MyMedR

Displaying publications 21 - 40 of 161 in total

Abstract:

Sort:

Fulltext Elevated interleukin-25 and its association to Th2 cytokines in systemic lupus erythematosus with lupus nephritis

Selvaraja M, Abdullah M, Arip M, Chin VK, Shah A, Amin Nordin S

PLoS One, 2019;14(11):e0224707.
PMID: 31697750 DOI: 10.1371/journal.pone.0224707

Systemic lupus erythematosus (SLE) is an autoimmune disorder that is associated with lupus nephritis, initiated by the deposition of immune complexes in the kidney; subsequently, this induces the overexpression of cytokines. Lupus nephritis is known as one of the major clinical manifestations that affect the disease severity in SLE patients. An increased number of resident periglomerular and immune cells in the kidney has the potential to affect the equilibrium of different immune cell subsets, such as Th1, Th2, Th17, and Tregs, which may be central to the induction of tissue damage in kidney by exerting either proinflammatory or anti-inflammatory effects, or both. This equilibrium has yet to be confirmed, as new players such as IL-25 remain undiscovered. IL-25 is a cytokine of the IL-17 family, which stimulates Th2-mediated immune response when overly expressed. Thus, the aim of this research is to determine the plasma levels of IL-25 and Th2-associated cytokines (IL-4, IL-5, IL-6, IL-9, IL-10, IL-13) in SLE patients with (SLE-LN) and without lupus nephritis. Sixty-four (n = 64) SLE patients and fifteen (n = 15) healthy individuals were recruited. This study demonstrated that the IL-9, IL-10 and IL-25 had significantly increased expressions in SLE-LN, followed by SLE without LN, compared to healthy controls. Meanwhile, IL-5 and IL-6 had significantly reduced. No significant difference was observed with IL-13, while the level of IL-4 was undetectable. Furthermore, IL-9 and IL-10 were significantly correlated with the IL-25, and IL-25, IL-9 and IL-10 were positively correlated with the disease severity score, SLEDAI. In conclusion, IL-25 and its associated Th2 cytokines (IL-9 and IL-10) may be involved in SLE pathogenesis. These cytokines could be potential biomarkers in monitoring and predicting the disease severity during SLE pathogenesis.
Fulltext Evaluating critical success factors in implementing E-learning system using multi-criteria decision-making

Naveed QN, Qureshi MRN, Tairan N, Mohammad A, Shaikh A, Alsayed AO, et al.

PLoS One, 2020;15(5):e0231465.
PMID: 32365123 DOI: 10.1371/journal.pone.0231465

Learning using the Internet or training through E-Learning is growing rapidly and is increasingly favored over the traditional methods of learning and teaching. This radical shift is directly linked to the revolution in digital computer technology. The revolution propelled by innovation in computer technology has widened the scope of E-Learning and teaching, whereby the process of exchanging information has been made simple, transparent, and effective. The E-Learning system depends on different success factors from diverse points of view such as system, support from the institution, instructor, and student. Thus, the effect of critical success factors (CSFs) on the E-Learning system must be critically analyzed to make it more effective and successful. This current paper employed the analytic hierarchy process (AHP) with group decision-making (GDM) and Fuzzy AHP (FAHP) to study the diversified factors from different dimensions of the web-based E-Learning system. The present paper quantified the CSFs along with its dimensions. Five different dimensions and 25 factors associated with the web-based E-Learning system were revealed through the literature review and were analyzed further. Furthermore, the influence of each factor was derived successfully. Knowing the impact of each E-Learning factor will help stakeholders to construct education policies, manage the E-Learning system, perform asset management, and keep pace with global changes in knowledge acquisition and management.
Exploring the current and future role of the pharmacists in osteoporosis screening and management in Malaysia

Toh LS, Lai PSM, Othman S, Shah A, Dang CPL, Low BY, et al.

Int J Clin Pharm, 2018 Apr;40(2):450-457.
PMID: 29380234 DOI: 10.1007/s11096-018-0597-9

Background: Several studies have found that pharmacists can assist in screening and prevention of osteoporosis by referring patients for bone mineral density scans and counselling on lifestyle changes. In Malaysia, screening osteoporosis in all elderly women is not mandatory due to its cost. One approach to address this gap is to develop a pharmacist-led osteoporosis screening and prevention program. However, there is a paucity of data on the perspectives of Malaysian pharmacists in this area.
Objective: To explore the perspective of stakeholders (policy makers, doctors, pharmacists, nurses and patients) towards the role of pharmacists in osteoporosis screening and management.
Setting: A primary care clinic located within a teaching hospital in Kuala Lumpur, Malaysia.
Method: Patients (n = 20), nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis. Main outcome measure Perspective of stakeholders on the current and future role of pharmacists.
Results: All participants perceived pharmacists to be suppliers of medication, although there was some recognition of roles in providing medication advice. Nonetheless, these stakeholders were eager for pharmacists to expand their non-dispensing roles towards counselling, creating awareness and screening of osteoporosis. Interviewed pharmacists referred to their current role as 'robotic dispensers' and unanimously agreed to spread out to osteoporosis management role.
Conclusion: Under stakeholders there is a willingness to expand the role of pharmacists in Malaysia to non-dispensing roles, particularly in osteoporosis screening and management.
Study site: Primary care clinic, teaching hospital, Kuala Lumpur, Malaysia
Prediction of functional outcome in patients with primary intracerebral hemorrhage by clinical-computed tomographic correlations

Rathor MY, Rani MF, Jamalludin AR, Amran M, Shahrin TC, Shah A

J Res Med Sci, 2012 Nov;17(11):1056-62.
PMID: 23833581

BACKGROUND: Primary intracerebral hemorrhage (PICH) remains the deadliest and most disabling form of stroke. The aim of our study was to determine the potential predictors for survival and neurological recovery in PICH patients by clinical-computed tomographic (CT) correlation.
MATERIALS AND METHODS: A prospective study conducted among PICH patients at a tertiary care hospital. The clinical and CT scan findings were correlated with the functional outcome using modified Rankin scores (mRS) of 0-5 at discharge and during six months follow-up.
RESULTS: The clinical and CT findings in 160 (93 male and 67 female) eligible adult patients with age range from 25 to 85 years (mean age 58.30 ± 11.44 years) were analyzed. The mean Glasgow Coma Scale [GCS] score was significantly higher among survivors. (12.8 ± 0.4 vs. 8.5 ± 0.5, P < 0.001) Based upon the pattern of the CT findings, the best outcome in terms of survival was for the patients with ICH in basal ganglia/internal capsule region (86.7 %), followed by lobar hemorrhage (67.1%). Good functional outcome was associated with a hematoma volume of less than 30 ml. At discharge majority of the survivors were functionally dependent 76 (70.4%) and only 32 (29.6%) achieved functional independence. The significant independent predictors of in- hospital survival were GCS score > 9 (OR 10.8; 95% CI 4.061 to 28.719), basal ganglia/internal capsule bleed (OR 9.750; 95% CI 2.122 to 45.004), hematoma volume <30 ml (OR 11.476; 95% CI 4. 810 to 27.434), no mid line shift (OR 4.901; 95% CI 2.405 to 9.987) and no intraventricular extension of hemorrhage (OR 7.040; 95% CI 3.358 to 14.458).
CONCLUSION: Outcome and functional status at discharge were well correlated with the initial CT scan findings and GCS score.
Fulltext Blood pressure control among diabetic hypertensives under cardiology follow-up at a regional hospital in rural Malaysia

Azarisman SM, Aszrin A, Marzuki AO, Fatnoon NN, Hilmi A, Hadzri MH, et al.

Southeast Asian J. Trop. Med. Public Health, 2010 Jul;41(4):973-81.
PMID: 21073073

Three hundred thirty-one consecutive patients presenting with hypertension to the outpatient medical clinic of Tengku Ampuan Afzan Hospital, Kuantan, Malaysia were screened and 150 patients with concurrent diabetes were enrolled into a cross-sectional study. The majority of patients were male (60.6%) with a mean age of 60.0 +/- 11.0 years. The mean systolic blood pressure (SBP) was 140.9 +/- 20.1 mmHg and the mean diastolic blood pressure (DBP) was 81.7 +/- 9.8 mmHg. Only 38.0% (57/150) of patients had blood pressures within recommended guidelines (130/80 mmHg). The mean blood pressure in this group was 123.7 +/- 8.5/76.4 +/- 5.6 mmHg. The majority of patients were on either 2 (41.3%) or 3 (31.3%) anti-hypertensives. Females had a significantly higher SBP 145.4 +/- 22.7 vs. 138.0 +/- 17.8 mmHg in males (p = 0.026). The level of blood pressure control in diabetics was unsatisfactory, especially in females and the elderly. A reassessment of priorities in the management of patients with concurrent hypertension and diabetes is therefore, urgently needed.

Study site: outpatient medical clinic of Tengku Ampuan Afzan Hospital,
Cardiovascular activity of the n-butanol fraction of the methanol extract of Loranthus ferrugineus Roxb

Ameer OZ, Salman IM, Siddiqui MJ, Yam MF, Sriramaneni RN, Sadikun A, et al.

Braz. J. Med. Biol. Res., 2010 Feb;43(2):186-94.
PMID: 20084331

We investigated the vascular responses and the blood pressure reducing effects of different fractions obtained from the methanol extract of Loranthus ferrugineus Roxb. (F. Loranthaceae). By means of solvent-solvent extraction, L. ferrugineus methanol extract (LFME) was successively fractionated with chloroform, ethyl acetate and n-butanol. The ability of these LFME fractions to relax vascular smooth muscle against phenylephrine (PE)- and KCl-induced contractions in isolated rat aortic rings was determined. In another set of experiments, LFME fractions were tested for blood pressure lowering activity in anesthetized adult male Sprague-Dawley rats (250-300 g, 14-18 weeks). The n-butanol fraction of LFME (NBF-LFME) produced a significant concentration-dependent inhibition of PE- and KCl-induced aortic ring contractions compared to other fractions. Moreover, NBF-LFME had a significantly higher relaxant effect against PE- than against high K+-induced contractions. In anesthetized Sprague-Dawley rats, NBF-LFME significantly lowered blood pressure in a dose-dependent manner and with a relatively longer duration of action compared to the other fractions. HPLC, UV and IR spectra suggested the presence of terpenoid constituents in both LFME and NBF-LFME. Accordingly, we conclude that NBF-LFME is the most potent fraction producing a concentration-dependent relaxation in vascular smooth muscle in vitro and a dose-dependent blood pressure lowering activity in vivo. The cardiovascular effects of NBF-LFME are most likely attributable to its terpenoid content.
Fulltext Hypocalcemia, hypochloremia, and eosinopenia as clinical predictors of leptospirosis: A retrospective study

Fish-Low CY, Balami AD, Than LTL, Ling KH, Mohd Taib N, Md Shah A, et al.

J Infect Public Health, 2020 Feb;13(2):216-220.
PMID: 31455598 DOI: 10.1016/j.jiph.2019.07.021

BACKGROUND: Underestimation of leptospirosis cases is happening in many countries. The most common factor of underreporting is misdiagnosis. Considering the limitations of direct detection of pathogen and serological diagnosis for leptospirosis, clinical features and blood tests though non-specific are usually referred in making presumptive diagnosis to decide disease management.
METHODS: In this single-centre retrospective study, comparative analysis on clinical presentations and laboratory findings was performed between confirmed leptospirosis versus non-leptospirosis cases.
RESULTS: In multivariate logistic regression evidenced by a Hosmer-Lemeshow significance value of 0.979 and Nagelkerke R square of 0.426, the predictors of a leptospirosis case are hypocalcemia (calcium <2.10mmol/L), hypochloremia (chloride <98mmol/L), and eosinopenia (absolute eosinophil count <0.040×109/L). The proposed diagnostic scoring model has a discriminatory power with area under the curve (AUC) 0.761 (p<0.001). A score value of 6 reflected a sensitivity of 0.762, specificity of 0.655, a positive predictive value of 0.38, negative predictive value of 0.91, a positive likelihood ratios of 2.21, and a negative likelihood ratios of 0.36.
CONCLUSION: With further validation in clinical settings, implementation of this diagnostic scoring model is helpful to manage presumed leptospirosis especially in the absence of leptospirosis confirmatory tests.
Thermo-catalytic decomposition of polystyrene waste: Comparative analysis using different kinetic models

Ali G, Nisar J, Iqbal M, Shah A, Abbas M, Shah MR, et al.

Waste Manag Res, 2019 Aug 13.
PMID: 31405341 DOI: 10.1177/0734242X19865339

Due to a huge increase in polymer production, a tremendous increase in municipal solid waste is observed. Every year the existing landfills for disposal of waste polymers decrease and the effective recycling techniques for waste polymers are getting more and more important. In this work pyrolysis of waste polystyrene was performed in the presence of a laboratory synthesized copper oxide. The samples were pyrolyzed at different heating rates that is, 5°Cmin-1, 10°Cmin-1, 15°Cmin-1 and 20°Cmin-1 in a thermogravimetric analyzer in inert atmosphere using nitrogen. Thermogravimetric data were interpreted using various model fitting (Coats-Redfern) and model free methods (Ozawa-Flynn-Wall, Kissinger-Akahira-Sunose and Friedman). Thermodynamic parameters for the reaction were also determined. The activation energy calculated applying Coats-Redfern, Ozawa-Flynn-Wall, Kissinger-Akahira-Sunose and Friedman models were found in the ranges 105-148.48 kJmol-1, 99.41-140.52 kJmol-1, 103.67-149.15 kJmol-1 and 99.93-141.25 kJmol-1, respectively. The lowest activation energy for polystyrene degradation in the presence of copper oxide indicates the suitability of catalyst for the decomposition reaction to take place at lower temperature. Moreover, the obtained kinetics and thermodynamic parameters would be very helpful in determining the reaction mechanism of the solid waste in a real system.
Inflammation targeted chitosan-based hydrogel for controlled release of diclofenac sodium

Gull N, Khan SM, Butt OM, Islam A, Shah A, Jabeen S, et al.

Int J Biol Macromol, 2020 Nov 01;162:175-187.
PMID: 32562726 DOI: 10.1016/j.ijbiomac.2020.06.133

Inflammation is a key challenge in the treatment of chronic diseases. Spurred by topical advancement in polymer chemistry and drug delivery, hydrogels that release a drug in temporal, spatial and dosage controlled fashion have been trendy. This research focused on the fabrication of hydrogels with controlled drug release properties to control inflammation. Chitosan and polyvinyl pyrrolidone were used as base polymers and crosslinked with epichlorohydrin to form hydrogel films by solution casting technique. Prepared hydrogels were analyzed by swelling analysis in deionized water, buffer and electrolyte solutions and gel fraction. Functional groups confirmation and development of new covalent and hydrogen bonds, thermal stability (28.49%) and crystallinity were evaluated by FTIR, TGA and WAXRD, respectively. Rheological properties including gel strength and yield stress, elasticity (2309 MPa), porosity (75%) and hydrophilicity (73°) of prepared hydrogels were also evaluated. In vitro studies confirmed that prepared hydrogels have good biodegradability, excellent antimicrobial property and admirable cytotoxicity. Drug release profile (87.56% in 130 min) along with the drug encapsulation efficiency (84%) of prepared hydrogels was also studied. These results paved the path towards the development of hydrogels that can release the drugs with desired temporal patterns.
Fulltext Elevated levels of IL-8 in fatal leptospirosis

Wan Yusoff WSY, Abdullah M, Sekawi Z, Amran F, Yuhana MY, Mohd Taib N, et al.

Pathog Glob Health, 2020 03;114(2):99-103.
PMID: 32024441 DOI: 10.1080/20477724.2020.1724356

Leptospirosis causes a wide range of clinical outcomes, including organ failure and death. Early treatment significantly increases the chances of cure. Interleukin-8 (IL-8) is a chemoattractant cytokine for neutrophil and is associated with multiple organ failure. Research has indicated IL-8 to be raised in severe and fatal cases of leptospirosis, but its suitability as a prognostic biomarker has yet to be confirmed. This study aimed to evaluate the significance of IL-8 with the clinical outcomes of leptospirosis patients. Plasma IL-8 was measured in fifty-two samples from hospitalized patients and nineteen healthy controls. The comparisons were made between mild, severe-survived and fatal groups identified by clinical or laboratory findings. IL-8 was significantly higher in fatal (p = 0.01) compared to mild cases. IL-8 was also significantly higher in fatal (p = 0.02) when compared to survived cases of leptospirosis. IL-8 levels in the plasma of fatal leptospirosis cases were significantly elevated compared to survived cases and may serve as a potential prognostic biomarker in determining the possible outcome of leptospirosis patients.
Significant Clinical Presentation of Leptospirosis in Relation to Sociodemographic and Risk Factors in a Tertiary Hospital, Malaysia

Mohd Taib N, Ahmad H, Soh KL, Md Shah A, Amin Nordin S, Than Thian Lung L, et al.

Vector Borne Zoonotic Dis, 2020 04;20(4):268-274.
PMID: 32013800 DOI: 10.1089/vbz.2018.2417

Introduction:
Incidence of leptospirosis has increased within the past few years in many countries. Its clinical presentations were generally nonspecific, making it difficult to assist in the diagnosis. Besides the determination of the common clinical features, the sociodemographic background is essential to identify high-risk populations to assist in prevention.
Methods:
Data for this study were obtained from electronic medical records among patients clinically diagnosed with leptospirosis at a tertiary hospital in Malaysia from the years 2011 to 2015 and were recorded using standard pro forma. Associations between clinical features and sociodemographics were performed using bivariate analysis and logistic regression.
Results:
Data were collected from 283 patients. Their mean age was 30.71 years old. Out of 283 patients, 206 (72.8%) were male. Involvement in outdoor events and water activities was the highest risk factor of acquiring leptospirosis in 64 (22.7%) patients followed by 59 (20.8%) patients who were staying in crowded housing areas with poor sanitation. Although fever was the main clinical presentation in 274 (96.8%) patients with leptospirosis, gastrointestinal (GIT) symptoms were the second most frequent in 159 (56.2%) patients followed by pulmonary symptoms, myalgia, headache, and jaundice. From the total number of 283 patients, only 21 (92.6%) presented with severe leptospirosis. GIT symptoms were a significant predictor for leptospirosis severity, while the age group was the significant sociodemographic factor toward GIT presentation in leptospirosis. The relationship between GIT symptoms and crowded housing areas with poor sanitation was also significant. Multivariable logistic regression showed that crowded housing areas with poor sanitation (odds ratio [OR] = 3.570, p
Fulltext Indirect immunofluorescence screening of potential arthritic autoantibodies in systemic lupus erythematosus

Selvaraja M, Che Ku Daud CKD, Abdul Jalil M, Md. Shah A, Amin Nordin S, Ahmad Bajari Z, et al.

Malaysian Journal of Medicine and Health Sciences, 2018;14(103):1-4.
MyJurnal

Joint involvement is common in systemic lupus erythematosus (SLE) patients, however, screening for joint specific autoantibodies in patients is not routinely performed. This may be due to the lack of known antigens and available tissue. The rat musculoskeletal tissue may be a suitable source of antigen to detect arthritic autoantibodies.
Method: We tested plasma of SLE patients, with arthritis (N=9) and without arthritis (N=7) as well as plasma from normal individuals (N=7) on fresh sectioned tissue from rat plantar hind paw using indirect immunofluorescence method.
Results: Binding of autoantibodies to striation in skeletal muscle cells in the tissue was clearly demonstrable in all samples from SLE with arthritis but not on slides incubated with plasma from normal or SLE without arthritis.
Conclusion: Thus, rat plantar tissue may be suitable for detecting autoantibodies from SLE patients that may be involved in the pathogenesis of lupus arthritis.
Fulltext Zircon-Type CaCrO4 Chromite Nanoparticles: Synthesis, Characterization, and Photocatalytic Application for Sunlight-Induced Degradation of Rhodamine B

Akbar N, Javed M, Arif Khan A, Masood A, Ahmed N, Mehmood RY, et al.

ACS Omega, 2023 Aug 22;8(33):30095-30108.
PMID: 37636959 DOI: 10.1021/acsomega.3c02457

The degradation of organic dye pollutants is a critical environmental issue that has garnered significant attention in recent years. To address this problem, we investigated the potential of CaCrO4 chromite (CCO) as a photocatalyst for the degradation of cationic and anionic dye solutions under sunlight irradiation. CaCrO4 was synthesized via a sol-gel auto-combustion route and sintered at 900 °C. The Rietveld refined XRD profile confirmed the zircon-type structure of CaCrO4 crystallized in the tetragonal unit cell with I41/amd space group symmetry. The surface morphology of the sample was investigated by field emission scanning electron microscopy (FESEM), which revealed the polyhedral texture of the grains. Energy-dispersive X-ray spectroscopy (EDX) and X-ray photoelectron spectroscopy (XPS) studies were carried out to analyze the elemental composition and chemical states of the ions present in the compound. Fourier transform infrared (FT-IR) spectroscopy analysis revealed the vibrational modes corresponding to the tetrahedral and dodecahedral metal oxide bonds. The optical band gap was approximated to be in the range of 1.928 eV by using the Tauc relation. The CaCrO4 catalyst with different contents (5, 20, 35, and 50 mg) was investigated for its photocatalytic performance for the degradation of RhB dye solution under sunlight irradiation using a UV-Vis spectrometer over the experimental wavelength range of 450-600 nm. The degradation efficacy increased from 70.630 to 93.550% for 5-35 mg and then decreased to 68.720% for 50 mg in 140 min under visible light illumination. The comparative study demonstrates that a higher degradation rate was achieved for cationic than anionic dyes in the order RhB > MB > MO. The highest deterioration (93.80%) was achieved for the RhB dye in 140 min. Equilibrium and kinetic studies showed that the adsorption process followed the Langmuir isotherm and pseudo-second-order models, respectively. The maximum adsorption capacity of 21.125 mg/g was observed for the catalyst concentration of 35 mg. From the cyclic test, it has been observed that the synthesized photocatalyst is structurally and morphologically stable and reusable. The radical trapping experiment demonstrated that superoxide and hydroxyl radicals were the primary species engaged in the photodegradation process. A possible mechanism for the degradation of RhB has been proposed. Hence, we conclude that CaCrO4 can be used as an efficient photocatalyst for the remediation of organic dye pollutants from the environment.
Overlap of disorders of gut-brain interaction: a systematic review and meta-analysis

Fairlie T, Shah A, Talley NJ, Chey WD, Koloski N, Yeh Lee Y, et al.

Lancet Gastroenterol Hepatol, 2023 Jul;8(7):646-659.
PMID: 37211024 DOI: 10.1016/S2468-1253(23)00102-4

BACKGROUND: Rome criteria differentiate distinct types of disorders of gut-brain interaction (DGBI); also known as functional gastrointestinal disorders. Overlap of symptom categories frequently occurs. This systematic review and meta-analysis aimed to define the prevalence of DGBI overlap and compare overlap in population-based, primary care or tertiary care health settings. Furthermore, we aimed to compare symptom severity of psychological comorbidities in DGBI with and without overlap.
METHODS: For this systematic review and meta-analysis we searched MEDLINE (PubMed) and Embase electronic databases from inception until March 1, 2022, for original articles and conference abstracts of observational cross-sectional, case-controlled, or cohort design studies that reported the prevalence of DGBI overlap in adult participants (aged ≥18 years). We included only those studies where the diagnosis of DGBI was based on clinical assessment, questionnaire data, or specific symptom-based criteria. Studies were excluded if reporting on mixed populations of DGBI and organic diseases. Aggregate patient data were extracted from eligible published studies. The prevalence of DGBI overlap in all studies was pooled using the DerSimonian and Laird random effects model, and further analysis stratified by subgroups (care setting, diagnostic criteria, geographic region, and gross domestic product per capita). We also assessed the relationship between DGBI overlap with anxiety, depression, and quality of life symptom scores. This study was registered with PROSPERO (CRD42022311101).
FINDINGS: 46 of 1268 screened studies, reporting on 75 682 adult DGBI participants, were eligible for inclusion in this systematic review and meta-analysis. Overall, 24 424 (pooled prevalence 36·5% [95% CI 30·7 to 42·6]) participants had a DGBI overlap, with considerable between-study heterogeneity (I2=99·51, p=0·0001). In the tertiary health-care setting, overlap among participants with DGBI was more prevalent (8373 of 22 617, pooled prevalence 47·3% [95% CI 33·2 to 61·7]) compared with population-based cohorts (11 332 of 39 749, pooled prevalence 26·5% [95% CI 20·5 to 33·4]; odds ratio 2·50 [95% CI 1·28 to 4·87]; p=0·0084). Quality of life physical component scores were significantly lower in participants with DGBI overlap compared with participants without overlap (standardised mean difference -0·47 [95% CI -0·80 to -0·14]; p=0·025). Participants with DGBI overlap had both increased symptom scores for anxiety (0·39 [95% CI 0·24 to 0·54]; p=0·0001) and depression (0·41 [0·30 to 0·51]; p=0·0001).
INTERPRETATION: Overlap of DGBI subtypes is frequent, and is more prevalent in tertiary care settings and associated with more severe symptom manifestations or psychological comorbidities. Despite the large sample size, the comparative analyses revealed substantial heterogeneity, and the results should be interpreted with caution.
FUNDING: National Health and Medical Research Council and Centre for Research Excellence.
Raised levels of Il-6, Il-17a, and Il-22 in fatal leptospirosis

Wan Yusoff WSY, Abdullah M, Sekawi Z, Amran F, Yuhana MY, Mohd Taib N, et al.

Eur J Clin Microbiol Infect Dis, 2019 Dec;38(12):2349-2353.
PMID: 31529307 DOI: 10.1007/s10096-019-03699-5

Clinical manifestations of leptospirosis range from mild, common cold-like illness, to a life-threatening condition. The host immune response has been hypothesized to play a major role in leptospirosis outcome. Increased levels of inflammatory mediators, such as cytokines, may promote tissue damage that lead to increased disease severity. The question is whether cytokines levels may predict the outcome of leptospirosis and guide patient management. This study aimed to assess the association between Th1-, Th2-, and Th17-related cytokines with the clinical outcome of patients with leptospirosis. Different cytokine levels were measured in fifty-two plasma samples of hospitalized patients diagnosed with leptospirosis in Malaysia (January 2016-December 2017). Patients were divided into two separate categories: survived (n = 40) and fatal outcome (n = 12). Nineteen plasma samples from healthy individuals were obtained as controls. Cytokine quantification was performed using Simple Plex™ assays from ProteinSimple (San Jose, CA, USA). Measurements were done in triplicate and statistical analysis was performed using GraphPad software and SPSS v20. IL-6 (p = 0.033), IL-17A (p = 0.022), and IL-22 (p = 0.046) were significantly elevated in fatal cases. IL-17A concentration (OR 1.115; 95% CI 1.010-1.231) appeared to be an independent predictor of fatality of leptospirosis. Significantly higher levels of TNF-α (p ≤ 0.0001), IL-6 (p ≤ 0.0001), IL-10 (p ≤ 0.0001), IL-12 (p ≤ 0.0001), IL17A (p ≤ 0.0001), and IL-18 (p ≤ 0.0001) were observed among leptospirosis patients in comparison with healthy controls. Our study shows that certain cytokine levels may serve as possible prognostic biomarkers in leptospirosis patients.
High-Sensitivity Cardiac Troponin I Levels in Normal and Hypertensive Pregnancy

Ravichandran J, Woon SY, Quek YS, Lim YC, Noor EM, Suresh K, et al.

Am J Med, 2019 03;132(3):362-366.
PMID: 30503877 DOI: 10.1016/j.amjmed.2018.11.017

PURPOSE: The purpose of this study was to examine the association of circulating concentrations of high-sensitivity cardiac troponin I (hs-cTn) in the various trimesters of pregnancy in patients with and without hypertension.
METHODS: This was a prospective cross-sectional study of pregnant and postnatal women aged between 18-35 years with no coexisting diseases. Serum samples were analysed for hs-TnI.
RESULTS: A total of 880 women (mean age = 29.1 years [standard deviation = 5.1 years]) were recruited with 129 (14%), 207 (24%), and 416 (47%) patients in the first, second, and third trimesters, respectively. Ninety (10%) participants were recruited in the postnatal period. During pregnancy 28 (3%) patients were classified as having pregnancy-induced hypertension and 10 (1%) as preeclampsia. High-sensitivity cardiac troponin I was measurable in 546 (62%) participants with a median of 1 ng/L (range 0 to 783 ng/L). Troponin concentrations were above the 99th percentile in 19 (2%) individuals. Patients with pregnancy-induced hypertension and preeclampsia had higher concentrations of hs-TnI (median 11 ng/L [interquartile range (IQR) 6 to 22 ng/L] vs 12ng/L [IQR 3 to 98 ng/L] vs 1 ng/L [IQR 0 to 1 ng/L]). In logistic regression modeling hs-cTnI concentration remained an independent predictor of pregnancy-induced hypertension or preeclampsia in both unadjusted and adjusted models (odds ratio 9.3 [95% confidence interval 5.8 to 16.3] and 11.5 [95% confidence interval 6.3 to 24.1], respectively, per doubling of hs-TnI concentrations).
CONCLUSIONS: Cardiac troponin measured using a high-sensitivity assay is quantifiable in the majority of young pregnant women with 2% of individuals having concentration above the 99th percentile sex-specific threshold. Patients with pregnancy-induced hypertension or preeclampsia had higher cardiac troponin concentrations. Cardiac troponin was a strong independent predictor of pregnancy-induced hypertension or preeclampsia in pregnant and postnatal women.
Fulltext Selective Arylation of 2-Bromo-4-chlorophenyl-2-bromobutanoate via a Pd-Catalyzed Suzuki Cross-Coupling Reaction and Its Electronic and Non-Linear Optical (NLO) Properties via DFT Studies

Nazeer U, Rasool N, Mujahid A, Mansha A, Zubair M, Kosar N, et al.

Molecules, 2020 Jul 31;25(15).
PMID: 32752125 DOI: 10.3390/molecules25153521

In the present study, 2-bromo-4-chlorophenyl-2-bromobutanoate (3) was synthesized via the reaction of 2-bromo-4-chlorophenol with 2-bromobutanoyl bromide in the presence of pyridine. A variety of 2-bromo-4-chlorophenyl-2-bromobutanoate derivatives (5a-f) were synthesized with moderate to good yields via a Pd-catalyzed Suzuki cross-coupling reaction. To find out the reactivity and electronic properties of the compounds, Frontier molecular orbital analysis, non-linear optical properties, and molecular electrostatic potential studies were performed.
Fulltext Dopant engineering for ZnO electron transport layer towards efficient perovskite solar cells

Zainal Abidin NA, Arith F, Noorasid NS, Sarkawi H, Mustafa AN, Safie NE, et al.

RSC Adv, 2023 Nov 16;13(48):33797-33819.
PMID: 38020037 DOI: 10.1039/d3ra04823c

The conventional electron transport layer (ETL) TiO2 has been widely used in perovskite solar cells (PSCs), which have produced exceptional power conversion efficiencies (PCE), allowing the technology to be highly regarded and propitious. Nevertheless, the recent high demand for energy harvesters in wearable electronics, aerospace, and building integration has led to the need for flexible solar cells. However, the conventional TiO2 ETL layer is less preferred, where a crystallization process at a temperature as high as 450 °C is required, which degrades the plastic substrate. Zinc oxide nanorods (ZnO NRs) as a simple and low-cost fabrication material may fulfil the need as an ETL, but they still suffer from low PCE due to atomic defect vacancy. To delve into the issue, several dopants have been reviewed as an additive to passivate or substitute the Zn2+ vacancies, thus enhancing the charge transport mechanism. This work thereby unravels and provides a clear insight into dopant engineering in ZnO NRs ETL for PSC.
Fulltext Asian-Pacific consensus on small intestinal bacterial overgrowth in gastrointestinal disorders: An initiative of the Indian Neurogastroenterology and Motility Association

Ghoshal UC, Sachdeva S, Ghoshal U, Misra A, Puri AS, Pratap N, et al.

Indian J Gastroenterol, 2022 Oct;41(5):483-507.
PMID: 36214973 DOI: 10.1007/s12664-022-01292-x

In the clinical setting, small intestinal bacterial overgrowth (SIBO) is a frequent, but under-diagnosed entity. SIBO is linked to various gastrointestinal (GI) and non-GI disorders with potentially significant morbidity. The optimal management of SIBO is undefined while there is a lack of published consensus guidelines. Against this background, under the auspices of the Indian Neurogastroenterology and Motility Association (INMA), formerly known as the Indian Motility and Functional Diseases Association (IMFDA), experts from the Asian-Pacific region with extensive research and clinical experience in the field of gut dysbiosis including SIBO developed this evidence-based practice guideline for the management of SIBO utilizing a modified Delphi process based upon 37 consensus statements, involving an electronic voting process as well as face-to-face meetings and review of relevant supporting literature. These statements include 6 statements on definition and epidemiology; 11 on etiopathogenesis and pathophysiology; 5 on clinical manifestations, differential diagnosis, and predictors; and 15 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservations was 80% or higher, the statement was regarded as accepted. The members of the consensus team consider that this guideline would be valuable to inform clinical practice, teaching, and research on SIBO in the Asian-Pacific region as well as in other countries.
Fulltext An online survey of clinical practice for allergic rhinitis among the Asia-Pacific representatives

Zheng M, Wang X, Latiff AHA, Shah A, Pham DL, Kim DY, et al.

Asian Pac J Allergy Immunol, 2022 Oct 18.
PMID: 36278781 DOI: 10.12932/AP-310322-1361

BACKGROUND: Physicians' knowledge and practice which are consistent with evidence-based guidelines can improve allergic rhinitis (AR) patients' care. Compared with western countries, the available literature about Asian doctors' perceptions and clinical practices regarding Allergic Rhinitis and its Impacts on Asthma (ARIA) guidelines is limited.
OBJECTIVE: To collect detailed information about the practical management patterns specific for AR patients and investigate compliance with ARIA in the clinical practice of Asian physicians and elucidate the possible inadequacy in the existing ARIA guidelines.
METHODS: An e-mail with a structured questionnaire was sent to members of the Asia-Pacific Association of Allergy, Asthma and Clinical Immunology. The questionnaire consisted of doctors' characteristics, environment of medical practice, routine clinical practice following ARIA guidelines and patients' adherence to the prescription.
RESULTS: Physicians from 14 countries and regions sent valid questionnaires back, 94.12% of whom were senior doctors with more than 10 years of experience. 88.24% of doctors diagnosed AR depending on the history combined with allergy tests. 82.35% of participants employed the classification criteria by ARIA. 94.12%, 88.24% and 41.8% of respondents recommended intranasal corticosteroids, oral antihistamines and leukotriene receptor antagonists as first-line medications. 5.88% treated perennial AR by intranasal corticosteroids alone. 11.76% of clinicians recommended no allergen immunotherapy (AIT) or biologics and 58.82% of interviewees reported AR patients occasionally or sometimes agreed with the recommendation of AIT.
CONCLUSIONS: There was high compliance with ARIA guidelines in Asian senior physicians' actual notion and practice in the management of AR. New-generation ARIA guidelines are imperative for unmet needs.

Filters

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links