A Gram-stain-positive, endospore-forming, rod-shaped bacterial strain, designated D5(T), was isolated from seawater collected from a sandy beach in a southern state of Malaysia and subjected to a polyphasic taxonomic study. Sequence analysis of the 16S rRNA gene demonstrated that this isolate belongs to the genus Jeotgalibacillus, with 99.87% similarity to Jeotgalibacillus alimentarius JCM 10872(T). DNA-DNA hybridization of strain D5(T) with J. alimentarius JCM 10872(T) demonstrated 26.3% relatedness. The peptidoglycan type was A1α linked directly to L-lysine as the diamino acid. The predominant quinones identified in strain D5(T) were menaquinones MK-7 and MK-8.The major fatty acids were iso-C15:0 and anteiso-C15:0. The G+C content of its DNA was 43.0 mol%. The major polar lipids were diphosphatidylglycerol, phosphatidylglycerol and sulfoquinovosyl diacylglycerol, as well as two unknown phospholipids and three unknown lipids. The phenotypic, chemotaxonomic and genotypic data indicated that strain D5(T) represents a novel species of the genus Jeotgalibacillus, for which the name Jeotgalibacillus malaysiensis sp. nov. is proposed (type strain D5(T) = DSM 28777(T) = KCTC33550(T)). An emended description of the genus Jeotgalibacillus is also provided.
Matched MeSH terms: Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry
A Gram-negative, filamentous aerobic bacterium designated as strain Mgbs1T was isolated on 12 April 2017 from the subsurface soil and leaf litter substrate at the base of a Koompassia malaccensis tree in a tropical peat swamp forest in the northern regions of the state of Selangor, Malaysia (3° 39' 04.7' N 101° 17' 43.7'' E). Phylogenetic analyses based on the full 16S rRNA sequence revealed that strain Mgbs1T belongs to the genus Chitinophaga with the greatest sequence similarity to Chitinophaga terrae KP01T (97.65 %), Chitinophaga jiangningensis DSM27406T (97.58 %), and Chitinophaga dinghuensis DHOC24T (97.17 %). The major fatty acids of strain Mgbs1T (>10 %) are iso-C15 : 0, C16 : 1 ω5c and iso-C17 : 0 3-OH while the predominant respiratory quinone is menaquinone-7. Strain Mgbs1T has a complete genome size of 8.03 Mb, with a G+C content of 48.5 mol%. The DNA-DNA hybridization (DDH) score between strain Mgbs1T and C. jiangningensis DSM27406T was 15.9 %, while in silico DDH values of strain Mgbs1T against C. dinghuensis DHOC24T and C. terrae KP01T were 20.0 and 19.10% respectively. Concurrently, Average Nucleotide Identity (ANI) scores between strain Mgbs1T against all three reference strains are 73.2 %. Based on the phenotypic, chemotaxonomic, and phylogenetic consensus, strain Mgbs1T represents a novel species of the genus Chitinophaga, for which the name Chitinophaga extrema sp. nov. is proposed (=DSM 108835T=JCM 33276T).
Matched MeSH terms: Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry
The genus Roseivirga currently includes five species: Roseivirga ehrenbergii, R. echinicomitans, R. spongicola, R. marina and R. maritima. Marinicola seohaensis SW-152T was renamed as Roseivirgaseohaensis SW-152T and then reclassified again as a later heterotypic synonym of R. ehrenbergii KMM 6017T. In this study, based on average nucleotide identity and digital DNA-DNA hybridization values obtained from in silico methods, together with fatty acid analyses and biochemical tests, we propose to reclassify R. ehrenbergii SW-152 as Roseivirga seohaensis comb. nov. (type strain SW-152T=KCTC 1231T=JCM 12600T). In this work, a Gram-negative, rod-shaped, aerobic and pink-pigmented strain designated as D-25T was isolated from seawater (Desaru Beach, Johor, Malaysia). The 16S rRNA gene analysis revealed that strain D-25T was related to the genus Roseivirga. Strain D-25T was found most closely related to R. seohaensis SW-152T based on average nucleotide identity and digital DNA-DNA hybridization values, phenotypic and chemotaxonomic analyses, indicating that these strains belong to the same species. Thus, it is proposed to split the species R.oseivirga seohaensis into two novel subspecies, Roseivirga seohaensissubsp. seohaensis subsp. nov. (type strain SW-152T=KCTC 12312T=JCM 12600T) and Roseivirga seohaensissubsp. aquiponti subsp. nov. (type strain D-25T=KCTC 42709T=DSM 101709T) and to emend the description of the genus Roseivirga.
Matched MeSH terms: Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry
To date, there is sparse information for the genus Robertkochia with Robertkochia marina CC-AMO-30DT as the only described member. We report here a new species isolated from mangrove soil collected at Malaysia Tanjung Piai National Park and perform polyphasic characterization to determine its taxonomic position. Strain CL23T is a Gram-negative, yellow-pigmented, strictly aerobic, catalase-positive and oxidase-positive bacterium. The optimal growth conditions were determined to be at pH 7.0, 30-37 °C and in 1-2 % (w/v) NaCl. The major respiratory quinone was menaquinone-6 (MK-6) and the highly abundant polar lipids were four unidentified lipids, a phosphatidylethanolamine and two unidentified aminolipids. The 16S rRNA gene similarity between strain CL23T and R. marina CC-AMO-30DT is 96.67 %. Strain CL23T and R. marina CC-AMO-30DT clustered together and were distinguished from taxa of closely related genera in 16S rRNA gene phylogenetic analysis. Genome sequencing revealed that strain CL23T has a genome size of 4.4 Mbp and a G+C content of 40.72 mol%. Overall genome related indexes including digital DNA-DNA hybridization value and average nucleotide identity are 17.70 % and approximately 70%, below the cutoffs of 70 and 95%, respectively, indicated that strain CL23T is a distinct species from R. marina CC-AMO-30DT. Collectively, based on the phenotypic, chemotaxonomic, phylogenetic and genomic evidences presented here, strain CL23T is proposed to represent a new species with the name Robertkochia solimangrovi sp. nov. (KCTC 72252T=LMG 31418T). An emended description of the genus Robertkochia is also proposed.
Matched MeSH terms: Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry
A Gram-negative, aerobic, polar-flagellated and rod-shaped, sometimes slightly curved bacterium, designated MA5T, was isolated from the gut of an abalone of the species Haliotis gigantea collected in Japan. Phylogenetic analyses based on 16S rRNA, gyrB, hsp60 and rpoB gene sequences placed strain MA5T in the genus Arcobacter in an independent phylogenetic line. Comparison of the 16S rRNA gene sequence of this strain with those of the type strains of the established Arcobacter species revealed A. nitrofigilis (95.1 %) as nearest neighbour. Strain MA5T grew optimally at 25 °C, pH 6.0 to 9.0 and in the presence of 2 to 5 % (w/v) NaCl under both aerobic and microaerobic conditions. The predominant fatty acids found were summed feature 3 (iso-C15 : 0 2-OH and/or C16 : 1 ω7c), C12 : 0 3-OH and C18 : 1 ω7c. Menaquinone-6 (MK-6) and menaquinone-7 (MK-7) were found as the major respiratory quinones. The major polar lipids detected were phosphatidylethanolamine and phosphatidylglycerol. Strain MA5T could be differentiated phenotypically from the phylogenetic closest Arcobacter species by its ability to grow on 0.05 % safranin and 0.01 % 2,3,5-triphenyl tetrazolium chloride (TTC), but not on 0.5 % NaCl. The obtained DNA G+C content of strain MA5T was 27.9 mol%. Based on the phylogenetic, chemotaxonomic and phenotypic distinctiveness of MA5T, this strain is considered to represent a novel species of the genus Arcobacter, for which the name Arcobacter haliotis sp. nov. is proposed. The type strain is MA5T (=LMG 28652T=JCM 31147T).
Matched MeSH terms: Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry
A taxonomic study was performed on a novel Gram-stain-positive, coccus-shaped, orange-pigmented motile bacterium, designated as strain L10.15T. The organism was isolated from a soil sample collected in Lagoon Island (close to Adelaide Island, western Antarctic Peninsula) using a quorum-quenching enrichment medium. Growth occurred at 4-30 °C, pH 6-11 and at moderately high salinity (0-15 %, w/v, NaCl), with optimal growth at 26 °C, at pH 7-8 and with 6 % (w/v) NaCl. 16S rRNA gene sequence analysis showed that strain L10.15T belonged to the genus Planococcus and was closely related to Planococcus halocryophilus Or1T (99.3 % similarity), Planococcus donghaensis JH1T (99.0 %), Planococcus antarcticus DSM 14505T (98.3 %), Planococcus plakortidis AS/ASP6 (II)T (97.6 %), Planococcus maritimus TF-9T (97.5 %), Planococcus salinarum ISL-6T (97.5 %) and Planococcus kocurii NCIMB 629T (97.5 %). However, the average nucleotide identity-MUMmer analysis showed low genomic relatedness values of 71.1-81.7 % to the type strains of these closely related species of the genus Planococcus. The principal fatty acids were anteiso-C15 : 0, C16 : 1ω7c and anteiso-C17 : 0, and the major menaquinones of strain L10.15T were MK-5 (48 %), MK-6 (6 %) and MK-7 (44 %). Polar lipid analysis revealed the presence of phosphatidylethanolamine, phosphatidylglycerol, diphosphatidylglycerol and aminophospholipid. The DNA G+C content was 39.4 mol%. The phenotypic and genotypic data indicate that strain L10.15T represents a novel species of the genus Planococcus, for which the name Planococcus versutus sp. nov. is proposed. The type strain is L10.15T (=DSM 101994T=KACC 18918T).
Matched MeSH terms: Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry
Four brown-alga-degrading, Gram-stain-negative, aerobic, non-flagellated, gliding and rod-shaped bacteria, designated LMG 28520T, LMG 28521, LMG 28522 and LMG 28523, were isolated from the gut of the abalone Haliotis gigantea obtained in Japan. The four isolates had identical random amplified polymorphic DNA patterns and grew optimally at 25 °C, at pH 6.0-9.0 and in the presence of 1.0-4.0 % (w/v) NaCl. Phylogenetic trees based on 16S rRNA gene sequences placed the isolates in the genus Formosa with Formosa algae and Formosa arctica as closest neighbours. LMG 28520T and LMG 28522 showed 100 % DNA-DNA relatedness to each other, 16-17 % towards F. algae LMG 28216T and 17-20 % towards F. arctica LMG 28318T; they could be differentiated phenotypically from these established species. The predominant fatty acids of isolates LMG 28520T and LMG 28522 were summed feature 3 (iso-C15 : 0 2-OH and/or C16 : 1ω7c), iso-C15 : 1 G and iso-C15 : 0. Isolate LMG 28520T contained menaquinone-6 (MK-6) as the major respiratory quinone and phosphatidylethanolamine, two unknown aminolipids and an unknown lipid as the major polar lipids. The DNA G+C content was 34.4 mol% for LMG 28520T and 35.5 mol% for LMG 28522. On the basis of their phylogenetic and genetic distinctiveness, and differential phenotypic properties, the four isolates are considered to represent a novel species of the genus Formosa, for which the name Formosa haliotis sp. nov. is proposed. The type strain is LMG 28520T ( = NBRC 111189T).
Matched MeSH terms: Vitamin K 2/analogs & derivatives; Vitamin K 2/chemistry
A novel actinobacterial strain, MUSC 78T, was isolated from a mangrove soil collected from Peninsular Malaysia. The taxonomic status of this strain was determined using a polyphasic approach. Comparative 16S rRNA gene sequence analysis revealed that strain MUSC 78T represented a novel lineage within the class Actinobacteria. Strain MUSC 78T formed a distinct clade in the family Intrasporangiaceae and was related most closely to members of the genera Terrabacter (98.3-96.8 % 16S rRNA gene sequence similarity), Intrasporangium (98.2-96.8 %), Humibacillus (97.2 %), Janibacter (97.0-95.3 %), Terracoccus (96.8 %), Kribbia (96.6 %), Phycicoccus (96.2-94.7 %), Knoellia (96.1-94.8 %), Tetrasphaera (96.0-94.9 %) and Lapillicoccus (95.9 %). Cells were irregular rod-shaped or cocci and stained Gram-positive. The cell-wall peptidoglycan type was A3γ, with ll-diaminopimelic acid as the diagnostic diamino acid. The main cell-wall sugar was mannose and lower amounts of galactose and rhamnose were present. The predominant menaquinone was MK-8(H4). The polar lipid profile consisted of phosphatidylglycerol, phosphatidylinositol, phosphatidylethanolamine, diphosphatidylglycerol and phosphoglycolipid. The predominant fatty acids were iso-C15 : 0, anteiso-C15 : 0 and iso-C16 : 0. The DNA G+C content was 73.1 mol%. Based on this polyphasic study, MUSC 78T exhibited phylogenetic and phenotypic differences from members of the genera of the family Intrasporangiaceae, and therefore a novel species of a new genus, Monashia flava gen. nov., sp. nov., is proposed. The type strain of Monashia flava is MUSC 78T ( = DSM 29621T = MCCC 1K00454T = NBRC 110749T).
Fresh-cut pineapple has experienced an increase in demand due to its great health benefits and is rich in vitamins A, B and C. Moreover, pineapple is known as a source of the enzyme bromelain, which has therapeutic applications, such as reducing inflammation, improving digestion and treating osteoarthritis. However, bromelain generally affects the pineapple’s flavour and is less preferred by consumers due to the uncomfortable prickling and tingling sensations it brings. In the present study, two types of gases and their combination, nitrogen (N2) and carbon dioxide (CO2), were used to evaluate their impacts on reducing the tingling and prickling sensations, as well as maintaining the postharvest qualities of fresh-cut pineapple stored at 5°C for 12 days. The parameters being evaluated were the bromelain enzyme activity, flesh colour, ascorbic acid concentration, flesh firmness, soluble solids concentration (SSC), titratable acidity (TA) and sensory evaluation. No significant differences were recorded for all parameters tested. Based on the sensory evaluations, all the attributes, such as colour, aroma, texture, sweetness, sourness, tingling and prickling sensations, and overall acceptance were not affected by the different gases application. Even though no apparent effect was observed, the 30 panellists preferred the aforementioned attributes, except sourness. In conclusion, the fumigation treatments with N2 and CO2 gases were not effective in reducing the tingling and prickling sensations of pineapples cv. Morris.
The outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later named COVID-19 by the World Health Organization (WHO), was initiated at Wuhan, Hubei, China, and there was a rapid spread of novel SARS-CoV-2 and the disease COVID-19 in late 2019. The entire world is now experiencing the challenge of COVID-19 infection. However, still very few evidence-based treatment options are available for the prevention and treatment of COVID-19 disease. The present review aims to summarize the publicly available information to give a comprehensive yet balanced scientific overview of all the fat-soluble vitamins concerning their role in SARS-CoV-2 virus infection. The roles of different fat-soluble vitamins and micronutrients in combating SARS-CoV-2 infection have been recently explored in several studies. There are various hypotheses to suggest their use to minimize the severity of COVID-19 infection. These vitamins are pivotal in the maintenance and modulation of innate and cell-mediated, and antibody-mediated immune responses. The data reported in recent literature demonstrate that deficiency in one or more of these vitamins compromises the patients' immune response and makes them more vulnerable to viral infections and perhaps worse disease prognosis. Vitamins A, D, E, and K boost the body's defense mechanism against COVID-19 infection and specifically prevent its complications such as cytokine storm and other inflammatory processes, leading to increased morbidity and mortality overemphasis. However, more detailed randomized double-blind clinical pieces of evidence are required to define the use of these supplements in preventing or reducing the severity of the COVID-19 infection.
Medicine is an essential need for many people to treat their illness. Creating awareness among general public regarding medicines use and common illnesses can promote healthy lifestyles among them. The objectives of this study are to determine public knowledge and perception of medicines use and; to explore the pattern of medicines used in the past 3 months. A cross‐sectional survey was carried out among the general public in Pulau Pinang. People who were using medications during the time of the survey or in the last 3 months were invited to participate in the study. Only Malaysians ≥18 years were selected by convenient sampling to participate in the survey. The results of this study showed that most of the respondents were using some sort of medications during the last 3 months. Around 30% did not read the label of the medicines before use. Furthermore, participants had low awareness towards some aspects of medicines use such as the name of generic and brand medicines, overuse of paracetamol or vitamins and their side effects, discontinuation of antibiotics, storing ointments and syrups in refrigerator, and the side effects of medicines registered in Malaysia. Efforts are still needed to increase the awareness of medicines use among the general public. More quantitative studies are needed to understand the factors that may influence public knowledge and perceptions on the use of medicines.
Honey is usually subjected to filtration and heating for bottling before commercialization. However, there is no standard procedure available for thermal treatment on honey. Honey is thermally heated at various temperature and duration based on individual experience to prolong the shelf life of honey in the market. The heating methods might decrease the biochemical components such as nutrients, enzymatic activities and vitamins to certain extent. In addition to water reduction, thermal treatment on sugar rich honey usually accompanied by the formation of 5-hydroxymethylfurfural (HMF). In the present study, the biochemical components in three commonly consumed honey in Malaysia, namely tualang, gelam and acacia honey were investigated before and after thermal treatment at 90oC for 30 min. The short period of heating time was found to degrade nutrients, enzymatic activities and water soluble vitamins in honey. The degradation of protein and enzyme via proteolytic digestion had attributed to the increase of free amino acids in honey. Based on the multivariate analysis, the most thermally affected biochemical components are crude fat, panthotenic acid (Vitamin B5) and diastase activity which explain for 86.4% of the total variance. The kinetic studies on the HMF formation revealed that the honey samples followed zero order kinetic model for the first 60 min of heating at 90oC. The findings indicate that the temperature and duration of heating during honey processing is essential to be investigated according to the honey origin. The initial biochemical composition of honey would affect the kinetic profile of HMF formation.
A novel strain, Streptomyces antioxidans MUSC 164(T) was recovered from mangrove forest soil located at Tanjung Lumpur, Malaysia. The Gram-positive bacterium forms yellowish-white aerial and brilliant greenish yellow substrate mycelium on ISP 2 agar. A polyphasic approach was used to determine the taxonomy status of strain MUSC 164(T). The strain showed a spectrum of phylogenetic and chemotaxonomic properties consistent with those of the members of the genus Streptomyces. The cell wall peptidoglycan was determined to contain LL-diaminopimelic acid. The predominant menaquinones were identified as MK-9(H6) and MK-9(H8), while the identified polar lipids consisted of aminolipid, diphosphatidylglycerol, glycolipid, hydroxyphosphatidylethanolamine, phospholipid, phosphatidylinositol, phosphatidylethanolamine, phosphatidylglycerol and lipid. The cell wall sugars consist of galactose, glucose and ribose. The predominant cellular fatty acids (>10.0%) were identified as iso-C15: 0 (34.8%) and anteiso-C15: 0(14.0%). Phylogenetic analysis identified that closely related strains for MUSC 164(T) as Streptomyces javensis NBRC 100777(T) (99.6% sequence similarity), Streptomyces yogyakartensis NBRC 100779(T) (99.6%) and Streptomyces violaceusniger NBRC 13459(T) (99.6%). The DNA-DNA relatedness values between MUSC 164(T) and closely related type strains ranged from 23.8 ± 0.3% to 53.1 ± 4.3%. BOX-PCR fingerprints comparison showed that MUSC 164(T) exhibits a unique DNA profile, with DNA G + C content determined to be 71.6 mol%. Based on the polyphasic study of MUSC 164(T), it is concluded that this strain represents a novel species, for which the name Streptomyces antioxidans sp. nov. is proposed. The type strain is MUSC 164(T) (=DSM 101523(T) = MCCC 1K01590(T)). The extract of MUSC 164(T) showed potent antioxidative and neuroprotective activities against hydrogen peroxide. The chemical analysis of the extract revealed that the strain produces pyrazines and phenolic-related compounds that could explain for the observed bioactivities.
The Malaysian skincare industry is growing rapidly with a vast number of new sunscreens being produced annually. Inadequate skincare regulations and lack of enforcement have resulted in the overrating of sunscreens’ quality. The objectives of this study were to evaluate the efficacy and safety of the local and international sunscreens and to determine the effects of adding concentrated antioxidants into them. Three local and three internationally manufactured sunscreens were tested for the in vitro Ultraviolet A protection factor (UVAPF), Sun Protection Factor (SPF) and photostability. The creams were spread onto roughened polymethylmethacrylate plates where the absorbance was measured using a spectrophotometer before and after two hours of sunlight irradiation. The procedure was repeated combining available concentrated vitamin C and E creams. International sunscreens were found to have more accurate SPF labels (p=0.009) while local sunscreens were found to be more photostable (p=0.003). However, both sunscreens had inadequate UVAPF (p=0.471). Vitamin C enhanced the SPF values (p= 0.04) of both groups of sunscreens while vitamin E enhanced their photostability (p=0.000). Interestingly, combining vitamins C and E rich creams with the sunscreens had no effect on the SPF and UVAPF values as compared to the use of a single vitamin. More importantly, the combination of vitamins decreased the photostability (p=0.002) of sunscreens as compared to the addition of vitamin E alone. In conclusion, photoprotection is best achieved when sunscreens are used together with creams containing either vitamin C or E alone.
Bee pollen is considered as one of the functional foods due to its complex biochemical
properties. Bee pollen which is collected from pollen grains from various botanical sources
contains almost a complete nutrition such as carbohydrates, proteins, amino acids, vitamins
and minerals. Its beneficial effect on health is thought to be due to the presence of phenolic
compounds with its antioxidant activity. Antioxidant activities of ethanolic bee pollen extract
(BPE) from three species of Malaysian stingless bee; Trigona thoracica, Trigona itama and
Trigona apicalis in this study were measured using DPPH-HPLC method and gallic acid (GA)
as a standard reference. The percentage of DPPH inhibition by T. apicalis BPE at 1 mg/mL
showed the highest inhibition (39%, GA equivalent to 0.3 mg/mL) compared with T. itama
(14.3%, GA equivalent to 0.1 mg/mL) and T. thoracica (6.7%, GA equivalent to 0.05 mg/mL).
Our result was the first in reporting antioxidant activity of BPE measured using DPPH-HPLC
method from three different species of Malaysian stingless bee.
Hydroxyapatite (HAP) is a significant bone mineral that establishes bone strength. HAP composites in combination with biodegradable and bioactive polymer poly xylitol sebacic adipate (PXSA) would result in a constant release at target sites. Numerous studies have shown that vitamin K (VK) might possess a vital function in bone metabolism. The purpose of the present study was to inspect the synthesized composite HAP/PXSA/VK in developing polymeric biomaterials composite for the application of bone tissue regeneration. FTIR, X-ray diffraction, SEM and TEM techniques were applied to characterize the prepared composites. The release of VK from the HAP/PXSA/VK composite was evidenced through UV-Vis spectroscopy. In vitro studies proved that the HAP/PXSA/VK composite is appropriate for mesenchymal stem cell culture. Compared to pure HAP prepared following the same method, HAP/PXSA/VK composite provided favourable microstructures and good biodegradation distinctiveness for the application of tissue engineering, as well as tissue in-growth characteristics and improved scaffold cell penetration. This work reveals that the HAP/PXSA/VK composites have the potential for applications in bone tissue engineering.
Mushrooms have been consumed by mankind for millennia. In Malaysia, there are many species of edible mushrooms which are either cultivated (Agaricus spp., Auricularia spp., Pleurotus spp.) or harvested in the wild (Ganoderma spp., Polyporus spp., Termitomyces spp.). With the advancement of technology, numerous discoveries have been made that elucidated the nutritional (high in fibres, proteins, vitamins; low in fats, cholesterols, sodium) and medicinal (anti-oxidative, anti-hypertensive, neuritogenesis) properties of edible mushrooms, all of which are highly beneficial for the maintenance of human health and well-being. This review thus compiles and documents the available literatures on edible mushrooms reported from Malaysia complete with scientific, English, and vernacular names for future references; provides a comprehensive and updated overview on the nutritional and medicinal properties edible mushrooms reported from Malaysia; and identifies the research gaps to promote further research and development on edible mushrooms reported from Malaysia. Overall, Malaysia is and remains a natural repository for wild and cultivated edible mushrooms. Deeper investigation on their nutritional and medicinal properties will certainly serve as an impetus for economic as well as scientific progress.
A 79-year-old lady, who was taking warfarin, presented to the Emergency Department with a painless anterior neck swelling, which was associated with hoarseness of voice, odynophagia, and shortness of breath. She first noticed the swelling after she removed her dentures in the evening. On examination, she had an increased respiratory rate. There was a large submandibular swelling at the anterior side of her neck. Upon mouth opening, there was a hematoma at the base of her tongue, which extended to both sides of the tonsillar pillars. The patient was intubated with a video laryngoscope due to her worsening respiratory distress. Intravenous vitamin K and fresh frozen plasma were given immediately. The patient was admitted to the ICU for ventilation and observation. The hematoma subsided after 2 days and she was discharged well.
Oral anticoagulants are widely used in the treatment and prevention of both venous and arterial thromboembolism. They are classified into vitamin K anticoagulants (VKAs) and non-vitamin K antagonist oral anticoagulants (NOACs). The main advantage of NOACs over VKAs is the absence of the need for continuous monitoring. However, there are concerns about their effectiveness and safety in certain clinical situations. In this manuscript, I discussed the possibility of using optical coherence tomography angiography [OCTA] in the monitoring of the activity of NOACs. The rapid development of OCTA technology is very promising. Further research and development will extend its use beyond the realm of ophthalmology.