Browse publications by year: 2024

  1. Ye Y, Su AT
    Front Public Health, 2024;12:1498296.
    PMID: 39866353 DOI: 10.3389/fpubh.2024.1498296
    BACKGROUND: Public health campaigns are essential for promoting vaccination behavior, but factors such as socioeconomic status, geographical location, campaign quality, and service accessibility influence vaccine uptake. In the Wuxi region of China, disparities in vaccination behavior are seen between urban and rural populations and among different socioeconomic groups. This study aims to explore the factors related to public health campaigns that affect vaccination behavior in Wuxi, contributing to better public health strategies.

    METHODS: A cross-sectional survey was conducted among 750 participants in Wuxi, focusing on their perceptions of socioeconomic status, geographical location, health campaign quality, and vaccination convenience. The questionnaire was developed based on a literature review and expert input using the Delphi method. Data were analyzed using descriptive statistics, reliability and validity tests, correlation analysis, and regression analysis, employing both SPSS and R software.

    RESULTS: Socioeconomic status, geographic location, campaign quality, and accessibility all significantly influence vaccination behavior. Higher socioeconomic backgrounds, urban residency, better campaign quality, and greater accessibility to vaccination services are positively correlated with higher vaccination uptake. Regression analysis revealed that public health campaigns and accessibility are particularly influential in promoting vaccination behavior.

    CONCLUSION: To improve vaccination rates, targeted strategies focusing on low socioeconomic groups, rural areas, and improving campaign quality and service accessibility are necessary. Public health campaigns should be clear, culturally relevant, and utilize multiple communication channels. Future research should address misinformation, explore behavioral economics, and integrate emerging technologies like AI to optimize vaccination efforts.

    MeSH terms: Adolescent; Adult; China; Cross-Sectional Studies; Female; Health Services Accessibility/statistics & numerical data; Humans; Male; Middle Aged; Public Health; Surveys and Questionnaires; Rural Population/statistics & numerical data; Socioeconomic Factors; Urban Population/statistics & numerical data; Vaccination/psychology; Vaccination/statistics & numerical data; Health Behavior; Young Adult
  2. Hasan F, Setia Budi H, Ramasamy R, Tantiana T, Ridwan RD, Winoto ER, et al.
    F1000Res, 2024;13:1080.
    PMID: 39866729 DOI: 10.12688/f1000research.155987.2
    BACKGROUND: The interaction between Streptococcus mutans (S. mutans) and Veillonella species (Veillonella spp.) is unclear. This study aims to investigate the interaction between S. mutans and Veillonella spp. on caries development using systematic review.

    METHODS: This systematic review was accorded to the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Three electronic databases, namely PubMed, Embase, and the Cochrane library, were used to conduct a systematic search for eligible studies from their inception until July 18, 2023. PROSPERO registration number was No. CRD42023445968.

    RESULTS: We initially identified 4,774 articles. After eliminating duplicates and irrelevant articles, 11 studies met the inclusion criteria. The studies revealed important aspects of the relationship between S. mutans and Veillonella spp. in dental caries. One significant finding is that Veillonella spp. can affect the acid production capacity of S. mutans. Some studies indicate that Veillonella spp. can inhibit the acid production by S. mutans, potentially reducing the cariogenic process. Another aspect is the competition for substrates. Veillonella spp. utilize lactic acid, which is a by product of S. mutans metabolism, as a source of carbon. This metabolic interaction may decrease the availability of lactic acid for S. mutans, potentially influencing its cariogenic potential.

    CONCLUSIONS: This systematic review highlights the emerging evidence on the interaction between S. mutans and Veillonella spp. in dental caries. The findings suggest that Veillonella spp. can modulate the acid production, and substrate competition of S. mutans, potentially influencing the cariogenic process.

    MeSH terms: Humans; Streptococcus mutans*; Veillonella*; Disease Progression
  3. Tan Y, Mohamed Ramlee FA, Harun MH, Jaapar MS, Tan CN
    Cureus, 2024 Dec;16(12):e76356.
    PMID: 39866983 DOI: 10.7759/cureus.76356
    Introduction Lumbar pyogenic spondylodiscitis is a challenging and rare spinal infection with high morbidity, particularly in patients with comorbidities. While the extreme lateral interbody fusion (XLIF) technique is established in treating degenerative spinal conditions, its efficacy in managing spondylodiscitis is less well-studied. This study aims to evaluate the clinical and radiographic outcomes of the XLIF approach combined with posterior instrumentation in patients with lumbar spondylodiscitis. Method In a multi-center, retrospective cohort study, 15 patients (mean age 66; 62.5% male) diagnosed with pyogenic spondylodiscitis underwent XLIF with posterior percutaneous fixation between January 2018 and December 2022 at two Malaysian hospitals. Patients were selected based on strict inclusion criteria, including a confirmed single-level disc infection and a minimum follow-up of one year. Clinical outcomes, including Visual Analog Scale (VAS) pain scores, infection markers (C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC)), and fusion rates, were recorded preoperatively and at six weeks, three months, six months, and one year postoperatively. Data were analyzed using appropriate statistical tests, with a significance level set at p<0.05. Results The study demonstrated a significant reduction in VAS scores, from a mean of 7 preoperatively to 1.87 at six weeks postoperatively, representing a 73.3% pain reduction (p<0.005). Mean blood loss was minimal (193.3 mL), and no patients required transfusions. Marked reductions in inflammatory markers were observed, with CRP, ESR, and WBC levels decreasing by 75%, 71.5%, and 38.5%, respectively, within the first six weeks (p<0.005). Radiological assessment showed a 100% fusion rate with a mean fusion time of 4.1 months. Complications were low, with only one case of screw malposition and one surgical site infection, both managed without further morbidity. Conclusion The XLIF approach with posterior instrumentation is a safe and effective intervention for lumbar spondylodiscitis, providing substantial pain relief, infection control, and reliable spinal fusion. These findings suggest XLIF as a viable surgical option for lumbar spondylodiscitis, especially for patients with multiple comorbidities, warranting consideration as a primary surgical strategy for this challenging condition.
  4. Albahar A, Sarmiti R, Hossienzadeh H, Houshmand M
    Cureus, 2024 Dec;16(12):e76477.
    PMID: 39867023 DOI: 10.7759/cureus.76477
    Laryngeal squamous cell cancer (LSCC) is one of the most common head and neck cancers in which genetic factors play an important role in its occurrence. This study investigated the association of KRAS and NRAS gene polymorphisms with the risk of LSCC. KRAS polymorphisms including rs712, rs61764370, rs8720, and rs9266, as well as NRAS rs14804, were compared in the patient group (n=120) and the control group (n=100). The Sanger sequencing method was used to identify these polymorphisms. The results showed that KRAS rs8720 is associated with an increased risk of LSCC; consequently, those with the CT genotype were at a higher risk than those with the CC genotype. Also, the CC genotype had a protective effect on rs14804 polymorphism of the NRAS gene. These findings show that some KRAS and NRAS polymorphisms can be used as diagnostic and prognostic biomarkers in LSCC, and their accurate identification by Sanger sequencing is of great importance in research related to cancer genetics.
  5. Mohd Nazri AK, Yahya N, Khan DM, Mohd Radzi NZ, Badruddin N, Abdul Latiff AH, et al.
    Front Neurosci, 2024;18:1524513.
    PMID: 39867451 DOI: 10.3389/fnins.2024.1524513
    INTRODUCTION: Excessive alcohol consumption negatively impacts physical and psychiatric health, lifestyle, and societal interactions. Chronic alcohol abuse alters brain structure, leading to alcohol use disorder (AUD), a condition requiring early diagnosis for effective management. Current diagnostic methods, primarily reliant on subjective questionnaires, could benefit from objective measures.

    METHOD: The study proposes a novel EEG-based classification approach, focusing on effective connectivity (EC) derived from resting-state EEG signals in combination with support vector machine (SVM) algorithms. EC estimation is performed using the partial directed coherence (PDC) technique. The analysis is conducted on an EEG dataset comprising 35 individuals with AUD and 35 healthy controls (HCs). The methodology evaluates the efficacy of connectivity features in distinguishing between AUD and HC and subsequently develops and assesses an EEG classification technique using EC matrices and SVM.

    RESULT: The proposed methodology demonstrated promising performance, achieving a peak accuracy of 94.5% and an area under the curve (AUC) of 0.988, specifically using frequency bands 29, 36, 45, 46, and 52. Additionally, feature reduction techniques applied to the PDC adjacency matrices in the gamma band further improved classification outcomes. The SVM-based classification achieved an accuracy of 96.37 ± 0.45%, showcasing enhanced performance through the utilization of reduced PDC adjacency matrices.

    DISCUSSION: These results highlight the potential of the developed algorithm as a robust diagnostic tool for AUD detection, enhancing precision beyond subjective methods. Incorporating EC features derived from EEG signals can inform tailored treatment strategies, contributing to improved management of AUD.

  6. Jiang C, Razak NA, Rasyid NM
    Front Psychol, 2024;15:1466985.
    PMID: 39868014 DOI: 10.3389/fpsyg.2024.1466985
    INTRODUCTION: This study aimed to investigate the relationship between need-supportive coaching behavior, subjective task value, goal orientation, and engagement among Chinese high school football players and propose four research hypotheses better to understand the determinants and mechanisms of athlete engagement.

    METHODS: Participants were 385 Chinese high school football players (228 boys; 157 girls; Mage = 16.07 years; SD = 1.15; range = 14-19 years) on 20 teams from 45 high schools using a proportional stratified random sampling method. Participants filled out previously validated questionnaires, including the Interpersonal Behaviors Questionnaire (IBQ), Subjective Task Value (STV), The Task and Ego Orientations Questionnaire (TEOSQ), and Athlete Engagement Questionnaire (AEQ). To address the hypothesis testing, this study utilized structural equation modeling (SEM) to analyze the proposed multiple mediation model.

    RESULTS: The research results indicated that need-supportive coaching behavior had a significant direct (β = 0.121, Z = 3.667, p 

  7. Ding CH, Navarathinam SD, Neoh HM, Tan TL
    J Infect Dev Ctries, 2024 Dec 31;18(12.1):S353-S357.
    PMID: 39863954 DOI: 10.3855/jidc.20096
    INTRODUCTION: Since the dawn of the new millennium, Candida species have been increasingly implicated as a cause of both healthcare-associated as well as opportunistic yeast infections, due to the widespread use of indwelling medical devices, total parenteral nutrition, systemic corticosteroids, cytotoxic chemotherapy, and broad-spectrum antibiotics. Candida tropicalis is a pathogenic Candida species associated with considerable morbidity, mortality, and drug resistance issues on a global scale.

    METHODOLOGY: We report a case of a 43-year-old man who was admitted to our hospital for further management of severe coronavirus disease 2019 (COVID-19) pneumonia. During his stay in the ward, he received systemic corticosteroids for a total duration of 32 days. A broad-spectrum antibiotic (piperacillin-tazobactam) was also given due to copious amounts of tracheostomy secretions.

    RESULTS: The patient's fever recurred following an afebrile interval of 11 days, and C. tropicalis was cultured from his blood. The yeast was highly resistant to fluconazole and voriconazole but remained susceptible to echinocandins. Unfortunately, the patient was unable to receive any echinocandin and eventually succumbed to candidemia.

    CONCLUSIONS: Multilocus sequence typing was used to characterize C. tropicalis as a novel diploid sequence type (i.e., 1515) that has not been previously reported.

    MeSH terms: Adult; Diploidy; Humans; Male
  8. Ismail UN, Yahya N, Manan HA
    Brain Res, 2024 Oct 01;1840:149023.
    PMID: 38815644 DOI: 10.1016/j.brainres.2024.149023
    INTRODUCTION: Stroke recovery is a complex process influenced by various factors, including specific neural reorganization. The objective of this systematic review was to identify important functional connectivity (FC) changes in resting-state fMRI data that were often correlated with motor, emotional, and cognitive outcome improvement.

    METHOD: A systematic search using PubMed and SCOPUS databases was conducted to identify relevant studies published between 2010 and 2023.

    RESULTS: A total of 766 studies were identified, of which 20 studies (602 S individuals) met the inclusion criteria. Fourteen studies focussed on motor recovery while six on cognitive recovery. All studies reported interhemispheric FC to be strongly associated with motor and cognitive recovery. The preservation and changes of M1-M1 (eight incidences) and M1-SMA (nine incidences) FC were found to be strongly correlated with motor function improvement. For cognitive recovery, restoration and preservation of FC with and between default mode network (DMN)-related regions were important for the process.

    CONCLUSIONS: This review identified specific patterns of FC that were consistently reported with recovery of motor and cognitive function. The findings may serve in refining future management strategies to enhance patient outcomes.

    MeSH terms: Brain Mapping/methods; Cognition/physiology; Humans; Nerve Net/physiopathology; Neural Pathways/physiopathology; Connectome/methods; Stroke Rehabilitation/methods
  9. AlTawari A, Zakaria M, Kamel W, Shaalan N, Elghazawi GAI, Ali MEA, et al.
    Neurol Int, 2024 Jun 04;16(3):631-642.
    PMID: 38921951 DOI: 10.3390/neurolint16030047
    Spinal muscular atrophy is a neuromuscular genetic condition associated with progressive muscle weakness and atrophy. Nusinersen is an antisense oligonucleotide therapy approved for the treatment of 5q spinal muscular atrophy in pediatric and adult patients. The objective of this clinical case series is to describe the efficacy and safety of nusinersen in treating spinal muscular atrophy in 20 pediatric and 18 adult patients across six treatment centers in Kuwait. Functional motor assessments (Children's Hospital of Philadelphia Infant Test of Neuromuscular Disorders, Hammersmith Functional Motor Scale Expanded, and Revised Upper Limb Module) were used to assess changes in motor function following nusinersen treatment. The safety assessment involved clinical monitoring of adverse events. The results demonstrate clinically meaningful or considerable improvement in motor performance for nearly all patients, lasting over 4 years in some cases. A total of 70% of patients in the pediatric cohort and 72% of patients in the adult cohort achieved a clinically meaningful improvement in motor function following nusinersen treatment. Additionally, nusinersen was well-tolerated in both cohorts. These findings add to the growing body of evidence relating to the clinical efficacy and safety of nusinersen.
  10. Wu YL, Guarneri V, Voon PJ, Lim BK, Yang JJ, Wislez M, et al.
    Lancet Oncol, 2024 Aug;25(8):989-1002.
    PMID: 39089305 DOI: 10.1016/S1470-2045(24)00270-5
    BACKGROUND: Patients with EGFR-mutated non-small-cell lung cancer (NSCLC) and MET amplification as a mechanism of resistance to first-line osimertinib have few treatment options. Here, we report the primary analysis of the phase 2 INSIGHT 2 study evaluating tepotinib, a highly selective MET inhibitor, combined with osimertinib in this population.

    METHODS: This open-label, phase 2 study was conducted at 179 academic centres and community clinics in 17 countries. Eligible patients were aged 18 years or older with an Eastern Cooperative Oncology Group performance status of 0 or 1 and advanced or metastatic EGFR-mutated NSCLC of any histology, with MET amplification by tissue biopsy fluorescence in-situ hybridisation (FISH; MET gene copy number of ≥5 or MET-to-CEP7 ratio of ≥2) or liquid biopsy next-generation sequencing (MET plasma gene copy number of ≥2·3), following progression on first-line osimertinib. Patients received oral tepotinib 500 mg plus oral osimertinib 80 mg once daily. The primary endpoint was independently assessed objective response in patients with MET amplification by central FISH treated with tepotinib plus osimertinib with at least 9 months of follow-up. Safety was analysed in patients who received at least one study drug dose. This study is registered with ClinicalTrials.gov, NCT03940703 (enrolment complete).

    FINDINGS: Between Feb 13, 2020, and Nov 4, 2022, 128 patients (74 [58%] female, 54 [42%] male) were enrolled and initiated tepotinib plus osimertinib. The primary activity analysis population included 98 patients with MET amplification confirmed by central FISH, previous first-line osimertinib and at least 9 months of follow-up (median 12·7 months [IQR 9·9-20·3]). The confirmed objective response rate was 50·0% (95% CI 39·7-60·3; 49 of 98 patients). The most common treatment-related grade 3 or worse adverse events were peripheral oedema (six [5%] of 128 patients), decreased appetite (five [4%]), prolonged electrocardiogram QT interval (five [4%]), and pneumonitis (four [3%]). Serious treatment-related adverse events were reported in 16 (13%) patients. Deaths of four (3%) patients were assessed as potentially related to either trial drug by the investigator due to pneumonitis (two [2%] patients), decreased platelet count (one [1%]), respiratory failure (one [1%]), and dyspnoea (one [1%]); one death was attributed to both pneumonitis and dyspnoea.

    INTERPRETATION: Tepotinib plus osimertinib showed promising activity and acceptable safety in patients with EGFR-mutated NSCLC and MET amplification as a mechanism of resistance to first-line osimertinib, suggesting a potential chemotherapy-sparing oral targeted therapy option that should be further investigated.

    FUNDING: Merck (CrossRef Funder ID: 10.13039/100009945).

    MeSH terms: Adult; Aged; Aged, 80 and over; Female; Gene Amplification*; Humans; Indoles; Male; Middle Aged; Mutation*; Piperidines; Pyridazines; Pyrimidines/administration & dosage; Pyrimidines/adverse effects; Pyrimidines/therapeutic use; Disease Progression
  11. Siew LY, Lee ZY, Yunos NM, Atan R, Cove ME, Lumlertgul N, et al.
    J Crit Care, 2024 Oct;83:154844.
    PMID: 38901069 DOI: 10.1016/j.jcrc.2024.154844
    PURPOSE: To evaluate the efficacy of the novel oXiris® membrane in critically ill adult patients.

    METHODS: We systematically searched MEDLINE, EMBASE, and CENTRAL from inception to 01/06/2023 for relevant randomised controlled trials (RCTs) and non-randomised studies of intervention (NRSI). The primary outcome was overall mortality. Random effect meta-analyses were conducted in RevMan 5.4.1. Study quality was evaluated using Cochrane's risk of bias tool. (PROSPERO: CRD42023389198).

    RESULTS: Ten studies (2 RCTs and 8 NRSIs) with 481 patients were included. None had low risk of bias. Treatment using oXiris® was associated with reduced overall mortality (RR 0.78, 95%CI 0.62-0.98; p = 0.03; 6 NRSI). One RCT reported 28-day mortality, finding no significant difference between groups. Besides, pooled NRSIs results showed significant reductions in SOFA scores, norepinephrine dosage, and several inflammatory biomarkers (C-reactive protein [CRP], lactate, and interleukin-6 [IL-6]) post oXiris® treatment. However, other clinical outcomes (ICU and hospital length of stay, mechanical ventilation duration) were similar between groups.

    CONCLUSION: In critically ill patients, the use of oXiris® membrane was associated with reduced overall mortality, norepinephrine dosage, CRP, IL-6, lactate levels, along with improved organ function. However, the certainty of evidence was very low, necessitating high-quality RCTs to further evaluate its efficacy in this population.

    MeSH terms: Hemofiltration/methods; Humans; Membranes, Artificial; Biomarkers/blood; Critical Illness*; Treatment Outcome
  12. Evelyn LLL, Abu Daud NH, Loh TC, Candyrine SCL
    Trop Anim Health Prod, 2024 Dec 23;57(1):8.
    PMID: 39710747 DOI: 10.1007/s11250-024-04264-9
    The effects of incorporating Illipe nut into the diet of pigs, in replacement of yellow maize, on their growth performance and meat quality was investigated in a 60 days feeding trial. Twenty-four male pigs were divided into two treatments and fed diets with 0% (T1) or 15% (T2) Illipe nut inclusion. Feed intake, live weight (LW) and backfat thickness (BFT) were taken and used to calculate average daily feed intake (ADFI), average daily gain (ADG), feed conversion ratio (FCR) and increase in backfat (IBF). At the end of the trial, final LW and BFT were measured. Pigs were then slaughtered and hot carcass weight (HCW), pH45mins, pH24hrs and dressing percentage (DP) were determined. Other analysis, including total moisture, thawing loss (TL), cooking loss (CL) and water holding capacity (WHC), were conducted on pork samples. Nutritional content and fatty acid (FA) composition of pork samples were analyzed, and nutritional indices were calculated. Improvements (P 
    MeSH terms: Animals; Animal Nutritional Physiological Phenomena; Body Composition; Zea mays*; Fatty Acids/analysis; Male; Nuts/chemistry; Sus scrofa/growth & development; Sus scrofa/physiology
  13. Al-Waisy AS, Al-Fahdawi S, Mohammed MA, Abdulkareem KH, Mostafa SA, Maashi MS, et al.
    Soft comput, 2024;28(Suppl 1):65.
    PMID: 39847664 DOI: 10.1007/s00500-024-09992-6
    [This retracts the article DOI: 10.1007/s00500-020-05424-3.].
  14. McBenedict B, Hauwanga WN, Fong YB, Pogodina A, Obinna EE, Pradhan S, et al.
    Cureus, 2024 Dec;16(12):e76290.
    PMID: 39850176 DOI: 10.7759/cureus.76290
    Awake craniotomy (AC) is a critical neurosurgical technique for maximizing tumor resection in eloquent brain regions while preserving essential neurological functions like speech and motor control. Despite its widespread adoption, no prior bibliometric analysis has evaluated the most influential research in this field. This study analyzed the top 100 most-cited articles on AC to identify key trends, influential works, and authorship demographics. A systematic search of the Web of Science Core Collection on September 17, 2024, yielded 718 publications, with the top 100 ranked by citation count. Analysis revealed a surge in AC research after 2013, peaking in 2021, with the Journal of Neurosurgery contributing significantly (49 articles; 2,611 citations). Themes included functional mapping, anesthetic techniques, and patient outcomes, with technological advancements such as intraoperative MRI and virtual reality enhancing surgical precision. Authorship analysis highlighted a gender disparity, with male authors occupying 77% of first authorship and 88% of senior roles. These findings underscore AC's evolution, foundational studies, and ongoing advancements while emphasizing the need for greater diversity and inclusion in the field.
  15. Dashti M, AlKandari H, Malik MZ, Nizam R, John SE, Jacob S, et al.
    Front Cell Infect Microbiol, 2024;14:1444216.
    PMID: 39844836 DOI: 10.3389/fcimb.2024.1444216
    BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a severe complication arising from SARS-CoV-2 infection, with indications that rare inborn errors of immunity may play a role in its pathogenesis. Recent studies suggest that genetic predispositions, particularly monogenic forms, could significantly influence the immune responses to SARS-CoV-2 in MIS-C.

    METHODS: We analysed 24 children under 12 years old, all of whom met the criteria provided by the World Health Organization, 2020 for MIS-C diagnosis, from the Paediatric COVID-19 Registry in Kuwait (PCR-Q8). Demographic and clinical data were collected from medical records, and exome sequencing was performed on the children and their parents to identify rare exonic variants. These variants were prioritized using two approaches: a candidate genes approach employing trio segregation analysis, and a candidate variants approach using a gene panel informed by previous studies on MIS-C-related genetic variants and datasets of differentially expressed genes in MIS-C patients.

    RESULTS: The candidate genes approach identified 53 unique genes in 20 of the 24 probands, including DDX60 and TMEM154, which were also differentially expressed between MIS-C and control groups. The candidate variants approach identified 33 rare, predicted deleterious heterozygous variants across 19 unique genes in 19 of the 24 probands, including both previously described and novel candidate variants for MIS-C. Pathway analysis of the identified genes from both approaches revealed significant involvement in immune response, viral defence, and inflammatory pathways.

    CONCLUSION: This study underscores the monogenic susceptibility to MIS-C, enhancing the evidence base through comprehensive genetic analysis. The findings highlight the critical role of genetic predispositions in MIS-C and suggest that further functional genomics work is necessary to explore the mechanistic contributions of these genes, facilitating the development of targeted diagnostic strategies.

    MeSH terms: Child; Child, Preschool; Female; Humans; Infant; Kuwait; Male; Genetic Predisposition to Disease*
  16. Yao P, Mohd Esah E, Zhao C
    Front Microbiol, 2024;15:1465373.
    PMID: 39845052 DOI: 10.3389/fmicb.2024.1465373
    Lactobacillus is widely recognized for its probiotic benefits and has been widely used in food production. While biofilms are typically associated with pathogenic bacteria, they also served as a self-protective mechanism formed by microorganisms in an adverse environments. In recent years, relevant studies have revealed the excellent characteristics of Lactobacillus biofilms, offering new insights into their potential applications in the food industry. The Lactobacillus biofilms is important in improving fermentation processes and enhancing the resilience of Lactobacillus in various conditions. This paper reviews how quorum sensing regulates the formation of Lactobacillus biofilms and explores their roles in stress resistance, bacteriostasis and food production. Additionally, it highlights the emerging concept of fourth-generation probiotics, developed through biofilm technology, as a novel approach to probiotic applications.
  17. Cheong WL, Kamisan N, Ismail II
    Cureus, 2024 Dec;16(12):e76248.
    PMID: 39845223 DOI: 10.7759/cureus.76248
    Distal humerus physeal separation is an uncommon and often misdiagnosed injury in infants and young children, frequently resulting in delayed treatment. We report three cases of distal humerus physeal separation that presented with different clinical scenarios with different management approaches. The first case describes a nine-month-old girl who was initially treated for presumed elbow cellulitis before presentation to our centre six weeks later. Conservative management, with further observation, noted remodelling of the distal humerus and full elbow range of motion (ROM) after 18 months. The second case involves a two-year-old girl with Kawasaki disease who underwent delayed closed reduction and percutaneous pinning after one week due to concurrent antiplatelet therapy. At four-month follow-up, there was cubitus varus deformity with slight limitation in elbow flexion. The third case is of a five-day-old male neonate with a right elbow deformity following an elective caesarean delivery at another hospital. Gentle manipulation was performed with a splint to improve alignment and immobilisation. The fracture united after five weeks. There was varus deformity but otherwise a full range of motion. These cases underscore the challenges in early diagnosis and management of distal humerus physeal separation in young children. Delayed treatment can lead to favourable outcomes, but follow-up is essential to observe for potential remodelling and residual deformity.
  18. Adzahar S, Daud A, Syed Hassan SNRK, Nordin MH, Rameli N, Nizam Akbar NA, et al.
    Cureus, 2024 Dec;16(12):e76277.
    PMID: 39845234 DOI: 10.7759/cureus.76277
    Haemoglobin (Hb) AE Bart's disease is a rare form of thalassemia that results from the co-inheritance of Hb E and alpha thalassemia, typically with Hb H disease. The clinical severity can vary depending on the underlying genetic mutations, particularly in the presence of Hb Constant Spring (Hb CS), which is a highly unstable form of alpha thalassemia. Understanding the genetic basis and haematological profiles of Hb AE Bart's disease is crucial for proper diagnosis and management. We report the case of a nine-year-old Malay boy presenting with severe hypochromic microcytic anemia, jaundice, and hepatosplenomegaly. Haemoglobin electrophoresis findings consistent with Hb H Constant Spring disease co-inherited with Hb E. Molecular genetic testing confirmed compound heterozygosity for the South East Asian (SEA) deletion and Hb CS mutation along with heterozygous Hb E. This case highlights the importance of considering complex haemoglobinopathies such as Hb AE Bart's disease in patients presenting with anemia, especially in regions with a high prevalence of thalassemia. Early diagnosis through a combination of Hb electrophoresis and molecular genetic testing is essential for proper management and genetic counseling to prevent long-term complications.
  19. Roslan NH, Zarkasi KA, Mohd Yusof YA, Makpol S
    Cureus, 2024 Dec;16(12):e76260.
    PMID: 39845239 DOI: 10.7759/cureus.76260
    A high-fat diet could lead to obesity, increasing colorectal cancer risk due to dyslipidemia and chronic inflammation, while Piper betle (PB) exhibits anti-tumor, anti-inflammation, and anti-oxidant benefits. This study aimed to determine whether PB possesses chemopreventive effects on high-fat diet (HFD)-induced and azoxymethane (AOM)-induced colon cancer. Male Sprague-Dawley rats receiving either a normal diet or HFD were divided into control, PB, AOM, and AOM+PB subgroups which were then sacrificed after 24 weeks. The lipid profile, leptin, and inflammatory markers were measured from serum, and aberrant crypt foci (ACF) in the colon were detected by methylene blue staining. Cellular proliferation was identified through immunohistochemical staining of antigen Kiel 67 (Ki67) and beta-catenin. There were significant differences in serum total cholesterol, low-density lipoprotein, triglycerides, and high-density lipoprotein in the HFD compared to the normal diet group. The AOM group for normal diet and HFD exhibited significantly increased serum leptin, interleukin-6, IL-12p70, tumor necrosis factor-α, and nuclear factor-κB, with overexpression of Ki67 and beta-catenin. These changes were reversed by PB supplementation. In conclusion, PB demonstrated lipid-modifying and chemopreventive effects against HFD and AOM-induced colon cancer in rats.
  20. Khatoon S, Kalam N
    Front Pharmacol, 2024;15:1531288.
    PMID: 39845785 DOI: 10.3389/fphar.2024.1531288
    Recurrent spontaneous seizures with an extended epileptic discharge are the hallmarks of epilepsy. At present, there are several available anti-epileptic drugs (AEDs) in the market. Still no adequate treatment for epilepsy treatment is available. The main disadvantages of AEDs are their associated adverse effects. It is a challenge to develop new therapies that can reduce seizures by modulating the underlying mechanisms with no adverse effects. In the last decade, the neuromodulatory potential of phytoconstituents has sparked their usage in the treatment of central nervous system disorders. Curcumin is an active polyphenolic component that interacts at cellular and molecular levels. Curcumin's neuroprotective properties have been discovered in recent preclinical and clinical studies due to its immunomodulatory effects. Curcumin has the propensity to modulate signaling pathways involved in cell survival and manage oxidative stress, apoptosis, and inflammatory mechanisms. Further, curcumin can persuade epigenetic alterations, including histone modifications (acetylation/deacetylation), which are the changes responsible for the altered expression of genes facilitating the process of epileptogenesis. The bioavailability of curcumin in the brain is a concern that needs to be tackled. Therefore, nanonization has emerged as a novel drug delivery system to enhance the pharmacokinetics of curcumin. In the present review, we reviewed curcumin's modulatory effects on potential biomarkers involved in epileptogenesis including dendritic cells, T cell subsets, cytokines, chemokines, apoptosis mediators, antioxidant mechanisms, and cognition impairment. Also, we have discussed the nanocarrier systems for encapsulating curcumin, offering a promising approach to enhance bioavailability of curcumin.
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