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

A prospective study was carried out to evaluate the sensitivity of dengue NS1 antigen-capture ELISA in comparison with dengue virus isolation, conventional RT-PCR and real-time RT-PCR for laboratory confi rmation of acute dengue based on single-acute serum samples. Four primary healthcare centres were involved to recruit patients with clinical diagnosis of dengue illness. Patient’s demographic, epidemiological and clinical information were collected on a standardized data entry form and 5 ml of venous blood was collected upon consent. In the laboratory, six types of laboratory tests were performed on each of the collected acute serum sample. Of the 558 acute serum samples collected from 558 patients with clinical diagnosis of dengue from mid-August 2006 to March 2009, 174 serum samples were tested positive by the dengue NS1 antigen-capture ELISA, 77 by virus isolation, 92 by RT-PCR and 112 by real-time RT-PCR. A total of 190 serum samples were tested positive by either one or a combination of the four methods whereas, only 59 serum samples were tested positive by all four methods. Thus, based on singleacute serum samples, 190 of the 558 patients (34.1%) were laboratory-confi rmed acute dengue. The overall test sensitivity was 91.6%, 40.5%, 48.4% and 58.9% for dengue NS1 antigen-capture ELISA, virus isolation, conventional RT-PCR and real-time RT-PCR respectively. Statistically, dengue NS1 antigen-capture ELISA was the most sensitive and virus isolation was the least sensitive test for the laboratory confi rmation of acute dengue based on single-acute serum specimens. Real-time RT-PCR was signifi cantly more sensitive than the conventional RT-PCR.

Ganglion cysts are tumor-like lesions in the soft tissues, generated by mucoid degeneration of the joint capsule, tendon or tendon sheaths on the dorsum of hand, wrist and foot. However, an intratendinous origin for a ganglion cyst is extremely rare. During dissection of the popliteal fossa, a cyst of 2.5 cmx2 cmx0.5 cm was observed in the tendon of right semimembranosus, 3.5 cm above the insertion of the muscle. Contrast X-ray revealed the cyst as not communicating with the knee joint or any adjacent bursae. Histopathological examination confirmed the diagnosis of ganglion cyst.
Diagnosis ; Foot ; Ganglion Cysts* ; Hand ; Joint Capsule ; Knee ; Knee Joint ; Tendons ; Wrist

Soil-transmitted helminth (STH) could possibly cause mild to severe health effects such as diarrhea, weakness, intestinal blood loss, and impaired cognitive development and growth. In Malaysia, previous studies depicted a high prevalence rate of STH was due to poor hygiene practice and low efficacies of anthelminthic drugs. This study was conducted to investigate hand hygiene practice and WASH criteria’s (Water, sanitation and hygiene) related to STH infection among two indigenous tribes in Peninsular Malaysia. A cross-sectional study was carried out to study the relationship among STH infection compared to water quality, sanitation, and hygiene conditions. A total of 190 individuals from two indigenous villages participated in the study, with ages ranging from 5 to 60 years old. In addition, Pearson’s Chisquare (X2) test was utilized to test the relationship among STH with demographic socioeconomic and behavioral factors. The confidence interval (CI) of 95% is used to estimate the precision of the odds ratio (OR). Multivariate logistic regression models were also used to identify the risk factors associated with STH infections. The overall findings indicated a prevalence rate of 72% for STH, and distributed mainly among children aged < 12 years. Furthermore, multivariate analyses using logistic regression revealed chronic health problems, incorrect hand washing, and walking bare footed were associated with STH infection. Overall results indicated high prevalence of STH among the indigenous villagers, which aligns with the published literature and proves to be a problem need to be addressed as neglected disease. Interestingly, there was a significant relationship between the presences of chronic diseases and STH infection, which prompted other questions the awareness needs to be educated and the simple and low-cost intervention on the proper way of hand washing may help to reduce STH infection in these indigenous communities.