Pulmonary thromboembolic disease associated with COVID-19 infection: a comparison between geriatric and non-geriatric populations.

INTRODUCTION: The magnitude of Coronavirus Disease 2019 (COVID-19) infection among the elderly population is expected to rise. Our study compares the clinical and computed tomographical (CT) features of pulmonary thromboembolic (PTE) disease associated with COVID-19 infection in geriatric and non-geriatric cases, and explores the 60-day mortality rate in these two groups. MATERIALS AND METHODS: We conducted this retrospective cross-sectional study in Hospital Tengku Ampuan Rahimah, Selangor, Malaysia. Patients admitted in April 2021 and May 2021 with concomitant COVID-19 infection and PTE disease were included. Demographic, clinical and laboratory data were retrieved, whilst CTPA images were analysed by a senior radiologist. RESULTS: A total of 150 patients were recruited, comprising 45 geriatric patients and 105 non-geriatric patients. The prevalence rate of hypertension, diabetes mellitus and dyslipidaemia were higher among the geriatric cohort. Evidently, the percentage of patients with fever and diarrhoea were significantly higher among the non-geriatric cohort. The geriatric cohort also recorded a significantly lower absolute lymphocyte count at presentation and albumin level during admission. Despite earlier presentation, the geriatric cohort suffered from more severe diseases. Analysis of the CT features demonstrated that the most proximal pulmonary thrombosis specifically limited to the segmental and subsegmental pulmonary arteries in both cohorts. The elderly suffered from a significantly higher inhospital mortality rate and their cumulative probability of survival was significantly lower. CONCLUSION: Typical COVID-19 symptoms may be absent among the elderly, prompting a lower threshold of suspicion during the COVID-19 pandemic. Additionally, the elderly demonstrated a higher probability of adverse outcomes despite earlier presentation and treatment.

Contribution of the lamellar morphology to the photocatalytic activity of alkaline-hydrothermally treated titania in rhodamine B photodegradation.

TiO2 particles with a specific morphology are essential for their accessibility and photoactivity. The present study shows that NH4OH-based alkaline-hydrothermal treatment affects the transformation of their particle morphology. We investigated the effect of NH4OH by varying the synthesis route. We observed that the TiO2 particles with an open channel pore structure only resulted in the alkaline-hydrothermally treated and calcined samples. Based on Raman and XRD analyses, we figured out the titanate layers as an intermediate phase resulting from the alkaline-hydrothermal treatment of the amorphous particles. The hydrothermal treatment changed the particle surface morphology into a lamellar structure with a high specific surface area. These are the anatase precursors with {200} planes that transform into the anatase phase after calcination. The calcination followed by alkaline-hydrothermal treatment converted the crystallinity without significantly changing their morphology. We found that the morphology of TiO2 particles can be modified via hydrothermal treatment using NH4OH as long as the particles remain uncrystallized. We suggested the modification of particle morphology through the swelling and phase segregation process by alkaline-hydrothermal treatment. All final products have been used for the photodegradation of rhodamine B. S-HT-500 and A-HT-500 show the best photocatalytic activity with their rate constants (k) of 47.9 and 30.9 × 10-2 min-1, and their surface area-normalized rate constants (ksa) of 6.5 and 2.6 × 10-3 L m-2 min-1, respectively, and have a photocatalytic efficiency of 90.93% and 67.78%, respectively, after 10 minutes of UV irradiation. This activity is approximately 3.5 times and 1.5 times higher than that of Degussa P25; 30 times and 20 times higher than that without a photocatalyst.

A survey on workplace violence among pre-hospital care personnel in Malaysia.

INTRODUCTION: Data on violence experienced by pre-hospital care (PHC) staff in developing countries are lacking. This study investigates incidence, effect, coping reaction, and action taken towards violence received by PHC staff in Malaysia, a developing country. MATERIALS AND METHODS: This is a multi-centred crosssectional survey. Questionnaire modified from the Joint Programme on Workplace Violence in the Healthcare Sector was applied. PHC staff include assistant medical officers, emergency medical technicians (EMTs), nurses, attendants, and ambulance drivers. This questionnaire involves workplace violence (WPV) experienced for 12 months since the beginning of this study among pre-hospital staff of three main hospitals in Klang Valley, Malaysia. RESULTS: Seventy-one PHC staff personnel responded to this questionnaire. Overall prevalence of at least one WPV incident over past 12 months was 56.3% (95% CI 44.8% to 65.8%). Fifty-three-point-five percent (95% CI 41.9% to 65.1%) experienced verbal abuse, 9.9% (95% CI 3% to 16.8%) experienced physical abuse, and 14.1% (95% CI 6.0% to 22.2%) experienced racial abuse. None of the participants experienced sexual abuse. Out of 38 staff that experienced verbal abuse, 16 (42%) took no action, 8 (21.1%) pretended it never happened, and only 5 (13.2%) filed an actual complaint. CONCLUSION: Verbal abuse was found to be the most common type of violence. Younger age group (<29 years) was more exposed to verbal (p = 0.014) and racial abuse (p = 0.007). Majority victims either responded by telling abusers to stop or taking no action at all.

Organic acid and probiotic derived from grass silage improved egg quality in Pegagan laying duck: a research note.

The aim of this study was to evaluate the effect of supplementation of organic acid and probiotic derived from grass silage on the egg quality of duck. Seventy-two Pegagan laying ducks (average age: 24 weeks) were randomly allocated to six treatment groups: basal diet, basal diet + organic acid, basal diet + probiotic, basal diet + tetracycline, basal diet + probiotic + organic acid, and basal diet + organic acid + tetracycline. The result showed that the feeding diets containing probiotics and organic acid significantly (P < 0.05) reduced yolk fat and yolk cholesterol and increased eggshell weight, egg index, yolk color score, Haugh unit, and protein content. However, egg weight, albumen weight, yolk weight, albumen index, yolk index, and water content were not significantly (P > 0.05) different. It is concluded that dietary supplementation of organic acid and probiotic derived from grass silage improved egg quality in terms of yolk color score, fat, and cholesterol content.

Transitioning pre-clinical glioblastoma models to clinical settings with biomarkers identified in 3D cell-based models: A systematic scoping review.

Glioblastoma (GBM) remains incurable despite the overwhelming discovery of 2-dimensional (2D) cell-based potential therapeutics since the majority of them have met unsatisfactory results in animal and clinical settings. Incremental empirical evidence has laid the widespread need of transitioning 2D to 3-dimensional (3D) cultures that better mimic GBM's complex and heterogenic nature to allow better translation of pre-clinical results. This systematic scoping review analyses the transcriptomic data involving 3D models of GBM against 2D models from 22 studies identified from four databases (PubMed, ScienceDirect, Medline, and Embase). From a total of 499 genes reported in these studies, 313 (63%) genes were upregulated across 3D models cultured using different scaffolds. Our analysis showed that 4 of the replicable upregulated genes are associated with GBM stemness, epithelial to mesenchymal transition (EMT), hypoxia, and migration-related genes regardless of the type of scaffolds, displaying close resemblances to primitive undifferentiated tumour phenotypes that are associated with decreased overall survival and increased hazard ratio in GBM patients. The upregulation of drug response and drug efflux genes (e.g. cytochrome P450s and ABC transporters) mirrors the GBM genetic landscape that contributes to in vivo and clinical treatment resistance. These upregulated genes displayed strong protein-protein interactions when analysed using an online bioinformatics software (STRING). These findings reinforce the need for widespread transition to 3D GBM models as a relatively inexpensive humanised pre-clinical tool with suitable genetic biomarkers to bridge clinical gaps in potential therapeutic evaluations.

Compliance of Malaysian healthcare workers towards tuberculosis prevention programmes in workplace: An exploratory sequential mixed method study protocol.

INTRODUCTION: The World Health Organization (WHO) stated that the incidence of tuberculosis among healthcare workers is increasing yearly and exceeds the incidence of tuberculosis in the community in almost all the countries that report to the WHO. The problem is greater in countries with high burden of tuberculosis disease in the community. The cause of this problem may be contributed by the attitudes of the healthcare workers themselves, such as non-compliance of the procedures at their work tasks meant to prevent them from contracting the disease. Therefore, this study aims to assess the perceptions and the behaviours of healthcare workers in relation to compliance towards prevention activities on tuberculosis at their workplace. MATERIALS AND METHODS: We plan to conduct a two-phase exploratory sequential mixed method study to determine the factors affecting compliance of Malaysian healthcare workers towards tuberculosis prevention programmes in their workplace based on the guidelines of the Ministry of Health, Malaysia. Phase one is a qualitative study with a focus group discussion and questionnaire development and phase two is a quantitative study where data will be collected among healthcare workers in government clinics and hospitals in Selangor. The data from phase one will be analysed using Atlas.Ti software for thematic analysis and data from phase two will be analysed using SEM AMOS software for structural equation modelling.

Emerging therapeutic potential of anti-psychotic drugs in the management of human glioma: A comprehensive review.

Despite numerous advancements in the last decade, human gliomas such as astrocytoma and glioblastoma multiforme have the worst prognoses among all cancers. Anti-psychotic drugs are commonly prescribed to treat mental disorders among cancer patients, and growing empirical evidence has revealed their antitumor, anti-metastatic, anti-angiogenic, anti-proliferative, chemo-preventive, and neo-adjuvant efficacies in various in vitro, in vivo, and clinical glioma models. Anti-psychotic drugs have drawn the attention of physicians and researchers owing to their beneficial effects in the prevention and treatment of gliomas. This review highlights data on the therapeutic potential of various anti-psychotic drugs as anti-proliferative, chemopreventive, and anti-angiogenic agents in various glioma models via the modulation of upstream and downstream molecular targets involved in apoptosis, autophagy, oxidative stress, inflammation, and the cell cycle in in vitro and in vivo preclinical and clinical stages among glioma patients. The ability of anti-psychotic drugs to modulate various signaling pathways and multidrug resistance-conferring proteins that enhance the efficacy of chemotherapeutic drugs with low side-effects exemplifies their great potential as neo-adjuvants and potential chemotherapeutics in single or multimodal treatment approach. Moreover, anti-psychotic drugs confer the ability to induce glioma into oligodendrocyte-like cells and neuronal-like phenotype cells with reversal of epigenetic alterations through inhibition of histone deacetylase further rationalize their use in glioma treatment. The improved understanding of anti-psychotic drugs as potential chemotherapeutic drugs or as neo-adjuvants will provide better information for their use globally as affordable, well-tolerated, and effective anticancer agents for human glioma.

Metastatic Pleomorphic Adenoma in the infratemporal fossa and neck following total parotidectomy after 30 years.

Metastasising pleomorphic adenoma is rare and may occur years after surgical excision of a pleomorphic adenoma (PA). We present a 61-year-old woman with a right infratemporal PA with metastases to the cervical lymph nodes after 30 years following a total parotidectomy. She was treated successfully with a resection of the tumour with combined neck and mandibulotomy approach along with postoperative radiotherapy given subsequently.

A case report of aluminium phosphide poisoning.

Aluminium phosphide (ALP) is highly toxic and poisoning can result in high mortality rates. A 26-year-old female who allegedly ingested a toxic dose of ALP presented with vomiting and diarrhoea. She developed cardiac arrest with refractory pulseless ventricular tachycardia. Despite aggressive resuscitation, she succumbed to death seven hours following ingestion. In cases like this, a better outcome can be achieved with early arrival, prompt diagnosis, aggressive resuscitation and intensive monitoring.

Internal Jugular Vein Height and Inferior Vena Cava Diameter Measurement using Ultrasound to Determine Central Venous Pressure: A Correlation Study.

OBJECTIVE: To determine the correlation between central venous pressure (CVP) measured by conventional central venous access and ultrasonographic measurement of internal jugular vein (IJV) height and inferior vena cava (IVC) diameter. METHODS: A prospective, cross-sectional, convenience sampling observational study. RESULTS: 25 patients from the Emergency Department (ED) Universiti Kebangsaan Malaysia Medical Centre (UKMMC) were studied between 1st March and 30th April 2013. The median age was 63 years (95% CI 54-67). There was a significant correlation between IJV height and CVP using central venous access (r=0.64 p<0.001). Correlation between IVC diameter in end expiration and CVP was 0.74 (p<0.001). An IJV height measurement >8cm predicted a CVP >8cm H2O (sensitivity 71.4%, specificity of 83.3%). CONCLUSION: Measurement of IJV height and IVC diameter by ultrasonography correlates well with invasive CVP and is useful for the assessment of volume status in critically ill patients in the ED.

Momordica charantia ointment accelerates diabetic wound healing and enhances transforming growth factor-ß expression.

OBJECTIVE: Transforming growth factor-ß (TGF-ß) plays an important role in wound healing. Delayed wound healing is a consequence of diabetes, leading to high morbidity and poor quality of life. Momordica charantia (MC) fruit possesses anti-diabetic and wound healing properties. This study aimed to explore the changes in TGF-ß expression in diabetic wounds treated with topical MC fruit extract. METHODS: Fifty-six male Sprague-Dawley rats were divided into a normal control group and five diabetic groups of ten rats each. Intravenous streptozotocin (50mg/kg) was given to induce diabetes in the diabetic groups. Full thickness excision wounds were created on the thoracodorsal region of the animals, and these wounds were then treated with vehicle, MC powder, MC ointment and povidone ointment or ointment base for ten days. Wound healing was determined by the rate of wound closure, total protein content and TGF-ß expression in the wounds, and histological observation. RESULTS: Diabetic groups showed delayed wound closure rates compared to the control group. The wound closure rate in the MC ointment group was significantly faster than that of the untreated diabetic group (p<0.05). The MC ointment group also showed intense TGF-ß expression and a high level of total protein content. CONCLUSION: MC ointment has a promising potential for use as an alternative topical medication for diabetic wounds. This work has shown that it accelerates wound healing in diabetic rats, and it is suggested here that this occurs by enhancing TGF-ß expression. Further work is recommended to explore this effect.

Urea Output by L3 Teladorsagia circumcincta and some Properties of Two Urea Producing Enzymes.

BACKGROUND: Like several other parasites, Teladorsagia circumcincta secretes or excretes urea, but neither the rate of efflux nor the possible metabolic sources of the urea has been considered. METHODS: Parasites were maintained by passage through sheep. Urea efflux was measured using phenol/hypochlorite after treatment with urea aminohydrolase. The kinetics of creatine amidinohydrolase and arginine amidinohydrolase were characterised by coupling the reactions with urea aminohydrolase and glutamate dehydrogenase. RESULTS: Infective L3 T. circumcincta secreted or excreted urea at 25% of the rate of NH3/NH4 (+). The rate of urea efflux was about 84 pmol h(-1) (10(3) larvae)(-1) over 4 hours, corresponding to about 11 nmol h(-1) mg(-1) protein. We could not detect urea aminohydrolase activity, but urea production by both creatine amidinohydrolase and arginine amidinohydrolase could be detected. The apparent K m and V max of creatine amidinohydrolase were 1.1 mM and 48 nmol h(-1) mg(-1) protein, respectively, and the activity was greatest at pH 8. The apparent K m and V max of arginine amidinohydrolase were 0.7 mM and 62 nmol h(-1) mg(-1) protein, respectively, and the activity was greatest at pH 7.9. CONCLUSION: The activity of creatine amidinohydrolase and arginine amidinohydrolase was sufficient to account for the rate of urea secretion or excretion.

Nitrogen excretion by the sheep abomasal parasite Teladorsagia circumcincta.

Excretion of nitrogenous substances by Teladorsagia circumcincta was investigated during incubation of L3 in phosphate buffer for up to 30h and adult worms for 4-6h. Ammonia was the main excretory product, with about 20% urea. For the first 4-6h, ammonia excretion by L3 was temperature dependent, directly proportional to the number of larvae, but independent of the pH or strength of the phosphate buffer. Later, ammonia excretion slowed markedly in L3 and adults and reversed to net uptake in L3 by 30h. An initial external ammonia concentration of 600 microM did not alter the pattern or magnitude of excretion. Re-uptake of ammonia did not occur at extremes of pH or low buffer strength and was slightly reduced at the highest external concentrations. Ammonium transporters and enzymes of glutamate metabolism, including glutamate dehydrogenase, glutamine synthetase and possibly glutamate synthase, are worthy of further investigation as anthelmintic targets.

Oto-mandibulo-facial dysostosis: a case report.

The case presented here is a 6 year old male child with oto-mandibulo-facial dysostosis syndrome. Oto-mandibulo-facial dysostosis is a term used for a unilateral congenital birth defect in which abnormalities can range from minor unilateral ear anomalies or preauricular tags to severe ones involving anotia and mandibular hypoplasia.