Adverse neonatal outcome associated with maternal tuberculosis in a public tertiary centre: a retrospective cohort study.

INTRODUCTION: The aim of this study was to evaluate a group of infants born to women with tuberculosis (TB) during pregnancy to determine the neonatal morbidities and its outcomes associated with tuberculosis in pregnancy. MATERIALS AND METHODS: Data from January 2007 to December 2021 was collected for analysis as part of a retrospective cohort study. This study was conducted in a tertiary public hospital in Malaysia, Hospital Sultan Idris Shah (HSIS). Cases were identified from the hospital's bacille Calmette-Guerin (BCG) vaccination notification forms and merged with records from the neonatal intensive care unit's census. Controls were infants born to mothers unaffected by TB within the same hospital and year as the index case (1:4 ratio). Descriptive statistics and logistic regression were used to analyse the data. The main outcome measures were the risk of congenital tuberculosis, premature birth, low birth weight, small for gestational age and low APGAR score. RESULTS: Data from January 2007 to December 2021 was collected for analysis as part of a retrospective cohort study. This study was conducted in a tertiary public hospital in Malaysia, Hospital Sultan Idris Shah (HSIS). Cases were identified from the hospital's bacille Calmette-Guerin (BCG) vaccination notification forms and merged with records from the neonatal intensive care unit's census. Controls were infants born to mothers unaffected by TB within the same hospital and year as the index case (1:4 ratio). Descriptive statistics and logistic regression were used to analyse the data. The main outcome measures were the risk of congenital tuberculosis, premature birth, low birth weight, small for gestational age and low APGAR score.

Ecofriendly adsorption and sensitive detection of Hg (II) by biomass-derived nitrogen-doped carbon dots: process modelling using central composite design.

In this study, luminescent bio-adsorbent nitrogen-doped carbon dots (N-CDs) was produced and applied for the removal and detection of Hg (II) from aqueous media. N-CDs were synthesized from oil palm empty fruit bunch carboxymethylcellulose (CMC) and urea. According to several analytical techniques used, the obtained N-CDs display graphitic core with an average size of 4.2 nm, are enriched with active sites, stable over a wide range of pH and have great resistance to photobleaching. The N-CDs have bright blue emission with an improved quantum yield (QY) of up to 35.5%. The effect of the variables including pH, adsorbent mass, initial concentration and incubation time on the removal of Hg (II) was investigated using central composite design. The statistical results confirmed that the adsorption process could reach equilibrium within 30 min. The reduced cubic model (R2 = 0.9989) revealed a good correlation between the observed values and predicted data. The optimal variables were pH of 7, dose of 0.1 g, initial concentration of 100 mg/L and duration of 30 min. Under these conditions, adsorption efficiency of 84.6% was obtained. The adsorption kinetic data could be well expressed by pseudo-second-order kinetic and Langmuir isotherm models. The optimal adsorption capacity was 116.3 mg g-1. Furthermore, the adsorbent has a good selectivity towards Hg (II) with a detection limit of 0.01 µM due to the special interaction between Hg (II) and carboxyl/amino groups on the edge of N-CDs. This work provided an alternative direction for constructing low-cost adsorbents with effective sorption and sensing of Hg (II).

Early-onset neonatal hypocalcaemia secondary to maternal vitamin D deficiency in an infant with DiGeorge syndrome: A first case report in Malaysia.

DiGeorge syndrome is a genetic disorder that is related to a wide range of defects affecting various parts of the body. The clinical expression shows marked variability making the diagnosis often missed or underdiagnosed. Here, we describe a neonate who presented with loud inspiratory stridor secondary to hypocalcaemia at birth. Physical examination revealed no abnormality other than evidence of congenital cardiac defect. Laboratory evaluations confirmed the diagnosis of maternal vitamin D deficiency that led to symptomatic hypocalcaemia in the newborn infant. The presence of hypocalcaemia coupled with episodes of recurrent infections led to the clinical suspicion of DiGeorge, which was later confirmed by fluorescence in situ hybridisation test.

Diagnosis of neonatal meningitis: is it time to use polymerase chain reaction?

Group B Streptococcus (GBS) is a predominant causative pathogen of neonatal meningitis that is associated with a high rate of mortality and morbidity. The establishment of antenatal screening and intrapartum chemoprophylaxis has led to a significant reduction in the incidence rate of invasive GBS disease in developed countries. However, these strategies are not routinely practiced in most developing countries. To ensure good recovery of infants affected with GBS, a prompt diagnostic strategy and appropriate therapy are essential. We highlight here the case of a preterm male infant diagnosed with early-onset of GBS meningitis diagnosed by using polymerase chain reaction (PCR) method on the cerebrospinal fluid (CSF) of the infant. Initially the pathogen was not isolated in both blood and CSF cultures as sampling was performed after the administration of antibiotics. Hence, PCR was a crucial diagnostic test in facilitating the detection of the pathogen in CSF. We believe that PCR is a potentially fast and precise diagnostic method for infection in a newborn.

Fluorescent recognition of Fe3+ in acidic environment by enhanced-quantum yield N-doped carbon dots: optimization of variables using central composite design.

A versatile synthetic approach for development of highly fluorescent nitrogen-doped carbon dots (N-CDs) from carboxymethylcellulose in the presence of linear polyethyleneimine (LPEI) has been developed. According to single factor method, central composite design incorporated with response surface methodology matrix was applied to find and model optimal conditions for the temperature (220-260 °C), duration (1-3 h) and LPEI weight (0.5-1.5%). The statistical results show that duration was the most significant parameter for efficient carbonization conversion rate in comparison with temperature and LPEI weight. The reduced cubic model (R2 = 0.9993) shows a good correlation between the experimental data and predicted values. The optimal variables were temperature of 260 °C, duration of 2 h and LPEI weight of 1%. Under these conditions, quantum yield of up to 44% was obtained. The numerically optimized N-CDs have an average size of 3.4 nm with graphitic nature owing to the abundant amino species incorporated into the carbon core framework. The blue-green N-CDs possess emission dependent upon the solvent polarity, wide pH stability with enhanced emission in an acidic environment. Impressively, the N-CDs show long-shelf-life for up to 1 year with no noticeable precipitation. The N-CDs were able to recognize a high concentration of Fe3+ ions with a detection limit of 0.14 µM in acidic solution owing to the special coordination for Fe3+ to be captured by electron-donating oxygen/ amino groups around N-CDs. Moreover, the N-CDs can also be used as a new kind of fluorescent ink for imaging applications.

Efficient removal of Cu(ii) from aqueous systems using enhanced quantum yield nitrogen-doped carbon nanodots.

The valorization of cellulose-based waste is of prime significance to green chemistry. However, the full exploitation of these lignocellulosic compounds to produce highly luminescent nanoparticles under mild conditions has not yet been achieved. In this context, we convert low-quality waste into value-added nanomaterials for the removal of Cu(ii) from wastewater. Carboxymethylcellulose (CMC), which was derived from empty fruit bunches, was selected for its high polymerization index to produce luminescent nitrogen-doped carbon dots (N-CDs) with the assistance of polyethylene glycol (PEG) as a dopant. The optimum N-CD sample with the highest quantum yield (QY) was characterized using various analytical techniques and the results show that the N-CDs have great crystallinity, are enriched with active sites and exhibit a long-shelf life with an enhanced QY of up to 27%. The influence of Cu2+ concentration, adsorbent (N-CDs) dosage, pH and contact time were investigated for the optimal adsorption of Cu2+. The experiments showed the rapid adsorption of Cu2+ within 30 min with a removal efficiency of over 83% under optimal conditions. The equilibrium isotherm investigation revealed that the fitness of the Langmuir isotherm model and kinetic data could be well explained by the pseudo-second order model. Desorption experiments proved that N-CDs can be regenerated successfully over five adsorption-desorption cycles owing to the ability of ascorbic acid (AA) to reduce the adsorbed nanocomplex into Cu+. The rapid adsorption property using low-cost materials identifies N-CDs as a superior candidate for water remedy.

A novel biocoagulant agent from mushroom chitosan as water and wastewater therapy.

A new commercial cationic polyelectrolyte chitosan (CM), obtained from the waste of mushroom production, was examined using models of water and wastewater namely kaolin and palm oil mill effluent (pome). As it is biocompatible, widely available, and economically feasible, chitosan mushroom has high potential to be a suitable replacement for alum. Also, it can be a promising alternative to chitosan obtained traditionally from Crustaceans due to its higher zeta potential and homogeneity based on the raw material required for its production. A wide range of coagulant dose (5-60 mg l-1) and wastewater pH (2-12) were taken into account to find the optimal conditions of coagulation. The optimal doses are 10 and 20 mg l-1 at best pH (11 and 3) when treated with kaolin and palm oil mill effluent, respectively, while 1200 mg l-1 of alum was not enough to reach the efficiency of chitosan mushroom. On the other hand, the optimum dose of chitosan mushroom (20 mg l-1) at pH 3 of pome produced (75, 73, and 98%) removal of chemical oxygen demand (COD), biological oxygen demand (BOD), and total suspended solids (TSS), respectively. The significant potential of chitosan mushroom was proved by zeta potential measurement. Indeed, it possesses the highest zeta potential (+70 mV) as compared to the traditional chitosan produced from crustaceans. In short, chitosan mushroom as a biocoagulant is eco-friendly and it enhances water quality that meets the requirements of environmental conservatives.

Dapsone syndrome--first Malaysian paediatric case report.

Dapsone syndrome is a potentially fatal hypersensitivity reaction to sulphone. We report a 12-year-old girl who developed high grade fever associated with intense jaundice, exfoliative skin rash and hepatomegaly after five weeks of starting the multidrug regimen for the treatment of Hansen's disease. Laboratory investigations revealed presence of leucocytosis with eosinophilia, deranged liver enzymes and an abnormal coagulation profile. Immediate cessation of the offending drug and administration of steroid proved successful. A high level of clinical awareness is fundamental for early diagnosis of dapsone syndrome as initiation of a prompt treatment may lead to rapid recovery.

Late onset group b beta-hemolytic streptococcus infection in a neonate manifesting as a urinary tract infection: a rare clinical presentation.

Group B beta-hemolytic streptococcus (GBS) sepsis is a serious bacterial infection in neonates, with significant morbidity and mortality. We report here a neonate with late onset GBS infection manifesting as a urinary tract infection (UTI) in an infant presenting with prolonged neonatal jaundice. The pathogenesis of this late onset is postulated.

Parotid abscess in a late premature infant: a case report.

Parotid abscess is uncommon in neonates. It is frequently related to prematurity, prolonged gavage feeding and dehydration. We report a case of a late preterm infant who developed the classical manifestation of unilateral acute Staphylococcus aureus suppurative parotitis progressing to formation of abscess which responded to surgical drainage and antibiotic therapy.

A preliminary study on Jatropha curcas as coagulant in wastewater treatment.

Many coagulants, mainly inorganic, are widely used in conventional water and wastewater treatment. Recent studies reported the occurrence of some chronic diseases associated with residual coagulant in treated wastewater. The use of alternative coagulants which are biodegradable and environmentally friendly could alleviate the problem associated with these diseases. This work investigates the capability of Jatropha curcas seed and presscake (the residue left after oil extraction) to reduce the turbidity of wastewater through coagulation. The coagulant was prepared by dissolving Jatropha curcas seed and presscake powder into solution. Then jar tests were conducted on kaolin solution as the model wastewater. The Jatropha seed was found to be an effective coagulant with more than 96% of turbidity removal at pH 1-3 and pH 11-12. The highest turbidity removal was recorded at pH 3 using a dosage of 120 mg/L. The flocs formed using Jatropha were observed to be bigger and to sediment faster when compared with flocs formed using alum. The turbidity removal was high (>98%) at all turbidities (100 NTU to 8000 NTU), suggesting its suitability for a wide range of industrial wastewater. The performance of Jatropha presscake after extraction of oil was also comparable to the fresh seed and alum at highly acidic and highly alkaline conditions. The addition of Jatropha did not significantly affect the pH of the kaolin samples after treatment and the sludge volume produced was less in comparison to alum. These results strongly support the use of Jatropha curcas seed and presscake as a potential coagulant agent.

Biological treatment of produced water in a sequencing batch reactor by a consortium of isolated halophilic microorganisms.

Produced water or oilfield wastewater is the largest volume ofa waste stream associated with oil and gas production. The aim of this study was to investigate the biological pretreatment of synthetic and real produced water in a sequencing batch reactor (SBR) to remove hydrocarbon compounds. The SBR was inoculated with isolated tropical halophilic microorganisms capable of degrading crude oil. A total sequence of 24 h (60 min filling phase; 21 h aeration; 60 min settling and 60 min decant phase) was employed and studied. Synthetic produced water was treated with various organic loading rates (OLR) (0.9 kg COD m(-3) d(-1), 1.8 kg COD m(-3) d(-1) and 3.6 kg COD m(-3) d(-1)) and different total dissolved solids (TDS) concentration (35,000 mg L(-1), 100,000 mg L(-1), 150,000 mg L(-1), 200,000 mg L(-1) and 250,000 mg L(-1)). It was found that with an OLR of 0.9 kg COD m(-3) d(-1) and 1.8 kg COD m(-3) d(-1), average oil and grease (O&G) concentrations in the effluent were 7 mg L(-1) and 12 mg L(-1), respectively. At TDS concentration of 35,000 mg L(-1) and at an OLR of 1.8 kg COD m(-3)d(-1), COD and O&G removal efficiencies were more than 90%. However, with increase in salt content to 250,000 mg L(-1), COD and O&G removal efficiencies decreased to 74% and 63%, respectively. The results of biological treatment of real produced water showed that the removal rates of the main pollutants of wastewater, such as COD, TOC and O&G, were above 81%, 83%, and 85%, respectively.

Ophthalmology inpatient consultation: does it make a difference to inpatient management?

Ophthalmology consultation is one of the commonest requested services for inpatients in a tertiary hospital. A total of 290 ophthalmology consultation requests were received over a period of six months (average 12 consultation requests per week) and from these, 222 patients were examined. The patient demographics, the hospitalization data, type of consultations (screening, new problem, preexisting problem), reasons for consultations and the ophthalmology diagnosis were determined. Out of 290 consultation requests, internal medicine services requested the highest number (95, 32.8%); the commonest type of consultation was screening for eye diseases (161, 55.5%) and the most common reason for consultation was to rule out diabetic retinopathy (125, 43.1%). The top five ophthalmology diagnoses after examination were diabetic retinopathy (45, 20.3%), diabetic retinopathy ruled out (37, 16.6%), conjunctivitis (12, 5.4%), refractive error (11, 4.8%) and normal ocular examination (11, 4.9%). Inpatient ophthalmologic procedures were performed in 146 patients, the commonest of which was retinal laser photocoagulation. A total of 133 (59.9%) inpatients had a change in their management as a result of the ophthalmology consultation.

Novel electrode structures for large scale dielectrophoretic separations based on textile technology.

The use of dielectrophoresis (DEP) to date has mainly been limited to processing small volumes due to difficulties in the fabrication of microelectrodes over large surface areas. To overcome this problem a novel approach to the construction of micro-electrode arrays has been developed based on weaving. A plain weave cloth was made from 100 microm diameter stainless steel wires and 75 decitex polyester yarns. The stainless steel wires formed the weft, and were kept parallel and apart by a warp of flexible polyester yarns, with a gap of around 150 microm between the metal wires. The metal wires were alternately connected to earth and signal of an AC power source, and it was shown that it was possible to collect yeast cells suspended in deionised water at the metal wire surfaces by dielectrophoresis. The polyester yarn was also found to distort the electric field, creating further areas of electric field non-uniformity around the polyester yarns, further enhancing the capability of the system to attract cells. A 14 ml separation chamber was built from the cloth by alternately sandwiching perspex slabs and cloth together. The DEP chamber was able to effectively collect life yeast from a flow of suspended cells through the cloth using an applied field of 1 MHz at flow rates up to 5 ml min-1. However, some loss occurred due to sedimentation. Also, the chamber was able to separate dead and live yeast cells at 30 Vpk-pk, 2 MHz, with some cell loss due to sedimentation.

Large scale dielectrophoretic construction of biofilms using textile technology.

Arrays of microelectrodes for AC electrokinetic experiments were fabricated by weaving together stainless steel wires (weft) and flexible polyester yarn (warp) in a plain weave pattern. The cloth produced can be used to collect cells in low conductivity media by dielectrophoresis (DEP). The construction of model biofilms consisting of a yeast layer on top of a layer of M. luteus is demonstrated, using polyethylenimine (PEI) as the flocculating agent. This technique offers an alternative to the formation of biofilms at microelectrodes made by photolithography, and would allow the construction of biofilms with defined internal architectures by DEP at much larger scales than was possible previously. Furthermore, the flexibility of the cloth would also allow it to be distorted or folded into various shapes.