Browse publications by year: 2021

  1. Chan YH, Liew KY, Tan JW, Shaari K, Israf DA, Tham CL
    Front Pharmacol, 2021;12:736339.
    PMID: 34531753 DOI: 10.3389/fphar.2021.736339
    2,4,6-Trihydroxy-3-geranyl acetophenone (tHGA) is a bioactive phloroglucinol compound found in Melicope pteleifolia (Champ. ex Benth.) T.G.Hartley, a medicinal plant vernacularly known as "tenggek burung". A variety of phytochemicals have been isolated from different parts of the plant including leaves, stems, and roots by using several extraction methods. Specifically, tHGA, a drug-like compound containing phloroglucinol structural core with acyl and geranyl group, has been identified in the methanolic extract of the young leaves. Due to its high nutritional and medicinal values, tHGA has been extensively studied by using various experimental models. These studies have successfully discovered various interesting pharmacological activities of tHGA such as anti-inflammatory, endothelial and epithelial barrier protective, anti-asthmatic, anti-allergic, and anti-cancer. More in-depth investigations later found that these activities were attributable to the modulatory actions exerted by tHGA on specific molecular targets. Despite these findings, the association between the mechanisms and signaling pathways underlying each pharmacological activity remains largely unknown. Also, little is known about the medicinal potentials of tHGA as a drug lead in the current pharmaceutical industry. Therefore, this mini review aims to summarize and relate the pharmacological activities of tHGA in terms of their respective mechanisms of action and signaling pathways in order to present a perspective into the overall modulatory actions exerted by tHGA. Besides that, this mini review will also pinpoint the unexplored potentials of this compound and provide some valuable insights into the potential applications of tHGA which may serve as a guide for the development of modern medication in the future.
  2. Zakaria Z, Hassan L, Ahmad N, Husin SA, Ali RM, Sharif Z, et al.
    Front Microbiol, 2021;12:652642.
    PMID: 34531832 DOI: 10.3389/fmicb.2021.652642
    Salmonella enterica subspecies enterica serovar Enteritidis is one of the major foodborne zoonotic pathogens globally. It has significantly impacted human health and global trade. In this investigation, whole-genome sequencing was employed to determine the antimicrobial resistance (AMR) pattern of a collection of Salmonella Enteritidis isolated from humans, poultry, and food sources. The study also investigated the virulence genes profile of the isolates as well as the phylogenetic relationships among strains. Illumina NextSeq technology was used to sequence the genome of 82 Salmonella Enteritidis strains isolated over 3 years (2016-2018) in Peninsular Malaysia. The pattern of resistance showed that tetracycline had the highest frequency (37/82, 45.12%), and isolates from food samples showed the highest rate of 9/18 (50.00%), followed by human 17/35 (48.57%) and then poultry 11/29 (37.93%). The second drug with the highest resistance rate is ampicillin with 5/29 (17.24%) for poultry, 4/35 (11.43%) for human, and 0/18 (0.00%) for food isolates respectively. Similarly, a total of 19 antimicrobial resistance (AMR) genes corresponding to the nine drugs used in the disc diffusion assay were evaluated from the whole genome sequence data. The aminoglycoside resistance gene aac(6')-ly was detected in 79 of the 82 isolates (96.34%). While the phylogenetic analysis revealed distinct lineages isolated, the three sources indicating possible cross-contamination. In conclusion, the results showed that the genomic profile of Salmonella Enteritidis isolated from humans, poultry, and food samples share genetic traits, hence the need to institute measures at controlling the continuous spread of these resistant pathogens.
  3. Wang S, Liu Q, Liu Y, Jia H, Abualigah L, Zheng R, et al.
    Comput Intell Neurosci, 2021;2021:6379469.
    PMID: 34531910 DOI: 10.1155/2021/6379469
    Based on Salp Swarm Algorithm (SSA) and Slime Mould Algorithm (SMA), a novel hybrid optimization algorithm, named Hybrid Slime Mould Salp Swarm Algorithm (HSMSSA), is proposed to solve constrained engineering problems. SSA can obtain good results in solving some optimization problems. However, it is easy to suffer from local minima and lower density of population. SMA specializes in global exploration and good robustness, but its convergence rate is too slow to find satisfactory solutions efficiently. Thus, in this paper, considering the characteristics and advantages of both the above optimization algorithms, SMA is integrated into the leader position updating equations of SSA, which can share helpful information so that the proposed algorithm can utilize these two algorithms' advantages to enhance global optimization performance. Furthermore, Levy flight is utilized to enhance the exploration ability. It is worth noting that a novel strategy called mutation opposition-based learning is proposed to enhance the performance of the hybrid optimization algorithm on premature convergence avoidance, balance between exploration and exploitation phases, and finding satisfactory global optimum. To evaluate the efficiency of the proposed algorithm, HSMSSA is applied to 23 different benchmark functions of the unimodal and multimodal types. Additionally, five classical constrained engineering problems are utilized to evaluate the proposed technique's practicable abilities. The simulation results show that the HSMSSA method is more competitive and presents more engineering effectiveness for real-world constrained problems than SMA, SSA, and other comparative algorithms. In the end, we also provide some potential areas for future studies such as feature selection and multilevel threshold image segmentation.
    MeSH terms: Algorithms*; Computer Simulation; Mutation
  4. Ahmed N, Abbasi MS, Haider S, Ahmed N, Habib SR, Altamash S, et al.
    Biomed Res Int, 2021;2021:3194433.
    PMID: 34532499 DOI: 10.1155/2021/3194433
    Objective: Analyzing and comparing the fit and accuracy of removable partial denture (RPDs) frameworks fabricated with CAD/CAM and rapid prototyping methods with conventional techniques.

    Materials and Methods: The present systematic review was carried out according to PRISMA guidelines. The search was carried out on PubMed/MEDLINE, Cochrane collaboration, Science direct, and Scopus scientific engines using selected MeSH keywords. The articles fulfilling the predefined selection criteria based on the fit and accuracy of removable partial denture (RPD) frameworks constructed from digital workflow (CAD/CAM; rapid prototyping) and conventional techniques were included.

    Results: Nine full-text articles comprising 6 in vitro and 3 in vivo studies were included in this review. The digital RPDs were fabricated in all articles by CAD/CAM selective laser sintering and selective laser melting techniques. The articles that have used CAD/CAM and rapid prototyping technique demonstrated better fit and accuracy as compared to the RPDs fabricated through conventional techniques. The least gaps between the framework and cast (41.677 ± 15.546 μm) were found in RPDs constructed through digital CAD/CAM systems.

    Conclusion: A better accuracy was achieved using CAD/CAM and rapid prototyping techniques. The RPD frameworks fabricated by CAD/CAM and rapid prototyping techniques had clinically acceptable fit, superior precision, and better accuracy than conventionally fabricated RPD frameworks.

    MeSH terms: Denture Design/methods*; Denture Design/trends*; Denture, Partial/trends; Denture, Partial, Removable/trends*; Humans; Lasers; Computer-Aided Design/trends; Workflow
  5. Hassan SN, Mohamed Yusoff AA, Idris Z, Mohd Redzwan N, Ahmad F
    Neurol Res, 2021 Sep 17.
    PMID: 34533110 DOI: 10.1080/01616412.2021.1975225
    BACKGROUND: Previous studies had reported on the cytotoxic activities of generic antibiotics such as doxycycline (DOXY) and azithromycin (AZI) in multiple types of human cancers. Given that resistance to standard anti-glioblastoma multiforme (GBM) drug [temozolomide (TMZ)] is common and inevitable, alternative candidates are greatly needed.

    PURPOSE AND METHOD: The present study was undertaken to explore the cytotoxicity and anticancer effects of DOXY and AZI on human GBM U87 cells via 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT), Hoechst, Annexin V-FITC/PI, and clonogenic assays. CompuSyn software was used to determine the combination index (CI) for DOXY+AZI.

    RESULT: Individual treatment with DOXY and AZI decreased U87 cell viability in dose- and time-dependent, and quantitatively comparable to TMZ. Nevertheless, combinations of both antibiotics evidenced antagonistic behaviour in U87 cells. Increased apoptotic event was also observed with the individual treatment of DOXY and AZI. Furthermore, the proliferative and clonogenic capability of 21-day survived U87 cells was completely terminated by DOXY and AZI, but not TMZ.

    CONCLUSION: The antiproliferative and apoptosis-inducing activity exhibited by both antibiotics against U87 cells demonstrates their potential as a likely alternative to combat GBM. It would be interesting to find out more about their molecular players and cytotoxic effects in different types of GBM cells, including glioma stem cells (GSCs).

  6. Sirunyan AM, Tumasyan A, Adam W, Ambrogi F, Bergauer T, Dragicevic M, et al.
    Phys Rev Lett, 2021 Sep 03;127(10):102002.
    PMID: 34533355 DOI: 10.1103/PhysRevLett.127.102002
    The CMS experiment at the LHC has measured the differential cross sections of Z bosons decaying to pairs of leptons, as functions of transverse momentum and rapidity, in lead-lead collisions at a nucleon-nucleon center-of-mass energy of 5.02  TeV. The measured Z boson elliptic azimuthal anisotropy coefficient is compatible with zero, showing that Z bosons do not experience significant final-state interactions in the medium produced in the collision. Yields of Z bosons are compared to Glauber model predictions and are found to deviate from these expectations in peripheral collisions, indicating the presence of initial collision geometry and centrality selection effects. The precision of the measurement allows, for the first time, for a data-driven determination of the nucleon-nucleon integrated luminosity as a function of lead-lead centrality, thereby eliminating the need for its estimation based on a Glauber model.
  7. Qualickuz Zanan NH, Azman M, Zainuddin K, Wan Puteh SE, Mohamed AS, Mat Baki M
    Acta Otorhinolaryngol Ital, 2021 Aug;41(4):348-355.
    PMID: 34533538 DOI: 10.14639/0392-100X-N1202
    Objective: This study aimed to describe the sound frequency of snoring in relation to the site of upper airway vibration among snorers.

    Methods: 383 snores from 40 participants who complained of snoring were digitally recorded during natural and induced sleep using a level III polysomnography monitor with a built-in microphone. During drug-induced sleep endoscopy (DISE), the real-time site of upper airway obstruction was assessed, and the sound frequency of snoring was recorded synchronously.

    Results: The mean peak of snoring frequency for unilevel palatal, oropharynx and epiglottis obstruction were 522.5, 482.4 and 300.0 Hz, respectively. Most participants showed multilevel obstruction at the palate and oropharynx, in which the mean for bi-peak snoring frequency were 402.90 Hz and 1086.96 Hz, respectively. Severity of OSA was significantly associated with multilevel obstruction.

    Conclusions: There was a significant association between the snoring sound frequency and site of unilevel obstruction. Palatal or oropharyngeal obstruction produced sound at mid-frequency range, while the epiglottis produced a low frequency range. Multilevel obstruction documented a bi-peak snoring frequency.

    MeSH terms: Epiglottis; Humans; Sleep; Snoring/epidemiology; Polysomnography; Sleep Apnea, Obstructive*
  8. Islam A, Haque S
    Memory, 2021 Nov;29(10):1296-1307.
    PMID: 34534045 DOI: 10.1080/09658211.2021.1978500
    This study investigated the self-defining periods (SPs) in private and public memories of Bangladeshi older adults (N = 476; mean age = 67.16 years) who, during adolescence and early adulthood, witnessed the 1960s Bengali nationalist movement and the 1971 Bangladesh War of Independence. Each participant retrieved three private and three public memories they considered to be highly significant. The lifespan distributions for private and public memories were identical; in both cases, participants recalled more than half of their memories from 10 to 29 years of age. The calendar-year distributions revealed that nearly one-fourth of private and one-third of public memories were recalled from the year of the War of Independence. The memory content analysis showed that participants sampled more negative than positive memories: 55% versus 45% for private memory and 66% versus 34% for public memory. The enhanced recollection of private and public memories from 10 to 29 years of age was predominantly shaped by memories of the independence struggle-a period that was self-defining for the entire Bangladeshi society.
  9. Khandakar A, Chowdhury MEH, Ibne Reaz MB, Md Ali SH, Hasan MA, Kiranyaz S, et al.
    Comput Biol Med, 2021 10;137:104838.
    PMID: 34534794 DOI: 10.1016/j.compbiomed.2021.104838
    Diabetes foot ulceration (DFU) and amputation are a cause of significant morbidity. The prevention of DFU may be achieved by the identification of patients at risk of DFU and the institution of preventative measures through education and offloading. Several studies have reported that thermogram images may help to detect an increase in plantar temperature prior to DFU. However, the distribution of plantar temperature may be heterogeneous, making it difficult to quantify and utilize to predict outcomes. We have compared a machine learning-based scoring technique with feature selection and optimization techniques and learning classifiers to several state-of-the-art Convolutional Neural Networks (CNNs) on foot thermogram images and propose a robust solution to identify the diabetic foot. A comparatively shallow CNN model, MobilenetV2 achieved an F1 score of ∼95% for a two-feet thermogram image-based classification and the AdaBoost Classifier used 10 features and achieved an F1 score of 97%. A comparison of the inference time for the best-performing networks confirmed that the proposed algorithm can be deployed as a smartphone application to allow the user to monitor the progression of the DFU in a home setting.
    MeSH terms: Machine Learning; Algorithms; Diabetes Mellitus*; Humans; Thermography; Neural Networks (Computer)
  10. Sergeev A, Shilkina N, Motyakin M, Barashkova I, Zaborova V, Kanina K, et al.
    Ultrason Sonochem, 2021 Oct;78:105751.
    PMID: 34534797 DOI: 10.1016/j.ultsonch.2021.105751
    Methods of NMR relaxation and differential scanning calorimetry (DSC) were used to study the crystallization of anhydrous milk fat (AMF) obtained from milk and subjected to ultrasonic (US) processing. Amongst the changes in the crystallization nature under the influence of ultrasound are the decrease in the crystallization temperature and the increase in the melting enthalpy of the anhydrous milk fat samples. The increase is ∼30% at 20 min of isothermal crystallization and is presumably explained by the additional formation of β'-form crystals from the melt. The parameters of the Avrami equation applied to the description of experimental data show an increase in the crystallization rate in samples with ultrasonic treatment and a change in the dimension of crystallization with a change in melting temperature.
    MeSH terms: Animals; Calorimetry, Differential Scanning; Crystallization; Goats; Milk*; Ultrasonics*
  11. Chong SC, Ang JK, Tan KP
    Asian J Psychiatr, 2021 Nov;65:102835.
    PMID: 34534918 DOI: 10.1016/j.ajp.2021.102835
    Covid-19 pandemic and the public health measure have forced an en masse transition to remote therapy from physical sessions. Remote psychodynamic psychotherapy is not a new treatment modality, but its effectiveness in holding the analytic frame has been concerned by some therapists. We would like to highlight some of the therapeutic processes involved with remote psychodynamic psychotherapy, via the help of a narrative experience of a psychiatry trainee who was novice to this delivery method of therapy. Reflections on these concerns have been made in line with the experiences highlighted.
  12. Low A, Kadir AJ, Wong KT, Choo MM
    Ophthalmic Plast Reconstr Surg, 2021 4 3;37(5):e193.
    PMID: 33795606 DOI: 10.1097/IOP.0000000000001947
    MeSH terms: Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Parotid Gland
  13. Koh B, Sulaiman N, Ismadi SNSW, Ramli R, Yunus SSM, Idrus RBH, et al.
    Biol Proced Online, 2021 Sep 15;23(1):18.
    PMID: 34521356 DOI: 10.1186/s12575-021-00155-7
    BACKGROUND: In the area of oral and maxillofacial surgery, regenerative endodontics aims to present alternative options to conventional treatment strategies. With continuous advances in regenerative medicine, the source of cells used for pulp tissue regeneration is not only limited to mesenchymal stem cells as the non-mesenchymal stem cells have shown capabilities too. In this review, we are systematically assessing the recent findings on odontoblastic differentiation induction with scaffold and non-scaffold approaches.

    METHODS: A comprehensive search was conducted in Pubmed, and Scopus, and relevant studies published between 2015 and 2020 were selected following the PRISMA guideline. The main inclusion criteria were that articles must be revolving on method for osteoblast differentiation in vitro study. Therefore, in vivo and human or animal clinical studies were excluded. The search outcomes identified all articles containing the word "odontoblast", "differentiation", and "mesenchymal stem cell".

    RESULTS: The literature search identified 99 related studies, but only 11 articles met the inclusion criteria. These include 5 odontoblastic differentiation induction with scaffold, 6 inductions without scaffolds. The data collected were characterised into two main categories: type of cells undergo odontoblastic differentiation, and odontoblastic differentiation techniques using scaffolds or non-scaffold.

    CONCLUSION: Based on the data analysis, the scaffold-based odontoblastic induction method seems to be a better option compared to the non-scaffold method. In addition of that, the combination of growth factors in scaffold-based methods could possibly enhance the differentiation. Thus, further detailed studies are still required to understand the mechanism and the way to enhance odontoblastic differentiation.

  14. Erman M, Biswas B, Danchaivijitr P, Chen L, Wong YF, Hashem T, et al.
    BMC Cancer, 2021 Sep 14;21(1):1021.
    PMID: 34521387 DOI: 10.1186/s12885-021-08738-z
    BACKGROUND: Clinical effectiveness and safety data of pazopanib in patients with advanced or mRCC in real-world setting from Asia Pacific, North Africa, and Middle East countries are lacking.

    METHODS: PARACHUTE is a phase IV, prospective, non-interventional, observational study. Primary endpoint was the proportion of patients remaining progression free at 12 months. Secondary endpoints were ORR, PFS, safety and tolerability, and relative dose intensity (RDI).

    RESULTS: Overall, 190 patients with a median age of 61 years (range: 22.0-96.0) were included. Most patients were Asian (70%), clear-cell type RCC was the most common (81%), with a favourable (9%), intermediate (47%), poor (10%), and unknown (34%) MSKCC risk score. At the end of the observational period, 78 patients completed the observational period and 112 discontinued the study; 60% of patients had the starting dose at 800 mg. Median RDI was 82%, with 52% of patients receiving  10%) TEAEs related to pazopanib included diarrhoea (30%), palmar-plantar erythrodysesthesia syndrome (15%), and hypertension (14%).

    CONCLUSIONS: Results of the PARACHUTE study support the use of pazopanib in patients with advanced or mRCC who are naive to VEGF-TKI therapy. The safety profile is consistent with that previously reported by pivotal and real-world evidence studies.

    MeSH terms: Adult; Africa, Northern; Aged; Aged, 80 and over; Antineoplastic Agents/therapeutic use*; Asia; Carcinoma, Renal Cell/drug therapy*; Carcinoma, Renal Cell/ethnology; Carcinoma, Renal Cell/mortality; Carcinoma, Renal Cell/pathology; Female; Humans; Indazoles/administration & dosage; Indazoles/adverse effects; Indazoles/therapeutic use*; Kidney Neoplasms/drug therapy*; Kidney Neoplasms/ethnology; Kidney Neoplasms/mortality; Kidney Neoplasms/pathology; Male; Middle Aged; Middle East; Prospective Studies; Pyrimidines/administration & dosage; Pyrimidines/adverse effects; Pyrimidines/therapeutic use*; Risk Factors; Sulfonamides/administration & dosage; Sulfonamides/adverse effects; Sulfonamides/therapeutic use*; Time Factors; Treatment Outcome; Angiogenesis Inhibitors/administration & dosage; Angiogenesis Inhibitors/adverse effects; Angiogenesis Inhibitors/therapeutic use*; Young Adult; Response Evaluation Criteria in Solid Tumors
  15. Antwi J, Arkoh AA, Choge JK, Dibo TW, Mahmud A, Vankhuu E, et al.
    Hum Resour Health, 2021 09 14;19(1):110.
    PMID: 34521441 DOI: 10.1186/s12960-021-00646-4
    BACKGROUND: Shortages and maldistribution of healthcare workers persist despite efforts to increase the number of practitioners. Evidence to support policy planning and decisions is essential. The World Health Organization has proposed National Health Workforce Accounts (NHWA) to facilitate human resource information systems for effective health workforce planning and monitoring. In this study, we report on the accreditation practices for accelerated medically trained clinicians in five countries: Ethiopia, Ghana, Kenya, Malaysia, and Mongolia.

    METHOD: Using open-ended survey responses and document review, information about accreditation practices was classified using NHWA indicators. We examined practices using this framework and further examined the extent to which the indicators were appropriate for this cadre of healthcare providers. We developed a data extraction tool and noted any indicators that were difficult to interpret in the local context.

    RESULTS: Accreditation practices in the five countries are generally aligned with the WHO indicators with some exceptions. All countries had standards for pre-service and in-service training. It was difficult to determine the extent to which social accountability and social determinants of health were explicitly part of accreditation practices as this cadre of practitioners evolved out of community health needs. Other areas of discrepancy were interprofessional education and continuing professional development.

    DISCUSSION: While it is possible to use NHWA module 3 indicators there are disadvantages as well, at least for accelerated medically trained clinicians. There are aspects of accreditation practices that are not readily coded in the standard definitions used for the indicators. While the indicators provide detailed definitions, some invite social desirability bias and others are not as easily understood by practitioners whose roles continue to evolve and adapt to their health systems.

    CONCLUSION: Regular review and revision of indicators are essential to facilitate uptake of the NHWA for planning and monitoring healthcare providers.

    MeSH terms: Accreditation*; Health Personnel*; Health Planning; Humans; Kenya
  16. Nooseisai M, Viwattanakulvanid P, Kumar R, Viriyautsahakul N, Muhammad Baloch G, Somrongthong R
    Prim Health Care Res Dev, 2021 Sep 15;22:e46.
    PMID: 34521493 DOI: 10.1017/S1463423621000505
    AIM: The aim of this study is to assess the effect of diabetes self-management education (DSME) on lowering blood glucose level, stress, and quality of life (QoL) among female patients with type 2 diabetes mellitus (T2DM) in Thailand.

    BACKGROUND: The burden of noncommunicable diseases has increased globally, and it has negatively affected the QoL of diabetic patients.

    METHODS: A quasi-experimental study was conducted by including 77 T2DM patients selected from 2 public health centers in Thailand. The respondents were randomly selected 38 in control group and 39 in intervention group. Pretested, piloted, and validated tool were used during this study. Knowledge on blood glucose level, stress, and QoL was measured at baseline and then compared to end line after 3 months of the intervention. The effects of intervention were estimated by regression coefficient of intervention on blood glucose level and QoL. The study was ethically approved by the Chulalongkorn University, Thailand.

    FINDINGS: Baseline characteristics of both the groups were similar before the start of the intervention and there were no significant differences observed in age, education, blood sugar monitoring behavior, medical checkup, knowledge, self-care, stress, and hemoglobin HbA1c (>0.05). However, blood HbA1c, stress level, and QoL among the T2DM patients had significant changes (<0.05) after the intervention. The control group was remained same and there was no statistically significant difference reported (>0.05).

    CONCLUSIONS: The study concluded that the designed intervention of DSME has proved effective in lowering the blood sugar level, HbA1c level, stress level, and improved QoL among T2DM patients during this limited period of time. Hence, policy-makers can replicate this intervention for diabetic patients in a similar context.

  17. Qureshi N, Akyea RK, Dutton B, Humphries SE, Abdul Hamid H, Condon L, et al.
    Heart, 2021 12;107(24):1956-1961.
    PMID: 34521694 DOI: 10.1136/heartjnl-2021-319742
    OBJECTIVE: Familial hypercholesterolaemia (FH) is a common inherited disorder that remains mostly undetected in the general population. Through FH case-finding and direct access to genetic testing in primary care, this intervention study described the genetic and lipid profile of patients found at increased risk of FH and the outcomes in those with positive genetic test results.

    METHODS: In 14 Central England general practices, a novel case-finding tool (Familial Hypercholetserolaemia Case Ascertainment Tool, FAMCAT1) was applied to the electronic health records of 86 219 patients with cholesterol readings (44.5% of total practices' population), identifying 3375 at increased risk of FH. Of these, a cohort of 336 consenting to completing Family History Questionnaire and detailed review of their clinical data, were offered FH genetic testing in primary care.

    RESULTS: Genetic testing was completed by 283 patients, newly identifying 16 with genetically confirmed FH and 10 with variants of unknown significance. All 26 (9%) were recommended for referral and 19 attended specialist assessment. In a further 153 (54%) patients, the test suggested polygenic hypercholesterolaemia who were managed in primary care. Total cholesterol and low-density lipoprotein-cholesterol levels were higher in those patients with FH-causing variants than those with other genetic test results (p=0.010 and p=0.002).

    CONCLUSION: Electronic case-finding and genetic testing in primary care could improve identification of FH; and the better targeting of patients for specialist assessment. A significant proportion of patients identified at risk of FH are likely to have polygenic hypercholesterolaemia. There needs to be a clearer management plan for these individuals in primary care.

    TRIAL REGISTRATION NUMBER: NCT03934320.

    MeSH terms: Cholesterol/blood*; England/epidemiology; Female; Genetic Testing/methods*; Humans; Hyperlipoproteinemia Type II/blood; Hyperlipoproteinemia Type II/genetics; Hyperlipoproteinemia Type II/epidemiology*; Male; Middle Aged; Primary Health Care/methods*; Retrospective Studies; Risk Factors; Incidence; Electronic Health Records/statistics & numerical data*
  18. Lim CC, Saniasiaya J, Kulasegarah J
    BMJ Case Rep, 2021 Sep 14;14(9).
    PMID: 34521741 DOI: 10.1136/bcr-2021-244769
    Croup (laryngotracheitis) is frequently encountered in the emergency department in a young child presenting with stridor. We describe a rare case of croup secondary to SARS-CoV-2 in an 18-month-old child who presented with stridor and respiratory distress and required urgent intubation. Subsequently, the child developed multisystem inflammatory syndrome in children (MIS-C). The child was monitored in paediatric intensive care unit. We would like to highlight that COVID-19 croup in children may be an indicator for MIS-C, and close monitoring is warranted as MIS-C is a life-threatening condition. Our limited experience suggests that COVID-19 croup especially if associated with MIS-C has an underlying more severe pathology and may require prolonged treatment in comparison with the typical croup or even COVID-19 croup. It is important to recognise this clinical entity during a time when most countries are in a third wave of COVID-19 pandemic.
    MeSH terms: Humans; Infant; Systemic Inflammatory Response Syndrome; Pandemics
  19. Ujang FA, Roslan AM, Osman NA, Norman A, Idris J, Farid MAA, et al.
    Sci Rep, 2021 Sep 14;11(1):18257.
    PMID: 34521938 DOI: 10.1038/s41598-021-97789-0
    The reason for such enormous efforts in palm oil mill effluent research would be what has been singled out as one of the major sources of pollution in Malaysia, and perhaps the most costly and complex waste to manage. Palm oil mill final discharge, which is the treated effluent, will usually be discharged to nearby land or river since it has been the least costly way to dispose of. Irrefutably, the quality level of the treated effluent does not always satisfy the surface water quality in conformity to physicochemical characteristics. To work on improving the treated effluent quality, a vertical surface-flow constructed wetland system was designed with Pennisetum purpureum (Napier grass) planted on the wetland floor. The system effectively reduced the level of chemical oxygen demand by 62.2 ± 14.3%, total suspended solid by 88.1 ± 13.3%, ammonia by 62.3 ± 24.8%, colour by 66.6 ± 13.19%, and tannin and lignin by 57.5 ± 22.3%. Heat map depicted bacterial diversity and relative abundance in life stages from the wetland soil, whereby bacterial community associated with the pollutant removal was found to be from the families Anaerolineaceae and Nitrosomonadaceae, and phyla Cyanobacteria and Acidobacteria.
  20. Raja Mamat TA, Sayuti KA, Nadarajan C, Mohd Zain MR
    SA J Radiol, 2021;25(1):2164.
    PMID: 34522433 DOI: 10.4102/sajr.v25i1.2164
    Pulmonary underdevelopment is a rare congenital disease which manifests as persistent hemithorax opacification at chest radiography. We present three patients with different types of pulmonary underdevelopment, their imaging features and associated anomalies. Case 1 is a premature neonate with persistent respiratory distress. Further imaging confirmed right pulmonary hypoplasia, associated with a patent foramen ovale, patent ductus arteriosus and vertebral anomalies. Case 2 is a 6-year-old child with corrected anorectal malformation, and recurrent pneumonia. Further imaging confirmed left pulmonary aplasia, associated with an aberrant right subclavian artery and vertebral anomaly. Case 3 is a full term neonate who developed excessive drooling of saliva and respiratory distress. Further imaging confirmed right pulmonary agenesis, associated with an atrial septal defect, patent ductus arteriosus and tracheo-oesophageal fistula. Pulmonary underdevelopment is classified into three types: hypoplasia, aplasia and agenesis. The majority of them have associated anomalies. This condition should be considered a differential diagnosis in paediatric patients with an opaque hemithorax on chest radiography.
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