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Effect of enzymatic interesterification on melting point of palm olein

Yassin AA, Mohamed IO, Ibrahim MN, Yusoff MS

Appl Biochem Biotechnol, 2003 Jul;110(1):45-52.
PMID: 12909731

Immobilized PS-C 'Amano' II lipase was used to catalyze the interesterification of palm olein (POo) with 30, 50, and 70% stearic acid in n-hexane at 60 degrees C. The catalytic performance of the immobilized lipase was evaluated by determining the composition change of fatty acyl groups and triacylglycerol (TAG) by gas liquid chromatography and high-performance liquid chromatography, respectively. The interesterification process resulted in the formation of new TAGs, mainly tripalmitin and dipalmitostearin, both of which were absent in the original oil. These changes in TAG composition resulted in an increase in slip melting point, from the original 25.5 degrees C to 36.3, 37.0, and 40.0 degrees C in the modified POo with 30, 50, and 70% stearic acid, respectively. All the reactions attained steady state in about 6 h. This type of work will find great applications in food industries, such as confectionery.
The value of life and accident costing: a willingness-to-pay study amongst motorcyclists in Malaysia

Mohd Fauzi MY, Nor Ghani MN, Radin Umar RS, Ahmad Hariza H

Appl Health Econ Health Policy, 2004;3(1):5-8.
PMID: 15702934

Motorcyclists constitute a large proportion of total road casualties in Asian countries Unfortunately, studies conducted for the purpose of evaluating the cost of traffic crashes, and cost-benefit analyses of safety interventions, are almost nonexistent in these countries. The loss-of-output approach to valuing life has been used for many years, yet this method has also long been criticised as it results in significant resource misallocation. This study attempts to overcome this problem by estimating the value of a statistical life among motorcyclists using the willingness-to-pay method that is commonly used in developed countries. The study recommends adopting a value of MYR1.1 million (almost five times the previous estimate) per statistical life for public policy analysis involving motorcycle safety.
Resting metabolic rate in a sample of girls in Malaysia and England

Henry CJ, Webster-Gandy JD, Koon PB, Ismail MN

Am J Hum Biol, 2005 Nov-Dec;17(6):818-20.
PMID: 16254909

This cross-sectional study of age matched (10-11 years), pre-menarcheal girls in England and Malaysia investigated the effect of ethnicity on resting metabolic rate (RMR). The children were recruited from schools in Oxford, England, and Kuala Lumpur, Malaysia, and all measurements were conducted in the schools. The Malaysian girls were shorter (143.7 +/- 6.5 cm and 140.1 +/- 5.3 cm (mean +/- SD) for the English and Malaysian girls respectively) and lighter (32.5 +/- 5.3 kg compared with 38.0 +/- 8.7 kg for the English girls) with a smaller fat mass and fat free mass (FFM) than the English girls. Energy expenditure was lower in the Malaysian girls (4555 +/- 531 kJ/day compared with 5178 +/- 688 kJ/day for the English girls). Although a difference in RMR was observed between the two groups, when corrected for body composition the difference was no longer significant. No effect of ethnicity on the relationship of FFM and RMR was shown when the data were analyzed using analysis of covariance.
Heavy metals (Cd, Pb, Zn, Ni, Cu and Cr(III)) removal from water in Malaysia: post treatment by high quality limestone

Aziz HA, Adlan MN, Ariffin KS

Bioresour Technol, 2008 Apr;99(6):1578-83.
PMID: 17540556

This paper presents the results of research on heavy metals removal from water by filtration using low cost coarse media which could be used as an alternative approach to remove heavy metals from water or selected wastewater. A series of batch studies were conducted using different particle media (particle size 2.36-4.75 mm) shaken with different heavy metal solutions at various pH values to see the removal behaviour for each metal. Each solution of cadmium (Cd), lead (Pb), zinc (Zn), nickel (Ni), copper (Cu) and chromium (Cr(III)) with a concentration of 2 mg/L was shaken with the media. At a final pH of 8.5, limestone has significantly removed more than 90% of most metals followed by 80% and 65% removals using crushed bricks and gravel, respectively. The removal by aeration and settlement methods without solid media was less than 30%. Results indicated that the removal of heavy metals was influenced by the media and not directly by the pH. Investigations on the removal behaviour of these metals indicated that rough solid media with the presence of carbonate were beneficial for the removal process. Adsorption and precipitation as metals oxide and probably as metals carbonate were among the two mechanisms that contributed to the removal of metals from solution.
Chronic nonhealing ulcer of the right thumb with multiple subcutaneous nodules

Manohar A, Nizlan MN

Orthopedics, 2008 Jul;31(7):710.
PMID: 19292371

A 60-year-old man presented with a 3-month history of nonhealing ulcer over the tip of his right thumb. The ulcer started as a blister over the tip of the thumb that later ruptured and spread proximally to cover the whole pulp area of the thumb. There was no history of trauma, fever, weight loss, or loss of appetite. He is a pensioner and an avid gardener. He has a few cats as pets. The patient initially presented to a private orthopedic surgeon with a nonhealing ulcer of the right thumb. Multiple debridements were unsuccessful in ameliorating the ulcer. Three months after the onset of the initial lesion, multiple painless erythematous nodules had developed on his right arm, and one on the right thigh. All routine blood investigations were nondiagnostic. Swab culture from the ulcer failed to grow any organism and a course of antibiotics did not resolve the problem. Cultures of the biopsy specimen using Sabouraud's dextrose agar and potato carrot medium grew dark brown plaques that microscopically appeared to be branching hyphae. A diagnosis of sporotrichosis of the right upper limb was made and the patient was started on antifungal treatment immediately (T. Itraconazole [Sporanox] 200 mg BD). One month after commencement of antifungal treatment, the ulcer began to dry up and at 3 months all the lesions including the one on the right thigh had healed.
Physicochemical properties of hydrothermally treated hemicellulose from oil palm frond

Fazilah A, Azemi MN, Karim AA, Norakma MN

J Agric Food Chem, 2009 Feb 25;57(4):1527-31.
PMID: 19166335 DOI: 10.1021/jf8028013

Hemicelluloses from oil palm frond (OPF) were extracted using 3 M potassium hydroxide (KOH) for 4 h at 40 degrees C with stirring at 400 rpm to obtain hemicelluloses A and B. The total yield of the hemicellulose isolated from OPF was 33% (dry weight). Both hemicelluloses A and B were then subjected to hydrothermal treatment at 121 degrees C and 1.03 x 10(5) Pa for 10, 30, and 50 min. Physicochemical characterizations of hydrothermally treated hemicelluloses, such as Klason lignin content and reducing sugar content, were performed to study the effect of autohydrolysis processing on OPF-derived hemicelluloses. It was shown that Klason lignin content in hemicellulose A was higher than that in hemicellulose B and decreased after hydrothermal treatment. Hydrothermal treatment enhanced the solubility of hemicelluloses, which reflects their higher reducing sugar content. Monosaccharide analysis using HPLC showed that xylose was the predominant monosaccharide for both hemicelluloses A and B.
Relationships among rat numbers, abundance of oil palm fruit and damage levels to fruit in an oil palm plantation

Puan CL, Goldizen AW, Zakaria M, Hafidzi MN, Baxter GS

Integr Zool, 2011 Jun;6(2):130-139.
PMID: 21645277 DOI: 10.1111/j.1749-4877.2010.00231.x

The relationships between vertebrate pests and crop damage are often complex and difficult to study. In palm oil plantations rodents remain the major pests, causing substantial monetary losses. The present study examined the numerical and functional responses of rodents to changes in the availability of oil palm fruit and the damage associated with that response. For the study, 200 traps were set in pairs on a 10 × 10 trapping grid for 3 consecutive nights in each of 6 study plots at 8-week intervals in a 2569 ha oil palm plantation at Labu, Negeri Sembilan state in Peninsular Malaysia over 14 months. A total of 1292 individual rats were captured over 25 200 trap-nights. Animals were identified, aged, sexed, weighed and measured. An index of the relative abundance of rats was calculated based on trapping success. Damage to infructescences was assessed at each trap point. Regardless of the age of palms, there were positive and significant relationships between the relative abundance of rats and numbers of infructescences. The levels of damage to infructescences were significantly correlated with the relative abundance of rats. A steep increase in damage was observed with an increase in mature infructescences, indicating a feeding preference of rats for mature infructescences. For both males and females of all rat species, there were weak and non-significant correlations between body condition and infructescence numbers. These results indicated that there was a numerical and a functional response by rats to the availability of palm fruit and a resulting increase in depredation of oil palm fruits. The ways in which this information might aid in future pest control are discussed.
Fulltext Mapping of mosquito breeding sites in malaria endemic areas in Pos Lenjang, Kuala Lipis, Pahang, Malaysia

Ahmad R, Ali WN, Nor ZM, Ismail Z, Hadi AA, Ibrahim MN, et al.

Malar J, 2011;10:361.
PMID: 22166101 DOI: 10.1186/1475-2875-10-361

The application of the Geographic Information Systems (GIS) to the study of vector transmitted diseases considerably improves the management of the information obtained from the field survey and facilitates the study of the distribution patterns of the vector species.
Fulltext Risk of metabolic syndrome among children living in metropolitan Kuala Lumpur: a case control study

Wee BS, Poh BK, Bulgiba A, Ismail MN, Ruzita AT, Hills AP

BMC Public Health, 2011;11:333.
PMID: 21592367 DOI: 10.1186/1471-2458-11-333

With the increasing prevalence of childhood obesity, the metabolic syndrome has been studied among children in many countries but not in Malaysia. Hence, this study aimed to compare metabolic risk factors between overweight/obese and normal weight children and to determine the influence of gender and ethnicity on the metabolic syndrome among school children aged 9-12 years in Kuala Lumpur and its metropolitan suburbs.
Fulltext Electrical property comparison and charge transmission in p-type double gate and single gate junctionless accumulation transistor fabricated by AFM nanolithography

Dehzangi A, Abdullah AM, Larki F, Hutagalung SD, Saion EB, Hamidon MN, et al.

Nanoscale Res Lett, 2012;7(1):381.
PMID: 22781031 DOI: 10.1186/1556-276X-7-381

The junctionless nanowire transistor is a promising alternative for a new generation of nanotransistors. In this letter the atomic force microscopy nanolithography with two wet etching processes was implemented to fabricate simple structures as double gate and single gate junctionless silicon nanowire transistor on low doped p-type silicon-on-insulator wafer. The etching process was developed and optimized in the present work compared to our previous works. The output, transfer characteristics and drain conductance of both structures were compared. The trend for both devices found to be the same but differences in subthreshold swing, 'on/off' ratio, and threshold voltage were observed. The devices are 'on' state when performing as the pinch off devices. The positive gate voltage shows pinch off effect, while the negative gate voltage was unable to make a significant effect on drain current. The charge transmission in devices is also investigated in simple model according to a junctionless transistor principal.
Fulltext Pinch-off mechanism in double-lateral-gate junctionless transistors fabricated by scanning probe microscope based lithography

Larki F, Dehzangi A, Abedini A, Abdullah AM, Saion E, Hutagalung SD, et al.

Beilstein J Nanotechnol, 2012;3:817-23.
PMID: 23365794 DOI: 10.3762/bjnano.3.91

A double-lateral-gate p-type junctionless transistor is fabricated on a low-doped (10(15)) silicon-on-insulator wafer by a lithography technique based on scanning probe microscopy and two steps of wet chemical etching. The experimental transfer characteristics are obtained and compared with the numerical characteristics of the device. The simulation results are used to investigate the pinch-off mechanism, from the flat band to the off state. The study is based on the variation of the carrier density and the electric-field components. The device is a pinch-off transistor, which is normally in the on state and is driven into the off state by the application of a positive gate voltage. We demonstrate that the depletion starts from the bottom corner of the channel facing the gates and expands toward the center and top of the channel. Redistribution of the carriers due to the electric field emanating from the gates creates an electric field perpendicular to the current, toward the bottom of the channel, which provides the electrostatic squeezing of the current.
A search for novel thermoluminescent radiation dosimeter media

Al-Hinai KH, Benkara Mohd N, Rozullyah Zulkepely N, Md Nor R, Mohd Amin Y, Bradley DA

Appl Radiat Isot, 2013 Dec;82:126-9.
PMID: 23978507 DOI: 10.1016/j.apradiso.2013.07.013

We describe two example pilot efforts to help define new thermoluminescent dosimeter media. The first concerns ZnS:Mn nanophosphors, prepared by chemical precipitation using zinc and sodium sulfate, doped with manganese sulfate at concentrations varying from 1 to 3mol. The second concerns chemical vapor deposited diamond, produced as a thin film or as amorphous carbon on a single-crystal silicon substrate, each deposited under the same conditions, use being made of the hot filament-chemical vapor deposition (HFCVD) technique. The gas concentrations used were 1% CH4 in 99% H2 and 25% CH4 in 75% H2. Characterization of formations used FESEM, XRD and EDX. The nanophosphors consisted of particles of sizes in the range 85-150nm, the thermoluminescence (TL)-based radiation detection medium giving rise to a single peaked glow curve of maximum yield at a temperature of 250°C at a heating rate of 5°C/s. The TL response increased linearly with radiation dose, ZnS doped to 2mol of Mn being found the most sensitive. Regarding chemical vapor deposited (CVD) carbon, inappreciable TL was found for the resultant ball-like amorphous carbon films, graphite, and the silicon substrate, whereas CVD diamond films showed a promising degree of linearity with dose. For both the ZnS and diamond samples, TL signal fading was appreciable, being some 40% per day for ZnS and>50% per day for CVD films even under storage in the dark at room temperature, making it apparent that there is need to adjust parameters such as the size of nanoparticles.
Influenza vaccines for preventing acute otitis media in infants and children

Norhayati MN, Ho JJ, Azman MY

Cochrane Database Syst Rev, 2015 Mar 24.
PMID: 25803008 DOI: 10.1002/14651858.CD010089.pub2

BACKGROUND: Acute otitis media (AOM) is one of the most common infectious diseases in children. It has been reported that 64% of infants have an episode of AOM by the age of six months and 86% by one year. Although most cases of AOM are due to bacterial infection, it is commonly triggered by a viral infection. In most children it is self limiting, but it does carry a risk of complications. Since antibiotic treatment increases the risk of antibiotic resistance, influenza vaccines might be an effective way of reducing this risk by preventing the development of AOM.
OBJECTIVES: To assess the effectiveness of influenza vaccine in reducing the occurrence of acute otitis media (AOM) in infants and children.
SEARCH METHODS: We searched CENTRAL (2014, Issue 6), MEDLINE (1946 to July week 1, 2014), EMBASE (2010 to July 2014), CINAHL (1981 to July 2014), LILACS (1982 to July 2014), Web of Science (1955 to July 2014) and reference lists of articles to July 2014.
SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing influenza vaccine with placebo or no treatment in infants and children aged younger than six years old. We included children of either sex and of any ethnicity, with or without a history of recurrent AOM.
DATA COLLECTION AND ANALYSIS: Two review authors independently screened studies, assessed trial quality and extracted data. We performed statistical analyses using the random-effects and fixed-effect models and expressed the results as risk ratio (RR), risk difference (RD) and number needed to treat to benefit (NNTB) for dichotomous outcomes, with 95% confidence intervals (CI).
MAIN RESULTS: We included 10 trials (six trials in high-income countries and four multicentre trials in high-, middle- and low-income countries) involving 16,707 children aged six months to six years. Eight trials recruited participants from a healthcare setting. Nine trials (and all five trials that contributed to the primary outcome) declared funding from vaccine manufacturers. Four trials reported adequate allocation concealment and nine trials reported adequate blinding of participants and personnel. Attrition was low for all trials included in the analysis.The primary outcome showed a small reduction in at least one episode of AOM over at least six months of follow-up (five trials, 4736 participants: RR 0.80, 95% CI 0.67 to 0.96; RD -0.04, 95% CI -0.07 to -0.02; NNTB 25, 95% CI 15 to 50).The subgroup analyses (i.e. number of courses, settings, seasons or types of vaccine administered) showed no differences.There was a reduction in the use of antibiotics in vaccinated children (two trials, 1223 participants: RR 0.70, 95% CI 0.59 to 0.83; RD -0.15, 95% CI -0.30 to -0.00).There was no significant difference in the utilisation of health care for the one trial that provided sufficient information to be included. The use of influenza vaccine resulted in a significant increase in fever (six trials, 10,199 participants: RR 1.15, 95% CI 1.06 to 1.24; RD 0.02, 95% CI -0.00 to 0.05) and rhinorrhoea (six trials, 10,563 children: RR 1.17, 95% CI 1.07 to 1.29; RD 0.09, 95% CI 0.01 to 0.16) but no difference in pharyngitis. No major adverse events were reported.Compared to the protocol, the review included a subgroup analysis of AOM episodes by season, and changed the types of influenza vaccine from a secondary outcome to a subgroup analysis.
AUTHORS' CONCLUSIONS: Influenza vaccine results in a small reduction in AOM. The observed reduction with the use of antibiotics needs to be considered in the light of current recommended practices aimed at avoiding antibiotic overuse. Safety data from these trials are limited. The benefits may not justify the use of influenza vaccine without taking into account the vaccine efficacy in reducing influenza and safety data. The quality of the evidence was high to moderate. Additional research is needed.
Fulltext Human neutrophil antigen profiles in Banjar, Bugis, Champa, Jawa and Kelantan Malays in Peninsular Malaysia

Manaf SM, NurWaliyuddin HZ, Panneerchelvam S, Zafarina Z, Norazmi MN, Chambers GK, et al.

Blood Transfus, 2015 Oct;13(4):610-5.
PMID: 26057487 DOI: 10.2450/2015.0278-14

Human neutrophil antigens (HNA) are polymorphic and immunogenic proteins involved in the pathogenesis of neonatal alloimmune neutropenia, transfusion-related acute lung injury (TRALI) and transfusion-related alloimmune neutropenia. The characterisation of HNA at a population level is important for predicting the risk of alloimmunisation associated with blood transfusion and gestation and for anthropological studies.
Fulltext Validation of the knowledge, attitude and perceived practice of asthma instrument among community pharmacists using Rasch analysis

Akram W, Hussein MS, Ahmad S, Mamat MN, Ismail NE

Saudi Pharm J, 2015 Oct;23(5):499-503.
PMID: 26594115 DOI: 10.1016/j.jsps.2015.01.011

There is no instrument which collectively assesses the knowledge, attitude and perceived practice of asthma among community pharmacists. Therefore, this study aimed to validate the instrument which measured the knowledge, attitude and perceived practice of asthma among community pharmacists by producing empirical evidence of validity and reliability of the items using Rasch model (Bond & Fox software®) for dichotomous and polytomous data. This baseline study recruited 33 community pharmacists from Penang, Malaysia. The results showed that all PTMEA Corr were in positive values, where an item was able to distinguish between the ability of respondents. Based on the MNSQ infit and outfit range (0.60-1.40), out of 55 items, 2 items from the instrument were suggested to be removed. The findings indicated that the instrument fitted with Rasch measurement model and showed the acceptable reliability values of 0.88 and 0.83 and 0.79 for knowledge, attitude and perceived practice respectively.
Fulltext Ancient Genetic Signatures of Orang Asli Revealed by Killer Immunoglobulin-Like Receptor Gene Polymorphisms

NurWaliyuddin HZ, Norazmi MN, Edinur HA, Chambers GK, Panneerchelvam S, Zafarina Z

PLoS One, 2015;10(11):e0141536.
PMID: 26565719 DOI: 10.1371/journal.pone.0141536

The aboriginal populations of Peninsular Malaysia, also known as Orang Asli (OA), comprise three major groups; Semang, Senoi and Proto-Malays. Here, we analyzed for the first time KIR gene polymorphisms for 167 OA individuals, including those from four smallest OA subgroups (Che Wong, Orang Kanaq, Lanoh and Kensiu) using polymerase chain reaction-sequence specific primer (PCR-SSP) analyses. The observed distribution of KIR profiles of OA is heterogenous; Haplotype B is the most frequent in the Semang subgroups (especially Batek) while Haplotype A is the most common type in the Senoi. The Semang subgroups were clustered together with the Africans, Indians, Papuans and Australian Aborigines in a principal component analysis (PCA) plot and shared many common genotypes (AB6, BB71, BB73 and BB159) observed in these other populations. Given that these populations also display high frequencies of Haplotype B, it is interesting to speculate that Haplotype B may be generally more frequent in ancient populations. In contrast, the two Senoi subgroups, Che Wong and Semai are displaced toward Southeast Asian and African populations in the PCA scatter plot, respectively. Orang Kanaq, the smallest and the most endangered of all OA subgroups, has lost some degree of genetic variation, as shown by their relatively high frequency of the AB2 genotype (0.73) and a total absence of KIR2DL2 and KIR2DS2 genes. Orang Kanaq tradition that strictly prohibits intermarriage with outsiders seems to have posed a serious threat to their survival. This present survey is a demonstration of the value of KIR polymorphisms in elucidating genetic relationships among human populations.
Fulltext SNF3 as High Affinity Glucose Sensor and Its Function in Supporting the Viability of Candida glabrata under Glucose-Limited Environment

Ng TS, Chew SY, Rangasamy P, Mohd Desa MN, Sandai D, Chong PP, et al.

Front Microbiol, 2015;6:1334.
PMID: 26648919 DOI: 10.3389/fmicb.2015.01334

Candida glabrata is an emerging human fungal pathogen that has efficacious nutrient sensing and responsiveness ability. It can be seen through its ability to thrive in diverse range of nutrient limited-human anatomical sites. Therefore, nutrient sensing particularly glucose sensing is thought to be crucial in contributing to the development and fitness of the pathogen. This study aimed to elucidate the role of SNF3 (Sucrose Non Fermenting 3) as a glucose sensor and its possible role in contributing to the fitness and survivability of C. glabrata in glucose-limited environment. The SNF3 knockout strain was constructed and subjected to different glucose concentrations to evaluate its growth, biofilm formation, amphotericin B susceptibility, ex vivo survivability and effects on the transcriptional profiling of the sugar receptor repressor (SRR) pathway-related genes. The CgSNF3Δ strain showed a retarded growth in low glucose environments (0.01 and 0.1%) in both fermentation and respiration-preferred conditions but grew well in high glucose concentration environments (1 and 2%). It was also found to be more susceptible to amphotericin B in low glucose environment (0.1%) and macrophage engulfment but showed no difference in the biofilm formation capability. The deletion of SNF3 also resulted in the down-regulation of about half of hexose transporters genes (four out of nine). Overall, the deletion of SNF3 causes significant reduction in the ability of C. glabrata to sense limited surrounding glucose and consequently disrupts its competency to transport and perform the uptake of this critical nutrient. This study highlighted the role of SNF3 as a high affinity glucose sensor and its role in aiding the survivability of C. glabrata particularly in glucose limited environment.
Fulltext Tonabersat Prevents Inflammatory Damage in the Central Nervous System by Blocking Connexin43 Hemichannels

Kim Y, Griffin JM, Nor MNM, Zhang J, Freestone PS, Danesh-Meyer HV, et al.

Neurotherapeutics, 2017 Oct;14(4):1148-1165.
PMID: 28560708 DOI: 10.1007/s13311-017-0536-9

The cis benzopyran compound tonabersat (SB-220453) has previously been reported to inhibit connexin26 expression in the brain by attenuating the p38-mitogen-activated protein kinase pathway. We show here that tonabersat directly inhibits connexin43 hemichannel opening. Connexin43 hemichannels have been called "pathological pores" based upon their role in secondary lesion spread, edema, inflammation, and neuronal loss following central nervous system injuries, as well as in chronic inflammatory disease. Both connexin43 hemichannels and pannexin channels released adenosine triphosphate (ATP) during ischemia in an in vitro ischemia model, but only connexin43 hemichannels contributed to ATP release during reperfusion. Tonabersat inhibited connexin43 hemichannel-mediated ATP release during both ischemia and reperfusion phases, with direct channel block confirmed using electrophysiology. Tonabersat also reduced connexin43 gap junction coupling in vitro, but only at higher concentrations, with junctional plaques internalized and degraded via the lysosomal pathway. Systemic delivery of tonabersat in a rat bright-light retinal damage model (a model for dry age-related macular degeneration) resulted in significantly improved functional outcomes assessed using electroretinography. Tonabersat also prevented thinning of the retina, especially the outer nuclear layer and choroid, assessed using optical coherence tomography. We conclude that tonabersat, already given orally to over 1000 humans in clinical trials (as a potential treatment for, and prophylactic treatment of, migraine because it was thought to inhibit cortical spreading depression), is a connexin hemichannel inhibitor and may have the potential to be a novel treatment of central nervous system injury and chronic neuroinflammatory disease.
Fulltext Influenza vaccines for preventing acute otitis media in infants and children

Norhayati MN, Ho JJ, Azman MY

Cochrane Database Syst Rev, 2017 Oct 17;10(10):CD010089.
PMID: 29039160 DOI: 10.1002/14651858.CD010089.pub3

BACKGROUND: Acute otitis media (AOM) is one of the most common infectious diseases in children. It has been reported that 64% of infants have an episode of AOM by the age of six months and 86% by one year. Although most cases of AOM are due to bacterial infection, it is commonly triggered by a viral infection. In most children AOM is self limiting, but it does carry a risk of complications. Since antibiotic treatment increases the risk of antibiotic resistance, influenza vaccines might be an effective way of reducing this risk by preventing the development of AOM.
OBJECTIVES: To assess the effectiveness of influenza vaccine in reducing the occurrence of acute otitis media in infants and children.
SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, LILACS, Web of Science, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov (15 February 2017). We also searched the reference lists of included studies to identify any additional trials.
SELECTION CRITERIA: Randomised controlled trials comparing influenza vaccine with placebo or no treatment in infants and children aged younger than six years. We included children of either sex and of any ethnicity, with or without a history of recurrent AOM.
DATA COLLECTION AND ANALYSIS: Two review authors independently screened studies, assessed trial quality, and extracted data. We performed statistical analyses using the random-effects and fixed-effect models and expressed the results as risk ratio (RR), risk difference (RD), and number needed to treat for an additional beneficial outcome (NNTB) for dichotomous outcomes, with 95% confidence intervals (CI).
MAIN RESULTS: We included 11 trials (6 trials in high-income countries and 5 multicentre trials in high-, middle-, and low-income countries) involving 17,123 children aged 6 months to 6 years. Eight trials recruited participants from a healthcare setting. Ten trials (and all four trials that contributed to the primary outcome) declared funding from vaccine manufacturers. Four trials reported adequate allocation concealment, and 10 trials reported adequate blinding of participants and personnel. Attrition was low for eight trials included in the analysis.The primary outcome showed a small reduction in at least one episode of AOM over at least six months of follow-up (4 trials, 3134 children; RR 0.84, 95% CI 0.69 to 1.02; RD -0.04, 95% CI -0.08 to -0.00; NNTB 25, 95% CI 12.5 to 100; low-quality evidence).The subgroup analyses (i.e. number of courses and types of vaccine administered) showed no differences.There was a reduction in the use of antibiotics in vaccinated children (2 trials, 1223 children; RR 0.70, 95% CI 0.59 to 0.83; RD -0.11, 95% CI -0.16 to -0.06; moderate-quality evidence).We were unable to demonstrate whether there was any difference in the utilisation of health care. The use of influenza vaccine resulted in a significant increase in fever (7 trials, 10,615 children; RR 1.15, 95% CI 1.06 to 1.24; RD 0.02, 95% CI 0.00 to 0.04; low-quality evidence), rhinorrhoea (6 trials, 10,563 children; RR 1.17, 95% CI 1.07 to 1.29; RD 0.09, 95% CI 0.01 to 0.16; low-quality evidence), but no difference in pharyngitis. No major adverse events were reported.Differing from the protocol, the original publication of the review included a subgroup analysis of AOM episodes by season, and the secondary outcome 'types of influenza vaccine' was changed to a subgroup analysis. For this update, we removed the subgroup analyses for trial setting, season, and utilisation of health care due to the small number of trials involved. We removed Belshe 2000 from primary and secondary outcomes (courses of vaccine and types of vaccine) because it reported episodes of AOM per person. We did not perform a subgroup analysis by type of adverse event. We have reported each type of adverse event as a separate analysis.
AUTHORS' CONCLUSIONS: Influenza vaccine results in a small reduction in AOM. The observed reduction in the use of antibiotics needs to be considered in light of current recommended practices aimed at avoiding antibiotic overuse. Safety data from these trials were limited. The benefits may not justify the use of influenza vaccine without taking into account the vaccine efficacy in reducing influenza and safety data. We judged the quality of the evidence to be low to moderate. Additional research is needed.
Fulltext Characterization of a Group B Streptococcus infection based on the demographics, serotypes, antimicrobial susceptibility and genotypes of selected isolates from sterile and non-sterile isolation sites in three major hospitals in Malaysia

Suhaimi MES, Desa MNM, Eskandarian N, Pillay SG, Ismail Z, Neela VK, et al.

J Infect Public Health, 2017 Jan-Feb;10(1):14-21.
PMID: 27095302 DOI: 10.1016/j.jiph.2016.01.009

BACKGROUND/PURPOSE: The purpose of this study is to characterize GBS isolates that were collected from three major hospitals in a densely populated area of Klang Valley for their demographics, serotypes, antibiotic susceptibility patterns and genetic background.

METHODS: Sixty GBS isolates from sterile and non-sterile samples in three major hospitals in the Klang Valley area of Malaysia were collected by convenience sampling from 2012 until March 2014. These isolates were studied for their antimicrobial susceptibilities, serotypes and genotypes. Patients' demographic data and clinical information were collected from lab request forms.

RESULTS: Diabetes mellitus was the only underlying condition (7 patients, 23.3%); the remaining samples were from patients who were immunocompromised due to medications. Fifty-nine (98%) isolates were sensitive to penicillin, while 78.3% and 88.3% of the isolates were sensitive to erythromycin and clindamycin, respectively. Serotype Ia was the most common serotype (n=27, 45%), followed by serotype III (n=10, 16.7%), V (n=9, 15%), VI (n=8, 13.3%), VIII (n=2, 3.3%) and VII (n=1, 1.7%). Random Amplified Polymorphic DNA (RAPD) typing showed a diverse genetic pedigree for all isolates, including four major groups that clustered according to geographical location.

CONCLUSION: This preliminary study determines the prevalence of limited common serotypes and antimicrobial resistance in distinct GBS isolates. Nonetheless, the RAPD clustering pattern suggests a close genetic lineage of the GBS isolates based on their isolation sites and location of hospitals.

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