Browse publications by year: 2021

  1. Mubarak AI, Wan Mohd Shukri WNA, Ismail AK
    Int Marit Health, 2021 7 3;72(2):93-98.
    PMID: 34212348 DOI: 10.5603/IMH.2021.0017
    BACKGROUND: Jellyfish stings are one of the commonest causes of marine animal related injuries in human. Despite mostly being harmless, box jellyfish species can cause major stings with fatalities or systemic envenoming symptoms. There are 15-20 species identified to be life-threatening. There are few reported cases that suggest the presence of deadly box jellyfish in the Malaysian coast. However, numbers of stings around Malaysia are still under reported.

    MATERIALS AND METHODS: This observational study was conducted in Manjung, Perak and Langkawi Island to look at the pattern and incidence of jellyfish stings which occur within 1 year.

    RESULTS: There were 45 sting incidents reported with the highest number of cases occurred in December and February. Cases mainly involved young adults aged 10 to 29 years old. The most common clinical symptom that presented was sudden and persistent pain. Vinegar was applied as first aid in 53.3% of reported stings. All patients were treated symptomatically and discharged well. Stings occurred at mean sea surface temperature of 29.38°C and the wind speed of 7.6 knots. All cases were mild and did not require antivenom.

    CONCLUSIONS: The study showed that the occurrence of jellyfish stings are affected by weather conditions. Jellyfish stings occur seasonally, thus making it predictable and easily preventable with public awareness, early first aid application and use of jellyfish nets.

    MeSH terms: Adolescent; Adult; Animals; Child; Government; Health Facilities; Humans; Malaysia/epidemiology; Incidence; Young Adult
  2. Rajhans V, Mohammed CA, Ve RS, Prabhu A
    Educ Health (Abingdon), 2021 7 3;34(1):22-28.
    PMID: 34213440 DOI: 10.4103/efh.EfH_69_20
    Background: Current trends in health professions education are aligned to meet the needs of the millennial learner. The aim of this study was to identify learners' perceptions of an ongoing journal club (JC) activity in the optometry curriculum and evaluate the utility and efficiency of this method in promoting student learning.

    Methods: A qualitative approach with a phenomenological research design was adopted. The perceptions of undergraduate and postgraduate optometry students about JCs were captured using focus group discussions. A narrative thematic analysis was done using the verbatim transcripts and moderator's notes. Results are reported using "consolidated criteria for reporting qualitative research" guidelines.

    Results: A total of 33 optometry students participated in the study. Data analysis revealed three major themes related to (i) The ongoing practice of JC, (ii) student perceptions of JC and its relevance in facilitating student learning, and (iii) suggestions for modification of JC for achieving optimal educational outcomes.

    Discussion: Student feedback indicates that an instructional redesigning of JC is necessary, considering the characteristics and expectations of the current generation of learners and the rapid strides made in the field of educational technology. The recommendations provided are likely to resurrect an age-old approach that still has educational relevance if blended with collaborative learning formats and appropriate technology.

    MeSH terms: Curriculum; Humans; Learning*; Students*; Focus Groups; Qualitative Research
  3. Jahan I, Begum M, Akhter S, Islam MZ, Jahan N, Samad N, et al.
    Ann Afr Med, 2021 7 3;20(2):69-77.
    PMID: 34213471 DOI: 10.4103/aam.aam_114_20
    Introduction: Alternate nostril breathing (ANB) is an effective breathing exercise with therapeutic benefits on cardiorespiratory functions for healthy and diseased individuals. This study was conducted to assess the effects of ANB exercise on cardiorespiratory tasks in healthy adults.

    Materials and Methods: This randomized experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, from July 2017 to June 2018. A total of 100 1st-year students, aged between 18 and 20 years, were included by a random sampling method. Fifty participants (25 males and 25 females) were enrolled in the experimental group, while age- and body mass index-matched another 50 participants (25 males and 25 females) served as the control group. Experimental group participants performed ANB exercise for 4 weeks. Cardiorespiratory parameters (pulse rate, blood pressure, forced vital capacity, forced expiratory volume in 1st s [FEV1], and peak expiratory flow rate [PEFR] were measured. Data were taken at the start and after 4 weeks in both groups.

    Results: Independent t-test showed no significant differences in the cardiorespiratory functions between the experimental and control groups among the male and female participants, except for the females' PEFR which showed small differences. On the other hand, repeated measure ANOVA shows significant improvement in the experimental groups among males (P < 0.001-0.028) and females (P < 0.001-0.001) in all the cardiorespiratory functions measured, except for the FEV1 and PEFR among males.

    Conclusion: The results of this study suggest that cardiorespiratory functions were improved after breathing exercise, and therefore, ANB can be recommended for increasing cardiorespiratory efficiency.

    MeSH terms: Adolescent; Blood Pressure/physiology; Breathing Exercises/methods*; Female; Heart Rate/physiology*; Humans; Male; Nasal Cavity/physiology*; Respiratory Mechanics/physiology*; Young Adult; Respiratory Rate/physiology*
  4. Chong WH, Leong SS, Lim J
    Electrophoresis, 2021 11;42(21-22):2303-2328.
    PMID: 34213767 DOI: 10.1002/elps.202100081
    Combining both device and particle designs are the essential concepts to be considered in magnetophoretic system development. Researcher efforts are often dedicated to only one of these design aspects and neglecting the interplay between them. Herein, to bring out importance of the idea of integration between device and particle, we reviewed the working principle of magnetophoretic system (includes both device and particle design concepts). Since, the magnetophoretic force is influenced by both field gradient and magnetization volume, hence, accurate prediction of the magnetophoretic force is relying on the availability of information on both parameters. In device design, we focus on the different strategies used to create localized high-field gradient. For particle design, we emphasize on the scaling between hydrodynamic size and magnetization volume. Moreover, we also briefly discussed the importance of magnetoshape anisotropy related to particle design aspect of magnetophoretic systems. Next, we illustrated the need for integration between device and particle design using microscale applications of magnetophoretic systems, include magnetic tweezers and microfluidic systems, as our working example. On the basis of our discussion, we highlighted several promising examples of microscale magnetophoretic systems which greatly utilized the interplay between device and particle design. Further, we concluded the review with several factors that possibly resulted in the lack of research efforts related to device and particle design integration.
    MeSH terms: Magnetics*; Microfluidics*
  5. Noh MAA, Fazalul Rahiman SS, A Wahab H, Mohd Gazzali A
    J Basic Clin Physiol Pharmacol, 2021 Jun 25;32(4):715-722.
    PMID: 34214294 DOI: 10.1515/jbcpp-2020-0435
    OBJECTIVES: Tuberculosis (TB) remains a public health concern due to the emergence and evolution of multidrug-resistant strains. To overcome this issue, reinforcing the effectiveness of first line antituberculosis agents using targeted drug delivery approach is an option. Glyceraldehyde-3-Phosphate Dehydrogenase (GADPH), a common virulence factor found in the pathogenic microorganisms has recently been discovered on the cell-surface of Mycobacterium tuberculosis, allowing it to be used as a drug target for TB. This study aims to discover active small molecule(s) that target GAPDH and eventually enhance the delivery of antituberculosis drugs.

    METHODS: Ten ligands with reported in vitro and/or in vivo activities against GAPDH were evaluated for their binding interactions through molecular docking studies using AutoDock 4.2 program. The ligand with the best binding energy was then modified to produce 10 derivatives, which were redocked against GAPDH using previous protocols. BIOVIA Discovery Studio Visualizer 2019 was used to explore the ligand-receptor interactions between the derivatives and GAPDH.

    RESULTS: Among the 10 ligands, curcumin, koningic acid and folic acid showed the best binding energies. Further analysis on the docking of two folic acid derivatives, F7 (γ-{[tert-butyl-N-(6-aminohexyl)]carbamate}folic acid) and F8 (folic acid N-hydroxysuccinimide ester) showed that the addition of a bulky substituent at the carboxyl group of the glutamic acid subcomponent resulted in improved binding energy.

    CONCLUSIONS: Folic acid and the two derivatives F7 and F8 have huge potentials to be developed as targeting agents against the GAPDH receptor. Further study is currently on-going to evaluate the effectiveness of these molecules in vitro.

    MeSH terms: Antitubercular Agents/pharmacology; Pharmaceutical Preparations; Folic Acid; Ligands; Drug Discovery*; Molecular Docking Simulation
  6. Loganathan K, Lv J, Cropley V, Zalesky A, Ho ETW
    Neurosci Res, 2021 Dec;173:114-120.
    PMID: 34214618 DOI: 10.1016/j.neures.2021.06.006
    Poly-drug consumption contributes to fatal overdose in more than half of all poly-drug users. Analyzing decision-making networks may give insight into the motivations behind poly-drug use. We correlated average functional connectivity of the valuation system (VS), executive control system (ECS) and valuation-control complex (VCC) in a large population sample (n = 992) with drug use behaviour. VS connectivity is correlated with sedative use, ECS connectivity is separately correlated with hallucinogens and opiates. Network connectivity is also correlated with drug use via two-way interactions with other substances including alcohol and tobacco. These preliminary findings can contribute to our understanding of the common combinations of substance co-use and associated neural patterns.
  7. Al-Gheethi A, Noman E, Saphira Radin Mohamed RM, Talip B, Vo DN, Algaifi HA
    J Hazard Mater, 2021 10 05;419:126500.
    PMID: 34214856 DOI: 10.1016/j.jhazmat.2021.126500
    The present study aimed to investigate the removal efficiency of cephalexin (CFX) by a novel Cu-Zn bionanocomposite biosynthesized in the secondary metabolic products of Aspergillus arenarioides EAN603 with pumpkin peels medium (CZ-BNC-APP). The optimization study was performed based on CFX concentrations (1, 10.5 and 20 ppm); CZ-BNC-APP dosage (10, 55 and 100 mg/L); time (10, 55 and 100 min), temperature (20, 32.5 and 45 °C). The artificial neural network (ANN) model was used to understand the CFX behavior for the factors affecting removal process. The CZ-BNC-APP showed an irregular shape with porous structure and size between 20 and 80 nm. The FTIR detected CC, C-O and OH groups. ANN model revealed that CZ-BNC-APP dosage exhibited the vital role in the removal process, while the removal process having a thermodynamic nature. The CFX removal was optimized with 12.41 ppm CFX, 60.60 mg/L of CZ-BNC-APP, after 97.55 min and at 35 °C, the real maximum removal was 95.53% with 100.52 mg g-1 of the maximum adsorption capacity and 99.5% of the coefficient. The adsorption of CFX on CZ-BNC-APP was fitted with pseudo-second-order model and both Langmuir and Freundlich isotherms models. These findings revealed that CZ-BNC-APP exhibited high potential to remove CFX.
    MeSH terms: Adsorption; Aspergillus; Cephalexin; Hydrogen-Ion Concentration; Kinetics; Zinc; Neural Networks (Computer); Cucurbita*
  8. Amelia Shoon, Wan Chin, Kartini, Abdul Ghani
    MyJurnal
    Reading strategies are seldom taught to students despite their importance in aiding reading comprehension. This study aimed to examine the effectiveness of the think-aloud strategy and investigate primary school students' perception of using the think-aloud strategy in assisting their reading comprehension. Twenty-seven primary school students were introduced and trained to use the think-aloud strategy through teacher-modelling and reciprocal think-aloud with comprehension passages related to the relevant English curriculum. Questionnaires and interview sessions were conducted to gather information on how the students perceive the use of think-aloud in reading comprehension. Findings revealed that students have positive perceptions towards using think-aloud as a reading strategy in their reading comprehension and were keen on using the strategy in their future reading.
  9. Aishath Niyaf, Sairah AK, Mohamed A. Abdalqader
    MyJurnal
    The incidence of breast cancer in Asian countries is continuously rising, with breast cancer-causing an increase in mortality among Asian women. The impact of low screening uptake is a matter of concern as in most cases, cancers have been diagnosed in the advanced stages where medical intervention is not curable but only intended to improve the quality of care. Therefore, there has been comprehensive advocacy for early detection and treatment of breast cancer as a strategy to mitigate breast cancer-related morbidity and mortality rates. This paper reviewed existing research on breast cancer screening and the factors that are associated with breast cancer screening among Asian women. The findings from numerous studies conducted in Asian countries provides evidence that the number of factors such as socio-demographic characteristics, knowledge on breast cancer, including its symptoms and risk factors as well as breast cancer screening modalities, beliefs or perceptions and barriers in terms of structural, psychological, cultural and social factors influences women's adherence to the preventive health promotive behaviour -breast cancer screening. These findings direct to the need for well-planned strategies and intervention that are culturally sensitive and specifically tailored to the needs of Asian women to successfully promote and advocate the importance of breast health, early detection of breast cancer and adoption of dynamic routine screening behaviours
  10. Mohd Fahimi Zakaria, Ashlah Ibrahim
    MyJurnal
    This research aims to understand the Chinese civilisation and education in Malaysia. Terms of education. This research used research journal and book research. Chinese civilisation began with the emergence of the Xia Dynasty in the Huang He valley around 2000 Before Century (BC). Chinese civilisation has produced many achievements in various literature, science, science and technology, traditional medicine, performing arts, art and fine arts. The main philosophies in Chinese society are Confucianism, Taoism and Legalism. This Classic Verse dramatically affects the lives of Chinese people. The establishment of the education system in Malaya develop in the 19th century. The Chinese community is very concerned about education and gives great honour to the educational struggle. School - Chinese school was formed and built wherever there are Chinese communities in Malaysia.
  11. Thin Thin Aung, Venkata Pavan Kumar, D.R. Eunice
    MyJurnal
    Background and Aims: The estimation of standard spirometric measurements needs to measure a participant’s non-mutated standing height. Even so, as a direct consequence of physical impairment, traumatic amputation, as well as other structural deformities or neuromuscular disablement, a few patients referred for lung function assessment cannot stand. Materials and methods: The study involved 202 participants and consist of two elements that are data collection and data analysis. There were four types of data: standing height measurement, arm span measurement, sitting height measurement and predicted pulmonary function, including forced vital capacity (FVC) and forced expiratory volume (FEV1), which was studied based on correlational analysis. Results: The study shows a positive, linear solid correlation between arm span and standing height measure in centimetre with an R-value of 0.919. There is a positive moderate linear correlation between arm span and sitting height measure in centimetre with an R-value of 0.604. Sitting height and standing height has a positive, strong linear correlation with an R-value of 0.744. For the pulmonary function test, a positive, strong linear correlation between Forced Vital Capacity prediction using sitting height and Forced Vital Capacity prediction using standing height with an R-value of 0.710. There was a positive moderate linear correlation between Forced Expiratory Volume prediction using sitting height and Forced Expiratory Volume prediction using standing height with an R-value of 0.577. The relationship between forced vital capacity and forced expiratory volume predicted value of a pulmonary function using arm span and forced vital capacity with forced expiratory volume predicted value of a pulmonary function using standing height shows a positive, strong linear correlation with forced vital capacity R-value of pulmonary function 0.950 and forced expiratory volume R-value of 0.938. Conclusion: Overall, based on the obtained results of the study, it has been proven that the arm span measurement would be the most compatible alternative measure to be used instead of standing height in the case of a patient with permanent disability or incapacitated for clinical purposes and pulmonary function test compared to sitting height.
  12. Khandoker Al Zisan, Ahmad Albattat, Siti Mariam Mohammad Abdul Basar
    MyJurnal
    This paper tries to fathom the perceptions of very last year tourism and hospitality college students regarding their education and the extent of self-belief that infused in them to stand the future tourism industry demanding situations. The use of multivariate measures has furnished four vital elements representing the underlying dimensions of instructional education: training pleasure, learning patterns, preceding experience, and pragmatic gaining knowledge of choices. The studies have proven thrilling correlations between preceding work elements enjoy with other features schooling delight and activist studying. Further high quality and terrible correlations had been recognised between scholar demographics gender and residing arrangements and former work revel in. The study has thrown new light at the student perception and their nature of preceding paintings experience. This has given impetus to research this region because it has findings almost about college students' mastering alternatives and former paintings enjoy.
  13. Ng AWR, Narayanan K
    Anal Biochem, 2021 09 01;628:114287.
    PMID: 34119486 DOI: 10.1016/j.ab.2021.114287
    Fabry disease is caused by reduced α-GAL A activity and accumulation of globotriaosylceramide (Gb3). Here, we describe a microplate Gb3 assay using fluorophore-tagged antibody and crude cellular lipid extracts. The assay is able to detect higher Gb3 concentrations in human Fabry cells compared to non-diseased cells. This result was verified by immunofluorescence staining that revealed large amounts of Gb3 deposits in Fabry cell lines, demonstrating the accuracy of this method. This assay may provide the basis for detecting Fabry disease by quantifying Gb3 deposits from human biological samples, for example, from urine and blood.
  14. Habib MAH, Ismail MN
    J Food Biochem, 2021 07;45(7):e13817.
    PMID: 34137461 DOI: 10.1111/jfbc.13817
    The fruit and leaf of God's crown (Phaleria macrocarpa) have been traditionally used to treat a wide variety of diseases. However, the proteins of this tropical plant are still heavily understudied. Three protein extraction methods; phenol (Phe), trichloroacetic acid (TCA)-acetone-phenol (TCA-A-Phe), and ultrasonic (Ult) were compared on the fruit and leaf of P. macrocarpa. The Phe extraction method showed the highest percentage of recovered protein after the resolubilization process for both leaf (12.24%) and fruit (30.41%) based on protein yields of the leaf (6.15 mg/g) and fruit (36.98 mg/g). Phe and TCA-A-Phe extraction methods gave well-resolved bands over a wide range of molecular weights through sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Following liquid chromatography-tandem mass spectrometry analysis, proteins identified through the Phe extraction method were 30%-35% enzymatic proteins, including oxidoreductases, transferases, hydrolases, lyases, isomerases, and ligases that possess various biological functions. PRACTICAL APPLICATIONS: Every part of God's crown plant is traditionally consumed to treat various illnesses. While plant's benefits are well known and have led to a plethora of health products, the proteome remains mostly unknown. This study compares three protein extraction methods for the leaf and fruit of P. macrocarpa and identifies their proteins thru LC-MS/MS coupled with PEAKS. These method comparisons can be a guide for works on other plants as well. In addition, the proteomics data from this study may shed light on the functional properties of these plant parts and their products.
    MeSH terms: Chromatography, Liquid; Fruit; Plants, Medicinal*; Proteomics; Tandem Mass Spectrometry
  15. Hiu JJ, Yap MKK
    Int J Biol Macromol, 2021 Aug 01;184:776-786.
    PMID: 34174307 DOI: 10.1016/j.ijbiomac.2021.06.145
    Naja sumatrana venom cytotoxin (sumaCTX) is a basic protein which belongs to three-finger toxin family. It has been shown to induce caspase-dependent, mitochondrial-mediated apoptosis in MCF-7 cells at lower concentrations. This study aimed to investigate the alteration of secretome in MCF-7 cells following membrane permeabilization by high concentrations of sumaCTX, using label-free quantitative (LFQ) approach. The degree of membrane permeabilization of sumaCTX was determined by lactate dehydrogenase (LDH) assay and calcein-propidium iodide (PI) assays. LDH and calcein-PI assays revealed time-dependent membrane permeabilization within a narrow concentration range. However, as toxin concentrations increased, prolonged exposure of MCF-7 cells to sumaCTX did not promote the progression of membrane permeabilization. The secretome analyses showed that membrane permeabilization was an event preceding the release of intracellular proteins. Bioinformatics analyses of the LFQ secretome revealed the presence of 105 significantly distinguished proteins involved in metabolism, structural supports, inflammatory responses, and necroptosis in MCF-7 cells treated with 29.8 μg/mL of sumaCTX. Necroptosis was presumably an initial stress response in MCF-7 cells when exposed to high sumaCTX concentration. Collectively, sumaCTX-induced the loss of membrane integrity in a concentration-dependent manner, whereby the cell death pattern of MCF-7 cells transformed from apoptosis to necroptosis with increasing toxin concentrations.
    MeSH terms: Animals; Breast Neoplasms/drug therapy; Breast Neoplasms/metabolism*; Cell Membrane Permeability/drug effects; Cell Survival/drug effects; Chromatography, Liquid; Cobra Neurotoxin Proteins/pharmacology*; Dose-Response Relationship, Drug; Elapid Venoms/pharmacology; Female; Humans; Time Factors; Gene Expression Regulation, Neoplastic/drug effects; Proteomics/methods*; Tandem Mass Spectrometry; MCF-7 Cells
  16. Sim EU, Lee CW, Narayanan K
    Biomark Res, 2021 Jun 30;9(1):51.
    PMID: 34193301 DOI: 10.1186/s40364-021-00311-x
    Ribosomal protein genes encode products that are essential for cellular protein biosynthesis and are major components of ribosomes. Canonically, they are involved in the complex system of ribosome biogenesis pivotal to the catalysis of protein translation. Amid this tightly organised process, some ribosomal proteins have unique spatial and temporal physiological activity giving rise to their extra-ribosomal functions. Many of these extra-ribosomal roles pertain to cellular growth and differentiation, thus implicating the involvement of some ribosomal proteins in organogenesis. Consequently, dysregulated functions of these ribosomal proteins could be linked to oncogenesis or neoplastic transformation of human cells. Their suspected roles in carcinogenesis have been reported but not specifically explained for malignancy of the nasopharynx. This is despite the fact that literature since one and half decade ago have documented the association of ribosomal proteins to nasopharyngeal cancer. In this review, we explain the association and contribution of dysregulated expression among a subset of ribosomal proteins to nasopharyngeal oncogenesis. The relationship of these ribosomal proteins with the cancer are explained. We provide information to indicate that the dysfunctional extra-ribosomal activities of specific ribosomal proteins are tightly involved with the molecular pathogenesis of nasopharyngeal cancer albeit mechanisms yet to be precisely defined. The complete knowledge of this will impact future applications in the effective management of nasopharyngeal cancer.
  17. Russell V, Loo CE, Walsh A, Bharathy A, Vasudevan U, Looi I, et al.
    BMJ Open, 2021 06 30;11(6):e043923.
    PMID: 34193478 DOI: 10.1136/bmjopen-2020-043923
    OBJECTIVES: To explore primary care clinician perceptions of barriers and facilitators in delivering care for common mental disorders (CMD) before and after implementation of a consultation-liaison psychiatry service (Psychiatry in Primary Care (PIPC)) in government-operated primary care clinics and to explore the clinicians' experience of the PIPC service itself.

    DESIGN: This longitudinal qualitative study was informed by the Normalisation Process Model and involved audiotaped semi-structured individual interviews with front-line clinicians before (Time 1) and after (Time 2) the PIPC intervention. The Framework Method was used in the thematic analysis of pre/post interview transcripts.

    SETTING: Two government-operated primary care clinics in Penang, Malaysia.

    PARTICIPANTS: 17 primary care medical, nursing and allied health staff recruited purposely to achieve a range of disciplines and a balanced representation from both clinics.

    INTERVENTION: Psychiatrists, accompanied by medical students in small numbers, provided one half-day consultation visit per week, to front-line clinicians in each clinic over an 8-month period. The service involved psychiatric assessment of patients with suspected CMDs, with face-to-face discussion with the referring clinician before and after the patient assessment.

    RESULTS: At Time 1 interviewees tended to equate CMDs with stress and embraced a holistic model of care while also reporting considerable autonomy in mental healthcare and positively appraising their current practices. At Time 2, post-intervention, participants demonstrated a shift towards greater understanding of CMDs as treatable conditions. They reported time pressures and the demands of key performance indicators in other areas as barriers to participation in PIPC. Yet they showed increased awareness of current service deficits and of their potential in delivering improved mental healthcare.

    CONCLUSIONS: Despite resource-related and structural barriers to implementation of national mental health policy in Malaysian primary care settings, our findings suggest that front-line clinicians are receptive to future interventions designed to improve the mental healthcare capacity.

    MeSH terms: Government; Humans; Malaysia; Perception; Primary Health Care; Psychiatry*; Referral and Consultation; Qualitative Research
  18. Rehman AU, Shah S, Abbas G, Harun SN, Shakeel S, Hussain R, et al.
    Sci Rep, 2021 Jun 30;11(1):13578.
    PMID: 34193949 DOI: 10.1038/s41598-021-92968-5
    Compromised lung function is a common feature of COPD patients, but certain factors increase the rate of lung function decline in COPD patients. The objective of the current study was to investigate the effect of different clinically important factors responsible for rapid deterioration of lung function quantified as ≥ 60 ml decline in FEV1 over a period of one year. COPD patients recruited from the chest clinic of Penang hospital were followed-up for one year from August 2018 to August 2019. Rapid deterioration of lung function was defined as greater than 60 ml/year decline in force expiratory volume in one second. Among 367 included patients 73.84% were male, with mean age 65.26 (9.6) years and % predicted FEV1 51.07 (11.84). 30.27% patients showed mean decline of ≥ 60 ml in FEV1. The regression analysis showed that current smoking relative risk (RR) = 2.38 (1.78-3.07), p 
    MeSH terms: Aged; Female; Forced Expiratory Volume; Humans; Longitudinal Studies; Male; Middle Aged; Prospective Studies; Quality of Life*; Risk Factors; Disease Progression; Pulmonary Disease, Chronic Obstructive/epidemiology*; Pulmonary Disease, Chronic Obstructive/physiopathology*
  19. Teh KY, Tham TM
    Urol Ann, 2021 04 13;13(2):156-162.
    PMID: 34194142 DOI: 10.4103/UA.UA_28_20
    Objectives: Percutaneous nephrolithotomy (PCNL) carries a small risk of postoperative sepsis due to the liberation of bacteria into the patients' bloodstream during stone fragmentation. The study aims to identify the incidence of post-PCNL sepsis in our center, as well as to delineate perioperative characteristics associated with increased rates of sepsis.

    Materials and Methods: We performed a retrospective review on all PCNLs performed in our center between July 2012 and June 2017, with emphasis on preoperative urine results, intra-operative findings, and postoperative septic complications.

    Results: Among 425 cases of PCNL performed, 16 (3.76%) developed sepsis postoperatively. Patients with positive preoperative urine cultures were almost four times as likely to develop post-PCNL sepsis compared to those with negative cultures (8.41% vs. 2.2%, P = 0.004). Among patients with positive urine leukocytes and positive urine cultures, the presence of Staghorn calculi and multiple PCNL punctures both predicted significantly higher risks of postoperative sepsis. In contrast, diabetes mellitus and preoperative stenting were not found to be associated with a greater risk of post-PCNL sepsis.

    Conclusions: Patients who had positive preoperative urine leukocytes and/or cultures, and either harbor Staghorn calculi or are deemed to require more than one puncture on PCNL, were at an increased risk of developing post-PCNL sepsis. Such at-risk patients should be identified preoperatively, given aggressive perioperative antibiotic treatment, and monitored closely for septic complications during the convalescence period.

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