trends ; Drug Addiction

An outbreak of rubella occurred amongst 303 newly recruited residential Form IV students in a military vocational training school in Malaysia. Of the 303 Form IV students, 77 gave a history of acute illness. Rubella specific IgM was detected in the sera of 46.5% (141/303) whereas rubella specific IgG was detected in 100% of all Form IV students. Sixty five students with no clinical history of acute illness during the outbreak period had detectable rubella IgM in their sera and rubella specific IgM was detected in the sera of all symptomatic students except one. Maculopapular rash was the commonest presenting clinical feature among students with acute rubella infection in this outbreak (97.4%) followed by fever (88.2%). The duration of rash ranged from one to nine days with a mean of 4.6 days. Of the 65 students that had both fever and rash, 56 (85.2%) students had maculopapular skin eruption on the same day as the date of onset of fever, six (9.2%) developed the rash a day after the onset of fever and three (4.6%) had the rash after two days of fever. The duration of fever ranged from one to eight days with a mean of 3.5 days. The duration of conjunctivitis ranged from one to four days with a mean of 2.3 days, and all those who developed conjunctivitis had mild eye-discharge without photophobia. The duration of arthralgia ranged from one to three days with a mean of 2.1 days. The commonest type of joints affected was knee joints (66.7%, 12/18), followed by elbow and shoulder joints (27.8%, 5/18) and wrist joints (5.6%, 1/18). A good clinical history of the temporal relationship between the occurrence of rash and fever during the outbreak could easily differentiate rubella illness from that of measles.
Rubella ; Fever ; Exanthema ; Roman Numeral IV ; Manufactured form

Introduction: Gestational diabetes mellitus (GDM) increases risks for type 2 diabetes and cardiovascular diseases. Low glycaemic index (GI) diets improve cardio-metabolic outcomes in insulin-resistant individuals. We examined the feasibility of lowering GI through GI-based-education among Asian post-GDM women. Methods: A 3-month investigation was carried out on 60 Malaysian women with a mean age of 31.0±4.5 years and a history of GDM. Subjects were randomised into two groups: LGIE and CHDR. The CHDR group received conventional healthy dietary recommendations only. The LGIE group received GI based-education in addition to conventional healthy dietary recommendations. At baseline and after 3-months, dietary intake of energy and macronutrient intakes including GI diet and glycaemic load was assessed using 3-day food records. Diabetes-Diet and GI-concept scores and physical activity levels were assessed using a questionnaire. Adherence to dietary instructions was measured at the end of 3 months. Results: At the end of 3 months, the LGIE group had significant reductions in energy intake (241.7±522.4Kcal, P=0.037, ES=0.463), total carbohydrate (48.7±83.5g, P=0.010, ES=0.583), GI (3.9±7.1, P=0.017, ES=0.549) and GL (39.0±55.3, P=0.003, ES=0.705) and significant increases in protein (3.7±5.4g, 0.003, ES=0.685) and diet fibre (4.6±7.3g, P=0.06). The CHDR group had a significant reduction in fat only (5.7±9.4g, P=0.006, ES=0.606). There was a 30% increase in GI-concept scores in the LGIE group (p< 0.001). Changes in GI-concept scores correlated significantly to the reduction in dietary GI (r = -0.642, P=0.045). Dietary adherence was comparable in both groups. Conclusion: GI-education improves GI-concept knowledge and helps lower dietary glycaemic index among women with a history of GDM.

We reviewed the current human immunodeficiency virus (HIV) prevention education programmes in Singapore, discussed the challenges faced and proposed prevention education interventions for the future. Education programmes on HIV prevention have shown some success as seen by reduced visits to sex workers among the general adult population and a marked increase in condom use among brothel-based sex workers. However, we still face many challenges such as low awareness of HIV preventive strategies and high prevalence of HIV stigma in the general population. Voluntary HIV testing and condom use remain low among the priority groups such as men who have sex with men (MSM) and heterosexual men who buy sex. Casual sex has increased markedly from 1.1% in 1989 to 17.4% in 2007 among heterosexuals in Singapore, with the majority (84%) practising unprotected sex. Sex workers have moved from brothels to entertainment venues where sex work is mostly hidden with lack of access to sexually transmitted infections (STIs)/ HIV prevention education and treatment programmes. Education programmes promoting early voluntary testing is hampered because of poor access, high cost and stigma towards people living with HIV. It remains a challenge to promote abstinence and consistent condom use in casual and steady sexual relationships among heterosexuals and MSM. New ways to promote condom use by using a positive appeal about its pleasure enhancing effects rather than the traditional disease-oriented approach should be explored. Education programmes promoting early voluntary testing and acceptance of HIV-infected persons should be scaled up and integrated into the general preventive health services.
Adolescent ; Adult ; Aged ; Female ; HIV Infections ; prevention & control ; transmission ; Health Education ; methods ; Health Knowledge, Attitudes, Practice ; Health Promotion ; Homosexuality, Male ; Humans ; Male ; Mass Screening ; Middle Aged ; Safe Sex ; Sex Work ; Sex Workers ; Singapore ; Young Adult

The aim of this study was to investigate the antiviral property of Eurycoma longifolia Jack (EL) against dengue virus. A propriety standardized extract of Eurycoma longifolia Jack (Physta®) was tested for anti-viral activity after viral adsorption in Vero cell line. Viral yield was measured by qRT-PCR in four serotypes of dengue virus. The antiviral activity was further investigated in an in vivo AG129 mouse model for dengue inhibitory candidates. 100 mg/kg EL extract was fed twice daily and challenged with a lethal dose of (~1x105 PFU per mouse) of DENV-2 over a period of six days. Antiviral activity with IC50 of 33.84, 33.55, 58.35 and 119 μg/ml for DENV-1, DENV-2, DENV-3 and DENV-4 serotypes respectively was observed. The selectivity index (SI) values determined as the ratio of cytotoxic concentration (CC50) to inhibitory concentration (IC50) was the lowest for DENV-2 at 28.9. The dengue virus (DENV) replication measured by qRT-PCR showed a reduction of 100% for DENV-1, DENV-2, DENV-3 and 80% for DENV-4 at day 2 of exposure. In the in vivo AG129 mouse model, a lower weight reduction, 30% lower viral load and 12% higher platelet in the extract group compared to the control was observed at day 6. The extract of E. longifolia has potential anti-dengue properties with improving trends in platelet counts. E. longifolia supplementation is potentially a two-pronged approach in treating dengue fever.

Dengue fever is one of major health problem around the world including Malaysia. It is caused by the arthropode-borne flavivirus and transmitted by the bite of the Aedes aegypti or Aedes albopictus mosquito infected with one of the four dengue virus serotypes (DENV-1, DENV-2, DENV-3, or DENV-4). In this study, a screening exercise of various Malaysian medicinal plants showed that the extracts of Lawsonia inermis, Dryobalanops aromatica, Punica granatum, Zizyphus jujuba Lam. and Zingiber zerumbet exhibited potent inhibitory activity against NS2B-NS3 serine protease. The methanol extracts of Dryobalanops aromatica showed inhibition of 99.70 % at concentration of 200 μg/mL with IC50 value of 0.30 ± 0.16 μg/mL.