Browse publications by year: 2021

  1. Zhou F, Lin S, Zhang J, Kong Z, Tan BK, Hamzah SS, et al.
    Photodiagnosis Photodyn Ther, 2021 Dec 08;37:102677.
    PMID: 34890782 DOI: 10.1016/j.pdpdt.2021.102677
    BACKGROUND: Pseudomonas aeruginosa (P. aeruginosa) is an emerging opportunistic pathogen, which can cause bacterial skin diseases such as green nail syndrome, interdigital infections and folliculitis. Curcumin-mediated antimicrobial photodynamic therapy (aPDT) has been demonstrated as a promising therapeutic option for the treatment of skin infection though its inactivation of gram-negative bacteria such as P. aeruginosa.

    MATERIALS AND METHODS: In the present study, we examined the adjuvant effect of polymyxin B on the antibacterial activity of curcumin-mediated aPDT against P. aeruginosa. P. aeruginosa was treated with curcumin in the presence of 0.1-0.5 mg/L polymyxin B and irradiated by blue LED light (10 J/cm2). Bacterial cultures treated with curcumin alone served as controls. Colony forming units (CFU) were counted and the viability of P. aeruginosa was calculated after aPDT treatment. The possible underlying mechanisms for the enhanced killing effects were also explored.

    RESULTS: The killing effects of curcumin-mediated aPDT against P. aeruginosa was significantly enhanced by polymyxin B (over 2-log reductions). Moreover, it was also observed that addition of polymyxin B in the curcumin-mediated aPDT led to the apparent bacterial membrane damage with increased leakage of cytoplasmic contents and extensive DNA and protein degradation.

    DISCUSSION: The photodynamic action of curcumin against P. aeruginosa could be significantly enhanced by the FDA-approved drug polymyxin B. Our results highlight the potential of introducing polymyxin B to enhance the effects of aPDT treatment against gram-negative skin infections, in particular, P. aeruginosa.

  2. Vijian D, Wan Ab Rahman WS, Ponnuraj KT, Zulkafli Z, Mohd Noor NH
    Medeni Med J, 2021;36(3):257-269.
    PMID: 34915685 DOI: 10.5222/MMJ.2021.14603
    Alpha thalassemia (α-thalassemia) is an autosomal recessive disorder due to the reduction or absence of α globin chain production. Laboratory diagnosis of α-thalassemia requires molecular analysis for the confirmatory diagnosis. A screening test, comprising complete blood count, blood smear and hemoglobin quantification by high performance liquid chromatography and capillary electrophoresis, may not possibly detect all the thalassemia diseases. This review focused on the molecular techniques used to detect α-thalassemia, and the advantages and disadvantages of each technique were highlighted. Multiplex gap-polymerase chain reaction, single-tube multiplex polymerase chain reaction, multiplex ligation-dependent probe amplification, and loop-mediated isothermal amplification were used to detect common deletion of α-thalassemia. Furthermore, the reverse dot blot analysis and a single tube multiplex polymerase chain reaction could detect non-deletion mutation of the α-globin gene. Sanger sequencing is widely used to detect non-deletion mutations of α-thalassemia. Recently, next-generation sequencing was introduced in the diagnosis of both deletion and point mutations of α-thalassemia. Despite the advantages and disadvantages of different techniques, the routine method employed in the laboratory should be based on the facility, expertise, available equipment, and economic conditions.
  3. Mohd Ramli SS, Abdullah A, Md Pauzi SH, Ramli M
    Medeni Med J, 2021;36(3):270-275.
    PMID: 34915686 DOI: 10.5222/MMJ.2021.36974
    Ceruminous adenoma is described as a glandular neoplasm of ceruminous glands. It is seen for less than one percent of all external ear tumours. Ceruminous adenoma cases were reported to have recurrence and residual tumour, however there was no malignant transformation known in ceruminous adenoma up to this date. Here, we report a young adult woman with two years history of progressive reduced hearing and tinnitus of the right ear. She was proven to have right moderate conductive hearing loss with pure tone audiometry. There was a cystic mass with serous content arising from the posterior wall of the right ear canal. We proceeded with wide local excision of the mass via trans-canal approach. Ceruminous adenoma was confirmed with histopathology and immunohistochemistry of CK7 staining. The hearing impairment was resolved completely post excision and there was no recurrence of the tumour on one year follow-up. We concluded wide local excision with appropriate margin of the mass is adequate to prevent recurrence in ceruminous adenoma cases.
  4. Khoo V, Khoo HSJ, Goh LC
    Medeni Med J, 2021;36(3):281-286.
    PMID: 34915688 DOI: 10.5222/MMJ.2021.80445
    IgG4-related disease (IgG4-RD) is a fibro-inflammatory condition associated with tumefactive lesions at multiple sites. IgG4-RD was initially recognized in 2001 in a case of autoimmune pancreatitis. However, the disease was not limited to the pancreas but involved other organs such as the bile ducts, lacrimal glands, lymph nodes and salivary glands. IgG4-RD is rarely seen with an estimated incidence of 0.2 to 1/100.000 as reported in Japan, but with minimal to no incidence data have been published in Western countries. We hereby report a case of an IgG4-related mass arising from the nasolacrimal duct, masquerading as a sinonasal mass.
  5. Ong HM, Azmi AFA, Leong SW, Abas F, Perimal EK, Farouk AAO, et al.
    Sci Rep, 2021 12 16;11(1):24121.
    PMID: 34916536 DOI: 10.1038/s41598-021-02961-1
    A novel synthetic compound from the 2-benzoyl-6-benzylidenecyclohexanone analogue, namely 2-benzoyl-6-(3-bromo-4-hydroxybenzylidene)cyclohexen-1-ol (BBHC), showed pronounced nitric oxide inhibition in IFN-γ/LPS-induced RAW 264.7 cells. Based on this previous finding, our present study aimed to investigate the antinociceptive effects of BBHC via chemical and thermal stimuli in vivo. The investigation of the antinociceptive activity of BBHC (0.1, 0.3, 1.0 and 3.0 mg/kg, i.p.) was initiated with 3 preliminary screening tests, then BBHC was subjected to investigate its possible involvement with excitatory neurotransmitters and opioid receptors. The potential acute toxicity of BBHC administration was also studied. Administration of BBHC significantly inhibited acetic acid-induced abdominal constrictions, formalin-induced paw licking activity and developed notable increment in the latency time. BBHC's ability to suppress capsaicin- and glutamate-induced paw licking activities, as well as to antagonise the effect of naloxone, had indicated the possible involvement of its antinociception with TRPV1, glutamate and opioid receptors, respectively. The antinociceptive activities of BBHC was not related to any sedative action and no evidence of acute toxic effect was detected. The present study showed that BBHC possessed significant peripheral and central antinociceptive activities via chemical- and thermal-induced nociceptive murine models without any locomotor alteration and acute toxicity.
    MeSH terms: RAW 264.7 Cells; Analgesics*; Animals; Disease Models, Animal; Drug Evaluation, Preclinical/methods; Glutamates; Male; Mice, Inbred ICR; Nitric Oxide/antagonists & inhibitors; Pain/drug therapy*; Receptors, Opioid; Neurotransmitter Agents; TRPV Cation Channels; Mice
  6. Savira YM, Tejamaya M, Putri AA
    Gac Sanit, 2021 12 22;35 Suppl 2:S374-S378.
    PMID: 34929854 DOI: 10.1016/j.gaceta.2021.10.054
    OBJECTIVE: This study aimed to analyse the health risks related to the use of chemicals among workers in small footwear factories.

    METHODS: This was a descriptive case study conducted in three selected small footwear factories located in Ciomas, Bogor, Indonesia. The assessment was conducted using the chemical health risk assessment method by the Department of Safety and Health Malaysia Year 2018.

    RESULTS: Results showed that the level of risk of chemicals through inhalation fell on the moderate and high-risk categories, indicating that high exposure could lead to carcinogenic effects. Dermal exposure was categorised as moderate risk, causing such health effects as skin and eye irritation.

    CONCLUSION: Factory X, Y, and Z have been found to have a significant risk of hazardous chemical exposure (i.e., benzene and toluene), specifically at the glueing stations, either from inhalation or dermal contact.

    MeSH terms: Benzene/analysis; Humans; Indonesia; Toluene/analysis; Risk Assessment
  7. Gayatri RW, Tama TD, Alma LR, Yun LW, Savira L, Kuroidah A
    Gac Sanit, 2021 12 22;35 Suppl 2:S438-S440.
    PMID: 34929871 DOI: 10.1016/j.gaceta.2021.10.071
    OBJECTIVE: This study aimed to analyze the relationship of behavioral risk factors for periodontal disease among 19-64 age group in Malang City.

    METHOD: A non-experimental quantitative analytic with a cross sectional study approach was used in this study. The respondents were 331 patients who visited the dental clinics of the Health Centers in Malang City. A cluster random sampling technique was used in this study. The instrument used was questionnaire. The data analysis was done through multivariate analyses use logistic-regression.

    RESULTS: The Wald test results on logistic-regression models showed there is no significant effect of smoking habits and consumption patterns on periodontal disease. There is a significant effect of systemic disease on periodontal disease with a significance value of 0.000 (p<0.05).

    CONCLUSIONS: There was a significant relationship and effect between systemic disease and periodontal disease in this study.

    MeSH terms: Cross-Sectional Studies; Humans; Indonesia/epidemiology; Risk Factors
  8. Wulandari P, Andika, Halide H
    Gac Sanit, 2021;35 Suppl 2:S455-S458.
    PMID: 34929874 DOI: 10.1016/j.gaceta.2021.07.024
    OBJECTIVE: The COVID-19 pandemic put enormous socio-economic pressures on most countries all over the world. In order to contain the spread of the coronavirus, governments implemented both pharmaceutical and non-pharmaceutical interventions. This simple modeling work aims to quantify the effect of three levels of social distancing and large-scale testing on daily COVID-19 cases in Malaysia, Republic of Korea, and Japan.

    METHOD: The model uses a Stepwise Multiple Regression (SWMR) method for selecting lagged mobility index and testing correlated with daily cases based on a 0.05 level of significance.

    RESULT: The models's predictability ranges are from 75% to 92%. It is also found that the mobility index plays a more important role, in comparison to testing rates, in determining daily confirmed cases.

    CONCLUSION: Behavioral changes that support physical distancing measures should be practiced to slow down the COVID-19 spreads.

    MeSH terms: Humans; Republic of Korea; Pandemics
  9. Salari N, Fatahi B, Bartina Y, Kazeminia M, Fatahian R, Mohammadi P, et al.
    J Transl Med, 2021 Dec 20;19(1):516.
    PMID: 34930325 DOI: 10.1186/s12967-021-03185-7
    BACKGROUND: Myasthenia gravis is a neuromuscular autoimmune disorder characterized by weakness and disability in the voluntary muscles. There have been several preliminary studies on the epidemiology of myasthenia gravis in different parts of the world and the effectiveness of common drugs in its treatment, but there has been no comprehensive study of the efficacy of common drugs in the treatment of myasthenia gravis. Therefore, this study aimed to determine the epidemiology of myasthenia gravis globally and the effectiveness of common drugs in its treatment using systematic review and meta-analysis.

    METHODS: Research studies were extracted from IranDoc, MagIran, IranMedex, SID, ScienceDirect, Web of Sciences (WoS), ProQuest, Medline (PubMed), Scopus and Google Scholar based on Cochran's seven-step guidelines using existing keywords extracted in MeSH browser. The I2 test was used to calculate the heterogeneity of studies, and Begg and Mazumdar rank correlation tests were used to assess publication bias. Data were analyzed using Comprehensive Meta-Analysis software (Version 2).

    RESULTS: In the search for descriptive studies based on the research question, 7374 articles were found. After deleting articles unrelated to the research question, finally, 63 articles with a sample size of 1,206,961,907 people were included in the meta-analysis. The prevalence of MG worldwide was estimated to be 12.4 people (95% CI 10.6-14.5) per 100,000 population. For analytical studies on the effectiveness of common myasthenia gravis drugs, 4672 articles were found initially, and after removing articles unrelated to the research question, finally, 20 articles with a sample size of 643 people in the drug group and 619 people in the placebo group were included in the study. As a result of the combination of studies, the difference between the mean QMGS score index after taking Mycophenolate and Immunoglobulin or plasma exchange drugs in the group of patients showed a significant decrease of 1.4 ± 0.77 and 0.62 ± 0.28, respectively (P < 0.01).

    CONCLUSION: The results of systematic review of drug evaluation in patients with myasthenia gravis showed that Mycophenolate and Immunoglobulin or plasma exchange drugs have positive effects in the treatment of MG. It also represents the positive effect of immunoglobulin or plasma exchange on reducing SFEMG index and QMGS index and the positive effect of Mycophenolate in reducing MG-ADL index, SFEMG and Anti-AChR antibodies index. In addition, based on a meta-analysis of the random-effect model, the overall prevalence of MG in the world is 12.4 people per 100,000 population, which indicates the urgent need for attention to this disease for prevention and treatment.

    MeSH terms: Humans; Immunosuppressive Agents/therapeutic use; Plasma Exchange; Prevalence
  10. Tan CS, Noni V, Sathiya Seelan JS, Denel A, Anwarali Khan FA
    BMC Res Notes, 2021 Dec 20;14(1):461.
    PMID: 34930456 DOI: 10.1186/s13104-021-05880-6
    OBJECTIVE: Coronaviruses (CoVs) are natural commensals of bats. Two subgenera, namely Sarbecoviruses and Merbecoviruses have a high zoonotic potential and have been associated with three separate spillover events in the past 2 decades, making surveillance of bat-CoVs crucial for the prevention of the next epidemic. The study was aimed to elucidate the presence of coronavirus in fresh bat guano sampled from Wind Cave Nature Reserve (WCNR) in Sarawak, Malaysian Borneo. Samples collected were placed into viral transport medium, transported on ice within the collection day, and preserved at - 80 °C. Nucleic acid was extracted using the column method and screened using consensus PCR primers targeting the RNA-dependent RNA polymerase (RdRp) gene. Amplicons were sequenced bidirectionally using the Sanger method. Phylogenetic tree with maximum-likelihood bootstrap and Bayesian posterior probability were constructed.

    RESULTS: CoV-RNA was detected in ten specimens (47.6%, n  = 21). Six alphacoronavirus and four betacoronaviruses were identified. The bat-CoVs can be phylogenetically grouped into four novel clades which are closely related to Decacovirus-1 and Decacovirus-2, Sarbecovirus, and an unclassified CoV. CoVs lineages unique to the Island of Borneo were discovered in Sarawak, Malaysia, with one of them closely related to Sarbecovirus. All of them are distant from currently known human coronaviruses.

    MeSH terms: Animals; Bayes Theorem; Borneo; Chiroptera*; Humans; Malaysia/epidemiology; Phylogeny
  11. Abdul-Kadir MA, Lim LT
    Int J Retina Vitreous, 2021 Dec 20;7(1):75.
    PMID: 34930488 DOI: 10.1186/s40942-021-00350-4
    Modern surgical interventions effectively treat macular holes (MHs) more than 90%. Current surgical treatment for MHs is pars plana vitrectomy with epiretinal membrane, internal limiting membrane (ILM) peeling, gas endotamponade, and prone posturing postoperatively. However, a small subset of MHs imposes challenges to surgeons and frustrations on patients. A narrative review was performed on the surgical treatment of challenging MHs including large and extra-large MHs, myopic MHs with or without retinal detachment, and chronic and refractory MHs. There are robust data supporting inverted ILM flap as the first-line treatment for large idiopathic MHs and certain secondary MHs including myopic MHs. In addition, several studies had shown that ILM flap manipulations in combination with surgical adjuncts increase surgical success, especially in difficult MHs. Even in eyes with limited ILM, surgical options included autologous retinal graft, human amniotic membrane, and creation of a distal ILM flap that can assist in MH closure even though the functional outcome may be affected by the MH chronicity. Despite relative success anatomically and visually after each technique, most techniques require a long-term study to analyze their safety profile and to establish any morphological changes of the MH plug in the closed MHs.
  12. Dempsey J, Irvine-Broque A, Bigger P, Christiansen J, Muchhala B, Nelson S, et al.
    Nat Ecol Evol, 2021 Dec 20.
    PMID: 34931053 DOI: 10.1038/s41559-021-01619-5
  13. Swami V, Todd J, Robinson C, Furnham A
    Pers Individ Dif, 2021 Dec;183:111130.
    PMID: 34931100 DOI: 10.1016/j.paid.2021.111130
    The ongoing coronavirus (COVID-19) pandemic and attendant lockdown mandates may have detrimental effects on body image outcomes, which in turn highlights the importance of identifying protective factors. Here, we examined associations between COVID-19-related stress and body image disturbance, as well as the potential mediating and moderating role of self-compassion. During the third lockdown in the United Kingdom, we asked an online sample of adults (N = 600) to complete measures of COVID-19-related stress, body image disturbance, and self-compassion. Mediation analysis showed that higher COVID-19-related stress was significantly associated with greater body image disturbance, and that this relationship was mediated by self-compassion. In contrast, self-compassion did not significantly moderate the effects of stress on body image disturbance. These results suggest that promoting greater self-compassion may be a viable means of mitigating adverse outcomes from the COVID-19 pandemic on body image disturbance.
  14. Razak NIA, Ezani NE, Ismail N
    Mediators Inflamm, 2021;2021:6609143.
    PMID: 34931116 DOI: 10.1155/2021/6609143
    The most prevalent cause of mortality and morbidity worldwide is acute coronary syndrome (ACS) and its consequences. Exposure to particulate matter (PM) from air pollution has been shown to impair both. Various plausible pathogenic mechanisms have been identified, including microRNAs (miRNAs), an epigenetic regulator for gene expression. Endogenous miRNAs, average 22-nucleotide RNAs (ribonucleic acid), regulate gene expression through mRNA cleavage or translation repression and can influence proinflammatory gene expression posttranscriptionally. However, little is known about miRNA responses to fine PM (PM2.5, PM10, ultrafine particles, black carbon, and polycyclic aromatic hydrocarbon) from air pollution and their potential contribution to cardiovascular consequences, including systemic inflammation regulation. For the past decades, microRNAs (miRNAs) have emerged as novel, prospective diagnostic and prognostic biomarkers in various illnesses, including ACS. We wanted to outline some of the most important studies in the field and address the possible utility of miRNAs in regulating particulate matter-induced ACS (PMIA) on inflammatory factors in this review.
  15. Ogawa S, Yamamoto N, Hagio H, Oka Y, Parhar IS
    J Neuroendocrinol, 2021 Nov 26.
    PMID: 34931380 DOI: 10.1111/jne.13068
    Three paralogous genes for gonadotropin-releasing hormone (GnRH; gnrh1, gnrh2, and gnrh3) and GnRH receptors exist in non-mammalian vertebrates. However, there are some vertebrate species in which one or two of these paralogous genes have become non-functional during evolution. The developmental migration of GnRH neurons in the brain is evolutionarily conserved in mammals, reptiles, birds, amphibians, and jawed teleost fish. The three GnRH paralogs have specific expression patterns in the brain and originate from multiple sites. In acanthopterygian teleosts (medaka, cichlid, etc.), the preoptic area (POA)-GnRH1 and terminal nerve (TN)-GnRH3 neuronal types originate from the olfactory regions. In other fish species (zebrafish, goldfish and salmon) with only two GnRH paralogs (GnRH2 and GnRH3), the TN- and POA-GnRH3 neuronal types share the same olfactory origin. However, the developmental origin of midbrain (MB)-GnRH2 neurons is debatable between mesencephalic or neural crest site. Each GnRH system has distinctive anatomical and physiological characteristics, and functions differently. The POA-GnRH1 neurons are hypophysiotropic in nature and function in the neuroendocrine control of reproduction. The non-hypophysiotropic GnRH2/GnRH3 neurons probably play neuromodulatory roles in metabolism (MB-GnRH2) and the control of motivational state for sexual behavior (TN-GnRH3).
  16. Daccache C, Rizk R, Dahham J, Evers SMAA, Hiligsmann M, Karam R
    Int J Technol Assess Health Care, 2021 Dec 21;38(1):e1.
    PMID: 34931601 DOI: 10.1017/S0266462321000659
    OBJECTIVES: To systematically identify the latest versions of official economic evaluation guidelines (EEGs) in low- and middle-income countries (LMICs) and explore similarities and differences in their content.

    METHODS: We conducted a systematic search in MEDLINE (Ovid), PubMed, EconLit, Embase (Ovid), the Cochrane Library, and the gray literature. Using a predefined checklist, we extracted the key features of economic evaluation and the general characteristics of EEGs. We conducted a comparative analysis, including a summary of similarities and differences across EEGs.

    RESULTS: Thirteen EEGs were identified, three pertaining to lower-middle-income countries (Bhutan, Egypt, and Indonesia), nine to upper-middle-income countries (Brazil, China, Colombia, Cuba, Malaysia, Mexico, Russian Federation, South Africa, and Thailand), in addition to Mercosur, and none to low-income countries. The majority (n = 12) considered cost-utility analysis and health-related quality-of-life outcome. Half of the EEGs recommended the societal perspective, whereas the other half recommended the healthcare perspective. Equity considerations were required in ten EEGs. Most EEGs (n = 11) required the incremental cost-effectiveness ratio and recommended sensitivity analysis, as well as the presentation of a budget impact analysis (n = 10). Seven of the identified EEGs were mandatory for pharmacoeconomics submission. Methodological gaps, contradictions, and heterogeneity in terminologies used were identified within the guidelines.

    CONCLUSION: As the importance of health technology assessment is increasing in LMICs, this systematic review could help researchers explore key aspects of existing EEGs in LMICs and explore differences among them. It could also support international organizations in guiding LMICs to develop their own EEGs and improve the methodological framework of existing ones.

    MeSH terms: Brazil; China; Colombia; Cost-Benefit Analysis; Developing Countries*
  17. Lee MY, Khong TK, Ramliy N, Yusof A
    PMID: 34931790 DOI: 10.23736/S0022-4707.21.13413-9
    BACKGROUND: Studies that investigate the effect of hydration on soccer performance in the heat are mostly carried out in a laboratory-controlled environment or simulated setting. Generally, on site, hydration is measured subjectively. Hence, the relationships between objective and subjective hydration measures during actual soccer matches in natural hot and humid environment with performance remain unclear.

    METHODS: Forty-two soccer players (age: 27.34 ± 3.62 years; BMI: 23.80 ± 2.70 kg / m2; temperature: 30.8 ± 1.92 º C; humidity: 82 ± 1.4 %) hydration status were assessed using urine specific gravity (USG) and bodyweight (BW) as the objective measures, meanwhile, thirst was measured subjectively using a thirst scale. For performance evaluation, 20 and 50 m sprint time were measured before and after match.

    RESULTS: The results showed a significant relationship between USG and sprint time (r = 1.00 (CI 0.98 - 0.99); p < 0.05), and as expected, USG at post-match was significantly higher than pre-match (p < 0.05) indicating dehydration. In line, changes (between post and pre-match) in BW also showed positive relationship with changes in sprint time (r = 0.99 (CI 0.98 - 0.99); p < 0.05). Not to our expectation, the self-reported thirst level was not found to be correlated with USG and sprint time.

    CONCLUSIONS: Objective measures better reflect hydration status and predict sprint performance compared to subjective measure when playing in hot and humid environment. Players need to monitor their hydration status to maintain their sprint performances.

  18. Sher A, Arfat MY, Ul-Allah S, Sattar A, Ijaz M, Manaf A, et al.
    PLoS One, 2021;16(12):e0260673.
    PMID: 34932582 DOI: 10.1371/journal.pone.0260673
    Sunflower production is significantly lower in arid and semi-arid regions due to various crop management problem. Conservation of tillage provides the most excellent opportunity to reduce degradation of soil reserves and increase soil productivity. The main objective of this study was to investigate the combined effects of conservation tillage and drought stress on growth and productivity of different sunflower hybrids. Experimental treatments included two sunflower hybrids ('NK-Senji' and 'S-278'), two drought stress treatments (i.e., well-watered and drought stress at flowering and grain filling stages) and three tillage practices (i.e., conservation, minimum and deep tillage). The results indicated that morphological and physiological parameters, and yield-related traits were significantly (P≤0.05) affected by all individual factors; however, their interactive effects were non-significant. Among sunflower hybrids, 'NK-Senji' performed better for morphological, physiological, and yield-related traits than 'S-278'. Similarly, conservation tillage observed better traits compared to the rest of the tillage practices included in the study. Nonetheless, conservation tillage improved growth and yield-related traits of hybrid 'NK-Senji' under drought stress. Hence, it is concluded that conservation tillage can improve the productivity of sunflower under low moisture availability. Therefore, conservation tillage could be suggested in the areas of lower water ability to improve sunflower production. Nonetheless, sunflower hybrids or varieties need thorough testing for their adaptability to conservation tillage and low moisture availability before making recommendations.
    MeSH terms: Adaptation, Physiological*; Agriculture/methods*; Chimera/genetics; Desert Climate; Helianthus/genetics; Helianthus/growth & development*; Helianthus/metabolism; Humans; Soil/chemistry*; Stress, Physiological; Water/metabolism; Crops, Agricultural/genetics; Crops, Agricultural/growth & development*; Crops, Agricultural/metabolism; Droughts; Agricultural Irrigation/methods
  19. Sasongko TH, Nagalla S
    Cochrane Database Syst Rev, 2021 Dec 21;12(12):CD009191.
    PMID: 34932828 DOI: 10.1002/14651858.CD009191.pub4
    BACKGROUND: Sickle cell disease is a group of disorders characterized by deformation of erythrocytes. Renal damage is a frequent complication in sickle cell disease as a result of long-standing anemia and disturbed circulation through the renal medullary capillaries. Due to the improvement in life expectancy of people with sickle cell disease, there has been a corresponding significant increase in the incidence of renal complications. Microalbuminuria and proteinuria are noted to be a strong predictor of subsequent renal failure. There is extensive experience and evidence with angiotensin-converting enzyme (ACE) inhibitors over many years in a variety of clinical situations for patients who do not have sickle cell disease, but their effect in people with this disease is unknown. It is common practice to administer ACE inhibitors for sickle nephropathy due to their renoprotective properties; however, little is known about their effectiveness and safety in this setting. This is an update of a Cochrane Review first published in 2013 and 2015.

    OBJECTIVES: To determine the effectiveness of ACE inhibitor administration in people with sickle cell disease for decreasing intraglomerular pressure, microalbuminuria and proteinuria and to to assess the safety of ACE inhibitors as pertains to their adverse effects.

    SEARCH METHODS: The authors searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Hameoglobinopathies Trials Register comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings. Date of the most recent search: 18 October 2021. We also searched clinical trial registries. Date of the most recent search: 22 August 2021.

    SELECTION CRITERIA: Randomized or quasi-randomized controlled trials of ACE inhibitors designed to reduce microalbuminuria and proteinuria in people with sickle cell disease compared to either placebo or standard treatment regimen.

    DATA COLLECTION AND ANALYSIS: Three authors independently applied the inclusion criteria in order to select studies for inclusion in the review. Two authors assessed the risk of bias of studies and extracted data and the third author verified these assessments.

    MAIN RESULTS: Seven studies were identified through the searches. Six studies were excluded. The included study randomized 22 participants (7 males and 15 females) having proteinuria or microalbuminuria with sickle cell disease and treated the participants for six months (median length of follow up of three months) with captopril or placebo. Overall, the certainty of the evidence provided in this review was very low, since most risk of bias domains were judged to have either an unclear or a high risk of bias. Because of this, we are uncertain whether captopril makes any difference, in total urinary albumin excretion (at six months) as compared to the placebo group, although it yielded a mean difference of -49.00 (95% confidence interval (CI) -124.10 to 26.10) or in the absolute change score, although it yielded a mean difference of -63.00 (95% CI -93.78 to -32.22). At six months albumin excretion in the captopril group was noted to decrease from baseline by a mean (standard deviation) of 45 (23) mg/day and the placebo group was noted to increase by 18 (45) mg/day. Serum creatinine and potassium levels were reported constant throughout the study (very low-certainty evidence). The potential for inducing hypotension should be highlighted; the study reported a decrease of 8 mmHg in systolic pressure and 5 mmHg in diastolic and mean blood pressure (very low-certainty evidence).

    AUTHORS' CONCLUSIONS: Overall, we judged the certainty of the evidence to be very low. The included study selectively reported its results, was not powered to detect a group difference, should it exist, and otherwise did not offer enough information to allow us to judge the bias inherent in the study. Indirectness (in relation to the limited age and type of population included) and imprecision (wide confidence intervals around the effect estimate) were observed. More long-term studies involving multiple centers and larger cohorts using a randomized-controlled design are warranted, especially among the pediatric age group. Detailed reporting of each outcome measure is necessary to allow a clear cut interpretation in a systematic review. One of the difficulties encountered in this review was the lack of detailed data reported in the included study. Overall, we judged the certainty of this evidence to be very low.

    MeSH terms: Angiotensins; Humans; Randomized Controlled Trials as Topic
  20. Baral S, Rao A, Twahirwa Rwema JO, Lyons C, Cevik M, Kågesten AE, et al.
    medRxiv, 2021 Dec 15.
    PMID: 33442703 DOI: 10.1101/2021.01.07.21249419
    BACKGROUND: COVID-19 has rapidly emerged as a global public health threat with infections recorded in nearly every country. Responses to COVID-19 have varied in intensity and breadth, but generally have included domestic and international travel limitations, closure of non-essential businesses, and repurposing of health services. While these interventions have focused on testing, treatment, and mitigation of COVID-19, there have been reports of interruptions to diagnostic, prevention, and treatment services for other public health threats.

    OBJECTIVES: We conducted a scoping review to characterize the early impact of COVID-19 on HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.

    METHODS: A scoping literature review was completed using searches of PubMed and preprint servers (medRxiv/bioRxiv) from January 1st to October 31st, 2020, using Medical Subject Headings (MeSH) terms related to SARS-CoV-2 or COVID-19 and HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition. Empiric studies reporting original data collection or mathematical models were included, and available data synthesized by region. Studies were excluded if they were not written in English.

    RESULTS: A total of 1604 published papers and 205 preprints met inclusion criteria, including 8.2% (132/1604) of published studies and 10.2% (21/205) of preprints: 7.3% (68/931) on HIV, 7.1% (24/339) on tuberculosis, 11.6% (26/224) on malaria, 7.8% (13/166) on sexual and reproductive health, and 9.8% (13/132) on malnutrition. Thematic results were similar across competing health risks, with substantial indirect effects of the COVID-19 pandemic and response on diagnostic, prevention, and treatment services for HIV, tuberculosis, malaria, sexual and reproductive health, and malnutrition.

    DISCUSSION: COVID-19 emerged in the context of existing public health threats that result in millions of deaths every year. Thus, effectively responding to COVID-19 while minimizing the negative impacts of COVID-19 necessitates innovation and integration of existing programs that are often siloed across health systems. Inequities have been a consistent driver of existing health threats; COVID-19 has worsened disparities, reinforcing the need for programs that address structural risks. The data reviewed here suggest that effective strengthening of health systems should include investment and planning focused on ensuring the continuity of care for both rapidly emergent and existing public health threats.

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