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Knowlesi Malaria in Children

Mohan K, Kumar M, Omar BJ

Curr Pediatr Rev, 2023;19(3):242-252.
PMID: 35366778 DOI: 10.2174/1573396318666220401110835

The fifth malaria parasite causing malaria- Plasmodium knowlesi (Pk), is not a novel emergent species but was an undiagnosed species before the availability of molecular methods as a tool from diagnostics and sometimes confused with morphologically similar human malaria parasite P. malariae or P. falciparum. Now it is well-distributed species in Southeast Asia, especially in Malaysia. Since 2004, cases of Pk malaria are continuously being reported in adults. Though adult age, forest-related activities and a recent visit to forested areas are well-known factors, childhood did not remain untouched by this disease. Few pieces of research and reports in the literature indicate that Infection in children is uncomplicated, but this may be attributed to the scarcity of data and research in this field. Pk malaria in pregnant females and infants are being well reported, so this indicates that the problem is not only restricted to known factors related to the disease, but we should think out of the box and take action before the disease takes the form of significant health burden on the human population as P. vivax and P. falciparum species did in the past. With the reports in literature of Pk malaria in pregnancy and early infancy, the possibility of congenital and neonatal malaria also cannot be denied. So more and more research is needed to understand Pk malaria in the pediatric population clearly. So this running review covers the problem status, demographic profile, clinical and haematological features, diagnosis, management and outcome of Pk malaria in paediatric group worldwide. This review also discusses the gaps in our present knowledge of the real problem status, prevention, control, diagnosis and management of Pk malaria, particularly in this age group.
Fulltext Impact of a Clinical Pharmacist Intervention on Medicine Costs in Patients with Chronic Obstructive Pulmonary Disease in India

Abdulsalim S, Unnikrishnan MK, Manu MK, Alsahali S, Alrasheedy AA, Martin AP, et al.

Pharmacoecon Open, 2020 Jun;4(2):331-342.
PMID: 31368087 DOI: 10.1007/s41669-019-0172-x

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, especially in low- and middle-income countries (LMICs) such as India. Medicine costs are a key issue in LMICs, with typically high patient co-payments. In addition, pharmacists are underutilised in LMICs, including India. However, pharmacist-led educational interventions may improve the care of patients with COPD, as well as reduce medicine costs. Consequently, the objective of this study was to assess the effectiveness of a pharmacist-led intervention in reducing medicine costs.
METHODOLOGY: We assessed the impact of a pharmacist intervention on direct medicine costs in COPD patients (medicine costs and pharmacist time) in a randomised controlled study involving an intervention and control group, conducted at a tertiary care teaching hospital in India.
RESULTS: The 6-monthly cost of medicines at baseline increased with disease severity, from a maximum of US$29.46 for those with mild COPD to US$63.28 for those with very severe COPD. Substantial savings in medical costs were achieved with the pharmacist-led programme, to a maximum of US$20.49 over 6 months for very severe patients. This equates to a reduction of 30.6% in medicine costs (p
Fulltext Genotoxic effects of tobacco use in residents of hilly areas and foot hills of Western Ghats, Southern India

Chandirasekar R, Murugan K, Muralisankar T, Uthayakumar V, Jayakumar R, Mohan K, et al.

Sci Rep, 2019 Oct 17;9(1):14898.
PMID: 31624274 DOI: 10.1038/s41598-019-51275-w

Smoking and smokeless tobacco consumption is a significant risk factor that provokes genetic alterations. The present investigation was to evaluate the biomarkers of genotoxicity including micronucleus (MN), chromosome aberrations (CA) and DNA strand breaks among tobacco consumers and control individuals residing in hilly areas of Western Ghats, Tamilnadu, South India. This study included 268 tobacco consumers with equal number of controls. The tobacco consumers were divided into Group I (<10 years of tobacco consumption with an age range from 15 to 35 years) and group II (>10 years consumption above 35 years of age). Chromosome aberration (CA) and comet assay were performed using blood and micronucleus assay from exfoliated buccal epithelial cells obtained from tobacco consumers and controls. Elevated levels of CA were found in group II (Chromatid type: 2.39 ± 1.13 and chromosome type: 1.44 ± 1.24) exposed subjects, high micronucleus and DNA damage (TL:4.48 ± 1.24 and TM:3.40 ± 1.58) levels were significantly (p
Fulltext Recent insights into the extraction, characterization, and bioactivities of chitin and chitosan from insects

Mohan K, Ganesan AR, Muralisankar T, Jayakumar R, Sathishkumar P, Uthayakumar V, et al.

Trends Food Sci Technol, 2020 Nov;105:17-42.
PMID: 32901176 DOI: 10.1016/j.tifs.2020.08.016

Background: Insects are a living resource used for human nutrition, medicine, and industry. Several potential sources of proteins, peptides, and biopolymers, such as silk, chitin, and chitosan are utilized in industry and for biotechnology applications. Chitosan is an amino-polysaccharide derivative of chitin that consists of linear amino polysaccharides with d-glucosamine and N-acetyl-d-glucosamine units. Currently, the chief commercial sources of chitin and chitosan are crustacean shells that accumulate as a major waste product from the marine food industry. Existing chitin resources have some natural challenges, including insufficient supplies, seasonal availability, and environmental pollution. As an alternative, insects could be utilized as unconventional but feasible sources of chitin and chitosan.
Scope and approach: This review focuses on the recent sources of insect chitin and chitosan, particularly from the Lepidoptera, Coleoptera, Orthoptera, Hymenoptera, Diptera, Hemiptera, Dictyoptera, and Odonata orders. In addition, the extraction methods and physicochemical characteristics are discussed. Insect chitin and chitosan have numerous biological activities and could be used for food, biomedical, and industrial applications.
Key findings and conclusions: Recently, the invasive and harmful effects of insect species causing severe damage in agricultural crops has led to great economic losses globally. These dangerous species serve as potential sources of chitin and are underutilized worldwide. The conclusion of the present study provides better insight into the conversion of insect waste-derived chitin into value-added products as an alternative chitin source to address food security related challenges.
Fulltext Cloud to cloud data migration using self sovereign identity for 5G and beyond

Aruna MG, Hasan MK, Islam S, Mohan KG, Sharan P, Hassan R

Cluster Comput, 2021 Nov 15.
PMID: 34803477 DOI: 10.1007/s10586-021-03461-7

The Coronavirus pandemic and the work-from-anywhere has created a shift toward cloud-based services. The pandemic is causing an explosion in cloud migration, expected that by 2025, 95% of workloads will live in the cloud. One of the challenges of the cloud is data security. It is the responsibility of cloud service providers to protect user data from unauthorized access. Historically, a third-party auditor (TPA) is used to provide security services over the cloud. With the tremendous growth of demand for cloud-based services, regulatory requirements, there is a need for a semi to fully automated self sovereign identity (SSI) implementation to reduce cost. It's critical to manage cloud data strategically and extend the required protection. At each stage of the data migration process, such as data discovery, classification, and cataloguing of the access to the mission-critical data, need to be secured. Cloud storage services are centralized, which requires users must place trust in a TPA. With the SSI, this can become decentralized, reducing the dependency and cost. Our current work involves replacing TPA with SSI. A cryptographic technique for secure data migration to and from the cloud using SSI implemented. SSI facilitate peer-to-peer transactions, meaning that the in-between presence of TPA needs no longer be involved. The C2C migration performance is recorded and found the background or foreground replication scenario is achievable. Mathematically computed encrypted and decrypted ASCII values for a word matched with the output by the algorithm. The keys generated by the algorithm are validated with an online validator to ensure the correctness of the generated keys. RSA based mutual TLS algorithm is a good option for SSI based C2C migration. SSI is beneficial because of the low maintenance cost, and users are more and more using a cloud platform. The result of the implemented algorithm shows that the SSI based implementation can provide a 13.32 Kbps encryption/decryption rate which is significantly higher than the TPA method of 1 Kbps.
Soft tissue changes with skeletal anchorage in comparison to conventional anchorage protocols in the treatment of bimaxillary proclination patients treated with premolar extraction : A systematic review

Mohan K, Sivarajan S, Lau MN, Othman SA, Fayed MMS

J Orofac Orthop, 2024 Mar;85(2):146-162.
PMID: 35829730 DOI: 10.1007/s00056-022-00411-9

PURPOSE: This review systematically evaluates the evidence related to comparisons between skeletal and conventional anchorage protocols in the treatment of bimaxillary proclination patients who underwent premolars extraction with respect to soft tissue profile changes, treatment duration and three-dimensional (3D) soft tissue changes.
METHODS: Electronic database search and hand search with no language limitations were conducted in the Cochrane Library, PubMed, Ovid, Web of Science, Scopus and ClinicalTrials.gov. The selection criteria were set to include studies with patients aged 13 years and above requiring extractions of upper and lower first premolars to treat bimaxillary proclination with high anchorage demand. Risk of bias assessment was undertaken with Cochrane's Risk Of Bias tool 2.0 (ROB 2.0) for randomised controlled trials (RCTs) and ROBINS‑I tool for nonrandomised prospective studies. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for quality assessment. Results were summarised qualitatively; no meta-analysis was conducted.
RESULTS: Two RCTs and two nonrandomised prospective studies were included. According to the GRADE approach, there is low to very low quality of evidence that treatment using mini-implant anchorage may significantly change nasolabial angle, upper and lower lip procumbence, and facial convexity angle compared to treatment with conventional anchorage. Similarly, very low quality evidence exists showing no differences in treatment duration between treatments with skeletal or conventional anchorage.
CONCLUSIONS: The overall existing evidence regarding the effect of anchorage protocols on soft tissue changes in patients with bimaxillary protrusion and premolar extraction treatment plans is of low quality.
TRIAL REGISTRATION NUMBER: PROSPERO CRD42020216684.
Fulltext Forecasting the Incidence and Prevalence of Patients with End-Stage Renal Disease in Malaysia up to the Year 2040

Bujang MA, Adnan TH, Hashim NH, Mohan K, Kim Liong A, Ahmad G, et al.

Int J Nephrol, 2017;2017:2735296.
PMID: 28348890 DOI: 10.1155/2017/2735296

Background. The incidence of patients with end-stage renal disease (ESRD) requiring dialysis has been growing rapidly in Malaysia from 18 per million population (pmp) in 1993 to 231 pmp in 2013. Objective. To forecast the incidence and prevalence of ESRD patients who will require dialysis treatment in Malaysia until 2040. Methodology. Univariate forecasting models using the number of new and current dialysis patients, by the Malaysian Dialysis and Transplant Registry from 1993 to 2013 were used. Four forecasting models were evaluated, and the model with the smallest error was selected for the prediction. Result. ARIMA (0, 2, 1) modeling with the lowest error was selected to predict both the incidence (RMSE = 135.50, MAPE = 2.85, and MAE = 87.71) and the prevalence (RMSE = 158.79, MAPE = 1.29, and MAE = 117.21) of dialysis patients. The estimated incidences of new dialysis patients in 2020 and 2040 are 10,208 and 19,418 cases, respectively, while the estimated prevalence is 51,269 and 106,249 cases. Conclusion. The growth of ESRD patients on dialysis in Malaysia can be expected to continue at an alarming rate. Effective steps to address and curb further increase in new patients requiring dialysis are urgently needed, in order to mitigate the expected financial and health catastrophes associated with the projected increase of such patients.
Trends in the extraction, purification, characterisation and biological activities of polysaccharides from tropical and sub-tropical fruits - A comprehensive review

Mohan K, Muralisankar T, Uthayakumar V, Chandirasekar R, Revathi N, Ramu Ganesan A, et al.

Carbohydr Polym, 2020 Jun 15;238:116185.
PMID: 32299552 DOI: 10.1016/j.carbpol.2020.116185

Tropical and sub-tropical fruits are tremendous sources of polysaccharides (PSs), which are of great interest in the human welfare system as natural medicines, food and cosmetics. This review paper aims to highlight the recent trends in extraction (conventional and non-conventional), purification and analytic techniques of fruit polysaccharides (FPSs). The chemical structure and biological activities, such as immunomodulatory, anti-cancer, anti-oxidant, anti-inflammatory, anti-viral, anti-coagulant and anti-diabetic effects, of PSs extracted from 53 various fruits were compared and discussed. With this wide coverage, a total of 172 scientific articles were reviewed and discussed. This comprehensive survey from previous studies suggests that the FPSs are non-toxic and highly biocompatible. In addition, this review highlights that FPSs might be excellent functional foods as well as effective therapeutic drugs. Finally, the future research advances of FPSs are also described. The content of this review will promote human wellness-based food product development in the future.
Fulltext Expert Consensus on the Management of Brain Arteriovenous Malformations

Kato Y, Dong VH, Chaddad F, Takizawa K, Izumo T, Fukuda H, et al.

Asian J Neurosurg, 2019 11 25;14(4):1074-1081.
PMID: 31903343 DOI: 10.4103/ajns.AJNS_234_19

Brain arteriovenous malformations (bAVMs) are complex, heterogeneous, and uncommon intracranial lesions. They can be treated by one or a combination of the following treatment modalities, namely embolization, radiosurgery, or microsurgical resection. In Spetzler-Martin Grade 4 and 5 arteriovenous malformations (AVMs), conservative management may be the best option. A group of experts in the management of AVMs of different disciplines gathered in January 2019 in Hanoi to compile the "Expert Consensus on the Management of Brain Arteriovenous Malformations".