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Fulltext Visualising functional 5-HT3 receptors containing A and C subunits at or near the cell surface

Abad IPL, Fam RL, Nguyen DT, Nowell CJ, Trinh PNH, Manallack DT, et al.

Biomed Pharmacother, 2020 Dec;132:110860.
PMID: 33059258 DOI: 10.1016/j.biopha.2020.110860

Five different subunits of the human serotonin 3 (5-hydroxytrptamine 3; 5-HT3) receptor exist and these are present in both central and peripheral systems. Different subunits alter the efficacy of 5-HT3 receptor antagonists used to treat diarrhoea predominant-irritable bowel syndrome, chemotherapy induced nausea and vomiting and depression. Cell surface arrangement of 5-HT3 receptor complexes and the contribution of C, D and E subunits to receptor function is poorly understood. Here, we examine interactions of A and C subunits using 5-HT3 receptor subunits containing fluorescent protein inserts between the 3rd and 4th transmembrane spanning region. HEK293T cells that do not normally express 5-HT3 receptor subunits, were transiently transfected with A or C or both subunits. Patch clamp experiments show that cells transfected with either fluorescent protein tagged A or A and C subunits generate whole cell currents in response to 5-HT. These findings correlate with the apparent distribution of fluorescent protein tagged A and C subunits at or near cell surfaces detected using TIRF microscopy. In co-transfected cells, the A and C subunits are associated forming AC heteromer complexes at or near the cell surface and a proportion can also form A or C homomers. In conclusion, it is likely that both A homomers and AC heteromers contribute to whole cell currents in response to 5-HT with minimal contribution from C homomers.
Vesicles and erosions in a patient with chronic eczema: is it just eczema?

Jamil A, Muthupalaniappen L

Ann Acad Med Singap, 2014 Feb;43(2):130-1.
PMID: 24652437
The effect of pre-phototest sun exposure on minimal erythema dose and minimal melanogenic dose among skin phototypes III, IV and V

Wong LC, Jamil A, Md Nor N

Photodermatol Photoimmunol Photomed, 2018 Nov;34(6):400-404.
PMID: 29953669 DOI: 10.1111/phpp.12410

BACKGROUND: Ethnicity, skin phototype and colour influenced minimal erythema dose (MED). Sun exposure has been postulated to increase MED. We determined immediate pigment darkening dose to UVA (IPDDA), MED and minimal melanogenic dose (MMD) for UVB and UVA, and investigated factors affecting these doses.
METHODS: Skin phototype was determined using Fitzpatrick phototype quiz, DSMII ColorMeter measured skin colours, sun exposure quantified using an index (SEI) and phototest performed with MEDlight-Multitester.
RESULTS: A total of 167 healthy volunteers participated. There were 110 (66%) females and 56 (34%) males; 124 (74.7%) were Malay, 27 (16.3%) Chinese and 14 (8.4%) Indians. One hundred and nine (65.7%) skin phototype IV, 30 (18.1%) phototype III and 27 (16.3%) phototype V. IPDDA ranges from 6 ± 1.5-5.7 ± 1.4 J/cm2 . MED-UVB were 96.9 ± 17.6, 124 ± 29.3 and 118.6 ± 27.4 mJ/cm2 for phototype III, IV and V, respectively. All MED-UVA were outside the tested dose range of 3.6-11 J/cm2 . MMD-UVB were 106 ± 18.2, 134 ± 25.6 and 136 ± 31.1 mJ/cm2 while MMD-UVA were 4.1 ± 4.1, 4.9 ± 3.8 and 5.7 ± 3.7 J/cm2 respectively for phototypes III, IV and V. MED-UVB, MMD-UVB and MMD-UVA did not depend on skin phototype. Facultative skin whiteness (L*), erythema (E) and melanin content (M) correlated significantly with MED-UVB while constitutive skin colours were significant for L*, yellowness (b*), E and M. Sun exposure did not significantly correlate with MED-UVB and MMDs, however, an inverse relationship with MED-UVB was demonstrated.
CONCLUSION: Minimal erythema doses in our cohort were slightly different from other regional countries. Constitutive and facultative skin whiteness, erythema and melanin content correlated with MED. There was no association between skin phototype and sun exposure with MED or MMD.
Fulltext The Effects of Acitretin on Insulin Resistance, Glucose Metabolism, and Lipid Levels in Patients with Psoriasis

Sachdev SS, Jamil A, Gunabalasingam P, Safdar NA

Indian J Dermatol, 2022;67(4):349-354.
PMID: 36578705 DOI: 10.4103/ijd.ijd_328_21

CONTEXT: Acitretin increases serum lipids. Data on its effects on insulin resistance and glucose metabolism are sparse and contradicting.
AIMS: The aim of this study is to investigate the effects of acitretin on insulin resistance, glucose metabolism, and lipids.
METHODS: Dermatology clinic in a public tertiary hospital. A cross sectional study involving chronic plaques psoriasis patients on acitretin plus topical therapy or topical therapy alone was performed. Fasting blood glucose (FBG), serum lipids, serum insulin, and glucose tolerance test (GTT) were performed. Homeostatic model of insulin resistance (HOMA-IR) was calculated. Psoriasis severity was evaluated using Psoriasis Area and Severity Index. Chi square and t-tests determined differences between cases and controls. Pearson's correlation coefficient test determined the relationship between continuous variables.
RESULTS: A total of 60 patients participated, 30 were on acitretin while 30 were on topical therapy. Psoriasis duration, disease severity, BMI, presence of metabolic syndrome, and other comorbidities between the two groups were similar. There were no significant differences in GTT, FBG, HOMA-IR, and serum lipids. Patients on acitretin >25 mg daily had lower FBG [4.4 (0.8) versus 4.9 (0.9), P = 0.04] and triglyceride [1.05 (0.33) versus 1.57 (1.03), P = 0.02] compared with doses ≤25 mg. Higher acitretin dose correlated with lower FBG (r = -0.36, P = 0.05) and triglycerides (r = -0.37, P = 0.05) while longer therapy duration correlated with lower total cholesterol (r = -0.37, P = 0.05). HOMA-IR showed inverse correlation with acitretin dose and duration (r = -0.10, P = 0.61 and r = -0.12, P = 0.53, respectively).
CONCLUSION: Acitretin therapy resulted in increased triglyceride. The effect of acitretin on glucose metabolism and insulin resistance maybe dependent on the dose and duration of therapy.
THE CONSISTENCY OF EXPOSURE INDICATOR VALUES IN DIGITAL RADIOGRAPHY SYSTEMS

Jamil A, Mohd MI, Zain NM

Radiat Prot Dosimetry, 2018 Dec 01;182(4):413-418.
PMID: 29767799 DOI: 10.1093/rpd/ncy082

After years of establishment of computed radiography (CR) and digital radiography (DR), manufacturers have introduced exposure indicator/index (EI) as a feedback mechanism for patient dose. However, EI consistency is uncertain for CR. Most manufacturers recommended EI values in a range of numbers for all examination, instead of giving the exact range for a specific body part, raising a concern of inappropriate exposure given to the patient in clinical practice. The aims of this study were to investigate the EI consistency in DR systems produced in constant exposure parameters and clinical condition, and to determine the interaction between the anatomical part and EI. A phantom study of skull, chest, abdomen and hand was carried out and four systems were used for comparison-Fuji CR, Carestream CR, Siemens DR and Carestream DR. For each projection, the phantom positioning and exposure parameters were set according to the standard clinical practice. All exposure parameters and clinical conditions were kept constant. Twenty (20) exposures were taken for each projection and the EI was recorded. Findings showed that EI is not consistent in DR systems despite constant exposure parameters and clinical condition except in Siemens DR, through skull examination. Statistical analysis showed a significant interaction between anatomical parts and EI values (P < 0.05). EI alone was proven to be less reliable to provide technologist a correct feedback on exposure level. The interaction between anatomical parts and EI values intensifies the need for an anatomical-specific EI values set by all manufacturers for accurate feedback on the exposure parameters used and the detector entrance dose.
Systemic lupus erythematosus among male patients in Malaysia: how are we different from other geographical regions?

Shaharir SS, Kadir WDA, Nordin F, Bakar FA, Ting MWH, Jamil A, et al.

Lupus, 2019 Jan;28(1):137-144.
PMID: 30458692 DOI: 10.1177/0961203318812676

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease which predominantly affects females. The disease characteristics in male SLE patients are reported to be distinct and may vary across ethnicities and geographical regions.
OBJECTIVE: To determine and compare the clinical phenotype and organ damage between male and female patients with SLE in Malaysia.
METHODOLOGY: This was a cross-sectional study involving SLE patients from Universiti Kebangsaan Malaysia Medical Centre from June 2016 until June 2017. Information on their socio-demographics and disease characteristics were obtained from the clinical records. Disease damage was assessed using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) damage index (SDI) scores. The disease characteristics, autoantibody profiles and organ damage were compared between male and female patients, and multivariable analysis using male sex as dependent variable was then performed.
RESULTS: A total of 418 patients were recruited and a total of 59 (14.1%) patients were male. Male patients presented with lower SLE ACR criteria at initial presentation but a significantly higher number of them had renal involvement (lupus nephritis) (78.0% versus 63.8%, p = 0.04). Male patients had less musculoskeletal involvement (45.8% versus 63.0%, p = 0.02) and tended to have lesser mucocutaneous involvement. Immunologic profile revealed that a lower number of male patients had positive anti-Ro antibody (22.7% versus 44.7%, p = 0.04) and they tended to have positive lupus anticoagulant antibody (27.6% versus 14.3%, p = 0.06). Presence of organ damage (SDI score ≥ 1) was significantly higher among males (55.9% versus 39.6%, p = 0.02) with higher renal damage (25.4% versus 9.2%, p = 0.004) and cardiovascular event of ischaemic heart disease or stroke (20.3% versus 7.0%, p = 0.004). They were also inclined to develop damage much earlier as compared to female patients, 3 (interquartile range (IQR) 7.5) versus 5 (IQR 7) years, p = 0.08. The occurrence of disease damage was independently associated with male gender with odds ratio of 1.9 (95% confidence interval 1.1-3.5), p = 0.02.
CONCLUSION: Male patients with SLE have more severe disease with renal damage and cardiovascular event.
Fulltext Spectrofluorometric and molecular docking studies on the binding of curcumenol and curcumenone to human serum albumin

Hamdi OA, Feroz SR, Shilpi JA, Anouar el H, Mukarram AK, Mohamad SB, et al.

Int J Mol Sci, 2015;16(3):5180-93.
PMID: 25756376 DOI: 10.3390/ijms16035180

Curcumenol and curcumenone are two major constituents of the plants of medicinally important genus of Curcuma, and often govern the pharmacological effect of these plant extracts. These two compounds, isolated from C. zedoaria rhizomes were studied for their binding to human serum albumin (HSA) using the fluorescence quench titration method. Molecular docking was also performed to get a more detailed insight into their interaction with HSA at the binding site. Additions of these sesquiterpenes to HSA produced significant fluorescence quenching and blue shifts in the emission spectra of HSA. Analysis of the fluorescence data pointed toward moderate binding affinity between the ligands and HSA, with curcumenone showing a relatively higher binding constant (2.46 × 105 M-1) in comparison to curcumenol (1.97 × 104 M-1). Cluster analyses revealed that site I is the preferred binding site for both molecules with a minimum binding energy of -6.77 kcal·mol-1. However, binding of these two molecules to site II cannot be ruled out as the binding energies were found to be -5.72 and -5.74 kcal·mol-1 for curcumenol and curcumenone, respectively. The interactions of both ligands with HSA involved hydrophobic interactions as well as hydrogen bonding.
Skin pH mapping and its relationship with transepidermal water loss, hydration and disease severity in adult patients with atopic dermatitis

Zainal H, Jamil A, Md Nor N, Tang MM

Skin Res Technol, 2020 Jan;26(1):91-98.
PMID: 31535769 DOI: 10.1111/srt.12768

BACKGROUND: Defective skin's acidic mantle is a component of atopic dermatitis (AD) pathophysiology. We mapped the skin pH and determine its relationship with transepidermal water loss (TEWL), hydration and disease severity.
MATERIALS AND METHODS: A cross-sectional study involving patients aged ≥18 years. Eczema Area and Severity Index (EASI) was assessed. Skin pH, TEWL and hydration were measured at 18 pre-determined sites.
RESULTS: Forty-eight patients participated, 33(68.8%) females and 15(31.3%) males aged 28.46 ± 12.07 years. The overall skin pH was 5.32 ± 0.68 ranging from 5.16 ± 0.75 to 5.52 ± 0.59. The lowest pH 5.16 ± 0.75 was at anterior leg, popliteal fossae 5.18 ± 0.67, lower back 5.21 ± 0.64, forehead 5.22 ± 0.62, upper back 5.25 ± 0.65 and neck 5.26 ± 0.76. Highest pH was at the cheek 5.52 ± 0.59, anterior thigh 5.47 ± 0.68, dorsal arm 5.46 ± 0.68, volar arm 5.43 ± 0.67 and abdomen 5.39 ± 0.67. Lesional areas' pH (5.40 ± 0.13) was higher than nonlesional (5.27 ± 0.14), P = .01. pH at AD predilection sites was significantly lower non-predilection sites (5.26 ± 0.59 vs 5.34 ± 0.64). pH did not correlate with TEWL (r = .23, P = .12), EASI (r = .19, P = .20) and itch (r = .06, P = .70) but correlated with hydration r = -.33, P = .02.
CONCLUSION: Skin pH was lower at AD predilection sites. There was no correlation between pH with AD severity and TEWL, pH correlated with hydration.
Severe cutaneous adverse reaction to drug excipient following brand-to-generic switch of levetiracetam

Lim JA, Jamil A, Ramli NA, Johar FM, Nor M

Am J Health Syst Pharm, 2024 Jan 24;81(3):e69-e72.
PMID: 37864830 DOI: 10.1093/ajhp/zxad264

PURPOSE: Levetiracetam is an antiepileptic drug known for its high tolerability, and severe adverse drug reactions are rare. We report the case of a severe cutaneous adverse drug reaction in a patient who was switched from brand-name to generic levetiracetam.
SUMMARY: A 29-year-old woman undergoing contrast-enhanced computed tomography developed lesions over her trunk starting 6 hours after imaging. Although initially diagnosed as an allergy to the radiocontrast agent, the condition progressively worsened into toxic epidermal necrolysis-drug reaction with eosinophilia and systemic symptoms overlap syndrome, despite adequate hydration and treatment. Investigation of the patient's medications revealed that she had been switched from brand-name to generic levetiracetam a week before the onset of symptoms. Levetiracetam was immediately discontinued, with the patient recovering after 2 weeks of intensive care. Adverse drug reaction analysis identified excipients in generic levetiracetam as the likely cause of the severe reaction.
CONCLUSION: This is the first reported case of severe cutaneous drug allergy after a brand-to-generic switch for levetiracetam. Brand-to-generic switches of medications can potentially cause severe allergic reactions due to differences in excipients.
Sarcoid Myopathy Mimicking Polymyositis: A Case Report and Pool Analysis of the Literature Reviews

Sazliyana Shaharir S, Jamil A, Kosasih S, Soo Fin L, Sridharan R, Hayati Md Pauzi S

Acta Med Iran, 2017 Dec;55(12):800-806.
PMID: 29373888

A 59-year-old man presented with proximal myopathy, myalgia, and weight loss, with the initial markedly elevated serum creatine kinase at 11,000 U/L. Due to his refusal for muscle biopsy, he was initially treated as inflammatory myositis and responded well with the corticosteroids. However, he subsequently had a relapse of the symptoms with more extensive systemic involvement, i.e., hypercalcemia, lymphadenopathy and subcutaneous nodules. Finally, a biopsy of the thigh and subcutaneous nodule revealed non-caseating granulomatous inflammation, consistent with sarcoidosis. He responded well to the corticosteroids, and finally, azathioprine was added as a steroid-sparing agent. Including our series, there are 103 cases of symptomatic muscle involvement in sarcoidosis patients published in the English literature to date. Further pool analysis of the cases will be reported in this review.
Fulltext Remote Heparin-Induced Haemorrhagic Bullae Occurring in a Patient Treated for Acute Coronary Syndrome: A Rare Entity

Mohd Parid R, Wan Ahmad Kammal WSL, Jamil A, Wan Ahmad Kammal WSE, Md Isa N, Md Nor N

Acta Cardiol Sin, 2021 Jan;37(1):111-113.
PMID: 33488036 DOI: 10.6515/ACS.202101_37(1).20201014A
Fulltext Primary dapsone resistant Mycobacterium leprae in a non endemic country

Jamil A, Noor NM, Osman AS, Baseri MM, Muthupalaniappen L

Indian J Dermatol Venereol Leprol, 2013 Jul-Aug;79(4):527-9.
PMID: 23760326 DOI: 10.4103/0378-6323.113096
Prick, patch or blood test? A simple guide to allergy testing

Muthupalaniappen L, Jamil A

Malays Fam Physician, 2021 Jul 22;16(2):19-26.
PMID: 34386160 DOI: 10.51866/rv1141

This article provides information on allergy testing and serves as a simple guide for physicians who are considering using allergy testing as a step in patient management. Basic principles of allergy testing, indications for testing, and how and when to choose a suitable allergy test are discussed. Allergy testing in general refers to evaluation of either type I or type IV hypersensitivity reactions. The type I (immediate) reaction is evaluated using the skin prick test (in vivo) or serum IgE (in vitro) test methods, while the type IV (delayed) reaction is determined via the skin patch test method. The allergens responsible for a specific reaction can be identified from allergy testing, and this information is useful in administering avoidance measures. Appropriate treatment of allergic reactions along with allergen avoidance ensure a successful treatment outcome and prevent future reactions.
Potential treatment of atopic dermatitis: tolerability and safety of cream containing nanoparticles loaded with hydrocortisone and hydroxytyrosol in human subjects

Siddique MI, Katas H, Jamil A, Mohd Amin MCI, Ng SF, Zulfakar MH, et al.

Drug Deliv Transl Res, 2019 04;9(2):469-481.
PMID: 29159691 DOI: 10.1007/s13346-017-0439-7

Hydrocortisone (HC), topical glucocorticoid along with hydroxytyrosol (HT), and anti-microbial- and anti-oxidant-loaded chitosan nanoparticles (CSNPs) were prepared in large scale and analyzed for their adverse effects on healthy human skin followed by repeated applications. Ten subjects were randomized to receive test (HC-HT CSNPs) and vehicle samples (aqueous (AQ) cream). They were applied on the arms for 28 days, and transepidermal water loss (TEWL), erythema intensity, and irritation score were measured. Blood samples were analyzed for blood hematology, blood biochemistry, and adrenal cortico-thyroid hormone (ACTH) levels. Skin biopsy was obtained to assess histopathological changes in the skin. HC-HT CSNP AQ cream was stored at 4, 25, and 45 °C for a period of 1 year, and its stability was assessed by monitoring their physical appearances, particle size, and pH. Spherical-shaped NPs were successfully upscaled using spinning-disc technology, with insignificant changes in particle size, zeta potential, and incorporation of drugs as compared to the well-established laboratory method. Particle size of HC-HT CSNPs was
Plant extract-based green fabrication of nickel ferrite (NiFe2O4) nanoparticles: An operative platform for non-enzymatic determination of pentachlorophenol

Taqvi SIH, Solangi AR, Buledi JA, Khand NH, Junejo B, Memon AF, et al.

Chemosphere, 2022 Jan 28;294:133760.
PMID: 35092751 DOI: 10.1016/j.chemosphere.2022.133760

Environmental pollution has become a major human concern with the extensive exploitation of pesticides. Pentachlorophenol (PCP) is the most hazardous of all chlorophenols which are being used as pesticide, fungicide, and wood preservative. Thus, the fabrication of ultrasensitive electrochemical methods for the determination of pesticides is of great significance. In the present experiment, a simple, green, and sensitive electrochemical sensor was constructed for the determination of PCP by using a chemically modified nickel ferrite glassy carbon electrode (NiFe2O4/GCE). The fabricated nanoparticles were primarily characterized by several analytical tools to confirm the functionalities, surface texture, crystallinity, and elemental composition. For the investigation of conductive nature, the proposed NiFe2O4/GCE was exploited to the primary electrochemical characterization tools e.g. Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The ultra-sensitive determination of PCP was carried out under the linear dynamic range from 0.01 to 90 μM at the pulse amplitude of 80 mV/s in BRB buffer pH of 4. The limit of detection of the developed methods for PCP was calculated to be 0.0016 μM. The analytical applicability of the fabricated sensor was tested in different water samples depicting the acceptable recovery values.
Photoprotection awareness and practices among patients with systemic lupus erythematosus and its association with disease activity and severity

Abdul Kadir WD, Jamil A, Shaharir SS, Md Nor N, Abdul Gafor AH

Lupus, 2018 Jul;27(8):1287-1295.
PMID: 29665756 DOI: 10.1177/0961203318770016

Objective The objective of this paper is to determine photoprotection awareness, knowledge, practices, and its relationship with disease activity and damage in patients with systemic lupus erythematosus (SLE).
Methods A cross-sectional study was performed. Data were acquired from in-person interviews and medical records.
Results A total of 199 (89.6%) females and 23 (10.4%) males were recruited. Median age was 39.00 (interquartile range (IQR) 18) years, disease duration 12.12 (IQR 8) years, Fitzpatrick skin phototype III 119 (53.6%) and IV 81 (36.5%). Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2 K) was 2.95 (IQR 4) while Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-ACR DI) was 1.20 (IQR 2). The majority 205 (92.3%) were aware of sun exposure effects on SLE. Photoprotection methods were shade seeking 209 (94.1%), sun avoidance 212 (95.5%), long pants 168 (75.7%), long sleeves 155 (69.8%), sunscreen 116 (52.3%), sunglasses 114 (51.4%) and head cover 103 (46.4%). Significantly higher photoprotection practice scores (PPS) were observed in females, Malays, and individuals with higher education level and internet accessibility. PPS were not significantly correlated with SLICC-ACR DI and SLEDAI-2 K. Independent predictors for good photoprotection practice (GPP) were ethnicity (OR = 3.66, 95% CI 1.78-7.53), awareness (OR = 3.77, 95% CI 1.09-13.08) and cutaneous involvement (OR = 2.43, 95% CI 1.11-5.28). Photoprotection methods and GPP were not predictors for disease activity or damage.
Conclusion Photoprotection awareness and knowledge was good. Shade seeking and sun avoidance were the common photoprotection methods practised. The use of sunscreen requires improvement. Photoprotection awareness and cutaneous manifestation were predictors for GPP. Neither photoprotection methods nor GPP were associated with disease activity or damage.
Study site: Nephrology, Rheumatology and Dermatology clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Mismanagement of cat bite wound: lessons to learn

Muthupalaniappen L, Siti Aishah MA, Wong YP, Jamil A

Clin Ter, 2013 May-Jun;164(3):225-7.
PMID: 23868624 DOI: 10.7417/CT.2013.1553

Animal inflicted wounds, left untreated may result in chronic bacterial or fungal infection. Clinical features of these infections may overlap leading to a delay in diagnosis and treatment. We report a case of chronic non-healing cat bite wound treated with several antibiotics without improvement. Later patient developed the classical "sporotrichoid spread" and a presumptive diagnosis of sporotrichosis was made. Laboratory investigation for fungal culture and skin biopsy failed to identify the underlying pathogen. A trial of oral antifungal agent resulted in complete recovery of the lesions implicating fungus as the causative pathogen. Physicians should have a high index of suspicion for fungal infections when managing animal inflicted wounds.
Minimization of Local and Systemic Adverse Effects of Topical Glucocorticoids by Nanoencapsulation: In Vivo Safety of Hydrocortisone-Hydroxytyrosol Loaded Chitosan Nanoparticles

Siddique MI, Katas H, Amin MCIM, Ng SF, Zulfakar MH, Buang F, et al.

J Pharm Sci, 2015 Dec;104(12):4276-4286.
PMID: 26447747 DOI: 10.1002/jps.24666

Hydrocortisone (HC) is a topical glucocorticoid for the treatment of atopic dermatitis (AD); the local as well as systemic side effects limit its use. Hydroxytyrosol (HT) is a polyphenol present in olive oil that has strong antimicrobial and antioxidant activities. HC-HT coloaded chitosan nanoparticles (HC-HT CSNPs) were therefore developed to improve the efficacy against AD. In this study, HC-HT CSNPs of 235 ± 9 nm in size and with zeta potential +39.2 ± 1.6 mV were incorporated into aqueous cream (vehicle) and investigated for acute dermal toxicity, dermal irritation, and repeated dose toxicity using albino Wistar rats. HC-HT CSNPs exhibited LD50 > 125 mg/body surface area of active, which is 100-fold higher than the normal human dose of HC. Compared with the commercial formulation, 0.5 g of HC-HT CSNPs did not cause skin irritation, as measured by Tewameter®, Mexameter®, and as observed visually. Moreover, no-observed-adverse-effect level was observed with respect to body weight, organ weight, feed consumption, blood hematological and biochemical, urinalysis, and histopathological parameters at a dose of 1000 mg/body surface area per day of HC-HT CSNPs for 28 days. This in vivo study demonstrated that nanoencapsulation significantly reduced the toxic effects of HC and this should allow further clinical investigations.
Merkel cell carcinoma: Preparing to go the distance

Arumugam M, Jamil A, Amiseno RA, Rosli N, Abdul Shukor N

Malays J Pathol, 2020 Aug;42(2):277-281.
PMID: 32860382

INTRODUCTION: Merkel cell carcinoma (MCC) is a rare and aggressive malignancy of the skin, with poor clinical outcomes. Typical conditions include a rapidly growing, solitary dome-shaped, violaceous nodule. Several root causes have been identified - sun exposure, age, lighter skin, immunocompromised state, and polyomavirus infection. Wide local excision is the best treatment. The tumour is radiotherapy-responsive. However, the success rate of the treatment with chemotherapy is rather limited. Immunotherapy has shown promising results. Early detection is important to prevent morbidity and mortality.
CASE REPORT: In this literature work, we reported on a particular case of MCC, as exhibited by an 84-year-old Chinese woman, and discussed the clinical features and management of MCC.
DISCUSSION: We highlighted that MCC cases have a link to the polyomavirus 5. Patients who were identified with the Polyomavirus 5, and underwent immunotherapy, were seen to depict much better prognosis.
Fulltext Maxillofacial trauma of paediatric patients: University of Malaya experience

Mohd Jamil A., Md Kamal F., Kathreena Kadir

Ann Dent, 2017;24(1):1-9.
MyJurnal

This study aimed to determine the incidence, aetiology, types of injury, management and the outcomes of
the treatment of maxillofacial trauma among paediatric patients treated in Faculty of Dentistry, University of
Malaya. A retrospective study (2005-2015) was carried out which involved retrieving past records (manual/
electronic form) of paediatric patients (under 16 years old) who presented with maxillofacial trauma. Data
collected was organized using descriptive statistics with SPSS version 12.0.1. The total number of patients
was 120 but only 93 had complete records. The ratio of boys to girls was 2:1. The main cause of injury
was falling (54%) followed by motor-vehicle accident (MVA) (42%), assault (3%), and sport (1%). The total
count of soft tissue injury only was about 41% while 59% presented with maxillofacial fracture. Midface
were the most common fracture occurred followed by mandibular fractures. Both fractures were mostly
managed by open reduction and internal fixation (ORIF) using non-resorbable plates except for condylar
fractures which were mostly managed conservatively. In conclusion, the incidence of maxillofacial trauma
in children increased within the time frame of this study. The most common aetiology was fall. Hard tissue
injury accounting for most of the cases whereby midface was the most common site involved. ORIF was the
treatment of choice for most of the fracture cases except for condylar fractures (conservative management).
All patients had achieved reasonable outcomes postoperatively in terms of form and functions.

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