Dengue remains a public health threat that consumes a significant number of resources for its prevention and control. This systematic review aimed to solidify recent costing evidence in dengue management among South East Asian (SEA) countries. All studies conducted between 2010 and 2020 were retrieved using four international databases i.e. PubMed, Scopus, Web of Science, and Emerald Insight. The review was reported according to PRISMA guidelines. Quality assessments were done independently by two reviewers using a checklist adapted for the cost of illness studies. We identified 13 original articles representing several SEA countries. Among the common reported costing measure include total cost/ health expenditure; direct medical cost; direct non-medical cost; and indirect cost. The estimated total cost for dengue management varied between countries largely due to the difference in the total incidence of dengue cases. The estimated cost spent on dengue per capita GDP ranges from less than 0.001% to 0.1%, depending on the recorded number of dengue cases of the year. The majority of the articles focused on the economic burden from the perspective of treatment such as hospitalization and ambulatory care. In a nutshell, the economic burden of managing dengue infection is costly and the evidence suggests a steady increase in health expenditure with the growing number of dengue cases

Cabaran Dalam Pencegahan dan Kawalan Plasmodium Knowlesi Malaria Di Rantau Asia Tenggara – Ulasan Naratif PengenalanDi sebalik kejayaan program penghapusan malaria manusia, terdapat peningkatan yang membimbangkan berkenaan jangkitan malaria Plasmodium knowlesi (P. knowlesi) di rantau Asia Tenggara. Pemahaman menyeluruh tentang cabaran dalam mencegah dan mengawal malaria zoonosis ini mesti diutarakan, terutamanya apabila menentukan strategi paling berkesan untuk menyekat penularan penyakit.MetodologiDi sebalik kejayaan program penghapusan malaria manusia, terdapat peningkatan yang membimbangkan berkenaan jangkitan malaria Plasmodium knowlesi (P. knowlesi) di rantau Asia Tenggara. Pemahaman menyeluruh tentang cabaran dalam mencegah dan mengawal malaria zoonosis ini mesti diutarakan, terutamanya apabila menentukan strategi paling berkesan untuk menyekat penularan penyakit.Hasil KajianKepelbagaian manusia, seperti sosioekonomi dan sosiobudaya tempatan yang majmuk, persepsi yang rendah dan pematuhan optimum terhadap langkah-langkah pencegahan dan kawalan perlu ditangani. Isu dana nasional, pelaksanaan program, dan birokrasi mesti diselesaikan dalam memastikan keberkesanan peranan kerajaan dan kerjasama pelbagai sektor apabila melibatkan pengurusan penyakit malaria. Kejayaan sesuatu program akan terhalang sekiranya tiada sokongan daripada pemimpin masyarakat dan bertentangan dengan dinamik sosial. Kebolehsuaian nyamuk Anopheles bertanggungjawab terutamanya terhadap cabaran yang dihadapi dalam kawalan vektor. Kesan anjakan ekologi dan perubahan iklim, ditambah dengan aktiviti antropogenik mewujudkan limpahan zoonosis dan variasi penyesuaian yang mengubah landskap transmisi sylvian dan manusia.KesimpulanCabaran daripada pelbagai faktor mengurangkan keberkesanan dalam mencegah penularan penyakit ini. Pendekatan baharu mesti dibangunkan untuk mencapai kawasan terjejas dengan intervensi jangka panjang, komprehensif dan berkesan.

Gema Ekologi: Meneroka Interaksi Antara Persekitaran Hutan dan Vektor Malaria Pendahuluan Malaria kekal sebagai salah satu cabaran kesihatan awam yang penting di seluruh dunia, dengan kemajuan telah terbantut dalam kebelakangan ini. Memandangkan peningkatan kes malaria terutamanya di beberapa kawasan tropika, pemahaman yang lebih baik tentang hubungan ekologi yang mendasari penularan vektor malaria perlu diberikan fokus. Pendekatan pelbagai disiplin yang melibatkan ekologi, entomologi dan kesihatan awam adalah diperlukanuntuk memahami kaitan antara malaria dan habitat persekitaran. Ulasan ini bertujuan untuk mensintesis penyelidikan sedia ada tentang bagaimana ekosistem hutan mempengaruhi dinamik penularan malaria.MetodologiMenggunakan pangkalandata PubMed, Google Scholar dan Scopus, kajian literatur komprehensif telah dijalankan menggunakan kata kunci tertentu. Artikel yang berkaitan telah dinilai untuk aliran tematik. Secara keseluruhan, 42 artikel telah dipilih untuk naratif ini.Hasil Iklim mikro hutan mempengaruhi kecergasan, tingkah laku, corak aktiviti dan fisiologi organisma. Relung biologiberbeza yang disebabkanoleh suhu, kelembapan, pendedahan cahaya dan kerpasan boleh memberi kesan kepada populasi nyamuk. Ciri-ciri fiziko-biokimia badan air, termasuk suhu, pH, jumlah pepejal terlarut (TDS), kandungan nitrat, dan paras oksigen terlarut, mempunyai kesan yang ketara ke atas banyaknya larva nyamuk anopheline. Kelimpahan vektor mungkin dipengaruhi oleh kehadiran perumah dan pemangsa semulajadi. Interaksi rumit geografi, tumbuh-tumbuhan hutan, kepadatan vektor malaria, dan tingkah laku mempunyai pengaruh besar ke atas dinamik penularan malaria. Penebangan hutan mengubah landskap dan ekosistem serpihan, yang mempunyai kesan besar ke atas habitat larva vektor Plasmodium. Perubahan iklim menimbulkan ancaman besar kepada kelimpahan vektor malaria dan dinamik penghantaran.KesimpulanTerdapat banyak aspek kepada interaksi kompleks antara persekitaran hutan dan penyebaran malaria,memerlukan pengetahuan yang mendalam dan lebih banyak penyiasatan. Kerjasama antara ahli ekologi, entomologi dan pakar kesihatan awam adalah penting dalam menghasilkan model komprehensif yang meramalkan risiko malaria dengan tepat dalam persekitaran yang berubah-ubah

Objective: To examine the effect of coadministration of different medicinal plant extracts (curcumin and extracts of Nigella sativa L. [N. sativa, Jia Hei Zhong Cao], Zingiber officinale Rosc. [Z. officinale, Sheng Jiang], and Punica granatum L. [P. granatum, Shi Liu]) with spiramycin (SP) against the cystogenic ME-49 Toxoplasma gondii (T. gondii) strain in immunocompromised mice. Methods: We utilized 68 mice categorized into 8 groups: 2 non-infected controls (immunocompetent and immunocompromised), 1 infected control, and 5 infected and treated groups. Following the experiment, the cerebral tissues of each mouse underwent parasitological, histopathological, and immunohistochemical evaluations. Results: Compared with the infected non-treated group, all infected treated groups showed significant reductions in brain cyst numbers (all P < .05), with the highest reduction rate (77.4%) recorded for P. granatum and SP combination (G8). Only G8 showed a significant reduction in mouse deaths compared with the other groups. With regards to restoring histopathological changes and decreasing inflammation, the groups infected and treated with curcumin and P. granatum combined with SP showed the best results (P < .05). Combinations of curcumin and extracts of Z. officinale and P. granatum with SP significantly restored the cerebral expression of caspase-3 compared with the N. sativa extract combination (P < .05). G8 showed non-significant expression compared with the local expression in the negative control groups. Conclusion Our study revealed that the coadministration of P. granatum extract with SP was the most effective combination against chronic cerebral toxoplasmosis.

Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such as machine learning, artificial neural networks, and deep learning, have shown great potential in andrology and reproductive medicine. AI-based tools are poised to become valuable assets with abilities to support and aid in diagnosing and treating male infertility, and in improving the accuracy of patient care. These automated, AI-based predictions may offer consistency and efficiency in terms of time and cost in infertility research and clinical management. In andrology and reproductive medicine, AI has been used for objective sperm, oocyte, and embryo selection, prediction of surgical outcomes, cost-effective assessment, development of robotic surgery, and clinical decision-making systems. In the future, better integration and implementation of AI into medicine will undoubtedly lead to pioneering evidence-based breakthroughs and the reshaping of andrology and reproductive medicine.

Introduction: Coconut sap is a sweet, fragrant liquid obtained from the inflorescence of coconut tree. In this study, a literature search was conducted using the Scopus database to study the trends of coconut sap research. Methods: Data extracted from the Scopus database were analysed and visualised using VOSviewer to determine top authors, papers, countries, collaborations, and research areas. A total of 76 publications up to year 2021 were identified and refined using keywords of “coconut sap”, “coconut sugar”, “coconut inflorescence”, “coconut inflorescence sap”, “coconut neera”, and “Cocos nucifera”. Results: Based on the analysis, research on coconut sap started in 1984, with a total of 53 authors, nine countries, and 12 sources that had published more than two documents. The analysis of countries and sources revealed that India and IOP Conference Series: Earth and Environmental Science (EES) were the most prolific country and sources, respectively. The most influential document was on the chemical compositions and bacteriology of coconut sap. The results also showed that research on coconut sap was in the field of food processing during the early years, followed by fermentation, agriculture, and bacteriology of coconut sap. Research on coconut sap’s bacteriology started in 1986 and became a major interest, especially among high impact journals. Conclusion: Overall, coconut sap is a potential target for the development of nutraceutical products, especially in the food and beverage industry.

Introduction: A dilemma arises when a bone graft or fracture fragment is accidentally dropped on the operation theatre floor and becomes contaminated. This study aimed to determine the efficacy of simple and readily available antiseptic solutions in disinfecting contaminated bones. Materials and methods: This experimental study involved 225 bone specimens prepared from discarded bone fragments during a series of 45 knee and hip arthroplasty surgeries. The bone fragments were cut into five identical cubes and were randomly assigned to either control (positive or negative), or experimental groups (0.5% chlorhexidine, 10% povidone-iodine or 70% alcohol). The control negative was to determine pre-contamination culture. All bone specimens, except the control negative group were uniformly contaminated by dropping on the operation theatre floor. Subsequently, the dropped bone specimens except for the control positive group, were disinfected by immersing in a respective antiseptic solution for 10 minutes, before transported to the microbiology laboratory for incubation. Results: The incidence of a positive culture from a dropped bone fragment was 86.5%. From the 37 specimens sent for each group, the incidence of positive culture was 5.4% (2 specimens) after being disinfected using chlorhexidine, 67.6% (25 specimens) using povidone-iodine and 81.1% (30 specimens) using alcohol. Simple logistic regression analysis demonstrated that chlorhexidine was significantly effective in disinfecting contaminated bones (p-value <0.001, odd ratio 0.009). Povidone-iodine and alcohol were not statistically significant (p-value 0.059 and 0.53, respectively). Organisms identified were Bacillus species and coagulase negative Staphylococcus. No gram-negative bacteria were isolated. Conclusion: A total of 0.5% chlorhexidine is effective and superior in disinfecting contaminated bones.

Fixed functional appliances are non-compliance dependent devices, which can assist the correction of Class II malocclusion. The mechanics of the fixed functional appliances may vary depending on the type of device used. We report the observed biomechanical effects of using the ForsusTM Fatigue Resistant Device (FRD) fixed functional appliance. The patient was a 14-year-old female presented with a Class II division I malocclusion on a Class II skeletal base. The malocclusion was complicated by a 10mm overjet and increased traumatic overbite. She was treated with the ForsusTM FRD appliance worn for 5 months after the alignment with fixed appliances (0.022” X0.028” MBT prescriptions) and finished on a non-extraction base. Dento-alveolar changes were the main contribution to the correction of the malocclusion and simultaneously improved the patient’s profile in the end of treatment. In conclusion, ForsusTM FRD appliance can be suggested to effectively correct Class II malocclusion.

BACKGROUND: Evaluation of left ventricular (LV) size and function is one of the important reasons for performing echocardiography. Real time three dimensional echocardiography (RT3DE) is now available for a precise non-invasive ventricular volumetry. Aim of work was to validate RT3DE as a non-invasive cardiac imaging method for measurement of LV volumes using cardiac angiography as the reference technique. METHODS: Prospective study on 40 consecutive patients with tetralogy of Fallot (TOF) referred for cardiac catheterization for preoperative assessment. Biplane cineangiography, conventional 2 dimensional echocardiography (2DE) and RT3DE were performed for the patients. A control group of 18 age and sex matched children was included and 2DE and RT3DE were performed for them. RESULTS: The mean LV end diastolic volume (LVEDV) and LVEDV index (LVEDVI) measured by RT3DE of patients were lower than controls (p value = 0.004, 0.01, respectively). There was strong correlation between the mean value of the LVEDV and the LVEDVI measured by RT3DE and angiography (r = 0.97, p < 0.001). The mean value of LV ejection fraction measured by RT3DE was lower than that assessed by 2DE (50 ± 6.2%, 65 ± 4.6%, respectively, p value < 0.001) in the studied TOF cases. There was good intra- and inter-observer reliability for all measurements. CONCLUSION: RT3DE is a noninvasive and feasible tool for measurement of LV volumes that strongly correlates with LV volumetry done by angiography in very young infants and children, and further studies needed.
Angiocardiography* ; Angiography ; Cardiac Catheterization ; Cardiac Catheters ; Child* ; Cineangiography ; Echocardiography ; Echocardiography, Three-Dimensional* ; Humans ; Infant ; Methods ; Prospective Studies ; Tetralogy of Fallot*

Toxoplasma gondii is a protozoan parasite with a broad range of intermediate hosts. Chickens as important food-producing animals can also serve as intermediate hosts. To date, experimental studies on the pathogenicity of T. gondii in broiler chickens were rarely reported. The objective of the present study was to compare the pathogenicity of 5 different T. gondii strains (RH, CN, JS, CAT2, and CAT3) from various host species origin in 10-day-old chickens. Each group of chickens was infected intraperitoneally with 5 x 10(8), 1 x 10(8), 1 x 10(7), and 1 x 10(6) tachyzoites of the 5 strains, respectively. The negative control group was mockly inoculated with PBS alone. After infection, clinical symptoms and rectal temperatures of all the chickens were checked daily. Dead chickens during acute phage of the infection were checked for T. gondii tachyzoites by microscope, while living cases were checked for T. gondii infection at day 53 post-inoculation (PI) by PCR method. Histopathological sections were used to observe the pathological changes in the dead chickens and the living animals at day 53 PI. No significant differences were found in survival periods, histopathological findings, and clinical symptoms among the chickens infected with the RH, CN, CAT2, and CAT3 strains. Histopathological findings and clinical symptoms of the JS (chicken origin) group were similar to the others. However, average survival times of infected chickens of the JS group inoculated with 5 x 10(8) and 1 x 10(8) tachyzoites were 30.0 and 188.4 hr, respectively, significantly shorter than those of the other 4 mammalian isolates. Chickens exposed to 10(8) of T. gondii tachyzoites and higher showed acute signs of toxoplasmosis, and the lesions were relatively more severe than those exposed to lower doses. The results indicated that the pathogenicity of JS strain was comparatively stronger to the chicken, and the pathogenicity was dose-dependent.
Animals ; Antibodies, Protozoan/blood ; Cat Diseases/parasitology ; Cats ; Chickens ; Poultry Diseases/blood/mortality/*parasitology/pathology ; Swine ; Swine Diseases/parasitology ; Toxoplasma/genetics/growth & development/*pathogenicity/physiology ; Toxoplasmosis, Animal/blood/mortality/*parasitology/pathology ; Virulence