Browse publications by year: 2024

  1. Li S, Nor NM, Kaliappan SR
    Heliyon, 2024 Apr 15;10(7):e28816.
    PMID: 38690001 DOI: 10.1016/j.heliyon.2024.e28816
    [This corrects the article DOI: 10.1016/j.heliyon.2024.e24630.].
  2. Swaminathan N, Awuah WA, Bharadwaj HR, Roy S, Ferreira T, Adebusoye FT, et al.
    Health Sci Rep, 2024 May;7(5):e2075.
    PMID: 38690005 DOI: 10.1002/hsr2.2075
    BACKGROUND AND AIMS: Diabetic Foot Ulcers (DFUs) are a significant health concern, particularly in Low- and Middle-Income Countries (LMICs). This review explores key strategies for managing DFUs in LMICs, including integrating podiatry, endocrinology, and wound care services, educating patients, promoting self-care, and preventive measures to reduce amputation rates.

    METHODS: A comprehensive literature review was conducted, focusing on studies conducted in Low and Middle Income Countries to facilitate a qualitative analysis. The review examined the aetiology and risk factors to developing DFUs, clinical presentation, multidisciplinary management and evidence based interventions, challenges to the provision of care and future directions, all pertaining to DFUs in low and middle income countries.

    RESULTS: The aetiology and risk factors contributing to the development of DFUs are complex and multifaceted. Factors such as limited access to health care, inadequate diabetes management, and socioeconomic disparities significantly influence the incidence of DFUs. Clinical presentation varies, with patients often presenting at advanced stages of the disease due to delayed or missed diagnoses. Multidisciplinary management, incorporating podiatry, endocrinology, and wound care services, has exhibited substantial promise in enhancing patient outcomes. Evidence-based interventions, including offloading techniques, wound debridement, and the use of advanced wound dressings, have proven effective in promoting ulcer healing.

    CONCLUSION: The burden of DFUs in LMICs requires comprehensive strategies. Integrating podiatry, endocrinology, and wound care services, along with patient education and self-care practices, is essential for reducing amputations and improving patients' quality of life. Regular follow-up and early detection are vital for effective DFU management, emphasizing the need for ongoing research and investment in LMIC health care infrastructure. Embracing these multidisciplinary, patient-centered approaches can effectively address the challenge of DFUs in LMICs, leading to better patient outcomes and improved quality of life.

  3. Bee Wah Y, Mohd Nasir NN, Hadrawi MF, Kamaruddin AA, Jannoo Z, Afthanorhan A
    Belitung Nurs J, 2024;10(2):201-208.
    PMID: 38690312 DOI: 10.33546/bnj.3096
    BACKGROUND: Mothers who have children with autism encounter significant difficulties in caring for their autistic youngsters, leading to higher stress levels and a reduced overall quality of life. External or internal factors can cause and respond to stress, affecting an individual's physical, psychological, and emotional health. Thus, it is crucial to examine the quality of life of mothers with autistic children.

    OBJECTIVES: This study aimed to investigate the relationships between stress, self-efficacy, and quality of life (QoL) in mothers of children with autism.

    METHODS: A cross-sectional study design was used. Self-administered questionnaires were distributed from October to November 2019 to mothers with autistic children using cluster sampling techniques to capture their demographics and perceptions of stress, self-efficacy, and QoL. The data analysis was performed using covariance-based structural equation modeling (CB-SEM).

    RESULTS: Of the 290 questionnaires distributed, 238 (response rate of 82%) sets were returned, but only 181 questionnaires were usable for further analysis. The findings demonstrated a notable impact of stress and self-efficacy on quality of life and an adverse effect of stress on self-efficacy. Self-efficacy serves as an intermediary in the relationship between stress and quality of life.

    CONCLUSION: In general, mothers of autistic children typically face moderate stress levels, but they have low levels of self-efficacy and quality of life. Mothers of children with autism need assistance and support from healthcare professionals, such as doctors, nurses, and psychiatrists, so that they can bear the challenges of raising children with special needs and enjoy a higher standard of living with less emotional and physical strain.

  4. Afzan A, Marcourt L, Abd Karim HA, Kasim N, Queiroz EF, Osman CP, et al.
    Data Brief, 2024 Jun;54:110414.
    PMID: 38690315 DOI: 10.1016/j.dib.2024.110414
    Phytochemical data for Ficus deltoidea Jack, a plant widely studied for its anti-hyperglycemic effect, are scarce. In the pursuit of characterizing the chemical constituents of this species, extraction and purifications were conducted using multiple chromatographic procedures on selected varieties (var. deltoidea, var. kunstleri and var. trengganuensis). Twenty-two constituents were unambiguously identified through NMR, MS and UV data. These included gallocatechin (S1), afzelechin-4-8″-gallocatechin (S2), catechin (S3), afzelechin-4-8″-catechin (S4), afzelechin (S5), epicatechin (S6), hovetrichoside C (S7), 6,8-di-C-glucopyranosylapigenin (vicenin-2) (S8), afzelechin-4-8″-epiafzelechin (S9), epiafzelechin (S10), 6-C-xylopyranosyl-8-C-glucopyranosylapigenin (vicenin-1) (S11), orientin (S13), schaftoside (S14), 6-C-glucopyranosyl-8-C-xylopyranosylapigenin (vicenin-3) (S16), vitexin (S17), vitexin 2″-O-rhamnoside (S19), isovitexin 2″-O-rhamnoside (S20), 6,8-di-C-arabinopyranosylapigenin (S21), 6,8-di-C-xylopyranosylapigenin (S22), 6-C-arabinopyranosyl-8-C-xylopyranosylapigenin (S23), rhoifolin (S24) and cerberic acid A (S26). The presented phytochemical data can assist ethnobotanists, chemists, and natural product researchers in investigating the medicinal properties of F. deltoidea by facilitating the dereplication of its constituents.
  5. Bhatti SM, Zia Ul Haq M, Kanwal S, Makhbul ZKM
    Data Brief, 2024 Jun;54:110419.
    PMID: 38690320 DOI: 10.1016/j.dib.2024.110419
    This dataset integrates and helps examine the impact of green intellectual capital (GIC) which comprises of green human capital (GHC), green structural capital (GSC), and green relational capital (GRC) on green organizational culture (GOC). Secondly, it enables the investigation of GOC as a mediation phenomenon between GIC and sustainable business model innovation (SBMI). Moreover, it highlights the moderation of frugal innovation (FGL) on GOC and SBMI relationship. An online survey was designed using Google forms to collect data from 345 middle/ senior management employees working in medium and large manufacturing firms in Pakistan. Unit of analysis is the organization; thus, each response represents one firm. SPSS and Smart PLS 4 were used for data analysis. Dataset demonstrates that GHC, GSC, and GRC positively impact GOC, which subsequently enhances SBMI. Moreover, effective implementation of FGL can bolster the effect of GOC on SBMI. The dataset is valuable as it can be reproduced and reanalyzed. It offers insights for professionals to revolutionize their innovation for environmental initiatives particularly in the manufacturing sector and train their staff to use modern eco-friendly ingenuities leading to enhanced business performance as well as sustainable development goals. Furthermore, the dataset holds significance for policymakers involved in implementing green economic revitalization programs, enabling them to offer incentives or penalties to encourage compliance.
  6. Tai TW, Chen HY, Shih CA, Huang CF, McCloskey E, Lee JK, et al.
    Osteoporos Sarcopenia, 2024 Mar;10(1):3-10.
    PMID: 38690538 DOI: 10.1016/j.afos.2024.02.001
    OBJECTIVES: This study aimed to present the Asia-Pacific consensus on long-term and sequential therapy for osteoporosis, offering evidence-based recommendations for the effective management of this chronic condition. The primary focus is on achieving optimal fracture prevention through a comprehensive, individualized approach.

    METHODS: A panel of experts convened to develop consensus statements by synthesizing the current literature and leveraging clinical expertise. The review encompassed long-term anti-osteoporosis medication goals, first-line treatments for individuals at very high fracture risk, and the strategic integration of anabolic and antiresorptive agents in sequential therapy approaches.

    RESULTS: The panelists reached a consensus on 12 statements. Key recommendations included advocating for anabolic agents as the first-line treatment for individuals at very high fracture risk and transitioning to antiresorptive agents following the completion of anabolic therapy. Anabolic therapy remains an option for individuals experiencing new fractures or persistent high fracture risk despite antiresorptive treatment. In cases of inadequate response, the consensus recommended considering a switch to more potent medications. The consensus also addressed the management of medication-related complications, proposing alternatives instead of discontinuation of treatment.

    CONCLUSIONS: This consensus provides a comprehensive, cost-effective strategy for fracture prevention with an emphasis on shared decision-making and the incorporation of country-specific case management systems, such as fracture liaison services. It serves as a valuable guide for healthcare professionals in the Asia-Pacific region, contributing to the ongoing evolution of osteoporosis management.

  7. Kannaiyan K, Rathod A, Bhushan P, Mailankote S, Almuraikhi T, Daghriri A
    J Contemp Dent Pract, 2024 Mar 19;25(3):241-244.
    PMID: 38690697 DOI: 10.5005/jp-journals-10024-3612
    AIM: The current study was designed to assess the linear dimensional changes and adaptability of two heat-cured denture base resins using various cooling methods.

    MATERIALS AND METHODS: To prepare a total of 90 acrylic resin samples (45 acrylic resin samples for each material), four rectangular stainless-steel plates measuring 25 × 25 × 10 mm were fabricated. For both groups, the material was put into the mold at the dough stage. Group I - SR Triplex Hot Heat Cure acrylic; group II - DPI Heat Cure acrylic. Both groups used the same curing procedure. One of the following three techniques was used to cool the material (15 samples from each material) once the curing cycle was finished: (A) water bath, (b) quenching, and (C) air. A traveling microscope was used to measure the distance between the markings on the acrylic samples. The data was recorded and statistically analyzed.

    RESULTS: In SR Triplex Hot heat cure acrylic material, the maximum linear dimensional changes were found in the quenching technique (0.242 ± 0.05), followed by the air technique (0.168 ± 0.11) and the least was found in the water bath technique (0.146 ± 0.01). In DPI Heat Cure acrylic material, the maximum linear dimensional changes were found in the quenching technique (0.284 ± 0.09), followed by the air technique (0.172 ± 0.18) and the least was found in the water bath technique (0.158 ± 0.10). There was a statistically significant difference found between these three cooling techniques. On comparison of adaptability, the water bath technique, the marginal gap SR Triplex Hot was 0.012 ± 0.02 and DPI Heat Cure was 0.013 ± 0.02. In the quenching technique, the marginal gap SR Triplex Hot was 0.019 ± 0.04 and DPI Heat Cure was 0.016 ± 0.04. In the air technique, the marginal gap SR Triplex Hot was 0.017 ± 0.01 and DPI Heat Cure was 0.019 ± 0.01.

    CONCLUSION: The present study concluded that among the different cooling methods, the water bath technique had the least linear dimensional change, followed by the air and quenching techniques. When comparing the materials, DPI Heat Cure acrylic resin showed a greater linear dimensional change than SR Triplex Hot heat cure acrylic resin.

    CLINICAL SIGNIFICANCE: During polymerization, heat-cured acrylic resins experience dimensional changes. Shrinkage and expansion are dimensional changes that occur in heat-cured acrylic resins and have an impact on the occlusal relationship and denture fit. However, the denture base's material qualities and the different temperature variations it experiences during production may have an impact on this. How to cite this article: Kannaiyan K, Rathod A, Bhushan P, et al. Assessment of Adaptability and Linear Dimensional Changes of Two Heat Cure Denture Base Resin with Different Cooling Techniques: An In Vitro Study. J Contemp Dent Pract 2024;25(3):241-244.

    MeSH terms: Cold Temperature; Dental Materials/chemistry; Denture Bases*; Hot Temperature*; Materials Testing*; In Vitro Techniques
  8. Ng YM, Sockalingam SNM, Shafiei Z, Zakaria ASI, Mahyuddin A, Rahman MA
    J Contemp Dent Pract, 2024 Mar 19;25(3):260-266.
    PMID: 38690700 DOI: 10.5005/jp-journals-10024-3645
    AIM AND BACKGROUND: This study aimed to explore the potential synergistic interaction of virgin coconut oil (VCO) and virgin olive oil (VOO) mixture against Streptococcus sanguinis, Streptococcus mutans, and Lactobacillus casei in a single and mixture species through the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), antiadherence, and antibiofilm activities.

    MATERIALS AND METHODS: The broth microdilution technique was used to individually determine the MIC of both oils and an oil mixture (in the ratio of 1:1) in a 96-well microtiter plate. As for the MBC, the subcultured method was used. The fractional inhibitory concentration index (ΣFIC) was determined to identify the interaction types between both oils. The oil mixture at its MIC was then tested on its antibiofilm and antiadherence effect.

    RESULTS: The MIC of the oil mixture against the tested microbiota was 50-100%. The oil mixture was bactericidal at 100% concentration for all the mentioned microbes except S. mutans. The ΣFIC value was 2 to 4, indicating that the VCO and VOO acted additively against the microbiota. Meanwhile, the oil mixture at MIC (50% for S. sanguinis and L. casei; 100% for S. mutans and mixture species) exhibited antiadherence and antibiofilm activity toward the microbiota in mixture species.

    CONCLUSION: The oil mixture possesses antibacterial, antibiofilm, and antiadherence properties toward the tested microbiota, mainly at 50-100% concentration of oil mixture. There was no synergistic interaction found between VCO and VOO.

    CLINICAL SIGNIFICANCE: Children and individuals with special care may benefit from using the oil mixture, primarily to regulate the biofilm formation and colonization of the bacteria. Furthermore, the oil mixture is natural and nontoxic compared to chemical-based oral healthcare products. How to cite this article: Ng YM, Sockalingam SNMP, Shafiei Z, et al. Biological Activities of Virgin Coconut and Virgin Olive Oil Mixture against Oral Primary Colonizers: An In Vitro Study. J Contemp Dent Pract 2024;25(3):260-266.

    MeSH terms: Anti-Bacterial Agents/pharmacology; Bacterial Adhesion/drug effects; Humans; Microbial Sensitivity Tests*; In Vitro Techniques
  9. Abdul Halim NSS, Mohd Ripin Z, Law MJJ, Karunagaran J, Yusof MI, Shaharudin S, et al.
    Disabil Rehabil Assist Technol, 2024 May;19(4):1531-1538.
    PMID: 37162275 DOI: 10.1080/17483107.2023.2210619
    PURPOSE: Despite the proven benefits of motorized lifting devices in reducing the physical stresses experienced by nurses during patient transfers, the low adoption of these devices remains limited. The study aimed to assess the perceptions of nurses regarding the new motorized lifting device (NEAR-1) in terms of their perceived workload and usability during patient transfers.

    MATERIALS AND METHODS: A cross-sectional study was conducted to evaluate the perceptions of nurses (n = 45) and students (n = 6) when performing patient transfers from bed to wheelchair and vice versa using the NEAR-1 compared to an existing floor lift, walking belt, and manual transfer. Participants filled out surveys evaluating the perceived task demands and usability of the NEAR-1, as well as open-ended interviews.

    RESULTS: The use of the NEAR-1 significantly reduced the mean of all NASA-TLX constructs (p 

    MeSH terms: Adult; Cross-Sectional Studies; Equipment Design; Female; Humans; Male; Middle Aged; Nurses; Patient Transfer; Task Performance and Analysis; Wheelchairs; Workload*; Young Adult
  10. Muhammad Yunus F, Alias Y, Yahya N, Mohamad Zain NN, Raoov M
    PMID: 38466777 DOI: 10.1080/19440049.2024.2326426
    Poly(methyl methacrylate-vinyl imidazole bromide) (poly-MMA-IL)-grafted magnetic nanoparticles were successfully developed and applied in the micro-magnetic solid phase extraction (μ-MSPE) for 16 types of polycyclic aromatic hydrocarbons (PAHs) from tea, fried food, and grilled food samples via gas chromatography flame ionization detector (GC-FID). One variable at a time (OVAT) and response surface methodology (RSM) were used for efficient optimization. The validation method showed a good coefficient of determination (R2) ranging from 0.9901 to 0.9982 (n = 3) with linearity of 0.2 μg L-1-500 μg L-1. Detection and quantification limits were 0.06 µg L-1-0.32 µg L-1 and 0.18 µg L-1-0.97 µg L-1. Additionally, satisfactory reproducibility was attained with intra-day and inter-day precisions having RSD ranges of 3.6%-11.1%. The spiked recovery value of 16 PAHs in fried food, grilled food and tea samples obtained from the night market in Malaysia ranged from 80%-12%, respectively.
    MeSH terms: Food Analysis*; Polymers/chemistry; Tea/chemistry; Solid Phase Extraction; Solid Phase Microextraction
  11. Abu Bakar N, Chung BLY, Smykla J, Karsani SA, Alias SA
    Mycologia, 2024;116(3):449-463.
    PMID: 38484286 DOI: 10.1080/00275514.2024.2313429
    Proteomics has been used extensively in the field of mycology, mainly in trying to understand the complex network of protein-protein interactions that has been implicated in the molecular functions of fungi. It is also a useful tool to compare metabolic differences within a genus. Species of Pseudogymnoascus, a genus under the phyla Ascomycota, have been shown to play an important role in the soil environment. They have been found in both polar and temperate regions and are a known producer of many extracellular hydrolases that contribute to soil decomposition. Despite the apparent importance of Pseudogymnoascus spp. in the soil ecosystem, investigations into their molecular functions are still very limited. In the present study, proteomic characterization of six Pseudogymnoascus spp. isolated from three biogeographic regions (the Arctic, Antarctic, and temperate regions) was carried out using tandem mass spectrometry. Prior to proteomic analysis, the optimization for protein extraction was carried out. Trichloroacetic acid‑acetone‑phenol was found to be the best extraction method to be used for proteomic profiling of Pseudogymnoascus spp. The proteomic analysis identified 2003 proteins that were successfully mapped to the UniProtKB database. The identified proteins were clustered according to their biological processes and molecular functions. The shared proteins found in all Pseudogymnoascus spp. (1201 proteins) showed a significantly close relationship in their basic cellular functions, despite differences in morphological structures. Analysis of Pseudogymnoascus spp. proteome also identified proteins that were unique to each region. However, a high number of these proteins belonged to protein families of similar molecular functions, namely, transferases and hydrolases. Our proteomic data can be used as a reference for Pseudogymnoascus spp. across different global regions and a foundation for future soil ecosystem function research.
    MeSH terms: Arctic Regions; Soil Microbiology*; Proteome; Proteomics*; Tandem Mass Spectrometry
  12. Verna R
    Malays J Pathol, 2024 Apr;46(1):1-10.
    PMID: 38682840
    This work highlights the role of the clinical laboratory, in the early detection of the use of substances prohibited for doping. This is because most people who practice sports today are non-professional athletes and amateurs, in particular young kids. These persons are not subjected to anti-doping controls but are at risk for their health. Endocrinologists and laboratory tests, by detecting evidence of such usage can help protect their health. Anti-doping testing require specific instruments for qualitative and quantitative chemistry, to meet regulations of official competitions but are impossible to be used in every person because of high cost. A particular role the clinical laboratory can acquire in the future is through its molecular biology sections, when genetic doping will probably be a reality and quantitative chemistry will be unable to detect it. A brief history of doping is provided to understand the reasons of its spread. Although doping has great resonance nowadays, it is not a recent problem. It was common among ancient Greek wrestlers and Romans, who used mixtures of herbs and stimulants. Ancient Greece started the Olympic Games and winners assumed great esteem, akin to demi-god status. Therefore, any attempt to improve athletic performance was a norm, also because the damage caused by the substances used was not known at that time. The use became so widespread that soldiers also used drugs to better combat during recent wars, and doping was practiced by athletes, actors and musicians in attempts to obtain better performance results. Today, doping has been refined so as not to be discovered and there is a continuous race between those who promote new substances and those who, like the World Anti-Doping Agency (WADA), were created to defend the health of athletes and comply with regulations of competitions. The clinical laboratory plays a fundamental role in identifying the use of prohibited substances, especially in competitions not classified as official, which are the majority and involve thousands of amateurs. In this paper a series of laboratory tests are proposed in this perspective, at low cost without the need of qualitative/quantitative chemical analyses required by the sport jurisdictions. Finally, a glance into genetic doping illustrates a likely future and imminent practice.
    MeSH terms: Humans
  13. Lim KG, Sumera A, Venkateswaran SP, Burud IAS, Albazah NIJ
    Malays J Pathol, 2024 Apr;46(1):11-20.
    PMID: 38682841
    Lymphomas are a diverse group of malignant proliferations that arise as discrete tissue masses. The most widely accepted taxonomy for lymphoma is the World Health Organization classification of tumours of haematopoietic and lymphoid tissues, the 5th edition of which was released in June 2022. Most (85% to 90%) lymphoid neoplasms are of B cell origin. Mature B-cell neoplasms are a heterogeneous group of malignancies with similar disease courses and treatment paradigms. This review focuses on the various mature B-cell lymphomas in Malaysia, including Hodgkin lymphoma. A literature search was performed in various bibliographic databases. A total of 64 papers were included in this review. We found 15 papers on Hodgkin lymphoma, 14 on follicular lymphoma, 12 on Burkitt lymphoma, 5 on mucosa-associated lymphoid tissue (MALT) lymphoma, 4 on plasmablastic lymphoma, 3 on mantle cell lymphoma, 1 each on primary mediastinal large B-cell lymphoma, B-lymphoblastic lymphoma, and 3 on other unspecified B-cell lymphomas. The site, age, distribution, prognostic markers, and the various subclassification of B cell lymphomas were studied from these papers. Prognostic genetic markers in B-cell lymphomas include C-MYC, BCL2 and BCL6 as they are the most prevalent mutations in this condition. Anecdotal outcomes range from rapid fatality to unexplained spontaneous remission. This review adds to the existing literature on lymphoma in Malaysia by compiling the evidence that may lead to further research on the diagnosis and treatment of lymphoma in Malaysia and worldwide.
    MeSH terms: Humans; Malaysia/epidemiology
  14. Saad S, Hisham S, Amir Hamzah SPA
    Malays J Pathol, 2024 Apr;46(1):21-40.
    PMID: 38682842
    INTRODUCTION: Sex estimation is crucial in forensic anthropology. In situations such as mass disasters, and forensic anthropology cases, sex estimation is a very important initial step in the disaster victim identification process. Literature has acknowledged that sex estimation is population-specific. However, sex estimation standards in South-East Asian populations are limited, leading to the usage of most Thais discriminant function equations on sex estimation by other South-East Asian countries including Malaysia. This systematic review was conducted to summarise the findings of sex estimation studies in South-East Asian countries.

    MATERIALS AND METHODS: A systematic literature search was performed through the SCOPUS database and Web of Science (WOS) database for relevant studies between 2014 and 2022. All published articles that are related to sex estimation from different types of bone, methods, landmarks, and sample sources (i.e., photographs, dry bones, and CT images) were included in this review. The main inclusion criteria were studies on (i) sex estimation; (ii) in South-East Asian populations; (iii) between the years 2014 and 2022; and (iv) in English.

    RESULTS: The literature search identified 30 potentially relevant studies, of which 15 publications met all the inclusion criteria. From those research, 13 studies were related to the Thai population and two to the Malaysian population. Only one study was based on morphological traits, while the rest were based on a morphometric approach.

    CONCLUSION: All studies found that sex estimation is populationspecific. Therefore, further research is recommended to explore more on population-specific sex estimation using different parts of bone.

    MeSH terms: Asia, Southeastern/ethnology; Female; Humans; Male; Sex Determination by Skeleton/methods
  15. Wong YP, Tan GC, Khong TY
    Malays J Pathol, 2024 Apr;46(1):41-49.
    PMID: 38682843
    INTRODUCTION: Identification of acute funisitis, a sign of foetal inflammatory response (FIR), is crucial as their presence is associated with ominous neonatal outcomes. Recommendation on which part of umbilical cord should be sampled to facilitate optimal identification of acute funisitis is limited.

    METHODS: This is a retrospective cross-sectional study over a seven-month duration recruiting all patients with clinical suspicion of chorioamnionitis and/or maternal intrapartum pyrexia. The distribution and the degree of cord inflammation were assessed. The cases were also evaluated for maternal inflammatory response (MIR) and chorionic vasculitis (CV).

    RESULTS: Of the 191 placentas, 88 (46.1%) had some degree of cord inflammation. Forty-nine (55.7%) had a differential in cord inflammation, with distal cord section (n = 38) demonstrating significant greater inflammation than that of proximal cord section (n = 11) (p<0.001). There were 20 cases with phlebitis only and 8 cases demonstrated arteritis only in either proximal or distal cord sections. Increasing magnitude of cord inflammation was significantly associated with increasing severity of MIR and the rate of CV (p<0.001). CV was observed in 25 (24.3%) cases showing absence of cord inflammation, while 12 (13.6%) cases with cord FIR demonstrated no CV.

    DISCUSSION: Inflammatory reaction can occur variably throughout the length of the umbilical cord and chorionic plate vessels, with greater inflammation seen in the distal cord section. We affirm the current Amsterdam recommendation of submitting at least two cross sections of the cord representing proximal and distal sites and two sections from placental parenchyma to facilitate the identification of FIR.

    MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Inflammation/pathology; Placenta/pathology; Pregnancy; Retrospective Studies
  16. Luena Victorio CB, Chua IL, Xu Y, Ng Q, Chua BH, Chow VTK, et al.
    Malays J Pathol, 2024 Apr;46(1):51-62.
    PMID: 38682844
    Small animal models play an important role in investigating and revealing the molecular determinants and mechanisms underlying neuro-virulence of enterovirus A71 (EV-A71). In our previous study, we successfully developed two mouse cell-line replication competent EV-A71 strains (EV71:TLLm and EV71:TLLmv) which were capable of inducing neuro-invasion in BALB/c mice. The more virulent EV71:TLLmv exhibited ability to induce acute encephalomyelitis accompanied by neurogenic pulmonary oedema. EV71:TLLcho virus strain was generated from EV71:TLLm by a series of passages in CHO-K1 cells. EV71:TLLcho demonstrated a broader range of infectivity across various mammalian cell lines and exhibited complete cytopathic effects (CPE) within 48 hours post-inoculation in comparison to EV71:TLLm or EV71:TLLmv. EV71:TLLcho consistently yielded higher levels of viral replication at all time points examined. In comparison to EV71:TLLm, EV71:TLLcho consistently induced more severe disease and increased mortality in one-week old BALB/c mice. However, unlike mice challenged with EV71:TLLmv, none of the mice challenged with EV71:TLLcho progressed to severe acute encephalomyelitis and developed neurogenic pulmonary oedema.
    MeSH terms: Animals; Disease Models, Animal*; Humans; Mice, Inbred BALB C*; Virus Replication; Enterovirus A, Human*; Mice
  17. Mohd Razi MS, Sugumaran Y, Mohd Haniz NA, Khilmie K, Osmera AH, Jauhary EJ, et al.
    Malays J Pathol, 2024 Apr;46(1):63-69.
    PMID: 38682845
    INTRODUCTION: Anti-nuclear antibody (ANA) testing is among the most common immunological test requested in the diagnostic immunology laboratory. The main purpose of this test is to screen for the underlying systemic autoimmune rheumatic diseases (SARDs). The gold standard laboratory method for ANA detection is by the indirect immunofluorescence (IIF) assay. In most laboratories, positive ANA-IIF is reported in terms of titration and pattern.

    OBJECTIVE: This study was conducted with the aim of determining the correlation between ANA-IIF titration and pattern for the diagnosis of SARDs.

    MATERIALS AND METHODS: A retrospective study was conducted whereby the positive ANA-IIF samples from 1st July 2018 until 31st December 2019 and 1st January 2021 until 31st March 2021 were included in this study. The duplicate samples were excluded. ANA-IIF titration and pattern were recorded for all patients. The demographic, clinical, and final diagnosis data were retrieved from each patient's clinical note.

    RESULTS: A total of 179 patients were included for analysis. The majority of the patients were female (79.9%) and from Malay ethnicity (66.5%). Sixty-five patients (36.3%) had ANA-IIF positive at 1:80 titration followed by 45 patients (25.1%) positive at titration of equal or more than 1:160. Speckled was the predominant pattern visualised in 90 patients (50.3%) followed by homogeneous in 76 patients (42.5%). Forty-five patients (25.1%) were finally diagnosed with SARDs with 41 of them diagnosed as SLE. ANA titration was significantly associated with the final diagnosis of SARDs at all titres (p<0.001) but the best cut-off was noted at a titre of equal or more than 1:320 with the sensitivity and specificity of 86.7% and 77.6% respectively. The homogeneous pattern was also significantly associated with SARDs (p=0.04). The final diagnosis of SARDs were significantly higher in female (p=0.03) and their age was significantly younger (p<0.001).

    CONCLUSION: ANA-IIF titration of equal or more than 1:320 can be used as the best titration for differentiating between SARDs and non-SARDs in a positive ANA sample. Patients with homogeneous pattern were more likely to be diagnosed with SARDs than other ANA-IIF patterns.

    MeSH terms: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Retrospective Studies; Fluorescent Antibody Technique, Indirect/methods; Young Adult
  18. Tzar MN, Mustakim S, Yusoff H, Tap RM
    Malays J Pathol, 2024 Apr;46(1):71-78.
    PMID: 38682846
    Invasive aspergillosis is the second most common invasive human mycosis but susceptibility data of Aspergillus species is limited. Antifungal treatment of aspergillosis is often done empirically without knowing the true susceptibility. Therefore, we aimed to determine antifungal susceptibility of Aspergillus species isolated from various clinical specimens over a 1-year period. We identified 28 Aspergillus isolates by sequencing the internal transcribed spacer (ITS) and β-tubulin genes and performed antifungal susceptibility testing on these isolates using Sensititre YeastOne. The isolates were identified as Aspergillus niger (60.7%), A. fumigatus (21.4%), A. flavus (10.7%), A. chevalieri (3.6%) and A. tubingensis (3.6%). Based on the European Committee on Antimicrobial Susceptibility Testing (EUCAST) Antifungal Clinical Breakpoint for Aspergillus spp., 16/17 (94.1%) A. niger isolates were susceptible to amphotericin B, all six isolates (100%) of A. fumigatus were susceptible to amphotericin B, itraconazole and voriconazole, but only 5/6 (83.3%) A. fumigatus were susceptible to posaconazole. Meanwhile, all three (100%) A. flavus isolates were susceptible to itraconazole. There are no other breakpoints established by the EUCAST for other antifungal-species combinations. In conclusions, Aspergillus niger remains the most commonly isolated species from clinical specimens and Aspergillus isolates at our centre are still largely susceptible to amphotericin B, echinocandins and most azoles. This information is valuable in guiding antifungal therapy in the treatment of aspergillosis.
    MeSH terms: Adult; Aged; Female; Humans; Male; Microbial Sensitivity Tests*; Middle Aged
  19. Ting SMV, Ismail Z, Hanafiah A
    Malays J Pathol, 2024 Apr;46(1):79-89.
    PMID: 38682847
    INTRODUCTION: Beta-lactamase producing bacterial infection has been on surge due to selection pressure and injudicious antibiotics usage. Organisms that co-produced more than one beta lactamase enzyme posed diagnostic challenges which may result in inadequate treatment. To date, there is no standardised guideline offering phenotypic detection of AmpC β-lactamase. The purpose of this study was to determine the prevalence of ESBLs, AmpC β-lactamase and co-producer organisms in a teaching hospital.

    MATERIALS AND METHODS: Three hundred and four isolates of E. coli and Klebsiella sp. had been selected via convenient sampling. These isolates were identified using conventional laboratory methods and their antimicrobial susceptibilities were determined using disc diffusion method. Those isolates were then proceeded with ESBL confirmatory test, cloxacillin-containing Muller Hinton confirmatory test, modified double disk synergy test and AmpC disk test.

    RESULTS: Out of 304 isolates, 159 isolates were E. coli and 145 were Klebsiella sp. The prevalence of organisms which co-produced AmpC β-lactamase and ESBL enzymes were 3.0%. Besides that, 39 cefoxitin resistant and three cefoxitin susceptible isolates (13.8%) were proven to produce AmpC β-lactamase through AmpC disk test. Through the CLSI confirmatory test, 252 (82.9%) isolates were identified as ESBLs producers and the prevalence increased slightly when cloxacillin-containing Muller Hinton were used. Only three ESBLs positive organisms were positive for modified double disk synergy test.

    CONCLUSION: Distinguishing between AmpC β-lactamase and ESBL-producing organisms has epidemiological significance as well as therapeutic importance. Moreover, AmpC β-lactamase and ESBLs co-producing organisms can lead to false negative ESBL confirmatory test. Therefore, knowing the local prevalence can guide the clinician in navigating the treatment.

    MeSH terms: Anti-Bacterial Agents/pharmacology; Bacterial Proteins/analysis; Cross Infection/microbiology; Cross Infection/epidemiology; Escherichia coli Infections/microbiology; Escherichia coli Infections/epidemiology; Hospitals, Teaching; Humans; Klebsiella Infections/microbiology; Klebsiella Infections/epidemiology; Microbial Sensitivity Tests; Prevalence
  20. Lim CCW, Punjabi LS, Bhatia A, Ng QJ, Jevon GP, Aggarwal IM
    Malays J Pathol, 2024 Apr;46(1):91-94.
    PMID: 38682848
    Intraplacental choriocarcinoma is a rare tumour, with approximately 62 reported cases. It may manifest as a spectrum of disease ranging from an incidental lesion diagnosed on routine placental examination to disseminated maternal and/or neonatal disease. In this case series, we presented two rare cases of intraplacental choriocarcinoma with extremely varied clinical presentations. The extremely varied clinical presentations of both patients described in the case series complicated the process of arriving at the diagnosis. In both cases, subsequent investigations showed no maternal or neonatal metastasis, and maternal serum beta-hCG levels downtrended with conservative management. We aim to highlight the importance of performing a detailed physical examination and evaluation of the patient and multidisciplinary management with oncology opinion. A detailed examination of the placenta should also be considered when faced with obstetric complications so that early diagnosis and the required management can be executed in a prompt fashion.
    MeSH terms: Adult; Female; Humans; Pregnancy; Pregnancy Complications, Neoplastic/diagnosis; Pregnancy Complications, Neoplastic/pathology; Uterine Neoplasms/diagnosis; Uterine Neoplasms/pathology; Tertiary Care Centers*
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