Serotyping of dengue virus in 2016-17 outbreak in Kudat, Sabah, Malaysia.

An outbreak of dengue in Kudat, northern Sabah in 2016-2017 provided an opportunity to investigate the circulating serotypes of dengue viruses of cases at Hospital Kudat. Between September 2016 and December 2017, a total of 156 dengue positive sera (tested positive by either NS1 antigen, or IgM and IgG antibody rapid test) were collected from dengue patients who had acute fever and showed signs and symptoms suggestive of dengue. RNA was extracted from the sera using QIAamp RNA Blood Mini Kit, and molecular amplification was performed using one-step RT-PCR kit, followed by nested PCR using HotStart Taq master mix kit with the primers of the dengue C-prM gene. There were 81 (52%) male and 75 (48%) female cases. The age group with the highest number of cases was the 10-19 years old, while the youngest infected was 8 months old and the oldest was 83 years old. RT-PCR results showed 88 sera dengue positive, 48 infected with a single serotype while another 40 with multiple serotypes. All four DENV serotypes were co-circulating during the outbreak period and DENV-1 was predominant. Molecular analysis also indicated 69.2%, 50.0%, 51.9% and 48.9% respectively of the NS1, IgM, IgG and IgM and IgG positive sera were RT-PCR positive for dengue. High number of cases were seen in December 2016, February and May 2017. The dengue outbreak might be related to switching of predominant serotype from DENV 4 to DENV 1.

Audit of a British Centre for spinal injury.

The aim of this study was to determine the benefits of patients admitted early to the specialist spinal injuries centre. The results show a significant reduction in the incidence of pressure sores in the early admitted patients and demonstrate the lowered incidence of both preventable and non preventable complications, as well as reduction of hospitalisation time.

Use of head injury instruction cards in accident centres.

This study reports on the value of head injury instruction cards as purveyors of information to patients. Patients over 10 years old attending the North Staffordshire Royal Infirmary Accident and Emergency Department with a mild head injury were invited to attend a special brain injury follow-up clinic, where they were asked to complete a questionnaire. Patients failing to attend this clinic were contacted and asked to complete the questionnaire. This revealed that they were no less severely affected by the injury as the attenders. They were asked why they had not attended and a significant number of patients had no recall of being given a head injury instruction card on which the information of the follow-up clinic was given. Memory loss was the most likely cause of this and is more common than is widely appreciated in patients attending accident and emergency departments.