Browse publications by year: 2020

  1. Htay MNN, Marzo RR, AlRifai A, Kamberi F, El-Abasiri RA, Nyamache JM, et al.
    J Glob Health, 2020 Dec;10(2):020381.
    PMID: 33214890 DOI: 10.7189/jogh.10.020381
    MeSH terms: Adult; Mental Disorders/etiology*; Female; Health Personnel/psychology*; Humans; Male; Middle Aged; Stress, Psychological/etiology*; Pandemics*
  2. Yusoff MSB
    Oman Med J, 2020 Nov;35(6):e199.
    PMID: 33214913 DOI: 10.5001/omj.2020.90
    Objectives: This study investigated the outcomes of multiple mini interviews and personal interview on personality traits, emotional intelligence, perceived educational environment, and stressors.

    Methods: This is a comparative cross-sectional study on two cohorts of pre-clinical medical students who were selected by multiple mini interviews and personal interview, respectively. Their personality traits, emotional intelligence, perceived educational environment, and perceived stressors were measured using different measurement tools.

    Results: Multiple mini interviews and personal interview demonstrated a similar ability to recruit medical students with a high level of emotional intelligence. The main advantage of personal interviews over multiple mini interviews in terms of personality traits is that it recruited candidates who had a higher level of conscientiousness trait. The main advantage of multiple mini interviews over personal interview on the educational environment is that medical students chosen by multiple mini interviews had a higher level of satisfaction with social aspects of medical training. Regardless of admission processes, the medical students were equally vulnerable to psychological distress due to various stressful events throughout medical training particularly related to academic loads.

    Conclusions: This study provided evidence to support the outcomes that multiple mini interviews and personal interview have on medical students' emotional intelligence, personality traits, perceived educational environment, and perceived stressors during the pre-clinical medical training. Interestingly, personal interview had a better outcome on conscientiousness while multiple mini interviews had a better outcome on the social aspect.

    MeSH terms: Cross-Sectional Studies; Ethnic Groups; Humans; Personal Satisfaction; Students, Medical; Students, Nursing; Emotional Intelligence
  3. Badai SS, Rasid OA, Parveez GKA, Masani MYA
    3 Biotech, 2020 Dec;10(12):530.
    PMID: 33214977 DOI: 10.1007/s13205-020-02514-9
    Cetyltrimethylammonium bromide (CTAB) is the preferred detergent in RNA extraction of oil palm tissues. However, the CTAB-based protocol is time-consuming. In this study, a combination of the CTAB-based method and silica-based purification reduced the extraction time from two days to five hours. Quality of total RNA from 27 different tissues of oil palm was shown to have an RNA integrity number (RIN) value of more than seven. The extracted RNA was evaluated by RT-qPCR using three reference oil palm genes (GRAS, CYP2, and SLU7) and three putative mesocarp-specific transcripts annotated as WRKY DNA-binding protein 70 (WRKY-70), metallothionein (MT) and pentatricopeptide repeat (PPR) genes. Tissue-specific expression profiling across complete developmental stages of mesocarp and vegetative tissues was determined in this study. Overall, the RNA extraction protocol described here is rapid, simple and yields good quality RNAs from oil palm tissues.
  4. Ngah NF, Muhamad NA, Asnir ZZ, Abdul Aziz RA, Mhad Kassim Z, Sahar SA, et al.
    Int J Ophthalmol, 2020;13(11):1808-1813.
    PMID: 33215014 DOI: 10.18240/ijo.2020.11.19
    AIM: To determine the prevalence of diabetic retinopathy (DR) among diabetic patients at the primary health clinics in Selangor, Malaysia.

    METHODS: All diabetic patients were screened in Retinal Disease Awareness Programme (RDAP) and those who had significant DR changes were referred to the hospital for further management. Descriptive analyses were done to determine the prevalence of DR and sociodemographic characteristics among patients with diabetic. Univariate and multivariable analysis using Logistic regression were performed to find association and predictor factors in this screening.

    RESULTS: A total of 3305 patients aged 40y and above were screened for DR. Of the patients screened, 9% patients were found to have DR and other visual complication such as maculopathy (0.9%), cataract (4.8%) and glaucoma (0.4%). The mean age of patients without retinopathy was 57.82±8.470y and the mean age of patients with DR was 63.93±9.857y. About 61.5% of the patients screened were aged below 60y and 38.5% were aged 60y and above. Majority of the patients screened were women 58.5% and Malay in the age group of 50-59y, while 27% were aged 60-69y. Significant association were found between age, sex, race, visual loss and DR.

    CONCLUSION: Although the prevalence of DR among patients is not alarming, effective interventions need to be implemented soon to avert a large burden of visual loss from DR.

    MeSH terms: Adult; Aged; Cataract; Diabetes Mellitus; Diabetic Retinopathy; Female; Glaucoma; Humans; Macular Degeneration; Malaysia; Middle Aged; Retinal Diseases; Prevalence; Logistic Models; Tetrahymenina
  5. Kim YJ, Qian L, Aslam MS
    JMIR Res Protoc, 2020 Nov 20;9(11):e23112.
    PMID: 33216000 DOI: 10.2196/23112
    BACKGROUND: Workplace cyberbullying harms the psychological and social functioning of professionals working in an organization and may decrease the productivity and efficiency of daily life tasks. A recent study on trainee doctors across 8 different United Kingdom National Health Service trusts found health issues and job dissatisfaction in people who have experienced workplace cyberbullying. This disabling effect is even more noticeable in low-socioeconomic communities within low-income countries. In Malaysia, there is a need to create a personalized mobile mental health intervention program for health care professionals. These programs should be directed to prevent and decrease psychosocial issues and enhance coordination among health care professionals to solve health issues in the community.

    OBJECTIVE: Our main objective is to study the pre-effects and posteffects of the Personalized Mobile Mental Health Intervention (PMMH-I) for workplace cyberbullying in public and private hospitals in Malaysia.

    METHODS: A hospital-based multimethod multi-analytic evidential approach is proposed, involving social and psychological health informatics. The project has been subdivided into 3 stages, starting with Phase 1, a prevalence study, followed by exploratory studies. Phase 2 consists of a quasi-experimental design, whereas the development of a prototype and their testing will be proposed in Phase 3. Each stage includes the use of quantitative and qualitative methods (mixed-method program), using SPSS (version 26.0; IBM Corp) and Stata (version 16.1; StataCorp) as tools for quantitative research, and NVivo (version 1.0; QSR International) and Atlas.ti (version 9.0.16; ATLAS.ti Scientific Software Development GmbH) for qualitative research.

    RESULTS: The results of this study will determine the pre- and posteffectiveness of an integrated PMMH-I for health care professionals. The prototype system platform will be developed and implemented in a public and private hospital. Results from Phase 1 will be published in 2021, followed by the implementation of Phase 2 in subsequent years.

    CONCLUSIONS: This study will provide evidence and guidance regarding the implementation of a personalized mobile mental health intervention for health care professionals into routine public and private hospitals to enhance communication and resolve conflicts.

    INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/23112.

    MeSH terms: Cross-Sectional Studies; Health Personnel; Humans; Malaysia; Medical Informatics; Mental Health; Physicians; Research Design; Software; State Medicine; Hospitals, Private; Workplace; Qualitative Research
  6. Azman SEN, Abd Razak FS, Kamal WHBW, Zheng GK, Ming LC, Uddin AH, et al.
    Int J Pharm Compd, 2020 11 21;24(6):509-514.
    PMID: 33217741
    Orally disintegrating tablets are a solid dosage form that will disintegrate rapidly within 3 minutes upon contact with saliva. Fillers or diluents are excipients that are used to make up the volume of orally disintegrating tablets, and some might act as a disintegrant or binder that will affect the physical properties of orally disintegrating tablets. The objective of this study was to formulate and evaluate physical properties of orally disintegrating tablets containing Annona muricata leaves extract by a freeze-drying method using different fillers at different concentrations. In this study, fifteen formulations of orally disintegrating tablets were prepared by a freeze-drying method with different fillers such as starch, lactose, microcrystalline cellulose, StarLac, and CombiLac at 5%, 10%, and 15%. The orally disintegrating tablets were evaluated for hardness, thickness, weight variation, friability, and disintegration time test. The optimum formulation was chosen and incorporated with Annona muricata leaves extract. The results obtained in this work indicated that Formulation 3, with 15% starch, was the most optimum formulation due to the shortest disintegration time (21.08 seconds ± 4.24 seconds), and all the physical tests were within the acceptable range. The orally disintegrating tablets containing Annona muricata leaves extract possessed antioxidant activity and stable at least for 3 months under 60°C and 75% relative humidity.
    MeSH terms: Administration, Oral; Drug Compounding; Excipients*; Plant Extracts; Solubility; Tablets; Annona*
  7. Shrestha S, Danekhu K, Kc B, Palaian S, Ibrahim MIM
    Ther Adv Drug Saf, 2020;11:2042098620922480.
    PMID: 32587678 DOI: 10.1177/2042098620922480
    Background: Bibliometric analyses have been used previously to study the measures of quality and impact of research performed in several health-related areas such as adverse drug reactions (ADRs) and pharmacovigilance (PV), etc. This method can assess the research performance of publications quantitatively and statistically. There is no evidence of bibilometric studies analyzing ADRs and PV from Nepal. Therefore, the present study aimed to assess scientific output on ADRs and PV-related research activities in Nepal using a bibliometric analysis of publications from 2004 January to December 2018, that is, 15 years.

    Methods: A systematic search was conducted in PubMed, Web of Science, Google Scholar, Scopus and Nepal Journal Online (NepJOL) databases. 'Adverse Drug Reactions' or 'ADRs' or 'ADR' or 'Adverse drug reaction' or 'AE' or 'Adverse Event' or 'Drug-Induced Reaction' or 'Pharmacovigilance' or 'PV' and 'Nepal'. The search covered 15 years (January 2004 to December 2018) of study on ADRs and PV in Nepal. Only articles retrieved from databases were included, whereas published/unpublished drug bulletins, pharmacy newsletters and thesis were excluded. The articles thus retrieved were recorded, and thereafter analyzed. Word count code was used for the analysis of keywords used in the retrieved articles.

    Results: A total of 124 articles were retrieved, with the highest rate of publications in 2006 and 2007, with 16 papers each. Among the articles, 10 (8.1%) were published in Kathmandu University Medical Journal (KUMJ). Single papers were published in 38 different journals. Brief reports (1.6%), case reports (31.2%), case series (0.8%), education forums (0.8%), letters to the editor (5.6%), original research articles (41.9%), review articles (9.7%), short communications and short reports (8.1%) on ADRs and PV were recorded. Out of 124 papers, 52 (41.9%) were original research publications. The majority (74.1%) of research was done in the category of ADR incidence, types, prevention, and management, followed by policy and suggestions for strengthening national and regional pharmacovigilance centers of Nepal (14.5%).

    Conclusions: During the study years, there was an increase in scientific publications on drug safety. A total of 124 published articles were found during bibliometric analysis of ADRs and PV research activities in Nepal.

    MeSH terms: Nepal; Periodicals as Topic; Publications; Universities; Bibliometrics; Incidence; PubMed; Pharmacovigilance; Drug-Related Side Effects and Adverse Reactions; Medical Writing
  8. Bohari NA, Siddiquee S, Saallah S, Misson M, Arshad SE
    Sensors (Basel), 2020 Nov 14;20(22).
    PMID: 33202533 DOI: 10.3390/s20226502
    In the present study, indium tin oxide (ITO) was used as a transparent working electrode for the development of an electrochemical sensor for the detection of mercury (II) ions (Hg2+). The electrode was modified by direct electrodeposition of polyaniline (PANI), multiwalled carbon nanotubes (MWCNTs) and gold nanoparticles (AuNPs) followed by optimization of the analyte and operating conditions, aiming to improve the selectivity, sensitivity and reliability of the electrode for mercury detection. Successful immobilization of the PANI and nanomaterials (MWCNTs and AuNPs) on the ITO electrode was confirmed by Scanning Electron Microscope (SEM), Energy Dispersive X-ray (EDX) and Fourier Transform Infrared Spectroscopy (FTIR) analyses. The optimum conditions for mercury detection using the modified ITO electrode were pH 7.0 of Tris-HCl buffer (50 mM) in the presence of 1 mM methylene blue (MB) as a redox indicator, a scan rate of 0.10 V·s-1 and a 70 s interaction time. The electrochemical behavior of the modified electrode under the optimized conditions indicated a high reproducibility and high sensitivity of mercury detection. It is therefore suggested that the PANI/MWCNT/AuNP-modified ITO electrode could be a promising material for the development of on-site mercury detection tools for applications in fields such as diagnostics, the environment, safety and security controls or other industries.
  9. Kadir NAAA, Azlan A, Abas F, Ismail IS
    Nutrients, 2020 Nov 14;12(11).
    PMID: 33202660 DOI: 10.3390/nu12113511
    A source of functional food can be utilized from a source that might otherwise be considered waste. This study investigates the hypocholesterolemic effect of defatted dabai pulp (DDP) from supercritical carbon dioxide extraction and the metabolic alterations associated with the therapeutic effects of DDP using 1H NMR urinary metabolomic analysis. Male-specific pathogen-free Sprague-Dawley rats were fed with a high cholesterol diet for 30 days to induce hypercholesterolemia. Later, the rats were administered with a 2% DDP treatment diet for another 30 days. Supplementation with the 2% DDP treatment diet significantly reduced the level of total cholesterol (TC), triglyceride, low-density lipoprotein (LDL), and inflammatory markers (C-reactive protein (CRP), interleukin 6 (IL6) and tumour necrosis factor-α (α-TNF)) and significantly increased the level of antioxidant profile (total antioxidant status (TAS), superoxide dismutase (SOD), glutathione peroxide (GPX), and catalase (CAT)) compared with the positive control group (PG) group (p < 0.05). The presence of high dietary fibre (28.73 ± 1.82 g/100 g) and phenolic compounds (syringic acid, 4-hydroxybenzoic acid and gallic acid) are potential factors contributing to the beneficial effect. Assessment of 1H NMR urinary metabolomics revealed that supplementation of 2% of DDP can partially recover the dysfunction in the metabolism induced by hypercholesterolemia via choline metabolism. 1H-NMR-based metabolomic analysis of urine from hypercholesterolemic rats in this study uncovered the therapeutic effect of DDP to combat hypercholesterolemia.
    MeSH terms: Animals; Anticholesteremic Agents/pharmacology; Antioxidants/pharmacology*; Catalase/urine; Dietary Fiber/administration & dosage; Glutathione/urine; Hypercholesterolemia/drug therapy; Hypercholesterolemia/metabolism; Hypercholesterolemia/urine*; Lipids/urine; Male; Phenols/pharmacology; Plant Extracts/pharmacology; Plant Oils/pharmacology*; Superoxide Dismutase/urine; Rats, Sprague-Dawley; Burseraceae/chemistry*; Rats; Metabolomics
  10. Arif MMA, Fauzi MB, Nordin A, Hiraoka Y, Tabata Y, Yunus MHM
    Polymers (Basel), 2020 Nov 13;12(11).
    PMID: 33202700 DOI: 10.3390/polym12112678
    Gelatin possesses biological properties that resemble native skin and can potentially be fabricated as a skin substitute for full-thickness wound treatment. The native property of gelatin, whereby it is easily melted and degraded at body temperature, could prevent its biofunctionality for various applications. This study aimed to fabricate and characterise buffalo gelatin (Infanca halal certified) crosslinked with chemical type crosslinker (genipin and genipin fortified with EDC) and physicaly crosslink using the dihydrothermal (DHT) method. A porous gelatin sponge (GS) was fabricated by a freeze-drying process followed by a complete crosslinking via chemical-natural and synthetic-or physical intervention using genipin (GNP), 1-ethyl-3-(3-dimethylaminopropyl) (EDC) and dihydrothermal (DHT) methods, respectively. The physicochemical, biomechanical, cellular biocompatibility and cell-biomaterial interaction of GS towards human epidermal keratinocytes (HEK) and dermal fibroblasts (HDF) were evaluated. Results showed that GS had a uniform porous structure with pore size ranging between 60 and 200 µm with high porosity (>78.6 ± 4.1%), high wettability (<72.2 ± 7.0°), high tensile strain (>13.65 ± 1.10%) and 14 h of degradation rate. An increase in the concentration and double-crosslinking approach demonstrated an increment in the crosslinking degree, enzymatic hydrolysis resistance, thermal stability, porosity, wettability and mechanical strength. The GS can be tuned differently from the control by approaching the GS via a different crosslinking strategy. However, a decreasing trend was observed in the pore size, water retention and water absorption ability. Crosslinking with DHT resulted in large pore sizes (85-300 µm) and low water retention (236.9 ± 18.7 g/m2·day) and a comparable swelling ratio with the control (89.6 ± 7.1%). Moreover no changes in the chemical content and amorphous phase identification were observed. The HEK and HDF revealed slight toxicity with double crosslinking. HEK and HDF attachment and proliferation remain similar to each crosslinking approach. Immunogenicity was observed to be higher in the double-crosslinking compared to the single-crosslinking intervention. The fabricated GS demonstrated a dynamic potential to be tailored according to wound types by manipulating the crosslinking intervention.
    MeSH terms: Animals; Biocompatible Materials; Body Temperature; Buffaloes; Epidermis; Freeze Drying; Gelatin; Humans; Hydrolysis; Skin; Water; Keratinocytes; Porosity; Wettability; Skin, Artificial; Iridoids
  11. Sadeghi H, Mohandes SR, Hosseini MR, Banihashemi S, Mahdiyar A, Abdullah A
    PMID: 33202768 DOI: 10.3390/ijerph17228395
    Occupational Health and Safety (OHS)-related injuries are vexing problems for construction projects in developing countries, mostly due to poor managerial-, governmental-, and technical safety-related issues. Though some studies have been conducted on OHS-associated issues in developing countries, research on this topic remains scarce. A review of the literature shows that presenting a predictive assessment framework through machine learning techniques can add much to the field. As for Malaysia, despite the ongoing growth of the construction sector, there has not been any study focused on OHS assessment of workers involved in construction activities. To fill these gaps, an Ensemble Predictive Safety Risk Assessment Model (EPSRAM) is developed in this paper as an effective tool to assess the OHS risks related to workers on construction sites. The developed EPSRAM is based on the integration of neural networks with fuzzy inference systems. To show the effectiveness of the EPSRAM developed, it is applied to several Malaysian construction case projects. This paper contributes to the field in several ways, through: (1) identifying major potential safety risks, (2) determining crucial factors that affect the safety assessment for construction workers, (3) predicting the magnitude of identified safety risks accurately, and (4) predicting the evaluation strategies applicable to the identified risks. It is demonstrated how EPSRAM can provide safety professionals and inspectors concerned with well-being of workers with valuable information, leading to improving the working environment of construction crew members.
    MeSH terms: Accidents, Occupational/prevention & control; Humans; Malaysia; Occupational Health*; Workplace/standards; Risk Assessment*
  12. Papadaki V, Asada K, Watson JK, Tamura T, Leung A, Hopkins J, et al.
    Cancers (Basel), 2020 Nov 13;12(11).
    PMID: 33202923 DOI: 10.3390/cancers12113362
    Osteomodulin (OMD) and proline/arginine-rich end leucine repeat protein (PRELP) are secreted extracellular matrix proteins belonging to the small leucine-rich proteoglycans family. We found that OMD and PRELP were specifically expressed in umbrella cells in bladder epithelia, and their expression levels were dramatically downregulated in all bladder cancers from very early stages and various epithelial cancers. Our in vitro studies including gene expression profiling using bladder cancer cell lines revealed that OMD or PRELP application suppressed the cancer progression by inhibiting TGF-β and EGF pathways, which reversed epithelial-mesenchymal transition (EMT), activated cell-cell adhesion, and inhibited various oncogenic pathways. Furthermore, the overexpression of OMD in bladder cancer cells strongly inhibited the anchorage-independent growth and tumorigenicity in mouse xenograft studies. On the other hand, we found that in the bladder epithelia, the knockout mice of OMD and/or PRELP gene caused partial EMT and a loss of tight junctions of the umbrella cells and resulted in formation of a bladder carcinoma in situ-like structure by spontaneous breakdowns of the umbrella cell layer. Furthermore, the ontological analysis of the expression profiling of an OMD knockout mouse bladder demonstrated very high similarity with those obtained from human bladder cancers. Our data indicate that OMD and PRELP are endogenous inhibitors of cancer initiation and progression by controlling EMT. OMD and/or PRELP may have potential for the treatment of bladder cancer.
    MeSH terms: Animals; Arginine; Urinary Bladder Neoplasms; Cell Adhesion; Epidermal Growth Factor; Humans; Leucine; Proline; Proteoglycans; Transforming Growth Factor beta; Extracellular Matrix Proteins; Mice, Knockout; Tight Junctions; Mice; Epithelial-Mesenchymal Transition; Heterografts; Small Leucine-Rich Proteoglycans
  13. Musa I, Rafii MY, Ahmad K, Ramlee SI, Md Hatta MA, Oladosu Y, et al.
    Plants (Basel), 2020 Nov 15;9(11).
    PMID: 33203189 DOI: 10.3390/plants9111583
    Grafting is regarded as an integral component of sustainable vegetable production. It is important in the management of soil-borne diseases, and reports suggest that grafting with viable rootstocks can enhance crop growth and yield. This research was conducted using splices and cleft grafting techniques to investigate graft compatibility among varieties of high yielding eggplant scion (MCV1, MCV2, CCV1, CCV2, CCV3, NCV, and TCV) grafted onto wild rootstocks (MWR, BWR, and TWR) to study their morphophysiological and yield characteristics. High yielding scions grafted onto wild relative rootstocks were compared with two controls including self-grafted and non-grafted. All the scion had a high rate of germination (≥95%) and remarkable graft success (100%) was recorded in MCV1, MCV2, and TCV using the cleft techniques. Generally, the use of rootstocks resulted in higher total and marketable fruit yield compared to the non-grafted and self-grafted scion plants, respectively. In particular, MWR and TWR rootstock conferred the highest vigour to the scion, resulting in the highest values recorded for total and marketable fruit yield, number of fruits per plant and average fruit weight. A similar result was obtained in fruit length and diameter, where long and wide fruits were observed in scions grafted onto MWR and TWR rootstocks, respectively. Grafting of high yielding eggplant scion onto resistant MWR, BWR and TWR eggplant rootstock was found to be beneficial for eggplant cultivation. The remarkable compatibility and vigour of the rootstock with scion led to the improvement in total and marketable yield of the fruits. As such, it can be concluded that the use of wild relative rootstocks of eggplant species can be a valuable method of improving eggplant production.
    MeSH terms: Vegetable Products; Body Weight; Food Hypersensitivity; Fruit; Soil; Vegetables; Germination; Solanum melongena
  14. Ang YLE, Ho GF, Soo RA, Sundar R, Tan SH, Yong WP, et al.
    BMC Cancer, 2020 Nov 17;20(1):1118.
    PMID: 33203399 DOI: 10.1186/s12885-020-07616-4
    BACKGROUND: We previously reported that low-dose, short-course sunitinib prior to neoadjuvant doxorubicin-cyclophosphamide (AC) normalised tumour vasculature and improved perfusion, but resulted in neutropenia and delayed subsequent cycles in breast cancer patients. This study combined sunitinib with docetaxel, which has an earlier neutrophil nadir than AC.

    METHODS: Patients with advanced solid cancers were randomized 1:1 to 3-weekly docetaxel 75 mg/m2, with or without sunitinib 12.5 mg daily for 7 days prior to docetaxel, stratified by primary tumour site. Primary endpoints were objective-response (ORR:CR + PR) and clinical-benefit rate (CBR:CR + PR + SD); secondary endpoints were toxicity and progression-free-survival (PFS).

    RESULTS: We enrolled 68 patients from 2 study sites; 33 received docetaxel-sunitinib and 35 docetaxel alone, with 33 breast, 25 lung and 10 patients with other cancers. There was no difference in ORR (30.3% vs 28.6%, p = 0.432, odds-ratio [OR] 1.10, 95% CI 0.38-3.18); CBR was lower in the docetaxel-sunitinib arm (48.5% vs 71.4%, p = 0.027 OR 0.37, 95% CI 0.14-1.01). Median PFS was shorter in the docetaxel-sunitinib arm (2.9 vs 4.9 months, hazard-ratio [HR] 2.00, 95% CI 1.15-3.48, p = 0.014) overall, as well as in breast (4.2 vs 5.6 months, p = 0.048) and other cancers (2.0 vs 5.3 months, p = 0.009), but not in lung cancers (2.9 vs 4.1 months, p = 0.597). Median OS was similar in both arms overall (9.9 vs 10.5 months, HR 0.92, 95% CI 0.51-1.67, p = 0.789), and in the breast (18.9 vs 25.8 months, p = 0.354), lung (7.0 vs 6.7 months, p = 0.970) and other cancers (4.5 vs 8.8 months, p = 0.449) subgroups. Grade 3/4 haematological toxicities were lower with docetaxel-sunitinib (18.2% vs 34.3%, p = 0.132), attributed to greater discretionary use of prophylactic G-CSF (90.9% vs 63.0%, p = 0.024). Grade 3/4 non-haematological toxicities were similar (12.1% vs 14.3%, p = 0.792).

    CONCLUSIONS: The addition of sunitinib to docetaxel was well-tolerated but did not improve outcomes. The possible negative impact in metastatic breast cancer patients is contrary to results of adding sunitinib to neoadjuvant AC. These negative results suggest that the intermittent administration of sunitinib in the current dose and schedule with docetaxel in advanced solid tumours, particularly breast cancers, is not beneficial.

    TRIAL REGISTRATION: The study was registered ( NCT01803503 ) prospectively on clinicaltrials.gov on 4th March 2013.

    MeSH terms: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*; Female; Follow-Up Studies; Humans; Male; Middle Aged; Neoplasms/drug therapy*; Neoplasms/pathology; Prognosis; Survival Rate; Case-Control Studies
  15. Mohd Yusof H, Abdul Rahman N, Mohamad R, Zaidan UH, Samsudin AA
    Sci Rep, 2020 Nov 17;10(1):19996.
    PMID: 33204003 DOI: 10.1038/s41598-020-76402-w
    This study aims to utilize the cell-biomass (CB) and supernatant (CFS) of zinc-tolerant Lactobacillus plantarum TA4 as a prospective nanofactory to synthesize ZnO NPs. The surface plasmon resonance for the biosynthesized ZnO NPs-CFS and ZnO NPs-CB was 349 nm and 351 nm, respectively, thereby confirming the formation of ZnO NPs. The FTIR analysis revealed the presence of proteins, carboxyl, and hydroxyl groups on the surfaces of both the biosynthesized ZnO NPs that act as reducing and stabilizing agents. The DLS analysis revealed that the poly-dispersity indexes was less than 0.4 for both ZnO NPs. In addition, the HR-TEM micrographs of the biosynthesized ZnO NPs revealed a flower-like pattern for ZnO NPs-CFS and an irregular shape for ZnO NPs-CB with particles size of 291.1 and 191.8 nm, respectively. In this study, the biosynthesized ZnO NPs exhibited antibacterial activity against pathogenic bacteria in a concentration-dependent manner and showed biocompatibility with the Vero cell line at specific concentrations. Overall, CFS and CB of L. plantarum TA4 can potentially be used as a nanofactory for the biological synthesis of ZnO NPs.
    MeSH terms: Animals; Anti-Bacterial Agents/pharmacology*; Anti-Bacterial Agents/chemistry*; Biocompatible Materials/chemistry*; Cell Line; Cercopithecus aethiops; Microbial Sensitivity Tests/methods; Particle Size; Prospective Studies; Vero Cells; Zinc Oxide/chemistry*; Biomass; Lactobacillus plantarum/metabolism*; Metal Nanoparticles/administration & dosage*; Metal Nanoparticles/chemistry*
  16. Maxwell SL, Cazalis V, Dudley N, Hoffmann M, Rodrigues ASL, Stolton S, et al.
    Nature, 2020 Dec;588(7837):E14.
    PMID: 33204035 DOI: 10.1038/s41586-020-2952-y
    An amendment to this paper has been published and can be accessed via a link at the top of the paper.
    MeSH terms: Humans
  17. Shakeel S, Hassali MA, Rehman H, Rehman AU, Muneswarao J
    Int J Gen Med, 2020;13:1075-1082.
    PMID: 33204142 DOI: 10.2147/IJGM.S266545
    Background: Pharmacists being the drug experts need to be well aware of the applied handling of biosimilar medicines (BSMs). They are an integral educator, trailblazer, and advocate of biosimilar integration across all clinical settings. Therefore, the current study was conducted to assess the pharmacists' knowledge, attitude, and practices of integrating BSMs into clinical practice.

    Methods: The cross-sectional study was conducted from August 2019 to November 2019. The community pharmacies, clinical and academic settings in Karachi were approached for gathering the responses of pharmacists towards BSMs and interchangeable products using a 30-item survey form. Pearson correlation and independent sample t-test were used to identify the relationship among independent variables and the responses, considering p values <0.05 as statistically significant.

    Results: Overall, there were 305 survey forms used with a response rate of 87.14%. More than 80% of the respondents have good knowledge about the definition, characteristics, safety and efficacy, compatibility, cost issues, and utilization of BSMs. Around half of the respondents (48.9%, [95% CI 46.6-51.2]) were confident in using BSMs in clinical practice. However, they were concerned about the BSM's safety profile (45.2%, [95% CI 42.1-48.3]), quality (30.2%, [95% CI 28.3-32.1]), and efficacy issues (32.3%, [95% CI 31.2-37.5]).

    Conclusion: The findings revealed that pharmacists were well informed about the BSMs. However, some of the responses to the attitude demonstrated a lack of understanding of the application of that knowledge. The respondents persuaded that advanced patterns of diseases, product marketing stipulations, and need for better patient care drives higher demand for developing BSMs and were enthusiastic about gaining more insight to integrate BSMs into routine clinical practice.

    MeSH terms: Awareness; Cross-Sectional Studies; Patient Care; Humans; Pharmacies; Pharmacists; Surveys and Questionnaires; Marketing; Biosimilar Pharmaceuticals
  18. Chong BTW, Wahab S, Muthukrishnan A, Tan KL, Ch'ng ML, Yoong MT
    Psychol Res Behav Manag, 2020;13:949-962.
    PMID: 33204188 DOI: 10.2147/PRBM.S266976
    Purpose: The shorter life expectancy and increased risk of suicide in patients with schizophrenia have been well documented. However, study outcomes on suicidality in this special population have been few to date. This study investigated the prevalence and factors associated with suicidal ideation in a population of institutionalized patients with schizophrenia.

    Methods: Two hundred fifty-six patients with schizophrenia between the age of 18 and 65 years were randomly recruited. This cross-sectional study utilised the Calgary Depression Scale for Schizophrenia (CDSS), the Positive and Negative Syndrome Scale (PANSS) and the Psychotic Symptom Rating Scale (PSYRATS-AH). Univariate analysis was performed using an independent t-test or chi-square test, followed by binary logistic regression to determine the factors associated with increased suicidal risks.

    Results: The socio-demographic factors associated with suicidal ideation included level of education (p=0.039); secondary-level education (OR=5.76, 95% CI:1.49, 22.34, p=0.011) and tertiary-level education (OR=9.30, 95% CI: 1.80, 48.12, p=0.008) posed a greater risk. A history of attempted suicide (OR=2.09, 95% CI: 1.01, 4.36, p=0.049) and the presence of co-morbid physical illnesses (OR=2.07, 95% CI: 1.02, 4.21, p=0.044) were also found to be associated with a suicidal ideation. Other significant factors associated with suicidal thoughts were concurrent depression (OR=9.68, 95% CI: 3.74, 25.05, p<0.001) and a higher PSYRATS score in emotional characteristics of auditory hallucinations (OR=1.13, 95% CI: 1.06, 1.21, p<0.001).

    Conclusion: Suicide in schizophrenia appears to be more closely associated with certain socio-demographic factors and affective symptoms. Appropriate screening and treatment addressing these challenges must be emphasized if suicidal thoughts and actions are to be reduced.

    MeSH terms: Adolescent; Adult; Affective Symptoms; Aged; Cross-Sectional Studies; Depression; Educational Status; Emotions; Hallucinations; Humans; Life Expectancy; Middle Aged; Schizophrenia; Suicide; Suicide, Attempted; Comorbidity; Prevalence; Chi-Square Distribution; Logistic Models; Young Adult; Suicidal Ideation
  19. Lestari W, Yusry WNAW, Haris MS, Jaswir I, Idrus E
    Jpn Dent Sci Rev, 2020 Nov;56(1):147-154.
    PMID: 33204370 DOI: 10.1016/j.jdsr.2020.09.001
    Managing a bleeding patient can be a challenge during dental surgery. Profuse hemorrhage due to platelet defects, coagulation disorders, vascular anomalies, medication-induced patients, as well as inherited bleeding ailments result in soft tissue hematoma, septic shock, compromised airway, and in some severe cases, death could occur. A vast array of surgical hemostatic agents are available to stop bleeding, including chitosan-based hemostatic agents. Chitosan has an advantage over other topical hemostatic materials for its ability to promote shorter bleeding times and assist in healing. Massive behind-the-scene research and development efforts are ongoing to increase the performance of chitosan as a hemostatic agent. Numerous studies on chitosan use in dental hemostasis have registered it as being safe, biodegradable, biocompatible, promoting healing, antimicrobial and bioactive. This article reviews the application of chitosan in managing hemostasis in dental patients.
    MeSH terms: Anti-Infective Agents; Bleeding Time; Blood Coagulation Disorders; Hematoma; Hemorrhage; Hemostasis; Hemostatics; Humans; Longitudinal Studies; Shock, Septic; Chitosan
  20. Kasinathan G, Sathar J
    Ann Med Surg (Lond), 2020 Dec;60:323-326.
    PMID: 33204423 DOI: 10.1016/j.amsu.2020.11.009
    Autoimmune hemolytic anaemia (AIHA) is a heterogenous disorder characterised by the presence of IgG or IgM pathological autoantibodies that target antigens of erythrocytes resulting in active hemolysis. Case presentation: A 40-year-old gentleman presented to a medical centre with chest pain and right sided hemiparesis for a week. He was pale and jaundiced. The power of the right upper and lower limbs was 3/5. His spleen was palpable. His complete blood count revealed macrocytic anaemia of 7.6 g/dL. The brain Magnetic Resonance Imaging (MRI) showed left fronto-parietal infarction. The right cardiac and left carotid angiogram revealed thromboses involving the right coronary and left internal carotid artery respectively. At the cardiology department, he was transfused with two units of red blood cells without his anemia being investigated and a stent was deployed to the left internal carotid artery. He was referred to the hematology department in which his peripheral blood smear revealed hemolysis and his direct antiglobulin test was positive. He responded to a course of steroids and direct oral anticoagulation and is in complete remission for the past 18 months. Conclusion: It is always imperative to investigate the cause of anaemia and consider hemolysis in a patient presenting with multiple unexplained thromboses.
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