The aim of this study was to determine the prevalence of sickness absenteeism among the three types of agencies, government, semi-government (boards) and private (public) companies. The methodology involved eliciting retrospective data on medical leave over the year 1990 by requesting the agencies to fill up a questionnaire (Appendix I), and calculating the indices of absenteeism from this data. The results show that the private agencies scored higher for all the indices but only the "lost time" percentage was significantly increased. Females also had significantly higher severity of sickness absenteeism rates in all the agencies. Overtime work was associated with higher absenteeism indices, markedly noted in the private agencies. In conclusion, agencies showed work out their own indices of absenteeism so that it could be compared with national rates.
Clear cell renal cell carcinoma (ccRCC) is very common and accounts for most kidney cancer deaths. While many studies are being conducted in finding the prognostic signatures of ccRCC, we believe that ferroptosis, which involves programmed cell death dependent on iron accumulation, has therapeutic potential in ccRCC. Recent research has shown that long noncoding RNAs (lncRNAs) are involved in ferroptosis-related tumour processes and are closely related to survival in patients with ccRCC. Hence, in this study we aim to further explore the role of ferroptosis-related lncRNAs (FRLs) in ccRCC, hoping to establish a signature to predict the survival outcome of ccRCC. We analysed transcriptome data from The Cancer Genome Atlas database (TCGA) and ferroptosis-related genes (FRGs) from FerrDb to identify FRLs using Pearson's correlation. Lasso Cox regression analysis and multivariate Cox proportional hazards models screened seventeen optimal FRLs for developing prognostic signatures. Kaplan-Meier survival curves and ROC curves were then plotted for validating the sensitivity, specificity, and accuracy of the identified signatures. Gene Set Enrichment Analysis and CIBERSORT algorithm were deployed to explore the role of these FRLs in the tumour microenvironment. It was concluded that these models demonstrate excellent performance in predicting prognosis among patients with ccRCC, also indicating association with the clinicopathologic parameters such as tumour grade, tumour stage and tumour immune infiltration. In conclusion, our findings provide novel insights into ferroptosis-related lncRNAs in ccRCC, which are important targets for investigating the tumorigenesis of ccRCC.
The results of this study indicate that the important viral agents associated with lower respiratory tract infections in young children are respiratory syncytial virus, rhinovirus, and parainfluenza virus, particularly in those under 2 years of age. This is in close agreement with studies done in temperate climates. Influenza A virus is seasonal and plays an important role in upper respiratory tract infections in older children.
Study site: Inpatients and outpatients, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Paired sera from 101 Malaysian children aged up to 10 years and suffering from respiratory illnesses were examined serologically for evidence of respiratory viral infections. Of these children, 32.6% showed rising antibody titres for one or more of the test agents. Respiratory syncytial virus appeared to be the main respiratory pathogen involved, followed by Mycoplasma pneumoniae, parainfluenza viruses, adenoviruses, and influenza A virus. These findings are generally similar to those reported by others in temperate and tropical countries.
Visual loss following secondary retinitis pigmentosa (RP) is a rare complication of cytotoxic chemotherapy. Few cases of docetaxel- and/or platinum-induced retinal toxicity have been reported. Routine ocular examination of patients undergoing chemotherapy is required for early recognition and intervention of ocular toxicity. A 72- year-old female undergoing docetaxel and carboplatin combination chemotherapy for the past 3 months presented with complaints of defective vision in both eyes for 2 months. Fundus examination revealed a waxy pale disc in both eyes, arteriolar attenuation, and peripheral bony spicules, suggesting secondary retinitis pigmentosa. Optical Coherence Tomography (OCT) of the macula revealed macular dystrophy. The Humphrey Visual Field (HVF) showed field defects. Despite the reduction in chemotherapy dosage, no improvement was observed during the threeweek follow-up period.
Tamoxifen, an oral medication that blocks estrogen activity, is frequently prescribed for the treatment of advanced breast cancer and as an additional therapy following surgical removal of early stage disease. A 45-year-old female with a history of breast carcinoma treated with tamoxifen presented with sudden onset bilateral visual impairment for 4 days. On ocular examination, the patient exhibited optic disc edema with hyperemia and bilateral anterior pathway defects in visual evoked potentials. Magnetic resonance imaging revealed a thickened right optic nerve sheath with patchy enhancement of the left optic nerve sheath. The patient was diagnosed with bilateral optic neuritis and treated with intravenous methylprednisolone, which resulted in significant improvement in visual acuity and resolution of optic disc edema. This case underscores the importance of vigilant ophthalmological monitoring in patients undergoing tamoxifen therapy to facilitate the early detection and management of ocular complications.
118 cases of cervical dysplasia were followed up by cytological smears for over 9 years to determine their biologic outcome. All grades of dysplasia showed evidence of regression and progression to more severe lesions, including carcinoma. Severe dysplasia however did not regress to normalcy and had the maximum conversion rates to malignancy. The period taken for transition to malignancy was found to be shorter than that generally described. Since even mild dysplasia carries with it a malignant potential, all patients with cervical dysplasia, irrespective of the grade, have to be followed up by repeated clinical and cytological examinations.
Introduction: Second generation functionalized nanocrystal is the advancement of nanocrystal technology with great potential to accommodate BCS (Biopharmaceutical Classification System) class II drugs to meet their formulation and drug delivery challenges. Gliclazide is a BCS class II drug used in the treatment of type 2 diabetes, shows poor water solubility and low rate of dissolution, leads to poor and variable oral bioavailability. The second generation poly(D,L-lactide-co-glycolide) (PLGA) Hydroxypropyl methylcellulose (HPMC) based functionalized nanocrystals of gliclazide were prepared by a combination method of emulsion diffusion-high pressure homogenization-solvent evaporation. Methods: Gliclazide second generation nanocrystals were fabricated with taguchi orthogonal experimental design in combination of step up and top down nanoformulation strategies using drug-polymer (PLGA) ratio at 1:0.5, 1:0.75, 1:1 with HPMC(0.5, 0.75, 1% w/v) as stabilizer. The formulated gliclazide PLGA-HPMC nanocrystals were investigated on particle size, polydispersity index, zeta potential, solubility study, drug entrapment efficiency, in vitro drug release, and surface morphology and compatibility studies. The gliclazide PLGA nanocrystals formulation was prepared with Drug : PLGA at 1: 1 ratio with concentrations 0.75% w/v HPMC at 5 homogenization cycles with 1000bar produce optimized gliclazide nanocrystals. Results: The optimized MSGNC8 formulation
showed particle size of 239.9 nm, entrapment efficiency 98.62%, and drug release of 43.75%, 82.12% and 98.08% at 3hrs, 24hrs, and 48hrs compared to pure gliclazide % drug release of 28.73%, 67.51% and 78.41% at 3hrs, 24hrs, 48hrs respectively. The solubility study of optimized formulation shows eight folds increased in saturation solubility compared to pure drug. Scanning electron microscopy (SEM) analysis of the gliclazide nanocrystals revealed that
gliclazide retained its crystal morphology in polymeric nanocrystals. Further, fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) studies on gliclazide PLGA-HPMC nanocrystals emphasize drug and excipient compatibility in development of gliclazide nanocrystals. Conclusion: The potential outcomes of research findings emphasize that the developed gliclazide second-generation nanocrystals, which resulted in increase in drug solubility and rate of dissolution with delayed modified release, can be explored in delivery of gliclazide for type 2 diabetes management.
The effect of selected high pressure processing (HPP) parameters on the sensory attributes and
shelf life of jackfruit bulb packed using vacuum skin (VS) and vacuum nylon (VN) packaging
was studied. The samples were stored at chilled temperature (4°C) for shelf life study. HPP
significantly (p < 0.05) increased the shelf life of VS- and VP-packed jackfruit bulbs to 60 d
during chilled storage. In terms of colour stability during storage, both VS- and VP-packed
HP-treated jackfruit bulbs exhibited no significant differences (p > 0.05) in L*, a*, and b*
values. Also, the VS- and VP-packed HP-treated samples exhibited no significant differences
(p > 0.05) in terms of texture. However, the sensory evaluation carried out among 48 panellists
showed that there were significant differences (p < 0.05) between the untreated and HP-treated jackfruit bulbs. The aforementioned results had proven that HPP treatment of 500 MPa for
5 min could successfully extend the shelf life and retain the physicochemical properties of
jackfruit bulbs, regardless of the types of packaging used.
The use of herbal preparations remained the main approach of folk medicine to the treatment of ailments and debilitating diseases. Initial intensive researches conducted on Lemongrass extracts (tea) may have showed conflicting evidences, however the resurgence in claims of folk medicine practitioners necessitated further inquiry into the efficacy of the tea. Lemongrass tea contains several biocompounds in its decoction, infusion and essential oil extracts. Anti-oxidant, anti-inflammatory, anti-bacterial, anti-obesity, antinociceptive, anxiolytic and antihypertensive evidences of lemongrass tea were clearly elucidated to support initial pharmacological claims. Lemongrass tea was non-toxic, non-mutagenic and receives wide acceptance among alternative medicine practitioners in several developing countries. This review therefore presents previous research activities, technologies and information surrounding bioactivities of lemongrass tea. Areas of future researches which may elucidate mechanisms of the biological properties of lemongrass extracts were highlighted.
Foreign workers in Malaysia are screened for certain infectious diseases prior to their entry to the country but some escape medical screening and others acquire infection during their stay in the country. The Faculty of Medicine, University of Malaya was commissioned to study the impact of foreign labour on the local health system and, as part of the investigations, 584 foreign workers attending local outpatient clinics were examined for serological evidence of syphilis, HIV infection, viral hepatitis B, C and E, as well as for enteric infections by Salmonella, Shigella and Vibrio cholerae. The results showed that apart from viral hepatitis E, the prevalence rates of the infections looked for were not notably higher than those for the general Malaysian population. The seroprevalence rates obtained were 2.6% for syphilis, 0.2% HIV infection, 3.8% viral hepatitis B, 1.0% viral hepatitis C, 14.4% viral hepatitis E. The detection of HEV IgM in 7.7% of the workers screened indicates that these infections could have been acquired during their stay in Malaysia.
During the study period, a total of 241 foreign workers were examined. The countries represented were Indonesia (103), Bangladesh (133), Myanmar (I), Pakistan (3) and others (1). The specimens collected were blood (238) and stool samples (173). The tests conducted on blood samples were for syphilis by RPR and TPHA, HIV, Hepatitis B, and from stool samples, enteric pathogens such as Salirzoirella spp, Shigelln spp. and Vibrio clrolerne. Table I shows the type of tests performed on the various nationalities and Table 2 the results of testing. Of the 230 blood samples tested by RPWPHA, five were positive, one from Indonesia (1.09%) and four from Bangladesh (3.79%). There was only one sample of blood out of 238 tested which was HIV positive (0.42%) and this was in an Indonesian. Twenty three workers were found to be Hepatitis B antigen positive (9.66%), 10 out of 102 (9.80%) from Indonesia and 13 out of 131 from Bangladesh (9.92%). As for the entric bacterial pathogens, only six out of 173 stool samples tested were positive, five for Saliizoilella Spp. and one for Slligdla sp. Of the five positives for Salmonella, one was from Indonesia and four from Bangladesh. The single isolate of Shigella was from Pakistan. From this pretiniinary study, it is obvious that hepatitis B is the most important problem among the workers from Indonesia and Bangladesh. The second of importance is venereal disease and enteric bacteria among Bangladesh workers. The other three national groups are too small to be analyzed. It is interesting to note that although these workers are supposed to have been screened for venereal diseases, a number of them were still found to be positive. However, we are not certain that these might not have been acquired locally. There was only one case of HIV detected but if the foreign workers continue with their pronliscuous lifestyle they are likely to pick up other sexually transmitted diseases including HIV and chlamydia1 infections. For those who were found to be stool positive for enteric pathogens, it is important to determine whether they are food-handlers as they will prove a significant risk for the spread of infections. Originally, it was intended to test blood samples for hepatitis C and E markers since the incidence in foreign countries from which the workers come are higher. However, due to the shortage of the samples, this had to be deferred. In the light that hepatitis carriage rate is the highest for the microbes tested, it is important to include these two markers in future studies.
Interleukin-6 (IL-6) signaling network has been implicated in oncogenic transformations making it attractive target for the discovery of novel cancer therapeutics. In this study, potent antiproliferative and apoptotic effect of diacerein were observed against breast cancer. In vitro apoptosis was induced by this drug in breast cancer cells as verified by increased sub-G1 population, LIVE/DEAD assay, cell cytotoxicity and presence of terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)-positive cells, as well as downregulation of antiapoptotic proteins Bcl-2 and Bcl-xL and upregulation of apoptotic protein Bax. In addition, apoptosis induction was found to be caspase dependent. Further molecular investigations indicated that diacerein instigated apoptosis was associated with inhibition of IL-6/IL-6R autocrine signaling axis. Suppression of STAT3, MAPK and Akt pathways were also observed as a consequence of diacerein-mediated upstream inhibition of IL-6/IL-6R. Fluorescence study and western blot analysis revealed cytosolic accumulation of STAT3 in diacerein-treated cells. The docking study showed diacerein/IL-6R interaction that was further validated by competitive binding assay and isothermal titration calorimetry. Most interestingly, it was found that diacerein considerably suppressed tumor growth in MDA-MB-231 xenograft model. The in vivo antitumor effect was correlated with decreased proliferation (Ki-67), increased apoptosis (TUNEL) and inhibition of IL-6/IL-6R-mediated STAT3, MAPK and Akt pathway in tumor remnants. Taken together, diacerein offered a novel blueprint for cancer therapy by hampering IL-6/IL-6R/STAT3/MAPK/Akt network.
BACKGROUND AND AIMS: Escitalopram has widely been recognized as one of the most frequently used antidepressants, with superior tolerability and great efficacy in preventing major depressive disorder (MDD) relapse and recurrence. However, anhedonia, which is a core symptom of MDD, remains difficult to treat. This study investigates the hedonic levels of MDD patients treated with Escitalopram.
MATERIALS AND METHODS: A total of 108 participants, 26 of whom with MDD on Escitalopram, were recruited in this cross sectional study. They were evaluated using the Snaith-Hamilton Pleasure Scale (SHAPS) and Beck Depression Inventory (BDI) questionnaires to assess their hedonic state, general mental health condition and level of depression.
RESULTS: Our study shows that most items in the SHAPS scores are significantly different between MDD patients on Escitalopram and the controls.
CONCLUSIONS: The hedonic capacity remains different between the two groups despite patients with MDD are put on Escitalopram treatment. Escitalopram fails to alleviate the hedonic state of MDD patients. Antidepressants that improve both depressive symptoms and hedonic states should be considered when treating MDD patients in clinical settings.
A late preterm newborn baby presented with respiratory distress and increasing cyanosis within 2 hours of birth. Bedside transthroracic echocardiography showed a critically obstructed vertical vein in a supracardiac total anomalous pulmonary venous drainage (TAPVd). Emergency stenting of the vertical vein was successfully performed at 24 hours of life.
Subtentorial subdural empyema is a rare and life threatening intracranial suppuration. It is usually an intracranial complication of otogenic infections. Early diagnosis and surgical drainage are the most important factors determining prognosis. The high mortality reported in the literature reflects the severity of subtentorial subdural empyema if proper management is delayed. Intracranial infections usually require between 4 to 6 weeks of intravenous antibiotics therapy. However, the prolonged duration of hospitalization as well as requirement for neurosurgically inserted indwelling devices may predispose these patients to new nosocomial infections.
Lignocellulosic biomass is a complex biopolymer that is primary composed of cellulose, hemicellulose, and lignin. The presence of cellulose in biomass is able to depolymerise into nanodimension biomaterial, with exceptional mechanical properties for biocomposites, pharmaceutical carriers, and electronic substrate's application. However, the entangled biomass ultrastructure consists of inherent properties, such as strong lignin layers, low cellulose accessibility to chemicals, and high cellulose crystallinity, which inhibit the digestibility of the biomass for cellulose extraction. This situation offers both challenges and promises for the biomass biorefinery development to utilize the cellulose from lignocellulosic biomass. Thus, multistep biorefinery processes are necessary to ensure the deconstruction of noncellulosic content in lignocellulosic biomass, while maintaining cellulose product for further hydrolysis into nanocellulose material. In this review, we discuss the molecular structure basis for biomass recalcitrance, reengineering process of lignocellulosic biomass into nanocellulose via chemical, and novel catalytic approaches. Furthermore, review on catalyst design to overcome key barriers regarding the natural resistance of biomass will be presented herein.
This study presents the isolation and screening of fungi with excellent ability to degrade untreated oil palm trunk (OPT) in a solid-state fermentation system (SSF). Qualitative assay of cellulases and xylanase indicates notable secretion of both enzymes by 12 fungal strains from a laboratory collection and 5 strains isolated from a contaminated wooden board. High production of these enzymes was subsequently quantified in OPT in SSF. Aspergillus fumigates SK1 isolated from cow dung gives the highest xylanolytic activity (648.448 U g(-1)), generally high cellulolytic activities (CMCase: 48.006, FPase: 6.860, beta-glucosidase: 16.328 U g(-1)) and moderate lignin peroxidase activity (4.820 U/g), and highest xylanolytic activity. The xylanase encoding gene of Aspergillus fumigates SK1 was screened using polymerase chain reaction by a pair of degenerate primers. Through multiple alignment of the SK1 strain's xylanase nucleotide sequences with other published xylanases, it was confirmed that the gene belonged to the xylanase glycoside hydrolase family 11 (GH11) with a protein size of 24.49 kD. Saccharification of lemongrass leaves using crude cellulases and xylanase gives the maximum reducing sugars production of 6.84 g/L with glucose as the major end product and traces of phenylpropanic compounds (vanillic acid, p-coumaric acid, and ferulic acid).
The healthcare industry is streamlining processes to offer more timely and effective services to all patients. Computerized software algorithm and smart devices can streamline the relation between users and doctors by providing more services inside the healthcare telemonitoring systems. This paper proposes a multi-sources framework to support advanced healthcare applications. The proposed framework named Multi Sources Healthcare Architecture (MSHA) considers multi-sources: sensors (ECG, SpO2 and Blood Pressure) and text-based inputs from wireless and pervasive devices of Wireless Body Area Network. The proposed framework is used to improve the healthcare scalability efficiency by enhancing the remote triaging and remote prioritization processes for the patients. The proposed framework is also used to provide intelligent services over telemonitoring healthcare services systems by using data fusion method and prioritization technique. As telemonitoring system consists of three tiers (Sensors/ sources, Base station and Server), the simulation of the MSHA algorithm in the base station is demonstrated in this paper. The achievement of a high level of accuracy in the prioritization and triaging patients remotely, is set to be our main goal. Meanwhile, the role of multi sources data fusion in the telemonitoring healthcare services systems has been demonstrated. In addition to that, we discuss how the proposed framework can be applied in a healthcare telemonitoring scenario. Simulation results, for different symptoms relate to different emergency levels of heart chronic diseases, demonstrate the superiority of our algorithm compared with conventional algorithms in terms of classify and prioritize the patients remotely.