Introduction: Staphylococcus aureus is the leading biofilmforming microorganisms in orthopaedic implant infections. The biofilms formed are difficult to eradicate and resistance to antibiotics. This current study aims to determine the effectiveness of povidone-iodine; an antiseptic solution in eradicating S. aureus biofilm on stainless steel alloy. In addition to the usual Colony-Forming Unit (CFU) used for verification, Scanning Electron Microscope (SEM) is used to validate the formation and eradication of the biofilms. Materials and methods: This is an in vitro study where the biofilm is formed by inoculating clinically isolated S. aureus, incubated for 24 hours onto stainless steel alloy 316L implants. The implants are then irrigated using povidoneiodine solution with varying concentrations (5 and 10%) and durations (30, 60, and 180 seconds). The anti-biofilm effect was evaluated using plating and SEM methods to confirm its effectiveness. The process is repeated after 24 hours of postirrigation reincubation to detect any rebound growth. Results: No biofilm seen after irrigation with povidoneiodine at 5% and 10% concentrations at 30, 60 and 180 seconds, respectively, in both CFU count and SEM. This result is replicated after 24 hours of reincubation, in assessing for rebound growth. Conclusion: Our study supports that a minimum of 5% povidone-iodine with a minimum irrigation time of 30 seconds are effective at eliminating S. aureus biofilm on stainless steel alloy implants. Both CFU count and SEM yield similar value in validating the presence of biofilm. Additionally, SEM allows visualisation of the morphology of the biofilm.

INTRODUCTION: Glaucoma is a leading cause of permanent blindness, often going undetected in its early, asymptomatic stages, especially in older age groups. In Malaysia, glaucoma is a growing public health issue due to an increase in the ageing population. While screening is essential for early glaucoma detection, the most suitable strategy for Malaysia's healthcare system remains unclear. This study explored the perspectives of eye healthcare professionals on the most suitable glaucoma screening strategies for Malaysia. MATERIAL AND METHODS: This qualitative study used semi-structured interviews with 19 eye health professionals (ophthalmologists, optometrists, nurses, ophthalmic technicians, and assistant medical officers) practicing in the Klang Valley. The interviews were conducted face-to-face in their workplace or via a video conferencing platform. All interviews were recorded, transcribed, and analysed using thematic analysis. RESULTS: Six major themes were identified: types of glaucoma screening programmes, accessible screening locations, target screening population, instruments and use of digital technology, trained personnel, and referral criteria. Opportunistic case finding and population-based programmes were identified as the glaucoma screening programmes in which trained personnel conducted screening at accessible locations. Glaucoma screening for high-risk individuals was recommended, focusing on visual acuity testing, tonometry, anterior chamber angle assessment, funduscopy, perimetry, and retinal nerve fibre assessment. A lack of clear referral criteria due to low awareness and poor implementation of existing guidelines was observed. CONCLUSION: Further investigations are required to identify the best combination of components for glaucoma screening. This will enable policymakers to develop an effective glaucoma screening programme in Malaysia.

Staphylococcus aureus is a common bacterial pathogen known to cause various kinds of infections due to its repertoire of virulence factors. This study aimed to investigate the distribution of 19 types of virulence genes among clinical isolates of methicillin-susceptible S. aureus (MSSA) using the polymerase chain reaction. A total of 109 MSSA isolates, i.e., 63 hospital-associated (HA) and 46 community-associated (CA) were collected from Hospital Sultanah Nur Zahirah, the main tertiary hospital in Terengganu, Malaysia, from July 2016 to June 2017. The most frequent virulence genes detected were hla (78.9%, n=86) and hld (78.0%, n=85) encoding hemolysins, lukED (56.9%, n=62) encoding leukotoxin ED, followed by seb (26.6%, n=29) and sea (24.8%, n=27) encoding enterotoxins. Among 34 (31.2%) isolates carrying six or more virulence genes, only five were multidrug resistant (MDR) while the remaining isolates were susceptible. Significant associations were discovered between the hld gene with CA-MSSA (p=0.016) and the seo gene with HA-MSSA (p=0.023). However, there is no significant association between virulence genes among the different types of infection. The clinical MSSA isolates in Terengganu showed high prevalence and high diversity of virulence gene carriage.

Aims: This study was aimed to characterise nine clinical isolates in our culture collection that were categorized as Diutina species based on their molecular genetic profiles. D. rugosa is a species complex comprising four taxa., i.e., D. rugosa sensu stricto, D. pseudorugosa, D. neorugosa and D. mesorugosa. The most commonly used phenotypic identification methods for yeasts often lead to the misidentification of this species complex. Methodology and results: The Diutina isolates were received from two local referral hospitals as pure cultures. Species confirmation was performed using conventional phenotypic methods; CHROMagar and RapID Yeast Plus Kit. To study the inter- and intraspecific relationships among the clinical isolates, ITS region, D1/D2 domain and random amplified polymorphic DNA (RAPD) analyses were performed. The results were further validated using the housekeeping gene sequence similarity technique coupled with pairwise sequence alignment. The results from phenotypic methods results were ambiguous and inconclusive. The sequence analyses of ITS regions and D1/D2 domains revealed that the samples consisted of three yeast species; D. rugosa complex: D. rugosa (n=1), D. mesorugosa (n=6), Candida pararugosa (n=1) and Meyerozyma guilliermondii (n=1). The RAPD analysis with random primers, OPG4, OPG11 and OPA18, demonstrated good banding patterns that could distinguish between the Diutina isolates. The pairwise sequence alignment revealed that the Diutina isolates were genetically similar to D. rugosa ATCC 10571. Conclusion, significance and impact of study The molecular methods, D1/D2 domain, ITS1 and ITS4 region, and RAPD analyses have proven helpful for accurately identifying the yeasts, especially closely related species; D. rugosa and D. mesorugosa.

Storage of dengue virus (DENV) culture stocks in -80°C is a common laboratory practice to maintain the viability of the virus for long-term usage. However, the efficiency of this method could still be hindered by multiple factors. In our laboratory, we observed a constant and substantial deterioration in the titer of DENV in Vero culture supernatant stored in -80°C. Such incident had badly hampered the laboratory work and prompted an investigation to determine the cause. DENV isolates representing all four serotypes were propagated and the culture supernatants were harvested and stored in aliquots of original stock and 10 fold dilutions (10-1 -10-4). DENV titer in these stocks was determined prior to storage and reassessed on the third and sixth month of storage by focus forming unit assay (FFUA). The result demonstrated a constant preservation of titer ranging from 104 ffu/ml to 105 ffu/ml in the diluted DENV virus culture stocks of 10-1, and 10-2 of DENV1-4, a minor reduction of titer from 103 ffu/ml to 102 ffu/ml at dilution 10-3 for DENV4 only and complete deterioration in undiluted culture stock and lower dilution (10-4) within 6 months of storage in -80°C for all serotypes. It is recommended that propagated DENV in Vero cells are stored in 10 fold dilutions as compared to the original form to preserve the titer for long-term usage.

Glaukoma adalah sejenis penyakit neurodegeneratif yang berlaku akibat ketidakseimbangan dalam peredaran cecair akues yang disebabkan oleh resistan pada sistem pengaliran keluar cecair tersebut. Ini meningkatkan tekanan intraokular (TIO) yang menyebabkan kerosakan pada saraf optik dan seterusnya mengakibatkan kebutaan yang kekal. Oleh kerana TIO adalah satu faktor risiko glaukoma yang boleh dikawal, ciri-ciri dan variasi tekanan sepanjang 24 jam perlu dikenalpasti sebelum rawatan dimulakan. Pemantauan TIO adalah satu aspek yang terpenting dan kritikal dalam pengurusan glaukoma. Pelbagai tindakan kawalan melalui penggunaan teknologi yang berbeza telah dan sedang dilakukan untuk pemantauan TIO yang kerap dan berterusan selama 24 jam untuk menentukan kewujudan TIO yang tinggi (peak) dan fluktuasi tekanan. Artikel ini bertujuan untuk meninjau pendekatan inovatif yang terkini serta untuk mengulas kepentingan dan kelemahan setiap teknik bagi memperolehi profil TIO selama 24 jam.

Mediastinal teratoma is an infrequent germ cell tumour and comprises of 1 to 5% of all mediastinal tumours. We report a case of mediastinal mature teratoma in a 12 year old boy who presented to us with persistent non-productive cough, fever and dyspnoea for the past 7 months. Computed tomographic scan of thorax revealed a large anterior mediastinal mass measuring 11.2x9.9x14cm with calcification within. He subsequently underwent a median sternotomy with left subcostal extension (L-incision) and excision of tumour. Histopathology of the tumour revealed a mature cystic teratoma. We would like to report a case of successful surgical management of a large mediastinal mature teratoma in a child.
Mediastinal Cyst