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Here, we present a 4,508,936-bp complete genome sequence of Stenotrophomonas maltophilia strain HW002Y, which was isolated from the tap water in an intensive care unit at Sultan Ahmad Shah Medical Centre at the International Islamic University of Malaysia (Kuantan, Pahang, Malaysia). Sequencing was performed using a Nanopore Flongle flow cell.

Background: Hepatitis C is one of the most common causes of liver disease worldwide. Health impacts of hepatitis C are not limited to physical morbidity but include psychosocial dimensions such as quality of life (QOL), depression, anxiety, and stigmatization. In Malaysia, modifiable factors that can improve QOL among hepatitis C patients have not been adequately studied. Resilience – defined as the capacity to endure hardships and rebound from life adversities – is associated with mental health and well-being. Our study aims to test the association between resilience and QOL among hepatitis C patients. Methods: Employing a cross-sectional design, 195 hepatitis C patients who attended Hospital Tengku Ampuan Afzan (HTAA) – the main public tertiary hospital in Pahang – were recruited through convenience sampling. Resilience was assessed using the Connor-Davidson resilience scale while Health-Related Quality of Life (HRQOL) was measured by 36-item short-form survey (SF-36v2). Multiple linear regression was run to determine the association between resilience and HRQOL. Results: We found significant associations between resilience and the physical (b=0.35; 95% CI: 0.11, 0.30; p

Background: There are several serological tests used in the diagnosis of melioidosis. However, the interpretation of the results can be problematic in endemic areas because there might be a high background positivity due to previous exposure. Objective: This study aimed to determine the usefulness of Indirect Immunofluorescent Antibody (IFA) IgM and IgG in the diagnosis of melioidosis and the time for seroconversion. Methodology: We prospectively studied the trend of IFA IgM and IgG in 40 patients with culture-confirmed melioidosis over three months at six different time points (days 1, 8, 15, 30, 60, and 90). Results: From the results, 37.5% and 32.5% of patients had IFA IgM and IgG of ≤ 1:20 respectively on day 1 when the blood culture was positive. The natural log (ln) of the titres was used for the analysis. Repeated measures ANOVA showed significant changes in both IgM (p= 0.001) and IgG (p= 0.045) respectively throughout six sampling time points. Both the means of ln IgM and ln IgG peaked at day 15. At day 90, mean ln IgG remained high but mean ln IgM dropped to a level below that of day one. All culture-confirmed melioidosis patients recorded a maximum IFA IgM titre of at least 1: 80, but all subsequently dropped to below this level at day 90. Conclusion: IFA IgM is a more useful diagnostic serological marker than IFA IgG in acute melioidosis. Bangladesh Journal of Infectious Diseases 2020;7(2):61-66

The SARS-CoV-2 has spread throughout the world since its discovery in China, and Malaysia is no exception. WGS has been a crucial approach in studying the evolution and genetic diversity of SARS-CoV-2 in the ongoing pandemic, and while an exceptional number of SARS-CoV-2 complete genomes have since been submitted to GISAID and NCBI, there is a scarcity of data from Malaysia. This study aims to report new Malaysian lineages responsible for the sustained spikes in COVID-19 cases during the third wave of the pandemic. Patients whose nasopharyngeal and oropharyngeal swabs were confirmed positive by real-time RT-PCR with Ct-value < 25 were chosen for WGS. The 10 SARS-CoV-2 isolates obtained were then sequenced, characterized and analyzed, including 1356 sequences of the dominant lineages of D614G variant currently circulating throughout Malaysia. The prevalence of clade GH and G formed strong ground of the discovery of two Malaysian lineages that caused sustained spikes of cases locally. Statistical analysis on the association of gender and age group with Malaysian lineages revealed a significant association (p < 0.05). Phylogenetic analysis revealed dispersion of 41 lineages, for which 22 lineages are still active. Mutational analysis observed unique G1223C missense mutation in Transmembrane Domain of Spike protein. Thus, calls for the large-scale WGS analysis of strains found around the world for greater understanding of viral evolution and genetic diversity especially in addressing the question of the effect of deleterious substitution mutation in transmembrane region of Spike protein.

Here, we report the nearly complete genome sequences of nine severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with the D614G mutation. These viruses were detected from various infected individuals with different levels of severity from Pahang, Malaysia. In addition, this study described the presence of lineage B.1.351 as a type of variant of concern (VOC) and lineages B.1.466.2 and B.1.524 as local variants.

Acute parkinsonism following streptococcal infection is rarely reported. To date, there is paucity of literature of post streptococcal immune mediated acute parkinsonism and dyskinesia among adult. We report a case of 18 years old woman, who presented with acute parkinsonism after streptococcal tonsillitis. The patient who was previously well presented with a two-month history of intermittent fever, associated with sore throat and sudden onset of behaviour changes. She has been found to be quieter and respond slowly to questions and commands in the preceding one week prior to admission. Features of secondary parkinsonism was noted during examination. Her blood counts, viral screenings and anti-NMDAR were unremarkable. Her lumbar puncture revealed an opening pressure of 10 cm CSF with normal constituents. The ASO titre was raised up to 400IU/ml. Electroencephalogram (EEG) shows mild encephalopathy changes and MRI brain shows normal finding. She was initially treated initially for meningoencephalitis with intravenous acyclovir 500mg q8h and ceftriaxone 2g q12h, concomitant with intravenous methylprednisolone 1g daily for 3 days. Intravenous immunoglobulin was started on her in view of poor response to the above treatment, which later resulted in significant and rapid clinical improvement. Upon clinic review at 3 months, her tremor, bradykinesia, and rigidity resolved. Her medication was able to be weaned off and she was referred to the ENT team for further evaluation for tonsillectomy. This case illustrates the importance of recognising post-streptococcal infection as aetiology of acute parkinsonism in young adults, to avoid treatment delay. As illustrated in our case, the prognosis was excellent with prompt immunomodulatory therapy. Bangladesh Journal of Infectious Diseases 2020;7(2):110-112

SARS-CoV-2 is a very transmissible and pathogenic coronavirus which detected in Malaysia in January 2020. Nevertheless, the sample from Malaysia is still under-sequenced. Hence lacking clarity of the circulating strain in Malaysia leads to a deadlock in understanding the virus infectivity. This study aimed to investigate the genome identity of circulating COVID-19 strains in Pahang and understand disease epidemiology during the pandemic. This study leveraged high-throughput sequencing analysis for the whole genome sequencing and implemented bioinformatic technique for the analysis. Here we reported that the virus with D614G mutation in Spike protein circulates in a few Malaysia states before the Sivagangga cluster announced in Kedah in July 2020. This mutated virus includes our virus sample isolated in April 2020 from an asymptomatic patient in Pahang. Based on the phylogenetic analysis, we discovered the origin of our sample Pahang/IIUM91 was not related to Sivagangga cluster. Here, we have generated 3D structure model of Pahang/IIUM91 Spike protein. D614G mutation in Pahang/IIUM91 Spike protein increases viral stability and flexibility, hence render higher infectivity. Collectively, our results suggest for the establishment of a complete SARS-CoV-2 genome database in Malaysia. Hence, more research should be established to learn the behaviour of this virus.

Pulmonary phaeohyphomycosis is a rare infection in the lung caused by black fungi containing a cytoplasmic melanin-like pigment. A 42-year-old man with underlying retroviral disease on HAART was investigated for having constitutional symptoms. Despite undetectable viral load and a high CD4 count, he was found to have unexplained significant loss of weight and appetite over a period of 6 months. Clinical examination revealed a cachexic man with multiple inguinal lymphadenopathies. Excisional biopsy of the inguinal lymph node revealed reactive follicular hyperplasia. CT Thorax, Abdomen and Pelvis was arranged to look for occult malignancy or infection and he was found to have multiple non-enhancing subcentimeter lung nodules mainly at the lateral segment of the right middle lobe of his lung. The largest nodule measured about 0.8 x 1.5 x 0.5 (AP x W x CC), with some nodules having an irregular margin with no extension into the adjacent bronchi. Bronchoscopy was done and demonstrated a black patch at the right intermedius, lateral segment of the middle lobe which did not disappear upon bronchial flush or wash. Histopathological examination found focal areas of blackish pigment and the bronchial alveolar lavage sent for fungal culture grew Cladosporium species. The patient was treated with oral Itraconazole with marked clinical improvement. This case highlights an unusual black fungi infection in the lung that stands out not only for its rarity and it's responsiveness to treatment, but also the susceptibility of an RVD positive patient to this infection despite having suppressed viral load and normal CD4 count.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S17

Acute pancreatitis related to mumps infection is rarely reported. In this case report, we highlight a case of acute pancreatitis caused by mumps infection in adulthood. A 25-year old woman treated for mumps developed sudden onset of vomiting and epigastric pain. She had an elevation of serum amylase and was treated for acute pancreatitis. She showed remarkable improvement of clinical symptoms with supportive treatment and after her bilateral parotid swelling receded.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 261-263

The pleuropulmonary solitary fibrous tumour (SFT) is a rare type of tumour. This paper outlined a 63-year-old female who came to the hospital with two weeks history of chronic cough, shortness of breath, and hypoglycemia. Contrast-Enhanced CT Thorax showed a huge heterogeneously-enhancing mass occupying the right hemithorax. US-guided biopsy followed by histological examination showed the features of an SFT. In view of the association between pleuropulmonary SFT and hypoglycaemia, the patient was highly likely to be suffering from a paraneoplastic syndrome known as Doege-Potter Syndrome.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 251-253

Pulmonary herpes simplex infection is rarely reported. To date, there is a paucity of literature on this infection. This case study describes a 64-year-old male with a background history of diabetes mellitus and hypertension who was intubated for acute respiratory failure. The managing team had difficulty to wean his oxygenation thus decided for bronchoscopy examination which showed suspicious growth at middle lobe of the right lung. Repeated bronchoscopy by pulmonologist revealed a nodular ‘warty’ appearance lesion at right bronchus intermedius. His biopsy revealed histopathological changes consistent with herpes simplex infection.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 112-114

Atypical lung carcinoid tumour, which is highly malignant has not been described widely in the literature. We report a middle-age woman who initially referred for possible lung malignancy. She presented with chronic diarrhoea to surgical team initially, who incidentally found to have a minimally enhancing irregular hypodense lesion at medial segment right lower lobe based on CT thorax finding. This patient later was diagnosed to have malignant lung carcinoid tumour based on histopathological examination with liver and bone metastasis. This case highlights the rare presentation of carcinoid tumour. A thorough history, supplemented by imaging and bronchoscopic examinations may lead to the diagnosis.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 108-111