An insight of -50 (G>A) mutation in the direct repeat element of the ß-globin gene: From Malaysian perspective.

No abstract available.

The prevalence of hypersensitivity reactions to snake antivenoms administered in sultanah nur zahirah hospital from 2013 to 2016.

INTRODUCTION: Snakebite is an important medical emergency. Antivenoms remain the only proven treatment for snake envenoming. However, the use of antivenom is associated with hypersensitivity reactions. The aims of this study were to determine the prevalence and types of hypersensitivity reactions and types and outcomes of pharmacological and non-pharmacological treatments for antivenom reactions among snakebite patients that received antivenoms. METHODS: This was a 4-year cross-sectional study of snakebite patients from January 2013 to December 2016 in Hospital Sultanah Nur Zahirah (HSNZ), Terengganu. Data was extracted from the Pharmacy Record on the usage of antivenom and patients of snakebites treated with antivenom were identified. Data of patients were then obtained from the electronic medical records.' Demographic details, clinical features and characteristics of antivenom reactions of patients were recorded in standardized data collection forms and analyzed using chi-square or Mann- Whitney U tests. RESULTS: Of the 44 patients who received antivenom, 24 (54.5%) developed hypersensitivity reaction. All patients developed reaction early. No patient developed delayed (serum-sickness) reaction. Of the 24 patients, 14 (58.3%) had moderate to severe hypersensitivity reaction and 9 (37.5%) patients had mild reactions. Only one (4.2%) patient presented with bradycardia. CONCLUSION: The prevalence of early hypersensitivity reaction to snake antivenom in HSNZ was relatively high. Healthcare providers should be aware of the appropriate method of preparing and administering antivenom, and the management for acute hypersensitivity reactions. This will optimize the management of snakebite and ensure patient safety.

Circulating 25-hydroxy vitamin D correlates with serum level of anti-Müllerian hormone in male patients with chronic kidney disease.

This study was designed to assess the relationship between serum levels of anti-Müllerian hormone and 25-hydroxy vitamin D in chronic kidney disease male patients. For that, serum 25-hydroxy vitamin D and anti-Müllerian hormone along with follicle-stimulating hormone, luteinising hormone, prolactin, total testosterone and estradiol were assayed in 59 patients with different stages of chronic kidney disease and 21 healthy participants. Compared to controls, serum levels of anti-Müllerian hormone and 25-hydroxy vitamin D were significantly decreased in patients with chronic kidney disease. The decreased anti-Müllerian hormone level correlated positively with estimated glomerular filtration rate and serum levels of testosterone and 25-hydroxy vitamin D. Meanwhile, it was negatively correlated with age and serum levels of urea, creatinine, follicle-stimulating hormone, luteinising hormone and prolactin. 25-Hydroxy vitamin D and luteinising hormone explained the 65.9% variability of anti-Müllerian hormone in a multiple linear regression model. However, anti-Müllerian hormone in crude correlation was more strongly associated with serum 25-hydroxy vitamin D than luteinising hormone. In conclusion, serum level of 25-hydroxy vitamin D might be a determinant factor of anti-Müllerian hormone level, and their relationship might explain in part the dysfunction of Sertoli cells and the impaired testicular functions in chronic kidney disease male patients.

The effect of three-monthly albendazole treatment on Th2 responses: Differential effects on IgE and IL-5.

Helminth parasites induce a strong Th2 response, characterized by high levels of IgE and elevated signature cytokines such as IL-5. As many global deworming programmes are underway, there is concern that this might lead to emergence of Th1-mediated pathologies when the counterbalancing helminth-induced Th2 response is absent. Therefore, we assessed the effect of deworming on Th2-mediated responses in a household-clustered randomized controlled trial in Indonesia. Total plasma IgE and whole-blood IL-5 responses to mitogen phytohaemagglutinin (PHA) were measured in 1494 and 682 subjects, respectively, at baseline, 9 and 21 months after three-monthly single-dose treatment with albendazole or placebo. Anthelmintic treatment did not result in complete removal of helminth infections in the community. However, treatment significantly decreased IgE levels in albendazole- compared to placebo-treated subjects. IL-5 responses to PHA were not significantly affected by anthelmintic treatment and tended to increase in albendazole-treated subjects, indicating that intensive treatment of helminth parasites has different outcomes on B-cell (IgE levels) and T-cell (IL-5) responses. The data shows that 2 years of deworming can have differential effects on responses typified as Th2-mediated, which needs to be taken into account when examining the impact of helminths on noncommunicable diseases.

Allergic disorders and socio-economic status: a study of schoolchildren in an urban area of Makassar, Indonesia.

BACKGROUND: In urban centres of developing countries, there is great variation in socio-economic status (SES) and lifestyle; however, little information is available on allergic disorders in groups with high- or low-SES within the same urban area. OBJECTIVE: To determine the prevalence of allergic disorders and investigate risk factors related to them among high- and low-SES schoolchildren in Makassar, the capital city of South Sulawesi, Indonesia. METHOD: This cross-sectional study was performed in 623 children originating from high- (N = 349) and low-SES (N = 274) schools. Information on reported allergic symptoms and potential factors associated with allergic disorders was obtained by questionnaire. Specific IgE and skin prick test (SPT) reactivity were determined against aeroallergens [Dermatophagoides pteronyssinus (HDM) and cockroach]. Total IgE and helminth infections were also assessed. RESULT: The prevalence of SPT to any aeroallergens was significantly higher in high-SES than in low-SES school (25% vs. 8%, P < 0.001, respectively). However, specific IgE against cockroach and total IgE were significantly lower in high- than in low-SES children. Allergic symptoms were reported more often in low- compared to high-SES children. Specific IgE to aeroallergens significantly increased the risk of SPT positivity to the same aeroallergen in the high-, but not in the low-SES children. In the high- but not in low-SES, there was a significant positive association between SPT to HDM and wheeze. Similarly, cockroach skin reactivity and elevated BMI increased the risk of eczema in the high-SES children only. CONCLUSION AND CLINICAL RELEVANCE: Skin prick test is higher in high-SES, whereas IgE and allergic symptoms are higher in low-SES children. Specific IgE is a risk factor for being SPT-positive, and SPT positivity is a risk factor for allergic symptoms but only in children of high- and not low-SES school. Therefore, the socio-economic status of a child might affect the diagnosis of allergic disease in a developing country.

Microstructure and tribological behavior of Al-TiC composite strips fabricated by a multi-step densification method.

This study aims to enhance the tribological properties of automotive applications by examining the effects of TiC content on the microstructure, mechanical properties, and wear behavior. This study investigates the production of Al-TiC composite strips using a novel multi-step densification process combining mechanical alloying and hot rolling with TiC concentrations ranging from 0 to 12 vol%. The novelty of this work lies in its comprehensive approach to developing and analyzing Al-TiC composite strips using a multistep densification method. This study integrates microstructural analysis, mechanical property evaluation, and detailed tribological behavior assessment under different wear loads (5-25 N). A key innovation is the application of the Abbott Firestone method to analyze worn surfaces, providing insights into optimal wear conditions. The study reveals that increasing the TiC content to 12 vol% significantly improves densification, hardness (up to 268.8% increase), and wear resistance (up to 95% improvement at a 5N load). Dry ball-on-flat sliding wear tests at loads of 5-25N demonstrate that TiC particles hindered complete delamination wear in the composite strips. The Abbott Firestone method analysis of worn surfaces indicated an optimal exploitation zone in the Al-6 vol% TiC composite at both low and high wear loads. This comprehensive approach provides valuable insights into optimizing Al-TiC composites for enhanced performance in automotive components that require improved wear resistance.

The influence of various welding wires on microstructure, and mechanical characteristics of AA7075 Al-alloy welded by TIG process.

Owing to their exceptional mechanical properties, the various welding wires used to combine aluminum can meet the needs of many engineering applications that call for components with both good mechanical and lightweight capabilities. This study aims to produce high-quality welds made of AA7075 aluminum alloy using the GTAW technique and various welding wires, such as ER5356, ER4043, and ER4047. The microstructure, macrohardness, and other mechanical characteristics, such as tensile strength and impact toughness, were analyzed experimentally. To check the fracture surface of the AA7075 welded joints, the specimens were examined using optical and scanning electron microscopy (SEM). A close examination of the samples that were welded with ER5356 welding wire revealed a fine grain in the weld zone (WZ). In addition, the WZ of the ER4043 and ER4047 welded samples had a coarse grain structure. Because the hardness values of the welded samples were lower in the WZ than in the base metal (BM) and heat-affected zone (HAZ), the joints filled with ER5356 welding wire provided the highest hardness values compared to other filler metals. Additionally, the ER4047 filler metal yielded the lowest hardness in the weld zone. The welding wire of ER5356 produced the greatest results for ultimate tensile stress, yield stress, welding efficiency, and strain-hardening capacity (Hc), whereas the filler metal of ER4043 produced the highest percentage of elongation. In addition, the ER4047 fracture surface morphology revealed coarser and deeper dimples than the ER5356 fine dimples in the welded joints. Finally, the highest impact toughness was obtained at joints filled with the ER4047 filler metal, whereas the lowest impact toughness was obtained at the BM.

Corticospinal excitability is enhanced after visuomotor adaptation and depends on learning rather than performance or error.

We used adaptation to high and low gains in a virtual reality setup of the hand to test competing hypotheses about the excitability changes that accompany motor learning. Excitability was assayed through changes in amplitude of motor evoked potentials (MEPs) in relevant hand muscles elicited with single-pulse transcranial magnetic stimulation (TMS). One hypothesis is that MEPs will either increase or decrease, directly reflecting the effect of low or high gain on motor output. The alternative hypothesis is that MEP changes are not sign dependent but rather serve as a marker of visuomotor learning, independent of performance or visual-to-motor mismatch (i.e., error). Subjects were required to make flexion movements of a virtual forefinger to visual targets. A gain of 1 meant that the excursions of their real finger and virtual finger matched. A gain of 0.25 ("low gain") indicated a 75% reduction in visual versus real finger displacement, a gain of 1.75 ("high gain") the opposite. MEP increases (>40%) were noted in the tonically activated task-relevant agonist muscle for both high- and low-gain perturbations after adaptation reached asymptote with kinematics matched to veridical levels. Conversely, only small changes in excitability occurred in a control task of pseudorandom gains that required adjustments to large errors but in which learning could not accumulate. We conclude that changes in corticospinal excitability are related to learning rather than performance or error.

Age-related rarefaction in retinal vasculature is not linear.

The fractal dimension is a global measure of complexity and is useful for quantifying anatomical structures, including the retinal vascular network. A previous study found a linear declining trend with aging on the retinal vascular fractal dimension (DF); however, it was limited to the older population (49 years and older). This study aimed to investigate the possible models of the fractal dimension changes from young to old subjects (10­73 years). A total of 215 right-eye retinal samples, including those of 119 (55%) women and 96 (45%) men, were selected. The retinal vessels were segmented using computer-assisted software, and non-vessel fragments were deleted. The fractal dimension was measured based on the log­log plot of the number of grids versus the size. The retinal vascular DF was analyzed to determine changes with increasing age. Finally, the data were fitted to three polynomial models. All three models are statistically significant (Linear: R(2) = 0.1270, 213 d.f., p < 0.001, Quadratic: R(2) = 0.1536, 212 d.f., p < 0.001, Cubic: R(2) = 0.1529, 211 d.f., p < 0.001). The quadratic regression is significantly better than the linear regression (p < 0.001); however, the increase in R(2) from the quadratic model to the cubic model is not significant (p = 0.97). These results suggest that the decreasing trend of the fractal dimension associated with aging is better explained by the quadratic model than by the linear and cubic models in a sample with a broader age spectrum.

Age-related rarefaction in retinal vasculature is not linear.

The fractal dimension is a global measure of complexity and is useful for quantifying anatomical structures, including the retinal vascular network. A previous study found a linear declining trend with aging on the retinal vascular fractal dimension (DF); however, it was limited to the older population (49 years and older). This study aimed to investigate the possible models of the fractal dimension changes from young to old subjects (10-73 years). A total of 215 right-eye retinal samples, including those of 119 (55%) women and 96 (45%) men, were selected. The retinal vessels were segmented using computer-assisted software, and non-vessel fragments were deleted. The fractal dimension was measured based on the log-log plot of the number of grids versus the size. The retinal vascular DF was analyzed to determine changes with increasing age. Finally, the data were fitted to three polynomial models. All three models are statistically significant (Linear: R2 = 0.1270, 213 d.f., p < 0.001, Quadratic: R2 = 0.1536, 212 d.f., p < 0.001, Cubic: R2 = 0.1529, 211 d.f., p < 0.001). The quadratic regression is significantly better than the linear regression (p < 0.001); however, the increase in R2 from the quadratic model to the cubic model is not significant (p = 0.97). These results suggest that the decreasing trend of the fractal dimension associated with aging is better explained by the quadratic model than by the linear and cubic models in a sample with a broader age spectrum.

The pattern of branching and intercommunications of the musculocutaneous nerve for surgical issues: anatomical study.

BACKGROUND: The aim of the present work was to provide evidence about the anatomical variations as regard the origin, distribution, and branching pattern of the musculocutaneous nerve (MCN). MATERIALS AND METHODS: Brachial plexus was dissected in 40 upper limbs of 20 male adult cadavers. The pattern of the MCN was photographed by a digital camera. RESULTS: The location and length of the nerve branches between left and right arms were recorded and statistically analysed. In 90% of specimens the MCN originates from the lateral cord of the brachial plexus, in 5% it arose from the median nerve (MN), while in the remaining 5% specimen, it was absent. The MCN pierced the coracobrachialis muscle in 90% of specimens, and in the remaining 10% did not pierce it. The motor branches to biceps brachii muscle were categorised into: type 1 (90%): one branch that divides to supply the two heads of biceps; type 2 (5%): double branches, innervating each head of biceps separately. The motor branches to brachialis muscle were categorised into: type 1 (82.9%): one branch; type 2 (14.2%): double branches and type 3 (2.9%): three branches that innervating brachialis muscle. Communications between the MCN and the MN were observed in 35% of specimens. CONCLUSIONS: The knowledge of the common and uncommon MCN variations is important especially to the surgeons for carrying out surgical procedures in axilla and arm.

Visuomotor gain distortion alters online motor performance and enhances primary motor cortex excitability in patients with stroke.

OBJECTIVES: Determine if ipsilesional primary motor cortex (M1) in stroke patients processes online visuomotor discordance in gain between finger movement and observed feedback in virtual reality (VR). MATERIALS AND METHODS: Chronic stroke patients flexed (N= 7) or extended (N= 1) their finger with real-time feedback of a virtual hand presented in VR. Virtual finger excursion was scaled by applying a low-gain (G(0.25) ), high-gain (G(1.75) ), or veridical (G(1.00) ) scaling factor to real-time data streaming from a sensor glove. Effects of visuomotor discordance were assessed through analysis of movement kinematics (joint excursion, movement smoothness, and angular velocity) and amplitude of motor evoked potentials (MEPs) elicited with transcranial magnetic stimulation applied to ipsilesional M1. Data were analyzed with a repeated-measures analysis of variance (significance set at 0.05). RESULTS: G(0.25) discordance (relative to veridical) leads to significantly larger joint excursion, online visuomotor correction evidenced by decreased trajectory smoothness, and significantly facilitated agonist MEPs. This effect could not be explained by potential differences in motor drive (background electromyographic) or by possible differences related to joint angle or angular velocity, as these variables remained invariant across conditions at the time of MEP assessment. M1 was not significantly facilitated in the G(1.75) condition. MEPs recorded in an adjacent muscle that was not involved in the task were unaffected by visual feedback in either discordance condition. These data suggest that the neuromodulatory effects of visuomotor discordance on M1 were relatively selective. CONCLUSIONS: Visuomotor discordance may be used to alter movement performance and augment M1 excitability in patients following stroke. Our data illustrate that visual feedback may be a robust way to selectively modulate M1 activity. These data may have important clinical implications for the development of future VR training protocols.

Pharmacological mechanisms underlying the efficacy of antibodies generated by a vaccine to treat oxycodone use disorder.

Therapeutic vaccines offer a viable strategy to treat opioid use disorders (OUD) complementary to current pharmacotherapies. The candidate Oxy(Gly)4-sKLH vaccine targeting oxycodone displayed pre-clinical proof of efficacy, selectivity and safety, and it is now undergoing clinical evaluation. To further support its implementation in the clinic, this study tested critical in vivo neuropsychopharmacological properties of the Oxy(Gly)4-sKLH vaccine in rats. While repeated immunizations with Oxy(Gly)4-sKLH were necessary to maintain the antibody response overtime, exposure to free oxycodone did not boost oxycodone-specific antibody levels in vaccinated rats, limiting concerns of immune-related side effects. Immunization with Oxy(Gly)4-sKLH achieved sustained antibody titers over a period of five months following initial vaccination, supporting its potential for providing long-lasting protection. In vivo studies of selectivity showed that vaccination prevented oxycodone-induced but not methadone-induced antinociception, while still preserving the opioid antagonist naloxone's pharmacological effects. Vaccination did not interfere with fentanyl-induced antinociception or fentanyl distribution to the brain. These in vivo data confirm the previously reported in vitro selectivity profile of Oxy(Gly)4-sKLH. Vaccination extended oxycodone's half-life up to 25 h compared to control. While vaccination reduced the reinforcing efficacy of oxycodone in an intravenous self-administration model, signs of toxicity were not observed. These rodent studies confirm that active immunization with Oxy(Gly)4-sKLH induces highly specific and long-lasting antibodies which are effective in decreasing the reinforcing effects of oxycodone while preserving the efficacy of medications used to treat OUD and overdose.

Prognostic value of bone marrow MUC4 expression in acute myeloid leukaemia.

Background: Aberrant expression of mucin-4 (MUC4) is present in a variety of solid cancers, but the expression pattern of MUC4 and its clinical relevance in acute myeloid leukaemia (AML) is unknown. We aimed to evaluate the expression level of MUC4 and explore its prognostic value in newly diagnosed adult patients with AML. Methods: Bone marrow from 70 AML patients and 26 healthy donors was obtained. MUC4 levels were quantified by quantitative real-time PCR. Routine blood indices were measured by standard techniques. Results: Bone marrow MUC4 expression levels were significantly elevated in AML patients compared to controls at median (range) 2.77 (0.7-16.6) and 1.14 (0.5-1.99) respectively (p = 0.005). Moreover, lower MUC4 expression was strongly associated with persistent remission (p = 0.001) while higher MUC4 levels were associated with worse overall as well as disease-free survival (p = 0.011 and p = 0.006, respectively). Thus, its level may act as an indicator of disease progression. High MUC4 expression was identified as an independent prognostic predictor for both overall survival and disease-free survival. Conclusion: MUC4 over-expression is an independent predictor of a poor prognosis in AML patients.

Human leukocyte antigen typing in Iraqi multiple sclerosis patients.

OBJECTIVE: To assess the relative frequency of human leukocyte antigen (HLA) class I and class II in Iraqi multiple sclerosis (MS) patients, and to ascertain whether they offer any etiologic or protective role. METHODS: We conducted this study in the Baghdad MS Clinic and Teaching Laboratory Institute, Medical City, Baghdad Teaching Hospital, Baghdad, Iraq from March to July 2004. We enrolled 44 randomly selected MS patients and 69 healthy unrelated age- and sex-matched controls. We carried out HLA class I and class II typing on both groups using the microlymphocytotoxicity test. RESULTS: The HLA class I typing revealed no consistent association between MS and HLA-A and -Cw, while HLA-B5 and -B44 were found to possibly be risk factors for MS with odds ratio (OR) of 10.2 for -B5 and 4.4 for -B44. The HLA-B35 may form a protective factor with OR of 0.1. The HLA class II typing revealed an etiologic risk for HLA-DR4 (OR=10.3) and a protective effect for HLA-DR2 (OR=0.3) and -DR7 (OR=0.2), and etiologic effect for -DQ1 (OR=3.3) and -DQ3 (OR=3). CONCLUSION: The HLA DR4 carries the strongest association with MS in Iraqi patients. This study adds to the well-known diversity of HLA-allelic association of MS in different populations, and emphasizes the complexity of genetic susceptibility to MS.

Prevalence and type of anaemia in young Egyptian patients with type 1 diabetes mellitus.

Over a 2-month period, 200 type 1 diabetic patients attending a paediatric diabetic clinic in Cairo, Egypt were screened for anaemia and other complications of diabetes. The mean age was 11.2 years and the mean duration of diabetes was 4.0 years. Anaemia was diagnosed in 75 patients (37.5%) overall: 45 had microcytic hypochromic anaemia, 18 normocytic normochromic and 12 macrocytic hyperchromic. Of the 75, 41 patients (54.7%) had iron deficiency, 14 (18.7%) had folate deficiency and 14 (18.7%) had thalassaemia minor. Three patients (4%) had coeliac disease, and 18 patients (24%) had parasitic infections. None of the patients had hypothyroidism, renal failure or vitamin B12 deficiency.

Pharmacological effects of the leaf-nosed viper snake (Eristocophis macmahoni) venom and its HPLC fractions.

Crude venom from Eristocophis macmahoni was demonstrated to exert a potent inhibition of human blood platelet aggregation mediated by adenosine diphosphate (ADP), platelet activating factor (PAF) and arachidonic acid (AA). The venom caused lysis of the platelets, however, the red blood cells were not lysed by the venom. Substantial oedema was produced upon injection of the venom into the rat hind paw. Contrarily, the intraperitoneal injection of the venom to the rats caused an inhibition of the carrageenin-induced rat paw oedema. However, an 100% lethality within 24 h was observed with a dose of 40 mg/kg body weight. The venom was fractionated by reverse phase high pressure liquid chromatography (HPLC) and the fractions were analyzed for their effect on ADP-induced platelet aggregation. The fraction eluted at 15.5 min (20% acetonitrile concentration) exhibited an inhibitory effect of several-fold greater potency than that of the crude venom. Fractions eluted at 18.5 min (25.4% acetonitrile concentration) and onward showed a proaggregatory but insignificant effect. It is suggested that although the venom contains pro aggregatory components, inhibition of platelet aggregation seems to be its predominant activity.

Intracranial epidural tuberculoma presenting as a scalp swelling.

The first case of an intracranial epidural tuberculoma with the absence of dural and brain involvement in a 27-year-old woman is presented. The possible pathogenesis of this unique lesion is discussed.

[Value of nitrates and nitrites in selected vegetables and potatoes sold in the marketplace of Bialystok in the years 1991-1992]. / Zawartosc azotanów i azotynów w wybranych warzywach i ziemniakach dostepnych w handlu Bialegostoku w latach 1991-1992.

Nitrate and nitrite contents were determined in selected vegetables and potatoes from the market in Bialystok and from ecology cultivation in the years 1991-1992. The modified Griess method was used for determination of nitrate. The results showed that the nitrate contents in red beets, cabbages, parsley, carrots, celery and potatoes, were higher than the suggested limit in Poland. In the group of vegetables from special cultivation plots, the nitrate contents also exceeded the maximal permissible level. Low nitrite concentrations were found in the studied vegetables.

Visuomotor discordance in virtual reality: effects on online motor control.

Virtual reality (VR) applications are rapidly permeating fields such as medicine, rehabilitation, research, and military training. However, VR-induced effects on human performance remain poorly understood, particularly in relation to fine-grained motor control of the hand and fingers. We designed a novel virtual reality environment suitable for hand-finger interactions and examined the ability to use visual feedback manipulations in VR to affect online motor performance. Ten healthy subjects performed a simple finger flexion movement toward a kinesthetically-defined 45° target angle while receiving one of three types of VR-based visual feedback in real-time: veridical (in which the virtual hand motion corresponded to subjects' actual motion), or scaled-down / scaled-up feedback (in which virtual finger motion was scaled by 25% / 175% relative to actual motion). Scaled down-and scaled-up feedback led to significant online modifications (increases and decreases, respectively) in angular excursion, despite explicit instructions for subjects to maintain constant movements across conditions. The latency of these modifications was similar across conditions. These findings demonstrate that a VR-based platform may be a robust medium for presenting visuomotor discordances to engender a sense of ownership and drive sensorimotor adaptation for (retraining motor skills. This may prove to be particularly important for retraining motor skills in patients with neurologically-based movement disorders.