Fatal case of amoebic liver abscess in a child

AbstractWe reported a case of amoebic liver abscess (ALA) in a 6-year-old Malaysian boy who presented with fever, lethargy, diarrhoea and right hypochondriac pain. On admission he was diagnosed with perforated acute appendicitis and a laparotomy was done. After surgery he developed acute respiratory distress. Ultrasonography, chest X-Ray and CT scan revealed two ALAs in the posterior segment of right lobe of liver, pleural effusion and collapsed consolidation of lungs bilaterally. Percutaneous liver abscesses drainage was done and intravenous Metronidazole was started. PCR carried out on the pus from the abscess was positive for Entamoeba histolytica. Patient however succumbed to the infection one week after admission

The Turtle Garden: Tan Kah Kee’s last spiritual world

This paper explores the role of diasporic subjects in China’s heritage-making through a case study of the Turtle Garden built by Tan Kah Kee in Xiamen, China. Tan is the first person with Overseas Chinese background who built museums in the P.R. China and has been regarded as a symbol of Overseas Chinese patriotism. This paper argues that the Turtle Garden, conceptualised as a postcolonial ‘carnivalesque’ space, is more than a civic museum for public education. It reflects the owner’s highly complex and sometimes conflicting museum outlook embedded in his life experience as a migrant, his encounter with (British) colonialism in Malaya, and integrated with his desire and despair about the Chinese Communist Party’s nation-building project in the 1950s. Rather than a sign of devotion to the socialist motherland as simplistically depicted in China’s discourse, the garden symbolises Tan’s last ‘spiritual world’ where he simultaneously engaged with soul-searching as a returned Overseas Chinese and alternative diasporic imagining of Chinese identities and nation. It brings to light the value of heritage-making outside centralised heritage discourses, and offers an invaluable analytical lens to disentangle the contested and ever shifting relationship between diasporic subjects, cultural heritage and nation-(re)building in the Chinese context and beyond

Low cost negative pressure wound healing device system

Negative Pressure Wound Therapy (NWPT) has been successfully used in treating acute and chronic wound by promoting wound healing. Many medical techniques like NPWT are available in this world but not approachable for many patients due to high in cost and lack of devices. In order for most of the patients accessible to NPWT, an inexpensive NPWT system is explored in this study. Aim of this work is to design a prototype of NPWT system that can generate negative pressure and the negative pressure can be regulated within the range. A NPWT system consists of vacuum pump, drainage tube, wound dressing, fluid collecting canister and adhesive film dressing. In this study, a miniature vacuum pump, canister and Arduino microcontroller were used in order to build up a functional NPWT system. The system has been designed to supply negative pressure from 0 mmHg to 200mmHg and negative pressure which can be controlled. To sum up, this system is able to function according to the require specification and suitable for home healthcare wound healing device with safety precaution implement and system stabilization is improved in future

Fatal case of amoebic liver abscess in a child

We reported a case of amoebic liver abscess (ALA) in a 6-year-old Malaysian boy who presented with fever, lethargy, diarrhoea and right hypochondriac pain. On admission he was diagnosed with perforated acute appendicitis and a laparotomy was done. After surgery he developed acute respiratory distress. Ultrasonography, chest X-Ray and CT scan revealed two ALAs in the posterior segment of right lobe of liver, pleural effusion and collapsed consolidation of lungs bilaterally. Percutaneous liver abscesses drainage was done and intravenous Metronidazole was started. PCR carried out on the pus from the abscess was positive for Entamoeba histolytica. Patient however succumbed to the infection one week after admission

Clinical features and mutational analysis of X-linked agammaglobulinemia patients in Malaysia

BackgroundBruton’s tyrosine kinase (BTK) is a cytoplasmic protein involved in the B cell development. X-linked agammaglobulinemia (XLA) is caused by mutation in the BTK gene, which results in very low or absent B cells. Affected males have markedly reduced immunoglobulin levels, which render them susceptible to recurrent and severe bacterial infections. Methods: Patients suspected with X-linked agammaglobulinemia were enrolled during the period of 2010-2018. Clinical summary, and immunological profiles of these patients were recorded. Peripheral blood samples were collected for monocyte BTK protein expression detection and BTK genetic analysis. The medical records between January 2020 and June 2023 were reviewed to investigate COVID-19 in XLA.ResultsTwenty-two patients (from 16 unrelated families) were molecularly diagnosed as XLA. Genetic testing revealed fifteen distinct mutations, including four splicing mutations, four missense mutations, three nonsense mutations, three short deletions, and one large indel mutation. These mutations scattered throughout the BTK gene and mostly affected the kinase domain. All mutations including five novel mutations were predicted to be pathogenic or deleterious by in silico prediction tools. Genetic testing confirmed that eleven mothers and seven sisters were carriers for the disease, while three mutations were de novo. Flow cytometric analysis showed that thirteen patients had minimal BTK expression (0-15%) while eight patients had reduced BTK expression (16-64%). One patient was not tested for monocyte BTK expression due to insufficient sample. Pneumonia (n=13) was the most common manifestation, while Pseudomonas aeruginosa was the most frequently isolated pathogen from the patients (n=4). Mild or asymptomatic COVID-19 was reported in four patients.ConclusionThis report provides the first overview of demographic, clinical, immunological and genetic data of XLA in Malaysia. The combination of flow cytometric assessment and BTK genetic analysis provides a definitive diagnosis for XLA patients, especially with atypical clinical presentation. In addition, it may also allow carrier detection and assist in genetic counselling and prenatal diagnosis

Microfluidics size fractionation of paclitaxel-loaded microspheres for breast cancer treatment

Drug-loaded microspheres are widely used in cancer treatment through targeted and sustained drug delivery. In this study, poly(lactic-co-glycolic acid) (PLGA) microspheres loaded with paclitaxel (PTX) are synthesized and size-fractionated using a novel inertial microfluidics strategy (Dean Flow Fractionation) for enhanced inhibition of breast cancer cell proliferation. The polydimethylsiloxane (PDMS) microdevice was characterized by optical imaging methods (high speed and fluorescence) and flow cytometry using fluorescent microbeads. After device optimization, PTX-loaded microparticles were fractionated into 3 different size groups (>5µm, 3-5µm and <3µm) and co-incubated with MCF-7 breast cancer cells. CCK Proliferation (CCK) assay and imaging showed that smaller microparticles (<3µm) were more effective at inhibiting cell proliferation. The developed technology provides a novel high throughput sample preparation method for nanoparticle synthesis and drug delivery systems.Bachelor of Engineering (Materials Engineering

Experimental investigation of forced convective heat transfer in nanofluids

Nanofluids are suspensions of nanoparticles (1 to 100 nm) in traditional base fluids and are seen as potential candidates to enhance heat transfer in various engineering applications. The main objective of this study was to investigate the forced convective heat transfer performance of four different types of nanofluids - γ-Al2O3/DIW, γ-Al2O3/50%EG, Fe3O4/DIW and Fe3O4/50%EG (φ = 0.5%, 1.0% and 2.0%) under laminar flow regime (200 < Re < 1700) and constant wall temperature boundary condition. An experimental setup was designed and fabricated to investigate the effects of the type of nanoparticle, the type of base fluid, the volume fraction of nanoparticles and the volumetric flow rate on the forced convective heat transfer performance of these four different types of nanofluids. The experimental setup was calibrated and validated by using crushed melting ice and deionized water, respectively. The experimental results showed that an addition of a small amount of nanoparticles into the base fluids increased the convective heat transfer enhancement significantly. The experimental results also showed that the average Nusselt number increased with increasing Peclet number and there was an optimum volume fraction of nanoparticles present in each type of nanofluid for achieving the maximum convective heat transfer enhancement. Besides the increase in the thermal conductivity of the nanofluids, other factors such as the chaotic movement and the dispersion effects of the nanoparticles in the base fluids might have contributed to the overall convective heat transfer performance of the nanofluids.Bachelor of Engineering (Mechanical Engineering

Estimating the population health and economic impacts of introducing a pneumococcal conjugate vaccine in Malaysia- an economic evaluation

Pneumococcal disease is a potentially fatal bacterial infection that is vaccine-preventable. Malaysia has yet to adopt a pneumococcal conjugate vaccine (PCV) into its national immunization program (NIP). In 2016, pneumonia was the 3rd leading cause of death in children under five in Malaysia, accounting for 3.8% of under-five deaths. Introducing a pneumococcal conjugate vaccine (PCV) is an effective strategy to reduce the disease burden. This study used a decision-analytic model to assess the potential impacts of introducing the available PCVs (13-valent and 10-valent) in Malaysia. Epidemiological and costs inputs were sourced from published literature. For each vaccination program, health outcomes and associated healthcare costs were estimated. The scenarios of initiating PCV13 vs. PCV10 and the status quo (no pneumococcal vaccine) were compared. Serotype trends of Finland and the U.K. were used to model the clinical impacts of PCV10 and PCV13 respectively. The base-case analysis used a societal perspective over a 5-year time horizon. Compared with PCV10, PCV13 was projected to avert an additional 190,628 cases of pneumococcal disease and 1126 cases of death. The acquisition of PCV13 was estimated to cost an incremental US$89,904,777, offset by a cost reduction of -US$250,219,914 on pneumococcal disease-related medical care and lost productivity. PCV13 demonstrated a higher cost-saving potential over PCV10. Compared with no vaccination, PCV13 was estimated as cost-saving. Results were robust across a series of sensitivity analyses. The introduction of PCV13 in a NIP was estimated to reduce a significant burden of disease and to be a cost-saving for the Malaysian health system