Simultaneous microwave digestion for total arsenic and inorganic arsenic in local shrimp and prawn commodities of Brunei Darussalam for regulatory and safety monitoring.

The data gap in food safety regulations have created misinformation leading to the rejection of commodities for trade. The evidence presented is the local regulation of arsenic in sea produce which is based on total arsenic, tAs, instead of toxic inorganic arsenic, iAs. Furthermore, tAs data in animal origin seafood has been widely proven to be dominated by the non-toxic Arsenobetaine, AsB. Therefore, if arsenic regulatory limit was set based only on tAs without reference to iAs data, seafood products might be wrongfully rejected for trade because of non-compliance to tAs limit. We provided analysis of tAs and iAs of 14 local prawn and shrimp commodities from three shrimp/prawn sector namely aquaculture (n = 3), capture (n = 5) and processed (n = 6) using effective extraction, as well as, a fit-for-purpose analytical method for iAs. A HVG-AAS method was developed and validated for iAs with LoQ of 1.6 ppb, analytical range of 0-6 ppb, repeatability RSDr of 0.5-3.1 %, coefficient of determination R2 of 0.9975, and percentage recovery of 90.9 %, while an existing method using ICP-MS was used to verify the tAs. Based on the AOAC Official Method 999.10 2005 with minor adjustments, seafood samples were digested with concentrated nitric acid and hydrogen peroxide under pressure in a closed vessel heated by a microwave digester. An additional step for iAs determination was necessary to ensure compatibility in HVG-AAS analysis. Further subdivision of the aquaculture and capture samples was done by dividing them into 3 fractions, namely head, flesh and peel. Comparison of tAs in all the three fractions indicated that for aquaculture sector, the highest tAs were found in the flesh (2nd highest in % weight) whereas for the capture sector, the highest amount of tAs correlated with the highest % weight of the fraction. On regulatory aspects, speciation analysis on the iAs indicated samples with quantifiable iAs value were in-compliance despite tAs were initially found to be higher than the national limits. Risk assessment of iAs indicated there were no risk for human daily intake based on the BDML0.5 value of 3.0 µg/kg b.w per day for an average 70 kg man. All findings concluded the need for doing arsenic speciation analysis of iAs along with tAs for routine monitoring of prawn/shrimp samples and to revise the local limits from tAs to iAs particularly for seafood commodities.

Outcome of chest re-exploration for haemostasis in intensive care unit post-cardiac surgery: A retrospective analysis.

INTRODUCTION: Chest re-exploration is potentially life-saving in the treatment of early post-operative complications of open-heart surgery such as for surgical haemostasis, hemodynamic instability, and cardiac arrest. The procedure is often performed in the intensive care unit (ICU) rather than in the operating theatre (OT). The incidence of chest reexploration may range from 2 to 12%. To analyse the complications of patients who underwent chest reexploration in the ICU for haemostasis after heart surgery vs in those who were operated in an OT. Secondary outcome measured is all-cause mortality in the patients involved. MATERIALS AND METHODS: This is a retrospective analysis of patients' medical records who underwent chest reexploration in the ICU for haemostasis over a 2-year period (2019 to 2020). The cases which needed re-exploration for haemostasis were divided into two groups: cases conducted in those ICU and those conducted in the OT. Complications post-chest re-exploration were measured and categorized into renal failure needing dialysis, pulmonary complication, gastrointestinal complication, heart failure, pericardial effusion, fever, and surgical site infection. RESULTS: 4406 cases of open-heart surgeries were analysed. 351 of the patients underwent chest re-exploration, and majority of the cases were re-explored for haemostasis (88.9%). 64.2% of the chest re-exploration were conducted in the ICU. 21.9% patients who underwent post-chest reexploration in the ICU died, while 13.1% of the patients died post- chest re-exploration in the OT. From the total number of cases of chest re-exploration, 75.9% of patients who had chest re-exploration in the ICU developed complication, whereas patients who developed complication post-chest re-exploration in the OT were 35.1% (p-value < 0.001). CONCLUSION: Chest re-exploration in the ICU for post-cardiacsurgery patients showed a higher percentage of complications, which contributes to mortality.

Early outcome of cardiac surgery in dialysis-dependent end-stage renal failure patients.

INTRODUCTION: Preoperative dialysis-dependent renal failure is a strong independent risk factor for in-hospital mortality and morbidity after open heart surgery. This retrospective study analyses the early outcome in dialysis-dependent renal failure patients who underwent elective open-heart surgery in the Institut Jantung Negara (IJN). METHODS: We retrospectively analyse a series of 228 consecutive postoperative patients with dialysis-dependent (end stage renal failure (ESRF)) admitted to the adult cardiothoracic ICU in IJN between January 2012 and December 2016. RESULTS: The overall early mortality rate included 34 patients (15.8%). Patients with ESRF underwent combined procedure recorded a very high mortality rate at 56.3%. Twenty-four patients (11.2%) needed resternotomy for postoperative bleeding or cardiac temponade. Postoperative mediastinitis rate was high, involving 13 patients (6%). The neurological and gastrointestinal complications rate were recorded at 2.3% (5 patients) and 6% (13 patients) respectively. In the group of patients (n=199) with sinus rhythm during the preoperative period, 100 patients (50.3%) developed postoperative AF. 77 patients (35.8%) stayed in hospital for more than 14 days. CONCLUSIONS: dialysis-dependent patients undergoing cardiac surgery poses higher perioperative risk of mortality and morbidity of 3-4 times higher compared to those patients with normal renal function. IJN shows acceptable perioperative risk of mortality and morbidity which is comparable to other centres.

Skin shop: A new model for high-volume skin cancer care.

INTRODUCTION: Non-melanoma skin cancer incidence is increasing in New Zealand. Increased cost of care has led to service pressure and a review of models of care. A high-volume skin surgery service at Waikato Hospital has been developed to reduce service costs. This study examines the oncological safety of the new model. METHODS: Prospective data for all skin lesions excised were collected from December 2014 to December 2016. Primary outcomes were rate of complete excision, rate of incomplete excision and rate of narrow excision. RESULTS: A total of 2076 lesions were excised: 92% were complete, 4.2% were narrow and 3.2% were incomplete. CONCLUSION: The rate of narrow and incomplete excisions was low in a service delivered by supervised surgical registrars. The Skin Shop model is safe, inexpensive and suitable for adaptation to safely reduce the cost of skin cancer surgery.

Associations between parents' perception of neighbourhood environments and safety with physical activity of primary school children in Klang, Selangor, Malaysia.

BACKGROUND: This study aimed to evaluate parental perception of neighbourhood environments and safety in association with children's physical activity among primary school children in Klang, Selangor, Malaysia. METHODS: A total of 250 children (9-12 years of age) and their parents participated in this cross-sectional study. Physical Activity Questionnaire for Older Children and Neighbourhood Environmental Walkability Scale as well as questions on constrained behaviours (avoidance and defensive behaviours) were used to assess the children's physical activity and parental perception of neighbourhood environment and safety, respectively. RESULTS: More than one-third (36.0%) of the children were physically inactive compared with only a small percentage (4.8%) who were physically active, with boys achieving higher physical activity levels than girls (t = 2.564, P = 0.011). For the environmental scale, parents' perception of land-use mix (access) (r = 0.173, P = 0.006), traffic hazards (r = -0.152, P = 0.016) and defensive behaviour (r = -0.024, P = 0.143) correlated significantly with children's physical activity. In multiple linear regression analysis, child's gender (ß = -0.226; P = 0.003), parent's education (ß = 0.140; P = 0.001), household income (ß = 0.151; P = 0.024), land-use mix (access) (ß = 0.134; P = 0.011) and defensive behaviour (ß = -0.017; P = 0.038) were significantly associated with physical activity in children (R = 0.349, F = 6.760; P < 0.001), contributing 12.2% of the variances in physical activity of the children. CONCLUSION: Results highlight the links between parental perception of neighbourhood environments, safety and constrained behaviours with their children's participation in active play. Interventions aimed to increase actual and perceived safety and reduce perceptions of risk by parents in safe neighbourhoods can be targeted to increase children's physical activity in their local neighbourhoods.

Classification of intelligence quotient via brainwave sub-band power ratio features and artificial neural network.

This paper elaborates on the novel intelligence assessment method using the brainwave sub-band power ratio features. The study focuses only on the left hemisphere brainwave in its relaxed state. Distinct intelligence quotient groups have been established earlier from the score of the Raven Progressive Matrices. Sub-band power ratios are calculated from energy spectral density of theta, alpha and beta frequency bands. Synthetic data have been generated to increase dataset from 50 to 120. The features are used as input to the artificial neural network. Subsequently, the brain behaviour model has been developed using an artificial neural network that is trained with optimized learning rate, momentum constant and hidden nodes. Findings indicate that the distinct intelligence quotient groups can be classified from the brainwave sub-band power ratios with 100% training and 88.89% testing accuracies.

Body mass index (BMI)-for-age and health-related quality of life (HRQOL) among high school students in Tehran.

BACKGROUND: The study aimed to determine the association between body mass index (BMI)-for-age and health-related quality of life (HRQOL) among high school students in Tehran. METHODS: A total of 465 high school students (227 girls and 238 boys) and their parents were participated in this cross-sectional study. Body weight and height of the students were measured. For assessing HRQOL, both adolescent self-report and parent proxy-report of the Persian version of Pediatric Quality of Life Inventory (PedsQL™4.0) questionnaire were completed by adolescents and their parents respectively. RESULTS: The prevalence of overweight and obesity (38.5%) was higher than severe thinness and thinness (2.8%). Mean of adolescent self-reported and parent proxy-reported HRQOL total score were 80.26 ± 12.07 and 81.30 ± 14.08 respectively. In terms of HRQOL subscale scores, the highest subscale score of HRQOL was reported in social functioning (87.27 ± 14.40) and the lowest score was reported in emotional functioning (69.83 ± 18.69). Based on adolescent self-report, adolescent boys had significantly higher mean score for total and all subscale scores of HRQOL compared with girls (P < 0.05). BMI-for-age was inversely correlated to adolescent self-reported HRQOL total score (r = -0.25, P < 0.05). Based on adolescents self-report, HRQOL total score was significantly different by body weight status (F = 16.16, P < 0.05). Normal weight adolescents had significantly higher HRQOL total score compared with overweight (mean difference: 7.32; P < 0.05) and obese adolescents (mean difference: 9.10, P < 0.05). The HRQOL total score was not significantly different between normal weight and underweight adolescents (mean difference: 1.65, P = 0.96). However, based on parent proxy-reports, HRQOL total score was not significantly different by body weight status (F = 2.64, P = 0.059). CONCLUSION: More than one-third of adolescents were overweight and obese. BMI-for-age was inversely correlated to adolescent self-reported HRQOL. Based on adolescents' perspective, overweight and obese adolescents had poorer HRQOL compared with normal weight adolescents. Intervention studies are needed to improve the HRQOL of overweight and obese adolescents in Tehran.

Non-invasive diagnosis of risk in dengue patients using bioelectrical impedance analysis and artificial neural network.

This paper presents a new approach to diagnose and classify early risk in dengue patients using bioelectrical impedance analysis (BIA) and artificial neural network (ANN). A total of 223 healthy subjects and 207 hospitalized dengue patients were prospectively studied. The dengue risk severity criteria was determined and grouped based on three blood investigations, namely, platelet (PLT) count (less than or equal to 30,000 cells per mm(3)), hematocrit (HCT) (increase by more than or equal to 20%), and either aspartate aminotransferase (AST) level (raised by fivefold the normal upper limit) or alanine aminotransferase (ALT) level (raised by fivefold the normal upper limit). The dengue patients were classified according to their risk groups and the corresponding BIA parameters were subsequently obtained and quantified. Four parameters were used for training and testing the ANN which are day of fever, reactance, gender, and risk group's quantification. Day of fever was defined as the day of fever subsided, i.e., when the body temperature fell below 37.5°C. The blood investigation and the BIA data were taken for 5 days. The ANN was trained via the steepest descent back propagation with momentum algorithm using the log-sigmoid transfer function while the sum-squared error was used as the network's performance indicator. The best ANN architecture of 3-6-1 (3 inputs, 6 neurons in the hidden layer, and 1 output), learning rate of 0.1, momentum constant of 0.2, and iteration rate of 20,000 was pruned using a weight-eliminating method. Eliminating a weight of 0.05 enhances the dengue's prediction risk classification accuracy of 95.88% for high risk and 96.83% for low risk groups. As a result, the system is able to classify and diagnose the risk in the dengue patients with an overall prediction accuracy of 96.27%.

Microwave non-destructive testing technique for characterization of HPMC-PEG 3000 films.

The capacity of microwave non-destructive testing (NDT) technique to characterize the matrix property of binary polymeric films for use as transdermal drug delivery system was investigated. Hydroxypropylmethylcellulose (HPMC) and polyethylene glycol (PEG) 3000 were the choice of polymeric matrix and plasticizer, respectively with loratadine as the model drug. Both blank and drug loaded HPMC-PEG 3000 films were prepared using the solvent-evaporation method. These films were conditioned at the relative humidity of 25, 50 and 75% prior to physicochemical characterization using the established methods of ultra-violet spectrophotometry, differential scanning calorimetry and Fourier transform infrared spectroscopy methods, as well as, novel microwave NDT technique. Blank films exhibited a greater propensity of polymer-polymer interaction at the O-H domain upon storage at a lower level of relative humidity, whereas drug loaded films exhibited a greater propensity of polymer-polymer, polymer-plasticizer and/or drug-polymer interaction via the O-H, C-H and/or aromatic C=C functional groups when they were stored at a lower or moderate level of relative humidity. The absorption and transmission characteristics of both blank and drug loaded films for microwave varied with the state of polymer-polymer, polymer-plasticizer, and/or drug-polymer interaction of the matrix. The measurements of microwave NDT test at 8 and 12 GHz were sensitive to the polar fraction of film involving functional group such as O-H moiety and the less polar environment of matrix consisting of functional groups such as C-H and aromatic C=C moieties. The state of interaction between polymer, plasticizer and/or drug of a binary polymeric film can be elucidated through its absorption and transmission profiles of microwave.

Analysis of water compartment in dengue patients.

This paper describes the water compartments in healthy subjects and dengue patients on the day of defervescence of fever using bioelectrical impedance analysis. A total of 223 healthy subjects (65 males and 158 females) and 210 dengue patients (119 males and 91 females) in Hospital Universiti Kebangsaan Malaysia (HUKM), were studied. The ages for healthy subjects vary between 14 and 60 years old with mean age of 26.05 years while the ages for the dengue patients vary between 12 and 83 years old with mean age of 30.14 years. The parameters of water compartments investigated were total body water (TBW), extracellular water (ECW) and intracellular water (ICW). There were significant difference between healthy subjects and dengue patients for both male (p<0.05) and female (p<0.001) beginning on fever day 0 till fever day 4. The mean TBW and ECW values of dengue patients obtained were found to be higher than the normal healthy subjects while the mean ICW was lower. The mean TBW and ICW for male were higher than female while the mean ECW for male was lower than female for healthy subjects and dengue patients.

Modeling of hemoglobin in dengue fever and dengue hemorrhagic fever using bioelectrical impedance.

This paper describes a model for predicting hemoglobin (Hb) by using bioelectrical impedance analysis (BIA) in dengue patients in the Hospital Universiti Kebangsaan Malaysia (HUKM). Bioelectrical impedance measurements were conducted on 83 (47 males and 36 females) serologically confirmed dengue fever (DF) and dengue hemorrhagic fever (DHF) patients during their hospitalization. The predictive equation for Hb was derived using multivariate analysis. We investigated all the parameters in BIA, patients' symptom and demographic data. In this developed model, four predictors (reactance (XC), sex, weight and vomiting) were found to be the best predictive factors for modeling Hb in dengue patients. However, the model can only explain approximately 42% of the variation in Hb status, thus single frequency bio-impedance stand-alone technique is insufficient to monitor Hb for the DF and DHF patients. Further investigation using multi-frequency BIA is recommended in modeling Hb to achieve the most parsimonious model.

Modified enzymes for reactions in organic solvents.

Recent studies on biocatalysis in water-organic solvent biphasic systems have shown that many enzymes retain their catalytic activities in the presence of high concentrations of organic solvents. However, not all enzymes are organic solvent tolerant, and most have limited and selective tolerance to particular organic solvents. Protein modification or protein tailoring is an approach to alter the characteristics of enzymes, including solubility in organic solvents. Particular amino acids may play pivotal roles in the catalytic ability of the protein. Attaching soluble modifiers to the protein molecule may alter its conformation and the overall polarity of the molecule. Enzymes, in particular lipases, have been chemically modified by attachment of aldehydes, polyethylene glycols, and imidoesters. These modifications alter the hydrophobicity and conformation of the enzymes, resulting in changes in the microenvironment of the enzymes. By these modifications, newly acquired properties such as enhancement of activity and stability and changes in specificity and solubility in organic solvents are obtained. Modified lipases were found to be more active and stable in organic solvents. The optimum water activity (a(w)) for reaction was also shifted by using modified enzymes. Changes in enantioselective behavior were also observed.

First report on sensitization to allergens of a house dust mite, Suidasia pontifica (Acari: Saproglyphidae).

A species of house dust mite, Suidasia pontifica, was recently shown to produce allergens affecting man. The species may be as important as other allergen producing mite in sensitization and causing allergic symptoms in Malaysians. Surveys conducted demonstrated that 80% of the houses surveyed were positive for this mite with densities ranged from 2 to 50 mites per gram of dust. Colonies of the species has been successfully established and materials from those colonies have been used to produce extracts for studies on sensitization to the mites. A total of 85 suspected allergic rhinitis patients were tested and 74.1% demonstrated positive reactions. Extract of this mite should be considered for routine diagnostic testing and possible immunotherapy.

Socio-economic determinants of nutritional status of children in rural peninsular Malaysia.

The data presented is part of the findings from a four-year collaborative research project between Universiti Putra Malaysia, the Institute for Medical Research and the Ministry of Health Malaysia. The project assessed the nutritional status of the major functional groups in Peninsular Malaysia. Mukim Sayong and Pulau Kemiri in the District of Kuala Kangsar, Perak were two of the subdistricts selected to represent small rubber holdings in Peninsular Malaysia. This paper attempts to analyse the socio-economic profile of the households and the nutritional status of children below 9 years of age. A total of 307 households were studied. Approximately 63% of the households were involved in rubber activities and the majority of them were hired tappers. The average monthly income of the households was RM467 and the income ranged between RM30 to RM2120. Based on the per capita poverty line income of RM84.38, it was found that 14.1% of the households earned less than RM42.19, which can be considered as hard-core poor, while 32.7% were poor (monthly per capita income between RM42.19 and RM84.38). Slightly more than half (52.7%) earned income above the poverty line. The average family size was 4.5, ranging from 1 through to 16. The majority of the heads of households (56.6%) had between 3 and 6 years of education, and 14.5% did not receive any formal education. The prevalence of stunting among children 0-5 years of age was 26%, while 31.5% were underweight and 3.8% wasted. Among children aged between 5 and 9 years, almost the same pattern of nutritional status was noted. The overall percentages of stunting, underweight and wasting among these children were 29.2%, 26.1% and 0.62%, respectively. Analysis on nutritional status according to income level showed a noticeable difference in the prevalence of malnutrition in children above and below the poverty line income. The Student's t-test indicated significant differences in weight-for-age and weight-for-height between the two poverty line income for children below 5 years of age. Pearson's correlation coefficient showed a significant correlation between height-for-age with household size (r = -0.26, p<0.05), and monthly per capita income with weight-for-height (r = 0.25, p<0.05). There was a highly significant correlation between acreage of land cultivated and weight-for-height (r = 0.42, p<0.01), and weight-for-age (r = 0.25, p<0.05). The findings indicated the influence of socio-economic factors on the nutritional status of children.

[Neonatal jaundice due to anti-D allo-immunization with negative direct Coombs' test]. / Ictere neonatal par allo-immunisation anti-D avec test de Coombs direct negatif

The case is reported of a newborn with jaundice due to anti-D Rh iso-immunization, with a negative Coombs' test. The finding of a positive red cell auto-agglutination test, the red cells being treated with bromelin and incubated in their own serum, suggests an immune phenomenon. Free antibody with anti-D specificity reacting with bromelin treated R.B.C.'s was found in the sera of the mother and infant.