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Concurrent stroke and ST-elevation myocardial infarction: Is it a contraindication for intravenous tenecteplase?

Wan Asyraf WZ, Elengoe S, Che Hassan HH, Abu Bakar A, Remli R

Med J Malaysia, 2020 03;75(2):169-170.
PMID: 32281601

Acute ischemic stroke (AIS) and acute ST-elevation myocardial infarction (STEMI) are leading causes of mortality worldwide. Concurrent AIS presentation with STEMI is rare and potentially fatal. Most importantly to date many centres in Malaysia are still not aware on how to treat this condition. We report a case of AIS, which was treated with intravenous tenecteplase (TNK) according to ischemic stroke dosage and lead to improvement of neurological deficit.
Fulltext The NeuroAiD Safe Treatment (NeST) Registry: a protocol

Venketasubramanian N, Kumar R, Soertidewi L, Abu Bakar A, Laik C, Gan R

BMJ Open, 2015 Nov 13;5(11):e009866.
PMID: 26567259 DOI: 10.1136/bmjopen-2015-009866

INTRODUCTION: NeuroAiD (MLC601, MLC901), a combination of natural products, has been shown to be safe and to aid neurological recovery after brain injuries. The NeuroAiD Safe Treatment (NeST) Registry aims to assess its use and safety in the real-world setting.
METHODS AND ANALYSIS: The NeST Registry is designed as a product registry that would provide information on the use and safety of NeuroAiD in clinical practice. An online NeST Registry was set up to allow easy entry and retrieval of essential information including demographics, medical conditions, clinical assessments of neurological, functional and cognitive state, compliance, concomitant medications, and side effects, if any, among patients on NeuroAiD. Patients who are taking or have been prescribed NeuroAiD may be included. Participation is voluntary. Data collected are similar to information obtained during standard care and are prospectively entered by the participating physicians at baseline (before initialisation of NeuroAiD) and during subsequent visits. The primary outcome assessed is safety (ie, non-serious and serious adverse event), while compliance and neurological status over time are secondary outcomes. The in-person follow-up assessments are timed with clinical appointments. Anonymised data will be extracted and collectively analysed. Initial target sample size for the registry is 2000. Analysis will be performed after every 500 participants entered with completed follow-up information.
ETHICS AND DISSEMINATION: Doctors who prescribe NeuroAiD will be introduced to the registry by local partners. The central coordinator of the registry will discuss the protocol and requirements for implementation with doctors who show interest. Currently, the registry has been approved by the Ethics Committees of Universiti Kebangsaan Malaysia (Malaysia) and National Brain Center (Indonesia). In addition, for other countries, Ethics Committee approval will be obtained in accordance with local requirements.
TRIAL REGISTRATION NUMBER: NCT02536079.
Management Options and Outcome of Cerebral Arteriovenous Malformation in Pregnancy: Case Series

Teik CK, Basri NI, Abdul Karim AK, Azrai Abu M, Ahmad MF, Abdul Ghani NA, et al.

Arch Iran Med, 2019 06 01;22(6):340-343.
PMID: 31356101

Cerebral arteriovenous malformation (AVM) is a rare entity with an estimated prevalence of 0.01-0.05% in the general population. We reviewed hospital obstetric records during 2010-2017 and reported a case series of six patients with cerebral AVM in pregnancy, of which five patients had successful pregnancy, and one maternal mortality.
Fulltext Mitochondrial DNA Mutations in Grade II and III Glioma Cell Lines Are Associated with Significant Mitochondrial Dysfunction and Higher Oxidative Stress

Soon BH, Abdul Murad NA, Then SM, Abu Bakar A, Fadzil F, Thanabalan J, et al.

Front Physiol, 2017;8:231.
PMID: 28484394 DOI: 10.3389/fphys.2017.00231

The role of mitochondria in tumorigenesis has regained much attention as it could dysregulate cellular energetics, oxidative stress and apoptosis. However, the role of mitochondria in different grade gliomasis still unknown. This study aimed to identify mitochondrial DNA (mtDNA) sequence variations that could possibly affect the mitochondrial functions and also the oxidative stress status. Three different grades of human glioma cell lines and a normal human astrocyte cell line were cultured in-vitro and tested for oxidative stress biomarkers. Relative oxidative stress level, mitochondria activity, and mitochondrial mass were determined by live cell imaging with confocal laser scanning microscope using CM-H2DCFDA, MitoTracker Green, and MitoTracker Orange stains. The entire mitochondrial genome was sequenced using the AffymetrixGeneChip Human Mitochondrial Resequencing Array 2.0. The mitochondrial sequence variations were subjected to phylogenetic haplogroup assessment and pathogenicity of the mutations were predicted using pMUT and PolyPhen2. The Grade II astrocytoma cells showed increased oxidative stress wherea high level of 8-OHdG and oxidative stress indicator were observed. Simultaneously, Grade II and III glioma cells showed relatively poor mitochondria functions and increased number of mutations in the coding region of the mtDNA which could be due to high levels of oxidative stress in these cells. These non-synonymous mtDNA sequence variations were predicted to be pathogenic and could possibly lead to protein dysfunction, leading to oxidative phosphorylation (OXPHOS) impairment, mitochondria dysfunction and could create a vicious cycle of oxidative stress. The Grade IV cells had no missense mutation but preserved intact mitochondria and excellent antioxidant defense mechanisms thus ensuring better survival. In conclusion, Grade II and III glioma cells demonstrated coding region mtDNA mutations, leading to mitochondrial dysfunction and higher oxidative stress.
Somatic mitochondrial DNA mutations in different grades of glioma

Soon BH, Abu N, Abdul Murad NA, Then SM, Abu Bakar A, Fadzil F, et al.

Per Med, 2022 01;19(1):25-39.
PMID: 34873928 DOI: 10.2217/pme-2021-0033

Aim: Mitochondrial DNA (mtDNA) alterations play an important role in the multistep processes of cancer development. Gliomas are among the most diagnosed brain cancer. The relationship between mtDNA alterations and different grades of gliomas are still elusive. This study aimed to elucidate the profile of somatic mtDNA mutations in different grades of gliomas and correlate it with clinical phenotype. Materials & methods: Forty histopathologically confirmed glioma tissue samples and their matched blood were collected and subjected for mtDNA sequencing. Results & conclusion: About 75% of the gliomas harbored at least one somatic mutation in the mtDNA gene, and 45% of these mutations were pathogenic. Mutations were scattered across the mtDNA genome, and the commonest nonsynonymous mutations were located at complex I and IV of the mitochondrial respiratory chain. These findings may have implication for future research to determine the mitochondrial energetics and its downstream metabolomics on gliomas.
Raised leptin concentrations in feto-placental tissues from women with preeclampsia

Singh HJ, Abu Bakar A, Che Romli A, Nila A

Hypertens Pregnancy, 2005;24(2):191-9.
PMID: 16036403

The aim of this study was to estimate the levels of leptin in the amnion, chorion laeve, and placenta and to examine for any differences in leptin levels in these tissues from preeclamptic and normotensive pregnant women.
Investigating the Co-Movement and Asymmetric Relationships of Oil Prices on the Shipping Stock Returns: Evidence from Three Shipping-Flagged Companies from Germany, South Korea, and Taiwan

Saputra J, Mokhtar K, Abu Bakar A, Ruslan SMM

Big Data, 2024 Feb 13.
PMID: 38354271 DOI: 10.1089/big.2023.0026

In the last 2 years, there has been a significant upswing in oil prices, leading to a decline in economic activity and demand. This trend holds substantial implications for the global economy, particularly within the emerging business landscape. Among the influential risk factors impacting the returns of shipping stocks, none looms larger than the volatility in oil prices. Yet, only a limited number of studies have explored the complex relationship between oil price shocks and the dynamics of the liner shipping industry, with specific focus on uncertainty linkages and potential diversification strategies. This study aims to investigate the co-movements and asymmetric associations between oil prices (specifically, West Texas Intermediate and Brent) and the stock returns of three prominent shipping companies from Germany, South Korea, and Taiwan. The results unequivocally highlight the indispensable role of oil prices in shaping both short-term and long-term shipping stock returns. In addition, the research underscores the statistical significance of exchange rates and interest rates in influencing these returns, with their effects varying across different time horizons. Notably, shipping stock prices exhibit heightened sensitivity to positive movements in oil prices, while exchange rates and interest rates exert contrasting impacts, one being positive and the other negative. These findings collectively illuminate the profound influence of market sentiment regarding crucial economic indicators within the global shipping sector.
Occurrence, distribution, and dechlorination of polychlorinated biphenyls and health risk assessment in Selangor River basin

Sakai N, Dayana E, Abu Bakar A, Yoneda M, Nik Sulaiman NM, Ali Mohd M

Environ Monit Assess, 2016 Oct;188(10):592.
PMID: 27679511

Polychlorinated biphenyls (PCBs) were monitored in surface water collected in the Selangor River basin, Malaysia, to identify the occurrence, distribution, and dechlorination process as well as to assess the potential adverse effects to the Malaysian population. Ten PCB homologs (i.e., mono-CBs to deca-CBs) were quantitated by using gas chromatography-mass spectrometry (GC/MS). The total concentration of PCBs in the 10 sampling sites ranged from limit of detection to 7.67 ng L(-1). The higher chlorinated biphenyls (tetra-CBs to deca-CBs) were almost not detected in most of the sampling sites, whereas lower chlorinated biphenyls (mono-CBs, di-CBs, and tri-CBs) dominated more than 90 % of the 10 homologs in all the sampling sites. Therefore, the PCB load was estimated to be negligible during the sampling period because PCBs have an extremely long half-life. The PCBs, particularly higher chlorinated biphenyls, could be thoroughly dechlorinated to mono-CBs to tri-CBs by microbial decomposition in sediment or could still be accumulated in the sediment. The lower chlorinated biphenyls, however, could be resuspended or desorbed from the sediment because they have faster desorption rates and higher solubility, compared to the higher chlorinated biphenyls. The health risk for the Malaysia population by PCB intake that was estimated from the local fish consumption (7.2 ng kg(-1) bw day(-1)) and tap water consumption (1.5 × 10(-3)-3.1 × 10(-3) ng kg(-1) bw day(-1)) based on the detected PCB levels in the surface water was considered to be minimal. The hazard quotient based on the tolerable daily intake (20 ng kg(-1) bw day(-1)) was estimated at 0.36.
Zinc: indications in brain disorders

Prakash A, Bharti K, Majeed AB

Fundam Clin Pharmacol, 2015 Apr;29(2):131-49.
PMID: 25659970 DOI: 10.1111/fcp.12110

Zinc is the authoritative metal which is present in our body, and reactive zinc metal is crucial for neuronal signaling and is largely distributed within presynaptic vesicles. Zinc also plays an important role in synaptic function. At cellular level, zinc is a modulator of synaptic activity and neuronal plasticity in both development and adulthood. Different importers and transporters are involved in zinc homeostasis. ZnT-3 is a main transporter involved in zinc homeostasis in the brain. It has been found that alterations in brain zinc status have been implicated in a wide range of neurological disorders including impaired brain development and many neurodegenerative disorders such as Alzheimer's disease, and mood disorders including depression, Parkinson's disease, Huntington's disease, amyotrophic lateral sclerosis, and prion disease. Furthermore, zinc has also been implicated in neuronal damage associated with traumatic brain injury, stroke, and seizure. Understanding the mechanisms that control brain zinc homeostasis is thus critical to the development of preventive and treatment strategies for these and other neurological disorders.
Fulltext Quantitating proteinuria using the urinary protein creatinine index

Norella Kong CT, Chin JH, Izham Cheong IK, Abu Bakar A

Med J Malaysia, 1988 Jun;43(2):134-7.
PMID: 3237129
Fulltext Evaluation of acute asthma management among emergency doctors using simulation-based assessment

Nagaretnam B, Md Jamal S, Abu Bakar A, Zaini IZ, Saiboon IM

Medicine (Baltimore), 2023 Jul 14;102(28):e34095.
PMID: 37443513 DOI: 10.1097/MD.0000000000034095

Assessment of asthma management competency using conventional methods remains challenging. This study aimed to explore the baseline knowledge, diagnosis accuracy and clinical management accuracy of acute asthma among emergency doctors using simulation-based assessment. We conducted a cross-sectional study involving 65 emergency department medical officers at a tertiary center. Participants were evaluated using 2 components: knowledge assessment of acute asthma and clinical performance assessment. Knowledge was evaluated using a standardized knowledge questionnaire. Clinical performance in managing acute asthma was assessed using a simulated acute asthma scenario and a standardized asthma management checklist using real-time assessments. The mean knowledge score was 14.69 ± 2.16. No significant differences were found in diagnosis and management accuracy in relation to knowledge (H = 0.644, P = .725, df = 6; H = 1.337, P = .512, df = 2). Acute-asthma attacks of all severities were poorly assessed, with accuracies of 27.3, 41.9, and 20.1% in mild, moderate, severe, and life-threatening cases, respectively. However, all participants provided high-quality treatment (accuracy = 82.3%) regardless of severity. Knowledge score does not influence the ability to differentiate asthma severity and management accuracy according to established asthma guidelines. The overall treatment accuracy was high, regardless of the severity of asthma. However, assessment of acute asthma requires further refinement.
Mitochondrial targeting of bilirubin regulatory enzymes: An adaptive response to oxidative stress

Muhsain SN, Lang MA, Abu-Bakar A

Toxicol Appl Pharmacol, 2015 Jan 1;282(1):77-89.
PMID: 25478736 DOI: 10.1016/j.taap.2014.11.010

The intracellular level of bilirubin (BR), an endogenous antioxidant that is cytotoxic at high concentrations, is tightly controlled within the optimal therapeutic range. We have recently described a concerted intracellular BR regulation by two microsomal enzymes: heme oxygenase 1 (HMOX1), essential for BR production and cytochrome P450 2A5 (CYP2A5), a BR oxidase. Herein, we describe targeting of these enzymes to hepatic mitochondria during oxidative stress. The kinetics of microsomal and mitochondrial BR oxidation were compared. Treatment of DBA/2J mice with 200mgpyrazole/kg/day for 3days increased hepatic intracellular protein carbonyl content and induced nucleo-translocation of Nrf2. HMOX1 and CYP2A5 proteins and activities were elevated in microsomes and mitoplasts but not the UGT1A1, a catalyst of BR glucuronidation. A CYP2A5 antibody inhibited 75% of microsomal BR oxidation. The inhibition was absent in control mitoplasts but elevated to 50% after treatment. An adrenodoxin reductase antibody did not inhibit microsomal BR oxidation but inhibited 50% of mitochondrial BR oxidation. Ascorbic acid inhibited 5% and 22% of the reaction in control and treated microsomes, respectively. In control mitoplasts the inhibition was 100%, which was reduced to 50% after treatment. Bilirubin affinity to mitochondrial and microsomal CYP2A5 enzyme is equally high. Lastly, the treatment neither released cytochrome c into cytoplasm nor dissipated membrane potential, indicating the absence of mitochondrial membrane damage. Collectively, the observations suggest that BR regulatory enzymes are recruited to mitochondria during oxidative stress and BR oxidation by mitochondrial CYP2A5 is supported by mitochondrial mono-oxygenase system. The induced recruitment potentially confers membrane protection.
Hybrid soliwave technique for mitigating sulfate-reducing bacteria in controlling biocorrosion: a case study on crude oil sample

Mohd Ali MKFB, Abu Bakar A, Md Noor N, Yahaya N, Ismail M, Rashid AS

Environ Technol, 2017 Oct;38(19):2427-2439.
PMID: 27875932 DOI: 10.1080/09593330.2016.1264486

Microbiologically influenced corrosion (MIC) is among the common corrosion types for buried and deep-water pipelines that result in costly repair and pipeline failure. Sulfate-reducing bacteria (SRB) are commonly known as the culprit of MIC. The aim of this work is to investigate the performance of combination of ultrasound (US) irradiation and ultraviolet (UV) radiation (known as Hybrid soliwave technique, HyST) at pilot scale to inactivate SRB. The influence of different reaction times with respect to US irradiation and UV radiation and synergistic effect toward SRB consortium was tested and discussed. In this research, the effect of HyST treatment toward SRB extermination and corrosion studies of carbon steel coupon upon SRB activity before and after the treatment were performed using weight loss method. The carbon steel coupons immersed in SRB sample were exposed to HyST treatment at different time of exposure. Additionally, Field Emission Scanning Electron Microscopy coupled with Energy Dispersive X-ray Spectroscopy were used to investigate the corrosion morphology in verifying the end product of SRB activity and corrosion formation after treatment. Results have shown that the US irradiation treatment gives a synergistic effect when combined with UV radiation in mitigating the SRB consortium.
Fulltext Outbreak detection model based on danger theory

Mohamad Mohsin MF, Abu Bakar A, Hamdan AR

Appl Soft Comput, 2014 Nov;24:612-622.
PMID: 32362801 DOI: 10.1016/j.asoc.2014.08.030

In outbreak detection, one of the key issues is the need to deal with the weakness of early outbreak signals because this causes the detection model to have has less capability in terms of robustness when unseen outbreak patterns vary from those in the trained model. As a result, an imbalance between high detection rate and low false alarm rate occurs. To solve this problem, this study proposes a novel outbreak detection model based on danger theory; a bio-inspired method that replicates how the human body fights pathogens. We propose a signal formalization approach based on cumulative sum and a cumulative mature antigen contact value to suit the outbreak characteristic and danger theory. Two outbreak diseases, dengue and SARS, are subjected to a danger theory algorithm; namely the dendritic cell algorithm. To evaluate the model, four measurement metrics are applied: detection rate, specificity, false alarm rate, and accuracy. From the experiment, the proposed model outperforms the other detection approaches and shows a significant improvement for both diseases outbreak detection. The findings reveal that the robustness of the proposed immune model increases when dealing with inconsistent outbreak signals. The model is able to detect new unknown outbreak patterns and can discriminate between outbreak and non-outbreak cases with a consistent high detection rate, high sensitivity, and lower false alarm rate even without a training phase.
Fulltext Psychiatric aspects of the acquired immunodeficiency syndrome. A case report

Maniam T, Abu Bakar AK

Med J Malaysia, 1988 Jun;43(2):166-9.
PMID: 3237133
Fulltext Malaysia Health System Review

Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al.

ISBN: 978-92-9061-584-2

Citation: Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al. Malaysia Health System Review. Geneva: World Health Organization; 2013

Malaysia is a federation of 13 states and 2 territories in a parliamentary democracy, with the Prime Minister the head of government and a constitutional monarch elected by the Sultans. Malaysia is a multicultural society and a secular state with Sunni Islam as the official religion. Classified by the World Bank as an upper middle-income country, its society and economy were transformed by rapid economic growth in the latter half of the 20th century. Malaysia’s population (now numbering over 28 million with 70% living in urban areas) has benefited from a well developed health care system, good access to clean water and sanitation, and strong social and economic programmes. Life expectancy at birth is 73 years. Noncommunicable diseases now account for most mortality and morbidity but communicable diseases remain a concern. Section 2 describes the organization and governance of the health system. Health care services consist of tax-funded and governmentrun primary health care centres and hospitals, and fast-growing private services mainly located in physician clinics and hospitals in urban areas. Public sector health services are administered by the Ministry of Health through its central, state and district offices. The Ministry of Health regulates the private sector, pharmaceutical industry and food safety and plans and regulates its own health care services. Legislation governing health care professionals requires them to register with statutory professional bodies. Section 3 reports on health care financing. Malaysia’s public health system is financed mainly through general revenue and taxation collected by the federal government, while the private sector is funded principally through out-of-pocket payments from patients and some private health insurance. Spending on health reached 4.6% of GDP in 2009 with the majority from public spending, reaching 56% of total health expenditure (THE) in 2009. The main sources of THE in 2008 were the Ministry of Health (42%), followed by household out-of-pocket expenditure at nearly 34%. The Ministry of Health funds public facilities through line item budgets and patients pay private physicians and private hospitals on a fee-for-service basis. Physical and human resources are described in Section 4. The number of public primary care facilities (currently 802 centres and over 2000 small community clinics) and dental clinics were expanded steadily in earlier decades, particularly to reach people in under-served rural areas. Secondary care is offered in smaller public hospitals and more complex tertiary care, in regional and national hospitals (including university teaching hospitals run by the Ministry of Higher Education). Growth has slowed in recent years, however, and public services in urban areas have not kept pace with rapid urbanization, while the population ratio of hospital beds has declined slightly. Private clinics and hospitals in urban areas have grown rapidly over the last decade. The supply of health professionals remains seriously below the required number, although the government has increased the number of training places. Section 5 looks at provision of services. National health policies stress public health and health promotion, that is, ‘a wellness’ as well as a ‘disease’ perspective. The Ministry of Health has developed an extensive network of public primary care centres and also dental services especially for children, but these services are under strain and have staff shortages, so patients often encounter long waits. Primary care exerts only a limited gatekeeper function since people can bypass a referral from a general practitioner and for a small additional fee (if in the public sector) can go directly to specialists and hospitals. Government services increasingly serve the poor and private services the better-off people who live in urban areas. Hospital policy currently has three main thrusts: strengthening specialty care in large public hospitals; increasing the number of day surgery centres; and expanding top-end private hospital care to cater to the medical tourism market (with 35 participating hospitals in 2010). Malaysia has a large pharmaceutical manufacturing sector that exports to other countries and also supplies 30% of domestic demand. The principal health care reforms are discussed in Section 6. The government has stepped up its surveillance and early response to infectious disease outbreaks as a result of recent pandemics such as SARS and avian flu, which had a major impact on the country’s economy. The Ministry of Health has maintained its extensive vaccination programmes, has consolidated its primary health care clinics and upgraded its hospitals, and is slowly introducing information communication technology into its public facilities. The government has increased training places to counter shortages of health professionals, has strengthened food and drug safety regulation, is considering price xv regulation of pharmaceuticals, and is positioning the country as a medical tourism destination. Section 7 provides an assessment of the health system. Malaysia has a strong population health tradition and well-established and extensive health care services. Although total health expenditure at 4.6% of GDP in 2008 is in the range for middle-income countries, the government is concerned about future sustainable financing. Successive administrators have prioritized the provision of cost-effective, preventative and mainly free primary health care in public clinics. The rapid growth of private health care means that private spending has risen faster than public spending, including out-of-pocket payments by the public, with the government share (from general revenue) just above half (56%) of health expenditure in 2009. In conclusion, Malaysia has achieved impressive health gains for its population with a low-cost health care system funded through general revenue that provides universal and comprehensive services. Like many other countries in the region, Malaysia has struggled to produce an adequate supply of health professionals, and to integrate and regulate its rapidly growing private health sector. Public services have not kept pace with population growth in urban areas and those with higher purchasing power use private rather than public doctors and hospitals, which leaves the public sector with more poorer and sicker patients. The Malaysian Government recently revived the debate over options for a national social health insurance scheme. The financing challenge is to agree on a scheme for fair and sustainable funding and its respective contributions from general revenue and private payments. The regulatory challenge for the Malaysian Government is to strengthen its governance of both public and private health services in order to ensure high quality and safe services and fair charges. The structural challenge is to determine the balance between public and private sector delivery and to engage in a more productive partnership between public and private sectors. The administrative challenge is to consider whether the community would be better served by more decentralized and responsive services. As Malaysia seeks to attain high income country status, and as demographic and epidemiological transitions continue and new technology expands the possibilities for intervention, the demand for xvi health care by the population will continue to rise. The government will need to address growing concerns about equity, efficiency and budgetary constraints and balance conflicting policy principles. Pressures are building up for health system reform in Malaysia looking towards the year 2020 and beyond.
Trace element speciation in sludge: a preliminary study to assess contamination levels in the sewage network

Islam MS, Phoungthong K, Ismail Z, Othman IK, Shahid S, Ishak DSM, et al.

J Environ Sci Health A Tox Hazard Subst Environ Eng, 2022;57(13-14):1073-1083.
PMID: 36644961 DOI: 10.1080/10934529.2022.2148811

The spreading of sewage sludge from wastewater treatment plants and various industries arouses the growing interest due to the contamination by trace elements. Sludges were collected from one sewage treatment plant and two industries in Dhaka City, Bangladesh to assess physicochemical parameters and total and fraction content of trace elements like Cr, Ni, Cu, As, Cd, Pb, Fe, Mn and Zn in sludges. We evaluated the bioavailability of theses metals by determining their speciation by sequential extraction, each metal being distributed among five fractions: exchangeable fraction, bound to carbonate fraction, Fe-Mn oxide bound fraction, organic matter bound fraction and residual fractions. We found that all the analyzed sludges had satisfactory properties from an agronomic quality point of view. The average concentration (mg/kg) of trace metals in sludge samples were in the following decreasing order Fe (12807) > Cr (200) > Mn (158) > Zn (132) > Cu (68.2) > Ni (42.5) > Pb (36.4) > As (35.1) > Cd (3.7). The results of the sequential extraction showed that Cr, Ni, Cu, Fe and Mn were largely associated with the residual fraction where As, Cd and Pb was dominantly associated with the exchangeable and carbonate bound fractions and Zn showed a considerable proportion in carbonate bound fraction. These results showed that regulations must take into account the bioavailability with regard to the characteristics of the agricultural soils on which sludge will be spread.
Fulltext Comparison of clinical and laboratory characteristics between severe and non-severe dengue in paediatrics

Idrus NL, Md Jamal S, Abu Bakar A, Embong H, Ahmad NS

PLoS Negl Trop Dis, 2023 Dec;17(12):e0011839.
PMID: 38113250 DOI: 10.1371/journal.pntd.0011839

BACKGROUND: The timely identification of severe dengue in peadiatric patients is of utmost importance, as any delay in diagnosis could lead to an irreversible state of shock potentially leading to fatal consequences. The primary aim of our study was to characterize dengue severity in paediatric patients based on initial symptoms, signs, and laboratory investigation of their presentation in the emergency department.
METHODOLOGY: We conducted a retrospective data retrieval from the medical records of 254 paediatric patients who had been diagnosed with confirmed cases of dengue fever. The clinical characteristics were compared between severe and non-severe dengue. Multiple logistic regression analysis was utilised to elucidate the variables that exhibited associations with severe dengue.
RESULTS: A total of 254 paediatric patients were included, among whom 15.4% (n = 39) were diagnosed with severe dengue. Multiple logistic regression analysis identified lethargy, systolic blood pressure (SBP) below 90 mmHg, capillary refilled time (CRT) longer than 2 seconds, ascites, and hepatomegaly were independently associated with severe dengue.
CONCLUSION: In paediatric patients, severe dengue is associated with specific clinical indicators, including lethargy, low systolic blood pressure, prolonged capillary refill time (CRT), and the presence of ascites and hepatomegaly. Identifying these clinical features early is crucial for primary care physicians, as it enables accurate diagnosis and timely intervention to manage severe dengue effectively.
Apoptosis induced by desmethyl-lasiodiplodin is associated with upregulation of apoptotic genes and downregulation of monocyte chemotactic protein-3

Hazalin NA, Lim SM, Cole AL, Majeed AB, Ramasamy K

Anticancer Drugs, 2013 Sep;24(8):852-61.
PMID: 23764760 DOI: 10.1097/CAD.0b013e3283635a47

There is growing interest in the discovery of bioactive metabolites from endophytes as an alternative source of therapeutics. Identification of their therapeutic targets is essential in understanding the underlying mechanisms and enhancing the resultant therapeutic effects. As such, bioactive compounds produced by endophytic fungi from plants at the National Park, Pahang, Malaysia, were investigated. Five known compounds were identified using LC-UV-MS-NMR and they include trichodermol, 7-epi-brefeldin A, (3R,4S)-4-hydroxymellein, desmethyl-lasiodiplodin and cytochalasin D. The present study went on to investigate the potential anticancer effects of these compounds and the corresponding molecular mechanisms of the lead compound against human breast adenocarcinoma, MCF-7. For the preliminary screening, the cytotoxicity and apoptotic effects of these compounds against MCF-7 were examined. The compounds were also tested against noncarcinogenic hepatocytes (WRL68). The differential cytotoxicity was then determined using the MTT assay. Desmethyl-lasiodiplodin was found to suppress the growth of MCF-7, yielding an inhibitory concentration (IC50) that was seven-fold lower than that of the normal cells. The cytotoxic effect of desmethyl-lasiodiplodin was accompanied by apoptosis. Subsequent analysis demonstrated increased expression levels of caspase 3, c-myc and p53. Further, desmethyl-lasiodiplodin resulted in inhibition of monocyte chemotactic protein (MCP)-3, a cytokine involved in cell survival and metastasis. Hence, this study proposed that desmethyl-lasiodiplodin inhibited growth and survival of MCF-7 through the induction of apoptosis. This anticancer effect is mediated, in part, by upregulation of apoptotic genes and downregulation of MCP-3. As desmethyl-lasiodiplodin elicited minimal impact against normal hepatocytes, our findings also imply its potential use as a specific apoptotic agent in breast cancer treatment.
Fulltext Pituitary apoplexy: a rare cause of middle cerebral artery infarction

Hassan R, Sharis Othman S, Ahmad Mukari SA, Abu Bakar A

Med J Malaysia, 2013 Jun;68(3):264-6.
PMID: 23749020 MyJurnal

Pituitary apoplexy is a well-known complication of a pituitary adenoma. However, an ischaemic event caused by pituitary apoplexy is rare. We reported a case of pituitary apoplexy with middle cerebral artery infarction in a 44-year old man who presented with a sudden onset of altered sensorium. Vasospasm is the most likely underlying cause of the infarction in this case secondary to transdiaphragmatic rupture of the sella tumour into the subarachnoid space.

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