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Fulltext Heavy metals (mercury, arsenic, cadmium, plumbum) in selected marine fish and shellfish along the Straits of Malacca

Alina, M., Azrina, A., Mohd Yunus, A.S., Mohd Zakiuddin, S., Mohd Izuan Effendi, H., Muhammad Rizal, R.

International Food Research Journal, 2012;19(1):135-140.
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Level of heavy metals in marine ecosystem has been intensively studied during recent years as these hazardous substances could be accumulated in the biota. Generally, the presence of contaminants in fish is a result of human activities such as industrial and agricultural wastes. In this study, the marine fish and shellfish from the Straits of Malacca were analyzed using Inductively Coupled Plasma Optical Emission Spectrophotometer (ICP-OES) and Flow Injection Mercury System (FIMS) for Cd, As and Pb and Hg, respectively. The Straits of Malacca is one of the busiest shipping routes in the world that make the level of heavy metals potentially high besides the various industrial activities along the west region of Peninsular Malaysia. The range of heavy metals in samples were 1.0-3-6.5-3 µg/ g wet sample for Hg, 0.5-2-47-2 µg/ g wet sample for Cd, 0.01-0.39 µg/ g wet sample for Pb and 0.14-6.57 µg/ g wet sample for As. Most part of the values was below the permitted limit set by FAO/WHO 2004 as well as Food Act 1983 and Food Regulations 1985. Therefore it can be generalized that fish and shellfish from the Straits of Malacca are safe to consume in terms of these heavy metals concentrationand do not constitute a risk for human health.
The thermoluminescence characteristics and the glow curves of Thulium doped silica fiber exposed to 10MV photon and 21MeV electron radiation

Alawiah A, Alina MS, Bauk S, Abdul-Rashid HA, Gieszczyk W, Noramaliza MN, et al.

Appl Radiat Isot, 2015 Apr;98:80-6.
PMID: 25644081 DOI: 10.1016/j.apradiso.2015.01.016

The thermoluminescence (TL) glow curves and kinetics parameters of Thulium (Tm) doped silica cylindrical fibers (CF) are presented. A linear accelerator (LINAC) was used to deliver high-energy radiation of 21MeV electrons and 10MV photons. The CFs were irradiated in the dose range of 0.2-10Gy. The experimental glow curve data was reconstructed by using WinREMS. The WinGCF software was used for the kinetic parameters evaluation. The TL sensitivity of Tm-doped silica CF is about 2 times higher as compared to pure silica CF. Tm-doped silica CF seems to be more sensitive to 21MeV electrons than to 10MV photons. Surprisingly, no supralinearity was displayed and a sub-linear response of Tm-doped silica CF was observed within the analyzed dose range for both 21MeV electrons and 10MV photons. The Tm-doped silica CF glow curve consists of 5 individual glow peaks. The Ea of peak 4 and peak 5 was highly dependent on dose when irradiated with photons. We also noticed that the electron radiation (21MeV) caused a shift of glow peak by 7-13°C to the higher temperature region compared with photons radiation (10MV). Our Tm-doped fibers seem to give high TL response after 21MeV electrons, which gives around 2 times higher peak integral as compared with 10MV photon radiation. We concluded that peak 4 is the first-order kinetic peak and can be used as the main dosimetric peak of Tm-doped silica CF.
Genotyping of Malaysian G6PD-deficient neonates by reverse dot blot flow-through hybridisation

Alina MF, Azma RZ, Norunaluwar J, Azlin I, Darnina AJ, Cheah FC, et al.

J Hum Genet, 2020 Mar;65(3):263-270.
PMID: 31863082 DOI: 10.1038/s10038-019-0700-7

G6PD deficiency is the commonest enzyme deficiency found in humans. Current diagnostic methods lack sensitivity to detect all cases of G6PD deficiency. We evaluated the reverse dot blot flow-through hybridisation assay designed to detect simultaneously multiple known G6PD mutations in a group of Malaysian neonates. Archival DNA samples from 141 G6PD-deficient neonates were subjected to reverse dot blot flow-through hybridisation assay using the GenoArray Diagnostic Kit (Hybribio Limited, Hong Kong) and DNA sequencing. The method involved PCR amplification of 5 G6PD exons using biotinylated primers, hybridisation of amplicons to a membrane containing oligoprobes designed for G6PD mutations known to occur in the Malaysian population and colour detection by enzyme immunoassay. The assay detected 13 of the 14 G6PD mutations and genotyped 133 (94.3%) out of 141 (102 males, 39 females) cases. Among the 39 female G6PD-deficient neonates, there were 7 homozygous and 6 compound heterozygous cases. The commonest alleles were G6PD Viangchan 871G > A (21%) and G6PD Mahidol 487G > A(20%) followed by G6PD Mediterranean 563C > T, (14%), G6PD Vanua Lava 383T > C (12%), G6PD Canton 1376G > T (10%), G6PD Orissa 131C > G (6.3%) G6PD Coimbra 592C > T (5.6%) plus 6 other mutations. DNA sequencing of remaining cases revealed 6 cases of intron 11 nt 93C > T not previously reported in Malaysia and two novel mutations, one case each of nt 1361G > T and nt 1030G > A. We found the reverse dot blot assay easy to perform, rapid, accurate and reproducible, potentially becoming an improved diagnostic test for G6PD deficiency.
Correction to 'Genotyping of Malaysian G6PD-deficient neonates by reverse dot blot flow-through hybridisation'

Alina MF, Azma RZ, Norunaluwar J, Azlin I, Darnina AJ, Cheah FC, et al.

J Hum Genet, 2020 07;65(7):635.
PMID: 32385338 DOI: 10.1038/s10038-020-0766-2

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Global survey of stigma among physicians and patients with nonalcoholic fatty liver disease

Younossi ZM, Alqahtani SA, Alswat K, Yilmaz Y, Keklikkiran C, Funuyet-Salas J, et al.

J Hepatol, 2024 Mar;80(3):419-430.
PMID: 37984709 DOI: 10.1016/j.jhep.2023.11.004

BACKGROUND & AIMS: Patients with fatty liver disease may experience stigma from the disease or comorbidities. In this cross-sectional study, we aimed to understand stigma among patients with nonalcoholic fatty liver disease (NAFLD)/nonalcoholic steatohepatitis (NASH) and healthcare providers.
METHODS: Members of the Global NASH Council created two surveys about experiences/attitudes toward NAFLD and related diagnostic terms: a 68-item patient and a 41-item provider survey.
RESULTS: Surveys were completed by 1,976 patients with NAFLD across 23 countries (51% Middle East/North Africa [MENA], 19% Europe, 17% USA, 8% Southeast Asia, 5% South Asia) and 825 healthcare providers (67% gastroenterologists/hepatologists) across 25 countries (39% MENA, 28% Southeast Asia, 22% USA, 6% South Asia, 3% Europe). Of all patients, 48% ever disclosed having NAFLD/NASH to family/friends; the most commonly used term was "fatty liver" (88% at least sometimes); "metabolic disease" or "MAFLD" were rarely used (never by >84%). Regarding various perceptions of diagnostic terms by patients, there were no substantial differences between "NAFLD", "fatty liver disease (FLD)", "NASH", or "MAFLD". The most popular response was being neither comfortable nor uncomfortable with either term (56%-71%), with slightly greater discomfort with "FLD" among the US and South Asian patients (47-52% uncomfortable). Although 26% of patients reported stigma related to overweight/obesity, only 8% reported a history of stigmatization or discrimination due to NAFLD. Among providers, 38% believed that the term "fatty" was stigmatizing, while 34% believed that "nonalcoholic" was stigmatizing, more commonly in MENA (43%); 42% providers (gastroenterologists/hepatologists 45% vs. 37% other specialties, p = 0.03) believed that the name change to metabolic dysfunction-associated steatotic liver disease (or MASLD) might reduce stigma. Regarding the new nomenclature, the percentage of providers reporting "steatotic liver disease" as stigmatizing was low (14%).
CONCLUSIONS: The perception of NAFLD stigma varies among patients, providers, geographic locations and sub-specialties.
IMPACT AND IMPLICATIONS: Over the past decades, efforts have been made to change the nomenclature of nonalcoholic fatty liver disease (NAFLD) to better align with its underlying pathogenetic pathways and remove any potential stigma associated with the name. Given the paucity of data related to stigma in NAFLD, we undertook this global comprehensive survey to assess stigma in NAFLD among patients and providers from around the world. We found there is a disconnect between physicians and patients related to stigma and related nomenclature. With this knowledge, educational programs can be developed to better target stigma in NAFLD among all stakeholders and to provide a better opportunity for the new nomenclature to address the issues of stigma.
The impact of stigma on quality of life and liver disease burden among patients with nonalcoholic fatty liver disease

Younossi ZM, AlQahtani SA, Funuyet-Salas J, Romero-Gómez M, Yilmaz Y, Keklikkiran C, et al.

JHEP Rep, 2024 Jul;6(7):101066.
PMID: 39022387 DOI: 10.1016/j.jhepr.2024.101066

BACKGROUND & AIMS: Patients with nonalcoholic fatty liver disease (NAFLD)/metabolic dysfunction-associated steatotic liver disease (MASLD) face a multifaceted disease burden which includes impaired health-related quality of life (HRQL) and potential stigmatization. We aimed to assess the burden of liver disease in patients with NAFLD and the relationship between experience of stigma and HRQL.
METHODS: Members of the Global NASH Council created a survey about disease burden in NAFLD. Participants completed a 35-item questionnaire to assess liver disease burden (LDB) (seven domains), the 36-item CLDQ-NASH (six domains) survey to assess HRQL and reported their experience with stigmatization and discrimination.
RESULTS: A total of 2,117 patients with NAFLD from 24 countries completed the LDB survey (48% Middle East and North Africa, 18% Europe, 16% USA, 18% Asia) and 778 competed CLDQ-NASH. Of the study group, 9% reported stigma due to NAFLD and 26% due to obesity. Participants who reported stigmatization due to NAFLD had substantially lower CLDQ-NASH scores (all p <0.0001). In multivariate analyses, experience with stigmatization or discrimination due to NAFLD was the strongest independent predictor of lower HRQL scores (beta from -5% to -8% of score range size, p <0.02). Experience with stigmatization due to obesity was associated with lower Activity, Emotional Health, Fatigue, and Worry domain scores, and being uncomfortable with the term "fatty liver disease" with lower Emotional Health scores (all p <0.05). In addition to stigma, the greatest disease burden as assessed by LDB was related to patients' self-blame for their liver disease.
CONCLUSIONS: Stigmatization of patients with NAFLD, whether it is caused by obesity or NAFLD, is strongly and independently associated with a substantial impairment of their HRQL. Self-blame is an important part of disease burden among patients with NAFLD.
IMPACT AND IMPLICATIONS: Patients with nonalcoholic fatty liver disease (NAFLD), recently renamed metabolic dysfunction-associated steatotic liver disease (MASLD), may experience impaired health-related quality of life and stigmatization. Using a specifically designed survey, we found that stigmatization of patients with NAFLD, whether it is caused by obesity or the liver disease per se, is strongly and independently associated with a substantial impairment of their quality of life. Physicians treating patients with NAFLD should be aware of the profound implications of stigma, the high prevalence of self-blame in the context of this disease burden, and that providers' perception may not adequately reflect patients' perspective and experience with the disease.