Sarcocystosis is a zoonotic disease caused by a coccidian intracellular protozoan parasite of the genus Sarcocystis. More than 200 Sarcocystis species have been recorded and the parasites are found in mammals, birds and reptiles. They require two hosts to complete their life cycle. In Malaysia, sarcocystosis was reported as a potential emerging food and water-borne disease after a series of large outbreak of human infections. There was not enough attention given before even though it was reported in both humans and animals. The first human case of invasive muscular sarcocystosis among local Malaysian was reported in 1975. Besides, a retrospective autopsy examination on 100 tongues revealed 21% positive cases. On top of that, a sero-epidemiological survey conducted in 243 subjects in West Malaysia showed that 19.7% had Sarcocystis antibodies. The clinical symptoms of muscular sarcocystosis were first described comprehensively in 1999. Meanwhile, many types of animals including livestock were found harbor the sarcocysts in their tissue. The first case of human intestinal sarcocystosis was reported in 2014. This review indicates that human sarcocystosis is currently endemic in Malaysia and parallel to that reported in animals. However, more studies and investigations need to be conducted since the source of human infection remains unknown.

Extensive peri acetabular osteolysis caused by malignant disease process is a major surgical challenge as conventional hip arthroplasty is not adequate. We describe a modified use of the Harrington procedure for acetabular insufficiency secondary to metastatic disease in twelve patients. The procedures include application of multiple threaded pins to bridge the acetabular columns, anti protrusio cage and cemented acetabular cup. Eleven patients were able to walk pain free and achieved a mean Musculoskeletal Tumour Society Functional Score of 80 (range, 68 to 86).
orthopaedic

Objective: To evaluate the cytotoxic activity of taraxerol isolated from the leaves of Pterospermum acerifolium and its EtOH extract against human breast, colon, and lung cancer cell lines and docking studies. Methods: The structures of the isolated compounds were elucidated by several spectroscopic methods such as

Objective To investigate the conversion potential of alginate encapsulated nodes of Glycyrrhiza glabra with phyto-chemical evaluation of root extract of field transferred plants. Methods The excised axenic nodal segments were encapsulated in alginate matrix planted on Murashige and Skoog (1962) medium with different supplementation and formulations of PGRs. The two year old field transferred plants were evaluated for phyto-compounds analysis using GC-MS technique. Results Varied responses were observed during the study, maximum conversion 95.83% ± 2.40% was obtained in these encapsulates when planted on MS medium containing 2.5 μM Kinetin and 0.5 μM α-Naphthalene acetic acid, which eventually developed into complete plantlets in a single step. Further, GC-MS analysis showed the presence of different phyto-compounds in the methanolic root extracts of in vitro converted plants. The results obtained revealed the presence of about 47 phyto-compounds along with various potential bioactive compounds useful for industrial and pharmaceutical purposes. Conclusions This study investigates high frequency regeneration and conversion of Glycyrrhiza glabra in a single step in short time. Also, the in vitro raised plants are analysed for bioactive compounds after field transfer, which shows the presence of numerous compounds useful for commercial and pharmacological purposes.

Toxoplasma gondii is a protozoan parasite that can infect all mammals, serving as intermediate hosts. The cause of congenital toxoplasmosis is transplacental transmission of the parasite to the foetus, resulting in wide range of manifestations from mild chorioretinitis to miscarriage. Its frequency can be reduced by early screening of pregnant women which is based mainly on tests for anti-Toxoplasma antibodies. We collected serum samples of 594 pregnant women (subjects) after taking their consent over a period of two years (2016-2018) and analyzed them for anti-Toxoplasma IgG by ELISA. The positive samples were then analyzed for IgG avidity test which could differentiate between recent and past infections. The seroprevalence was also correlated with the age of the subjects and their contact with cats. 162 subjects were found positive out of which only three showed a recent infection. After following up until delivery, one of them delivered a baby who had jaundice and was diagnosed with anti-Toxoplasma IgM at birth. The foetus of the second subject died in-utero, while the third woman delivered a normal baby after being given spiramycin when diagnosed with toxoplasmosis in the first trimester. It was found that most of the positive subjects had frequent contact with cats. Invasion of the parasite during third trimester resulted in death in-utero and jaundice. Most common cause of pregnancy wastage during our study was spontaneous abortions while pregnancy loss due to congenital anomalies was rare.

Objective: To determine the activity of superoxide dismutase (SOD) in the male and female haematophagous caprine worms, Haemonchus contortus infecting Capra hircus, and their E/S products and also to analyse the effect of Haemonchus infection on the level of host SOD. Methods: The SOD activity was analysed by using the pyrogallol autoxidation assay and non-denaturing polyacrylamide gel electrophoresis followed by specific enzyme staining by riboflavin-nitroblue tetrazolium method. Results: The adult females were found to have higher enzyme activity than the male worms. Appreciable amount of SOD activity was also detected in the worm culture medium and female worms secreted more SOD in comparison to the male parasites. The SOD activity was negatively correlated to the worm burden. Statistically significant decrease in SOD activity (P<0.05) was observed in the heavily infected host tissue in comparison to the control non-infected host tissue. SOD profile of the crude extracts of both the sexes revealed polymorphism and a fast migrating activity band being characteristic of E/S products. The SOD activities were found highly sensitive to potassium cyanide indicating the Cu/Zn form of SOD. Conclusions: Haemonchus contortus is a key model parasite for drug and vaccine discovery. The presences of SOD activity in appreciable amount in the parasite as well as its E/S products indicate that it has a well-developed active antioxidant system to protect itself from the host immune attack. SOD could be the target for vaccine development which is the need of the hour as mass drug administration for parasite control has resulted in anthelmintic resistance across the globe and threatens the viability of sheep and goat industry in many regions of the world. The infection with Haemonchus causes a drastic reduction in SOD activity of the host tissue thus effecting its protective potential. One characteristic SOD band was found in the females which was not present in any other preparations and thus could be exploited for further studies on diagnostic/control measures.

The Osteoporosis Self-Assessment Tool for Asians (OSTA) score has been developed to identify women at risk of osteoporosis. It can be used as a screening tool for patients at risk who would benefit from bone mineral density measurement and treatment. It was developed based on data from eight countries including Malaysia. However, most subjects were of Chinese (59%). This study evaluated the performance of OSTA among 152 post-menopausal Malay women. OSTA score calculation and DEXA scan were performed. Our results showed that the OSTA score is a good predictor of patients at risk of osteoporosis based on BMD measurements at the proximal femur. Instrument sensitivity was 87.5%, specificity was 95.8%, positive predictive value (PPV) was 0.538, negative predictive value (NPV) was 0.993, and the area under the receiver operating characteristic curve (ROC) was 0.895. We conclude that use of the OSTA score in postmenopausal Malay women is effective and has adequate sensitivity and specificity.

Traumatic hemipelvectomy is an uncommon and life threatening injury. We report a case of a 16-year-old boy involved in a traffic accident who presented with an almost circumferential pelvic wound with wide diastasis of the right sacroiliac joint and symphysis pubis. The injury was associated with complete avulsion of external and internal iliac vessels as well as the femoral and sciatic nerves. He also had ipsilateral open comminuted fractures of the femur and tibia. Emergency debridement and completion of amputation with preservation of the posterior gluteal flap and primary anastomosis of the inferior gluteal vessels to the internal iliac artery stump were performed. A free fillet flap was used to close the massive exposed area.

Aims: Urinary tract infection (UTI) is a common infection caused by many virulent bacteria. Multidrug resistance (MDR) by bacteria represents a major therapeutic challenge worldwide. MRD bacteria have different mechanisms to avoid antibiotics; one of them is horizontal gene transfer. Such genes, encoding antimicrobial resistance, are easily transferred from one bacterium to another. Magnesium and calcium chloride (MgCl2 and CaCl2) have an effect on the permeability of bacterial cell membrane. We aimed these chemical materials could increase the antibiotics efficiency on multidrug resistance bacteria. 250 UTI specimens were collected to isolate multidrug resistant bacteria. Depending on antibiotics resistance, we selected three species of virulent bacteria: Escherichia coli, Staphylococcus aureus and Proteus mirabilis. Then, we tested the effect of MgCl2 and CaCl2 on their antibiotics resistance. Methodology and results: The results showed that percentage of E. coli in UTI infection is the highest (45%), while Enterococcus faecalis is the lowest (3%). The effect of MgCl2 and CaCl2 on bacterial antibiotics resistance has been tested using different types of antibiotics. The findings showed that MgCl2 has significant effect to aid antibiotics against bacteria. In particular, nalidixic acid has shown more efficiency against E. coli and S. aureus but not P. mirabilis. Using different concentrations of CaCl2 increased the efficiency of gentamycin, amoxicillin and trimethoprim against S. aureus, while has increased the efficiency of ampicillin and nalidixic acid against E. coli. However, CaCl2 has no effect on the efficiency of antibiotics against P. mirabilis. In addition, MgCl2, and CaCl2 had no toxic effects in both T24 and 5637 urinary bladder cell lines. Finally, plasmids were isolated from these species to detect any antimicrobial resistance gene such as qnr-A. Conclusion, significance and impact of study: MDR distribution in the worldwide was increased, we highly recommend the avoidance of the random antibiotic usages. The salts CaCl2 and/or MgCl2 can be used at specific concentration to enhance the antibiotics permeability and therefore to decrease the antibiotic resistance.

Breast cancer cure aims at complete elimination of malignant cells and essentially requires detection and treatment of any micrometastases. Here, we present a review of the current methods in use and the potential role of the quantum dots (QDs) in detection and visualization of sentinel lymph node and micrometastases in breast cancer patients. The traditional histopathological, immunohistochemical, and reverse transcriptase polymerase chain reaction procedures being used for micrometastases detection had serious drawbacks of high false negativity, specificity variations and false positivity of the results. Photon emission fluorescence multiplexing characteristics of the quantum dots make them potentially ideal probes for studying the dynamics of cellular processes over time such as continuous tracking of cell migration, differentiation, and metastases. In breast cancer, QDs based molecular and genomic detections had an unparallel high sensitivity and specificity.
Breast ; Breast Neoplasms ; Cell Movement ; Early Detection of Cancer ; Fluorescence ; Humans ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm Micrometastasis ; Nitriles ; Pyrethrins ; Quantum Dots ; Reverse Transcriptase Polymerase Chain Reaction ; Sensitivity and Specificity ; Track and Field