This study determined the association between nutritional status and the use of protease inhibitors (PI) containing regimen among HIV-infected children receiving treatment at the referral centres in Klang Valley. A total of 95 children currently on antiretroviral (ARV) therapy, aged one to eighteen years, were recruited using purposive sampling. Demographic data, anthropometric measurements, medical history, were collected using a structured questionnaire. Serum micronutrients levels and lipid profile were also examined using blood samples. Mean age was 8.8 3.9 years and 44.2% were on PI. Age ( 2 = 10.351, p = .006), weight-for-age ( 2 = 6.567, p = .010), serum selenium ( 2 = 4.225, p = .040) and HDL-C ( 2 = 7.539, p = .006) were significantly associated with the use of PI. Fewer children on PI were deficient in selenium as compared to those not on PI. On the contrary, more children on PI were underweight and had low HDL-C. The use of PI was found to have both positive and negative effects with better selenium level but poorer HDL-C level and weight status.

Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aims of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.

Objective: A cross-sectional study was conducted in Malaysia with the objectives of determining the prevalence of smoking in Malaysia, reasons for starting to smoke, age first started to smoke, duration of smoking and to determine the relationship between smoking and age, sex,race, education level, peer influence and parental smoking status. Methods:All residents aged 18 years and above from selected households were included in this study. A standardised pre-tested structured questionnaire was used in this study. Results: The results showed that the overall mean age of the 17.246 respondents was 38.8 (95% CI=38.5-39.2) years with a range of 18-100 years. The majority were Malays (55.5%) followed by Chinese (21.2%) and Indians (11.2%). The age , sex and ethnicity adjusted prevalence of ever and current smokers were 32.0% and 24.9% respectively. The prevalence of ever and current smokers for males was 59.3% and 47.2% respectively. For the females,the prevalence of ever and current smokers was 4.8% and 2.7% respectively. The highest ethnicity adjusted prevalence of current smokers was in Malays (28.9%) followed by the Chinese (18.7%). The lowest prevalence was amongst the Indians (16.8%). The highest prevalence of current smokers was found in Kelantan (30.2%), Terengganu (29.7%), Pahang (28.7%) and Kedah (26.9%); the lowest prevalence was in Kuala Lumpur, Federal Territory (20.4%). The overall mean initiation age of current smokers was 19.2 years (95% CI=19.1. 19.4 years). The mean initiation age of male current smokers was significantly lower (18.9 years) compared to female current smokers(24.1 years). The mean duartion of smoking amongst the current smokers was 18.6 years .Males smoked significantly more cigarettes than the females (p<0.001). Discussion: Multivirate logistic regression analysis showed that smoking was significantly associated with age, sex, ethnicity, educational level and peer and family influence.

INTRODUCTIONAn investigation was carried out to determine the morphological characteristics of fibroblasts in two portions of the vocal fold (VF) mucosa, the macula flava (MF) and Reinke's space (RS), of three different age groups: newborns, adults and geriatrics.

METHODSNormal human VF obtained from autopsy cases were included in this study: four from mature newborns; four from middle-aged adults; and four from geriatric cases. Fibroblasts in RS and MF were investigated by transmission electron microscopy.

RESULTSThe fibroblasts of the MF in both adults and newborns tended to be stellate in shape, with a small nucleus/cytoplasm (N/C) ratio and a well-developed rough endoplasmic reticulum (rER) and Golgi apparatus (GA). Most of the fibroblasts present in RS were oval in newborns and spindle-shaped in adults, with a large N/C ratio and less developed rER and GA. The majority of fibroblasts of the geriatric MF were stellate in shape; while in geriatric RS, the majority of fibroblasts were spindle-shaped with an N/C ratio of 0.5 to 2.0 as in the case of adults. However, the development of rER and GA was less marked in geriatrics than in adults.

CONCLUSIONHistological changes of fibroblasts in the VF mucosa are one of the important causes of the change in voice quality with ageing. Furthermore, geriatric changes in the vocal ligament can be attributed to the activities and the presence of ageing processes in fibroblasts of geriatric VF mucosa.

Adult ; Age Factors ; Aged ; Cell Nucleus ; ultrastructure ; Cytoplasm ; ultrastructure ; Endoplasmic Reticulum ; ultrastructure ; Female ; Fibroblasts ; ultrastructure ; Golgi Apparatus ; ultrastructure ; Humans ; Infant, Newborn ; Laryngeal Mucosa ; ultrastructure ; Male ; Microscopy, Electron, Transmission ; methods ; Vocal Cords ; ultrastructure

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anti-Bacterial Agents ; pharmacology ; Ceftriaxone ; pharmacology ; Child, Preschool ; Drug Resistance, Microbial ; Hospitals, Public ; Humans ; Infant ; Microbial Sensitivity Tests ; Middle Aged ; Salmonella ; classification ; drug effects ; isolation & purification ; Salmonella Infections ; drug therapy ; microbiology ; Singapore ; beta-Lactamases ; genetics ; isolation & purification

Malaria is one of the most dangerous infectious diseases due to its high infection and mortality rates, especially in the tropical belt. Plasmodium falciparum (P. falciparum), the most virulent malaria parasite in humans, was recently reported to develop resistance against the final efficient antimalarial drug, artemisinin. Little is known about the resistance mechanisms, which further complicates the problem as a proper counteraction is unable to be taken. Hence, the understanding of drug mode of action and its molecular target is valuable knowledge that needs to be considered to develop the next generation of antimalarial drugs. P. falciparum protein kinase (Pf PK) is an attractive target for antimalarial chemotherapy due to its vital roles in all P. falciparum life stages. Moreover, overall structural differences and the presence of unique Pf PKs that are absent in human kinome, suggesting specific inhibition of Pf PK without affecting human cells is achievable. To date, at least 86 eukaryotic protein kinases have been identified in P. falciparum kinome, by which less than 40 were validated as potential targets at the erythrocytes stage. In this review, recent progress of the furthest validated Pf PKs; Pf Nek-1, Pf CDPK1, Pf CDPK4, Pf PKG, and Pf CLK-3 will be briefly discussed.

OBJECTIVE: Nutraceutical products are widely used for their claimed therapeutic benefits. However, falsified or adulterated nutraceuticals present a major health threat to consumers. This study investigates the pharmaceutical quality, safety and anti-inflammatory effects of six male enhancement nutraceuticals that claim to be 100% natural. METHODS: Three batches of six male enhancement products were tested to detect the presence and levels of adulterants via high-performance liquid chromatography (HPLC). The pharmaceutical quality of the selected nutraceuticals was tested with near infrared spectroscopy (NIR) and SeDeM. The cytotoxic effects of these products on HepG2 cells were determined through cell proliferation (XTT) and lactate dehydrogenase (LDH) cytotoxicity assays. Lastly, the in vitro inflammatory effects of these products were investigated using murine J774 macrophages through cytokine release analysis. RESULTS: HPLC analysis detected the presence of sildenafil citrate, a vasodilator, and the active ingredient in Viagra and Revatio, in all batches of the products we analyzed. Amount of sildenafil citrate ranged from 0.45 mg to 51.85 mg among different batches. NIR assessment showed inter- and intra-batch heterogeneity in product composition. Results of the XTT and LDH assays showed significant cytotoxic effects of the analyzed products. XTT analysis revealed that the viability of HepG2 treated with tested products varied from 27.57% to 41.43%. Interestingly, the male enhancement products also showed anti-inflammatory effects. CONCLUSION Despite their labeling as 100% natural, all products tested in this study contained levels of sildenafil citrate, which was not reported on the packaging. There was a lack of pharmaceutical uniformity among products of the same batch and across different batches. Additionally, the products we tested had cytotoxic effects. These study findings highlight the adulteration, poor quality and hazard of these nutraceuticals. Therefore, strict regulation of these products and standardization of the definition of nutraceuticals are urgently needed. Further, these falsely advertised products should be withdrawn from the market due to potential adverse effects on the health of their consumers.