Prevalence of thyroid disorders and thyroid autoantibodies among coastal communities of Malaysia (part of nationwide study of thyroid disorders in Malaysia)

Objectives To determine the prevalence of thyroid disorders and thyroid autoantibodies in the coastal communities of Malaysia. This study is part of a nationwide study looking into the prevalence of thyroid disorders. Methods A cross sectional study was performed in two coastal districts of rural Selangor. A village from each district was chosen where a participant from each household from the village was selected using KISH tables. Sociodemographic data, medical history, anthropometric measurement and thyroid examination were performed. The presence of goiter was recorded according to the World Health Organization (WHO) goiter grading system. Blood withdrawn was tested for thyroid function and thyroid autoantibodies. Thyroid antibodies analyses were done using Immulite 2000 system. Lowest detectable limit for anti-thyroperoxidase (antiTPO) and antithyroglobulin (antiTG) are 10 IU/mL and 20 IU/mL respectively. Low, moderate and high titre is defined 40 - 100 IU/mL, 101-1000 IU/mL and >1000 IU/mL respectively. Results A total of 418 subjects were recruited with a mean age of 54.1 ± 14.2 years. Majority were Malays (86.8%), followed by Indians (11.7%) and Chinese (1.4%). Among respondents, 2.9% had Grade 1 and 8.9% had Grade 2 goitre. A mere 3.4% had clinically palpable thyroid nodules. A total of 411 blood samples were available for thyroid level assessment, with 1.9% of respondents were found to have hypothyroidism while 85.6% had TSH in the range of 0.32-2.5 mIU/L. The prevalence of overt and subclinical hypothyroidism was 0.2% and 1.7% AFES 2015 10 – 13 December 2015 respectively. On the otherhand, 3.4% of respondents were hyperthyroid (TSH < 0.32 mIU/L) with prevalence of overt and subclinical hyperthyroidism being 0.5% and 2.9% respectively. Among 417 samples which were available for antiTPO analysis, 8.9% has detectable antiTPO titre (>40.0 IU/mL), with 4.3% had moderate and 2.4% had high antiTPO titres. One respondent (10%) from among those with high antiTPO titres was found to have T3 thyrotoxicosis. Fourty percent of euthyroid respondents with high titre and 38.9% with moderate titre had high normal TSH, in the range of 2.51 – 5.00 mIU/L (p<0.001). Among 417 samples which are available for antiTG analysis, 3.4% and 5.3% had low detectable and moderate antiTG titres respectively. Only 0.5% (2 respondents) had high antiTG titre (>1000 IU/mL) and found to be hypothyroid. Among those with moderately positive titre, 9.1% were hyperthyroid and majority (63.6%), although euthyroid, had TSH levels between 0.32 – 2.50 mIU/L (p<0.001). Conclusion The low prevalence of thyroid antibodies and thyroid disorders in coastal communities could be attributed to the iodine sufficient status in those areas. Euthyroid respondents with moderate and high antiTPO titres tend to have higher TSH levels, while those with moderate and high antiTG titres had lower TSH levels

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

The effect of magnetic field and thermal relaxation on 2-D problem of generalized thermoelastic diffusion

The generalized magneto-thermoelasticity is developed. The formulation is done under two theories: the generalized thermoelasticity coupled theory and Lord – Shulman theory with one relaxation time. The normal mode analysis is used to obtain the expres- sions for temperature, displacement components, the thermal stresses distributions and concentration of diffusion. The variations of the considered variables are represented graphically. A comparison is made with the results predicted by two theories in presence and absence of the magnetic field.Розвинуто узагальнену теорію магнітотермопружності. Сформульовано задачу в рамках двох підходів: теорії узагальненої зв’язаної термопружності та теорії Лорда – Шульмана з одним часом релаксації. Використано аналіз нормальної моди для отримання виразів для температури, компонентів зміщень, розподілу температурних напружень та концентрації дифузії. Зміну вказаних вище змінних представлено графічно. Порівняно результати в рамках обох теорій за умови наявності та відсутності магнітного поля

Zerumbone-loaded nanostructured lipid carriers: preparation, characterization, and antileukemic effect

Heshu Sulaiman Rahman,1&ndash;3 Abdullah Rasedee,1,2 Chee Wun How,2 Ahmad Bustamam Abdul,2 Nazariah Allaudin Zeenathul,1,2 Hemn Hassan Othman,1 Mohamed Ibrahim Saeed,2 Swee Keong Yeap21Department of Microbiology and Pathology, Faculty of Veterinary Medicine, University Putra Malaysia, Serdang, Selangor, Malaysia; 2Institute of Bioscience, University Putra Malaysia, Serdang, Selangor, Malaysia; 3Department of Microbiology, Faculty of Veterinary Medicine, University of Sulaimanyah, Sulaimanyah City, Kurdistan Region, Northern IraqAbstract: Zerumbone, a natural dietary lipophilic compound with low water solubility (1.296 mg/L at 25&deg;C) was used in this investigation. The zerumbone was loaded into nanostructured lipid carriers using a hot, high-pressure homogenization technique. The physicochemical properties of the zerumbone-loaded nanostructured lipid carriers (ZER-NLC) were determined. The ZER-NLC particles had an average size of 52.68 &plusmn; 0.1 nm and a polydispersity index of 0.29 &plusmn; 0.004 &micro;m. Transmission electron microscopy showed that the particles were spherical in shape. The zeta potential of the ZER-NLC was &minus;25.03 &plusmn; 1.24 mV, entrapment efficiency was 99.03%, and drug loading was 7.92%. In vitro drug release of zerumbone from ZER-NLC was 46.7%, and for a pure zerumbone dispersion was 90.5% over 48 hours, following a zero equation. Using the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay in human T-cell acute lymphoblastic leukemia (Jurkat) cells, the half maximal inhibitory concentration (IC50) of ZER-NLC was 5.64 &plusmn; 0.38 &micro;g/mL, and for free zerumbone was 5.39 &plusmn; 0.43 &micro;g/mL after 72 hours of treatment. This study strongly suggests that ZER-NLC have potential as a sustained-release drug carrier system for the treatment of leukemia.Keywords: zerumbone, nanostructured lipid carrier, leukemi

Zerumbone-loaded nanostructured lipid carrier induces G2/M cell cycle arrest and apoptosis via mitochondrial pathway in a human lymphoblastic leukemia cell line

Heshu Sulaiman Rahman,1&ndash;3 Abdullah Rasedee,1,2 Ahmad Bustamam Abdul,2,4 Nazariah Allaudin Zeenathul,1,2 Hemn Hassan Othman,1,3 Swee Keong Yeap,2 Chee Wun How,2 Wan Abd Ghani Wan Nor Hafiza4,51Faculty of Veterinary Medicine, 2Institute of Bioscience, Universiti Putra Malaysia, Selangor, Malaysia; 3Faculty of Veterinary Medicine, University of Sulaimanyah, Sulaimanyah City, Kurdistan Region, Northern Iraq; 4Faculty of Medicine and Health Science, Universiti Putra Malaysia, Selangor, Malaysia; 5College of Medical Laboratory Technology, Institute for Medical Research, Kuala Lumpur, MalaysiaAbstract: This investigation evaluated the antileukemia properties of a zerumbone (ZER)-loaded nanostructured lipid carrier (NLC) prepared by hot high-pressure homogenization techniques in an acute human lymphoblastic leukemia (Jurkat) cell line in vitro. The apoptogenic effect of the ZER-NLC on Jurkat cells was determined by fluorescent and electron microscopy, Annexin V-fluorescein isothiocyanate, Tdt-mediated dUTP nick-end labeling assay, cell cycle analysis, and caspase activity. An MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium bromide) assay showed that ZER-NLC did not have adverse effects on normal human peripheral blood mononuclear cells. ZER-NLC arrested the Jurkat cells at G2/M phase with inactivation of cyclin B1 protein. The study also showed that the antiproliferative effect of ZER-NLC on Jurkat cells is through the intrinsic apoptotic pathway via activation of caspase-3 and caspase-9, release of cytochrome c from the mitochondria into the cytosol, and subsequent cleavage of poly (adenosine diphosphate-ribose) polymerase (PARP). These findings show that the ZER-NLC is a potentially useful treatment for acute lymphoblastic leukemia in humans.Keywords: zerumbone-loaded nanostructured lipid carrier, cell cycle arrest, apoptosis, mitochondrial pathwa