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The Malaysian state's response to migration

Pillai P

Sojourn, 1999 Apr;14(1):178-97.
PMID: 12295145
Optimization of fluoride removal by Al doped ZnO nanoparticles using response surface methodology from groundwater

Pillai P, Dharaskar S, Khalid M

Chemosphere, 2021 Dec;284:131317.
PMID: 34216929 DOI: 10.1016/j.chemosphere.2021.131317

The current novel work presents the optimization of factors affecting defluoridation by Al doped ZnO nanoparticles using response surface methodology (RSM). Al doped ZnO nanoparticles were synthesized by the sol-gel method and validated by FTIR, XRD, TEM/EDS, TGA, BET, and particle size analysis. Moreover, a central composite design (CCD) was developed for the experimental study to know the interaction between Al doped ZnO adsorbent dosage, initial concentration of fluoride, and contact time on fluoride removal efficiency (response) and optimization of the process. Analysis of variance (ANOVA) was achieved to discover the importance of the individual and the effect of variables on the response. The model predicted that the response significantly correlated with the experimental response (R2 = 0.97). Among the factors, the effect of adsorbent dose and contact time was considered to have more influence on the response than the concentration. The optimized process parameters by RSM presented the adsorbent dosage: 0.005 g, initial concentration of fluoride: 1.5 g/L, and contact time: 5 min, respectively. Kinetic, isotherm, and thermodynamic studies were also investigated. The co-existing ions were also studied. These results demonstrated that Al doped ZnO could be a promising adsorbent for effective defluoridation for water.
Synthesis, characterization, and application of iron oxyhydroxide coated with rice husk for fluoride removal from aqueous media

Pillai P, Lakhtaria Y, Dharaskar S, Khalid M

Environ Sci Pollut Res Int, 2020 Jun;27(17):20606-20620.
PMID: 31368069 DOI: 10.1007/s11356-019-05948-8

A novel nanoparticle (NPs) iron oxyhydroxide modified with rice husk (RH + FeOOH) was synthesized with wet chemical method. Batch study was performed to investigate fluoride removal and adsorption capacity. The RH + FeOOH NPs were characterized by using Fourier transform infrared spectroscopy, X-ray powder diffraction, Brunauer-Emmett-Teller, scanning electron microscope with energy dispersion, transmission electron microscope, and particle size analyzer. By varying parameters, batch adsorption with adsorption capacity was performed such as contact time, stirring rate, adsorbent dosage, temperature, initial concentration, and pH. The BET surface area and the pore volume of the FeOOH and RH + FeOOH were found to be 157 m2 g-1, 195 m2 g-1 and 0.136 m2 g-1, 0.224 m2 g-1. Based on kinetic study, pseudo-second-order was followed by regression coefficient (R2) 0.99. Langmuir isotherm model showed the best adsorption capacity of 26 mg g-1. Moreover, the RH + FeOOH showed best affinity towards fluoride removal and may act as an excellent adsorbent for fluoride treatment from aqueous solution. Synthesis and Fluoride Adsorption Mechanism of Iron Oxyhydroxide Modified with rice husk.
Fulltext COVID-19 and Major Organ Thromboembolism: Manifestations in Neurovascular and Cardiovascular Systems

Pillai P, Joseph JP, Fadzillah NHM, Mahmod M

J Stroke Cerebrovasc Dis, 2021 Jan;30(1):105427.
PMID: 33137615 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105427

COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been shown to cause multisystemic damage. We undertook a systematic literature review and comprehensive analysis of a total of 55 articles on arterial and venous thromboembolism in COVID-19 and articles on previous pandemics with respect to thromboembolism and compared the similarities and differences between them. The presence of thrombosis in multiple organ systems points to thromboembolism being an integral component in the pathogenesis of this disease. Thromboembolism is likely to be the main player in the morbidity and mortality of COVID -19 in which the pulmonary system is most severely affected. We also hypothesize that D-dimer values could be used as an early marker for prognostication of disease as it has been seen to be raised even in the pre-symptomatic stage. This further strengthens the notion that thromboembolism prevention is necessary. We also examined literature on the neurovascular and cardiovascular systems, as the manifestation of thromboembolic phenomenon in these two systems varied, suggesting different pathophysiology of damage. Further research into the role of thromboembolism in COVID-19 is important to advance the understanding of the virus, its effects and to tailor treatment accordingly to prevent further casualties from this pandemic.
Fulltext Angiographic Systems for Classifying Distal Arterial Occlusions

Pillai P, Mitchell PJ, Phan TG, Ma H, Yan B

Cerebrovasc Dis, 2023;52(3):353-362.
PMID: 36423598 DOI: 10.1159/000526873

BACKGROUND: Extensive randomized controlled clinical trials for endovascular thrombectomy in anterior circulation large vessel occlusions (internal carotid arteries and M1 segment of middle cerebral arteries) have been published over the past decade, but there have not been randomized controlled trials for distal arterial occlusions to date. Distal arterial occlusion randomized controlled trials are essential to decide on patient selection, imaging criteria, and endovascular approach to improve the outcome and reduce complications.
SUMMARY: The definition of distal arterial occlusion is however unclear, and we believe that a uniform nomenclature of distal arterial occlusions is essential for the design of robust randomized controlled studies. We undertook a systematic literature review and comprehensive analysis of 70 articles looking at distal arterial occlusions and previous attempts at classifying them as well as comparing their similarities and differences with a more selective look at the middle cerebral artery. Thirty-two articles were finally deemed suitable and included for this review. In this review article, we present 3 disparate classifications of distal arterial occlusions, namely, classical/anatomical, functional/imaging, and structural/calibre, and compare the similarities and differences between them.
KEY MESSAGES: We propose the adoption of functional/imaging classification to guide the identification of distal arterial occlusions with the M2 segment starting at the point of bifurcation of the middle cerebral artery trunk/M1 segment. With regards to the anterior temporal artery, we propose that it will be considered a branch of the M1 and only be considered as the M2 segment if it is a holo-temporal artery. We believe that this is a practical method of classification in the time-critical decision-making period.
Relapsing GABA(A) Receptor Encephalitis After Stem Cell Transplant for Acute Myeloid Leukaemia

Ooi JCE, Pillai P, Lee S, Ong SAM, Koh KL, Chia YK

Can J Neurol Sci, 2023 Jul 12.
PMID: 37434473 DOI: 10.1017/cjn.2023.252
Atrial fibrillation is associated with higher first pass effect following thrombectomy for large vessel occlusion

Pillai P, Bush SJ, Kusuma Y, Churilov L, Dowling RJ, Luu VD, et al.

J Neurointerv Surg, 2024 Feb 01.
PMID: 37355258 DOI: 10.1136/jnis-2023-020512

BACKGROUND: First pass effect (FPE), defined as single-pass complete or near complete reperfusion during endovascular thrombectomy (EVT) for large vessel occlusion (LVO) strokes, is a critical performance metric. Atrial fibrillation (AF)-related strokes have different clot composition compared with non-AF strokes, which may impact thrombectomy reperfusion results. We compared FPE rates in AF and non-AF stroke patients to evaluate if AF-related strokes had higher FPE rates.
METHODS: We conducted a post-hoc analysis of the DIRECT-SAFE trial data, including patients with retrievable clots on the initial angiographic run. Patients were categorized into AF and non-AF groups. The primary outcome was the presence or absence of FPE (single-pass, single-device resulting in complete/near complete reperfusion) in AF and non-AF groups. We used multivariable logistic regression to examine the association between FPE and AF, adjusting for thrombolysis pre-thrombectomy and clot location.
RESULTS: We included 253 patients (67 with AF, 186 without AF). AF patients were older (mean age: 74 years vs 67.5 years, p=0.001), had a higher proportion of females (55% vs 40%, p=0.044), and experienced more severe strokes (median National Institutes of Health Stroke Scale (NIHSS) score: 17 vs 14, p=0.009) than non-AF patients. No differences were observed in thrombolytic agent usage, time metrics, or clot location. AF patients achieved a higher proportion of FPE compared with non-AF patients (55.22% vs 37.3%, adjusted odds ratio 2.00 (95% CI 1.13 to 3.55), p=0.017).
CONCLUSIONS: AF-related strokes in LVO patients treated with EVT were associated with FPE. This highlights the need for preparedness for multiple passes and potential adjuvant/rescue therapy in non-AF-related strokes.