Evaluation of Interleukin-6 In Tears and Serum and Its Associated Factors in Age Related Macular Degeneration Patients

OBJECTIVE: The objective of this study was to evaluate the Interleukin-6 (IL-6) in tears and serum in age related macular degeneration (AMD) patients and to determine its associated factors. METHODS: This was a comparative cross-sectional study. Patients with Early AMD, Late AMD and Control group whom fulfilled the inclusion criteria were recruited into this study. Tears and serum samples were collected. The samples were analysed using commercial Human IL-6 enzyme-linked immunosorbent assay kit to measure IL-6 levels in tears and serum. Only late neovascular AMD (nAMD) was enrolled in this study since there was no late dry AMD available during the study period. RESULTS: A total of 142 patients (56 early AMD, 56 late nAMD and 30 Control group) were recruited in this study. AMD showed significantly higher mean tears IL-6 (21.91 (95%CI: 19.89, 23.93), p= 0.014) and serum IL-6 (12.01 (95%CI: 10.93, 13.08), p= 0.004) compared to control group after adjusted with covariates. Only mean serum IL-6 level was significantly in late nAMD (13.97 (95%CI: 12.43, 15.52), p= 0.001) compared to early AMD after adjusted with covariates. There was no significant association found between IL-6 level in tears with duration of AMD, serum level of IL-6, smoking status and AMD status. CONLUSION: IL-6 in tears and serum showed significant elevation among AMD. Therefore, tears sample can be used as non-invasive biomarker for AMD screening

Reading Carol Ann Duffy’s “Politics” through unnatural ecopoetics

Carol Ann Duffy is one of the most notable poets in contemporary English poetry. In accordance with her poetic dexterity, she was appointed as Great Britain’s Poet Laureate in 2009. This study deals with Duffy’s “Politics,” which was introduced in The Bees (2011), her first collection published after having been named Poet Laureate. In this poem, the poet tackled natural and unnatural imagery resultant from diverse experiences. This study proposes that the material environment surrounding Carol Ann Duffy is intertwined with her nonmaterial environment in “Politics.” This argument runs parallel with the concept of unnatural ecopoetics, which is considered to be a new direction in ecopoetics in examining contemporary poetry. The current study argues that the poet’s ideology after becoming poet laureate and also her experience as a Scottish, feminist, bisexual poet have all together configured a kind of nonmaterial environment intertwined with the material world or nature in the textual space through “Politics”. This assumption is not far from Sarah Nolan’s concept of Unnatural Ecopoetics in her book Unnatural Ecopoetics: Unlikely Spaces of Contemporary Poetry (2017). So, this study is conducted in the light of Nolan’s concept, which denotes the relations between the human, natural, and unnatural environments and the language in the poetic text. Accordingly, more focus will be on the poet’s experiences, memories, ideology, and feelings which inspired her to symbolize nature in another dimension in “Politics” as an unnatural ecopoetics poem

Unilateral branch retinal artery occlusion due to internal carotid artery occlusive disease in a young adult: a rare case report

Branch retinal artery occlusion occurs when an artery in the branch retina is blocked, most commonly due to emboli. The sensitive neural tissue of the retina is highly dependent on adequate blood flow and hypoperfusion of retinal tissue can cause visual field loss. We report a case of a 23-year-old librarian presented to us with the complaint of sudden onset painless inferior visual field loss in the right eye for three days. She had no other co-morbidities, was a non-smoker and denied any history of head and neck trauma. Clinical examination revealed vision in the right eye was 6/6 and no Marcus Gunn Pupil with Humphrey Visual Field showed hemifield respecting the vertical meridian at inferior part. IOP was 13 mmHg. Fundoscopy revealed a retinal whitening on the superior part with minimal cotton wool spots and Hollen haurst plaque at end of vessels. Left eye examination was unremarkable, with 6/6 vision. Systemic examination revealed a BP of 121/88 mmHg, no cardiac murmurs and absent carotid bruit. Blood and imaging studies were performed to determine the underlying cause of Branch Retinal Artery Occlusion. These include screening for diabetes, dyslipidemia, valvular or cardiac wall abnormalities, vasculitis, coagulopathies and carotid artery stenosis. The blood investigation results revealed that the patient was dyslipidemic. The Carotid Doppler demonstrated proximal right internal carotid artery thrombosis causing significant Internal Carotid stenosis. An urgent vascular, cardiology & haematology referral was done. Endarterectomy was not required and she was treated conservatively with aspirin and statins

Rambutan related ocular trauma

Rambutan trees are widely planted in rural areas. Regardless of the small size, its physical characteristics may inflict ocular trauma when it accidentally hit the eyes. We report a case of a 61-year-old gentleman who suffered from a right eye deeply embedded cornea foreign body and fungal keratitis following direct ocular trauma by rambutan fruit. He complained of right eye pain with reduced vision after being alleged hit by rambutan fruit during harvesting from the tree. Upon slit-lamp examination, there were multiple woody-like cornea foreign bodies in which one of it had deeply embedded up to the deep stromal layer. Following uncomplicated cornea foreign bodies removal under general anaesthesia, the patient had developed fungal keratitis which was successfully treated with topical and oral antifungal. This report highlights the importance of prompt diagnosis and proper management of rambutan related ocular trauma. Early removal of cornea foreign body as well as early initiation of topical and systemic antibiotic and antifungal following vegetative material injury able to prevent more serious corneal infection and endophthalmitis

Unilateral ischemic central retinal vein occlusion in a young healthy adult: a case report

Central retinal vein occlusion (CRVO) is an obstruction of central retinal vein due to the impingement from the fellow central retinal artery. It is the second most common retinal vascular disease after diabetic retinopathy. Risk factor of CRVO includes diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, male gender and age above 50 years; with 90% of the cases occurred in individual aged 55 years and above. We report a rare case of left eye ischemic CRVO in a 24-year-old healthy gentleman who later on found out to have hypercholesterolemia. He presented with a sudden onset of reduced vision of his left eye. Examination revealed visual acuity (VA) of the left eye was 6/120. Fundus examination showed marked papilloedema with dilated and tortuous blood vessels and extensive flame-shaped hemorrhages with cotton wool spots in all four retinal quadrants. There was a presence of macular edema as well. The ancillary tests confirmed the diagnosis of left eye ischemic CRVO with significant macular edema. The blood investigation revealed elevated cholesterol levels. For treatment, 6 times of monthly intravitreal Ranibizumab injections were planned for the macular edema and oral Atorvastatin 40 milligrams daily was started. Following the intravitreal Ranibizumab injection, his VA has significantly improved with a reduction of macular edema. This report highlights the importance of prompt diagnosis and investigation of CRVO, especially in the younger age group. Early treatment of macular edema secondary to CRVO is able to reduce the edema thus leads to VA improvement

Sinonasal undifferentiated carcinoma – a rare cause of proptosis in elderly

Sinonasal undifferentiated carcinoma is a rare and extremely aggressive sinonasal tract malignancy. It is a rapidly enlarging tumour and a highly destructive lesion. We hereby report a 71-year-old Malay male with progressive left proptosis for one month, associated with reduced vision in the left eye, intermittent diplopia and anosmia. He was later diagnosed as having sinonasal undifferentiated carcinoma. The patient subsequently underwent a series of radiotherapy and showed improvement following treatment. This case was reported to highlight the importance identifying this entity and emphasise that sinonasal undifferentiated carcinoma should be considered in an elderly patient with proptosis associated with nasal symptoms

MANUAL FOR IBADAH CAMP ORGANIZER A PART OF THE IIUM FLAGSHIP ENTITLED “GENDER DYSPHORIA”

Maknyah or male-to-female transgender are those who transform their identity biologically from male to female through crossdressing and their lifestyle associated with homosexuality. Crossdressing and homosexuality are unlawful in accordance with Islamic practices. Often, these transgenders are associated with being sex workers in major hotspots such as in Federal Territory Kuala Lumpur, Selangor, Negeri Sembilan, Pulau Pinang, Pahang and Sarawak.1 It is estimated that the population size of sex workers in Malaysia in 2018 is 37,000 (22,000 Female Sex Workers and 15,000 Transgender Sex Workers). Despite the reducing number of transgender sex workers in Malaysia (as compared to previous Key Population Estimates in 2010), it is still a concern to Muslims and this trend needs to be relieved promptly

Adsorption of fatty acid on beta-cyclodextrin functionalized cellulose nanofiber

Fatty acids in wastewater contribute to high chemical oxygen demand. The use of cellulose nanofiber (CNF) to adsorb the fatty acids is limited by its strong internal hydrogen bonding. This study aims to functionalize CNF with β-cyclodextrin (β-CD) and elucidate the adsorption behaviour which is yet to be explored. β-CD functionalized CNF (CNF/β-CD) was achieved by crosslinking of β-CD and citric acid. Functionalization using 7% (w/v) β-CD and 8% (w/v) citric acid enhanced mechanical properties by increasing its thermal decomposition. CNF/β-CD was more efficient in removing palmitic acid, showcased by double adsorption capacity of CNF/β-CD (33.14% removal) compared to CNF (15.62% removal). CNF/β-CD maintained its adsorption performance after five cycles compared to CNF, which reduced significantly after two cycles. At 25 °C, the adsorption reached equilibrium after 60 min, following a pseudo-second-order kinetic model. The intraparticle diffusion model suggested chemical adsorption and intraparticle interaction as the controlling steps in the adsorption process. The maximum adsorption capacity was 8349.23 mg g−1 and 10485.38 mg g−1 according to the Sips and Langmuir isotherm model, respectively. The adsorption was described as monolayer and endothermic, and it involved both a physisorption and chemisorption process. This is the first study to describe the adsorption behaviour of palmitic acid onto CNF/β-CD

Evaluation of interleukin-6 and tumor necrosis factor-alpha in tears and serum and its associated factors in age related macular degeneration patients

Introduction: Age-Related Macular Degeneration (AMD) is a progressive neurodegenerative disease that affect the macula lutea. AMD is the leading cause of irreversible central vision loss in elderly population in developed countries. AMD is a multifactorial disease. The development of AMD involve continuous interaction between genetic factors, oxidative stress and environmental factors. Recent studies has been showing that inflammation plays a critical role in pathogenesis of AMD. Increased in Interleukin-6 (IL-6) and Tumor necrosis factor alpha (TNF-α) in the serum and intraocular fluid has been associated with AMD and its progression. Measurement of IL-6 and TNF-α in tears will provide a potential non-invasive biomarker for the progression and monitoring of AMD. Objectives: Our objective was to evaluate IL-6 and TNF-α in tears and serum between AMD patients and Control group as well as between Early AMD and Late AMD. Our objective also was to determine the association between IL-6 and TNF-α in tears with duration of AMD, serum level of IL-6 and TNF-α, smoking status and AMD status. Methods: A comparative cross-sectional study was conducted at a tertiary hospital in Malaysia, Hospital Universiti Sains Malaysia (USM) from June 2018 till May 2021. This study involved patients with Early AMD, Late AMD and Control group who attended Ophthalmology Clinic. Tears and serum samples were collected. The samples were analysed using commercial Human IL-6 and TNF-α ELISA kit to measure IL-6 and TNF-α levels in tears and serum. Statistical analysis was done using SPSS Inc Version 24. Results: A total of 142 patients (56 early AMD, 56 late AMD and 30 Control group) were recruited and analysed in this study. In the late AMD group, there was no late dry AMD and only include late neovascular AMD (nAMD). The adjusted mean for IL-6 in tears was significantly higher in AMD compared to Control group (21.91 (95%CI: 19.89, 23.93) vs 16.27 (95%CI: 12.32, 20.22), respectively, p= 0.014) after adjusted with covariates. The adjusted mean for IL-6 in serum also was significantly higher in AMD compared to Control group (12.01 (95%CI: 10.93, 13.08) vs 8.51 (95%CI: 6.41, 10.62), respectively, p= 0.004) after adjusted with covariates. The adjusted mean IL-6 in serum was significantly higher in Late nAMD compared to Early AMD (13.97 (95%CI: 12.43, 15.52) vs 10.03 (95%CI: 8.49, 11.58), respectively, p= 0.001) after adjusted with covariates. The adjusted mean TNF-α in serum was significantly higher in AMD compared to Control group (18.49 (95%CI: 17.11, 19.86) versus 13.96 (95%CI: 11.27, 16.65), respectively, p= 0.004) after adjusted with covariates. There was no significant association found between IL-6 and TNF-α level in tears with duration of AMD, serum level of IL-6 and TNF-α, smoking status and AMD status. Conclusion: Systemic IL-6 level was significantly higher in Late nAMD. There was no different in the level of IL-6 and TNF-α in tears between Early AMD and Late nAMD. There was also no significant factors associated with IL-6 and TNF-α in tears among AMD patients. A large cohort study is needed for further evaluation of tears inflammatory biomarkers level in AMD patients

Evaluation of interleukin-6 and Tumor Necrosis Factor- Alpha in tears and its associated factors in age-related macular degeneration patients

OBJECTIVE: The objective of this study was to evaluate the Interleukin-6 (IL-6) and Tumor Necrosis Factor-Alpha (TNF-α) in tears in age related macular degeneration (AMD) patients and to determine its associated factors. METHODS: This was a comparative cross-sectional study. Patients with Early AMD, Late AMD and Control group whom fulfilled the inclusion criteria were recruited into this study. Tears samples were collected, then analysed using commercial Human IL-6 and TNF-α enzyme-linked immunosorbent assay kit to measure IL-6 and TNF-α levels in tears. Only late neovascular AMD (nAMD) was enrolled in this study since there was no late dry AMD available during the study period. RESULTS: A total of 142 patients (56 early AMD, 56 late nAMD and 30 Control group) were recruited in this study. AMD showed significantly higher mean tears IL-6 (21.91 (95%CI: 19.89, 23.93), p= 0.014) compared to control group after adjusted with covariates. However there was no significant difference of mean tears IL-6 between early and late nAMD group after adjusted with covariates (p=0.844). For TNF-α, there was no significant differences of mean tears TNF- α between AMD and control group as well as between early and late nAMD after adjusted with covariates (p=0.324 and p=0.749 respectively). There was no significant association found between IL-6 and TNF-α level in tears with duration of AMD, serum level of IL-6 and TNF-α, smoking status and AMD status. CONLUSION: IL-6 in tears showed significant elevation among AMD. Therefore, IL-6 in tears can be used as non-invasive biomarker for AMD screening