Soil transmitted helminth infection among children admitted to Hospital Tengku Ampuan Afzan, Kuantan, Pahang

Introduction: Soil-transmitted helminth (STH) infections by Ascaris lumbricoides, Trichuris trichiura and hookworms still persist in rural and urban areas of developing communities. Recent studies in Malaysia focused on Orang Asli communities and none in the hospital settings. This study aimed to investigate the prevalence and associated risk factors for STH among children admitted to Paediatric ward of the Hospital Tengku Ampuan Afzan (HTAA). Materials and Methods: This study was conducted among 135 (78 males, 57 females) patients in HTAA from December 2017 to May 2018. Faecal samples were examined using wet smear, Kato-Katz, Harada-Mori and sedimentation techniques. Demographic data and hygiene practice information were collected using a pre-tested questionnaire. Results: The overall prevalence of STH was 5.9% (A.lumbricoides 5.2%, T.trichiura 0.7%, and hookworms 0.7%). Prevalence among males was 3.8% and females 8.8%. Majority (95.6%) were Malays. Chi square analysis showed that factors significantly associated with STH infections are household monthly income (p<0.05), education level of mother (p<0.05) and father (p<0.05), the source of drinking water (p<0.05), the method of garbage disposal (p<0.05). Logistic regression analysis confirmed garbage disposal via burning as a risk factor of STH infections (p= 0.021, OR=23.8, 95% CI=1.6- 350.06). Conclusion: This study shows that the prevalence of STH infections is low in children probably due to the effective implementation of control programs and good hygiene practice. Differences in individual lifestyles and the humid weather condition are probable reasons for sporadic infection to still exist

Increased regulatory T cells in acute lymphoblastic leukemia patients

Introduction: Regulation in adaptive immune response balances a fine line that prevents instigation of self-damage or fall into unresponsiveness permitting abnormal cell growth. Mechanisms that keep this balance in check include regulatory T cells (Tregs). Tregs consist of a small but heterogeneous population which may be identified by the phenotype, CD3+CD4+CD25+CD127-. Role of Tregs in pathogenesis of cancers is thus far supported by evidence of increased Tregs in various cancers and may contribute to poorer prognosis. Tregs may also be important in acute leukemias. Objective: A review of the literature on Tregs in acute leukemias was conducted and Tregs were determined in B-cell acute lymphoblastic leukemias (ALLs). Results: Studies on Tregs in B-cell ALL are few and controversial. We observed a significantly increased percentage of Tregs (mean ± SD, 9.72 ± 3.79% vs. 7.05 ± 1.74%; P = 0.047) in the bone marrow/peripheral blood of ALL (n = 17) compared to peripheral blood of normal controls (n = 35). A positive trend between Tregs and age (R = 0.474, P = 0.055, n = 17) implicates this factor of poor prognosis in B-cell ALL. Discussion: Tregs in cancer are particularly significant in immunotherapy. The manipulation of the immune system to treat cancer has for a long time ignored regulatory mechanisms inducible or in place. In lymphoma studies tumor-specific mechanisms that are unlike conventional methods in the induction of Tregs have been hypothesized. In addition, tumor-infiltrating Tregs may present different profiles from peripheral blood pictures. Tregs will continue to be dissected to reveal their mysteries and their impact on clinical significance

Indirect immunofluorescence screening of potential arthritic autoantibodies in systemic lupus erythematosus

Introduction: Joint involvement is common in systemic lupus erythematosus (SLE) patients, however, screening for joint specific autoantibodies in patients is not routinely performed. This may be due to the lack of known antigens and available tissue. The rat musculoskeletal tissue may be a suitable source of antigen to detect arthritic autoantibodies. Method: We tested plasma of SLE patients, with arthritis (N=9) and without arthritis (N=7) as well as plasma from normal individuals (N=7) on fresh sectioned tissue from rat plantar hind paw using indirect immunofluorescence method. Results: Binding of autoantibodies to striation in skeletal muscle cells in the tissue was clearly demonstrable in all samples from SLE with arthritis but not on slides incubated with plasma from normal or SLE without arthritis. Conclusion: Thus, rat plantar tissue may be suitable for detecting autoantibodies from SLE patients that may be involved in the pathogenesis of lupus arthritis

Soil transmitted helminth infections among children admitted to Hospital Tengku Ampuan Afzan, Kuantan, Pahang

Introduction: Soil-transmitted helminth (STH) infections by Ascaris lumbricoides, Trichuris trichiura and hookworms still persist in poor communities in rural and urban areas. Recent studies in Malaysia focused on Orang Asli communities and few in hospital settings. This study determines the prevalence and risk factors for STH among children admitted to Paediatric ward of Hospital Tengku Ampuan Afzan (HTAA). Materials and Methods: This study was conducted among 133 (77 males,56 females) paediatric patients in Hospital Tengku Ampuan Afzan from Dec 2017 to May 2018. Faecal samples were examined using wet smear, Kato-Katz, Harada-Mori and sedimentation techniques. Demographic data and hygiene practice information were collected using a pre-tested questionnaire. Results: The overall prevalence of STHs was 6% (A.lumbricoides 5.3%, T.trichiura 0.8%, and hookworms 0.8%). Prevalence among males was 3.9% and females 8.9%. Majority (94.7%) were Malays. There were two Orang Asli children and both were infected, one of whom had a mixed infection. Chi square analysis showed that the important risk factors for STH infections are education level of mother (p<0.05) and father (p<0.05), the source of drinking water (p<0.05), and the method of trash disposal (p<0.05). Conclusion: This study shows that the prevalence of STH infections is low in children due to better socio-economy and good hygiene practice. Differences in individual lifestyles and humid weather condition are probable reasons for sporadic infection to still exist