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Fulltext Case study of occupational hazards amongst the gastrointestinal assistants (GIA) exposed to Succindialdehyde (SA) in the endoscopy unit of Queen Elizabeth Hospital (QEH)

Michal, C.S., Nadirah, S., Ammar, R., Philip, G., Jayaram, M., Savio, S.

Journal of Occupational Safety and Health, 2016;13(2):15-22.
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Introduction: Workers in hospitals are exposed to various occupational hazards such as high level disinfectants (HLD).
Disinfection is an essential component of the endoscope reprocessing. In the Endoscopy Unit of Queen Elizabeth Hospital,
Succindialdehyde (SA) is used as the disinfectant for endoscope reprocessing. SA has properties that are similar to formaldehyde
in regard to contact allergies and toxicity. The purpose of this case study is to describe the occurrence of work related symptoms
(WRS), the proper use of personal protective attire (PPE) and the need of pre-employment health enquiries for those exposed to SA.

Methodology: This was a cross sectional case study. Twenty eight gastrointestinal assistants (GIA) from the thirty two exposed staff
working with the Queen Elizabeth Hospital’s Endoscopy Unit, who fulfilled the study criteria, were given a modified Respiratory
Surveillance Questionnaire. This questionnaireis used as the health surveillance tool for the staff exposed to the occupational
respiratory hazard by the Occupational Health Unit, University of Edinburgh. Results: Most of the GIAs complained of headache
(85.7%), skin irritations (60.7%) followed by 57.1% watery eyes, wheeziness and runny nose. Majority (92.9%) of the GIAs wore
personal protective equipment (PPE) during the disinfection procedure. Pre-employment enquiries regarding asthma, skin and
mucosal sensitivity problems and lung function were not made to any of the GIAs. Only 14.3% of them do annual health surveillances.

Conclusion: Most of the GIAs, 92.9% experienced at least one WRS despite wearing PPE. Staff exposed to the chemical disinfectants
should wear proper PPE and do annual health surveillances. By practising this, we may avoid WRS and treat the staff accordingly.
Aquilaria spp. (agarwood) as source of health beneficial compounds: A review of traditional use, phytochemistry and pharmacology

Hashim YZ, Kerr PG, Abbas P, Mohd Salleh H

J Ethnopharmacol, 2016 Aug 02;189:331-60.
PMID: 27343768 DOI: 10.1016/j.jep.2016.06.055

ETHNOPHARMACOLOGICAL RELEVANCE: Aquilaria spp. (agarwood) has been a part of Ayurvedic and Traditional Chinese Medicine for centuries. Agarwood has also been used as a traditional medicine in Southeast Asian countries, Bangladesh and Tibet. Its common uses include the treatment of joint pain, inflammatory-related ailments, and diarrhoea, as well as a stimulant, sedative and cardioprotective agent. In this paper, we aim to provide an overview of the phytochemistry, ethnomedicinal use, pharmacological activities and safety of plant materials from Aquilaria spp. as an evidence base to further appraise its potential use as a source of health beneficial compounds.
MATERIALS AND METHODS: Literature abstracts and full text articles from journals, books, reports and electronic searches (Google Scholar, Elsevier, PubMed, Read Cube, Scopus, Springer, and Web of Science), as well as from other relevant websites, are surveyed, analysed and included in this review.
RESULTS: A literature survey of agarwood plant materials showed that they contain sesquiterpenes, 2(-2-phenylethyl)-4H-chromen-4-one derivatives, genkwanins, mangiferins, iriflophenones, cucurbitacins, terpenoids and phenolic acids. The crude extracts and some of the isolated compounds exhibit anti-allergic, anti-inflammatory, anti-diabetic, anti-cancer, anti-oxidant, anti-ischemic, anti-microbial, hepatoprotective, laxative, and mosquitocidal properties and effects on the central nervous system. Agarwood plant materials are considered to be safe based on the doses tested. However, the toxicity and safety of the materials, including the smoke from agarwood incense burning, should be further investigated. Future research should be directed towards the bio-guided isolation of bioactive compounds with proper chemical characterisation and investigations of the underlying mechanisms towards drug discovery.
CONCLUSIONS: The traditional medicinal use of agarwood plant materials has provided clues to their pharmacological properties. Indeed, agarwood contains a plethora of bioactive compounds that now elegantly support their use in traditional medicine. As wild agarwood trees are critically endangered and vulnerable, sustainable agricultural and forestry practices are necessary for the further development and utilization of agarwood as a source of health beneficial compounds.
Fulltext Psychiatric presentation of Huntington's disease in a Malaysian family

Chin CN, S'ng KH, Philip G, Rosdinom R, Wahidah A

Med J Malaysia, 1996 Mar;51(1):153-6.
PMID: 10968000

A 32-year-old Chinese lady presented to the Psychiatric Clinic with a history of change in personality for 2 years and abnormal movements for a year. After thorough investigations and observation a diagnosis of Huntington's Disease was made. Her elder brother was traced and found to have Huntington's Disease as well. He had a long standing history of antisocial behaviour and substance abuse long before the onset of the choreiform movements. Her younger brother also has choreiform movements for the last 2 years and had recent change in personality. Their mother also had abnormal movements and was recorded to be depressed and attempted suicide. The maternal grandfather had a mental illness and was warded at a mental institution till his death in 1942. Psychiatric presentation of Huntington's Disease in this Malaysian family is prominent and preceded the characteristic movements in the present generation.
Fulltext A double blind comparison of zuclopenthixol acetate with haloperidol in the management of acutely disturbed schizophrenics

Chin CN, Hamid AR, Philip G, Ramlee T, Mahmud M, Zulkifli G, et al.

Med J Malaysia, 1998 Dec;53(4):365-71.
PMID: 10971979

The aim of this study was to evaluate the efficacy and side effects of zuclopenthixol acetate compared with haloperidol in the management of the acutely disturbed schizophrenic patient. Suitable subjects diagnosed as having schizophreniform disorder or acute exacerbation of schizophrenia admitted to the psychiatric wards Hospital Kuala Lumpur were randomised to receive either zuclopenthixol acetate or haloperidol. They were rated blind for three consecutive days using the Brief Psychiatric Rating Scale (BPRS), Clinical Global Impression (CGI) and UKU Side Effects Scale. Apart from repeat injections of the same medication, no other anti-psychotic was given for the duration of the study. 50 subjects entered the study of which 44 completed. 23 were given zuclopenthixol acetate and 21 haloperidol. Both groups significantly reduced BPRS and CGI scores on all 3 days compared to the initial rating (p < 0.001). There was however no difference between the zuclopenthixol acetate and haloperidol group scores on all days (p > 0.05). More subjects on haloperidol than zuclopenthixol required more than 1 injection during the study. Both groups had minimal side effects. Zuclopenthixol acetate was effective in the management of the acutely disturbed schizophrenic.
Active restoration accelerates the carbon recovery of human-modified tropical forests

Philipson CD, Cutler MEJ, Brodrick PG, Asner GP, Boyd DS, Moura Costa P, et al.

Science, 2020 08 14;369(6505):838-841.
PMID: 32792397 DOI: 10.1126/science.aay4490

More than half of all tropical forests are degraded by human impacts, leaving them threatened with conversion to agricultural plantations and risking substantial biodiversity and carbon losses. Restoration could accelerate recovery of aboveground carbon density (ACD), but adoption of restoration is constrained by cost and uncertainties over effectiveness. We report a long-term comparison of ACD recovery rates between naturally regenerating and actively restored logged tropical forests. Restoration enhanced decadal ACD recovery by more than 50%, from 2.9 to 4.4 megagrams per hectare per year. This magnitude of response, coupled with modal values of restoration costs globally, would require higher carbon prices to justify investment in restoration. However, carbon prices required to fulfill the 2016 Paris climate agreement [$40 to $80 (USD) per tonne carbon dioxide equivalent] would provide an economic justification for tropical forest restoration.
Translocation of Fungicides and Their Efficacy in Controlling Phellinus noxius, the Cause of Brown Root Rot Disease

Liao TZ, Chen YH, Tsai JN, Chao C, Huang TP, Hong CF, et al.

Plant Dis, 2023 Jul;107(7):2039-2053.
PMID: 36428260 DOI: 10.1094/PDIS-06-22-1285-RE

Brown root rot disease (BRRD), caused by Phellinus noxius, is an important tree disease in tropical and subtropical areas. To improve chemical control of BRRD and deter emergence of fungicide resistance in P. noxius, this study investigated control efficacies and systemic activities of fungicides with different modes of action. Fourteen fungicides with 11 different modes of action were tested for inhibitory effects in vitro on 39 P. noxius isolates from Taiwan, Hong Kong, Malaysia, Australia, and Pacific Islands. Cyproconazole, epoxiconazole, and tebuconazole (Fungicide Resistance Action Committee [FRAC] 3, target-site G1) inhibited colony growth of P. noxius by 99.9 to 100% at 10 ppm and 97.7 to 99.8% at 1 ppm. The other effective fungicide was cyprodinil + fludioxonil (FRAC 9 + 12, target-site D1 + E2), which showed growth inhibition of 96.9% at 10 ppm and 88.6% at 1 ppm. Acropetal translocation of six selected fungicides was evaluated in bishop wood (Bischofia javanica) seedlings by immersion of the root tips in each fungicide at 100 ppm, followed by liquid or gas chromatography tandem mass spectrometry analyses of consecutive segments of root, stem, and leaf tissues at 7 and 21 days posttreatment. Bidirectional translocation of the fungicides was also evaluated by stem injection of fungicide stock solutions. Cyproconazole and tebuconazole were the most readily absorbed by roots and efficiently transported acropetally. Greenhouse experiments suggested that cyproconazole, tebuconazole, and epoxiconazole have a slightly higher potential for controlling BRRD than mepronil, prochloraz, and cyprodinil + fludioxonil. Because all tested fungicides lacked basipetal translocation, soil drenching should be considered instead of trunk injection for their use in BRRD control.
Global variations in the prevalence, treatment, and impact of atrial fibrillation in a multi-national cohort of 153 152 middle-aged individuals

Joseph PG, Healey JS, Raina P, Connolly SJ, Ibrahim Q, Gupta R, et al.

Cardiovasc Res, 2021 05 25;117(6):1523-1531.
PMID: 32777820 DOI: 10.1093/cvr/cvaa241

AIMS: To compare the prevalence of electrocardiogram (ECG)-documented atrial fibrillation (or flutter) (AF) across eight regions of the world, and to examine antithrombotic use and clinical outcomes.
METHODS AND RESULTS: Baseline ECGs were collected in 153 152 middle-aged participants (ages 35-70 years) to document AF in two community-based studies, spanning 20 countries. Medication use and clinical outcome data (mean follow-up of 7.4 years) were available in one cohort. Cross-sectional analyses were performed to document the prevalence of AF and medication use, and associations between AF and clinical events were examined prospectively. Mean age of participants was 52.1 years, and 57.7% were female. Age and sex-standardized prevalence of AF varied 12-fold between regions; with the highest in North America, Europe, China, and Southeast Asia (270-360 cases per 100 000 persons); and lowest in the Middle East, Africa, and South Asia (30-60 cases per 100 000 persons) (P