METHODS: Isolates were characterized by Gram staining, catalase reaction, growth at 37°C, and tolerance to phenol, pH, and gastrointestinal conditions. Molecular identification using 16S rRNA sequencing. Evaluations included hydrophobicity, auto-aggregation, HT-29 cell line adhesion, antimicrobial activity, and antibiotic susceptibility. Enzyme inhibition was measured for α-glucosidase and α-amylase using cell-free supernatant, cell extract, and intact cells. Adipogenesis was assessed through Oil-Red O staining, gene expression analysis (PPAR-γ, C/EBPα, Adiponectin, Glut-4, FAS), and glucose uptake assays on 3T3-L1 cells.
RESULTS: All isolates showed good tolerance to pH (≤9.15 CFU/ml), phenol (≤9.90 CFU/ml), hydrophobicity (≤78.14%), and auto-aggregation (≤92.23%). RAMULAB51 demonstrated the highest tolerance, hydrophobicity, and auto-aggregation. It strongly co-aggregated with Micrococcus luteus and Bacillus subtilis, showing significant antimicrobial activity with a 24 mm inhibition zone against Micrococcus luteus. All isolates were sensitive to Ampicillin, Azithromycin, Streptomycin, and Tetracycline, but resistant to Methicillin and Vancomycin. RAMULAB51 demonstrated the highest enzyme inhibition: α-glucosidase (68.45% CFS, 60.18% CE, 42.15% IC) and α-amylase (80.74% CFS, 61.23% CE, 35.12% IC). By inhibiting these digestive enzymes, RAMULAB51 reduces the conversion of carbohydrates into glucose, thereby decreasing blood glucose levels. This reduction in circulating glucose subsequently influences adipocyte function, as evidenced by the enhanced glucose uptake (1000 µg/mL) and upregulation of PPAR-γ, C/EBPα, Adiponectin, and Glut-4, alongside the downregulation of FAS.
CONCLUSION: The study highlights RAMULAB51's potential for improving glucose and lipid metabolism. Further, in vivo research is needed to explore its full therapeutic benefits. These findings confirm RAMULAB51's significant probiotic potential and its promise for diabetes management, warranting further clinical investigation.
METHODS: We retrospectively analyzed vascular anomaly referral letters received by Hospital Tunku Azizah from 2018 to 2023. Specifically, we descriptively analyzed the inclusion of vascular anomaly characteristics, the demographic profiles of referrers and patients, and basic clinical findings. Subsequently, we developed a redesigned proforma.
RESULTS: Overall, 47 referral letters were analyzed. The patients comprised 25 boys and 22 girls, with ages ranging from birth to 14 years. Patient name, sex, and date of birth, along with the referrer's name and address, were satisfactorily documented. The review revealed that 44 (93.6%) of the letters included the patient's presenting problem, 43 (91.5%) contained clinical findings, 37 (78.7%) reported diagnostic investigations, and 29 (61%) referenced medical history. Regarding characteristics of vascular conditions, over half of the letters detailed time of appearance (n= 40, 85%), growth (n= 24, 66%), complications (n= 25, 53.2%), color (n= 32, 68%), and shape (n= 34, 72%). However, fewer than half mentioned compressibility (n= 7, 14.8%), pulsation (n= 7, 14.7%), and associated conditions (n= 2, 4.3%), and none referenced involution.
CONCLUSION: Although demographic data were generally well-documented, critical medical history information was frequently omitted, including a lack of adequate pre-referral investigations. Key characteristics of vascular anomalies, namely compressibility, pulsation, associated conditions, and involution, were frequently overlooked. Accurate documentation of these features is crucial for determining treatment urgency. A standardized proforma must be implemented to ensure that vital information is captured, thus facilitating diagnosis and optimizing patient care.
METHOD: Resin-modified GIC, Fuji II LC (F2) and high-fluoride cGIC, Fuji VII (F7) were used as controls. HCD was synthesized in-house, incorporated into both RMGIC and cGICs at 1 % and 2 % weight percentages (w/w), and chemically analyzed using Fourier transform infrared (FTIR) spectroscopy. Then, the F2 containing HCD (GIC-HCD F2) and F7 containing HCD (GIC-HCD F7) were evaluated for HCD and fluoride release profiles using UV Visible spectrophotometer and pH/ISE benchtop fluoridemeter, respectively. The antibacterial properties were assessed against Streptococcus sanguinis using the agar well diffusion method and measurement of bacterial growth turbidity, followed by the observation of the bacterial morphology using scanning electron microscope. The data were statistically analyzed using one-way ANOVA and Bonferroni post-hoc tests.
RESULTS: The FTIR spectra confirmed the presence of HCD in the GIC-HCD matrices. HCD was successfully released from both GIC-HCD F2 and GIC-HCD F7 matrices at both weight percentages. Higher fluoride release and inhibitory zones were observed compared to the control groups, with GIC-HCD F2 having a more significant effect than GIC-HCD F7. Additionally, the incorporation of HCD slowed down the growth of Streptococcus sanguinis and showed remarkable changes in bacterial shape specifically on GIC-HCD F2.
CONCLUSION: The incorporation of HCD into both RMGIC and cGIC improved fluoride release and enhanced the antibacterial activities, with a more significant effect observed in RMGIC compared to cGIC.
METHODS: We used secondary data from the National Health and Morbidity Survey 2022. It is a cross-sectional study with a multistage stratified cluster sampling study design including 32,290 students aged 13 to 17 years old. It utilized the self-administered questionnaire from the validated Malaysian Global School-based Health Survey (GSHS). The associations between the truancy and its associated factors were examined using multivariate logistic regression, a complex sample analysis with sampling weightage.
RESULTS: The prevalence of truancy was 25.6% (95% CI=24.25, 26.98). In the multivariate analysis, truancy was significantly associated with older age groups (P<0.001), adolescents with separated/ divorced/ widowed parents (P<0.001), those with current any tobacco product use (P<0.001), those with ever drug use (P<0.001), those who have been physically attacked (P<0.001) and being bullied (P<0.001).
CONCLUSION: Gender, age, parent marital status, and adolescents with risk behavior were associated with truancy. This information may provide evidence for the implementation of effective prevention and intervention strategies to reduce truancy among these school-going adolescents.
METHODS: A cross-sectional study was conducted in 2023 among 285 COMBI CHVs from 5 health operational zones in Kuala Lumpur and Putrajaya. The CHVs were stratified proportionately, with 45.5% of respondents randomly selected from each stratum based on their zones. Self-administered questionnaires assessed their performance level and associated factors, including training, supervision, knowledge, motivation, and job satisfaction. Chi-square and Multiple Logistic Regression tests were used to determine the factors and predictors of high-performance COMBI CHVs.
RESULTS: The prevalence of high-performance COMBI CHVs was 59.3%, significantly associated with training factors (experience, duration, and adequacy of training), supervision factors (being supervised, supervision frequency, and encouragement from supervision), motivation and job satisfaction level. As for significant predictors, having at least one day of training (AOR=14.557), being supervised by medical personnel (AOR=4.997), having a high motivation level (AOR=5.538) and having a high job satisfaction level (AOR=4.562) were more likely to have a high-performance level.
CONCLUSION: Training duration, supervisor background, motivation and job satisfaction can contribute to high-performance levels among COMBI CHVs, which can applied in evidence-based policies and strategies for performance improvement and more effective community healthcare delivery.
METHODOLOGY: This cross-sectional study enrolled 162 patients with suspected DF symptoms. The diagnosis was confirmed through dengue immunoglobulin M (IgM) capture enzyme-linked immunosorbent assay (ELISA) or Dengue Early ELISA for nonstructural protein 1 (NS1) antigen detection. Hematological parameters were measured using the Coulter DxH 800 hematology analyzer (Beckman Coulter, Brea, CA), and the statistical analysis was performed using SPSS version 22 (IBM Corp., Armonk, NY).
RESULTS: A total of 108 patients tested positive for DF, while 54 tested negative. We observed significant differences in WBC count, platelet count, and monocyte percentage between patients with DF and non-DF, while no significant correlation was noted for MMV. Subsequent statistical analysis, including receiver operating characteristic (ROC) curve analysis, revealed that monocyte percentage exhibited the largest area under the curve (0.715), indicating its potential as moderate discriminative power in diagnosing DF.
CONCLUSIONS: Our study findings indicate that monocyte percentage and MMV outcomes are insufficient for predicting DF, suggesting potential areas for further research.
PURPOSE: To evaluate the opioids dispensing competencies among the final year Pharm-D students in Punjab, Pakistan.
DESIGN: A multicenter cross-sectional study.
METHODS: A validated survey was used to evaluate 11 competencies related to opioid use from the final year Pharm-D students from diversely located accredited institutes. On a summative scale, correct response to each survey item was worth a score/point. Descriptive statistics was used for categorical variables while independent t-test computed group differences.
RESULTS: A total of n = 661 final year Pharm-D students from 28 institutes (8 public and 20 private) completed the survey with an overall response rate of 78.5%. Comparatively, the students who had either completed a community or hospital internship, or studying in the educational institutions located in the provincial capital demonstrated a significant higher competency score. There was no significant difference in the overall mean competency scores based on gender or system of assessment used in the Pharm-D degree programs. Among eleven opioid competencies, students received the lowest scores for "opioid overdose management", "opioid monitoring" and "therapeutic uses of opioids".
CONCLUSION: Pharm-D students in Pakistan require additional training and skills on many of the opioids related competencies to ensure patient's safety in healthcare settings. There is a need to revise the curriculum and teaching methodologies to improve the competencies of Pharm-D students in opioid dispensing.
METHODS: Plasmodium berghei ANKA infection in ICR mice was used as a malaria model. OGG1 concentration and oxidative stress levels in P. berghei-infected mice and their control counterparts were assessed during malaria using enzyme-linked immunosorbent assay. OGG1 activity in malaria mice was modulated using treatment with TH5487 and O8-OGG1 inhibitors. The effects of modulating OGG1 activity using OGG1 inhibitors on cytokine release and anemia during P. berghei malaria infection were assessed by cytometric bead array and measurement of total normal red blood cell count respectively.
RESULTS: The plasma OGG1 level was significantly upregulated and positively correlated with parasitemia during P. berghei malaria in mice. Modulation of OGG1 ameliorated malaria severity by improving the total normal RBC count in TH5487 and O8-treated mice. Modulation of OGG1 with TH5487 caused significant reductions in serum levels of TNF-α, IFN-γ, IL-6, and IL-10. Similarly, OGG1 modulation activity using an O8-OGG1 inhibitor caused a significant reduction in serum levels of TNF-α, IL-2, IL-6, and IL-10.
CONCLUSION: The findings indicate the involvement of OGG1 in the P. berghei malaria infection. OGG1 inhibition by TH5487 and O8-OGG1 inhibitors suppressed excessive cytokine release, and this may represent a novel therapeutic strategy for ameliorating the severity of malaria infection.