Displaying publications 21 - 40 of 92 in total

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  1. Morphometrics of nuchal ligament in greyhound in different neck and body positions
    Ismail SMY, Murray CM, Olusa TAO, Ismail MM, Hailat NQ, Yen HH, et al.
    Anat Histol Embryol, 2022 Jan;51(1):143-152.
    PMID: 34882828 DOI: 10.1111/ahe.12771
    This study was conducted to describe the morphometrics of nuchal ligament and investigate the effects of different neck and body positions on the nuchal ligament in greyhounds. Nine adult greyhounds cadavers without any locomotion abnormalities were dissected through the neck musculature on the left side to expose the nuchal ligament. Three pins were placed to mark regions of interest on the nuchal ligament: at one cm cranial to the site of origin (the most dorsal point of the spinous process of the first thoracic vertebra), at the midpoint of the nuchal ligament and one cm caudal to the nuchal ligament site of insertion (close to the caudal aspect of the spinous process of the axis). Each cadaver was positioned on a masonite board and placed on a table on the floor in their lateral recumbency and seven different standardized body positions; P1-P7 were mimicked using goniometers and metal wires. Photographs were taken by positioning and fixing the camera above the nuchal ligament region. The length and widths (W1, W2 and W3) of nuchal ligament were measured using Image Pro software (Image-Pro Express version 5.0) on standardized photographs of each of seven different body and neck positions. The length of nuchal ligament in relation to the neutral position (P1) was less (- 7%, p > 0·05) in P6 (neck elevated) and increased in all other positions (+1%, p > 0·05 for P2, +19%, p  0·05 for P5, +40%, p 
  2. Fulltext A comprehensive review on modelling the adsorption process for heavy metal removal from waste water using artificial neural network technique
    Fiyadh SS, Alardhi SM, Al Omar M, Aljumaily MM, Al Saadi MA, Fayaed SS, et al.
    Heliyon, 2023 Apr;9(4):e15455.
    PMID: 37128319 DOI: 10.1016/j.heliyon.2023.e15455
    Water is the most necessary and significant element for all life on earth. Unfortunately, the quality of the water resources is constantly declining as a result of population development, industry, and civilization progress. Due to their extreme toxicity, heavy metals removal from water has drawn researchers' attention. A lot of scientific applications use artificial neural networks (ANNs) because of their excellent ability to map nonlinear relationships. ANNs shown excellent modelling capabilities for the water treatment remediation. The adsorption process uses a variety of variables, making the interaction between them nonlinear. Selecting the best technique can produce excellent results; the adsorption approach for removing heavy metals is highly effective. Different studies show that the ANNs modelling approach can accurately forecast the adsorbed heavy metals and other contaminants in order to remove them.
  3. Corrigendum to "A comprehensive review on modelling the adsorption process for heavy metal removal from waste water using artificial neural network technique" [Heliyon 9(4) (April 2023) e15455]
    Fiyadh SS, Alardhi SM, Al Omar M, Aljumaily MM, Al Saadi MA, Fayaed SS, et al.
    Heliyon, 2023 Jul;9(7):e17675.
    PMID: 37539279 DOI: 10.1016/j.heliyon.2023.e17675
    [This corrects the article DOI: 10.1016/j.heliyon.2023.e15455.].
  4. Fulltext The cytotoxic effect and glucose uptake modulation of Baeckea frutescens on breast cancer cells
    Shahruzaman SH, Mustafa MF, Ramli S, Maniam S, Fakurazi S, Maniam S
    BMC Complement Altern Med, 2019 Aug 19;19(1):220.
    PMID: 31426778 DOI: 10.1186/s12906-019-2628-z
    BACKGROUND: Baeckea frutescens (B. frutescens) of the family Myrtaceae is a plant that has been used in traditional medicine. It is known to have antibacterial, antipyretic and cytoprotective properties. The objective of this study is to explore the mechanism of B. frutescens leaves extracts in eliminating breast cancer cells.

    METHOD: B. frutescens leaves extracts were prepared using Soxhlet apparatus with solvents of different polarity. The selective cytotoxicity of these extracts at various concentrations (20 to 160 μg/ml) were tested using cell viability assay after 24, 48 and 72 h of treatment. The IC50 value in human breast cancer (MCF-7 and MDA-MB-231) and mammary breast (MCF10A) cell lines were determined. Apoptotic study using AO/PI double staining was performed using fluorescent microscope. The glucose uptake was measured using 2-NBDG, a fluorescent glucose analogue. The phytochemical screening was performed for alkaloids, flavonoids, tannins, triterpenoids, and phenols.

    RESULTS: B. frutescens leaves extracts showed IC50 value ranging from 10 -127μg/ml in MCF-7 cells after 72 h of treatment. Hexane extract had the lowest IC50 value (10μg/ml), indicating its potent selective cytotoxic activity. Morphology of MCF-7 cells after treatment with B. frutescens extracts exhibited evidence of apoptosis that included membrane blebbing and chromatin condensation. In the glucose uptake assay, B. frutescens extracts suppressed glucose uptake in cancer cells as early as 24 h upon treatment. The inhibition was significantly lower compared to the positive control WZB117 at their respective IC50 value after 72 h incubation. It was also shown that the glucose inhibition is selective towards cancer cells compared to normal cells. The phytochemical analysis of the extract using hexane as the solvent in particular gave similar quantities of tannin, triterpenoids, flavonoid and phenols. Presumably, these metabolites have a synergistic effect in the in vitro testing, producing the potent IC50 value and subsequently cell death.

    CONCLUSION: This study reports the potent selective cytotoxic effect of B. frutescens leaves hexane extract against MCF-7 cancer cells. B. frutescens extracts selectively suppressed cancer cells glucose uptake and subsequently induced cancer cell death. These findings suggest a new role of B. frutescens in cancer cell metabolism.

  5. Fulltext The Cytotoxic Properties of Baeckea frutescens Branches Extracts in Eliminating Breast Cancer Cells
    Shahruzaman SH, Mustafa MF, Ramli S, Maniam S, Fakurazi S, Maniam S
    Evid Based Complement Alternat Med, 2019;2019:9607590.
    PMID: 31178918 DOI: 10.1155/2019/9607590
    Breast cancer is the leading cause of cancer death in women in over 100 countries worldwide and accounts for almost 1 in 4 cancer cases among women. Baeckea frutescens of the family Myrtaceae has been used in traditional medicine and is known to possess antibacterial, antipyretic, and cytoprotective properties. In this study, we investigated the role of Baeckea frutescens branches extracts against human breast cancer cells. Baeckea frutescens branches extracts were prepared using Soxhlet apparatus with solvents of different polarity. The selective cytotoxic activity and the glucose consumption rate of Baeckea frutescens branches extracts of various concentrations (20 to 160 ug/ml) at 24-, 48-, and 72-hour time points were studied using MTT and glucose uptake assay. The IC50 values in human breast cancer (MCF-7 and MDA-MB-231) and mammary breast (MCF10A) cell lines were determined. Apoptotic study using AO/PI double staining was performed using fluorescent microscopy. The glucose uptake was measured using 2-NBDG, a fluorescent glucose analogue. The phytochemical screening of major secondary metabolites in plants was performed. This study reports that Baeckea frutescens branches extracts showed potent selective cytotoxic activity against MCF-7 cells compared to MDA-MB-231 cells after 72 hours of treatment. Evidence of early apoptosis which includes membrane blebbing and chromatin condensation was observed after 72 hours of treatment with Baeckea frutescens branches extracts. Interestingly, for the glucose uptake assay, the inhibition was observed as early as 24 hours upon treatment. All Baeckea frutescens extracts showed the presence of major secondary metabolites such as tannin, triterpenoid, flavonoid, and phenol. However, alkaloid level was unable to be determined. The identification of Baeckea frutescens and its possible role in selectively inhibiting glucose consumption in breast cancer cells defines a new role of natural product that can be utilised as an effective agent that regulates metabolic reprogramming in breast cancer.
  6. A PROspective study on the Usage patterns of Doripenem in the Asia-Pacific region (PROUD study)
    Mustafa M, Chan WM, Lee C, Harijanto E, Loo CM, Van Kinh N, et al.
    Int J Antimicrob Agents, 2014 Apr;43(4):353-60.
    PMID: 24636429 DOI: 10.1016/j.ijantimicag.2014.01.017
    Doripenem is approved in the Asia-Pacific (APAC) region for treating nosocomial pneumonia (NP) including ventilator-associated pneumonia (VAP), complicated intra-abdominal infections (cIAIs) and complicated urinary tract infections (cUTIs). Clinical usage of doripenem (500mg intravenously, infused over 1h or 4h every 8h for 5-14 days) in APAC was evaluated in a prospective, open-label, non-comparative, multicentre study of inpatients (≥18 years) with NP, VAP, cIAI or cUTI. A total of 216 [intention-to-treat (ITT)] patients received doripenem: 53 NP (24.5%); 77 VAP (35.6%); 67 cIAI (31.0%); and 19 cUTI (8.8%). Doripenem MIC90 values for Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli and Klebsiella pneumoniae were 32, 32, 0.094 and 0.64μg/mL, respectively. Doripenem was used most commonly as monotherapy (86.6%) and as second-line therapy (62.0%). The clinical cure rate in clinically evaluable patients was 86.7% at the end of therapy (EOT) and 87.1% at test of cure (TOC) (7-14 days after EOT). In the ITT population, overall clinical cure rates were 66.2% at EOT and 56.5% at TOC. The median duration of hospital stay, intensive care unit (ICU) stay and mechanical ventilation was 20, 12 and 10 days, respectively. Of 146 discharged patients, 7 were re-admitted within 28 days of EOT; 1 VAP patient was re-admitted to the ICU. The all-cause mortality rate was 22.7% (49/216). The most common treatment-related adverse events were diarrhoea (1.4%) and vomiting (1.4%). Doripenem is a viable option for treating APAC patients with NP, VAP, cIAI or cUTI. [ClinicalTrials.gov: NCT 00986102].
  7. New alkaloids from Phoebe scortechinii
    Awang K, Mukhtar MR, Mustafa MR, Litaudon M, Shaari K, Mohamad K, et al.
    Nat Prod Res, 2007 Jul 10;21(8):704-9.
    PMID: 17616898
    The leaves of the Phoebe scortechinii (Gamb.) Kochummen Comb. Nov. (Lauraceae), afforded one new proaporphine-tryptamine dimer; (-)-phoebescortechiniine (1), along with two known ones; phoebegrandine A and phoebegrandine B. The proaporphine, tetrahydropronuciferine (2), was isolated for the first time as a natural product. The alkaloids were elucidated primarily by means of high field NMR and HRMS.
  8. Neuromuscular blocking activity of a glycosidic extract of the plant Sarcolobus globosus
    Mustafa MR, Hadi AH
    Toxicon, 1990;28(10):1237-9.
    PMID: 2264070
    Crude glycoside extracts from the plant, Sarcolobus globosus, were tested on the rat phrenic nerve-diaphragm, chick biventer cervicis and frog rectus abdominis preparations. Nerve-stimulated twitches were inhibited by the extract. The muscle paralysis was not similar to that by curare-like blockers as it was not reversed by neostigmine or by a tetanus. Although contractures to acetylcholine or carbachol were not affected by 0.6 mg/ml of the extract, higher concentration of the extracts (3 mg/ml) depressed the log dose-response curve of acetylcholine and carbachol. The results suggest that the neuromuscular blocking effect of the extracts is either dose-dependent or due to a mixture of toxins with presynaptic or postsynaptic actions.
  9. Fulltext Dynamic response and low voltage ride-through enhancement of brushless double-fed induction generator using Salp swarm optimization algorithm
    Memon A, Wazir Bin Mustafa M, Anjum W, Ahmed A, Ullah S, Altbawi SMA, et al.
    PLoS One, 2022;17(5):e0265611.
    PMID: 35551274 DOI: 10.1371/journal.pone.0265611
    A brushless double-fed induction generator (BDFIG) has shown tremendous success in wind turbines due to its robust brushless design, smooth operation, and variable speed characteristics. However, the research regarding controlling of machine during low voltage ride through (LVRT) need greater attention as it may cause total disconnection of machine. In addition, the BDFIG based wind turbines must be capable of providing controlled amount of reactive power to the grid as per modern grid code requirements. Also, a suitable dynamic response of machine during both normal and fault conditions needs to be ensured. This paper, as such, attempts to provide reactive power to the grid by analytically calculating the decaying flux and developing a rotor side converter control scheme accordingly. Furthermore, the dynamic response and LVRT capability of the BDFIG is enhanced by using one of the very intelligent optimization algorithms called the Salp Swarm Algorithm (SSA). To prove the efficacy of the proposed control scheme, its performance is compared with that of the particle swan optimization (PSO) based controller in terms of limiting the fault current, regulating active and reactive power, and maintaining the stable operation of the power system under identical operating conditions. The simulation results show that the proposed control scheme significantly improves the dynamic response and LVRT capability of the developed BDFIG based wind energy conversion system; thus proves its essence and efficacy.
  10. Fulltext Data-driven models for atmospheric air temperature forecasting at a continental climate region
    Alomar MK, Khaleel F, Aljumaily MM, Masood A, Razali SFM, AlSaadi MA, et al.
    PLoS One, 2022;17(11):e0277079.
    PMID: 36327280 DOI: 10.1371/journal.pone.0277079
    Atmospheric air temperature is the most crucial metrological parameter. Despite its influence on multiple fields such as hydrology, the environment, irrigation, and agriculture, this parameter describes climate change and global warming quite well. Thus, accurate and timely air temperature forecasting is essential because it provides more important information that can be relied on for future planning. In this study, four Data-Driven Approaches, Support Vector Regression (SVR), Regression Tree (RT), Quantile Regression Tree (QRT), ARIMA, Random Forest (RF), and Gradient Boosting Regression (GBR), have been applied to forecast short-, and mid-term air temperature (daily, and weekly) over North America under continental climatic conditions. The time-series data is relatively long (2000 to 2021), 70% of the data are used for model calibration (2000 to 2015), and the rest are used for validation. The autocorrelation and partial autocorrelation functions have been used to select the best input combination for the forecasting models. The quality of predicting models is evaluated using several statistical measures and graphical comparisons. For daily scale, the SVR has generated more accurate estimates than other models, Root Mean Square Error (RMSE = 3.592°C), Correlation Coefficient (R = 0.964), Mean Absolute Error (MAE = 2.745°C), and Thiels' U-statistics (U = 0.127). Besides, the study found that both RT and SVR performed very well in predicting weekly temperature. This study discovered that the duration of the employed data and its dispersion and volatility from month to month substantially influence the predictive models' efficacy. Furthermore, the second scenario is conducted using the randomization method to divide the data into training and testing phases. The study found the performance of the models in the second scenario to be much better than the first one, indicating that climate change affects the temperature pattern of the studied station. The findings offered technical support for generating high-resolution daily and weekly temperature forecasts using Data-Driven Methodologies.
  11. Fulltext An evaluation of the World Health Organization's 1997 and 2009 dengue classifications in hospitalized dengue patients in Malaysia
    Zakaria Z, Zainordin NA, Sim BL, Zaid M, Haridan US, Aziz AT, et al.
    J Infect Dev Ctries, 2014 Jul;8(7):869-75.
    PMID: 25022297 DOI: 10.3855/jidc.4283
    INTRODUCTION: The latest revised version of the World Health Organization's dengue classification was released in 2009. A handful of studies have taken initiatives to evaluate the old and revised guidelines to determine early signs and symptoms of severe dengue. This retrospective study aimed to compare the classification of dengue using both the 1997 and 2009 guidelines in a selected cohort of dengue patients from Peninsular Malaysia between 2008 and 2012.
    METHODOLOGY: Adult dengue patients were recruited from tertiary hospitals in two different states, Selangor and Kelantan, in Peninsular Malaysia. Their clinical manifestations were assessed.
    RESULTS: A total of 281 confirmed dengue patients were enrolled; the mean duration of illness at admission was five days. Of these, 88.6%, 10.7%, and 0.7% were classified according to the 1997 guidelines as having dengue fever (DF), dengue hemorrhagic fever (DHF), and dengue shock syndrome (DSS), respectively. When the WHO 2009 guidelines were applied, 17.1%, 78.3%, and 4.6% were classified as dengue without warning signs, dengue with warning signs, and severe dengue, respectively.
    CONCLUSIONS: Our data suggests that the revised WHO 2009 guidelines stratify a much larger proportion of patients into a category that requires a higher level of medical and nursing care.
  12. Fulltext Dentatin Induces Apoptosis in Prostate Cancer Cells via Bcl-2, Bcl-xL, Survivin Downregulation, Caspase-9, -3/7 Activation, and NF-κB Inhibition
    Arbab IA, Looi CY, Abdul AB, Cheah FK, Wong WF, Sukari MA, et al.
    Evid Based Complement Alternat Med, 2012;2012:856029.
    PMID: 23091559 DOI: 10.1155/2012/856029
    This study was set to investigate antiproliferative potential of dentatin (a natural coumarin isolated from Clausena excavata Burm. F) against prostate cancer and to delineate the underlying mechanism of action. Treatment with dentatin dose-dependently inhibited cell growth of PC-3 and LNCaP prostate cancer cell lines, whereas it showed less cytotoxic effects on normal prostate epithelial cell line (RWPE-1). The inhibitory effect of dentatin on prostate cancer cell growth was due to induction of apoptosis as evidenced by Annexin V staining and cell shrinkage. We found that dentatin-mediated accumulation of reactive oxygen species (ROS) and downregulated expression levels of antiapoptotic molecules (Bcl-2, Bcl-xL, and Survivin), leading to disruption of mitochondrial membrane potential (MMP), cell membrane permeability, and release of cytochrome c from the mitochondria into the cytosol. These effects were associated with induction of caspase-9, -3/7 activities, and subsequent DNA fragmentation. In addition, we found that dentatin inhibited TNF-α-induced nuclear translocation of p65, suggesting dentatin as a potential NF-κB inhibitor. Thus, we suggest that dentatin may have therapeutic value in prostate cancer treatment worthy of further development.
  13. Muscarinic receptor binding activity of polyoxygenated flavones from Melicope subunifoliolata
    Chung LY, Yap KF, Goh SH, Mustafa MR, Imiyabir Z
    Phytochemistry, 2008 May;69(7):1548-54.
    PMID: 18334259 DOI: 10.1016/j.phytochem.2008.01.024
    The bark extract of Melicope subunifoliolata (Stapf) T.G. Hartley showed competitive muscarinic receptor binding activity. Six polymethoxyflavones [melibentin (1); melisimplexin (3); 3,3',4',5,7-pentamethoxyflavone (4); meliternatin (5); 3,5,8-trimethoxy-3',4',6,7-bismethylenedioxyflavone (6); and isokanugin (7)] and one furanocoumarin [5-methoxy-8-geranyloxypsoralen (2)] were isolated from the bark extract. Compounds 2 and 6 were isolated for the first time from M. subunifoliolata. The methoxyflavones (compounds 1, 3, 4, 5, 6, and 7) show moderate inhibition in a muscarinic receptor binding assay, while the furanocoumarin (compound 2) is inactive. The potency of the methoxyflavones to inhibit [(3)H]NMS-muscarinic receptor binding is influenced by the position and number of methoxy substitution. The results suggest these compounds are probably muscarinic modulators, agonists or partial agonists/antagonists.
  14. Isolation, characterization, and identification of potential Diuron-degrading bacteria from surface sediments of Port Klang, Malaysia
    Hanapiah M, Zulkifli SZ, Mustafa M, Mohamat-Yusuff F, Ismail A
    Mar Pollut Bull, 2018 Feb;127:453-457.
    PMID: 29475685 DOI: 10.1016/j.marpolbul.2017.12.015
    Diuron is an alternative biocide suggested to replace organotin in formulating antifouling paints to be applied on water-going vessels hull. However, it is potentially harmful to various non-targeted marine organisms due to its toxic properties. Present study aimed to isolate, screen and identify the potential of Diuron-degrading bacteria collected from the marine sediments of Port Klang, Malaysia. Preliminary screening was conducted by exposing isolated bacteria to 430ng/L (background level), followed by 600ng/L and 1000ng/L of Diuron concentrations. Nine bacteria colonies survived the exposure of the above concentrations. However, only two strains can tolerate to survive up to 1000μg/L, which were then characterised and identified using phenotypic tests and the standard 16S rRNA molecular identification. The strains were identified as Comamonas jiangduensis SZZ 10 and Bacillus aerius SZZ 19 (GenBank accession numbers: KU942479 and KU942480, respectively). Both strains have the potential of Diuron biodegradation for future use.
  15. Fulltext Nigella sativa and Its Protective Role in Oxidative Stress and Hypertension
    Leong XF, Rais Mustafa M, Jaarin K
    Evid Based Complement Alternat Med, 2013;2013:120732.
    PMID: 23533459 DOI: 10.1155/2013/120732
    Hypertension increases the risk for a variety of cardiovascular diseases, including stroke, coronary artery disease, heart failure, and peripheral vascular disease. The increase in oxidative stress has been associated with the pathogenesis of hypertension. Increase of blood pressure is due to an imbalance between antioxidants defence mechanisms and free radical productions. Excessive production of reactive oxygen species reduces nitric oxide bioavailability leading to an endothelial dysfunction and a subsequent increase in total peripheral resistance. Hypertension can cause few symptoms until it reaches the advanced stage and poses serious health problems with lifelong consequences. Hypertensive patients are required to take drugs for life to control the hypertension and prevent complications. Some of these drugs are expensive and may have adverse reactions. Hence, it is timely to examine scientifically, complimentary therapies that are more effective and with minimal undesirable effects. Nigella sativa (NS) and its active constituents have been documented to exhibit antioxidant, hypotensive, calcium channel blockade and diuretic properties which may contribute to reduce blood pressure. This suggests a potential role of NS in the management of hypertension, and thus more studies should be conducted to evaluate its effectiveness.
  16. Fulltext Inhibitory effects of Ephedra alte on IL-6, hybrid TLR4, TNF-α, IL-1β, and extracted TLR4 receptors: in silico molecular docking
    Salman HA, Yaakop AS, Aladaileh S, Mustafa M, Gharaibeh M, Kahar UM
    Heliyon, 2023 Jan;9(1):e12730.
    PMID: 36685394 DOI: 10.1016/j.heliyon.2022.e12730
    Inflammation is a physiological reaction of the immune system required to remove the presence of pathogenic germs. Many herbal-derived extracts and phytoconstituents show anti-inflammatory effects. Among these natural phytoconstituents is Ephedra alte (E. alte), which shows pepsin enzyme inhibitory, antibacterial, and antioxidant activities. In this work, molecular docking study is conducted on five major human anti-inflammatory cytokines receptors (IL-6, hybrid TLR4, TNF-α, IL-1β, and extracted TLR4) to explore the molecular recognition process and complex ligand-receptor interactions of E. alte phytoconstituents. Human TLR4 receptor has been computationally extracted, for the first time, from the hybrid TLR4 human and VLRB inshore hagfish. Among E. alte phytoconstituents, only β-Sitosterol and Androstan-3-one have better LBE (Lowest Binding Energy) scores with inhibition constant (K i) values than those of other tested compounds. The β-Sitosterol and Androstan-3-one results indicate that these compounds could be efficient inhibitors of inflammation and reduce the oxidative stress by interfering with the activity of the five studied proteins.
  17. Fulltext Transmitted drug resistance and antiretroviral treatment outcomes in non-subtype B HIV-1-infected patients in South East Asia
    Phanuphak P, Sirivichayakul S, Jiamsakul A, Sungkanuparph S, Kumarasamy N, Lee MP, et al.
    J Acquir Immune Defic Syndr, 2014 May 01;66(1):74-9.
    PMID: 24413039 DOI: 10.1097/QAI.0000000000000108
    BACKGROUND: We compared treatment outcomes of transmitted drug resistance (TDR) in patients on fully or partially sensitive drug regimens.

    METHODS: Factors associated with survival and failure were analyzed using Cox proportional hazards and discrete time conditional logistic models.

    RESULTS: TDR, found in 60 (4.1%) of 1471 Asian treatment-naive patients, was one of the significant predictors of failure. Patients with TDR to >1 drug in their regimen were >3 times as likely to fail compared to no TDR.

    CONCLUSIONS: TDR was associated with failure in the context of non-fully sensitive regimens. Efforts are needed to incorporate resistance testing into national treatment programs.

  18. Resolution of Acanthosis Nigricans Following Curative Gastric Carcinoma Resection
    Jagwani AV, Reynu R, Affirul CA, Mustafa MT, Kosai NR
    Clin Ter, 2016;167(4):99-100.
    PMID: 27598021 DOI: 10.7417/CT.2016.1937
    We discuss a 48-year old, who presented with upper epigastrium pain associated with early satiety and significant weight loss. Physical examination revealed a thickening and darkening of skins around the skin folds, scalp, back and front of abdomen. A diagnosis of gastro-esophageal junction adenocarcinoma was confirmed by oesophagogastroduodenoscopy (OGDS) and biopsy. The biopsy of the skin lesion revealed a diagnosis of acanthosis nigricans, He underwent a total gastrectomy followed by adjuvant chemo-radiotherapy. Recovery is unremarkable. Interestingly, the skin lesions disappear following our therapy. We believe this may be attributed to the treatment of the malignancy. We highlight the interesting association, pathophysiology and therapy.
  19. Fulltext Natural history of asymptomatic gallstones: differential behaviour in male and female subjects
    Sood S, Winn T, Ibrahim S, Gobindram A, Arumugam AA, Razali NC, et al.
    Med J Malaysia, 2015 Dec;70(6):341-5.
    PMID: 26988206 MyJurnal
    OBJECTIVE: The natural history of asymptomatic (silent) gallstones has been inadequately studied. Existing information derives from studies based on oral cholecystography or relatively small sample sizes. We planned a retrospective cohort study in subjects with gallstones to determine conversion rates from asymptomatic to symptomatic.
    METHODS: We extracted data from computerised databases of one government hospital and two private clinics in Malaysia. Files were scrutinised to ensure that criteria for asymptomatic gallstones were fulfilled. Patients were called on telephone, further questioned to confirm that the gallstones at detection were truly asymptomatic, and asked about symptoms that were consistent with previously defined criteria for biliary colic. Appropriate ethical clearances were taken.
    RESULTS: 213 (112 males) patients fulfilled the criteria for asymptomatic gallstones and could be contacted. 23 (10.8%) developed pain after an average follow up interval of 4.02 years (range 0.1-11 years). Conversion rates from asymptomatic to symptomatic gallstones were high in the first two years of follow up, averaging 4.03±0.965 per year. Over time the conversion rates slowed, and by year 10 the annual conversion rate averaged only 1.38±0.29. Conversion rates were much higher for females compared to males (F:M hazard ratio 3.23, SE 1.54, p>z 0.014). The lifetime risks for conversion approached 6.15% for males, and 22.1% for females.
    CONCLUSION: In conclusion, asymptomatic gallstones are much more likely to convert to symptomatic in females than in males. Males in whom asymptomatic stones are discovered should be advised conservative treatment. Surgery may be preferable to conservative management if the subject is a young female.
    m radiology records of Hospital
    Study site: Computerised database, Hospital Selayang, Selangor; private clinics, Kuala Lumpur, Malaysia
  20. Fulltext Trends in first-line antiretroviral therapy in Asia: results from the TREAT Asia HIV observational database
    Boettiger DC, Kerr S, Ditangco R, Merati TP, Pham TT, Chaiwarith R, et al.
    PLoS One, 2014;9(9):e106525.
    PMID: 25184314 DOI: 10.1371/journal.pone.0106525
    Antiretroviral therapy (ART) has evolved rapidly since its beginnings. This analysis describes trends in first-line ART use in Asia and their impact on treatment outcomes.
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