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Fulltext Internet addiction among secondary school students in Klang Valley, Malaysia: what is the association with depressive symptoms, anxiety symptoms, and selfesteem?

Abdul Aziz, M., Wan Ismail W.S., Bahar N., Mahadevan R., Azhar Shah S.

International Medical Journal Malaysia, 2018;17(2):17-26.
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Introduction: Internet addiction is becoming a global problem and has been associated with mental health issues such as depression and anxiety. There is a strong need for local research, given the recent rise of mental health issues amongst children and adolescents in Malaysia, as well as lack of research in this field locally. Methods: This study assessed the prevalence of internet addiction, and its association with internetrelated factors, depressive symptoms, anxiety symptoms, and self-esteem, amongst selected secondary school students in the Klang Valley, Malaysia. In a cross-sectional study, 199 adolescents were conveniently chosen from six randomly selected secondary schools within Klang Valley. Subjects completed a demographic questionnaire, as well as Malay versions of the Internet Addiction Test (MVIAT), Children’s Depression Inventory (CDI), Depression Anxiety Stress Scales-21 anxiety subscale (DASS-21) and Rosenberg Self-Esteem Scale (RSES). Multiple logistic regression analysis was carried out. Results: This study found that 49.2% of students were addicted to the internet. Significant factors associated with internet addiction were spending longer hours online during the holidays (OR 1.20, CI 1.01-1.35), easy access to a computer (OR 4.01, CI 1.50 - 10.76), confiding on the internet (OR 4.07, CI 1.49-11.13), severe level of anxiety (OR 3.63, CI 1.04-12.73) and high depression scores (OR 1.10, CI 1.01-1.20). Contrary to previous studies, self-esteem was not found to be significantly associated with internet addiction. Conclusion: This study has important implications in relation to clinical practice, research, and policy-making in Malaysia.
Fulltext Generalized epilepsy with febrile seizure plus (GEFS+) spectrum: Novel de novo mutation of SCN1A detected in a Malaysian patient

Tan EH, Yusoff AA, Abdullah JM, Razak SA

J Pediatr Neurosci, 2012 May;7(2):123-5.
PMID: 23248692 DOI: 10.4103/1817-1745.102575

In this report, we describe a 15-year-old Malaysian male patient with a de novo SCN1A mutation who experienced prolonged febrile seizures after his first seizure at 6 months of age. This boy had generalized tonic clonic seizure (GTCS) which occurred with and without fever. Sequencing analysis of voltage-gated sodium channel a1-subunit gene, SCN1A, confirmed a homozygous A to G change at nucleotide 5197 (c.5197A > G) in exon 26 resulting in amino acid substitution of asparagines to aspartate at codon 1733 of sodium channel. The mutation identified in this patient is located in the pore-forming loop of SCN1A and this case report suggests missense mutation in pore-forming loop causes generalized epilepsy with febrile seizure plus (GEFS+) with clinically more severe neurologic phenotype including intellectual disabilities (mental retardation and autism features) and neuropsychiatric disease (anxiety disorder).
The oral and intratracheal toxicities of ROUNDUP and its components to rats

Adam A, Marzuki A, Abdul Rahman H, Abdul Aziz M

Vet Hum Toxicol, 1997 Jun;39(3):147-51.
PMID: 9167243

The toxicities of ROUNDUP and its component chemicals, glyphosate (N-phosphonomethylglycine) and polyoxyethyleneamine (POEA), were determined at 0, 1, 3, 6 and 24 h following administration to rats. The intratracheal administration of glyphosate (0.2 g/kg), POEA (0.1 g/kg), a mixture of glyphosate (0.2 g/kg) + POEA (0.1 g/kg), or ROUNDUP (containing 0.2 g/kg glyphosate and 0.1 g/kg POEA) elicited immediate respiratory effects which were more severe and which lasted longer in the groups receiving the POEA-containing preparations than in the glyphosate alone group. By 1 h, all test preparations had caused deaths, but more occurred from the POEA-containing preparations than from glyphosate. The po administration of POEA (1 g/kg), the mixture of glyphosate (2 g/kg) +POEA (1 g/kg), or ROUNDUP (containing 2 g/kg glyphosate and 1 g/kg POEA) produced diarrhea and blood-stained weeping from noses. Death was only seen from POEA at 24 h. Glyphosate (2 g/kg po) produced transient diarrhea without nose bleeds; POEA caused diarrhea at 1 h; and the mixture of POEA + glyphosate produced diarrhea later that increased in severity with time. Bloody nose secretions were seen only with the preparations that contained POEA. No deaths, respiratory effects or bloody nose secretions occurred in controls given saline. Both POEA and glyphosate caused lung hemorrhages and lung epithelial cell damage with po or intratracheal exposures. These results indicate POEA and preparations that contained POEA were more toxic than glyphosate.
Aerobic treatment of palm oil mill effluent

Vijayaraghavan K, Ahmad D, Ezani Bin Abdul Aziz M

J Environ Manage, 2007 Jan;82(1):24-31.
PMID: 16584834

In this study treatment of palm oil mill effluent (POME) was investigated using aerobic oxidation based on an activated sludge process. The effects of sludge volume index, scum index and mixed liquor suspended solids during the acclimatizing phase and biomass build-up phase were investigated in order to ascertain the reactor stability. The efficiency of the activated sludge process was evaluated by treating anaerobically digested and diluted raw POME obtained from Golden Hope Plantations, Malaysia. The treatment of POME was carried out at a fixed biomass concentration of 3900+/-200mg/L, whereas the corresponding sludge volume index was found to be around 105+/-5mL/g. The initial studies on the efficiency of the activated sludge reactor were carried out using diluted raw POME for varying the hydraulic retention time, viz: 18, 24, 30 and 36h and influent COD concentration, viz: 1000, 2000, 3000, 4000 and 5000mg/L, respectively. The results showed that at the end of 36h of hydraulic retention time for the above said influent COD, the COD removal efficiencies were found to be 83%, 72%, 64%, 54% and 42% whereas at 24h hydraulic retention time they were 57%, 45%, 38%, 30% and 27%, respectively. The effectiveness of aerobic oxidation was also compared between anaerobically digested and diluted raw POME having corresponding CODs of 3908 and 3925mg/L, for varying hydraulic retention time, viz: 18, 24, 30, 36, 42, 48, 54 and 60h. The dissolved oxygen concentration and pH in the activated sludge reactor were found to be 1.8-2.2mg/L and 7-8.5, respectively. The scum index was found to rise from 0.5% to 1.9% during the acclimatizing phase and biomass build-up phase.
Fulltext Determination of the Small-Field Output Factor for 6 MV Photon Beam Using EGSnrc Monte Carlo

Chuah KW, Abdul Aziz MZ, Jayamani J

J Med Phys, 2022;47(3):301-308.
PMID: 36684700 DOI: 10.4103/jmp.jmp_40_22

Accuracy of ionization chamber (IC) to measure the scatter output factor (Scp) of a linear accelerator (linac) is crucial, especially in small field (<4 cm × 4 cm). The common IC volume of 0.6 cc is not adequate for small-field measurement and not all radiotherapy centers can afford to purchase additional IC due to the additional cost. This study aimed to determine the efficiency of the EGSnrc Monte Carlo (MC) to calculate the Scp for various field sizes including small field in Elekta Synergy (Agility multileaf collimator) linac. The BEAMnrc and DOSXYZnrc user codes were used to simulate a 6 MV linac model for various field sizes and calculate the radiation dose output in water phantom. The modeled linac treatment head was validated by comparing the percentage depth dose (PDD), beam profile, and beam quality (Tissue Phantom Ratio (TPR)20,10) with the IC measurement. The validated linac model was simulated to calculate the Scp consisting of collimator scatter factor (Sc) and phantom scatter factor (Sp). The PDD and beam profile of the simulated field sizes were within a good agreement of ±2% compared with the measured data. The TPR20,10 value was 0.675 for field size 10 cm × 10 cm. The Scp, Sc, and Sp simulated values were close to the IC measurement within ±2% difference. The simulation for Sc and Sp in 3 cm × 3 cm field size was calculated to be 0.955 and 0.884, respectively. In conclusion, this study validated the efficiency of the MC simulation as a promising tool for the Scp calculation including small-field size for linac.
Fulltext Adult entero-enteric intussusception secondary to lipoma

Hanafiah M, Abdul Aziz M, Rusli SM

Clin Case Rep, 2019 Nov;7(11):2267-2268.
PMID: 31788299 DOI: 10.1002/ccr3.2460

Diagnostic imaging methods are normally required to make the preoperative diagnosis of adult intussusception. Furthermore, it helps to define the location and nature of the associated mass as lead point if present. Lipoma may appear as lesion of fat attenuation expressed in Hounsfield unit on CT scan.
Influenza B outbreak in female psychiatric ward of Hospital Kuala Lumpur, Malaysia

Mohamad Isa MF, Tan JM, Abdul Aziz MF, Leong CL

Med J Malaysia, 2018 12;73(6):405-406.
PMID: 30647214

Influenza outbreaks in tropical countries are rarely reported. This article reports four cases of influenza within a psychiatric ward of a tertiary hospital in Malaysia. These were patients with severe mental illness who were involuntarily admitted and did not show the classical triad of influenza-like-illness (ILI) at the beginning. However, severe respiratory complications developed requiring intubation. Referral and cooperation with the infectious disease team was initiated to help manage the outbreak while continuing psychiatric treatment. Incidences of influenza among hospitalised psychiatric patients should be treated seriously with immediate multidisciplinary approach to prevent severe unwanted complications.
Fulltext Periadrenal inflammatory myofibroblastic tumour: half a decade before cure

Abdul Ghani R, Mohamed Shah FZ, Hanafiah M, Abdul Aziz M

BMJ Case Rep, 2019 Feb 01;12(2).
PMID: 30709882 DOI: 10.1136/bcr-2018-225687

A 30-year-old ex-smoker with a background history of childhood asthma presented with worsening shortness of breath despite receiving high doses of oral corticosteroid for pemphigus vulgaris which was diagnosed 5 years earlier. A high-resolution CT examination of the thorax reported non-specific bronchiectatic changes and revealed an incidental suprarenal mass. A subsequent CT scan confirmed a large adrenal mass with areas of necrosis and calcification. Serum renin and aldosterone, urinary catecholamine and 5-hydroxyindoleacetic acid were within normal limits. Surgical intervention was delayed due to difficulty in optimising preoperative respiratory functions. He finally underwent a midline laparotomy for removal of the tumour. Histopathological examinations revealed extrapulmonary inflammatory myofibroblastic tumour arising from the periadrenal soft-tissue, with presence of normal adrenal gland. He showed immediate improvements of his asthmatic symptoms and pemphigus vulgaris following the surgery. His oral steroid was rapidly reduced and he achieved complete remission 2 months later.
Oil palm EgCBF3 conferred stress tolerance in transgenic tomato plants through modulation of the ethylene signaling pathway

Ebrahimi M, Abdullah SN, Abdul Aziz M, Namasivayam P

J Plant Physiol, 2016 Sep 01;202:107-20.
PMID: 27513726 DOI: 10.1016/j.jplph.2016.07.001

CBF/DREB1 is a group of transcription factors that are mainly involved in abiotic stress tolerance in plants. They belong to the AP2/ERF superfamily of plant-specific transcription factors. A gene encoding a new member of this group was isolated from ripening oil palm fruit and designated as EgCBF3. The oil palm fruit demonstrates the characteristics of a climacteric fruit like tomato, in which ethylene has a major impact on the ripening process. A transgenic approach was used for functional characterization of the EgCBF3, using tomato as the model plant. The effects of ectopic expression of EgCBF3 were analyzed based on expression profiling of the ethylene biosynthesis-related genes, anti-freeze proteins (AFPs), abiotic stress tolerance and plant growth and development. The EgCBF3 tomatoes demonstrated altered phenotypes compared to the wild type tomatoes. Delayed leaf senescence and flowering, increased chlorophyll content and abnormal flowering were the consequences of overexpression of EgCBF3 in the transgenic tomatoes. The EgCBF3 tomatoes demonstrated enhanced abiotic stress tolerance under in vitro conditions. Further, transcript levels of ethylene biosynthesis-related genes, including three SlACSs and two SlACOs, were altered in the transgenic plants' leaves and roots compared to that in the wild type tomato plant. Among the eight AFPs studied in the wounded leaves of the EgCBF3 tomato plants, transcript levels of SlOSM-L, SlNP24, SlPR5L and SlTSRF1 decreased, while expression of the other four, SlCHI3, SlPR1, SlPR-P2 and SlLAP2, were up-regulated. These findings indicate the possible functions of EgCBF3 in plant growth and development as a regulator of ethylene biosynthesis-related and AFP genes, and as a stimulator of abiotic stress tolerance.
Fulltext A novel strain of acetic acid bacteria Gluconobacter oxydans FBFS97 involved in riboflavin production

Noman AE, Al-Barha NS, Sharaf AM, Al-Maqtari QA, Mohedein A, Mohammed HHH, et al.

Sci Rep, 2020 08 11;10(1):13527.
PMID: 32782276 DOI: 10.1038/s41598-020-70404-4

A novel bacterial strain of acetic acid bacteria capable of producing riboflavin was isolated from the soil sample collected in Wuhan, China. The isolated strain was identified as Gluconobacter oxydans FBFS97 based on several phenotype characteristics, biochemicals tests, and 16S rRNA gene sequence conducted. Furthermore, the complete genome sequencing of the isolated strain has showed that it contains a complete operon for the biosynthesis of riboflavin. In order to obtain the maximum concentration of riboflavin production, Gluconobacter oxydans FBFS97 was optimized in shake flask cultures through response surface methodology employing Plackett-Burman design (PBD), and Central composite design (CCD). The results of the pre-experiments displayed that fructose and tryptone were found to be the most suitable sources of carbon and nitrogen for riboflavin production. Then, PBD was conducted for initial screening of eleven minerals (FeSO4, FeCl3, KH2PO4, K2HPO4, MgSO4, ZnSO4, NaCl, CaCl2, KCl, ZnCl2, and AlCl3.6H2O) for their significances on riboflavin production by Gluconobacter oxydans strain FBFS97. The most significant variables affecting on riboflavin production are K2HPO4 and CaCl2, the interaction affects and levels of these variables were optimized by CCD. After optimization of the medium compositions for riboflavin production were determined as follows: fructose 25 g/L, tryptone 12.5 g/L, K2HPO4 9 g/L, and CaCl2 0.06 g/L with maximum riboflavin production 23.24 mg/L.
Improvement of tissue culture, genetic transformation, and applications of biotechnology to Brassica

Ravanfar SA, Orbovic V, Moradpour M, Abdul Aziz M, Karan R, Wallace S, et al.

Biotechnol Genet Eng Rev, 2017 Apr;33(1):1-25.
PMID: 28460558 DOI: 10.1080/02648725.2017.1309821

Development of in vitro plant regeneration method from Brassica explants via organogenesis and somatic embryogenesis is influenced by many factors such as culture environment, culture medium composition, explant sources, and genotypes which are reviewed in this study. An efficient in vitro regeneration system to allow genetic transformation of Brassica is a crucial tool for improving its economical value. Methods to optimize transformation protocols for the efficient introduction of desirable traits, and a comparative analysis of these methods are also reviewed. Hence, binary vectors, selectable marker genes, minimum inhibitory concentration of selection agents, reporter marker genes, preculture media, Agrobacterium concentration and regeneration ability of putative transformants for improvement of Agrobacterium-mediated transformation of Brassica are discussed.
Dose perturbation effects by metal hip prosthesis in gynaecological 192Ir HDR brachytherapy

Ab Shukor NS, Abdullah R, Abdul Aziz MZ, Samson DO, Musarudin M

Appl Radiat Isot, 2023 Jun;196:110751.
PMID: 36871495 DOI: 10.1016/j.apradiso.2023.110751

The present study was conducted to elucidate the effects of hip prostheses in 192Ir HDR brachytherapy and determine dose uncertainties introduced by the treatment planning. A gynaecological phantom irradiated using Nucletron 192Ir microSelectron HDR source was modeled using MCNP5 code. Three hip materials considered in this study were water, bone, and metal prosthesis. According to the obtained results, a dose perturbation was observed within the medium with a higher atomic number, which reduced the dose to the nearby region.
Fulltext The effects of trans fat diet intake on metabolic parameters and pancreatic tissue in offspring of prenatal bisphenol A exposed rats

Abulehia H, Mohd Nor NS, Sheikh Abdul Kadir SH, Abdul Aziz M, Zulkifli S

Sci Rep, 2023 Jun 08;13(1):9322.
PMID: 37291156 DOI: 10.1038/s41598-023-36043-1

Bisphenol A (BPA) is a plasticiser used in the manufacturing of many products and its effects on human health remain controversial. Up till now, BPA involvement in metabolic syndrome risk and development is still not fully understood. In this study, we aimed to investigate the effect of prenatal BPA exposure with postnatal trans-fat diet intake on metabolic parameters and pancreatic tissue histology. Eighteen pregnant rats were divided into control (CTL), vehicle tween 80 (VHC), and BPA (5 mg/kg/day) from gestational day (GD) 2 until GD 21, then their weaning rat's offspring were fed with normal diet (ND) or trans-fat diet (TFD) from postnatal week (PNW) 3 until PNW 14. The rats were then sacrificed and the blood (biochemical analysis) and pancreatic tissues (histological analysis) were collected. Glucose, insulin, and lipid profile were measured. The study has shown that there was no significant difference between groups with regard to glucose, insulin, and lipid profiles (p > 0.05). All pancreatic tissues showed normal architecture with irregular islets of Langerhans in TFD intake groups compared to offspring that consumed ND. Furthermore, the pancreatic histomorphometry was also affected whereby the study findings revealed that there was a significant increase in the mean number of pancreatic islets in rats from BPA-TFD group (5.987 ± 0.3159 islets/field, p = 0.0022) compared to those fed with ND and BPA non-exposed. In addition, the results have found that prenatal BPA exposure resulted in a significant decrease in the pancreatic islets diameter of the BPA-ND group (183.3 ± 23.28 µm, p = 0.0022) compared to all other groups. In conclusion, prenatal BPA exposure with postnatal TFD in the offspring may affect glucose homeostasis and pancreatic islets in adulthood, and the effect may be more aggravated in late adulthood.
The relations of internet and smartphone addictions to depression, anxiety, stress, and suicidality among public university students in Klang Valley, Malaysia

Wan Ismail WS, Sim ST, Tan KA, Bahar N, Ibrahim N, Mahadevan R, et al.

Perspect Psychiatr Care, 2020 Oct;56(4):949-955.
PMID: 32363648 DOI: 10.1111/ppc.12517

PURPOSE: This cross-sectional study examined the cyber-psychological correlates of depression, anxiety, stress, and suicidality among public university students in Klang Valley, Malaysia.
DESIGN AND METHODS: Participants were randomly selected using multi-stage sampling methods from three public universities in the study location. Participants completed measures of internet and smartphone addictions, depression, anxiety, stress, and suicidality, along with sociodemographic items.
FINDINGS: At bivariate level, both internet and smartphone addictions were found to have significant positive correlations with depression, anxiety, stress, and suicidality. At multivariate level, only internet addiction emerged as a consistent significant predictor for depression, anxiety, stress, and suicidality.
PRACTICE IMPLICATIONS: The present findings have implications for mental health professionals to routinely screen for psychological disturbance in young adults who have potential risks for internet addiction.
3D Flower-Like FeWO4/CeO2 Hierarchical Architectures on rGO for Durable and High-Performance Microalgae Biophotovoltaic Fuel Cells

Karthikeyan C, Jenita Rani G, Ng FL, Periasamy V, Pappathi M, Jothi Rajan M, et al.

Appl Biochem Biotechnol, 2020 Nov;192(3):751-769.
PMID: 32557232 DOI: 10.1007/s12010-020-03352-4

A facile chemical reduction approach is adopted for the synthesis of iron tungstate (FeWO4)/ceria (CeO2)-decorated reduced graphene oxide (rGO) nanocomposite. Surface morphological studies of rGO/FeWO4/CeO2 composite reveal the formation of hierarchical FeWO4 flower-like microstructures on rGO sheets, in which the CeO2 nanoparticles are decorated over the FeWO4 microstructures. The distinct anodic peaks observed for the cyclic voltammograms of studied electrodes under light/dark regimes validate the electroactive proteins present in the microalgae. With the cumulative endeavors of three-dimensional FeWO4 microstructures, phase effect between rGO sheet and FeWO4/CeO2, highly exposed surface area, and light harvesting property of CeO2 nanoparticles, the relevant rGO/FeWO4/CeO2 nanocomposite demonstrates high power and stable biophotovoltaic energy generation compared with those of previous reports. Thus, these findings construct a distinct horizon to tailor a ternary nanocomposite with high electrochemical activity for the construction of cost-efficient and environmentally benign fuel cells.
Fulltext Are Malaysian Youths Overdependent on the Internet?: A Narrative Review

Nik Jaafar NR, Bahar N, Ibrahim N, Baharudin A, Wan Ismail WS, Sim ST, et al.

Front Psychiatry, 2021;12:710790.
PMID: 34484002 DOI: 10.3389/fpsyt.2021.710790

Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.
The Dual Systems Model-Impulsivity and Narcissism as the Reflexive System and Self-Regulation as the Reflective System-of Smartphone Addiction

Tan KA, Nik Jaafar NR, Bahar N, Ibrahim N, Baharudin A, Wan Ismail WS, et al.

Cyberpsychol Behav Soc Netw, 2024 Feb;27(2):156-162.
PMID: 38232711 DOI: 10.1089/cyber.2023.0337

The exploration of underlying mechanisms leading to the development of smartphone addiction has been limited, with only a few studies incorporating theories to provide explanations. Drawing upon the Dual Systems Model, this study tested the hypothesis that the reflective system of self-regulation would mediate the relation between the reflexive system of impulsivity and narcissism, and smartphone addiction in a sample of 298 undergraduate students. Participants completed a self-administrated web-based questionnaire containing measures of impulsivity (the Barratt Impulsiveness Scale), narcissism (the Narcissistic Personality Inventory), self-regulation (the Self-Regulation Scale), and smartphone addiction (the Smartphone Addiction Inventory). The findings from structural equation modeling revealed that self-regulation served as a significant mediator between impulsivity and smartphone addiction, as well as between narcissism and smartphone addiction. These findings offer insights that can contribute to the development of interventions and strategies that target impulsivity and narcissism by enhancing self-regulation skills.
Fulltext Untargeted serum metabolites profiling in high-fat diet mice supplemented with enhanced palm tocotrienol-rich fraction using UHPLC-MS

Goon DE, Ab-Rahim S, Mohd Sakri AH, Mazlan M, Tan JK, Abdul Aziz M, et al.

Sci Rep, 2021 10 25;11(1):21001.
PMID: 34697380 DOI: 10.1038/s41598-021-00454-9

Excessive high fat dietary intake promotes risk of developing non-alcoholic fatty liver disease (NAFLD) and predisposed with oxidative stress. Palm based tocotrienol-rich fraction (TRF) has been reported able to ameliorate oxidative stress but exhibited poor bioavailability. Thus, we investigated whether an enhanced formulation of TRF in combination with palm kernel oil (medium-chain triglycerides) (ETRF) could ameliorate the effect of high-fat diet (HFD) on leptin-deficient male mice. All the animals were divided into HFD only (HFD group), HFD supplemented with ETRF (ETRF group) and HFD supplemented with TRF (TRF group) and HFD supplemented with PKO (PKO group). After 6 weeks, sera were collected for untargeted metabolite profiling using UHPLC-Orbitrap MS. Univariate analysis unveiled alternation in metabolites for bile acids, amino acids, fatty acids, sphingolipids, and alkaloids. Bile acids, lysine, arachidonic acid, and sphingolipids were downregulated while xanthine and hypoxanthine were upregulated in TRF and ETRF group. The regulation of these metabolites suggests that ETRF may promote better fatty acid oxidation, reduce oxidative stress and pro-inflammatory metabolites and acts as anti-inflammatory in fatty liver compared to TRF. Metabolites regulated by ETRF also provide insight of its role in fatty liver. However, further investigation is warranted to identify the mechanisms involved.
Pleural fluid residue as a diagnostic tool for cytology-negative malignant pleural effusion: A proof-of-concept study

Nyanti LE, Huan NC, Ramarmurty HY, Renganathan T, Bin Abdul Aziz MA, Low JL, et al.

Afr J Thorac Crit Care Med, 2023;29(4):e1149.
PMID: 38239775 DOI: 10.7196/AJTCCM.2023.v29i4.1149

BACKGROUND: Pleural fluid residue, or macroscopic tissue, circulating freely in the pleural fluid obtained through direct filtration, may carry diagnostic histopathological information. We aimed to determine the histopathological concordance of pleural fluid residue in diagnosing TPE and MPE, compared with conventional pleural biopsy. This was a prospective cohort study of consecutive inpatients with cytology-negative exudative effusion who underwent pleuroscopy and had their initial suctioned pleural fluid filtered for residue samples. Pleural fluid residue demonstrated malignant cells in four out of seven cases of pleural biopsy-confirmed malignancy. Pleural fluid residue has comparable cytomorphology but reduced cellularity compared with pleural biopsy. No tuberculous histological features were present in the pleural fluid residue samples. In this preliminary study pleural fluid residue provided histopathological information for malignant pleural effusion, but no incremental diagnostic information for tuberculous effusion. However larger and more definitive studies are required to clarify these findings, and to explore the utility and suitability of pleural fluid residue for mutational analysis.
WHAT THE STUDY ADDS: This study demonstrates the potential of pleural fluid residue as a non-invasive diagnostic method for confirming malignancy in cytology-negative exudative effusion.
WHAT ARE THE IMPLICATIONS OF THE FINDINGS: In resource-limited settings or patients contraindicated for pleural biopsy, pleural fluid residue may provide a viable diagnostic alternative; however, this observation needs further validation.

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