Aims: Laccase is a blue copper oxidase that catalyses four electron reduction of molecular oxygen to water. It is able to oxidise aromatic compounds with molecular oxygen as the terminal electron acceptor. The aim of this study was to screen for laccase producing basidiomycetes isolated from decaying woods and tree trunks around Kampar, Perak. Methodology and results: The isolated basidiomycetes were screened for their laccase activity on different agar plates supplemented with 2, 2-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS), guaiacol and Remazol Brillant Blue R (RBBR), respectively. In the presence of laccase, the colourless ABTS and guaiacol were oxidised to form blue-green and reddish-brown coloured zone around the fungal colony, respectively; whereas the blue RBBR was decolourised by the enzyme. Colour or colourless halo zones that are formed on the agar plates indicate the presence of ligninolytic enzyme activities. Isolates KA1 and TR9 indicated the highest enzymatic hydrolysis on ABTS plates with the halo zone ratio of 1.43  0.04 and 0.98  0.01, respectively. Based on the BLAST results from the amplicon of ITS1 and ITS4 primers, Isolates KA1 and TR9 were identified as Trametes lactinea and Pycnoporous coccineus, respectively. Under submerged fermentation, P. coccineus has higher laccase production (0.72 U/mL) compared with T. lactinea (0.16 U/mL). Conclusion, significance and impact of study: Both T. lactinea and P. coccineus are potential strains for laccase production which can be used for dye decolourisation and degradation. Future studies will focus on the application of the laccase in textile dye degradation.
Laccase

Chronic kidney disease (CKD) has emerged as a major medical illness that drew the attention of the community. This research focused on the prevalence of five contributing factors to the progression of CKD, namely blood pressure control, glycaemic control, lipid control, smoking and alcohol intake, and explored significant association between these variables. This was a cross-sectional study that examined the progression of CKD based on the worsening of CKD stages. This study was conducted among CKD patients with type 2 diabetes mellitus who attended Nephorology Clinic, UKMMC from April to May 2011. The progression of CKD was observed for 3 consecutive visits with 3 months intervals between the visits. Information regarding demographic data and social history were obtained through face-to-face interview, followed by case note review of the blood results. Data collected was analysed using SPSS version 19.0. A total of 201 respondents were investigated, which included 39.3% (n=79) female and 60.7% (n=122) male. The mean age for the respondents was 66.9 years old (±SD 9.00). Among the respondents, 71.5% had poor glycaemic control; 59.7% had poor blood pressure control; 65.2% had poor lipid control; 19.9% smoked and 3.5% consumed alcohol. There was poor correlation, there were statistically significant association between systolic blood pressure control with the glomerular filtration rate (GFR) (p=0.001; r=-0.229). From this research, high systolic blood pressure was associated with low GFR, which indicated poor kidney function and resulted in progression of CKD. This study has clearly demonstrated that the control of blood pressure was essential in delaying the progression of CKD.
Renal Insufficiency, Chronic ; Risk Factors ; Diabetes Mellitus, Type 2 ; Disease Progression ; Blood Pressure

INTRODUCTIONAnaesthetists may be called upon to emergently secure the airway of a laterally positioned patient. Intubating a patient's trachea in the lateral position may be difficult due to unfamiliarity. This exploratory study aimed to investigate the success rate of lateral intubation performed by novices in a controlled setting.

METHODSIn this observational study, all patients who presented for elective surgery requiring the lateral position with planned lateral intubation at Singapore General Hospital were included. The trainee assigned to each patient had no prior indication of the proposed lateral intubation until the start of the case. Verbal instructions were given before the start of and during the procedure. The consultant anaesthetist in attendance could intervene at any point to prevent patient harm or if the trainee requested assistance. Time to intubation, adjuncts used and complications encountered were recorded.

RESULTSA total of 44 consecutive patients were included in this study. The trainees completed 42 of the 44 lateral intubations, with 41 being successfully performed on the first attempt. All patients were intubated successfully in a lateral position within two attempts. The mean duration of intubation was 57.3 ± 36.4 seconds. There was no difference between left and right lateral intubation. Other than one episode of transient desaturation on pulse oximetry, there were no complications.

CONCLUSIONLateral intubation by trainees had a high success rate when supervised by an experienced operator. Intubation of patients in unconventional positions using routine airway equipment should be included in airway training for trainees.

Anesthesia ; Anesthesiology ; education ; Elective Surgical Procedures ; Humans ; Intubation, Intratracheal ; Laryngoscopy ; education ; Patient Positioning ; Posture ; Singapore ; Trachea ; pathology