Browse publications by year: 2024

  1. Zhang Y, Gong X, Peng P, Wang J, Lu D, Zhan J, et al.
    Environ Pollut, 2024 Sep 03.
    PMID: 39236843 DOI: 10.1016/j.envpol.2024.124872
    Heterocapsa bohaiensis is a newly identified dinoflagellate species that causes harmful blooms in coastal areas in China, Malaysian, and New Caledonian. These blooms have led to substantial economic losses for local aquaculture. Previous studies have mainly focused on understanding the toxicity of H. bohaiensis. However, the causes of H. bohaiensis blooms remain unknown. In this study, we aimed to ascertain nitrogen (N) and phosphorus (P) requirements for the growth and reproduction of H. bohaiensis. Additionally, we sought to understand the functional mechanisms by comparing the transcriptomes of H. bohaiensis under nutrient-limited conditions and control conditions. The results revealed a wide range of acceptable N:P ratios for H. bohainensis, attributed to a mechanism involving nutrient storage, which allowed H. bohainensis to sustain its growth even when either nitrate or phosphate was depleted. Higher N:P ratios (> 27.5) were more conducive to the growth of H. bohainensis than f/2 medium or low ratios, which is related to the N:P ratios absorbed by H. bohainensis. The toxicity of H. bohainensis was significantly enhanced in N-limited or P-limited states. These findings underscore the significance of the physiological metabolism of H. bohainensis in adapting to environmental stresses induced by human activities and establishing the dominance of blooms.
  2. Rajasegaran S, Ahmad NA, Tan SK, Lechmiannandan A, Tan YW, Sanmugam A, et al.
    J Pediatr Surg, 2024 Aug 13.
    PMID: 39237378 DOI: 10.1016/j.jpedsurg.2024.161687
    BACKGROUND: Quality of life (QOL) is an important clinical endpoint in paediatric chronic conditions. How parent-proxy reports differ from child self-reported QOL in patients with anorectal malformation (ARM) and Hirschsprung's disease (HD) has not been well examined to date. This study evaluates agreement between parent-proxy and child-reported QOL scores in ARM and HD patients compared to healthy controls.

    METHODS: We recruited ARM and HD patients aged 5-17 years and their parents at four tertiary referral centres between December 2020 to February 2023 who had corrective surgery done >12 months prior. Healthy controls were age-matched and gender-matched. They completed the Pediatric Quality of Life Inventory™ (PedsQL™) Generic Core Scales and General Well-Being (GWB) Scale. The questionnaires were administered in parallel parent-proxy-report and child self-report formats. Appropriate statistical analysis was performed with p 

  3. Rahim H, Dapari R, Che Dom N, Mohd Noor MI
    Sci Rep, 2024 Sep 05;14(1):20735.
    PMID: 39237550 DOI: 10.1038/s41598-024-71294-6
    Safety culture is a critical determinant of organisational performance, particularly in high-risk industries especially in oil and gas. Understanding stakeholder preferences is essential for developing effective strategies that enhance safety culture. This study utilised the Analytic Hierarchy Process (AHP) to prioritise stakeholder preferences, identifying key elements of safety culture in Malaysia's oil and gas sector. This study employed a structured methodology to evaluate safety culture within the oil and gas industry, focusing on 18 sub-elements across three key domains: psychological, behavioural, and situational factors. A diverse sample of industry experts was recruited using purposeful and snowball sampling to ensure a comprehensive representation of stakeholder views. The AHP framework was applied to analyse the data, utilizing structured questionnaires and multicriteria decision-making techniques to prioritize the identified safety culture elements. The AHP analysis identified distinct priorities among different professional groups within the oil and gas sector. Safety and Health Practitioners emphasized practical elements such as safety rules and management commitment, while academicians prioritized knowledge and training. Management personnel highlighted the importance of safety ownership and communication, whereas policymakers focused on broader, policy-oriented aspects. The findings suggest that safety culture improvement initiatives should be tailored to address the specific needs and priorities of each professional group. A nuanced understanding of stakeholder preferences is crucial for developing comprehensive strategies that integrate observable behaviours, situational conditions, and psychological factors, ultimately fostering a robust safety culture in the oil and gas industry.
    MeSH terms: Oil and Gas Industry*; Adult; Decision Making; Female; Humans; Malaysia; Male; Surveys and Questionnaires; Organizational Culture; Safety Management
  4. Akgül A, Ahmed N, Shahzad M, Baber MZ, Iqbal MS, Chan CK
    Sci Rep, 2024 Sep 06;14(1):20776.
    PMID: 39237562 DOI: 10.1038/s41598-024-69445-w
    In this paper, we investigate the optimal conditions to the boundaries where the unique existence of the solutions to an advection-diffusion-reaction equation is secured by applying the contraction mapping theorem from the study of fixed points. Also, we extract, traveling wave solutions of the underlying equation. To this purpose, a new extended direct algebraic method with traveling wave transformation has been used. Achieved soliton solutions are different functions which are hyperbolic, trigonometric, exponential, and some mixed trigonometric functions. These functions show the nature of solitons. Two and three-dimensional plots are drawn using different values of parameters and coefficients for the comparison and behavior of solitons as combined bright-dark, dark, and bright solitons.
  5. Wang J, Jiang B, Li J, Liu L, Du X, Jiang H, et al.
    Leukemia, 2024 Sep 05.
    PMID: 39237634 DOI: 10.1038/s41375-024-02382-9
    The phase 3 COMMODORE trial evaluated gilteritinib versus salvage chemotherapy (SC) in a predominantly Asian relapsed/refractory (R/R) FLT3-mutated (FLT3mut+) acute myeloid leukemia (AML) patient population. The primary endpoint was overall survival (OS); secondary endpoints included event-free survival (EFS) and complete remission (CR) rate. As of June 30, 2020 (interim analysis: 32.2 months after study initiation), 234 patients were randomized (gilteritinib, n = 116; SC, n = 118). Median OS was significantly longer with gilteritinib versus SC (9.6 vs. 5.0 months; HR 0.566 [95% CI: 0.392, 0.818]; p = 0.00211) with a median follow-up of 10.3 months. Median EFS was also significantly longer with gilteritinib (2.8 vs. 0.6 months; HR 0.551 [95% CI: 0.395, 0.769]; p = 0.00004). CR rates with gilteritinib and SC were 16.4% and 10.2%, respectively; composite CR rates were 50.0% and 20.3%, respectively. Exposure-adjusted grade ≥3 adverse event (AE) rates were lower with gilteritinib (58.38 events/patient-year [E/PY]) versus SC (168.30 E/PY). Common AEs with gilteritinib were anemia (77.9%) and thrombocytopenia (45.1%). Gilteritinib plasma concentration peaked ~4 h postdose; ~3-fold accumulation occurred with multiple dosing. The COMMODORE trial demonstrated that gilteritinib significantly improved OS and EFS in predominantly Asian patients, validating the outcomes of gilteritinib from the ADMIRAL trial in R/R FLT3mut+ AML.
  6. Hargreaves AL, Ensing J, Rahn O, Oliveira FMP, Burkiewicz J, Lafond J, et al.
    Nat Ecol Evol, 2024 Sep 05.
    PMID: 39237759 DOI: 10.1038/s41559-024-02504-7
    Urbanization is creating a new global biome, in which cities and suburbs around the world often resemble each other more than the local natural areas they replaced. But while urbanization can profoundly affect ecology at local scales, we know little about whether it disrupts large-scale ecological patterns. Here we test whether urbanization disrupts a macroecological pattern central to ecological and evolutionary theory: the increase in seed predation intensity from high to low latitudes. Across 14,000 km of latitude spanning the Americas, we compared predation intensity on two species of standardized experimental seeds in urbanized and natural areas. In natural areas, predation on both seed species increased fivefold from high latitudes to the tropics, one of the strongest latitudinal gradients in species interactions documented so far. Surprisingly, latitudinal gradients in predation were equally strong in urbanized areas despite significant habitat modification. Nevertheless, urbanization did affect seed predation. Compared with natural areas, urbanization reduced overall predation and vertebrate predation, did not affect predation by invertebrates in general, and increased predation by ants. Our results show that macroecological patterns in predation intensity can persist in urbanized environments, even as urbanization alters the relative importance of predators and potentially the evolutionary trajectory of urban populations.
  7. Biswas A, A JM, Lewis SA, Raja S, Paul A, Ghosal K, et al.
    AAPS PharmSciTech, 2024 Sep 05;25(7):203.
    PMID: 39237802 DOI: 10.1208/s12249-024-02909-4
    Normal skin is the first line of defense in the human body. A burn injury makes the skin susceptible to bacterial infection, thereby delaying wound healing and ultimately leading to sepsis. The chances of biofilm formation are high in burn wounds due to the presence of avascular necrotic tissue. The most common pathogen to cause burn infection and biofilm is Pseudomonas aeruginosa. The purpose of this study was to create a microemulsion (ME) formulation for topical application to treat bacterial burn infection. In the present study, tea tree oil was used as the oil phase, Tween 80 and transcutol were used as surfactants, and water served as the aqueous phase. Pseudo ternary phase diagrams were used to determine the design space. The ranges of components as suggested by the design were chosen, optimization of the microemulsion was performed, and in vitro drug release was assessed. Based on the characterization studies performed, it was found that the microemulsion were formulated properly, and the particle size obtained was within the desired microemulsion range of 10 to 300 nm. The I release study showed that the microemulsion followed an immediate release profile. The formulation was further tested based on its ability to inhibit biofilm formation and bacterial growth. The prepared microemulsion was capable of inhibiting biofilm formation.
    MeSH terms: Chemistry, Pharmaceutical/methods; Emulsions*; Humans; Particle Size; Polysorbates/chemistry; Surface-Active Agents/chemistry; Tea Tree Oil/administration & dosage; Tea Tree Oil/pharmacology; Tea Tree Oil/chemistry; Drug Liberation
  8. Nisar M, Tasleem Z, Muhammad SA, Javid A, Rasool MF, Karuniawati H, et al.
    Cost Eff Resour Alloc, 2024 Sep 05;22(1):65.
    PMID: 39237946 DOI: 10.1186/s12962-024-00566-9
    BACKGROUND: The direct and indirect costs of chronic kidney disease (CKD) are substantial and increase over time. Concerns regarding our capacity to manage the financial burden that CKD) places on patients, caregivers, and society are raised by its increasing prevalence and progression. Lack of awareness of CKD's economic effects is a major reason that lawmakers and administrators pay little attention to this chronic illness.

    OBJECTIVE: We aimed to analyze the direct burden of CKD across Asian countries and evaluate the main cost drivers among all mentioned cost centers in previous studies.

    METHODOLOGY: Related works evaluating the expenditures of CKD from the perspective of the patient were interpreted by a thorough search of PUBMED and GOOGLE SCHOLAR.

    RESULTS: Country-wise, in Asia, the direct mean average medical costs in RRT patients were reported in 8 studies as $4574, $18668, $2901, $6848, $16669, $3489, $5945, and $6344 in Singapore, Korea, Taiwan, China, Jordan, Vietnam, Lebanon, and India respectively and the direct mean average medical costs in non-RRT patients were reported in six studies as $3412, $2241, $4534, $290 and $1500 in Singapore, Japan, China, Vietnam, and India respectively.

    CONCLUSION: Hemodialysis is the main cost driver having an average mean cost of $23,358 per patient per year while the average mean cost of disease management is $4977 per patient per year. More research is needed to understand the specific economic challenges disadvantaged populations face, including the impact of income, education, and access to healthcare resources on the financial burden of CKD.

  9. Samsudin L, Mohd Jaafar MF, Kamarulzaman MKA, Mohd Nor NN, Ahmad Shafei S, Mohamad Shukor NA, et al.
    Malar J, 2024 Sep 05;23(1):269.
    PMID: 39238007 DOI: 10.1186/s12936-024-05095-7
    BACKGROUND: In Malaysia, despite a decline in cases, malaria remains a major public health concern, especially among the vulnerable indigenous people (i.e. Orang Asli) in remote areas. Effective preventive and control measures require an evidence-based understanding of their knowledge, attitudes, and practices (KAP) regarding malaria. This study aimed to evaluate the KAP regarding malaria in an indigenous settlement in Peninsular Malaysia.

    METHODS: A household-based cross-sectional study was conducted in March 2024 in six Semai sub-ethnic indigenous villages in Pos Lenjang, Kuala Lipis, Pahang. A structured questionnaire was administered to randomly selected individuals (≥ 12 years old) to collect data on sociodemographic characteristics and KAP. Data were analysed using descriptive statistics and predictors of KAP were determined using logistic regression. A p-value less than 0.05 was considered statistically significant.

    RESULTS: A total of 267 individuals from 160 households were interviewed. Nearly half had good knowledge (49.4%) and positive attitudes (54.3%) towards malaria, with high practice scores for prevention and control (83.1%). Multivariate logistic regression analysis showed higher odds of good knowledge in those aged 40-59 years (adjusted odd ratio [aOR] = 6.90, p = 0.034), with primary (aOR = 2.67, p = 0.015) or secondary education (aOR = 2.75, p = 0.019), and with previous malaria history (aOR = 5.14, p 

    MeSH terms: Adolescent; Adult; Aged; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Male; Middle Aged; Surveys and Questionnaires; Young Adult
  10. Pendi FH, Hussain H
    BMC Res Notes, 2024 Sep 05;17(1):251.
    PMID: 39238033 DOI: 10.1186/s13104-024-06924-3
    OBJECTIVE: Sago palm (Metroxylon sagu Rottb.) is one of the most important economic crops abundantly found in Mukah, Sarawak, Malaysia. The robustness of the palm triggered the Sarawak government's selection as one of the state's commodity crops, with the opening of several sago palm plantations. However, stunted (non-trunking) palms were reported in several sago palm plantations despite attaining a maturity period of more than ten years after cultivation. Research targeting this problem has been conducted in various fields, yet information on molecular mechanisms is still scarce. This study aimed to determine the genes responsible for sago palm's normal phenotype (trunking) by attaining leaf transcriptomes from samples of all trunking sago palms from different sago palm plantations.

    DATA DESCRIPTION: The conventional CTAB method was employed in the present investigation to extract total RNA from leaf tissues. Transcriptome sequencing was conducted on the Illumina NovaSeq 6000 platform. Differential expression analysis was performed using the DESeq2 package. A total of 6,119 differentially expressed genes, comprising 4,384 downregulated and 1,735 upregulated genes, were expressed in all three sago palm datasets. The datasets provide insights into the commonly expressed genes among trunking sago palms.

    MeSH terms: Malaysia; Phenotype; Gene Expression Regulation, Plant; Plant Leaves/genetics; Gene Expression Profiling/methods
  11. Srisuka W, Takaoka H, Taai K, Maleewong W, Aupalee K, Saeung A
    Parasit Vectors, 2024 Sep 05;17(1):379.
    PMID: 39238034 DOI: 10.1186/s13071-024-06441-z
    BACKGROUND: Black flies are among the most medically and veterinary important insects, as adult females of certain species are the sole vector of Onchocerca volvulus. Here, a new black fly species belonging to the subgenus Asiosimulium Takaoka & Choochote, 2005, is described and formally named as Simulium (Asiosimulium) kittipati sp. nov.

    METHODS: Pupae and larvae of black flies were collected from available substrates in the stream from central Thailand. Pupae were individually separated in plastic tubes and maintained until adult flies emerged. The emerged adult flies associated with their pupal exuviae and cocoon as well as mature larvae preserved in 85% ethanol were used to describe the new species based on an integrated approach of morphological examination and molecular analysis of the COI gene.

    RESULTS: The new species is characterized in the female by the medium-long sensory vesicle with a medium-sized opening apically, scutum with three faint longitudinal vittae, and the ellipsoidal spermatheca; in the male by the number of upper-eye (large) facets in 20 vertical columns and 21 horizontal rows, hind basitarsus slender, nearly parallel-sided, and median sclerite much wider and upturned apically; in the pupa by the head and thoracic integument densely covered with tiny tubercles, and the pupal gill of arborescent type with 28-30 filaments; and in the larva by the postgenal cleft deep, nearly reaching the posterior margin of the hypostoma, and dark pigmented sheath of the subesophageal ganglion. The DNA barcode successfully differentiated the new species from its congeners with an interspecific genetic divergence of 1.74-18.72%, confirming the morphological identification that the species is a new member of the subgenus Asiosimulium. Phylogenetic analyses also indicated that the new species is genetically closely related to Simulium phurueaense Tangkawanit, Wongpakam & Pramual, 2018, further supporting its morphological classification.

    CONCLUSIONS: This is the ninth species assigned to the subgenus Asiosimulium within the genus Simulium Latreille, 1802. Taxonomic notes and identification keys are given to distinguish this new species from the eight known species members in its same subgenus. Additionally, a distribution map of all species members in this subgenus occurring in Thailand and other countries is provided.

    MeSH terms: Animals; Electron Transport Complex IV/genetics; Female; Insect Vectors/anatomy & histology; Insect Vectors/classification; Insect Vectors/genetics; Male; Phylogeny*; Thailand
  12. Norazman CW, Lee LK
    Womens Health (Lond), 2024;20:17455057241275587.
    PMID: 39238240 DOI: 10.1177/17455057241275587
    Postpartum depression (PPD) is a mental health disorder that affects 10%-15% women globally. Longitudinal and meta-analyses have consistently demonstrated the negative impacts of PPD on both the affected mothers and subsequent infant development. Given the consideration that antidepressant side effects in breastfeeding infants and the cost-effectiveness considerations of psychotherapies, attention has been paid towards the promising role of social support interventions in order to prevent and reduce the PPD symptoms. Confirming the assertion, this narrative review examines the potential of five social support interventions to ameliorate PPD-related maternal and infant outcomes. The wide implications of psychoeducational strategy, nurses' supportive and non-directive counselling and home-visiting approach are outlined. Furthermore, the evidence underlying the role of peer support, culturally tailored intervention and community-based participatory approach in PPD is elucidated. In clinical practice, this review reinforce the roles of discharge educational intervention led by the experienced nurse during the postpartum stay, in order to maintain psychological mental health among the postpartum mothers. More importantly, the skilled and competence public health nurses act as valuable assets in treating PPD, and this effective treatment alternative should be considered by healthcare planners. In future, major investigations will be strategized to discover the synergistic effects of combined social support approaches to yield a better outcome in the prevention and treatment of PPD.
    MeSH terms: Counseling/methods; Female; Humans; Mothers/psychology; Social Support*
  13. Zhu Z, Deng T, Pan X
    J Glob Health, 2024 Sep 06;14:03032.
    PMID: 39238356 DOI: 10.7189/jogh.14.03032
    MeSH terms: Hot Temperature/adverse effects; Humans; Global Health; Climate Change*
  14. Roslan A
    Echocardiography, 2024 Sep;41(9):e15925.
    PMID: 39238470 DOI: 10.1111/echo.15925
    MeSH terms: Echocardiography/methods; Humans; Male; Predictive Value of Tests
  15. McBenedict B, Hauwanga WN, Amadi ES, Yau MCY, Amuzie CR, Abdelraof MO, et al.
    Cureus, 2024 Aug;16(8):e66259.
    PMID: 39238676 DOI: 10.7759/cureus.66259
    Dilated cardiomyopathy (DCM) is a prevalent heart muscle disease characterized by ventricular dilation and systolic dysfunction, leading to severe heart failure (HF) and often requiring heart transplantation (HTx). This systematic review aimed to synthesize information regarding the role of ventricular assist devices (VADs) in managing HF patients due to DCM. A comprehensive search was conducted across PubMed, Embase, Scopus, Web of Science, and Cochrane databases for studies published between 2014 and 2024. Inclusion criteria were studies involving adult patients with HF due to DCM treated with VADs. Exclusion criteria included non-human studies, pediatric populations, and non-peer-reviewed articles. Thirty-one studies met the inclusion criteria. The included studies demonstrated that the use of VADs in patients with DCM resulted in significant improvements in left ventricular ejection fraction (LVEF), myocardial fibrosis reduction, and reverse ventricular remodeling. Studies reported enhanced survival rates, reduced symptoms, and better quality of life. VADs served as a critical bridge to HTx and, in some cases, as long-term destination therapy. However, complications such as thrombus formation, anemia, and kidney failure were noted, emphasizing the need for vigilant monitoring and management. Continuous advancements in VAD technology and patient management protocols were found to be essential for optimizing outcomes. We conclude that VADs play a crucial role in managing advanced HF due to DCM by providing mechanical circulatory support, improving cardiac function, and enhancing patient survival and quality of life. Despite associated complications, VADs are invaluable for patients with severe HF, offering both immediate and long-term therapeutic benefits. Future research should focus on minimizing complications and further improving VAD technology to enhance patient outcomes.
  16. Chew JX, Tan JK, Cheong XK, Ho WC, Mohamed Arifin N, Chinnasami S, et al.
    Cureus, 2024 Aug;16(8):e66231.
    PMID: 39238702 DOI: 10.7759/cureus.66231
    Neurocysticercosis (NCC) is a central nervous system infection caused by Taenia solium or pork tapeworm. It affects millions worldwide and represents a leading cause of epilepsy in developing countries. NCC may be challenging to distinguish from intracranial tuberculomas, with tuberculosis being highly prevalent in developing countries. We highlight the importance of clinical history, including exposure history and neuroimaging, in obtaining an accurate diagnosis to enable prompt treatment. This report presents the case of a 26-year-old man diagnosed with NCC and presenting with acute giddiness and headache. Otherwise, there was no history of fever or constitutional symptoms. Neuroimaging demonstrated multiple cerebral lesions over both hemispheres, with degenerating scolex on brain MRI. He recovered well following a combination of oral albendazole, praziquantel, and corticosteroids. This case highlights the salient features that distinguish NCC from intracranial tuberculoma. Early and precise diagnosis will ensure that patients receive optimal treatment, expedite recovery, and prevent further complications.
  17. Mohajer F, Khoradmehr A, Riazalhosseini B, Zendehboudi T, Nabipour I, Baghban N
    Front Cell Dev Biol, 2024;12:1440091.
    PMID: 39239558 DOI: 10.3389/fcell.2024.1440091
    Marine invertebrate stem cells (MISCs) represent a distinct category of pluripotent and totipotent cells with remarkable abilities for self-renewal and differentiation into multiple germ layers, akin to their vertebrate counterparts. These unique cells persist throughout an organism's adult life and have been observed in various adult marine invertebrate phyla. MISCs play crucial roles in numerous biological processes, including developmental biology phenomena specific to marine invertebrates, such as senescence, delayed senescence, whole-body regeneration, and asexual reproduction. Furthermore, they serve as valuable models for studying stem cell biology. Despite their significance, information about MISCs remains scarce and scattered in the scientific literature. In this review, we have carefully collected and summarized valuable information about MISC detection by perusing the articles that study and detect MISCs in various marine invertebrate organisms. The review begins by defining MISCs and highlighting their unique features compared to vertebrates. It then discusses the common markers for MISC detection and in vitro techniques employed in invertebrate and vertebrates investigation. This comprehensive review provides researchers and scientists with a cohesive and succinct overview of MISC characteristics, detection methods, and associated biological phenomena in marine invertebrate organisms. We aim to offer a valuable resource to researchers and scientists interested in marine invertebrate stem cells, fostering a better understanding of their broader implications in biology. With ongoing advancements in scientific techniques and the continued exploration of marine invertebrate species, we anticipate that further discoveries will expand our knowledge of MISCs and their broader implications in biology.
  18. Goh XX, Tee SF, Tang PY, Chee KY, Loh KKW
    J Psychiatr Res, 2024 Jul;175:350-358.
    PMID: 38761517 DOI: 10.1016/j.jpsychires.2024.05.005
    Antipsychotics with weight gain as side effect and vitamin D receptor dysfunction associated with single nucleotide polymorphisms (VDR SNPs) may have different effects on vitamin D status. Hence, present study aimed to investigate the relationship between vitamin D with body mass index (BMI), antipsychotics and VDR SNPs (rs2228570, rs1544410, rs7975232 and rs731236) in Malaysian patients with schizophrenia. Serum vitamin D level was measured using competitive enzyme-linked immunosorbent assay kit. VDR SNPs were analyzed using polymerase chain reaction-restriction fragment length polymorphism. We found significantly lower serum vitamin D level in patients with schizophrenia (p 
    MeSH terms: Adult; Female; Genotype; Humans; Malaysia; Male; Middle Aged; Vitamin D/blood; Body Mass Index*; Genetic Predisposition to Disease; Polymorphism, Single Nucleotide*
  19. Mohd Adzlan F, Mohd K, Ahmad N, Ramli R
    BMJ Case Rep, 2024 May 22;17(5).
    PMID: 38782440 DOI: 10.1136/bcr-2024-259861
    Obstructed Hemi Vagina with Ipsilateral Renal Agenesis (OHVIRA) syndrome is a rarely encountered müllerian duct anomaly. Delayed diagnosis is common due to normal onset of puberty and menstruation. We report a case of a woman in her early 20s with a background history of multiple emergency department visits, ward admissions and surgeries for chronic abdominal pain. She was reviewed at 1 month postlaparotomy for recurrent pelvic abscess and was finally diagnosed to have an OHVIRA syndrome, 11 years after her first clinical presentation. Excision of the vaginal septum completely resolved her symptoms. We are reporting this case to highlight the clinical implications resulting from the delayed diagnosis, to look into factors contributing to the delay and to highlight the importance of having a high index of suspicion to diagnose this unique condition.
    MeSH terms: Congenital Abnormalities/diagnosis; Congenital Abnormalities/surgery; Abnormalities, Multiple/diagnosis; Adult; Diagnosis, Differential; Female; Humans; Kidney Diseases/congenital; Kidney Diseases/diagnosis; Mullerian Ducts/abnormalities; Mullerian Ducts/surgery; Syndrome; Abdominal Pain/etiology; Young Adult; Delayed Diagnosis*
  20. Tew WY, Tan CS, Yan CS, Loh HW, Wang X, Wen X, et al.
    Hypertens Res, 2024 Sep;47(9):2416-2434.
    PMID: 38914702 DOI: 10.1038/s41440-024-01652-4
    Hesperetin is one of the prominent flavonoids found in citrus fruit. Several research studies have reported that hesperetin can promote vasodilation in vascular tissue by increasing the level of nitric oxide and cyclic nucleotides. However, these may not be the only pathway for hesperetin to exert its vasodilatory effect. In addition to vasodilation, hesperetin has been found to carry an antihypertensive effect through intraperitoneal injection, although no study has comprehensively investigated the antihypertensive effect of hesperetin through oral administration. Therefore, this study aimed to determine the possible mechanism pathways involved in hesperetin-induced vasodilation and investigated its antihypertensive effects on hypertensive rats' model via oral administration. The ex vivo experimental findings showed that the NO/sGC/cGMP signalling pathway was involved in hesperetin-mediated vasodilation. Moreover, hesperetin activated the AC/cAMP/PKA pathway through PGI2 and activated the β2-adrenergic receptor. Hesperetin can act as a voltage-gated potassium channel (KV) and ATP-sensitive potassium channel (KATP) opener. The intracellular calcium in vascular smooth muscle was reduced by hesperetin through blocking the voltage-operated calcium channels (VOCC) and inositol triphosphate receptor (IP3R). In the in vivo assessment, hesperetin shows a significant decrease in Spontaneously Hypertensive rats' blood pressure following 21 days of oral treatment. The sub-chronic toxicity assessment demonstrated that hesperetin exhibited no deleterious effects on the body weights, clinical biochemistry and haematological profile of Sprague-Dawley rats. This study implies that hesperetin holds promise as a potential medication for hypertension treatment, devoid of undesirable side effects.
    MeSH terms: Animals; Blood Pressure/drug effects; Cyclic GMP/metabolism; Hypertension/drug therapy; Hypertension/physiopathology; Male; Muscle, Smooth, Vascular/drug effects; Muscle, Smooth, Vascular/metabolism; Nitric Oxide/metabolism; Rats, Inbred SHR; Vasodilator Agents/pharmacology; Signal Transduction/drug effects; Rats, Sprague-Dawley*; Rats
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