Multi-Drug Resistant Pathogenic Escherichia coli Isolated from Wild Birds, Chicken, and the Environment in Malaysia.

Transmission of pathogenic microorganisms in the last decades has been considered a significant health hazard and pathogenic E. coli, particularly antibiotic-resistant strains, have long been identified as a zoonotic problem. This study aimed to investigate multidrug resistant pathogenic E. coli isolates from wild birds, chickens, and environment in selected Orang Asli and Malay villages in Peninsular Malaysia. The bacteriological culture-based technique, disc diffusion method, and multiplex Polymerase Chain Reaction (mPCR) assay was used to determine the occurrence of pathogenic E. coli strains in the several samples in the study. E. coli isolates showed a variety of multi-drug resistant (MDR) antibiotypes and Enteropathogenic E. coli (EPEC) and Enteroinvasive E. coli (EIEC) were the most predominantly identified pathogenic E. coli strains. The findings of this study demonstrated the significance of animal reservoirs and the environment as sources of pathogenic E. coli, resistant bacteria, and resistance genes. Hence, there is a need for adoption of a practical surveillance approach on MDR pathogens to control foodborne contamination.

A statistical analysis based recommender model for heart disease patients.

OBJECTIVES: An intelligent information technology based system could have a positive impact on the life-style of patients suffering from chronic diseases by providing useful health recommendations. In this paper, we have proposed a hybrid model that provides disease prediction and medical recommendations to cardiac patients. The first part aims at implementing a prediction model, that can identify the disease of a patient and classify it into one of the four output classes i.e., non-cardiac chest pain, silent ischemia, angina, and myocardial infarction. Following the disease prediction, the second part of the model provides general medical recommendations to patients. METHODS: The recommendations are generated by assessing the severity of clinical features of patients, estimating the risk associated with clinical features and disease, and calculating the probability of occurrence of disease. The purpose of this model is to build an intelligent and adaptive recommender system for heart disease patients. The experiments for the proposed recommender system are conducted on a clinical data set collected and labelled in consultation with medical experts from a known hospital. RESULTS: The performance of the proposed prediction model is evaluated using accuracy and kappa statistics as evaluation measures. The medical recommendations are generated based on information collected from a knowledge base created with the help of physicians. The results of the recommendation model are evaluated using confusion matrix and gives an accuracy of 97.8%. CONCLUSION: The proposed system exhibits good prediction and recommendation accuracies and promises to be a useful contribution in the field of e-health and medical informatics.

Wrapper method for feature selection to classify cardiac arrhythmia.

Efficient monitoring of cardiac patients can save tremendous amount of lives. Cardiac disease prediction and classification has gained utmost significance in this regard during the past few years. This paper presents a predictive model for classification of arrhythmias. The model works by selecting best features using wrapper algorithm around random forest, followed by implementing various machine learning classifiers on the selected features. Cardiac arrhythmia dataset from University of California, Irvine (UCI) machine learning repository has been used for the experimental purpose. After normalizing the data, repeated cross validation with 10 folds is applied on support vector machine (SVM), K nearest neighbor (KNN), Naïve Bayes, random forest, and Multi-Layer perceptron (MLP). The experimental results demonstrate that MLP beats other classifiers by achieving an average accuracy of 78.26%, while accuracies calculated for KNN and SVM are 76.6% and 74.4% respectively, outperforming the accuracies of previous models.

Incidence of colorectal cancer in Kashmir valley, India.

BACKGROUND: There is wide variation in the incidence of colorectal cancer globally and also within the same country among different racial or ethnic groups. The present population-based study was undertaken to determine the incidence of colorectal cancer in Kashmiri population which is non-migratory and ethnically homogeneous having stable food habits. METHODS: Over a period of one year, all newly diagnosed and histological proved cases of colorectal cancer in all possible areas, where such patients are diagnosed and treated were prospectively registered. RESULTS: A total of 212 cases of colorectal cancers were registered; of them 113 (53.3%) originated in the colon and other 99 (46.7%) in rectum. Male to female ratio was 1.2:1. The crude incidence rate of colorectal cancer was 3.65/100,000; it was 3.78 in males, and 3.50/100,000 in females. The incidence rates for colorectal cancer in Muslims and Hindus were different. The crude incidence rate for colorectal carcinoma was highest for district Srinagar 6.19/100,000 (urban area) and lowest for district Kupwara (rural area) 1.59/100,000. The highest numbers of cases were detected in the age group 55-59 years (n = 34). The age-specific rate for colorectal carcinoma was highest in the age group 55-59 years (17.21/100,000), followed by 65-69 years (14.86/100,000). The age standardized incidence rate was 4.52/100,000 per year. The truncated age adjusted incidence rates in age group 35-64 years was 8.31/100,000; while that for colorectal carcinoma was 8.77/100,000 in males and 7.66/100,000 in females. CONCLUSION: We conclude that the incidence of colorectal cancer in Kashmir valley is similar to that reported in the rest of India.

Association and pattern of diastolic dysfunction in patients of metabolic syndrome.

BACKGROUND: Diastolic dysfunction is important predictor of morbidity and mortality in patients with metabolic syndrome. This prospective study is to evaluate an association and pattern of diastolic dysfunction in patients of metabolic syndrome in our population. This cross-sectional study was performed at Armed Forces Institute of Cardiology Rawalpindi for a period of 6 months from 20th November 2007 to 20th April 2008. METHODS: One hundred eligible and consenting patients having metabolic syndrome reporting in the OPD were registered. Inclusion criteria included patients of metabolic syndrome with negative ETT and normal systolic function. Exclusion criteria were patients with age above 60 years and valvular heart disease. Data was collected by a structured clinical interview with a physician, ECG and a transthoracic M-mode, 2D and TDI echocardiogram. The metabolic syndrome was defined according to International Diabetes Federation. RESULTS: There was a positive association between the degree of the metabolic syndrome-assessed as number of concurrently present components-and parameters of cardiac structure and function, with a consistent and statistically significant trend for all cardiac variables considered (p = 0.000). There was also a positive association between each parameter and the cardiac diastolic dysfunction grading, e.g., systolic blood pressure (p = 0.000), diastolic blood pressure (p = 0.005), waist circumference (p = 0.004), fasting blood sugar (p = 0.008), triglycerides (p = 0.006), HDL cholesterol (p = 0.001). CONCLUSION: Several cardiac functional abnormalities regardless of symptoms increased progressively with increasing degree of metabolic syndrome.

Successful treatment of niclosamide- and praziquantel-resistant beef tapeworm infection with nitazoxanide.

BACKGROUND: Beef tapeworm (Taenia saginata) infection is acquired by eating inadequately cooked beef that contains the larvae or cysticerci of T. saginata. Niclosamide and praziquantel have proved effective for its treatment but treatment failures are well known. We report herein the results of nitazoxanide therapy. METHODS: A prospective study was conducted in 18 children and 34 adults to assess the efficacy and safety of nitazoxanide in the treatment of niclosamide- and praziquantel-resistant T. saginata infection. Nitazoxanide was administered twice daily for 3 days in 500-mg doses for those aged over 14 years and at 20mg/kg body weight/day in children aged 5-14 years. Post-treatment follow-up was undertaken at 1, 2, 4, 8, and 12 weeks for fecal samples for proglottides, and to check the presence, number, and viability of Taenia eggs. RESULTS: Nitazoxanide cured 51 of 52 (98.1%) patients. Mild side effects occurred in seven patients, which resolved spontaneously. There were no abnormalities in laboratory parameters. CONCLUSIONS: Nitazoxanide is a safe, effective, inexpensive, and well-tolerated drug for the treatment of niclosamide- and praziquantel-resistant beef tapeworm infection.

Body mass index and nutritional status of adults in two rural villages in northern malaysia.

There has been a change in the lifestyles of populations, including reduced physical activity and consumption of foods high in calories. Overweight and obesity are now replacing the more traditional public health concerns such as under-nutrition and infectious diseases as some of the most significant contributors to ill health. Determination of the body mass index (BMI) profile and nutritional status of adults of two rural coastal villages in Northern Malaysia was part of a community diagnosis in a community survey. Height and weight were measured and BMI calculated. Blood pressure was measured using a manual sphygmomanometer according to WHO guidelines. A standardised questionnaire was used to interview the villagers concerning their health. Out of the total population, 504 were above 20 years of age. Data was available for 441 persons for analysis. There were 210 (47.6%) males and 231 (52.4%) females. The prevalence of underweight was 9.8% (n=43), overweight 25.9% (n=114) and obesity 17% (n=75). The problem of over-nutrition was significantly higher among females, especially housewives. (p< 0.05). Those in ages 41-70 years were the majority with problems of over-nutrition (p=<0.05). More than half (52.9%; n=39) of those who were obese had hypertension (p=<0.05). Results show that a higher number of women especially housewives were obese and more than half of those obese subjects had hypertension. A more thorough nutritional profile using waist, hip and body fat measurement as well as an assessment of the dietary intake and activity regime of these villagers is needed. Interventions need to be carried out before more serious complications of obesity become rooted in this community.

Polymorphonuclear leukocyte mediated oxidative inactivation of alpha-1-proteinase inhibitor: Modulation by nitric oxide.

Alpha-1-proteinase inhibitor activity was studied in presence of resting and activated polymorphonuclear leucocytes. Four different agonists; phorbol myristic acetate, N-formyl-methionyl-leucyl-phenylalanine, opsonised zymosan and arachidonic acid decreased the inhibitor activity by 23.3%, 20%, 12% and 16.6^ respectively. The inhibitor activity was protected by using various free radical scavengers. Catalase and superoxide dismutase both restored activity by about 18%, mannitol by 13% and sodium azide by 17.3%. The inhibitor activity was also protected significantly by pretreatment of polymorphs with L-Arg, a precursor of nitric oxide, before activation. L-Arg was also observed to suppress the generation of superoxide and hydroxyl radical appreciably. The nitric oxide synthase inhibitor, aminoguanidine drastically inhibited the nitrite release and reversed the protection offered by L-Arg to the inhibitor activity. Our results indicate a multifactorial nature of the inactivation process, the culprit species being superoxide, hydrogen peroxide, hydroxyl radical and hypohalides. Nitric oxide seems to scavenge the superoxide radical directly after its formation rather than inhibiting its generation by NADPH oxidase as was believed earlier.