Factors associated with tuberculosis treatment success among tuberculosis and human immunodeficiency virus co-infected patients in Kelantan.

INTRODUCTION: Tuberculosis (TB) and human immunodeficiency virus (HIV) co-infection is a global public health issue among people living with HIV. The objective was to assess the prevalence of TB treatment outcomes (successful and unsuccessful) and associated factors with TB treatment success among TB and HIV co-infected patients in Kelantan for 5 years (2014-2018). The successful TB treatment was defined as the sum of cured patients and those who completed the treatment. The unsuccessful treatment was defined as the sum of treatment failed, died, and default. MATERIALS AND METHODS: A cross-sectional study was conducted at the TB/Leprosy Unit of the State Health Department of Kelantan (JKNK) using secondary data from January 2014 to December 2018 assessed in the MyTB online system. The data were analyzed using SPSS 25.0 and STATA 14. Ethics approvals were obtained from Medical Research Ethics Committee (MREC) and UniSZA Human Research Ethics Committee (UHREC). RESULTS: Kelantan had 6,313 TB cases from January 2014 to December 2018. There were 703 (11.1%) cases of TB and HIV co-infection. The prevalence of successful treatment among TB and HIV co-infected patients was 57.1%. The duration of treatment and anatomy of TB location was significantly associated with TB treatment success. CONCLUSION: This study's findings showed that the prevalence of TB treatment success rate was 57.1%, and the unsuccessful rate was 42.9%. The treatment duration and the TB location's anatomy were significantly associated with the treatment success rate. Improving TB treatment outcomes should be started with anti-TB treatment immediately after TB diagnosis. Therefore, the government should strengthen the TB/HIV collaborative efforts to achieve good treatment outcomes among these vulnerable patients.

The Cobblestone Heart.

Sarcoidosis is a chronic, multisystem disorder. A 38 years old lady presented at Hospital Raja Perempuan Zainab II, Kota Bharu ,Malaysia with cough and breathless for 2 months and constitutional symptoms of weight loss and loss of appetite. She was initially treated as smear negative pulmonary tuberculosis for 5 months. However, her clinical condition deteriorated with worsening New York Heart Association (NYHA) class 1 to class 3. Subsequently, workout of computed tomography( CT) thorax showed multiple perilymphatic distribution of nodules and multiple mediastinal lymphadenopathy coupled with pleura biopsy showed non caseating granuloma and cardiac magnetic resonance imaging (MRI) with positive late gadolinium enhancement revised the diagnosis of pulmonary sarcoidosis with cardiac involvement. Patient's functional status and cough improved with immunosuppresant was given in tapering dose fashion.

The effect of Tualang honey on the quality of life of patients with chronic obstructive pulmonary disease: A randomized controlled trial.

OBJECTIVES: This study aimed to assess the efficacy of a 6-months regime of honey supplementation in improving the quality of life (QoL) of patients with chronic obstructive pulmonary disease (COPD). METHODS: A single blind randomized controlled trial on 34 patients with COPD was conducted. The participants were divided into two groups, including honey (n = 22) and standard care (n = 12). St. George's Respiratory Questionnaire (SGRQ) was used to assess the QoL. The QoL total score was analysed using repeated measure ANOVA. RESULT: There were no significant differences between the honey and standard care groups for socio-demographic and QoL variables. The within-time analysis showed statistically significant differences between baseline and post 2, 4 and 6-months in the total QoL score in the honey group. Otherwise, only marginally significant difference was detected between baseline and post 2-months in the standard care group. A comparison of total QoL score between the two groups, based on time (between and within), favoured the honey group. The honey group demonstrated a significantly lower mean total QoL score compared with the standard group at 4-months (28.89; 95% CI: 21.19, 36.59 vs 42.38; 95% CI: 31.95, 52.81) and 6 months (22.91; 95% CI: 14.94, 30.87 vs 41.95; 95% CI: 31.17, 52.73). CONCLUSION: Supplementation of honey in patients with COPD results in better intermediate and long-term changes in the overall QoL.

De novo transcriptome analysis shows differential expression of genes in salivary glands of edible bird's nest producing swiftlets.

BACKGROUND: Edible bird's nest (EBN), produced from solidified saliva secretions of specific swiftlet species during the breeding season, is one of the most valuable animal by-products in the world. The composition and medicinal benefits of EBN have been extensively studied, however, genomic and transcriptomic studies of the salivary glands of these birds have not been conducted. RESULTS: The study described the transcriptomes of salivary glands from three swiftlet species (28 samples) generated by RNASeq. A total of 14,835 annotated genes and 428 unmapped genes were cataloged. The current study investigated the genes and pathways that are associated with the development of salivary gland and EBN composition. Differential expression and pathway enrichment analysis indicated that the expression of CREB3L2 and several signaling pathways involved in salivary gland development, namely, the EGFR, BMP, and MAPK signaling pathways, were up-regulated in swiftlets producing white EBN (Aerodramus fuciphagus) and black EBN (Aerodramus maximus) compared with non-EBN-producing swiftlets (Apus affinis). Furthermore, MGAT, an essential gene for the biosynthesis of N-acetylneuraminic acid (sialic acid), was highly expressed in both white- and black-nest swiftlets compared to non-EBN-producing swiftlets. Interspecies comparison between Aerodramus fuciphagus and Aerodramus maximus indicated that the genes involved in N-acetylneuraminic and fatty acid synthesis were up-regulated in Aerodramus fuciphagus, while alanine and aspartate synthesis pathways were up-regulated in Aerodramus maximus. Furthermore, gender-based analysis revealed that N-glycan trimming pathway was significantly up-regulated in male Aerodramus fuciphagus from its natural habitat (cave) compared to their female counterpart. CONCLUSIONS: Transcriptomic analysis of salivary glands of different swiftlet species reveal differential expressions of candidate genes that are involved in salivary gland development and in the biosynthesis of various bioactive compounds found in EBN.