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Betta nuluhon, a new species of fighting fish from western Sabah, Malaysia (Teleostei: Osphronemidae)

Kamal NSS, Tan HH, Ng CKC

Zootaxa, 2020 Jul 22;4819(1):zootaxa.4819.1.11.
PMID: 33055678 DOI: 10.11646/zootaxa.4819.1.11

Betta nuluhon, new species, is described from a hill stream habitat in western Sabah. This species is allied to both B. chini and B. balunga, and differs from rest of its congeners in the B. akarensis group in having the following combination of characters: yellow iris when live; mature males with greenish-blue iridescence on opercle when live; mature fish with distinct transverse bars on caudal fin; slender body (body depth 22.1-25.2 % SL); belly area with faint reticulate pattern (scales posteriorly rimmed with black); absence of tiny black spots on anal fin; lateral scales 29-31 (mode 30); predorsal scales 20-21 (mode 20). Notes on a fresh series of B. chini are also provided.
Fulltext Resveratrol affects Zika virus replication in vitro

Mohd A, Zainal N, Tan KK, AbuBakar S

Sci Rep, 2019 10 04;9(1):14336.
PMID: 31586088 DOI: 10.1038/s41598-019-50674-3

Zika virus (ZIKV) infection is a serious public health concern. ZIKV infection has been associated with increased occurrences of microcephaly among newborns and incidences of Guillain-Barré syndrome among adults. No specific therapeutics or vaccines are currently available to treat and protect against ZIKV infection. Here, a plant-secreted phytoalexin, resveratrol (RES), was investigated for its ability to inhibit ZIKV replication in vitro. Several RES treatment regimens were used. The ZIKV titers of mock- and RES-treated infected cell cultures were determined using the focus-forming assay and the Zika mRNA copy number as determined using qRT-PCR. Our results suggested that RES treatment reduced ZIKV titers in a dose-dependent manner. A reduction of >90% of virus titer and ZIKV mRNA copy number was achieved when infected cells were treated with 80 µM of RES post-infection. Pre-incubation of the virus with 80 µM RES showed >30% reduction in ZIKV titers and ZIKV mRNA copy number, implying potential direct virucidal effects of RES against the virus. The RES treatment reduced >70% virus titer in the anti-adsorption assay, suggesting the possibility that RES also interferes with ZIKV binding. However, there was no significant decrease in ZIKV titer when a short-period of RES treatment was applied to cells before ZIKV infection (pre-infection) and after the virus bound to the cells (virus internalization inhibition), implying that RES acts through its continuous presence in the cell cultures after virus infection. Overall, our results suggested that RES exhibited direct virucidal activity against ZIKV and possessed anti-ZIKV replication properties, highlighting the need for further exploration of RES as a potential antiviral molecule against ZIKV infection.
Effects of beta-glucanase-producing Lactobacillus strains on growth, dry matter and crude protein digestibilities and apparent metabolisable energy in broiler chickens

Sieo CC, Abdullah N, Tan WS, Ho YW

Br Poult Sci, 2005 Jun;46(3):333-9.
PMID: 16050187

The effects of beta-glucanase expressed by transformed Lactobacillus strains on growth performance, apparent digestibilities of dry matter and crude protein, and apparent metabolisable energy were studied. Two hundred and forty 1-d-old chicks (Avian-43) were randomly divided into three dietary treatment groups and fed with the following diets: (i) basal diet (control) (BD); (ii) basal diet with parental Lactobacillus strains (BDP) and (iii) basal diet with transformed Lactobacillus strains (BDT). At 21 d of age, the body weight, body weight gain and feed conversion ratio of the BDT-fed chickens were significantly improved. At 14 and 21 d of age, the proportions of dry matter in the duodenum, jejunum, ileum, caeca and excreta of chickens given the BDT diet were significantly higher than those of chickens given the BD and BDP diets. Apparent metabolisable energy, digestibilities of crude protein and dry matter were also significantly improved (by 3.5, 5.6 and 3.5%, respectively) by the BDT diet. These results showed that the transformed Lactobacillus strains improved digestibility as well as enhanced the growth performance of chickens.
Employability in people with epilepsy: A systematic review

Wo MC, Lim KS, Choo WY, Tan CT

Epilepsy Res, 2015 Oct;116:67-78.
PMID: 26354169 DOI: 10.1016/j.eplepsyres.2015.06.016

People with epilepsy were (PWE) reported to have poorer employment rate. However, the methodologies used differ greatly from one study to another, making global comparison difficult. We aimed to determine the employment rate of PWE globally using a unified definition of employment rate and to summarize the reported positive and negative factors affecting employability in PWE, using a systematic review.
De-novo mutations and genetic variation in the SCN1A gene in Malaysian patients with generalized epilepsy with febrile seizures plus (GEFS+)

Tan EH, Razak SA, Abdullah JM, Mohamed Yusoff AA

Epilepsy Res, 2012 Dec;102(3):210-5.
PMID: 22944210 DOI: 10.1016/j.eplepsyres.2012.08.004

Generalized epilepsy with febrile seizures plus (GEFS+) comprises a group of clinically and genetically heterogeneous epilepsy syndrome. Here, we provide the first report of clinical presentation and mutational analysis of SCN1A gene in 36 Malaysian GEFS+ patients. Mutational analysis of SCN1A gene revealed twenty seven sequence variants (missense mutation and silent polymorphism also intronic polymorphism), as well as 2 novel de-novo mutations were found in our patients at coding regions, c.5197A>G (N1733D) and c.4748A>G (H1583R). Our findings provide potential genetic insights into the pathogenesis of GEFS+ in Malaysian populations concerning the SCN1A gene mutations.
Factors affecting the employability in people with epilepsy

Wo MC, Lim KS, Choo WY, Tan CT

Epilepsy Res, 2016 Dec;128:6-11.
PMID: 27792885 DOI: 10.1016/j.eplepsyres.2016.10.003

PURPOSE: People with epilepsy (PWE) are negatively prejudiced in their ability to work. This study aimed to examine demographic, clinical and psychological factors associated with employability in PWE.

METHODS: This study recruited epilepsy patients from a neurology clinic in Malaysia. Employability was measured using employment ratio, with a ratio ≥90% (ER90) classified as high employability. Basic demographic data such as age, gender, marital status, religion, education level and household income was collected. Clinical measures consisted of age of seizure onset, seizure frequency, type of epilepsy, aura, polytherapy, nocturnal seizures and seizure control. Psychological measures included Work Self-Determination Index (WSDI), Rosenberg Self-Esteem Scale (SES), and Multidimensional Scale of Perceived Social Support (MSPSS).

RESULTS: Of 146 PWE, 64.4% had high employability. The participants were predominantly female (52%), Chinese (50.7%), single (50%), having tertiary education (55.5%) and focal epilepsy (72.6%). Clinically, only type of epilepsy was significantly correlated to employability of PWE. Employability of PWE was associated with ability to work (indicated by education level, work performance affected by seizures, ability to travel independently and ability to cope with stress at work) and family overprotection. The high employability group was found to have lower self-perceived stigma (ESS), higher self-determined motivation (WSDI), self-esteem (SES) and perceived social support (MSPSS), than the low employability group. Logistic regression analysis showed that tertiary education level (AOR 3.42, CI: 1.46-8.00), higher self-determination (WSDI, AOR 1.09, CI: 1.012-1.17), lower family overprotection (AOR 0.76, CI: 0.61-0.95), and generalised epilepsy (AOR 4.17, CI: 1.37-12.70) were significant predictors for higher employability in PWE.

CONCLUSION: Ability to work (education level), clinical factor (type of epilepsy) and psychological factor (self-determined motivation and family overprotection) were important factors affecting employability in PWE.

Study site: neurology clinic Universiti Malaya Medical Centre (UMMC)
An Application of pET SUMO Protein Expression System in Escherichia coli: Cloning, Expression, Purification, and Characterisation of Native Kras4BG12V Oncoprotein

Tan MS, Teh YH, Ho KL, Stanslas J

Protein J, 2020 02;39(1):54-61.
PMID: 31620959 DOI: 10.1007/s10930-019-09872-1

Being an important regulator of cell growth and survival, a point mutation at glycine-12 residue of Kras4B to valine (V), renders Kras4BG12V oncogenic. Kras4B recombinant protein is used as a bait to fish its potential ligands in the attempt of drugging this oncoprotein and to validate its pharmacologically relevant ligand in protein-ligand interaction studies. Nevertheless, synthesis of Kras4B recombinant protein is challenging as it was reported being susceptible to aggregation into inclusion bodies in the bacterial host, resulting in a poor yield of recombinant protein. Here, we describe a novel method to produce native Kras4BG12V protein by using pET SUMO protein expression system as a solution to the formation of inclusion bodies. Kras4BG12V oncogene was cloned into pET SUMO vector, followed by a 12 h chemically induced protein expression in Escherichia coli at 20 °C. Native Kras4BG12V protein was produced in a series of protein purification steps involving immobilised nickel ion-affinity column chromatography, SUMO fusion protein and polyhistidine tag removal, and size exclusion column chromatography. The identity of the purified Kras4BG12V protein was validated by immunoblot analysis. The purified protein exhibited self-dimerising, indicating that the purified protein structurally resembles Kras4B. Its physical interaction with 4,6-dichloro-2-methyl-3-aminoethyl-indole (DCAI), a known binder of Kras4B, confirms the identity of the purified protein as Kras4BG12V. The native Kras4BG12V protein was successfully purified in a substantial amount by using the pET SUMO protein expression system.
Fulltext Percutaneous pedicle screw for unstable spine fractures in polytraumatized patients: A report of two cases

Tan BB, Chan CY, Saw LB, Kwan MK

Indian J Orthop, 2012 Nov;46(6):710-3.
PMID: 23325978 DOI: 10.4103/0019-5413.104235

Unstable spine fractures commonly occur in the setting of a polytraumatized patient. The aim of management is to balance the need for early operative stabilization and prevent additional trauma due to the surgery. Recent published literature has demonstrated the benefits of early stabilization of an unstable spine fracture particularly in patients with higher injury severity score (ISS). We report two cases of polytrauma with unstable spine fractures stabilized with a minimally invasive percutaneous pedicle screw instrumentation system as a form of damage control surgery. The patients had good recovery from the polytrauma injuries. These two cases illustrate the role of minimally invasive stabilization, its limitations and technical pitfalls in the management of unstable spine fractures in the polytrauma setting as a form of damage control surgery.
Collision tumor of the ovary: Fibroma and mature cystic teratoma

Tan GC, Chandramaya SF, Noordin A, S Tay PY

Indian J Pathol Microbiol, 2021 1 13;64(1):171-173.
PMID: 33433434 DOI: 10.4103/IJPM.IJPM_670_19

Collision tumor consists of two tumors occurring in the same organ without intermixture of the two cell types. The most common type of collision tumor in ovary is between teratoma and surface epithelial tumor. A 38-year-old woman presented with complained of lower abdominal pain and tightness, and a solid partially cystic left ovarian mass with minimal ascites was detected. Left salpingo-oophorectomy was performed. The ovarian mass measured 15 × 12 × 7 cm with a pedunculated mass on its surface which measured 6 × 2.5 × 2.5 cm. Histologically, it was a collision tumor of fibroma and mature cystic teratoma. Fibroma becomes more edematous as their size increases, which is frequently accompanied by the escape of increasing quantities of fluid from the tumor surfaces. Ascites is often detected when the fibroma is more than a diameter of 10 cm. It is important to identify the different components of a collision tumor for proper management.
pink1, atp13a2 and uchl1 expressions are affected by inflammation in the brain

Moriya S, Tan VP, Yee AK, Parhar IS

Neurosci Lett, 2019 08 24;708:134330.
PMID: 31201839 DOI: 10.1016/j.neulet.2019.134330

In Parkinson's disease (PD), several genes have been identified as the PD-related genes, however, the regulatory mechanisms of these gene expressions have not been fully identified. In this study, we investigated the effect of inflammation, one of the major risk factors in PD on expressions of the PD-related genes. Lipopolysaccharide (LPS) was intraperitoneally administered to mature male zebrafish and gene expressions in the brains were examined by real-time PCR. In the inflammation-related genes, expressions of tnfb, il1b and il6 were increased at 2 days post administration in the 10 μg group, and tnfb expression was also increased at 4 days post administration in the 1 μg and 10 μg group. In the PD-related genes, pink1 expression was significantly decreased at 4 days, atp13a2 expression was significantly increased at 7 days, and uchl1 expression was significantly decreased at 7 days. This suggests that pink1, atp13a2 and uchl1 expressions are regulated by inflammation, and this regulatory mechanism might be involved in the progress of PD.
Amblyomma cordiferum Neumann, 1899 (Acari: Ixodidae) parasitizing reticulated pythons, Malayopython reticulatus (Schneider, 1801) (Reptilia: Pythonidae) in Peninsular Malaysia

Tan LP, Choong SS, Samsuddin AS, Lee SH

Ticks Tick Borne Dis, 2019 10;10(6):101285.
PMID: 31494069 DOI: 10.1016/j.ttbdis.2019.101285

Two ticks were collected from a reticulated python (Malayopython reticulatus) caught in Tumpat District, Kelantan, Peninsular Malaysia. The ticks were first identified as Ambylomma sp. through morphological comparison with identification keys. Determination of the tick species was made through PCR and sequencing. However, BLAST analysis revealed 85-88% sequence nucleotide identity with Amblyomma nitidum and Amblyomma geoemydae. Additionally, the morphological features of the ticks collected in this study did not match either A. nitidum or A. geoemydae. Further examination of the ticks confirmed the species as Amblyomma cordiferum. This is the first record of A. cordiferum DNA sequence with morphological support of colour illustrations for adult A. cordiferum. This is also the most recent record of this host association in Peninsular Malaysia. Information from this report can serve as a reference for species identification using the described morphology or molecular sequences.
Fulltext Obesity and unhealthy lifestyle associated with poor executive function among Malaysian adolescents

Tee JYH, Gan WY, Tan KA, Chin YS

PLoS One, 2018;13(4):e0195934.
PMID: 29664932 DOI: 10.1371/journal.pone.0195934

The understanding on the roles of obesity and lifestyle behaviors in predicting executive function of adolescents has been limited. Low executive function proficiency may have adverse effects on adolescents' school academic performance. This cross-sectional study aimed to examine the relationship between BMI-for-age and multiple lifestyle behaviors (operationalized as meal consumption, physical activity, and sleep quality) with executive function (operationalized as inhibition, working memory, and cognitive flexibility) on a sample of Malaysian adolescents aged between 12 and 16 years (N = 513). Participants were recruited from two randomly selected schools in the state of Selangor in Malaysia. Using a self-administered questionnaire, parent participants provided information concerning their sociodemographic data, whereas adolescent participants provided information regarding their meal consumptions, physical activity, and sleep quality. The modified Harvard step test was used to assess adolescents' aerobic fitness, while Stroop color-word, digit span, and trail-making tests were used to assess adolescents' inhibition, working memory, and cognitive flexibility, respectively. Three separate hierarchical regression analyses were conducted for each outcome namely, inhibition, working memory, and cognitive flexibility. After adjusted for sociodemographic factors and BMI-for-age, differential predictors of inhibition and working memory were found. Habitual sleep efficiency significantly and positively predicted inhibition. Regular dinner intakes, physical activity levels, and sleep quality significantly and positively predicted working memory. Household income emerged as a consistent predictor for all executive function domains. In conclusion, an increased trend of obesity and unhealthy lifestyles among adolescents were found to be associated with poorer executive function. Regular dinner intakes, higher physical activity levels and better sleep quality predicted better executive function despite the inverse relationship between obesity and executive function. Future studies may explore how lifestyle modifications can optimize the development of executive function in adolescents as well as relieve the burden of obesity.
Automated beat-wise arrhythmia diagnosis using modified U-net on extended electrocardiographic recordings with heterogeneous arrhythmia types

Oh SL, Ng EYK, Tan RS, Acharya UR

Comput Biol Med, 2019 Feb;105:92-101.
PMID: 30599317 DOI: 10.1016/j.compbiomed.2018.12.012

Abnormality of the cardiac conduction system can induce arrhythmia - abnormal heart rhythm - that can frequently lead to other cardiac diseases and complications, and are sometimes life-threatening. These conduction system perturbations can manifest as morphological changes on the surface electrocardiographic (ECG) signal. Assessment of these morphological changes can be challenging and time-consuming, as ECG signal features are often low in amplitude and subtle. The main aim of this study is to develop an automated computer aided diagnostic (CAD) system that can expedite the process of arrhythmia diagnosis, as an aid to clinicians to provide appropriate and timely intervention to patients. We propose an autoencoder of ECG signals that can diagnose normal sinus beats, atrial premature beats (APB), premature ventricular contractions (PVC), left bundle branch block (LBBB) and right bundle branch block (RBBB). Apart from the first, the rest are morphological beat-to-beat elements that characterize and constitute complex arrhythmia. The novelty of this work lies in how we modified the U-net model to perform beat-wise analysis on heterogeneously segmented ECGs of variable lengths derived from the MIT-BIH arrhythmia database. The proposed system has demonstrated self-learning ability in generating class activations maps, and these generated maps faithfully reflect the cardiac conditions in each ECG cardiac cycle. It has attained a high classification accuracy of 97.32% in diagnosing cardiac conditions, and 99.3% for R peak detection using a ten-fold cross validation strategy. Our developed model can help physicians to screen ECG accurately, potentially resulting in timely intervention of patients with arrhythmia.
Diagnostic Value of the EZH2 Immunomarker in Malignant Effusion Cytology

Ang PP, Tan GC, Karim N, Wong YP

Acta Cytol., 2020;64(3):248-255.
PMID: 31352449 DOI: 10.1159/000501406

BACKGROUND: Differentiating reactive mesothelial cells from metastatic carcinoma in effusion cytology is a challenging task. The application of at least 4 monoclonal antibodies including 2 epithelial markers (Ber-EP4, MOC-31, CEA, or B72.3) and 2 mesothelial markers (calretinin, WT-1, CK5/6, or HBME-1) are often useful in this distinction; however, it is not readily available in many resource-limited developing countries. Aberrant immunoexpression of enhancer of zeste homolog 2 (EZH2), a transcriptional repressor involved in cancer progression, is observed widely in various malignancy. In this study, we evaluate the diagnostic value of EZH2 as a single reliable immunomarker for malignancy in effusion samples.
METHODS: A total of 108 pleural, peritoneal, and pericardial effusions/washings diagnosed as unequivocally reactive (n = 41) and metastatic carcinoma (n = 67) by cytomorphology over 18 months were reviewed. Among the metastatic carcinoma cases, 54 were adenocarcinoma and others were squamous cell carcinoma (n = 1), carcinosarcoma (n = 1), and carcinoma of undefined histological subtypes (n = 11). Cell block sections were immunostained by EZH2 (Cell Marque, USA). The percentages of EZH2-immunolabeled cells over the total cells of interest were calculated. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off score to define EZH2 immunopositivity.
RESULTS: A threshold of 8% EZH2-immunolabeled cells allows distinction between malignant and reactive mesothelial cells, with 95.5% sensitivity, 100% specificity, 100% positive predictive value, and 93.2% negative predictive value (p < 0.0001). The area under the curve was 0.988.
CONCLUSION: EZH2 is a promising diagnostic biomarker for malignancy in effusion cytology which is inexpensive yet trustworthy and could potentially be used routinely in countries under considerable economic constraints.
Soy husk extract improves physical and biochemical parameters of obese-diabetic rats through the regulation of PPARγ expression

Tan ST, Ismail A, Hamid M, Chong PP, Sun J

J Food Biochem, 2019 05;43(5):e12843.
PMID: 31353513 DOI: 10.1111/jfbc.12843

Unhealthy eating habits and lack of physical activities are among the contributing factors for obesity and diabetes. It has been reported that consumption of naturally occurring phenolics could exert beneficial effects toward these diseases. Therefore, this study aims to evaluate the ability of phenolic-rich soy husk powder extract (SHPE) in modifying the physical and biochemical parameters for obesity and diabetes. Forty-nine Sprague Dawley rats were divided into seven groups, including three supplementary/treatment groups. Rats in supplementary/treatment groups were provided with either 4 mg/kg BW Rosiglitazone Maleate, 250 mg SHPE/kg BW, or 500 mg SHPE/kg BW. The effectiveness of SHPE in alleviating obesity-diabetes was evaluated by measuring body weight (physical parameter), blood glucose metabolisms (biochemical parameters), and PPARγ expression. Findings in the present study revealed that short-term SHPE and Rosiglitazone Maleate administration improved the physical and biochemical parameters of obese-diabetic rats. In addition, SHPE was also demonstrated to upregulate PPARγ expression in adipocytes. These findings suggest that soy husk could emerge as a potential hypoglycemic and anti-adipogenic nutraceutical in future. PRACTICAL APPLICATIONS: This was the first study to evaluate the potential effects of soy husk against the parameters of obese-diabetes in rats. In addition, promising effects derived from this study might explore the possibility of soy husk to be utilized as an antidiabetes nutraceutical.
Fulltext Swallow syncope: a case report and review of literature

Siew KSW, Tan MP, Hilmi IN, Loch A

BMC Cardiovasc Disord, 2019 08 07;19(1):191.
PMID: 31391000 DOI: 10.1186/s12872-019-1174-4

BACKGROUND: Swallow or deglutition syncope is an unusual type of neurally-mediated syncope associated with life-threatening bradyarrhythmia and hypotension. It is a difficult condition to diagnose with commonly delayed diagnosis and management. There is lack of review articles that elucidate the basic demographics, clinical characteristics and management of this rare condition. This publication systematically reviews the 101 case reports published since 1793 on swallow syncope.
CASE PRESENTATION: A 59-year-old man presented with the complaint of recurrent dizziness associated with meals. A 24-h ambulatory ECG recording confirmed an episode of p-wave asystole at the time of food intake. Oesophagogastroduodenoscopy with balloon inflation in the mid to lower oesophagus resulted in a 5.6 s sinus pause. The patient's symptoms resolved completely following insertion of a permanent dual chamber pacemaker.
CONCLUSIONS: Swallow syncope is extremely rare, but still needs to be considered during diagnostic workup. It is commonly associated with gastro-intestinal disease. Permanent pacemaker implantation is the first line treatment.
Transcriptomic data of mature oil palm basal trunk tissue infected with Ganoderma boninense

Othman NQ, Sulaiman S, Lee YP, Tan JS

Data Brief, 2019 Aug;25:104288.
PMID: 31453289 DOI: 10.1016/j.dib.2019.104288

To date, Ganoderma boninense is known to be the causal agent of basal stem rot (BSR) disease in oil palm (Elaeis guineensis). This disease causes rotting in the roots, basal and upper stem of oil palm. Infection causes progressive destruction of the basal tissues at the oil palm trunk and internal dry rotting, particularly at the intersection between the bole and trunk. Molecular responses of oil palm during infection are not well study although this information is crucial to strategize effective measures to control or eliminate BSR. Here we report three sets of transcriptome data from samples of near-rot section of basal stem tissue of oil palm tree infected with G. boninense (IPIT), healthy section of basal stem tissue of the same G. boninense infected palm (IPHT) and the healthy section of basal stem tissue of the healthy palm (HPHT). The raw reads were deposited into NCBI database and can be accessed via BioProject accession number PRJNA530030.
Fulltext Thermal inactivation of lipoxygenase in soya bean using superheated steam to produce low beany flavour soya milk

Chong WK, Mah SY, Easa AM, Tan TC

J Food Sci Technol, 2019 Sep;56(9):4371-4379.
PMID: 31478006 DOI: 10.1007/s13197-019-03905-4

Time and temperature parameters of superheated steam (SHS) treatment were optimised using response surface methodology (RSM) for specific lipoxygenase (LOX) activity in soya beans and crude protein content in soya milk. The optimal SHS treatment was obtained at 9.3 min and 119 °C. The predicted values of specific LOX activity and crude protein content by RSM were 0.0098 μmol/(min mg protein) and 3.2%, respectively. These values were experimentally verified to be 0.0081 ± 0.0002 μmol/(min mg protein) and 3.0 ± 0.1%, respectively. Sensory evaluation showed that the beany flavour of soya milk produced from SHS treated soya beans was significantly weaker (P
Gardnerella vaginalis in perinatology: An overview of the clinicopathological correlation

Wong YP, Tan GC, Wong KK, Anushia S, Cheah FC

Malays J Pathol, 2018 Dec;40(3):267-286.
PMID: 30580358

Gardnerella vaginalis (GV) is a facultatively anaerobic gram-variable bacillus and is the major organism involved in bacterial vaginosis. GV-associated bacterial vaginosis has been associated with adverse pregnancy outcomes include preterm parturition and subclinical chorioamnionitis. Inflammatory response induced by GV presents paediatric problems as well. Studies had shown that increased levels of proinflammatory cytokines include TNF-α, IL-1β and IL-6 following fetal inflammatory response syndrome secondary to GV-induced intrauterine infection may result in the development of periventricular leukomalacia and bronchopulmonary dysplasia in the infected fetus. There is increasing evidence that GV-associated BV infection serves as a risk factor for long-term neurological complications, such as cerebral palsy and learning disability. GV is fastidious and could elude conventional detection methods such as bacterial cultures. With current more sophisticated molecular biology detection methods, its role and pathogenic effects have been shown to have a greater impact on intrauterine inflammation and fetal/neonatal infection. This review gives an overview on the characteristics of GV and its virulence properties. Its detrimental role in causing unfavourable GV-related perinatal outcomes, with emphasis on the possible mechanistic pathways is discussed. The discovery of disease mechanisms allows the building of a strong platform where further research on innovative therapies can be based on, for instance, an anti-TLR monoclonal antibody as therapeutic agent to halt inflammation-precipitate adverse perinatal outcomes.
Fulltext Partially Reversible Acute Renal Cortical Necrosis Secondary to Hyperhomocysteinemia - A Case Report and Literature Review

Tan W, Abd Ghani F, Seong Lim CT

Indian J Nephrol, 2019 8 20;29(4):288-290.
PMID: 31423065 DOI: 10.4103/ijn.IJN_153_18

Acute renal cortical necrosis (ACN) is a potentially fatal renal condition. Our objective is to report a case of ACN in a young man who had developed premature atherosclerotic vascular disease and required intermittent hemodialysis support. His renal biopsy showed diffuse cortical necrosis. Subsequently, 2 weeks after the renal insult, he developed a cardioembolic stroke and was anticoagulated with low-molecular-weight heparin. Thrombophilia screen revealed elevated serum homocystein and he was treated with folate supplement and vitamin B12 injection. With these treatments, he had partial renal recovery and became dialysis independent. In conclusion, this is a rare case of ACN, which may have occurred as a complication of hyperhomocysteinemia.

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