Browse publications by year: 2018

  1. Motalebi SA, Cheong LS, Iranagh JA, Mohammadi F
    Exp Aging Res, 2018 1 18;44(1):48-61.
    PMID: 29336735 DOI: 10.1080/0361073X.2017.1398810
    Background/Study Context: Given the rapid increase in the aging population worldwide, fall prevention is of utmost importance. It is essential to establish an efficient, simple, safe, and low-cost intervention method for reducing the risk of falls. This study examined the effect of 12 weeks of progressive elastic resistance training on lower-limb muscle strength and balance in seniors living in the Rumah Seri Kenangan, social welfare home in Cheras, Malaysia.

    METHODS: A total of 51 subjects qualified to take part in this quasi-experimental study. They were assigned to either the resistance exercise group (n = 26) or control group (n = 25). The mean age of the 45 participants who completed the program was 70.7 (SD = 6.6). The exercise group met twice per week and performing one to three sets of 8 to 10 repetitions for each of nine lower-limb elastic resistance exercises. All exercises were conducted at low to moderate intensities in sitting or standing positions. The subjects were tested at baseline and 6 and 12 weeks into the program.

    RESULTS: The results showed statistically significant improvements in lower-limb muscle strength as measured by five times sit-to-stand test (%Δ = 22.6) and dynamic balance quantified by the timed up-and-go test (%Δ = 18.7), four-square step test (%Δ = 14.67), and step test for the right (%Δ = 18.36) and left (%Δ = 18.80) legs. No significant changes were observed in static balance as measured using the tandem stand test (%Δ = 3.25), and one-leg stand test with eyes opened (%Δ = 9.58) and eyes closed (%Δ = -0.61) after completion of the program.

    CONCLUSION: The findings support the feasibility and efficacy of a simple and inexpensive resistance training program to improve lower-limb muscle strength and dynamic balance among the institutionalized older adults.

    MeSH terms: Accidental Falls/prevention & control*; Aged; Aging; Postural Balance/physiology*; Female; Homes for the Aged*; Humans; Leg/physiology; Malaysia; Male; Muscle Strength/physiology*; Resistance Training/methods*
  2. Mohd-Sidik S, Akhtari-Zavare M, Periasamy U, Rampal L, Fadhilah SI, Mahmud R
    Patient Educ Couns, 2018 05;101(5):862-871.
    PMID: 29336859 DOI: 10.1016/j.pec.2018.01.004
    OBJECTIVES: The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the "Managing Patients on Chemotherapy" module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia.

    METHODS: A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted.

    RESULTS: Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P 

    MeSH terms: Analysis of Variance; Anxiety; Counseling; Depression; Follow-Up Studies; Government; Humans; Malaysia; Neoplasms; Nerve Tissue Proteins; Pharmacists; Self Concept; RNA-Binding Proteins; Control Groups
  3. Odak JA, Manguro LOA, Wong KC
    J Asian Nat Prod Res, 2018 Jun;20(6):510-524.
    PMID: 29338355 DOI: 10.1080/10286020.2017.1420648
    The plant species Elaeodendron buchananii Loes is widely used in folklore medicine to manage microbial infections in Kenya. Previous studies on the plant fruits and root bark revealed the presence of steroids and terpenoids. The present phytochemical analysis of the plant stem bark has led to the isolation of four new triterpenes characterized as methyl 3β-acetoxy-11α, 19α, 28-trihydroxyurs-12-en-23-oic acid (1), 3β, 11α, 19α-trihydroxyurs-12-en-23, 28-dioic acid (2), 3β-acetoxy-19α, 23, 28-trihydroxyurs-12-ene (3) and 3-oxo-19α, 28-dihydroxyurs-12-en-24-oic acid (4), together with ten known ones (5-14), whose structures were elucidated using spectroscopic techniques. The isolate canophyllol (8) showed promising antibacterial activity against N. meningitides with MIC value of 31.25 μg/ml.
    MeSH terms: Anti-Bacterial Agents/isolation & purification*; Anti-Bacterial Agents/chemistry; Antifungal Agents/isolation & purification*; Antifungal Agents/chemistry; Microbial Sensitivity Tests; Triterpenes/isolation & purification*; Triterpenes/chemistry; Molecular Structure; Plant Bark/chemistry; Celastraceae/chemistry*
  4. Swarna Nantha Y, Wee LH, Chan CM
    BMC Fam Pract, 2018 01 16;19(1):18.
    PMID: 29338699 DOI: 10.1186/s12875-017-0690-5
    BACKGROUND: Providing sickness certification is a decision that primary care physicians make on a daily basis. The majority of sickness certification studies in the literature involve a general assessment of physician or patient behaviour without the use of a robust psychological framework to guide research accuracy. To address this deficiency, this study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians.

    METHODS: A cross-sectional study was conducted among N = 271 primary care physicians from 86 primary care practices throughout two states in Malaysia. Questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to the provision of sickness leave. Questionnaire validity was established through factor analysis and the determination of internal consistency between theoretically related constructs. The temporal stability of the indirect measures was determined via the test-retest correlation analysis. Structural equation modelling was conducted to determine the strength of predictors related to intentions.

    RESULTS: The mean scores for intention to provide patients with sickness was low. The Cronbach α value for the direct measures was good: overall physician intent to provide sick leave (0.77), physician attitude towards prescribing sick leave for patients (0.77) and physician attitude in trusting the intention of patients seeking sick leave (0.83). The temporal stability of the indirect measures of the questionnaire was satisfactory with significant correlation between constructs separated by an interval of two weeks (p 

    MeSH terms: Adult; Attitude of Health Personnel*; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Reproducibility of Results; Sick Leave*; Health Care Surveys; Intention*; Prescriptions*; Physicians, Primary Care*
  5. Ng HS, Chai CXY, Chow YH, Loh WLC, Yim HS, Tan JS, et al.
    J Biosci Bioeng, 2018 May;125(5):585-589.
    PMID: 29339003 DOI: 10.1016/j.jbiosc.2017.12.010
    Xylanase enzyme degrades linear polysaccharide β-1,4 xylan and the hemicellulose of the plant cell wall. There is a growing demand in finding a cost-effective alternative for industrial scale production of xylanase with high purity for pharmaceutical applications. In this study, an alcohol/salt aqueous biphasic system (ABS) was adopted to recover xylanase from the Bacillus subtilis fermentation broth. The effects of several ABS parameters such as types and concentrations of alcohols and salts (i.e., sulphate, phosphate, and citrate), amount of crude loading and pH of the system on the recovery of xylanase were investigated. Partition coefficient of xylanase (KE), selectivity (S) and yield (YT) of xylanase in top phase of the ABS were measured. Highest KE (6.58 ± 0.05) and selectivity (4.84 ± 0.33) were recorded in an ABS of pH 8 composed of 26% (w/w) 1-propanol, 18% (w/w) ammonium sulphate. High YT of 71.88% ± 0.15 and a purification fold (PFT) of 5.74 ± 0.33 were recorded with this optimum recovery of xylanase using alcohol/salt ABS. The purity of xylanase recovered was then qualitatively verified with sodium dodecyl sulphate (SDS) gel electrophoresis. The SDS profile revealed the purified xylanase was successfully obtained in the top phase of the one-step 1-propanol/sulphate ABS with a distinct single band.
    MeSH terms: Ethanol/chemistry; Bacillus subtilis/enzymology*; Bacillus subtilis/metabolism; Culture Media/chemistry*; Fermentation*; Hydrogen-Ion Concentration; Sodium Chloride/chemistry; Water/chemistry; Bioreactors/microbiology; Endo-1,4-beta Xylanases/isolation & purification*; Endo-1,4-beta Xylanases/metabolism; Batch Cell Culture Techniques/methods
  6. Wu KL, Kuo CM, Yao CC, Tai WC, Chuah SK, Lim CS, et al.
    J Formos Med Assoc, 2018 Nov;117(11):973-978.
    PMID: 29339035 DOI: 10.1016/j.jfma.2017.11.001
    BACKGROUND: Acid changes in gastroesophageal reflux with vary component in the food have less been studied, especially carbohydrate. We plan to clarify the effect of different carbohydrate density on low esophageal acid and reflux symptoms of patients with gastroesophgeal reflux disease.

    METHODS: Twelve patients (52 ± 12 years old; five female) with gastroesophageal reflux disease were recruited for the prospective crossover study. Each patient was invited for panendoscope, manometry and 24 h pH monitor. The two formulated liquid meal, test meal A: 500 ml liquid meal (containing 84.8 g carbohydrate) and B: same volume liquid meal (but 178.8 g carbohydrate) were randomized supplied as lunch or dinner. Reflux symptoms were recorded.

    RESULTS: There are significant statistic differences in more Johnson-DeMeester score (p = 0.019), total reflux time (%) (p = 0.028), number of reflux periods (p = 0.026) and longest reflux (p = 0.015) after high carbohydrate diet than low carbohydrate. Total reflux time and number of long reflux periods more than 5 min are significant more after high carbohydrate diet.

    CONCLUSION: More acid reflux symptoms are found after high carbohydrate diet. High carbohydrate diet could induce more acid reflux in low esophagus and more reflux symptoms in patients with gastroesophageal reflux disease.

    MeSH terms: Adult; Dietary Carbohydrates/administration & dosage; Dietary Carbohydrates/adverse effects*; Female; Gastroesophageal Reflux/physiopathology*; Humans; Hydrogen-Ion Concentration; Male; Manometry; Middle Aged; Prospective Studies; Cross-Over Studies
  7. Bello AU, Idrus Z, Meng GY, Narayan EJ, Farjam AS
    Gen Comp Endocrinol, 2018 05 01;260:146-150.
    PMID: 29339185 DOI: 10.1016/j.ygcen.2018.01.012
    Tryptophan (Trp) has been associated with the regulation of several behavioral and physiological processes, through stimulation of serotonergic activity. Tryptophan utilization at the metabolic level is influenced by the competitive carrier system it shares with large neutral amino acids (LNAA). This study was carried out using meat-type chicken as a model, to investigate the dose response effects of Trp/LNAA on fear response (tonic immobility; TI) and hormonal responses, including corticosterone (CORT), serotonin (5-HT), triiodothyronine (T3) and thyroxine (T4). A total of 12 cages (48 birds) were assigned to each of the six experimental groups at 29-42 days of age. Experimental diets were formulated to have incremental levels of Trp/LNAA (0.025, 0.030, 0.035, 0.040, 0.045, and 0.050). The results revealed that, Trp/NAA had no significant effect on growth performance and TI of the birds. However, elevation of Trp/LNAA was concurred with a linear reduction in CORT (P 
    MeSH terms: Animals; Biological Phenomena; Chickens; Corticosterone; Diet; Fear; Meat; Physiological Phenomena; Serotonin; Thyroxine; Triiodothyronine; Tryptophan; Amino Acids, Neutral
  8. Kano R, Hsiao YH, Siew HH, Chen C, Hasegawa A, Kamata H
    Mycopathologia, 2018 Jan 16.
    PMID: 29340910 DOI: 10.1007/s11046-018-0242-0
    To clarify the terbinafine (TRF) resistance mechanism in a TRF-resistant strain of Microsporum canis, the expression of the pleiotropic drug resistance (PDR1), multidrug resistance (MDR1), MDR2 and MDR4 genes were investigated by real-time quantitative PCR (RT-qPCR) analysis, given the known interaction of the corresponding proteins with antifungals and with the efflux blocker FK506. The expression of the PDR1, MDR1, MDR2 and MDR4 genes was 2-4 times higher in the TRF-resistant strain grown in the presence of 0.14 µg/mL of TRF than in TRF-susceptible strains cultured in the absence of TRF. The TRF-resistant strain exhibited MICs of > 32 µg/mL for TRF alone; this resistance was attenuated to an MIC of 8 µg/mL in the presence of FK506, indicating that the TRF inhibitory concentration index value was
    MeSH terms: Antifungal Agents; Microsporum; Naphthalenes; Polymerase Chain Reaction; Tacrolimus; Drug Resistance, Multiple; ATP-Binding Cassette Transporters
  9. Mohd Firdaus MA, Agatz A, Hodson ME, Al-Khazrajy OSA, Boxall ABA
    Environ Toxicol Chem, 2018 05;37(5):1420-1429.
    PMID: 29341233 DOI: 10.1002/etc.4094
    Nanopesticides are novel plant protection products offering numerous benefits. Because nanoparticles behave differently from dissolved chemicals, the environmental risks of these materials could differ from conventional pesticides. We used soil-earthworm systems to compare the fate and uptake of analytical-grade bifenthrin to that of bifenthrin in traditional and nanoencapsulated formulations. Apparent sorption coefficients for bifenthrin were up to 3.8 times lower in the nano treatments than in the non-nano treatments, whereas dissipation half-lives of the nano treatments were up to 2 times longer. Earthworms in the nano treatments accumulated approximately 50% more bifenthrin than those in the non-nano treatments. In the non-nano treatments, most of the accumulated material was found in the earthworm tissue, whereas in the nano treatments, the majority resided in the gut. Evaluation of toxicokinetic modeling approaches showed that models incorporating the release rate of bifenthrin from the nanocapsule and distribution within the earthworm provided the best estimations of uptake from the nano-formulations. Overall, our findings indicate that the risks of nanopesticides may be different from those of conventional formulations. The modeling presented provides a starting point for assessing risks of these materials but needs to be further developed to better consider the behavior of the nanoencapsulated pesticide within the gut system. Environ Toxicol Chem 2018;37:1420-1429. © 2018 SETAC.
    MeSH terms: Animals; Environment*; Half-Life; Models, Biological; Oligochaeta/metabolism*; Pesticides/metabolism*; Pyrethrins/metabolism; Risk Factors; Soil/chemistry*; Risk Assessment*; Nanoparticles/chemistry*
  10. Singh S, Agarwal R, Razak ZA, Ngu R, Nyein LL, Vasudevan S, et al.
    J Ocul Pharmacol Ther, 2018 01 17;34(1-2):214-223.
    PMID: 29341837 DOI: 10.1089/jop.2017.0098
    PURPOSE: Pseudomonas aeruginosa is the most common causative organism for contact lens-associated corneal ulcer and is commonly treated with fluoroquinolones. With the emergence of resistant strains, it is important to investigate alternative therapies. Despite well-established efficacy of tazocin against systemic Pseudomonas infections, its topical use for the treatment of Pseudomonas keratitis has not been described, hence this study was aimed to find the ocular permeation of Tazocin and its efficacy in treating keratitis in rabbit eyes.

    METHODS: We investigated the ocular permeation of topical tazocin after single drop application in normal rabbit eyes by estimating piperacillin and tazobactam concentrations in cornea, aqueous, and vitreous using a validated LC-MS/MS method. Furthermore, we determined the efficacy of repeated dose administration of tazocin against experimentally induced P. aeruginosa keratitis in rabbits in comparison to moxifloxacin. To determine the efficacy, clinical examination, histopathological examination, and estimation of bacterial load and inflammatory cytokines in cornea were done.

    RESULTS: Significant corneal concentration of piperacillin and tazobactam was detected in normal rabbit corneas after single dose treatment with tazocin. In rabbits with Pseudomonas-induced keratitis, topical tazocin caused significant clinical and histopathological improvement. This improvement was associated with reduction in corneal bacterial load and inflammatory cytokines. Compared to moxifloxacin 0.5%, tazocin treated group showed greater clinical response which was associated with higher interleukin (IL)-1β, lower tumor necrosis factor (TNF)-α, a comparable level of IL-8, greater reduction in corneal bacterial load, and lesser inflammatory cell infiltration.

    CONCLUSION: Tazocin showed good ocular penetration and was effective in treatment of Pseudomonas induced keratitis in rabbits.

    MeSH terms: Administration, Topical; Animals; Anti-Bacterial Agents/administration & dosage; Anti-Bacterial Agents/pharmacology*; Cornea/drug effects*; Cornea/metabolism; Cornea/pathology; Keratitis/drug therapy*; Keratitis/metabolism; Keratitis/microbiology; Permeability/drug effects; Pseudomonas aeruginosa/drug effects*; Rabbits
  11. Ong CB, Annuar MSM
    Prep Biochem Biotechnol, 2018 Feb 07;48(2):181-187.
    PMID: 29341838 DOI: 10.1080/10826068.2018.1425707
    Immobilization of cross-linked tannase on pristine multiwalled carbon nanotubes (MWCNT) was successfully performed. Cross-linking of tannase molecules was made through glutaraldehyde. The immobilized tannase exhibited significantly improved pH, thermal, and recycling stability. The optimal pH for both free and immobilized tannase was observed at pH 5.0 with optimal operating temperature at 30°C. Moreover, immobilized enzyme retained greater biocatalytic activities upon 10 repeated uses compared to free enzyme in solution. Immobilization of tannase was accomplished by strong hydrophobic interaction most likely between hydrophobic amino acid moieties of the glutaraldehyde-cross-linked tannase to the MWCNT.
    MeSH terms: Aspergillus/enzymology*; Aspergillus/chemistry; Carboxylic Ester Hydrolases/chemistry*; Cross-Linking Reagents/chemistry*; Enzyme Stability; Enzymes, Immobilized/chemistry*; Glutaral/chemistry*; Hydrogen-Ion Concentration; Temperature; Nanotubes, Carbon/chemistry*; Biocatalysis
  12. Tan MH, Austin CM, Hammer MP, Lee YP, Croft LJ, Gan HM
    Gigascience, 2018 03 01;7(3):1-6.
    PMID: 29342277 DOI: 10.1093/gigascience/gix137
    Background: Some of the most widely recognized coral reef fishes are clownfish or anemonefish, members of the family Pomacentridae (subfamily: Amphiprioninae). They are popular aquarium species due to their bright colours, adaptability to captivity, and fascinating behavior. Their breeding biology (sequential hermaphrodites) and symbiotic mutualism with sea anemones have attracted much scientific interest. Moreover, there are some curious geographic-based phenotypes that warrant investigation. Leveraging on the advancement in Nanopore long read technology, we report the first hybrid assembly of the clown anemonefish (Amphiprion ocellaris) genome utilizing Illumina and Nanopore reads, further demonstrating the substantial impact of modest long read sequencing data sets on improving genome assembly statistics.

    Results: We generated 43 Gb of short Illumina reads and 9 Gb of long Nanopore reads, representing approximate genome coverage of 54× and 11×, respectively, based on the range of estimated k-mer-predicted genome sizes of between 791 and 967 Mbp. The final assembled genome is contained in 6404 scaffolds with an accumulated length of 880 Mb (96.3% BUSCO-calculated genome completeness). Compared with the Illumina-only assembly, the hybrid approach generated 94% fewer scaffolds with an 18-fold increase in N50 length (401 kb) and increased the genome completeness by an additional 16%. A total of 27 240 high-quality protein-coding genes were predicted from the clown anemonefish, 26 211 (96%) of which were annotated functionally with information from either sequence homology or protein signature searches.

    Conclusions: We present the first genome of any anemonefish and demonstrate the value of low coverage (∼11×) long Nanopore read sequencing in improving both genome assembly contiguity and completeness. The near-complete assembly of the A. ocellaris genome will be an invaluable molecular resource for supporting a range of genetic, genomic, and phylogenetic studies specifically for clownfish and more generally for other related fish species of the family Pomacentridae.

    MeSH terms: Animals; Perciformes/genetics*; Phylogeny*; Genome/genetics; Sequence Analysis, DNA/methods*; Genomics; Nanopores; Molecular Sequence Annotation; High-Throughput Nucleotide Sequencing
  13. Rhee KY, Sung TY, Kim JD, Kang H, Mohamad N, Kim TY
    J Int Med Res, 2018 Mar;46(3):1238-1248.
    PMID: 29332409 DOI: 10.1177/0300060517746841
    Objective To determine whether pre-treatment with high-dose ulinastatin provides enhanced postoperative oxygenation in patients who have undergone aortic valve surgery with moderate hypothermic cardiopulmonary bypass (CPB). Methods Patients who underwent aortic valve surgery with moderate hypothermic CPB were retrospectively evaluated. In total, 94 of 146 patients were included. The patients were classified into one of two groups: patients in whom ulinastatin (10,000 U/kg followed by 5,000 U/kg/h) was administered during CPB (Group U, n = 38) and patients in whom ulinastatin was not administered (Group C, n = 56). The PaO2/FiO2 ratio was calculated at the following time points: before CPB (pre-CPB), 2 h after weaning from CPB (post-CPB), and 6 h after arrival to the intensive care unit (ICU-6). The incidence of a low PaO2/FiO2 ratio was also compared among the time points. Results Group U showed a significantly higher PaO2/FiO2 ratio (F(4, 89.0) = 657.339) and a lower incidence of lung injury (PaO2/FiO2 ratio 
    MeSH terms: Aortic Valve; Cardiopulmonary Bypass; Glycoproteins; Humans; Intensive Care Units; Lung; Postoperative Period; Pulmonary Ventilation; Retrospective Studies; Weaning; Incidence; Lung Injury
  14. Muhammad SA, Seow EK, Mohd Omar AK, Rodhi AM, Mat Hassan H, Lalung J, et al.
    Sci Justice, 2018 Jan;58(1):59-66.
    PMID: 29332695 DOI: 10.1016/j.scijus.2017.05.008
    A total of 33 crude palm oil samples were randomly collected from different regions in Malaysia. Stable carbon isotopic composition (δ13C) was determined using Flash 2000 elemental analyzer while hydrogen and oxygen isotopic compositions (δ2H and δ18O) were analyzed by Thermo Finnigan TC/EA, wherein both instruments were coupled to an isotope ratio mass spectrometer. The bulk δ2H, δ18O and δ13C of the samples were analyzed by Hierarchical Cluster Analysis (HCA), Principal Component Analysis (PCA) and Orthogonal Partial Least Square-Discriminant Analysis (OPLS-DA). Unsupervised HCA and PCA methods have demonstrated that crude palm oil samples were grouped into clusters according to respective state. A predictive model was constructed by supervised OPLS-DA with good predictive power of 52.60%. Robustness of the predictive model was validated with overall accuracy of 71.43%. Blind test samples were correctly assigned to their respective cluster except for samples from southern region. δ18O was proposed as the promising discriminatory marker for discerning crude palm oil samples obtained from different regions. Stable isotopes profile was proven to be useful for origin traceability of crude palm oil samples at a narrower geographical area, i.e. based on regions in Malaysia. Predictive power and accuracy of the predictive model was expected to improve with the increase in sample size. Conclusively, the results in this study has fulfilled the main objective of this work where the simple approach of combining stable isotope analysis with chemometrics can be used to discriminate crude palm oil samples obtained from different regions in Malaysia. Overall, this study shows the feasibility of this approach to be used as a traceability assessment of crude palm oils.
    MeSH terms: Carbon; Carbon Isotopes; Hydrogen; Malaysia; Oxygen Isotopes; Petroleum; Cluster Analysis; Discriminant Analysis; Least-Squares Analysis; Sample Size; Principal Component Analysis
  15. Mohan V, Paungmali A, Sitilertpisan P
    J Bodyw Mov Ther, 2018 01;22(1):11-12.
    PMID: 29332732 DOI: 10.1016/j.jbmt.2017.03.017
    MeSH terms: Chronic Disease; Humans; Pain Measurement*; Low Back Pain*; Chronic Pain
  16. Tan GH
    Investig Clin Urol, 2018 01;59(1):68.
    PMID: 29333519 DOI: 10.4111/icu.2018.59.1.68
    MeSH terms: Humans; Male; Prostatic Hyperplasia/surgery; Urologic Surgical Procedures; Urethral Stricture*; Transurethral Resection of Prostate*
  17. Chan WK, Treeprasertsuk S, Imajo K, Nakajima A, Seki Y, Kasama K, et al.
    Aliment Pharmacol Ther, 2018 Mar;47(6):816-825.
    PMID: 29333610 DOI: 10.1111/apt.14506
    BACKGROUND: The Gut and Obesity Asia (GO ASIA) workgroup was formed to study the relationships between obesity and gastrointestinal diseases in the Asia Pacific region.

    AIM: To study factors associated with nonalcoholic steatohepatitis (NASH) and advanced fibrosis, and medical treatment of biopsy-proven nonalcoholic fatty liver disease (NAFLD) patients.

    METHODS: Retrospective study of biopsy-proven NAFLD patients from centres in the GO ASIA Workgroup. Independent factors associated with NASH and with advanced fibrosis on binary logistic regression analyses in a training cohort were used for the development of their corresponding risk score, which were validated in a validation cohort.

    RESULTS: We included 1008 patients from nine centres across eight countries (NASH 62.9%, advanced fibrosis 17.2%). Independent predictors of NASH were body mass index ≥30 kg/m2 , diabetes mellitus, dyslipidaemia, alanine aminotransferase ≥88 U/L and aspartate aminotransferase ≥38 U/L, constituting the Asia Pacific NASH risk score. A high score has a positive predictive value of 80%-83% for NASH. Independent predictors of advanced fibrosis were age ≥55 years, diabetes mellitus and platelet count <150 × 109 /L, constituting the Asia-Pacific NAFLD advanced fibrosis risk score. A low score has a negative predictive value of 95%-96% for advanced fibrosis. Only 1.7% of patients were referred for structured lifestyle program, 4.2% were on vitamin E, and 2.4% were on pioglitazone.

    CONCLUSIONS: More severe liver disease can be suspected or ruled out based on factors identified in this study. Utilisation of structured lifestyle program, vitamin E and pioglitazone was limited despite this being a cohort of biopsy-proven NAFLD patients with majority of patients having NASH.

    MeSH terms: Adult; Asia/epidemiology; Biopsy; Female; Gastrointestinal Diseases/complications; Gastrointestinal Diseases/epidemiology*; Gastrointestinal Diseases/pathology; Humans; Liver/pathology; Male; Middle Aged; Obesity/complications; Obesity/epidemiology*; Obesity/pathology; Pacific Ocean/epidemiology; Retrospective Studies; Cohort Studies; Body Mass Index; Asian Continental Ancestry Group/statistics & numerical data; Non-alcoholic Fatty Liver Disease/complications; Non-alcoholic Fatty Liver Disease/epidemiology*; Non-alcoholic Fatty Liver Disease/pathology; Non-alcoholic Fatty Liver Disease/therapy*
  18. Bukhsh A, Rehman H, Mallhi TH, Ata H, Rehman IU, Lee LH, et al.
    Hum Vaccin Immunother, 2018 04 03;14(4):952-957.
    PMID: 29333939 DOI: 10.1080/21645515.2017.1415686
    National immunization program of Pakistan does not include Influenza vaccines. The low rate of immunization might be attributed to the poor knowledge of influenza vaccination in Pakistan. Current study was aimed to assess the knowledge and attitude of influenza vaccination among parents. A questionnaire-based cross sectional study was conducted among randomly selected parents with at least one child aged >6 months. The responses were recorded against 27 items questionnaire assessing knowledge, perception, attitude and behaviours of parents. Data were analysed by using appropriate statistical methods. A total 532 responses were recorded with male gender preponderance (65%). Most of the parents (61.1%) reported that their children had received or planned to receive all recommended vaccines in Expanded Program on Immunization (EPI) of Pakistan. Only one third of the parents (24.4%) were aware of the availability of influenza vaccines in Pakistan, and very few (6.6%) reported vaccinating their child against influenza. Exploring the parents' attitudes regarding children vaccination, the top motivator was 'immunization is important to keep my children healthy' (relative index = 0.93, p < 0.000). However, substantial number of parents believed that influenza is not a serious disease (18.5%) and vaccines are accompanied by several side effects (24.6%). A positive attitude was reflected among parents who were aware of influenza vaccines in Pakistan. About 35% participants believed that influenza vaccines are not required for healthy children. Current study demonstrated very low vaccination rate against influenza. Awareness and health literacy regarding influenza vaccine is poor among parents. These findings necessitate the need to appropriately structured awareness programs regarding influenza vaccination among parents.
    MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Female; Humans; Immunization/psychology; Influenza, Human/immunology; Influenza, Human/prevention & control*; Influenza, Human/psychology*; Influenza Vaccines/immunology*; Health Knowledge, Attitudes, Practice; Male; Middle Aged; Pakistan; Parents/psychology*; Surveys and Questionnaires; Vaccination/psychology*; Immunization Programs/methods; Young Adult
  19. Ahmad Kamal NH, Selamat J, Sanny M
    PMID: 29334335 DOI: 10.1080/19440049.2018.1425553
    This study investigated the simultaneous formation of polycyclic aromatic hydrocarbons (PAHs) and heterocyclic aromatic amines (HCAs) in gas-grilled beef satay at different temperatures (150, 200, 250, 300, and 350°C). Solid-phase extraction (SPE) was used for sample clean-up. Fifteen PAHs were determined using high performance liquid chromatography with fluorescence detection (HPLC-FLD) and nine HCAs were quantified using liquid chromatography tandem-mass spectrometry (LC-MS/MS) with a gradient programme. The lowest significantly concentrations of PAHs and HCAs were generated at 150°C; the formation of PAHs and HCAs simultaneously increased with temperatures. Benzo[a]pyrene was detected in all samples and increased markedly at 300 and 350°C. The sums of 4 PAHs (PAH4) in marinated beef satay at 300 and 350°C exceeded the maximum level in Commission Regulation (EU) 2015/1125. Significant reductions of polar and non-polar HCAs (except PhIP) were found in marinated beef satay across all temperatures. Overall, PAHs and HCAs showed opposite trends of formation in beef satay with marination.
    MeSH terms: Amines/analysis*; Animals; Cattle; Chromatography, High Pressure Liquid; Cooking*; Food Contamination/analysis*; Heterocyclic Compounds/analysis*; Meat/analysis*; Polycyclic Hydrocarbons, Aromatic/analysis*; Temperature*; Solid Phase Extraction; Tandem Mass Spectrometry
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