Displaying publications 3801 - 3820 of 8505 in total

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  1. Tan SSN, Koh KT, Tiong LL, Ong TK, Fong AYY
    Pharmacogenomics, 2018 10;19(15):1151-1157.
    PMID: 30191759 DOI: 10.2217/pgs-2018-0082
    AIM: Recurrent thrombotic events still occur despite dual antiplatelet therapy in patient's post percutaneous coronary intervention (PCI) could be attributed to high on-treatment platelet reactivity.

    METHODS: A 44-year-old male, who had staged PCI to left anterior descending (LAD) 2 weeks after an anterior MI, with a drug-coated stent was readmitted with new anterior STEMI 35 days later. Coronary angiogram revealed mid-stent thrombus in situ. He had further uncomplicated PCI. Platelet function testing and genotyping showed clopidogrel high on-treatment platelet reactivity and CYP2C19*3/*17 genotype. Ticagrelor was commenced.

    RESULTS & CONCLUSION: This case study is the first reported in Malaysia to document a patient with a CYP2C19*3/*17 genotype presenting with a stent thrombosis after an uncomplicated index PCI procedure.

  2. Hamid ZA, Tan HY, Chow PW, Harto KAW, Chan CY, Mohamed J
    Sultan Qaboos Univ Med J, 2018 May;18(2):e130-e136.
    PMID: 30210840 DOI: 10.18295/squmj.2018.18.02.002
    Objectives: The ex vivo maintenance of haematopoietic stem/progenitor cells (HSPCs) is crucial to ensure a sufficient supply of functional cells for research or therapeutic applications. However, when exposed to reactive oxygen species (ROS) in a normoxic microenvironment, HSPCs exhibit genomic instability which may diminish their quantity and quality. This study aimed to investigate the role of N-acetylcysteine (NAC) supplementation on the oxidative stress levels, genotoxicity and lineage commitment potential of murine haematopoietic stem/progenitor cells (HSPCs).

    Methods: This study was carried out at the Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia, between June 2016 and July 2017. Bone marrow cells were isolated from nine mice and cultured in a growth medium. Various concentrations of NAC between 0.125-2 μM were added to the culture for 48 hours; these cells were then compared to non-supplemented cells harvested from the remaining three mice as the control group. A trypan blue exclusion test was performed to determine cell viability, while intracellular ROS levels and genotoxicity were determined by hydroethidine staining and comet assay, respectively. The lineage commitment potential of erythroid, myeloid and pre-B-lymphoid progenitor cells was evaluated via colony-forming cell assay.

    Results: NAC supplementation at 0.25, 0.5 and 2 μM significantly increased cell viability (P <0.050), while intracellular ROS levels significantly decreased at 0.25 and 0.5 μM (P <0.050). Moreover, DNA damage was significantly reduced at all NAC concentrations (P <0.050). Finally, the potential lineage commitment of the cells was not significantly affected by NAC supplementation (P >0.050).

    Conclusion: The findings of this study indicate that NAC supplementation may potentially overcome the therapeutic limitations of ex vivo-maintained HSPCs.

  3. Tan T, Li Z, Liu H, Zanjani FG, Ouyang Q, Tang Y, et al.
    PMID: 30324036 DOI: 10.1109/JTEHM.2018.2865787
    Bronchoscopy inspection, as a follow-up procedure next to the radiological imaging, plays a key role in the diagnosis and treatment design for lung disease patients. When performing bronchoscopy, doctors have to make a decision immediately whether to perform a biopsy. Because biopsies may cause uncontrollable and life-threatening bleeding of the lung tissue, thus doctors need to be selective with biopsies. In this paper, to help doctors to be more selective on biopsies and provide a second opinion on diagnosis, we propose a computer-aided diagnosis (CAD) system for lung diseases, including cancers and tuberculosis (TB). Based on transfer learning (TL), we propose a novel TL method on the top of DenseNet: sequential fine-tuning (SFT). Compared with traditional fine-tuning (FT) methods, our method achieves the best performance. In a data set of recruited 81 normal cases, 76 TB cases and 277 lung cancer cases, SFT provided an overall accuracy of 82% while other traditional TL methods achieved an accuracy from 70% to 74%. The detection accuracy of SFT for cancers, TB, and normal cases are 87%, 54%, and 91%, respectively. This indicates that the CAD system has the potential to improve lung disease diagnosis accuracy in bronchoscopy and it may be used to be more selective with biopsies.
  4. Choo KY, Kho C, Ong YY, Thoo YY, Lim RLH, Tan CP, et al.
    Food Sci Biotechnol, 2018 Oct;27(5):1411-1417.
    PMID: 30319851 DOI: 10.1007/s10068-018-0367-4
    The objective of this work was to study the effect of storage temperatures and duration on the stability of fermented red dragon fruit drink (FRDFD) on its betacyanins content, physicochemical and microbiological qualities (BPM) and determining sensory acceptability. Results showed that both storage temperatures and duration have a significant effect on betacyanins content and physicochemical properties of FRDFD. Aerobic mesophilic and yeast and mold counts were lower than 1 × 103 CFU/mL for FRDFD stored at both temperatures. The loss of betanin (16.53-13.93 g/L) at 4 °C was 15.73% with no significant changes in physicochemical properties from week two onwards compared to 56.32% (16.53-7.22 g/L) of betanin loss at 25 °C. At week eight, FRDFD stored at 4 °C still contained 13.93 g/L betanin with a pH value of 3.46, suggested its potential as a functional drink which is sensory acceptable (mean score > 80% using hedonic test) among consumers.
  5. Sangal V, Goodfellow M, Blom J, Tan GYA, Klenk HP, Sutcliffe IC
    Front Microbiol, 2018;9:2281.
    PMID: 30319584 DOI: 10.3389/fmicb.2018.02281
    Strains belonging to the genus Amycolatopsis are well known for the production of a number of important antimicrobials and other bioactive molecules. In this study, we have sequenced the genomes of five Amycolatopsis strains including Amycolatopsis circi DSM 45561T, Amycolatopsis palatopharyngis DSM 44832T and Amycolatopsis thermalba NRRL B-24845T. The genome sequences were analyzed with 52 other publically available Amycolatopsis genomes, representing 34 species, and 12 representatives from related genera including Saccharomonospora, Saccharopolyspora, Saccharothrix, Pseudonocardia and Thermobispora. Based on the core genome phylogeny, Amycolatopsis strains were subdivided into four major clades and several singletons. The genus Amycolatopsis is homogeneous with only three strains noted to group with other genera. Amycolatopsis halophila YIM93223T is quite distinct from other Amycolatopsis strains, both phylogenetically and taxonomically, and belongs to a distinct genus. In addition, Amycolatopsis palatopharyngis DSM 44832T and Amycolatopsis marina CGMCC4 3568T grouped in a clade with Saccharomonospora strains and showed similar taxogenomic differences to this genus as well as other Amycolatopsis strains. The study found a number of strains, particularly those identified as Amycolatopsis orientalis, whose incorrect identification could be resolved by taxogenomic analyses. Similarly, some unclassified strains could be assigned with species designations. The genome sequences of some strains that were independently sequenced by different laboratories were almost identical (99-100% average nucleotide and amino acid identities) consistent with them being the same strain, and confirming the reproducibility and robustness of genomic data. These analyses further demonstrate that whole genome sequencing can reliably resolve intra- and, inter-generic structures and should be incorporated into prokaryotic systematics.
  6. Kemung HM, Tan LT, Khan TM, Chan KG, Pusparajah P, Goh BH, et al.
    Front Microbiol, 2018;9:2221.
    PMID: 30319563 DOI: 10.3389/fmicb.2018.02221
    Methicillin-resistant Staphylococcus aureus (MRSA) pose a significant health threat as they tend to cause severe infections in vulnerable populations and are difficult to treat due to a limited range of effective antibiotics and also their ability to form biofilm. These organisms were once limited to hospital acquired infections but are now widely present in the community and even in animals. Furthermore, these organisms are constantly evolving to develop resistance to more antibiotics. This results in a need for new clinically useful antibiotics and one potential source are the Streptomyces which have already been the source of several anti-MRSA drugs including vancomycin. There remain large numbers of Streptomyces potentially undiscovered in underexplored regions such as mangrove, deserts, marine, and freshwater environments as well as endophytes. Organisms from these regions also face significant challenges to survival which often result in the production of novel bioactive compounds, several of which have already shown promise in drug development. We review the various mechanisms of antibiotic resistance in MRSA and all the known compounds isolated from Streptomyces with anti-MRSA activity with a focus on those from underexplored regions. The isolation of the full array of compounds Streptomyces are potentially capable of producing in the laboratory has proven a challenge, we also review techniques that have been used to overcome this obstacle including genetic cluster analysis. Additionally, we review the in vivo work done thus far with promising compounds of Streptomyces origin as well as the animal models that could be used for this work.
  7. Mutha NVR, Mohammed WK, Krasnogor N, Tan GYA, Choo SW, Jakubovics NS
    Mol Oral Microbiol, 2018 12;33(6):450-464.
    PMID: 30329223 DOI: 10.1111/omi.12248
    Cell-cell interactions between genetically distinct bacteria, known as coaggregation, are important for the formation of mixed-species biofilms such as dental plaque. Interactions lead to gene regulation in the partner organisms that may be critical for adaptation and survival in mixed-species biofilms. Here, gene regulation responses to coaggregation between Streptococcus gordonii and Fusobacterium nucleatum were studied using dual RNA-Seq. Initially, S. gordonii was shown to coaggregate strongly with F. nucleatum in buffer or human saliva. Using confocal laser scanning microscopy and transmission electron microscopy, cells of different species were shown to be evenly distributed throughout the coaggregate and were closely associated with one another. This distribution was confirmed by serial block face sectioning scanning electron microscopy, which provided high resolution three-dimensional images of coaggregates. Cell-cell sensing responses were analysed 30 minutes after inducing coaggregation in human saliva. By comparison with monocultures, 16 genes were regulated following coaggregation in F. nucleatum whereas 119 genes were regulated in S. gordonii. In both species, genes involved in amino acid and carbohydrate metabolism were strongly affected by coaggregation. In particular, one 8-gene operon in F. nucleatum encoding sialic acid uptake and catabolism was up-regulated 2- to 5-fold following coaggregation. In S. gordonii, a gene cluster encoding functions for phosphotransferase system-mediated uptake of lactose and galactose was down-regulated up to 3-fold in response to coaggregation. The genes identified in this study may play key roles in the development of mixed-species communities and represent potential targets for approaches to control dental plaque accumulation.
  8. Muhammad AA, Tan MK, Abdullah NA, Azirun MS, Bhaskar D, Skejo J
    Zootaxa, 2018 Sep 25;4485(1):1-70.
    PMID: 30313773 DOI: 10.11646/zootaxa.4485.1.1
    Pygmy grasshoppers (Tetrigidae) are a speciose group of complicated taxonomy, with many species requiring clarification on their species boundaries, and more still awaiting discovery. Two new species of Scelimena Serville, 1838 are described: (1) from S. discalis species group S. gombakensis sp. nov. and (2) from S. hexodon species group Scelimena marta sp. nov. Catalogue of Scelimenini genera (15) and species (100) is presented and taxonomy and biogeography of the tribe are discussed. New and resurrected combinations are: Falconius becvari (Buzzetti Devriese, 2008) comb. nov. (of Gavialidium becvari), Gavialidium carli Hebard, 1930 comb. resurr. (of Bidentatettix carli), Indoscelimena india (Hancock, 1907) comb. nov. (of Scelimena india), Paragavialidium nodiferum (Walker, 1871) comb. nov. (of Platygavialidium nodiferum), Platygavialidium productum (Walker, 1871) comb. nov. (of Gavialidium productum), Scelimena hexodon (Haan, 1843) comb. resurr. (of Hexocera hexodon), Scelimena rosacea (Hancock, 1915) comb. resurr. (of Amphibotettix rosaceus), Tegotettix bufocrocodil (Storozhenko Dawwrueng, 2015) comb. nov. (of Gavialidium bufocrocodil). New synonyms are: Gavialidium phangensum Mahmood, Idris Salmah, 2007 syn. nov. (of Eufalconius pendleburyi), Gavialidium philippinum Bolívar, 1887 syn. nov. (of Platygavialidium productum comb. nov.), Hexocera Hancock, 1915 syn. nov. (of Scelimena), Paracriotettix Liang, 2002 syn. nov. (of Scelimena), Paracriotettix zhengi Liang, 2002 syn. nov. (of Scelimena melli), Scelimena mellioides Deng, 2016 syn. nov. (of Scelimena melli), Scelimena wuyishanensis Deng, 2016 syn. nov. (of Platygavialidium sinicum). The genus Scelimena is divided into six species groups. Eucriotettix neesoon Tan Storozhenko nom. nov. is new name for homonym Eucriotettix guentheri Tan Storozhenko, 2017. Finally, a tabular key to 15 Scelimenini genera, based on 16 morphological characters, is presented.
  9. Tan JSJ, Ong KC, Ong DBL, Razack A, Lim J, Yunus R, et al.
    Malays J Pathol, 2018 Aug;40(2):103-110.
    PMID: 30173226 MyJurnal
    INTRODUCTION: Prostate cancer is a heterogenous disease and the mechanisms that drive it to behave differently are not well understood. Tumour expression of the ERG oncogene occurs in the majority of patients with prostate cancer in Western studies. This is considered to be oncogenic as ERG acts as a transcription factor to regulate genes involved in tumour proliferation and invasion. In this study we investigated expression of ERG in Malaysian men with prostate cancer.

    METHODS: Tissues were collected from 80 patients with clinically detected prostate cancer and treated with radical prostatectomy. Cases were tested for ERG by immunohistochemistry using the mouse monoclonal antibody EP111. All blocks on 48 cases were tested in order to determine the extent of heterogeneity of ERG expression within individual cases. ERG expression was analysed in relation to patient age, ethnicity and tumour stage and grade.

    RESULTS: Forty-six percent of cases were ERG positive. There was no significant association between ERG and tumour grade or stage. Sixty-nine percent of Indian patients had ERG positive tumours; this was significantly higher (p=0.031) than for Chinese (40%) and Malay (44%) patients. Heterogeneity of ERG expression, in which both positive and negative clones were present, was seen in 35% of evaluated cases. Evaluation by tumour foci showed younger patients had more ERG positive tumour foci than older patients (p=0.01). Indian patients were more likely to have the majority of tumour foci with ERG staining positively, compared to either Chinese or Malay patients (P <0.01).

    CONCLUSION: In this study, tumour expression of ERG was more likely to occur in patients of Indian ethnicity.

  10. Homouz D, Joyce-Tan KH, ShahirShamsir M, Moustafa IM, Idriss HT
    J Mol Graph Model, 2018 09;84:236-241.
    PMID: 30138833 DOI: 10.1016/j.jmgm.2018.08.007
    DNA polymerase β is a 39 kDa enzyme that is a major component of Base Excision Repair in human cells. The enzyme comprises two major domains, a 31 kDa domain responsible for the polymerase activity and an 8 kDa domain, which bind ssDNA and has a deoxyribose phosphate (dRP) lyase activity. DNA polymerase β was shown to be phosphorylated in vitro with protein kinase C (PKC) at serines 44 and 55 (S44 and S55), resulting in loss of its polymerase enzymic activity, but not its ability to bind ssDNA. In this study, we investigate the potential phosphorylation-induced structural changes for DNA polymerase β using molecular dynamics simulations. The simulations show drastic conformational changes of the polymerase structure as a result of S44 phosphorylation. Phosphorylation-induced conformational changes transform the closed (active) enzyme structure into an open one. Further analysis of the results points to a key hydrogen bond and newly formed salt bridges as potential drivers of these structural fluctuations. The changes observed with S55/44 and S55 phosphorylation were less dramatic and the integrity of the H-bond was not compromised. Thus the phosphorylation of S44 is the major contributor to structural fluctuations that lead to loss of enzymatic activity.
  11. McDonald SA, Azzeri A, Shabaruddin FH, Dahlui M, Tan SS, Kamarulzaman A, et al.
    Appl Health Econ Health Policy, 2018 12;16(6):847-857.
    PMID: 30145775 DOI: 10.1007/s40258-018-0425-3
    INTRODUCTION: The World Health Organisation (WHO) has set ambitious goals to reduce the global disease burden associated with, and eventually eliminate, viral hepatitis.

    OBJECTIVE: To assist with achieving these goals and to inform the development of a national strategic plan for Malaysia, we estimated the long-term burden incurred by the care and management of patients with chronic hepatitis C virus (HCV) infection. We compared cumulative healthcare costs and disease burden under different treatment cascade scenarios.

    METHODS: We attached direct costs for the management/care of chronically HCV-infected patients to a previously developed clinical disease progression model. Under assumptions regarding disease stage-specific proportions of model-predicted HCV patients within care, annual numbers of patients initiated on antiviral treatment and distribution of treatments over stage, we projected the healthcare costs and disease burden [in disability-adjusted life-years (DALY)] in 2018-2040 under four treatment scenarios: (A) no treatment/baseline; (B) pre-2018 standard of care (pegylated interferon/ribavirin); (C) gradual scale-up in direct-acting antiviral (DAA) treatment uptake that does not meet the WHO 2030 treatment uptake target; (D) scale-up in DAA treatment uptake that meets the WHO 2030 target.

    RESULTS: Scenario D, while achieving the WHO 2030 target and averting 253,500 DALYs compared with the pre-2018 standard of care B, incurred the highest direct patient costs over the period 2018-2030: US$890 million (95% uncertainty interval 653-1271). When including screening programme costs, the total cost was estimated at US$952 million, which was 12% higher than the estimated total cost of scenario C.

    CONCLUSIONS: The scale-up to meet the WHO 2030 target may be achievable with appropriately high governmental commitment to the expansion of HCV screening to bring sufficient undiagnosed chronically infected patients into the treatment pathway.

  12. Tan CY, Arumugam T, Razali SNO, Yahya MA, Goh KJ, Shahrizaila N
    J Clin Neurosci, 2018 Nov;57:198-201.
    PMID: 30145079 DOI: 10.1016/j.jocn.2018.08.031
    Diabetic patients with poor glycaemic control can demonstrate demyelinating distal sensorimotor polyneuropathy (D-DSP) on electrophysiology. Distinguishing D-DSP from chronic inflammatory demyelinating polyneuropathy (CIDP) can be challenging. In this study, we investigated the role of nerve ultrasound in differentiating the two neuropathies. Nerve ultrasound findings of D-DSP patients (fulfilling the electrophysiological but not clinical criteria for CIDP) were compared with non-diabetic CIDP patients (fulfilling both criteria). We studied 108 and 95 nerves from 9 D-DSP and 10 CIDP patients respectively. CIDP patients had significantly larger cross-sectional areas of the median nerve at the mid-arm (17.0 ± 12.5 vs 8.7 ± 2.6; p = 0.005), ulnar nerve at the wrist (7.3 ± 3.1 vs 4.1 ± 1.0; p = 0.001), mid forearm (8.8 ± 5.3 vs 5.5 ± 1.5; p = 0.002) and mid-arm (14.5 ± 14.1 vs 7.5 ± 1.9; p = 0.013), and radial nerve at mid forearm (4.1 ± 2.4 vs 1.2 ± 0.4; p 
  13. Phoon PHY, MacLaren G, Ti LK, Tan JSK, Hwang NC
    J Cardiothorac Vasc Anesth, 2019 Dec;33(12):3394-3401.
    PMID: 30131218 DOI: 10.1053/j.jvca.2018.07.018
    Singapore is a small Southeast Asian island city-state located at the tip of the Malay peninsula with a population of 5.61 million people. It was a former British colony that went on to become a part of Malaysia before gaining independence in 1965. Since then, Singapore has developed tremendously from a small fishing village into the region's medical hub. This article will explore the roots of cardiac anesthesia in Singapore and how it has developed into a subspecialty today.
  14. Park YC, Yang SY, Chong MY, Kanba S, Sartorius N, Shinfuku N, et al.
    Psychiatry Investig, 2018 Oct;15(10):1007-1008.
    PMID: 30373360 DOI: 10.30773/pi.2018.09.06
    The REAP-AP study recruited 3,746 patients with schizophrenia, in March and April 2016, from 71 centers in 15 Asian countries/territories namely Bangladesh, China, Hong Kong, India, Indonesia, Japan, Korea, Malaysia, Myanmar, Pakistan, Singapore, Sri Lanka, Taiwan, Thailand and Vietnam. Our findings reveal a trend according to which high dose antipsychotic prescription is more prevalent in Eastern Asia (especially, Japan and Korea) than in other regions of Asia. This historical factor may be associated with our finding of an Eastern Asian preponderance of high dose antipsychotic prescription.
  15. Chiu YW, Gan YC, Kuo PH, Hsu KC, Tan MS, Ju YM, et al.
    Biochem Genet, 2018 Oct 26.
    PMID: 30367289 DOI: 10.1007/s10528-018-9892-3
    According to geological history, Peninsular Malaysia and Borneo formed at different times and were once connected during Quaternary glaciations. To determine how this history has influenced phylogeography, our study examined the population genetic structure of the tropical freshwater gastropod Melanoides tuberculata across Peninsular Malaysia and Borneo using the sequences from mitochondrial DNA 16S rRNA and cytochrome oxidase subunit I genes (1168 bp). In total, 104 specimens were collected from seventeen populations. All mtDNA haplotypes were identified as belonging to two highly divergent lineages, and these lineages were almost allopatric in their distributions. Our study found that the freshwater fauna in Malaysia might be divided into four regions: northeast Peninsular Malaysia, northwest Peninsular Malaysia, south Peninsular Malaysia, and Borneo. The phylogeography of M. tuberculata in Malaysia was shaped by the landforms of Peninsular Malaysia and by the paleo-river systems in the Sunda continental shelf. In addition, our study found that these two lineages in Malaysia have invaded the globe. These results suggest that Malaysia is located in important shipping lanes throughout the world, and the populations of M. tuberculate might be widely distributed throughout the world by shipping.
  16. Li C, Wang R, Xu J, Luo Y, Tan ML, Jiang Y
    Int J Biometeorol, 2018 Dec;62(12):2197-2204.
    PMID: 30368677 DOI: 10.1007/s00484-018-1623-2
    Understanding the impacts of climate change on crop yield is important for improving crop growth and yield formation in northwestern China. In this study, we evaluated the relationship between meteorological dryness/wetness conditions and spring wheat yield in the Ili river basin (IRB). The climate and yield data from 1961 to 2013 were collected to analyze characteristics and correlations between these two variables using the standardized precipitation evapotranspiration index (SPEI), yield detrending method, modified Mann-Kendall test and Spearman correlation analysis. Main results were as follows: (1) correlations between monthly SPEI values (MSV) and climatic yield of spring wheat indicated that the dryness/wetness condition in May was a key factor affecting yield in the whole region; (2) although the MSV in May and yield fluctuated from negative to positive values in time, the severely and extremely dryness events were in good agreement with the higher yield losses; (3) each increase of 0.5 MSV in May promoted over 3% increase of yield in most part of IRB; however, the larger variability of MSV in May resulted in larger yield fluctuations; and (4) the Tibetan Plateau index in April showed significant correlations with the MSV in May and yield, which provided a precursory signal for decision-makers to better understand potential yield fluctuations.
  17. Lian W, Li D, Zhang L, Wang W, Faiza M, Tan CP, et al.
    Enzyme Microb Technol, 2018 Oct;117:56-63.
    PMID: 30037552 DOI: 10.1016/j.enzmictec.2018.06.007
    Conjugated linoleic acid (CLA)-rich triacylglycerols (TAG) have received significant attention owing to their health promoting properties. In this study, CLA-rich TAG were successfully synthesized by an immobilized mutant lipase (MAS1-H108A)-catalyzed esterification of CLA-rich fatty acids and glycerol under vacuum. MAS1-H108A was first immobilized onto ECR1030 resin. Results showed that the lipase/support ratio of 41 mg/g was suitable for the immobilization and the thermostability of immobilized MAS1-H108A was greatly enhanced. Subsequently, the immobilized MAS1-H108A was employed for the synthesis of CLA-rich TAG and 95.21% TAG with 69.19% CLA was obtained under the optimized conditions. The TAG content (95.21%) obtained by immobilized MAS1-H108A is the reported highest value thus far, which was significantly higher than that (9.26%) obtained by Novozym 435 under the same conditions. Although the TAG content comparable to the results obtained in this study could also be obtained by Novozym 435, the used enzyme amount is approximately 5-fold of the immobilized MAS1-H108A. Additionally, the immobilized MAS1-H108A exhibited excellent recyclability during esterification retaining 95.11% of its initial activity after 10 batches. Overall, such immobilized mutant lipase with superior esterification activity and recyclability has the potential to be used in oils and fats industry.
  18. Tan YF, Lim CY, Chong CW, Lim PKC, Yap IKS, Leong PP, et al.
    Intervirology, 2018;61(2):92-95.
    PMID: 30121676 DOI: 10.1159/000491602
    BACKGROUND: The giant amoebal viruses of Mimivirus and Marseillevirus are large DNA viruses and have been documented in water, soil, and sewage samples. The trend of discovering these giant amoebal viruses has been increasing throughout Asia with Japan, India, and Saudi Arabia being the latest countries to document the presence of these viruses. To date, there have been no reports of large amoebal viruses being isolated in South East Asia.

    OBJECTIVE: In this study, we aim to discover these viruses from soil samples in an aboriginal village (Serendah village) in Peninsular -Malaysia.

    METHOD AND RESULTS: We successfully detected and isolated both Mimivirus-like and Marseillevirus-like viruses using Acanthamoeba castellanii. Phylogeny analysis identified them as Mimivirus and Marseillevirus, respectively.

    CONCLUSION: The ubiquitous nature of both Mimivirus and Marseillevirus is further confirmed in our study as they are detected in higher quantity in soil that is near to water vicinities in an aboriginal village in Peninsular Malaysia. However, this study is limited by our inability to investigate the impact of Mimivirus and Marseillevirus on the aboriginal villagers. More studies on the potential impact of these viruses on human health, especially on the aborigines, are warranted.

  19. Mustafa S, Hassan NB, Tan SC, Ab Rahman AK, Low LL, Wan Yusuf WN
    Turk J Med Sci, 2016 Dec 20;46(6):1875-1881.
    PMID: 28081342 DOI: 10.3906/sag-1503-116
    BACKGROUND/AIM: Nevirapine is a reverse-transcriptase inhibitor widely used in combination therapy to treat HIV infection. Nevirapine is extensively metabolized in the liver and CYP2B6 is mainly responsible for oxidation of 3-hydroxynevirapine (3-OH NVP). This study aims to explore CYP2B6 activity by measuring 2-hydroxynevirapine (2-OH NVP) and 3-OH NVP in plasma and to identify factors associated with nevirapine pharmacokinetic parameters.

    MATERIALS AND METHODS: A total of 112 patients were recruited and treated with nevirapine-based antiretroviral therapy. Plasma nevirapine and metabolite concentrations were assayed using high-performance liquid chromatography via liquid-liquid extraction.

    RESULTS: Thirty-nine (34.8%) of the patients had no 3-OH NVP detected in their plasma while 2-OH NVP was detected in all patients. Metabolite concentrations were low compared to nevirapine. Positive correlations were observed between nevirapine and its metabolites, 2-OH NVP (P < 0.01) and 3-OH NVP (P = 0.012). Nevirapine concentration was decreased when concomitantly administered with methadone. Univariate analysis showed that ALT level, AST level, and detection of 3-OH NVP were associated with nevirapine pharmacokinetic parameters.

    CONCLUSION: The variability of nevirapine pharmacokinetic parameters was caused by liver enzymes and the presence of 3-OH NVP metabolites. The presence of 3-OH NVP can probably be used to distinguished CYP2B6 activity and efficacy of nevirapine in patients with HIV infection.

  20. Ekker MS, Boot EM, Singhal AB, Tan KS, Debette S, Tuladhar AM, et al.
    Lancet Neurol, 2018 09;17(9):790-801.
    PMID: 30129475 DOI: 10.1016/S1474-4422(18)30233-3
    Epidemiological evidence suggests that the incidence of ischaemic stroke in young adults (18-50 years) has increased substantially. These patients have a long life expectancy after stroke, and the costs of long-term care pose huge challenges to health-care systems. Although the current recommendations for treatment of young and old (>50 years) patients with stroke are similar, the optimal management of young adult patients with stroke is unknown. They are usually not included in trials, and specific subanalyses limited to young adult patients with stroke are usually not done, owing to lower incidence of stroke and lower prevalence of vascular risk factors in young adults. Progress has been made in identifying patients with a considerable risk of stroke occurrence, such as those with patent foramen ovale. Future prevention studies might result in a decrease in the incidence of stroke and its sequelae in young adults. The development of guidelines specifically devoted to the management of stroke in young adults will be an important step in achieving this aim.
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