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Estimation of Total Body Surface Area Burned: A Comparison Between Burn Unit and Referring Facilities

Ho HL, Halim AS, Sulaiman WAW, Fatimah MJ

Ann Burns Fire Disasters, 2023 Mar;36(1):19-28.
PMID: 38680901

Accuracy of burn size estimation is critical in acute burn management because it directly affects the patient's outcome and prognosis. This study aims to quantify the discrepancies of total body surface area (TBSA) burned between the burn unit (TBSAb) and the referring facilities (TBSAr). Data of all referred adult and paediatric patients admitted to the Hospital Universiti Sains Malaysia Burn Unit within 24 hours post burn were retrospectively reviewed from 2015 to 2019. %TBSA discrepancies were calculated by the differences between TBSAb and TBSAr. A total of 208 patients (111 adults and 97 paediatric patients) were recruited in this study. Of these, the TBSA was overestimated in 60.58% cases, underestimated in 13.46% cases, accurate in 7.69% cases, and in 18.27% cases the referrals had no TBSAr stated. The %TBSA discrepancy was the highest in severe burns (mean 10.80% in adults and 7.59 in paediatric patients; P<0.001). The time interval between referral and reassessment and patients' body mass index (BMI) were not statistically significant for the magnitude of TBSA discrepancy. The number of burn areas involved correlated with the %TBSA discrepancies, with the highest recorded discrepancy being 21.50% in whole body involvement. There were significant discrepancies in TBSA estimations between the referring facilities and those of the Hospital Universiti Sains Malaysia (USM) burn unit, especially among the paediatric patients and those with severe burns. Implementation of educational programs by burn care experts and agreement on a universal method of TBSA assessment are necessary in reducing the discrepancies.
Clinical use of clopidogrel in acute coronary syndrome

Zambahari R, Kwok OH, Javier S, Mak KH, Piyamitr S, Tri Ho HQ, et al.

Int J Clin Pract, 2007 Mar;61(3):473-81.
PMID: 17313616

Several therapeutic approaches have been developed to improve the outcome among patients with acute coronary syndrome (ACS). However, treatment with antithrombotic therapies such as oral glycoprotein IIb/IIIa inhibitors has been limited by the lack of efficacy and excess bleeding complications. As the publication of the landmark study Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE), the clinical benefit of early and intermediate-term use of combined antiplatelet agents--clopidogrel plus aspirin--in non-ST-segment elevation myocardial infarction (NSTEMI) patients became evident. Pretreatment and intermediate-term therapy with clopidogrel in NSTEMI ACS patients undergoing percutaneous coronary intervention (PCI) was further supported by the PCI-CURE trial. Recently, the results of two major trials Clopidogrel as Adjunctive Reperfusion Therapy-Thrombolysis in Myocardial Infarction 28, Clopidogrel and Metoprolol in Myocardial Infarction Trial established the pivotal role of clopidogrel in the other spectrum of ACS-STEMI. Coupled with the results from previous multicentre trials, these two studies provide a guide for the early and long-term use of clopidogrel in the whole spectrum of ACS. A review summarising the results of the recent clinical trials and a discussion on its implications for the clinical management of ACS is presented.
Clinical evidence on dietary supplementation with chia seed (Salvia hispanica L.): a systematic review and meta-analysis

Teoh SL, Lai NM, Vanichkulpitak P, Vuksan V, Ho H, Chaiyakunapruk N

Nutr Rev, 2018 04 01;76(4):219-242.
PMID: 29452425 DOI: 10.1093/nutrit/nux071

Context: Chia seed is a popular dietary supplement, taken mainly for its high content of alpha-linolenic acid, vegetable protein, and dietary fiber, yet information about its clinical effects is lacking.
Objective: This review aims to summarize the clinical evidence regarding the use of chia seed for a wide variety of health conditions.
Data Sources: A number of databases, including PubMed and Embase, were searched systematically.
Study Selection: Randomized controlled trials that assessed the clinical effects of chia seed consumption in human participants were included. The quality of trials was assessed using the Cochrane Risk of Bias Tool.
Data Extraction: Data on study design, blinding status, characteristics of participants, chia seed intervention, comparator, clinical assessment, duration of intake, interval of assessment, and study funding status were extracted. Meta-analysis was performed.
Results: Twelve trials were included. Participants included healthy persons, athletes, diabetic patients, and individuals with metabolic syndrome. Pooling of results showed no significant differences except for the following findings of subgroup analysis at higher doses of chia seed: (1) lower postprandial blood glucose level (mean difference [MD] of -33.95 incremental area under the curve [iAUC] [mmol/L × 2 h] [95%CI, -61.85, -6.05] and -51.60 iAUC [mmol/L × 2 h] [95%CI, -79.64, -23.56] at medium doses and high doses, respectively); (2) lower high-density lipoprotein in serum (MD of -0.10 mmol/L [95%CI, -0.20, -0.01]); and (3) lower diastolic blood pressure (MD of -7.14 mmHg [95%CI, -11.08, -3.19]). The quality of all evidence assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was low or very low. All trials employed only surrogate markers as outcomes.
Conclusions: Future trials with improved methodological quality, well-described clinical events, and validated surrogate markers as outcomes are needed to support the potential health benefits of chia seed consumption.
Systematic Review Registration: PROSPERO registration no. CRD42015029990.
Fulltext Prognostic factors and epidemiology of adult open globe injuries from Western Sydney: a twelve-year review

Ho H, Foo J, Li YC, Bobba S, Go C, Chandra J, et al.

BMC Ophthalmol, 2021 Apr 10;21(1):173.
PMID: 33838650 DOI: 10.1186/s12886-021-01929-z

BACKGROUND: To identify prognostic factors determining final visual outcome following open globe injuries.
METHODS: Retrospective case series of patients presenting to Westmead Hospital, Sydney, Australia with open globe injuries from 1st January 2005 to 31st December 2017. Data collected included demographic information, ocular injury details, management and initial and final visual acuities.
RESULTS: A total of 104 cases were identified. Predictors of poor final visual outcomes included poor presenting visual acuity (p
Fulltext Gender differences in body mass index, body weight perception and weight loss strategies among undergraduates in Universiti Malaysia Sarawak

Kuan PX, Ho HL, Shuhaili MS, Siti AA, Gudum HR

Malays J Nutr, 2011 Apr;17(1):67-75.
PMID: 22135866 MyJurnal

INTRODUCTION:
This study was carried out among undergraduate students in Universiti Malaysia Sarawak with the objective of examining gender differences in body mass index (BMI), body weight perception, eating attitudes and weightloss strategies.

METHODS:
Subjects consisted of 600 undergraduates (300 males and 300 females) recruited from the various faculties between September 2008 until mid-November 2008. The Original Figure Rating Scale: Body Weight Perception, Body Shape Questionnaire (BSQ) and Eating Attitudes Test-26 (EAT-26) were used as assessment tools.

RESULTS:
Overall, 52.8% of students had normal BMI, with approximately an equal number of both sexes. More males than females were overweight (33.7%), while more females were underweight (25.3%). Males were more likely to perceive themselves as overweight, and fail to see themselves as underweight. More than half of the females preferred their ideal figure to be underweight, whereas about 30% males chose an overweight figure as their ideal model. Females were generally more concerned about body weight, body shape and eating than males. They diet more frequently, had self-induced vomiting, and used laxatives and exercise as their weight-loss strategies.

CONCLUSION:
Issues pertaining to body weight perception, eating attitudes and weight-loss strategies exist with differences among male and female undergraduates. Thus, in order to correct misperceptions among young adults, a more tailored intervention programme and more in-depth studies into the various factors involved are required
Patency of permanent vascular access creation in paediatric patients with end stage renal disease

Ho HL, Halim AS, Mat Saadk AZ, Sulaiman WAW, Ilias MI

Med J Malaysia, 2021 Sep;76(5):737-740.
PMID: 34508385

Renal transplant is the first-line therapy in paediatric patients with end-stage renal disease (ESRD). Wong HS and Goh BL reported up to 79% of 1061 paediatric patients still require long-term haemodialysis (HD).1 The lack of deceased and living donors is attributable to the poor awareness, cultural and religious grounds. Permanent vascular access (PVA) in paediatrics therefore, serves more as a long term treatment rather than a bridging therapy. We observed 5 children and an adolescent, all with previous indwelling catheters, who underwent arteriovenous fistula (AVF) creation and report the outcomes. The aim of this report is to determine the factors that influence the longterm patency of paediatric AVF. Factors such as body weight, vessel diameter, preoperative preparations, microsurgical technique and postoperative maintenance are discussed. In addition, considerations on the choice and timing of PVA is highlighted.
Fulltext Dairy Cattle, a Potential Reservoir of Human Campylobacteriosis: Epidemiological and Molecular Characterization of Campylobacter jejuni From Cattle Farms

An JU, Ho H, Kim J, Kim WH, Kim J, Lee S, et al.

Front Microbiol, 2018;9:3136.
PMID: 30619204 DOI: 10.3389/fmicb.2018.03136

Campylobacter jejuni is a major foodborne pathogen that is increasingly found worldwide and that is transmitted to humans through meat or dairy products. A detailed understanding of the prevalence and characteristics of C. jejuni in dairy cattle farms, which are likely to become sources of contamination, is imperative and is currently lacking. In this study, a total of 295 dairy cattle farm samples from 15 farms (24 visits) in Korea were collected. C. jejuni prevalence at the farm level was 60% (9/15) and at the animal level was 23.8% (68/266). Using the multivariable generalized estimating equation (GEE) model based on farm-environmental factors, we estimated that a high density of cattle and average environmental temperature (7 days prior to sampling) below 24°C affects the presence and survival of C. jejuni in the farm environment. Cattle isolates, together with C. jejuni from other sources (chicken and human), were genetically characterized based on analysis of 10 virulence and survival genes. A total of 19 virulence profile types were identified, with type 01 carrying eight genes (all except hcp and virB11) being the most prevalent. The prevalence of virB11 and hcp was significantly higher in isolates from cattle than in those from other sources (p < 0.05). Multilocus sequence typing (MLST) of C. jejuni isolates from three different sources mainly clustered in the CC-21 and CC-48. Within the CC-21 and CC-48 clusters, cattle isolates shared an indistinguishable pattern with human isolates according to pulsed-field gel electrophoresis (PFGE) and flaA-restriction fragment length polymorphism (RFLP) typing. This suggests that CC-21 and CC-48 C. jejuni from dairy cattle are genetically related to clinical campylobacteriosis isolates. In conclusion, the farm environment influences the presence and survival of C. jejuni, which may play an important role in cycles of cattle re-infection, and dairy cattle represent potential reservoirs of human campylobacteriosis. Thus, environmental management practices could be implemented on cattle farms to reduce the shedding of C. jejuni from cattle, subsequently reducing the potential risk of the spread of cattle-derived C. jejuni to humans through the food chain.
Bioinformatic Approach to Investigate Larvae Gut Microbiota Cellulosimicrobium protaetiae via Whole-Genome Analysis

Le Ho H, Tran-Van L, Quyen PTQ, Kim SG, Jiang LM, Chew KW, et al.

Mol Biotechnol, 2024 Jan 17.
PMID: 38231315 DOI: 10.1007/s12033-023-00984-9

The insect larvae Protaetia brevitarsis seulensis have recently been researched as a nutritious food source and concentrated on their environmental impacts. Therefore, their gut microbiota has been studied to elucidate their effects and roles on the environment. Of the abundance of bacterial genus identified based on the 16S rRNA genes from isolates of the gut of insect larva Protaetia brevitarsis seulensis, six of the prominent genus were identified as Bacillus (40.2%), Cellulosimicrobium (33.5%), Microbacterium (2.8%), Streptomyces (3%), Krasilnikoviella (17.5%), and Isoptericola (3%) and their similarity of 16S rRNA blast changed from 99 to 100%. Cellulosimicrobium protaetiae BI34T showed strong denitrification and cellulose degradation activity. The newly complete genome sequence of BI34T and the genomes of five species was published in the genus Cellulosimicrobium with emphasis on the denitrification and secondary metabolite genes. In order to elucidate the relationship between the strain BI34T and the host insect larva, the whole-genome sequence was analyzed and compared with the genomes of five strains in the same genus, Cellulosimicrobium, loaded from GenBank. Our results revealed the composition of the gut microbiota of the insect larvae and analyzed the genomic data for the new strain to predict its characteristics and to understand the nitrogen metabolism pathway.
Green biorefinery: Microalgae-bacteria microbiome on tolerance investigations in plants

Bui-Xuan D, Tang DYY, Chew KW, Nguyen TDP, Le Ho H, Tran TNT, et al.

J Biotechnol, 2022 Jan 10;343:120-127.
PMID: 34896159 DOI: 10.1016/j.jbiotec.2021.12.002

Co-culture of microalgae and microorganisms, supported with the resulting synergistic effects, can be used for wastewater treatment, biomass production, agricultural applications and etc. Therefore, this study aimed to explore the role of Bacillus subtilis (B. subtilis) in tolerance against the harsh environment of seafood wastewater, at which these microalgal-bacterial flocs were formed by microalgae cultivation. In this present study, B. subtilis isolated from the cultivation medium of Chlorella vulgaris and exposed to different salinity (0.1-4% w/v sodium chloride) and various pH range to determine the tolerant ability and biofilm formation. Interestingly, this bacteria strain that isolated from microalgae cultivation medium showed the intense viability in the salt concentration exceeding up to 4% (w/v) NaCl but demonstrated the decrease in cell division as environmental culture undergoing over pH 10. Cell viability was recorded higher than 71% and 92% for B. subtilis inoculum in media with salt concentration greater than 20 gL-1 and external pH 6.5-9, respectively. This showed that B. subtilis isolated from microalgal-bacteria cocultivation exhibited its tolerant ability to survive in the extremely harsh conditions and thus, mitigating the stresses due to salinity and pH.
Fulltext Cardio-oncology in advanced prostate cancer

Chen K, Wong TH, Tan YG, Tay KJ, Tan WC, Chan J, et al.

Front Oncol, 2024;14:1386597.
PMID: 38947889 DOI: 10.3389/fonc.2024.1386597

Treatment intensification with androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPi) have led to improved survival in advanced prostate cancer. However, ADT is linked to significant cardiovascular toxicity, and ARPi also negatively impacts cardiovascular health. Together with a higher prevalence of baseline cardiovascular risk factors reported among prostate cancer survivors at diagnosis, there is a pressing need to prioritise and optimise cardiovascular health in this population. Firstly, While no dedicated cardiovascular toxicity risk calculators are available, other tools such as SCORE2 can be used for baseline cardiovascular risk assessment. Next, selected patients on combination therapy may benefit from de-escalation of ADT to minimise its toxicities while maintaining cancer control. These patients can be characterised by an exceptional PSA response to hormonal treatment, favourable disease characteristics and competing comorbidities that warrant a less aggressive treatment regime. In addition, emerging molecular and genomic biomarkers hold the potential to identify patients who are suited for a de-escalated treatment approach either with ADT or with ARPi. One such biomarker is AR-V7 splice variant that predicts resistance to ARPi. Lastly, optimization of modifiable cardiovascular risk factors for patients through a coherent framework (ABCDE) and exercise therapy is equally important. This article aims to comprehensively review the cardiovascular impact of hormonal manipulation in metastatic hormone-sensitive prostate cancer, propose overarching strategies to mitigate cardiovascular toxicity associated with hormonal treatment, and, most importantly, raise awareness about the detrimental cardiovascular effects inherent in our current management strategies involving hormonal agents.
Antibiotic use in a co-infection of respiratory syncytial virus and pathogenic bacteria in children in a resource-limited setting in northeast Peninsular Malaysia

Liew CSL, Guad RM, Taylor-Robinson AW, Teck KS, Mandrinos S, Duin EV, et al.

Trop Biomed, 2024 Sep 01;41(3):310-315.
PMID: 39548785 DOI: 10.47665/tb.41.3.011

To investigate co-infection of bacterial isolates associated with respiratory syncytial virus (RSV) in children aged less than two years who were admitted to hospital with confirmed lower respiratory tract infection (LRTI) in Kelantan, Malaysia. The demographic data, clinical history, case management, haematological as well as infectious parameters (white blood cell differential and count, plus C-reactive protein, CRP) of the patients were systematically recorded. Less than one-third of cases were RSV-positive (21.03% and 26.23% were diagnosed as acute bronchiolitis or pneumonia, respectively). Blood cultures from approximately 10% of patients demonstrated growth of Haemophilus influenzae, Staphylococcus aureus, coagulase-negative Staphylococcus, Pseudomonas stutzeri, haemolytic Streptococcus group A, and Bacillus subtilis. Further analysis indicated that children with positive bacterial growth had an insignificant predictive value of CRP (2.32-7.16 mg/dl). The total white cell counts were 2.97-7.33 x 109sup>/L despite increased lymphocyte values in the bacteria-positive blood culture. Platelet counts were also within normal limits except for a single case of H. influenzae infection (685.50 x 109sup>/L). Interestingly, 95.01% of patients were treated with antibiotics; 66.23% of RSV infection cases were administered with a combination of antibiotics and 33.77% with only a single antibiotic. The data indicate that the use of antibiotics, either singly or in combination, is not always effective in treating LRTI in infants. Alternative therapeutic regimens should be considered, especially in Asian countries that may have limited resources.

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