Methods: The study analysed 54 decompensated liver cirrhotic patients including 17 females and 37 males between May 2016 and May 2017 at the Haji Adam Malik General Hospital, Medan, Indonesia. Ferritin levels were, then, divided into trichotomous cut-off value (< 200 ng/mL, n = 22; 200-400 ng/mL, n = 5; and > 400 ng/mL, n = 27). Data was analysed using SPSS version 12.0 (continuous variables were assessed by the Kruskal-Wallis test and Chi-square test was used for categorical variables). In addition, Spearman correlation test was used to determine any significant correlation between ferritin levels and CTP score.
Results: Based on data analysis, gender and CTP score were related to higher ferritin levels (P = 0.002 and P = 0.018, respectively). Furthermore, a significant correlation between serum ferritin levels and CTP score was obtained in to moderate degree (P = 0.000; r = 0.487).
Conclusions: There might be a significant role of serum ferritin levels in predicting mortality and prognosis among decompensated liver cirrhosis patients but it still needs further attention.
Methods: This is a cross-sectional study in which all the elderly patients who underwent early primary total knee replacement due to trauma around the knee at the Segamat Hospital between January 2015 and June 2019 were identified. Data were collected from clinical and operative notes. The clinical outcomes of these patients were evaluated by the range of motion of the knee and the Knee Society Score (KSS).
Results: Ten patients were identified to have undergone this procedure. Six patients sustained supracondylar femur fractures, two patients had tibial plateau fractures and two patients had concurrent supracondylar femur and tibial plateau fractures. The mean follow-up duration was 22.3 ± 13.9 months, the mean knee score was 87.7 ± 10.0 and the mean functional knee score was 56 ± 41.9.
Conclusion: In this cohort, good short-term outcomes close to pre-fracture condition was noted in patients who did not suffer from any complications during the post-operative period. Two patients who had surgical site infection had lower functional knee scores. Another two patients with lower knee scores experienced surgical site infection of the distal tibia and contralateral fixed flexion deformity of the knee. Early primary total knee replacement remains a viable option in treating fractures around the knee in the elderly. Infection, which in this study affected 20% of the patients, is the main deterring factor in performing this procedure.
Methods: The study used kaolin-induced hydrocephalic rats. Obstructive hydrocephalus was expected to develop within seven days after induction. The hydrocephalus animals were killed at day 7, 14 and 21 after induction. One group of the saline-injected animals was used for sham-treatment.
Results: We demonstrated that the hydrocephalic rats exhibited a high expression of 4-hydroxynonenal (4-HNE) in the periventricular area. The expression of β-catenin also increased, following the pattern of 4-HNE. Reactive astrocyte, expressed by positive glial fibrillary acidic protein (GFAP), was upregulated in an incremental fashion as well as the microglia.
Conclusion: This work suggests that lipid peroxidation product, 4-HNE, activated the WNT/β-catenin pathway, leading to the development of reactive astrocyte and microglia activation in hydrocephalus.
Methods: Using a pilocarpine-induced epileptic mouse model, sensory-motor and visual cortical slices were prepared, and the whole-cell patch clamp technique was used to record spontaneous inhibitory post-synaptic currents (sIPSCs).
Results: The primary finding was that the mean amplitude of sIPSC from the sensory-motor cortex increased significantly in epileptic mice when the recording pipette contained MK-801 compared to control mice, whereas the mean sIPSC frequency was not significantly different, indicating that post-synaptic mechanisms are involved. However, there was no significant pre-synaptic inhibition through preNMDARs in the acute brain slices from pilocarpine-induced epileptic mice.
Conclusion: In the acute case of epilepsy, a compensatory mechanism of post-synaptic inhibition, possibly from ambient GABA, was observed through changes in the amplitude without significant changes in the frequency of sIPSC compared to control mice. The role of preNMDAR-mediated inhibition in epileptogenesis during the chronic condition or in the juvenile stage warrants further investigation.
DESIGN: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 flow checklist. A population-exposure-outcome framework was established. Population referred to the general global population of all ages, the exposure of interest was air pollution and its projection, and the outcome was the occurrence of NCDs attributable to air pollution and burden of disease (BoD) based on the health indices of mortality, morbidity, disability-adjusted life years, years of life lost and years lived with disability.
DATA SOURCES: The Web of Science, Ovid MEDLINE and EBSCOhost databases were searched for articles published from 2005 to 2023.
ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The eligible articles were evaluated using the modified scale of a checklist for assessing the quality of ecological studies.
DATA EXTRACTION AND SYNTHESIS: Two reviewers searched, screened and selected the included studies independently using standardised methods. The risk of bias was assessed using the modified scale of a checklist for ecological studies. The results were summarised based on the projection of the BoD of NCDs attributable to air pollution.
RESULTS: This review included 11 studies from various countries. Most studies specifically investigated various air pollutants, specifically particulate matter <2.5 µm (PM2.5), nitrogen oxides and ozone. The studies used coupled-air quality and climate modelling approaches, and mainly projected health effects using the concentration-response function model. The NCDs attributable to air pollution included cardiovascular disease (CVD), respiratory disease, stroke, ischaemic heart disease, coronary heart disease and lower respiratory infections. Notably, the BoD of NCDs attributable to air pollution was projected to decrease in a scenario that promotes reduced air pollution, carbon emissions and land use and sustainable socioeconomics. Contrastingly, the BoD of NCDs was projected to increase in a scenario involving increasing population numbers, social deprivation and an ageing population.
CONCLUSION: The included studies widely reported increased premature mortality, CVD and respiratory disease attributable to PM2.5. Future NCD projection studies should consider emission and population changes in projecting the BoD of NCDs attributable to air pollution in the climate change era.
PROSPERO REGISTRATION NUMBER: CRD42023435288.
METHODS: A cross-sectional study was conducted in 2023 among 285 COMBI CHVs from 5 health operational zones in Kuala Lumpur and Putrajaya. The CHVs were stratified proportionately, with 45.5% of respondents randomly selected from each stratum based on their zones. Self-administered questionnaires assessed their performance level and associated factors, including training, supervision, knowledge, motivation, and job satisfaction. Chi-square and Multiple Logistic Regression tests were used to determine the factors and predictors of high-performance COMBI CHVs.
RESULTS: The prevalence of high-performance COMBI CHVs was 59.3%, significantly associated with training factors (experience, duration, and adequacy of training), supervision factors (being supervised, supervision frequency, and encouragement from supervision), motivation and job satisfaction level. As for significant predictors, having at least one day of training (AOR=14.557), being supervised by medical personnel (AOR=4.997), having a high motivation level (AOR=5.538) and having a high job satisfaction level (AOR=4.562) were more likely to have a high-performance level.
CONCLUSION: Training duration, supervisor background, motivation and job satisfaction can contribute to high-performance levels among COMBI CHVs, which can applied in evidence-based policies and strategies for performance improvement and more effective community healthcare delivery.