Distribution of hyaluronidase-producing staphylococcus aureus and staphylococcus epidermidis isolated from palm skin and anterior nares of healthy Malaysian adults

Introduction: The distribution of Staphylococcus aureus and Staphylococcus epidermidis among Malaysian healthy adults and their capability to produce enzyme hyaluronidase are less reported. Hyaluronidase degrade hyaluronic acid in animal connective tissue and facilitate bacterial spreading in host body. This study aims to identify the distribution of both Staphylococci species in healthy subject, the hyaluronidase producer among the isolates and the association of the latter with site of isolation (palm skin and anterior nares) and gender of the host. Methods: A total of 108 swab samples were collected from anterior nares and palm of 54 healthy subjects. The bacteria were identified through microscopic and biochemical tests, before screened for hyaluronidase production using hyaluronic acid diffusion rapid plate method. Results: Total of 139 bacterial isolates were identified; 68 isolates are S. aureus, 63 S. epidermidis and 8 other bacterial species. Staphylococcus aureus was highly isolated from palm (57%) than anterior nares (47%). On the contrary for S. epidermidis was highly isolated from anterior nares (53%) than from palm skin (43%). Equal proportion was found for both species in male and female subject. A total of 77 (59%) isolates produced hyaluronidase; 55% are S. aureus and 45% are S. epidermidis. Hyaluronidase-producer isolates are equally found between anterior nares (56%) and palm skin (61%) or male (57%) and female subject (60%) regardless of Staphylococcal species. No significant value was recorded for any analysis. Conclusion: Capability of commensal S. aureus and S. epidermidis isolated from healthy subject to produce hyaluronidase may indicate their potential as opportunistic pathogen whenever the opportunity arises in any way

PCR-based construction and transformation of CodY gene deletion construct in streptococcus pneumoniae

Introduction: Streptococcus pneumoniae (S. pneumoniae) is a gram-positive diplococci belonging to the genus Streptococcus and it is a well-studied pathogenic bacterium. Pneumococcal diseases such as otitis media, pneumonia, sepsis and meningitis caused by pathogenic strains of S. pneumoniae still brought significant mortality and morbidity worldwide. The pathogenicity of S. pneumoniae is exerted by various virulence factors and one of it is the enzyme hyaluronate lyase. Hyaluronate lyase plays a major role in the invasive capability of S. pneumoniae. Its mechanism of action and crystallographic structure have been determinedbut its regulatory mechanism is still poorly understood. Drawing connections between the nutritional behaviour and invasive property of S. pneumoniae, CodY regulator is hypothesized as a potential hyaluronate lyase regulator. This work was aimed to construct CodY deficient mutant of S. pneumoniae to form foundational work for the study of CodY regulatory effect on hyaluronate lyase. Materials and method: A single gene-deletion method was chosen to create CodY mutant construct containing aphA-3 gene (encoding kanamycin resistance protein) replacement cassette by employing recombinant fusion PCR method. A single band DNA product at the expected size of 2,563 bp after recombinant fusion PCR was visualized on agarose gel electrophoresis. This indicated that the linear recombinant amplicon has been successfully constructed. The recombinant amplicon was transformed into S. pneumoniae cells of Malaysian local clinical isolate by employing the competence stimulating peptide (CSP-1) to enhance and induce natural competence. Results: No viable CodY mutant was evident post-transformation. The negative transformation result was postulated to be due to the essential nature of CodY regulator. Conclusion: This work can provide basis for recombinant fusion PCR method in designing and constructing single gene deletion construct. However, further work is needed to identify the regulatory agent of hyaluronate lyas

Antibiotic susceptibility of staphylococcus epidermidis among undergraduate students in Malaysia public university health campus

Staphylococcus epidermidis (S. epidermidis) has become one of the major concerns in the hospital setting due to its ability to cause hospital-acquired infection particularly from medical device contamination. The management of S. epidermidis infections become more challenging with the increase of antimicrobial resistance cases over the past years. Limited reports on S. epidermidis antibiotic resistance among healthy people leave uncertainty about the magnitude of antimicrobial resistance spreads among the community. Therefore, this study aimed to identify the antibiotic susceptibility pattern of S. epidermidis isolated from healthy undergraduate students in one of Malaysia public universities health campuses. Ninety-six hand palm swab samples were collected and undergo several tests, including microscopic, biochemical identification tests and antibiotic susceptibility test for erythromycin, oxacillin, gentamicin, penicillin and tetracycline following Kirby-Bauer test. A total of 43 samples showed the presence of S. epidermidis (44.8%), where 72.1% of the isolates showed resistance towards at least one type of antibiotic. The highest and lowest resistance was observed for penicillin and gentamycin, respectively. Although there is no significant difference of antibiotic susceptibility pattern was observed between genders, the presence of high antibiotic resistance in S. epidermidis among these healthy communities should warrant further investigation since the spreading of the resistant strain could occur in the wider community population without notice. ******************************************************************************* Staphylococcus epidermidis (S. epidermidis) menjadi salah satu keprihatinan utama dalam pengurusan hospital berikutan kebolehannya menyebabkan jangkitan perolehan hospital terutamanya daripada alatan perubatan yang tercemar. Pengurusan jangkitan S. epidermidis semakin mencabar dengan peningkatan kes kerintangan terhadap antibiotik sejak kebelakangan ini. Laporan terhad mengenai kerintangan terhadap antibiotik oleh S. epidermidis di kalangan kumpulan komuniti yang sihat meninggalkan satu persoalan mengenai tahap penyebaran bakteria rintang antibiotik di kalangan komuniti. Oleh itu, kajian ini bertujuan untuk mengenalpasti corak rentan antibiotik oleh S. epidermidis yang dipencilkan daripada pelajar-pelajar sihat di salah satu kampus kesihatan di universiti awam. Sebanyak 96 sampel sapuan telapak tangan telah diambil dan melalui beberapa ujikaji termasuk ujian pengenalpastian secara mikroskopik, biokimia dan juga ujian rentan antiobiotik untuk eryhtromycin, oxacillin, gentamicin, penicillin dan tetracycline menerusi ujian Kirby Bauer. Sejumlah 43 sampel menunjukkan kehadiran S. epidermidis (44.8%), di mana 72.1% daripada jumlah pencilan bakteria ini menunjukkan kerintangan terhadap sekurang-kurangnya satu jenis antibiotik. Tahap kerintangan tertinggi dan terendah masing-masing didapati pada penicillin dan gentamicin. Walaupun tiada perbezaan yang signifikan antara corak rentan antibiotik antara kumpulan jantina, tahap kerintangan antibiotik yang tinggi di kalangan komuniti sihat menunjukkan terdapat keperluan terhadap kajian lanjut kerana penyebaran strain bakteria rintang antibiotik boleh berlaku kepada populasi komuniti lain dengan lebih meluas dan tanpa disedari

Students’ perception and effectiveness of learning human structure and functions II (AHS 1023) through problem-based learning (PBL): a preliminary study

Introduction: Anatomy is a prerequisite course for other courses in the health based programmes. Realizing that basic understanding of anatomy is vital to understand clinical subjects in the later semesters, problem-based learning (PBL) is implemented to supplement the lecture sessions. However, previous studies have showed inconsistent findings on the effectiveness of PBL in teaching and learning anatomy. Thus, the present study aimed to evaluate students’ perception and effectiveness of learning the Human Structure and Functions II (AHS 1023) through the PBL. Materials and Methods: A total of 42 participants were divided into PBL and the non-PBL groups, by using a stratified systematic sampling. All participants were involved in answering the questionnaire, the pre- and post-test following the lecture and practical on the Endocrine System. However, only the PBL group attended the PBL sessions after the pre-test session. Results and Discussion: The results showed that most of the participants were having a positive perception towards the implementation of PBL in AHS 1023. For the PBL-group, their performance was slightly increased (p = 0.068) and significantly higher (p = 0.002) than the non-PBL participants, in the post-test. The higher performance in the PBL than non-PBL group was attributed to their ability to answer the medium (p = 0.002) and hard (p = 0.011) types of questions, suggesting that the PBL may increase the effectiveness of deep learning and thinking process. However, there was no correlation between the positive perception and the performance of participants in the PBL session, the pre- (r = 0.147, p = 0.351) and post-test (r = 0.008, p = 0.973). Conclusion: This implies student’s performance is independent of their initial perception towards the course

PCR-based construction and transformation of CodY gene deletion construct in Streptococcus pneumoniae

Introduction: Streptococcus pneumoniae (S. pneumoniae) is a gram-positive diplococci belonging to the genus Streptococcus and it is a well-studied pathogenic bacterium. Pneumococcal diseases such as otitis media, pneumonia, sepsis and meningitis caused by pathogenic strains of S. pneumoniae still brought significant mortality and morbidity rate worldwide. The pathogenicity of S. pneumoniae is exerted by various virulence factors and one of it is the enzyme hyaluronate lyase. Hyaluronate lyase plays major role in invasive capability of S. pneumoniae. Its mechanism of action and crystallographic structure has been determined but its regulatory mechanism is still poorly understood. Drawing connections between nutritional behaviours and invasive property of S. pneumoniae, CodY regulator is hypothesized as a potential hyaluronate lyase regulator. This work is aimed to construct CodY deficient mutant of S. pneumoniae to form foundational work for the study of CodY regulatory effect on hyaluronate lyase. Materials and method: A single gene-deletion method was chosen to create CodY mutant construct containing aphA-3 gene (encoding kanamycin resistance protein) replacement cassette by employing recombinant fusion PCR method. A single band DNA product at the expected size of 2,563 bp after recombinant fusion PCR was visualized on agarose gel electrophoresis. This indicates a high probability that the linear recombinant amplicon has been successfully constructed. The recombinant amplicon was transformed into S. pneumoniae cells of Malaysian local clinical isolate by employing the competence stimulating peptide (CSP-1) to enhance and induce natural competence. Results: No viable CodY mutant was evident post-transformation. The negative transformation results are postulated to be due to the essential nature of CodY regulator. Conclusion: This work can provide basis for recombinant fusion PCR method in designing and constructing single gene deletion construct. However, further works are needed to identify the regulatory agent of hyaluronate lyase

Perceived Symptoms of Depression, Anxiety and Stress amongst Staff in a Malaysian Public University: A Workers Survey

Mental health conditions are a major part of workers’ health that predisposes to poor self-motivation for sustaining productivity. This study was aimed to determine the prevalence of depression, anxiety, and stress among staff in a Malaysian public university and its associated factors. A cross-sectional study was conducted among 459 staff from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. A questionnaire that consisted of items on socio-demographic and socioeconomic characteristics, employment description, lifestyle risk behaviors, personal medical history, and symptoms of depression, anxiety, and stress was administered to participants. Descriptive and inferential statistics were conducted using SPSS version 22.0. The prevalence of perceived symptoms of depression, anxiety, and stress among the respondents was 28.7%, 50.1%, and 14.8%, respectively. Over one-quarter (26.5%) of the participants presented symptoms of two or more mental disorders. Women, those aged less than 40 years old, and non-academic professionals were more likely to exhibit depressive symptoms, while those with medical conditions that required hospitalizations sustained anxiety symptoms. Perceived stress was more likely to be prevalent among staff with secondary education or less and smokers. Proactive support for staff needs to be offered in sustaining their emotional well-being

Implants for surgery - skeletal pins and wires - part 3: Kirschner skeletal wires (ISO 5838-3:1993, MOD)

Specifies the characteristics (dimensions, ends, marking and packaging) of Kirschner wires. Material and mechanical requirements are covered by ISO 5838-1

Implants for surgery - skeletal pins and wires - part 2: Steinmann skeletal pins - Dimensions (ISO 5838-2:1991, MOD)

This Malaysian Standard specifies the dimensions of Steinmann skeletal Pins. Material and mechanical requirements are covered by ISO 5838-1

Empagliflozin in Patients with Chronic Kidney Disease

Background The effects of empagliflozin in patients with chronic kidney disease who are at risk for disease progression are not well understood. The EMPA-KIDNEY trial was designed to assess the effects of treatment with empagliflozin in a broad range of such patients. Methods We enrolled patients with chronic kidney disease who had an estimated glomerular filtration rate (eGFR) of at least 20 but less than 45 ml per minute per 1.73 m(2) of body-surface area, or who had an eGFR of at least 45 but less than 90 ml per minute per 1.73 m(2) with a urinary albumin-to-creatinine ratio (with albumin measured in milligrams and creatinine measured in grams) of at least 200. Patients were randomly assigned to receive empagliflozin (10 mg once daily) or matching placebo. The primary outcome was a composite of progression of kidney disease (defined as end-stage kidney disease, a sustained decrease in eGFR to < 10 ml per minute per 1.73 m(2), a sustained decrease in eGFR of & GE;40% from baseline, or death from renal causes) or death from cardiovascular causes. Results A total of 6609 patients underwent randomization. During a median of 2.0 years of follow-up, progression of kidney disease or death from cardiovascular causes occurred in 432 of 3304 patients (13.1%) in the empagliflozin group and in 558 of 3305 patients (16.9%) in the placebo group (hazard ratio, 0.72; 95% confidence interval [CI], 0.64 to 0.82; P < 0.001). Results were consistent among patients with or without diabetes and across subgroups defined according to eGFR ranges. The rate of hospitalization from any cause was lower in the empagliflozin group than in the placebo group (hazard ratio, 0.86; 95% CI, 0.78 to 0.95; P=0.003), but there were no significant between-group differences with respect to the composite outcome of hospitalization for heart failure or death from cardiovascular causes (which occurred in 4.0% in the empagliflozin group and 4.6% in the placebo group) or death from any cause (in 4.5% and 5.1%, respectively). The rates of serious adverse events were similar in the two groups. Conclusions Among a wide range of patients with chronic kidney disease who were at risk for disease progression, empagliflozin therapy led to a lower risk of progression of kidney disease or death from cardiovascular causes than placebo