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

The expansion of healthcare services to serve as many people as possible has led to the decentralisation of laboratory testing. Many laboratory tests are now made available at district hospitals and rural health clinics for certain states or provinces. Consequently, there is a proliferation of laboratory tests, techniques, equipment, and other required commodities at the different medical laboratories. The lack of central governance has resulted in a widely-diverse and non-standardised laboratory services that may eventually affect the quality of healthcare delivery to patients. To ensure a high-quality and standardised healthcare delivery across a state or a province, it is important that the relevant stakeholders outline and implement the necessary strategies to establish a streamlined medical laboratory network. In this article, we discuss the significance of laboratory procurement consolidation and centralisation in the steering of the standardisation of laboratory operations leading to a high-quality and efficient chemical pathology services in a defined region.

Medical implants are normally used in clinical practice to treat most orthopaedics situations involving bone fractures, deformities, dislocation, and lengthening. It should be noted that specific measures regarding biomechanical and biomaterial characteristics are required for a successful post-surgery procedure. Biomechanical evaluations on the medical implants could be performed by utilising computer and engineering technology. One of them is in silico studies using finite element method that could be simulated in high-performance computer. However, various assumptions are required in computer simulation, such as the constraints on data input and computer resources. This review paper discusses current approaches of constructing a finite element model of human bone with specific material properties for upper limb such as the shoulder joint, humerus, elbow joint, radius and wrist joint. Previous related literatures were reviewed from selected keywords and search engines. To narrow the literature search in this study, inclusion and exclusion criteria of the literature searching were applied. We looked at the current level of knowledge in this field and offered recommendations for future study. In conclusion, studies from previous literature have demonstrated several ways for developing mathematical models and simulating medical implants.

Introduction: Obesity has been linked to coronary artery disease, type II diabetes, metabolic syndrome, stroke, and cancer. Pomegranate (Punica granatum; PG) has been used extensively in folk medicine for several therapeutic purposes. The goal of this study is to investigate the anti-obesity effect of PG peel and pulp methanolic extracts in highfat diet (HFD)-induced Sprague-Dawley rats. Methods: The animals were separated into 7 groups namely Normal control group (normal diet); HFD-induced only as negative control group, and positive control group (HFD-induced + orlistat); treatment group included HFD-induced + peel 125 mg/kg, HFD-induced +peel 250 mg/kg, HFD-induced + pulp 125 mg/kg and HFD-induced + pulp 250 mg/kg. Results: It was observed that methanolic extract of peel and pulp PG 250 mg/kg showed low increment of body weight with a reduction in weight of liver, visceral fat, and subcutaneous fat. Compared to the negative control group, total cholesterol, triglyceride, and low-density lipoprotein levels were shown to be lowered for PG peel and pulp groups also showed higher values in high-density lipoprotein. Conclusion: PG reduced obesity-related markers in blood, liver, and adipose tissue and inhibited obesity caused by a high-fat diet probably because of its antioxidant properties.

Introduction: The gingival phenotype (GP) of teeth at the aesthetic zone often influences dental rehabilitation plans and treatment outcomes. This study aimed to assess the prevalence of GP in the Malay population in relation to gender and age. Methods: The GP of 100 patients were determined using the Probe test method. Other clinical parameters were assessed include crown width/crown length (CW/CL) ratio, tooth morphology and width of keratinised tissue. Periodontal parameters were assessed by two calibrated examiners. Data were analysed using descriptive statistics, one-way ANOVA and Kruskal-Wallis test. Results: A higher prevalence of thick GP was found at the maxilla for both genders, whereas a thin phenotype was observed at the mandible. At maxilla, both thick and thin GP were found in all age groups, while the mandible showed a higher prevalence of thin GP. Significant differences in GP were found between males and females for mandibular and maxillary anterior teeth and the mandibular lateral incisor (p<0.05), while no significant difference was found for other parameters assessed; age group, CW/CL, tooth morphology and WKT. Conclusion: Thicker GP is more prevalent in male population and at maxillary anterior. Mandibular anterior GP presented commonly with a thin GP regardless of gender or age-group.

Aims: Rhodotorula sp. (USM-PSY62) is a psychrophilic yeast isolated from Antarctic sea ice that grows optimally at 15°C. The inevitable global warming poses many challenges to the microbial community in Antarctica. Therefore, this studywas conceptualized to observe how USM-PSY62 adapted to fluctuations in temperature. Methodology and results : Rhodotorula sp. (USM-PSY62) was grown in YPD broth until the mid-log phase. Then, the culture was transferred to four different temperatures, specifically at 0 °C, 5 °C, 15 °C and 21 °C for 24 h. Then, the RNA was extracted, sequenced and analysed. During cold adaptation, an elevated transcription of the CorA magnesium transporter gene in USM-PSY62 indicated a higher requirement for magnesium ions to gain additional enzyme cofactors or maintain cytoplasmic fluidity. The HepA homologue coding for DNA/RNA helicase was also over-expressed with log fold change 2.89 in cold conditions possibly to reorganize secondary structures of DNA and RNA. An up-regulation of the catalase gene was also observed, reflecting an increment in the concentration of reactive oxygen species and fluctuations in the associated antioxidant system. The YOP1 gene, which encodes a membrane protein associated with protein transport and membrane traffic, was the most down-regulated, with log2 fold change values of -6.93 lower under cold shock conditions. The genes responsible for the structural maintenance of chromosome (SMC) have a -8.80 in expression log2 fold change, indicating the gene was down-regulated when the temperature was shifted to 0 °C. Upon cold shock, the gene for heat shock factor protein 1 (HSF1) was also down-regulated with a log2 fold change value of - 5.86. Hsf1 is a transcriptional regulator which regulates the heat shock responses. Conclusion, significance and impact of study: In conclusion, the transcriptomic responses demonstrated by Rhodotorula sp. USM-PSY62 characterized critical physiological and biochemical compensatory mechanisms especially cellular processes and signalling, information storage and processing, and metabolism to survive at low and high temperatures. This study provides valuable data for industry, especially in the usage of molecular chaperones.

Rare but serious thrombotic incidents in relation to thrombocytopenia, termed vaccine-induced immune thrombotic thrombocytopenia (VITT), have been observed since the vaccine rollout, particularly among replication-defective adenoviral vector-based severe acute respiratory syndrome coronavirus 2 vaccine recipients. Herein, we comprehensively reviewed and summarized reported studies of VITT following the coronavirus disease 2019 (COVID-19) vaccination to determine its prevalence, clinical characteristics, as well as its management. A literature search up to October 1, 2021 using PubMed and SCOPUS identified a combined total of 720 articles. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline, after screening the titles and abstracts based on the eligibility criteria, the remaining 47 full-text articles were assessed for eligibility and 29 studies were included. Findings revealed that VITT cases are strongly related to viral vector-based vaccines, which are the AstraZeneca COVID-19 vaccine (95%) and the Janssen COVID-19 vaccine (4%), with much rarer reports involving messenger RNA-based vaccines such as the Moderna COVID-19 vaccine (0.2%) and the Pfizer COVID-19 vaccine (0.2%). The most severe manifestation of VITT is cerebral venous sinus thrombosis with 317 cases (70.4%) and the earliest primary symptom in the majority of cases is headache. Intravenous immunoglobulin and non-heparin anticoagulant are the main therapeutic options for managing immune responses and thrombosis, respectively. As there is emerging knowledge on and refinement of the published guidelines regarding VITT, this review may assist the medical communities in early VITT recognition, understanding the clinical presentations, diagnostic criteria as well as its management, offering a window of opportunity to VITT patients. Further larger sample size trials could further elucidate the link and safety profile.

Microorganisms, such as spanning bacteria, archaea and fungi, were ubiquitous and played pivotal roles in shaping ecosystems. This review offered a comprehensive investigation into the multifaceted strategies employed by microorganisms to thrive and adapt within complex ecological niches. Key themes explored in this review encompassed microbial defence mechanisms, biofilm formation, quorum sensing and altruistic behaviours. Microbial defence mechanisms were scrutinized, with a focus on bacteriocin production. Despite the costs associated with production, bacteriocins served as potent weapons that selectively targeted closely related strains, reducing competition and conferring indirect benefits to the producer's genetic kin. Biofilm formation, a critical facet of microbial survival, was discussed in detail. These structured microbial communities encased in self-secreted extracellular matrices provided structural support and protection, demonstrating their significance in diverse ecological contexts. The review further delved into the evolutionary implications of quorum sensing and altruism within microbial communities. Quorum sensing, a mechanism that allowed population density-dependent communication and cooperation, was revealed as essential for microbial survival. In conclusion, this review enhanced our understanding of the intricate strategies microorganisms employed for survival, adaptation and competition in intricate ecosystems. By shedding light on these mechanisms, it advanced our comprehension of microbial community dynamics and their indispensable roles in diverse environments.

The study of transposable genetic elements, a cornerstone of molecular genetics, offers profound insights into the dynamic nature of genetic material. This exploration encompasses various types found in bacteria, including insertion sequences, composite and non-composite transposons. These elements are instrumental in shaping bacterial genomes by facilitating the movement of genetic information, driving evolution and contributing to genetic diversity. Understanding the mechanisms of transposition is essential for unravelling the intricate processes governing genetic rearrangements. Replicative and conservative transposition mechanisms, exemplified by the Tn3 family and phage Mu, illustrate the remarkable adaptability of these systems in reshaping genomes. However, it is the transposon Tn5 that steals the spotlight as a versatile molecular genetics tool. Tn5's transposition mechanism, characterized by precise control over gene expression, translational regulation, protein localization and the induction of conditional mutations, empowers researchers to dissect gene regulation intricacies with unprecedented accuracy. Transposable genetic elements, epitomized by Tn5, are indispensable instruments in molecular genetics. They allow researchers to navigate the intricate landscape of genetics, exploring gene regulation, protein function, and genetic diversity with unparalleled precision. These elements continue to be at the forefront of molecular genetics research, driving innovations that deepen our understanding of the fundamental mechanisms governing life's genetic code.

Background: Knee osteoarthritis (KOA) is the most prevalent joint disease worldwide which reduces function and quality of life. It is linked to balance disorders and increased fall risk. Core strengthening may potentially improve balance, pain, and function in these patients. Methods: This pre-post intervention study involved 20 subjects who were diagnosed with KOA. Ten KOA patients (55.90 ± 7.74 years) in the control group (CG) received conventional treatment only, while 10 intervention group (IG) patients (56.40 ±8.87 years) received conventional treatment and core strengthening. Both groups performed thrice weekly home-based exercises for 6 weeks. Static and dynamic balance, functional-perfomance tests, and Knee Injury and Osteoarthritis Outcome Score (KOOS) assessing pain and function was done at baseline and after 6 weeks, with KOOS repeated after 12 weeks. Results: There was statistically significant within-group improvement in KOOS pain and function (p<0.05) after 6 and 12 weeks, however in between-group difference was insignificant. Functional tests and balance showed more improvement in the IG but was insignificant (p>0.05). No adverse events were reported with core strengthening in the IG. Conclusion Core strengthening is a safe, practical, and feasible intervention for KOA patients which may improve balance, pain, and physical function.
Exercise