one of the most painful and progressive sight-threatening ocular parasitic infectious diseases. If not diagnose early and treated aggressively, it may cause severe ocular inflammation and visual loss. In vitro studies on the susceptibility of Acanthainoeba isolates may prove beneficial for application of early treatment regimens. The aims of the present study were to determine the effectiveness of the drugs in therapeutic dose and the minimum cysticidal concentrations (MCC5) of the drugs on Acanthamoeba isolates from Malaysia. Materials and Methods: Serial doubling dilutions of chlorhexidine digluconate from 200 μg/ml to 0.0977 μg/ml, propamidine isethionate (Brolene®) from 1000 μg/ml to 0.4883 μg/ml and gentamicin from 40000 μg/ml to 19.5313 μg/ml were performed in microtiter plate and tested against three Acanthainoeba isolates which were isolated from peat soil. After the exposure of the cysts to the drugs for 24 hours, the cysts were washed free of drugs by centrifugation. The deposit (cysts) was cultured onto non- nutrient agar plates overlaid with heat-killed Eschericlzia coli. The growth and replication of the trophozoites from cysts exposed to each of the dilutions were observed and recorded microscopically for 14 days to determine the MCC of each drug. The effectiveness of the drugs in therapeutic dose against the cysts was tested directly without any doubling dilutions. Results: Chlorhexidine digluconate and propamidine isethionate (Brolene®) successfully demonstrated their cysticidal activi- ties in therapeutic dose but not for gentamicin and chloramphenicol. The minimum cysticidal concentration (MCC) of chlorhex- idine ranged from 6.25 μg/ml to 25 pg/ml, propamidine isethionate was 1000 μg/ml and gentamicin 10000 11g/ml. The mean MCC of chlorhexidine, propamidine isethionate and gentamicin on Acanthamoeba isolates was 12.50 ± 10.82 μg/ml, 1000.00 g/ml and 10000.00 μg/ml, respectively. From this study, it was clear that there were major differences between the four tested drugs in the in vitro susceptibility test on the Acanthainoeba spp. Conclusion: The present study has indicated that the in vitro susceptibility test has enabled the determination of MCC of drugs on Acanthamoeba isolates. The tested drugs with the MCC values can be considered alone or in combination as potential anti-acanthamoebal therapeutic agents for the treatment of the Acantharnoeba keratitis. [ABSTRACT FROM AUTHOR]

Introduction: Intestinal parasitic infections still continue to be the most common cause of chronic infections, in communities living in resource poor countries situated in the tropics and subtropics. This study was undertaken to investigate the prevalence of cryptosporidiosis amongst the Orang Asli (aborigine) children at Sg. Rual Post, Jeli, Kelantan. Materials and Methods: In this study, 111 Orang Asli primary school children aged 4-12 years were screened for the presence of Cryptosporidium oocysts in faecal samples using the Modified Ziehl-Neelsen staining technique. Results: Based on a single stool sample, 34.2% (38/111) of the overall population had cryptosporidiosis comprising of 35.8% (24/67) females and 31.8% (14/44) males. This indicates a high prevalence of this infection among the Orang Asli community of Post Sungai Rual. There was no significant difference in the prevalence of cryptosporidiosis between age and sex of the children who participated in this study. The high prevalence of cryptosporidiosis in this community may be attributed to their poor personal hygiene, socioeconomic status, living conditions, educational background and the lack of safe water supply. Conclusion: The high prevalence of cryptosporidiosis in this community warrants a spotlight on it as a public health problem. Public health personnel need to re-look at the current control measures and identify innovative and integrated ways in order to reduce cryptosporidiosis significantly and it is recommended that routine screening of stool samples for parasites should include the detection of Cryptosporidium. [ABSTRACT FROM AUTHOR]

Introduction: Contact lens wear is a major risk factor for Acanthamoeba keratitis. Disinfection solutions effective at killing Acanthamoeba organisms are important in preventing corneal infection. This study was therefore performed to gain insight into how commercial contact lens disinfecting solutions affect cysts of a clinical isolate of Acanthamoeba castellani. Materials and Methods: Three brands of multipurpose contact lens disinfecting solutions currently available in the market consisting of Boston SIMPLICITY™, Opti-Free Express® and Complete™ were tested. Suspension of cysts was exposed to the disinfecting solutions at intervals varying from 4 to 8 hours and later cultured onto non-nutrient agar Iawned with Escherichia coli for the growth of Acanthamoeba trophozoites. Results: All three multipurpose contact lens disinfecting solutions (Boston SIMPLICITY™, Opti-Free Express® and Complete™) showed no effect on Acanthamoeba castellani cysts in time suggested by the manufacturers but Boston SIMPLICITY™ was effective at inactivating the cysts at 8 hours. Conclusion: This study has proven that though contact lens disinfecting solutions have antimicrobial properties, not all are effective against Acanthamoeba cysts. Boston SIMPLICITY™ showed its effectiveness when the exposure time is extended to 8 hours. [ABSTRACT FROM AUTHOR]

Introduction: Disinfections of contact lens play a crucial part in eliminating Acanthamoeba keratitis. This study was therefore performed to evaluate the effectiveness of contact lens disinfecting solutions on cysts of Acanthamoeba castellani derived clinically from keratitis case based on the exposure times suggested by manufacturers, 4 hours and 8 hours. Materials and Methods: Three brands of multipurpose contact lens disinfecting solutions currently available in the market consisting of Freshlook All in One™, Solo Care® Plus' and Renu Multi-Plus® were tested. Suspension of cysts was exposed to the disinfecting solutions at intervals varying from 5 minutes to 8 hours and later cultured onto non-nutrient agar lawned with Escherichia coli for the growth of Acanthamoeba trophozoites. Results: All three multipurpose contact lens disinfecting solutions (Freshlook All in One™, Solo Care® Plus' and Renu Multi-Plus®) showed no effect on Acanthamoeba castellani cysts in time suggested by the manufacturers, 4 hours, and 8 hours. Conclusion: This study has proven that though contact lens disinfecting solutions have antimicrobial properties, not all are effective against Acanthamoeba cysts. The search for a solution which is effective against Acanthamoeba cysts would be desirable for contact lens wearers. [ABSTRACT FROM AUTHOR]

A study on the isolation and identification of bacterial flora from hot spring was carried out using water from Bentong hot spring in Pahang. In general most of the bacteria identified from the hot springs were from Bacillus sp. This was due to its ability to adapt to high temperature mainly by forming endospore. The objective of this study was to identify bacteria other than Bacillus that were able to survive in hot springs. Three hot spring pools were identified (A,B and C) with temperatures ranging from 36°C to 52°C and pH values between 7.88-8.65. This study has succesfully isolated two species of Gram positive cocci and three species of Gram negative bacilli. The two Gram positives were Streptococcus sp. and Staphylococcus sp. The three species of Gram negative rods were unidentified and were denoted as X, XI and XII. [ABSTRACT FROM AUTHOR]

Introduction: Acanthamoeba keratitis is one of the most severe and potentially sight-threatening ocular parasitic infectious diseases and is recognized as the most challenging among ocular infections. In vitro susceptibility testing of Acanthamoeba isolates may prove beneficial for application of early treatment regimens. This study was conducted to determine the effectiveness of the drugs in therapeutic dose and the minimum cysticidal concentrations (MCCs) of the drugs. Materials and Methods: Serial doubling dilutions of chlorhexidine digluconate from 200 µg/ml to 0.0977 µg/ml, propamidine isethionate (Brolene®) from 1000 µg/ml to 0.4883 µg/ml and gentamicin from 40000 µg/ml to 19.5313 µg/ml were performed in microtiter plate and tested against 3 Acanthamoeba isolates which were isolated from keratitis cases. After the exposure of the cysts to the drugs for 24 hours, the cysts were washed free of drugs by centrifugation. The deposit (cysts) was cultured onto nonnutrient agar plates overlaid with heat-killed Escherichia coli. The replication and growth of the trophozoites from cysts exposed to each of the dilutions were observed and recorded microscopically for 14 days to determine the MCC of each drug. The effectiveness of the drugs in therapeutic dose against the cysts was tested directly without any doubling dilutions. Results: Chlorhexidine digluconate and propamidine isethionate (Brolene®) successfully exhibited their cysticidal activities in therapeutic dose but not for gentamicin and chloramphenicol. The minimum cysticidal concentration (MCC) of chlorhexidine ranged from 25 µg/ml to 50 µg/ml, propamidine isethionate ranged from 500 µg/ml to 1000 µg/ml and gentamicin ranged from 10000 µg/ml to 20000 µg/ml. The mean MCC of chlorhexidine, propamidine isethionate and gentamicin on Acanthamoeba isolates was 33.33 µg/ml, 666.66 µg/ml and 13333.33 µg/ml respectively. Conclusion: The in vitro sensitivity test enables the determination of MCC of drugs on Acanthamoeba isolates and can be used for the screening of new anti-acanthamoebal therapeutic agents. [ABSTRACT FROM AUTHOR]

Introduction: Intestinal parasitic infections are still a major public health problem among the poor and underprivileged communities in Malaysia. Such infections including ascariasis may contribute to poor cognitive functions and learning ability. Improvements in socioeconomic status in Malaysia have shown positive impact on the reduction of intestinal parasitic infections in other communities, however, this positive impact is less significant in the Orang Asli communities. Objective: This study was undertaken to investigate the prevalence of Ascaris infections amongst the Orang Asli (aborigine) children at Pos Sinderut, Pahang. Materials and Methods: In this study, 272 Orang Asli primary school children aged 7-12 years were screened for the presence of Ascaris lumbricoides in faecal samples using the direct smear technique. Results: 45.6% (124/272) of the overall population had Ascaris lumbricoides infection comprising of 46.8% (67/143) females and 44.2% (57/129) males. This indicates the high level of environmental contamination with human feces and the poor state of personal hygiene and feeding practices of this community. The lower primary school group showed 50.4% infection whereas the higher primary school group showed 42%. Younger children may be particularly susceptible to the adverse effects of A. lumbricoides infections due to their incomplete physical development and their greater immunological vulnerability. Conclusion: The infection rate of Ascaris lumbricoides is high and thus necessitates frequent and periodic deworming among children. Public health personnel need to re-look at the current control measures and identify innovative and integrated ways in order to reduce ascariasis significantly in the rural communities. There is an urgent need to improve the hygiene, education and living standards of this population. [ABSTRACT FROM AUTHOR]

The current study determined the prevalence of intestinal protozoan infections among the Orang Asli schoolchildren in Pos Senderut, Pahang, Malaysia. The overall intestinal protozoan infection rate was 85% (261 out of 307). The highest prevalence rates were due to Entamoeba coli (24.4%), Giardia lamblia (21.8%), Blastocystis hominis (21.2%) and Entamoeba histolytica (15.0%). The prevalence of Iodamoeba butschlii was only 2.9%. Among the positive samples, mixed infection with B. hominis and E. histolytica was 3.3%, B. hominis and G. lamblia was 2.9%, G. lamblia and E. histolytica was 2.0% and triple infections (B. hominis, G. lamblia and E. histolytica) was 1.0 %. The prevalence of the infection was high in all age groups (6-14 years old). Thus, we can conclude that intestinal protozoan infections are still representing a serious public health problem in aboriginal communities, especially among children.