Browse publications by year: 2021

  1. Khor BH, Tiong HC, Tan SC, Wong SK, Chin KY, Karupaiah T, et al.
    PLoS One, 2021;16(7):e0255205.
    PMID: 34297765 DOI: 10.1371/journal.pone.0255205
    Studies investigating the effects of tocotrienols on inflammation and oxidative stress have yielded inconsistent results. This systematic review and meta-analysis aimed to evaluate the effects of tocotrienols supplementation on inflammatory and oxidative stress biomarkers. We searched PubMed, Scopus, and Cochrane Central Register of Controlled Trials from inception until 13 July 2020 to identify randomized controlled trials supplementing tocotrienols and reporting circulating inflammatory or oxidative stress outcomes. Weighted mean difference (WMD) and corresponding 95% confidence interval (CI) were determined by pooling eligible studies. Nineteen studies were included for qualitative analysis, and 13 studies were included for the meta-analyses. A significant reduction in C-reactive protein levels (WMD: -0.52 mg/L, 95% CI: -0.73, -0.32, p < 0.001) following tocotrienols supplementation was observed, but this finding was attributed to a single study using δ-tocotrienols, not mixed tocotrienols. There were no effects on interleukin-6 (WMD: 0.03 pg/mL, 95% CI: -1.51, 1.58, p = 0.966), tumor necrosis factor-alpha (WMD: -0.28 pg/mL, 95% CI: -1.24, 0.68, p = 0.571), and malondialdehyde (WMD: -0.42 μmol/L, 95% CI: -1.05, 0.21, p = 0.189). A subgroup analysis suggested that tocotrienols at 400 mg/day might reduce malondialdehyde levels (WMD: -0.90 μmol/L, 95% CI: -1.20, -0.59, p < 0.001). Future well-designed studies are warranted to confirm the effects of tocotrienols on inflammatory and oxidative stress biomarkers, particularly on different types and dosages of supplementation. PROSPERO registration number: CRD42020198241.
    MeSH terms: Adult; Anti-Inflammatory Agents/administration & dosage; Anti-Inflammatory Agents/pharmacology*; Antioxidants/administration & dosage; Antioxidants/pharmacology*; Female; Humans; Male; Middle Aged; Vitamins/administration & dosage; Vitamins/pharmacology*; Biomarkers/blood; Randomized Controlled Trials as Topic; Oxidative Stress/drug effects; Dietary Supplements; Tocotrienols/administration & dosage; Tocotrienols/pharmacology*
  2. Aghamiri S, Zandsalimi F, Raee P, Abdollahifar MA, Tan SC, Low TY, et al.
    Pharmacol Res, 2021 09;171:105777.
    PMID: 34298112 DOI: 10.1016/j.phrs.2021.105777
    Breast cancer is the most common and deadliest cancer in women worldwide. Although notable advances have been achieved in the treatment of breast cancer, the overall survival rate of metastatic breast cancer patients is still considerably low due to the development of resistance to breast cancer chemotherapeutic agents and the non-optimal specificity of the current generation of cancer medications. Hence, there is a growing interest in the search for alternative therapeutics with novel anticancer mechanisms. Recently, antimicrobial peptides (AMPs) have gained much attention due to their cost-effectiveness, high specificity of action, and robust efficacy. However, there are no clinical data available about their efficacy. This warrants the increasing need for clinical trials to be conducted to assess the efficacy of this new class of drugs. Here, we will focus on the recent progress in the use of AMPs for breast cancer therapy and will highlight their modes of action. Finally, we will discuss the combination of AMP-based therapeutics with other breast cancer therapy strategies, including nanotherapy and chemotherapy, which may provide a potential avenue for overcoming drug resistance.
  3. Wong XY, Quesada-González D, Manickam S, Muthoosamy K
    Anal Chim Acta, 2021 Aug 29;1175:338745.
    PMID: 34330444 DOI: 10.1016/j.aca.2021.338745
    Metal ions homeostasis plays an important role in biological processes. The ability to detect the concentration of metal ions in biological fluids is often challenged by the obvious interference or competitive binding nature of other alkaline metals ions. Common analytical techniques employed for metal ions detection are electrochemical, fluorescence and colorimetric methods. However, most reported metal ions sensors are complicated, time-consuming and involve costly procedures with limited effectiveness. Herein, a nanobiosensor for detecting sodium and potassium ions using folic acid-functionalised reduced graphene oxide-modified RNase A gold nanoclusters (FA-rGO-RNase A/AuNCs) based on fluorescence "turn-off/turn-on" is presented. Firstly, a facile and optimised protocol for the fabrication of RNase A/AuNCs is developed. The activity of RNase A protein after the formation of RNase A/AuNCs is studied. RNase A/AuNCs is then loaded onto FA-rGO, in which FA-rGO is used as a potential carrier and fluorescence quencher for RNase A/AuNCs. Finally, a fluorescence "turn-on" sensing strategy is developed using the as-synthesised FA-rGO-RNase A/AuNCs to detect sodium and potassium ions. The developed nanobiosensor revealed an excellent sensing performance and meets the sensitivity required to detect both sodium and potassium ions. To the best of our knowledge, this is the first work done on determining the RNase A protein activity in RNase A/AuNCs and exploring the potential application of RNase A/AuNCs as a metal ion sensor. This work serves as a proof-of-concept for combining the potential of drug delivery, active targeting and therapy on cancer cells, as well as biosensing of metal ions into a single platform.
    MeSH terms: Folic Acid; Gold; Graphite; Ions; Spectrometry, Fluorescence; Biosensing Techniques*; Metal Nanoparticles*
  4. Mathiesen ER, Ali N, Alibegovic AC, Anastasiou E, Cypryk K, de Valk H, et al.
    Diabetes Care, 2021 09;44(9):2069-2077.
    PMID: 34330786 DOI: 10.2337/dc21-0472
    OBJECTIVE: To compare the risk of severe adverse pregnancy complications in women with preexisting diabetes.

    RESEARCH DESIGN AND METHODS: Multinational, prospective cohort study to assess the prevalence of newborns free from major congenital malformations or perinatal or neonatal death (primary end point) following treatment with insulin detemir (detemir) versus other basal insulins.

    RESULTS: Of 1,457 women included, 727 received detemir and 730 received other basal insulins. The prevalence of newborns free from major congenital malformations or perinatal or neonatal death was similar between detemir (97.0%) and other basal insulins (95.5%) (crude risk difference 0.015 [95% CI -0.01, 0.04]; adjusted risk difference -0.003 [95% CI -0.03, 0.03]). The crude prevalence of one or more congenital malformations (major plus minor) was 9.4% vs. 12.6%, with a similar risk difference before (-0.032 [95% CI -0.064, 0.000]) and after (-0.036 [95% CI -0.081, 0.009]) adjustment for confounders. Crude data showed lower maternal HbA1c during the first trimester (6.5% vs. 6.7% [48 vs. 50 mmol/mol]; estimated mean difference -0.181 [95% CI -0.300, -0.062]) and the second trimester (6.1% vs. 6.3% [43 vs. 45 mmol/mol]; -0.139 [95% CI -0.232, -0.046]) and a lower prevalence of major hypoglycemia (6.0% vs. 9.0%; risk difference -0.030 [95% CI -0.058, -0.002]), preeclampsia (6.4% vs. 10.0%; -0.036 [95% CI -0.064, -0.007]), and stillbirth (0.4% vs. 1.8%; -0.013 [95% CI -0.024, -0.002]) with detemir compared with other basal insulins. However, differences were not significant postadjustment.

    CONCLUSIONS: Insulin detemir was associated with a similar risk to other basal insulins of major congenital malformations, perinatal or neonatal death, hypoglycemia, preeclampsia, and stillbirth.

    MeSH terms: Insulin Detemir/adverse effects; Blood Glucose; Diabetes Mellitus*; Female; Hemoglobin A, Glycosylated/analysis; Humans; Hypoglycemic Agents/adverse effects; Infant, Newborn; Pregnancy; Prospective Studies; Pregnant Women; Insulin, Long-Acting; Perinatal Death*
  5. Ibrahim NA, Alimon AR, Yaakub H, Samsudin AA, Candyrine SCL, Wan Mohamed WN, et al.
    Trop Anim Health Prod, 2021 Jul 31;53(4):422.
    PMID: 34331142 DOI: 10.1007/s11250-021-02863-4
    Understanding the nature of ruminant nutrition and digestion is essential to improve feeding management and animal production. Among many approaches, manipulating ruminant nutrition and fermentation through feed supplementation is being practised and researched. Over the last decade, the utilization of vegetable oils in feed formulation and their effects on various aspects of ruminants have been reported by many researchers. It is important to understand the lipid metabolism in ruminants by microorganisms because it affects the quality of ruminant-derived products such as meat and milk. Majority of vegetable oil supplementation could reduce rumen protozoa population in ruminants due to the effects of medium-chain fatty acids (FAs). However, vegetable oil also contains unsaturated FAs that are known to have a negative effect on cellulolytic bacteria which could show inhibitory effects of the fibre digestion. In this paper, the physiology of nutrient digestion of ruminants is described. This paper also provides a current review of studies done on improvement and modification of rumen fermentation and microbial population through vegetable oil supplementation.
    MeSH terms: Animals; Animal Feed/analysis; Diet/veterinary; Digestion; Fermentation; Ruminants; Dietary Supplements
  6. Karkada G, Maiya GA, Arany P, Rao M, Adiga S, Kamath SU
    Cell Biochem Biophys, 2021 Jul 30.
    PMID: 34331219 DOI: 10.1007/s12013-021-01021-9
    BACKGROUND: Prolonged and overlapping phases of wound healing in diabetes are mainly due to the redox imbalance resulting in the chronicity of the wound. Photobiomodulation therapy works on the principle of absorption of photon energy and its transduction into a biological response in the living tissue. It alleviates the cellular responses, thereby improving the mechanism of wound healing in diabetes.

    OBJECTIVE: To find out the effect of photobiomodulation therapy of dosage 4 J/cm2 in the healing dynamics of diabetic neuropathic wounds in Wistar rats and its relation with oxidative stress markers.

    METHODOLOGY: Diabetes was induced using Streptozotocin of 60 mg/kg of body weight to eighteen female Wistar rats. Neuropathy was induced by the sciatic nerve crush injury followed by an excisional wound of 2 cm2 on the back of the animal. Experimental group animals were treated with dosage 4 J/cm2 of wavelength 655 and 808 nm, and control group animals were kept unirradiated. The biomechanical, histopathological, and biochemical changes were analysed in both groups.

    RESULTS: There was a reduction in mean wound healing time and an increased rate of wound contraction in the experimental group animals compared to its control group. The experimental group showed improved redox status, and histopathological findings revealed better proliferative cells, keratinisation, and epithelialization than un-irradiated controls.

    CONCLUSIONS: Photobiomodulation therapy of dosage 4 J/cm2 enhanced the overall wound healing dynamics of the diabetes-induced neuropathic wound and optimised the oxidative status of the wound, thereby facilitating a faster healing process.

  7. Ehteram M, Sammen SS, Panahi F, Sidek LM
    Environ Sci Pollut Res Int, 2021 Dec;28(46):66171-66192.
    PMID: 34331228 DOI: 10.1007/s11356-021-15223-4
    The agricultural sector is one of the most important sources of CO2 emissions. Thus, the current study predicted CO2 emissions based on data from the agricultural sectors of 25 provinces in Iran. The gross domestic product (GDP), the square of the GDP (GDP2), energy use, and income inequality (Gini index) were used as the inputs. The study used support vector machine (SVM) models to predict CO2 emissions. Multiobjective algorithms (MOAs), such as the seagull optimization algorithm (MOSOA), salp swarm algorithm (MOSSA), bat algorithm (MOBA), and particle swarm optimization (MOPSO) algorithm, were used to perform three important tasks for improving the SVM models. Additionally, an inclusive multiple model (IMM) used the outputs of the MOSOA, MOSSA, MOBA, and MOPSO algorithms as the inputs for predicting CO2 emissions. It was observed that the best kernel function based on the SVM-MOSOA was the radial function. Additionally, the best input combination used all the gross domestic product (GDP), squared GDP (GDP2), energy use, and income inequality (Gini index) inputs. The results indicated that the quality of the obtained Pareto front based on the MOSOA was better than those of the other algorithms. Regarding the obtained results, the IMM model decreased the mean absolute errors of the SVM-MOSOA, SVM-MOSSA, SVM-MOBA, and SVM-PSO models by 24, 31, 69, and 76%, respectively, during the training stage. The current study showed that the IMM model was the best model for predicting CO2 emissions.
  8. Ong MF, Soh KL, Saimon R, Wai MW, Mortell M, Soh KG
    J Nurs Manag, 2021 Nov;29(8):2674-2688.
    PMID: 34331491 DOI: 10.1111/jonm.13434
    OBJECTIVES: This review aims to identify types of the existing fall prevention education (FPE) and their effectiveness in promoting fall risk awareness, knowledge and preventive fall behaviour change among community-dwelling older people.

    BACKGROUND: FPE is a cost-effective and helpful tool for reducing fall occurrences.

    EVALUATION: This is a systematic review study using electronic searches via EBSCOHost® platform, ScienceDirect, Scopus and Google Scholar in March 2021. The review protocol was registered with PROSPERO (CRD42021232102). The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement flow chart guided the search strategy. Articles published from January 2010 to March 2021 were included for quality appraisal using the 'Transparent Reporting of Evaluations with Non-randomised Designs' (TREND) and the 'Consolidated Standards of Reporting Trials' (CONSORT) statement for randomised controlled trial studies.

    KEY ISSUES: Six FPE studies selected emphasised on personal health status, exercise and environmental risk factors. These studies reported an increase in fall risk awareness or knowledge and a positive change in fall preventive behaviours. Two studies included nurses as educators in FPE.

    CONCLUSION: FPE evidently improved awareness or knowledge and preventive fall behaviour change among older adults. Nurses are in great potential in planning and providing FPE for older adults in community settings.

    IMPLICATIONS FOR NURSING MANAGEMENT: Expand nurses' roles in fall prevention programmes in community settings by using high-quality and evidence-based educational tools. Highlight the nurse's role and collaborative management in FPE.

    MeSH terms: Aged; Humans; Controlled Clinical Trials as Topic; Nurse's Role; Independent Living*
  9. Chu SY, Foong JH, Lee J, Ben-David BM, Barlow SM, Hsu C
    PMID: 34331497 DOI: 10.1111/1460-6984.12653
    BACKGROUND: It is unclear whether oral diadochokinetic rate (oral-DDK) performance is affected by different languages within a multilingual country.

    AIMS: This study investigated the effects of age, sex, and stimulus type (real word in L1, L2 vs. non-word) on oral-DDK rates among healthy Malaysian-Malay speakers in order to establish language- and age-sensitive norms. The second aim was to compared the nonword 'pataka' oral-DDK rates produced by Malaysian-Malay speakers on currently available normative data for Hebrew speakers and Malaysian-Mandarin speakers.

    METHODS & PROCEDURES: Oral-DDK performance of 90 participants (aged 20-77 years) using nonword ('pataka'), Malay real word ('patahkan'), and English real word ('buttercake') was audio recorded. The number of syllables produced in 8 seconds was calculated. Mixed analysis of variance (ANOVA) was conducted to examine the effects of stimulus type (nonword, Malay, and English real word), sex (male, female), age (younger, 20-40 years; middle, 41-60 years; older, ≥61 years), and their interactions on the oral-DDK rate. Data obtained were also compared with the raw data of Malaysian-Mandarin and Hebrew speakers from the previous studies.

    OUTCOMES & RESULTS: A normative oral-DDK rate has been established for healthy Malaysian-Malay speakers. The oral-DDK rate was significantly affected by stimuli (p 

  10. Suardi N, Khaniabadi PM, Taggo A, Zulbaharin SFM, Azman DKM, Gemanam SJ
    Lasers Med Sci, 2021 Jul 31.
    PMID: 34331605 DOI: 10.1007/s10103-021-03384-0
    Breast cancer is responsible for one of the top leading causes of cancer deaths among women. Radiotherapy (RT) uses high energy radiation to kill cancer cells, but this method has been reportedly linked to risks of toxicity. Post-therapeutic relapse from RT believed to be caused by its toxicity is one of the challenges encountered during tumour therapy. Therefore, further attention should be devoted to developing novel anti-tumour therapeutic approaches. The role of low-level laser therapy (LLLT) in breast cancer management is to alleviate the side effects arising from RT, instead of acting against the tumour cells directly. This study investigated the effects of low-level laser (532 nm), as well as single and fractionated irradiation, on breast cancer MCF 7 cell line. Additionally, this study assessed the most effective laser parameter for fractionated irradiation. The MCF 7 cells were irradiated with green laser power at 1.5, 45.0, and 100.0 mW with a spot size diameter of 0.7 mm for 1, 5, 10, and 15 min. The irradiation was carried out in single, double, and triple fractionation separated by 5- and 10-min intervals in between the fractional regimes. The laser output of 100 mW showed a promising potential in killing cells with single fractionation. However, as the irradiation was fractionated into two, power of 1.5 mW appeared to be more effective in cell death, which contributed to the lowest percentage cells viable of 31.4% recorded in the study. It was proven that fractionated regime was more successful in tumour cell death.
  11. Subramaniam S, Anandha Rao JS, Ramdas P, Ng MH, Kannan Kutty M, Selvaduray KR, et al.
    Clin Exp Immunol, 2021 Nov;206(2):161-172.
    PMID: 34331768 DOI: 10.1111/cei.13650
    Gamma-tocotrienol (γT3) is an analogue of vitamin E with beneficial effects on the immune system, including immune-modulatory properties. This study reports the immune-modulatory effects of daily supplementation of γT3 on host T helper (Th) and T regulatory cell (Treg ) populations in a syngeneic mouse model of breast cancer. Female BALB/c mice were fed with either γT3 or vehicle (soy oil) for 2 weeks via oral gavage before they were inoculated with syngeneic 4T1 mouse mammary cancer cells (4T1 cells). Supplementation continued until the mice were euthanized. Mice (n = 6) were euthanized at specified time-points for various analysis (blood leucocyte, cytokine production and immunohistochemistry). Tumour volume was measured once every 7 days. Gene expression studies were carried out on tumour-specific T lymphocytes isolated from splenic cultures. Supplementation with γT3 increased CD4+ (p 
  12. Reginald K, Wong YR, Shah SMR, Teh KF, Freddy Jalin EJ, Khan NA
    Microbes Infect, 2021 07 28;23(9-10):104876.
    PMID: 34332091 DOI: 10.1016/j.micinf.2021.104876
    BACKGROUND: Insects models are excellent models of the innate immune system, as they are free from the influences of vertebrate adaptive immunity. Crickets are hemimetabolous insects belonging to the order Orthopteran order that have not been as extensively characterized as other holometabolous insects, and may provide new insights into the insect immune responses. In this study, we aim to characterize the innate immune responses of the common house cricket, Acheta domesticus in response to a human pathogenic bacterium E. coli K1.

    METHODS: Crickets were injected with sterile buffer, live E. coli K1 or heat-killed E. coli K1. Physiological effects such as mortality and weight change of the crickets were determined 24-, 48- and 72-h post injection while immunological effects such as hemocyte counts, bacteremia, phenoloxidase and lysozyme activity of the crickets were measured at 2- and 24-h post-injection.

    RESULTS: The injection of E. coli K1 in crickets resulted in >85% mortality 3-days post injection, accompanied by significant weight loss. E. coli K1 injection caused a significant increase in both phenoloxidase and lysozyme activities in cricket hemolymphs 24-h post injection. Live E. coli K1 injected crickets resulted in a significant reduction in circulating hemocytes 24-h post injection which was not observed in other treatment groups. This was consistent with the resolution of bacteremia observed 24-h post infection in live E. coli K1 injected crickets.

    CONCLUSION: Our study provides new insights on the innate immune response to pathogenic E. coli K1 in a cricket model.

  13. Yang CL, Chao YJ, Wang HC, Hou YC, Chen CG, Chang CC, et al.
    Nanomedicine, 2021 10;37:102450.
    PMID: 34332115 DOI: 10.1016/j.nano.2021.102450
    Epigenetic inhibitors have shown anticancer effects. Combination chemotherapy with epigenetic inhibitors has shown high effectiveness in gastric cancer clinical trials, but severe side effect and local progression are the causes of treatment failure. Therefore, we sought to develop an acidity-sensitive drug delivery system to release drugs locally to diminish unfavorable outcome of gastric cancer. In this study, we showed that, as compared with single agents, combination treatment with the demethylating agent 5'-aza-2'-deoxycytidine and HDAC inhibitors Trichostatin A or LBH589 decreased cell survival, blocked cell cycle by reducing number of S-phase cells and expression of cyclins, increased cell apoptosis by inducing expression of Bim and cleaved Caspase 3, and reexpressed tumor suppressor genes more effectively in MGCC3I cells. As a carrier, reconstituted apolipoprotein B lipoparticles (rABLs) could release drugs in acidic environments. Orally administrated embedded drugs not only showed inhibitory effects on gastric tumor growth in a syngeneic orthotopic mouse model, but also reduced the hepatic and renal toxicity. In conclusion, we have established rABL-based nanoparticles embedded epigenetic inhibitors for local treatment of gastric cancer, which have good therapeutic effects but do not cause severe side effects.
    MeSH terms: Acids/metabolism; Animals; Apolipoproteins B/genetics; Apolipoproteins B/pharmacology*; Apolipoproteins B/chemistry; Cell Survival/drug effects; Humans; Hydroxamic Acids/pharmacology; Liposomes/pharmacology*; Liposomes/chemistry; Stomach Neoplasms/genetics; Stomach Neoplasms/pathology; Stomach Neoplasms/therapy*; Gene Expression Regulation, Neoplastic/genetics; S Phase/drug effects; Drug Delivery Systems*; Apoptosis/drug effects; Epigenesis, Genetic/drug effects*; Epigenesis, Genetic/genetics; Cell Line, Tumor; Cell Proliferation/drug effects; Mice; Nanoparticles/chemistry; Histone Deacetylase Inhibitors/pharmacology; Bcl-2-Like Protein 11/genetics
  14. Keating SE, Blumer M, Grismer LL, Lin A, Nielsen SV, Thura MK, et al.
    Genes (Basel), 2021 01 19;12(1).
    PMID: 33477871 DOI: 10.3390/genes12010116
    Lizards and snakes (squamates) are known for their varied sex determining systems, and gecko lizards are especially diverse, having evolved sex chromosomes independently multiple times. While sex chromosomes frequently turnover among gecko genera, intrageneric turnovers are known only from Gekko and Hemidactylus. Here, we used RADseq to identify sex-specific markers in two species of Burmese bent-toed geckos. We uncovered XX/XY sex chromosomes in Cyrtodactylus chaunghanakwaensis and ZZ/ZW sex chromosomes in Cyrtodactylus pharbaungensis. This is the third instance of intrageneric turnover of sex chromosomes in geckos. Additionally, Cyrtodactylus are closely related to another genus with intrageneric turnover, Hemidactylus. Together, these data suggest that sex chromosome turnover may be common in this clade, setting them apart as exceptionally diverse in a group already known for diverse sex determination systems.
    MeSH terms: Animals; Female; Lizards/genetics*; Male; Phylogeny; Sex Chromosomes/genetics*; Sequence Analysis, DNA/methods; Sex Determination Processes/genetics*
  15. Ng JYM, Lim TW, Tarib N, Ho TK
    Health Informatics J, 2021 7 31;27(3):14604582211035821.
    PMID: 34325550 DOI: 10.1177/14604582211035821
    This study aimed to evaluate the effect of a novel progressive web application (PWA) on the patient's oral and denture knowledge and hygiene. Fifty-two removable partial denture wearers were randomised to receive education using the PWA, or verbal instructions accompanied by demonstration of hygienic procedures. Changes in the participants' knowledge score, plaque index, gingival index and denture plaque was evaluated during a follow-up period of 3 months. The participants' acceptance of PWA was explored through usage logs and a feedback form. Both groups showed significant improvement in knowledge scores, oral and denture hygiene indices (p < 0.001) after education. The PWA group demonstrated significantly lower gingival index score than control (p = 0.008) at the third month review. In conclusion, there is potential of using mobile application in educating elderly patients and the PWA is a viable option for providing post-denture delivery instructions.
    MeSH terms: Aged; Denture, Partial, Removable*; Humans; Hygiene; Oral Hygiene*
  16. Shah A, Ong CE, Pan Y
    Curr Drug Metab, 2021;22(9):698-708.
    PMID: 34325630 DOI: 10.2174/1389200222666210729115151
    BACKGROUND: In recent years, the significance of cytochrome P450 enzymes (CYPs) has expanded beyond their role in the liver. Factors such as genetics, environmental toxins, drug biotransformation and underlying diseases mediate the expression of these enzymes. Among the CYP enzymes, CYP2E1, a well-recognized monooxygenase enzyme involved in the metabolism of various endogenous and exogenous substances, plays a crucial role in the brain concerning the development of Parkinson's disease. The expression of CYP2E1 varies in different brain regions making certain regions more vulnerable than others. CYP2E1 expression is inducible which generates tissuedamaging radicals leading to oxidative stress, mitochondrial dysfunction and ultimately neurodegeneration.

    OBJECTIVE: Less is understood about the role of CYP2E1 in the central nervous system, therefore the purpose of the study was to investigate the relationship between the expression and activity of CYP2E1 enzyme relevant to Parkinson's disease and to identify whether an increase in the expression of CYP2E1 is associated with neurodegeneration.

    METHODS: The objectives of the study were achieved by implicating an unsystematic integrative literature review approach in which the literature was qualitatively analysed, critically evaluated and a new theory with an overall view of the mechanism was presented.

    RESULTS: The contribution of CYP2E1 in the development of Parkinson's disease was found to be significant as the negative effects of CYP2E1 overshadowed its protective detoxifying role.

    CONCLUSION: Overexpression of CYP2E1 seems detrimental to dopaminergic neurons, therefore, to overcome this, a synthetic biochemical is required, which paves the way for further research and development of valuable biomolecules.

    MeSH terms: Brain/metabolism*; Gene Expression Regulation; Humans; Cytochrome P-450 CYP2E1/metabolism*; Drug Discovery; Dopaminergic Neurons/metabolism
  17. Zakaria NF, Ahmad NI, Mokhtar E, Zukiman WZHHW, Shah AM
    J Med Case Rep, 2021 Jul 30;15(1):420.
    PMID: 34325745 DOI: 10.1186/s13256-021-02895-2
    BACKGROUND: Patients who undergo peritoneal dialysis (PD) are at risk of gut bacteria translocation leading to peritonitis when there is chronic diarrhea. Chronic diarrhea is defined as any course of diarrhea that lasts at least 4 weeks, which can be continuous or intermittent. Chronic diarrhea of any duration may cause dehydration, electrolyte imbalance, and life-threatening hypovolemic shock. In PD patients, excessive ultrafiltration from the exchanges, combined with severe gastrointestinal loss, may cause hypovolemic shock, electrolyte imbalance, and metabolic acidosis. There are multiple causes of chronic diarrhea in PD patients including infective causes, mitotic lesions, and rarely the regular and excessive use of laxatives, which is a diagnosis of exclusion.

    CASE PRESENTATION: We report a case of Melanau lady with chronic diarrhea secondary to laxative usage in a patient being treated with automated peritoneal dialysis (APD). The patient went into hypovolemic shock, but luckily did not contract peritonitis. A colonoscopy revealed brown to black discoloration of the colon, a feature suggestive of melanosis coli. A biopsy of the intestine further confirmed the diagnosis by histopathological examination. Withdrawal of laxatives and the introduction of probiotics improved the symptoms tremendously.

    CONCLUSIONS: The chronic use of laxatives in PD patients can potentially lead to a devastating problem; thus, the management team must monitor treatment commencement appropriately.

    MeSH terms: Diarrhea; Humans; Melanosis*; Peritonitis*
  18. Chua SW, Mustapha M, Wong KK, Ami M, Mohd Zahidin AZ, Nasaruddin RA
    Clin Ophthalmol, 2021;15:3147-3152.
    PMID: 34326630 DOI: 10.2147/OPTH.S320987
    Purpose: The objectives of this study were to determine the prevalence of microbial contamination of multi-user preserved ophthalmic drops (POD) in Ophthalmology Outpatient Clinic (OOC), to compare the rate of contamination between the dropper tip and the residual contents in the bottle, and to identify the contaminating organisms.

    Methods: This was an observational cross-sectional study using a convenience sampling method conducted in the OOC of Universiti Kebangsaan Malaysia Medical Center, Malaysia. The samples of POD bottles were divided into groups obtained after 14 days (T14) and after 30 days (T30) of use. The contamination rate at the dropper tip and in the residual contents was determined and the contaminating organisms were identified.

    Results: A total of 140 of 149 extended-use POD bottles were included. The prevalence of contamination was 30%. There was a statistically significant difference in the rate of contamination between samples T14 and T30 (19% and 11%, respectively; p=0.046). Proparacaine and tropicamide showed higher contamination rates in the T14 samples (p=0.027 and p=0.497, respectively) than in the T30 samples. The site of contamination was higher at the dropper tip than in the residual contents (p>0.05). Coagulase-negative Staphylococcus species were the most frequently identified contaminants (89%).

    Conclusion: The dropper tip was more contaminated than the residual contents, and coagulase-negative Staphylococcus species, which are common commensal flora of the ocular conjunctiva and skin, were the most frequently identified organisms.

  19. Mulyani S, Salameh AA, Komariah A, Timoshin A, Hashim NAAN, Fauziah RSP, et al.
    Front Psychol, 2021;12:655850.
    PMID: 34326792 DOI: 10.3389/fpsyg.2021.655850
    This research aimed to identify whether improvement in working conditions, children's classroom behavior and work-life balance can lower teacher burnout ratio in Pakistan's special schools by using techniques such as emotions regulation. The researcher employed a quantitative research methodology to fulfill the research's purpose. The data for this research was collected using a questionnaire-based instrument. The confirmatory factor analysis and structural equation modeling techniques were used to test the construct validity and underlying structural relationships. The findings demonstrated that the impacts of all three variables are significant in reducing job burnout in teachers. Emotional regulation helps decrease the impact of working conditions and the children's behavior. Nevertheless, it does not aid work-life balance as it requires other techniques of emotional regulation. The research is significant as it highlights the importance of overall working conditions' improvement for teachers working with special needs children. The improvements are essential because the teachers must take extra effort and emotions into their job compared to a typical teacher. The researcher has highlighted the key finding, implications and limitations of this research besides suggesting directions for future research to facilitate peer researchers.
  20. Che Sulaiman IS, Mohamad A, Ahmed OH
    PMID: 34326890 DOI: 10.1155/2021/9976202
    This review provides an updated and comprehensive overview on the ethnomedicinal use, phytochemistry, pharmacology, and toxicology of M. loriformis. Phytochemical analysis of M. loriformis revealed that it is composed of phenolics, flavonoids, condensed tannins, chlorophylls, alkaloids, and steroids. Numerous compounds including syringic acid, ß-O-D-glucopyranosyl-2-(2'-hydroxy-Z-6'-enecosamide) sphingosine, isovitexin, and 3β-O-D-glucopyranosyl-24ξ-ethylcholest-5-ene have been identified and isolated from this plant species. The present review attempts to bridge the gap between traditional use and pharmacological studies of M. loriformis while improving their existing therapeutic agents and product applications based on this plant.
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