A clinical audit of interventional pain procedures performed as part of the newly initiated pain service in a local neurosurgical centre.

Interventional Pain Procedures (IPPs) is a relatively new treatment modality for chronic pain in Malaysia. The Interventional Pain Service (IPS) newly set up in our institution is led by a pain neurosurgeon and provides a whole package of multimodal pain management including different range of IPPs. This clinical audit is to examine the quality of IPPs performed within the IPS in our institution since its initiation. A total of 87 IPPs were performed on 56 chronic pain patients over 3-year duration. As high as 81.8% of the procedures were effective and 81.5% of patients were satisfied. Only one minor transient complication occurred after an intradiscal procedure but none resulted in death or permanent disability. Thus, safe and effective IPPs can be provided as part of IPS in a local neurosurgical pain centre to bring more comprehensive and less fragmented care for chronic pain patients.

Prevalence of leptospiral DNA among wild rodents from a selected area in Beguk Dam Labis, Segamat, Johor, Malaysia.

Leptospirosis is an emerging infectious disease. The differential diagnosis of leptospirosis is difficult due to the varied and often "flu like" symptoms which may result in a missed or delayed diagnosis. Leptospira is the aetiological agent of leptospirosis, a bacterial zoonosis with worldwide distribution. There are over 230 known serovars in the genus Leptospira. The true prevalence of leptospirosis in Malaysia is unknown or underestimated. Our goal was to determine the prevalence for Leptospira infection in rodents in a selected area in Beguk Dam Labis, Segamat, Johor. A study was carried out on 69 serum samples of trapped wild rodents. DNA was extracted from the sera using Leptospira PCR kit (Shanghai ZJ Bio-Tech Co., Ltd). Of 69 rodent serum samples tested by PCR, 9 (13%) showed positive results. In this study we found that (13%) of wild rodents caught in Beguk Dam Labis were infected by Leptospira.

Endo-parasite fauna of rodents caught in five wet markets in Kuala Lumpur and its potential zoonotic implications.

Rodents were collected from five wet markets (Chow Kit, Dato Keramat, Setapak, Jinjang and Kepong) in Kuala Lumpur, Federal Territory between March to April 2006. Ninety seven rats were trapped using wire traps measuring 29 x 22 x 50 cm baited with fruits, coconuts, dried fish or sweet potatoes. A total of 17 different species of parasites were identified from three species of rats out of which 11 (65%) were identified to be zoonotic. The helminths identified from the urban rats were nematodes- Capillaria hepatica, Gongylonema neoplasticum, Heterakis spumosa, Heterakis sp., Masterphorus muris, Nippostrongylus brasiliensis, Physolaptera sp., Pterogodermatis sp., Rictularia tani and Syphacia muris; cestodes- Hymenolepis nana, Hymenolepis diminuta, Hymenolepis sabnema, Hymenolepis sp., Raillietina sp. and Taenia taeniaeformis, and acanthocephalan- Moniliformis moniliformis. The following parasites are of potential medical importance: C. hepatica, G. neoplasticum, R. tani, S. muris, H. diminuta, H. nana, Raillietina sp. and T. taeniaeformis.

Ectoparasite fauna of rodents and shrews from four habitats in Kuala Lumpur and the states of Selangor and Negeri Sembilan, Malaysia and its public health significance.

A total of 204 rodents comprising 14 host species from four different habitats were examined. Nine rodent species were trapped from the forest and another five species were trapped from the coastal, rice field and urban habitats. Rattus rattus diardii (67%) was the predominant rodent species examined. Fifty six (47.3%) rodents and shrews were found to be infested with at least one of the 20 species of ectoparasite recovered. Mites belonging to the family Trombiculidae were the predominant ectoparasite species recovered. Ticks belonging to the family Ixodidae were recovered mainly from the forest dwelling rodents. Polyplax spinulosa and Hoplopleura pacifica were the common lice species found infesting the urban rodents. Xenopsylla cheopis was the only flea species recovered. The following ecto-parasites have been incriminated as important vectors or as mechanical carriers for the transmission of zoonotic diseases: Ixodes granulatus, Dermacentor sp. Haemaphysalis sp., Amblyomma sp. Ascoschoengastia indica, Leptotrombidium deliense, Ornithonyssus bacoti, Laelaps nuttalli, H. pacifica, P. spinulosa and Xenopsylla cheopis. Urban and forest rodents were significantly higher in ecto-parasitic infestation, compared to rats from the other two habitats. However, there was no significant statistical association between male and female rodents infested with ectoparasites.

A transmission electron microscopy study on effects of a modified Glutaraldehyde fixation on Acanthamoeba castellanii.

Transmission electron microscopy (TEM) can provide high resolution imaging of biological specimens. The study is to establish the effects of a modified glutaraldehyde (GA) compare to the standard GA fixation on Acanthamoeba castellanii from TEM perspectives and thus provide precise and accurate information on the ultrastructure studies of the parasite. By increasing the contrast, the ultrastructures of the parasite were more evident. The TEM images were obtained from parasites fixed with the modified GA and the standard GA and then the area of the nucleus and the gray values of the image of the nucleus of the parasites were measured. The mean areas of the nucleus were found to be significantly reduced in the standard GA fixed parasites (12210.4 nm2) compared to the modified GA fixed parasites (8676.3 nm2) (p < 0.05). The mean gray values of the image were significantly reduced from 2024 in the standard GA fixed parasites (2024) to the modified GA fixed parasites (1636) (p < 0.05). The study shows that the modified GA produced significantly better contrast on TEM images of the A. castellanii compared to the standard GA. This was because the modified GA generated more free water molecules during fixation and the uptake of modified GA by the nucleus of the parasite organizing all protein constituents in the cell into a more closely packed configuration than that of the standard GA. With such properties, the modified GA is a better fixative providing better images for ultrastructures of the parasite.

Notes on some ectoparasites received by the Medical Entomology Unit, Institute for Medical Research.

There were a spate of recent complaints of insect bites and the entomological specimens received from various sources were identified to be those of cat flea (Ctenocephalides felis) and rat flea (Xenopsylla cheopis), the tropical bed-bug (Cimex hemipterus) and the dog louse (Heterodoxus spiniger). Only the fleas and the bed-bug are known to attack humans.

Helminth infections in small mammals from Ulu Gombak Forest Reserve and the risk to human health.

A survey for small mammal parasites carried out in a secondary forest of Ulu Gombak, Selangor, Peninsula Malaysia yielded the following animals: Rattus bowersi (7), Rattus tiomanicus jalorensis (2), Maxomys rajah (12), Maxoyms whiteheadi (3), Leopoldamys sabanus(13), Sundamys muelleri(10), Lariscus insignis (1), Sundasciurus tenuis (1) and Tupaia glis (2). The following nematodes: Capillaria hepatica, Hepatojarakus malayae, Trichostrongylus sp. and Streptopharagus sp., the following cestodes: Hymenolepis sp., Raillietina sp. and Taenia taeniaformis; and trematode, Zonorchis sp. from Tupaia glis were recovered. No parasites were observed during blood examination. No endoparasite was seen in Maxomys whiteheadi, Lariscus insignis and Sundasciurus tenuis. The following parasites, Capillaria hepatica, Hymenolepis sp., Raillietina sp. and Taenia taeniaformis are considered of medical importance.