METHODS: Exosomes were isolated by ultracentrifugation and characterized using nanoparticle tracking analysis (NTA), scanning electron microscopy (SEM), and Western blot. The effect of exosomes in modulating monocyte phenotypes as well as cytokine secretion were further assessed in a co-culture condition using flow cytometry and ELISA accordingly.
RESULTS: Exosomes were identified as spherical particles with a size distribution ranging from 30 nm to 150 nm. These nanoparticles intensely expressed exosome protein markers including CD9, CD63, CD81, and HSP70. The expression of HLA-DR, CD14, and CD11b on monocytes decreased in the presence of exosomes after 24 h of incubation, regardless of the dose. Exosomes significantly induced the release of anti-inflammatory cytokines IL-1Ra in a time- and dose-dependent manner, while TNF-α secretion remains unchanged regardless of the presence or absence of exosomes.
CONCLUSION: This study highlights the immunoregulatory role of exosomes on monocytes, emphasizing the need for further studies into the underlying mechanism.
MATERIALS AND METHODS: A quasi-experimental study employing a one-group pre- and post-intervention was carried out involving 142 male firefighter recruits from a Fire and Rescue Academy in Malaysia. Various aspects of physical fitness changes, including speed, agility, and coordination (SAC), muscle strength, endurance, and power, were evaluated at baseline (Week 1) and upon completion of the first phase (Week 5). Changes in health parameters, such as blood pressure, resting heart rate, body weight, muscle mass, body fat percentage, and body mass index, were also assessed. A paired sample t-test was conducted with the significance level set at 0.05. The magnitude of changes was assessed using the following criteria: values of 0.3 were considered a small effect size, 0.5 indicated a moderate effect size, and 0.8 signified a large effect size.
RESULTS: Upon completion of the first phase of the physical training regimen, there was a statistically significant improvement in cardiorespiratory fitness, with a mean increment of VO2max was 9 mL/kg/min (95% CI: 8.33, 9.58, p<0.001, large effect size of 2.40). Both pre-and postintervention assessments of abdominal and upper body muscle strength and endurance showed statistically significant improvement with the mean difference of 11 situps (95%CI: 10.08, 12.01; p<0.001, large effect size of 1.89) and 1.5 pull-ups (95%CI: 1.07, 1.86; p<0.001, moderate effect size of 0.63), respectively. Health parameters showed similar, except for systolic BP (SBP). There was a small increment in recruits' SBP following the 4-week training period with a mean difference of 4.3 mmHg (95%CI: 2.37, 6.24; effect size = 0.37, p<0.001).
CONCLUSION: The first phase of the newly introduced fourweek physical training regimen has proven effective in enhancing cardiorespiratory fitness, as well as abdominal and upper body muscle strength and endurance. Additionally, the regimen has positively influenced several health parameters, except for systolic blood pressure. The observed increase in average systolic blood pressure indicates a necessity for continuous monitoring at the academy to address this issue effectively. confirm our findings.
RESULTS: Five repatriation missions performed was led by the National Agency for Disaster Management (NADMA) with the Ministry of Health providing technical expertise. A total of 432 citizens were repatriated from the missions. The operations were divided into four phases: the pre-boarding screening phase, the boarding and in-flight phase, the reception phase and the quarantine phase. The commercial aircraft used were from two different commercial airlines. Each mission had flight crew members between 10 and 17 people. There were 82 positive cases detected among the repatriated citizens. There was a single positive case of a healthcare worker involved in the mission, based on the sample taken on arrival of the flight. There were no infections involving flight team members.
CONCLUSION: Medical flight crew must be familiar with aircraft fittings that differ from one commercial airline to another as it influences infection control practices. A clear understanding of socio-political situation of a country, transmission routes of a pathogen, disease presentation, and knowledge of aviation procedures, aircraft engineering and design is of great importance in preparing for such missions. Our approach of multidiscipline team involvement managed to allow us to provide and execute the operations successfully.
Methods: A cross-sectional study was conducted at the haemodialysis (HD) unit of a tertiary hospital in Malaysia from January 2018 to February 2019. Dialysis-dependent ESRD patients were included and those with a recent history of ACS (within 30 days) were excluded. Pre-dialysed serum hs-cTnT levels were measured using Cobas e411. The upper limit of the 99th percentile value for troponin T was 14 ng/L.
Results: A total of 150 patients were recruited as study participants. The majority were female (62%) and of Malay ethnicity (94%), and the mean (SD) age was 45.19 (16.36) years old. The hs-cTnT range (min, max) was 11.39-738.30 ng/L and the median (interquartile range [IQR]) of hs-cTnT was 59.20 (83.41) ng/L. Elevated hs-cTnT levels were observed in 149/150 (99%) of the study participants (54/55 [98.2%] of the patients were on HD, and 95/95 [100.0%] of the patients were on continuous ambulatory peritoneal dialysis).
Conclusion: This study supports prior research showing that even without ACS, most ESRD patients have elevated concentrations of cardiac troponin. Furthermore, our study illustrates the need to revisit the use of absolute troponin values when making a diagnosis of ACS in ESRD patients.
METHODS: This prospective cohort study was conducted in the Critical Care Unit of HPUSM from September 2019 to March 2021. Eligible participants included patients with a positive blood culture recorded after 48 hours of admission to hospital.
RESULTS: There was a total of 250 patients, whose positive blood cultures were isolated. The main isolated organisms were Klebsiella pneumonia (23.6%), Pseudomonas spp. (19.2%), Escherichia coli (12.8%) and Acinetobacter sp. (9.2%). The mortality of hospital-acquired BSI was 27.6%. Multiple logistic regression analysis revealed that age [adjusted odds ratio (OR) = 1.06; 95% confidence interval (CI): 1.03, 1.09; p < 0.001], cases with extended-spectrum beta-lactamases (ESBL) (adjusted OR = 5.57; 95% CI: 2.04, 15.21; p = 0.001), with multidrug-resistant (MDR) organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p < 0.001) and those with a sequential organ failure assessment (SOFA) score > 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015) had statistically significant associations with treatment failure. Factors significantly associated with 28-day mortality included age (adjusted OR: 1.06: 95% CI; 1.03, 1.09; p < 0.001), MDR organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p < 0.001) and SOFA score > 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015).
CONCLUSION: The elderly, ESBL, MDR organisms and high SOFA scores were associated with treatment failure and 28-day mortality in hospital-acquired BSI.
METHODS: A descriptive and analytic cross sectional study design was conducted from March to September 2021, among antenatal mothers attending routine antenatal follow-ups at 17 public health clinics in Selangor, Malaysia. A validated and reliable self administered questionnaire was used to collect data on demographic characteristics, knowledge, risk perceptions, health self-efficacy, and vaccination intentions among antenatal mothers. Multiple linear regression analysis was used to identify determinants of vaccination intention among antenatal mothers.
RESULTS: The study included 796 antenatal mothers, predominantly Malay mothers (87.5%). The respondents presented a high mean vaccination intention score of 26.02 ± 2.77. Significant determinants of vaccination intention among antenatal mothers included the number of children (β = 0.156, 95% CI [0.013, 0.299], p = 0.032), knowledge score (β = 0.397, 95% CI [0.288, 0.506], p