Penjujukan Eksom Bagi Penyakit Jarang Jumpa, Mullerian Agenesis dan Agenesis Anotectal anomaly: Kajian Kes (Whole Exome Sequencing of a Rare Disease, Mullerian Agenesis and Anorectal Anomaly: A Case Report) / Jurnal Sains Kesihatan Malaysia

@#Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser Syndrome (MRKH) Type-II is a congenital defect in the Mullerian duct that results in the absence of a uterus in women. The aetiology of this syndrome is unknown and has been considered a sporadic genetic disease. MRKH, together with anorectal anomaly, is an extremely rare condition and has only been reported in a few cases without any information on genetic analysis. This study investigated the mutational profile of a girl diagnosed with MRKH and anorectal anomalies with rectovaginal fistula. The whole exome sequencing (WES) trio-genetic analysis of a 5-year-old Malaysian girl diagnosed with MRKH (having anorectal anomaly with rectovaginal fistula) was performed together with her normal parents, using the Ion AmpliSeq Exome RDY kit (ThermoFisher Scientific, USA). Data were analysed using Torrent Suite v.5.0.4 and annotated using ANNOVAR. Single nucleotide polymorphisms (SNPs) with an allele frequency >0.01 were excluded, and the remaining variants were filtered based on de novo mutations, autosomal recessive, and autosomal recessive genetic traits. Related genes were analysed by biological pathway analysis (g:Profiler) and protein-protein interaction (HIPPIE v.2.3, STRING v.11.5, dan GeneMANIA). A total of 36 mutations were identified, and two of them, the LHX5 (p.P358Q), inherited from the father, and CFTR (p.R1158X), inherited from the mother. There were 28 de-novo mutations from 28 genes. All genes were involved in 27 biological processes that connected with 23 interactions, and are likely to cause MRKH syndrome in this patient.

Agro Meteorological Indices Influenced by Varying Sowing Environment and Varieties of Wheat in Western Maharashtra Plain Zone

An agro-meteorological investigation was undertaken during rabi, 2016 and 2017 at Farm, Department of Agricultural Meteorology, College of Agriculture, Pune, Maharashtra State (India). The experiment was laid out in split plot design with three replications. The treatment comprised of four varieties viz. V1: NIAW-301 (Trymbak ) V2: NIAW-917 (Tapovan), V3: NIAW-1415 (Netravati) and V4:NIAW-1994 (Phule Samadhan) as main plot and four sowing windows viz., S1: 43rd MW (22-28 October), S2: 45th MW (5-11November), S3: 47th MW (19-25 November) and S4: 49th MW (3-9 December) as sub plot treatments. The agrometeorological indices indicated more values for 45th MW (5-11November) and 47th MW (19-25 November) sown wheat crops and lowest values in late sown crop. Days to crown root stage, tillering stage, ear emergence stage, 50% flowering stage, milking stage, dough stage and physiology maturity matched closely with observed values for all sowing environments. It revealed that the grain yields were significantly higher in NIAW-1994 (51.07 and 48.52 qha-1) and significantly superior to the rest of the wheat varieties. This was followed by NIAW-917(45.72 and 43.43 q ha-1), NIAW-301(43.57 and 41.27 q ha-1). The variety NIAW-1415 recorded significantly lower grain yield (40.89 and 38.84 qha-1) during 2016 and 2017, respectively. The grain yield was maximum at 47th MW sowing window (50.40 and 47.88 qha-1), the grain yield of 45th MW (47.94 and 45.42 qha-1) were at par with 47th MW sowing window. This was followed by 43rd MW sowing window (43.88 and 41.68 q ha-1), 49th MW sowing window (39.04 and 37.07 q ha-1) during 2016 and 2017, respectively.

Assessment of Crop Weather Relations in Wheat (Triticum aestivum) in Western Maharashtra Plain Zone

Wheat (Triticum aestivum L.) is a thermo-sensitive long-day crop. Temperature is a major determinant of its growth and productivity. Late sown wheat exposes preanthesis phenological events to high temperature that influence grain development and ultimately the yield [1]. Comprehensive assessments of the influence of climate variability on crop yields at local and regional scales can be highly beneficial. With an aim to assess the weather influences on wheat at local scale this study was taken up. An experiment was conducted at Department of Agricultural Meteorology Farm, College of Agriculture, Pune, Maharashtra State (India) in a split-plot design with three replications and sixteen treatment combinations of four different varieties and four sowing windows. Four varieties used were NIAW-301 (Trymbak ), NIAW-917 (Tapovan), NIAW-1415 (Netravati) and NIAW-1994 (Phule Samadhan). Four sowings were taken up on 43rd MW (22-28 October), 45th MW (5-11November), 47th MW (19-25 November) and 49th MW (3-9 December). The grain yield of wheat was influenced significantly by wheat varieties. The grain yields were significantly higher in NIAW-1994 (51.07 and 48.52 qha-1) and significantly superior to the rest of the wheat varieties. This was followed by NIAW-917(45.72 and 43.43qha-1), NIAW-301(43.57 and 41.27 q ha-1). The variety NIAW-1415 recorded significantly lower grain yield (40.89 and 38.84 qha-1) during 2016 and 2017, respectively. Correlation analysis with weather parameters e.g. Temperature (Maximum and Minimum), Relative humidity (Morning and Evening), Rainfall and bright sunshine hours and yield showed that from tillering to 50% flowering stage, maximum temperature (-0.962*) was significantly negatively correlated with grain yield (r = -0.980**), (r =-0.950**) during 2016 and 2017, respectively in NIAW-301 (Trymbak ). The same trend was observed in the remaining varieties also. Regression equations were developed to predict the yield.

Thermal Indices Requirement of Kharif Groundnut (Arachis hypogaea L.) Varieties under Different Sowing Window in Western Maharashtra, India

An agro-meteorological investigation was undertaken during the kharif season of 2017 and 2018 at the Department of Agricultural Meteorology Farm, College of Agriculture, Pune, Maharashtra State (India). The experiment was laid out in split plot design with three replications. The treatment comprised of four varieties viz., V1: JL-501, V2: RHRG-6083 (Phule Unnati), V3: TAG-24 and V4: JL-776 (Phule Bharati) and four sowing windows viz., S1: 25rd MW (18th to 24th June), S2: 26th MW (25th June to 01st July), S­3: 27th MW (2nd to 8th July) and S4: 28th MW (09th to 15th July). Results showed that the higher GDD was observed in 26th MW sowing window with variety JL-776 (1826 and 1723) and RHRG-6083 (1763 and 1690) followed by variety JL-501 and TAG-24, whereas, higher heat use efficiency (0.088 and 0.100 g/GDD) at peg formation to rapid kernel growth stage was observed under 26th MW sowing window (S2) with variety JL-776 (V2) during 2017 and 2018, respectively. The highest HTU was observed in 26th MW sowing window in variety JL-776 (8254 and 6924) and RHRG-6083 (8171 and 7074) followed by variety JL-501 and TAG-24, whereas, higher heliothermal use efficiency (0.0200 and 0.0309 g/HTU) at peg formation to rapid kernel growth stage was observed under 26th MW sowing window (S2) in variety JL-776 (V2) during 2017 and 2018, respectively. Higher PTU (4818.42 and 4890.75) was observed under 26th MW sowing window (S2) in variety JL-776 (V2) this was followed by var. RHRG-6083, JL-501 and TAG-24 whereas, higher photothermal use efficiency (0.0284 and 0.293 g/PTU) at physiological maturity was observed under 26th MW sowing window (S2) with variety JL-776 (V2) followed by variety RHRG-6083, JL-501 and TAG-24 during 2017 and 2018, respectively.

Impact on Yield Attributes and Yields of Groundnut Varieties under Different Sowing Windows in Western Maharashtra, India

Present experiment was undertaken to study the “Impact of yield attributes and yields of groundnut varieties under different sowing windows in Western Maharashtra Plain Zone” at Department of Agricultural Meteorology Farm, Centre of Advanced Faculty Training (CAFT) in Agricultural Meteorology, College of Agriculture, Pune, Maharashtra State (India). The experiment was laid out in split plot design comprised of four varieties viz., V1: JL-501, V2: RHRG-6083 (Phule Unnati), V3: TAG-24 and V4: JL-776 (Phule Bharati) as main plot and four sowing windows viz., S1: 25rd MW (18th to 24th June), S2: 26th MW (25th June to 01st July), S­3: 27th MW (2nd to 8th July) and S4: 28th MW (09th to 15th July) as sub plot treatments. The number of pods plant-1, weight of pods plant-1, 100 kernel weight (g), shelling (%) and yields as influenced by the different treatments were recorded at harvest. Yield contributing characters viz., number of pods-1 (45.25 and 43.29) and weight of pods-1 (12.99 and 13.82) were found significantly higher in variety JL-776 over RHRG-6083, JL-501 and TAG-24, whereas shelling percentage (75.12 and 76.60) were found significantly higher in variety TAG-24 followed by JL-501, JL-776 and RHRG-6083. Pod yield (26.59 and 28.14 q ha-1) and haulm yield (39.61 and 36.7 q ha-1) were significantly higher in JL-776 followed by RHRG-6083, JL-501 and TAG-24. Amongst all the groundnut varieties, JL-776 (Phule Bharati) is significantly superior under extended sowing windows followed by varieties RHRG-6083, TAG-24 and JL-501. Sowing during 26th MW was observed to be most suitable and optimum for groundnut considering the growth and yield attributes. This sowing window was at par with 27th MW sowing window.

Assessment of Groundnut (Arachis hypogaea L.) Varieties under Various Sowing Windows for Crop Growth, Development and Yield in Western Maharashtra, India

The present experiment was carried out at Department of Agricultural Meteorology Farm, Centre of Advanced Faculty Training, College of Agriculture, Pune, MPKV, Rahuri for assessment of different groundnut (Arachis hypogaea L.) varieties for crop growth, development and yields under various sowing windows in Western Maharashtra Plain Zone during the Kharif season of 2017 and 2018. The experiment was laid out in split plot design with three replications. The treatment comprised of four varieties viz., V1: JL-501, V2: RHRG-6083 (Phule Unnati), V3: TAG-24 and V4: JL-776 (Phule Bharati) as main plot and four sowing windows viz., S1: 25th MW, S2: 26th MW, S­3: 27th MW and S4: 28th MW as sub plot treatments. From the result of the study, all the growth attributes were increased with the advancement in age of the groundnut crop. Plant height 35.27 and 33.34 cm, total number branches 11.34 and 10.55, total dry matter accumulation plant-1 34.36 and 32.11 g during both the years of experiment, which were found significantly higher in variety JL-776 over RHRG-6083, JL-501 and TAG-24. Among all the sowing windows 26th MW (S2) recorded the highest growth attributes viz., plant height (33.67 and 31.94 cm), total number of branches plant-1 (11.34 and 10.58 g) and total dry matter accumulation plant-1 (34.75 and 32.78 g) during both year of experiment. 26th MW sowing window was at par with the 27th MW sowing window with all growth attributes. Pod yield (26.59 and 28.14 q ha-1) and haulm yield (39.61 and 36.7 q ha-1) were significantly higher in variety in JL-776 followed by RHRG-6083, JL-501 and TAG-24. Pod yield (27.25 and 28.84 q ha-1) and haulm yield (40.60 and 37.61 q ha-1) was higher in 26th MW sowing window, which were at par with 27th MW sowing window during both the year.

COVID-19 infection and vaccine status in patients with chronic kidney diseases

Background: The COVID-19 virus has had a great effect globally, changing many commonalities. The incidence of COVID-19 had weakened the immune system, leading to more severe outcomes of various common diseases. Since its early development, the vaccination of COVID-19 has also had mixed responses. The aim of the study was to observe the incidence rate of COVID-19 infection and vaccination status among chronic kidney disease patients. Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Majority (41.61%) of the participants had been between the ages of 41-55 years old, and 64.84% male prevalence was observed. 60.65% of the participants had been from rural areas. A large portion of the participants (38.06%) did not have any comorbidities, while multiple comorbidities were present among many of the remaining participants. Hypertension was the most common comorbidity, observed in 56.45% of the participants. 72.26% of the present study participants had been asymptomatic, while 13.23% had a fever as their symptom of COVID-19. COVID-19 test was done on 81 patients, among whom 64 had tested positive. Among the total 310 participants, 29.03% had not received any vaccinations, while 14.19% had received only 1st dose of vaccination, 47.2% had received up to their 2nd dose, and 9.35% had received their booster dose. Conclusions: The present study observed a low incidence rate of COVID-19 positive patients among those affected by chronic kidney disease. However, the study also observed a significant positive relation between COVID-19 positive patients and the need for additional medical support, leading to the conclusion that COVID-19 can significantly affect the severity of CKD.

COVID-19 infection and vaccine status in patients with chronic kidney diseases

Background: The COVID-19 virus has had a great effect globally, changing many commonalities. The incidence of COVID-19 had weakened the immune system, leading to more severe outcomes of various common diseases. Since its early development, the vaccination of COVID-19 has also had mixed responses. The aim of the study was to observe the incidence rate of COVID-19 infection and vaccination status among chronic kidney disease patients. Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Majority (41.61%) of the participants had been between the ages of 41-55 years old, and 64.84% male prevalence was observed. 60.65% of the participants had been from rural areas. A large portion of the participants (38.06%) did not have any comorbidities, while multiple comorbidities were present among many of the remaining participants. Hypertension was the most common comorbidity, observed in 56.45% of the participants. 72.26% of the present study participants had been asymptomatic, while 13.23% had a fever as their symptom of COVID-19. COVID-19 test was done on 81 patients, among whom 64 had tested positive. Among the total 310 participants, 29.03% had not received any vaccinations, while 14.19% had received only 1st dose of vaccination, 47.2% had received up to their 2nd dose, and 9.35% had received their booster dose. Conclusions: The present study observed a low incidence rate of COVID-19 positive patients among those affected by chronic kidney disease. However, the study also observed a significant positive relation between COVID-19 positive patients and the need for additional medical support, leading to the conclusion that COVID-19 can significantly affect the severity of CKD.

Evaluation of Visual Acuity, Macular Thickness, and Level of Proteinuria in Children with Nephrotic Syndrome

Purpose@#Macular edema, serous retinal detachment, and retinal pigment epithelial detachment have been reported in patients with nephrotic syndrome. However, there is limited data about macular thickness in children with nephrotic syndrome. The aim of this study was to compare the mean macular thickness in children with nephrotic syndrome and in a control group and to correlate it with visual acuity and level of proteinuria. @*Methods@#The comparative cross-sectional study included 66 children aged 6 to 17 years with nephrotic syndrome and healthy control seen in two tertiary centers in Malaysia. We recorded demographic data, as well as visual acuity, level of proteinuria, and the mean macular thicknesses in both groups. The mean macular thickness was measured using Stratus optical coherence tomography according to nine areas of the Early Treatment Diabetic Retinopathy Study map. @*Results@#The mean foveal thickness was 238.15 ± 22.98 µm for children with nephrotic syndrome and 237.01 ± 22.60 µm for the control group. There was no significant difference in the mean macular thickness between the groups (p = 0.843). A significant correlation with visual acuity was observed in the superior outer macula (r = –0.41, p = 0.019), the nasal outer macula (r = –0.41, p = 0.019), and the inferior outer macula (r = –0.40, p = 0.021). There was no significant correlation between the mean macular thickness and level of proteinuria (p = 0.338), although those with higher levels of proteinuria demonstrated a trend towards increased macular thickness. @*Conclusions@#The mean macular thickness in children with nephrotic syndrome was similar to that of healthy children. A significant correlation between the mean thickness of the outer macular layer and the presenting visual acuity was observed. There was no correlation between the mean macular thickness and the level of proteinuria.

GSK-3β inhibition with antiplasmodial activities from the extracts of actinomycetes isolated from Malaysian forest soil

Aims@#Glycogen synthase kinase-3 (GSK-3 (EC:2.7.11.1)) is one of the main therapeutic targets for treating cancer, diabetes, neurological illness and parasitic infection. Due to their distinctive structural characteristics and wide-ranging biological actions, small compounds from soil bacteria have been the most sought-after source for GSK-3 inhibitors. This study assessed the activities of soil actinomycetes isolated from Sabah, Malaysia, against human GSK-3β. @*Methodology and results@#A total of 514 actinomycetes strains were isolated from 144 soil samples. The activities of the crude extracts were evaluated against GSK-3β and its upstream regulators (MKK1 and PP1/GLC7) using yeast-based assays. Eight actinomycetes extracts showed selective human GSK-3β inhibition without affecting MKK1 and PP1/GLC7. The extract from one of these eight isolates, FA013, also showed potent and selective anti-plasmodial activities against Plasmodium falciparum 3D7 strain (IC50 = 0.18 μg/mL, SI = 13,850) with a non-toxic effect against Chang liver cells. @*Conclusion, significance and impact of study @#This study identified FA013 as a potential isolate from Malaysian rainforest soil with inhibitory activities against GSK-3β and malaria parasites for future drug development.

Cytogenomic Profiling of Chronic Lymphocytic Leukaemia Patients Using DNA Microarray

@#Introduction: Chronic lymphocytic leukaemia (CLL) is the most frequent adult leukaemia in the Western world. The clinical presentation varies greatly, from very indolent cases to those with aggressive and fast advancing disease. This variation has significant implications for clinical approaches, therapeutic tactics, and, ultimately, survival durations from diagnosis. Acquired chromosomal aberrations play a key role in CLL aetiology. Due to difficulty to obtain abnormal metaphases for analysis, few methods such as fluorescence in-situ hybridization (FISH) and multiplex ligation-dependent probe assay (MLPA) were employed to detect chromosomal aberration however the methods are limited to specific locus only. Thus, this study is aimed to detect the chromosomal aberrations using DNA microarray platform. Methods: In this retrospective study, DNA archive obtained from 7 CLL patients which collected at diagnosis and subjected to Affymetrix CytoScan® 750K single nucleotide polymorphism (SNP) array following the manufacture procedure. The raw data obtained were analysed using the Chromosome Analysis Suite (ChAS) software (Affymetrix) using annotations of genome version GRCh38 (hg38). Result: Out of 7 patients, 4 of them showing deletion of 13q while 3 of them showing deletion of 14q in various region . Some of the deleted loci were too small (0.42-0.6Mb) to be detected by conventional cytogenetic analysis (CCA). There was also the presence of additional chromosomal aberrations that could be missed by CCA, FISH, or MLPA due to cryptic deletion or duplication that was as small as 0.4MB in size. Conclusion: The present study showed that low resolution chromosomal aberration was able to be detected using DNA microarray platform in comparison to CCA, FISH and MLPA.

A Case of Lymphoma with Multiple Identities

@#Discordant lymphoma (DL) is the coexistence of two or more distinct subtypes in separate anatomic sites. There are limited reports on DL cases especially involving more than two subtypes in more than two sites. We report a 76-year-old man who presented with constitutional symptoms, flank mass and painless lymphadenopathies for six months. Laboratory tests revealed moderate anaemia, markedly elevated serum IgM (13400 mg/dL), IgM Lambda paraproteinemia and Lambda light chain paraproteinuria with unmeasurable serum lactate dehydrogenase due to hyperviscous sample. CT scan showed multiple subcutaneous masses over chest wall and retroperitoneum, with lytic bone lesions, and hepatosplenomegaly. Further biopsy findings with morphological, immunohistochemical and molecular analysis of the tissue sections revealed diffuse large B-Cell lymphoma in the chest wall mass, follicular lymphoma in the inguinal lymph node and lymphoplasmacytic lymphoma in the bone marrow. This case highlights the rare DL. The importance of histopathological evaluation of lymphoma despite the availability of PET-CT scans for disease staging is undeniable.

Cytotoxic Activity of Ethanolic Extract Aquilaria malaccensis Leaves Against MCF-7 Cells

@#Introduction: Aquilaria malaccensis, also known as “Pokok Karas” in Malaysia, is widely used in Southeast Asian countries for the treatment of joint pain, diarrhoea and inflammatory diseases, and has shown beneficial effects as an anticancer agent. The aim of this study was to investigate the effect of ethanol leaf extracts of A. malaccensis on MCF-7 cells. Methods: MTT-based cytotoxic and antiproliferative assay was used to determine the outcome of ethanolic extract toward MCF-7 cells. The mode of cell death was determined by the AO/PI double staining assay and the depolarisation of the mitochondria membrane potential. Results: IC50 value of the extract against MCF-7 cells treated for 72 hours was 4.1 ± 2.08 µg/mL, while the IC50 value for doxorubicin was 2.92 ± 0.12 µg/mL. The extract showed a lower cytotoxic effect against the NIH/3T3 cells and inhibited the growth of MCF-7 cells in a dose dependent manner. AO/PI double stain showed that the ethanolic extract of A. malaccensis leaves induced MCF-7 cells into apoptotic cell death. The present study showed that the ethanolic extract of A. malaccensis induced apoptosis through mitochondrial pathway as indicated by its ability to take up JC-1. Conclusion: The study found that ethanolic extract obtained from A. malaccensis leaves is cytotoxic on MCF-7 cells, resulting to apoptotic cell death of the cells.

Prevalence and Susceptibility of Staphylococcus aureus Nasal Carriage Strains Isolated from Haemodialysis Patients

@#Introduction: Staphylococcus aureus is part of the normal human flora that can commonly be found on the skin and mucous membranes of the nasal area. However, in immunosuppressed patients such as those with kidney failures, colonization can potentially lead to infection. There is a concern of increasing antibiotic resistance in S. aureus. This study aimed to determine the prevalence of S. aureus nasal colonization and its antimicrobial susceptibility among haemodialysis-dependent populations. Methods: A cross-sectional study at the Nephrology Unit, Hospital Canselori Tuanku Mukhriz (HCTM) was conducted among haemodialysis-dependent patients between February 2017 to February 2018. Nasal swabs were obtained and cultured on mannitol salt agar. S. aureus isolates were identified by gram staining, tube coagulase and Deoxyribonuclease (DNase). Cefoxitin disc (30 µg) were used to identified the presence of MRSA (methicillin-resistance S. aureus). The S. aureus colonies were further tested against six antibiotics using Kirby Bauer disc diffusion. Result: A total of 134 patients were recruited. S. aureus isolates were detected from 27 patients (20.1%). All S. aureus were phenotypically identified as methicillin-sensitive S. aureus (MSSA) based on the cefoxitin disc. Teicoplanin and linezolid were the most effective with 100% susceptibility. S. aureus exhibited a high resistance rate towards erythromycin (29.6%). No MRSA was isolated in this study. Conclusion: This study highlighted the high prevalence of S. aureus nasal colonization in haemodialysis patients. Teicoplanin and linezolid were found to be the most effective antibiotics against isolated S. aureus.

The Sanitary Conditions of Bakeries and Food Safety Practices Assessment of Bakers in Tamale Metropolis, Ghana

There is a lack of research on the safety of bread in Ghana, although it is one of the foods consumed by most Ghanaians daily. The study, therefore, assessed the sanitary conditions of bakeries in the Tamale Metropolis and further evaluated the food safety practices of bakers in these bakeries. The study employed the use of a questionnaire to collect data in 24 carefully selected bakeries and then the food safety practices of bakers in these bakeries. Results showed that 91.7% of the bakeries had bakers wearing protective gears while working. All (100%) the bakeries were free of domestic animals and a visible presence of insects, rodents or vectors. However, 6(25%) bakeries placed their solid waste containers in the bakery premises. Also, 89.5% of the bakers indicated that they always wash their hands with soap and water before working or handling baking ingredients and materials. All (100%) bakers indicated that they check the expiry dates of their bakery ingredients before using them. 29.8% of the bakers, however, did not make it a practice of refrigerating bakery ingredients that require to be stored in the fridge when not in use. In conclusion, most bakeries had good sanitary conditions and were managed in a manner that ensure food safety. Bakers also exhibited a good level of food safety adherence. Managers should continue to ensure that good sanitary standards are followed and food risk analysis concepts like HACCP are implemented in the bakery to check new and complex food safety threats.

Long-term Safety and Efficacy of Esketamine Nasal Spray Plus an Oral Antidepressant in Patients with Treatment-resistant Depression– an Asian Sub-group Analysis from the SUSTAIN-2 Study

Objective@#To evaluate the long-term safety and efficacy of intranasal esketamine in patients with treatment-resistant depression from the Asian subgroup of the SUSTAIN-2 study. @*Methods@#SUSTAIN-2 was a phase 3, open-label, single-arm, multicenter study comprising a 4-week screening, 4-week induction, 48-week optimization/maintenance, and 4-week follow-up (upon esketamine discontinuation) phase. Patients with treatment-resistant depression received esketamine plus an oral antidepressant during the treatment period. @*Results@#The incidence of ≥ 1 serious treatment-emergent adverse event (TEAE) among the 78 subjects from the Asian subgroup (Taiwan: 33, Korea: 26, Malaysia: 19) was 11.5% (n = 9); with no fatal TEAE. 13 Asian patients (16.7%) discontinued esketamine due to TEAEs. The most common TEAEs were dizziness (37.2%), nausea (29.5%), dissociation (28.2%), and headache (21.8%). Most TEAEs were mild to moderate in severity, transient and resolved on the same day. Upon discontinuation of esketamine, no trend in withdrawal symptoms was observed to associate long-term use of esketamine with withdrawal syndrome. There were no reports of drug seeking, abuse, or overdose. Improvements in symptoms, functioning and quality of life, occurred during in the induction phase and were generally maintained through the optimization/maintenance phases of the study. @*Conclusion@#The safety and efficacy of esketamine in the Asian subgroup was generally consistent with the total SUSTAIN-2 population. There was no new safety signal and no indication of a high potential for abuse with the long-term (up to one year) use of esketamine in the Asian subgroup. Most of the benefits of esketamine occurred early during the induction phase.

Laplace-Based Interpolation Method in Reduction of Metal Artifact in Computed Tomography Imaging

@#Introduction: Metal artifacts can degrade the image quality of computed tomography (CT) images which lead to errors in diagnosis. This study aims to evaluate the performance of Laplace interpolation (LI) method for metal artifacts reduction (MAR) in CT images in comparison with cubic spline (CS) interpolation. Methods: In this study, the proposed MAR algorithm was developed using MATLAB platform. Firstly, the virtual sinogram was acquired from CT image using Radon transform function. Then, dual-adaptive thresholding detected and segmented the metal part within the CT sinogram. Performance of the two interpolation methods to replace the missing part of segmented sinogram were evaluated. The interpolated sinogram was reconstructed, prior to image fusion to obtain the final corrected image. The qualitative and quantitative evaluations were performed on the corrected CT images (both phantom and clinical images) to evaluate the effectiveness of the proposed MAR technique. Results: From the findings, LI method had successfully replaced the missing data on both simple and complex thresholded sinogram as compared to CS method (p-value = 0.17). The artifact index was significantly reduced by LI method (p-value = 0.02). For qualitative analysis, the mean scores by radiologists for LI-corrected images were higher than original image and CS-corrected images. Conclusion: In conclusion, LI method for MAR produced better results as compared to CS interpolation method, as it worked more effective by successfully interpolated all the missing data within sinogram in most of the CT images.

Projection of Infant Mortality Rate in Malaysia using R (Unjuran kadar kematian bayi di Malaysia menggunakan R) / Jurnal Sains Kesihatan Malaysia

@#Projecting future infant mortality rate (IMR) is an important subject in ensuring the stability of health in one nation or a specific region in general. Secondary data of IMR from December 1950 until December 2020 from United NationsWorld Population Prospects were used to project the trend of IMR in Malaysia up to 2023. In this study, five different forecasting models were adopted including Mean model, Naïve model, Autoregressive Integrated Moving Average (ARIMA) model, Exponential State Space model and Neural Network model. The results were analyzed using R programing and RStudio. The out-sample forecasts of mortality rates were evaluated using six error measures namely, Mean Error (ME), Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Percentage Error (MPE), Mean Absolute Percentage Error (MAPE) and Mean Absolute Scaled Error (MASE). Consequently, the keen analysis was focused on the trend and projection of infant mortality rate in the future using the most accurate model. The results showed that the “win” model for this study is ARIMA (0,2,0) model. The model provided a consistent estimate of IMR in relation to a similar decreasing pattern as shown by the original data and hence a reliable projection of IMR. The three ahead forecast values showed that IMR is likely to keep on continuously decreasing in the future. This study could become a guideline for human resource management and health care allocation planning. A forecast of IMR can help the implementation of interventions to reduce the burden of infant mortality within the target range.

Calcium and iron intakes of adolescents in Malaysia and their relationships with body mass index (BMI): Findings from the Adolescent Nutrition Survey 2017

@#Introduction: Adolescent health is a priority considering they represent the future generation. Data from the Adolescent Nutrition Survey 2017 were analysed to determine the prevalence of micronutrient inadequacy, particularly calcium and iron, and the relationship with body mass index (BMI) among Malaysian secondary school students. Methods: This cross-sectional study included students aged 13 to 17 years old studying at public and private schools. Twenty-four hours dietary recall via face-to-face interview was conducted by trained nutritionists to obtain data on dietary intake. For nutritional status, BMI-for-age z-score (BAZ) was analysed using WHO Anthroplus software. Results: From 999 respondents, 449 were boys and 550 were girls. Overall findings indicated that both boys and girls had inadequate intakes of calcium and iron in their daily diet. Mean intakes of calcium (695.7±463.2 mg/day) and iron (23.4±21.0 mg/day) were higher among boys aged 16 to 17 years old. Mean intake of iron were higher among the older age groups. Majority of the respondents (boys: 94%; girls: 97%) did not meet the recommended nutrient intake (RNI) for calcium and more than half (boys: 50%; girl: 80%) did not achieve the RNI for iron. Current findings also found significant positive but weak correlations between calcium (r=0.112, p=0.001) and iron (r=0.084, p=0.008) intakes with BMI-for-age. Conclusion: BMI-for-age was related to calcium and iron intakes among secondary school students in Malaysia. Thus, intervention strategies should focus on early screening and nutrition education on food choices of high calcium and high iron contents, including iron supplementation programmes, if needed.

Fruit and vegetable intake among overweight and obese school children: A cluster randomised control trial

@#Introduction: Adequate daily intake of fruits and vegetables is crucial for the prevention of chronic diseases. This study aimed to determine the effects of My Body is Fit and Fabulous at School (MyBFF@school) with nutrition education intervention (NEI) on the stages of change for fruit and vegetable intake among overweight and obese secondary school children based on the trans-theoretical model (TTM). Methods: This was a cluster randomised controlled trial involving 15 out of 415 eligible government secondary schools in central Peninsular Malaysia, which were randomly assigned into intervention (six schools; 579 school children) and control (nine schools; 462 school children). The intervention group was given NEI for 24 weeks, while the control group followed the existing school programme by the Ministry of Education. Results: There was no significant difference between the intervention and control groups for the stages of change, with majority at the maintenance stage after six months (intervention: 34.9%; control: 39.0%). The within group analysis showed a significant reduction after six months for those at the action stage (action and maintenance stage) from 68.0% to 60.4% in the intervention group and from 71.4% to 65.6% in the control group. However, there was a significant increase among those with adequate fruit and vegetable intake in the intervention group and no significant increase in the control group. Conclusion: MyBFF@school with NEI based on TTM provided acceptable changes in fruit and vegetable intake among overweight and obese secondary school children.