Browse publications by year: 2017

  1. Harsha MS, Praffulla M, Babu MR, Leneena G, Krishna TS, Divya G
    J Clin Diagn Res, 2017 May;11(5):ZC45-ZC48.
    PMID: 28658906 DOI: 10.7860/JCDR/2017/25305.9856
    INTRODUCTION: Cavity preparations of posterior teeth have been frequently associated with decreased fracture strength of the teeth. Choosing the correct indirect restoration and the cavity design when restoring the posterior teeth i.e., premolars was difficult as it involves aesthetic, biomechanical and anatomical considerations.

    AIM: To evaluate the fracture resistance and failure pattern of three different cavity designs restored with monolithic zirconia.

    MATERIALS AND METHODS: Human maxillary premolars atraumatically extracted for orthodontic reasons were chosen. A total of 40 teeth were selected and divided into four groups (n=10). Group I-Sound teeth (control with no preparation). Group II-MOD Inlay, Group III-Partial Onlay, Group IV-Complete Onlay. Restorations were fabricated with monolithic partially sintered zirconia CAD (SAGEMAX- NexxZr). All the 30 samples were cemented using Multilink Automix (Ivoclar) and subjected to fracture resistance testing using Universal Testing Machine (UTM) (Instron) with a steel ball of 3.5 mm diameter at crosshead speed of 0.5 mm/minute. Stereomicroscope was used to evaluate the modes of failure of the fractured specimen. Fracture resistance was tested using parametric one way ANOVA test, unpaired t-test and Tukey test. Fracture patterns were assessed using non-parametric Chi-square test.

    RESULTS: Group IV (Complete Onlay) presented highest fracture resistance and showed statistical significant difference. Group II (MOD Inlay) and Group III (Partial Onlay) showed significantly lower values than the Group I (Sound teeth). However, Groups I, II and III presented no significant difference from each other. Coming to the modes of failure, Group II (MOD Inlay) and Group III (Partial Onlay) presented mixed type of failures; Group IV (Complete Onlay) demonstrated 70% Type I failures.

    CONCLUSION: Of the three cavity designs evaluated, Complete Onlay had shown a significant increase in the fracture resistance than the Sound teeth.

    MeSH terms: Analysis of Variance; Bicuspid; Dental Cavity Preparation; Esthetics; Humans; Inlays; Steel; Waxes; Zirconium
  2. Singh VA, Shah SU, Yasin NF, Abdullah BJJ
    J Orthop Surg (Hong Kong), 2017 May-Aug;25(2):2309499017716256.
    PMID: 28659052 DOI: 10.1177/2309499017716256
    AIMS: Magnetic resonance guided focused ultrasound (MRgFUS) is a new modality in the management of primary and secondary bone tumors. We aimed to investigate the safety, efficacy, and feasibility of using MRgFUS for the treatment of (1) benign bone tumors with the intent of complete tumor ablation, (2) primary malignant bone tumors with the intent to assess its effectiveness in causing tumor necrosis, and (3) metastatic bone disease with the intent of pain relief.

    METHOD: Twenty-four patients with benign bone tumors, primary malignant bone tumors, and metastatic bone disease were treated with one session of MRgFUS. Contrast-enhanced (CE) magnetic resonance imaging (MRI) was carried out post-procedure to assess and quantify the area of ablation. Those with malignant primary tumors had the tumors resected 2 weeks after the treatment and the ablated areas were examined histopathologically (HPE). The other patients were followed up for 3 months to assess for the side effects and pain scores.

    RESULTS: Significant volume of ablation was noted on CE MRI after the treatment. Benign bone tumors were ablated with minimal adverse effects. Metastatic bone disease was successfully treated with significant decrease in pain scores. Ablated primary malignant tumors showed significant coagulative necrosis on MRI and the HPE showed 100% necrosis. Pain scores significantly decreased 3 months after the procedure. Only two patients had superficial skin blistering and three patients had increase in pain scores immediately after treatment.

    CONCLUSION: MRgFUS is effective, safe, and noninvasive procedure that can be an adjunct in the management of primary and metastatic bone tumors.
    MeSH terms: Adolescent; Adult; Bone Neoplasms/pathology; Bone Neoplasms/therapy*; Child; Feasibility Studies; Female; Humans; Magnetic Resonance Imaging*; Male; Middle Aged; Pain/etiology; Pain/prevention & control; Ultrasonic Therapy/methods*; Treatment Outcome; Young Adult
  3. Suppiah J, Chan SY, Ng MW, Khaw YS, Ching SM, Mat-Nor LA, et al.
    J Biomed Sci, 2017 Jun 28;24(1):40.
    PMID: 28659189 DOI: 10.1186/s12929-017-0344-x
    BACKGROUND: Dengue and leptospirosis infections are currently two major endemics in Malaysia. Owing to the overlapping clinical symptoms between both the diseases, frequent misdiagnosis and confusion of treatment occurs. As a solution, the present work initiated a pilot study to investigate the incidence related to co-infection of leptospirosis among dengue patients. This enables the identification of more parameters to predict the occurrence of co-infection.

    METHOD: Two hundred sixty eight serum specimens collected from patients that were diagnosed for dengue fever were confirmed for dengue virus serotyping by real-time polymerase chain reaction. Clinical, laboratory and demographic data were extracted from the hospital database to identify patients with confirmed leptospirosis infection among the dengue patients. Thus, frequency of co-infection was calculated and association of the dataset with dengue-leptospirosis co-infection was statistically determined.

    RESULTS: The frequency of dengue co-infection with leptospirosis was 4.1%. Male has higher preponderance of developing the co-infection and end result of shock as clinical symptom is more likely present among co-infected cases. It is also noteworthy that, DENV 1 is the common dengue serotype among all cases identified as dengue-leptospirosis co-infection in this study.

    CONCLUSION: The increasing incidence of leptospirosis among dengue infected patients has posed the need to precisely identify the presence of co-infection for the betterment of treatment without mistakenly ruling out either one of them. Thus, anticipating the possible clinical symptoms and laboratory results of dengue-leptospirosis co-infection is essential.

    MeSH terms: Adult; Dengue/diagnosis*; Dengue/epidemiology*; Dengue/virology; Dengue Virus/isolation & purification; Female; Humans; Leptospira/isolation & purification; Leptospirosis/diagnosis*; Leptospirosis/microbiology; Leptospirosis/epidemiology*; Malaysia/epidemiology; Male; Pilot Projects; Retrospective Studies; Serotyping; Incidence; Prevalence; Young Adult; Coinfection/diagnosis*; Coinfection/microbiology; Coinfection/epidemiology*; Coinfection/virology; Real-Time Polymerase Chain Reaction
  4. Singh VA, Lim CY, Yan HC, Rahman NA
    J Foot Ankle Surg, 2017 06 26;56(6):1292-1297.
    PMID: 28659241 DOI: 10.1053/j.jfas.2017.05.005
    Melanoma is a well-known malignant neoplasm of the skin, although it can also arise from other structures. Bone metastasis is not an uncommon event associated with melanoma, although primary osseous melanoma is very rare. In the present report, we describe a case of primary melanoma arising from the left third metatarsal in an adult male. The lesion was treated with surgical excision without adjunct chemotherapy, and recurrence developed approximately 12 months after the foot surgery. The patient died of the cancer 34 months after it had been identified. Primary melanoma arising in a metatarsal is rare, and we wished to highlight this unusual presentation.
    MeSH terms: Adult; Biopsy, Needle; Bone Neoplasms/pathology*; Bone Neoplasms/surgery*; Humans; Immunohistochemistry; Magnetic Resonance Imaging/methods; Male; Melanoma/pathology*; Melanoma/surgery*; Metatarsal Bones/pathology*; Metatarsal Bones/surgery; Neoplasm Invasiveness/pathology; Neoplasm Recurrence, Local/pathology; Neoplasm Recurrence, Local/surgery; Neoplasm Staging; Tomography, X-Ray Computed; Fatal Outcome; Disease Progression; Risk Assessment; Rare Diseases
  5. Moriyama T, Yang YL, Nishii R, Ariffin H, Liu C, Lin TN, et al.
    Blood, 2017 Sep 07;130(10):1209-1212.
    PMID: 28659275 DOI: 10.1182/blood-2017-05-782383
    Prolonged exposure to thiopurines (eg, mercaptopurine [MP]) is essential for curative therapy in acute lymphoblastic leukemia (ALL), but is also associated with frequent dose-limiting hematopoietic toxicities, which is partly explained by inherited genetic polymorphisms in drug metabolizing enzymes (eg, TPMT). Recently, our group and others identified germ line genetic variants in NUDT15 as another major cause of thiopurine-related myelosuppression, particularly in Asian and Hispanic people. In this article, we describe 3 novel NUDT15 coding variants (p.R34T, p.K35E, and p.G17_V18del) in 5 children with ALL enrolled in frontline protocols in Singapore, Taiwan, and at St. Jude Children's Research Hospital. Patients carrying these variants experienced significant toxicity and reduced tolerance to MP across treatment protocols. Functionally, all 3 variants led to partial to complete loss of NUDT15 nucleotide diphosphatase activity and negatively influenced protein stability. In particular, the p.G17_V18del variant protein showed extremely low thermostability and was completely void of catalytic activity, thus likely to confer a high risk of thiopurine intolerance. This in-frame deletion was only seen in African and European patients, and is the first NUDT15 risk variant identified in non-Asian, non-Hispanic populations. In conclusion, we discovered 3 novel loss-of-function variants in NUDT15 associated with MP toxicity, enabling more comprehensive pharmacogenetics-based thiopurine dose adjustments across diverse populations.
    MeSH terms: Adolescent; Child; Child, Preschool; Female; Humans; Infant; Male; Models, Molecular; Mutation/genetics*; Pyrophosphatases/genetics; Pyrophosphatases/chemistry; 6-Mercaptopurine/adverse effects*; 6-Mercaptopurine/therapeutic use*; European Continental Ancestry Group/genetics*; Asian Continental Ancestry Group/genetics*; Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy*; Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics*
  6. Bonakdari H, Ebtehaj I, Akhbari A
    Water Sci Technol, 2017 Jun;75(12):2791-2799.
    PMID: 28659519 DOI: 10.2166/wst.2017.158
    Electrocoagulation (EC) is employed to investigate the energy consumption (EnC) of synthetic wastewater. In order to find the best process conditions, the influence of various parameters including initial pH, initial dye concentration, applied voltage, initial electrolyte concentration, and treatment time are investigated in this study. EnC is considered the main criterion of process evaluation in investigating the effect of the independent variables on the EC process and determining the optimum condition. Evolutionary polynomial regression is combined with a multi-objective genetic algorithm (EPR-MOGA) to present a new, simple and accurate equation for estimating EnC to overcome existing method weaknesses. To survey the influence of the effective variables, six different input combinations are considered. According to the results, EPR-MOGA Model 1 is the most accurate compared to other models, as it has the lowest error indices in predicting EnC (MARE = 0.35, RMSE = 2.33, SI = 0.23 and R2 = 0.98). A comparison of EPR-MOGA with reduced quadratic multiple regression methods in terms of feasibility confirms that EPR-MOGA is an effective alternative method. Moreover, the partial derivative sensitivity analysis method is employed to analyze the EnC variation trend according to input variables.
    MeSH terms: Algorithms; Electrocoagulation; Waste Disposal, Fluid/methods*; Waste Disposal, Fluid/statistics & numerical data; Models, Statistical*; Waste Water*
  7. Tan CW, Malcolm TTH, Kuan CH, Thung TY, Chang WS, Loo YY, et al.
    Front Microbiol, 2017;8:1087.
    PMID: 28659901 DOI: 10.3389/fmicb.2017.01087
    Numerous prevalence studies and outbreaks of Vibrio parahaemolyticus infection have been extensively reported in shellfish and crustaceans. Information on the quantitative detection of V. parahaemolyticus in finfish species is limited. In this study, short mackerels (Rastrelliger brachysoma) obtained from different retail marketplaces were monitored with the presence of total and pathogenic strains of V. parahaemolyticus. Out of 130 short mackerel samples, 116 (89.2%) were detected with the presence of total V. parahaemolyticus and microbial loads of total V. parahaemolyticus ranging from <3 to >10(5) MPN/g. Prevalence of total V. parahaemolyticus was found highest in wet markets (95.2%) followed by minimarkets (89.1%) and hypermarkets (83.3%). Pathogenic V. parahaemolyticus strains (tdh+ and/or trh+) were detected in 16.2% (21 of 130) of short mackerel samples. The density of tdh+ V. parahaemolyticus strains were examined ranging from 3.6 to >10(5) MPN/g and microbial loads of V. parahaemolyticus strains positive for both tdh and trh were found ranging from 300 to 740 MPN/g. On the other hand, antibiotic susceptibility profiles of V. parahaemolyticus strains isolated from short mackerels were determined through disc diffusion method in this study. Assessment of antimicrobial susceptibility profile of V. parahaemolyticus revealed majority of the isolates were highly susceptible to ampicillin sulbactam, meropenem, ceftazidime, and imipenem, but resistant to penicillin G and ampicillin. Two isolates (2.99%) exhibited the highest multiple antibiotic resistance (MAR) index value of 0.41 which shown resistance to 7 antibiotics. Results of the present study demonstrated that the occurrence of pathogenic V. parahaemolyticus strains in short mackerels and multidrug resistance of V. parahaemolyticus isolates could be a potential public health concerns to the consumer. Furthermore, prevalence data attained from the current study can be further used to develop a microbial risk assessment model to estimate health risks associated with the consumption of short mackerels contaminated with pathogenic V. parahaemolyticus.
    MeSH terms: Ampicillin; Animals; Anti-Bacterial Agents; Ceftazidime; Cross-Sectional Studies; Drug Resistance, Microbial; Penicillin G; Public Health; Shellfish; Sulbactam; Vibrio parahaemolyticus; Imipenem; Prevalence; Drug Resistance, Multiple
  8. Nguyen NH, Hamzah A, Thoa NP
    Front Genet, 2017;8:82.
    PMID: 28659970 DOI: 10.3389/fgene.2017.00082
    The extent to which genetic gain achieved from selection programs under strictly controlled environments in the nucleus that can be expressed in commercial production systems is not well-documented in aquaculture species. The main aim of this paper was to assess the effects of genotype by environment interaction on genetic response and genetic parameters for four body traits (harvest weight, standard length, body depth, body width) and survival in Red tilapia (Oreochromis spp.). The growth and survival data were recorded on 19,916 individual fish from a pedigreed population undergoing three generations of selection for increased harvest weight in earthen ponds from 2010 to 2012 at the Aquaculture Extension Center, Department of Fisheries, Jitra in Kedah, Malaysia. The pedigree comprised a total of 224 sires and 262 dams, tracing back to the base population in 2009. A multivariate animal model was used to measure genetic response and estimate variance and covariance components. When the homologous body traits in freshwater pond and cage were treated as genetically distinct traits, the genetic correlations between the two environments were high (0.85-0.90) for harvest weight and square root of harvest weight but the estimates were of lower magnitudes for length, width and depth (0.63-0.79). The heritabilities estimated for the five traits studied differed between pond (0.02 to 0.22) and cage (0.07 to 0.68). The common full-sib effects were large, ranging from 0.23 to 0.59 in pond and 0.11 to 0.31 in cage across all traits. The direct and correlated responses for four body traits were generally greater in pond than in cage environments (0.011-1.561 vs. -0.033-0.567 genetic standard deviation units, respectively). Selection for increased harvest body weight resulted in positive genetic changes in survival rate in both pond and cage culture. In conclusion, the reduced selection response and the magnitude of the genetic parameter estimates in the production environment (i.e., cage) relative to those achieved in the nucleus (pond) were a result of the genotype by environment interaction and this effect should be taken into consideration in the future breeding program for Red tilapia.
    MeSH terms: Animals; Body Weight; Breeding; Environment, Controlled; Fisheries; Malaysia; Pedigree; Weight Gain; Survival Rate; Tilapia; Aquaculture; Models, Animal; Gene-Environment Interaction; Ponds
  9. Adeeb F, Khan MU, Li X, Stack AG, Devlin J, Fraser AD
    Int J Inflam, 2017;2017:8608716.
    PMID: 28660088 DOI: 10.1155/2017/8608716
    Vitamin D plays a significant role in the immune system modulation and may confer a protective role in autoimmune diseases. We conducted a case-control study to compare 25(OH)D levels in patients with BD who were managed at a regional rheumatology programme in the midwest region of Ireland compared to matched controls. Healthy controls were selected from the Irish health system and matched in 1 : 5 ratio for age, sex, and the month of the year. 25(OH)D levels <20 nmol/L were classified as deficient while levels between 20 and 40 nmol/L were classified as insufficient. Differences between groups were assessed using Mann-Whitney test and associations between cases and controls were expressed as odds ratios and 95% confidence intervals. Nineteen patients with BD were compared with 95 controls matched by age, sex, and month of blood draw. 25(OH)D levels were significantly higher in patients in BD than in matched controls (median values: 45 nmol/L versus 22 nmol/L, p < 0.005) and tended to be lower in patients with active disease than in those without (median values: 35 nmol/L (IQR: 22.75-47.25 nm/L) versus 50 nmol/L (IQR: 35-67 nmol/L), p = 0.11). Compared to controls, patients with BD were significantly less likely to have 25(OH)D deficiency or insufficiency (OR: 0.09, 95% CI: 0.03-0.28, p < 0.001). Our findings suggest a possible role for 25(OH)D in modifying the inflammatory response in BD and uncover a potential opportunity to assess whether correction of Vit D deficiency confers protective benefits.
  10. Kamalaldin NA, Sulaiman SA, Yusop MR, Yahaya B
    Int J Inflam, 2017;2017:8741851.
    PMID: 28660089 DOI: 10.1155/2017/8741851
    Many studies have been done to evaluate the effect of various natural products in controlling asthma symptoms. Virgin coconut oil (VCO) is known to contain active compounds that have beneficial effects on human health and diseases. The objective of this study was to evaluate the effect of VCO inhalation on airway remodelling in a rabbit model of allergic asthma. The effects of VCO inhalation on infiltration of airway inflammatory cells, airway structures, goblet cell hyperplasia, and cell proliferation following ovalbumin induction were evaluated. Allergic asthma was induced by a combination of ovalbumin and alum injection and/or followed by ovalbumin inhalation. The effect of VCO inhalation was then evaluated via the rescue or the preventive route. Percentage of inflammatory cells infiltration, thickness of epithelium and mucosa regions, and the numbers of goblet and proliferative cells were reduced in the rescue group but not in preventive group. Analysis using a gas chromatography-mass spectrometry found that lauric acid and capric acid were among the most abundant fatty acids present in the sample. Significant improvement was observed in rescue route in alleviating the asthma symptoms, which indicates the VCO was able to relieve asthma-related symptoms more than preventing the onset of asthma.
  11. Verkicharla PK, Ramamurthy D, Nguyen QD, Zhang X, Pu SH, Malhotra R, et al.
    Transl Vis Sci Technol, 2017 Jun;6(3):20.
    PMID: 28660095 DOI: 10.1167/tvst.6.3.20
    PURPOSE: To develop a fitness tracker (FitSight) to encourage children to increase time spent outdoors. To evaluate the wear pattern for this tracker and outdoor time pattern by estimating light illumination levels among children.

    METHODS: The development of the FitSight fitness tracker involved the designing of two components: (1) the smartwatch with custom-made FitSight watch application (app) to log the instant light illuminance levels the wearer is exposed to, and (2) a companion smartphone app that synchronizes the time outdoors recorded by the smartwatch to smartphone via Bluetooth communication. Smartwatch wear patterns and tracker-recorded daily light illuminance levels data were gathered over 7 days from 23 Singapore children (mean ± standard deviation age: 9.2 ± 1.4 years). Feedback about the tracker was obtained from 14 parents using a three-level rating scale: very poor/poor/good.

    RESULTS: Of the 14 parents, 93% rated the complete "FitSight fitness tracker" as good and 64% rated its wearability as good. While 61% of 23 children wore the watch on all study days (i.e., 0 nonwear days), 26% had 1 nonwear day, and 4.5% children each had 3, 4, and 5 nonwear days, respectively. On average, children spent approximately 1 hour in light levels greater than 1000 lux on weekdays and 1.3 hours on weekends (60 ± 46 vs. 79 ± 53 minutes, P = 0.19). Mean number of outdoor "spurts" (light illuminance levels >1000 lux) per day was 8 ± 3 spurts with spurt duration of 34 ± 32 minutes.

    CONCLUSION: The FitSight tracker with its novel features may motivate children to increase time outdoors and play an important role in supplementing community outdoor programs to prevent myopia.

    TRANSLATIONAL RELEVANCE: If the developed noninvasive, wearable, smartwatch-based fitness tracker, FitSight, promotes daytime outdoor activity among children, it will be beneficial in addressing the epidemic of myopia.

  12. Kaiser E, Jaganathan SK, Supriyanto E, Ayyar M
    3 Biotech, 2017 Jul;7(3):174.
    PMID: 28660462 DOI: 10.1007/s13205-017-0830-6
    Atrial septal defect (ASD) constitutes 30-40% of all congenital heart diseases in adults. The most common complications in the treatment of ASD are embolization of the device and thrombosis formation. In this research, an occluding patch was developed for ASD treatment using a well-known textile technology called electrospinning. For the first time, a cardiovascular occluding patch was fabricated using medical grade polyurethane (PU) loaded with bioactive agents namely chitosan nanoparticles (Cn) and collagen (Co) which is then coated with heparin (Hp). Fourier transform infrared spectrum showed characteristic vibrations of several active constituents and changes in the absorbance due to the inclusion of active ingredients in the patch. The contact angle analysis demonstrated no significant decrease in contact angle compared to the control and the composite patches. The structure of the electrospun nanocomposite (PUCnCoHp) was examined through scanning electron microscopy. A decrease in nanofiber diameter between control PU and PUCnCoHp nanocomposite was observed. Water uptake was found to be decreased for the PUCnCoHp nanocomposite against the control. The hemocompatibility properties of the PUCnCoHp ASD occluding patch was inferred through in vitro hemocompatibility tests like activated partial thromboplastin time (APTT), prothrombin time (PT) and hemolysis assay. It was found that the PT and APTT time was significantly prolonged for the fabricated PUCnCoHp ASD occluding patch compared to the control. Likewise, the hemolysis percentage was also decreased for the PUCnCoHp ASD patch against the control. In conclusion, the developed PUCnCoHp patch demonstrates potential properties to be used for ASD occlusion.
  13. Granados A, Brodie JF, Bernard H, O'Brien MJ
    Ecol Appl, 2017 10;27(7):2092-2101.
    PMID: 28660670 DOI: 10.1002/eap.1592
    Vertebrate granivores destroy plant seeds, but whether animal-induced seed mortality alters plant recruitment varies with habitat context, seed traits, and among granivore species. An incomplete understanding of seed predation makes it difficult to predict how widespread extirpations of vertebrate granivores in tropical forests might affect tree communities, especially in the face of habitat disturbance. Many tropical forests are simultaneously affected by animal loss as well as habitat disturbance, but the consequences of each for forest regeneration are often studied separately or additively, and usually on a single plant demographic stage. The combined impacts of these threats could affect plant recruitment in ways that are not apparent when studied in isolation. We used wire cages to exclude large (elephants), medium, (sambar deer, bearded pigs, muntjac deer), and small (porcupines, chevrotains) ground-dwelling mammalian granivores and herbivores in logged and unlogged forests in Malaysian Borneo. We assessed the interaction between habitat disturbance (selective logging) and experimental defaunation on seed survival, germination, and seedling establishment in five dominant dipterocarp tree species spanning a 21-fold gradient in seed size. Granivore-induced seed mortality was consistently higher in logged forest. Germination of unpredated seeds was reduced in logged forest and in the absence of small to large-bodied mammals. Experimental defaunation increased germination and reduced seed removal but had little effect on seed survival. Seedling recruitment however, was more likely where logging and animal loss occurred together. The interacting effects of logging and hunting could therefore, actually increase seedling establishment, suggesting that the loss of mammals in disturbed forest could have important consequences for forest regeneration and composition.
    MeSH terms: Animals; Borneo; Longevity; Malaysia; Mammals/physiology; Population Dynamics; Trees/growth & development; Trees/physiology*; Forestry*; Germination*; Seedlings/growth & development; Seedlings/physiology; Dipterocarpaceae/growth & development; Dipterocarpaceae/physiology*; Herbivory*; Forests
  14. Kwan Z, Wong SM, Robinson S, Tan LL, Ismail R
    Australas J Dermatol, 2017 Nov;58(4):e267-e268.
    PMID: 28660702 DOI: 10.1111/ajd.12541
    MeSH terms: Adolescent; Adult; Aged; Dermatomycoses/epidemiology; Eczema/epidemiology; Female; Humans; Leprosy/epidemiology; Malaysia/epidemiology; Male; Middle Aged; Outpatient Clinics, Hospital/statistics & numerical data; Psoriasis/epidemiology; Retrospective Studies; Sex Factors; Skin Diseases/epidemiology*; Skin Neoplasms/epidemiology; Urban Health Services/statistics & numerical data*; Young Adult; Tertiary Care Centers/statistics & numerical data
  15. Loo GH, Mohamad Abu Zeid WM, Lim SL, Ismail AM
    Ann R Coll Surg Engl, 2017 Jul;99(6):e188-e190.
    PMID: 28660832 DOI: 10.1308/rcsann.2017.0104
    Enteroenteric intussusception is a condition in which the full-thickness bowel wall becomes telescoped into the lumen of distal bowel. Intussusception in adult occurs infrequently and varies from childhood intussusception, particularly in its presentation, aetiology and treatment. Duodenoduodenal intussusception is rare because the duodenum is fixed in the retroperitoneal position. It usually occurs secondary to tumour, lipoma, Brunner's gland hamartomatous polyp or adenoma. The diagnosis in adults is usually made at laparotomy, where presentation is with intestinal obstruction. In non-emergency presentation, it may be difficult to arrive at an accurate diagnosis as symptoms may be vague, self-limiting intermittent abdominal pain. Clinical examinations and investigations may not be conclusive and another working diagnosis such as irritable bowel syndrome would be made. We describe a case where a patient initially presented with symptoms mimicking pancreatitis but his symptoms persisted over the course of 2 weeks. When a laparotomy was performed, duodenoduodenal intussusception was discovered and confirmed with histopathology. In this case, a discernible leading point could not be identified.
    MeSH terms: Adult; Humans; Male; Abdominal Pain; Pancreaticoduodenectomy; Young Adult
  16. Chooi WT, Mohd Zaharim N, Desrosiers A, Ahmad I, Yasin MAM, Syed Jaapar SZ, et al.
    J Psychoactive Drugs, 2017 06 29;49(4):326-332.
    PMID: 28661714 DOI: 10.1080/02791072.2017.1342152
    Amphetamine-type stimulants (ATS) use is increasingly prevalent in Malaysia, including among individuals who also use opioids. We evaluated cognitive functioning profiles among individuals with co-occurring opioid and ATS dependence and their lifetime patterns of drug use. Participants (N = 50) enrolling in a clinical trial of buprenorphine/naloxone treatment with or without atomoxetine completed the Raven's Standard Progressive Matrices, Rey-Osterrieth Complex Figure Test, Digit Span, Trail Making and Symbol Digit Substitution tasks. Multidimensional scaling and a K-means cluster analyses were conducted to classify participants into lower versus higher cognitive performance groups. Subsequently, analyses of variance procedures were conducted to evaluate between group differences on drug use history and demographics. Two clusters of individuals with distinct profiles of cognitive performance were identified. The age of ATS use initiation, controlling for the overall duration of drug use, was significantly earlier in the lower than in the higher cognitive performance cluster: 20.9 (95% CI: 18.0-23.8) versus 25.2 (95% CI: 22.4-28.0, p = 0.038). While adverse effects of ATS use on cognitive functioning can be particularly pronounced with younger age, potentially related to greater vulnerability of the developing brain to stimulant and/or neurotoxic effects of these drugs, the current study findings cannot preclude lowered cognitive performance before initiation of ATS use.
    MeSH terms: Adult; Amphetamine/adverse effects*; Central Nervous System Stimulants/adverse effects*; Analgesics, Opioid/adverse effects*; Cognition/drug effects*; Humans; Malaysia; Male; Middle Aged; Neuropsychological Tests; Amphetamine-Related Disorders/etiology*; Young Adult
  17. Masood M, Reidpath DD
    PLoS One, 2017;12(6):e0178928.
    PMID: 28662041 DOI: 10.1371/journal.pone.0178928
    BACKGROUND: This study explores the relationship between BMI and national-wealth and the cross-level interaction effect of national-wealth and individual household-wealth using multilevel analysis.

    METHODS: Data from the World Health Survey conducted in 2002-2004, across 70 low-, middle- and high-income countries was used. Participants aged 18 years and over were selected using multistage, stratified cluster sampling. BMI was used as outcome variable. The potential determinants of individual-level BMI were participants' sex, age, marital-status, education, occupation, household-wealth and location(rural/urban) at the individual-level. The country-level factors used were average national income (GNI-PPP) and income inequality (Gini-index). A two-level random-intercepts and fixed-slopes model structure with individuals nested within countries was fitted, treating BMI as a continuous outcome.

    RESULTS: The weighted mean BMI and standard-error of the 206,266 people from 70-countries was 23.90 (4.84). All the low-income countries were below the 25.0 mean BMI level and most of the high-income countries were above. All wealthier quintiles of household-wealth had higher scores in BMI than lowest quintile. Each USD10000 increase in GNI-PPP was associated with a 0.4 unit increase in BMI. The Gini-index was not associated with BMI. All these variables explained 28.1% of country-level, 4.9% of individual-level and 7.7% of total variance in BMI. The cross-level interaction effect between GNI-PPP and household-wealth was significant. BMI increased as the GNI-PPP increased in first four quintiles of household-wealth. However, the BMI of the wealthiest people decreased as the GNI-PPP increased.

    CONCLUSION: Both individual-level and country-level factors made an independent contribution to the BMI of the people. Household-wealth and national-income had significant interaction effects.

    MeSH terms: Adult; Developing Countries*; Female; Humans; Income*; Male; Middle Aged; Body Mass Index*; Developed Countries*
  18. Chin MC, Sivasampu S, Khoo EM
    PLoS One, 2017;12(6):e0180443.
    PMID: 28662193 DOI: 10.1371/journal.pone.0180443
    OBJECTIVE: Use of oral short-acting beta 2-agonist (SABA) persists in non-resource poor countries despite concerns for its lower efficacy and safety. Utilisation and reasons for such use is needed to support the effort to discourage the use of oral SABA in asthma. This study examined the frequency of oral short-acting Beta 2-agonist (SABA) usage in the management of asthma in primary care and determined correlates of its usage.
    METHODS: Data used were from the 2014 National Medical Care Survey in Malaysia, a nationally representative survey of primary care encounters (weighted n = 325818). Using methods of analysis of data for complex surveys, we determined the frequency of asthma diagnosis in primary care and the rate of asthma medication prescription, which includes oral SABA. Multivariate logistic regression models were built to assess associations with the prescription of oral SABA.
    RESULTS: A weighted estimate of 9241 encounters presented to primary care with asthma in 2014. The mean age of the patients was 39.1 years. The rate of oral SABA, oral steroids, inhaled SABA and inhaled corticosteroids prescriptions were 33, 33, 50 and 23 per 100 asthma encounters, respectively. It was most commonly used in patients with the age ranged between 20 to less than 40 years. Logistic regression models showed that there was a higher odds of oral SABA usage in the presence of respiratory infection, prescription of oral corticosteroids and in the private sector.
    CONCLUSION: Oral SABA use in asthma is found to be common in a non- resource poor setting and its use could be attributed to a preference for oral medicines along undesirable clinical practices within a fragmented health system.
    MeSH terms: Administration, Oral; Adolescent; Adrenergic beta-Agonists/administration & dosage; Adrenergic beta-Agonists/therapeutic use*; Adult; Ambulatory Care Facilities; Asthma/drug therapy*; Child; Child, Preschool; Cross-Sectional Studies; Developing Countries*; Female; Humans; Infant; Malaysia; Male; Middle Aged; Poverty*; Receptors, Adrenergic, beta-2/drug effects*; Young Adult
  19. Costantini D, Sebastiano M, Goossens B, Stark DJ
    Folia Primatol., 2017;88(1):46-56.
    PMID: 28662508 DOI: 10.1159/000477540
    Accelerometers enable scientists to quantify the activity of free-living animals whose direct observation is difficult or demanding due to their elusive nature or nocturnal habits. However, the deployment of accelerometers on small-bodied animals and, in particular, on primates has been little explored. Here we show the first application of accelerometers on the western tarsier (Cephalopachus bancanus borneanus), a nocturnal, small-bodied primate endemic to the forests of Borneo. The fieldwork was carried out in the Lower Kinabatangan Wildlife Sanctuary, Sabah, Malaysian Borneo. We provide guidelines for the deployment of accelerometers on tarsiers that might also be applied to other primate species. Our collected data on 2 females show levels of leaping activity comparable to those previously described using direct observation of wild or captive individuals. The 2 females showed different patterns of leaping activity, which calls for work to explore individual differences further. Our work demonstrates that accelerometers can be deployed on small primates to acquire body motion data that would otherwise be demanding to collect using classic field observations. Future work will be focused on using accelerometer data to discriminate in more detail the different behaviours tarsiers can display and to address the causes and consequences of individual variations in activity.
    MeSH terms: Animals; Animals, Wild; Borneo; Female; Habits; Individuality; Malaysia; Primates; Tarsiidae; Accelerometry; Forests
  20. Dang K, Doggett SL, Veera Singham G, Lee CY
    Parasit Vectors, 2017 Jun 29;10(1):318.
    PMID: 28662724 DOI: 10.1186/s13071-017-2232-3
    The worldwide resurgence of bed bugs [both Cimex lectularius L. and Cimex hemipterus (F.)] over the past two decades is believed in large part to be due to the development of insecticide resistance. The transcriptomic and genomic studies since 2010, as well as morphological, biochemical and behavioral studies, have helped insecticide resistance research on bed bugs. Multiple resistance mechanisms, including penetration resistance through thickening or remodelling of the cuticle, metabolic resistance by increased activities of detoxification enzymes (e.g. cytochrome P450 monooxygenases and esterases), and knockdown resistance by kdr mutations, have been experimentally identified as conferring insecticide resistance in bed bugs. Other candidate resistance mechanisms, including behavioral resistance, some types of physiological resistance (e.g. increasing activities of esterases by point mutations, glutathione S-transferase, target site insensitivity including altered AChEs, GABA receptor insensitivity and altered nAChRs), symbiont-mediated resistance and other potential, yet undiscovered mechanisms may exist. This article reviews recent studies of resistance mechanisms and the genes governing insecticide resistance, potential candidate resistance mechanisms, and methods of monitoring insecticide resistance in bed bugs. This article provides an insight into the knowledge essential for the development of both insecticide resistance management (IRM) and integrated pest management (IPM) strategies for successful bed bug management.
    MeSH terms: Animals; Bedbugs/drug effects; Bedbugs/genetics*; Ectoparasitic Infestations/parasitology*; Glutathione Transferase/genetics*; Insecticide Resistance/genetics*; Insecticides/pharmacology*; Point Mutation
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