Objective: The study examined the efficacy of various generations of cephalosporins against biofilms developed by pathogenic S. aureus and E. coli. Methods: The development of biofilms by both bacteria was assessed using petri-plate and microplate methods. Biofilm hydrolysis and inhibition were tested using first to fourth generations of cephalosporins, and the effects were analyzed by crystal violet staining and phase contrast microscopy. Results: Both bacterial strains exhibited well-developed biofilms in petri-plate and microplate assays. Cefradine (first generation) showed 76.78% hydrolysis of S. aureus biofilm, while significant hydrolysis (59.86%) of E. coli biofilm was observed by cefipime (fourth generation). Similarly, cefuroxime, cefadroxil, cefepime, and cefradine caused 78.8%, 71.63%, 70.63%, and 70.51% inhibition of the S. aureus biofilms, respectively. In the case of E. coli, maximum biofilm inhibition (66.47%) was again shown by cefepime. All generations of cephalosporins were more effective against S. aureus than E. coli, which was confirmed by phase contrast microscopy. Conclusions and Relevance: Cephalosporins exhibit dual capabilities of hydrolyzing and inhibiting S. aureus and E. coli biofilms. First-generation cephalosporins exhibited the highest inhibitory activity against S. aureus, while the third and fourth generations significantly inhibited E. coli biofilms. This study highlights the importance of tailored antibiotic strategies based on the biofilm characteristics of specific bacterial strains.

The technetium-99m methylene diphosphonate (99mTc-MDP) whole-body bone scan along with single-photon emission computed tomography (SPECT/CT) can detect challenging soft tissue uptake patterns. We present a case of a 67-year-old female in whom the 99mTc-MDP scan, performed 3 hours after injection, revealed abnormal soft tissue uptake in the right thoracic region. No functioning right kidney was seen in the right lumbar region. Hybrid SPECT/CT revealed an ectopic right kidney in the subdiaphragmatic location, accompanied by gut loops and eventration of the right-sided diaphragm. This case underscores the value of SPECT/CT in identifying and characterizing unexpected anatomical abnormalities, such as ectopic kidneys.

BACKGROUND: Cardiovascular disease is a significant contributor to the disease burden in geriatric patients. Underlying systemic inflammation is thought to be the cause of age-related changes in the bone marrow and a major risk factor for atherosclerosis. The purpose of the study was to assess the accuracy of these hematological biomarkers in predicting 30-day mortality in older patients with acute coronary syndrome (ACS). METHODS: This was a prospective observational study of 601 older adult patients (age > 60 years) with ACS who underwent percutaneous coronary intervention over two years (2017-2019). The relationship between baseline hematological parameters and mortality was assessed during the 30-day follow-up. Logistic regression analysis and receiver operating characteristic curve analysis were done to evaluate for diagnostic accuracy of various hematological parameters. RESULTS: The mean age of presentation was 77 ± 17 years. The mean neutrophil-lymphocyte ratio (NLR) value was 5.07 ± 4.90 and the mean platelet-lymphocyte ratio (PLR) value was 108.65 ± 85.82. On univariate analysis, total leucocyte count [odds ratio (OR) = 0.85, P = 0.021], hematocrit (OR = 0.91, P = 0.018), NLR (OR = 1.10, P = 0.001) and PLR (OR = 1.05, P = 0.001) were associated with mortality. On receiver operating characteristic curve analysis, NLR predicted mortality with 68.1% and PLR with 65.7% accuracy. On multivariate analysis, NLR (OR = 1.096, 95% CI: 1.006-1.15, P = 0.035) was an independent predictor of 30-day mortality. CONCLUSIONS For the risk classification of all elderly ACS patients, we highly advise using NLR rather than the total white blood cell count.

Introduction: Flooding has become a major natural disaster in Malaysia in recent decades. There may be a gender difference in many aspects related to flood response and practice. This study aimed to examine the gender gap in knowledge, attitudes, and practice of flood preparedness in Malaysia. Method: This cross-sectional study was conducted among patients attending the primary care clinic at Universiti Sains Malaysia health campus, Kelantan. A validated questionnaire was used for data collection. Results: 328 subjects were recruited, 56.1% of them were females. The female respondents were younger than the males (36 vs. 41 years old). However, females have better knowledge, and practice on flood preparedness compared to male respondents. Among those, women were more aware of the local emergency plan than males (p=0.01). More female respondents kept their vaccination and personal medical records in a waterproof container or sealed plastic bag during past and future flood preparations (3-5 day supply of non-perishable food) than male respondents (p<0.05). In addition, with the practice of keeping a one-week supply of medication, and having their medical records in a waterproof container along with a first-aid kit (p=0.001). For future flood preparation, more women would filter the cloudy water through clean clothes for boiling (p=0.035). The determinants of good preparedness for future floods for female were older-age (p=0.001), blue-collar (p=0.043); whereas male were lower household income (p=0.014), being blue collar (0.014) and white collar (0.039) compared with student/retiree based on multivariate logistic regression. Conclusion: Our study reported that the determinants of good preparedness for future floods were older-age, blue-collar and having a lower-household income.

Introduction: Lumbar stabilization exercises may improve core stability and reduce low back pain among older persons. However, the evidence is scarce. The objective of this study was to update evidence on the effectiveness of lumbar stabilization exercises on pain, disability, and functional performance among older persons with low back pain. Methods: This systematic review retrieved articles from PubMed, MEDLINE (via EBSCO), PEDro, Google Scholar, and ScienceDirect published from 2005 to 2020. The selected articles were scored using the McMaster Critical Review Form for Quantitative Studies for quality assessment. The data was extracted based on the study design, sample size, inclusion criteria, intervention, outcome, and conclusion. Results: A total of 2349 articles were found but only two articles met the inclusion criteria with both showing excellent scores on the McMaster Critical Review Form for Quantitative Studies. The findings showed lumbar stabilization exercises alone or combined with other interventions were effective in reducing pain intensity, and improving disability, and gait functional performance among older persons with low back pain. Conclusion: The current study suggests lumbar stabilization exercise is effective for pain, disability, and functional performance among older persons. However, further investigation is needed to gain more conclusive evidence for clinical practice.

Background: A written asthma action plan (WAAP) is one of the treatment strategies to achieve good asthma control in children. Methods: This randomized controlled trial was conducted to observe the effect of WAAP on asthma control and quality of life using the Asthma Control Questionnaire and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) at baseline and after 3 months. A repeated measure analysis of variance was used to analyze the mean score difference between the two groups. Results: There was no significant difference in mean score for asthma control at baseline between groups (F[degree of freedom (df)]=1.17 [1, 119], P=0.282). However, at 3 months, a significant difference in mean scores between groups was observed (F[df]=7.32 [1, 119], P=0.008). The mean±standard deviation (SD) scores in the intervention and control groups were 0.96±0.53 and 1.21±0.49, respectively. For the analysis of the PAQLQ, no significant difference was observed in the mean score for the quality of life baseline in both groups. There were significant mean score changes for the quality of life (F[df]=10.9 [1, 119], P=0.001) at 3 months follow-up, where those in the intervention group scored a mean±SD score of 6.19±0.45, and those in the control group scored 5.94±0.38. A time-group interaction analysis using repeated-measures analysis of variance showed significant differences in mean score changes (F[df]=5.03 [1, 116], P=0.027) and (F[df]=11.55 [1, 116], P=0.001) where a lower mean score was observed in the intervention group, indicating better asthma control and quality of life, respectively. A significant (P<0.001) negative Pearson correlation between asthma control and quality of life (-0.65) indicated a moderate correlation. Conclusion WAAP, along with standard asthma treatment, improves asthma care.

The severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which caused the coronavirus disease 2019(COVID-19)pandemic,has affected more than 400 million people worldwide.With the recent rise of new Delta and Omicron variants,the efficacy of the vaccines has become an important question.The goal of various studies has been to limit the spread of the virus by utilizing wireless sensing technologies to prevent human-to-human interactions,particularly for healthcare workers.In this paper,we discuss the current literature on invasive/contact and non-invasive/non-contact technologies(including Wi-Fi,radar,and software-defined radio)that have been effectively used to detect,diagnose,and monitor human activities and COVID-19 related symptoms,such as irregular respiration.In addition,we focused on cutting-edge machine learning algorithms(such as generative adversarial networks,random forest,multilayer perceptron,support vector machine,extremely randomized trees,and k-nearest neighbors)and their essential role in intelligent healthcare systems.Furthermore,this study highlights the limitations related to non-invasive techniques and prospective research directions.

Objectives: Dengue remains hyperendemic in Malaysia despite extensive vector control activities. With dynamic changes in land use, urbanisation and population movement, periodic updates on dengue transmission patterns are crucial to ensure the implementation of effective control strategies. We sought to assess shifts in the trends and spatial patterns of dengue in Kelantan, a north-eastern state of Malaysia (5°15’N 102°0’E). Methods: This study incorporated data from the national dengue monitoring system (eDengue system). Confirmed dengue cases registered in Kelantan with disease onset between January 1, 2016 and December 31, 2018 were included in the study. Yearly changes in dengue incidence were mapped by using ArcGIS. Hotspot analysis was performed using Getis-Ord Gi to track changes in the trends of dengue spatial clustering. Results: A total of 10 645 dengue cases were recorded in Kelantan between 2016 and 2018, with an average of 10 dengue cases reported daily (standard deviation, 11.02). Areas with persistently high dengue incidence were seen mainly in the coastal region for the 3-year period. However, the hotspots shifted over time with a gradual dispersion of hotspots to their adjacent districts. Conclusions A notable shift in the spatial patterns of dengue was observed. We were able to glimpse the shift of dengue from an urban to peri-urban disease with the possible effect of a state-wide population movement that affects dengue transmission.

Aims: This paper presents the report on biodiesel and biogas production at a laboratory scale from Scenedesmus strain. Methodology and results: Previously isolated and identified Scenedesmus were grown in 10 Liter flask using BG-11 media at 16 h light and 8 h dark cycle. Oven-dried biomass (20 g) from 16-day-old culture of Scenedesmus was finely grounded and subjected to lipids extraction by chloroform-methanol-NaCl mixture. Microalgal lipids (6 mL) were subjected to transesterification by using NaOH leading to the production of 5 mL biodiesel and 4 mL of glycerin. Biodiesel was rich in methyl esters of linoleic acid, phosphorothioc acid and dodecanoic acid, as shown by gas chromatography-mass spectrometry (GC-MS) analysis. Oven-dried microalgae (2 g) without lipid extraction and leftover biomass (2 g) after lipid extraction were subject to biogas production through anaerobic digestion. Biogas (34, 27 and 19 mL) were recorded respectively in oven-dried whole biomass; lipid extracted biomass and control over a period of 15 days of anaerobic digestion. Conclusion, significance and impact of study It was concluded that water bodies are rich in diverse algae, especially Scenedesmus sp., and this algae can be cultured to produce biodiesel and biogas. But the lipid accumulation potential of microalgae requires special treatment and lipid extraction methods are not up to the mark, which is a major bottleneck in biofuel production from microalgae.
Biofuels ; Scenedesmus--isolation & ; purification

Introduction: Vascular dysregulation is postulated to be involved in the pathogenesis of primary open angle glaucoma (POAG). Systemic arterial stiffness may accelerate the pre-existing damage. The purpose of this study was to determine the association of arterial stiffness with severity and progression of visual field in Malay patients with POAG. Methods: A cross-sectional study was conducted with 55 patients with POAG and 55 age- and sex-matched control subjects. The patients with POAG were further divided in accordance with their Advanced Glaucoma Intervention Study (AGIS) scores on their visual fields (VFs) (mild in 23 patients, moderate in 18, and severe in 14). Progression was defined as the worsening of the VF defect quantified as an increase in AGIS score of 4 points from the baseline. Arterial stiffness was measured using SphygmoCor and quantified as pulse wave analysis (PWA) and pulse wave velocity (PWV). Results: No significant differences in PWA and PWV were found between the patients with POAG and the control subjects (p=0.333 and p=0.443, respectively). The mean follow-up duration for the patients with POAG was 4.7±3.1 years. PWA and PWV showed no significant association with POAG severity after the confounding factors were controlled for. Ten patients with progression of VF were identified. In the analysis of covariance, a significantly higher PWV was found in the patients with disease progression (p=0.036). Conclusion: VF severity and progression were not associated with systemic arterial stiffness. The probable reason is that other factors affecting retinal microcirculation may play a larger role in the severity and progression of POAG.