Malaysian Journal of Medical Sciences最新文献

Background: Non-obstructive coronary artery disease (NOCAD) is a condition in stable patients that experience angina despite not having significant coronary obstructive lesion. Knowledge on the role of certain biomarkers in patients with NOCAD is still limited. This study aimed to evaluate the roles of inflammation and adhesion molecules in the development of NOCAD. The correlations between the peripheral and coronary levels of the inflammatory biomarkers and adhesion molecules were also investigated.

Methods: In this cross-sectional study, symptomatic angina patients scheduled for coronary angiograms were recruited and separated into obstructive coronary artery disease (OCAD) and NOCAD groups based on those angiograms. Peripheral and coronary blood samples were taken to measure inflammation biomarkers [high sensitivity C-reactive protein (hsCRP) and growth differentiation factor 15 (GDF-15)], and adhesion molecules [vascular cell adhesion molecule-1 (VCAM-1)]. Subjects without angina symptoms were recruited for the control group.

Results: The hsCRP, GDF-15, and VCAM-1 levels were higher in the OCAD and NOCAD groups than in the control group. VCAM-1 levels successfully predicted the incidence of NOCAD [p = 0.010, area under the curve (AUC) = 0.716]. All biomarkers' levels in the peripheral and coronary blood were correlated in OCAD and NOCAD patients (p < 0.001).

Conclusion: Elevated levels of the hsCRP, GDF-15, and VCAM-1 were found with NOCAD, despite the absent of significant coronary obstruction. VCAM-1 successfully predicted NOCAD and may thus serve as an early NOCAD biomarker. Significant correlations of hsCRP, GDF-15, and VCAM-1 level in peripheral and coronary blood indicate that the peripheral levels of these biomarkers reflect the levels and changes that occur at the coronary level.

Localisation in neurology is an important step in determining the location of a neurological lesion based on history taking and clinical examination before confirmation with imaging. Lesions can vary from the cortical to the subcortical, brainstem, and spinal cord levels, in which every presentation and finding from the patient can provide a rough idea of where the pathology is located. A differential diagnosis can later be made according to the duration of the symptoms and the cumulative signs and symptoms presented. This is considered the most important step in managing neurological patients to ensure that no stone is left unturned in making an accurate diagnosis.

Background: Respiratory syncytial virus (RSV) is a common aetiological agent that causes respiratory infections, especially among infants. Identifying circulating RSV genotypes is an essential strategy for understanding the spread of the virus in a certain area. Sequencing the variable regions of the attachment glycoprotein (G) gene of RSV is a quick and direct approach for identifying the genotypes.

Methods: This study was aimed to sequence the G gene region of RSV isolated from patients admitted to hospitals in Baghdad, Iraq, during the autumn of 2022 and winter of 2023. To achieve this goal, 150 patients with lower respiratory symptoms were screened for RSV infections. RSV-positive samples were detected and confirmed using the reverse transcription-quantitative polymerase chain reaction (RT-qPCR) approach, which involved the use of specific TaqMan primer sets targeting RSV subgroups. Then, a G gene region that included hypervariable region 2 (HVR2) was amplified and sequenced using the Sanger sequencing method. Furthermore, molecular and phylogenetic analyses were performed on the G gene region to determine the variability profile of the tested specimens.

Results: There were 41 (26.6%) RSV-positive cases. Of these, the RSV-B subgroup was the most prevalent (82.90%), while the RSV-A subgroup incidence rate was 17.07%. The phylogenetic analysis showed that the RSV-B isolates were related to the BA genotype and shared nucleotide sequence similarities with isolates from India, Australia and the UK. The RSV-A isolates belonged to the ON genotype and had some degree of similarities with isolates from Italy, Tunisia, and France.

Conclusion: Seasonal tracking of the RSV isolates would facilitate a better understanding of virus evolution, viral pathogenesis, and genetic diversity.

Immunonutrition, which involves the targeted use of specific nutrients to enhance immune function and mitigate inflammation, has recently become a mainstay for both medical and surgical benefits. This review explores the evolution, mechanisms, and clinical applications of immunonutrition, with a focus on essential nutrients, such as omega-3 fatty acids, glutamine, arginine, and vitamins. These immunonutrients modulate immune responses, reduce pro-inflammatory cytokines, and support tissue repair. Clinical evidence indicates that immunonutrition reduces postoperative complications, shortens the duration of hospitalisation, and lowers the rate of infection, mainly in high-risk surgical patients and those with cancer or chronic diseases. In this regard, nutrients such as glutamine and omega-3 fatty acids have improved the nutritional status and recovery of cancer patients, while omega-3 fatty acids and antioxidant vitamins have exerted an anti-inflammatory effect, improving heart health in patients with cardiovascular disease. Immunonutrition has bright prospects in the management of infectious diseases, where certain nutrients, including vitamin D and zinc, aid in fighting immune defences and reducing the severity of infection. Future studies should investigate the molecular mechanisms underlying immunonutrition and its role in personalised nutrition. This could revolutionise dietary interventions based on genetic and proteomic profiling.

Delayed onset muscle soreness (DOMS) and impaired muscle recovery significantly affect athletes and recreational exercisers, influencing their performance and training consistency. Resveratrol, a natural polyphenol known for its anti-inflammatory and antioxidant properties, is thought to mitigate these effects, yet its effectiveness remains to be fully verified. This systematic review evaluates the impact of RES supplementation on muscle recovery in adults by examining its influence on DOMS, oxidative stress, and inflammation, along with its interactions with other supplements. Three electronic databases and one registry were searched in October 2023. A total of 10 studies met the inclusion criteria, encompassing a combined participant count of 238 (N=238). The review encompassed diverse participant populations, exercise types, and resveratrol dosages. The findings indicated that resveratrol potentially reduces markers of muscle damage, such as creatine kinase and lactate dehydrogenase, and alleviates DOMS symptoms to varying degrees. However, results varied based on exercise intensity, participant demographics, timing of supplementations and dosages. Synergistic interaction studies suggested that resveratrol, in combination with other compounds, could be more effective in exerting its effects. Despite promising findings, the research was limited by diverse study designs and the absence of long-term impact assessments. Further studies should standardise methods and explore resveratrol's long-term safety and effectiveness. Nevertheless, these results underscore resveratrol's potential as a beneficial supplement in exercise and sports medicine, meriting additional detailed exploration to refine its use.

This editorial reviews the Malaysian Journal of Medical Sciences' performance over 2023-2024, highlighting key achievements and challenges. It aims to provide a detailed analysis of the journal's processes and identify areas for improvement.

Background: Hospital-acquired bloodstream infections (BSI) are associated with high morbidity and mortality rates. This study was conducted to describe the outcomes and the prognosis of hospital-acquired BSI in the Critical Care Unit, Hospital Pakar Universiti Sains Malaysia (HPUSM), as well as to identify associated factors of treatment failure and mortality at 28 days.

Methods: This prospective cohort study was conducted in the Critical Care Unit of HPUSM from September 2019 to March 2021. Eligible participants included patients with a positive blood culture recorded after 48 hours of admission to hospital.

Results: There was a total of 250 patients, whose positive blood cultures were isolated. The main isolated organisms were Klebsiella pneumonia (23.6%), Pseudomonas spp. (19.2%), Escherichia coli (12.8%) and Acinetobacter sp. (9.2%). The mortality of hospital-acquired BSI was 27.6%. Multiple logistic regression analysis revealed that age [adjusted odds ratio (OR) = 1.06; 95% confidence interval (CI): 1.03, 1.09; p < 0.001], cases with extended-spectrum beta-lactamases (ESBL) (adjusted OR = 5.57; 95% CI: 2.04, 15.21; p = 0.001), with multidrug-resistant (MDR) organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p < 0.001) and those with a sequential organ failure assessment (SOFA) score > 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015) had statistically significant associations with treatment failure. Factors significantly associated with 28-day mortality included age (adjusted OR: 1.06: 95% CI; 1.03, 1.09; p < 0.001), MDR organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p < 0.001) and SOFA score > 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015).

Conclusion: The elderly, ESBL, MDR organisms and high SOFA scores were associated with treatment failure and 28-day mortality in hospital-acquired BSI.

Cervical cancer poses a significant challenge to global health, particularly in low- and middle-income countries. Tracking the survival rates of cancer patients through data gathered by population-based cancer registries constitutes a crucial aspect of cancer management. In recent years, attention within bibliometric studies has been directed towards examining the correlation between inflammation and radiotherapy in cervical cancer. However, to date, there is no published literature investigating research trends in cervical cancer survival through bibliometric analysis. Thus, this study was undertaken to identify and analyse global research patterns and hotpots in this area. A systematic search was performed within the Web of Science Core Collection (WoSCC) database, employing the following search parameters: TITLE - (((survival) OR (survival rate) OR (survival analysis) OR (survival probability)) AND ((cervical cancer) OR (cervical carcinoma))). A comprehensive analysis of research trends was conducted utilising various tools on the WoSCC website and VOSviewer. A total of 840 papers pertaining to cervical cancer and survival were identified from 45 distinct departments or subjects. Notably, the People's Republic of China and the USA collectively accounted for half of all publications from 2000 to 2023. An extensive cohort comprising 4,759 authors affiliated with 1,454 institutions across 82 countries contributed to the progression of this research domain. Despite a substantial increase in research on cervical cancer survival over the last decade, it is essential to encourage and conduct research, particularly in high-risk regions, especially in countries classified as low- or middle-income.

Food safety is a key priority for public health. However, consumer demand for cheese products may expose the population to the risk of mycotoxicosis and cancer, among others. Acute mycotoxicosis and cancer are examples of linked disorders. Among the most frequent toxic agents that enter the human body through food consumption are mycotoxins. This review study highlights the significance of the impact of the most important mycotoxins on public health through the consumption of cheese products. Despite being a poor substrate for mycotoxin development, cheese products have been found to contain harmful toxins. Aflatoxin M₁ (AFM₁) and ochratoxin A (OTA) are the main mycotoxins in cheese products, and they are very harmful to human health. Adherence to legislative limits and the implementation of appropriate control measures by food business operators (FBOs) are considered necessary to protect consumers' health.