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Fulltext Novel and Highly Sensitive Electrochemical Sensor for the Determination of Oxytetracycline Based on Fluorine-Doped Activated Carbon and Hydrophobic Deep Eutectic Solvents

Wannasri N, Uppachai P, Seehamart K, Jantrasee S, Butwong N, Mukdasai K, et al.

ACS Omega, 2022 Dec 13;7(49):45654-45664.
PMID: 36530264 DOI: 10.1021/acsomega.2c06462

Residues of oxytetracycline (OTC), a veterinary antibiotic and growth promoter, can be present in animal-derived foods; their consumption is harmful to human health and their presence must therefore be detected and regulated. However, the maximum residue limit is low, and consequently highly sensitive and accurate detectors are required to detect the residues. In this study, a novel highly sensitive electrochemical sensor for the detection of OTC was developed using a screen-printed electrode modified with fluorine-doped activated carbon (F-AC/SPE) combined with a novel deep eutectic solvent (DES). The modification of activated carbon by doping with fluorine atoms (F-AC) enhanced the adsorption and electrical activity of the activated carbon. The novel hydrophobic DES was prepared from tetrabutylammonium bromide (TBABr) and a fatty acid (malonic acid) using a green synthesis method. The addition of the DES increased the electrochemical response of F-AC for OTC detection; furthermore, it induced preconcentration of OTC, which increased its detectability. The electrostatic interactions between DES and OTC as well as the adsorption of OTC on the surface of the modified electrode through H-bonding and π-π interactions helped in OTC detection, which was quantified based on the decrease in the anodic peak potential (E pa = 0.3 V) of AC. The electrochemical behavior of the modified electrode was investigated by cyclic voltammetry, differential pulse voltammetry, and electrochemical impedance spectroscopy. Under optimum conditions, the calibration plot of OTC exhibited a linear response in the range 5-1500 μg L-1, with a detection limit of 1.74 μg L-1. The fabricated electrochemical sensor was successfully applied to determine the OTC in shrimp pond and shrimp samples with recoveries of 83.8-100.5% and 93.3-104.5%, respectively. In addition to the high sensitivity of OTC detection, the proposed electrochemical sensor is simple, cost-effective, and environmentally friendly.
Fulltext Polystyrene microplastics induce gut microbiome and metabolome changes in Javanese medaka fish (Oryzias javanicus Bleeker, 1854)

Usman S, Razis AFA, Shaari K, Azmai MNA, Saad MZ, Isa NM, et al.

Toxicol Rep, 2022;9:1369-1379.
PMID: 36518379 DOI: 10.1016/j.toxrep.2022.05.001

Microplastics (MPs) have become emerging pollutants of public health concern, due to their impact on aqua-terrestrial ecosystems and integration into the food web, with evidence of human exposure and unrevealed health implications. There is a paucity of information regarding the effects of MPs exposure on the gut system using metagenomic and metabolomic approaches. In this study, Javanese medaka fish was exposed to 5 µm beads of polystyrene microplastics (PS-MPs) suspensions, at concentrations of 100 μg/L (MP-LOW), 500 μg/L (MP-MED), and 1000 μg/L (MP-HIGH), for a duration of 21 days, and evaluated for gut microbiome and metabolome responses. The results revealed a significant reduction (p < 0.05) in richness and diversity of the gut microbiome in the MP-HIGH group, and identification of 7 bacterial genera as differential features by the Linear discriminant analysis Effect Size (LEfSe). The gut metabolic profile revealed upregulation of 9 metabolites related to energy metabolism, via tricarboxylic acid cycle (TCA), creatine pathway, and urea cycle, as determined by the pathway analysis. Furthermore, positive correlation was found between the genus Aeromonas and glucose, lactate, and creatine metabolites. The study revealed that PS-MPs exposure resulted in altered bacterial microbiome and metabolic disorder related to energy metabolism. It further provided additional data on gut bacterial genera and metabolites associated with MPs toxicity in aquatic organism, which will inevitably enable its future health risks assessment in animals and possibly humans.
Evaluation of the Relationship between Fractional Exhaled Nitric Oxide (FeNO) with Indoor PM10, PM2.5 and NO2 in Suburban and Urban Schools

Mohd Isa KN, Jalaludin J, Mohd Elias S, Mohamed N, Hashim JH, Hashim Z

Int J Environ Res Public Health, 2022 Apr 11;19(8).
PMID: 35457448 DOI: 10.3390/ijerph19084580

Numerous epidemiological studies have evaluated the association of fractional exhaled nitric oxide (FeNO) and indoor air pollutants, but limited information available of the risks between schools located in suburban and urban areas. We therefore investigated the association of FeNO levels with indoor particulate matter (PM10 and PM2.5), and nitrogen dioxide (NO2) exposure in suburban and urban school areas. A comparative cross-sectional study was undertaken among secondary school students in eight schools located in the suburban and urban areas in the district of Hulu Langat, Selangor, Malaysia. A total of 470 school children (aged 14 years old) were randomly selected, their FeNO levels were measured, and allergic skin prick tests were conducted. The PM2.5, PM10, NO2, and carbon dioxide (CO2), temperature, and relative humidity were measured inside the classrooms. We found that the median of FeNO in the school children from urban areas (22.0 ppb, IQR = 32.0) were slightly higher as compared to the suburban group (19.5 ppb, IQR = 24.0). After adjustment of potential confounders, the two-level hierarchical multiple logistic regression models showed that the concentrations of PM2.5 were significantly associated with elevated of FeNO (>20 ppb) in school children from suburban (OR = 1.42, 95% CI = 1.17−1.72) and urban (OR = 1.30, 95% CI = 1.10−1.91) areas. Despite the concentrations of NO2 being below the local and international recommendation guidelines, NO2 was found to be significantly associated with the elevated FeNO levels among school children from suburban areas (OR = 1.11, 95% CI = 1.06−1.17). The findings of this study support the evidence of indoor pollutants in the school micro-environment associated with FeNO levels among school children from suburban and urban areas.
Fulltext Perceived Risk for Dengue Infection Mediates the Relationship between Attitude and Practice for Dengue Prevention: A Study in Seremban, Malaysia

Ahmad Zamzuri M'I, Abd Majid FN, Dapari R, Hassan MR, Isa AMM

Int J Environ Res Public Health, 2022 Oct 14;19(20).
PMID: 36293856 DOI: 10.3390/ijerph192013252

Dengue remains a public health concern due to limited curative treatment and safe vaccine availability. Prevention by individual is utmost necessary but its practice is still lacking. Perceived risk to disease has been reported to exert a good effect on health behaviour change. However, limited evidence showed its relationship towards attitude and practice for dengue prevention. Hence, we aim to measure the mediating effect of dengue risk perception in the relationship between dengue attitude and dengue prevention practice. A cross-sectional study was conducted from April 2021 to November 2021 in a district of Seremban using a pre-validated questionnaire. Informed consent was obtained from the respondents prior to inclusion in the study. The study was approved by the ethical research committee. A total of 347 respondents took part in the survey, but only 341 data points were included in the final analysis. The majority of the respondents were female (63.0%), of Malay ethnicity (86.8%), married (55.4%), and currently employed (71.0%). The pooled confirmatory factor analysis result demonstrated an RMSEA value of 0.038 (<0.08), CFI value of 0.969 (>0.90), TLI value of 0.9565 (>0.90), and ChiSq/df = 1.479 (<3.0). All the hypotheses for direct effect yielded a significant and positive relationship. Bootstrapping analysis to test for mediation revealed a partial mediation effect as both indirect and direct effects are significant. Risk perception is a mediator variable between attitude and dengue prevention practice. Therefore, our recommendation is to increase health awareness activity that helps to improve individual's risk perception through active health promotion and a health educational campaign that inculcates dengue risk messages. Ultimately, this effort can enhance good health prevention behaviour.
Fulltext Brain herniation in a neonate

Wong CY, Azizi AB, Shareena I, Rohana J, Boo NY, Isa MR

Singapore Med J, 2010 Oct;51(10):e166-8.
PMID: 21103805

Brain herniation is generally thought to be unlikely to occur in newborns due to the presence of the patent fontanelles and cranial sutures. A review of the literature published from 1993 to 2008 via MEDLINE search revealed no reports on neonatal brain herniation from intracranial tumour. We report a preterm Malay male infant born via elective Caesarean section for antenatally diagnosed intracerebral tumour, which subsequently developed herniation. Cerebral magnetic resonance imaging showed features that were compatible with a large complex intracranial tumour causing mass effect and gross hydrocephalus. Tumour excision was scheduled when the infant was two weeks old. Unfortunately, on the morning of the surgery, he developed signs of brain herniation and had profuse tumour haemorrhage during the attempted excision. Histopathological examination revealed an embryonal tumour, possibly an atypical rhabdoid/teratoid tumour. This case illustrates that intracranial tumours in newborns can herniate and should therefore be closely monitored.
Fulltext Pyrolysis of Canarium schweinfurthii hard-shell: Thermochemical characterisation and pyrolytic kinetics studies

Garba K, Mohammed IY, Isa YM, Abubakar LG, Abakr YA, Hameed BH

Heliyon, 2023 Feb;9(2):e13234.
PMID: 36785823 DOI: 10.1016/j.heliyon.2023.e13234

Canarium schweinfurthii fruit used in food and cosmetics produces waste nuts with a hard shell (hard-shell) and kernel. The hard-shell contained lignin and holocellulose, besides 51.99 wt% carbon, 6.0 wt% hydrogen, 41.68 wt% oxygen, and 70.97 wt% volatile matter. Therefore, this study commenced thermochemical investigations on the hard-shell through extensive intermediate pyrolysis and kinetic studies. During the active stage of thermogravimetric pyrolysis, the hard-shell lost a maximum of 56.45 wt%, and the activation energies obtained by the Kissinger-Akahira-Sunose, Flynn-Wall-Ozawa, and Starink methods were 223, 221 and 217 kJ/mol, respectively. The Flynn-Wall-Ozawa method depicted the degradation process accurately, where the Coat-Redfern method's contraction and diffusion mechanisms governed the pyrolysis reactions at activation energies of 16.62 kJ/mol and 38.83 kJ/mol, respectively. The pyrolysis process produced 25 wt% biochar and 25 wt% bio-oil under optimum conditions. The calorific values of the bio-oils with 6.81-7.11 wt% hydrogen and 68.01-71.12 wt% carbon was 26.32-27.83 MJ/kg, with phenolics and n-hexadecanoic and oleic acids as major compounds. Biochar, by contrast, has a high carbon content of 75.11-79.32 wt% and calorific values of 25.45-28.61 MJ/kg. These properties assert the biochar and bio-oils among viable bioenergy sources.
Understanding knowledge of hypertension among affected individuals in low-Income (B40) communities in Malaysia: The RESPOND study

Ariffin F, Isa MR, Nafiza MN, Mazapuspavina MY, Fadhlina AM, Palafox B, et al.

Med J Malaysia, 2022 Sep;77(5):542-551.
PMID: 36169064

INTRODUCTION: Achieving optimal control of blood pressure is easier when those affected understand the risks and consequences of hypertension and the principles of management. It is particularly important in disadvantaged groups among whom blood pressure control is often poor. However, effective responses require evidence of the knowledge and beliefs of those affected. This was undertaken as part of a larger study of the therapeutic journeys followed by individuals living in B40 (bottom 40% by income) households in Malaysia, the Responsive and Equitable Health Systems-Partnership on Non- Communicable Diseases (RESPOND).This paper describes their reported knowledge of hypertension, health, and measures that can improve hypertensive control.
MATERIALS AND METHODS: The communities were selected from rural and urban populations in four peninsular states (Selangor, Kelantan, Perak, and Johor). Following a multistage sampling approach, communities in each stratum were selected according to probability proportional to the size and identified based on national census data by the community and administrative registers. Households were randomly selected. Eligible individuals were those aged between 35 and 70 years old, self-reported or identified as hypertensive at screening. Informed consent was taken. A survey using validated questionnaires was conducted.
RESULTS: The total number of respondents was 579. The mean age was 59.0 (95%: 58.4, 59.7) and more were women (71.5%) than men (28.5%). Regarding respondents selfreported level of hypertension knowledge, 2.9% reported having no knowledge at all, 80.1% had little knowledge, and 17.9% were very familiar. Among all respondents, 56.2% (95% CI: 50.7, 61.6) correctly answered at least four out of five objective knowledge questions.Almost all (91.5%) were aware that hypertension could cause a stroke. However, one-fifth believed it could cause cancer. Almost threequarters said that people with high blood pressure generally felt well (72.1%) and recognized that they should not stop taking their medication (70.7%). Most of the respondents knew that people should take their medication even if they feel well (73.6%). Although more than half (66.0%) of the respondents rated their health as poor. Interestingly, most did not perceive themselves as having a long-term illness (95.0%).
CONCLUSION: This study provides reassurance that individuals with hypertension in disadvantaged communities in Malaysia have a relatively good understanding of hypertension. Further research should explore the challenges they face on their therapeutic journeys.
An overview of municipal solid waste management and landfill leachate treatment: Malaysia and Asian perspectives

Kamaruddin MA, Yusoff MS, Rui LM, Isa AM, Zawawi MH, Alrozi R

Environ Sci Pollut Res Int, 2017 Dec;24(35):26988-27020.
PMID: 29067615 DOI: 10.1007/s11356-017-0303-9

Currently, generation of solid waste per capita in Malaysia is about 1.1 kg/day. Over 26,500 t of solid waste is disposed almost solely through 166 operating landfills in the country every day. Despite the availability of other disposal methods, landfill is the most widely accepted and prevalent method for municipal solid waste (MSW) disposal in developing countries, including Malaysia. This is mainly ascribed to its inherent forte in terms cost saving and simpler operational mechanism. However, there is a downside. Environmental pollution caused by the landfill leachate has been one of the typical dilemmas of landfilling method. Leachate is the liquid produced when water percolates through solid waste and contains dissolved or suspended materials from various disposed materials and biodecomposition processes. It is often a high-strength wastewater with extreme pH, chemical oxygen demand (COD), biochemical oxygen demand (BOD), inorganic salts and toxicity. Its composition differs over the time and space within a particular landfill, influenced by a broad spectrum of factors, namely waste composition, landfilling practice (solid waste contouring and compacting), local climatic conditions, landfill's physico-chemical conditions, biogeochemistry and landfill age. This paper summarises an overview of landfill operation and leachate treatment availability reported in literature: a broad spectrum of landfill management opportunity, leachate parameter discussions and the way forward of landfill leachate treatment applicability.
Enhancement of anaerobic digestibility of waste activated sludge using photo-Fenton pretreatment

Heng GC, Isa MH, Lim JW, Ho YC, Zinatizadeh AAL

Environ Sci Pollut Res Int, 2017 Dec;24(35):27113-27124.
PMID: 28963706 DOI: 10.1007/s11356-017-0287-5

Biological treatments, such as activated sludge process, are common methods to treat municipal and industrial wastewaters. However, they produce huge amounts of waste activated sludge (WAS). The excess sludge treatment and disposal are a challenge for wastewater treatment plants due to economic, environmental, and regulatory factors. In this study, photo-Fenton pretreatment (oxidation using hydrogen peroxide and iron catalyst aided with UV light) was optimized using response surface methodology (RSM) and central composite design (CCD) to determine the effects of three operating parameters (H2O2 dosage, H2O2/Fe2+ molar ratio, and irradiation time) on disintegration and dewaterability of WAS. MLVSS removal, capillary suction time (CST) reduction, sCOD, and EPS were obtained as 70%, 25%, 12,000 mg/L, and 500 mg/L, respectively, at the optimal conditions, i.e., 725 g H2O2/kg TS, H2O2/Fe2+ molar ratio 80, and irradiation time 40 min. Two batch-fed completely mixed mesophilic anaerobic digesters were then operated at 15-day solid retention time (SRT) and 37 ± 0.5 °C to compare the digestibility of untreated and photo-Fenton pretreated sludge in terms of volatile solids (VS) reduction, COD removal, and biogas production at steady-state operations. Photo-Fenton pretreatment followed by anaerobic digestion of WAS was very effective and yielded 75.7% total VS reduction, 81.5% COD removal, and 0.29-0.31 m3/kg VSfed·d biogas production rate, compared to 40.7% total VS solid reduction, 54.7% COD removal, and 0.12-0.17 m3/kg VSfed·d biogas production rate for control. Thus, photo-Fenton can be a useful pretreatment step in sludge management.
Fulltext Gut bacteria influence Blastocystis sp. phenotypes and may trigger pathogenicity

Rajamanikam A, Isa MNM, Samudi C, Devaraj S, Govind SK

PLoS Negl Trop Dis, 2023 Mar;17(3):e0011170.
PMID: 36989208 DOI: 10.1371/journal.pntd.0011170

Whilst the influence of intestinal microbiota has been shown in many diseases such as irritable bowel syndrome, colorectal cancer, and aging, investigations are still scarce on its role in altering the nature of other infective organisms. Here we studied the association and interaction of Blastocystis sp. and human intestinal microbiota. In this study, we investigated the gut microbiome of Blastocystis sp.-free and Blastocystis sp. ST3-infected individuals who are symptomatic and asymptomatic. We tested if the expression of phenotype and pathogenic characteristics of Blastocystis sp. ST3 was influenced by the alteration of its accompanying microbiota. Blastocystis sp. ST3 infection alters bacterial composition. Its presence in asymptomatic individuals showed a significant effect on microbial richness compared to symptomatic ones. Inferred metagenomic findings suggest that colonization of Blastocystis sp. ST3 could contribute to the alteration of microbial functions. For the first time, we demonstrate the influence of bacteria on Blastocystis sp. pathogenicity. When Blastocystis sp. isolated from a symptomatic individual was co-cultured with bacterial suspension of Blastocystis sp. from an asymptomatic individual, the parasite demonstrated increased growth and reduced potential pathogenic expressions. This study also reveals that Blastocystis sp. infection could influence microbial functions without much effect on the microbiota diversity itself. Our results also demonstrate evidence on the influential role of gut microbiota in altering the characteristics of the parasite, which becomes the basis for the contradictory findings on the parasite's pathogenic role seen across different studies. Our study provides evidence that asymptomatic Blastocystis sp. in a human gut can be triggered to show pathogenic characteristics when influenced by the intestinal microbiota.
Fulltext Latent toxoplasmosis in patients with different malignancy: a hospital based study

Nimir A, Othman A, Ee S, Musa Z, Majid IA, Kamarudin Z, et al.

J Clin Med Res, 2010 May 19;2(3):117-20.
PMID: 21629523 DOI: 10.4021/jocmr2010.06.375w

Seroprevalence of toxoplasmosis in different populations may vary according to different environments, social customs and habits. This study was designed to measure the seroprevalence of toxoplasmosis among patients with different malignancies and to ascertain the association between common risk factors and disease transmission.
Remediation of carcinogenic PAHs from landfill leachate by Electro-Fenton process - Optimization and modeling

Singa PK, Rajamohan N, Isa MH, Azner Abidin CZ, Ibrahim AH

Chemosphere, 2024 May 04;359:142248.
PMID: 38710412 DOI: 10.1016/j.chemosphere.2024.142248

PAHs is the group of emerging micro-pollutants present in most environmental matrices that has the tendency to bioaccumulate and cause carcinogenic effects to human health. The present research involved the quantification and treatment of leachate produced from secured landfill, to eliminate the PAHS. Electro-Fenton process, a class of advanced oxidation process, is adopted to degrade the PAHs using titanium electrodes as both anode and cathode. Artificial intelligence based statistical tool "Central Composite Design" a module of JMP -19 software was used to design the experiments and optimize the critical parameters involved in the research. It was observed that the value of P is significant (P
A systematic review of thromboembolic complications and outcomes in hospitalised COVID-19 patients

Othman HY, Zaki IAH, Isa MR, Ming LC, Zulkifly HH

BMC Infect Dis, 2024 May 10;24(1):484.
PMID: 38730292 DOI: 10.1186/s12879-024-09374-1

Thromboembolic (TE) complications [myocardial infarction (MI), stroke, deep vein thrombosis (DVT), and pulmonary embolism (PE)] are common causes of mortality in hospitalised COVID-19 patients. Therefore, this review was undertaken to explore the incidence of TE complications and mortality associated with TE complications in hospitalised COVID-19 patients from different studies. A literature search was performed using ScienceDirect and PubMed databases using the MeSH term search strategy of "COVID-19", "thromboembolic complication", "venous thromboembolism", "arterial thromboembolism", "deep vein thrombosis", "pulmonary embolism", "myocardial infarction", "stroke", and "mortality". There were 33 studies included in this review. Studies have revealed that COVID-19 patients tend to develop venous thromboembolism (PE:1.0-40.0% and DVT:0.4-84%) compared to arterial thromboembolism (stroke:0.5-15.2% and MI:0.8-8.7%). Lastly, the all-cause mortality of COVID-19 patients ranged from 4.8 to 63%, whereas the incidence of mortality associated with TE complications was between 5% and 48%. A wide range of incidences of TE complications and mortality associated with TE complications can be seen among hospitalized COVID-19 patients. Therefore, every patient should be assessed for the risk of thromboembolic complications and provided with an appropriate thromboprophylaxis management plan tailored to their individual needs.
Fulltext Development and validation of a video-based intervention on self-care practices for patients with hypertension in Malaysian primary care settings

Raja-Ismail RI, Badlishah-Sham SF, Nik-Nasir NM, Isa MR

Malays Fam Physician, 2024;19:40.
PMID: 39011296 DOI: 10.51866/oa.480

INTRODUCTION: Self-care practices among patients with hypertension have been shown to improve blood pressure control. Video-based interventions (VBIs) are helpful in enhancing patients' selfcare practices. However, validated VBIs in the Malay language for patients in primary care settings are scarce. This study aimed to develop and validate a VBI series in the Malay language to educate patients with hypertension on self-care practices in primary care settings.
METHODS: This study was conducted in three phases: (1) pre-production, (2) production and (3) post-production. The pre-production phase involved designing the storyboard and scripts, which underwent content validation by content experts and subsequently by patients with hypertension. Once the storyboards and scripts achieved acceptable consensus, the videos were recorded (production phase). The post-production phase included video editing and face validation among patients with hypertension. Statistical analysis included the calculation of the item-level content validation index (I-CVI) and item-level face validation index (I-FVI) during content and face validation, respectively.
RESULTS: The storyboards and scripts for five videos were developed. The I-CVI of all videos was 1.0 after two rounds of content validation among six content experts. The I-CVI of all videos was 1.0 among five patients with hypertension. Five videos were recorded and edited, achieving an I-FVI of 1.0 during face validation among 10 patients.
CONCLUSION: A VBI series consisting of five videos was developed and validated for use among patients with hypertension in primary care settings to improve their knowledge of self-care practices.
Fulltext A new perspective on Alzheimer's disease: microRNAs and circular RNAs

Abidin SZ, Mat Pauzi NA, Mansor NI, Mohd Isa NI, Hamid AA

Front Genet, 2023;14:1231486.
PMID: 37790702 DOI: 10.3389/fgene.2023.1231486

microRNAs (miRNAs) play a multifaceted role in the pathogenesis of Alzheimer's disease (AD). miRNAs regulate several aspects of the disease, such as Aβ metabolism, tau phosphorylation, neuroinflammation, and synaptic function. The dynamic interaction between miRNAs and their target genes depends upon various factors, including the subcellular localization of miRNAs, the relative abundance of miRNAs and target mRNAs, and the affinity of miRNA-mRNA interactions. The miRNAs are released into extracellular fluids and subsequently conveyed to specific target cells through various modes of transportation, such as exosomes. In comparison, circular RNAs (circRNAs) are non-coding RNA (ncRNA) characterized by their covalently closed continuous loops. In contrast to linear RNA, RNA molecules are circularized by forming covalent bonds between the 3'and 5'ends. CircRNA regulates gene expression through interaction with miRNAs at either the transcriptional or post-transcriptional level, even though their precise functions and mechanisms of gene regulation remain to be elucidated. The current stage of research on miRNA expression profiles for diagnostic purposes in complex disorders such as Alzheimer's disease is still in its early phase, primarily due to the intricate nature of the underlying pathological causes, which encompass a diverse range of pathways and targets. Hence, this review comprehensively addressed the alteration of miRNA expression across diverse sources such as peripheral blood, exosome, cerebrospinal fluid, and brain in AD patients. This review also addresses the nascent involvement of circRNAs in the pathogenesis of AD and their prospective utility as biomarkers and therapeutic targets for these conditions in future research.
Fulltext ABC approach for the management of adults with hyperthyroidism: A practical strategy in primary care

Jamaluddin J, Zainal Abidin S, Kathitasapathy G, Mohamad Isa MZ, Mohamed Kamel MA, Kaur P, et al.

Malays Fam Physician, 2023;18:57.
PMID: 37814670 DOI: 10.51866/rv.303

Hyperthyroidism is commonly seen in primary care settings. However, the management of hyperthyroidism might be unclear to primary care doctors. Various guidelines have been published to assist clinicians in the management of thyroid disorders at various levels of care. The extensive coverage of these guidelines may not appeal to busy clinicians, and the guidelines do not focus on often resource-limited primary care settings. In this article, we aim to describe a practical guide for managing hyperthyroidism in primary care settings using an ABC approach.
Comparison of Cytokine Profile between Postmenopausal Women with and Without Osteoporosis - A Case-Control Study

Soh GT, Mohammad AH, Syed Isa SNL, Chin KY, Mohamed N

Endocr Metab Immune Disord Drug Targets, 2023;23(6):811-817.
PMID: 36380416 DOI: 10.2174/1871530323666221114111029

BACKGROUND: Chronic low-grade inflammation is involved in the pathogenesis of postmenopausal osteoporosis, but the cytokines implicated remain elusive.
OBJECTIVE: This study aimed to compare the difference in cytokine profile between postmenopausal women with and without osteoporosis in Klang Valley, Malaysia.
METHODS: Postmenopausal women with (n = 20) and without osteoporosis (n = 20) were recruited for this study. Their bone health status was determined using dual-energy X-ray absorptiometry. Their fasting blood was collected for proteomic analysis. A protein array was performed for four subjects randomly selected from each group to screen the potential cytokines. Three cytokines at least 20% different between groups and consistently expressed by each subject were selected for validation using enzyme-linked immunosorbent assays (ELISA).
RESULTS: The protein array screening demonstrated that platelet-derived growth factor-BB, interleukin- 6 receptor (IL-6R), and tissue inhibitor of metallopeptidase-2 were higher in women with osteoporosis than women without osteoporosis (n = 4 per group), and consistently expressed by all women. Only body mass index (BMI)-adjusted logarithmically transformed IL-6R levels were lower among postmenopausal women with osteoporosis compared to women with normal bone health (p = 0.026) (n = 16 per group) in the ELISA test.
CONCLUSION: IL-6R was lower among postmenopausal women with osteoporosis compared to women with normal bone health after adjusting for BMI. However, a large-scale epidemiological study with proteomic analysis needs to confirm the findings.
Fulltext Bilateral metachronous breast malignancies: Malignant phylloides and invasive breast carcinoma-a case report

Abdullah N, Rizuana IH, Goh JHL, Lee QZ, Md Isa N, Md Pauzi SH

Front Oncol, 2023;13:1034556.
PMID: 37035170 DOI: 10.3389/fonc.2023.1034556

A 57-year-old Malay nullipara initially presented with a right breast lump that was increasing in size but defaulted follow-up. Two years later, she developed a contralateral breast lump. She only returned to the hospital when the right breast lump had become painful, 4 years from its onset. The biopsy of the right breast lump was a phylloides tumor and that of the left breast lump was a carcinoma. She had bilateral palpable axillary lymph nodes. She underwent bilateral mastectomy and axillary dissection. The pathology report confirmed the right breast lesion to be a malignant phylloides and the left breast lesion to be a carcinoma (pT3N2). She declined adjuvant treatment. A year after the surgical operation of the metachronous lesions, she had a right chest wall recurrence with widespread pulmonary metastases. She was given palliative chemotherapy but succumbed several months later.
Fulltext The Effects of Green Intellectual Capital on Green Innovation: A Green Supply Chain Integration Perspective

Liu D, Yu X, Huang M, Yang S, Isa SM, Hu M

Front Psychol, 2022;13:830716.
PMID: 35837635 DOI: 10.3389/fpsyg.2022.830716

To demonstrate how green innovation (GI) effectively occurs, this study examines the effects of green intellectual capital (GIC) on GI from the perspective of green supply chain integration (GSCI). Based on a natural-resource-based view and knowledge-based view, the authors constructed an intermediary model of GIC-GSCI-GI, and analyzed the effects of green absorptive ability (GAA) and relationship learning ability (RLA) as moderators. An empirical survey of 328 Chinese manufacturing companies was conducted. Our results indicate that three dimensions of GIC positively impact GI. The mediating effects of internal and external GSCI exist in the relationship between GIC and GI. The moderating effects of GAA and RLA in these effects were also verified. Our study provides further empirical evidence for the relationship between GIC and GI, highlights the effects of companies' internal and external abilities on GI, and suggests new ways and implementation contexts for GI.
Fulltext The Impact of Heat Waves on Health Care Services in Low- or Middle-Income Countries: Protocol for a Systematic Review

Sapari H, Selamat MI, Isa MR, Ismail R, Wan Mahiyuddin WR

JMIR Res Protoc, 2023 Oct 16;12:e44702.
PMID: 37843898 DOI: 10.2196/44702

BACKGROUND: Heat waves significantly impact ecosystems and human health, especially that of vulnerable populations, and are associated with increased morbidity and mortality. Besides being directly related to climate-sensitive health outcomes, heat waves have indirectly increased the burden on our health care systems. Although the existing literature examines the impact of heat waves and morbidity, past research has mostly been conducted in high-income countries (HICs), and studies on the impact of heat waves on morbidity in low- or middle-income countries (LMICs) are still scarce.
OBJECTIVE: This paper presents the protocol for a systematic review that aims to provide evidence of the impact of heat waves on health care services in LMICs.
METHODS: We will identify peer-reviewed studies from 3 online databases, including the Web of Science, PubMed, and SCOPUS, published from January 2002 to April 2023, using the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment will be conducted using the Navigation Guide checklist. Key search terms include heatwaves, extreme heat, hospitalization, outpatient visit, burden, health services, and morbidity.
RESULTS: This systematic review will provide insight into the impact of heat waves on health care services in LMICs, especially on emergency department visits, ambulance call-outs, hospital admissions, outpatient department visits, in-hospital mortality, and health care operational costs.
CONCLUSIONS: The results of this review are anticipated to help policymakers and key stakeholders obtain a better understanding of the impact of heat waves on health care services and prioritize investments to mitigate the effects of heat waves in LMICs. This entails creating a comprehensive heat wave plan and ensuring that adequate infrastructure, capacity, and human resources are allocated in the health care sector. These measures will undoubtedly contribute to the development of resilience in health care systems and hence protect the health and well-being of individuals and communities.
TRIAL REGISTRATION: PROSPERO CRD42022365471; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=365471.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44702.

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