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Fulltext The Impact of Social Media Shared Health Content on Protective Behavior against COVID-19

Mohammed F, Al-Kumaim NH, Alzahrani AI, Fazea Y

Int J Environ Res Public Health, 2023 Jan 18;20(3).
PMID: 36767142 DOI: 10.3390/ijerph20031775

The use of social media has increased during the COVID-19 pandemic because people are isolated and working from home. The use of social media enhances information exchange in society and may influence public protective behavior against the COVID-19 pandemic. The purpose of this study is to identify the factors affecting public protective behavior when relying on COVID-19 pandemic-related content shared on social media. A model based on Protection Motivation Theory (PMT) was proposed and validated using a quantitative survey approach. A questionnaire was distributed to random respondents, and 488 responses were received and analyzed using Smart-PLS software. The findings showed that perceived risk, e-health literacy, public awareness, and health experts' participation influence public protective behavior when using social media to share COVID-19-relevant content. The outcomes of this study can enhance government agencies' and public health care authorities' understanding of how to use social media to raise awareness and reduce panic among the public.
Fulltext Effect of prone versus supine position in COVID-19 patients: A systematic review and meta-analysis

Chua EX, Zahir SMISM, Ng KT, Teoh WY, Hasan MS, Ruslan SRB, et al.

J Clin Anesth, 2021 Nov;74:110406.
PMID: 34182261 DOI: 10.1016/j.jclinane.2021.110406

STUDY OBJECTIVE: To review the effects of prone position and supine position on oxygenation parameters in patients with Coronavirus Disease 2019 (COVID-19).
DESIGN: Systematic review and meta-analysis of non-randomized trials.
PATIENTS: Databases of EMBASE, MEDLINE and CENTRAL were systematically searched from its inception until March 2021.
INTERVENTIONS: COVID-19 patients being positioned in the prone position either whilst awake or mechanically ventilated.
MEASUREMENTS: Primary outcomes were oxygenation parameters (PaO₂/FiO₂ ratio, PaCO₂, SpO₂). Secondary outcomes included the rate of intubation and mortality rate.
RESULTS: Thirty-five studies (n = 1712 patients) were included in this review. In comparison to the supine group, prone position significantly improved the PaO₂/FiO₂ ratio (study = 13, patients = 1002, Mean difference, MD 52.15, 95% CI 37.08 to 67.22; p
Fulltext Combined immunodeficiency in a patient with c-Rel deficiency

Beaussant-Cohen S, Jaber F, Massaad MJ, Weeks S, Jones J, Alosaimi MF, et al.

J Allergy Clin Immunol, 2019 Aug;144(2):606-608.e4.
PMID: 31103457 DOI: 10.1016/j.jaci.2019.05.003

This study reports a homozygous mutation in REL abrogating c-Rel protein expression in a patient with combined immunodeficiency characterized by susceptibility to Mycobacterium tuberculosis, Salmonella, Cryptosporidium, and cytomegalovirus.
The diuretic effect of adding aminophylline or theophylline to furosemide in pediatric populations: a systematic review

Van Siang Lian Mang P, Hui JC, Tan RSJ, Hasan MS, Choo YM, Abosamak MF, et al.

Eur J Pediatr, 2023 Jan;182(1):1-8.
PMID: 36251063 DOI: 10.1007/s00431-022-04655-w

The diuretic effect of the combined furosemide and aminophylline/theophylline among pediatric patients remains unclear. The primary aim of this systematic review was to examine the clinical diuretic effects (urine output and fluid balance) of co-administration of furosemide and aminophylline/theophylline as compared to furosemide alone in pediatric population. Ovid MEDLINE, CENTRAL, and EMBASE were searched from its inception until March 2022 for observational studies and randomized controlled trials (RCTs) comparing the administration of furosemide versus furosemide and aminophylline/theophylline in pediatric population. Case reports, case series, commentaries, letters to editors, systematic reviews, and meta-analyses were excluded. Five articles with a total sample population of 187 patients were included in this systematic review. As compared to the furosemide alone, our pooled data demonstrated that co-administration of furosemide and aminophylline/theophylline was associated with higher urine output (mean difference: 2.91 [90% CI 1.54 to 4.27], p
Fulltext Selenium Nanoparticles as a Natural Antioxidant and Metabolic Regulator in Aquaculture: A Review

Dawood MAO, Basuini MFE, Yilmaz S, Abdel-Latif HMR, Kari ZA, Abdul Razab MKA, et al.

Antioxidants (Basel), 2021 Aug 27;10(9).
PMID: 34572996 DOI: 10.3390/antiox10091364

Balanced aquafeed is the key factor for enhancing the productivity of aquatic animals. In this context, aquatic animals require optimal amounts of lipids, proteins, carbohydrates, vitamins, and minerals. The original plant and animals' ingredients in the basal diets are insufficient to provide aquafeed with suitable amounts of minerals. Concurrently, elements should be incorporated in aquafeed in optimal doses, which differ based on the basal diets' species, age, size, and composition. Selenium is one of the essential trace elements involved in various metabolic, biological, and physiological functions. Se acts as a precursor for antioxidative enzyme synthesis leading to high total antioxidative capacity. Further, Se can enhance the immune response and the tolerance of aquatic animals to infectious diseases. Several metabolic mechanisms, such as thyroid hormone production, cytokine formation, fecundity, and DNA synthesis, require sufficient Se addition. The recent progress in the nanotechnology industry is also applied in the production of Se nanoparticles. Indeed, Se nanoparticles are elaborated as more soluble and bioavailable than the organic and non-organic forms. In aquaculture, multiple investigations have elaborated the role of Se nanoparticles on the performances and wellbeing of aquatic animals. In this review, the outputs of recent studies associated with the role of Se nanoparticles on aquatic animals' performances were simplified and presented for more research and development.
Dietary Guduchi (Tinospora cordifolia) enhanced the growth performance, antioxidative capacity, immune response and ameliorated stress-related markers induced by hypoxia stress in Nile tilapia (Oreochromis niloticus)

El Basuini MF, Teiba II, Shahin SA, Mourad MM, Zaki MAA, Labib EMH, et al.

Fish Shellfish Immunol, 2022 Jan;120:337-344.
PMID: 34883256 DOI: 10.1016/j.fsi.2021.12.002

Nile tilapia can tolerate a wide range of farming conditions; however, fluctuations in the environmental conditions may impair their health status. The incorporation of medicinal herbs in aquafeed is suggested to overcome stressful conditions. In this study, dietary Guduchi (Tinospora cordifolia) was evaluated on the growth performance, antioxidative capacity, immune response, and resistance of Nile tilapia against hypoxia stress. Fish fed five diets incorporated with Guduchi at 0, 2, 4, 6, and 8 g/kg for 56 days then exposed with hypoxia stress for 72 h. The growth performance, feed intake, and feed efficiency ratio were significantly (P
Fulltext Sinomenine accelerate wound healing in rats by augmentation of antioxidant, anti-inflammatory, immunuhistochemical pathways

Jabbar AAJ, Abdul-Aziz Ahmed K, Abdulla MA, Abdullah FO, Salehen NA, Mothana RA, et al.

Heliyon, 2024 Jan 15;10(1):e23581.
PMID: 38173533 DOI: 10.1016/j.heliyon.2023.e23581

Sinomenine (SN) is a well-documented unique plant alkaloid extracted from many herbal medicines. The present study evaluates the wound healing potentials of SN on dorsal neck injury in rats. A uniform cut was created on Sprague Dawley rats (24) which were arbitrarily aligned into 4 groups receiving two daily topical treatments for 14 days as follows: A, rats had gum acacia; B, rats addressed with intrasite gel; C and D, rats had 30 and 60 mg/ml of SN, respectively. The acute toxicity trial revealed the absence of any toxic signs in rats after two weeks of ingestion of 30 and 300 mg/kg of SN. SN-treated rats showed smaller wound areas and higher wound closure percentages compared to vehicle rats after 5, 10, and 15 days of skin excision. Histological evaluation of recovered wound tissues showed increased collagen deposition, fibroblast content, and decreased inflammatory cells in granulated tissues in SN-addressed rats, which were statistically different from that of gum acacia-treated rats. SN treatment caused positive augmentation of Transforming Growth Factor Beta 1 (angiogenetic factor) in wound tissues, denoting a higher conversion rate of fibroblast into myofibroblast (angiogenesis) that results in faster wound healing action. Increased antioxidant enzymes (SOD and CAT), as well as decreased MDA contents in recovered wound tissues of SN-treated rats, suggest the antioxidant potentials of SN that aid in faster wound recovery. Wound tissue homogenates showed higher hydroxyproline amino acid (collagen content) values in SN-treated rats than in vehicle rats. SN treatment suppressed the production of pro-inflammatory cytokines and increased anti-inflammatory cytokines in the serum of wounded rats. The outcomes present SN as a viable pharmaceutical agent for wound healing evidenced by its positive modulation of the antioxidant, immunohistochemically proteins, hydroxyproline, and anti-inflammatory cytokines.
Fulltext Cumin (Cuminum cyminum L.) seeds accelerates wound healing in rats: Possible molecular mechanisms

Ahmed KA, Jabbar AAJ, Galali Y, M Al-Qaaneh A, Akçakavak G, Salehen NA, et al.

Skin Res Technol, 2024 May;30(5):e13727.
PMID: 38711343 DOI: 10.1111/srt.13727

Wound healing is a complex, intricate, and dynamic process that requires effective therapeutic management. The current study evaluates the wound healing potentials of methanolic extract of Cuminum cyminum L. seeds (CCS) in rats. Sprague Dawley (24) rats were distributed into four cages, wounds produced on the back of the neck, and received two daily topical treatments for 14 days: A, rats received normal saline; B, wounded rats treated with intrasite gel; C and D, rats received 0.2 mL of 250 and 500 mg/kg of CCS, respectively. After that, wound area and closure percentage were evaluated, and wound tissues were dissected for histopathological, immunohistochemical, and biochemical examinations. Acute toxicity trials of methanolic extract of CCS showed the absence of any physiological changes or mortality in rats. CCS application caused a significant reduction in wound size and a statistically elevated percentage of wound contraction than those of vehicle rats. CCS treatment caused significant up-regulation of collagen fiber, fibroblasts, and fewer inflammatory cells (inflammation) in granulation tissues. TGF-β1 (angiogenetic factor) was significantly more expressed in CCS-treated rats in comparison to normal saline-treated rats; therefore, more fibroblasts transformed into myofibroblasts (angiogenesis). CCS-treated rats showed remarkable antioxidant potentials (higher SOD and CAT enzymes) and decreased MDA (lipid peroxidation) levels in their wound tissue homogenates. Hydroxyproline amino acid (collagen) was significantly up-regulated by CCS treatment, which is commonly related to faster wound closure area. The outcomes suggest CCS as a viable new source of pharmaceuticals for wound treatment.
Comparative impact of replacing fish meal with azolla on growth, water quality, and physiology of red tilapia fingerlings at varying salinities

Sallam GR, Helal AM, Mabrouk HAH, Hermina AHFG, Habib YJ, Fayed WM, et al.

J Anim Physiol Anim Nutr (Berl), 2024 Sep;108(5):1370-1382.
PMID: 38689484 DOI: 10.1111/jpn.13980

A 210-day experiment to assess the efficacy of substituting azolla plant powder at levels of 0, 20, 40, and 60% for fish meal on red tilapia fingerlings (RTF, initial weight of 18.23 ± 0.12 g) performance under salinity levels of 5, 18, and 28ppt. Among the various conditions, RTF-fed 20% azolla at 28 and 5ppt salinity showcased the highest specific growth rate (SGR), whereas the lowest SGR was observed in fish-fed 60% azolla at 5ppt salinity. Upon azolla incorporation, noteworthy elevations in phytoplankton, zooplankton, dissolved oxygen (DO), pH, NH3, and NO3 were noted and conversely, azolla introduction led to decreased NH4 and NO2 concentrations in all salinity levels. Further, a significant (p
Fulltext A Saudi Heart Association Position Statement on Cardiovascular Diseases and Diabetes Mellitus

Alhabeeb W, Elasfar A, Kinsara AJ, Aljizeeri A, Jelaidan I, Alghalayini K, et al.

J Saudi Heart Assoc, 2024;36(4):385-407.
PMID: 39822337 DOI: 10.37616/2212-5043.1407

BACKGROUND: Cardiovascular disease (CVD) and diabetes mellitus are prominent public health concerns in Saudi Arabia owing to their increasingly high prevalence and burden. Based on this, the Saudi Heart Association (SHA) set out to develop an official position statement on CVD and diabetes mellitus, with a focus on the prevention and management of these conditions and relevant special populations in the context of Saudi Arabia.
METHODS: A multidisciplinary panel of experts met under the auspices of the SHA in a series of meetings to review and discuss available evidence on the prevention and management of comorbid CVD and diabetes mellitus. Specialized subcommittees reviewed the data and offered context-specific recommendations (taking into account Saudi population characteristics, local healthcare system, available resources and medical expertise), which were later approved by the full expert panel.
RESULTS AND CONCLUSIONS: The prevalence of diabetes mellitus and CVD is alarming in the Saudi Arabian population. Diabetes mellitus and CVD are interconnected on several levels, including cellular and molecular events as well as epigenetic and genetic mechanisms. Screening for CVD is a priority for patients with diabetes and concomitant risk factors. The expert panel also recommends aggressive management of high blood pressure and dyslipidemia in addition to lifestyle changes and achieving glycemic targets for the prevention of CVD in patients with diabetes. Some glucose-lowering drug classes, namely SGLT2-inhibitors and GLP-1 receptor agonists, offer significant benefits on the level of cardiovascular risk reduction and are thus a powerful addition to the clinical management armamentarium in CVD and diabetes. Special consideration is also advised for patient populations with distinct clinical presentation and needs, such as coronary artery disease, heart failure, and chronic kidney disease, among others.
Giant Cell Tumor of the Ribs and Aneurysmal Bone Cyst Presenting With Hemothorax in a Child

Alias H, Doris Lau SC, Loh CK, Ishak MI, Mohammed F, Jamal R, et al.

J Pediatr Hematol Oncol, 2017 11;39(8):e463-e465.
PMID: 28859035 DOI: 10.1097/MPH.0000000000000960

Giant cell tumor (GCT) is one of the most common tumors of bone and is the most common precursor of aneurysmal bone cysts (ABC). The clinical behavior of concurrent GCT and ABC can be very aggressive in children. GCT of the ribs, with or without ABC, is rarely seen in children. We report a case of an 8-year-old girl with GCT and associated ABC of the ribs who presented with sudden onset of chest pain and breathlessness due to a hemothorax. The patient was successfully treated by surgical resections and arterial embolization. She has remained well for 4 years after the initial surgery.
Diffuse hepatic haemangiomatosis: A case report and review of literature

Rao R, Naidu J, Muhammad Nawawi KN, Wong ZQ, Ngiu CS, Mohammed F, et al.

Med J Malaysia, 2018 12;73(6):436-438.
PMID: 30647226

Hepatic haemangioma is a solitary liver lesion and prevalent among the female patients. We report a case of diffuse hepatic haemangiomatosis in a 62-year-old man, who was referred for an incidental finding of multiple liver nodules. History and physical examinations were unremarkable. Computed tomography and magnetic resonance imaging of the liver were performed and showed multiple haemangiomatosis. In view of the rarity of this condition in men, a liver biopsy was done and confirmed haemangiomas. Available published literature on diffuse hepatic haemangiomatosis was reviewed.
A case of surgically resected cardiac rhabdomyoma with progressive left ventricular outflow tract obstruction

Mohammed F, Tan GC, Hor KN, Arnold M, Wong YP

Cardiovasc Pathol, 2020 05 12;49:107226.
PMID: 32574866 DOI: 10.1016/j.carpath.2020.107226

Cardiac rhabdomyoma is the most prevalent cardiac tumors in the pediatric population, in close association with tuberous sclerosis complex. It is usually detected antenatally or postnatally by echocardiography. Clinical presentations depend greatly on the size and position of the tumor mass. Interestingly, rhabdomyoma has a propensity to regress spontaneously and is not usually operated upon, unless the patient becomes hemodynamically compromised. Herein, we report an unusual case of surgically treated cardiac rhabdomyoma in a baby boy presented at birth with a progressive enlarging intraventricular mass, complicated with left ventricular outflow tract obstruction 7 weeks later. Histopathological examination of the intracardiac mass revealed sheets of tumor cells with spider-like morphology (known as "spider cells"), confirmed the diagnosis of rhabdomyoma. Close disease monitoring of patient's hemodynamic status in a newly diagnosed cardiac rhabdomyoma is inevitable as the tumor, although rare, may progress.
Fulltext Effect of Licorice Essential Oil (Glycyrrhizaglabraglabra) on Performance and Some Biochemical Parameters of Broiler Chickens

Dheyauldeen Salahdin O, Othman H, Hafsan H, Mohammed F, Ahmed Hamza T, Kadhim MM, et al.

Arch Razi Inst, 2023 Feb;78(1):95-105.
PMID: 37312740 DOI: 10.22092/ARI.2022.359522.2442

Due to its beneficial components, such as glycyrrhizin, licorice is regarded a medicinal and fragrant plant. This research was designed to investigate the efficacy of licorice essential oil as an alternative to chemical antibiotics on broiler production, carcass features, cellular and humoral safety, and numerous biochemical variables in broiler blood serum. A total of 160 day-old broiler chicks were assigned to four treatment groups using a totally randomized approach. Each treatment consisted of 4 replicates, with 10 chicks in each replication. The experimental treatments included a control group, a group receiving an elemental diet containing 0.1% licorice essential oil, a group receiving an elemental diet containing 0.2% licorice essential oil, and a group receiving an elemental diet containing 0.3% licorice essential oil. Broilers had ad libitum access to feed and water in accordance with a three-phase feeding schedule consisting of a starter, grower, and finisher diet. There was no statistically significant difference (P>0.05) in body weight, feed intake, or feed conversion ratio between birds given the control or essential oil licorice at various stages of the experiment. However, birds receiving 0.1% licorice essential oil had a lower gallbladder relative weight and 0.3% licorice essential oil had less abdominal fat than the control group (P<0.05). Blood glucose, cholesterol, and LDL concentrations all fell considerably in licorice essential oil-treated birds relative to controls (P<0.05). The cellular immune response of birds fed licorice-containing diets did not differ from that of control birds (P>0.05), however there was a significant difference in the humoral immune response at 0.1% licorice essential oil compared to the control group (P<0.05). In overall, the results of this experiment demonstrated that incorporating licorice essential oil into a bird's diet improves its health and safety.
Fulltext Evaluation of Phosphorus Storage and Performance of Broilers Using Phytase Synthetic Enzyme

Hafsan H, Mahmood Saleh M, Baban J, Mohammed F, Ahmed Hamza T, Ibrahim I, et al.

Arch Razi Inst, 2023 Feb;78(1):107-114.
PMID: 37312704 DOI: 10.22092/ARI.2022.359524.2443

Phytic acid is a stored form of phosphorus in cereals, 65 to 70% of phosphorus in plant sources is phytate, and broilers are only able to use part of the phosphorus in plant sources. To meet the needs of chickens, it is necessary to use other artificial resources, which not only impose part of the cost of the breeding period because of its presence in the manure but is one of the factors polluting the environment. This study aimed to use different levels of phytase enzyme to reduce dietary phosphorus levels. 600 Ross 308 broilers were used in this experiment with five treatments and six replications, and in each replication, 20 chickens were used in a completely randomized design (CRD). Experimental treatments include 1) basal diet (control) 2) basal diet with 15% less phosphorus 3) basal diet with 15% less phosphorus + 1250 (FTU) phytase enzyme 4) basal diet with 15% less phosphorus + 2500 (FTU) phytase enzyme 5) basal diet with 15% less phosphorus + 5000 (FTU) phytase enzyme. The evaluated traits included weekly feed intake, weekly weight gain, feed conversion ratio, carcass characteristics, ash, calcium, and bone phosphorus. The use of phytase enzyme in different diets had no significant effect on food intake, weight gain, and feed conversion ratio (P>0.05). However, the use of phytase in different diets significantly affected the percentage of Gizzard, Heart, Liver, Proventriculus, and Spleen (P<0.05). The most changes were the increase in the ratio of feed intake and weight gain in the fourth week compared to the third week so that the changes in the ratio of feed intake ranged from 1.85 to 1.91, and this ratio for weight gain also ranged from 3.12 to 3.86 was recorded, and the lowest feed conversion ratio was obtained at the same age. The percentage of raw ash in broiler chickens was significantly increased by adding dietary phytase. The lowest amount of ash, calcium, and phosphorus belonged to the second group (diets with low phosphorus and no enzyme). The difference between the other groups and the control was not significant. Feed intake, weight gain, and feed conversion ratio with the addition of phytase enzyme were not affected by phosphorus reduction and had no significant effect on carcass characteristics. Environmental pollution can be prevented by reducing the level of dietary phosphorus and reducing excreted phosphorus.
Fulltext NK/T cell lymphoma associated with peripheral eosinophilia

Yap E, Wan Jamaluddin WF, Tumian NR, Mashuri F, Mohammed F, Tan GC, et al.

Malays J Pathol, 2014 Dec;36(3):201-5.
PMID: 25500520 MyJurnal

NK/T cell lymphoma, nasal type is an aggressive and uncommon malignancy. Disease that occurs outside of the aerodigestive tract exhibits an even more aggressive clinical behaviour and does not respond as well to conventional therapy compared to its nasal counterpart. We report such a case of NK/T cell lymphoma, nasal type, that presented as an anterior chest wall mass, arising from the left pectoralis muscle. An interesting feature we wish to highlight is the associated eosinophilia that corresponded to disease activity, exhibiting fluctuations with surgical resection and chemotherapy. To the best of our knowledge this is the third reported case of NK/T cell lymphoma that is associated with peripheral eosinophilia. Our case highlights the role of certain NK cell subsets that play a major role in eosinophilic activation in NK/T lymphomas and calls for more research into further classification of this disease by virtue of its NK cell subsets.
Fulltext Expanding Arsenal against Neurodegenerative Diseases Using Quercetin Based Nanoformulations: Breakthroughs and Bottlenecks

Vishwas S, Kumar R, Khursheed R, Ramanunny AK, Kumar R, Awasthi A, et al.

Curr Neuropharmacol, 2023;21(7):1558-1574.
PMID: 35950245 DOI: 10.2174/1570159X20666220810105421

Quercetin (Qu), a dietary flavonoid, is obtained from many fruits and vegetables such as coriander, broccoli, capers, asparagus, onion, figs, radish leaves, cranberry, walnuts, and citrus fruits. It has proven its role as a nutraceutical owing to numerous pharmacological effects against various diseases in preclinical studies. Despite these facts, Qu and its nanoparticles are less explored in clinical research as a nutraceutical. The present review covers various neuroprotective actions of Qu against various neurodegenerative diseases (NDs) such as Alzheimer's, Parkinson's, Huntington's, and Amyotrophic lateral sclerosis. A literature search was conducted to systematically review the various mechanistic pathways through which Qu elicits its neuroprotective actions and the challenges associated with raw Qu that compromise therapeutic efficacy. The nanoformulations developed to enhance Qu's therapeutic efficacy are also covered. Various ongoing/completed clinical trials related to Qu in treating various diseases, including NDs, are also tabulated. Despite these many successes, the exploration of research on Qu-loaded nanoformulations is limited mostly to preclinical studies, probably due to poor drug loading and stability of the formulation, time-consuming steps involved in the formulation, and their poor scale-up capacity. Hence, future efforts are required in this area to reach Qu nanoformulations to the clinical level.
Psychological Perceptions and Preparedness during Novel Coronavirus Disease - 2019 (COVID-19) Pandemic - A Multinational Cross-sectional Study among Healthcare Professionals

Fairozekhan AT, Mohamed S, Mohammed F, Kumaresan R, Bugshan ASM, B SC, et al.

Braz Dent J, 2021 11 18;32(4):116-126.
PMID: 34787247 DOI: 10.1590/0103-6440202103821

Novel Coronavirus Disease 2019 (COVID-19) has caused serious repercussions both physically and mentally. The crisis has laid an enormous workload on the global healthcare fraternity. This article has attempted to study the emotional and psychological status of the medical and dental fraternity across seven Asian countries (India, Malaysia, the Gulf Cooperation countries (GCC) and, others) and also deduce the degree of mental preparedness as they spearhead the war against COVID-19. A cross-sectional, descriptive online survey was carried out among potential participants from online forums and other health-related social communities. Bivariate analysis with descriptive statistics was applied to decipher the results. A total of 788 complete responses were analyzed. The response rate was 77.1%. Results revealed the perception of the Healthcare Professionals about COVID-19 and its implications in their personal and professional lives. Many categories from psychological and emotional standpoints were analyzed. Older HCPs (above 35 years) reported high levels of stress at the workplace (p = 0.002). About 43.5% of the HCPs from India reported that they have not received any specialized training on containing COVID-19 or any contagious disease. Intense emotional stress was reported by the HCPs when colleagues get infected. The medical professionals (61.7%) exhibited more work stress compared to their dental counterparts. Analyzing the psychological and emotional status of HCPs is imperative especially in this COVID-19 situation. Similar analyses are crucial to gauge the quality of our healthcare system and take necessary actions like training the workforce, revamping the infrastructure, and regulating the workflow.
Marrow talaromycosis as the initial presentation in a case of Burkitt lymphoma

Hasbullah NE, Raja Sabudin RZA, Asri AS, Yusof N, Leong CF, Mohammed F, et al.

Malays J Pathol, 2024 Aug;46(2):325-329.
PMID: 39207011

Talaromyces marneffei is a thermally dimorphic fungus which causes opportunistic infections in immunocompromised individuals. The diagnosis of T. marneffei infection rests on the microscopic demonstration of the fungus in the tissues and/or isolation of the fungus from clinical specimens. In this report, we discuss a case involving a 23-year-old man who presented with a history of intermittent fever, cough and constitutional symptoms. Clinically, the patient exhibited pallor, jaundice, generalized seborrhoeic dermatitis, hepatomegaly, and small palpable cervical lymph nodes. A computed tomography (CT) scan of the abdomen showed homogenous hypodense lesions in both liver lobes. HIV screening result was reactive. Microscopic examination of the bone marrow aspirate smear and trephine biopsy identified fungal bodies, and culture of the marrow aspirate confirmed the presence of T. marneffei. Notably, the liver biopsy revealed Burkitt lymphoma alongside fungal bodies. He was treated with intravenous Amphotericin B but ultimately succumbed to the illness due to severe metabolic acidosis and multiorgan failure. This case underscores the importance of presumptive diagnosis through morphological or histological examination of bone marrow samples, as microbiologic culture methods can be time-consuming. Timely diagnosis and aggressive treatment are critical in managing patients with T. marneffei infection.
HER2 testing by immunohistochemistry in breast cancer: A multicenter proficiency ring study

Md Pauzi SH, Masir N, Yahaya A, Mohammed F, Tizen Laim NMS, Mustangin M, et al.

Indian J Pathol Microbiol, 2021 10 22;64(4):677-682.
PMID: 34673585 DOI: 10.4103/IJPM.IJPM_983_20

Background: Human epidermal growth factor receptor 2 (HER2) over-expression in breast cancer is associated with aggressive tumor behavior and predicts response to targeted therapy. Accurate HER2 result is paramount for optimal patient management. However, routine HER2 immunohistochemistry (IHC) testing are subjected to intra- and inter-laboratory variability.
Objective: This study aims to determine inter-laboratory variation in HER2 IHC testing through a slide-exchange program between five main reference laboratories.
Method: A total of 20 breast carcinoma cases with different known HER2 expression and gene status were selected by the central laboratory in five testing rounds. Three unstained tissue sections from each case were sent to participating laboratories, which immunostained and interpreted the HER2 immunohistochemistry result. One of the stained slides was sent to one designated participating laboratory for evaluation. Results were analyzed by the central laboratory.
Results: A complete concordance was achieved in six IHC-positive and six IHC-negative cases, its gene status of which was confirmed by in-situ-hybridization (ISH) study. The discordant results were observed in six equivocal cases, one negative case and one positive case with a concordance rate of 50-88.3%. Interestingly, the negative discordant case actually displays tumor heterogeneity. Good inter-observer agreement was achieved for all participating laboratories (k = 0.713-1.0).
Conclusion: Standardization of HER2 testing method is important to achieve optimum inter-laboratory concordance. Discordant results were seen mainly in equivocal cases. Intra-tumoral heterogeneity may impact the final HER2 IHC scoring. The continuous quality evaluation is therefore paramount to achieve reliable HER2 results.

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