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Epidemiology, clinical characteristics, and immediate outcome of Kawasaki disease: a population-based study from a tropical country

Mat Bah MN, Alias EY, Razak H, Sapian MH, Foo FH, Abdullah N

Eur J Pediatr, 2021 Aug;180(8):2599-2606.
PMID: 34086103 DOI: 10.1007/s00431-021-04135-7

Data on Kawasaki disease from tropical countries are scarce. Hence, this population-based study aims to determine the epidemiology, clinical characteristics, and outcome of Kawasaki disease in children enrolled in the Kawasaki disease registry between 2006 and 2019 in Southern Malaysia. Diagnosis of Kawasaki disease was made using standard criteria. Primary outcome measure was a coronary artery aneurysm. Multivariable logistic regression was used to analyze the associated risk factors for coronary artery aneurysm. There were 661 Kawasaki disease, with 27% incomplete and 11% atypical presentations. Male-to-female ratio was 2:1, and median age of diagnosis was 1.4 years (interquartile range 9 to 32 months). Incidence in children of less than 5 years was 14.8 (95% confidence interval [CI]: 13.6 to 16.0) per 100,000 population, higher in males (19/100,000) and Chinese (22/100,000), with a gradual increase from 5.7/100,000 in 2006 to 19.6/100,000 in 2019, p < 0.001. Incidence in children between 5 and 9 years old was 1.3 (95% CI: 0.9 to 1.6) per 100,000 population and remained stable over time. There was a seasonal pattern with peak incidence during the rainy season. Out of 625 intravenous immunoglobulins (IVIG)-treated Kawasaki disease, 7.4% were resistant, and 9% had coronary artery aneurysms. Atypical presentation, male sex, late diagnosis, and IVIG resistance were independent risk factors for coronary artery aneurysms.Conclusions: Despite the tropical climate, Kawasaki disease epidemiology is similar to non-tropic regions with seasonal patterns and a rising incidence. Atypical presentation, male sex, late diagnosis, and IVIG resistance were significantly associated with coronary artery aneurysms. What is Known: • Kawasaki disease predominantly occurs in males, children less than 5 years old, and the Asian population. • Male sex, late diagnosis, incomplete Kawasaki disease, and IVIG resistance were associated with coronary artery aneurysms. What is New: • In multi-ethnic Asian countries such as Malaysia, ethnic Chinese have a higher prevalence of Kawasaki disease compared to other ethnicities. • Kawasaki disease with atypical presentation can occur in both complete and incomplete Kawasaki disease and is significantly associated with a coronary artery aneurysm.
Fulltext Comparative Toxicity Assessment of Kratom Decoction, Mitragynine and Speciociliatine Versus Morphine on Zebrafish (Danio rerio) Embryos

Damodaran T, Chear NJ, Murugaiyah V, Mordi MN, Ramanathan S

Front Pharmacol, 2021;12:714918.
PMID: 34489704 DOI: 10.3389/fphar.2021.714918

Background: Kratom (Mitragyna speciosa Korth), a popular opioid-like plant holds its therapeutic potential in pain management and opioid dependence. However, there are growing concerns about the safety or potential toxicity risk of kratom after prolonged use. Aim of the study: The study aimed to assess the possible toxic effects of kratom decoction and its major alkaloids, mitragynine, and speciociliatine in comparison to morphine in an embryonic zebrafish model. Methods: The zebrafish embryos were exposed to kratom decoction (1,000-62.5 μg/ml), mitragynine, speciociliatine, and morphine (100-3.125 μg/ml) for 96 h post-fertilization (hpf). The toxicity parameters, namely mortality, hatching rate, heart rate, and morphological malformations were examined at 24, 48, 72, and 96 hpf, respectively. Results: Kratom decoction at a concentration range of ≥500 μg/ml caused 100% mortality of zebrafish embryos and decreased the hatching rate in a concentration-dependent manner. Meanwhile, mitragynine and speciociliatine exposure resulted in 100% mortality of zebrafish embryos at 100 μg/ml. Both alkaloids caused significant alterations in the morphological development of zebrafish embryos including hatching inhibition and spinal curvature (scoliosis) at the highest concentration. While exposure to morphine induced significant morphological malformations such as pericardial oedema, spinal curvature (lordosis), and yolk edema in zebrafish embryos. Conclusion: Our findings provide evidence for embryonic developmental toxicity of kratom decoction and its alkaloids both mitragynine and speciociliatine at the highest concentration, hence suggesting that kratom consumption may have potential teratogenicity risk during pregnancy and thereby warrants further investigations.
Survival and Associated Risk Factors for Mortality Among Infants with Critical Congenital Heart Disease in a Developing Country

Mat Bah MN, Sapian MH, Jamil MT, Alias A, Zahari N

Pediatr Cardiol, 2018 Oct;39(7):1389-1396.
PMID: 29756159 DOI: 10.1007/s00246-018-1908-6

Critical congenital heart disease (CCHD) is associated with significant morbidity and mortality. However, data on survival of CCHD and the risk factors associated with its mortality are limited. This study examined CCHD survival and the risk factors for CCHD mortality. Using a retrospective cohort study of infants born with CCHD from 2006 to 2015, survival over 10 years was estimated using Kaplan-Meier analysis, and the risk factors for mortality were analyzed using multivariate Cox proportional hazards regression. A total of 491 CCHD cases were included in the study, with an overall mortality rate of 34.8% (95% confidence interval [CI] 30.6-39.2). The intervention/surgical mortality rate was 9.8% ≤ 30 days and 11.5% > 30 days after surgery, and 17% died before surgery or intervention. The median age at death was 2.7 months [first quartile: 1 month, third quartile: 7.3 months]. The CCHD survival rate was 90.4% (95% CI 89-91.8%) at 1 month, 69.3% (95% CI 67.2-71.4%) at 1 year, 63.4% (95% CI 61.1-65.7%) at 5 years, and 61.4% (95% CI 58.9-63.9%) at 10 years. Weight of
The birth prevalence, severity, and temporal trends of congenital heart disease in the middle-income country: A population-based study

Mat Bah MN, Sapian MH, Jamil MT, Abdullah N, Alias EY, Zahari N

Congenit Heart Dis, 2018 Nov;13(6):1012-1027.
PMID: 30289622 DOI: 10.1111/chd.12672

OBJECTIVES: There is limited data on congenital heart disease (CHD) from the lower- and middle-income country. We aim to study the epidemiology of CHD with the specific objective to estimate the birth prevalence, severity, and its trend over time.

DESIGN: A population-based study with data retrieved from the Pediatric Cardiology Clinical Information System, a clinical registry of acquired and congenital heart disease for children.

SETTING: State of Johor, Malaysia.

PATIENTS: All children (0-12 years of age) born in the state of Johor between January 2006 and December 2015.

INTERVENTION: None.

OUTCOME MEASURE: The birth prevalence, severity, and temporal trend over time.

RESULTS: There were 531,904 live births during the study period with 3557 new cases of CHD detected. Therefore, the birth prevalence of CHD was 6.7 per 1000 live births (LB) (95% confidence interval [CI]: 6.5-6.9). Of these, 38% were severe, 15% moderate, and 47% mild lesions. Hence, the birth prevalence of mild, moderate, and severe CHD was 3.2 (95% CI: 3.0-3.3), 0.9 (95% CI: 0.9- 1.1), and 2.6 (95% CI: 2.4-2.7) per 1000 LB, respectively. There was a significant increase in the birth prevalence of CHD, from 5.1/1000 LB in 2006 to 7.8/1000 LB in 2015 (P
Postoperative major surgery patients developing silent deep vein thrombosis: A prospective observational study

Wong MP, Zahari Z, Abdullah MS, Ramely R, Md Hashim MN, Zakaria Z, et al.

J Vasc Nurs, 2018 Dec;36(4):173-180.
PMID: 30458938 DOI: 10.1016/j.jvn.2018.07.001

Surgical patients are at high risk for developing deep vein thrombosis (DVT). There are many reports concerning DVT, but little is known about silent deep vein thrombosis (sDVT). This study aimed to determine the incidence of sDVT. Secondary objective is to identify the associated factors for the use of DVT prophylaxis and Caprini risk scores among major surgery patients. This prospective observational study involved postoperative surgical patients who are at risk of developing sDVT. The Caprini risk-assessment scores were calculated, and each subject had a preoperative and postoperative compression ultrasound complemented by duplex venous ultrasonography of deep venous system. No patient from the study experienced sDVT. There were significant associations between Caprini risk score group (odds ratio, 8.16; 95% confidence interval [CI], 1.01-68.74; P = .016) and the use of central venous catheter (odds ratio, 6.34; 95% CI, 1.62-24.80; P = .008) with DVT prophylaxis. Interestingly, the use of central venous catheter resulted in more than four-point increment of Caprini risk scores (mean increment, 4.19; 95% CI, 3.16-5.21; P
Fulltext An approach to develop clinical prediction rule for candidemia in critically ill patients: A retrospective observational study

Jameran AS, Cheah SK, Tzar MN, Musthafa QA, Low HJ, Maaya M, et al.

J Crit Care, 2021 10;65:216-220.
PMID: 34252648 DOI: 10.1016/j.jcrc.2021.06.018

PURPOSE: Early detection of candidemia in critically ill patients is important for preemptive antifungal treatment. Our study aimed to identify the independent risk factors for the development of a new candidemia prediction score.
METHODS: This single-centre retrospective observational study evaluated 2479 intensive care unit (ICU) cases from January 2016 to December 2018. A total of 76 identified candidemia cases and 76 matched control cases were analyzed. The patients' demographic characteristics and illness severity were analyzed, and possible risk factors for candidemia were investigated.
RESULTS: Multivariate logistic regression analysis identified renal replacement therapy (RRT) (odds ratio [OR]: 52.83; 95% confidence interval [CI]: 7.82-356.92; P < 0.0001), multifocal Candida colonization (OR: 23.55; 95% CI: 4.23-131.05; P < 0.0001), parenteral nutrition (PN) (OR: 63.67; 95% CI: 4.56-889.77; P = 0.002), and acute kidney injury (AKI) (OR: 7.67; 95% CI: 1.24-47.30; P = 0.028) as independent risk factors. A new prediction score with a cut-off value of 5.0 (80.3% sensitivity and 77.3% specificity) was formulated from the logit model equation.
CONCLUSIONS: Renal replacement therapy, AKI, PN, and multifocal Candida colonization were the independent risk factors for the new candidemia prediction score with high discriminatory performance and predictive accuracy.
Fulltext Towards a systematic description of the field using bibliometric analysis: malware evolution

Mat SRT, Ab Razak MF, Kahar MNM, Arif JM, Mohamad S, Firdaus A

Scientometrics, 2021;126(3):2013-2055.
PMID: 33583978 DOI: 10.1007/s11192-020-03834-6

Malware is a blanket term for Trojan, viruses, spyware, worms, and other files that are purposely created to harm computers, mobile devices, or computer networks. Malware commonly steals, encrypts, damages, and causes a mess in these devices. The growth of malware attacks has a consequence on the growth and attractiveness of mobile features in mobile devices. Most malware research aims to probe the different methods of preventing, analysing, and detecting malware attacks. This paper aims to demonstrate an exhaustive knowledge map of the Android malware by collecting a ten (10) year dataset from the Web of Science database. A bibliometric analysis was employed for analysing articles published between 2010 and 2019. Using the keyword "malware", 5622 articles were retrieved. After scrutinising with the keywords of "Android malware", 1278 articles were then collected. This study provides an overview of the articles, productivity, research area, the Web of Science categories, authors, high-cited articles, institutions, and impact journals examining malware. Research activities are continued by placing terms in the classification of malware detection systems that outline important areas in malware research. From the analysis, it can be concluded that the highest number of publications focusing on malware studies came from the continent of Asia. Additionally, this study discusses the challenges of malware studies in the recent research studies as well as the future direction.
Fulltext Exophiala dermatitidis, 'the real black fungus' fungemia in a patient with COVID-19

Tzar MN, Meor Jamaludin WHB, Abdul Wahab A, Ding CH

IDCases, 2022;27:e01428.
PMID: 35127454 DOI: 10.1016/j.idcr.2022.e01428

The second wave of the COVID-19 pandemic in India had brought with it a surge of 'black fungus' co-infection, which is a misnomer for mucormycosis. The present case illustrates the 'real black fungus' infection in a 50-year old male patient with COVID-19 pneumonia, who otherwise had no significant previous medical history. He was admitted on day 8 of COVID-19 illness and was intubated due to persistently low oxygen saturation. Blood cultures were positive for flask-shaped dematiaceous budding yeasts with pseudohyphae formation, which grew as brown-black fuzzy colonies on Sabouraud dextrose agar. The isolate was identified as Exophiala dermatitidis based on phenotypic characterization. Despite antifungal therapy with amphotericin B and itraconazole, the patient deteriorated rapidly and succumbed to acute respiratory distress syndrome and multiorgan failure. A review of reported cases of Exophiala dermatitidis fungemia over the last 5-years is discussed.
Fulltext Survival and associated risk factors for mortality among infants with persistent pulmonary hypertension of the newborn in Malaysia

Mat Bah MN, Tan RYH, Razak H, Sapian MH, Abdullah N, Alias EY

J Perinatol, 2021 04;41(4):786-793.
PMID: 33589728 DOI: 10.1038/s41372-021-00962-6

OBJECTIVE: This study aims to determine the immediate outcome of persistent pulmonary hypertension of the newborn (PPHN) and risk factors for mortality in the era of inhaled nitric oxide (iNO).
STUDY DESIGN: This observational cross-sectional study includes 195 confirmed PPHN with a gestational age of ≥34 weeks without congenital heart disease. Multivariable logistic regression was used to identify risk factors for mortality.
RESULTS: The mortality rate was 16.4%, with the highest mortality with pulmonary hypoplasia. Of 195, 65% received iNO; 18% were iNO non-responders with the majority having pulmonary hypoplasia. Independent risk factors for mortality were the presence of reversal of flow at the descending aorta, pulmonary hypoplasia, APGAR scores ≤ 5 at 5 min, and idiopathic PPHN with an adjusted odds ratio of 15.9, 7.5, 6.7, and 6.4, respectively.
CONCLUSIONS: Despite the usage of iNO, mortality due to PPHN remains high and is related to etiology and cardiac function.
Fulltext Isolation of an obscure fungus, Parengyodontium album, from the blood of a severely neutropenic patient: The first reported case from Malaysia

Mohamed N, Ding CH, Wahab AA, Tzar MN, Hassan M

J Infect Dev Ctries, 2022 Oct 31;16(10):1668-1670.
PMID: 36332225 DOI: 10.3855/jidc.17016

Parengyodontium album is a very rarely encountered opportunistic fungal pathogen. A severely neutropenic 11-year-old boy with acute T-cell lymphoblastic leukemia/lymphoma was febrile and lethargic during his admission for elective chemotherapy. No cutaneous lesion or obvious source of infection was noted, and clinical examination was otherwise unremarkable. A blood specimen was sent for culture and fungal elements were visualized. Amphotericin B was administered empirically while awaiting fungal identification. Morphologically, a hyaline mould with thin septate hyphae plus smooth-walled conidiophores and conidiogenous cells arranged in whorls of up to four was cultured. Internal transcribed spacer region sequencing identified the fungus conclusively as P. album. Repeat blood culture was also positive for the same fungus. Following a two-week course of amphotericin B, fungemia clearance was attained.
Epigenetic oncogenesis, biomarkers and emerging chemotherapeutics for breast cancer

Ayipo YO, Ajiboye AT, Osunniran WA, Jimoh AA, Mordi MN

Biochim Biophys Acta Gene Regul Mech, 2022 10;1865(7):194873.
PMID: 36064110 DOI: 10.1016/j.bbagrm.2022.194873

Breast cancer remains one of the leading causes of cancer-related deaths globally and the most prominent among females, yet with limited effective therapeutic options. Most of the current medications are challenged by various factors including low efficacy, incessant resistance, immune evasion and frequent recurrence of the disease. Further understanding of the prognosis and identification of plausible therapeutic channels thus requires multimodal approaches. In this review, epigenetics studies of several pathways to BC oncogenesis via the inducement of oncogenic changes on relevant markers have been overviewed. Similarly, the counter-epigenetic mechanisms to reverse such changes as effective therapeutic strategies were surveyed. The epigenetic oncogenesis occurs through several pathways, notably, DNMT-mediated hypermethylation of DNA, dysregulated expression for ERα, HER2/ERBB and PR, histone modification, overexpression of transcription factors including the CDK9-cyclin T1 complex and suppression of tumour suppressor genes. Scientifically, the regulatory reversal of the mechanisms constitutes effective epigenetic approaches for mitigating BC initiation, progression and metastasis. These were exhibited at various experimental levels by classical chemotherapeutic agents including some repurposable drugs, endocrine inhibitors, monoclonal antibodies and miRNAs, natural products, metal complexes and nanoparticles. Dozens of the potential candidates are currently in clinical trials while others are still at preclinical experimental stages showing promising anti-BC efficacy. The review presents a model for a wider understanding of epigenetic oncogenic pathways to BC and reveals plausible channels for reversing the unpleasant changes through epigenetic modifications. It advances the science of therapeutic designs for ameliorating the global burden of BC upon further translational studies.
Fulltext Reliability Study of Solder Paste Alloy for the Improvement of Solder Joint at Surface Mount Fine-Pitch Components

Rahman MNA, Zubir NSM, Leuveano RAC, Ghani JA, Mahmood WMFW

Materials (Basel), 2014 Dec 02;7(12):7706-7721.
PMID: 28788270 DOI: 10.3390/ma7127706

The significant increase in metal costs has forced the electronics industry to provide new materials and methods to reduce costs, while maintaining customers' high-quality expectations. This paper considers the problem of most electronic industries in reducing costly materials, by introducing a solder paste with alloy composition tin 98.3%, silver 0.3%, and copper 0.7%, used for the construction of the surface mount fine-pitch component on a Printing Wiring Board (PWB). The reliability of the solder joint between electronic components and PWB is evaluated through the dynamic characteristic test, thermal shock test, and Taguchi method after the printing process. After experimenting with the dynamic characteristic test and thermal shock test with 20 boards, the solder paste was still able to provide a high-quality solder joint. In particular, the Taguchi method is used to determine the optimal control parameters and noise factors of the Solder Printer (SP) machine, that affects solder volume and solder height. The control parameters include table separation distance, squeegee speed, squeegee pressure, and table speed of the SP machine. The result shows that the most significant parameter for the solder volume is squeegee pressure (2.0 mm), and the solder height is the table speed of the SP machine (2.5 mm/s).
A simple approach for rapid detection and quantification of adulterants in stingless bees (Heterotrigona itama) honey

Se KW, Ghoshal SK, Wahab RA, Ibrahim RKR, Lani MN

Food Res Int, 2018 03;105:453-460.
PMID: 29433236 DOI: 10.1016/j.foodres.2017.11.012

In this study, we propose an easy approach by combining the Fourier transform infrared and attenuated total reflectance (FTIR-ATR) spectroscopy together with chemometrics analysis for rapid detection and accurate quantification of five adulterants such as fructose, glucose, sucrose, corn syrup and cane sugar in stingless bees (Heterotrigona itama) honey harvested in Malaysia. Adulterants were classified using principal component analysis and soft independent modeling class analogy, where the first derivative of the spectra in the wavenumber range of 1180-750cm-1 was utilized. The protocol could satisfactorily discriminate the stingless bees honey samples that were adulterated with the concentrations of corn syrup above 8% (w/w) and cane sugar over 2% (w/w). Feasibility of integrating FTIR-ATR with chemometrics for precise quantification of the five adulterants was affirmed using partial least square regression (PLSR) analysis. The study found that optimal PLSR analysis achieved standard error of calibrations and standard error of predictions within an acceptable range of 0.686-1.087% and 0.581-1.489%, respectively, indicating good predictive capability. Hence, the method developed here for detecting and quantifying adulteration in H. itama honey samples is accurate and rapid, requiring only 7-8min to complete as compared to 3h for the standard method, AOAC method 998.12.
Fulltext Pathomechanisms, therapeutic targets and potent inhibitors of some beta-coronaviruses from bench-to-bedside

Ayipo YO, Yahaya SN, Alananzeh WA, Babamale HF, Mordi MN

Infect Genet Evol, 2021 Sep;93:104944.
PMID: 34052418 DOI: 10.1016/j.meegid.2021.104944

Since the emergence of their primitive strains, the complexity surrounding their pathogenesis, constant genetic mutation and translation are contributing factors to the scarcity of a successful vaccine for coronaviruses till moment. Although, the recent announcement of vaccine breakthrough for COVID-19 renews the hope, however, there remains a major challenge of accessibility to urgently match the rapid global therapeutic demand for curtailing the pandemic, thereby creating an impetus for further search. The reassessment of results from a stream of experiments is of enormous importance in identifying bona fide lead-like candidates to fulfil this quest. This review comprehensively highlights the common pathomechanisms and pharmacological targets of HCoV-OC43, SARS-CoV-1, MERS-CoV and SARS-CoV-2, and potent therapeutic potentials from basic and clinical experimental investigations. The implicated targets for the prevention and treatment include the viral proteases (Mpro, PLpro, 3CLpro), viral structural proteins (S- and N-proteins), non-structural proteins (nsp 3, 8, 10, 14, 16), accessory protein (ns12.9), viroporins (3a, E, 8a), enzymes (RdRp, TMPRSS2, ADP-ribosyltransferase, MTase, 2'-O-MTase, TATase, furin, cathepsin, deamidated human triosephosphate isomerase), kinases (MAPK, ERK, PI3K, mTOR, AKT, Abl2), interleukin-6 receptor (IL-6R) and the human host receptor, ACE2. Notably among the 109 overviewed inhibitors include quercetin, eriodictyol, baicalin, luteolin, melatonin, resveratrol and berberine from natural products, GC373, NP164 and HR2P-M2 from peptides, 5F9, m336 and MERS-GD27 from specific human antibodies, imatinib, remdesivir, ivermectin, chloroquine, hydroxychloroquine, nafamostat, interferon-β and HCQ from repurposing libraries, some iron chelators and traditional medicines. This review represents a model for further translational studies for effective anti-CoV therapeutic designs.
Fulltext Development and Validation of a Questionnaire Assessing the Perception and Practice of Workplace Violence Prevention Among Employers at Healthcare Facilities in North-Eastern Malaysia

Mohamad Yazid MN, Nik Husain NR, Daud A, Osman Y, Mustapa N, Abdul Hadi A

Cureus, 2023 Jan;15(1):e34046.
PMID: 36824545 DOI: 10.7759/cureus.34046

Introduction Healthcare workers have been suffering from workplace violence in alarming numbers, showing the importance of its prevention initiative. This study aims to develop and validate a new questionnaire to assess the perception and practice scores of workplace violence prevention among employers at healthcare facilities. Methods Existing literature has been reviewed to establish the domains and refine the items. The first drafted domain was the perception constructed by six components and 59 items. The second drafted domain was practice, consisting of six components and 41 items. Content validation was measured by a panel of experts using the item-level content validity index (I-CVI). Then, face validation analysis was carried out among 10 healthcare employers and presented as the item-level face validity index (I-FVI). Lastly, 222 participants were recruited to determine the validity and reliability of the questionnaire by using an exploratory factor analysis (EFA) and internal consistency reliability. Results Following content validation, two items in the practice domain were removed because of the I-CVI below 0.78. The I-CVI values of the remaining items for both domains were above 0.78, indicating good relevancy of 59 items to assess the perception and 39 items to evaluate the practice domains. The I-FVI values for both domains were above 0.80, suggesting that the participants easily understood the questionnaire. Bartlett's test of sphericity was significant for both domains (p<0.001). The Kaiser-Meyer-Olkin measure was 0.879 for the perception domain and 0.941 for the practice domain. All items load above 0.6 in their respective factor. In addition, Cronbach's alpha coefficient of reliability test ranged from 0.71 to 0.92 and from 0.82 to 0.97 for the perception and practice domains, respectively. The final revised questionnaire consisted of nine components (35 items) for perception and four components (27 items) for practice. Conclusion The newly developed set of questionnaires is a valid and reliable tool to assess the perception and practice of workplace violence prevention among employers at healthcare facilities.
Fulltext Perineum Spindle Cell Sarcoma in Neurofibromatosis Type 1

Sandrasecra S, Vasan S, Henry F, Abdullah S, Hashim MNM, Merican SRHI, et al.

Oman Med J, 2023 Jan;38(1):e471.
PMID: 36825248 DOI: 10.5001/omj.2023.08

Soft tissue neoplasm is common among patients with neurofibromatosis type 1 (NF-1). We present a case of a middle-aged woman with NF-1 who presented with a painless, insidiously increasing perineal mass for the past eight months. She underwent colonoscopy, computed tomography staging, magnetic resonance imaging of the pelvis, core-needle biopsy, and later wide local excision of left perineum swelling. Histopathological examination showed a high-grade spindle cell sarcoma, which is a rare association among NF-1. Spindle cell sarcoma is a group of malignant soft tissue tumors with locally destructive growth with spindle-shaped neoplastic cells. The solitary spindle cell sarcoma of the perineum is rare, and wide local resection with a clear margin is the only treatment at present-the scarcely available evidence limiting the use of adjuvant chemotherapy, immunotherapy, and radiotherapy.
Fulltext Evaluation of end-of-life vehicle recycling system in India in responding to the sustainability paradigm: an explorative study

Molla AH, Shams H, Harun Z, Kasim ANC, Nallapaneni MK, Rahman MNA

Sci Rep, 2023 Mar 13;13(1):4169.
PMID: 36914813 DOI: 10.1038/s41598-023-30964-7

The growing number of end-of-life vehicles (ELVs) engenders a genuine concern for achieving sustainable development. Properly recycling ELV is paramount to checking pollution, reducing landfills, and conserving natural resources. The present study evaluates the sustainability of India's ELV recycling system from techno-socio-economic and environmental aspects as an instrumental step for assessing performance and progress. This investigation has performed the Strength-Weakness-Opportunity-Threat (SWOT) analysis to evaluate ELV recycling in the long-term viability and examine the critical factors and potential. This research makes practical recommendations for effectively encountering persistent challenges in the ELV recycling system based on Indian values. This research adopts an explorative and Integrated bottom-up mixed approach; it interfaces qualitative and quantitative data and secondary research. This study reveals that the social, economic, technological, and environmental aspects of the sustainability of India's ELV recycling system are comparatively limited. The SWOT analysis demonstrates that potential market size and resource recovery are more significant strengths, whereas lack of an appropriate framework and limited technology are major challenges in the recycling of ELVs in India. Sustainable development and economic viability have emerged as great opportunities, while informality and environmental impact have surfaced as primary potential threats to ELV recycling in India. This paper offers insights and yields critical real-world data that may assist in rational decision-making and developing and implementing any subsequent framework.
Molecular modelling and structure-activity relationship of a natural derivative of o-hydroxybenzoate as a potent inhibitor of dual NSP3 and NSP12 of SARS-CoV-2: in silico study

Ayipo YO, Ahmad I, Najib YS, Sheu SK, Patel H, Mordi MN

J Biomol Struct Dyn, 2023 Mar;41(5):1959-1977.
PMID: 35037841 DOI: 10.1080/07391102.2022.2026818

The nsp3 macrodomain and nsp12 (RdRp) enzymes are strongly implicated in the virulent regulation of the host immune response and viral replication of SARS-CoV-2, making them plausible therapeutic targets for mitigating infectivity. Remdesivir remains the only FDA-approved small-molecule inhibitor of the nsp12 in clinical conditions while none has been approved yet for the nsp3 macrodomain. In this study, 69,067 natural compounds from the IBScreen database were screened for efficacious potentials with mechanistic multitarget-directed inhibitory pharmacology against the dual targets using in silico approaches. Standard and extra precision (SP and XP) Maestro glide docking analyses were employed to evaluate their inhibitory interactions against the enzymes. Four compounds, STOCK1N-45901, 03804, 83408, 08377 consistently showed high XP scores against the respective targets and interacted strongly with pharmacologically essential amino acid and RNA residues, in better terms than the standard, co-crystallized inhibitors, GS-441524 and remdesivir. Further assessments through the predictions of ADMET and mutagenicity distinguished STOCK1N-45901, a natural derivative of o-hydroxybenzoate as the most promising candidate. The ligand maintained a good conformational and thermodynamic stability in complex with the enzymes throughout the trajectories of 100 ns molecular dynamics, indicated by RMSD, RMSF and radius of gyration plots. Its binding free energy, MM-GBSA was recorded as -54.24 and -31.77 kcal/mol against the respective enzyme, while its structure-activity relationships confer high probabilities as active antiviral, anti-inflammatory, antiinfection, antitussive and peroxidase inhibitor. The IBScreen database natural product, STOCK1N-45901 (2,3,4,5,6-pentahydroxyhexyl o-hydroxybenzoate) is thus recommended as a potent inhibitor of dual nsp3 and nsp12 of SARS-CoV-2 for further study. Communicated by Ramaswamy H. Sarma.
Fulltext In Vitro antioxidant and xanthine oxidase inhibitory activities of methanolic Swietenia mahagoni seed extracts

Sahgal G, Ramanathan S, Sasidharan S, Mordi MN, Ismail S, Mansor SM

Molecules, 2009 Nov 06;14(11):4476-85.
PMID: 19924080 DOI: 10.3390/molecules14114476

This study examines the in vitro antioxidant activities of the methanol extract of Swietenia mahagoni seeds (SMCM seed extract). The extract was screened for possible antioxidant activities by free radical scavenging activity (DPPH), xanthine oxidase inhibition (XOI), hydrogen peroxide scavenging activity (HPSA) and ferric-reducing antioxidant power (FRAP) assays. The total phenolic and flavonoid contents were also determined. The extract exhibits antioxidant activity of 23.29% with an IC(50 )value of 2.3 mg/mL in the DPPH radical scavenging method, 47.2% in the XOI assay, 49.5% by the HPSA method, and 0.728 mmol/Fe(II)g in the FRAP method at the concentration tested. The amount of total phenolics and flavonoid contents was 70.83 mg gallic acid equivalent (GAE) and 2.5 +/- 0.15 mg of catechin equivalent per gram of dry extract, respectively. High Performance Thin Layer Chromatography (HPTLC) screening indicates the presence of phenolic compounds in the SMCM seed extract. The results indicate that the extract has both high free radical scavenging and xanthine oxidase inhibition activity. The antioxidant activity of SMCM seed extract is comparable with that of other Malaysian tropical fruits and herbal plants.
Computational modelling of potential Zn-sensitive non-β-lactam inhibitors of imipenemase-1 (IMP-1)

Ayipo YO, Ahmad I, Alananzeh W, Lawal A, Patel H, Mordi MN

J Biomol Struct Dyn, 2023 Nov;41(19):10096-10116.
PMID: 36476097 DOI: 10.1080/07391102.2022.2153168

Antibiotic resistance (AR) remains one of the leading global health challenges, mostly implicated in disease-related deaths. The Enterobacteriaceae-producing metallo-β-lactamases (MBLs) are critically involved in AR pathogenesis through Zn-dependent catalytic destruction of β-lactam antibiotics, yet with limited successful clinical inhibitors. The efficacy of relevant broad-spectrum β-lactams including imipenem and meropenem are seriously challenged by their susceptibility to the Zn-dependent carbapenemase hydrolysis, as such, searching for alternatives remains imperative. In this study, computational molecular modelling and virtual screening methods were extensively applied to identify new putative Zn-sensitive broad-spectrum inhibitors of MBLs, specifically imipenemase-1 (IMP-1) from the IBScreen database. Three ligands, STOCK3S-30154, STOCK3S-30418 and STOCK3S-30514 selectively displayed stronger binding interactions with the enzymes compared to reference inhibitors, imipenem and meropenem. For instance, the ligands showed molecular docking scores of -9.450, -8.005 and -10.159 kcal/mol, and MM-GBSA values of -40.404, -31.902 and -33.680 kcal/mol respectively against the IMP-1. Whereas, imipenem and meropenem showed docking scores of -9.038 and -10.875 kcal/mol, and MM-GBSA of -31.184 and -32.330 kcal/mol respectively against the enzyme. The ligands demonstrated good thermodynamic stability and compactness in complexes with IMP-1 throughout the 100 ns molecular dynamics (MD) trajectories. Interestingly, their binding affinities and stabilities were significantly affected in contacts with the remodelled Zn-deficient IMP-1, indicating sensitivity to the carbapenemase active Zn site, however, with non-β-lactam scaffolds, tenable to resist catalytic hydrolysis. They displayed ideal drug-like ADMET properties, thus, representing putative Zn-sensitive non-β-lactam inhibitors of IMP-1 amenable for further experimental studies.

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