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2021 Asia-Pacific League of Associations for Rheumatology clinical practice guideline for treatment of gout

Lorenzo JPP, Sollano MHMZ, Salido EO, Li-Yu J, Tankeh-Torres SA, Wulansari Manuaba IAR, et al.

Int J Rheum Dis, 2022 Jan;25(1):7-20.
PMID: 34931463 DOI: 10.1111/1756-185X.14266

BACKGROUND: Gout is the most prevalent inflammatory arthritis in the Asia-Pacific region and worldwide. This clinical practice guideline (CPG) aims to provide recommendations based on systematically obtained evidence and values and preferences tailored to the unique needs of patients with gout and hyperuricemia in Asia, Australasia, and the Middle East. The target users of these guidelines are general practitioners and specialists, including rheumatologists, in these regions.
METHODS: Relevant clinical questions were formulated by the Steering Committee. Systematic reviews of evidence were done, and certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation methodology. A multi-sectoral consensus panel formulated the final recommendations.
RESULTS: The Asia-Pacific League of Associations for Rheumatology Task Force developed this CPG for treatment of gout with 3 overarching principles and 22 recommendation statements that covered the treatment of asymptomatic hyperuricemia (2 statements), treatment of acute gout (4 statements), prophylaxis against gout flare when initiating urate-lowering therapy (3 statements), urate-lowering therapy (3 statements), treatment of chronic tophaceous gout (2 statements), treatment of complicated gout and non-responders (2 statements), treatment of gout with moderate to severe renal impairment (1 statement), and non-pharmacologic interventions (5 statements).
CONCLUSION: Recommendations for clinically relevant scenarios in the management of gout were formulated to guide physicians in administering individualized care.
Fulltext A Comprehensive Study of Artificial Intelligence and Machine Learning Approaches in Confronting the Coronavirus (COVID-19) Pandemic

Rahman MM, Khatun F, Uzzaman A, Sami SI, Bhuiyan MA, Kiong TS

Int J Health Serv, 2021 10;51(4):446-461.
PMID: 33999732 DOI: 10.1177/00207314211017469

The novel coronavirus disease (COVID-19) has spread over 219 countries of the globe as a pandemic, creating alarming impacts on health care, socioeconomic environments, and international relationships. The principal objective of the study is to provide the current technological aspects of artificial intelligence (AI) and other relevant technologies and their implications for confronting COVID-19 and preventing the pandemic's dreadful effects. This article presents AI approaches that have significant contributions in the fields of health care, then highlights and categorizes their applications in confronting COVID-19, such as detection and diagnosis, data analysis and treatment procedures, research and drug development, social control and services, and the prediction of outbreaks. The study addresses the link between the technologies and the epidemics as well as the potential impacts of technology in health care with the introduction of machine learning and natural language processing tools. It is expected that this comprehensive study will support researchers in modeling health care systems and drive further studies in advanced technologies. Finally, we propose future directions in research and conclude that persuasive AI strategies, probabilistic models, and supervised learning are required to tackle future pandemic challenges.
Fulltext A Novel RNA Virus, Macrobrachium rosenbergii Golda Virus (MrGV), Linked to Mass Mortalities of the Larval Giant Freshwater Prawn in Bangladesh

Hooper C, Debnath PP, Biswas S, van Aerle R, Bateman KS, Basak SK, et al.

Viruses, 2020 10 02;12(10).
PMID: 33023199 DOI: 10.3390/v12101120

Mass mortalities of the larval stage of the giant freshwater prawn, Macrobrachium rosenbergii, have been occurring in Bangladesh since 2011. Mortalities can reach 100% and have resulted in an 80% decline in the number of hatcheries actively producing M. rosenbergii. To investigate a causative agent for the mortalities, a disease challenge was carried out using infected material from a hatchery experiencing mortalities. Moribund larvae from the challenge were prepared for metatranscriptomic sequencing. De novo virus assembly revealed a 29 kb single‑stranded positive-sense RNA virus with similarities in key protein motif sequences to yellow head virus (YHV), an RNA virus that causes mass mortalities in marine shrimp aquaculture, and other viruses in the Nidovirales order. Primers were designed against the novel virus and used to screen cDNA from larvae sampled from hatcheries in the South of Bangladesh from two consecutive years. Larvae from all hatcheries screened from both years were positive by PCR for the novel virus, including larvae from a hatchery that at the point of sampling appeared healthy, but later experienced mortalities. These screens suggest that the virus is widespread in M. rosenbergii hatchery culture in southern Bangladesh, and that early detection of the virus can be achieved by PCR. The hypothesised protein motifs of Macrobrachium rosenbergii golda virus (MrGV) suggest that it is likely to be a new species within the Nidovirales order. Biosecurity measures should be taken in order to mitigate global spread through the movement of post-larvae within and between countries, which has previously been linked to other virus outbreaks in crustacean aquaculture.
A Review of Machine Learning Methods of Feature Selection and Classification for Autism Spectrum Disorder

Rahman MM, Usman OL, Muniyandi RC, Sahran S, Mohamed S, Razak RA

Brain Sci, 2020 Dec 07;10(12).
PMID: 33297436 DOI: 10.3390/brainsci10120949

Autism Spectrum Disorder (ASD), according to DSM-5 in the American Psychiatric Association, is a neurodevelopmental disorder that includes deficits of social communication and social interaction with the presence of restricted and repetitive behaviors. Children with ASD have difficulties in joint attention and social reciprocity, using non-verbal and verbal behavior for communication. Due to these deficits, children with autism are often socially isolated. Researchers have emphasized the importance of early identification and early intervention to improve the level of functioning in language, communication, and well-being of children with autism. However, due to limited local assessment tools to diagnose these children, limited speech-language therapy services in rural areas, etc., these children do not get the rehabilitation they need until they get into compulsory schooling at the age of seven years old. Hence, efficient approaches towards early identification and intervention through speedy diagnostic procedures for ASD are required. In recent years, advanced technologies like machine learning have been used to analyze and investigate ASD to improve diagnostic accuracy, time, and quality without complexity. These machine learning methods include artificial neural networks, support vector machines, a priori algorithms, and decision trees, most of which have been applied to datasets connected with autism to construct predictive models. Meanwhile, the selection of features remains an essential task before developing a predictive model for ASD classification. This review mainly investigates and analyzes up-to-date studies on machine learning methods for feature selection and classification of ASD. We recommend methods to enhance machine learning's speedy execution for processing complex data for conceptualization and implementation in ASD diagnostic research. This study can significantly benefit future research in autism using a machine learning approach for feature selection, classification, and processing imbalanced data.
A case of mycotic aneurysm due to Burkholderia pseudomallei

Ding CH, Hussin S, Tzar MN, Rahman MM, Ramli SR

Pak J Med Sci, 2013 Apr;29(2):666-8.
PMID: 24353601

Burkholderia pseudomallei is an free-living gram-negative bacterium causing melioidosis and is endemic in Southeast Asia. A 56-year-old diabetic construction worker with a 1-month history of abdominal pain and 1-day history of high-grade fever was found to have a left non-dissecting infrarenal mycotic aortic aneurysm by abdominal computerized tomography scan. Bacteriological examination of his blood yielded Burkholderia pseudomallei. The patient was treated with right axillo-bifemoral bypass with excision of aneurysm and high-dose intravenous ceftazidime for two weeks, followed by oral trimethoprim/sulfamethoxazole and oral doxycycline for a minimum of five months.
A comparison between ice and salt storages on bacteriological quality of Asian seabass (Lates calcarifer)

Rahman MM, Nasrun M, Hossain MY, Aa'zamuddin M

Pak J Biol Sci, 2012 Jun 15;15(12):583-8.
PMID: 24191620

The study compares the bacteriological quality on Asian seabass (Lates calcarifer) between ice and salt storage methods. The main objectives of the study were to identify different bacteria constituents and quantitative bacterial load in Asian seabass when preserved with ice and sea salt. For the purpose of this study, Asian seabass was stored in two different conditions of ice-chilled and salted for 2 days. All fish samples were analyzed by performing bacteriological analysis and the isolated bacteria were identified by using API identification system. In case of the quantity of bacteria in the flesh, Chilling and salting had no significant difference to the quantity of bacteria on fish flesh. As for the skin, salt-preserved fish showed higher quantity of bacteria than ice-preserved fish. Acinetobacter baumannii and Pseudomonas fluorescens had been identified from skin sample of ice-chilled fish. Besides P. fluorescens and A. baumannii other isolates identified include Vibrio and Myxobacteria. All bacteria were cocci-shaped except a few bacilli. In term of bacteria number and morphological characteristics, ice-chilled preserved fish was better than salt preserved fish. Overall, less number of bacteria was observed in both ice-chilled and sea salt preserved fish. The result of this study indicated that the quick preservation is a very important factor to control bacterial load in the preserved fish.
A review of okara (soybean curd residue) utilization as animal feed: Nutritive value and animal performance aspects

Rahman MM, Mat K, Ishigaki G, Akashi R

Anim Sci J, 2021 Dec;92(1):e13594.
PMID: 34289204 DOI: 10.1111/asj.13594

Year by year, huge quantities of by-products are generated during the manufacturing process of soybean-based products. Okara is one of the by-products, and it is an insoluble portion of the soybean. It consists of high moisture (8.4-22.9%); on dry matter basis, it contains high metabolizable energy (9.0-14.2 MJ/kg) and other components that include crude protein (20.9-39.1%), crude fiber (12.2-61.3%), crude fat (4.9-21.5%), and ash (3.4-5.3%). Fermentation of okara improves its nutritional quality and reduces its anti-nutrient contents. Due to animals' palatability, okara can be used to replace the soybean meal/concentrate feed partially or completely in ruminant's diet and partially in nonruminant's diet. Okara feeding does not depress the intake, digestibility, growth, milk production, blood metabolic profiles, and meat quality of animals. However, this by-product decays quickly due to its high moisture content, and its heavy weight and sticky nature make it difficult to process and expensive to dry using conventional methods. This paper thoroughly summarizes the utilization of okara as animal feed in the cause of developing a general guideline with favorable levels of inclusion in the diets of animals for its exploitation and valorization. This review will encourage further research to develop eco-friendly and value added feed for animals.
A review of oxalate poisoning in domestic animals: tolerance and performance aspects

Rahman MM, Abdullah RB, Wan Khadijah WE

J Anim Physiol Anim Nutr (Berl), 2013 Aug;97(4):605-14.
PMID: 22548678 DOI: 10.1111/j.1439-0396.2012.01309.x

Published data on oxalate poisoning in domestic animals are reviewed, with a focus on tolerance and performance. Oxalic acid is one of a number of anti-nutrients found in forage. It can bind with dietary calcium (Ca) or magnesium (Mg) to form insoluble Ca or Mg oxalate, which then may lead to low serum Ca or Mg levels as well as to renal failure because of precipitation of these salts in the kidneys. Dietary oxalate plays an important role in the formation of Ca oxalate, and a high dietary intake of Ca may decrease oxalate absorption and its subsequent urinary excretion. Oxalate-rich plants can be supplemented with other plants as forage for domestic animals, which may help to reduce the overall intake of oxalate-rich plants. Non-ruminants appear to be more sensitive to oxalate than ruminants because in the latter, rumen bacteria help to degrade oxalate. If ruminants are slowly exposed to a diet high in oxalate, the population of oxalate-degrading bacteria in the rumen increases sufficiently to prevent oxalate poisoning. However, if large quantities of oxalate-rich plants are eaten, the rumen is overwhelmed and unable to metabolize the oxalate and oxalate-poisoning results. Based on published data, we consider that <2.0% soluble oxalate would be an appropriate level to avoid oxalate poisoning in ruminants, although blood Ca level may decrease. In the case of non-ruminants, <0.5% soluble oxalate may be acceptable. However, these proposed safe levels of soluble oxalate should be regarded as preliminary. Further studies, especially long-term studies, are needed to validate and improve the recommended safe levels in animals. This review will encourage further research on the relationships between dietary oxalate, other dietary factors and renal failure in domestic animals.
A suitable method for the detection of a potential fraud of bringing macaque monkey meat into the food chain

Rashid NR, Ali ME, Hamid SB, Rahman MM, Razzak MA, Asing, et al.

Food Addit Contam Part A Chem Anal Control Expo Risk Assess, 2015;32(7):1013-22.
PMID: 25906074 DOI: 10.1080/19440049.2015.1039073

Being the third-largest primate population has not made macaque (Macaca fascicularis sp.) monkeys less exposed to threats and dangers. Despite wildlife protection, they have been widely hunted and consumed in several countries because of their purported nutritional values. In addition to trading as pure bush meats in several places, monkey meat has been sold in meatball and soup products in Indonesia. Thus the possibility of macaque meat trafficking under the label of common meats is quite high. This paper reports the development of a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assay with the shortest amplicon length for the confirmed detection of monkey meat under compromised states which are known to degrade DNA. We amplified a 120-bp region of d-loop gene using a pair of macaque-specific primers and confirmed their specificity for the target species through cross-challenging against 17 different species using a 141-bp site of an 18 S rRNA gene as an endogenous control for eukaryotes. This eliminated the possibilities of any false-negative detection with complex matrices or degraded specimens. The detection limit was 0.00001 ng DNA in a pure state and 0.1% of meat in mixed matrices and commercial meatball products. RFLP analysis further authenticated the originality of the PCR product and distinctive restriction patterns were found upon AluI and CViKI-1 digestion. A micro-fluidic lab-on-a-chip automated electrophoretic system separated the fragments with high resolution. The assay was validated for screening commercial meatball products with sufficient internal control.
Fulltext Adsorption Studies of Volatile Organic Compound (Naphthalene) from Aqueous Effluents: Chemical Activation Process Using Weak Lewis Acid, Equilibrium Kinetics and Isotherm Modelling

Akinpelu AA, Chowdhury ZZ, Shibly SM, Faisal ANM, Badruddin IA, Rahman MM, et al.

Int J Mol Sci, 2021 Feb 19;22(4).
PMID: 33669883 DOI: 10.3390/ijms22042090

This study deals with the preparation of activated carbon (CDSP) from date seed powder (DSP) by chemical activation to eliminate polyaromatic hydrocarbon-PAHs (naphthalene-C10H8) from synthetic wastewater. The chemical activation process was carried out using a weak Lewis acid of zinc acetate dihydrate salt (Zn(CH3CO2)2·2H2O). The equilibrium isotherm and kinetics analysis was carried out using DSP and CDSP samples, and their performances were compared for the removal of a volatile organic compound-naphthalene (C10H8)-from synthetic aqueous effluents or wastewater. The equilibrium isotherm data was analyzed using the linear regression model of the Langmuir, Freundlich and Temkin equations. The R2 values for the Langmuir isotherm were 0.93 and 0.99 for naphthalene (C10H8) adsorption using DSP and CDSP, respectively. CDSP showed a higher equilibrium sorption capacity (qe) of 379.64 µg/g. DSP had an equilibrium sorption capacity of 369.06 µg/g for C10H8. The rate of reaction was estimated for C10H8 adsorption using a pseudo-first order, pseudo-second order and Elovich kinetic equation. The reaction mechanism for both the sorbents (CDSP and DSP) was studied using the intraparticle diffusion model. The equilibrium data was well-fitted with the pseudo-second order kinetics model showing the chemisorption nature of the equilibrium system. CDSP showed a higher sorption performance than DSP due to its higher BET surface area and carbon content. Physiochemical characterizations of the DSP and CDSP samples were carried out using the BET surface area analysis, Fourier-scanning microscopic analysis (FSEM), energy-dispersive X-ray (EDX) analysis and Fourier-transform spectroscopic analysis (FTIR). A thermogravimetric and ultimate analysis was also carried out to determine the carbon content in both the sorbents (DSP and CDSP) here. This study confirms the potential of DSP and CDSP to remove C10H8 from lab-scale synthetic wastewater.
Fulltext An assessment of health management practices and occupational health hazards in tiger shrimp (Penaeus monodon) and freshwater prawn (Macrobrachium rosenbergii) aquaculture in Bangladesh

Ali H, Rahman MM, Rico A, Jaman A, Basak SK, Islam MM, et al.

Vet Anim Sci, 2018 Jun;5:10-19.
PMID: 32734040 DOI: 10.1016/j.vas.2018.01.002

Diseases have been recognized as the major obstacle to the shrimp (Penaeus monodon) and prawn (Macrobrachium rosenbergii) aquaculture production in Bangladesh. This study provides an assessment of shrimp and prawn diseases/syndromes, health management practices, and occupational health hazards associated with the handling of chemical and biological products to prevent and treat shrimp and prawn diseases. A survey was conducted using a semi-structured questionnaire with 380 shrimp and prawn farmers in the southwest of Bangladesh during February and June of 2016. The farms were categorized on the basis of the three cropping patterns: shrimp polyculture, prawn polyculture, and shrimp and prawn polyculture. Eight different diseases and/or symptoms were reported by the surveyed farmers. The white spot disease and the broken antenna and rostrum symptom were the most common in shrimp and prawn species, respectively. In total, 35 chemical and biological products (4 antibiotics, 15 disinfectants, 13 pesticides, 2 feed additives and probiotics) were used to treat and/or prevent diseases in the all farm categories. The major constraints for disease management were limited access to disease diagnostic service, inadequate product application information and lack of knowledge on better management practices. Handling chemicals and preparation of medicated feed with bare hands was identified as a potential occupational health hazard. This study suggests improvements in farmers' knowledge and skill in disease diagnostics and health management practices, and appropriate handling of potentially hazardous chemicals.
An ethnobotanical study of medicinal plants used by tribal and native people of Madhupur forest area, Bangladesh

Islam MK, Saha S, Mahmud I, Mohamad K, Awang K, Jamal Uddin S, et al.

J Ethnopharmacol, 2014 Feb 3;151(2):921-30.
PMID: 24342778 DOI: 10.1016/j.jep.2013.11.056

Madhupur forest area, Tangail is one of early human settlements in Bangladesh. Having abode in the vicinity of the forest, a strong ethnobotanical practice has prevailed in this area since ancient time. Due to the rapid deforestation during the last few decades, many plants have already disappeared or are facing extinction. Thus we attempted to document the medicinal plant use of Madhupur forest area with a view to preserve the ethnobotanical knowledge and in order to protect the biodiversity of this area.
Fulltext Anti-cyclic citrullinated peptide antibody is a good indicator for the diagnosis of rheumatoid arthritis

Abdul Wahab A, Mohammad M, Rahman MM, Mohamed Said MS

Pak J Med Sci, 2013 May;29(3):773-7.
PMID: 24353626

Objectives: Anti-cyclic citrullinated peptide (CCP) antibody has recently been used in the classification
of rheumatoid arthritis (RA). This antibody is more specific than rheumatoid factor (RF) for the diagnosis of RA. The study objectives were to determine the sensitivity, specificity, positive and negative predictive values of anti-CCP in RA diagnosis.
Methodology: Eighty RA patients and 80 non-RA individuals were included in the study. Blood was collected from both arms of study subjects and tested for anti-CCP and RF antibodies. Relevant clinical information and laboratory profiles of the RA patients were evaluated using patients’ medical records and Integrated Laboratory Management System (ILMS), respectively.
Results: The sensitivity and specificity of anti-CCP were 35% and 100% respectively. The positive and
negative predictive values were 100% and 61%, respectively. Positive anti-CCP was found significantly
associated with multiple joint pain (p < 0.001) and hand’s joints pain (p=0.01), symmetrical joints
involvement (p=0.015) and high CRP value (p < 0.001). Anti-CCP was also found to have positive association with RF (p < 0.001).
Conclusion: Anti-CCP is highly specific for the diagnosis of RA. High positive predictive value should be taken into consideration for effective treatment.
KEY WORD: Rheumatoid arthritis, anti-CCP, Rheumatoid factor, Sensitivity, Specificity, Positive predictive value, Negative predictive value.
Study site: Rheumatology Unit, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Antibody dynamics post-Comirnaty and CoronaVac vaccination in Malaysia

Tan CS, Noni V, Melina WUHU, Abdorahman US, Bimbang JN, Malik NMA, et al.

Sci Rep, 2022 09 19;12(1):15665.
PMID: 36123431 DOI: 10.1038/s41598-022-19776-3

Several vaccines have been fast-tracked through clinical trials to mitigate the progression of the SARS‑CoV‑2 pandemic. We analyzed sequential blood samples from 314 recipients of Comirnaty and CoronaVac in East Malaysia for the spike-binding IgG (IgG-S), nucleocapsid-binding IgG (IgG-N), spike-binding IgM (IgM-S) and serum vitamin D (VitD). A subset of samples was analyzed for the neutralizing antibodies (Ig-RBD). Results showed that IgG-S due to Comirnaty was significantly higher than CoronaVac. IgM-S was detected in 80.0% Comirnaty and 69.5% CoronaVac recipients, while IgG-N was detected in 58.1% CoronaVac but not in Comirnaty recipients. All IgG-S-positive vaccines possessed detectable Ig-RBD after the second dose but with a weak to moderate correlation. The serum VitD levels did not influence the antibody magnitude in both vaccines. In essence, SARS-CoV-2 vaccination is an IgG-S-dominant event, Comirnaty was more effective than CoronaVac in mounting IgG-S and Ig-RBD responses, independent of the patient's VitD level.
Fulltext Antimicrobial compounds from leaf extracts of Jatropha curcas, Psidium guajava, and Andrographis paniculata

Rahman MM, Ahmad SH, Mohamed MT, Ab Rahman MZ

ScientificWorldJournal, 2014;2014:635240.
PMID: 25250382 DOI: 10.1155/2014/635240

The present research was conducted to discover antimicrobial compounds in methanolic leaf extracts of Jatropha curcas and Andrographis paniculata and ethanolic leaf extract of Psidium guajava and the effectiveness against microbes on flower preservative solution of cut Mokara Red orchid flowers was evaluated. The leaves were analyzed using gas chromatography-mass spectrometry. A total of nine, 66, and 29 compounds were identified in J. curcas, P. guajava, and A. paniculata leaf extracts, with five (88.18%), four (34.66%), and three (50.47%) having unique antimicrobial compounds, respectively. The experimental design on vase life was conducted using a completely randomized design with 10 replications. The flower vase life was about 6 days in the solution containing the P. guajava and A. paniculata leaf extracts at 15 mg/L. Moreover, solution with leaf extracts of A. paniculata had the lowest bacterial count compared to P. guajava and J. curcas. Thus, these leaf extracts revealed the presence of relevant antimicrobial compounds. The leaf extracts have the potential as a cut flower solution to minimize microbial populations and extend flower vase life. However, the activities of specific antimicrobial compounds and double or triple combination leaf extracts to enhance the effectiveness to extend the vase life need to be tested.
Fulltext Application of Rapid Biological Indicators Coupled With Auto-Reader for the Quality Assurance of Surgical Instruments After Sterilization at a Cardiac Hospital in Bangladesh

Zaman SU, Sadia I, Yasmin N, Islam KN, Rahman MM, Haq A, et al.

Cureus, 2021 Nov;13(11):e19428.
PMID: 34926019 DOI: 10.7759/cureus.19428

Background Sterilization failure is one of the main reasons for surgical site infections (SSIs). The biological indicator (BI) test is the most reliable test to check sterilization efficiencies. But 48 hours BI test result makes the monitoring process time-consuming. Rapid BI testing can be time demanding in this regard. Therefore, the objective is to determine the importance of rapid BI monitoring for the quality assurance of sterile surgical instruments. Methods This study was conducted in the Labaid Cardiac Hospital, Bangladesh from April 1, 2021, to July 8, 2021. A total of 100 steam and 100 ethylene oxide (EO) rapid BIs and an auto reader incubator were used to conduct this research. Quick BI of steam and EO were used once per day and tested by the auto reader. Later, all the tested BIs were incubated for 48 hours by a conventional incubator to confirm the auto reader's rapid BI test results. Result All the EO BI results were found negative, but the BI was found positive twice in steam sterilization. Surgical items of those two loads were re-sterilized. Again, after checking the BI result, the items were released. All BIs except positive steam rapid BIs were found with no growth after 48 hours of incubation for cross-checking of auto reader results. In positive rapid BI of steam, growth was found after 48 hours of incubation. Conclusion When sterilization failure occurred, process recall could not be possible at that time if rapid BI tests were not performed. So, integration of a rapid BI test with an auto reader can save the patient from critical SSI.
Fulltext Artificial neural network with Taguchi method for robust classification model to improve classification accuracy of breast cancer

Rahman MA, Muniyandi RC, Albashish D, Rahman MM, Usman OL

PeerJ Comput Sci, 2021;7:e344.
PMID: 33816995 DOI: 10.7717/peerj-cs.344

Artificial neural networks (ANN) perform well in real-world classification problems. In this paper, a robust classification model using ANN was constructed to enhance the accuracy of breast cancer classification. The Taguchi method was used to determine the suitable number of neurons in a single hidden layer of the ANN. The selection of a suitable number of neurons helps to solve the overfitting problem by affecting the classification performance of an ANN. With this, a robust classification model was then built for breast cancer classification. Based on the Taguchi method results, the suitable number of neurons selected for the hidden layer in this study is 15, which was used for the training of the proposed ANN model. The developed model was benchmarked upon the Wisconsin Diagnostic Breast Cancer Dataset, popularly known as the UCI dataset. Finally, the proposed model was compared with seven other existing classification models, and it was confirmed that the model in this study had the best accuracy at breast cancer classification, at 98.8%. This confirmed that the proposed model significantly improved performance.
Fulltext Asian-Pacific consensus on small intestinal bacterial overgrowth in gastrointestinal disorders: An initiative of the Indian Neurogastroenterology and Motility Association

Ghoshal UC, Sachdeva S, Ghoshal U, Misra A, Puri AS, Pratap N, et al.

Indian J Gastroenterol, 2022 Oct;41(5):483-507.
PMID: 36214973 DOI: 10.1007/s12664-022-01292-x

In the clinical setting, small intestinal bacterial overgrowth (SIBO) is a frequent, but under-diagnosed entity. SIBO is linked to various gastrointestinal (GI) and non-GI disorders with potentially significant morbidity. The optimal management of SIBO is undefined while there is a lack of published consensus guidelines. Against this background, under the auspices of the Indian Neurogastroenterology and Motility Association (INMA), formerly known as the Indian Motility and Functional Diseases Association (IMFDA), experts from the Asian-Pacific region with extensive research and clinical experience in the field of gut dysbiosis including SIBO developed this evidence-based practice guideline for the management of SIBO utilizing a modified Delphi process based upon 37 consensus statements, involving an electronic voting process as well as face-to-face meetings and review of relevant supporting literature. These statements include 6 statements on definition and epidemiology; 11 on etiopathogenesis and pathophysiology; 5 on clinical manifestations, differential diagnosis, and predictors; and 15 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservations was 80% or higher, the statement was regarded as accepted. The members of the consensus team consider that this guideline would be valuable to inform clinical practice, teaching, and research on SIBO in the Asian-Pacific region as well as in other countries.
Fulltext Aspirin resistance in patients with acute coronary events: risk factors and prevalence as determined by whole blood multiple electrode aggregometry

Ibrahim O, Maskon O, Darinah N, Raymond AA, Rahman MM

Pak J Med Sci, 2013 Nov;29(6):1319-22.
PMID: 24550945

OBJECTIVES: To determine the prevalence of aspirin resistance and associated risk factors based on biochemical parameters using whole blood multiple electrode aggregometry.
METHODS: The study was conducted at the outpatients cardiology clinic of the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from August 2011 to February 2012. Subjects on aspirin therapy were divided into two groups; first-ever coronary event and recurrent coronary event. Aspirin resistance was measured by a Multiplate(®) platelet analyser.
RESULTS: A total of 74 patients (63 male, 11 female), with a mean age of 57.93 ± 74.1years were enrolled in the study. The patients were divided into two groups -first-ever coronary event group (n=52) and recurrent coronary event group (n=22). Aspirin resistance was observed in 12 out of 74 (16%) of the study patients, which consisted of 11 patients from the first-ever coronary event group and one patient from the recurrent coronary event group. There were significant correlations between aspirin resistance and age (r = -0.627; p = 0.029), total cholesterol (r = 0.608; p = 0.036) and LDL (r = 0.694; p = 0.012). LDL was the main predictor for area under the curve (AUC) for aspirin resistance. However, there was no association between aspirin resistance and cardiovascular events in both groups in this study.
CONCLUSIONS: Aspirin resistance was observed in 16% of the study population. LDL was the major predictor of aspirin resistance. No association was found in the study between aspirin resistance with recurrent coronary events.
KEYWORDS: Aspirin resistance; Multiplate® platelet analyser; aspirin responsiveness; first-ever coronary event; recurrent coronary event
Fulltext Assessing the link between witnessing inter-parental violence and the perpetration of intimate partner violence in Bangladesh

Islam MJ, Rahman M, Broidy L, Haque SE, Saw YM, Duc NH, et al.

BMC Public Health, 2017 02 10;17(1):183.
PMID: 28187721 DOI: 10.1186/s12889-017-4067-4

BACKGROUND: We aimed to examine the influence of witnessing father-to-mother violence on: 1) perpetration of intimate partner violence (IPV); and 2) endorsement of attitudes justifying wife beating in Bangladesh.
METHODS: This paper used data from the 2007 Bangladesh Demographic Health Survey. The analyses were based on the responses of 3374 ever-married men. Exposure to IPV was determined by men's self-reports of witnessing inter-parental violence in childhood. We used adjusted binary logistic regression models to assess the influence of exposure on husbands' perpetration of IPV and their endorsement of attitudes justifying wife beating.
RESULTS: Nearly 60% of men reported violent behaviour towards an intimate partner and 35.7% endorsed attitudes justifying spousal abuse. Men who witnessed father-to-mother violence had higher odds of reporting any physical or sexual IPV (adjusted OR [AOR] = 3.26; 95% CI = 2.61, 4.06). Men who had witnessed father-to-mother violence were also 1.34 times (95% CI = 1.08, 1.65) more likely endorse attitudes justifying spousal abuse.
CONCLUSIONS: Committing violence against an intimate partner is an all too frequent practice among men in Bangladesh. The study indicated that men who had witnessed father-to-mother violence were more likley to perpetrate IPV, suggesting an intergenerational transmission of violence. This transmission of violence may operate through the learning and modelling of attitudes favourable to spousal abuse. In support of this, witnnessing inter-parental violence was also associated with the endorsement of attitudes justifying spousal abuse. Our findings indicate the continued importance of efforts to identify and assist boys who have witnessed domestic violence and suggest such efforts should aim to change not just behaviours but also attitudes that facilitate such violence.

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