Clinical outcomes of children with COVID-19 infection in a low-risk centre in Malaysia.

INTRODUCTION: According to WHO, long-COVID or post- COVID-19 condition is defined as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation. A systematic review and meta-analyses published in 2022, which mainly focus on the Western population, revealed that the prevalence of long COVID was 25.24%. Literature regarding long-COVID in children in Asia was scarce. The objectives of our study were to assess the long-term effect of COVID-19 infection in children and its correlation to their acute COVID- 19 infection. MATERIALS AND METHODS: This study was conducted in Hospital Kepala Batas (HKB), a district hospital in Penang State, Malaysia, which was the designated regional COVID hospital during the pandemic. It was a retrospective observational study, where children who were admitted from November 2020 to March 2021, and attended follow-up clinics from Jan 2021 to May 2021, were recruited. RESULTS: This study comprised 90 subjects, from 3 months old to 12 years old, mean of 6.5 years old. When comparing asymptomatic and symptomatic children, children with comorbidities were more likely to be symptomatic with a pvalue of 0.045 using the Pearson Chi-square test. All our patients' symptoms resolved upon discharge. During followup at 2-4 months after COVID-19 infection, all children were reported as back to their usual selves. Fifteen patients had recurrent symptoms. Most of their symptoms pointed towards an acute infection. One patient had two episodes of illness, while the rest had one. The most common symptoms were cough, fever and runny nose. The average duration of illness of these 16 episodes was 4.5 days with a standard deviation of 2.48. None of these symptoms lasted more than seven days. None of them required hospital admission. None of them had recurrent COVID-19 infections. Tweleve out of 72 children who had been going to school stopped physical school after COVID-19 infection. Our findings differed from other studies. These could be due to the limitations that we faced. CONCLUSION: Most children who contracted COVID-19 infection recovered fully after acute infection, and most of them recovered fully without long-term sequelae.

The aquaculture supply chain in the time of covid-19 pandemic: Vulnerability, resilience, solutions and priorities at the global scale.

The COVID-19 global pandemic has had severe, unpredictable and synchronous impacts on all levels of perishable food supply chains (PFSC), across multiple sectors and spatial scales. Aquaculture plays a vital and rapidly expanding role in food security, in some cases overtaking wild caught fisheries in the production of high-quality animal protein in this PFSC. We performed a rapid global assessment to evaluate the effects of the COVID-19 pandemic and related emerging control measures on the aquaculture supply chain. Socio-economic effects of the pandemic were analysed by surveying the perceptions of stakeholders, who were asked to describe potential supply-side disruption, vulnerabilities and resilience patterns along the production pipeline with four main supply chain components: a) hatchery, b) production/processing, c) distribution/logistics and d) market. We also assessed different farming strategies, comparing land- vs. sea-based systems; extensive vs. intensive methods; and with and without integrated multi-trophic aquaculture, IMTA. In addition to evaluating levels and sources of economic distress, interviewees were asked to identify mitigation solutions adopted at local / internal (i.e., farm-site) scales, and to express their preference on national / external scale mitigation measures among a set of a priori options. Survey responses identified the potential causes of disruption, ripple effects, sources of food insecurity, and socio-economic conflicts. They also pointed to various levels of mitigation strategies. The collated evidence represents a first baseline useful to address future disaster-driven responses, to reinforce the resilience of the sector and to facilitate the design reconstruction plans and mitigation measures, such as financial aid strategies.

Disturbance of mangrove forests causes alterations in estuarine phytoplankton community structure in Malaysian Matang mangrove forests.

To assess the effects of environmental changes on phytoplankton community structure in a mangrove ecosystem, phytoplankton distribution in Matang mangrove, Malaysia was examined. Phytoplankton and water samples, and in situ environmental parameters from three estuaries with differing levels of disturbance were examined monthly for one year. Two species, Cyclotella choctawhatcheeana and Skeletonema costatum, were dominant in the least disturbed and moderately disturbed areas, respectively. Skeletonema costatum was also the most dominant in the most disturbed area. Significant differences in phytoplankton density and biodiversity between the least and most disturbed areas were also observed. Principle component 1 (salinity, conductivity, total solids/water transparency and nitrogenous compounds) and PC2 (dissolved oxygen, pH and temperature) explained 60.4% of the total variance. This study illustrated that changes in phytoplankton community structure in Matang mangrove estuaries were significantly correlated with environmental parameters which were in turn influenced by ecosystem disturbance levels as well as seasonal changes.

Rupture of an unsuspected ectopic pregnancy following a hysterosalpingography-A case report.

INTRODUCTION: Hysterosalpingography (HSG) is routinely performed in the mid-follicular phase of a woman's menstrual cycle for cavity and tubal patency assessment as a part of the infertility screening. A pre-procedural pregnancy test is not routinely required unless the patient reports abnormal menstrual bleeding or irregular menstrual pattern. PRESENTATION OF CASE: We present the case of a 29 year-old sub fertile woman who had a HSG performed on day 12 of her menstrual cycle. She developed abdominal pain shortly after and was diagnosed with a ruptured ectopic pregnancy, resulting in a right salpingectomy. The patient was discharged well 3 days later. DISCUSSION: Based on available guidelines and the rare occurrence of such complication, we find insufficient evidence to perform universal pre-procedural pregnancy testing. However, we strongly recommend doing it for abnormal menstrual cycles (cycles shorter than 21 or longer than 35 days, unreliable menstrual history or unusual menstrual flow pattern). Furthermore, HSG should be scheduled during the follicular phase after practicing safe sex within the two weeks preceding the test. CONCLUSION: While pre-procedural pregnancy test should not be performed for all, a high index of suspicion for early pregnancy should be maintained as undetected ectopic and heterotopic pregnancies could lead to serious complications once the HSG is done.

Ciguatera fish poisoning: First reported case in Sabah, Malaysia.

Ciguatera fish poisoning (CFP) is the most common natural marine toxin poisoning worldwide and yet under recognised in Malaysia. We report the first confirmed case of CFP in Sabah with severe neurological, cardiovascular and gastrointestinal manifestations after consumption of emperor snapper. Early recognition of CFP is important because it will result in improved patient care and public health intervention.