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Delay in the diagnosis and treatment of pulmonary tuberculosis in patients attending a university teaching hospital

Liam CK, Tang BG

Int J Tuberc Lung Dis, 1997 Aug;1(4):326-32.
PMID: 9432388

University Hospital, Kuala Lumpur, Malaysia.
Fulltext Attitudes and knowledge of newly diagnosed tuberculosis patients regarding the disease, and factors affecting treatment compliance

Liam CK, Lim KH, Wong CM, Tang BG

Int J Tuberc Lung Dis, 1999 Apr;3(4):300-9.
PMID: 10206500

SETTING: An urban university teaching hospital.
OBJECTIVES: To determine patients' attitudes to tuberculosis and their knowledge of the disease, and factors associated with treatment compliance.
DESIGN: All adult patients commenced on treatment for tuberculosis from September 1994 to February 1996 were interviewed on initiation of treatment. To assess patient compliance with treatment, hospital clinical records were reviewed retrospectively.
RESULTS: A total of 135 patients with a mean age (±SD) of 41.9 (±17.4) years (range 15–84 years) were interviewed. The patients had limited understanding and knowledge about tuberculosis. There was a negative correlation between patient age and tuberculosis knowledge score (r = −0.18, P = 0.038). Patients with tertiary education had better knowledge than the others. Of 118 patients who were followed-up in our chest clinic, 80 (67.8%) completed the prescribed treatment. Compliance with treatment and follow-up was not affected by age, sex, ethnic group, educational level, occupation, extent of knowledge, tuberculosis symptoms, hospitalisation for tuberculosis or duration of the prescribed treatment regimen. There was a trend toward poorer compliance among patients who equated disappearance of tuberculosis symptoms with cure of the disease.
CONCLUSIONS: Malaysian patients with newly diagnosed tuberculosis attending a university teaching hospital had misconceptions and limited knowledge about the disease and its treatment. Educational background was an important determinant of a patient's level of knowledge about tuberculosis. Compliance was not affected by patient characteristics. Adequate counselling and education of patients and close relatives on tuberculosis and the necessity for prolonged treatment may help to improve treatment compliance.
Study site: Chest clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
Fulltext Bio-processing of algal bio-refinery: a review on current advances and future perspectives

Koyande AK, Show PL, Guo R, Tang B, Ogino C, Chang JS

Bioengineered, 2019 Dec;10(1):574-592.
PMID: 31668124 DOI: 10.1080/21655979.2019.1679697

Microalgae biomass contains various useful bio-active components. Microalgae derived biodiesel has been researched for almost two decades. However, sole biodiesel extraction from microalgae is time-consuming and is not economically feasible due to competitive fossil fuel prices. Microalgae also contains proteins and carbohydrates in abundance. Microalgae are likewise utilized to extract high-value products such as pigments, anti-oxidants and long-chain polyunsaturated fatty acids which are useful in cosmetic, pharmaceutical and nutraceutical industry. These compounds can be extracted simultaneously or sequentially after biodiesel extraction to reduce the total expenditure involved in the process. This approach of bio-refinery is necessary to promote microalgae in the commercial market. Researchers have been keen on utilizing the bio-refinery approach to exploit the valuable components encased by microalgae. Apart from all the beneficial components housed by microalgae, they also help in reducing the anthropogenic CO2 levels of the atmosphere while utilizing saline or wastewater. These benefits enable microalgae as a potential source for bio-refinery approach. Although life-cycle analysis and economic assessment do not favor the use of microalgae biomass feedstock to produce biofuel and co-products with the existing techniques, this review still aims to highlight the beneficial components of microalgae and their importance to humans. In addition, this article also focuses on current and future aspects of improving the feasibility of bio-processing for microalgae bio-refinery.
Eimeria infections of plateau pika altered the patterns of temporal alterations in gut bacterial communities

Li M, Wang S, Zhong L, Heděnec P, Tan Z, Wang R, et al.

Front Microbiol, 2023;14:1301480.
PMID: 38274745 DOI: 10.3389/fmicb.2023.1301480

Intestinal parasites, such as Eimeria, are common among plateau pika (Ochotona curzoniae). The gut microbiome is an essential driver of the host response to gastrointestinal parasites. However, the effects of intestinal protozoal parasites on the temporal variations in the gut microbiome and behavioral and physiological activities remain unknown. Our study conducted treatments involving experimental feeding of pika with Eimeria oocysts or anticoccidia under laboratory conditions to focus on the parasite-associated alterations in gut bacterial communities, host behavioral activity, physiology, and host-bacteria relationships. The results showed insignificant differences in bacterial community structures among treatments on the basis of Bray-Curtis distance metrics, whereas the patterns of temporal alterations in the bacterial communities were changed by the treatments. Bacterial alpha diversities did not vary with the treatments, and experimental feeding with Eimeria slowed down the decrement rate of alpha diversity. Furthermore, few bacterial members were significantly changed by the treatments-only the genus Ruminococcus and the species Ruminococcus flavefaciens, which were associated with energy metabolism. Experimental feeding with Eimeria modified the temporal variations in the bacterial members, including a lower loss rate of the relative abundance of the dominant families Muribaculaceae and Ruminococcaceae in the group with Eimeria experimental feeding. Moreover, a shifting energy trade-off was suggested by the parasite-induced increments in thyroid hormones (triiodothyronine and tetraiodothyronine) and decrements in exploration behavior in the group with Eimeria feeding. However, we did not detect specific connections between gut bacterial communities and pika behaviors and physiology in terms of energy trade-offs. Further in-depth research is needed to examine the role of Eimeria-modified differences in the gut bacteria of plateau pika.
Fulltext Sequencing of Historical Isolates, K-mer Mining and High Serological Cross-Reactivity with Ross River Virus Argue against the Presence of Getah Virus in Australia

Rawle DJ, Nguyen W, Dumenil T, Parry R, Warrilow D, Tang B, et al.

Pathogens, 2020 Oct 16;9(10).
PMID: 33081269 DOI: 10.3390/pathogens9100848

Getah virus (GETV) is a mosquito-transmitted alphavirus primarily associated with disease in horses and pigs in Asia. GETV was also reported to have been isolated from mosquitoes in Australia in 1961; however, retrieval and sequencing of the original isolates (N544 and N554), illustrated that these viruses were virtually identical to the 1955 GETVMM2021 isolate from Malaysia. K-mer mining of the >40,000 terabases of sequence data in the Sequence Read Archive followed by BLASTn confirmation identified multiple GETV sequences in biosamples from Asia (often as contaminants), but not in biosamples from Australia. In contrast, sequence reads aligning to the Australian Ross River virus (RRV) were readily identified in Australian biosamples. To explore the serological relationship between GETV and other alphaviruses, an adult wild-type mouse model of GETV was established. High levels of cross-reactivity and cross-protection were evident for convalescent sera from mice infected with GETV or RRV, highlighting the difficulties associated with the interpretation of early serosurveys reporting GETV antibodies in Australian cattle and pigs. The evidence that GETV circulates in Australia is thus not compelling.
Fulltext Improve the Prevention of Sudden Cardiac Arrest in Patients With Post-Acute Myocardial Infarction

Zhang S, Chen WJ, Sankardas MA, Ahmed WH, Liew HB, Gwon HC, et al.

JACC Asia, 2022 Oct;2(5):559-571.
PMID: 36518723 DOI: 10.1016/j.jacasi.2022.06.006

BACKGROUND: Implantable cardioverter-defibrillator (ICD) implantation to prevent sudden cardiac death (SCD) in post-myocardial infarction (MI) patients varies by geography but remains low in many regions despite guideline recommendations.
OBJECTIVES: This study aimed to characterize the care pathway of post-MI patients and understand barriers to referral for further SCD risk stratification and management in patients meeting referral criteria.
METHODS: This prospective, nonrandomized, multi-nation study included patients ≥18 years of age, with an acute MI ≤30 days and left ventricular ejection fraction <50% ≤14 days post-MI. The primary endpoint was defined as the physician's decision to refer a patient for SCD stratification and management.
RESULTS: In total, 1,491 post-MI patients were enrolled (60.2 ± 12.0 years of age, 82.4% male). During the study, 26.7% (n = 398) of patients met criteria for further SCD risk stratification; however, only 59.3% of those meeting criteria (n = 236; 95% CI: 54.4%-64.0%) were referred for a visit. Of patients referred for SCD risk stratification and management, 94.9% (n = 224) attended the visit of which 56.7% (n =127; 95% CI: 50.1%-63.0%) met ICD indication criteria. Of patients who met ICD indication criteria, 14.2% (n = 18) were implanted.
CONCLUSIONS: We found that ∼40% of patients meeting criteria were not referred for further SCD risk stratification and management and ∼85% of patients who met ICD indications did not receive a guideline-directed ICD. Physician and patient reasons for refusing referral to SCD risk stratification and management or ICD implant varied by geography suggesting that improvement will require both physician- and patient-focused approaches. (Improve Sudden Cardiac Arrest [SCA] Bridge Study; NCT03715790).