MATERIALS AND METHODS: This was a retrospective study that included all RA patients receiving biologics therapy in 13 tertiary hospitals in Malaysia from January 2008 to December 2018.
RESULTS: We had 735 RA patients who received biologics therapy. Twenty-one of the 735 patients were diagnosed with TB infection after treatment with biologics. The calculated prevalence of TB infection in RA patients treated with biologics was 2.9% (29 per 1000 patients). Four groups of biologics were used in our patient cohort: monoclonal TNF inhibitors, etanercept, tocilizumab, and rituximab, with monoclonal TNF inhibitors being the most commonly used biologic. The median duration of biologics therapy before the diagnosis of TB was 8 months. 75% of patients had at least one co-morbidity and all patients had at least one ongoing cDMARD therapy at the time of TB diagnosis. More than half of the patients were on steroid therapy with an average prednisolone dose of 5 mg daily.
CONCLUSION: Although the study population and data were limited, this study illustrates the spectrum of TB infections in RA patients receiving biologics and potential risk factors associated with biologics therapy in Malaysia.
MATERIALS AND METHODS: This is a prospective observational study to develop, validate and evaluate the ARSIA questionnaire based on ARIA guidelines. The sample will be obtained from the list of patients under follow-up in the ORL clinic HSAH and HUSM with ages of 18 to 60 years, patients clinically diagnosed with allergic rhinitis, and with positive skin prick test.
RESULTS: A total of 150 patients with a positive skin prick test participated in this study. In the 'nasal symptom' and 'impact on daily activities' domains, calculated Cronbach's alpha shows a value of 0.878 and 0.811 respectively. The inter-item correlation was calculated to analyse internal consistency reliability. Items B3 and B4 were dropped from the questionnaire as both showed a low correlation with other items. New Cronbach's alpha for the daily activities domain was 0.830, which showed better internal consistency reliability. All of the items were analysed for sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Clinician diagnosis from the proforma was used as a comparison to the participant's responses. In the analysis, a cut-off points of 12 was used to classify the patient's nasal symptoms into intermittent or persistent, with a sensitivity of 75%, specificity of 86%, PPV of 95%, and NPV of 51%. Whereas, a cut-off point of 15 was used to classify the rhinitis impact on daily activities into mild or moderate/severe, with a sensitivity of 58%, specificity of 100%, PPV of 100%, and NPV of 42%. The only item in the 'control' domain has been dropped out following a consensus of experts and judgement as it has not been used in the clinician diagnosis and thus, is unable to test for sensitivity, specificity, PPV, and NPV.
CONCLUSION: This newly developed, validated, and evaluated questionnaire is a good tool for the evaluation of allergic rhinitis symptoms and their impact on daily activities. It is important to understand that AR symptoms could have a significant impact on daily activities. Although further study and testing are needed, it provides an initial means for evaluating the patient condition and control level, as well as patients' perception of their rhinitis control.
MATERIALS AND METHODS: Oesophagoduodenoscopy (OGDS) reports of COVID-19 patients with indication of upper GI bleeding from March 2021 to April 2022 were reviewed. Data of 35 patients were then analysed.
RESULTS: Of the 35 patients, 8.6% (n = 3) were female and 91.4% (n = 32) were males. A total of 31.4% (n = 11) were below 50 years and 68.6% (n = 24) were 50 and above. 34.3% (n = 12) with lesions requiring endoscopic intervention, 34.3% (n = 12) with lesions not requiring endoscopic intervention, 31.4% (n = 11) has no significant stigmata of recent haemorrhage. Among subgroup requiring endoscopic intervention, 50% (n = 6) are non-variceal bleeding (NVUIB), and 50% (n = 6) are variceal bleeding (VUGIB). Among NVUGIB, 16.7% (n = 1) is gastric and duodenal angiodysplasia requiring argon plasma coagulation, 50% (n = 3) are duodenal F2A ulcer requiring thermoablation, 16.7% (n = 1) is gastric F2A ulcer requiring hemoclip, and 16.6% (n = 1) is Cameron's ulcer requiring hemoclip. Among VUGIB, 100% (n = 6) are oesophageal varices requiring endoscopic variceal banding (EVL).
CONCLUSIONS: Lower proportion of NVUGIB among COVID-19 patients raises hypothesis on whether prothrombotic state of COVID-19 is a protective factor of NVUGIB. Studies with larger sample size are needed to establish significance.
METHODOLOGY: A cross-sectional comparative study was carried out in the Otorhinolaryngology - HNS Department, Universiti Kebangsaan Malaysia Medical Center (UKMMC). Subjective assessments of nasal symptoms and quality of life (QoL) using SNOT-22 and Visual Analogue Scale (VAS) and objective endoscopic assessment was undertaken using a modified Hadley endoscopic examination.
RESULTS: There was no significant statistical difference in the quality of life between the ECRSwNP and non-ECRSwNP groups as evidenced by the SNOT-22 score and the VAS comparison (p>0.05). However, there was a significant difference in terms of recurrence of disease with the presence of nasal polyps on endoscopic examination. (p = 0.016) CONCLUSION: In conclusion, we found that there is no significant difference in QoL between ECRSwNP and non- ECRSwNP. There is higher frequency of recurrence of nasal polyps amongst ECRSwNP.
MATERIALS AND METHODS: Study was conducted in the neonatal intensive care unit (NICU) of Saveetha Medical College Hospital, India, in 2023, between January and June. This study enrolled 100 neonates who underwent hemodynamic monitoring over 48-72 hours. Hemodynamic parameters including heart rate, blood pressure, and PI were systematically recorded. Statistical and Receiver operating characteristic curve analyses were used to assess the relationship between PI and shock.
RESULTS: Neonates experiencing shock exhibited significantly lower PI values than those without (P < 0.05). ROC curve analysis identified a PI threshold of 0.7 for predicting shock, demonstrating a high sensitivity (92.5%) and specificity (94.78%). Additionally, a significant association was observed between PI and serum lactate level (p < 0.05), underscoring the utility of PI as a predictor of shock severity.
CONCLUSION: The study suggests that a PI < 0.7 may serve as an indicator of circulatory shock in neonates, offers good sensitivity and specificity. The PI, along with clinical parameters and serum lactate levels, is a valuable tool for early shock identification in neonatal intensive care. Further research, including multicenter studies, are warranted to validate these findings.
MATERIALS AND METHODS: Retrospective cohort study conducted at Department of ENT and Head & Neck Surgery, Saveetha Medical College Hospital, Thandalam, Chennai, Tamil Nadu, India from September 2022 to March 2024. We included patients presenting with vertigo or dizziness, excluding those with non-vestibular dizziness or incomplete medical records. We analysed demographic data, medical history, and clinical findings from patient records. Data analysis was performed. Continuous variables were compared using independent sample t-tests and categorical variables using chi-square tests.
RESULTS: The study included 268 patients, predominantly females (57.8%) and individuals aged 40-50 years (29.9%). Benign Paroxysmal Positional Vertigo (BPPV) was the most common etiological factor (41.0%), followed by orthostatic dysregulation (17.2%) and vestibular peripheral dysfunction (VPD) (16.0%). Clinical presentations and outcomes varied with the underlying etiology. Overall, 91.0% of the patients showed improvement following treatment, with 7.1% achieving full recovery.
CONCLUSION: This study highlights the complexity of vertigo and dizziness, which are influenced by various factors and demographics. This emphasizes the importance of tailored management strategies and a patient-centered, multidisciplinary approach, emphasizing customized treatments to improve patient outcomes.
METHODOLOGY: This prospective, randomized, controlled trial enrolled pregnant females undergoing LSCS after spinal anesthesia. The participants were randomized into two groups: a novel 3D device group and a traditional wedge group. Primary outcome measures included the incidence of SHS, while secondary outcomes included maternal hemodynamic parameters, fetal outcomes, feasibility, ease of use, and the safety profile of the devices.
RESULTS: Baseline characteristics were well balanced between the two groups. Although some differences in maternal hemodynamic parameters were noted, the incidence of SHS was significantly lower in the novel 3D device group than that in the traditional wedge group. Fetal outcomes did not differ significantly between the groups. The novel 3D device demonstrated high compatibility with various patient anatomies and was easy to integrate into routine practice. The adverse event profiles were similar between the groups.
CONCLUSION: This study highlights the potential of a novel 3D-printed uterine displacement device for preventing SHS during LSCS, thereby improving maternal and fetal outcomes. Future research should further validate these findings and explore the long-term implications of the maternal and neonatal outcomes.
MATERIALS AND METHODS: A UV-visible spectrophotometer and SEM were used to characterize the green synthesized SeNPs. The anti-inflammatory and anti-diabetic activities of green synthesized SeNPs were measured using the alphaamylase inhibitory & beta-glucosidase enzyme inhibition assay and the egg albumin, bovine serum albumin, and membrane stabilization assays. A test for the mortality of brine shrimp was used to determine the cytotoxic impact of SeNPs.
RESULTS: A. linearis powder was used for the green synthesis of selenium nanoparticles, which exhibited the highest peak at 440 nm when analyzed using a UV-visible spectrophotometer. The In vitro anti-inflammatory effect of synthesized SeNPs was maximally inhibited by 44-83% in the bovine serum albumin assay 54-79% in the egg albumin assay, and 54-86% in the membrane stabilization assay compared with standard. The inhibition percentage of antidiabetic activity was found to be 50-86% in the alphaamylase assay and 49-85% in the beta-glucosidase assay when compared to standards at various concentrations. Furthermore, the cytotoxicity impact shows that 70% of brine shrimp were alive at the maximum fixation of 80 µg/mL.
CONCLUSION: The SeNPs showed concentration-dependent anti-inflammatory and anti-diabetic action, and the green synthesized SeNPs demonstrated an excellent antiinflammatory and anti-diabetic agent. The brine shrimp lethality assay confirmed the SeNPs' biocompatible nature even at high concentrations with less toxicity. Hence the study may enhance SeNPs in developing inflammation drugs and can also be utilized in diabetes management.
MATERIALS AND METHODS: The antioxidant activity was tested by Hydrogen Peroxide [H2O2] assay, Fluorescence recovery after photo-bleaching [FRAP] assay and 2, 2-diphenyl-1- picrylhydrazyl[DPPH] assay. All tests have shown very good results for the ZnO-TiO2 NCs.
RESULTS: In this study, we present a straightforward, ecofriendly alternative for producing non-toxic zinc oxide and titanium oxide nano-composite material. This study could make a valuable contribution and create new opportunities in the market such as biological and pharmaceutical applications.
CONCLUSION: The in vitro tests concluded that the novel nanocomposite containing ZnO-TiO2 and green tea extract has good anti-oxidant properties and it is non-toxic to the biological systems.
MATERIALS AND METHODS: UV-visible spectra analysis was employed to investigate the optical characteristics and surface morphology, such as the size and shape of PPE CaSo4 NPs synthesized at different time intervals, which were characterized using a Scanning Electron Microscope. Anti-inflammatory activity was evaluated using bovine serum albumin denaturation assay (BSA), and egg albumin denaturation assay (EA) was compared with diclofenac sodium as a standard. Antioxidant activity was measured using 2,2 Diphenyl -1- Picryl hydraxylhydrate assay (DPPH), hydrogen peroxide radical scavenging assay (H2O2), and Ferric Reducing Antioxidant power assay (FRAP). Comparison made with ascorbic acid as the standard.
RESULTS: Anti-inflammatory activity was observed at all concentrations of PPE CaSo4 NPs, and there was no significant difference between the test material and the standard p>0.05. A significant difference was found for the antioxidant activity between PPE CaSo4 NPs and the standard in concentrations of 10 μl, for DPPH, 10 μl and 20 μl for H2O2 (p<0.05) between the concentrations of 30, 40, and 50, and there was no significant difference between the test material and the standard in all three tests conducted.
CONCLUSION: The study concluded that the PPE CaSo4 NPs have Anti-inflammatory and Antioxidant activities and are concentration-dependent.
MATERIALS AND METHODS: The produced nanoparticles were characterized using UV-visible spectroscopy. The Bovine Serum Assay (BSA) and Egg Albumin (EA) assays were used to assess the anti-inflammatory effects. The protein denaturation of AgNPs was calculated and compared to a standard to determine the anti-inflammatory activity of green synthesized AgNPs. Using varying concentrations of OGmediated AgNPs in Mueller Hinton Agar (MHA), the antimicrobial effects of OG have been investigated against E. coli, S. aureus, and Pseudomonas sp. Additionally, by measuring optical density, the time-kill curve analysis for E. Coli and S. Aureus has been examined from one hour for up to five hours.
RESULTS: The green synthesized AgNPs were developed successfully using a plant Ocimum gratissimum. The synthesized AgNPs exhibited a maximum absorption peak at 440 nm and SEM analysis revealed that the synthesized AgNPs were spherical and oval. The result findings of the anti-inflammatory activity reveal that AgNPs have great potential when compared to the standard. At the concentration of 50 μg/mL, AgNPs exhibit 76% in BSA assay and 74% in EA assay, where the standard shows 80% inhibition. The antimicrobial activity showed a zone of inhibition around 19mm for E. coli and a 20mm zone of inhibition for S. aureus and Pseudomonas sp., which shows the efficacy of AgNPs. The time-kill assay shows that the optical density of E. coli and S. aureus was reduced to 0.1 after 5 hours of incubation, which shows the potential of green synthesized AgNPs.
CONCLUSION: OG-mediated AgNPs have both antiinflammatory and antimicrobial effects. Anti-inflammatory effects are better when compared to standard drugs. Antimicrobial effects are better for Gram-negative bacteria.
MATERIALS AND METHODS: Biogenically synthesized silver nanoparticles (Ag NPs) from an herbal formulation containing Zingiber officinale and Ocimum gratissimum were tested at various concentrations using the DPPH (2,2- diphenyl-1-picrylhydrazyl) assay. The absorbance was measured at 517 nm to quantify DPPH free radicals. With Ag NP concentrations, the H2O2 test exhibited increased activity. This work evaluated the antibacterial activity of Ag NPs mediated by Zingiber officinale and Ocimum gratissimum against Staphylococcus aureus, Streptococcus mutans, Candida albicans, and Enterococcus faecalis.
RESULTS: The utilization of herbal formulations from Z. officinale and O. gratissimum to synthesize Ag NPs revealed considerable therapeutic effectiveness. At a concentration of 50 μl, the maximal inhibition was 76%, which is comparable in effectiveness to that of standard ascorbic acid. Significant blood clot dissolution was observed during thrombolytic testing at a concentration of 100μg/ml, indicating promising prospects for the treatment of thrombotic disorders. Nanoparticles dose-dependently inhibited E. faecalis, C. albicans, S. aureus, and S. mutans in antibacterial testing. These results show the potential of the nanoparticles as supplementary or alternative treatments to conventional antibiotics, particularly in light of the increasing prevalence of antibiotic resistance.
CONCLUSION: The further investigation of nanoparticles into their mechanisms and efficacy in therapeutic applications, positioning Zingiber officinale and Ocimum gratissimum formulation-mediated Ag NPs as viable candidates in developing antioxidant, thrombolytic, and antimicrobial treatments.
MATERIALS AND METHODS: Red tea and clove-mediated ZnO NPs were synthesized using the green synthesis method. The anti-microbial activity was tested against oral pathogens using the agar well diffusion method, while the anti-diabetic activity was estimated using the alpha-amylase inhibitory assay method by using red tea and clovemediated ZnO NPs.
RESULTS: ZnO NPs were successfully synthesized using red tea and clove-formulated extract. The synthesized ZnO NPs using Aspalathus linearis (red tea) and Syzygium aromaticum (clove) mediated ZnO NPs were characterized using UV visible spectrophotometry and SEM (Scanning Electron Microscope) analysis. The green synthesized ZnO NPs show promising anti-microbial activity by exhibiting a 12 mm zone of inhibition against S. aureus, 11 mm in E. faecalis, 9 mm in S. mutans, and 11 mm in C. albicans. In anti-diabetic activity, the green synthesized ZnO NPs showed a maximum inhibition percentage of up to 80% at the maximum concentration of 50 µg/mL.
CONCLUSION: Green synthesized ZnO NPs using red tea and clove showed maximum efficacy in anti-microbial properties which can lead to huge potential use as antibacterial agents. Simultaneously, anti-diabetic activity showed an excellent inhibition percentage which can be a potent therapeutic agent in the field of nanomedicine in diabetes management.
MATERIALS AND METHODS: Participants from the governmental departments were recruited and divided into intervention group and control group. A translated and validated questionnaire on awareness and knowledge related to glaucoma were used. Educational interventions were given for both groups. Post-test assessments were completed at one month and three months post intervention.
RESULTS: A total of 202 participants enrolled for the study (102 intervention group and 100 control group). 64.9% of the participants were aware of glaucoma and 49% of the participants had good knowledge score on glaucoma. Higher educational attainments (bachelor and diploma holders) were the only factors significantly associated with good glaucoma knowledge (p <0.001). There was significant increase in the proportion of good glaucoma knowledge in the intervention group one month after the educational intervention (p < 0.001) and the effect persisted after three months (p < 0.003). There was also significantly higher proportion of good post-test glaucoma knowledge between intervention and control group (p = 0.003).
CONCLUSION: Although the public was well aware of glaucoma, there was relatively little understanding of the condition. Educational interventions can be effective to bridge the gap in promoting the glaucoma awareness and better understanding of glaucoma.
MATERIALS AND METHODS: This is a retrospective unmatched case-control study. The required data was obtained from the medical records maintained by the University Tanjungpura Hospital, Pontianak City, Indonesia. Simple random sampling was used to select and equally divide the 60 chosen respondents into LBW case and normal birth weight control groups.
RESULTS: Mothers with low educational levels had a 1.5 times greater chance of giving birth to LBW babies. The results of the multivariate analysis also revealed a correlation between gestational age (GA), incidence of premature rupture of membranes (PROM), and intrauterine growth restriction (IUGR) and that their combined effects that contributed to 56% of LBWIs.
CONCLUSION: Low maternal education level, low gestational age, IUGR, and premature rupture of membranes contribute to LBW babies. This study recommends that it is necessary to educate women of childbearing age about routine antenatal care checks to identify risk factors that can lead to LBW.
MATERIALS AND METHODS: This descriptive retrospective study featured 221 patients diagnosed with clinically critical COVID-19 from August 2021 to March 2022 in the Intensive Care Unit (ICU) of RSUP Dr. M. Djamil, Padang, Indonesia. The study employed a total sampling technique to collect data from medical records in the hospital. Patients aged 18 years or older who underwent testing for leukocytes, platelets, neutrophils, and lymphocytes were included in the study. We analysed the data using descriptive univariate analysis. Then, the NLR and PLR of the patients were statistically compared based on comorbidities and coincidence.
RESULTS: According to the study, most patients with critically ill COVID-19 exhibited high levels of NLR (88.2%) and PLR (71.1%). The severe COVID-19 patients with comorbidity of kidney disease had the highest NLR (Mean ± SD) of 31.74 ± 27.95 (p-value <0.001) and the highest mean PLR (Mean ± SD) of 469.33 ± 362.95 (p-value 0.001).
CONCLUSION: Our findings showed a significantly higher NLR and PLR in patients with critically ill COVID-19, particularly in patients with comorbidity of kidney disease. Thus, elevated levels of NLR and PLR were identified as potential prognostic markers for predicting disease severity in COVID-19 patients, especially those with kidney comorbidity.