Browse publications by year: 2022

Fulltext Knowledge and Perceptions on End-of-life Care among End-stage Renal Disease Patients on Hemodialysis

Rozi NRB, Bin Wan Ali WASR, Bin Draman CR, Pasi HB, Rathor MY

Saudi J Kidney Dis Transpl, 2022 Sep 01;33(5):664-673.
PMID: 37955458 DOI: 10.4103/1319-2442.389426

The role of end-of-life care is fundamental for end-stage renal disease (ESRD) patients, who are known to have a high morbidity and mortality rate despite being on dialysis. This requires effective communication and shared decision-making. Thus, exploring patients' knowledge and perceptions is essential to improve the gaps in delivering end-of-life care. This study aimed to describe the knowledge and perceptions of end-of-life care among ESRD patients on hemodialysis (HD). This was a cross-sectional study involving 14 outpatient HD centers in Kuantan, Malaysia. Patients were recruited from March to June 2019. A validated questionnaire was delivered via interview-based surveys by the researcher or trained interviewers. The majority of the respondents had poor knowledge of the disease and end-of-life care. However, more than 70% of the respondents felt that it was important for them to be actively involved in medical decision-making, as well as being prepared and planning for death. End-of-life needs, which included management of symptoms and psychological, social, and spiritual support, were important to most respondents. Additionally, patients with higher educational backgrounds were observed to have higher scores for both knowledge and perceptions (P <0.05). The study found poor knowledge but acceptable perceptions among patients. This highlights the gaps in the current local approach in clinical practice to end-of-life care in ESRD.

MeSH terms: Cross-Sectional Studies; Renal Dialysis/adverse effects; Renal Dialysis/psychology; Humans; Outpatients
Fulltext Tinnitus prevalence in Europe: a multi-country cross-sectional population study

Biswas R, Lugo A, Akeroyd MA, Schlee W, Gallus S, Hall DA

Lancet Reg Health Eur, 2022 Jan;12:100250.
PMID: 34950918 DOI: 10.1016/j.lanepe.2021.100250

BACKGROUND: Tinnitus prevalence studies report large variability across countries that might be due to inconsistent research methods. Our study aimed to report a single Pan-European estimate for tinnitus prevalence and investigate the effect of individual and country-level characteristics on prevalence. We explored the relationships of healthcare resource use and hearing difficulty with tinnitus symptoms.
METHODS: Between 2017-2018, a cross-sectional European Tinnitus Survey (ETS) was conducted in 12 European Union nations (Bulgaria, England, France, Germany, Greece, Ireland, Italy, Latvia, Poland, Portugal, Romania, and Spain), using a standardised set of tinnitus-related questions and response options in country-specific languages. We recruited 11,427 adults aged ≥18 years.
FINDINGS: Prevalence of any tinnitus was 14·7% (14·0% in men and 15·2% in women), ranging from 8·7% in Ireland to 28·3% in Bulgaria. Severe tinnitus was found in 1·2% participants (1·0% in men and 1·4% in women), ranging from 0·6% in Ireland to 4·2% in Romania. Tinnitus prevalence significantly increased with increasing age and worsening of hearing status. Healthcare resource use for tinnitus increased with increasing tinnitus symptom severity.
INTERPRETATION: This is the first multinational report of Pan-European tinnitus prevalence using standardised questions. The overall prevalence estimates refine previous findings, although widespread inter-country heterogeneity was noted. The results indicate that more than 1 in 7 adults in the EU have tinnitus. Extrapolating to the overall population, approximately 65 million adults in EU28 have tinnitus, 26 million have bothersome tinnitus and 4 million have severe tinnitus.
FUNDING: National Institute for Health Research, European Union's Horizon 2020, Medical Research Council, and GENDER-Net Co-Plus Fund.
Fulltext Awareness, attitude and willingness regards cadaveric organ donation and awaness of brain death among Sarawakians in Kuching, Malaysia

Lim KG, Tan AS, Wong SC, Tee EG, Burud IA

Ceylon Med J, 2022 Nov 30;67(3):113-120.
PMID: 37933994 DOI: 10.4038/cmj.v67i3.9699
MeSH terms: Brain Death*; Cadaver; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Tissue and Organ Procurement*; Surveys and Questionnaires
Fulltext Multipotent Cholinesterase Inhibitors for the Treatment of Alzheimer's Disease: Synthesis, Biological Analysis and Molecular Docking Study of Benzimidazole-Based Thiazole Derivatives

Hussain R, Ullah H, Rahim F, Sarfraz M, Taha M, Iqbal R, et al.

Molecules, 2022 Sep 18;27(18).
PMID: 36144820 DOI: 10.3390/molecules27186087

Twenty-four analogues of benzimidazole-based thiazoles (1-24) were synthesized and assessed for their in vitro acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) inhibitory potential. All analogues were found to exhibit good inhibitory potential against cholinesterase enzymes, having IC50 values in the ranges of 0.10 ± 0.05 to 11.10 ± 0.30 µM (for AChE) and 0.20 ± 0.050 µM to 14.20 ± 0.10 µM (for BuChE) as compared to the standard drug Donepezil (IC50 = 2.16 ± 0.12 and 4.5 ± 0.11 µM, respectively). Among the series, analogues 16 and 21 were found to be the most potent inhibitors of AChE and BuChE enzymes. The number (s), types, electron-donating or -withdrawing effects and position of the substituent(s) on the both phenyl rings B & C were the primary determinants of the structure-activity relationship (SAR). In order to understand how the most active derivatives interact with the amino acids in the active site of the enzyme, molecular docking studies were conducted. The results obtained supported the experimental data. Additionally, the structures of all newly synthesized compounds were elucidated by using several spectroscopic methods like 13C-NMR, 1H-NMR and HR EIMS.

MeSH terms: Acetylcholinesterase/metabolism; Amino Acids; Benzimidazoles/chemistry; Butyrylcholinesterase/chemistry; Humans; Structure-Activity Relationship; Thiazoles/pharmacology; Molecular Structure; Molecular Docking Simulation
Fulltext Targets and management of hypertension in heart failure: focusing on the stages of heart failure

Miao H, Zou C, Yang S, Chia YC, Van Huynh M, Sogunuru GP, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1218-1225.
PMID: 36196463 DOI: 10.1111/jch.14553

Hypertension is highly prevalent worldwide and is the major risk factor for heart failure (HF). More than half of the patients with HF in Asia suffer from hypertension. According to the 2022 American Heart Association/American College of Cardiology/Heart Failure Society of America HF guideline, there are four stages of HF, including at risk for HF (stage A), pre-HF (stage B), symptomatic HF (stage C), and advanced HF (stage D). Given the high prevalence of hypertension as well as HF and the stronger association between hypertension and cardiovascular diseases in Asians compared to the west, measures to prevent and alleviate the progression to clinical HF, especially controlling the blood pressure (BP), are of priority for Asian populations. After reviewing evidence-based studies, we propose a BP target of less than 130/80 mmHg for patients at stages A, B, and C. However, relatively higher BP may represent an opportunity to maximize guideline-directed medical therapy (GDMT), which could potentially result in a better prognosis for patients at stage D. Traditional antihypertensive drugs are the cornerstones for the management of hypertension at stages A and B. Notably, calcium channel blockers (CCBs) are inferior to other drug classes for the preventing of HF, whereas diuretics are superior to others. For patients at stage C, GDMT is essential which also helps the control of BP. In particular, sodium-glucose cotransporter-2 (SGLT2) inhibitors are newer therapies recommended for the treatment of HF and presumably even in hypertension to prevent HF. Regarding patients at stage D, GDMT is also recommended if tolerable and measures should be taken to improve hemodynamics.

MeSH terms: Antihypertensive Agents/therapeutic use; Calcium Channel Blockers/therapeutic use; Diuretics/therapeutic use; Humans
Fulltext The role of renal nerve stimulation in percutaneous renal denervation for hypertension: A mini-review

Huang HC, Cheng HM, Chia YC, Li Y, Van Minh H, Siddique S, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1187-1193.
PMID: 36196464 DOI: 10.1111/jch.14554

Recent trials have demonstrated the efficacy and safety of percutaneous renal sympathetic denervation (RDN) for blood pressure (BP)-lowering in patients with uncontrolled hypertension. Nevertheless, major challenges exist, such as the wide variation of BP-lowering responses following RDN (from strong response to no response) and lack of feasible and reproducible peri-procedural predictors for patient response. Both animal and human studies have demonstrated different patterns of BP responses following renal nerve stimulation (RNS), possibly related to varied regional proportions of sympathetic and parasympathetic nerve tissues along the renal arteries. Animal studies of RNS have shown that rapid electrical stimulation of the renal arteries caused renal artery vasoconstriction and increased norepinephrine secretion with a concomitant increase in BP, and the responses were attenuated after RDN. Moreover, selective RDN at sites with strong RNS-induced BP increases led to a more efficient BP-lowering effect. In human, when RNS was performed before and after RDN, blunted changes in RNS-induced BP responses were noted after RDN. The systolic BP response induced by RNS before RDN and blunted systolic BP response to RNS after RDN, at the site with maximal RNS-induced systolic BP response before RDN, both correlated with the 24-h ambulatory BP reductions 3-12 months following RDN. In summary, RNS-induced BP changes, before and after RDN, could be used to assess the immediate effect of RDN and predict BP reductions months following RDN. More comprehensive, large-scale and long term trials are needed to verify these findings.

MeSH terms: Animals; Blood Pressure/physiology; Denervation; Humans; Kidney; Norepinephrine; Sympathectomy; Treatment Outcome
Fulltext The HOPE Asia network 2022 up-date consensus statement on morning hypertension management

Kario K, Wang JG, Chia YC, Wang TD, Li Y, Siddique S, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1112-1120.
PMID: 36196465 DOI: 10.1111/jch.14555

Morning hypertension is an important clinical target in the management of hypertension for perfect 24-h blood pressure (BP) control. Morning hypertension is generally categorized into two types: "morning surge" type and "sustained nocturnal and morning hypertension" type. The "morning surge" type is characterized by an exaggerated morning blood pressure surge (MBPS), and the "sustained nocturnal and morning hypertension" type with continuous hypertension from nighttime to morning (non-dipper/riser type). They can be detected by home and ambulatory blood pressure measurements (HBPM and ABPM). These two forms of morning hypertension both increase the risk of cardiovascular and renal diseases, but may occur via different pathogenic mechanisms and are associated with different conditions. Morning hypertension should be treated to achieve a morning BP level of

MeSH terms: Antihypertensive Agents/therapeutic use; Asia/epidemiology; Blood Pressure/physiology; Circadian Rhythm; Humans; Blood Pressure Monitoring, Ambulatory; Consensus
Fulltext Role of α1-blockers in the current management of hypertension

Li H, Xu TY, Li Y, Chia YC, Buranakitjaroen P, Cheng HM, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1180-1186.
PMID: 36196467 DOI: 10.1111/jch.14556

There is emerging evidence that α1-blockers can be safely used in the treatment of hypertension. These drugs can be used in almost all hypertensive patients for blood pressure control. However, there are several special indications. Benign prostatic hyperplasia is a compelling indication of α1-blockers, because of the dual treatment effect on both high blood pressure and lower urinary tract symptoms. Many patients with resistant hypertension would require α1-blockers as add-on therapy. Primary aldosteronism screen is a rapidly increasing clinical demand in the management of hypertension, where α1-blockers are useful for blood pressure control in the preparation for the measurement of plasma aldosterone and renin. Nonetheless, α1-blockers have to be used under several considerations. Among the currently available agents, only long-acting α1-blockers, such as doxazosin gastrointestinal therapeutic system 4-8 mg daily and terazosin 2-4 mg daily, should be chosen. Orthostatic hypotension is a concern with the use of α1-blockers especially in the elderly, and requires careful initial bedtime dosing and avoiding overdosing. Fluid retention is potentially also a concern, which may be overcome by combining an α1-blocker with a diuretic.

MeSH terms: Adrenergic alpha-Antagonists/therapeutic use; Aged; Aldosterone; Antihypertensive Agents/pharmacology; Antihypertensive Agents/therapeutic use; Diuretics/therapeutic use; Humans; Renin; Doxazosin/therapeutic use
Fulltext Who should be screened for primary aldosteronism? A comprehensive review of current evidence

Huang WC, Lin YH, Wu VC, Chen CH, Siddique S, Chia YC, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1194-1203.
PMID: 36196469 DOI: 10.1111/jch.14558

Arterial hypertension is a major risk factor for cardiovascular disease. The prevalence of primary aldosteronism (PA) ranges from 5% to 10% in the general hypertensive population and is regarded as one of the most common causes of secondary hypertension. There are two major causes of PA: bilateral adrenal hyperplasia and aldosterone-producing adenoma. The diagnosis of PA comprises screening, confirmatory testing, and subtype differentiation. The Endocrine Society Practice Guidelines for the diagnosis and treatment of PA recommends screening of patients at an increased risk of PA. These categories include patients with stage 2 and 3 hypertension, drug-resistant hypertension, hypertensive with spontaneous or diuretic-induced hypokalemia, hypertension with adrenal incidentaloma, hypertensive with a family history of early onset hypertension or cerebrovascular accident at a young age, and all hypertensive first-degree relatives of patients with PA. Recently, several studies have linked PA with obstructive sleep apnea and atrial fibrillation unexplained by structural heart defects and/or other conditions known to cause the arrhythmia, which may be partly responsible for the higher rates of cardiovascular and cerebrovascular accidents in patients with PA. The aim of this review is to discuss which patients should be screened for PA, focusing not only on well-established guidelines but also on additional groups of patients with a potentially higher prevalence of PA, as has been reported in recent research.

MeSH terms: Aldosterone; Diuretics; Humans; Renin
Fulltext Hypertensive emergencies in Asia: A brief review

Kotruchin P, Tangpaisarn T, Mitsungnern T, Sukonthasarn A, Hoshide S, Turana Y, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1226-1235.
PMID: 36196470 DOI: 10.1111/jch.14547

Hypertensive emergency is one of the most challenging conditions to treat in the emergency department (ED). From previous studies, about 1%-3% of hypertensive individuals experienced hypertensive emergencies. Its prevalence varied by country and region throughout Asia. Asian populations have more different biological and cultural backgrounds than Caucasians and even within Asian countries. However, there is a scarcity of research on clinical features, treatment, and outcomes in multinational Asian populations. The authors aimed to review the current evidence about epidemiology, clinical characteristics and outcomes, and practice guidelines in Asia. Five observational studies and nine clinical practice guidelines across Asia were reviewed. The prevalence of hypertensive emergencies ranged from .1% to 1.5%. Stroke was the most common target organ involvement in Asians who presented with hypertensive emergencies. Although most hypertensive emergency patients required hospitalization, the mortality rate was low. Given the current lack of data among Asian countries, a multinational data repository and Asian guidelines on hypertensive emergency management are mandatory.

MeSH terms: Antihypertensive Agents/therapeutic use; Emergencies; Emergency Service, Hospital; Hospitalization; Humans
Fulltext Neurodegenerative diseases and blood pressure variability: A comprehensive review from HOPE Asia

Turana Y, Shen R, Nathaniel M, Chia YC, Li Y, Kario K

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1204-1217.
PMID: 36196471 DOI: 10.1111/jch.14559

Asia has an enormous number of older people and is the primary contributor to the rise in neurodegenerative diseases such as Alzheimer's and Parkinson's disease. The therapy of many neurodegenerative diseases has not yet progressed to the point where it is possible to alter the course of the disease. Mid-life hypertension is an important predictor of later-life cognitive impairment and brain neurodegenerative conditions. These findings highlight the pivotal role of preventing and managing hypertension as a risk factor for neurodegenerative disease. Autonomic dysfunction, neuropsychiatric and sleep disturbances can arise in neurodegenerative diseases, resulting in blood pressure variability (BPV). The BPV itself can worsen the progression of the disease. In older people with neurodegenerative disease and hypertension, it is critical to consider 24-h blood pressure monitoring and personalized blood pressure therapy.

MeSH terms: Aged; Asia/epidemiology; Blood Pressure/physiology; Blood Pressure Determination/methods; Humans
Fulltext Standardized home blood pressure monitoring: Rationale behind the 722 protocol

Lin HJ, Pan HY, Chen CH, Cheng HM, Chia YC, Sogunuru GP, et al.

J Clin Hypertens (Greenwich), 2022 Sep;24(9):1161-1173.
PMID: 36196472 DOI: 10.1111/jch.14549

Home blood pressure (HBP) has been recognized as a prognostic predictor for cardiovascular events, and integrated into the diagnosis and management of hypertension. With increasing accessibility of oscillometric blood pressure devices, HBP monitoring is easy to perform, more likely to obtain reliable estimation of blood pressures, and feasible to document long-term blood pressure variations, compared to office and ambulatory blood pressures. To obtain reliable HBP estimates, a standardized HBP monitoring protocol is essential. A consensus regarding the optimal duration and frequency of HBP monitoring is yet to be established. Based on the current evidence, the "722" protocol, which stands for two measurements on one occasion, two occasions a day (morning and evening), and over a consecutive of 7 days, is most commonly used in clinical studies and recommended in relevant guidelines and consensus documents. HBP monitoring based on the "722" protocol fulfills the minimal requirement of blood pressure measurements to achieve agreement of blood pressure classifications defined by office blood pressures and to predict cardiovascular risks. In the Taiwan HBP consensus, the frequency of repeating the "722" protocol of HBP monitoring according to different scenarios of hypertension management, from every 2 weeks to 3 months, is recommended. It is reasonable to conclude that the "722" protocol for HBP monitoring is clinically justified and can serve as a basis for standardized HBP monitoring.

MeSH terms: Blood Pressure; Blood Pressure Determination/methods; Humans; Prognosis
Fulltext A rare case of prostate neuroendocrine tumor: A case report

Teh S, Inn FX, Rizuana IH, Wm WM

Front Oncol, 2022;12:1009146.
PMID: 36263212 DOI: 10.3389/fonc.2022.1009146

Small cell prostate neuroendocrine carcinoma (SCPC) is a rare and highly aggressive malignant tumor. We present a case of a 52-year-old Iranian man, presenting with complaints of occasional gross hematuria and perineal pain for 6 months. PSA was 0.8 ng/ml. A digital rectal examination found a huge and hard prostate mass. He underwent a transrectal ultrasound-guided (TRUS) biopsy of the prostate. Histopathology showed high-grade small cell neuroendocrine carcinoma. Immunohistochemical markers were positive for synaptophysin with a Ki67 index of almost 100%. However, CD56 and chromogranin A markers were negative. Magnetic resonance imaging (MRI) of the prostate showed a prostate mass with invasion to the rectum, while contrast-enhanced computed tomography of the thorax, abdomen, and pelvis (CT TAP) ruled out metastasis. A multidisciplinary team discussion was carried out, and a decision was made for concurrent chemotherapy and radiation (cisplatin and etoposide for 4 cycles and 70 Gy, 35 fractions). There is a lack of consensus on the management of SCPC. The main modality of management in advanced (stage IV) disease is chemotherapy. It is a highly aggressive tumor with a poor prognosis and is not responsive to hormonal therapy.
Fulltext The COVID-19/Tuberculosis Syndemic and Potential Antibody Therapy for TB Based on the Lessons Learnt From the Pandemic

Dass SA, Balakrishnan V, Arifin N, Lim CSY, Nordin F, Tye GJ

Front Immunol, 2022;13:833715.
PMID: 35242137 DOI: 10.3389/fimmu.2022.833715

2020 will be marked in history for the dreadful implications of the COVID-19 pandemic that shook the world globally. The pandemic has reshaped the normality of life and affected mankind in the aspects of mental and physical health, financial, economy, growth, and development. The focus shift to COVID-19 has indirectly impacted an existing air-borne disease, Tuberculosis. In addition to the decrease in TB diagnosis, the emergence of the TB/COVID-19 syndemic and its serious implications (possible reactivation of latent TB post-COVID-19, aggravation of an existing active TB condition, or escalation of the severity of a COVID-19 during TB-COVID-19 coinfection), serve as primary reasons to equally prioritize TB. On a different note, the valuable lessons learnt for the COVID-19 pandemic provide useful knowledge for enhancing TB diagnostics and therapeutics. In this review, the crucial need to focus on TB amid the COVID-19 pandemic has been discussed. Besides, a general comparison between COVID-19 and TB in the aspects of pathogenesis, diagnostics, symptoms, and treatment options with importance given to antibody therapy were presented. Lastly, the lessons learnt from the COVID-19 pandemic and how it is applicable to enhance the antibody-based immunotherapy for TB have been presented.

MeSH terms: Antibodies/immunology; Antibodies/therapeutic use*; Humans; Immunotherapy; Mycobacterium tuberculosis; Receptors, Antigen, T-Cell/immunology; Tuberculosis/diagnosis; Tuberculosis/immunology; Tuberculosis/epidemiology*; Tuberculosis/therapy*; Coinfection/diagnosis; Coinfection/immunology; Coinfection/epidemiology; Coinfection/therapy*
Fulltext Interspecific differences in the responses of root phosphatase activities and morphology to nitrogen and phosphorus fertilization in Bornean tropical rain forests

Hirano Y, Kitayama K, Imai N

Ecol Evol, 2022 Feb;12(3):e8669.
PMID: 35309744 DOI: 10.1002/ece3.8669

Soil organic phosphorus (P) compounds can be the main P source for plants in P-limited tropical rainforests. Phosphorus occurs in diverse chemical forms, including monoester P, diester P, and phytate, which require enzymatic hydrolysis by phosphatase into inorganic P before assimilation by plants. The interactions between plant interspecific differences in organic P acquisition strategies via phosphatase activities with root morphological traits would lead to P resource partitioning, but they have not been rigorously evaluated. We measured the activities of three classes of phosphatases (phosphomonoesterase, PME; phosphodiesterase, PDE; and phytase, PhT), specific root length (SRL), root diameter, and root tissue density in mature tree species with different mycorrhizal associations (ectomycorrhizal [ECM] or arbuscular mycorrhizal [AM]) and different successional status (climax or pioneer species) in Sabah, Malaysia. We studied nitrogen (N)- and P-fertilized plots to evaluate the acquisition strategies for organic P under P-limited conditions 7 years after fertilization was initiated. P fertilization reduced the PME activity in all studied species and reduced PhT and PDE activities more in climax species than in the two pioneer species, irrespective of the mycorrhizal type. PDE activity increased in some climax species after N fertilization, suggesting that these species allocate excess N to the synthesis of PDE. Moreover, PME and PhT activities, but not PDE activity, correlated positively with SRL. We suggest that climax species tend to be more strongly dependent on recalcitrant organic P (i.e., phytate and/or diester P) than pioneer species, regardless of the mycorrhizal type. We also suggest that trees in which root PME or PhT activity is enhanced can increase their SRL to acquire P efficiently. Resource partitioning of soil organic P would occur among species through differences in their phosphatase activities, which plays potentially ecologically important role in reducing the competition among coexisting tree species in lowland tropical rainforests.
Fulltext Bacterial Metabolomics: Sample Preparation Methods

Mohd Kamal K, Mahamad Maifiah MH, Abdul Rahim N, Hashim YZH, Abdullah Sani MS, Azizan KA

Biochem Res Int, 2022;2022:9186536.
PMID: 35465444 DOI: 10.1155/2022/9186536

Metabolomics is a comprehensive analysis of metabolites existing in biological systems. As one of the important "omics" tools, the approach has been widely employed in various fields in helping to better understand the complex cellular metabolic states and changes. Bacterial metabolomics has gained a significant interest as bacteria serve to provide a better subject or model at systems level. The approach in metabolomics is categorized into untargeted and targeted which serves different paradigms of interest. Nevertheless, the bottleneck in metabolomics has been the sample or metabolite preparation method. A custom-made method and design for a particular species or strain of bacteria might be necessary as most studies generally refer to other bacteria or even yeast and fungi that may lead to unreliable analysis. The paramount aspect of metabolomics design comprises sample harvesting, quenching, and metabolite extraction procedures. Depending on the type of samples and research objective, each step must be at optimal conditions which are significantly important in determining the final output. To date, there are no standardized nor single designated protocols that have been established for a specific bacteria strain for untargeted and targeted approaches. In this paper, the existing and current developments of sample preparation methods of bacterial metabolomics used in both approaches are reviewed. The review also highlights previous literature of optimized conditions used to propose the most ideal methods for metabolite preparation, particularly for bacterial cells. Advantages and limitations of methods are discussed for future improvement of bacterial metabolomics.
Fulltext Determinants of delayed tuberculosis treatment among patients in Selangor: A study protocol

Makeswaran P, Shah SA, Safian N, Muhamad NA, Harith AA

PLoS One, 2022;17(4):e0266746.
PMID: 35468167 DOI: 10.1371/journal.pone.0266746

The high prevalence rate and ever-increasing incidence of tuberculosis (TB) worldwide remain a significant issue in healthcare. In Malaysia, the incidence and mortality rate of TB is increasing due to the delayed presentation of TB patients to healthcare facilities. However, there is a lack of local studies on the contributing factors of delayed presentation of TB patients in Malaysia. This study aims to establish a social epidemiology framework by analysing social factors including socio-epidemiological, socio-cultural, and health-seeking behaviours associated with the delay in seeking TB treatment among patients in Selangor, Malaysia. A sequential exploratory mixed-method study design that combines qualitative and quantitative research methods will be employed. This study will recruit adult patients who have been diagnosed with TB using chest X-ray and sputum smear microscopy. Four districts with the highest recorded cases in the state of Selangor will be selected as study locations. The qualitative study will involve a Focus Group Discussion (FGD) to explore six components, namely demographic, socio-cultural, health-seeking behaviours, social support and resources, previous knowledge and experience with illness, and treatment pathway. Meanwhile, the quantitative study will incorporate a structured survey that will be developed based on the themes identified in the qualitative phase and a review of several studies in the literature. Several quality control measures will be taken while ensuring that the survey questionnaires are anonymised and participants' confidentiality is maintained. The data obtained from both qualitative and quantitative approaches will be combined to provide a more robust assessment of the study. Given that this study will focus on districts with high recorded cases of TB in Selangor, the findings might assist to address TB-related issues such as the increasing incidence and mortality rates, which are mainly attributed to the delayed presentation of TB patients to healthcare facilities.

MeSH terms: Adult; Health Facilities; Humans; Review Literature as Topic; Focus Groups; Qualitative Research
Fulltext Diabetes care and prevention services provided by pharmacists: Progress made during the COVID-19 pandemic and the need for additional efforts in the post-pandemic era

Elnaem MH, Nuffer W

Explor Res Clin Soc Pharm, 2022 Jun;6:100137.
PMID: 35469121 DOI: 10.1016/j.rcsop.2022.100137

Diabetes is a challenging metabolic disease that significantly impacts people's health worldwide. It requires a comprehensive approach for better prevention and control, especially during challenging times such as the recent pandemic. The COVID-19 pandemic has altered how health care professionals, including pharmacists, provide health care. With the widespread use of virtual and online platforms for service delivery, pharmacist-led diabetes care has been transformed to meet the needs of patients during the pandemic. This article aims to discuss examples of pharmacist-led diabetes care services during the pandemic and highlight areas where additional pharmacist efforts are needed in the post-pandemic era.
Fulltext A deep crowd density classification model for Hajj pilgrimage using fully convolutional neural network

Bhuiyan MR, Abdullah J, Hashim N, Al Farid F, Ahsanul Haque M, Uddin J, et al.

PeerJ Comput Sci, 2022;8:e895.
PMID: 35494812 DOI: 10.7717/peerj-cs.895

This research enhances crowd analysis by focusing on excessive crowd analysis and crowd density predictions for Hajj and Umrah pilgrimages. Crowd analysis usually analyzes the number of objects within an image or a frame in the videos and is regularly solved by estimating the density generated from the object location annotations. However, it suffers from low accuracy when the crowd is far away from the surveillance camera. This research proposes an approach to overcome the problem of estimating crowd density taken by a surveillance camera at a distance. The proposed approach employs a fully convolutional neural network (FCNN)-based method to monitor crowd analysis, especially for the classification of crowd density. This study aims to address the current technological challenges faced in video analysis in a scenario where the movement of large numbers of pilgrims with densities ranging between 7 and 8 per square meter. To address this challenge, this study aims to develop a new dataset based on the Hajj pilgrimage scenario. To validate the proposed method, the proposed model is compared with existing models using existing datasets. The proposed FCNN based method achieved a final accuracy of 100%, 98%, and 98.16% on the proposed dataset, the UCSD dataset, and the JHU-CROWD dataset, respectively. Additionally, The ResNet based method obtained final accuracy of 97%, 89%, and 97% for the proposed dataset, UCSD dataset, and JHU-CROWD dataset, respectively. The proposed Hajj-Crowd-2021 crowd analysis dataset and the model outperformed the other state-of-the-art datasets and models in most cases.
Fulltext Oral Health Status in Marfan Syndrome: A Systematic Review and Meta-Analysis of 353 Cases

Alam MK, Alfawzan AA, Shrivastava D, Srivastava KC, Alswairki HJ, Mussallam S, et al.

Int J Environ Res Public Health, 2022 Apr 21;19(9).
PMID: 35564443 DOI: 10.3390/ijerph19095048

This meta-analysis aimed to compare Marfan syndrome (MFS) patients with non-MFS populations based on orofacial health status to combine publicly available scientific information while also improving the validity of primary study findings. A comprehensive search was performed in the following databases: PubMed, Google Scholar, Scopus, Medline, and Web of Science, for articles published between 1 January 2000 and 17 February 2022. PRISMA guidelines were followed to carry out this systematic review. We used the PECO system to classify people with MFS based on whether or not they had distinctive oral health characteristics compared to the non-MFS population. The following are some examples of how PECO is used: P denotes someone who has MFS; E stands for a medical or genetic assessment of MFS; C stands for people who do not have MFS; and O stands for the orofacial characteristics of MFS. Using the Newcastle-Ottawa Quality Assessment Scale, independent reviewers assessed the articles' methodological quality and extracted data. Four case-control studies were analyzed for meta-analysis. Due to the wide range of variability, we were only able to include data from at least three previous studies. There was a statistically significant difference in bleeding on probing and pocket depth between MFS and non-MFS subjects. MFS patients are more prone to periodontal tissue inflammation due to the activity of FBN1 and MMPs. Early orthodontic treatment is beneficial for the correction of a narrow upper jaw and a high palate, as well as a skeletal class II with retrognathism of the lower jaw and crowding of teeth.

MeSH terms: Cleft Palate*; Humans; Marfan Syndrome*; Oral Health; Case-Control Studies

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