Pub Date : 2024-02-01DOI: 10.4103/apjtm.apjtm_645_23
Siew-Keah Lee, A. Chua, Clement Heng Yew Fong, Ban Hao Brian Cong, Wen Ling Ng, Jing Feng Kong, Yik-Ling Chew, K. Liew, Yang Shao
To investigate the interrelationship between cardiovascular health awareness, risk perception, behavioural intention, and INTERHEART risk stratification in a middle-aged adult population in Malaysia. A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023. Participants completed validated questionnaires assessing cardiovascular health awareness, risk perception of cardiovascular diseases, behavioural intention towards adopting healthy habits, and INTERHEART risk stratification score (IHRS) based on established risk factors. A total of 602 respondents were included in the final analysis. Data were analysed with independent t-test/one-way ANOVA or Mann- Whitney/Kruskai-Wailis to test the differences, Pearson correlation or linear regression test to analyze the association of independent and dependent variables. There was a significant positive correlation between medical knowledge related to cardiovascular disease (CVD) and knowledge related to CVD risk prevention, risk perception, behavioural intention and IHRS (P<0.05, Pearson correlation). Notably, individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention, risk perception, and behavioural intention. Males, laborers, active/former smokers, individuals with lower household income and educational levels, those involved in occupations not related to the healthcare sector, and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge, risk perception, and poorer behavioural intention regarding cardiovascular health (P<0.05, one-way ANOVA). While educational level, smoking status, awareness about CVD poster, self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention, risk perception, behavioral intention and/or IHRS (P<0.05, linear regression). These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk. Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.
{"title":"Cardiovascular health awareness, risk perception, behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia","authors":"Siew-Keah Lee, A. Chua, Clement Heng Yew Fong, Ban Hao Brian Cong, Wen Ling Ng, Jing Feng Kong, Yik-Ling Chew, K. Liew, Yang Shao","doi":"10.4103/apjtm.apjtm_645_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_645_23","url":null,"abstract":"\u0000 \u0000 To investigate the interrelationship between cardiovascular health awareness, risk perception, behavioural intention, and INTERHEART risk stratification in a middle-aged adult population in Malaysia.\u0000 \u0000 \u0000 \u0000 A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023. Participants completed validated questionnaires assessing cardiovascular health awareness, risk perception of cardiovascular diseases, behavioural intention towards adopting healthy habits, and INTERHEART risk stratification score (IHRS) based on established risk factors. A total of 602 respondents were included in the final analysis. Data were analysed with independent t-test/one-way ANOVA or Mann- Whitney/Kruskai-Wailis to test the differences, Pearson correlation or linear regression test to analyze the association of independent and dependent variables.\u0000 \u0000 \u0000 \u0000 There was a significant positive correlation between medical knowledge related to cardiovascular disease (CVD) and knowledge related to CVD risk prevention, risk perception, behavioural intention and IHRS (P<0.05, Pearson correlation). Notably, individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention, risk perception, and behavioural intention. Males, laborers, active/former smokers, individuals with lower household income and educational levels, those involved in occupations not related to the healthcare sector, and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge, risk perception, and poorer behavioural intention regarding cardiovascular health (P<0.05, one-way ANOVA). While educational level, smoking status, awareness about CVD poster, self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention, risk perception, behavioral intention and/or IHRS (P<0.05, linear regression).\u0000 \u0000 \u0000 \u0000 These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk. Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.\u0000","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140466651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.4103/apjtm.apjtm_762_23
Samuel M. Ngui, Joseph M. Mwangangi, Joachim Richter, J. Ngunjiri
To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba, Kwale County, Kenya. A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age (15-<50 years) from four villages in Mwaluphamba location. Stool specimens were collected and examined using the Kato-Katz method, while filtration technique was used to analyze urine specimens. Participants’ sociodemographic details were obtained using a standardized questionnaire. Urinary schistosomiasis prevalence was at 4.7% (20/422, 95% CI 2.8%-6.9%) while the prevalence of soil-transmitted helminthiasis infection was 4.5% (19/422, 95% CI 2.6%-6.7%). The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL. The patients were diagnosed with light infection, of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms, respectively. Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine. Similarly, use of surface water (aOR=1.0, 95% CI 0.2-1.4, P=0.010) and crossing the river to go to a place (aOR=1.1, 95% CI 0.3-1.6, P=0.009) were statistically significant risk factors for getting urinary schistosomiasis. In bivariable regression analysis, defecating around the water source (OR=4.3, 95% CI 1.5-12.9) had a statistically significant association with the prevalence of soil-transmitted helminthiasis (P=0.008). This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.
评估肯尼亚夸莱县姆瓦卢班巴育龄妇女尿路血吸虫病和土壤传播蠕虫病的流行情况。 该研究采用社区横断面研究设计，从姆瓦卢班巴地区的四个村庄随机抽取了 422 名育龄妇女（15-<50 岁）。研究人员采用卡托-卡茨法收集和检测粪便标本，并采用过滤技术分析尿液标本。参与者的社会人口详情通过标准化问卷调查获得。 尿血吸虫病感染率为 4.7%（20/422，95% CI 2.8%-6.9%），而土壤传播蠕虫病感染率为 4.5%（19/422，95% CI 2.6%-6.7%）。研究参与者的尿血吸虫病感染强度介于 1 至 120 个卵/10 mL 尿液之间，卵数中位数为 18.45 个卵/10 mL。患者被诊断为轻度感染，毛滴虫和钩虫的感染率分别为 56.16 个卵/克和 48.48 个卵/克。与有厕所的妇女相比，没有厕所的妇女患尿路血吸虫病的风险高出 15.7 倍。同样，使用地表水（aOR=1.0，95% CI 0.2-1.4，P=0.010）和过河去某个地方（aOR=1.1，95% CI 0.3-1.6，P=0.009）也是患尿路血吸虫病的显著风险因素。在二变量回归分析中，在水源周围排便（OR=4.3，95% CI 1.5-12.9）与土壤传播的蠕虫病发病率有统计学意义（P=0.008）。 这项研究揭示了姆瓦卢班巴地区尿路血吸虫病和土壤传播蠕虫病的流行程度和强度，为加强这些被忽视的热带疾病的控制和消除计划奠定了基础。
{"title":"Prevalence and intensity of urinary schistosomiasis and soil-transmitted helminths among women of reproductive age in Mwaluphamba, Kwale","authors":"Samuel M. Ngui, Joseph M. Mwangangi, Joachim Richter, J. Ngunjiri","doi":"10.4103/apjtm.apjtm_762_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_762_23","url":null,"abstract":"\u0000 \u0000 To assess the epidemiology of urinary schistosomiasis and soil-transmitted helminthiasis among women of reproductive age in Mwaluphamba, Kwale County, Kenya.\u0000 \u0000 \u0000 \u0000 A community-based cross-sectional study design was employed to randomly sample 422 women of reproductive age (15-<50 years) from four villages in Mwaluphamba location. Stool specimens were collected and examined using the Kato-Katz method, while filtration technique was used to analyze urine specimens. Participants’ sociodemographic details were obtained using a standardized questionnaire.\u0000 \u0000 \u0000 \u0000 Urinary schistosomiasis prevalence was at 4.7% (20/422, 95% CI 2.8%-6.9%) while the prevalence of soil-transmitted helminthiasis infection was 4.5% (19/422, 95% CI 2.6%-6.7%). The infection intensities of urinary schistosomiasis among the study participants ranged from 1 to 120 eggs/10 mL of urine with median egg count of 18.45 eggs/10 mL. The patients were diagnosed with light infection, of 56.16 egg/gram and 48.48 egg/gram for Trichuris trichiura and hookworms, respectively. Women without latrines had 15.7 times higher risk of having urinary schistosomiasis compared to those with a latrine. Similarly, use of surface water (aOR=1.0, 95% CI 0.2-1.4, P=0.010) and crossing the river to go to a place (aOR=1.1, 95% CI 0.3-1.6, P=0.009) were statistically significant risk factors for getting urinary schistosomiasis. In bivariable regression analysis, defecating around the water source (OR=4.3, 95% CI 1.5-12.9) had a statistically significant association with the prevalence of soil-transmitted helminthiasis (P=0.008).\u0000 \u0000 \u0000 \u0000 This study has given an insight on the prevalence and intensity of urinary schistosomiasis and soil-transmitted helminthiasis in Mwaluphamba location that form a basis for strengthening the control and elimination programmes for these neglected tropical diseases.\u0000","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.4103/apjtm.apjtm_540_23
E. Chong, Joveen Wan Fen Neoh, Tiek Ying Lau, K. Chua, Yvonne Ai-Lian Lim, P. Lee
To determine the genetic diversity of Plasmodium (P.) knowlesi isolates from Sabah, Malaysian Borneo and Peninsular Malaysia, targeting the S-type SSU rRNA gene and including aspects of natural selection and haplotype. Thirty-nine blood samples infected with P. knowlesi were collected in Sabah, Malaysian Borneo and Peninsular Malaysia. The S-type SSU rRNA gene was amplified using polymerase chain reaction, cloned into a vector, and sequenced. The natural selection and haplotype of the S-type SSU rRNA gene sequences were determined using DnaSP v6 and illustrated using NETWORK v10. This study's 39 S-type SSU rRNA sequences and eight sequences from the Genbank database were subjected to phylogenetic analysis using MEGA 11. Overall, the phylogenetic analysis showed no evidence of a geographical cluster of P. knowlesi isolates from different areas in Malaysia based on the S-type SSU rRNA gene sequences. The S-type SSU rRNA gene sequences were relatively conserved and with a purifying effect. Haplotype sharing of the S-type SSU rRNA gene was observed between the P. knowlesi isolates in Sabah, Malaysian Borneo, but not between Sabah, Malaysian Borneo and Peninsular Malaysia. This study suggests that the S-type SSU rRNA gene of P. knowlesi isolates in Sabah, Malaysian Borneo, and Peninsular Malaysia has fewer polymorphic sites, representing the conservation of the gene. These features make the S-type SSU rRNA gene suitable for comparative studies, such as determining the evolutionary relationships and common ancestry among P. knowlesi species.
以 S 型 SSU rRNA 基因为目标，确定来自沙巴、马来西亚婆罗洲和马来西亚半岛的克雷西疟原虫分离株的遗传多样性，包括自然选择和单倍型等方面。 研究人员在沙巴、马来西亚婆罗洲和马来西亚半岛采集了 39 份感染克雷西氏疟原虫的血液样本。利用聚合酶链反应扩增了 S 型 SSU rRNA 基因，将其克隆到载体中并进行了测序。使用 DnaSP v6 测定了 S 型 SSU rRNA 基因序列的自然选择和单倍型，并使用 NETWORK v10 进行了图解。 总体而言，根据 S 型 SSU rRNA 基因序列，系统进化分析表明没有证据表明来自马来西亚不同地区的 P. knowlesi 分离物存在地理集群。S 型 SSU rRNA 基因序列相对保守，具有净化作用。在沙巴、马来西亚婆罗洲和马来西亚半岛的 P. knowlesi 分离物之间观察到 S 型 SSU rRNA 基因的单倍型共享，但在沙巴、马来西亚婆罗洲和马来西亚半岛之间没有观察到。 这项研究表明，沙巴、马来西亚婆罗洲和马来西亚半岛分离的 P. knowlesi 的 S 型 SSU rRNA 基因具有较少的多态性位点，代表了该基因的保守性。这些特点使得S型SSU rRNA基因适用于比较研究，如确定知更鸟物种之间的进化关系和共同祖先。
{"title":"Genetic diversity of the S-type small subunit ribosomal RNA gene of Plasmodium knowlesi isolates from Sabah, Malaysian Borneo and Peninsular Malaysia","authors":"E. Chong, Joveen Wan Fen Neoh, Tiek Ying Lau, K. Chua, Yvonne Ai-Lian Lim, P. Lee","doi":"10.4103/apjtm.apjtm_540_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_540_23","url":null,"abstract":"\u0000 \u0000 To determine the genetic diversity of Plasmodium (P.) knowlesi isolates from Sabah, Malaysian Borneo and Peninsular Malaysia, targeting the S-type SSU rRNA gene and including aspects of natural selection and haplotype.\u0000 \u0000 \u0000 \u0000 Thirty-nine blood samples infected with P. knowlesi were collected in Sabah, Malaysian Borneo and Peninsular Malaysia. The S-type SSU rRNA gene was amplified using polymerase chain reaction, cloned into a vector, and sequenced. The natural selection and haplotype of the S-type SSU rRNA gene sequences were determined using DnaSP v6 and illustrated using NETWORK v10. This study's 39 S-type SSU rRNA sequences and eight sequences from the Genbank database were subjected to phylogenetic analysis using MEGA 11.\u0000 \u0000 \u0000 \u0000 Overall, the phylogenetic analysis showed no evidence of a geographical cluster of P. knowlesi isolates from different areas in Malaysia based on the S-type SSU rRNA gene sequences. The S-type SSU rRNA gene sequences were relatively conserved and with a purifying effect. Haplotype sharing of the S-type SSU rRNA gene was observed between the P. knowlesi isolates in Sabah, Malaysian Borneo, but not between Sabah, Malaysian Borneo and Peninsular Malaysia.\u0000 \u0000 \u0000 \u0000 This study suggests that the S-type SSU rRNA gene of P. knowlesi isolates in Sabah, Malaysian Borneo, and Peninsular Malaysia has fewer polymorphic sites, representing the conservation of the gene. These features make the S-type SSU rRNA gene suitable for comparative studies, such as determining the evolutionary relationships and common ancestry among P. knowlesi species.\u0000","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140463985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.4103/apjtm.apjtm_567_23
Raghunath Hazra, Amrita Kar, S. K. Mahapatra
Visceral leishmaniasis (VL) is a neglected tropical disease, and this review has summarized the current treatment scenario and its prospects. It also highlights alternative approaches used by research groups in India and around the world to develop cutting-edge and potent anti-leishmanial treatments. Even though numerous medications could be utilized to treat VL, the limitations of current treatments including their toxicity, cost, route of administration, and duration of doses, have contributed to the emergence of resistance. Combination therapy might be a better option due to its shorter duration, easier route of administration, and ability to extend the lifespan of individual drugs. However, there is a risk of not delivering both the drugs to the target site together, which can be overcome by the liposomal entrapment of those drugs and at a time knock an opportunity to reduce the dosage of amphotericin B if the combination drug provides a synergistic effect with it. Therefore, this review presents a novel strategy to fight against VL by introducing dual drug-loaded liposomes.
内脏利什曼病（VL）是一种被忽视的热带疾病，本综述总结了目前的治疗情况及其前景。综述还重点介绍了印度和世界各地的研究小组为开发最先进的强效抗利什曼病疗法而采用的替代方法。尽管可以使用多种药物治疗 VL，但目前治疗方法的局限性（包括毒性、成本、给药途径和用药时间）导致了抗药性的出现。联合疗法可能是一个更好的选择，因为它疗程短、给药途径简单，并能延长单个药物的寿命。不过，联合疗法也存在无法将两种药物同时送达靶点的风险，而脂质体药物可以克服这一风险，如果联合药物与两性霉素 B 产生协同效应，还可以减少两性霉素 B 的用量。因此，本综述提出了一种通过引入双重药物负载脂质体来抗击 VL 的新策略。
{"title":"Liposomal dual delivery systems in visceral leishmaniasis enhance the synergistic effects of combination therapy: A promise for the future","authors":"Raghunath Hazra, Amrita Kar, S. K. Mahapatra","doi":"10.4103/apjtm.apjtm_567_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_567_23","url":null,"abstract":"Visceral leishmaniasis (VL) is a neglected tropical disease, and this review has summarized the current treatment scenario and its prospects. It also highlights alternative approaches used by research groups in India and around the world to develop cutting-edge and potent anti-leishmanial treatments. Even though numerous medications could be utilized to treat VL, the limitations of current treatments including their toxicity, cost, route of administration, and duration of doses, have contributed to the emergence of resistance. Combination therapy might be a better option due to its shorter duration, easier route of administration, and ability to extend the lifespan of individual drugs. However, there is a risk of not delivering both the drugs to the target site together, which can be overcome by the liposomal entrapment of those drugs and at a time knock an opportunity to reduce the dosage of amphotericin B if the combination drug provides a synergistic effect with it. Therefore, this review presents a novel strategy to fight against VL by introducing dual drug-loaded liposomes.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140464370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-01DOI: 10.4103/apjtm.apjtm_592_23
Kang Wh, N. Wahab
Adrenal histoplasmosis can present as bilateral adrenal enlargement with constitutional symptoms and/or adrenal insufficiency. Often these patients are initially investigated as secondary adrenal metastases before eventually their diagnosis established by histopathological examination of the adrenal tissues. We report 4 cases of patients aged 55-78 who presented with hypocortisolism and bilateral adrenal masses. Bilateral adrenal histoplasmosis. Three patients received antifungal treatment for at least one year while 1 patient passed away before the initiation of antifungal treatment. Two patients’ adrenal function recovered not requiring any steroid replacement, while 1 patient still requires long-term steroid replacement. Adrenal histoplasmosis should be excluded in patients from endemic areas presenting with bilateral adrenal masses and adrenal insufficiency. Usually patients have an exposure to bird droppings, bat guano or soil contaminated with histoplasmosis fungi. Histopathological examination of biopsied adrenal tissues is still the gold standard investigation as serology and molecular diagnostic methods are still not widely available in most centers in Malaysia.
{"title":"Bilateral adrenal histoplasmosis in a Malaysian tertiary hospital: Report of four cases","authors":"Kang Wh, N. Wahab","doi":"10.4103/apjtm.apjtm_592_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_592_23","url":null,"abstract":"\u0000 \u0000 Adrenal histoplasmosis can present as bilateral adrenal enlargement with constitutional symptoms and/or adrenal insufficiency. Often these patients are initially investigated as secondary adrenal metastases before eventually their diagnosis established by histopathological examination of the adrenal tissues.\u0000 \u0000 \u0000 \u0000 We report 4 cases of patients aged 55-78 who presented with hypocortisolism and bilateral adrenal masses.\u0000 \u0000 \u0000 \u0000 Bilateral adrenal histoplasmosis.\u0000 \u0000 \u0000 \u0000 Three patients received antifungal treatment for at least one year while 1 patient passed away before the initiation of antifungal treatment.\u0000 \u0000 \u0000 \u0000 Two patients’ adrenal function recovered not requiring any steroid replacement, while 1 patient still requires long-term steroid replacement.\u0000 \u0000 \u0000 \u0000 Adrenal histoplasmosis should be excluded in patients from endemic areas presenting with bilateral adrenal masses and adrenal insufficiency. Usually patients have an exposure to bird droppings, bat guano or soil contaminated with histoplasmosis fungi. Histopathological examination of biopsied adrenal tissues is still the gold standard investigation as serology and molecular diagnostic methods are still not widely available in most centers in Malaysia.\u0000","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140465990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/apjtm.apjtm_614_23
Ahlam Sundus, R. Sellappans, Tan Maw Pin
To explore existing practices and challenges in the delivery of geriatric home medication review (HMR). The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR. This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals. The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR. Based on the emerging themes from the qualitative data, the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits, encompassing a diverse patient population with various healthcare needs. However, it faces challenges such as the lack of outcome monitoring, formal training, and workforce constraints. Despite these hurdles, there is a pressing need for the expansion of this service to better serve the community, and collaboration with community pharmacists holds potential to broaden its scope. Ultimately, the findings suggest that pharmacist- led HMR is both warranted and feasible within the Malaysian healthcare context. In order to optimize medicine-use among older people living in the community, approaches for expanding geriatric HMR services in Malaysia must be developed. This study holds profound implications as it attempts to illuminate policy makers in developing countries, enabling them to formulate effective HMR plans. By considering the challenges highlighted within this research, policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.
{"title":"Informing policy makers in developing countries: Practices and limitations of geriatric home medication review in Malaysia-A qualitative inquiry","authors":"Ahlam Sundus, R. Sellappans, Tan Maw Pin","doi":"10.4103/apjtm.apjtm_614_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_614_23","url":null,"abstract":"\u0000 \u0000 To explore existing practices and challenges in the delivery of geriatric home medication review (HMR). The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR.\u0000 \u0000 \u0000 \u0000 This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals. The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR.\u0000 \u0000 \u0000 \u0000 Based on the emerging themes from the qualitative data, the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits, encompassing a diverse patient population with various healthcare needs. However, it faces challenges such as the lack of outcome monitoring, formal training, and workforce constraints. Despite these hurdles, there is a pressing need for the expansion of this service to better serve the community, and collaboration with community pharmacists holds potential to broaden its scope. Ultimately, the findings suggest that pharmacist- led HMR is both warranted and feasible within the Malaysian healthcare context. In order to optimize medicine-use among older people living in the community, approaches for expanding geriatric HMR services in Malaysia must be developed.\u0000 \u0000 \u0000 \u0000 This study holds profound implications as it attempts to illuminate policy makers in developing countries, enabling them to formulate effective HMR plans. By considering the challenges highlighted within this research, policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.\u0000","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140524847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/1995-7645.390169
Hekmatollah Khoubfekr, M. Jokar, Vahid Rahmanian, Hasan Blouch, M. Shirzadi, R. Bashar
Rabies is a zoonotic disease with a high mortality, primarily transmitted through the bite of infected mammals, particularly dogs and cats. Despite being a well-known disease since ancient times, it continues to cause a significant number of human deaths worldwide, with approximately 65 000 fatalities reported annually. We present two fatal cases of rabies in a 12-year- old immigrant boy and a 7-year-old boy. The first case was subject to a 24-hour delay in receiving appropriate medical attention and rabies preventive measures due to the lack of awareness among emergency hospital staff, leading to the administration of wound dressing only. The second case received timely rabies immunoglobulin administration; however, there was a 4-day delay in administering the fourth dose of the rabies vaccine, despite presenting evident symptoms of rabies. Postmortem examination of brain samples from both patients confirmed the presence of rabies virus. Post-exposure prophylaxis for rabies. Both patients were admitted to the hospital after the manifestation of rabies-related symptoms, with the 12-year-old child seeking medical care 47 days after the animal bite and the 7-year-old child seeking medical care 58 days after the exposure. Finally, the first patient died after 27 days and the second patient died after 40 days of hospitalization. There is an urgent need for heightened awareness and education among both healthcare professionals and the public regarding the urgency of seeking immediate medical attention after potential rabies exposure. Timely recognition and initiation of post-exposure prophylaxis are pivotal in preventing the progression of the disease. Strengthening surveillance and reporting systems, coupled with continuous training for healthcare professionals, can contribute to early detection and management of rabies cases.
{"title":"Fatal cases in pediatric patients after post-exposure prophylaxis for rabies: A report of two cases","authors":"Hekmatollah Khoubfekr, M. Jokar, Vahid Rahmanian, Hasan Blouch, M. Shirzadi, R. Bashar","doi":"10.4103/1995-7645.390169","DOIUrl":"https://doi.org/10.4103/1995-7645.390169","url":null,"abstract":"\u0000 \u0000 Rabies is a zoonotic disease with a high mortality, primarily transmitted through the bite of infected mammals, particularly dogs and cats. Despite being a well-known disease since ancient times, it continues to cause a significant number of human deaths worldwide, with approximately 65 000 fatalities reported annually.\u0000 \u0000 \u0000 \u0000 We present two fatal cases of rabies in a 12-year- old immigrant boy and a 7-year-old boy. The first case was subject to a 24-hour delay in receiving appropriate medical attention and rabies preventive measures due to the lack of awareness among emergency hospital staff, leading to the administration of wound dressing only. The second case received timely rabies immunoglobulin administration; however, there was a 4-day delay in administering the fourth dose of the rabies vaccine, despite presenting evident symptoms of rabies.\u0000 \u0000 \u0000 \u0000 Postmortem examination of brain samples from both patients confirmed the presence of rabies virus.\u0000 \u0000 \u0000 \u0000 Post-exposure prophylaxis for rabies.\u0000 \u0000 \u0000 \u0000 Both patients were admitted to the hospital after the manifestation of rabies-related symptoms, with the 12-year-old child seeking medical care 47 days after the animal bite and the 7-year-old child seeking medical care 58 days after the exposure. Finally, the first patient died after 27 days and the second patient died after 40 days of hospitalization.\u0000 \u0000 \u0000 \u0000 There is an urgent need for heightened awareness and education among both healthcare professionals and the public regarding the urgency of seeking immediate medical attention after potential rabies exposure. Timely recognition and initiation of post-exposure prophylaxis are pivotal in preventing the progression of the disease. Strengthening surveillance and reporting systems, coupled with continuous training for healthcare professionals, can contribute to early detection and management of rabies cases.\u0000","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140522052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/apjtm.apjtm_303_23
Nurul Syazrah Anuar, Hazmin Hazman, Sharven Raj Jeyakumar, Mohd Nasir Desa, Hasni Idayu Saidi, S. Masri, Nur Afiza Aziz, N. Sulaiman
To determine the distribution, phenotypic and genetic background of extended spectrum β-lactamases (ESBL)-producing Klebsiella (K.) pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia. A total of 192 K. pneumoniae isolates were collected and subjected to antibiotic susceptibility, hypermucoviscosity test and multiplex PCR to detect the presence of K1- and K2- serotype associated genes. Multilocus sequence typing (MLST) was performed on ESBL-producing K. pneumoniae isolates presented with K1 and K2 serotypes, followed by phylogenetic analysis. A total of 87 out of 192 (45.3%) of the K. pneumoniae isolates collected were ESBL producers. However, only 8.3% (16/192) and 10.9% (21/192) of the total isolates were detected to carry K1- and K2-serotype associated genes, respectively. Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype (P=0.196). However, they were significantly associated with hypervirulent, as demonstrated by the positive string test (P<0.001). MLST analysis revealed that ST23 as the predominant sequence type (ST) in the K1 serotype, while the ST in the K2 serotype is more diverse. Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low, their coexistence warrants the need for continuous surveillance. MLST showed that these isolates were genetically heterogeneous.
{"title":"Occurrence of K1 and K2 serotypes and genotypic characteristics of extended spectrum β-lactamases-producing Klebsiella pneumoniae isolated from selected hospitals in Malaysia","authors":"Nurul Syazrah Anuar, Hazmin Hazman, Sharven Raj Jeyakumar, Mohd Nasir Desa, Hasni Idayu Saidi, S. Masri, Nur Afiza Aziz, N. Sulaiman","doi":"10.4103/apjtm.apjtm_303_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_303_23","url":null,"abstract":"\u0000 \u0000 To determine the distribution, phenotypic and genetic background of extended spectrum β-lactamases (ESBL)-producing Klebsiella (K.) pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia.\u0000 \u0000 \u0000 \u0000 A total of 192 K. pneumoniae isolates were collected and subjected to antibiotic susceptibility, hypermucoviscosity test and multiplex PCR to detect the presence of K1- and K2- serotype associated genes. Multilocus sequence typing (MLST) was performed on ESBL-producing K. pneumoniae isolates presented with K1 and K2 serotypes, followed by phylogenetic analysis.\u0000 \u0000 \u0000 \u0000 A total of 87 out of 192 (45.3%) of the K. pneumoniae isolates collected were ESBL producers. However, only 8.3% (16/192) and 10.9% (21/192) of the total isolates were detected to carry K1- and K2-serotype associated genes, respectively. Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype (P=0.196). However, they were significantly associated with hypervirulent, as demonstrated by the positive string test (P<0.001). MLST analysis revealed that ST23 as the predominant sequence type (ST) in the K1 serotype, while the ST in the K2 serotype is more diverse.\u0000 \u0000 \u0000 \u0000 Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low, their coexistence warrants the need for continuous surveillance. MLST showed that these isolates were genetically heterogeneous.\u0000","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140519993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/apjtm.apjtm_435_23
Neha Surela, Amrendra Chaudhary, Poonam Kataria, Jyoti Das
Malaria presents a significant global public health challenge, with severe malarial anaemia being a primary manifestation of the disease. The understanding of anaemia caused by malaria remains incomplete, making the treatment more complex. Iron is a crucial micronutrient essential for haemoglobin synthesis, oxygen delivery, and other vital metabolic functions in the body. It is indispensable for the growth of human beings, as well as bacteria, protozoa, and viruses in vitro and in vivo. Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life. Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis, leading to anaemia. Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy, infancy, and childhood. Dietary intake alone may not suffice to meet adequate iron requirements, thus highlighting the vital role of iron supplementation. While iron supplementation can alleviate iron deficiency, it can exacerbate malaria infection by providing additional iron for the parasites. However, in the context of pregnancy and childhood, iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development, respectively. This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.
{"title":"Iron supplementation during malaria infection in pregnancy and childhood: A review","authors":"Neha Surela, Amrendra Chaudhary, Poonam Kataria, Jyoti Das","doi":"10.4103/apjtm.apjtm_435_23","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_435_23","url":null,"abstract":"Malaria presents a significant global public health challenge, with severe malarial anaemia being a primary manifestation of the disease. The understanding of anaemia caused by malaria remains incomplete, making the treatment more complex. Iron is a crucial micronutrient essential for haemoglobin synthesis, oxygen delivery, and other vital metabolic functions in the body. It is indispensable for the growth of human beings, as well as bacteria, protozoa, and viruses in vitro and in vivo. Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life. Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis, leading to anaemia. Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy, infancy, and childhood. Dietary intake alone may not suffice to meet adequate iron requirements, thus highlighting the vital role of iron supplementation. While iron supplementation can alleviate iron deficiency, it can exacerbate malaria infection by providing additional iron for the parasites. However, in the context of pregnancy and childhood, iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development, respectively. This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140519844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01DOI: 10.4103/apjtm.apjtm_2_24
Rabin Debnath, Arshdeep Singh, Kushal Seni, Anjali Sharma, V. Chawla, Pooja A. Chawla
{"title":"Mapping COVID-19 in India: Southern states at the forefront of new JN.1 variant","authors":"Rabin Debnath, Arshdeep Singh, Kushal Seni, Anjali Sharma, V. Chawla, Pooja A. Chawla","doi":"10.4103/apjtm.apjtm_2_24","DOIUrl":"https://doi.org/10.4103/apjtm.apjtm_2_24","url":null,"abstract":"","PeriodicalId":8559,"journal":{"name":"Asian Pacific journal of tropical medicine","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140521788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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