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Fulltext Biotechnological Aspects and Perspective of Microbial Keratinase Production

Gopinath SC, Anbu P, Lakshmipriya T, Tang TH, Chen Y, Hashim U, et al.

Biomed Res Int, 2015;2015:140726.
PMID: 26180780 DOI: 10.1155/2015/140726

Keratinases are proteolytic enzymes predominantly active when keratin substrates are available that attack disulfide bridges in the keratin to convert them from complex to simplified forms. Keratinases are essential in preparation of animal nutrients, protein supplements, leather manufacture, textile processing, detergent formulation, feather meal processing for feed and fertilizer, the pharmaceutical and biomedical industries, and waste management. Accordingly, it is necessary to develop a method for continuous production of keratinase from reliable sources that can be easily managed. Microbial keratinase is less expensive than conventionally produced keratinase and can be obtained from fungi, bacteria, and actinomycetes. In this overview, the expansion of information about microbial keratinases and important considerations in keratinase production are discussed.
Introgression of blast resistance genes into the elite rice variety MR263 through marker-assisted backcrossing

Hasan MM, Rafii MY, Ismail MR, Mahmood M, Alam MA, Abdul Rahim H, et al.

J Sci Food Agric, 2016 Mar 15;96(4):1297-305.
PMID: 25892666 DOI: 10.1002/jsfa.7222

Blast caused by the fungus Magnaporthe oryzae is a significant disease threat to rice across the world and is especially prevalent in Malaysia. An elite, early-maturing, high-yielding Malaysian rice variety, MR263, is susceptible to blast and was used as the recurrent parent in this study. To improve MR263 disease resistance, the Pongsu Seribu 1 rice variety was used as donor of the blast resistance Pi-7(t), Pi-d(t)1 and Pir2-3(t) genes and qLN2 quantitative trait locus (QTL). The objective was to introgress these blast resistance genes into the background of MR263 using marker-assisted backcrossing with both foreground and background selection.
Parthenolide reduces empty lacunae and osteoclastic bone surface resorption induced by polyethylene particles in a murine calvarial model of peri-implant osteolysis

Zawawi MS, Marino V, Perilli E, Cantley MD, Xu J, Purdue PE, et al.

J Biomed Mater Res A, 2015 Nov;103(11):3572-9.
PMID: 25903444 DOI: 10.1002/jbm.a.35484

The study aimed to determine the effects of parthenolide (PAR) on bone volume (BV) and bone surface resorption as assessed by live-animal microcomputed tomography (μCT) and possible osteocyte death as indicated by empty lacunae histologically in polyethylene (PE) particle-induced calvarial osteolysis in mice. Baseline μCT scans were conducted 7 days preimplantation of 2 × 10(8) PE particles/mL over the calvariae (day 0). PAR at 1 mg/kg/day was subcutaneously injected on days 0, 4, 7, and 10. At day 14, BV and surface resorption was analyzed with μCT. Calvarial tissue was processed for histomorphometric osteocyte evaluation. Serum was analyzed for type-1 carboxy-terminal collagen crosslinks (CTX-1) and osteoclast associated receptor (OSCAR) levels by ELISA. PE significantly decreased BV (p = 0.0368), increased surface bone resorption area (p = 0.0022), and increased the percentage of empty lacunae (p = 0.0043). Interestingly, PAR significantly reduced the resorption surface area (p = 0.0022) and the percentage of empty osteocyte lacunae (p = 0.0087) in the PE-calvariae, but it did not affect BV, serum CTX-1 or OSCAR levels. The ability of PAR to inhibit PE-induced surface bone erosion may better reflect the in vivo situation, where bone resorption occurs on the surface at the bone-implant interface and may also be related to the role of osteocytes in this pathology.
Fulltext Plasmodium knowlesi genome sequences from clinical isolates reveal extensive genomic dimorphism

Pinheiro MM, Ahmed MA, Millar SB, Sanderson T, Otto TD, Lu WC, et al.

PLoS One, 2015;10(4):e0121303.
PMID: 25830531 DOI: 10.1371/journal.pone.0121303

Plasmodium knowlesi is a newly described zoonosis that causes malaria in the human population that can be severe and fatal. The study of P. knowlesi parasites from human clinical isolates is relatively new and, in order to obtain maximum information from patient sample collections, we explored the possibility of generating P. knowlesi genome sequences from archived clinical isolates. Our patient sample collection consisted of frozen whole blood samples that contained excessive human DNA contamination and, in that form, were not suitable for parasite genome sequencing. We developed a method to reduce the amount of human DNA in the thawed blood samples in preparation for high throughput parasite genome sequencing using Illumina HiSeq and MiSeq sequencing platforms. Seven of fifteen samples processed had sufficiently pure P. knowlesi DNA for whole genome sequencing. The reads were mapped to the P. knowlesi H strain reference genome and an average mapping of 90% was obtained. Genes with low coverage were removed leaving 4623 genes for subsequent analyses. Previously we identified a DNA sequence dimorphism on a small fragment of the P. knowlesi normocyte binding protein xa gene on chromosome 14. We used the genome data to assemble full-length Pknbpxa sequences and discovered that the dimorphism extended along the gene. An in-house algorithm was developed to detect SNP sites co-associating with the dimorphism. More than half of the P. knowlesi genome was dimorphic, involving genes on all chromosomes and suggesting that two distinct types of P. knowlesi infect the human population in Sarawak, Malaysian Borneo. We use P. knowlesi clinical samples to demonstrate that Plasmodium DNA from archived patient samples can produce high quality genome data. We show that analyses, of even small numbers of difficult clinical malaria isolates, can generate comprehensive genomic information that will improve our understanding of malaria parasite diversity and pathobiology.
Fulltext Bacterial pathogens from the intestinal tracts of various species of cockroaches

Rampal L, Oothuman P, Jeffery J, Daud MZ, Shekhar C, Senan P, et al.

Med J Malaysia, 1983 Jun;38(2):104-7.
PMID: 6353184

Bacterial isolates were made from the intestinal tracts ofcarious species of cockroaches (Periplaneta americana, Periplaneta brunnea, Periplaneta australasiae, Neostylopyga rhombifolia, Nauphoeta cinerea) trapped from kitchens and stores (houses and hospital), Shigello, flexneri, Salmonella typhi, Escherichia coli and Salmonella sp. were some of the bacteria isolated and identified.
Fulltext COVID-19 outbreak in Malaysia: Actions taken by the Malaysian government

Shah AUM, Safri SNA, Thevadas R, Noordin NK, Rahman AA, Sekawi Z, et al.

Int J Infect Dis, 2020 Aug;97:108-116.
PMID: 32497808 DOI: 10.1016/j.ijid.2020.05.093

BACKGROUND: Coronavirus disease 2019 (COVID-19), a novel pneumonia disease originating in Wuhan, was confirmed by the World Health Organization on January 12, 2020 before becoming an outbreak in all countries.
OUTBREAK SITUATION: A stringent screening process at all airports in Malaysia was enforced after the first case outside China was reported in Thailand. Up to April 14, 2020, Malaysia had reported two waves of COVID-19 cases, with the first wave ending successfully within less than 2 months. In early March 2020, the second wave occurred, with worrying situations.
ACTIONS TAKEN: The Government of Malaysia enforced a Movement Control Order starting on March 18, 2020 to break the chain of COVID-19. The media actively spread the hashtag #stayhome. Non-governmental organizations, as well as prison inmates, started to produce personal protective equipment for frontliners. Various organizations hosted fundraising events to provide essentials mainly to hospitals. A provisional hospital was set up and collaborations with healthcare service providers were granted, while additional laboratories were assigned to enhance the capabilities of the Ministry of Health.
ECONOMIC DOWNTURN: An initial financial stimulus amounting to RM 20.0 billion was released in February 2020, before the highlighted PRIHATIN Package, amounting to RM 250 billion, was announced. The PRIHATIN Package has provided governmental support to society, covering people of various backgrounds from students and families to business owners.
Carbamoylphosphate synthetase 1 (CPS1) deficiency: clinical, biochemical, and molecular characterization in Malaysian patients

Ali EZ, Khalid MK, Yunus ZM, Yakob Y, Chin CB, Abd Latif K, et al.

Eur J Pediatr, 2016 Mar;175(3):339-46.
PMID: 26440671 DOI: 10.1007/s00431-015-2644-z

Carbamoyl phosphate synthetase 1 (CPS1) deficiency is a rare autosomal recessive disorder of ureagenesis presenting as life-threatening hyperammonemia. In this study, we present the main clinical features and biochemical and molecular data of six Malaysian patients with CPS1 deficiency. All the patients have neonatal-onset symptoms, initially diagnosed as infections before hyperammonemia was recognized. They have typical biochemical findings of hyperglutaminemia, hypocitrullinemia, and low to normal urinary excretion of orotate. One neonate succumbed to the first hyperammonemic decompensation. Five neonatal survivors received long-term treatment consisting of dietary protein restriction and ammonia-scavenging drugs. They have delayed neurocognitive development of varying severity. Genetic analysis revealed eight mutations in CPS1 gene, five of which were not previously reported. Five mutations were missense changes while another three were predicted to create premature stop codons. In silico analyses showed that these new mutations affected different CPS1 enzyme domains and were predicted to interrupt interactions at enzyme active sites, disturb local enzyme conformation, and destabilize assembly of intact enzyme complex.
CONCLUSION: All mutations are private except one mutation; p.Ile1254Phe was found in three unrelated families. Identification of a recurrent p.Ile1254Phe mutation suggests the presence of a common and unique mutation in our population. Our study also expands the mutational spectrum of the CPS1 gene.
Fulltext Dataset for the morphological and erythrocytes parameters of Clarias gariepinus, Pangasianodon hypophthalmus, and their reciprocal hybrids

Okomoda VT, Koh ICC, Hassan A, Oladimeji AS, Ikhwanuddin M, Abol-Munafi AB, et al.

Data Brief, 2020 Oct;32:106151.
PMID: 32904264 DOI: 10.1016/j.dib.2020.106151

Discrimination of different fishes can be done through different means which includes morphological appearance. When two fishes are successfully hybridized, they produce progenies that have shared morphology between their pure parent, hence, making morphometric characterization an important aspect of hybrid discrimination. However, erythrocyte characterization is also a simpler method for characterization. The dataset presented in this article represents the traditional morphological data, truss network data and erythrocyte data of pure and novel hybrids from reciprocal crosses of African catfish Clarias gariepinus and Asian catfish Pangasianodon hypophthalmus. Breeding of the broodstocks was done to produce pure and hybrid progenies which were maintained for a period of four to six months. Based on the cross combinations and morphotypes, traditional measurement of twenty-five morphological characters and five meristic counts were recorded. Thereafter pictures of the different fish groups were used to determine values of thirty-six distances between ten landmark points. The morphological abnormality of the hybrids at market size is also presented in this data article for the very first time. Blood was then collected from the caudal peduncle of ten fish per group and smeared on a slide for observation under a compound microscope (at 100 × magnification). Data gotten included erythrocytes parameters such as cell major axis, cell minor axis, nucleus major axis, nucleus minor axis cell area, nucleus area, cell volume, and nucleus volume. Data recording was through the Microsoft excel spreadsheet; which was also used to process the data to get the exclusive ranges of values for paired progenies. The data as presented is associated with the research article "Morphological characterization of the progenies of pure and reciprocal crosses of Pangasianodon hypophthalmus (Sauvage, 1878) and Clarias gariepinus (Burchell, 1822)" [1]. The dataset presented in this article can be used for easy identification of the novel hybrid progenies of the African Catfish and Asian Catfish.
Dose-response analysis of toxic effect from palm oil mill effluent (POME) by-products on biohydrogen producing bacteria - A preliminary study on microbial density and determination of EC50

Arisht SN, Abdul PM, Jasni J, Mohd Yasin NH, Lin SK, Wu SY, et al.

Ecotoxicol Environ Saf, 2020 Oct 15;203:110991.
PMID: 32888602 DOI: 10.1016/j.ecoenv.2020.110991

The stimulant and toxicity effects of reported organic (acetic acid, propionic acid, butyric acid, formic acid, oil & grease) and inorganic (copper) by-products presented in palm oil mill effluent on anaerobic bacterial population were examined in this paper. The toxicity test had shown that acetic, propionic and butyric acids tend to stimulate the bacterial density level (survival rate more than 50%), while formic acid, copper, oil and grease were shown to have suppressed the density level (survival rate less than 50%). The highest biomass recorded was 1.66 mg/L for the concentration of acetic acid at 216 mg/L and lowest biomass concentration, 0.90 mg/L for copper at 1.40 mg/L. Biohydrogen-producing bacteria have a favourable growth rate around pH 5.5. The comparison of half maximal effective concentration (EC50) values between two test duration on the effects of organic and inorganic by-products postulate that bacteria had a higher tolerance towards volatile fatty acids. While acetic, butyric and propionic acids had exhibited higher tolerance EC50 values for bacteria, but the opposite trend was observed for formic acid, copper and oil & grease.
Fulltext Investigation of Heat Transfer and Pressure Drop in Microchannel Heat Sink Using Al2O3 and ZrO2 Nanofluids

Khan MZU, Uddin E, Akbar B, Akram N, Naqvi AA, Sajid M, et al.

Nanomaterials (Basel), 2020 Sep 09;10(9).
PMID: 32916991 DOI: 10.3390/nano10091796

A new micro heat exchanger was analyzed using numerical formulation of conjugate heat transfer for single-phase fluid flow across copper microchannels. The flow across bent channels harnesses asymmetric laminar flow and dean vortices phenomena for heat transfer enhancement. The single-channel analysis was performed to select the bent channel aspect ratio by varying width and height between 35-300 μm for Reynolds number and base temperature magnitude range of 100-1000 and 320-370 K, respectively. The bent channel results demonstrate dean vortices phenomenon at the bend for Reynolds number of 500 and above. Thermal performance factor analysis shows an increase of 18% in comparison to straight channels of 200 μm width and height. Alumina nanoparticles at 1% and 3% concentration enhance the Nusselt number by an average of 10.4% and 23.7%, respectively, whereas zirconia enhances Nusselt number by 16% and 33.9% for same concentrations. On the other hand, thermal performance factor analysis shows a significant increase in pressure drop at high Reynolds number with 3% particle concentration. Using zirconia for nanofluid, Nusselt number of the bent multi-channel model is improved by an average of 18% for a 3% particle concentration as compared to bent channel with deionized water.
Fulltext Treatment of Palm Oil Refinery Effluent Using Tannin as a Polymeric Coagulant: Isotherm, Kinetics, and Thermodynamics Analyses

Mat Yasin NMF, Hossain MS, H P S AK, Zulkifli M, Al-Gheethi A, Asis AJ, et al.

Polymers (Basel), 2020 Oct 14;12(10).
PMID: 33066451 DOI: 10.3390/polym12102353

The refining of the crude palm oil (CPO) generates the palm oil refinery effluent (PORE). The presence of high contents of biochemical oxygen demand (BOD), chemical oxygen demand (COD), turbidity, and suspended solids (SS) in PORE encourages the determination of an effective treatment process to minimize the environmental pollution and preserve aquatic life. In the present study, a biodegradable natural polymer, namely tannin, was utilized as a coagulant to treat PORE. The coagulation experiment was conducted using a jar test apparatus. The tannin coagulation efficiency was evaluated based on the BOD, COD, turbidity, and SS removal from PORE by varying the tannin dose (50-300 mg/L), pH (pH 4-10), treatment time (15-90 min), and sedimentation time (15-90 min). It was found that the maximum removal of BOD, COD, turbidity, and SS was 97.62%, 88.89%, 93.01%, and 90.21%, respectively, at pH 6, a tannin dose of 200 mg/L, 60 min of coagulation time, and 60 min of sedimentation time. Analyses of isotherm models revealed that the Freundlich isotherm model was well fitted with the coagulation study. Kinetics studies show that the pseudo-second-order kinetics model was the well-fitted kinetics model for the BOD, COD, turbidity, and SS removal from PORE using tannin as a polymeric coagulant. The determination of thermodynamics parameters analyses revealed that BOD, COD, turbidity, and SS removal from PORE was spontaneous, exothermic, and chemical in nature. The finding of the present study shows that tannin as a natural polymeric coagulant would be utilized in PORE treatment to avoid toxic sludge generation.
Fulltext Prospective evaluation of using multiparametric magnetic resonance imaging in cognitive fusion prostate biopsy compared to the standard systematic 12-core biopsy in the detection of prostate cancer

Lim LY, Tan GH, Zainuddin ZM, Fam XI, Goh EH, Syaris OS, et al.

Urol Ann, 2020 07 17;12(3):276-282.
PMID: 33100755 DOI: 10.4103/UA.UA_98_19

Purpose: There is mounting evidence to suggest that multiparametric magnetic resonance imaging (mpMRI)-guided biopsy is better than systematic biopsy for the diagnosis of prostate cancer (PCa). Cognitive fusion biopsy (CFB) involves targeted biopsies of areas of suspicious lesions noted on the mpMRI by transrectal ultrasound (TRUS) operator. This study was undertaken to determine the accuracy of mpMRI of the prostate with Prostate Imaging-Reporting and Data System (PI-RADS) version 2 in detecting PCa. We also compare the cancer detection rates between systematic 12-core TRUS biopsy and CFB.
Materials and Methods: Sixty-nine men underwent mpMRI of the prostate followed by TRUS biopsy. In addition to 12-core biopsy, CFB was performed on abnormal lesions detected on MRI.
Results: Abnormal lesions were identified in 98.6% of the patients, and 59.4% had the highest PI-RADS score of 3 or more. With the use of PI-RADS 3 as cutoff, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI for the detection of PCa were 91.7%, 57.8%, 53.7%, and 92.8%, respectively. With the use of PI-RADS 4 as cutoff, the sensitivity, specificity, PPV, and NPV of mpMRI were 66.7%, 91.1%, 80%, and 83.7%, respectively. Systematic biopsy detected more PCa compared to CFB (29% vs. 26.1%), but CFB detected more significant (Gleason grade ≥7) PCa (17.4% vs. 14.5%) (P < 0.01). CFB cores have a higher PCa detection rate as compared to systematic cores (P < 0.01).
Conclusions: mpMRI has a good predictive ability for PCa. CFB is superior to systematic biopsy in the detection of the significant PCa.
Cell-targeting aptamers act as intracellular delivery vehicles

Gopinath SC, Lakshmipriya T, Chen Y, Arshad MK, Kerishnan JP, Ruslinda AR, et al.

Appl Microbiol Biotechnol, 2016 Aug;100(16):6955-69.
PMID: 27350620 DOI: 10.1007/s00253-016-7686-2

Aptamers are single-stranded nucleic acids or peptides identified from a randomized combinatorial library through specific interaction with the target of interest. Targets can be of any size, from small molecules to whole cells, attesting to the versatility of aptamers for binding a wide range of targets. Aptamers show drug properties that are analogous to antibodies, with high specificity and affinity to their target molecules. Aptamers can penetrate disease-causing microbial and mammalian cells. Generated aptamers that target surface biomarkers act as cell-targeting agents and intracellular delivery vehicles. Within this context, the "cell-internalizing aptamers" are widely investigated via the process of cell uptake with selective binding during in vivo systematic evolution of ligands by exponential enrichment (SELEX) or by cell-internalization SELEX, which targets cell surface antigens to be receptors. These internalizing aptamers are highly preferable for the localization and functional analyses of multiple targets. In this overview, we discuss the ways by which internalizing aptamers are generated and their successful applications. Furthermore, theranostic approaches featuring cell-internalized aptamers are discussed with the purpose of analyzing and diagnosing disease-causing pathogens.
Fulltext Prevalence and risk factors of prehypertension in university students in Sabah, Borneo Island of East Malaysia

Qaiser S, Daud MNM, Ibrahim MY, Gan SH, Rahman MS, Sani MHM, et al.

Medicine (Baltimore), 2020 May 22;99(21):e20287.
PMID: 32481309 DOI: 10.1097/MD.0000000000020287

Unhealthy lifestyle contributes mainly to an increased prevalence of non-communicable diseases including hypertension and cardiovascular diseases tend to increase in Malaysia. These diseases lead to an increased risk of end organ damage and cardiovascular complications. In this study, the prevalence of prehypertension and its associated risk factors among a cohort of university students in Sabah was determined.This is a prospective, cross-sectional study conducted among 365 undergraduate students irrespective of faculties at Universiti Malaysia Sabah (UMS). Standardized and validated World Health Organization (WHO) STEPS questionnaires were used to collect sociodemographic data. Additionally, clinical and anthropometric data were measured and recorded by a trained staff, followed by descriptive and logistic regression analyses.A total of 365 UMS undergraduate students aged 18 years and above participated in the study. The prevalence of prehypertension among university students was high (31%) (95% CI [29.1%, 34.3%]). Well-known risk factors for hypertension including family history of hypertension, reduced sleep duration, reduced physical activity, smoking, being overweight or obese were significantly associated with the risk of developing prehypertension (P
Fulltext Unexpected complication of arteriovenous fistula of the left common carotid to internal jugular vein following central venous catheterization

Henry TCL, Huei TJ, Yuzaidi M, Safri LS, Krishna K, Rizal IA, et al.

Chin J Traumatol, 2020 Feb;23(1):29-31.
PMID: 31744657 DOI: 10.1016/j.cjtee.2019.10.001

Incidence of inadvertent arterial puncture secondary to central venous catheter insertion is not common with an arterial puncture rate of <1%. This is due to the advancements and wide availability of ultrasound to guide its insertion. Formation of arteriovenous fistula after arterial puncture is an unexpected complication. Till date, only five cases (including this case) of acquired arteriovenous fistula formation has been described due to inadvertent common carotid puncture. The present case is a 26-year-old man sustained traumatic brain injuries, chest injuries and multiple bony fractures. During resuscitative phase, attempts at left central venous catheter via left internal jugular vein under ultrasound guidance resulted in inadvertent puncture into the left common carotid artery. Surgical neck exploration revealed that the catheter had punctured through the left internal jugular vein into the common carotid artery with formation of arteriovenous fistula. The catheter was removed successfully and common carotid artery was repaired. Postoperatively, the patient recovered and clinic visits revealed no neurological deficits. From our literature review, the safest method for removal is via endovascular and open surgical removal. The pull/push technique (direct removal with compression) is not recommended due to the high risk for stroke, bleeding and hematoma formation.
Schiff base-nickel, palladium, and platinum complexes derived from N-cyclohexyl hydrazine carbothioamide and 3-hydroxy-4-methoxybenzaldehyde: Selective antiproliferative and proapoptotic effects against colorectal carcinoma

Arafath MA, Al-Suede FSR, Adam F, Al-Juaid S, Khadeer Ahamed MB, Majid AMSA

Drug Dev Res, 2019 09;80(6):778-790.
PMID: 31215682 DOI: 10.1002/ddr.21559

The bidentate N-cyclohexyl-2-(3-hydroxy-4-methoxybenzylidene)hydrazine-1-carbothioamide Schiff base ligand (HL) was coordinated to divalent nickel, palladium and platinum ions to form square planar complexes. The nickel and palladium complexes, [NiL2 ], [PdL2 ] form square planar complexes with 2:1 ligand to metal ratio. The platinum complex, [PtL(dmso)Cl] formed a square planar complex with 1:1 ligand to metal ratio. Platinum undergoes in situ reaction with DMSO before complexing with the ligand in solution. The cytotoxicity of HL, [NiL2 ], [PdL2 ], and [PtL(dmso)Cl] were evaluated against human colon cancer cell line (HCT-116), human cervical cancer (Hela) cell line, melanoma (B16F10) cells, and human normal endothelial cell lines (Eahy926) by MTT assay. The [NiL2 ] complex displayed selective cytotoxic effect against the HCT 116 cancer cell line with IC50 of 7.9 ± 0.2 μM. However, HL, [PdL2 ], and [PtL(dmso)Cl] only exhibited moderate cytotoxic activity with IC50 = 75.9 ± 2.4, 100.0 ± 1.8, and 101.0 ± 3.6 μM, respectively. The potent cytotoxicity of [NiL2 ] was characterized using Hoechst and Rhodamine assays. The nickel complex, [NiL2 ], caused remarkable nuclear condensation and reduction in mitochondrial membrane potential. In addition, molecular docking studies confirms that [NiL2 ] possesses significant binding efficiency with Tyrosine kinase. Altogether, the results revealed that [NiL2 ] exhibits cytotoxicity against the cancer cells via Tyrosine kinase-induced proapoptosis pathway. This study demonstrates that the [NiL2 ] complex could be a promising therapeutic agent against colorectal carcinoma.
An Evidence-Based Perspective on Movement and Activity Following Median Sternotomy

El-Ansary D, LaPier TK, Adams J, Gach R, Triano S, Katijjahbe MA, et al.

Phys Ther, 2019 12 16;99(12):1587-1601.
PMID: 31504913 DOI: 10.1093/ptj/pzz126

Cardiac surgery via median sternotomy is performed in over 1 million patients per year worldwide. Despite evidence, sternal precautions in the form of restricted arm and trunk activity are routinely prescribed to patients following surgery to prevent sternal complications. Sternal precautions may exacerbate loss of independence and prevent patients from returning home directly after hospital discharge. In addition, immobility and deconditioning associated with restricting physical activity potentially contribute to the negative sequelae of median sternotomy on patient symptoms, physical and psychosocial function, and quality of life. Interpreting the clinical impact of sternal precautions is challenging due to inconsistent definitions and applications globally. Following median sternotomy, typical guidelines involve limiting arm movement during loaded lifting, pushing, and pulling for 6 to 8 weeks. This perspective paper proposes that there is robust evidence to support early implementation of upper body activity and exercise in patients recovering from median sternotomy while minimizing risk of complications. A clinical paradigm shift is encouraged, one that encourages a greater amount of controlled upper body activity, albeit modified in some situations, and less restrictive sternal precautions. Early screening for sternal complication risk factors and instability followed by individualized progressive functional activity and upper body therapeutic exercise is likely to promote optimal and timely patient recovery. Substantial research documenting current clinical practice of sternal precautions, early physical therapy, and cardiac rehabilitation provides support and the context for understanding why a less restrictive and more active plan of care is warranted and recommended for patients following a median sternotomy.
Fulltext The role of edible bird's nest and mechanism of averting lead acetate toxicity effect on rat uterus

Albishtue AA, Yimer N, Zakaria MZA, Haron AW, Babji AS, Abubakar AA, et al.

Vet World, 2019 Jul;12(7):1013-1021.
PMID: 31528026 DOI: 10.14202/vetworld.2019.1013-1021

Aim: This study aimed to evaluate the protective effect of edible bird's nest (EBN) supplement on the uteri of rats exposed to lead acetate (LA) toxicity.
Materials and Methods: Five treatment groups were established as follows: Group 1 (C), which was given distilled water; Group 2 (T0), which was administered with LA (10 mg/kg body weight [BW]); and Groups 3 (T1), 4 (T2), and 5 (T3), which were given LA (10 mg/kg BW) plus graded concentrations of 30, 60, and 120 mg/kg BW of EBN, respectively. Rats were euthanized at week 5 to collect blood for superoxide dismutase (SOD) assay, and uterus for histomorphological study and expression analyses of epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), and proliferating cell nuclear antigen (PCNA).
Results: Results revealed that LA causes destruction of uterine lining cells and necrosis of uterine glands of exposed rats without EBN supplement while the degree of damage decreased among EBN treated groups; T3 showed the highest ameliorating effect against LA toxicity, as well as an increased number of uterine glands. Increased levels of SOD were also achieved in EBN supplemented groups than the controls. Results of immunohistochemistry showed significantly higher expressions of EGF, VEGF, and PCNA levels (p<0.05) in T3 compared to other treatments. EBN maintained upregulation of antioxidant - reactive oxygen species balance.
Conclusion: The findings showed that EBN could ameliorate the detrimental effects of LA toxicity on the uterus possibly by enhancing enzymatic antioxidant (SOD) activity as well as expressions of EGF, VEGF, and PCNA with cell proliferation roles.
Fulltext Evaluation of types of poisoning exposure calls managed by the Malaysia National Poison Centre (2006-2015): A retrospective review

Tangiisuran B, Jiva M, Ariff AM, Abdul Rani NA, Misnan A, Rashid SM, et al.

BMJ Open, 2018 12 31;8(12):e024162.
PMID: 30598487 DOI: 10.1136/bmjopen-2018-024162

OBJECTIVE: Accidental or intentional poisoning is a public health concern requiring intervention. The current study designs to evaluate the types of poisoning exposure calls received by the Malaysia National Poison Centre (NPC) over a 10-year period.
SETTINGS AND DATA SOURCES: The poisoning enquiries database (2006-2015) from the Malaysia NPC was used for the analysis.
PARTICIPANTS: The NPC records all telephone calls that it manages using a validated and standardised form. Demographics and types of the poisoning exposure calls were extracted and descriptive analysis was applied.
PRIMARY AND SECONDARY OUTCOMES: The primary outcome of this study is to evaluate NPC data for trends in the poisoning exposure calls based on the types and modes of poisoning over a 10-year period. The secondary outcome is to evaluate the characteristics of human exposure cases based on the calls received by the NPC.
RESULTS: There was a notable increase in the number of poisoning exposure calls noticed during the 10-year period but dropped significantly in 2012. The highest number of poisoning exposure calls came from Selangor (21.0%), Perak (18.0%) and Negeri Sembilan (9.8%). More than half of the exposure was intentional (53.8%) involving more women (50.3%) as compared with men (41.9%), and in the 20-29 years age group category (33.5%). Exposure mostly occurred at home (96%) through the ingestion route (94.1%). Pharmaceutical products (40.5%), pesticides (31.7%) and household products (20.1%) were the common agents implicated for intentional exposure.
CONCLUSIONS: There is an increasing trend in enquiries on poisoning exposure calls made to the NPC. Most of the intentional poisoning exposures occurred among younger women and involved pharmaceuticals, pesticides or household products. Poisoning safety education and other interventions are needed to curb poisoning incidents.
Risk of concentrations of major air pollutants on the prevalence of cardiovascular and respiratory diseases in urbanized area of Kuala Lumpur, Malaysia

Tajudin MABA, Khan MF, Mahiyuddin WRW, Hod R, Latif MT, Hamid AH, et al.

Ecotoxicol Environ Saf, 2019 Apr 30;171:290-300.
PMID: 30612017 DOI: 10.1016/j.ecoenv.2018.12.057

Rapid urbanisation in Malaysian cities poses risks to the health of residents. This study aims to estimate the relative risk (RR) of major air pollutants on cardiovascular and respiratory hospitalisations in Kuala Lumpur. Daily hospitalisations due to cardiovascular and respiratory diseases from 2010 to 2014 were obtained from the Hospital Canselor Tuanku Muhriz (HCTM). The trace gases, PM10 and weather variables were obtained from the Department of Environment (DOE) Malaysia in consistent with the hospitalisation data. The RR was estimated using a Generalised Additive Model (GAM) based on Poisson regression. A "lag" concept was used where the analysis was segregated into risks of immediate exposure (lag 0) until exposure after 5 days (lag 5). The results showed that the gases could pose significant risks towards cardiovascular and respiratory hospitalisations. However, the RR value of PM10 was not significant in this study. Immediate effects on cardiovascular hospitalisations were observed for NO2 and O3 but no immediate effect was found on respiratory hospitalisations. Delayed effects on cardiovascular and respiratory hospitalisations were found with SO2 and NO2. The highest RR value was observed at lag 4 for respiratory admissions with SO2 (RR = 1.123, 95% CI = 1.045-1.207), followed by NO2 at lag 5 for cardiovascular admissions (RR = 1.025, 95% CI = 1.005-1.046). For the multi-pollutant model, NO2 at lag 5 showed the highest risks towards cardiovascular hospitalisations after controlling for O3 8 h mean lag 1 (RR = 1.026, 95% CI = 1.006-1.047), while SO2 at lag 4 showed highest risks towards respiratory hospitalisations after controlling for NO2 lag 3 (RR = 1.132, 95% CI = 1.053-1.216). This study indicated that exposure to trace gases in Kuala Lumpur could lead to both immediate and delayed effects on cardiovascular and respiratory hospitalisations.

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