Browse publications by year: 2021

  1. Al-Raad AA, Hanafiah MM
    J Environ Manage, 2021 Dec 15;300:113696.
    PMID: 34509809 DOI: 10.1016/j.jenvman.2021.113696
    Electrocoagulation (ECoag) technique has shown considerable potential as an effective method in separating different types of pollutants (including inorganic pollutants) from various sources of water at a lower cost, and that is environmentally friendly. The EC method's performance depends on several significant parameters, including current density, reactor geometry, pH, operation time, the gap between electrodes, and agitation speed. There are some challenges related to the ECoag technique, for example, energy consumption, and electrode passivation as well as its implementation at a larger scale. This review highlights the recent studies published about ECoag capacity to remove inorganic pollutants (including salts), the emerging reactors, and the effect of reactor geometry designs. In addition, this paper highlights the integration of the ECoag technique with other advanced technologies such as microwave and ultrasonic to achieve higher removal efficiencies. This paper also presents a critical discussion of the major and minor reactions of the electrocoagulation technique with several significant operational parameters, emerging designs of the ECoag cell, operating conditions, and techno-economic analysis. Our review concluded that optimizing the operating parameters significantly enhanced the efficiency of the ECoag technique and reduced overall operating costs. Electrodes geometry has been recommended to minimize the passivation phenomenon, promote the conductivity of the cell, and reduce energy consumption. In this review, several challenges and gaps were identified, and insights for future development were discussed. We recommend that future studies investigate the effect of other emerging parameters like perforated and ball electrodes on the ECoag technique.
    MeSH terms: Electrocoagulation; Electrodes; Environmental Pollutants*; Hydrogen-Ion Concentration; Waste Disposal, Fluid; Water Pollutants, Chemical*; Water Purification*
  2. John JL, Mori D, Amit LN, Mosiun AK, Chin AZ, Ahmed K
    J Clin Virol, 2021 10;143:104968.
    PMID: 34509928 DOI: 10.1016/j.jcv.2021.104968
    Globally, norovirus (NoV) has become one of the important causes of acute gastroenteritis (AGE) in children. It is responsible for death of children younger than 5 years in developing countries. Although there is limited information and the rate of child mortality caused by diarrhea is low in Malaysia, the burden of diarrhea is high, especially in Sabah. NoV GI, GII and GIV genogroups are known to infect humans, and GII.4 is the predominant genotype distributed worldwide. Better understanding of the etiology of NoV will help to inform policies for prevention and control. The aim of this study was to determine the burden and genotype distribution of NoV in children younger than 5 years with AGE who attended health-care facilities in Sabah, Malaysia. Diarrhea stool samples were collected from 299 children with AGE and NoV was detected by amplifying the capsid and RNA-dependent RNA polymerase gene and reverse transcription-polymerase chain reaction (RT-PCR) analysis. Nucleotide sequencing of the amplicons was used for genotypes and phylogenetic analyses . NoV-positive stool samples were found in 17.7% (53/299) among which 13/53 (24.5%), 38/53 (71.7%), and 2/53 (3.8%) identified as NoV GI, GII and combination of GI and GII, respectively. The most common genotypes were GII.3 [P12] (80%) followed by GII.6 [P7] (13.3%), and GII.17 [P17] (6.7%). In the phylogenetic tree, all Sabahan NoV samples were shown to share ancestry with their respective genotype from predominantly East Asian countries and to some extent Australia and Europe. However, the Sabahan strains formed independent clusters with significant bootstrap values, indicating a clonal spread after the strains had entered Sabah.
    MeSH terms: Borneo; Child; Feces; Genotype; Humans; Infant; Malaysia/epidemiology; Phylogeny; Genetic Variation
  3. Lee WWH, Cheong YK, Teh CL, Wan SA, Chuah SL, Singh BSM
    Clin Rheumatol, 2021 11;40(11):4775-4777.
    PMID: 34510293 DOI: 10.1007/s10067-021-05920-3
    MeSH terms: Hospitalization; Humans; Lupus Erythematosus, Systemic*
  4. Aghalari Z, Dahms HU, Sillanpää M
    Life Sci Soc Policy, 2021 Sep 13;17(1):8.
    PMID: 34511108 DOI: 10.1186/s40504-021-00116-8
    OBJECTIVE: The use of nanotechnologies is important to reduce environmental health problems in Iran, so the present study was conducted to determine the effectiveness of nanotechnologies in environmental health. This is a cross-sectional descriptive study for 11-year periods (2008-2018) on all articles published in three specialized journals of environmental health with emphasis on the use of nanotechnologies in various fields of environmental health (water, air, sewage, waste, food, radiation, etc).

    RESULTS: In this study, 774 articles related to 114 issues of 3 specialized environmental health journals were reviewed. A review of 774 articles showed that 80 articles (10.3%) were published in the field of nanotechnologies. Out of 80 articles published in the field of nanotechnology, 66 articles (82.5%) were published on the subject of water, 9 articles (11.3%) on wastewater and 5 articles (6.2%) on air pollution. Subject review of articles showed that articles using carbon nanotubes to remove natural organic pollutants, surfactants, hydroxybenzenes, phenol, dimethyl phthalates, use of titanium dioxide nanoparticles, iron-magnesium nanoparticles for wastewater treatment, Silver nanoparticles were used to remove air pollution. The results showed that published articles on nanotechnology in the field of environmental health were few.

    MeSH terms: Cross-Sectional Studies; Environmental Health; Humans; Periodicals as Topic*; Silver; Nanotechnology; Nanotubes, Carbon*; Metal Nanoparticles*
  5. Daningrat WOD, Amalia H, Ayu IM, Satzke C, Safari D
    PMID: 34511388 DOI: 10.1016/j.jmii.2021.08.002
    A number of pneumococcal carriage studies in children have been conducted in recent years. However, summary data of carriage prevalence and serotype distribution from South East Asia Region (SEAR) are limited. This may lead to the misconception that Streptococcus pneumoniae vaccine-types are uncommon in the region. Systematic reviews of pneumococcal carriage and the distribution of serotypes are critically important for evidence-based decision-making. We aimed to summarize published data on the serotype prevalence of S. pneumoniae carried in the nasopharynx of children under 5 years of age in SEAR. We performed a systematic review and meta-analysis for relevant studies on S. pneumoniae carriage conducted prior to PCV program implementation from online journal databases published between January 2001 to December 2019. The pooled prevalence of S. pneumoniae in healthy children under 5 years of age in SEAR was 36.0% (95% CI 34.2%-37.8%), and ranged from 68.0% (95% CI: 61.9%-74.0%) in Cambodia to 7.6% (95% CI: 5.7%-9.6%) in Malaysia. Serotypes 6A/B, 23F and 19F were the most common serotypes in children <5 years, accounting for 12.9% (95% CI: 9.4%-16.3%), 9.3% (95% CI: 5.9%-12.8%) and 10.1% (95% CI: 6.6%-13.5%) of isolates, respectively. Vaccine policy makers should take these results into account when making decisions on pneumococcal conjugate vaccine programs implementation. Given the paucity of data, collection of more extensive and updated information of S. pneumoniae serotype epidemiology in children under five years in SEAR is also very important for future studies.
  6. Miloslavsky D, Mysnychenko O, Penkova M, Schenyavska Е, Koval S
    Georgian Med News, 2021 9 14.
    PMID: 34511461
    In review provides data on pathophysiological relationships of intestinal microbiota with body weight regulation in patients with abdominal obesity. In manuscript discusses the leading mechanisms by which the gut microbiota can contribute to obesity and metabolic diseases, analyzes its components, including gastrointestinal peptides, short-chain fatty acids, bile acids, farnesoid receptors, etc. Western diet high in salt, dysbiosis and endotoxemia can be powerful pro-inflammatory factors responsible for the development of insulin resistance and weight gain. It is promising to prescribe agonists of gastrointestinal peptides, probiotics and prebiotics, which in abdominal obesity are able to inhibit dysbiosis, regulate immune functions, and protect the organism from low-intensity chronic inflammation.
    MeSH terms: Gastrointestinal Microbiome*; Humans; Inflammation; Obesity; Obesity, Abdominal*; Dysbiosis
  7. Alyasseri ZAA, Al-Betar MA, Doush IA, Awadallah MA, Abasi AK, Makhadmeh SN, et al.
    Expert Syst, 2021 Jul 28.
    PMID: 34511689 DOI: 10.1111/exsy.12759
    COVID-19 is the disease evoked by a new breed of coronavirus called the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recently, COVID-19 has become a pandemic by infecting more than 152 million people in over 216 countries and territories. The exponential increase in the number of infections has rendered traditional diagnosis techniques inefficient. Therefore, many researchers have developed several intelligent techniques, such as deep learning (DL) and machine learning (ML), which can assist the healthcare sector in providing quick and precise COVID-19 diagnosis. Therefore, this paper provides a comprehensive review of the most recent DL and ML techniques for COVID-19 diagnosis. The studies are published from December 2019 until April 2021. In general, this paper includes more than 200 studies that have been carefully selected from several publishers, such as IEEE, Springer and Elsevier. We classify the research tracks into two categories: DL and ML and present COVID-19 public datasets established and extracted from different countries. The measures used to evaluate diagnosis methods are comparatively analysed and proper discussion is provided. In conclusion, for COVID-19 diagnosing and outbreak prediction, SVM is the most widely used machine learning mechanism, and CNN is the most widely used deep learning mechanism. Accuracy, sensitivity, and specificity are the most widely used measurements in previous studies. Finally, this review paper will guide the research community on the upcoming development of machine learning for COVID-19 and inspire their works for future development. This review paper will guide the research community on the upcoming development of ML and DL for COVID-19 and inspire their works for future development.
  8. Haranal M, Srimurugan B, Dinh DM, Sivalingam S
    Indian J Thorac Cardiovasc Surg, 2021 Sep;37(5):526-532.
    PMID: 34511759 DOI: 10.1007/s12055-021-01206-0
    Berry syndrome is a rare congenital cardiac anomaly, characterized by distal aortopulmonary window, hypoplasia or interruption of the aortic arch, intact ventricular septum, and aortic origin of the right pulmonary artery and patent ductus arteriosus. Anatomic depiction of each component is important for the diagnosis. Single-stage surgical repair is challenging but feasible with good survival outcomes. The available literature on this anomaly is limited. Hence, this paper aims at reviewing the literature on Berry syndrome.
  9. Meyer J, Price C, Tracey D, Sharpless L, Song Y, Madden L, et al.
    Patient Prefer Adherence, 2021;15:1913-1927.
    PMID: 34511887 DOI: 10.2147/PPA.S315543
    Background: Women with substance use disorders (SUDs) are a key population for HIV prevention with pre-exposure prophylaxis (PrEP), though uptake is limited by awareness of PrEP, misestimation of personal HIV risk, and minimally integrated HIV prevention and addiction treatment services. Patient-centered decision aids (DA) could address these barriers to PrEP, but no extant DA for PrEP has been published, including for women with SUDs.

    Methods: We developed a patient-centered PrEP DA for women in addiction treatment. In a pilot randomized preference trial, we compared the DA to enhanced standard of care (eSOC) providing standardized information. The primary outcome was opting to receive more information through the DA; we also assessed the impact of the DA on PrEP decisional preference and PrEP uptake over 12 months.

    Results: A total of 164 enrolled participants (DA: 83; eSOC: 81) were similar in terms of HIV risk and demographics, which are representative of women in addiction treatment programs nationally, and most (92%) had opioid use disorder. Half of participants were PrEP eligible, though 37% underestimated their personal HIV risk. Independent correlates of selecting the PrEP DA relative to eSOC included higher alcohol use severity (aOR 4.13, 95% CI 1.05-16.28, p=0.04) and perception of high risk for HIV (aOR 2.95, 95% CI 1.19-7.35, p=0.02). For those selecting the DA, interest in PrEP increased significantly from 25% to 89%. DA participants were also significantly more likely than eSOC participants to see a provider for PrEP during follow-up (15.7% vs 6.2%; p=0.05).

    Conclusion: Half of the women selected to use the DA, and those who did significantly increased their engagement in the HIV prevention cascade through increased interest in and initiation of PrEP. Future iterations should accelerate the HIV prevention cascade for women with SUDs by integrating PrEP decision aids into existing addiction treatment services and actively linking women to PrEP.

  10. Ahmedy F, Mohd Tuah N, Mohamad Hashim N, Sybil Shah S, Ahmedy I, Tan SF
    J Multidiscip Healthc, 2021;14:2391-2396.
    PMID: 34511922 DOI: 10.2147/JMDH.S320543
    Purpose: To collectively identify the clinical characteristics determining the risk of developing spasticity after stroke.

    Patients and Methods: A cross-sectional study was conducted at a single rehabilitation outpatient clinic from June to December 2019. Inclusion criteria were stroke duration of over four weeks, aged 18 years and above. Exclusion criteria were presence of concurrent conditions other than stroke that could also lead to spasticity. Recruited patients were divided into "Spasticity" and "No spasticity" groups. Univariate analysis was deployed to identify significant predictive spasticity factors between the two groups followed by a two-step clustering approach for determining group of characteristics that collectively contributes to the risk of developing spasticity in the "Spasticity" group.

    Results: A total of 216 post-stroke participants were recruited. The duration after stroke (p < 0.001) and the absence of hemisensory loss (p = 0.042) were two significant factors in the "Spasticity" group revealed by the univariate analysis. From a total of 98 participants with spasticity, the largest cluster of individuals (40 patients, 40.8%) was those within less than 20 months after stroke with moderate stroke and absence of hemisensory loss, while the smallest cluster was those within less than 20 months after severe stroke and absence of hemisensory loss (21 patients, 21.4%).

    Conclusion: Analyzing collectively the significant factors of developing spasticity may have the potential to be more clinically relevant in a heterogeneous post-stroke population that may assist in the spasticity management and treatment.

  11. Sari DK, Ichwan M, Masyithah D, Dharmajaya R, Khatib A
    J Multidiscip Healthc, 2021;14:2437-2444.
    PMID: 34511927 DOI: 10.2147/JMDH.S324774
    Purpose: Obesity that occurs in adulthood is influenced by various factors, not only energy balance, especially concerning the amount of energy consumed, but also heredity. The hereditary factors of obese parents on childhood obesity have been studied, but what about adulthood? This study examines the relationship between a history of obesity in adolescence, and maternal and paternal incidences of adult obesity.

    Patients and Methods: This study was a cross-sectional study that included adult men and women aged 20-60 years old. The subjects had no chronic or metabolic disease. This research was conducted from April to November, 2020, in North Sumatra Province, Indonesia. The parameters studied were demographics, daily food intake, anthropometry and a history of obesity in adolescence, and for the participants' fathers and mothers. The statistical test used was the chi-squared test/Fisher test.

    Results: This study included 136 research subjects, 60 male and 76 female; based on the results of the study, 47.8% were found to be obese, but food intake showed a low intake (96.2%). There was a significant relationship between a history of obesity in adolescence and incidences of obesity (≥30 kg/m2) in the mother and father, with significance values of p=0.01, p=0.004, and p=0.001, respectively.

    Conclusion: This study found that there was a significant relationship between a history of obesity in adolescence and incidences of adult obesity (≥ 30kg/m2) in parents, but not with the level of food intake per day. The risk of obesity will increase further with a history of obesity in parents and obesity in adolescence, and this can be used to understand and prevent obesity.

  12. Rasasoran DR, Atil A, Jeffree MS, Saupin S, Lukman KA
    Risk Manag Healthc Policy, 2021;14:3653-3658.
    PMID: 34512052 DOI: 10.2147/RMHP.S319858
    Introduction: Almost 90% of the reported occupational diseases in Sabah, Malaysian Borneo were due to hearing loss. The manufacturing industry was the main contributor to this problem. This study aims to identify the prevalence and associated factors for hearing loss among workers in the palm oil manufacturing industry in Sabah.

    Material and Methods: A cross-sectional study was done among 312 respondents from five palm oil mills in Sabah from January to April 2019. Audiometric tests, validated questionnaires and sound level meters were used. Chi-square test and independent t-test were conducted to determine the associated factors for hearing loss.

    Results: 75% (n = 234) of the respondents were diagnosed with hearing loss. Most of them were male (96.2%) with a mean age of 44.4 (SD 9.8) years, mean duration of employment of 16.2 (SD 9.7) years and mean noise exposure of 96.1 (SD 4.8) dB(A). The significant factors associated with hearing loss were older age (p = 0.001), married (p = 0.001), blue-collar jobs (p = 0.003), smoking (p = 0.001), works with noisy machinery (p = 0.005), lower level of noise exposed (p = 0.015), longer duration of employment (p = 0.001), and longer overtime hours per week (p = 0.001).

    Conclusion: The prevalence of hearing loss among workers in the noise-exposed palm oil industries was high. Annual audiometry testing and job rotation from noise-exposed workstations were recommended. A smoking cessation program may help but reduction of noise from the source by engineering control is still the best method.

  13. Hroneš M, Leong-Škorničková J, Niissalo MA, Dančák M
    PhytoKeys, 2021;181:9-19.
    PMID: 34512094 DOI: 10.3897/phytokeys.181.69045
    Hanguanadeflexa sp. nov. (Hanguanaceae) from Lawas district, Sarawak, Malaysia (northern Borneo) is described and illustrated, bringing the total number of species in Borneo to eight. The new species differs from all other recognized Hanguana species by a combination of flat leaf blade, deflexed infructescences, one-seeded dull red fruits with centrally positioned stigma and globose seed with wedge-shaped ostiole. Revised key for Bornean Hanguana species is presented.
  14. Nour Azimah Z, Abdullah JM
    Malays J Med Sci, 2021 Aug;28(4):1-4.
    PMID: 34512125 DOI: 10.21315/mjms2021.28.4.1
    In this Editorial, we report on the trend of manuscript submissions during the peak of COVID-19 pandemic in 2020. The total monthly new manuscript submissions from 2018 to 2020 were compared to examine the overall trends in submission and publication activities. Apart from that, we also report on the changes in the journal's administration and the external recognition received by the journal.
  15. Kadharusman MM, Antarianto RD, Hardiany NS
    Malays J Med Sci, 2021 Aug;28(4):5-13.
    PMID: 34512126 DOI: 10.21315/mjms2021.28.4.2
    Calorie restriction (CR) prolongs lifespan in various species and also minimises pathologies caused by aging. One of the characteristics seen in age-related pathologies is stem cell exhaustion. Here, we review the various impacts of CR on mammalian health mediated through stem cell potency in various tissues. This study comprised of a literature search through NCBI, Science Direct, Google Scholar and PubMed, focusing on the impact of CR on pluripotency. In the skeletal muscle, CR acts as an anti-inflammatory agent and increases the presence of satellite cells endogenously to improve regeneration, thus causing a metabolic shift to oxidation to meet oxygen demand. In the intestinal epithelium, CR suppresses the mechanistic target of rapamycin complex 1 (mTORC1) signalling in Paneth cells to shift the stem cell equilibrium towards self-renewal at the cost of differentiation. In haematopoiesis, CR prevents deterioration or maintains the function of haematopoietic stem cells (HSCs) depending on the genetic variation of the mice. In skin and hair follicles, CR increases the thickness of the epidermis and hair growth and improves hair retention through stem cells. CR mediates the proliferation and self-renewal of stem cells in various tissues, thus increasing its regenerative ability.
  16. Nik Ramli NN, Asokan A, Mayakrishnan D, Annamalai H
    Malays J Med Sci, 2021 Aug;28(4):14-23.
    PMID: 34512127 DOI: 10.21315/mjms2021.28.4.3
    Ranked as the second leading cause of death and the primary factor to adult disability worldwide, stroke has become a global epidemic problem and burden. As a developing country, Malaysia still faces challenges in providing ideal rehabilitation services to individuals with physical disabilities including stroke survivors. Conventional post-stroke care is often delivered in a team-based approach and involves several disciplines, such as physical therapy, occupational therapy, speech and language therapy, depending on the nature and severity of the deficits. Robots are potential tools for stroke rehabilitation as they can enhance existing conventional therapy by delivering a precise and consistent therapy of highly repetitive movements. In addition, robot-assisted physiotherapy could facilitate the effectiveness of unsupervised rehabilitation and thus, may reduce the cost and duration of therapist-assisted rehabilitation. Research on robot-assisted physiotherapy for stroke in Malaysia is slowly coming into the limelight in the past two decades. This review explores the effectiveness of robot-assisted physiotherapy particularly in improving motor functions of stroke survivors in Malaysia.
  17. Jalil MTM, Ibrahim D
    Malays J Med Sci, 2021 Aug;28(4):24-36.
    PMID: 34512128 DOI: 10.21315/mjms2021.28.4.4
    BACKGROUND: The emergence of multidrug-resistant pathogens associated with biofilm formation can cause life-threatening infections to humans. Therefore, the present study aims to evaluate the effects of the fungal extract of Lasiodiplodia pseudotheobromae (L. pseudotheobromae) Industrial Biotechnology Research Laboratory (IBRL) OS-64 on bacterial cells and the biofilm formation of methicillin-resistant Staphylococcus aureus (MRSA).

    METHODS: Broth microdilution and semi-quantitative adherence assays were conducted to determine the anti-biofilm activity of the fungal extract. Light and scanning electron microscopy (SEM) analyses were performed to observe the effect of the fungal extract on biofilm formation by MRSA.

    RESULTS: The transmission electron microscopy (TEM) microphotographs showed that the bacterial cells were severely damaged upon 24 h exposure to the extract and displayed several symptoms such as cell shrinkage and breakage. Meanwhile, results from the antibiofilm study indicated the extract attenuated the initial and preformed biofilms of MRSA by 80.82% and 61.39%, respectively. The initial biofilm was more sensitive to the extract compared to the pre-formed biofilm, as evidenced by the light microscopy and SEM observations that demonstrated more severe bacterial cell damage on the initial biofilms compared to pre-formed biofilms.

    CONCLUSION: The ethyl acetate extract of L. pseudotheobromae IBRL OS-64 significantly inhibited bacterial cells growth and eliminated biofilm formation by MRSA.

  18. Eremwanarue OA, Nwawuba SU, Shittu OH
    Malays J Med Sci, 2021 Aug;28(4):37-49.
    PMID: 34512129 DOI: 10.21315/mjms2021.28.4.5
    Background: Pseudomonas aeruginosa (P. aeruginosa) is prevalent in hospital-acquired surgical wound infections. It exhibits both innate and acquired resistance to a broad range of antimicrobials and remains a principal problem in clinical practice.

    Methods: In total, 284 sterile surgical wound swabs (142 each) were collected from two government hospitals: Central Hospital Benin (CHB) and University of Benin Teaching Hospital (UBTH) in Benin City, Nigeria. Pseudomonas spp. isolated from both hospitals were screened with eight different antibiotics by way of disk diffusion method. Polymerase chain reaction (PCR) amplification of 34 multiple drug-resistant isolates was carried out using genus-specific primer set on extracted genomic DNA for the identification of Pseudomonas spp. and substituent 16S rRNA sequencing to determine the prevailing strains in the two locations.

    Results: Sixty-two Pseudomonas spp. were isolated from the two locations (27 isolates from CHB and 35 isolates from the UBTH). Surgical wound infections screened with regularly used antibiotics revealed that 17 (62.9%) isolates from CHB and 20 (57.1%) isolates from UBTH were multiple drug resistant Pseudomonas spp. PCR identification using Pseudomonas spp. specific primer showed that 16 (94.1%) isolates from CHB and 18 (90%) isolates from UBTH were confirmed. The 16S DNA sequencing revealed that P. aeruginosa strain H25883 was dominant in both locations.

    Conclusion: High antibiotic resistance among P. aeruginosa isolates was established in our study. PCR technique revealed a more reliable method of bacterial identification. H25883 strain of P. aeruginosa is the prevalent strain in both locations and it should be given attention in nosocomial surgical wound infections.

  19. Joodaki M, Radahmadi M, Alaei H
    Malays J Med Sci, 2021 Aug;28(4):50-62.
    PMID: 34512130 DOI: 10.21315/mjms2021.28.4.6
    Background: Depression affects various brain functions. According to previous studies, escitalopram influences brain functions in depression and crocin reduces memory impairments. Therefore, this study aimed to compare the therapeutic effects of using crocin and escitalopram (separately and in combination) on learning and memory in rats with stress-induced depression.

    Methods: Fifty-six rats were allocated into seven groups of control, sham, continuous depression, recovery period, daily injections of escitalopram, crocin and escitalopram-crocin during 14 days after inducing depression by stress. Passive avoidance (PA) test was used to assess brain functions.

    Results: Latency has significant differences in depression group. Also, it significantly increased in depression-crocin, depression-escitalopram and depression-escitalopram-crocin groups compared to the depression group. The dark stay (DS) time was significantly higher in the depression and depression-recovery groups. However, the DS time significantly decreased in the depression-crocin, depression-escitalopram and depression-escitalopram-crocin groups. Furthermore, the number of entrances to the dark room was significantly lower in depression-crocin and depression-escitalopram-crocin groups compared to the depression one.

    Conclusion: Different depression treatments (i.e. crocin, escitalopram and crocin-escitalopram) reduced depression-induced memory deficits. Crocin and escitalopram-crocin, respectively, improved brain functions and locomotor activity more than escitalopram. Comparatively, in subjects with depression, crocin, which is an effective saffron constituent, partially affected the memory deficits better than escitalopram (as a chemical component).

  20. Ismail MI, Idris Z, Abdullah JM, Rahman NAA, Nordin M
    Malays J Med Sci, 2021 Aug;28(4):63-70.
    PMID: 34512131 DOI: 10.21315/mjms2021.28.4.7
    Background: Patients with severe traumatic brain injury (TBI) were expected to have poor Glasgow Coma Scale (GCS) recovery and prolonged intubation. Therefore, an early tracheostomy procedure was indicated for all severe TBI. In view of growing concern regarding the safety and outcome of early tracheostomy on these patients, it was deemed valid and needed to be addressed.

    Methods: This study was conducted to compare the outcomes of early and late tracheostomies in severe TBI. Only severe TBI patients who were admitted to the Neurosurgery High Dependency Unit (NHDU), Hospital Sultanah Aminah (HSA), Johor Bahru, Johor, Malaysia and who had underwent a tracheostomy were recruited. Three main outcomes noted: duration on ventilation, length of NHDU stay and rate of ventilator associated pneumonia (VAP).

    Results: Out of 155 patients, 72 (46.5%) were in early tracheostomy group (ETG) and 83 (53.5%) were in late tracheostomy group (LTG). The majority of the participants, 95 (61.3%) were ethnic Malays. The mean duration on ventilator use was 2.65 days (1.57) for ETG and 5.63 days (2.35) for LTG. While, mean NHDU stay was 4.75 days (1.98) for ETG and 9.77 days (2.70) for LTG. Upon independent t-test, early duration of tracheostomies had shown significant outcome in reducing length of NHDU stay, (P < 0.001) and had shortening participants' time on mechanical ventilator (P < 0.001). Then, based on forward multiple logistic regression test, there were significant association between comorbid (P = 0.003) and tracheostomy (P = 0.020) towards presence of VAP when adjusted for other variables.

    Conclusion: In this study it was found that early tracheostomy was significant in shortening the duration on ventilator, reducing the length of NHDU stay and reducing the rate of VAP.

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