Influenza in Malaysian adult patients hospitalized with community-acquired pneumonia, acute exacerbation of chronic obstructive pulmonary disease or asthma: a multicenter, active surveillance study.

BACKGROUND: Available data on influenza burden across Southeast Asia are largely limited to pediatric populations, with inconsistent findings. METHODS: We conducted a multicenter, hospital-based active surveillance study of adults in Malaysia with community-acquired pneumonia (CAP), acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute exacerbation of asthma (AEBA), who had influenza-like illness ≤10 days before hospitalization. We estimated the rate of laboratory-confirmed influenza and associated complications over 13 months (July 2018-August 2019) and described the distribution of causative influenza strains. We evaluated predictors of laboratory-confirmed influenza and severe clinical outcomes using multivariate analysis. RESULTS: Of 1106 included patients, 114 (10.3%) were influenza-positive; most were influenza A (85.1%), with A/H1N1pdm09 being the predominant circulating strain during the study following a shift from A/H3N2 from January-February 2019 onwards. In multivariate analyses, an absence of comorbidities (none versus any comorbidity [OR (95%CI), 0.565 (0.329-0.970)], p = 0.038) and of dyspnea (0.544 (0.341-0.868)], p = 0.011) were associated with increased risk of influenza positivity. Overall, 184/1106 (16.6%) patients were admitted to intensive care or high-dependency units (ICU/HDU) (13.2% were influenza positive) and 26/1106 (2.4%) died (2.6% were influenza positive). Males were more likely to have a severe outcome (ICU/HDU admission or death). CONCLUSIONS: Influenza was a significant contributor to hospitalizations associated with CAP, AECOPD and AEBA. However, it was not associated with ICU/HDU admission in this population. Study registration, NMRR ID: NMRR-17-889-35,174.

Action of metformin therapy against advanced glycation, oxidative stress and inflammation in type 2 diabetes patients: 3 months follow-up study.

BACKGROUND: Persistence hyperglycemia results in the formation of advanced glycation end products (AGEs) by non-enzymatic glycation. AGEs and their receptor RAGE play an important role in generation of inflammatory molecules and oxidative stress. Metformin regulates insulin responsive gene and helps to achieve glycemic control however, no extensive study reported about its role against glycation induced oxidative stress and vascular inflammation. Therefore, present work focused on clinical relevance of three months metformin therapy in type 2 diabetes mellitus patients against glycation induced oxidative stress and vascular inflammation. METHODS: Among recruited 40 medicated-naive type 2 diabetes mellitus patients, 31 patients were continued with metformin therapy. Biomarkers of plasma protein glycation (fructosamine, protein carbonyls, ß-amyloid) antioxidants and oxidative stress markers (GSH, catalase, NO, PON-1, AOPP, LPO; RAGE isoforms (sRAGE, esRAGE); inflammatory markers (IL-6, TNF-α) were determined at baseline and after 3-months of treatment. The expression profile of membrane RAGE, NF-κB, CML was studied in PBMNCs and GLUT-1 in erythrocyte ghost by western blotting. RESULTS: Metformin showed maximum percent declined from baseline to three months therapy in levels of fructosamine, ß-amyloid, sRAGE, inflammatory cytokines (IL-6, TNF-α) and percent increment in esRAGE and antioxidants levels. It showed reduced levels of IL-6 and TNF-α by declining expression of CML, membrane RAGE and NF-κB in type 2 diabetes mellitus patients after three months therapy. CONCLUSIONS: First report in Indian diabetes mellitus patients, where metformin showed effective inhibition against glycation and receptor mediated cellular inflammation. However, these findings need to be tested in a randomized trial.

Evaluation of flexural strength and color stability of different denture base materials including flexible material after using different denture cleansers.

AIMS: Present study aimed at evaluating the colour stability and flexural strength of flexible denture base materials (Valplast) and Polymethyl methacrylate (PMMA) denture base material (Meliodent) processed by two different methods (Injection moulding and compression moulding) after immersing them in three different denture cleansers with acidic, basic and neutral PH. METHODS AND MATERIALS: Total 120 specimens (65 × 10 × 3 mm3), 40 specimens of each material (Valplast, Meliodent compression moulding and injection moulding) were immersed in denture cleansers having different PH; Valclean (Acidic), Clinsodent (Basic) and Polident (Neutral) as well as Distilled Water. Color changes were measured with a spectrophotometer after 1 month, 3 months and 6 months of immersion cycle. A flexural 3-point bending test was carried out by using an Instron universal testing machine after 6 months of soaking. Data were analyzed using SPSS software. RESULTS: Maximum effect on colour stability was noted with Clinsodent followed by Valclean. Least color changes were observed after immersion in Polident. Colour difference was increased significantly as the immersion time increased. For both Meliodent and Nylon resins, statistically significant change in flexural strength occurred with immersion in all denture cleansers. Clinsodent has greater effect as compared to Valclean and Polident. CONCLUSIONS: Polident and Valclean can be safely used as denture cleanser for both nylon and acrylic resin denture base materials as far as colour stability and flexural strength both are concerned.