Browse publications by year: 2019

  1. Mohamad Shakir SM, Wong LP, Abdullah KL, Adam P
    Sex Health, 2019 Mar 19.
    PMID: 30885292 DOI: 10.1071/SH17198
    Background:The Internet is an important resource of information about sexually transmissible infections (STIs) among young people. Little is known of the facilitators of online STI information seeking. This study aimed to identify the factors associated with online STI information seeking among youth in Malaysia. Methods: A cross-sectional online survey was conducted among Malaysian youth aged 18-25 years who were recruited through social media. Results: Among 1530 respondents who completed the survey, 57.1% sought online STI information in the past 12 months mostly from general Internet websites, health websites, and Facebook. Respondents' overall STI knowledge was low. Young people who had higher STI knowledge (OR = 2.47, 95% CI = 1.87-3.25, P = 0.000), had intention-to-seek online STI information (OR = 2.02, 95% CI = 1.23-3.30, P = 0.000), identified as homosexual or bisexual (OR = 1.67, 95% CI = 1.08-2.57, P = 0.020), experienced STI symptoms (OR = 1.51, 95%CI = 1.02-2.22, P = 0.040), were in a relationship (OR = 1.42, 95% CI = 1.08-1.86, P = 0.012) and had high perceived quality of online STI information (OR = 1.41, 95%CI = 1.09-1.83, P = 0.009) were more likely to seek online STI information. Conclusions: Findings suggest the need to increase STI knowledge and perceived quality of online STI information among Malaysian youth. Young people with low STI knowledge, who are heterosexual, sexually active without STI symptoms and single would benefit from reliable sources of online STI information for STI prevention.
  2. Xu SW, Dong M, Zhang Q, Yang SY, Chen LY, Sim K, et al.
    Psychiatry Res, 2019 Mar 15.
    PMID: 30885383 DOI: 10.1016/j.psychres.2019.02.056
    Clozapine is an effective antipsychotic medication for treatment resistant schizophrenia and is widely used in Asian countries. This study investigated clozapine prescription patterns and their associated factors in Asian countries and territories based on the database of the Research on Asian Psychotropic prescription study (REAP) conducted in 2016. Demographic and clinical information of 3744 schizophrenia patients in 15 Asian countries and territories was collected with a standardized data collection form. In total, 18.4% of the sample received clozapine, ranging from 2.6% in Japan to 32.3% in Hong Kong. Binary logistic regression analysis revealed that higher antipsychotic dose (OR = 1.002, P 
  3. Yee PTI, Tan SH, Ong KC, Tan KO, Wong KT, Hassan SS, et al.
    Sci Rep, 2019 Mar 18;9(1):4805.
    PMID: 30886246 DOI: 10.1038/s41598-019-41285-z
    Besides causing mild hand, foot and mouth infections, Enterovirus A71 (EV-A71) is associated with neurological complications and fatality. With concerns about rising EV-A71 virulence, there is an urgency for more effective vaccines. The live attenuated vaccine (LAV) is a more valuable vaccine as it can elicit both humoral and cellular immune responses. A miRNA-based vaccine strain (pIY) carrying let-7a and miR-124a target genes in the EV-A71 genome which has a partial deletion in the 5'NTR (∆11 bp) and G64R mutation (3Dp°l) was designed. The viral RNA copy number and viral titers of the pIY strain were significantly lower in SHSY-5Y cells that expressed both let-7a and miR-124a. Inhibition of the cognate miRNAs expressed in RD and SHSY-5Y cells demonstrated de-repression of viral mRNA translation. A previously constructed multiply mutated strain, MMS and the pIY vaccine strain were assessed in their ability to protect 4-week old mice from hind limb paralysis. The MMS showed higher amounts of IFN-γ ex vivo than the pIY vaccine strain. There was absence of EV-A71 antigen in the skeletal muscles and spinal cord micrographs of mice vaccinated with the MMS and pIY strains. The MMS and pIY strains are promising LAV candidates developed against severe EV-A71 infections.
  4. Lim YH, Foo HL, Loh TC, Mohamad R, Abdullah N
    PMID: 30886709 DOI: 10.1186/s40104-019-0323-z
    Background: Increasing understanding on the functions of amino acids (AA) has led to new commercial applications and expansion of the worldwide markets. However, the current technologies rely heavily on non-food grade microorganism and chemical synthesis for the production of AA. Several studies reported that lactic acid bacteria (LAB) have the capability of producing AA owing to their well-established proteolytic system and amino acid biosynthesis genes. Hence, the objectives of this study were to explore the extracellular proteolytic activity of LAB isolated from various Malaysian fermented foods and their potential to produce AA extracellularly as feed supplements.

    Results: All the studied LAB isolates were versatile extracellular protease producers, whereby extracellular protease activities were detected from acidic to alkaline pH (pH 5, pH 6.5, pH 8) using qualitative and quantitative proteolytic assays. The highest proteolytic activity at pH 5 (15.76 U/mg) and pH 8 (19.42 U/mg) was achieved by Lactobacillus plantarum RG14, while Lactobacillus plantarum RS5 exhibited the highest proteolytic activity of 17.22 U/mg at pH 6.5. As for the results of AA production conducted in de Man, Rogosa and Sharpe medium and analysed by high pressure liquid chromatography system, all LAB isolates were capable of producing an array of AA. Generally, Pediococcus sp. showed greater ability for AA production as compared to Lactobacillus sp. Moreover, the studied LAB were able to produce a few major feed supplement AA such as methionine, lysine, threonine and tryptophan. P. pentosaceus TL-3 recorded the highest methionine and threonine productivity of 3.72 mg/L/h and 5.58 mg/L/h respectively. However, L. plantarum I-UL4 demonstrated a lysine productivity of 1.24 mg/L/h, while P. acidilactici TP-6 achieved up to 1.73 mg/L/h of tryptophan productivity.

    Conclusion: All the 17 studied LAB isolates possessed versatile extracellular proteolytic system and have vast capability of producing various amino acids including a few major feed supplement AA such as methionine, lysine, threonine and tryptophan. Despite AA production was strain dependent, the studied LAB isolates possessed vast potential and can be exploited further as a bio-agent or an alternative amino acids and bioactive peptide producers.

  5. Santos ALC, Terças Trettel ACP, Ribeiro LJBB, Vasconcellos ML, Zenazokenae LE, Atanaka Santos M, et al.
    Parasite Epidemiol Control, 2019 May;5:e00097.
    PMID: 30886914 DOI: 10.1016/j.parepi.2019.e00097
    Toxoplasma gondii is the etiological agent of toxoplasmosis, a widespread zoonosis that affects several homeothermic animals, including humans. This disease causes serious health problems, such that 10% of infected individuals develop clinical manifestations. Some studies on indigenous human populations have indicated variations in seroprevalence from 10.6% to 80.4% in such populations in different regions of Brazil and in other countries like Venezuela and Malaysia. To date, there have been no studies regarding the prevalence of anti-T. gondii antibodies in Haliti-Paresí Indians living in Campo Novo do Parecis, Mato Grosso, Brazil. Our objective here was to determine the frequency of occurrence of antibodies against this protozoon in nine Haliti-Paresí villages by correlating seroprevalence with locations and variables. Serodiagnoses were made using the indirect immunofluorescence antibody test (IFAT) and enzyme-linked immunosorbent assay (ELISA) in the Laboratory for Toxoplasmosis and Other Protozoan Diseases of IOC/Fiocruz. It was considered that samples tested positive for T. gondii infection if IgG/IgM antibodies against this protozoon were detected through serodiagnosis using either IFAT or ELISA. Among the 293 samples analyzed, 66.9% presented anti-T. gondii IgG and 3.4% presented anti-T. gondii IgM. It was observed that there were no statistically significant differences in frequency of antibody occurrence among infected individuals, based on sex, schooling or occupation/activities. However, there were statistical differences based on age and villages. The prevalence observed in this study is in agreement with values found in other studies on indigenous populations in Latin America. Like among other such populations, the Haliti-Paresí villages are located close to forests and the individuals have domestic cats as pets, are involved in hunting and farming and consume water directly from water accumulation sources. These factors might cause exposure to T. gondii tissue cysts and oocysts.
  6. Show PL, Pal P, Leong HY, Juan JC, Ling TC
    Environ Monit Assess, 2019 Mar 18;191(4):227.
    PMID: 30887225 DOI: 10.1007/s10661-019-7380-9
    Landfill application is the most common approach for biowaste treatment via leachate treatment system. When municipal solid waste deposited in the landfills, microbial decomposition breaks down the wastes generating the end products, such as carbon dioxide, methane, volatile organic compounds, and liquid leachate. However, due to the landfill age, the fluctuation in the characteristics of landfill leachate is foreseen in the leachate treatment plant. The focuses of the researchers are keeping leachate from contaminating groundwater besides keeping potent methane emissions from reaching the atmosphere. To address the above issues, scientists are required to adopt green biological methods to keep the environment safe. This review focuses on the assorting of research papers on organic content and nitrogen removal from the leachate via recent effective biological technologies instead of conventional nitrification and denitrification process. The published researches on the characteristics of various Malaysian landfill sites were also discussed. The understanding of the mechanism behind the nitrification and denitrification process will help to select an optimized and effective biological treatment option in treating the leachate waste. Recently, widely studied technologies for the biological treatment process are aerobic methane oxidation coupled to denitrification (AME-D) and partial nitritation-anammox (PN/A) process, and both were discussed in this review article. This paper gives the idea of the modification of the conventional treatment technologies, such as combining the present processes to make the treatment process more effective. With the integration of biological process in the leachate treatment, the effluent discharge could be treated in shortcut and novel pathways, and it can lead to achieving "3Rs" of reduce, reuse, and recycle approach.
  7. Pulikkotil SJ, Jayaraman J, Nagendrababu V
    PMID: 30887462 DOI: 10.1007/s40368-019-00432-w
    AIM: To systematically evaluate the reporting quality of the abstract of systematic reviews and meta-analyses in paediatric dentistry journals.

    MATERIALS AND METHODS: Systematic reviews with meta-analyses in paediatric dentistry were searched in PubMed and Scopus databases from inception to December 2017. Selection of studies by title and abstract screening followed by full-text assessment was independently done by two reviewers. The quality of abstracts was assessed by PRISMA-Abstract checklist comprising of 12 items; one each for title and objective, three items for methods, three items for results, two items for discussion and two items for others. PRISMA-A median scores were calculated and compared with the article characteristics. Statistical significance was set at p 

  8. Al Farraj DA, Hadibarata T, Yuniarto A, Syafiuddin A, Surtikanti HK, Elshikh MS, et al.
    PMID: 30888502 DOI: 10.1007/s00449-019-02096-8
    Polycyclic aromatics hydrocarbons (PAHs) are ubiquitous and toxic pollutants that are dangerous to humans and living organism in aquatic environment. Normally, PAHs has lower molecular weight such as phenanthrene and naphthalene that are easy and efficient to degrade, but high-molecular-weight PAHs such as chrysene and pyrene are difficult to be biodegraded by common microorganism. This study investigated the isolation and characterization of a potential halophilic bacterium capable of utilizing two high-molecular-weight PAHs. At the end of the experiment (25-30 days of incubation), bacterial counts have reached a maximum level (over 40 × 1016 CFU/mL). The highest biodegradation rate of 77% of chrysene in 20 days and 92% of pyrene in 25 days was obtained at pH 7, temperature 25 °C, agitation of 150 rpm and Tween 80 surfactant showing to be the most impressive parameters for HMWPAHs biodegradation in this research. The metabolism of initial compounds revealed that Hortaea sp. B15 utilized pyrene to form phthalic acid while chrysene was metabolized to form 1-hydroxy-2-naphthoic acid. The result showed that Hortaea sp. B15 can be promoted for the study of in situ biodegradation of high molecular weight PAH.
  9. Landoni G, Lomivorotov VV, Nigro Neto C, Monaco F, Pasyuga VV, Bradic N, et al.
    N. Engl. J. Med., 2019 Mar 19.
    PMID: 30888743 DOI: 10.1056/NEJMoa1816476
    BACKGROUND: Volatile (inhaled) anesthetic agents have cardioprotective effects, which might improve clinical outcomes in patients undergoing coronary-artery bypass grafting (CABG).

    METHODS: We conducted a pragmatic, multicenter, single-blind, controlled trial at 36 centers in 13 countries. Patients scheduled to undergo elective CABG were randomly assigned to an intraoperative anesthetic regimen that included a volatile anesthetic (desflurane, isoflurane, or sevoflurane) or to total intravenous anesthesia. The primary outcome was death from any cause at 1 year.

    RESULTS: A total of 5400 patients were randomly assigned: 2709 to the volatile anesthetics group and 2691 to the total intravenous anesthesia group. On-pump CABG was performed in 64% of patients, with a mean duration of cardiopulmonary bypass of 79 minutes. The two groups were similar with respect to demographic and clinical characteristics at baseline, the duration of cardiopulmonary bypass, and the number of grafts. At the time of the second interim analysis, the data and safety monitoring board advised that the trial should be stopped for futility. No significant difference between the groups with respect to deaths from any cause was seen at 1 year (2.8% in the volatile anesthetics group and 3.0% in the total intravenous anesthesia group; relative risk, 0.94; 95% confidence interval [CI], 0.69 to 1.29; P = 0.71), with data available for 5353 patients (99.1%), or at 30 days (1.4% and 1.3%, respectively; relative risk, 1.11; 95% CI, 0.70 to 1.76), with data available for 5398 patients (99.9%). There were no significant differences between the groups in any of the secondary outcomes or in the incidence of prespecified adverse events, including myocardial infarction.

    CONCLUSIONS: Among patients undergoing elective CABG, anesthesia with a volatile agent did not result in significantly fewer deaths at 1 year than total intravenous anesthesia. (Funded by the Italian Ministry of Health; MYRIAD ClinicalTrials.gov number, NCT02105610.).

  10. Khandaker MU, Shuaibu HK, Alklabi FAA, Alzimami KS, Bradley DA
    Health Phys, 2019 Mar 19.
    PMID: 30889102 DOI: 10.1097/HP.0000000000001042
    The presence of natural radionuclides in the food chain point to a need to assess concentration levels and concomitant radiological risk. Highly popular and forming a staple part of the diet in North Africa, the Arabian Peninsula, and West Asia, palm dates growing naturally there have even greater marketability than simple satisfaction of domestic demand, the palm dates representing a valuable export item. Accurate knowledge of the levels of natural radioactivity in the fruit is thus of importance. In this study, using high-purity germanium gamma-ray spectrometry, quantification has been made of natural radionuclide concentrations in imported dates originating from Iran, Saudi Arabia, and Tunisia. Sample analyses reveal respective mean activity concentrations of 1.4 ± 0.3, 0.8 ± 0.4, and 186 ± 9 Bq kg dry weight for Ra, Ra, and K. For each nuclide, the mean concentration varies little between the dates of the three represented regions. The estimated committed effective dose resulting from the consumption of date fruits for a typical adult was found to be 29.9 μSv y, well below the global internal dose of 290 μSv y assessed by the United Nations Scientific Committee on the Effects of Atomic Radiation to be due to food and water intake. Similarly, the excess lifetime cancer risk due to naturally occurring radioactive material exposure via date fruit consumption is seen to be below the International Commission on Radiological Protection cancer risk factor of 2.5 × 10 based on the additional annual dose limit of 1 mSv for a member of the general public. The results show no significant uptake in the analyzed date fruits.
  11. Wong SY, Hashim OH, Hayashi N
    PLoS ONE, 2019;14(3):e0213947.
    PMID: 30889197 DOI: 10.1371/journal.pone.0213947
    The primary components of human hair shaft-keratin and keratin-associated proteins (KAPs), together with their cross-linked networks-are the underlying reason for its rigid structure. It is therefore requisite to overcome the obstacle of hair insolubility and establish a reliable protocol for the proteome analysis of this accessible specimen. The present study employed an alkaline-based method for the efficient isolation of hair proteins and subsequently examined them using gel-based proteomics. The introduction of two proteomic protocols, namely the conventional and modified protocol, have resulted in the detection of more than 400 protein spots on the two-dimensional gel electrophoresis (2DE). When compared, the modified protocol is deemed to improve overall reproducibility, whilst offering a quick overview of the total protein distribution of hair. The development of this high-performance protocol is hoped to provide a new approach for hair analysis, which could possibly lead to the discovery of biomarkers for hair in health and diseases in the future.
  12. Cooper DJ, Rajahram GS, William T, Jelip J, Mohammad R, Benedict J, et al.
    Clin. Infect. Dis., 2019 Mar 19.
    PMID: 30889244 DOI: 10.1093/cid/ciz237
    BACKGROUND: Malaysia aims to eliminate malaria by 2020. However, while cases of Plasmodium falciparum and P. vivax have fallen substantially, the incidence of zoonotic malaria from P. knowlesi continues to increase, presenting a major challenge to regional malaria control efforts. Here we report incidence of all Plasmodium species in Sabah, including zoonotic P. knowlesi, during 2015-2017.

    METHODS: Microscopy-based malaria notification data and PCR results were obtained from the Sabah Department of Health and State Public Health Laboratory, respectively, from January 2015 to December 2017. From January 2016 this was complemented by a state-wide prospective hospital surveillance study. Databases were matched, and species was determined by PCR, or microscopy if PCR was not available.

    RESULTS: A total of 3867 malaria cases were recorded between 2015 and 2017, with PCR performed in 93%. Using PCR results, and microscopy if PCR was unavailable, P. knowlesi accounted for 817 (80%), 677 (88%), and 2030 (98%) malaria cases in 2015, 2016, and 2017, respectively. P. falciparum accounted for 110 (11%), 45 (6%), and 23 (1%) cases, and P. vivax 61 (6%), 17 (2%), and 8 (0.4%) cases, respectively. Of those with P. knowlesi, median age was 35 (IQR 24 - 47) years, and 85% were male.

    CONCLUSIONS: Malaysia is approaching elimination of the human-only Plasmodium species. However, the ongoing increase in P. knowlesi incidence presents a major challenge to malaria control and warrants increased focus on knowlesi-specific prevention activities. Wider molecular surveillance in surrounding countries is required.

  13. Taheri E, Mollabahrami F, Farokhzad M, Ghasemi F, Assari MJ
    PMID: 30879332 DOI: 10.1080/09603123.2019.1588232
    In the laboratories staffs, there is potential for adverse health effects in exposure to chemicals. Therefore, risk assessment is one of the main issues to prevent these effects. The purpose of this study was to assess the health risk of laboratory staffs and compare the two methods, including 'Chemical Health Risk Assessment' (CHRA) and 'Regional Screening Levels' (RSLs), that developed by the Department of Occupational Safety and Health of Malaysia and the Environmental Protection Agency respectively. Using these two methods, the places with the highest risk were identified. Comparisons showed that RSLs is a precise method without personal judgment. The CHRA is a simple method for wider chemicals that categorize risk. But CHRA includes fewer parameters compared to RSLs, as well as personal judgment. The results of the present study showed that two methods did not compatible. According to the characteristics of these two methods, it is recommended to use them as a compliment each other to obtain accurate results.
    MeSH terms: Judgment; Laboratories; Malaysia; United States; United States Environmental Protection Agency; Occupational Health; Risk Assessment; Drug-Related Side Effects and Adverse Reactions
  14. Rosli NA, Ahmad I, Anuar FH, Abdullah I
    Carbohydr Polym, 2019 Jun 01;213:50-58.
    PMID: 30879689 DOI: 10.1016/j.carbpol.2019.02.074
    In this study, modified agave cellulose fibre combined by graft copolymerisation with methylmethacrylate was tested as a potential reinforcement for polylactic acid (PLA)-natural rubber/liquid natural rubber blends. Mechanical, morphological, thermal, wetting, and biodegradation characterisations were performed to assess the influence of cellulose-graft-polymethylmethacrylate (cell-g-PMMA) content on the properties of biocomposites. The addition of cell-g-PMMA improved the mechanical properties of the composites because of the chemical interaction between PLA and PMMA. Thermal stability decreased slightly upon cell-g-PMMA addition because of the low thermal stability of PMMA. A soil burial test revealed that the degradation of composites decreased with an increase in the cell-g-PMMA content. However, the weight loss after burial, which directly affected the water absorption capacity, was still higher for the cell-g-PMMA composites than for the polymer alone.
    MeSH terms: Burial; Cellulose; Dietary Fiber; Polyesters; Polymers; Rubber; Soil; Water; Weight Loss; Wettability; Polymethyl Methacrylate; Methylmethacrylate; Agave; Polymerization
  15. Kim YJ
    PMID: 30880255 DOI: 10.1016/j.jams.2018.05.008
    Sleep disturbance is one of the more common risk factors, numerous other negative physical health outcomes, and it is defined as self-reported poor quality of sleep, short sleep duration, daytime sleepiness, and insomnia symptoms. It is a common risk factor for depression and anxiety. Here, a case of sleep disturbance that received 72 sessions of acupuncture treatment delivered is reported. After acupuncture treatment, the patient's PSQI, HDRS, and SAS score decreased, as well as the plasma TNF-α, and IL-6 are reduced. No adverse effects were observed. The clinical studies findings are provide evidence based supporting the acupuncture effects in reducing sleep disturbance patient.
  16. Pang Sing T, Julian R, Hatai K
    Biocontrol Sci, 2019;24(1):1-11.
    PMID: 30880308 DOI: 10.4265/bio.24.1
     The prevalence of antibiotic resistant bacteria in aquaculture has reached alarming proportions and intensified the search for microbe derived antimicrobial compounds. This study isolated bacteria from the intestine of Sagor catfish (Hexanematichthys sagor) and screened it for antagonistic properties. Five out of 334 bacterial isolates inhibited growth of fish pathogens. The 5 bacterial strains included relatives of Shewanella haliotis, Myroides odoratimimus, Vibrio harveyi, Vibrio alginolyticus and Alcaligenes faecalis. The growth profiles and probiotic properties of these bacteria were examined. The results showed that the isolate 9 (3) 7.5.2.1, whose closest relative was S. haliotis exhibited growth and probiotic advantage compared to the other bacterial strains, such as highest doubling time and the ability to survive at all experimental temperatures (18 to 60℃) , and bile concentrations (0.01 to 1.00%) and pH (pH2 to 9) . While the bacteria with probiotic properties were successfully isolated. Further study is necessary to examine the efficiency of the probiotic candidate bacteria in boosting fish immunity against pathogens.
  17. Ab Rahman J, Mohd Yusoff MF, Nik Mohamed MH, Mahadir Naidu B, Hock LK, Hiong TG, et al.
    PMID: 30880403 DOI: 10.1177/1010539519834735
    Electronic cigarettes (e-cigarettes) are a new method for the consumption of nicotine. A nationwide survey among 4288 Malaysian adults was conducted in 2016 to measure the prevalence and to describe the population characteristics of e-cigarette users. A complex sampling design was used, and data were collected using a face-to-face questionnaire. The overall prevalence of current, ever, former, and dual users of e-cigarettes in Malaysia were 3.2% (95% confidence interval [CI] = 2.5-4.1), 11.9% (95% CI = 10.5-13.5), 8.6% (95% CI = 7.5-9.8), and 2.3% (95% CI = 1.8-3.1), respectively. The prevalence of all type of e-cigarette use was higher in urban than in rural areas. Current e-cigarette users were likely to be younger, males, and with higher education level. Among current e-cigarette users, 74% (95% CI = 64-82) also smoked conventional cigarettes (dual user). E-cigarette use is prevalent in Malaysia. It is common among younger adults, males, and cigarette smokers.
    MeSH terms: Adult; Humans; Malaysia; Male; Nicotine; Surveys and Questionnaires; Smoke; Tobacco; Prevalence; Confidence Intervals; Tobacco Products
  18. Draman MS, Morris D, Evans S, Haridas A, Pell J, Greenwood R, et al.
    Thyroid, 2019 Mar 18.
    PMID: 30880626 DOI: 10.1089/thy.2018.0506
    BACKGROUND: Previous in vitro experiments have demonstrated that PGF2α reduced proliferation and adipogenesis in a murine cell line and human orbital fibroblasts derived from subjects with inactive Graves' orbitopathy (GO). The objective of this study was to determine if the PGF2α analogue Bimatoprost is effective at reducing proptosis in this population.

    METHODS: A randomized controlled double-masked crossover trial was conducted in a single tertiary care academic medical center. Patients with longstanding, inactive GO but persistent proptosis (> 20 mm in at least one eye) were recruited. Allowing for a 15% dropout rate, 31 patients (26 females) were randomized in order to identify a treatment effect of 2.0 mm (p=0.05, two-sided paired t-test, power 0.88). Following informed consent, participants were randomized to receive Bimatoprost or placebo for three months after which they underwent a two-month washout, before switching to the opposite treatment. The primary outcome was the change in exophthalmometry readings over the two 3-month treatment periods.

    RESULTS: The mean exophthalmometer at baseline was 23.6 (range 20.0-30.5) mm and the mean age was 55 (range 28-74) years. The median duration of GO was 7.6 (IQR 3.6-12.3) years. The majority were still suffering from diplopia (61.3%) with bilateral involvement (61.3%). Using multilevel modeling adjusted for baseline, period and carryover, Bimatoprost resulted in a -0.17 mm (reduction) exophthalmometry change (95% CI -0.67 to +0.32) p=0.490. Intraocular pressure was reduced -2.7 mmHg (95% CI -4.0 to -1.4) p=0.0070. One patient showed periorbital fat atrophy (PAP) on treatment which resolved on stopping treatment. Independent analysis of proptosis by photographic images (all subjects) and subgroup analysis on monocular disease (n=12) did not show any apparent benefit.

    CONCLUSION: In inactive GO, Bimatoprost treatment over a 3-month period does not result in an improvement in proptosis.

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