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Childhood-Onset Systemic Lupus Erythematosus Presenting With Concomitant Gastrointestinal Manifestation and Antiphospholipid Syndrome

Mohd Shukri ND, Wan Mohamad WM, Wan Ab Rahman WS

Cureus, 2023 Nov;15(11):e49205.
PMID: 38024034 DOI: 10.7759/cureus.49205

Childhood-onset systemic lupus erythematosus is a rare disease that is more prevalent in Southeast Asian children than in Western children. It is characterised by a peripubertal onset and a female predominance that rises with age. Haematological, renal, and mucocutaneous are among the frequently involved organs upon diagnosis. Some of the typical symptoms include cutaneous vasculitis, malar rash, and fever. Patients frequently had proliferative class IV lupus nephritis, which increases disease activity and kidney damage. We reported a child presented with fever associated with multiple joint pain, skin rashes over the fingers of the right hand, and generalised abdominal pain.
Fulltext A fuzzy graph approach analysis for COVID-19 outbreak

Hassan N, Ahmad T, Ashaari A, Awang SR, Mamat SS, Wan Mohamad WM, et al.

Results Phys, 2021 Jun;25:104267.
PMID: 33968605 DOI: 10.1016/j.rinp.2021.104267

Complex systems require rigorous analysis using effective method, in order to handle and interpret their information. Spectrum produced from Fourier transform infrared (FTIR) instrument is an example of a complex system, due to their overlapped bands and interactions within the spectrum. Thus, chemometrics techniques are required to further analyze the data, in particular, chemometrics fuzzy autocatalytic set (c-FACS). The c-FACS is initially used to analyze the FTIR spectra of gelatins. However, in this study, the c-FACS is generalized and implemented for analysis of Coronavirus disease 2019 (Covid-19), particularly, the pandemic outbreak in Malaysia. The daily Covid-19 cases in states in Malaysia are modeled and analyzed using c-FACS, to observe the trend and severity of the disease in Malaysia. As a result, the classification of severity of zones in Malaysia are identified. The obtained results offer descriptive insight for strategizing purposes in combating the Covid-19 outbreak in Malaysia.
Fulltext Supplementation of Eurycoma longifolia Jack Extract for 6 Weeks Does Not Affect Urinary Testosterone: Epitestosterone Ratio, Liver and Renal Functions in Male Recreational Athletes

Chen CK, Mohamad WM, Ooi FK, Ismail SB, Abdullah MR, George A

Int J Prev Med, 2014 Jun;5(6):728-33.
PMID: 25013692

Background: Eurycoma longifolia Jack (ElJ) has been shown to elevate serum testosterone and increased muscle strength in humans. This study investigated the effects of Physta(®) a standardized water extract of ElJ (400 mg/day for 6 weeks) on testosterone: epitestosterone (T:E) ratio, liver and renal functions in male recreational athletes.

Methods: A total of 13 healthy male recreational athletes were recruited in this double blind, placebo-controlled, cross-over study. The participants were required to consume either 400 mg of ElJ or placebo daily for 6 weeks in the first supplementation regimen. Following a 3 week wash-out period, the participants were requested to consume the other supplement for another 6 weeks. Mid-stream urine samples and blood samples were collected prior to and after 6 weeks of supplementation with either ElJ or placebo. The urine samples were subsequently analyzed for T:E ratio while the blood samples were analyzed for liver and renal functions.

Results: T:E ratio was not significantly different following 6 weeks supplementation of either ElJ or placebo compared with their respective baseline values. Similarly, there were no significant changes in both the liver and renal functions tests following the supplementation of ElJ.

Conclusions: Supplementation of ElJ i.e. Physta(®) at a dosage of 400 mg/day for 6 weeks did not affect the urinary T:E ratio and hence will not breach any doping policies of the International Olympic Committee for administration of exogenous testosterone or its precursor. In addition, the supplementation of ElJ at this dosage and duration was safe as it did adversely affect the liver and renal functions.

Keywords: Doping; Eurycoma longifolia Jack; liver function; renal function; testosterone: epitestosterone ratio.
Effectiveness of Conventional Periodontal Treatment With Tetracycline Fiber Versus Minocycline Gel Application Subgingivally in Periodontitis Patients

Zainuddin SLA, Latib N, Taib H, Ahmad B, Sabarudin MA, Wan Mohamad WM

Cureus, 2024 Feb;16(2):e55167.
PMID: 38558744 DOI: 10.7759/cureus.55167

BACKGROUND: Locally delivered antibiotics are adjunctive therapies for the selective removal or inhibition of pathogenic microbes in combination with scaling and root planing (SRP) for the management of periodontitis.
OBJECTIVE: The primary objective of this study was to evaluate the effectiveness of tetracycline fibers against minocycline gel when used as local drug delivery in conjunction with SRP for treating periodontitis.
METHODS AND MATERIALS: This is a pilot randomized open single, blinded trial study comparing three treatment modalities: SRP with topical tetracycline fibers (SRP+T), SRP with topical minocycline HCL 2% gel (SRP+M), and SRP only as a control group. Probing pocket depth (PPD), clinical attachment loss (CAL), and bleeding on probing (BOP) percentages were recorded at baseline, one month, and at the end of three months. The data were subjected to analysis using IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. Repeated measures ANOVA was used to compare the clinical outcomes between the three treatment groups, accounting for the repeated measurements at baseline, one month, and three months. A p-value less than 0.05 at a 95% confidence interval was deemed statistically significant.
RESULTS: There were statistically significant changes within the groups in all the clinical parameters, including pocket depth, clinical attachment loss, and bleeding on probing score, at different time intervals, with the greatest mean pocket depth changes seen in the tetracycline group after one month (mean changes = 1.4 mm, P < 0.001) and over three months (mean changes = 1.79 mm, p < 0.001). For clinical attachment loss, after one month, the highest improvement in clinical level was seen in the minocycline group (mean changes = 0.7mm, p < 0.05), and the overall improvement was seen in the control group (mean changes = 1.1mm, p < 0.05). The minocycline group showed greater mean changes in bleeding on probing percentage, with the greatest changes after one month (mean changes = 19.34%, p < 0.001) and over three months (mean changes = 26.42%, p <0.001). However, there was no significant difference between the groups.
CONCLUSION: Locally delivered tetracycline and minocycline gel are effective as adjuncts to SRP and may improve the healing outcome in the management of periodontitis.
Potential and limitations of IL-37, a cytokine targeted for therapy of systemic lupus erythematosus: A Systematic Review

Mohamed Thaha UAB, Wan Mohamad WM, Nik Husain NR, Yusop N, Mohamud R, Wan Ghazali WS

Int Immunopharmacol, 2024 Nov 19;144:113597.
PMID: 39566387 DOI: 10.1016/j.intimp.2024.113597

BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by dysregulated immune responses and inflammation. Interleukin-37 (IL-37) is a recently discovered immunomodulatory cytokine with potential anti-inflammatory properties. This systematic review explores the relationship between IL and 37 and SLE disease activity, and evaluates its potential as a therapeutic agent.
METHODS: Electronic databases were searched for studies investigating IL-37 and SLE. Data on IL-37 levels, SLE Disease Activity Index (SLEDAI) score, genetic polymorphisms, and its therapeutic effects from pre-clinical studies were extracted.
RESULTS: Previous studies presented conflicting findings on IL-37 levels in SLE patients. Some reported positive correlations with disease activity, while others observed associations between lower IL-37 and increased activity. Genetic variations in the IL-37 gene linked to SLE susceptibility have been reported. Pre-clinical studies using engineered mesenchymal stem cells or direct IL-37 treatment showed promise in reducing disease severity in mouse models and cell cultures of SLE. The analysis of multiple studies reveals that IL-37 expression varies significantly across different SLE subtypes.
CONCLUSIONS: While a potential link exists between IL and 37 and disease activity, genetic predisposition, and therapeutic benefit, further research is needed. Future studies with standardized designs, larger and more diverse populations, and mechanistic investigations are crucial to determine the therapeutic potential of IL-37 for SLE. This review highlights the need for well-designed clinical trials to evaluate the safety and efficacy of IL-37 therapy in patients with SLE.
Elevated serum rheumatoid factor, anti-citrullinated protein antibodies and active rheumatoid arthritis disease are not associated with chronic periodontitis

Che Rahim MJ, Wan Mohamad WM, Saddki N, Taib H, Wan Abhamid WZ, Wong KK, et al.

Malays J Pathol, 2019 Dec;41(3):267-272.
PMID: 31901911

INTRODUCTION: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease of the joints with the involvement of other systems. Previous studies have demonstrated its association with chronic periodontitis (CP), a chronic inflammatory disease of tooth-supporting tissues. Positive rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) in RA patients have been found to be associated with CP. The aim of this study is to determine the prevalence of CP in RA patients, and to investigate the association of ACPA, RF status and RA disease activity with CP and non-CP RA patients.
MATERIALS AND METHODS: A comparative cross-sectional study involving 98 RA patients was conducted at Hospital Universiti Sains Malaysia, Kubang Kerian, Malaysia. Clinical oral examination was carried out to determine the CP status of RA patients. RF, ACPA and erythrocyte sedimentation rate (ESR) were measured, and the 28-joint Disease Activity Score (DAS-28) was assessed.
RESULTS: Forty-five patients (45.9%) were found to have CP (95% CI: 0.36-0.56). No significant difference was observed in the prevalence of positive RF (p=0.989) or ACPA (p=0.431) in CP and non-CP RA patients. There was also no significant association between active RA disease (DAS-28 score ≥3.2) and RF positivity in CP (p=0.927) and non-CP (p=0.431) RA patients as well as ACPA positivity in CP (p=0.780) and non-CP (p=0.611) RA patients.
CONCLUSION: In our cohort of RA patients, we did not find significant associations between elevated RF, ACPA, or active RA disease with the presence of CP. There were also no significant associations between elevated RF or ACPA with active RA disease.