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  1. Kow RY, Che-Ahmad A, Ayeop MAS, Ahmad MW, Yusof S
    J Orthop Surg (Hong Kong), 2021 11 11;29(3):23094990211043987.
    PMID: 34753329 DOI: 10.1177/23094990211043987
    BACKGROUND: Strayer's gastrocnemius recession is a common technique in treating ankle equinus of gastrocnemius origin. Nevertheless, this technique is associated with a few flaws. We aim to introduce a novel technique of isolated gastrocnemius recession and perform a cadaveric study to evaluate its safety and at the same time compare this novel technique with the existing Strayer procedure biomechanically.

    METHODS: Eight fresh cadaveric models of gastrocnemius tightness were established by isolated traction of the gastrocnemius muscles. Gastrocnemius recession was performed on all eight models with Strayer method and the novel method randomized equally. The safety of both the techniques was evaluated by identifying any iatrogenic injury to the surrounding structures. The lengthening and improvement of the ankle dorsiflexion was measured and compared between the two techniques.

    RESULTS: There was no iatrogenic sural nerve or saphenous vein injury in all eight models. There was no significant difference between the two techniques in terms of lengthening (24.25 mm vs 21.00 mm; p = 0.838) and improvement of ankle dorsiflexion (26.5° vs 26°; p = .829).

    CONCLUSIONS: Both Strayer technique and the novel technique of gastrocnemius recession lengthened the gastrocnemius and improved the ankle dorsiflexion in this cadaver trial. Both procedures were safe with proper techniques, and there was no significant difference in efficacy between them.

    LEVEL OF EVIDENCE: Level II, randomized controlled trial.

  2. Soesilawati P, Rizqiawan A, Roestamadji RI, Arrosyad AR, Firdauzy MAB, Abu Kasim NH
    Clin Cosmet Investig Dent, 2021;13:443-449.
    PMID: 34744460 DOI: 10.2147/CCIDE.S313184
    Aim: Demineralized dentin material membrane (DDMM) is a novel bioresorbable guided bone regeneration (GBR) which is derived from the demineralization process of bovine dentin. This material/process could be an alternative to resolve musculoskeletal dysfunction that harms the quality of human life.

    Purpose: To evaluate the cytotoxic effect of DDMM as GBR membrane on MC3T3-E1 osteoblast cell line.

    Methods: Cytotoxic effect was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Osteoblast MC3T3-E1 cell culture was used as a parameter of cell viability after reacting with GBR materials. The absorbance values were examined at each treatment to determine the percentage of cell viability. There were four groups created in the present study: two treatment groups and two control groups. The treatment groups consisted of a DDMM group and a bovine pericardium collagen membrane (BPCM) group. The control groups comprised a group containing cell culture medium as a negative control group and another positive control group that contained cell cultures.

    Results: The results revealed no significant difference in MC3T3-E1 cell viability between the treatment and control groups (p < 0.05). Moreover, as observed in the DDMM group, there was an increase in the number of osteoblast cells.

    Conclusion: DDMM is a suitable alternative biomaterial for GBR as it is non-cytotoxic and could potentially increase the rate of repair of craniofacial defects.

  3. Farook TH, Jamayet NB, Asif JA, Din AS, Mahyuddin MN, Alam MK
    Sci Rep, 2021 04 19;11(1):8469.
    PMID: 33875672 DOI: 10.1038/s41598-021-87240-9
    Palatal defects are rehabilitated by fabricating maxillofacial prostheses called obturators. The treatment incorporates taking deviously unpredictable impressions to facsimile the palatal defects into plaster casts for obturator fabrication in the dental laboratory. The casts are then digitally stored using expensive hardware to prevent physical damage or data loss and, when required, future obturators are digitally designed, and 3D printed. Our objective was to construct and validate an economic in-house smartphone-integrated stereophotogrammetry (SPINS) 3D scanner and to evaluate its accuracy in designing prosthetics using open source/free (OS/F) digital pipeline. Palatal defect models were scanned using SPINS and its accuracy was compared against the standard laser scanner for virtual area and volumetric parameters. SPINS derived 3D models were then used to design obturators by using (OS/F) software. The resultant obturators were virtually compared against standard medical software designs. There were no significant differences in any of the virtual parameters when evaluating the accuracy of both SPINS, as well as OS/F derived obturators. However, limitations in the design process resulted in minimal dissimilarities. With further improvements, SPINS based prosthetic rehabilitation could create a viable, low cost method for rural and developing health services to embrace maxillofacial record keeping and digitised prosthetic rehabilitation.
  4. Gunasekharan M, Choi TI, Rukayadi Y, Mohammad Latif MA, Karunakaran T, Mohd Faudzi SM, et al.
    Molecules, 2021 Sep 01;26(17).
    PMID: 34500755 DOI: 10.3390/molecules26175314
    Bacterial infections are regarded as one of the leading causes of fatal morbidity and death in patients infected with diseases. The ability of microorganisms, particularly methicillin-resistant Staphylococcus aureus (MRSA), to develop resistance to current drugs has evoked the need for a continuous search for new drugs with better efficacies. Hence, a series of non-PAINS associated pyrrolylated-chalcones (1-15) were synthesized and evaluated for their potency against MRSA. The hydroxyl-containing compounds (8, 9, and 10) showed the most significant anti-MRSA efficiency, with the MIC and MBC values ranging from 0.08 to 0.70 mg/mL and 0.16 to 1.88 mg/mL, respectively. The time-kill curve and SEM analyses exhibited bacterial cell death within four hours after exposure to 9, suggesting its bactericidal properties. Furthermore, the docking simulation between 9 and penicillin-binding protein 2a (PBP2a, PDB ID: 6Q9N) suggests a relatively similar bonding interaction to the standard drug with a binding affinity score of -7.0 kcal/mol. Moreover, the zebrafish model showed no toxic effects in the normal embryonic development, blood vessel formation, and apoptosis when exposed to up to 40 µM of compound 9. The overall results suggest that the pyrrolylated-chalcones may be considered as a potential inhibitor in the design of new anti-MRSA agents.
  5. Irfan M, Hussain NHN, Noor NM, Mohamed M, Sidi H, Ismail SB
    Am J Mens Health, 2020 7 7;14(4):1557988320937200.
    PMID: 32623948 DOI: 10.1177/1557988320937200
    Male sexual dysfunctions (MSDs) often remain undiagnosed and untreated in Asia compared to Europe due to conservative cultural and religious beliefs, socioeconomic conditions, and lack of awareness. There is a tendency for the use of traditional medicines and noncompliance with and reduced access to modern healthcare. The present systematic review compared the incidence and factors of MSD in European and Asian populations. English language population/community-based original articles on MSDs published in MEDLINE from 2008 to 2018 were retrieved. A total of 5392 studies were retrieved, of which 50 (25 Asian and 25 European) were finally included in this review. The prevalence of erectile dysfunction (ED) (0%-95.0% vs. 0.9%-88.8%), low satisfaction (3.2%-37.6% vs. 4.1%-28.3%), and hypoactive sexual desire disorder (HSDD) (0.7%-81.4 vs. 0%-65.5%) was higher in Asian than in European men, whereas the prevalence of anorgasmia (0.4% vs. 3%-65%) was lower in Asian than in European men. Age was an independent positive factor of MSD. In European men over 60 years old, the prevalence of premature ejaculation (PE) decreased. The prevalence of MSD was higher in questionnaires than in interviews. The significant factors were age, single status, low socioeconomic status, poor general health, less physical activity, cardiovascular diseases, diabetes, obesity, lower urinary tract symptoms, prostatitis, anxiety, depression and alcohol, tobacco, and drug use. The prevalence of MSD differed slightly in Asian and European men. There is a need to conduct large studies on the various Asian populations for the effective management of MSD.
  6. Sharif O, Islam MR, Hasan MZ, Kabir MA, Hasan ME, AlQahtani SA, et al.
    J Healthc Inform Res, 2022;6(1):72-90.
    PMID: 34549163 DOI: 10.1007/s41666-021-00105-8
    The aim of this study is to analyse the coronavirus disease 2019 (COVID-19) outbreak in Bangladesh. This study investigates the impact of demographic variables on the spread of COVID-19 as well as tries to forecast the COVID-19 infected numbers. First of all, this study uses Fisher's Exact test to investigate the association between the infected groups of COVID-19 and demographical variables. Second, it exploits the ANOVA test to examine significant difference in the mean infected number of COVID-19 cases across the population density, literacy rate, and regions/divisions in Bangladesh. Third, this research predicts the number of infected cases in the epidemic peak region of Bangladesh for the year 2021. As a result, from the Fisher's Exact test, we find a very strong significant association between the population density groups and infected groups of COVID-19. And, from the ANOVA test, we observe a significant difference in the mean infected number of COVID-19 cases across the five different population density groups. Besides, the prediction model shows that the cumulative number of infected cases would be raised to around 500,000 in the most densely region of Bangladesh, Dhaka division.
  7. Noh MAA, Fazalul Rahiman SS, A Wahab H, Mohd Gazzali A
    J Basic Clin Physiol Pharmacol, 2021 Jun 25;32(4):715-722.
    PMID: 34214294 DOI: 10.1515/jbcpp-2020-0435
    OBJECTIVES: Tuberculosis (TB) remains a public health concern due to the emergence and evolution of multidrug-resistant strains. To overcome this issue, reinforcing the effectiveness of first line antituberculosis agents using targeted drug delivery approach is an option. Glyceraldehyde-3-Phosphate Dehydrogenase (GADPH), a common virulence factor found in the pathogenic microorganisms has recently been discovered on the cell-surface of Mycobacterium tuberculosis, allowing it to be used as a drug target for TB. This study aims to discover active small molecule(s) that target GAPDH and eventually enhance the delivery of antituberculosis drugs.

    METHODS: Ten ligands with reported in vitro and/or in vivo activities against GAPDH were evaluated for their binding interactions through molecular docking studies using AutoDock 4.2 program. The ligand with the best binding energy was then modified to produce 10 derivatives, which were redocked against GAPDH using previous protocols. BIOVIA Discovery Studio Visualizer 2019 was used to explore the ligand-receptor interactions between the derivatives and GAPDH.

    RESULTS: Among the 10 ligands, curcumin, koningic acid and folic acid showed the best binding energies. Further analysis on the docking of two folic acid derivatives, F7 (γ-{[tert-butyl-N-(6-aminohexyl)]carbamate}folic acid) and F8 (folic acid N-hydroxysuccinimide ester) showed that the addition of a bulky substituent at the carboxyl group of the glutamic acid subcomponent resulted in improved binding energy.

    CONCLUSIONS: Folic acid and the two derivatives F7 and F8 have huge potentials to be developed as targeting agents against the GAPDH receptor. Further study is currently on-going to evaluate the effectiveness of these molecules in vitro.

  8. Bonny SQ, Hossain MAM, Uddin SMK, Pulingam T, Sagadevan S, Johan MR
    Crit Rev Food Sci Nutr, 2022;62(5):1317-1335.
    PMID: 33146031 DOI: 10.1080/10408398.2020.1841728
    Vibrio parahaemolyticus, Vibrio cholerae and Vibrio vulnificus are the most significant aquatic pathogens of the genera Vibrio, account for most Vibrio-associated outbreaks worldwide. Rapid identification of these pathogens is of great importance for disease surveillance, outbreak investigations and food safety maintenance. Traditional culture dependent methods are time-consuming and labor-intensive whereas culture-independent polymerase chain reaction (PCR) based assays are reliable, consistent, rapid and reproducible. This review covers the recent development and applications of PCR based techniques, which have accelerated advances in the analysis of nucleic acids to identify three major pathogenic vibrios. Emphasis has been given to analytical approaches as well as advantages and limits of the available methods. Overall, this review article possesses the substantial merit to be used as a reference guide for the researchers to develop improved PCR based techniques for the differential detection and quantification of Vibrio species.
  9. Adi O, Baherin MF, Fong CP, Fatan AAA, Ahmad AH, Yusof AA, et al.
    Am J Emerg Med, 2022 Mar;53:23-28.
    PMID: 34968971 DOI: 10.1016/j.ajem.2021.12.027
    As foreign body airway obstruction (FBAO) can be life-threatening, it has to be promptly diagnosed and treated. We report a case series of three patients presenting to the emergency department with cardiac arrest due to FBAO. In each case, ventilation was difficult due to high airway resistance. As FBAO was suspected, the emergency physician did a prompt flexible bronchoscopy to confirm the diagnosis and retrieve the foreign body. Flexible bronchoscopy is an important diagnostic and therapeutic tool for emergency airway management, and is a relatively safe procedure if performed by a trained personnel. The life-saving benefits of bronchoscopy outweigh the small risks of complications such as bleeding, desaturation and pneumothorax. In the three cases, the removal of the obstructing material led to immediate improvements in oxygenation and ventilation. The patients had return of spontaneous circulation after cardiopulmonary resuscitation and definite airway control.
  10. Akhtar A, Hassali MAA, Zainal H, Ali I, Iqbal MS, Khan AH
    Ther Adv Respir Dis, 2021 4 30;15:1753466620971141.
    PMID: 33910420 DOI: 10.1177/1753466620971141
    BACKGROUND: Geriatric individuals are more susceptible to different infections, especially respiratory-tract infections (RTIs) due to their compromised immune system. Hence, the objectives of the present study were to evaluate the prevalence, medication regimen complexity and factors associated with the treatment outcomes of different RTIs among geriatrics.

    METHODS: A retrospective cross-sectional study (5 years) was conducted at the respiratory department, Hospital Pulau Pinang. Patients aged ⩾65 years with confirmed diagnosis of RTI were included in the study.

    RESULTS: A total of 474 patients were included, and the most prevalent RTIs were community-acquired pneumonia (65.6%) followed by chronic obstructive pulmonary disease (20.7%), bronchitis (8.2%) and hospital-acquired pneumonia (5.5%). Amoxicillin/clavulanate (69.8%), ampicillin/sulbactam (9.1%) and cefuroxime (6.5%) are the most common antibiotics prescribed to treat RTIs among geriatrics. Smoking, alcohol consumption, polypharmacy and presence of other co-morbidities are statistically significant factors associated with treatment outcomes of RTIs among geriatrics.

    CONCLUSION: Prevalence of community-acquired pneumonia (65.6%) among older patients aged 65 years and older higher than other RTIs. Smoking, alcohol use, presence of polypharmacy and other co-morbidities are important factors associated with the treatment outcomes of RTIs.The reviews of this paper are available via the supplemental material section.

  11. Fareez IM, Seng WY, Zaki RM, Shafiq A, Izwan IM
    Curr Mol Med, 2022;22(2):132-150.
    PMID: 33568034 DOI: 10.2174/1566524021666210210121905
    Extracellular vesicles (EVs), which are released by most of the cells, constitute a new system of cell-cell communication by transporting DNA, RNA, and proteins in various vesicles namely exosomes, apoptotic bodies, protein complexes, high-density lipid (HDL) microvesicles, among others. To ensure accurate regulation of somatic stem cell activity, EVs function as an independent metabolic unit mediating the metabolic homeostasis and pathophysiological of several diseases such as cardiovascular diseases, metabolic diseases, neurodegenerative diseases, immune diseases, and cancer. Whist examining the EV biomolecules cargos and their microenvironments that lead to epigenetic alteration of the cell in tissue regeneration, studies have gained further insights into the biogenesis of EVs and their potential roles in cell biology and pathogenicity. Due to their small size, non-virulence, flexibility, and ability to cross biological barriers, EVs have promising therapeutic potentials in various diseases. In this review, we describe EV's mechanism of action in intercellular communication and transfer of biological information as well as some details about EVinduced epigenetic changes in recipient cells that cause phenotypic alteration during tissue regeneration. We also highlight some of the therapeutic potentials of EVs in organ-specific regeneration.
  12. Uddin S, Islam MR, Chowdhury MR, Wakabayashi R, Kamiya N, Moniruzzaman M, et al.
    ACS Appl Bio Mater, 2021 08 16;4(8):6256-6267.
    PMID: 35006923 DOI: 10.1021/acsabm.1c00563
    Lipid-based biocompatible ionic liquids (LBILs) have attracted attention as carriers in transdermal drug delivery systems (TDDSs) because of their lipophilic character. In this study, we report the formulation of a peptide-LBIL complex microencapsulated in an oil phase as a potential carrier for the transdermal delivery of leuprolide acetate as a model hydrophilic peptide. The peptide-LBIL complexes were prepared via a water-in-oil emulsion composed of 1,2-dimyristoyl-sn-glycerol-3-ethyl-phosphatidylcholine (EDMPC), a fatty acid (stearic, oleic, and linoleic acid)-based LBIL, and cyclohexane followed by freeze-drying to remove the water and cyclohexane. Then, the peptide-LBIL complexes were nanodispersed and stabilized in isopropyl myristate (IPM) using sorbitol laurate (Span-20). Ionic-liquid-in-oil nanodispersions (IL/O-NDs) were prepared with varying weight ratios of LBILs and Span-20 as the surfactant and the cosurfactant, respectively. Keeping the overall surfactant constant at 10 wt % in IPM, a 5:5 wt % ratio of surfactant (IL) and cosurfactant (Span-20) in the IL/O-NDs significantly (p < 0.0001) increased the physiochemical stability, drug-loading capacity, and drug encapsulation efficiency. The in vitro and in vivo peptide delivery across the skin was increased significantly (p < 0.0001) using IL/O-NDs, compared with non-IL-treated groups. Of all of the LBIL-based formulations, [EDMPC][Linoleate]/O-ND was considered the most preferable for a TDDS based on the pharmacokinetic parameters. The transdermal delivery flux with [EDMPC][Linoleate]/O-ND was increased 65-fold compared with the aqueous delivery vehicle. The IL/O-NDs were able to deform the lipid and protein arrangements of the skin layers to enhance the transdermal permeation of the peptide. In vitro and in vivo cytotoxicity studies of the IL/O-NDs revealed the biocompatibility of the LBIL-based formulations. These results indicated that IL/O-NDs are promising biocompatible carriers for lipid-peptide TDDSs.
  13. Alrosan M, Tan TC, Mat Easa A, Gammoh S, Alu'datt MH
    Food Chem, 2022 Feb 10;383:132386.
    PMID: 35176718 DOI: 10.1016/j.foodchem.2022.132386
    Due to its high nutritional value and increasing consumption trends, plant-based proteins were used in a variety of dietary products, either in their entirety or as partial substitutions. There is indeed a growing need to produce plant-based proteins as alternatives to dairy-based proteins that have good functional properties, high nutritional values, and high protein digestibility. Among the plant-based proteins, both lentil and quinoa proteins received a lot of attention in recent years as dairy-based protein alternatives. To ensure plant-based proteins a success in food applications, food industries and researchers need to have a comprehensive scientific understanding of these proteins. The demand for proteins is highly dependent on several factors, mainly functional properties, nutritional values, and protein digestibility. Fermentation and protein complexation are recognised to be suitable techniques in enhancing the functional properties, nutritional values, and protein digestibility of these plant-based proteins, making them potential alternatives for dairy-based proteins.
  14. Manik H, Triyoga RS, Siregar MFG, Rochadi RK, Poddar S
    J Public Health Res, 2021 Dec 28;10(s2).
    PMID: 34964570 DOI: 10.4081/jphr.2021.2707
    BACKGROUND: Health and mortality problems are closely related to the maternal mortality rate (MMR). Efforts to reduce MMR have been carried out by many countries, including the Indonesian government.

    DESIGN AND METHODS: This research was conducted using two approaches, namely quantitative and qualitative or mixed methods and 149 respondents and 26 informants, to reduce MMR in Dairi Regency. This study was also carried out to determine the dominant variable that affects mother's behavior in an effort to reduce MMR in accordance with the existing theory.

    RESULT: Mother's intention to contribute to the reduction of MMR in this study was influenced by the good factor directly or indirectly. This is indicated by the score p<0.005. The study also shows that it is very important for the health workers to be able to communicate well with individuals and communities.

    CONCLUSION: The present study will help to reduce maternal fatalities, and will help to build systems and processes that will allow control the behaviour of the pregnant women and determine the cause of death as well as its contributing factors.

  15. Yehya AHS, Asif M, Abdul Majid AMS, Oon CE
    Biomed J, 2021 Dec;44(6):694-708.
    PMID: 35166208 DOI: 10.1016/j.bj.2020.05.015
    BACKGROUND: Pancreatic cancer is one of the most notorious cancers and is known for its highly invasive characteristics, drug resistance, and metastatic progression. Unfortunately, many patients with advanced pancreatic cancer become insensitive towards gemcitabine treatment. Orthosiphon stamineus (O.s) is used widely as a traditional medicine for the treatment of multiple ailments, including cancer in South East Asia. The present in vitro study was designed to investigate the complementary effects of an ethanolic extract of O.s (Et. O.s) or rosmarinic acid in combination with gemcitabine on Panc-1 pancreatic cancer cells.

    METHOD: Cell viability and colony formation assays were used to determine the 50% inhibitory concentration (IC50) of Et. O.s, rosmarinic acid, and gemcitabine. Different doses of gemcitabine in combination with Et. O.s or rosmarinic acid were tested against Panc-1 to select the best concentrations which possessed synergistic effects. Elucidation of molecular mechanisms responsible for mediating chemo-sensitivity in Panc-1 was performed using Quantitative Real-time PCR (QPCR), flow cytometry and immunohistochemistry.

    RESULTS: Et. O.s was found to significantly sensitise Panc-1 towards gemcitabine by reducing the gene expression of multidrug-resistant protein family (MDR) (MDR-1, MRP-4, and MRP-5) and molecules related to epithelial-mesenchymal transition (ZEB-1 and Snail-1). An induction of the human equilibrate nucleoside transporter-1 (hENT-1) gene was also found in cells treated with Et. O.s-gemcitabine. The Et. O.s-gemcitabine combination induced cellular senescence, cell death and cell cycle arrest in Panc-1. In addition, the inhibition of Notch signalling was demonstrated through the downregulation of Notch 1 intracellular domain in this treatment group. In contrast, rosmarinic acid-gemcitabine combination showed no additional effects on cellular senescence, apoptosis, epithelial mesenchymal transition (EMT) markers, the MRP-4 and MRP-5 multi-drug resistance protein family, hENT-1, and the Notch pathway through Notch 1 intracellular domain.

    CONCLUSION: This study provides valuable insights on the use of Et. O.s to complement gemcitabine in targeting pancreatic cancer in vitro, suggesting its potential use as a novel complementary treatment in pancreatic cancer patients.

  16. Ahmed A, Dujaili JA, Jabeen M, Umair MM, Chuah LH, Hashmi FK, et al.
    Front Pharmacol, 2021;12:807446.
    PMID: 35153763 DOI: 10.3389/fphar.2021.807446
    Background: With the increased availability of safe antiretroviral therapy (ART) in recent years, achieving optimal adherence and patient retention is becoming the biggest challenge for people living with HIV (PLWH). Care retention is influenced by several socioeconomic, socio-cultural, and government policies during the COVID-19 pandemic. Therefore, we aim to explore barriers and facilitators to adherence to ART among PLWH in Pakistan in general and COVID-19 pandemic related in particular. Methods: Semi-structured interviews were conducted among 25 PLWH from December 2020 to April 2021 in the local language (Urdu) at the ART centre of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Interviews were audio-recorded in the local Urdu language, and bilingual expert (English, Urdu) transcribed verbatim, coded for themes and sub-themes, and analyzed using a phenomenological approach for thematic content analysis. Results: Stigma and discrimination, fear of HIV disclosure, economic constraints, forgetfulness, religion (Ramadan, spiritual healing), adverse drug reactions, lack of social support, alternative therapies, and COVID-19-related lock-down and fear of lesser COVID-19 care due to HIV associated stigma were identified as barriers affecting the retention in HIV care. At the same time, positive social support, family responsibilities, use of reminders, the beneficial impact of ART, and initiation of telephone consultations, courier delivery, and long-term delivery of antiretrovirals during COVID-19 were identified as facilitators of HIV retention. Conclusion: Improving adherence and retention is even more challenging due to COVID-19; therefore, it requires the integration of enhanced access to treatment with improved employment and social support. HIV care providers must understand these reported factors comprehensively and treat patients accordingly to ensure the continuum of HIV care. A coordinated approach including different stakeholders is required to facilitate patient retention in HIV care and consequently improve the clinical outcomes of PLWH.
  17. Khan SA, Kassim NFA, Webb CE, Aqueel MA, Ahmad S, Malik S, et al.
    Sci Rep, 2021 12 21;11(1):24298.
    PMID: 34934127 DOI: 10.1038/s41598-021-03765-z
    The nutritional requirements of mosquitoes include both sugar (generally derived from the nectar of flowers) and blood (humans or animals). Mosquitoes express different degrees of preferences towards hosts depending on behavioral, ecological, and physiological factors. These preferences have implications for mosquito-borne disease risk. The present study is directed to reveal the effect of the human blood groups on the fecundity and fertility of the malaria vector Anopheles stephensi. In laboratory tests, mosquitoes were fed on ABO blood groups via artificial membrane feeders, and the level of attraction against different blood groups was tested by the electroantennogram and wind tunnel bioassay under control conditions. Results indicate that the female mosquitoes had a strong preference towards the blood group B, while in the case of females fed on O blood group had the highest digestibility rate. Overall, the human blood type had a significant impact on the fecundity and fertility of female An. stephensi. The highest numbers of eggs are laid, in the case of blood group B, (mean (± SD)) 216.3 (8.81) followed by the AB, 104.06 (7.67), and O, 98.01 (7.04). In the case of blood group B, females attain the highest fertility of about 92.1 (9.98). This study provides novel insight into the ABO blood type host choice of the mosquitoes that are still partially unknown and suggests encouraging personal protection for relevant individuals within communities at risk, which is a useful tool for preventing malaria where the An. stephensi is present as a dominant vector.
  18. Venkatason P, Zaharan NL, Ismail MD, Wan Ahmad WA, Mahmood Zuhdi AS
    Eur J Clin Pharmacol, 2018 Jul;74(7):953-960.
    PMID: 29582106 DOI: 10.1007/s00228-018-2451-3
    PURPOSE: Information is lacking on prescribing of preventative cardiovascular pharmacotherapies for patients with non-ST elevation myocardial infarction (NSTEMI) in the Asian region. This study examined the prescribing rate of these pharmacotherapies, comparing NSTEMI to STEMI, and variations across demographics and clinical factors within the NSTEMI group in the multi-ethnic Malaysian population.

    METHODS: This is a retrospective analysis of the Malaysian National Cardiovascular Disease Database-Acute Coronary Syndrome registry from year 2006 to 2013 (n = 30,873). On-discharge pharmacotherapies examined were aspirin, ADP-antagonists, statins, ACE-inhibitors, angiotensin-II-receptor blockers, and beta-blockers. Multivariate logistic regression was used to calculate adjusted odds ratio of receiving individual pharmacotherapies according to patients' characteristics in NSTEMI patients (n = 11,390).

    RESULTS: Prescribing rates for cardiovascular pharmacotherapies had significantly increased especially for ADP-antagonists (76%) in NSTEMI patients. More than 85% were prescribed statins and antiplatelets but rates remained significantly lower compared to STEMI. Women and those over 65 years old were less likely to be prescribed these pharmacotherapies compared to men and younger NSTEMI patients. Chinese and Indians were more likely to receive selected pharmacotherapies compared to Malays (main ethnicity). Geographical variations were observed; East Malaysian (Malaysian Borneo) patients were less likely to receive these compared to Western region of Malaysian Peninsular. Underprescribing in patients with risk factors such as diabetes were observed with other co-morbidities influencing prescribing selectively.

    CONCLUSION: This study uncovers demographic and clinical variations in cardiovascular pharmacotherapies prescribing for NSTEMI. Concerted efforts by policy makers, specialty societies, and physicians are required focusing on elderly, women, Malays, East Malaysians, and high-risk patients.

  19. Tanveer M, Ahmed A, Iqbal M, Aslam F, Saqlain M, Ur Rehman I, et al.
    Epilepsy Behav, 2022 Jan 29;128:108565.
    PMID: 35104734 DOI: 10.1016/j.yebeh.2022.108565
    BACKGROUND: Epilepsy is one of the most common but manageable neurological disorder. The relation between epilepsy, sleep, and health-related quality of life (HRQoL) in culturally distinct environment of Pakistan remains unclear. The purpose of this study was to determine prevalence and predictors of excessive daytime sleepiness (EDS), poor sleep quality (SQ), and to analyze their association with HRQoL in people with epilepsy (PWE).

    METHODS: A study was conducted among PWE attending two tertiary care hospitals of Islamabad and Rawalpindi, Pakistan. The EDS, SQ, and HRQoL were evaluated by Urdu versions of Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Quality of Life in Epilepsy-31 (QOLIE-31).

    RESULTS: The study included 200 PWE and 51 healthy controls with mean (SD) ages of 33.1 ± 13.9, 32.9 ± 10.9, and a disease duration of 5.01 ± 6.17, respectively. The majority of the respondents (n = 130, 65%) had poor seizure control, and most of these (n = 88, 68%) were on combination antiepileptic drug (AED) therapy. In comparison to controls, a higher number of PWE had EDS by ESS (score ≥ 11, 10% vs. 40%, p-value 0.00), and poor SQ by PSQI (score > 5, 9% vs. 71%, p-value 0.00). A multiple logistic regression analysis reveals that the factors significantly associated with EDS were: female gender; increasing age; seizure control; duration of epilepsy; and combination AED therapy. A second multiple binary logistic regression analysis suggests that factors significantly associated with poor SQ were: increasing age; female gender; poor seizure control; and combination therapy. The Hierarchical multivariate analysis suggests that poor seizure control, EDS, and poor SQ were significant predictors of low HRQoL.

    CONCLUSION: The findings suggest high prevalence of EDS and poor SQ in PWE in Pakistan. A significant negative association exists between sleep complaints and HRQoL. During routine clinical consultations, awareness about sleep hygiene practices must be provided to enhance HRQoL.

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