Epidemiology of Streptococcus pneumoniae infection in Malaysia

During a 1-year period from October 1995 to September 1996, 273 isolations of Streptococcus pneumoniae were made from various types of clinical specimens. The majority of the isolates (39.2%) were from sputum whilst 27.5% were from blood, CSF and other body fluids. The organism was isolated from patients of all age groups, 31.1% from children aged 10 years and below, 64.7% of which come from children aged 2 years or below. The majority of the isolates belong to serotypes 1, 6B, 19B, 19F and 23F. Serotypes 1 and 19B were the most common serotypes associated with invasive infection. About 71.9% of the invasive infections were due to serotypes included in the available 23 valent polysaccharide vaccine. The rates of resistance to penicillin and erythromycin were 7.0 and 1.1% respectively. Our findings show that the serotypes of S. pneumoniae causing most invasive infections in Malaysia are similar to those in other parts of the world and the available vaccine may have a useful role in this population.     

Preoperative physiotherapy and short-term functional outcomes of primary total knee arthroplasty

INTRODUCTION

Physiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA).

METHODS

50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months.

RESULTS

Both groups showed a significant difference in all algofunctional KOOS subscales (p < 0.001). The mean score difference at six weeks and three months was not significant in the sports and recreational activities subscale for both groups (p > 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928).

CONCLUSION

Six-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA.     

Relationship between pulmonary function and degree of spinal deformity,location of apical vertebrae and age among adolescent idiopathic scoliosis patients

INTRODUCTION

This retrospective review aimed to examine the relationship between preoperative pulmonary function and the Cobb angle, location of apical vertebrae and age in adolescent idiopathic scoliosis (AIS). To our knowledge, there have been no detailed analyses of preoperative pulmonary function in relation to these three factors in AIS.

METHODS

A total of 38 patients with thoracic or thoracolumbar scoliosis were included. Curvature of spinal deformity was measured using the Cobb method. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were used to evaluate preoperative pulmonary function. Statistical methods were used to analyse the relationship between preoperative pulmonary function and the factors that may contribute to poor pulmonary function.

RESULTS

The mean age of the patients was 16.68 ± 6.04 years. An inverse relationship was found between the degree of the Cobb angle and FVC as well as FEV1; however, the relationships were not statistically significant (p = 0.057 and p = 0.072, respectively). There was also a trend towards a significant negative correlation between the thoracic curve and FVC (p = 0.014). Patients with larger thoracic curves had lower pulmonary function. A one-year increase in age significantly decreased FVC by 1.092 units (p = 0.044). No significant relationship between age and preoperative FEV1 was found. The median FVC was significantly higher in patients with affected apical vertebrae located at levels L1–L3 than at T6–T8 or T9–T12 (p = 0.006).

CONCLUSION

Lung function impairment was seen in more severe spinal deformities, proximally-located curvature and older patients.     

Chemical composition and biological activities of essential oil of Beilschmiedia pulverulenta

Context: The ethnopharmacological study of Beilschmiedia indicates that several species are used for the treatment of various ailments.

Objective: This is the first study of the chemical composition of Beilschmiedia pulverulenta Kosterm (Lauraceae) essential oil and its antioxidant, antimicrobial, antityrosinase, anti-inflammatory, and anticholinesterase activities.

Materials and methods: The antioxidant activities were evaluated by β-carotene, 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical scavenging, ferric-reducing antioxidant power (FRAP), and phenolic content at different concentrations. The antimicrobial activities against Gram-positive and Gram-negative bacteria and fungi were revealed by disk diffusion and microdilution. The antityrosinase and anti-inflammatory activities were assayed against mushroom tyrosinase and lipoxygenase enzymes. The anticholinesterase activity was analyzed using acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) enzymes.

Results: Forty-two components were detected in B. pulverulenta oil with eugenol (45.3%) being the major component. The oil phenolic content and the FRAP were 660.1?mg gallic acid/g and 604.0?mg ascorbic acid/g, respectively. The oil gave an IC₅₀ value of 94.5?µg/mL and an inhibition of 93.9% in DPPH and β-carotene, respectively. The antimicrobial activity showed that the oil had strong activity against all Gram-positive bacteria with an minimum inhibitory concentration (MIC) value each of 62.5?µg/mL and moderate against all fungi with MIC and minimum bactericidal concentration (MBC) values each of 125?µg/mL. The oil showed significant antityrosinase and anti-inflammatory activities with 67.6 and 62.5% inhibition, respectively. In addition, the oil had moderate AChE (56.5%) and BChE (48.2%) activities.

Discussion and conclusion: The results show that the oil could potentially be used for nutraceutical industries, food manufactures, and therapeutic agents against various diseases such as inflammation and rheumatism.