Browse publications by year: 2024

Fulltext DeepSplice: a deep learning approach for accurate prediction of alternative splicing events in the human genome

Abrar M, Hussain D, Khan IA, Ullah F, Haq MA, Aleisa MA, et al.

Front Genet, 2024;15:1349546.
PMID: 38974384 DOI: 10.3389/fgene.2024.1349546

Alternative splicing (AS) is a crucial process in genetic information processing that generates multiple mRNA molecules from a single gene, producing diverse proteins. Accurate prediction of AS events is essential for understanding various physiological aspects, including disease progression and prognosis. Machine learning (ML) techniques have been widely employed in bioinformatics to address this challenge. However, existing models have limitations in capturing AS events in the presence of mutations and achieving high prediction performance. To overcome these limitations, this research presents deep splicing code (DSC), a deep learning (DL)-based model for AS prediction. The proposed model aims to improve predictive ability by investigating state-of-the-art techniques in AS and developing a DL model specifically designed to predict AS events accurately. The performance of the DSC model is evaluated against existing techniques, revealing its potential to enhance the understanding and predictive power of DL algorithms in AS. It outperforms other models by achieving an average AUC score of 92%. The significance of this research lies in its contribution to identifying functional implications and potential therapeutic targets associated with AS, with applications in genomics, bioinformatics, and biomedical research. The findings of this study have the potential to advance the field and pave the way for more precise and reliable predictions of AS events, ultimately leading to a deeper understanding of genetic information processing and its impact on human physiology and disease.
Fulltext Urine manganese, cadmium, lead, arsenic, and selenium among autism spectrum disorder children in Kuala Lumpur

Rafi'i MR, Ja'afar MH, Abd Wahil MS, Md Hanif SA

PeerJ, 2024;12:e17660.
PMID: 38974411 DOI: 10.7717/peerj.17660

BACKGROUND: The development of autism spectrum disorder (ASD) may stem from exposure to environmental pollutants such as heavy metals. The primary objective of this study is to determine the role of heavy metals of concern such as manganese (Mn), cadmium (Cd), lead (Pb), arsenic (As), and essential trace element selenium (Se) among ASD children in Kuala Lumpur, Malaysia.
METHOD: A total of 155 preschoolers in Kuala Lumpur between the ages 3 to 6 participated in an unmatched case-control study, comprising ASD children (n = 81) recruited from an early intervention program for autism, and 74 children without autism who were recruited from public preschools. Urine samples were collected at home, delivered to the study site, and transported to the environmental lab within 24 hours. Inductively coupled plasma mass spectrometry (ICP-MS) was applied to measure the concentration of heavy metals in the samples. Data were analysed using bivariate statistical tests (Chi-square and T-test) and logistic regression models.
RESULT: This study demonstrated that Cd, Pb, and As urine levels were significantly greater in children without autism relative to those affected with ASD (p 1, p

MeSH terms: Child; Child, Preschool; Environmental Exposure/adverse effects; Environmental Exposure/analysis; Environmental Pollutants/adverse effects; Environmental Pollutants/urine; Female; Humans; Malaysia/epidemiology; Male; Case-Control Studies; Metals, Heavy/adverse effects; Metals, Heavy/urine
Fulltext Endoscopic Evacuation of Acute Subdural Hematomas: A New Selection Criterion

Sam JE, Komatsu F, Yamada Y, Tanaka R, Sasaki K, Tamura T, et al.

Asian J Neurosurg, 2024 Jun;19(2):153-159.
PMID: 38974426 DOI: 10.1055/s-0044-1787101

Introduction Acute subdural hematomas (ASDHs) have a high mortality rate and unfavorable outcomes especially in the elderly population even after surgery is performed. The conventional recommended surgeries by the Brain Trauma Foundation in 2006 were craniotomies or craniectomies for ASDH. As the world population ages, and endoscopic techniques improve, endoscopic surgery should be utilized to improve the outcomes in elderly patients with ASDH. Materials and Methods This was a single-center retrospective report on our series of six patients that underwent endoscopic ASDH evacuation (EASE). Demographic data, the contralateral global cortical atrophy (GCA) score, evacuation rates, and outcomes were analyzed. Results All patients' symptoms and Glasgow Coma Scale improved or were similar after EASE with no complications. Good outcome was seen in 4 (66.7%) patients. Patients with poor outcome had initial low Glasgow Coma Scale scores on admission. The higher the contralateral GCA score, the higher the evacuation rate ( r = 0.825, p ≤ 0.043). All the patients had a GCA score of ≥7. Conclusion EASE is at least not inferior to craniotomy for the elderly population in terms of functional outcome for now. Using the contralateral GCA score may help identify suitable patients for this technique instead of just using a cut-off age as a criteria.
Fulltext Development and Evaluation of Content Validity and Acceptance of a Multidomain Intervention Module for Reversal of Cognitive Frailty Among Older Adults

Mustafa Khalid N, Ponvel P, Ibrahim AM, Mohd Safien A, Md Fadzil NH, Singh DKA, et al.

Clin Interv Aging, 2024;19:1189-1202.
PMID: 38974508 DOI: 10.2147/CIA.S458600

PURPOSE: There is a limited availability of multidomain interventions that target cognitive frailty. Thus, the aim of the present study was to develop and evaluate the content validity and acceptance of the multidomain intervention module to reverse cognitive frailty among older adults (iAGELESS).
PATIENTS AND METHODS: This study was conducted in two phases: Phase I included the development of the multidomain intervention module iAGELESS and evaluation of content validity, while Phase II consisted of evaluating the acceptance of the module among 18 healthcare and social care providers, 13 older adults with cognitive frailty, and 13 caregivers. Content validity index (CVI) was used to quantify the content validity. Respondents completed a questionnaire which consisted of information on sociodemographic, followed by module acceptance evaluation with respect to content, terminologies, and graphics. The data was then analyzed descriptively.
RESULTS: A multidomain intervention module, iAGELESS was developed. The module was found to have appropriate content validity (overall CVI = 0.83). All the caregivers, 92% of older adults with cognitive frailty and 83% of healthcare and social care providers were satisfied with the overall content of the module. More than 50% of those who accepted the module had satisfactory consensus on the ease of the terminologies, length of sentences, pictures, information, color, and font size included in the module.
CONCLUSION: The iAGELESS module demonstrated good content validity and was well accepted, thus warranting its utilization in future studies to determine its effectiveness in reversing cognitive frailty among older adults.

MeSH terms: Aged; Aged, 80 and over; Female; Health Personnel/psychology; Humans; Male; Middle Aged; Surveys and Questionnaires; Reproducibility of Results; Mild Cognitive Impairment
Fulltext Updates in the skeletal and joint protective effects of tocotrienol: a mini review

Chin KY

Front Endocrinol (Lausanne), 2024;15:1417191.
PMID: 38974581 DOI: 10.3389/fendo.2024.1417191

Osteoporosis and osteoarthritis continue to pose significant challenges to the aging population, with limited preventive options and pharmacological treatments often accompanied by side effects. Amidst ongoing efforts to discover new therapeutic agents, tocotrienols (TTs) have emerged as potential candidates. Derived from annatto bean and palm oil, TTs have demonstrated efficacy in improving skeletal and joint health in numerous animal models of bone loss and osteoarthritis. Mechanistic studies suggest that TTs exert their effects through antioxidant, anti-inflammatory, Wnt-suppressive, and mevalonate-modulating mechanisms in bone, as well as through self-repair mechanisms in chondrocytes. However, human clinical trials in this field remain scarce. In conclusion, TTs hold promise as agents for preventing osteoporosis and osteoarthritis, pending further evidence from human clinical trials.

MeSH terms: Animals; Bone and Bones/drug effects; Bone and Bones/metabolism; Humans
Fulltext Posttonsillectomy Pain Relief and Wound Healing by Applying Bismuth Iodoform Paraffin Paste (BIPP) to Dissected Tonsillar Beds

Idris R, Ramli RR, Yaacob WNW, Hassan S

Int Arch Otorhinolaryngol, 2024 Jul;28(3):e440-e450.
PMID: 38974633 DOI: 10.1055/s-0043-1777295

Introduction Tonsillectomy is one of the most common operations performed by otorhinolaryngology surgeons worldwide; however, the insufficient quality of the postoperative pain management and effective posttonsillectomy pain relief remain a clinical dilemma. Objective To evaluate the efficacy of applying bismuth iodine paraffin paste (BIPP) to the dissected fossa as an adjuvant therapy for a better outcome in terms of posttonsillectomy pain management and due to its wound healing properties. Methods The present is a prospective randomized control pilot study with 44 patients aged > 7 years who underwent tonsillectomy. The patients were divided into two groups: the control group and the group that had BIPP applied to the dissected tonsillar fossa. The visual analogue scale score and the post-onsillectomy percentage of tonsillar fossa epithelization were recorded and evaluated. Results Both subjectively and objectively, there a was statistically significant pain-relieving effect in the BIPP group within the first 5 postoperative days ( p
Fulltext Fatty Acid Profile and Thermal Behavior of Fat-Rich Edible Insect Oils Compared to Commonly Consumed Animal and Plant Oils

Chantakun K, Petcharat T, Wattanachant S, Karim MSBA, Kaewthong P

Food Sci Anim Resour, 2024 Jul;44(4):790-804.
PMID: 38974734 DOI: 10.5851/kosfa.2024.e44

This study compared the physicochemical properties of edible insect oils from silkworm (Bombyx mori) pupa (SP), sago palm weevil (Rhynchophorus ferrugineus) larva (PW), and bamboo caterpillar (Omphisa fuscidentalis; BC) to oils from chicken skin (CK), beef back fat (BF), pork back fat (PF), salmon belly (SB), sea bass belly (BB), coconut (C), and peanut (P). The fatty acid profiles and thermal behaviors (crystallization and melting) of the extracted oils were evaluated. PW and BC oils had more saturated fatty acids (SFAs) than CK, PF, SB, BB, and P oils. SP oil had equivalent SFA content to CK and BB oils. Insect oils exhibited similar monounsaturated fatty acid concentrations in all samples, except C oils. PW and BC oils exhibited a higher content of palmitoleic acid than the other oils. SP oils contained polyunsaturated fatty acids similar to those in SB and BB oils, which were higher than those in PW, BC, CK, BF, and PF oils. SP oil also exhibited the highest concentration of α-linolenic acid (C18:3 n-3). Arachidonic acid (0.01-0.02 g/100 g) in all insect oils was lower level compared to CK, BF, PF, SB, and BB oils. SP oil (0.03 g/100 g) exhibited a slightly higher level of eicosapentaenoic acid compared to PW (0.01 g/100 g) and BC (0.01 g/100 g) oils. The insect oils were liquid at ambient temperature, solid below -15°C, and required less energy (△Hm-max) for melting than other samples. This study indicated that insects, particularly SP, could serve as an alternative source of fat to meet its growing demand.
Fulltext Application of machine learning approach on halal meat authentication principle, challenges, and prospects: A review

Mustapha A, Ishak I, Zaki NNM, Ismail-Fitry MR, Arshad S, Sazili AQ

Heliyon, 2024 Jun 30;10(12):e32189.
PMID: 38975107 DOI: 10.1016/j.heliyon.2024.e32189

Meat is a source of essential amino acids that are necessary for human growth and development, meat can come from dead, alive, Halal, or non-Halal animal species which are intentionally or economically (adulteration) sold to consumers. Sharia has prohibited the consumption of pork by Muslims. Because of the activities of adulterators in recent times, consumers are aware of what they eat. In the past, several methods were employed for the authentication of Halal meat, but numerous drawbacks are attached to this method such as lack of flexibility, limited application, time,consumption and low level of accuracy and sensitivity. Machine Learning (ML) is the concept of learning through the development and application of algorithms from given data and making predictions or decisions without being explicitly programmed. The techniques compared with traditional methods in Halal meat authentication are fast, flexible, scaled, automated, less expensive, high accuracy and sensitivity. Some of the ML approaches used in Halal meat authentication have proven a high percentage of accuracy in meat authenticity while other approaches show no evidence of Halal meat authentication for now. The paper critically highlighted some of the principles, challenges, successes, and prospects of ML approaches in the authentication of Halal meat.
Fulltext The parameter of the Sick Building Syndrome: A systematic literature review

Subri MSM, Arifin K, Sohaimin MFAM, Abas A

Heliyon, 2024 Jun 30;10(12):e32431.
PMID: 38975158 DOI: 10.1016/j.heliyon.2024.e32431

Sick Building Syndrome (SBS) is a collection of symptoms assumed to be related to spending time in a certain building, most typically a workplace, but no specific cause has been identified. The need to measure and assess various types of parameters of SBS is crucial and it is important to explore what parameter has been used in the previous studies of SBS. Therefore, this study aims to systematically review the parameter that has been used to monitor the SBS. This study was conducted using the PRISMA Statement and the search was conducted using two scientific databases which were Scopus and Web of Science. After a thorough and tight process, a total of 55 articles have been finalized and selected for thematic analysis. Two themes have been identified which were a) Indoor Environmental Quality (IEQ) and b) Occupant. This study also found that the spatial distribution pattern revealed that the Sick Building Syndrome research was spread over 26 nations, with the majority of articles originating from the United States and China. In terms of context, the majority of the selected publications employed the survey approach to investigate SBS parameters. Aside from that, the most researched form of building is the business building. This study has found that it would be more impactful for the SBS study if researchers could incorporate both indoor environmental quality and occupant factors into a study, resulting in more holistic conclusions.
Fulltext Highly sensitive detection of low-concentration sodium chloride solutions based on a gold-coated prism in Kretschmann setup

Na'imah S, Apsari R, Masruroh, Yasin M, Wadi Harun S

Heliyon, 2024 Jun 30;10(12):e32349.
PMID: 38975194 DOI: 10.1016/j.heliyon.2024.e32349

A gold-coated Kretschmann setup has been constructed and explored as a surface plasmon resonance (SPR) platform, specifically tailored for the detection of low-concentration sodium chloride (NaCl) solutions. The setup employs a BK7 prism coated with a 50 nm gold layer, serving as a plasmonic layer, to induce resonance. This resonance arises from the interplay between light waves and free electrons propagating at the interface of two media. The experimental findings reveal a notable resonance angle shift of 10° when the NaCl concentration is varied from 0 to 2.5 %. Furthermore, angle interrogation provides insightful details about the sensor's response to changes in the refractive index, showcasing a commendable sensitivity of 2400°/RIU, a high level of linearity at 0.9771, and an impressive resolution of 0.217 %. The demonstrated capabilities of this sensor underscore its potential for widespread applications, particularly in the monitoring of salt concentration across diverse domains such as seawater analysis, food processing, and fermentation processes. The robust performance and precision of this proposed sensor position it as a valuable tool with promising prospects for addressing the needs of various industries dependent on accurate salt concentration measurements.
Fulltext An event triggered control scheme for enhanced production of Escherichia coli and biomass concentration during fed-batch cultivation

Murugan C, Subbian S, Kaliyaperumal S, Sadasivuni KK, Siddiqui MIH, Muthusamy S, et al.

Heliyon, 2024 Jun 30;10(12):e32210.
PMID: 38975212 DOI: 10.1016/j.heliyon.2024.e32210

Control of a bioprocess is a challenging task mainly due to the nonlinearity of the process, the complex nature of microorganisms, and variations in critical parameters such as temperature, pH, and agitator speed. Generally, the optimum values chosen for critical parameters during Escherichia coli (E.coli) K-12fed-batch fermentation are37 ᵒC for temperature, 7 for pH, and 35 % for Dissolved Oxygen (DO). The objective of this research is to enhance biomass concentration while minimizing energy consumption. To achieve this, an Event-Triggered Control (ETC) scheme based on feedback-feed forward control is proposed. The ETC system dynamically adjusts the substrate feed rate in response to variations in critical parameters. We compare the performance of classical Proportional Integral (PI) controllers and advanced Model Predictive Control (MPC) controllers in terms of bioprocess yield. Initially, the data are collected from a laboratory-scaled 3L bioreactor setup under fed-batch operating conditions, and data-driven models are developed using system identification techniques. Then, classical Proportional Integral (PI) and advanced Model Predictive Control (MPC) based feedback controllers are developed for controlling the yield of bioprocess by manipulating substrate flow rate, and their performances are compared. PI and MPC-based Event Triggered Feed Forward Controllers are designed to increase the yield and to suppress the effect of known disturbances due to critical parameters. Whenever there is a variation in the value of a critical parameter, it is considered an event, and ETC initiates a control action by manipulating the substrate feed rate. PI and MPC-based ETC controllers are developed in simulation, and their closed-loop performances are compared. It is observed that the Integral Square Error (ISE) is notably minimized to 4.668 for MPC with disturbance and 4.742 for MPC with Feed Forward Control. Similarly, the Integral Absolute Error (IAE) reduces to 2.453 for MPC with disturbance and 0.8124 for MPC with Feed Forward Control. The simulation results reveal that the MPC-based ETC control scheme enhances the biomass yield by 7 %, and this result is verified experimentally. This system dynamically adjusts the substrate feed rate in response to variations in critical parameters, which is a novel approach in the field of bioprocess control. Also, the proposed control schemes help reduce the frequency of communication between controller and actuator, which reduces power consumption.
Fulltext Exchange rate volatility and COVID-19 effects on Indonesia's food products' trade: Symmetric and asymmetric approach

Hannafi Ibrahim K, Dwi Handoyo R, Dwi Kristianto F, Kusumawardani D, Ogawa K, Azlan Shah Zaidi M, et al.

Heliyon, 2024 Jun 30;10(12):e32611.
PMID: 38975235 DOI: 10.1016/j.heliyon.2024.e32611

This study aims to determine the symmetric and asymmetric effects of exchange rate volatility and other explanatory variables (real exchange rate, industrial production index, and COVID-19) on sixteen (16) food products traded between Indonesia and the United States, Indonesia and China. The study used the ARCH/GARCH approach and estimate the volatility of the exchange rate. Linear and nonlinear autoregressive distributed lag (ARDL) were applied to estimate the short- and long-run effect for the period 2009:M1-2020:M12. Findings from the ARDL method indicate that, in the short-term exchange rate volatility has a significant positive/negative effect on many products exported and imported throughout the study period. Different results were found in the Nonlinear ARDL method where a significant effect occurred especially on the food products import. The result further indicates that exchange rate volatility has a more negative effect symmetrically or asymmetrically. These results imply that most Indonesian traders to the United States and China tend to behave as risk-averse in the long run when responding to the phenomenon of exchange rate volatility. As a measure of robustness, a quantile regression further confirms that exchange rate volatility consistently affects food product trade. With this, therefore, stable exchange rate policies are needed to lessen the harmful effect of volatility on trade flows and balance the risk-taking behaviour among importers and exporters.
Fulltext Loss of Sunda clouded leopards and forest integrity drive potential impacts of mesopredator release on vulnerable avifauna

Mayhew DS, Hearn AJ, Devineau O, Linnell JDC, Macdonald DW

Heliyon, 2024 Jun 30;10(12):e32801.
PMID: 38975237 DOI: 10.1016/j.heliyon.2024.e32801

Amongst the unintended consequences of anthropogenic landscape conversion is declining apex predator abundance linked to loss of forest integrity, which can potentially re-order trophic networks. One such re-ordering, known as mesopredator release, occurs when medium-sized predators, also called mesopredators, rapidly increase in abundance following the decline in apex predator abundance, consequently reducing the abundance of mesopredator prey, notably including terrestrial avifauna. We examine the cascading impacts of declining Sunda clouded leopard abundance, itself consequent upon a reduction in forest integrity, on the mesopredator community of Sabah, Malaysia, to determine whether the phenomenon of mesopredator release is manifest and specifically whether it impacts the terrestrial avifauna community of pheasants and pittas. To explore this trophic interaction, we used a piecewise structural equation model to compare changes in the relative abundance of organisms. Our results suggest that loss of forest integrity may have broad impacts on the community and trigger mesopredator release, the two acting additively in their impact on already vulnerable species of terrestrial avifauna: a result not previously documented in tropical systems and rarely detected even on a global scale. The limiting effect that the Sunda clouded leopard has on the Sunda leopard cat could illuminate the mechanism whereby mesopredator release impacts this system. Both Bulwer's pheasant and pittas appear to be significantly impacted by the increase in Sunda leopard cats, while the great argus pheasant shows similar compelling, although not statistically significant, declines as Sunda leopard cats increase. The inverse relationship between Sunda clouded leopards and Sunda leopard cats suggests that if a mesopredator release exists it could have downstream consequences for some terrestrial avifauna. These results suggest the under-studied interface between mammalian carnivores and avifauna, or more broadly species interactions in general, could offer important conservation tool for holistic ecosystem conservation efforts.
Fulltext Deep neural network-based prediction of tsunami wave attenuation by mangrove forests

Adytia D, Tarwidi D, Saepudin D, Husrin S, Kasim ARM, Romlie MF, et al.

MethodsX, 2024 Dec;13:102791.
PMID: 38975289 DOI: 10.1016/j.mex.2024.102791

The goal of this research is to develop a model employing deep neural networks (DNNs) to predict the effectiveness of mangrove forests in attenuating the impact of tsunami waves. The dataset for the DNN model is obtained by simulating tsunami wave attenuation using the Boussinesq model with a staggered grid approximation. The Boussinesq model for wave attenuation is validated using laboratory experiments exhibiting a mean absolute error (MAE) ranging from 0.003 to 0.01. We employ over 40,000 data points generated from the Boussinesq numerical simulations to train the DNN. Efforts are made to optimize hyperparameters and determine the neural network architecture to attain optimal performance during the training process. The prediction results of the DNN model exhibit a coefficient of determination (R2 ) of 0.99560, an MAE of 0.00118, a root mean squared error (RMSE) of 0.00151, and a mean absolute percentage error (MAPE) of 3 %. When comparing the DNN model with three alternative machine learning models- support vector regression (SVR), multiple linear regression (MLR), and extreme gradient boosting (XGBoost)- the performance of DNN is superior to that of SVR and MLR, but it is similar to XGBoost.•High-accuracy DNN models require hyperparameter optimization and neural network architecture selection.•The error of DNN models in predicting the attenuation of tsunami waves by mangrove forests is less than 3 %.•DNN can serve as an alternate predictive model to empirical formulas or classical numerical models.
Fulltext Albania and Kosovo-Albania Immigrants' Perceptions of Mental Well-Being and the Psychological Challenges Faced in Malaysia

Thartori V, Ismail NAH

J Migr Health, 2024;10:100234.
PMID: 38975293 DOI: 10.1016/j.jmh.2024.100234

BACKGROUND: Immigrants who relocate to a foreign country often face numerous stressors and challenges as they try to assimilate to a new culture. This transition can often have a significant impact on their mental well-being. In this qualitative study, we aim to explore and examine the life experiences of 16 Albanian and Kosovo-Albania immigrants who have settled in Malaysia, as well as those who previously resided in Malaysia but are now living in Australia and Albania.
OBJECTIVES: This study aimed to investigate two main objectives: (i) to explore immigrants' psychological problems and how they perceive and approach mental well-being; and (ii) to identify the challenges and barriers that immigrants face in Malaysia.
METHODS: The data was obtained using a qualitative phenomenological case study, using in-depth semi-structured interviews. The interviews were audio-recorded, transcribed, and thematically analysed.
RESULTS: The study's findings indicate that immigrants' mental well-being is positively affected by inner peace, happiness, fulfilling family needs, a balanced life, and self-improvement. On the other hand, challenges related to visa and employment pass issues, difficulty in securing employment status, feeling like a foreigner, and lack of family support have a negative impact on their mental well-being.
IMPLICATIONS: The study's findings advocate for targeted support programmes to address the psychological challenges of Albanian immigrants. Prioritising inner peace and self-improvement benefits their mental well-being. Policymakers are encouraged to prioritise reducing employment pass difficulties and fostering an inclusive job market to improve employment opportunities for this community.
Fulltext Advances and Challenges in the Management of Brugada Syndrome: A Comprehensive Review

McBenedict B, Alphonse B, Devan JN, Singh G, Goh KS, Yau RCC, et al.

Cureus, 2024 Jun;16(6):e61837.
PMID: 38975383 DOI: 10.7759/cureus.61837

Brugada syndrome (BrS) is an inherited arrhythmogenic disorder marked by distinctive ST-segment elevations on electrocardiograms (ECG) and an increased risk of sudden cardiac death. Characterized by mutations primarily in the SCN5A gene, BrS disrupts cardiac ion channel function, leading to abnormal electrical activity and arrhythmias. Although BrS primarily affects young, healthy males, it poses significant diagnostic challenges due to its often concealed or intermittent ECG manifestations and clinical presentation that can mimic other cardiac disorders. Current management strategies focus on symptom control and prevention of sudden death, with implantable cardioverter-defibrillators (ICD) serving as the primary intervention for high-risk patients. However, the complications associated with ICDs and the lack of effective pharmacological options necessitate a cautious and personalized approach. Recent advancements in catheter ablation have shown promise, particularly for managing ventricular fibrillation (VF) storms and reducing ICD shocks. Additionally, pharmacological treatments such as quinidine have been effective in specific cases, though their use is limited by availability and side effects. This review highlights significant gaps in the BrS literature, particularly in terms of long-term management and novel therapeutic approaches. The importance of genetic screening and tailored treatment strategies to better identify and manage at-risk individuals is emphasized. The review aims to enhance the understanding of BrS and improve patient outcomes, advocating for a multidisciplinary approach to this complex syndrome.
Fulltext Uncommon Site Presentation: A Case Report of Extraparotid Warthin's Tumor

Zakaria NA, Chen IHK, Yong E, Mahadzir M

Cureus, 2024 Jun;16(6):e61734.
PMID: 38975407 DOI: 10.7759/cureus.61734

Warthin's tumor, also known as adenolymphoma or papillary cystadenoma lymphomatosum, is a benign tumor almost exclusively found in the parotid gland and is the second most common type of benign parotid tumor. Its manifestation as an extraparotid lesion is rare, with a low incidence in the submandibular gland. In this context, we present a case of Warthin's tumor of the submandibular gland in a 66-year-old man who presented with a painless lateral cystic cervical mass. This case highlights the clinical and radiological evidence of an uncommon extraparotid tumor location, with the diagnosis becoming evident only after the enucleation of the mass. Despite the rarity of extraparotid Warthin's tumor and its potential variation in location, the authors recommend considering Warthin's tumor of the submandibular gland in the differential when assessing lateral cervical masses.
Fulltext Rhegmatogenous Retinal Detachment in Anterior Scleritis With Ulcerative Colitis

Jayallan B, Mustafa MH, Md Din N, Bastion MC

Cureus, 2024 Jun;16(6):e61819.
PMID: 38975419 DOI: 10.7759/cureus.61819

Rhegmatogenous retinal detachment (RRD) is an ocular emergency as it is sight-threatening and requires urgent surgical intervention. Ulcerative colitis (UC) is an immune-mediated inflammatory bowel disease that can present with ocular manifestations. The objective of this case report is to share the rare presentation of RRD associated with UC leading to diagnosis and management dilemmas. A 35-year-old man with active UC presented with a right chronic red eye for two months. The best corrected visual acuity (BCVA) was 6/6 in both eyes (OU). On examination, sectoral inferotemporal anterior scleritis (AS) with subclinical inferior RRD with peripheral holes in the lattice at the 6 o'clock position was noted. There was no posterior vitreous detachment. Optical coherence tomography (OCT) delineated the RRD objectively and was non-progressive for nine months. Barricade laser was given, in addition to intravenous methylprednisolone (IVMP), followed by a tapering dose of oral prednisolone and topical dexamethasone 0.1% over three months. Over a year, the scleritis resolved. However, six months later, while still on immunomodulating agents, the inferior RRD progressed on OCT. Segmental scleral buckle, indirect laser retinopexy, and subtenon triamcinolone injection were performed. IVMP 1 g per day was given for three days prior to surgery. Two months later, his BCVA was 6/6, with signs of fluid resorption and normal intraocular pressure. No recurrent AS was seen. Treatment of non-progressive, subclinical RRD patients with UC and active AS can be delayed with regular follow-up. When RRD progressed and there was no AS activity, it was the window of opportunity for the success of scleral buckle and perioperative steroids.
Fulltext Pregnancy Outcomes and Maternal Periodontal Diseases: The Unexplored Connection

Mariam S, Hasan S, Shinde M, Gupta J, Buch SA, Rajpurohit KS, et al.

Cureus, 2024 Jun;16(6):e61697.
PMID: 38975478 DOI: 10.7759/cureus.61697

In the early 20th century, numerous in-vitro studies, animal studies, epidemiological studies, and human trials have attempted to demonstrate the interrelationship between pregnancy outcomes and maternal periodontal disease. This review aims to shed light on the unexplored connections between pregnancy outcomes and maternal periodontal diseases. A literature search was conducted using electronic databases such as PubMed, Scopus, Google Scholar, Web of Science, and Embase. Our research focuses on the role of epigenetics, maternal vitamin D status, stress levels, genetic factors, innate immunity, pattern recognition receptors, and any potential paternal influence, and their possible connections to maternal periodontal disease. Although the precise etiologies and pathogenic mechanisms of the adverse pregnancy outcomes remain obscure, substantial affirmation of the inter-relationship between maternal periodontal diseases and adverse pregnancy outcomes may prove to be of public health relevance as periodontitis can certainly be prevented and treated. Maternal periodontal disease may augment the probability of jeopardizing maternal health causing adverse effects on the pregnancy and neonatal morbidity. Hence, emphasis should be placed on an early diagnosis and management of periodontal diseases. Routine oral health evaluation during prenatal care should be encouraged to combat complications. Ensuing endeavors should be undertaken to help find plausible mechanisms keeping in view the future research domains and new pathways.
Fulltext Clinical and Laboratory Diagnosis of Antiphospholipid Syndrome: A Review

Zahidin MA, Iberahim S, Hassan MN, Zulkafli Z, Mohd Noor NH

Cureus, 2024 Jun;16(6):e61713.
PMID: 38975541 DOI: 10.7759/cureus.61713

The antiphospholipid syndrome (APS) manifests through venous or arterial thrombosis, with or without pregnancy complication alongside the continuous presence of antiphospholipid antibodies (aPL). APS classification relies on three aPL subtypes: anticardiolipin (aCL), anti-β2-glycoprotein I antibodies (anti-β2GPI), and lupus anticoagulants (LA) antibodies. Given that thrombosis and pregnancy issues are not unique to APS, the precise and reliable identification of aPL forms the basis for diagnosis. Semi-quantitative solid-phase assays identify two antibodies, aCL and anti-β2GPI, while LA detection occurs through various phospholipid-dependent coagulation assays that are based on antibody behaviour. LA, specifically, is conclusively associated with thrombosis, prompting discussions around the serological criteria for APS. Despite advancements in LA detection, the standardisation of all aPL detection assays remains imperative. The combined presence of aCL and anti-β2GPI with thrombosis inconsistently triggers concern. Initial presentations by APS patients commonly exhibit a heightened risk of stroke, miscarriages in the later stages of pregnancy, positive results of LA tests, and widespread thrombosis across multiple organs, often leading to adverse outcomes. Correctly diagnosing this condition is pivotal to avoid unnecessary long-term secondary thromboprophylaxis.

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