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Comparison of antimicrobial resistance in neonatal and adult intensive care units in a tertiary teaching hospital

Ariffin N, Hasan H, Ramli N, Ibrahim NR, Taib F, Rahman AA, et al.

Am J Infect Control, 2012 Aug;40(6):572-5.
PMID: 22854380 DOI: 10.1016/j.ajic.2012.02.032

Intrahospital variations in antimicrobial profiles may be related to many factors. This study compared causative agents of nosocomial bloodstream infections between a neonatal intensive care unit (NICU) that adopted a ward-tailored antibiotic policy and adult intensive care units (ICUs). Data on organisms from blood cultures obtained from the respective wards between 2005 and 2009 were analyzed. Compared with the adult ICUs, the NICU had a higher frequency of Enterobacteriacae and lower frequencies of typical hospital-acquired pathogens (eg, Klebsiella pneumoniae, 17.4% vs 10.0% [P < .001]; Acinetobacter baumannii, 3.9% vs 11.6% [P < .001]). Antibiotic resistance of gram-negative organisms was also significantly lower in the NICU, including resistance to imipenem (5.7% vs 32.1%; P < .001), amikacin (8.8% vs 30.3%), and ceftriaxone (36.1% vs 74.6%; P < .001). This could possibly be due to the ward-tailored antibiotic policy adopted by the NICU but not by the other ICUs.
Frequencies of A(TA)7TAA, G71R, and G493R mutations of the UGT1A1 gene in the Malaysian population

Yusoff S, Van Rostenberghe H, Yusoff NM, Talib NA, Ramli N, Ismail NZ, et al.

Biol. Neonate, 2006;89(3):171-6.
PMID: 16210851

Gilbert syndrome is caused by defects in the uridine diphosphate glucuronosyltransferase 1A1 (UGT1A1) gene. These mutations differ among different populations and many of them have been found to be genetic risk factors for the development of neonatal jaundice.
Fulltext Pulchrin A, a New Natural Coumarin Derivative of Enicosanthellum pulchrum, Induces Apoptosis in Ovarian Cancer Cells via Intrinsic Pathway

Nordin N, Fadaeinasab M, Mohan S, Mohd Hashim N, Othman R, Karimian H, et al.

PLoS One, 2016;11(5):e0154023.
PMID: 27136097 DOI: 10.1371/journal.pone.0154023

Drug resistance presents a challenge in chemotherapy and has attracted research interest worldwide and particular attention has been given to natural compounds to overcome this difficulty. Pulchrin A, a new compound isolated from natural products has demonstrated novel potential for development as a drug. The identification of pulchrin A was conducted using several spectroscopic techniques such as nuclear magnetic resonance, liquid chromatography mass spectrometer, infrared and ultraviolet spectrometry. The cytotoxicity effects on CAOV-3 cells indicates that pulchrin A is more active than cisplatin, which has an IC50 of 22.3 μM. Significant changes in cell morphology were present, such as cell membrane blebbing and formation of apoptotic bodies. The involvement of phosphatidylserine (PS) in apoptosis was confirmed by Annexin V-FITC after a 24 h treatment. Apoptosis was activated through the intrinsic pathway by activation of procaspases 3 and 9 as well as cleaved caspases 3 and 9 and ended at the executioner pathway, with the occurrence of DNA laddering. Apoptosis was further confirmed via gene and protein expression levels, in which Bcl-2 protein was down-regulated and Bax protein was up-regulated. Furthermore, the CAOV-3 cell cycle was disrupted at the G0/G1 phase, leading to apoptosis. Molecular modeling of Bcl-2 proteins demonstrated a high- binding affinity, which inhibited the function of Bcl-2 proteins and led to cell death. Results of the current study can shed light on the development of new therapeutic agents, particularly, human ovarian cancer treatments.
Fulltext Usage of traditional and complementary medicine (T & CM): Prevalence, practice and perception among post stroke patients attending conventional stroke rehabilitation in a teaching hospital in Malaysia

Ali MF, Abdul Aziz AF, Rashid MR, Che Man Z, Amir AA, Lim YS, et al.

Med J Malaysia, 2015 Feb;70(1):18-23.
PMID: 26032524

INTRODUCTION: The lack of evidence that proves the benefit of traditional and complementary medicines (T & CM) in treating chronic medical conditions does not deter its usage among patients worldwide. Prevalence of usage among post-stroke patients in Malaysia especially is unknown. This study aims to determine the prevalence, practice and perception of T & CM use among stroke survivors attending an outpatient rehabilitation program in a teaching hospital.
METHODS: A cross-sectional study was conducted among 104 post stroke patients attending an outpatient rehabilitation program. A structured self-administered questionnaire was used to collect data on sociodemographic and clinical profile of patients, as well as types of therapy used and perception on T & CM usage. Descriptive analysis was done, and bivariate analysis was used to determine associations between categorical data.
RESULTS: Mean age of patients was 62 years (SD 12.2), 54% were Chinese and 75% of the patients had ischaemic stroke. Mean age of T & CM users was younger compared to non- T & CM users (61 years vs. 66 years, p=0.04). Two-thirds (66%) of patients admitted to concurrent T & CM usage while attending conventional post stroke rehabilitation. Acupuncture (40.4%), massage (40.4%) and traditional Chinese medicine (11.5%) were the most common T & CM used. Positive perception was recorded in terms of ability of T & CM usage to relieve post stroke symptoms (68%), and it was safe to use because it was made from 'natural sources'. Negative perception recorded: T & CM caused significant adverse effects (57.6%) and was not safe to be used in combination with other conventional medicines (62.5%).
CONCLUSIONS: Concurrent T & CM usage among post-stroke patients attending structured outpatient rehabilitation program is widely practised especially acupuncture, massage and traditional Chinese medicines. Overall the perception towards its use is favourable.
Study site: Medical Rehabilitation Services Department, Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Fulltext Combined Optimization of Codon Usage and Glycine Supplementation Enhances the Extracellular Production of a β-Cyclodextrin Glycosyltransferase from Bacillus sp. NR5 UPM in Escherichia coli

Nik-Pa NIM, Sobri MFM, Abd-Aziz S, Ibrahim MF, Kamal Bahrin E, Mohammed Alitheen NB, et al.

Int J Mol Sci, 2020 May 30;21(11).
PMID: 32486212 DOI: 10.3390/ijms21113919

Two optimization strategies, codon usage modification and glycine supplementation, were adopted to improve the extracellular production of Bacillus sp. NR5 UPM β-cyclodextrin glycosyltransferase (CGT-BS) in recombinant Escherichia coli. Several rare codons were eliminated and replaced with the ones favored by E. coli cells, resulting in an increased codon adaptation index (CAI) from 0.67 to 0.78. The cultivation of the codon modified recombinant E. coli following optimization of glycine supplementation enhanced the secretion of β-CGTase activity up to 2.2-fold at 12 h of cultivation as compared to the control. β-CGTase secreted into the culture medium by the transformant reached 65.524 U/mL at post-induction temperature of 37 °C with addition of 1.2 mM glycine and induced at 2 h of cultivation. A 20.1-fold purity of the recombinant β-CGTase was obtained when purified through a combination of diafiltration and nickel-nitrilotriacetic acid (Ni-NTA) affinity chromatography. This combined strategy doubled the extracellular β-CGTase production when compared to the single approach, hence offering the potential of enhancing the expression of extracellular enzymes, particularly β-CGTase by the recombinant E. coli.
Adult-onset neuronal intranuclear inclusion disease mimicking Fragile X-associated tremor-ataxia syndrome in ethnic Chinese patients

Lim SY, Ishiura H, Ramli N, Shibata S, Almansour MA, Tan AH, et al.

Parkinsonism Relat Disord, 2020 05;74:25-27.
PMID: 32289521 DOI: 10.1016/j.parkreldis.2020.03.025

Two ethnic Chinese men with clinico-radiologic features of Fragile X-associated tremor-ataxia syndrome (FXTAS) were found on genetic testing to have neuronal intranuclear inclusion disease (NIID), highlighting that NIID should be considered in the differential diagnosis of FXTAS. NIID may also be much more common than FXTAS in certain Asian populations.
A one-step self-sustained low temperature carbonization of coconut shell biomass produced a high specific surface area biochar-derived nano-adsorbent

Samsudin MH, Hassan MA, Idris J, Ramli N, Mohd Yusoff MZ, Ibrahim I, et al.

Waste Manag Res, 2019 May;37(5):551-555.
PMID: 30727859 DOI: 10.1177/0734242X18823953

A one-step self-sustained carbonization of coconut shell biomass, carried out in a brick reactor at a relatively low temperature of 300-500°C, successfully produced a biochar-derived adsorbent with 308 m2/g surface area, 2 nm pore diameter, and 0.15 cm3/g total pore volume. The coconut shell biochar qualifies as a nano-adsorbent, supported by scanning electron microscope images, which showed well-developed nano-pores on the surface of the biochar structure, even though there was no separate activation process. This is the first report whereby coconut shell can be converted to biochar-derived nano-adsorbent at a low carbonization temperature, without the need of the activation process. This is superior to previous reports on biochar produced from oil palm empty fruit bunch.
Microstructural Integrity of Peripheral Nerves in Charcot-Marie-Tooth Disease: An MRI Evaluation Study

Cheah PL, Krisnan T, Wong JHD, Rozalli FI, Fadzli F, Rahmat K, et al.

J Magn Reson Imaging, 2021 02;53(2):437-444.
PMID: 32918328 DOI: 10.1002/jmri.27354

BACKGROUND: Charcot-Marie-Tooth (CMT) disease is diagnosed through clinical findings and genetic testing. While there are neurophysiological tools and clinical functional scales in CMT, objective disease biomarkers that can facilitate in monitoring disease progression are limited.
PURPOSE: To investigate the utility of diffusion tensor imaging (DTI) in determining the microstructural integrity of sciatic and peroneal nerves and its correlation with the MRI grading of muscle atrophy severity and clinical function in CMT as determined by the CMT neuropathy score (CMTNS).
STUDY TYPE: Prospective case-control.
SUBJECTS: Nine CMT patients and nine age-matched controls.
FIELD STRENGTH/SEQUENCE: 3 T T1 -weighted in-/out-of phase spoiled gradient recalled echo (SPGR) and DTI sequences.
ASSESSMENT: Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) values for sciatic and peroneal nerves were obtained from DTI. Muscle atrophy was graded according to the Goutallier classification using in-/out-of phase SPGRs. DTI parameters and muscle atrophy grades were compared between CMT and controls, and the relationship between DTI parameters, muscle atrophy grades, and CMTNS were assessed.
STATISTICAL TESTS: The Wilcoxon Signed Ranks test was used to compare DTI parameters between CMT and controls. The relationship between DTI parameters, muscle atrophy grades, and CMTNS were analyzed using the Spearman correlation. Receiver operating characteristic (ROC) analyses of DTI parameters that can differentiate CMT from healthy controls were done.
RESULTS: There was a significant reduction in FA and increase in RD of both nerves (P
Optic Canal Analysis in Syndromic Craniosynostosis: Volumetric and Surface Area Validation Study Using Different Measurement Modalities

Hariri F, Zainudin NAA, Anuar AMS, Ibrahim N, Abdullah NA, Aziz IA, et al.

J Craniofac Surg, 2020 11 7;32(1):355-359.
PMID: 33156163 DOI: 10.1097/SCS.0000000000006981

BACKGROUND: In syndromic craniosynostosis (SC), unlike persistent corneal irritation due to severe exophthalmos and increased intracranial pressure, optic canal (OC) stenosis has been scarcely reported to cause visual impairment. This study aimed to validate the OC volumetric and surface area measurement among SC patients.
METHODS: Sixteen computed tomography scan of SC patients (8 months-6 years old) were imported to Materialise Interactive Medical Image Control System (MIMICS) and Materialise 3-matics software. Three-dimensional (3D) OC models were fabricated, and linear measurements were obtained. Mathematical formulas were used for calculation of OC volume and surface area from the 3D model. The same measurements were obtained from the software and used as ground truth. Data normality was investigated before statistical analyses were performed. Wilcoxon test was used to validate differences of OC volume and surface area between 3D model and software.
RESULTS: The mean values for OC surface area for 3D model and MIMICS software were 103.19 mm2 and 31.27 mm2, respectively, whereas the mean for OC volume for 3D model and MIMICS software were 184.37 mm2 and 147.07 mm2, respectively. Significant difference was found between OC volume (P = 0.0681) and surface area (P = 0.0002) between 3D model and software.
CONCLUSION: Optic canal in SC is not a perfect conical frustum thus making 3D model measurement and mathematical formula for surface area and volume estimation not ideal. Computer software remains the best modality to gauge dimensional parameter and is useful to elucidates the relationship of OC and eye function as well as aiding intervention in SC patients.
Fulltext Missense Mutation of Brain Derived Neurotrophic Factor (BDNF) Alters Neurocognitive Performance in Patients with Mild Traumatic Brain Injury: A Longitudinal Study

Narayanan V, Veeramuthu V, Ahmad-Annuar A, Ramli N, Waran V, Chinna K, et al.

PLoS One, 2016;11(7):e0158838.
PMID: 27438599 DOI: 10.1371/journal.pone.0158838

The predictability of neurocognitive outcomes in patients with traumatic brain injury is not straightforward. The extent and nature of recovery in patients with mild traumatic brain injury (mTBI) are usually heterogeneous and not substantially explained by the commonly known demographic and injury-related prognostic factors despite having sustained similar injuries or injury severity. Hence, this study evaluated the effects and association of the Brain Derived Neurotrophic Factor (BDNF) missense mutations in relation to neurocognitive performance among patients with mTBI. 48 patients with mTBI were prospectively recruited and MRI scans of the brain were performed within an average 10.1 (SD 4.2) hours post trauma with assessment of their neuropsychological performance post full Glasgow Coma Scale (GCS) recovery. Neurocognitive assessments were repeated again at 6 months follow-up. The paired t-test, Cohen's d effect size and repeated measure ANOVA were performed to delineate statistically significant differences between the groups [wildtype G allele (Val homozygotes) vs. minor A allele (Met carriers)] and their neuropsychological performance across the time point (T1 = baseline/ admission vs. T2 = 6th month follow-up). Minor A allele carriers in this study generally performed more poorly on neuropsychological testing in comparison wildtype G allele group at both time points. Significant mean differences were observed among the wildtype group in the domains of memory (M = -11.44, SD = 10.0, p = .01, d = 1.22), executive function (M = -11.56, SD = 11.7, p = .02, d = 1.05) and overall performance (M = -6.89 SD = 5.3, p = .00, d = 1.39), while the minor A allele carriers showed significant mean differences in the domains of attention (M = -11.0, SD = 13.1, p = .00, d = .86) and overall cognitive performance (M = -5.25, SD = 8.1, p = .01, d = .66).The minor A allele carriers in comparison to the wildtype G allele group, showed considerably lower scores at admission and remained impaired in most domains across the timepoints, although delayed signs of recovery were noted to be significant in the domains attention and overall cognition. In conclusion, the current study has demonstrated the role of the BDNF rs6265 Val66Met polymorphism in influencing specific neurocognitive outcomes in patients with mTBI. Findings were more detrimentally profound among Met allele carriers.
Fulltext A Patient with Beta-Propeller Protein-Associated Neurodegeneration: Treatment with Iron Chelation Therapy

Lim SY, Tan AH, Ahmad-Annuar A, Schneider SA, Bee PC, Lim JL, et al.

J Mov Disord, 2018 May;11(2):89-92.
PMID: 29860786 DOI: 10.14802/jmd.17082

We present a case of beta-propeller protein-associated neurodegeneration, a form of neurodegeneration with brain iron accumulation. The patient harbored a novel mutation in the WDR45 gene. A detailed video and description of her clinical condition are provided. Her movement disorder phenomenology was characterized primarily by limb stereotypies and gait dyspraxia. The patient's disability was advanced by the time iron-chelating therapy with deferiprone was initiated, and no clinical response in terms of cognitive function, behavior, speech, or movements were observed after one year of treatment.
Two-hourly versus 3-hourly feeding for very low birthweight infants: a randomised controlled trial

Ibrahim NR, Kheng TH, Nasir A, Ramli N, Foo JLK, Syed Alwi SH, et al.

Arch. Dis. Child. Fetal Neonatal Ed., 2017 May;102(3):F225-F229.
PMID: 27671836 DOI: 10.1136/archdischild-2015-310246

OBJECTIVE: To determine whether feeding with 2-hourly or 3-hourly feeding interval reduces the time to achieve full enteral feeding and to compare their outcome in very low birthweight preterm infants.
DESIGN: Parallel-group randomised controlled trial with a 1:1 allocation ratio.
SETTING: Two regional tertiary neonatal intensive care units.
PATIENTS: 150 preterm infants less than 35 weeks gestation with birth weight between 1.0 and 1.5 kg were recruited.
INTERVENTIONS: Infants were enrolled to either 2-hourly or 3-hourly interval feeding after randomisation. Blinding was not possible due to the nature of the intervention.
MAIN OUTCOME MEASURES: The primary outcome was time to achieve full enteral feeding (≥100 mL/kg/day). Secondary outcomes include time to regain birth weight, episode of feeding intolerance, peak serum bilirubin levels, duration of phototherapy, episode of necrotising enterocolitis, nosocomial sepsis and gastro-oesophageal reflux.
RESULTS: 72 infants were available for primary outcome analysis in each group as three were excluded due to death-three deaths in each group. The mean time to full enteral feeding was 11.3 days in the 3-hourly group and 10.2 days in the 2-hourly group (mean difference 1.1 days; 95% CI -0.4 to 2.5; p=0.14). The mean time to regain birth weight was shorter in 3-hourly group (12.9 vs 14.8 days, p=0.04). Other subgroup analyses did not reveal additional significant results. No difference in adverse events was found between the groups.
CONCLUSION: 3-hourly feeding was comparable with 2-hourly feeding to achieve full enteral feeding without any evidence of increased adverse events.
TRIAL REGISTRATION NUMBER: ACTRN12611000676910, pre-result.
Lipid Fraction Derived From MRI In- and Opposed-Phase Sequence as a Novel Biomarker for Predicting Survival Outcome of Glioma

Seow P, Narayanan V, Romelean RJ, Wong JHD, Win MT, Chandran H, et al.

Acad Radiol, 2020 02;27(2):180-187.
PMID: 31155487 DOI: 10.1016/j.acra.2019.04.015

RATIONALE AND PURPOSE: Our study evaluated the capability of magnetic resonance imaging in- and opposed-phase (IOP) derived lipid fraction as a novel prognostic biomarker of survival outcome in glioma.
MATERIALS AND METHODS: We analyzed 46 histologically proven glioma (WHO grades II-IV) patients using standard 3T magnetic resonance imaging brain tumor protocol and IOP sequence. Lipid fraction was derived from the IOP sequence signal-loss ratio. The lipid fraction of solid nonenhancing region of glioma was analyzed, using a three-group analysis approach based on volume under surface of receiver-operating characteristics to stratify the prognostic factors into three groups of low, medium, and high lipid fraction. The survival outcome was evaluated, using Kaplan-Meier survival analysis and Cox regression model.
RESULTS: Significant differences were seen between the three groups (low, medium, and high lipid fraction groups) stratified by the optimal cut-off point for overall survival (OS) (p ≤ 0.01) and time to progression (p ≤ 0.01) for solid nonenhancing region. The group with high lipid fraction had five times higher risk of poor survival and earlier time to progression compared to the low lipid fraction group. The OS plot stratified by lipid fraction also had a strong correlation with OS plot stratified by WHO grade (R = 0.61, p < 0.01), implying association to underlying histopathological changes.
CONCLUSION: The lipid fraction of solid nonenhancing region showed potential for prognostication of glioma. This method will be a useful adjunct in imaging protocol for treatment stratification and as a prognostic tool in glioma patients.
Effect of modified Otago exercises on postural balance, fear of falling, and fall risk in older fallers with knee osteoarthritis and impaired gait and balance: A secondary analysis

Mat S, Ng CT, Tan PJ, Ramli N, Fadzli F, Rozalli FI, et al.

PM R, 2018 03;10(3):254-262.
PMID: 28827207 DOI: 10.1016/j.pmrj.2017.08.405

BACKGROUND: Osteoarthritis (OA) is considered an established risk factor for falls. Published studies evaluating secondary falls prevention strategies among individuals with OA are limited.
OBJECTIVE: To evaluate the effect of a personalized home-based exercise program to improve postural balance, fear of falling, and falls risk in older fallers with knee OA and gait and balance problems.
DESIGN: Randomized controlled trial.
SETTING: University of Malaya Medical Centre.
PARTICIPANTS: Fallers who had both radiological OA and a Timed Up and Go (TUG) score of over 13.5 seconds.
MAIN OUTCOME MEASURE: Postural sway (composite sway) was quantified with the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB) under 4 different sensory conditions: eyes open on firm surface, eyes closed on firm surface, eyes open on unstable foam surface, and eyes closed on unstable foam surface. Participants were asked to stand upright and to attempt to hold their position for 10 seconds for each test condition. The average reading for all conditions were calculated.
METHODS: Participants randomized to the intervention arm received a home-based modified Otago Exercise Program (OEP) as part of a multifactorial intervention, whereas control participants received general health advice and conventional treatment. This was a secondary subgroup analysis from an original randomized controlled trial, the Malaysian Falls Assessment and Intervention Trial (MyFAIT) (trial registration number: ISRCTN11674947). Posturography using a long force plate balance platform (Balancemaster, NeuroCom, USA), the Knee injury and Osteoarthritis Outcome Score (KOOS) and the short-form Falls Efficacy Scale-International (short FES-I) were assessed at baseline and 6 months.
RESULTS: Results of 41 fallers with radiological evidence of OA and impaired TUG (intervention, 17; control, 24) were available for the final analysis. Between-group analysis revealed significant improvements in the Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), and short FES-I scores by the intervention group compared to the control group at 6 months. No significant difference in time to first fall or in fall-free survival between the intervention and control groups was found.

CONCLUSION: Home-based balance and strength exercises benefited older fallers with OA and gait and balance disorders by improving postural control, with no observable trend in reduction of fall recurrence. Our findings will now inform a future, adequately powered, randomized controlled study using fall events as definitive outcomes.

LEVEL OF EVIDENCE: I.
Fulltext Diffusion Tensor Imaging Parameters in Mild Traumatic Brain Injury and Its Correlation with Early Neuropsychological Impairment: A Longitudinal Study

Veeramuthu V, Narayanan V, Kuo TL, Delano-Wood L, Chinna K, Bondi MW, et al.

J Neurotrauma, 2015 Oct 1;32(19):1497-509.
PMID: 25952562 DOI: 10.1089/neu.2014.3750

We explored the prognostic value of diffusion tensor imaging (DTI) parameters of selected white matter (WM) tracts in predicting neuropsychological outcome, both at baseline and 6 months later, among well-characterized patients diagnosed with mild traumatic brain injury (mTBI). Sixty-one patients with mTBI (mean age=27.08; standard deviation [SD], 8.55) underwent scanning at an average of 10 h (SD, 4.26) post-trauma along with assessment of their neuropsychological performance at an average of 4.35 h (SD, 7.08) upon full Glasgow Coma Scale recovery. Results were then compared to 19 healthy control participants (mean age=29.05; SD, 5.84), both in the acute stage and 6 months post-trauma. DTI and neuropsychological measures between acute and chronic phases were compared, and significant differences emerged. Specifically, chronic-phase fractional anisotropy and radial diffusivity values showed significant group differences in the corona radiata, anterior limb of internal capsule, cingulum, superior longitudinal fasciculus, optic radiation, and genu of corpus callosum. Findings also demonstrated associations between DTI indices and neuropsychological outcome across two time points. Our results provide new evidence for the use of DTI as an imaging biomarker and indicator of WM damage occurring in the context of mTBI, and they underscore the dynamic nature of brain injury and possible biological basis of chronic neurocognitive alterations.
The effect of calcium hydroxide addition on enhancing ammonia recovery during thermophilic composting in a self-heated pilot-scale reactor

Tie HO, Che Man H, Koyama M, Syukri F, Md Yusoff F, Toda T, et al.

Waste Manag, 2023 Jul 01;166:194-202.
PMID: 37178588 DOI: 10.1016/j.wasman.2023.04.046

A modified outdoor large-scale nutrient recycling system was developed to compost organic sludge and aimed to recover clean nitrogen for the cultivation of high-value-added microalgae. This study investigated the effect of calcium hydroxide addition on enhancing NH3 recovery in a pilot-scale reactor self-heated by metabolic heat of microorganisms during thermophilic composting of dewatered cow dung. 350 kg-ww of compost was prepared at the ratio of 5: 14: 1 (dewatered cowdung: rice husk: compost-seed) in a 4 m3 cylindrical rotary drum composting reactor for 14 days of aerated composting. High compost temperature up to 67 °C was observed from day 1 of composting, proving that thermophilic composting was achieved through the self-heating process. The temperature of compost increases as microbial activity increases and temperature decreases as organic matter decreases. The high CO2 evolution rate on day 0-2 (0.02-0.08 mol/min) indicated that microorganisms are most active in degrading organic matter. The increasing conversion of carbon demonstrated that organic carbon was degraded by microbial activity and emitted as CO2. The nitrogen mass balance revealed that adding calcium hydroxide to the compost and increasing the aeration rate on day 3 volatilized 9.83 % of the remaining ammonium ions in the compost, thereby improving the ammonia recovery. Moreover, Geobacillus was found to be the most dominant bacteria under elevated temperature that functions in the hydrolysis of non-dissolved nitrogen for better NH3 recovery. The presented results show that by thermophilic composting 1 ton-ds of dewatered cowdung for NH3 recovery, up to 11.54 kg-ds of microalgae can be produced.
Fulltext Indications, Measurements, and Complications of Ten Essential Neonatal Procedures

Zubi ZBH, Abdullah AFB, Helmi MABM, Hasan TH, Ramli N, Ali AABM, et al.

Int J Pediatr, 2023;2023:3241607.
PMID: 37705709 DOI: 10.1155/2023/3241607

About 10% of newborns require some degree of assistance to begin their breathing, and 1% necessitates extensive resuscitation. Sick neonates are exposed to a number of invasive life-saving procedures as part of their management, either for investigation or for treatment. In order to support the neonates with the maximum possible benefits and reduce iatrogenic morbidity, health-care providers performing these procedures must be familiar with their indications, measurements, and potential complications. Hence, the aim of this review is to summarise ten of the main neonatal intensive care procedures with highlighting of their indications, measurements, and complications. They include the umbilical venous and arterial catheterizations and the intraosseous line which represent the principal postnatal emergency vascular accesses; the peripherally inserted central catheter for long-term venous access; the endotracheal tube and laryngeal mask airway for airway control and ventilation; chest tube for drainage of air and fluid from the thorax; and the nasogastric/orogastric tube for enteral feeding. Furthermore, lumber puncture and heel stick were included in this review as very important and frequently performed diagnostic procedures in the neonatal intensive care unit.
Fulltext Dynamics of Microbial Populations Responsible for Biodegradation during the Full-Scale Treatment of Palm Oil Mill Effluent

Mohd-Nor D, Ramli N, Sharuddin SS, Hassan MA, Mustapha NA, Ariffin H, et al.

Microbes Environ, 2019 Jun 27;34(2):121-128.
PMID: 30905894 DOI: 10.1264/jsme2.ME18104

Despite efforts to address the composition of the microbial community during the anaerobic treatment of palm oil mill effluent (POME), its composition in relation to biodegradation in the full-scale treatment system has not yet been extensively examined. Therefore, a thorough analysis of bacterial and archaeal communities was performed in the present study using MiSeq sequencing at the different stages of the POME treatment, which comprised anaerobic as well as facultative anaerobic and aerobic processes, including the mixed raw effluent (MRE), mixing pond, holding tank, and final discharge phases. Based on the results obtained, the following biodegradation processes were suggested to occur at the different treatment stages: (1) Lactobacillaceae (35.9%) dominated the first stage, which contributed to high lactic acid production; (2) the higher population of Clostridiaceae in the mixing pond (47.7%) and Prevotellaceae in the holding tank (49.7%) promoted acetic acid production; (3) the aceticlastic methanogen Methanosaetaceae (0.6-0.8%) played a role in acetic acid degradation in the open digester and closed reactor for methane generation; (4) Syntrophomonas (21.5-29.2%) appeared to be involved in the degradation of fatty acids and acetic acid by syntrophic cooperation with the hydrogenotrophic methanogen, Methanobacteriaceae (0.6-1.3%); and (5) the phenols and alcohols detected in the early phases, but not in the final discharge phase, indicated the successful degradation of lignocellulosic materials. The present results contribute to a better understanding of the biodegradation mechanisms involved in the different stages of the full-scale treatment of POME.
Fulltext The Challenges and Future Perspective of Woven Kenaf Reinforcement in Thermoset Polymer Composites in Malaysia: A Review

Lee CH, Khalina A, Nurazzi NM, Norli A, Harussani MM, Rafiqah SA, et al.

Polymers (Basel), 2021 Apr 25;13(9).
PMID: 33922885 DOI: 10.3390/polym13091390

In this review, the challenges faced by woven kenaf thermoset polymer composites in Malaysia were addressed with respect to three major aspects: woven kenaf reinforcement quality, Malaysian citizen awareness of woven kenaf thermoset composite products, and government supports. Kenaf plantations were introduced in Malaysia in the last two decades, but have generally not produced much kenaf composite product that has been widely accepted by the public. However, woven kenaf fiber enhances the thermoset composites to a similar degree or better than other natural fibers, especially with respect to impact resistance. Woven kenaf composites have been applied in automotive structural studies in Malaysia, yet they are still far from commercialization. Hence, this review discusses the kenaf fiber woven in Malaysia, thermoset and bio-based thermoset polymers, thermoset composite processing methods and, most importantly, the challenges faced in Malaysia. This review sets guidelines, provides an overview, and shares knowledge as to the potential challenges currently faced by woven kenaf reinforcements in thermoset polymer composites, allowing researchers to shift their interests and plans for conducting future studies on woven kenaf thermoset polymer composites.
Integrated nutrient recycling: Ammonia recovery from thermophilic composting of shrimp aquaculture sludge via self-heated bench-scale reactor and mango plant growth enhancement by the compost

Tie HO, Che Man H, Koyama M, Syukri F, Md Yusoff F, Toda T, et al.

Waste Manag, 2024 May 15;180:55-66.
PMID: 38520898 DOI: 10.1016/j.wasman.2024.03.021

Due to the rapid growth of the aquaculture industry, large amounts of organic waste are released into nature and polluted the environment. Traditional organic waste treatment such as composting is a time-consuming process that retains the ammonia (NH3) in the compost, and the compost produced has little economic value as organic fertilizer. Illegal direct discharge into the environment is therefore widespread. This study investigates the recovery of NH3 through thermophilic composting of shrimp aquaculture sludge (SAS) and its application as a soil conditioner for the growth of mango plants. A maximum composting temperature of 57.10 °C was achieved through self-heating in a 200 L bench-scale reactor, resulting in NH3 recovery of 224.04 mol/ton-ds after 14 days. The addition of calcium hydroxide and increased aeration have been shown to increase NH3 volatilization. The recovered NH3 up to 3 kg-N can be used as a source of clean nitrogen for high-value microalgae cultivation, with a theoretical yield of up to 34.85 kg-algae of microalgae biomass from 1 ton-ds of SAS composting. Despite the high salinity, SAS compost improved mango plant growth and disease resistance. These results highlight the potential of SAS compost as a sustainable source of clean nitrogen for microalgae cultivation and soil conditioner, contributing to a waste-free circular economy through nutrient recycling and sustainable agriculture.

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