Probability of Concurrent Deficiency of Vitamin D and Iron in Hypothyroidism: A Cross-Sectional Study.

BACKGROUND: Hypothyroidism is the most common pathophysiological condition that affects mostly females in both developed and developing countries. Data on hypothyroidism among adult females are essential to understand the underactive status of the thyroid gland among the female population and its correlated effects on a deficiency of vitamin D and iron, as effective prevention of osteoporotic changes and iron deficiency anemia is possible. Therefore, the present study was designed to investigate the probability of concurrent iron and vitamin D deficiency among the adult hypothyroid female population of Abu Dhabi, UAE. MATERIALS AND METHODS: This cross-sectional study was carried out from September 2019 to July 2021 among 500 adult females aged 18 to 45 years old in Sheikh Shakhbout Medical City (SSMC) and Sheikh Khalifa Medical City (SKMC), Abu Dhabi, UAE. After obtaining written informed consent, subjects' demographic characteristics (sun exposure, dressing code, food consumption), anthropometry (height, weight, BMI), and biochemical parameters (thyroid profile, vitamin D profile, iron profile, and blood indices) were measured. RESULTS: In this study, serum vitamin D and iron levels were significantly (p<0.01) decreased in the hypothyroid female group (study group). The serum vitamin D and iron levels showed a significant negative (p<0.01) correlation with thyroid-stimulating hormone (TSH). Out of 250 study group participants, 61 had a concurrent deficiency of serum vitamin D and iron, yielding a probability (P of low vitamin D and iron and hypothyroidism) of 0.244, which indicates that if 1000 hypothyroid patients are tested for serum vitamin D and iron levels, 24 patients are probable to have low vitamin D and iron. CONCLUSION: The study concluded that vitamin D and iron bi-deficiency were observed in adult hypothyroid females in Abu Dhabi, UAE. So, the routine check-up of thyroid function and vitamin D and iron profiles should be done early. Therefore, early vitamin D and iron deficiencies can be detected, and supplements can be given to prevent further health complications like osteoporosis and iron deficiency anemia.

A multivariate analysis to propose linear models for the stature estimation in the Sabahan young adult population.

BACKGROUND: Stature is one of the significant parameters to confirm a biological profile besides sex, age, and ancestry. Sabah is in the Eastern part of Malaysia and is populated by multi-ethnic groups. To date, limited studies on stature estimation have been conducted in Sabah. Hence, this study aims to construct population-specific stature estimation equations for the large ethnic groups in Sabah, Malaysia. OBJECTIVE: The aim is to propose linear models using different hand dimensions (hand span, handbreadth, hand length, middle finger length, and the second inter-crease in the middle finger) for the young adult male and females of the major ethnic groups in Sabah. MATERIALS & METHODS: This cross-sectional study framework used stratified random sampling on 184 male and 184 female young adults. An unpaired t-test and a one-way ANOVA were used to assess the differences in the mean between sex and ethnicities, respectively. The link between the response variable and explanatory variables was initially investigated using simple linear regression, followed by multiple linear regression. RESULT: The present study demonstrated the highest association for the quantitative explanatory variables among hand length and stature (right side: r = 0.833; left side: r = 0.842). Simple equations were specifically developed without sex indicators, and ethnic and multiple linear regression was developed with sex and ethnic indicators. Multiple linear regression provided good estimation r2 = 0.7886 and adjusted r2 = 0.7853. The stature of 18 to 25 year old large ethnic groups in Sabah can be estimated using the developed models 90.218 + 3.845 LHL -5.950 Sex-2.308 Bajau -1.673 KadazanDusun + 2.676 L2ICL. While, formula for each ethnic and sex KadazanDusun Male: Stature = 88.545 + 3.845 LHL+ 2.676 L2ICL, KadazanDusun Female: Stature = 82.595 + 3.845 LHL+ 2.676 L2ICL, Bajau Male: Stature = 87.910 + 3.845 LHL+ 2.676 L2ICL, Bajau Female: Stature = 81.960 + 3.845 LHL+ 2.676 L2ICL, Malay Male: Stature = 90.218 + 3.845 LHL+ 2.676 L2ICL, Malay Female: Stature = 84.268 + 3.845 LHL+ 2.676 L2ICL, Chinese Male: Stature = 90.218 + 3.845 LHL+ 2.676 L2ICL, and Chinese Female: Stature = 84.268 + 3.845 LHL+ 2.676 L2ICL. CONCLUSION: The study reports anthropometric data and formulas for measuring the stature of major ethnic groups in Sabah, which can be used to compare future work.

Predicting handgrip power of young adult population among major ethnic groups of Sabah: a multivariate analysis.

BACKGROUND: Handgrip power is an essential indicator of health, vital for grasping or gripping sports, and crucial for providing information related to work capacity. The present study investigated any linear relationship of handgrip power with hand anthropometric variables (hand length, handbreadth, middle finger length, second inter-crease length of the middle finger, and hand span), gender, and ethnicity in young adults of Sabah. METHODS: In this cross-sectional study (from January 2020 to December 2021), the adult Sabahan population (18-25 years) was stratified into four ethnicities (KadazanDusun, Bajau, Malay, and Chinese) and was further stratified as males and females. Then, 46 subjects were randomly selected from each gender, and the ethnic group met the intended sample size. The hand dimensions were measured using a digital calliper, and the handgrip power was measured using a portable dynamometer. The relationship between the response variable and explanatory variables was analyzed at first through simple linear regression and then multiple linear regression. R2, adjusted R2, and standard errors of the estimates were used to compare different models. Statistical analyses were performed using IBM SPSS Statistics 27 and StatCrunch. RESULTS: The study found a linear relationship between gender, height, hand length, handbreadth, hand span, middle finger length, and second inter-crease length of both hands with the corresponding hand's grip power. The highest percentage (68% and 67%) of handgrip variability was demonstrated by the model predicting handgrip power for right-handed subjects, followed by the general models without stratifying based on hand dominance which was able to explain 63% and 64% of the variability of handgrip power. The study proposes the models for predicted right (RHGP) and left handgrip power (LHGP) of 18 to 25 years old adults from major ethnic groups of Sabah RHGP = - 18.972 - 8.704 Gender + 7.043 Right hand breadth and LHGP = - 11.621 - 9.389 Gender + 5.861 Left hand breadth respectively. CONCLUSION: The predicted handgrip power would be a key to selecting a better player or a better worker or assessing the prognosis of a disease or the wellbeing of a person. The study can be further expanded to all ethnicities and ages of people of Sabah or even Malaysia.

Carpaine Promotes Proliferation and Repair of H9c2 Cardiomyocytes after Oxidative Insults.

Carpaine has long been identified as the major alkaloid in Carica papaya leaves that possess muscle relaxant properties. Limited study on the molecular signaling properties of carpaine urges us to conduct this study that aims to elucidate the mechanism underlying the cardioprotective effect of carpaine in embryonic cardiomyocytes of the H9c2 cell line. The 50% inhibitory concentration (IC50) of carpaine was first determined using a colorimetric MTT assay to establish the minimum inhibitory concentration for the subsequent test. Using a 1 µM carpaine treatment, a significant increase in the H9c2 proliferation rate was observed following 24 and 48 h of incubation. A Western blot analysis also revealed that carpaine promotes the upregulation of the cell cycle marker proteins cyclin D1 and PCNA. Carpaine-induced H9c2 cell proliferation is mediated by the activation of the FAK-ERK1/2 and FAK-AKT signaling pathways. In the setting of ischemia-reperfusion injury (IRI), carpaine provided a significant protective role to recover the wounded area affected by the hydrogen peroxide (H2O2) treatment. Furthermore, the oxidative-stress-induced reduction in mitochondrial membrane potential (MMP) and overproduction of reactive oxygen species (ROS) were attenuated by carpaine treatment. The current study revealed a novel therapeutic potential of carpaine in promoting in vitro cardiomyocyte proliferation and repair following injury.

Diagnostic challenges and Gene-Xpert utility in detecting Mycobacterium tuberculosis among suspected cases of Pulmonary tuberculosis.

The incidence of pulmonary tuberculosis (PTB) can be reduced by preventing transmission with rapid and precise case detection and early treatment. The Gene-Xpert MTB/RIF assay is a useful tool for detecting Mycobacterium tuberculosis (MTB) with rifampicin resistance within approximately two hours by using a nucleic acid amplification technique. This study was designed to reduce the underdiagnosis of smear-negative pulmonary TB and to assess the clinical and radiological characteristics of PTB patients. This cross-sectional study included 235 participants who went to the Luyang primary health care clinic from September 2016 to June 2017. The demographic data were analyzed to investigate the association of patient gender, age group, and ethnicity by chi-square test. To assess the efficacy of the diagnostic test, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated. The area under the curve for sputum for both AFB and gene-Xpert was analyzed to compare their accuracy in diagnosing TB. In this study, TB was more common in males than in females. The majority (50.71%) of the cases belonged to the 25-44-year-old age group and the Bajau ethnicity (57.74%). Out of 50 pulmonary TB cases (smear-positive with AFB staining), 49 samples were positive according to the Gene-Xpert MTB/RIF assay and was confirmed by MTB culture. However, out of 185 smear-negative presumptive cases, 21 cases were positive by Gene-Xpert MTB/RIF assay in that a sample showed drug resistance, and these results were confirmed by MTB culture, showing resistance to isoniazid. In comparison to sputum for AFB, Gene-Xpert showed more sensitivity and specificity with almost complete accuracy. The additional 21 PTB cases detection from the presumptive cases by GeneXpert had significant impact compared to initial observation by the routine tests which overcame the diagnostic challenges and ambiguities.

Comprehensive care of a patient with obesity of BMI >70 kg/m2.

A 31-year-old woman, with a body mass index of 70.31 kg/m2, presented with progressive worsening of dyspnoea for 3 days. She had multiple comorbidities, including obesity hypoventilation syndrome. The patient developed type II respiratory failure with respiratory acidosis along with multiorgan failure. She was intubated and put on a mechanical ventilator and treated with intravenous diuretics, subcutaneous low-molecular-weight heparin and other supportive measures. Later, she was on noninvasive, continuous positive airway pressure ventilation overnight. She was prescribed a very-low-calorie diet along with physiotherapy and exercise. The patient underwent bariatric surgery 2 months after resolution of acute illness. Ten months after surgery, her body weight reduced from 180 kg to 121 kg, and her general condition improved. Successful management before and after surgical intervention depends on multidisciplinary teamwork, which includes the dietician, physiotherapist, endocrinologist, pulmonologist, nursing care and other supportive care.