Browse publications by year: 2020

  1. Kamal H, Tan GC, Ibrahim SF, Shaikh MF, Mohamed IN, Mohamed RMP, et al.
    Front Cell Neurosci, 2020;14:282.
    PMID: 33061892 DOI: 10.3389/fncel.2020.00282
    Alcohol use disorder (AUD) has been associated with neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Prolonged excessive alcohol intake contributes to increased production of reactive oxygen species that triggers neuroimmune response and cellular apoptosis and necrosis via lipid peroxidation, mitochondrial, protein or DNA damage. Long term binge alcohol consumption also upregulates glutamate receptors, glucocorticoids and reduces reuptake of glutamate in the central nervous system, resulting in glutamate excitotoxicity, and eventually mitochondrial injury and cell death. In this review, we delineate the following principles in alcohol-induced neurodegeneration: (1) alcohol-induced oxidative stress, (2) neuroimmune response toward increased oxidants and lipopolysaccharide, (3) glutamate excitotoxicity and cell injury, and (4) interplay between oxidative stress, neuroimmune response and excitotoxicity leading to neurodegeneration and (5) potential chronic alcohol intake-induced development of neurodegenerative diseases, including Alzheimer's and Parkinson's disease.
    MeSH terms: Alcohol Drinking; Alcoholism; Alzheimer Disease; Glucocorticoids; Mitochondria; Parkinson Disease; Receptors, Glucocorticoid; Lipid Peroxidation; Oxidants; Apoptosis; Reactive Oxygen Species; Receptors, Glutamate; Oxidative Stress; Glutamic Acid; Neurodegenerative Diseases
  2. Chen S, Lin Z, Tan KL, Chen R, Su W, Zhao H, et al.
    Front Psychiatry, 2020;11:564843.
    PMID: 33061920 DOI: 10.3389/fpsyt.2020.564843
    Butyrylcholinesterase (BChE) efficiently hydrolyzes acetylcholine (ACh) at high concentrations when acetylcholinesterase (AChE) is substrate-inhibited. Recent studies have shown that BChE also has a function that is independent of ACh, but it has not been fully explored. Low BChE expression is accompanied with higher stress-induced aggression and ghrelin levels in stress models, and BChE knockout mice exhibit cognitive and memory impairments. However, the role of BChE in posttraumatic stress disorder (PTSD) remains unclear. In the present study, we investigated the role of BChE in contextual fear memory and its regulatory effect on the expression of factors related to the glutamate (Glu)-glutamine (Gln) cycle via knockdown studies. We used AAVs and lentiviruses to knockdown BChE expression in the mouse hippocampal CA1 region and C8D1A astrocytes. Our behavioral data from those mice injected with AAV-shBChE in the hippocampal CA1 region showed strengthened fear memory and increased dendritic spine density. Elevated Glu levels and glutamine synthetase (GS) enzyme activity were detected in contextual fear conditioned-BChE knockdown animals and astrocytes. We observed that an AAV-shBChE induced lowering of BChE expression in the hippocampus CA1 region enhanced contextual fear memory expression and promoted the astrocytic Glu-Gln cycle but did not elevate ACh-hydrolyzing activity. This study provides new insight into the regulatory role of BChE in cognition and suggests potential target for stress-related psychiatric disorder such as PTSD where patients experience fear after exposure to severe life-threatening traumatic events.
    MeSH terms: Acetylcholine; Acetylcholinesterase; Aggression; Animals; Astrocytes; Butyrylcholinesterase; Fear; Glutamine; Glutamate-Ammonia Ligase; Memory; Stress Disorders, Post-Traumatic; Lentivirus; Mice, Knockout; Dendritic Spines; Mice; Ghrelin; CA1 Region, Hippocampal
  3. Saran R, Upadhya NP, Ginjupalli K, Amalan A, Rao B, Kumar S
    Int J Dent, 2020;2020:8896225.
    PMID: 33061975 DOI: 10.1155/2020/8896225
    Introduction: Glass ionomer cements (GICs) are commonly used for cementation of indirect restorations. However, one of their main drawbacks is their inferior mechanical properties.

    Aim: Compositional modification of conventional glass ionomer luting cements by incorporating two types of all-ceramic powders in varying concentrations and evaluation of their film thickness, setting time, and strength. Material & Methods. Experimental GICs were prepared by adding different concentrations of two all-ceramic powders (5%, 10, and 15% by weight) to the powder of the glass ionomer luting cements, and their setting time, film thickness, and compressive strength were determined. The Differential Scanning Calorimetry analysis was done to evaluate the kinetics of the setting reaction of the samples. The average particle size of the all-ceramic and glass ionomer powders was determined with the help of a particle size analyzer.

    Results: A significant increase in strength was observed in experimental GICs containing 10% all-ceramic powders. The experimental GICs with 5% all-ceramic powders showed no improvement in strength, whereas those containing 15% all-ceramic powders exhibited a marked decrease in strength. Setting time of all experimental GICs progressively increased with increasing concentration of all-ceramic powders. Film thickness of all experimental GICs was much higher than the recommended value for clinical application.

    Conclusion: 10% concentration of the two all-ceramic powders can be regarded as the optimal concentration for enhancing the glass ionomer luting cements' strength. There was a significant increase in the setting time at this concentration, but it was within the limit specified by ISO 9917-1:2007 specifications for powder/liquid acid-base dental cements. Reducing the particle size of the all-ceramic powders may help in decreasing the film thickness, which is an essential parameter for the clinical performance of any luting cement.

    MeSH terms: Acrylic Resins; Bone Cements; Calorimetry, Differential Scanning; Cementation; Ceramics; Glass Ionomer Cements; Kinetics; Particle Size; Powders; Silicon Dioxide; Compressive Strength
  4. Chin SP, Mohd-Shahrizal MY, Liyana MZ, Then KY, Cheong SK
    Stem Cells Int, 2020;2020:8877003.
    PMID: 33061992 DOI: 10.1155/2020/8877003
    Background: Mesenchymal stem cells (MSCs) express growth factors and other cytokines that stimulate repair and control the immune response. MSCs are also immunoprivileged with low risk of rejection. Umbilical cord-derived MSCs (UCMSCs) are particularly attractive as an off-the-shelf allogeneic treatment in emergency medical conditions. We aim to determine the safety and efficacy of intravenous allogeneic infusion of UCMSCs (CLV-100) by Cytopeutics® (Selangor, Malaysia) in healthy volunteers, and to determine the effective dose at which an immunomodulatory effect is observed. Methodology. Umbilical cord samples were collected after delivery of full-term, healthy babies with written consent from both parents. All 3 generations (newborn, parents, and grandparents) were screened for genetic mutations, infections, cancers, and other inherited diseases. Samples were transferred to a certified Good Manufacturing Practice laboratory for processing. Subjects were infused with either low dose (LD, 65 million cells) or high dose (HD, 130 million cells) of CLV-100 and followed up for 6 months. We measured cytokines using ELISA including anti-inflammatory cytokines interleukin 1 receptor antagonist (IL-1RA), interleukin 10 (IL-10), pro-/anti-inflammatory cytokine interleukin 6 (IL-6), and the proinflammatory cytokine tumor necrosis factor-alpha (TNF-α).

    Results: 11 healthy subjects (LD, n = 5; HD, n = 6; mean age of 55 ± 13 years) were recruited. All subjects tolerated the CLV-100 infusion well with no adverse reaction throughout the study especially in vital parameters and routine blood tests. At 6 months, the HD group had significantly higher levels of anti-inflammatory markers IL1-RA (705 ± 160 vs. 306 ± 36 pg/mL; p = 0.02) and IL-10 (321 ± 27 vs. 251 ± 28 pg/mL; p = 0.02); and lower levels of proinflammatory marker TNF-α (74 ± 23 vs. 115 ± 15 pg/mL; p = 0.04) compared to LD group.

    Conclusion: Allogeneic UCMSCs CLV-100 infusion is safe and well-tolerated in low and high doses. Anti-inflammatory effect is observed with a high-dose infusion.

    MeSH terms: Grandparents; Adult; Aged; Anti-Inflammatory Agents; Emergency Service, Hospital; Hematologic Tests; Humans; Infant, Newborn; Malaysia; Middle Aged; Tumor Necrosis Factor-alpha; Umbilical Cord; Biomarkers; Interleukin-6; Cytokines; Interleukin-10; Interleukin 1 Receptor Antagonist Protein; Healthy Volunteers
  5. Tay AK, Khat Mung H, Badrudduza M, Balasundaram S, Fadil Azim D, Arfah Zaini N, et al.
    Eur J Psychotraumatol, 2020 Sep 16;11(1):1807170.
    PMID: 33062211 DOI: 10.1080/20008198.2020.1807170
    Background: The ability to adapt to the psychosocial disruptions associated with the refugee experience may influence the course of complicated grief reactions. Objective: We examine these relationships amongst Myanmar refugees relocated to Malaysia who participated in a six-week course of Integrative Adapt Therapy (IAT). Method: Participants (n = 170) included Rohingya, Chin, and Kachin refugees relocated to Malaysia. At baseline and six-week post-treatment, we applied culturally adapted measures to assess symptoms of Prolonged Complex Bereavement Disorder (PCBD) and adaptive capacity to psychosocial disruptions, based on the Adaptive Stress Index (ASI). The ASI comprises five sub-scales of safety/security (ASI-1); bonds and networks (ASI-2); injustice (ASI-3); roles and identity (ASI-4); and existential meaning (ASI-5). Results: Multilevel linear models indicated that the relationship between baseline and posttreatment PCBD symptoms was mediated by the ASI scale scores. Further, ASI scale scores assessed posttreatment mediated the relationship between baseline and posttreatment PCBD symptoms. Mediation of PCBD change was greatest for the ASI II scale representing disrupted bonds and networks. Conclusion: Our findings are consistent with the informing model of IAT in demonstrating that changes in adaptive capacity, and especially in dealing with disrupted bonds and networks, may mediate the process of symptom improvement over the course of therapy.
    MeSH terms: Bereavement; Myanmar; Chin; Existentialism; Grief; Humans; Malaysia; Refugees; Linear Models
  6. Abdul Manap AS, Madhavan P, Vijayabalan S, Chia A, Fukui K
    PeerJ, 2020;8:e10003.
    PMID: 33062432 DOI: 10.7717/peerj.10003
    Previously, we reported the synergistic effects of curcumin and piperine in cell cultures as potential anti-cholinesterase and anti-amyloidogenic agents. Due to limited findings on the enrolment of these compounds on epigenetic events in AD, we aimed at elucidating the expression profiles of Aβ42-induced SH-SY5Y cells using microarray profiling. In this study, an optimized concentration of 35 µM of curcumin and piperine in combination was used to treat Aβ42 fibril and high-throughput microarray profiling was performed on the extracted RNA. This was then compared to curcumin and piperine used singularly at 49.11 µM and 25 µM, respectively. Our results demonstrated that in the curcumin treated group, from the top 10 upregulated and top 10 downregulated significantly differentially expressed genes (p 
    MeSH terms: Alkaloids; Cholinesterase Inhibitors; Curcumin; Piperidines; RNA; Epigenesis, Genetic; Benzodioxoles; Polyunsaturated Alkamides
  7. Lee NSM, Clements GR, Ting ASY, Wong ZH, Yek SH
    PeerJ, 2020;8:e10033.
    PMID: 33062440 DOI: 10.7717/peerj.10033
    Background: Human population growth has led to biodiversity declines in tropical cities. While habitat loss and fragmentation have been the main drivers of urban biodiversity loss, man-made interventions to reduce health risks have also emerged as an unintentional threat. For instance, insecticide fogging to control mosquito populations has become the most common method of preventing the expansion of mosquito-borne diseases such as Dengue. However, the effectiveness of fogging in killing mosquitoes has been called into question. One concern is the unintended effect of insecticide fogging on non-target invertebrates that are crucial for the maintenance of urban ecosystems. Here, we investigate the impacts of fogging on: (1) target invertebrate taxon (Diptera, including mosquitoes); (2) non-target invertebrate taxa; and (3) the foraging behavior of an invertebrate pollinator taxon (Lepidoptera) within an urban tropical forest.

    Methods: We carried out fogging with Pyrethroid insecticide (Detral 2.5 EC) at 10 different sites in a forest situated in the state of Selangor, Peninsular Malaysia. Across the sites, we counted the numbers of knocked-down invertebrates and identified them based on morphology to different taxa. We constructed Bayesian hierarchical Poisson regression models to investigate the effects of fogging on: (1) a target invertebrate taxon (Diptera) 3-h post-fogging; (2) selected non-target invertebrate taxa 3-h post-fogging; and (3) an invertebrate pollinator taxon (Lepidoptera) 24-h post-fogging.

    Results: A total of 1,874 invertebrates from 19 invertebrate orders were knocked down by the fogging treatment across the 10 sites. Furthermore, 72.7% of the invertebrates counted 3-h post-fogging was considered dead. Our regression models showed that given the data and prior information, the probability that fogging had a negative effect on invertebrate taxa 3-h post-fogging was 100%, with reductions to 11% of the pre-fogging count of live individuals for the target invertebrate taxon (Diptera), and between 5% and 58% of the pre-fogging count of live individuals for non-target invertebrate taxa. For the invertebrate pollinator, the probability that fogging had a negative effect 24-h post-fogging was also 100%, with reductions to 53% of the pre-fogging count of live individuals.

    Discussion: Our Bayesian models unequivocally demonstrate that fogging has detrimental effects on one pollinator order and non-target invertebrate orders, especially taxa that have comparatively lower levels of chitinisation. While fogging is effective in killing the target order (Diptera), no mosquitos were found dead in our experiment. In order to maintain urban biodiversity, we recommend that health authorities and the private sector move away from persistent insecticide fogging and to explore alternative measures to control adult mosquito populations.

    MeSH terms: Animals; Bayes Theorem; Chitin; Cities; Humans; Insecticides; Invertebrates; Lepidoptera; Malaysia; Culicidae; Population Growth; Pyrethrins; Private Sector; Ecosystem; Biodiversity; Pollination; Forests
  8. Maran S, Faten SA, Lim SE, Lai KS, Ibrahim WPW, Ankathil R, et al.
    Biomed Res Int, 2020;2020:6945730.
    PMID: 33062692 DOI: 10.1155/2020/6945730
    Background: The 22q11.2 deletion syndrome (22q11.2DS) is the most common form of deletion disorder in humans. Low copy repeats flanking the 22q11.2 region confers a substrate for nonallelic homologous recombination (NAHR) events leading to rearrangements which have been reported to be associated with highly variable and expansive phenotypes. The 22q11.2DS is reported as the most common genetic cause of congenital heart defects (CHDs).

    Methods: A total of 42 patients with congenital heart defects, as confirmed by echocardiography, were recruited. Genetic molecular analysis using a fluorescence in situ hybridization (FISH) technique was conducted as part of routine 22q11.2DS screening, followed by multiplex ligation-dependent probe amplification (MLPA), which serves as a confirmatory test.

    Results: Two of the 42 CHD cases (4.76%) indicated the presence of 22q11.2DS, and interestingly, both cases have conotruncal heart defects. In terms of concordance of techniques used, MLPA is superior since it can detect deletions within the 22q11.2 locus and outside of the typically deleted region (TDR) as well as duplications.

    Conclusion: The incidence of 22q11.2DS among patients with CHD in the east coast of Malaysia is 0.047. MLPA is a scalable and affordable alternative molecular diagnostic method in the screening of 22q11.2DS and can be routinely applied for the diagnosis of deletion syndromes.

    MeSH terms: DiGeorge Syndrome/diagnosis*; DiGeorge Syndrome/genetics*; DiGeorge Syndrome/epidemiology; Female; Humans; Infant, Newborn; Malaysia; Male; Pilot Projects; Incidence; Gene Deletion; In Situ Hybridization, Fluorescence; Molecular Diagnostic Techniques/methods*; Multiplex Polymerase Chain Reaction/methods*
  9. Chellaih P, Sivadas G, Vaishnavi Vedam VK
    PMID: 33062740 DOI: 10.4103/jehp.jehp_194_20
    AIM: This study was intended to evaluate the knowledge and attitudes regarding infant's oral health care among graduating medical students from Kulasekaram, Tamil Nadu.

    MATERIALS AND METHODS: A cross-sectional survey research design was employed in this study. Self-administered questionnaire of the validated "Graduating medical students' Knowledge and Attitudes Survey Regarding Infant's oral health care" were utilized to ascertain the baseline levels of knowledge and attitudes of graduating medical students' in Kulasekaram hospital. In this regard, a preliminary study with a convenience sample of 100 medical students was conducted so as to assess the knowledge of infant oral health care among graduating medical students in Kulasekaram. This study, while limited in sample size, benefits the general practitioners as target readers to assess the abnormalities in children at early stages of life.

    RESULTS: The results of the study revealed that the mean percentage score overall was 65.7%. Only 3.2% of participants obtained a passing score of 80% or greater. Widespread knowledge deficits and poor attitudes among graduating medical students were noted in this study, particularly in the domain of pharmacological management of pain. Positive correlations were observed between the respondents' score and level of education. Further analysis revealed respondents had an inaccurate self-evaluation of their pain management knowledge.

    CONCLUSION: The results of this study reveal that there is dearth of knowledge and attitudes of graduating medical students' regarding infant oral health care. Educational and quality improvement initiatives in oral health care of infants could enhance medical student's knowledge baseline in the area of oral health care and possibly improve practices.

    MeSH terms: Attitude; Child; Cross-Sectional Studies; Educational Status; Humans; India; Infant; Infant Care; Oral Health; Pain; Surveys and Questionnaires; Self-Assessment; Students, Medical; Sample Size; General Practitioners; Quality Improvement; Diagnostic Self Evaluation; Pain Management
  10. Keat GY, Ahmad SS, Subramaniam S, Ghani SA, Samsudin A
    Indian J Sex Transm Dis AIDS, 2020 06 18;41(1):119-122.
    PMID: 33062999 DOI: 10.4103/ijstd.IJSTD_90_15
    The most frequent ocular manifestation of acquired immunodeficiency syndrome (AIDS) is cytomegalovirus retinitis (CMVR). This infection is reportedly inversely proportional to the CD4 counts. Usually CMVR develops once the CD4 counts fall below 50/mm3. Our case report documents an AIDS patient who developed CMVR despite CD4 counts being persistently >200/mm3. The patient was self-administering dehydroepiandrosterone, high dose Vitamin C, testosterone and hydrocortisone. This case report describes a unique case of pharmacologically induced elevated CD4 counts, which however, did not prevent the development of CMVR in the patient.
    MeSH terms: Acquired Immunodeficiency Syndrome; Ascorbic Acid; Dehydroepiandrosterone; Eye; Humans; Hydrocortisone; Testosterone; Cytomegalovirus Retinitis; CD4 Lymphocyte Count; Testosterone Congeners
  11. Mohamad Asri SF, Soelaiman IN, Mohd Moklas MA, Mohd Nor NH, Mohamad Zainal NH, Mohd Ramli ES
    Int J Mol Sci, 2020 Oct 19;21(20).
    PMID: 33086468 DOI: 10.3390/ijms21207715
    Glucocorticoids are one of the causes of secondary osteoporosis. The aqueous extract of Piper sarmentosum contains flavonoids that possess antioxidant effects. In this study, we determined the effects of aqueous Piper sarmentosum leaf extract on structural, dynamic and static histomorphometric changes from osteoporotic bones of rats induced with glucocorticoids. Thirty-two Sprague-Dawley rats were divided equally into four groups-Sham control group given vehicles (intramuscular (IM) olive oil and oral normal saline); AC: Adrenalectomised (Adrx) control group given IM dexamethasone (DEX) (120 μg/kg/day) and vehicle (oral normal saline); AP: Adrx group administered IM DEX (120 μg/kg/day) and aqueous Piper sarmentosum leaf extract (125 mg/kg/day) orally; and AG: Adrx group administered IM DEX (120 μg/kg/day) and oral glycyrrhizic acid (GCA) (120 mg/kg/day). Histomorphometric measurements showed that the bone volume, trabecular thickness, trabecular number, osteoid and osteoblast surfaces, double-labelled trabecular surface, mineralizing surface and bone formation rate of rats given aqueous Piper sarmentosum leaf extract were significantly increased (p < 0.05), whereas the trabecular separation and osteoclast surface were significantly reduced (p < 0.05). This study suggests that aqueous Piper sarmentosum leaf extract was able to prevent bone loss in prolonged glucocorticoid therapy. Thus, Piper sarmentosum has the potential to be used as an alternative medicine against osteoporosis and osteoporotic fractures in patients undergoing long-term glucocorticoid therapy.
    MeSH terms: Animals; Bone and Bones/drug effects; Bone and Bones/pathology*; Calcification, Physiologic/drug effects; Male; Plant Extracts/pharmacology*; Water/chemistry*; Rats, Sprague-Dawley; Protective Agents/pharmacology*; Piper/chemistry*; Cancellous Bone/drug effects; Cancellous Bone/pathology
  12. Syafiq R, Sapuan SM, Zuhri MYM, Ilyas RA, Nazrin A, Sherwani SFK, et al.
    Polymers (Basel), 2020 Oct 19;12(10).
    PMID: 33086533 DOI: 10.3390/polym12102403
    Recently, many scientists and polymer engineers have been working on eco-friendly materials for starch-based food packaging purposes, which are based on biopolymers, due to the health and environmental issues caused by the non-biodegradable food packaging. However, to maintain food freshness and quality, it is necessary to choose the correct materials and packaging technologies. On the other hand, the starch-based film's biggest flaws are high permeability to water vapor transfer and the ease of spoilage by bacteria and fungi. One of the several possibilities that are being extensively studied is the incorporation of essential oils (EOs) into the packaging material. The EOs used in food packaging films actively prevent inhibition of bacteria and fungi and have a positive effect on food storage. This work intended to present their mechanical and barrier properties, as well as the antimicrobial activity of anti-microbacterial agent reinforced starch composites for extending product shelf life. A better inhibition of zone of antimicrobial activity was observed with higher content of essential oil. Besides that, the mechanical properties of starch-based polymer was slightly decreased for tensile strength as the increasing of essential oil while elongation at break was increased. The increasing of essential oil would cause the reduction of the cohesion forces of polymer chain, creating heterogeneous matrix and subsequently lowering the tensile strength and increasing the elongation (E%) of the films. The present review demonstrated that the use of essential oil represents an interesting alternative for the production of active packaging and for the development of eco-friendly technologies.
    MeSH terms: Anti-Infective Agents; Bacteria; Drug Packaging; Fungi; Oils, Volatile; Permeability; Polymers; Starch; Steam; Tensile Strength; Food Packaging; Physical Phenomena; Food Storage
  13. Sulaiman SB, Idrus RBH, Hwei NM
    Polymers (Basel), 2020 Oct 19;12(10).
    PMID: 33086577 DOI: 10.3390/polym12102404
    The gelatin microsphere (GM) provides an attractive option for tissue engineering due to its versatility, as reported by various studies. This review presents the history, characteristics of, and the multiple approaches to, the production of GM, and in particular, the water in oil emulsification technique. Thereafter, the application of GM as a drug delivery system for cartilage diseases is introduced. The review then focusses on the emerging application of GM as a carrier for cells and biologics, and biologics delivery within a cartilage construct. The influence of GM on chondrocytes in terms of promoting chondrocyte proliferation and chondrogenic differentiation is highlighted. Furthermore, GM seeded with cells has been shown to have a high tendency to form aggregates; hence the concept of using GM seeded with cells as the building block for the formation of a complex tissue construct. Despite the advancement in GM research, some issues must still be addressed, particularly the improvement of GM's ability to home to defect sites. As such, the strategy of intraarticular injection of GM seeded with antibody-coated cells is proposed. By addressing this in future studies, a better-targeted delivery system, that would result in more effective intervention, can be achieved.
    MeSH terms: Biological Products; Cartilage; Cartilage Diseases; Cell Differentiation; Gelatin; Immunoglobulins; Injections, Intra-Articular; Microspheres; Water; Drug Delivery Systems; Chondrocytes; Chondrogenesis; Tissue Engineering; Cell Proliferation
  14. Lim SL, Ong PS, Khor CG
    Mod Rheumatol Case Rep, 2020 07;4(2):237-242.
    PMID: 33086999 DOI: 10.1080/24725625.2020.1754567
    Tuberculosis (TB) and its association with rheumatic diseases have been widely recognised. Occurrence of multifocal skeletal involvement constitutes <5% of all skeletal TB cases. We present a Malay patient with multifocal osteoarticular TB (OATB). A 35 year-old SLE woman with background usage of corticosteroid therapy and Azathioprine presented with lupus nephritis flare. Renal biopsy revealed diffuse proliferative lupus nephritis and intravenous (IV) Cyclophosphamide 0.5 g/m2 (850 mg) was initiated. One week later, patient complained dorsum of left hand and right knee swelling. On physical examination, patient was afebrile and the left hand swelling was cystic in consistency while right knee was warm and tender. Erythrocyte Sedimentation Rate (ESR) was 50 mm/hr and C-Reactive Protein (CRP) was 9.4 mg/L. Her Mantoux test was positive with 20 mm induration. Wrist radiograph and chest radiograph was normal. Musculoskeletal ultrasound showed 4th extensor compartment tenosynovitis with Doppler signal and right knee effusion with synovial proliferation. Extensor tenosynovectomy and right knee aspiration was performed. Left hand excised tissue and right knee synovial fluid for acid-fast bacilli (AFB) stain, TB PCR, bacterial and fungal cultures were negative. Urgent histopathological examination of the excised tissue showed necrotising granulomatous inflammation. Patient was empirically started on TB treatment and subsequent mycobacterial culture confirmed the diagnosis of TB. The joints swelling resolved after one month of TB treatment. Multifocal OATB is an infrequent form of extrapulmonary TB and diagnosing OATB requires high index of suspicion particularly in SLE patient on immunosuppression. Prompt investigations are essential to the diagnosis of this rare condition for early initiation of anti-tuberculous therapy.
    MeSH terms: Adult; Biopsy; Disease Susceptibility; Female; Humans; Lupus Erythematosus, Systemic/complications*; Lupus Nephritis/complications; Lupus Nephritis/diagnosis; Osteomyelitis/diagnosis*; Osteomyelitis/drug therapy; Osteomyelitis/etiology*; Tuberculosis, Osteoarticular/diagnosis*; Tuberculosis, Osteoarticular/drug therapy; Tuberculosis, Osteoarticular/etiology*; Biomarkers; Symptom Assessment
  15. Chia KS, Jam MNH, Gan Z, Ismail N
    J Food Sci Technol, 2020 Dec;57(12):4533-4540.
    PMID: 33087966 DOI: 10.1007/s13197-020-04492-5
    Exported fresh intact pineapples must fulfill the minimum internal quality requirement of 12 degree brix. Even though near-infrared (NIR) spectroscopic approaches are promising to non-destructively and rapidly assess the internal quality of intact pineapples, these approaches involve expensive and complex NIR spectroscopic instrumentation. Thus, this research evaluates the performance of a proposed pre-dispersive NIR light sensing approach in non-destructively classifying the Brix of pineapples using K-fold cross-validation, holdout validation, and sensitive analysis. First, the proposed pre-dispersive NIR sensing device that consisted of a light sensing element and five NIR light emitting diodes with peak wavelengths of 780, 850, 870, 910, and 940 nm, respectively, was developed. After that, the diffuse reflectance NIR light of intact pineapples was non-destructively acquired using the developed NIR sensing device before their Brix values were conventionally measured using a digital refractometer. Next, an artificial neural network (ANN) was trained and optimized to classify the Brix values of pineapples using the acquired NIR light. The results of the sensitivity analysis showed that either one wavelength that was near to the water absorbance or chlorophyll band was redundant in the classification. The performance of the trained ANN was tested using new pineapples with the optimal classification accuracy of 80.56%. This indicates that the proposed pre-dispersive NIR light sensing approach coupled with the ANN is promising to be an alternative to non-destructively classifying the internal quality of fruits.
  16. Haw YT, Sim YY, Nyam KL
    J Food Sci Technol, 2020 Dec;57(12):4588-4598.
    PMID: 33087971 DOI: 10.1007/s13197-020-04497-0
    Kenaf (Hibiscus cannabinus) leaves are produced as the by product when kenaf stems were harvested. The kenaf leaves was examed for the applicable possibility as herbal tea due to their rich phenolic content. In this study, the effect of steam blanching and high temperature drying on physicochemical properties, antioxidant activity and consumer acceptability of the kenaf tea leaves were studied. Results showed that steam blanching prior oven-drying improved the extractability of phenolic compounds, leading to the increase in total flavonoid content, 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity, and ferric reducing antioxidant power. Drying at 120 °C was able to preserve more phenolic compounds, at the same time developing better taste, mouthfeel, and overall acceptability of kenaf leaves tea. Caffeic acid, tannic acid, catechin, and chlorogenic acid in kenaf tea leaves infusion were analyzed by ultra high performances liquid chromatography. In conclusion, steam blanching prior to 120 °C oven-drying was the best process method for the production of kenaf leaves into acceptable tea type.
  17. How YK, Siow LF
    J Food Sci Technol, 2020 Dec;57(12):4637-4648.
    PMID: 33087975 DOI: 10.1007/s13197-020-04501-7
    This study aims to investigate the antioxidant, physicochemical and functional properties of convection-, vacuum-and freeze-dried stink bean (Parkia speciosa) powder upon storage at various relative humidity (RH) at room temperature, 25 °C. Both convection- and vacuum-dried samples exhibited stronger DPPH free radical scavenging activity (7.62 ± 1.77 and 10.38 ± 0.63 mg AA/g·db respectively) and ferric ion-chelating (FIC) ability (16.55 ± 1.29 and 18.88 ± 2.36 mg/mL·db respectively) compared to the fresh and freeze-dried samples. Stink bean powder had low water solubility index, water holding capacity and oil holding capacity but it had the potential as emulsifier in food systems. Apparent formation of clumps were observed after 25-day storage of powder at RH of 43%, 54% or 75% due to absorption of moisture from surroundings. Generally, the antioxidant properties and colour of the powders deteriorated after storage especially at higher RH. Vacuum drying would be the most suitable drying method to produce stink bean powder because of its enhanced antioxidant capacities, light colour and relatively more stable after storage.
  18. Vankayala B, Anantula K, Saladi H, Gudugunta L, Basavarajaiah JM, Yadav SS
    J Conserv Dent, 2020 08 20;22(6):559-563.
    PMID: 33088065 DOI: 10.4103/JCD.JCD_221_19
    Aim: This study aims to evaluate the amount of apical extrusion of bacteria during root canal instrumentation using K3XF, Protaper Gold, Edge taper platinum, and Hyflex CM Rotary systems.

    Materials and Methods: Sixty freshly extracted maxillary incisors teeth collected in saline. Access cavity prepared and canals were made free of bacterial and pulp. The teeth were mounted on the bacteria collecting apparatus. Root canals were contaminated with the Fusobacterium Nucleatum (ATCC25586) and dried at 37°C for 24 h. In Group 1 (Control group): No instrumentation was done and biomechanical preparation done in all other groups with Group 2: Hand K-files, Group 3: Protaper gold, Group 4: K3XF, Group 5: Edge taper platinum, and Group 6: Hyflex CM rotary file systems. Then, the extrude was collected, and it is incubated in Mueller-Hinton agar for 24 h and the number of colony forming units were counted and statistical comparison was done using Kruskal-Wallis test and Mann-Whitney U test.

    Results: Hand K-files extruded more bacteria when compared to other four rotary systems, K3XF file system extruded least number of bacteria.

    Conclusion: All instrumentation techniques extruded intracanal bacteria apically. However, engine-driven nickel-titanium instruments extruded less bacteria than the manual technique. The K3XF rotary file system comparatively extruded less bacteria than other rotary file systems.

    MeSH terms: Agar; Alloys; Dental Pulp Cavity; Gold; Incisor; Nickel; Platinum; Root Canal Therapy; Stem Cells; Titanium; Fusobacterium nucleatum; Statistics, Nonparametric; Control Groups
  19. Omar N, Koshy M, Hanafiah M, Hatta SFWM, Shah FZM, Johari B, et al.
    J Res Med Sci, 2020;25:64.
    PMID: 33088301 DOI: 10.4103/jrms.JRMS_560_17
    Background: Nonalcoholic fatty liver disease (NAFLD) has become one of the major diseases plaguing worldwide. Several studies reported its association with ischemic heart disease (IHD). This study aims to determine the relationships between severity of steatosis with glycemic control and carotid intima-media thickness (CIMT) among a high-risk population of type 2 diabetes mellitus (T2DM) with proven IHD.

    Materials and Methods: This was a cross-sectional study involving patients aged between 18 and 65 years diagnosed with T2DM with IHD (n = 150). Ultrasonography of the abdomen to determine NAFLD severity category and CIMT measurements was performed by two independent radiologists. NAFLD was graded according to the severity of steatosis (NAFLD-3, NAFLD-2, NAFLD-1, and NAFLD-0). Comparison between different stages of NAFLD (NAFLD-3, NAFLD-2, NAFLD-1, and NAFLD-0) was analyzed using Chi-square and analysis of variance tests for categorical and continuous variables, respectively.

    Results: The prevalence of NAFLD was 71% (n = 107). NAFLD-1 was detected in 39% of the patients, 32% had NAFLD-2, no patients with NAFLD-3, and 29% had non-NAFLD. There were no patients with NAFLD-2 having higher systolic and diastolic blood pressure, weight, body mass index, waist circumference, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol. Glycated hemoglobin (HbA1c) concentration was highest within the NAFLD-2. NAFLD-2 showed higher mean CIMT. Every 1% rise in HbA1c for patients with NAFLD significantly increases the CIMT by 0.03 mm (95% CI: 0.009, 0.052, P = 0.006).

    Conclusion: These findings suggest additional atherosclerotic risks within the NAFLD-2 group with significantly higher HbA1c and CIMT compared to the NAFLD-1 and NAFLD-0 groups. It is, therefore, vital to incorporate stricter glycemic control among patients with T2DM and IHD with moderate NAFLD as part of atherosclerotic risk management strategy.

    MeSH terms: Adolescent; Adult; Aged; Blood Glucose; Blood Pressure; Body Weight; Cross-Sectional Studies; Diabetes Mellitus, Type 2; Humans; Cholesterol, HDL; Cholesterol, LDL; Middle Aged; Triglycerides; Body Mass Index; Prevalence; Abdominal Cavity; Waist Circumference; Young Adult; Carotid Intima-Media Thickness; Non-alcoholic Fatty Liver Disease
  20. Etminani R, Manaf ZA, Shahar S, Azadbakht L, Adibi P
    Int J Prev Med, 2020;11:113.
    PMID: 33088441 DOI: 10.4103/ijpvm.IJPVM_274_19
    Background: The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide. Therefore, we sought to determine the most important predictors of NAFLD among middle-aged men and women in Isfahan, Iran.

    Methods: A total of 413 individuals (163 men and 250 women) aged 30-60 years were selected by stratified random sampling. The participants had safe alcohol consumption habits (<2 drinks/day) and no symptoms of hepatitis B and C. NAFLD was diagnosed through ultrasound. Blood pressure, anthropometric, and body composition measurements were made and liver function tests were conducted. Biochemical assessments, including the measurement of fasting blood sugar (FBS) and ferritin levels, as well as lipid profile tests were also performed. Metabolic syndrome was evaluated according to the International Diabetes Federation (IDF) criteria.

    Results: The overall prevalence of ultrasound-diagnosed NAFLD was 39.3%. The results indicated a significantly higher prevalence of NAFLD in men than in women (42.3% vs 30.4%; P < 0.05). Binary logistic regression analysis was performed to determine the significant variables as NAFLD predictors. Overall, male gender, high body mass index (BMI), high alanine aminotransferase (ALT), high FBS, and high ferritin were identified as the predictors of NAFLD. The only significant predictors of NAFLD among men were high BMI and high FBS. These predictors were high BMI, high FBS, and high ferritin in women (P < 0.05 for all variables).

    Conclusions: The metabolic profile can be used for predicting NAFLD among men and women. BMI, FBS, ALT, and ferritin are the efficient predictors of NAFLD and can be used for NAFLD screening before liver biopsy.

    MeSH terms: Adult; Alanine Transaminase; Anthropometry; Blood Glucose; Blood Pressure; Fasting; Female; Ferritins; Humans; Iran; Liver Function Tests; Male; Middle Aged; Body Mass Index; Prevalence; Logistic Models; D-Alanine Transaminase; Metabolome; Non-alcoholic Fatty Liver Disease
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