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Fulltext Retrospective study on the microbial drug resistance profile and predictive risk factors in early infection of open fractures.

Tai KM, Sulong AF, Mohd. Yusof N

IIUM Medical Journal Malaysia, 2019;18(3):96-103.
MyJurnal

This study was conducted to evaluate the susceptibility of microorganisms involved in early infection of open fractures in orthopaedics to current prophylactic antibiotics practice and determine the association of various parameters related to the causative organism, patient, injury and management to the resistance of such microorganisms. Methods: This is a retrospective study that reviewed cases collected from the surgical operations record from January 2015 to December 2017 in Hospital Tengku Ampuan Afzan, Kuantan. A total of 179 cases were collected with 110 cases fulfilling the proposed inclusion / exclusion criteria. They all underwent routine debridement followed by culture and sensitivity. Previous clinical records were traced to identify the various risk factors for infection and evaluate these against the resistance of the microorganisms to prophylactic antimicrobial drugs. Results: Admission to the intensive care unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of admission were all significantly associated with resistance of microorganism. The study also demonstrated the predominance of Gram-negative microorganisms constituting 65.9% of isolates. Gram-negative microorganisms were seen more in higher fracture grades and Injury Severity Scale, and longer duration of admission and antibiotic treatment. The overall susceptibility of microorganisms to antibiotics was also demonstrated with up to 68.6% resistance to cefuroxime and 36.9% to Gentamicin. Staphylococcus aureus and MRSA were the commonest Gram-positive organisms while Pseudomonas and Acinetobacter spp. the commonest Gram-negatives. Conclusion: Admission to Intensive Care Unit, blood transfusion, antibiotic regime and duration, fracture grade, injury severity score and duration of antibiotics have a significant positive predictive value to the development of resistance of microorganisms. The shift to predominantly Gram-negative microorganisms indicate an urgency to modify management of open fracture to achieve optimal results. This will also prevent the emergence of new multi-drug resistance microorganism which is already a worldwide public health problem.
Fulltext Confocal laser scanning microscope analysis on post-biofilm assessment of biofilmproducing osteomyelitic Staphylococcus aureus treated with new Gentamicin-Nigella sativa fusion emulsion (GNFE)

Yaakob, K.I., Mohd Shafri, M.A., Mohd Yusof, N., Mohamed, F.

Malaysian Journal of Microscopy, 2015;11(1):68-73.
MyJurnal

Biofilm complicates osteomyelitis as there is antibiotic resistance and toxicity involved. In order to overcome the challenges of current treatment, gentamicin, the current antibiotic of choice for osteomyelitis, is fused with Nigella sativa oil to form an emulsion. Its efficacy as anti-biofilm agent is assessed using confocal laser scanning microscope (CLSM) against different strains of biofilm-producing Staphylococcus aureus. These strains of S.aureus were first allowed to express biofilm before being exposed for 24 hours to the emulsion with (0.1% (w/v) gentamicin; 40.2% (v/v) N.sativa. Later, the emulsion was removed and the biofilm was stained with fluorescence staining. The slides were viewed under CLSM at 100 times resolution. 3D images of biofilm were reconstructed, using Image J software, to measure the thickness of biofilm and viability of bacteria cells. Results revealed that the emulsion significantly reduced biofilm thickness compared to gentamicin and N.sativa alone in all strains of S.aureus (Tukey’s test p < 0.05). The emulsion was also able to produce more than 80% and 15% surface percentage (%) of non-viable (dead) bacteria in the sensitive and resistant strain, respectively, at a significant level when compared to gentamicin and N.sativa (Tukey’s test p < 0.05). As a conclusion, this new fusion of gentamicin-N.sativa may be effective towards the biofilm of S.aureus, and can be developed further as a new promising anti-biofilm agent in osteomyelitis.
Fulltext Perforators in the Leg: Why It Is Important for Orthopaedic Surgeons to Know

Mohd-Yusof N, Ahmad-Alwi AA

Malays Orthop J, 2017 Mar;11(1):85-87.
PMID: 28435585 DOI: 10.5704/MOJ.1703.014
Novel protocol optimized for microalgae lutein used as food additives

Low KL, Idris A, Mohd Yusof N

Food Chem, 2020 Mar 01;307:125631.
PMID: 31634761 DOI: 10.1016/j.foodchem.2019.125631

Lutein available in the current market is derived from marigold petals. However, extensive studies showed that microalgae are rich in lutein content and potentially exploitable for its dietary and other industrial applications. In this study, microwave assisted binary phase solvent extraction method (MABS) was the novel protocol being developed and optimized to achieve maximum lutein recovery from microalgae Scenedesmus sp. biomass. Results showed that 60% potassium hydroxide solution with acetone in the ratio of 0.1 (ml/ml) was the ideal binary phase solvent composition. Empirical model developed using response surface methodology revealed highest lutein content can be recovered through MABS extraction method at 55 °C treatment temperature, 36 min in extraction time, 0.7 (mg/ml) for biomass to solvent ratio, 250 Watt microwave power and 250 rpm stirring speed. This optimized novel protocol had increased the amount of lutein recovered by 130% and shorten the overall extraction time by 3-folds.
A review of: application of synthetic scaffold in tissue engineering heart valves

Fallahiarezoudar E, Ahmadipourroudposht M, Idris A, Mohd Yusof N

Mater Sci Eng C Mater Biol Appl, 2015 Mar;48:556-65.
PMID: 25579957 DOI: 10.1016/j.msec.2014.12.016

The four heart valves represented in the mammalian hearts are responsible for maintaining unidirectional, non-hinder blood flow. The heart valve leaflets synchronically open and close approximately 4 million times a year and more than 3 billion times during the life. Valvular heart dysfunction is a significant cause of morbidity and mortality around the world. When one of the valves malfunctions, the medical choice is may be to replace the original valves with an artificial one. Currently, the mechanical and biological artificial valves are clinically used with some drawbacks. Tissue engineering heart valve concept represents a new technique to enhance the current model. In tissue engineering method, a three-dimensional scaffold is fabricated as the template for neo-tissue development. Appropriate cells are seeded to the matrix in vitro. Various approaches have been investigated either in scaffold biomaterials and fabrication techniques or cell source and cultivation methods. The available results of ongoing experiments indicate a promising future in this area (particularly in combination of bone marrow stem cells with synthetic scaffold), which can eliminate the need for lifelong anti-coagulation medication, durability and reoperation problems.
Investigation of highly unsaturated fatty acid metabolism in the Asian sea bass, Lates calcarifer

Mohd-Yusof NY, Monroig O, Mohd-Adnan A, Wan KL, Tocher DR

Fish Physiol Biochem, 2010 Dec;36(4):827-43.
PMID: 20532815 DOI: 10.1007/s10695-010-9409-4

Lates calcarifer, commonly known as the Asian sea bass or barramundi, is an interesting species that has great aquaculture potential in Asia including Malaysia and also Australia. We have investigated essential fatty acid metabolism in this species, focusing on the endogenous highly unsaturated fatty acid (HUFA) synthesis pathway using both biochemical and molecular biological approaches. Fatty acyl desaturase (Fad) and elongase (Elovl) cDNAs were cloned and functional characterization identified them as ∆6 Fad and Elovl5 elongase enzymes, respectively. The ∆6 Fad was equally active toward 18:3n-3 and 18:2n-6, and Elovl5 exhibited elongation activity for C18-20 and C20-22 elongation and a trace of C22-24 activity. The tissue profile of gene expression for ∆6 fad and elovl5 genes, showed brain to have the highest expression of both genes compared to all other tissues. The results of tissue fatty acid analysis showed that the brain contained more docosahexaenoic acid (DHA, 22:6n-3) than flesh, liver and intestine. The HUFA synthesis activity in isolated hepatocytes and enterocytes using [1-(14)C]18:3n-3 as substrate was very low with the only desaturated product detected being 18:4n-3. These findings indicate that L. calcarifer display an essential fatty acid pattern similar to other marine fish in that they appear unable to synthesize HUFA from C18 substrates. High expression of ∆6 fad and elovl5 genes in brain may indicate a role for these enzymes in maintaining high DHA levels in neural tissues through conversion of 20:5n-3.
Mechanical properties and biocompatibility of co-axially electrospun polyvinyl alcohol/maghemite

Ngadiman NH, Mohd Yusof N, Idris A, Kurniawan D

Proc Inst Mech Eng H, 2016 Aug;230(8):739-49.
PMID: 27194535 DOI: 10.1177/0954411916649632

Electrospinning is a simple and efficient process in producing nanofibers. To fabricate nanofibers made of a blend of two constituent materials, co-axial electrospinning method is an option. In this method, the constituent materials contained in separate barrels are simultaneously injected using two syringe nozzles arranged co-axially and the materials mix during the spraying process forming core and shell of the nanofibers. In this study, co-axial electrospinning method is used to fabricate nanofibers made of polyvinyl alcohol and maghemite (γ-Fe2O3). The concentration of polyvinyl alcohol and amount of maghemite nanoparticle loading were varied, at 5 and 10 w/v% and at 1-10 v/v%, respectively. The mechanical properties (strength and Young's modulus), porosity, and biocompatibility properties (contact angle and cell viability) of the electrospun mats were evaluated, with the same mats fabricated by regular single-nozzle electrospinning method as the control. The co-axial electrospinning method is able to fabricate the expected polyvinyl alcohol/maghemite nanofiber mats. It was noticed that the polyvinyl alcohol/maghemite electrospun mats have lower mechanical properties (i.e. strength and stiffness) and porosity, more hydrophilicity (i.e. lower contact angle), and similar cell viability compared to the mats fabricated by single-nozzle electrospinning method.
Amphetamine-type stimulants (ATS) drug classification using shallow one-dimensional convolutional neural network

Mohd Yusof N, Muda AK, Pratama SF, Carbo-Dorca R

Mol Divers, 2021 Aug 02.
PMID: 34338915 DOI: 10.1007/s11030-021-10289-1

Amphetamine-type stimulants (ATS) drug analysis and identification are challenging and critical nowadays with the emergence production of new synthetic ATS drugs with sophisticated design compounds. In the present study, we proposed a one-dimensional convolutional neural network (1DCNN) model to perform ATS drug classification as an alternative method. We investigate as well as explore the classification behavior of 1DCNN with the utilization of the existing novel 3D molecular descriptors as ATS drugs representation to become the model input. The proposed 1DCNN model is composed of one convolutional layer to reduce the model complexity. Besides, pooling operation that is a standard part of traditional CNN is not applied in this architecture to have more features in the classification phase. The dropout regularization technique is employed to improve model generalization. Experiments were conducted to find the optimal values for three dominant hyper-parameters of the 1DCNN model which are the filter size, transfer function, and batch size. Our findings found that kernel size 11, exponential linear unit (ELU) transfer function and batch size 32 are optimal for the 1DCNN model. A comparison with several machine learning classifiers has shown that our proposed 1DCNN has achieved comparable performance with the Random Forest classifier and competitive performance with the others.
A novel nonlinear time-varying sigmoid transfer function in binary whale optimization algorithm for descriptors selection in drug classification

Mohd Yusof N, Muda AK, Pratama SF, Abraham A

Mol Divers, 2023 Feb;27(1):71-80.
PMID: 35254585 DOI: 10.1007/s11030-022-10410-y

In computational chemistry, the high-dimensional molecular descriptors contribute to the curse of dimensionality issue. Binary whale optimization algorithm (BWOA) is a recently proposed metaheuristic optimization algorithm that has been efficiently applied in feature selection. The main contribution of this paper is a new version of the nonlinear time-varying Sigmoid transfer function to improve the exploitation and exploration activities in the standard whale optimization algorithm (WOA). A new BWOA algorithm, namely BWOA-3, is introduced to solve the descriptors selection problem, which becomes the second contribution. To validate BWOA-3 performance, a high-dimensional drug dataset is employed. The proficiency of the proposed BWOA-3 and the comparative optimization algorithms are measured based on convergence speed, the length of the selected feature subset, and classification performance (accuracy, specificity, sensitivity, and f-measure). In addition, statistical significance tests are also conducted using the Friedman test and Wilcoxon signed-rank test. The comparative optimization algorithms include two BWOA variants, binary bat algorithm (BBA), binary gray wolf algorithm (BGWOA), and binary manta-ray foraging algorithm (BMRFO). As the final contribution, from all experiments, this study has successfully revealed the superiority of BWOA-3 in solving the descriptors selection problem and improving the Amphetamine-type Stimulants (ATS) drug classification performance.
Fulltext Optical reflectometric measurement of SARS-CoV-2 (COVID-19) RNA based on cationic cysteamine-capped gold nanoparticles

Diyana Jamaluddin N, Ibrahim N, Yuziana Mohd Yusof N, Ta Goh C, Ling Tan L

Opt Laser Technol, 2023 Jan;157:108763.
PMID: 36212170 DOI: 10.1016/j.optlastec.2022.108763

The coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a major public health outbreak in late 2019 and was proclaimed a global pandemic in March 2020. A reflectometric-based RNA biosensor was developed by using cysteamine-stabilized gold nanoparticles (cysAuNPs) as the colorimetric probe for bioassay of COVID-19 RNA (SARS-CoV-2 RNA) sequence. The cysAuNPs aggregated in the presence of DNA probes via cationic and anionic electrostatic attraction between the positively charged cysteamine ligands and the negatively charged sugar-phosphate backbone of DNA, whilst in the presence of target RNAs, the specific recognition between DNA probes and targets depleted the electrostatic interaction between the DNA probes and cysAuNPs signal probe, leading to dispersed particles. This has rendered a remarkable shifting in the surface plasmon resonance (SPR) on the basis of visual color change of the RNA biosensor from red to purplish hue at the wavelength of 765 nm. Optical evaluation of SARS-CoV-2 RNA by means on reflectance transduction of the RNA biosensor based on cysAuNPs optical sensing probes demonstrated rapid response time of 30 min with high sensitivity, good linearity and high reproducibility across a COVID-19 RNA concentration range of 25 nM to 200 nM, and limit of detection (LOD) at 0.12 nM. qPCR amplification of SARS-CoV-2 viral RNA showed good agreement with the proposed RNA biosensor by using spiked RNA samples of the oropharyngeal swab from COVID-19 patients. Therefore, this assay is useful for rapid and early diagnosis of COVID-19 disease including asymptomatic carriers with low viral load even in the presence of co-infection with other viruses that manifest similar respiratory symptoms.
Fulltext Mono-Lateral External Fixation for Treatment of Femoral Osteomyelitis

Mohd Yusof N, Saleh AK, Abuomira IEAA, Attallah AA, Elshal EA, Khames AAA

Orthop Res Rev, 2022;14:437-443.
PMID: 36444242 DOI: 10.2147/ORR.S383863

BACKGROUND AND AIM: Maintenance of stability using external fixation devices is an important principle to ensure successful treatment of osteomyelitis (OM). In this study, we report our experience with femoral OM treated with acute compression and bone transport using the Orthofix limb reconstruction system (LRS).
PATIENTS AND METHODS: This prospective study included 30 consecutive patients with femoral OM. LRS insertion and corticotomy were done according to the standard technique. Radiographic evaluation was performed every 2 weeks during the distraction phase and every 2-4 weeks during the consolidation phase. The clinical outcome measurements included union time, limb length discrepancy, additional operative procedures, refracture and infection.
RESULTS: The present study included 30 patients with femoral OM. They comprised 27 males (90.0%) and 3 females (10.0%) with an age of 28.1 ± 15.6 years. All, except one, achieved union with a mean union time of 8.6 months (range 4-20 months). The mean union time for acute compression was 7.6 months (range 4-20 months) while for patients with bone transport it was 14.5 months (range 12-18 months). The mean limb length discrepancy was 1.8 cm (range 0-4 cm). At the end of the follow=up, two patients were not able to ambulate without support; one due to non-union and one due to paraplegia.
CONCLUSION: The present study identified treatment of femoral OM using LRS as a feasible and effective technique with good outcomes. Reported complications could be adequately managed in most cases.
Fulltext A Rare Case of Salter-Harris Type I Growth Plate Injury in a Patient Undergoing Limb-Lengthening Procedure

Esmat SM, Sulong AF, Awang MS, Oon ZS, Mohd Yusof N

Cureus, 2023 Aug;15(8):e43448.
PMID: 37711923 DOI: 10.7759/cureus.43448

Growth plate injuries over the distal femur typically occur due to high-energy trauma. It is commonly associated with serious complications such as growth disturbance. Its occurrence in children undergoing limb-lengthening procedures is uncommon. We report a case of distal femur growth plate injury in a 13-year-old boy undergoing a limb-lengthening procedure for femoral hypoplasia. Conservative treatment yielded a good functional outcome in this patient.
Fulltext Review on Nanocrystalline Cellulose in Bone Tissue Engineering Applications

Murizan NIS, Mustafa NS, Ngadiman NHA, Mohd Yusof N, Idris A

Polymers (Basel), 2020 Nov 27;12(12).
PMID: 33261121 DOI: 10.3390/polym12122818

Nanocrystalline cellulose is an abundant and inexhaustible organic material on Earth. It can be derived from many lignocellulosic plants and also from agricultural residues. They endowed exceptional physicochemical properties, which have promoted their intensive exploration in biomedical application, especially for tissue engineering scaffolds. Nanocrystalline cellulose has been acknowledged due to its low toxicity and low ecotoxicological risks towards living cells. To explore this field, this review provides an overview of nanocrystalline cellulose in designing materials of bone scaffolds. An introduction to nanocrystalline cellulose and its isolation method of acid hydrolysis are discussed following by the application of nanocrystalline cellulose in bone tissue engineering scaffolds. This review also provides comprehensive knowledge and highlights the contribution of nanocrystalline cellulose in terms of mechanical properties, biocompatibility and biodegradability of bone tissue engineering scaffolds. Lastly, the challenges for future scaffold development using nanocrystalline cellulose are also included.

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