Browse publications by year: 2017

Increased circulating oxidised low-density lipoprotein and antibodies to oxidised low-density lipoprotein in preeclampsia

Arifin R, Kyi WM, Che Yaakob CA, Yaacob NM

J Obstet Gynaecol, 2017 Jul;37(5):580-584.
PMID: 28358592 DOI: 10.1080/01443615.2016.1269227

Enhanced oxidative stress is involved in the pathogenesis of endothelial dysfunction in preeclampsia (PE). Circulating oxidised LDL (oxLDL) and antibodies to oxLDL (Ab-oxLDL) have been found to be associated with atherosclerosis. The objectives of this study were to investigate the association of oxLDL and Ab-oxLDL with PE and to assess the association between oxLDL and Ab-oxLDL. The levels of oxLDL and Ab-oxLDL were measured by enzyme-linked immunoassay in 78 women with preeclampsia (PE group) and 78 women with normal pregnancy (control group). The PE group had higher oxLDL and Ab-oxLDL levels than the control group (485.1vs.145.9 ng/ml, p
Major health impact of accelerated aging in young HIV-infected individuals on antiretroviral therapy

Rajasuriar R, Chong ML, Ahmad Bashah NS, Abdul Aziz SA, Mcstea M, Lee ECY, et al.

AIDS, 2017 06 19;31(10):1393-1403.
PMID: 28358731 DOI: 10.1097/QAD.0000000000001475

BACKGROUND: Aging among HIV-infected individuals on antiretroviral therapy (ART) is a significant clinical challenge; however, studies assessing multidimensional aspects of aging are lacking. We characterized 10 geriatric conditions encompassing multiple functional domains, its health impact and associated risk factors in HIV-infected and age-matched uninfected controls.

METHODS: HIV-infected individuals were recruited from the outpatient clinic in University Malaya Medical Centre, Malaysia and controls from the community. All participants were aged at least 25 years of age with no acute illness, and HIV-infected individuals were on stable ART. Geriatric conditions were assessed and the burden scored as a composite of geriatric conditions present in an individual (total score = 10). Multivariate regression analysis was performed to determine the risk factors and health impact associated with the burden of geriatric conditions.

RESULTS: We analyzed data from 336 HIV-infected individuals (total HIV+), of whom 172 were matched for age, sex, and ethnicity with 172 HIV-uninfected controls (matched subset). In the total HIV-positive cohort, median (interquartile range) age was 44 (38-51) years and CD4 T-cell count was 562 (398-737) cells/μl. The burden of geriatric conditions was significantly higher in the HIV-infected group compared with controls (P

MeSH terms: Academic Medical Centers; Adult; Female; Hospitals, University; Humans; Malaysia; Male; Middle Aged; Outpatient Clinics, Hospital; Surveys and Questionnaires; HIV Infections/complications*; HIV Infections/drug therapy*; Case-Control Studies; Aging, Premature/epidemiology*; Aging, Premature/pathology*; Anti-Retroviral Agents/therapeutic use*
Fulltext Inactivation, Clearance, and Functional Effects of Lung-Instilled Short and Long Silver Nanowires in Rats

Chung KF, Seiffert J, Chen S, Theodorou IG, Goode AE, Leo BF, et al.

ACS Nano, 2017 03 28;11(3):2652-2664.
PMID: 28221763 DOI: 10.1021/acsnano.6b07313

There is a potential for silver nanowires (AgNWs) to be inhaled, but there is little information on their health effects and their chemical transformation inside the lungs in vivo. We studied the effects of short (S-AgNWs; 1.5 μm) and long (L-AgNWs; 10 μm) nanowires instilled into the lungs of Sprague-Dawley rats. S- and L-AgNWs were phagocytosed and degraded by macrophages; there was no frustrated phagocytosis. Interestingly, both AgNWs were internalized in alveolar epithelial cells, with precipitation of Ag2S on their surface as secondary Ag2S nanoparticles. Quantitative serial block face three-dimensional scanning electron microscopy showed a small, but significant, reduction of NW lengths inside alveolar epithelial cells. AgNWs were also present in the lung subpleural space where L-AgNWs exposure resulted in more Ag+ve macrophages situated within the pleura and subpleural alveoli, compared with the S-AgNWs exposure. For both AgNWs, there was lung inflammation at day 1, disappearing by day 21, but in bronchoalveolar lavage fluid (BALF), L-AgNWs caused a delayed neutrophilic and macrophagic inflammation, while S-AgNWs caused only acute transient neutrophilia. Surfactant protein D (SP-D) levels in BALF increased after S- and L-AgNWs exposure at day 7. L-AgNWs induced MIP-1α and S-AgNWs induced IL-18 at day 1. Large airway bronchial responsiveness to acetylcholine increased following L-AgNWs, but not S-AgNWs, exposure. The attenuated response to AgNW instillation may be due to silver inactivation after precipitation of Ag2S with limited dissolution. Our findings have important consequences for the safety of silver-based technologies to human health.
A review of evolution of electrospun tissue engineering scaffold: From two dimensions to three dimensions

Ngadiman NHA, Noordin MY, Idris A, Kurniawan D

Proc Inst Mech Eng H, 2017 Jul;231(7):597-616.
PMID: 28347262 DOI: 10.1177/0954411917699021

The potential of electrospinning process to fabricate ultrafine fibers as building blocks for tissue engineering scaffolds is well recognized. The scaffold construct produced by electrospinning process depends on the quality of the fibers. In electrospinning, material selection and parameter setting are among many factors that contribute to the quality of the ultrafine fibers, which eventually determine the performance of the tissue engineering scaffolds. The major challenge of conventional electrospun scaffolds is the nature of electrospinning process which can only produce two-dimensional electrospun mats, hence limiting their applications. Researchers have started to focus on overcoming this limitation by combining electrospinning with other techniques to fabricate three-dimensional scaffold constructs. This article reviews various polymeric materials and their composites/blends that have been successfully electrospun for tissue engineering scaffolds, their mechanical properties, and the various parameters settings that influence the fiber morphology. This review also highlights the secondary processes to electrospinning that have been used to develop three-dimensional tissue engineering scaffolds as well as the steps undertaken to overcome electrospinning limitations.

MeSH terms: Electricity*; Tissue Engineering/instrumentation; Tissue Engineering/methods*; Tissue Scaffolds*
Fulltext Diabetes and Ramadan: Practical guidelines

Hassanein M, Al-Arouj M, Hamdy O, Bebakar WMW, Jabbar A, Al-Madani A, et al.

Diabetes Res Clin Pract, 2017 Apr;126:303-316.
PMID: 28347497 DOI: 10.1016/j.diabres.2017.03.003

Ramadan fasting is one of the five pillars of Islam and is compulsory for all healthy Muslims from puberty onwards. Exemptions exist for people with serious medical conditions, including many with diabetes, but a large number will participate, often against medical advice. Ensuring the optimal care of these patients during Ramadan is crucial. The International Diabetes Federation (IDF) and Diabetes and Ramadan (DAR) International Alliance have come together to deliver comprehensive guidelines on this subject. The key areas covered include epidemiology, the physiology of fasting, risk stratification, nutrition advice and medication adjustment. The IDF-DAR Practical Guidelines should enhance knowledge surrounding the issue of diabetes and Ramadan fasting, thereby empowering healthcare professionals to give the most up-to-date advice and the best possible support to their patients during Ramadan.

MeSH terms: Adolescent; Adult; Counseling/standards*; Diabetes Mellitus/drug therapy; Diabetes Mellitus/therapy*; Fasting*; Female; Humans; Islam*; Patient Education as Topic/standards; Pregnancy; Pregnancy in Diabetics/therapy; Risk; Practice Guidelines as Topic*; Young Adult
Fulltext Informing pneumococcal conjugate vaccine policy in middle-income countries: The case of Malaysia

Tricarico S, McNeil HC, Head MG, Cleary DW, Clarke SC, MYCarriage

Vaccine, 2017 04 25;35(18):2288-2290.
PMID: 28347503 DOI: 10.1016/j.vaccine.2017.03.053
MeSH terms: Child, Preschool; Humans; Immunization/legislation & jurisprudence*; Immunization/statistics & numerical data; Infant; Malaysia; Pneumonia, Pneumococcal/mortality; Pneumonia, Pneumococcal/prevention & control*; Immunization Programs/legislation & jurisprudence*; Vaccines, Conjugate/administration & dosage
Cytochrome c oxidase subunit I haplotype diversity of Angiostrongylus cantonensis (Nematoda: Angiostrongylidae)

Eamsobhana P, Song SL, Yong HS, Prasartvit A, Boonyong S, Tungtrongchitr A

Acta Trop, 2017 Jul;171:141-145.
PMID: 28347653 DOI: 10.1016/j.actatropica.2017.03.020

The rat lungworm Angiostrongylus cantonensis is a food-borne zoonotic parasite of public health importance worldwide. It is the primary etiologic agent of eosinophilic meningitis and eosinophilic meningoencephalitis in humans in many countries. It is highly endemic in Thailand especially in the northeast region. In this study, A. cantonensis adult worms recovered from the lungs of wild rats in different geographical regions/provinces in Thailand were used to determine their haplotype by means of the mitochondrial partial cytochrome c oxidase subunit I (COI) gene sequence. The results revealed three additional COI haplotypes of A. cantonensis. The geographical isolates of A. cantonensis from Thailand and other countries formed a monophyletic clade distinct from the closely related A. malaysiensis. In the present study, distinct haplotypes were identified in seven regions of Thailand - AC10 in Phitsanulok (northern region), AC11 in Nakhon Phanom (northeastern region), AC15 in Trat (eastern region), AC16 in Chantaburi (eastern region), AC4 in Samut Prakan (central region), AC14 in Kanchanaburi (western region), and AC13 in Ranong (southern region). Phylogenetic analysis revealed that these haplotypes formed distinct lineages. In general, the COI sequences did not differentiate the worldwide geographical isolates of A. cantonensis. This study has further confirmed the presence of COI haplotype diversity in various geographical isolates of A. cantonensis. The COI gene sequence will be a suitable marker for studying population structure, phylogeography and genetic diversity of the rat lungworm.

MeSH terms: Animals; Electron Transport Complex IV/genetics*; Haplotypes*; Phylogeny; Rodent Diseases/epidemiology; Rodent Diseases/parasitology*; Thailand; Genetic Variation; Gene Expression Regulation, Enzymologic; Angiostrongylus cantonensis/enzymology*; Angiostrongylus cantonensis/genetics; Strongylida Infections/parasitology; Strongylida Infections/veterinary*; Rats; Phylogeography
Letter to the Editor Regarding Article, "Assembling a Functional Clitoris and Vulva from a Pseudo-Penis: A Surgical Technique for an Adult Woman with Congenital Adrenal Hyperplasia"

Hisham A, Mat Zain MA

J Pediatr Adolesc Gynecol, 2017 08;30(4):513.
PMID: 28347813 DOI: 10.1016/j.jpag.2017.02.008
Fulltext Dental Anxiety among Medical and Paramedical Undergraduate Students of Malaysia

Gunjal S, Pateel DG, Parkar S

Int J Dent, 2017;2017:4762576.
PMID: 28348593 DOI: 10.1155/2017/4762576

Aim. To assess the dental anxiety level among dental, medical, and pharmacy students of MAHSA University, Malaysia. Materials and Methods. A cross-sectional questionnaire study was conducted among 1500 undergraduate students of MAHSA University. The Modified Dental Anxiety Scale (MDAS) was used to measure dental anxiety among the study population. The responses were assessed by 5-point likert scale ranging from 1 to 5. The level of anxiety was categorized into lowly anxious (5-11), moderately anxious (12-18), and severely anxious ≥19. Out of 1500 students enrolled, 1024 students (342 males and 682 females) completed and returned the questionnaire having response rate of 68.26%. Results. There was a statistically significant difference (P < 0.001) when the mean dental anxiety scores were compared among the three faculties and dental students had lowest mean score (11.95 ± 4.21). The fifth year (senior) dental students scored significantly (P = 0.02) lower mean anxiety score as compared to the first dental students (junior). The students were anxious mostly about tooth drilling and local anesthetic injection. Conclusions. Dental students have a significantly low level of dental anxiety as compared with medical and pharmacy students. Incorporation of dental health education in preuniversity and other nondental university curriculums may reduce dental anxiety among the students.
Fulltext Diversity of Leptospira spp. in Rats and Environment from Urban Areas of Sarawak, Malaysia

Pui CF, Bilung LM, Apun K, Su'ut L

J Trop Med, 2017;2017:3760674.
PMID: 28348601 DOI: 10.1155/2017/3760674

Various prevalence studies on Leptospira in animals and humans, as well as environmental samples, had been conducted worldwide, including Malaysia. However, limited studies have been documented on the presence of pathogenic, intermediate, and saprophytic Leptospira in selected animals and environments. This study was therefore conducted to detect Leptospira spp. in rats, soil, and water from urban areas of Sarawak using the polymerase chain reaction (PCR) method. A total of 107 rats, 292 soil samples, and 324 water samples were collected from April 2014 to February 2015. Pathogenic Leptospira was present in 5.6% (6/107) of rats, 11.6% (34/292) of soil samples, and 1.9% (6/324) of water samples. Intermediate Leptospira was present in 2.7% (8/292) of soil samples and 1.9% (6/324) of water samples. Saprophytic Leptospira was present in 10.3% (11/107) of rats, 1.4% (4/292) of soil samples, and 0.3% (1/324) of water samples. From this study, 76 Leptospira spp. were isolated. Based on DNA sequencing, the dominant Leptospira spp. circulating in urban areas of Sarawak are pathogenic Leptospira noguchii, intermediate Leptospira wolffii serovar Khorat, and saprophytic Leptospira meyeri, respectively. Overall, this study provided important surveillance data on the prevalence of Leptospira spp. from rats and the environment, with dominant local serovars in urban areas of Sarawak.

MeSH terms: Animals; Base Sequence; Cross-Sectional Studies; Humans; Leptospira; Leptospirosis; Malaysia; Soil; Water; Prevalence; Polymerase Chain Reaction; Sequence Analysis, DNA; Rats; Serogroup
Fulltext Whole-genome Sequencing of Vibrio sinaloensis T47, a Tropical Marine Isolate with Quorum Sensing Properties

Mohamad NI, How KY, Yin WF, Chan KG

J Genomics, 2017;5:48-50.
PMID: 28348643 DOI: 10.7150/jgen.16163

A large number of Vibrio sp. thrive in the marine environment and they are notable to cause food borne infection associated with undercooked seafood. In this study, we report the whole genome sequence of Vibrio sinaloensis T47 which was isolated from coastal marine water in Morib Beach, Hulu Selangor. The genome is made up of approximately 4.59 Mbp with 80 contigs and 46% G+C content. From the annotated genome, genes associated with quorum sensing (QS) were identified. This research provides a genetic basis for better understanding of QS pathway which contributes to the physiological traits of strain T47 to thrive in the marine environment.
Fulltext An EEG-based machine learning method to screen alcohol use disorder

Mumtaz W, Vuong PL, Xia L, Malik AS, Rashid RBA

Cogn Neurodyn, 2017 Apr;11(2):161-171.
PMID: 28348647 DOI: 10.1007/s11571-016-9416-y

Screening alcohol use disorder (AUD) patients has been challenging due to the subjectivity involved in the process. Hence, robust and objective methods are needed to automate the screening of AUD patients. In this paper, a machine learning method is proposed that utilized resting-state electroencephalography (EEG)-derived features as input data to classify the AUD patients and healthy controls and to perform automatic screening of AUD patients. In this context, the EEG data were recorded during 5 min of eyes closed and 5 min of eyes open conditions. For this purpose, 30 AUD patients and 15 aged-matched healthy controls were recruited. After preprocessing the EEG data, EEG features such as inter-hemispheric coherences and spectral power for EEG delta, theta, alpha, beta and gamma bands were computed involving 19 scalp locations. The selection of most discriminant features was performed with a rank-based feature selection method assigning a weight value to each feature according to a criterion, i.e., receiver operating characteristics curve. For example, a feature with large weight was considered more relevant to the target labels than a feature with less weight. Therefore, a reduced set of most discriminant features was identified and further be utilized during classification of AUD patients and healthy controls. As results, the inter-hemispheric coherences between the brain regions were found significantly different between the study groups and provided high classification efficiency (Accuracy = 80.8,sensitivity = 82.5,and specificity = 80,F-Measure = 0.78). In addition, the power computed in different EEG bands were found significant and provided an overall classification efficiency as (Accuracy = 86.6,sensitivity = 95,specificity = 82.5,and F-Measure = 0.88). Further, the integration of these EEG feature resulted into even higher results (Accuracy = 89.3 %,sensitivity = 88.5 %,specificity = 91 %,and F-Measure = 0.90). Based on the results, it is concluded that the EEG data (integration of the theta, beta, and gamma power and inter-hemispheric coherence) could be utilized as objective markers to screen the AUD patients and healthy controls.
Fulltext Forecasting the Incidence and Prevalence of Patients with End-Stage Renal Disease in Malaysia up to the Year 2040

Bujang MA, Adnan TH, Hashim NH, Mohan K, Kim Liong A, Ahmad G, et al.

Int J Nephrol, 2017;2017:2735296.
PMID: 28348890 DOI: 10.1155/2017/2735296

Background. The incidence of patients with end-stage renal disease (ESRD) requiring dialysis has been growing rapidly in Malaysia from 18 per million population (pmp) in 1993 to 231 pmp in 2013. Objective. To forecast the incidence and prevalence of ESRD patients who will require dialysis treatment in Malaysia until 2040. Methodology. Univariate forecasting models using the number of new and current dialysis patients, by the Malaysian Dialysis and Transplant Registry from 1993 to 2013 were used. Four forecasting models were evaluated, and the model with the smallest error was selected for the prediction. Result. ARIMA (0, 2, 1) modeling with the lowest error was selected to predict both the incidence (RMSE = 135.50, MAPE = 2.85, and MAE = 87.71) and the prevalence (RMSE = 158.79, MAPE = 1.29, and MAE = 117.21) of dialysis patients. The estimated incidences of new dialysis patients in 2020 and 2040 are 10,208 and 19,418 cases, respectively, while the estimated prevalence is 51,269 and 106,249 cases. Conclusion. The growth of ESRD patients on dialysis in Malaysia can be expected to continue at an alarming rate. Effective steps to address and curb further increase in new patients requiring dialysis are urgently needed, in order to mitigate the expected financial and health catastrophes associated with the projected increase of such patients.
Suicide patterns in children and adolescents: a review from a pediatric institution in England

Zainum K, Cohen MC

Forensic Sci Med Pathol, 2017 Jun;13(2):115-122.
PMID: 28349246 DOI: 10.1007/s12024-017-9860-y

Suicide is a catastrophic event to both families and communities yet it is potentially preventable. This study aims to determine incidence and patterns of suicide in children and young adolescents in our region, raise awareness of this entity as a potentially preventable cause of death in this age group, and identify its possible associated risk factors. We retrospectively reviewed suicide cases presenting as sudden unexpected death in children and adolescents that underwent coronial post-mortems at our institution. This is the largest pathological review of completed suicide in children and young adolescents within a single institution in the United Kingdom. We identified 23 suicide cases during a 12 year period from 2003 to 2015, in which 18 cases (78%) were male and 5 cases (22%) were female. The age range was from 8 to 16 years (mean age 12.82 +/- 2.52 SD). With the exception of one case, all of the victims were Caucasian. The majority, 19 cases (81%), were found dead inside their place of residence, 15 of whom were discovered in their own bedrooms. Twenty-one cases (91%) died from neck compression due to hanging; 6 cases (26%) had used the cord of a dressing gown and 5 (22%) opted to use a belt as the ligature. Two cases (9%) that died from multiple-drug toxicity were female. In 7 cases (30.5%) there was evidence of self-harm and in 3 cases (13%) there was a history of previous suicide attempts. Petechial hemorrhages were found at autopsy in more than half of hanging victims and only three cases (14%) displayed dual distribution of post-mortem hypostasis (back and legs). Seven victims (30.5%) left some form of suicide message to family members and friends, 2 of which wrote the message on their arm. Parental separation, conflict with parents, and depression, were common amongst decedents prior to committing suicide. Substance abuse was uncommon in suicide within our cases. Valuable information is available from thorough review of suicide data in children and young adolescents from a single institution. Pathologists and clinicians can play crucial roles in identifying potential risk factors that may contribute to prevent future deaths.

MeSH terms: Adolescent; Asphyxia/mortality; Child; Depression/psychology; Divorce/psychology; England/epidemiology; Female; Humans; Male; Poisoning/mortality; Purpura/pathology; Retrospective Studies; Suicide/statistics & numerical data*; Correspondence as Topic; Age Distribution; Sex Distribution; Neck Injuries/mortality; Family Conflict/psychology
Comparing the effects of different dietary organic acids on the growth, intestinal short-chain fatty acids, and liver histopathology of red hybrid tilapia (Oreochromis sp.) and potential use of these as preservatives

Ebrahimi M, Daeman NH, Chong CM, Karami A, Kumar V, Hoseinifar SH, et al.

Fish Physiol Biochem, 2017 Aug;43(4):1195-1207.
PMID: 28349418 DOI: 10.1007/s10695-017-0365-0

Dietary organic acids are increasingly being investigated as a potential means of improving growth and nutrient utilization in aquatic animals. A 9-week study was performed to compare equal amounts (2%) of different organic acids (sodium butyrate, acetate, propionate, or formate) on the growth, muscle proximate composition, fatty acid composition, cholesterol and lipid peroxidation, differential cell counts, plasma biochemistry, intestinal short-chain fatty acid (SCFA) level, and liver histopathology to red hybrid tilapia (Oreochromis sp.) (initial mean weight of 2.87 g). A second experiment was performed to determine their effects on lipid peroxidation and trimethylamine (TMA) when added at 1% to tilapia meat and left out for 24 h. The results of the first experiment showed no treatment effect to growth, feeding efficiencies, or muscle fatty acid composition, but all dietary organic acids significantly decreased intestinal SCFA. Dietary butyrate and propionate significantly decreased muscle lipid peroxidation compared to the control group, but the dietary formate treatment had the lowest lipid peroxidation compared to all treatments. Muscle crude protein and lipid in tilapia fed the formate diet were significantly lower and higher, respectively, and showed evidence of stress based on the differential cell counts, significantly higher plasma glucose and liver glycogen, as well as inflammatory responses in the liver. Although a potential benefit of dietary organic acids was a reduction to lipid peroxidation, this could be accomplished post-harvest by direct additions to the meat. In addition, inclusions of butyrate and propionate to tilapia meat significantly decreased TMA, which might be a more cost-effective option to improve the shelf life of tilapia products.

MeSH terms: Animals; Animal Feed/analysis; Animal Nutritional Physiological Phenomena; Diet/veterinary*; Fatty Acids, Volatile/adverse effects; Fatty Acids, Volatile/pharmacology*; Liver/drug effects; Liver/pathology*; Tilapia/genetics*; Tilapia/physiology*; Drug-Induced Liver Injury/veterinary*
Fulltext Metabolomics approach for multibiomarkers determination to investigate dengue virus infection in human patients

Shahfiza N, Osman H, Hock TT, Abdel-Hamid AZ

Acta Biochim. Pol., 2017;64(2):215-219.
PMID: 28350402 DOI: 10.18388/abp.2015_1224

BACKGROUND: Dengue is one of the major public health problems in the world, affecting more than fifty million cases in tropical and subtropical region every year. The metabolome, as pathophysiological end-points, provide significant understanding of the mechanism and progression of dengue pathogenesis via changes in the metabolite profile of infected patients. Recent developments in diagnostic technologies provide metabolomics for the early detection of infectious diseases.
METHODS: The mid-stream urine was collected from 96 patients diagnosed with dengue fever at Penang General Hospital (PGH) and 50 healthy volunteers. Urine samples were analyzed with proton nuclear magnetic resonance (1H NMR) spectroscopy, followed by chemometric multivariate analysis. NMR signals highlighted in the orthogonal partial least square-discriminant analysis (OPLS-DA) S-plots were selected and identified using Human Metabolome Database (HMDB) and Chenomx Profiler. A highly predictive model was constructed from urine profile of dengue infected patients versus healthy individuals with the total R2Y (cum) value 0.935, and the total Q2Y (cum) value 0.832.
RESULTS: Data showed that dengue infection is related to amino acid metabolism, tricarboxylic acid intermediates cycle and β-oxidation of fatty acids. Distinct variations in certain metabolites were recorded in infected patients including amino acids, various organic acids, betaine, valerylglycine, myo-inositol and glycine.
CONCLUSION: Metabolomics approach provides essential insight into host metabolic disturbances following dengue infection.

MeSH terms: Adult; Amino Acids/metabolism; Dengue/metabolism*; Dengue/pathology; Dengue/virology; Dengue Virus/metabolism*; Dengue Virus/pathogenicity; Fatty Acids/metabolism; Humans; Male; Magnetic Resonance Spectroscopy; Biomarkers; Principal Component Analysis; Metabolomics*; Metabolome/genetics*
Pulmonary hypertension complicating systemic sclerosis: A successful pregnancy outcome

Chew KT, Ahmad MF, Yong SL, Mohamed Ismail NA

J Obstet Gynaecol, 2017 Jul;37(5):677-678.
PMID: 28350528 DOI: 10.1080/01443615.2017.1284774
MeSH terms: Adult; Female; Hospitals, University; Humans; Hypertension, Pulmonary; Malaysia; Pregnancy; Scleroderma, Systemic*
Visit-to-visit SBP variability and cardiovascular disease in a multiethnic primary care setting: 10-year retrospective cohort study

Chia YC, Ching SM, Lim HM

J Hypertens, 2017 05;35 Suppl 1:S50-S56.
PMID: 28350621 DOI: 10.1097/HJH.0000000000001333

OBJECTIVES: The current study aims to determine the relationship of long-term visit-to-visit variability of SBP to cardiovascular disease (CVD) in a multiethnic primary care setting.
METHOD: This is a retrospective study of a cohort of 807 hypertensive patients over a period of 10 years. Three-monthly clinic blood pressure readings were used to derive blood pressure variability (BPV), and CVD events were captured from patient records.
RESULTS: Mean age at baseline was 57.2 ± 9.8 years with 63.3% being women. The BPV and mean SBP over 10 years were 14.7 ± 3.5 and 142 ± 8 mmHg, respectively. Prevalence of cardiovascular event was 13%. In multivariate logistic regression analysis, BPV was the predictor of CVD events, whereas the mean SBP was not independently associated with cardiovascular events in this population. Those with lower SBP and lower BPV had fewer cardiovascular events than those with the same low mean SBP but higher BPV (10.5 versus 12.8%). Similarly those with higher mean SBP but lower BPV also had fewer cardiovascular events than those with the same high mean and higher BPV (11.6 versus 16.7%). Other variables like being men, diabetes and Indian compared with Chinese are more likely to be associated with cardiovascular events.
CONCLUSION: BPV is associated with an increase in CVD events even in those who have achieved lower mean SBP. Thus, we should prioritize not only control of SBP levels but also BPV to reduce CVD events further.

MeSH terms: Aged; Ambulatory Care Facilities; Blood Pressure*; China/ethnology; Coronary Disease/ethnology; Coronary Disease/epidemiology*; Female; Follow-Up Studies; Heart Failure/ethnology; Heart Failure/epidemiology*; Hospitals, University; Humans; Hypertension/physiopathology*; India/ethnology; Malaysia/epidemiology; Male; Middle Aged; Outpatient Clinics, Hospital; Primary Health Care*; Retrospective Studies; Systole; Time Factors; Cohort Studies; Prevalence; Stroke/ethnology; Stroke/epidemiology*; Peripheral Arterial Disease/ethnology; Peripheral Arterial Disease/epidemiology*
Fulltext Reduction of oxidative-nitrosative stress underlies anticataract effect of topically applied tocotrienol in streptozotocin-induced diabetic rats

Abdul Nasir NA, Agarwal R, Sheikh Abdul Kadir SH, Vasudevan S, Tripathy M, Iezhitsa I, et al.

PLoS One, 2017;12(3):e0174542.
PMID: 28350848 DOI: 10.1371/journal.pone.0174542

Cataract, a leading cause of blindness, is of special concern in diabetics as it occurs at earlier onset. Polyol accumulation and increased oxidative-nitrosative stress in cataractogenesis are associated with NFκB activation, iNOS expression, ATP depletion, loss of ATPase functions, calpain activation and proteolysis of soluble to insoluble proteins. Tocotrienol was previously shown to reduce lens oxidative stress and inhibit cataractogenesis in galactose-fed rats. In current study, we investigated anticataract effects of topical tocotrienol and possible mechanisms involved in streptozotocin-induced diabetic rats. Diabetes was induced in Sprague Dawley rats by intraperitoneal injection of streptozotocin. Diabetic rats were treated with vehicle (DV) or tocotrienol (DT). A third group consists of normal, non-diabetic rats were treated with vehicle (NV). All treatments were given topically, bilaterally, twice daily for 8 weeks with weekly slit lamp monitoring. Subsequently, rats were euthanized and lenses were subjected to estimation of polyol accumulation, oxidative-nitrosative stress, NFκB activation, iNOS expression, ATP levels, ATPase activities, calpain activity and total protein levels. Cataract progression was delayed from the fifth week onwards in DT with lower mean of cataract stages compared to DV group (p<0.01) despite persistent hyperglycemia. Reduced cataractogenesis in DT group was accompanied with lower aldose reductase activity and sorbitol level compared to DV group (p<0.01). DT group also showed reduced NFκB activation, lower iNOS expression and reduced oxidative-nitrosative stress compared to DV group. Lenticular ATP and ATPase and calpain 2 activities in DT group were restored to normal. Consequently, soluble to insoluble protein ratio in DT group was higher compared to DV (p<0.05). In conclusion, preventive effect of topical tocotrienol on development of cataract in STZ-induced diabetic rats could be attributed to reduced lens aldose reductase activity, polyol levels and oxidative-nitrosative stress. These effects of tocotrienol invlove reduced NFκB activation, lower iNOS expression, restoration of ATP level, ATPase activities, calpain activity and lens protein levels.

MeSH terms: Adenosine Triphosphatases/metabolism; Adenosine Triphosphate/metabolism; Administration, Topical; Animals; Antioxidants/administration & dosage; Antioxidants/pharmacology; Blood Glucose/metabolism; Body Weight/drug effects; Calpain; Catalase/metabolism; Cataract/complications; Cataract/prevention & control*; Diabetes Mellitus, Experimental/blood; Diabetes Mellitus, Experimental/complications*; Glutathione/metabolism; Lens, Crystalline/drug effects*; Lens, Crystalline/metabolism; Lens, Crystalline/pathology; Male; Pilot Projects; Superoxide Dismutase/metabolism; Time Factors; Nitrosation/drug effects; Gene Expression/drug effects; NF-kappa B/metabolism; Rats, Sprague-Dawley; Oxidative Stress/drug effects*; Tocotrienols/administration & dosage; Tocotrienols/pharmacology*; Nitric Oxide Synthase Type II/genetics; Nitric Oxide Synthase Type II/metabolism
Utilization of second derivative photoplethysmographic features for myocardial infarction classification

Mahri N, Gan KB, Meswari R, Jaafar MH, Mohd Ali MA

J Med Eng Technol, 2017 May;41(4):298-308.
PMID: 28351231 DOI: 10.1080/03091902.2017.1299229

Myocardial infarction (MI) is a common disease that causes morbidity and mortality. The current tools for diagnosing this disease are improving, but still have some limitations. This study utilised the second derivative of photoplethysmography (SDPPG) features to distinguish MI patients from healthy control subjects. The features include amplitude-derived SDPPG features (pulse height, ratio, jerk) and interval-derived SDPPG features (intervals and relative crest time (RCT)). We evaluated 32 MI patients at Pusat Perubatan Universiti Kebangsaan Malaysia and 32 control subjects (all ages 37-87 years). Statistical analysis revealed that the mean amplitude-derived SDPPG features were higher in MI patients than in control subjects. In contrast, the mean interval-derived SDPPG features were lower in MI patients than in the controls. The classifier model of binary logistic regression (Model 7), showed that the combination of SDPPG features that include the pulse height (d-wave), the intervals of "ab", "ad", "bc", "bd", and "be", and the RCT of "ad/aa" could be used to classify MI patients with 90.6% accuracy, 93.9% sensitivity and 87.5% specificity at a cut-off value of 0.5 compared with the single features model.

MeSH terms: Adult; Aged; Aged, 80 and over; Electrocardiography; Female; Humans; Male; Middle Aged; Myocardial Infarction/diagnosis*; Sensitivity and Specificity; Logistic Models; Photoplethysmography/methods*

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