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Effect of Artocarpus integer lectin on functional activity of guinea-pig complement

Hashim OH, Gendeh GS, Cheong CN, Jaafar MI

Immunol Invest, 1994 Mar;23(2):153-60.
PMID: 8194855

The effect of Artocarpus integer lectin (lectin C) on the functional activity of guinea-pig complement was investigated. Purified and crude extract of lectin C from six cultivars of Artocarpus integer seeds were found to consume complement and thus decreased the complement-induced haemolytic activity of sensitized sheep erythrocytes. The change in the complement-mediated haemolytic activity was significantly decreased when incubation of the lectins was performed in the presence of melibiose. The reversal effect of the carbohydrate, which is a potent inhibitor of the lectin's binding to O-linked oligosaccharides of glycoprotein, demonstrate involvement of the lectins interaction with O-glycans of glycoproteins in the consumption of guinea-pig complement.
Fulltext Effectiveness of preoxygenation during endotracheal intubation in a head-elevated position: a systematic review and meta-analysis of randomized controlled trials

Hung Tsan S, Viknaswaran N, Lau J, Cheong C, Wang C

Anaesthesiol Intensive Ther, 2022;54(5):413-424.
PMID: 36734452 DOI: 10.5114/ait.2022.123197

Preoxygenation during endotracheal intubation is important to ensure the safety of the procedure. This systematic review and meta-analysis aimed to evaluate the efficacy of preoxygenation in the head-elevated position as compared to the supine position. The Medline, PubMed, Scopus, Embase, and CENTRAL databases were searched systematically from inception of the study until 29 June 2021. Only randomized controlled trials (RCTs) were included. The Cochrane Risk of Bias Assessment Tool and GRADE assessment of certainty of evidence were used. Seven RCTs (n = 508) were analysed, of which 6 were included in the meta-analysis (n = 227). Six studies were carried out in the operating theatre (OT), while one was performed in the critical care (ICU) setting. Compared to the supine position, the head-elevated position significantly increased the duration of the safe apnoea period (mean difference 61.99 s; 95% confidence interval 42.93-81.05 s; P < 0.00001; I2 = 30%; certainty of evidence = high). This improvement was seen in both the obese and non-obese population (I2 = 0%). No differences were seen between both groups with regard to recovery time after apnoea, arterial oxygen tension after preoxygenation, and the incidence of adverse events. In the ICU setting, no difference was found between groups for the incidence of hypoxaemia and the lowest oxygen saturation between induction and after intubation. This meta-analysis demonstrated that the head-elevated position significantly improved the efficacy of preoxygenation during elective intubation in the OT. Clinicians should consider the head-elevated position as a starting intubating position for all patients undergoing anaesthesia in view of its many benefits and the lack of proven adverse consequences. Protocol Registration: This systematic review was registered prospectively in PROSPERO (CRD42019128962).
Smoking status and its relationship with depression among the elderly population in Malaysia: Findings from the National Health and Morbidity Survey 2018

Ariaratnam S, Kee CC, Krishnapillai AD, Sanaudi R, Tohit NM, Ho KB, et al.

Tob Induc Dis, 2023;21:109.
PMID: 37654502 DOI: 10.18332/tid/169682

INTRODUCTION: Literature exploring smoking status and its association with depression among the elderly population using nationwide data in Malaysia is limited. Hence, a nationwide survey to determine the prevalence of smoking and depression among the elderly (aged ≥60 years) population was undertaken.
METHODS: This secondary dataset analysis used data from the National Health and Morbidity Survey (NHMS) 2018. Data from 3914 participants were collected on elderly health in the Malaysian population. Sociodemographic characteristics were recorded. Smoking status was grouped as current smokers, former smokers, and non-smokers. A validated Malay language version of the Geriatric Depression Scale (M-GDS-14) was used to screen for depression among the elderly.
RESULTS: There was a significant association between smoking status with location, gender, employment status, marital status, ethnicity, education level, income, and depression. Current smokers are significantly higher in rural than urban areas. Among depressed participants, 65.7%, 17.1% and 17.2% were non-smokers, former smokers and current smokers, respectively. Multiple logistic regression showed that single (unmarried/separated/ divorced/widowed) participants were more likely to be depressed compared to married participants (AOR=1.68; 95% CI: 1.16-2.43). Whilst unemployed participants were more likely to be depressed than those who were employed (AOR=1.72; 95% CI: 1.22-2.44). Other Bumiputras were more likely to have depression compared to Malay, Chinese and Indian participants. Participants without formal education were more likely to be depressed compared to those having tertiary education. These participants have a 2-fold increased risk of depression (AOR=2.13; 95% CI: 1.02-4.45). Participants whose monthly salaries were <2000 MYR (AOR=3.67; 95% CI: 1.84-7.31) and 1000-1999 MYR (AOR=2.71; 95% CI: 1.23-5.94) were more likely to have depression compared with those who had received ≥3000 MYR. Ever smokers were more likely to be depressed than non-smokers (AOR=1.68; 95% CI: 1.23-2.29).
CONCLUSIONS: Elderly Malaysians are indeed at risk of developing depression particularly if they had ever smoked. Public health awareness and campaigning are pertinent to disseminate these outcomes in order to spread the awareness associated with smoking-related depression.
Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis

Tsan SEH, Viknaswaran NL, Cheong CC, Cheah S, Ng KT, Mong SXY, et al.

Anaesthesia, 2023 Sep;78(9):1153-1161.
PMID: 37314744 DOI: 10.1111/anae.16058

Tranexamic acid is an antifibrinolytic drug that is widely used during surgery, but there are concerns about its thromboembolic effects. We aimed to investigate the effect of prophylactic intravenous tranexamic acid on thromboembolic outcomes in patients undergoing non-cardiac surgery. The MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched. Randomised controlled trials comparing intravenous tranexamic acid with placebo or no treatment in patients undergoing non-cardiac surgery were included. The primary outcome was a composite of peri-operative cardiovascular thromboembolic events, defined as any deep vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or cerebral ischaemia/infarction. A total of 191 randomised controlled trials (40,621 patients) were included in the review. The primary outcome occurred in 4.5% of patients receiving intravenous tranexamic acid compared with 4.9% of patients in the control group. Our analysis showed that there was no difference between groups for composite cardiovascular thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65, I2 0%, n = 37,512). This finding remained robust when sensitivity analysis was performed with continuity correction and in studies with a low risk of bias. However, in trial sequential analysis, our meta-analysis only achieved 64.6% of the required information size. There was no association between intravenous tranexamic acid and seizure rate or mortality rate within 30 days. Intravenous tranexamic acid was associated with a reduced blood transfusion rate compared with control (9.9% vs. 19.4%, risk ratio 0.46, 95%CI 0.41-0.51, p