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Fulltext Experimental and numerical evaluations of composite concrete-to-concrete interfacial shear strength under horizontal and normal stresses

Al-Fasih MY, Mohamad ME, Ibrahim IS, Ahmad Y, Ariffin MAM, Sarbini NN, et al.

PLoS One, 2021;16(5):e0252050.
PMID: 34015027 DOI: 10.1371/journal.pone.0252050

Effects of different surface textures on the interface shear strength, interface slip, and failure modes of the concrete-to-concrete bond are examined through finite element numerical model and experimental methods in the presence of the horizontal load with 'push-off' technique under different normal stresses. Three different surface textures are considered; smooth, indented, and transversely roughened to finish the top surfaces of the concrete bases. In the three-dimensional modeling via the ABAQUS solver, the Cohesive Zone Model (CZM) is used to simulate the interface shear failure. It is observed that the interface shear strength increases with the applied normal stress. The transversely roughened surface achieves the highest interface shear strength compared with those finished with the indented and smooth approaches. The smooth and indented surfaces are controlled by the adhesive failure mode while the transversely roughened surface is dominated by the cohesive failure mode. Also, it is observed that the CZM approach can accurately model the interface shear failure with 3-29% differences between the modeled and the experimental test findings.
Fulltext Fatal Delayed Haemolytic Transfusion Reaction and Hyperhaemolysis Syndrome in a Pregnant Woman with Sickle Cell Anaemia

Asnawi AW, Sathar J, Mohamed R, Deraman R, Kumaran S, Hamid SS, et al.

Indian J Hematol Blood Transfus, 2016 Jun;32(Suppl 1):251-3.
PMID: 27408406 DOI: 10.1007/s12288-014-0495-9

Clinical manifestations of sickle cell disease (SCD) arise from the tendency of the sickle haemoglobin to polymerize and deform red blood cells into the characteristic sickle shape. Sickle cell crisis is a devastating complication that may occur in patients with SCD. If not managed properly permanent organ damage and even death may be the final outcome. A case of a 32-year-old Nigerian lady, Gravida 1 Para 0 in her first trimester, with SCD who developed signs and symptoms of delayed haemolytic transfusion reaction after receiving packed red cell transfusion is demonstrated. Multiple red cell alloantibodies were detected in the patient's plasma; anti-Fy a, anti-Jk b and anti-E. The patient miscarriaged and succumbed to complications of hyperhaemolysis with delayed haemolytic transfusion reaction, acute chest syndrome and renal failure. There is an urgent need for mandatory red cell antibody screen and identification especially in high-risk cases. Prevention of alloimmunization by supplying phenotype-specific red cells is also required.
Fatty liver is associated with advanced fibrosis but does not predict adverse outcomes in patients with chronic hepatitis B

Wong SW, Chan WK, Mohamed R

J Viral Hepat, 2020 12;27(12):1297-1305.
PMID: 32668489 DOI: 10.1111/jvh.13361

Hepatic steatosis is increasingly common and has been implicated in progression of liver fibrosis in chronic hepatitis B (CHB) patients. We aimed to investigate the impact of hepatic steatosis on liver fibrosis and clinical outcomes in CHB patients. Consecutive CHB patients who underwent transient elastography between 2013 and 2017 at a tertiary hospital were included in this longitudinal cohort study. Presence of hepatic steatosis was defined as controlled attenuation parameter, CAP ≥ 248 dB/m, while advanced liver fibrosis was defined as liver stiffness measurement, LSM ≥ 9.4 kPa. Cardiovascular events, liver-related complications, malignancy and mortality and a composite of these outcomes were evaluated with Kaplan-Meier analysis and Cox proportional hazards regression. Our study cohort included 614 patients with median follow-up of 45 (32-63) months. Hepatic steatosis was present in 294 patients (47.9%), and advanced liver fibrosis was present in 127 patients (21.0%). Presence of hepatic steatosis (OR: 1.956, 95% CI: 1.250-3.060) and diabetes mellitus (OR: 3.507, 95% CI: 2.069-5.944) was independently associated with advanced fibrosis. Advanced fibrosis was independently associated with composite outcome (HR: 2.496, 95% CI: 1.352-4.606), liver-related complications (HR: 3.765, 95% CI: 1.380-10.271) and mortality (HR: 3.632, 95% CI: 1.342-9.826), but not cardiovascular events and malignancy. Hepatic steatosis was not associated with any adverse outcomes. We conclude that hepatic steatosis is common and associated with advanced fibrosis in CHB patients. Unlike advanced fibrosis, hepatic steatosis does not predict adverse outcomes in CHB patients.
Findings from a large Asian chronic hepatitis C real-life study

Lim SG, Phyo WW, Shah SR, Win KM, Hamid S, Piratvisuth T, et al.

J Viral Hepat, 2018 12;25(12):1533-1542.
PMID: 30141214 DOI: 10.1111/jvh.12989

There is a paucity of information on chronic hepatitis C (CHC) patients treated with direct antiviral agents (DAAs) in Asia. We invited Asia-Pacific physicians to collate databases of patients enrolled for CHC treatment, recording baseline clinical, virologic and biochemical characteristics, sustained virologic response at week 12 (SVR12) and virologic failure. SVR12 outcome was based on intention to treat (ITT). Multivariate analysis was used to assess independent risk factors for SVR12 using SPSS version 20. A total of 2171 patients from India (n = 977), Myanmar (n = 552), Pakistan (n = 406), Thailand (n = 139), Singapore (n = 72) and Malaysia (n = 25) were collected. At baseline, mean age was 49 years, 50.2% were males, and 41.8% had cirrhosis. Overall, SVR12 was 89.5% and by genotype (GT) based on ITT and treatment completion, respectively, was 91% and 92% for GT1, 100% and 100% for GT2, 91% and 97% for GT3, 64% and 95% for GT4, 87% and 87% for GT6 and 79% and 91% for GT untested. Patients with cirrhosis had SVR12 of 85% vs 93% for noncirrhosis (P < 0.001) (RR 2.1, 95% CI 1.4-3.1, P = 0.0002). Patients with GT1 and GT3 treated with sofosbuvir/ribavirin (SR) had 88% and 89% SVR12, respectively, but those GT6 treated with sofosbuvir/ledipasvir (SL) had only 77.6% SVR12. Multivariate analysis showed absence of cirrhosis was associated with higher SVR12 (OR 2.0, 95% CI 1.3-3.1, P = 0.002). In conclusion, patients with GT1 and GT3 with/without cirrhosis had surprisingly high efficacy using SR, suggesting that Asians may respond better to some DAAs. However, poor GT6 response to SL suggests this regimen is suboptimal for this genotype.
Fulltext Galerkin finite element study for mixed convection (TiO2-SiO2/water) hybrid-nanofluidic flow in a triangular aperture heated beneath

Redouane F, Jamshed W, Suriya Uma Devi S, Prakash M, Nisar KS, Nasir NAAM, et al.

Sci Rep, 2021 Nov 25;11(1):22905.
PMID: 34824297 DOI: 10.1038/s41598-021-02216-z

Fluidity and thermal transport across the triangular aperture with lower lateral inlet and apply placed at the vertical outlet of the chamber which filled with efficient TiO2-SiO2/water hybrid nanofluid under the parametrical influence. Several parameters are tested like the numbers of Hartmann ([Formula: see text]), Richardson ([Formula: see text]), and Reynolds ([Formula: see text]) were critiqued through streamlines, isotherms, and Nusselt number ([Formula: see text]). Numerical model has to be developed and solved through the Galerkin finite element method (GFEM) by discretized with 13,569 triangular elements optimized through grid-independent analysis. The Hartmann number ([Formula: see text]), exerts minimal impact over the flow and thermal aspects while the other parameters significantly manipulate the physical nature of the flowing and thermal aspects behaviors.
Fulltext Genetic polymorphisms in LDLR, APOB, PCSK9 and other lipid related genes associated with familial hypercholesterolemia in Malaysia

Lye SH, Chahil JK, Bagali P, Alex L, Vadivelu J, Ahmad WA, et al.

PLoS One, 2013;8(4):e60729.
PMID: 23593297 DOI: 10.1371/journal.pone.0060729

Familial hypercholesterolemia (FH) is an autosomal dominant disorder characterized by elevations in total cholesterol (TC) and low density lipoprotein cholesterol (LDLc). Development of FH can result in the increase of risk for premature cardiovascular diseases (CVD). FH is primarily caused by genetic variations in Low Density Lipoprotein Receptor (LDLR), Apolipoprotein B (APOB) or Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) genes. Although FH has been extensively studied in the Caucasian population, there are limited reports of FH mutations in the Asian population. We investigated the association of previously reported genetic variants that are involved in lipid regulation in our study cohort. A total of 1536 polymorphisms previously implicated in FH were evaluated in 141 consecutive patients with clinical FH (defined by the Dutch Lipid Clinic Network criteria) and 111 unrelated control subjects without FH using high throughput microarray genotyping platform. Fourteen Single Nucleotide Polymorphisms (SNPs) were found to be significantly associated with FH, eleven with increased FH risk and three with decreased FH risk. Of the eleven SNPs associated with an increased risk of FH, only one SNP was found in the LDLR gene, seven in the APOB gene and three in the PCSK9 gene. SNP rs12720762 in APOB gene is associated with the highest risk of FH (odds ratio 14.78, p<0.001). Amongst the FH cases, 108 out of 141 (76.60%) have had at least one significant risk-associated SNP. Our study adds new information and knowledge on the genetic polymorphisms amongst Asians with FH, which may serve as potential markers in risk prediction and disease management.
Fulltext Genome Size, Molecular Phylogeny, and Evolutionary History of the Tribe Aquilarieae (Thymelaeaceae), the Natural Source of Agarwood

Farah AH, Lee SY, Gao Z, Yao TL, Madon M, Mohamed R

Front Plant Sci, 2018;9:712.
PMID: 29896211 DOI: 10.3389/fpls.2018.00712

The tribe Aquilarieae of the family Thymelaeaceae consists of two genera, Aquilaria and Gyrinops, with a total of 30 species, distributed from northeast India, through southeast Asia and the south of China, to Papua New Guinea. They are an important botanical resource for fragrant agarwood, a prized product derived from injured or infected stems of these species. The aim of this study was to estimate the genome size of selected Aquilaria species and comprehend the evolutionary history of Aquilarieae speciation through molecular phylogeny. Five non-coding chloroplast DNA regions and a nuclear region were sequenced from 12 Aquilaria and three Gyrinops species. Phylogenetic trees constructed using combined chloroplast DNA sequences revealed relationships of the studied 15 members in Aquilarieae, while nuclear ribosomal DNA internal transcribed spacer (ITS) sequences showed a paraphyletic relationship between Aquilaria species from Indochina and Malesian. We exposed, for the first time, the estimated divergence time for Aquilarieae speciation, which was speculated to happen during the Miocene Epoch. The ancestral split and biogeographic pattern of studied species were discussed. Results showed no large variation in the 2C-values for the five Aquilaria species (1.35-2.23 pg). Further investigation into the genome size may provide additional information regarding ancestral traits and its evolution history.
Fulltext Genome-wide analysis of copy number variation identifies candidate gene loci associated with the progression of non-alcoholic fatty liver disease

Zain SM, Mohamed R, Cooper DN, Razali R, Rampal S, Mahadeva S, et al.

PLoS One, 2014;9(4):e95604.
PMID: 24743702 DOI: 10.1371/journal.pone.0095604

Between 10 and 25% of individuals with non-alcoholic fatty liver disease (NAFLD) develop hepatic fibrosis leading to cirrhosis and hepatocellular carcinoma (HCC). To investigate the molecular basis of disease progression, we performed a genome-wide analysis of copy number variation (CNV) in a total of 49 patients with NAFLD [10 simple steatosis and 39 non-alcoholic steatohepatitis (NASH)] and 49 matched controls using high-density comparative genomic hybridization (CGH) microarrays. A total of 11 CNVs were found to be unique to individuals with simple steatosis, whilst 22 were common between simple steatosis and NASH, and 224 were unique to NASH. We postulated that these CNVs could be involved in the pathogenesis of NAFLD progression. After stringent filtering, we identified four rare and/or novel CNVs that may influence the pathogenesis of NASH. Two of these CNVs, located at 13q12.11 and 12q13.2 respectively, harbour the exportin 4 (XPO4) and phosphodiesterase 1B (PDE1B) genes which are already known to be involved in the etiology of liver cirrhosis and HCC. Cross-comparison of the genes located at these four CNV loci with genes already known to be associated with NAFLD yielded a set of genes associated with shared biological processes including cell death, the key process involved in 'second hit' hepatic injury. To our knowledge, this pilot study is the first to provide CNV information of potential relevance to the NAFLD spectrum. These data could prove invaluable in predicting patients at risk of developing NAFLD and more importantly, those who will subsequently progress to NASH.
Genome-wide prediction and annotation of Burkholderia pseudomallei AraC/XylS family transcription regulator

Lim BS, Chong CE, Zamrod Z, Nathan S, Mohamed R

In Silico Biol. (Gedrukt), 2007;7(4-5):389-97.
PMID: 18391231

Many members of the AraC/XylS family transcription regulator have been proven to play a critical role in regulating bacterial virulence factors in response to environmental stress. By using the Hidden Markov Model (HMM) profile built from the alignment of a 99 amino acid conserved domain sequence of 273 AraC/XylS family transcription regulators, we detected a total of 45 AraC/XylS family transcription regulators in the genome of the Gram-negative pathogen, Burkholderia pseudomallei. Further in silico analysis of each detected AraC/XylS family transcription regulatory protein and its neighboring genes allowed us to make a first-order guess on the role of some of these transcription regulators in regulating important virulence factors such as those involved in three type III secretion systems and biosynthesis of pyochelin, exopolysaccharide (EPS) and phospholipase C. This paper has demonstrated an efficient and systematic genome-wide scale prediction of the AraC/XylS family that can be applied to other protein families.
Fulltext Genomic analysis of Hepatitis B virus and its association with disease manifestations in Bangladesh

Raihan R, Akbar SMF, Al Mahtab M, Takahashi K, Masumoto J, Tabassum S, et al.

PLoS One, 2019;14(6):e0218744.
PMID: 31251754 DOI: 10.1371/journal.pone.0218744

The direct cytopathic effects of the hepatitis B virus (HBV) on subsequent liver damage are not fully understood in HBV-infected patients. However, associations between the prevalence of various HBV genotypes and the extent of liver damage have been reported from different parts of the world. The purpose of this study was to determine the distribution of HBV genotypes in patients with chronic HBV infection in Bangladesh, a country of 160 million people, of which approximately 3-6 million are chronically infected HBV patients. In addition, whole and partial genome sequencing of HBV was performed to evaluate the relationship between HBV mutations and genotypes. We found that 42% of the patients with low HBV DNA and normal levels of alanine aminotransferase (ALT) had HBV genotype D. In contrast, the HBV genotype C was dominant among patients with high HBV DNA levels (>2000 IU/ml) and elevated ALT and in patients with liver cirrhosis (LC) and hepatocellular carcinomas (HCC). Whole and partial genome sequences of HBV revealed that most patients with LC and HCC had HBV genotype C with mutations at the T1762/A1764 positions. It seems that Bangladesh represents a borderline country, situated within East Asia, which mainly consists of individuals with HBV genotypes B and C, whereas in the western parts of Asia, HBV genotypes A and D are prevalent. Bangladesh is, therefore, an excellent model for the comparison of the pathophysiology of three major HBV genotypes in a single population. The findings of this study suggest a possible association between HBV viral factors and the extent of liver damage in chronic HBV-infected patients.
Fulltext Geopolymer Ceramic Application: A Review on Mix Design, Properties and Reinforcement Enhancement

Mohd Mortar NA, Abdullah MMAB, Abdul Razak R, Abd Rahim SZ, Aziz IH, Nabiałek M, et al.

Materials (Basel), 2022 Oct 28;15(21).
PMID: 36363159 DOI: 10.3390/ma15217567

Geopolymers have been intensively explored over the past several decades and considered as green materials and may be synthesised from natural sources and wastes. Global attention has been generated by the use of kaolin and calcined kaolin in the production of ceramics, green cement, and concrete for the construction industry and composite materials. The previous findings on ceramic geopolymer mix design and factors affecting their suitability as green ceramics are reviewed. It has been found that kaolin offers significant benefit for ceramic geopolymer applications, including excellent chemical resistance, good mechanical properties, and good thermal properties that allow it to sinter at a low temperature, 200 °C. The review showed that ceramic geopolymers can be made from kaolin with a low calcination temperature that have similar properties to those made from high calcined temperature. However, the choice of alkali activator and chemical composition should be carefully investigated, especially under normal curing conditions, 27 °C. A comprehensive review of the properties of kaolin ceramic geopolymers is also presented, including compressive strength, chemical composition, morphological, and phase analysis. This review also highlights recent findings on the range of sintering temperature in the ceramic geopolymer field which should be performed between 600 °C and 1200 °C. A brief understanding of kaolin geopolymers with a few types of reinforcement towards property enhancement were covered. To improve toughness, the role of zirconia was highlighted. The addition of zirconia between 10% and 40% in geopolymer materials promises better properties and the mechanism reaction is presented. Findings from the review should be used to identify potential strategies that could develop the performance of the kaolin ceramic geopolymers industry in the electronics industry, cement, and biomedical materials.
Group B streptococci in a maternity unit

Jamal F, Mohamed R, Zainal Z, Arshat H

Med J Malaysia, 1979 Jun;33(4):349-51.
PMID: 574917
Gynura procumbens ethanol extract and its fractions inhibit macrophage derived foam cell formation

Manogaran M, Vuanghao L, Mohamed R

J Ethnopharmacol, 2020 Mar 01;249:112410.
PMID: 31747560 DOI: 10.1016/j.jep.2019.112410

ETHNOPHARMACOLOGY RELEVANCE: Gynura procumbens (Lour.) Merr. displayed cardio-protective effect that may prevent atherogenesis. The primary underlying pathological process of cardiovascular disease is atherosclerosis. Atherosclerotic lesion composed of macrophages, T cells and other immune cells which incorporated with cholesterol that infiltrates from the blood.
AIM OF THE STUDY: The present study was performed to determine underlying mechanism of G. procumbens ethanol extract and its fractions such as aqueous, chloroform, ethyl acetate and hexane affect macrophage derived foam cell formation.
MATERIALS AND METHODS: Lipid droplets accumulation in treated macrophages were visualized by Oil Red O staining while the total cholesterol present in the treated macrophages were measured using Cholestryl Ester quantification assay kit. Enzyme-Linked Immunosorbent Assay (ELISA) were used to detect TNF-α and IL-1β secretion in the supernatant of treated macrophages. Gene expression of Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) and ATP-binding cassette transporter A-1 (ABCA-1) in treated macrophages were analyzed using Real-Time Quantitative Polymerase Chain Reaction (RT-qPCR).
RESULTS: G. procumbens ethanol extract and its fractions reduced lipid droplet accumulation and total cholesterol in oxLDL-treated macrophages together with significantly reduction of TNF-α and IL-1β secretions in supernatant oxLDL-treated macrophages. LOX-1 gene expression was significantly reduced when G. procumbens ethanol extract and its fractions were added in oxDL-treated macrophages. In contrast, G. procumbens ethanol extract and its fractions significantly increased the expression of ABCA-1 gene in oxLDL-treated macrophages.
CONCLUSION: In conclusion, G. procumbens ethanol extract and its fractions inhibit the formation of macrophage derived foam cell by reducing TNF-α and IL-1β expression, which usually highly expressed in atherosclerotic plaques, suppressing scavenger receptor LOX-1 gene that binds oxLDL but induced ABCA-1 gene that mediate lipid efflux from macrophages.
Harvesting of microalgae biomass from the phycoremediation process of greywater

Atiku H, Mohamed RMSR, Al-Gheethi AA, Wurochekke AA, Kassim AHM

Environ Sci Pollut Res Int, 2016 12;23(24):24624-24641.
PMID: 27544526 DOI: 10.1007/s11356-016-7456-9

The wide application of microalgae in the field of wastewater treatment and bioenergy source has improved research studies in the past years. Microalgae represent a good source of biomass and bio-products which are used in different medical and industrial activities, among them the production of high-valued products and biofuels. The present review focused on greywater treatment through the application of phycoremediation technique with microalgae and presented recent advances in technologies used for harvesting the microalgae biomass. The advantages and disadvantages of each method are discussed. The microbiological aspects of production, harvesting and utilization of microalgae biomass are viewed.
Fulltext Heat flow saturate of Ag/MgO-water hybrid nanofluid in heated trigonal enclosure with rotate cylindrical cavity by using Galerkin finite element

Redouane F, Jamshed W, Devi SSU, Prakash M, Nasir NAAM, Hammouch Z, et al.

Sci Rep, 2022 Feb 10;12(1):2302.
PMID: 35145142 DOI: 10.1038/s41598-022-06134-6

MHD Natural convection, which is one of the principal types of convective heat transfer in numerous research of heat exchangers and geothermal energy systems, as well as nanofluids and hybrid nanofluids. This work focuses on the investigation of Natural convective heat transfer evaluation inside a porous triangular cavity filled with silver-magnesium oxide/water hybrid nanofluid [H2O/Ag-MgO]hnf under a consistent magnetic field. The laminar and incompressible nanofluid flow is taken to account while Darcy-Forchheimer model takes account of the advection inertia effect in the porous sheet. Controlled equations of the work have been approached nondimensional and resolved by Galerkin finite element technique. The numerical analyses were carried out by varying the Darcy, Hartmann, and Rayleigh numbers, porosity, and characteristics of solid volume fraction and flow fields. Further, the findings are reported in streamlines, isotherms and Nusselt numbers. For this work, the parametric impact may be categorized into two groups. One of them has an effect on the structural factors such as triangular form and scale on the physical characteristics of the important outputs such as fluidity and thermal transfer rates. The significant findings are the parameters like Rayleigh and slightly supported by Hartmann along with Darcy number, minimally assists by solid-particle size and rotating factor as clockwise assists the cooler flow at the center and anticlockwise direction assists the warmer flow. Clear raise in heat transporting rate can be obtained for increasing solid-particle size.
Heavy Metal Concentrations in Malaysian Adults' Hair and Associated Variables in Bukit Mertajam, Penang, Malaysia

Aziz MY, Hussain SH, Ishak AR, Abdullah MA, Mohamed R, Ruzi II, et al.

Biol Trace Elem Res, 2021 Sep 30.
PMID: 34591221 DOI: 10.1007/s12011-021-02942-5

The presence of heavy metals in human hair is being tracked to predict health risk, forensics, and environmental monitoring. Heavy metals are typically non-biodegradable and have a lengthy half-life, allowing them to linger in humans and the environment for many years. Heavy metal exposure in hair has been attributed to multiple sources from the environment and food intake. In this study, copper (Cu), nickel (Ni), zinc (Zn), chromium (Cr), manganese (Mn), lead (Pb), and cadmium (Cd) levels were measured in the scalp hair of 50 individuals in Bukit Mertajam, Penang, Malaysia. In conjunction with sampling, subjects' age, gender, lifestyle, diet, and working environment were also obtained through the questionnaire. The Atomic Absorption Spectrometry (AAS) method was used to extract all the metals in the hair samples. The mean concentrations of heavy metals were found to be in the following order (unit of mg/kg): Cr > Zn > Pb > Ni > Cd > Cu. Manganese was detected below the limit of quantitation among the elements (
Fulltext Helicobacter pylori cagA gene variants in Malaysians of different ethnicity

Mohamed R, Hanafiah A, Rose IM, Manaf MR, Abdullah SA, Sagap I, et al.

Eur J Clin Microbiol Infect Dis, 2009 Jul;28(7):865-9.
PMID: 19247698 DOI: 10.1007/s10096-009-0712-x

We have defined DNA repeat variability in the 3'-terminus of the cagA gene of Helicobacter pylori strains from Malaysian patients of different ethnicities. We identified different alleles based on the EPIYA repeats. cagA types A-B-D and A-B-B-D are more similar to the sequence of Japanese strains, whereas cagA types A-B-C, A-B-C-C, A-B and A-C displayed similarity to strain 26695 sequences. A significant association was found between cagA genotypes and patients' ethnicity, with cagA type A-B-D being predominantly isolated from Chinese patients and cagA type A-B-C from Malays and Indians. Our data further corroborate the possibility that variant biological activity of CagA may affect the host specificity and/or pathogenicity of H. pylori.
Fulltext Hemorrhagic cardiac tamponade: rare complication of radiofrequency ablation of hepatocellular carcinoma

Loh KB, Bux SI, Abdullah BJ, Raja Mokhtar RA, Mohamed R

Korean J Radiol, 2012 Sep-Oct;13(5):643-7.
PMID: 22977334 DOI: 10.3348/kjr.2012.13.5.643

Local treatment for hepatocellular carcinoma (HCC) has been widely used in clinical practice due to its minimal invasiveness and high rate of cure. Percutaneous radiofrequency ablation (RFA) is widely used because its treatment effectiveness. However, some serious complications can arise from percutaneous RFA. We present here a rare case of hemorrhagic cardiac tamponade secondary to an anterior cardiac vein (right marginal vein) injury during RFA for treatment of HCC.
Hepatitis B and hepatitis C in southeast and southern Asia: challenges for governments

Wait S, Kell E, Hamid S, Muljono DH, Sollano J, Mohamed R, et al.

Lancet Gastroenterol Hepatol, 2016 11;1(3):248-255.
PMID: 28404097 DOI: 10.1016/S2468-1253(16)30031-0

In 2015, the Coalition to Eradicate Viral Hepatitis in Asia Pacific gathered leading hepatitis experts from Bangladesh, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand to discuss common challenges to the burden posed by hepatitis B virus (HBV) and hepatitis C virus (HCV), to learn from each other's experience, and identify sustainable approaches. In this report, we summarise these discussions. Countries differ in their policy responses to HBV and HCV; however, substantial systemic, cultural, and financial barriers to achievement of elimination of these infections persist in all countries. Common challenges to elimination include limited availability of reliable epidemiological data; insufficient public awareness of risk factors and modes of transmission, leading to underdiagnosis; high rates of transmission through infected blood products, including in medical settings; limited access to care for people who inject drugs; prevailing stigma and discrimination against people infected with viral hepatitis; and financial barriers to treatment and care. Despite these challenges, promising examples of effective programmes, public-private initiatives, and other innovative approaches are evident in all countries we studied in Asia Pacific. The draft WHO Global Health Sector Strategy on Viral Hepatitis 2016-21 provides a solid framework upon which governments can build their local strategies towards viral hepatitis. However, greater recognition by national governments and the international community of the urgency to comprehensively tackle both HBV and HCV are still needed. In all countries, strategic plans and policy goals need to be translated into resources and concrete actions, with national governments at the helm, to enable a sustainable response to the rising burden of hepatitis B and C in all countries.
Hepatitis B virus DNA methylation and its potential role in chronic hepatitis B

Low WF, Ngeow YF, Chook JB, Tee KK, Ong SK, Peh SC, et al.

Expert Rev Mol Med, 2022 Nov 16;25:e11.
PMID: 36380484 DOI: 10.1017/erm.2022.38

Hepatitis B virus (HBV) infection led to 66% liver deaths world-wide in year 2015. Thirty-seven per cent of these deaths were the result of chronic hepatitis B (CHB)-associated hepatocellular carcinoma (HCC). Although early diagnosis of HCC improves survival, early detection is rare. Methylation of HBV DNA including covalently closed circular DNA (cccDNA) is more often encountered in HCC cases than those in CHB and cirrhosis. Three typical CpG islands within the HBV genome are the common sites for methylation. The HBV cccDNA methylation affects the viral replication and protein expression in the course of infection and may associate with the disease pathogenesis and HCC development. We review the current findings in HBV DNA methylation that provide insights into its role in HCC diagnosis.

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