Bauhinia purpurea leaves’ extracts exhibited in vitro antiproliferative and antioxidant activities

The antiproliferative and antioxidant activities of various extracts of the leaves of Bauhinia purpurea were studied using in vitro standard assays. The aqueous and chloroform extracts successfully inhibited the proliferation of all cancer cells while the methanol extract inhibited the proliferation of all cells except the CEMss cells when assessed using the 3,(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) (MTT) assay. The aqueous extract was effective against MCF-7 (IC50 ≈ 9 μg/ml), MDA-MB 231 (IC50 ≈ 17 μg/ml) and Caov-3 (IC50 ≈ 16 μg/ml); the chloroform extract was highly effective against the CEMss (IC50 ≈ 18 μg/ml) and HeLa (IC50 ≈ 21 μg/ml); and the methanol extract was highly effective only against the HL-60 (≈ 12 μg/ml) cell lines. Interestingly, all extracts did not inhibit the proliferation of 3T3 cells suggesting their non-cytotoxic properties. The aqueous and methanol, but not chloroform, extracts of B. purpurea (20, 100 and 500 μg/ml) exhibited concentration-dependent antioxidant activity only in the superoxide scavenging assay, but low to moderate activity in the 2,2- diphenyl-1 picrylhydrazyl (DPPH) radical scavenging assay, which could be associated with their total phenolic contents. In conclusion, the B. purpurea leaf possesses potential antiproliferative and concentration-dependent antioxidant activities. Purification and determination of active compounds are required for further study.Keywords: Bauhinia purpurea, in vitro, antiproliferative activity, antioxidant activity, phenolic compound

Prevalence of methicillin-resistant Staphylococcus aureus at a tertiary teaching hospital in Malaysia

Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen that causes severe morbidity, mortality and high medical expenses in many hospitals worldwide. The present study aimed to determine the prevalence of MRSA nosocomial infection, its associated factors, and its antimicrobial susceptibility pattern. This was a retrospective analysis of a database of Multidrug- Resistant Organism (MDRO) that was cultured from patients admitted to Hospital Canselor Tuanku Mukhriz (HCTM) over a period of 2 years (2018-2019). MRSA accounted for 23.6% of total MDRO isolates. The male gender had a higher risk for MRSA acquisition (p<0.05), while the most prevalent setting for MRSA was the orthopaedic ward (47.5%) followed by the medical ward (29.4%). The MRSA strains were significantly isolated from respiratory specimens (55.6%) followed by tissue (50.8%) and blood (27.8%). All MRSA isolates were resistant to penicillin G, oxacillin followed by ciprofloxacin (83.8%) erythromycin (71.5%) and clindamycin (53.5%). MRSA isolates were most susceptible to teicoplanin (99.7%), mupirocin (99.3%), co-trimoxazole (98.4%), rifampicin (97.8%), doxycycline (97.4%), linezolid (95.8%), gentamicin (93.9%) and fusidic acid (86.2%). The trend for MRSA’s antibiotic susceptibility in HCTM for the past 2 years (2018 to 2019) remains unchanged. Further research will be required to investigate the predictor of MRSA by clearly differentiating between MRSA infections and colonisations, hospitalacquired MRSA and community-acquired MRSA

Microarray analysis revealed different gene expression patterns in HepG2 cells treated with low and high concentrations of the extracts of Anacardium occidentale shoots

In this study, the effects of low and high concentrations of the Anacardium occidentale shoot extracts on gene expression in liver HepG2 cells were investigated. From MTT assays, the concentration of the shoot extracts that maintained 50% cell viability (IC50) was 1.7 mg/ml. Cell viability was kept above 90% at both 0.4 mg/ml and 0.6 mg/ml of the extracts. The three concentrations were subsequently used for the gene expression analysis using Affymetrix Human Genome 1.0 S.T arrays. The microarray data were validated using real-time qRT–PCR. A total of 246, 696 and 4503 genes were significantly regulated (P < 0.01) by at least 1.5-fold in response to 0.4, 0.6 and 1.7 mg/ml of the extracts, respectively. Mutually regulated genes in response to the three concentrations included CDKN3, LOC100289612, DHFR, VRK1, CDC6, AURKB and GABRE. Genes like CYP24A1, BRCA1, AURKA, CDC2, CDK2, CDK4 and INSR were significantly regulated at 0.6 mg/ml and 1.7 mg but not at 0.4 mg/ml. However, the expression of genes including LGR5, IGFBP3, RB1, IDE, LDLR, MTTP, APOB, MTIX, SOD2 and SOD3 were exclusively regulated at the IC50 concentration. In conclusion, low concentrations of the extracts were able to significantly regulate a sizable number of genes. The type of genes that were expressed was highly dependent on the concentration of the extracts used

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Multiplexed internet traffic modelling and evaluation

The characteristics of multiplexed Internet traffic is studied in this paper. On-Off models were developed to represent both voice over IP (VoIP) and HTTP traffic. The main aim of this study is to investigate whether it is possible to characterize multiplexed Internet traffic using simple mathematical terms instead of the current model offerings which are too complex for them to be of any practical use. While the mathematical derivation is not included in this study, the results of the simulation seem to indicate that this is a possibility. © 2002 by University of Surrey

Multiplexed internet traffic modelling and evaluation

The characteristics of multiplexed Internet traffic is studied in this paper. On-Off models were developed to represent both voice over IP (VoIP) and HTTP traffic. The main aim of this study is to investigate whether it is possible to characterize multiplexed Internet traffic using simple mathematical terms instead of the current model offerings which are too complex for them to be of any practical use. While the mathematical derivation is not included in this study, the results of the simulation seem to indicate that this is a possibility. © 2002 by University of Surrey

Does vocational training meet the construction industry needs in Malaysia? Feedback from ex-trainees of the basic electrical wiring course from one training institution

Purpose – Malaysia has been facing a shortage of construction craftworkers since the late 1980s. This is despite the fact that various public vocational training institutes have been established by the government ever since independence. This study aims to determine whether ex-trainees of National Youth Skills Institutes (NYSIs) in the One Phase Electrical Wiring course had joined the construction industry to determine whether the shortage is in any way contributed by them. The reasons why they took up the course and why they chose to work as electricians were among the specific matters that were looked into to help in understanding their industry choice. Design/methodology/approach – Data were collected through postal questionnaire survey. Findings – The study found that half of the respondents joined the construction industry, the other half in other economic sectors. Research limitations/implications – The

CFD investigation of indoor hygrothermal performance in academic research storage room : measurement and validation

Poor hygrothermal performance exacerbates deterioration risk from mould growth, corrosion and damage to archival materials. Improved microcomputers’ computational power has significantly advanced computational fluid dynamics (CFD) models and research developments in indoor airflow, heat transfer and contaminant transport. Nevertheless, numerous uncertainties exist in the CFD experiments which require adequate clarifications for improved results’ reliability. This paper presents the measurement and validation of a CFD model for the investigation of the hygrothermal performance in an indoor environment with known cases of microbial proliferations. The room, 5.2 m × 4.8 m × 3.0 m high, is air-conditioned and ventilated by constant air volume (CAV) system controlling the indoor airflow and hygrothermal profiles with ceiling mounted four-way supply diffuser and extract grille for indoor air distribution. The methodology combines in-situ experiment and numerical simulation with a commercial CFD tool using the standard k–ε model. Microclimate and airflow parameters obtained from in-situ experiments were used as boundary conditions in the CFD. The study shows a good agreement between the predicted and measured indoor hygrothermal profile with less than 10% deviation. The results indicate that the model can be employed for further investigation with high confidence