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The Soil Micro-Fungi of Selected Areas of Malaysia

Volz PA, Ahmad J. Makhtar

Sains Malaysiana, 1997;26.

Four areas of Malaysia were selected for the study of filamentous microÂ fungi occupying soil habitats. Ampang, Kota Bharu, Bandar Melaka, and Kuantan were examined for micro-fungi species content and diversity of isolates. Species recovered from the soils of Malaysia, represent 63 genera and four classes, according to current concepts of fungal taxonomy (Clements and Shear, 1964; Domsch and Gams, 1980). Most isolates belonged to the imperfect fungal class Deuteromycetes, a few species represented the Zygomycetes, and only isolated incidents of Mastigomycetes and Ascomycetes were found occupying the soil of these regions.
Empat kawasan di Malaysia di pilih untuk penyelidikan pembiakan mikrofungi dipermukaan tanah. Kawasan-kawasan kajian yang mengandungi berbagai-bagai species mikro-fungi tersebut ialah Ampang, Kota Bharu, Bandar Melaka, dan Kuantan. Mengikut pengelasan konsep fungi (Clements dan Shear, 1964; Domish dan Gams, 1980) species mikro-fungi yang ditemui dipermukaan tanah Malaysia terdiri dari 63 "genera" dan empat kelas. Kebanyakannya terdiri dari kelas "Deuteromycetes", sebilangannya mewakili kelas "Zygomycetes", dan cuma sebilangan kecil sahaja terdiri dari kelas "Mastigomycetes" dan "Ascomycetes ".
The emergence of Nipah virus, a highly pathogenic paramyxovirus

Lo MK, Rota PA

J Clin Virol, 2008 Dec;43(4):396-400.
PMID: 18835214 DOI: 10.1016/j.jcv.2008.08.007

Nipah virus first emerged in Malaysia and Singapore between 1998 and 1999, causing severe febrile encephalitis in humans with a mortality rate of close to 40%. In addition, a significant portion of those recovering from acute infection had relapse encephalitis and long-term neurological defects. Since its initial outbreak, there have been numerous outbreaks in Bangladesh and India, in which the mortality rate rose to approximately 70%. These subsequent outbreaks were distinct from the initial outbreak, both in their epidemiology and in their clinical presentations. Recent developments in diagnostics may expedite disease diagnosis and outbreak containment, while progress in understanding the molecular biology of Nipah virus could lead to novel therapeutics and vaccines for this deadly pathogen.
A review of Nipah and Hendra viruses with an historical aside

Ksiazek TG, Rota PA, Rollin PE

Virus Res, 2011 Dec;162(1-2):173-83.
PMID: 21963678 DOI: 10.1016/j.virusres.2011.09.026

The emergence of Hendra and Nipah viruses in the 1990s has been followed by the further emergence of these viruses in the tropical Old World. The history and current knowledge of the disease, the viruses and their epidemiology is reviewed in this article. A historical aside summarizes the role that Dr. Brian W.J. Mahy played at critical junctures in the early stories of these viruses.
Fulltext Current and future trends in socio-economic, demographic and governance factors affecting global primate conservation

Estrada A, Garber PA, Chaudhary A

PeerJ, 2020;8:e9816.
PMID: 32884865 DOI: 10.7717/peerj.9816

Currently, ~65% of extant primate species (ca 512 species) distributed in 91 countries in the Neotropics, mainland Africa, Madagascar, South Asia and Southeast Asia are threatened with extinction and 75% have declining populations as a result of deforestation and habitat loss resulting from increasing global market demands, and land conversion for industrial agriculture, cattle production and natural resource extraction. Other pressures that negatively impact primates are unsustainable bushmeat hunting, the illegal trade of primates as pets and as body parts, expanding road networks in previously isolated areas, zoonotic disease transmission and climate change. Here we examine current and future trends in several socio-economic factors directly or indirectly affecting primates to further our understanding of the interdependent relationship between human well-being, sustainable development, and primate population persistence. We found that between 2001 and 2018 ca 191 Mha of tropical forest (30% canopy cover) were lost as a result of human activities in the five primate range regions. Forty-six percent of this loss was in the Neotropics (Mexico, Central and South America), 30% in Southeast Asia, 21% in mainland Africa, 2% in Madagascar and 1% in South Asia. Countries with the greatest losses (ca 57% of total tree cover loss) were Brazil, Indonesia, DRC, China, and Malaysia. Together these countries harbor almost 50% of all extant primate species. In 2018, the world human population was estimated at ca 8bn people, ca 60% of which were found in primate range countries. Projections to 2050 and to 2100 indicate continued rapid growth of the human populations in these five primate range regions, with Africa surpassing all the other regions and totaling ca 4bn people by the year 2100. Socioeconomic indicators show that, compared to developed nations, most primate range countries are characterized by high levels of poverty and income inequality, low human development, low food security, high levels of corruption and weak governance. Models of Shared Socioeconomic Pathway scenarios (SSPs) projected to 2050 and 2100 showed that whereas practices of increasing inequality (SSP4) or unconstrained growth in economic output and energy use (SSP5) are projected to have dire consequences for human well-being and primate survivorship, practices of sustainability-focused growth and equality (SSP1) are expected to have a positive effect on maintaining biodiversity, protecting environments, and improving the human condition. These results stress that improving the well-being, health, and security of the current and future human populations in primate range countries are of paramount importance if we are to move forward with effective policies to protect the world's primate species and promote biodiversity conservation.
Nipah virus: an emergent paramyxovirus causing severe encephalitis in humans

Bellini WJ, Harcourt BH, Bowden N, Rota PA

J Neurovirol, 2005 Oct;11(5):481-7.
PMID: 16287690

Nipah virus is a recently emergent paramyxovirus that is capable of causing severe disease in both humans and animals. The first outbreak of Nipah virus occurred in Malaysia and Singapore in 1999 and, more recently, outbreaks were detected in Bangladesh. In humans, Nipah virus causes febrile encephalitis with respiratory syndrome that has a high mortality rate. The reservoir for Nipah virus is believed to be fruit bats, and humans are infected by contact with infected bats or by contact with an intermediate animal host such as pigs. Person to person spread of the virus has also been described. Nipah virus retains many of the genetic and biologic properties found in other paramyxoviruses, though it also has several unique characteristics. However, the virologic characteristics that allow the virus to cause severe disease over a broad host range, and the epidemiologic, environmental and virologic features that favor transmission to humans are unknown. This review summarizes what is known about the virology, epidemiology, pathology, diagnosis and control of this novel pathogen.
Fulltext Interferon Regulatory Factor 9 Structure and Regulation

Paul A, Tang TH, Ng SK

Front Immunol, 2018;9:1831.
PMID: 30147694 DOI: 10.3389/fimmu.2018.01831

Interferon regulatory factor 9 (IRF9) is an integral transcription factor in mediating the type I interferon antiviral response, as part of the interferon-stimulated gene factor 3. However, the role of IRF9 in many important non-communicable diseases has just begun to emerge. The duality of IRF9's role in conferring protection but at the same time exacerbates diseases is certainly puzzling. The regulation of IRF9 during these conditions is not well understood. The high homology of IRF9 DNA-binding domain to other IRFs, as well as the recently resolved IRF9 IRF-associated domain structure can provide the necessary insights for progressive inroads on understanding the regulatory mechanism of IRF9. This review sought to outline the structural basis of IRF9 that guides its regulation and interaction in antiviral immunity and other diseases.
Long term mesenchymal stem cell culture on a defined synthetic substrate with enzyme free passaging

Duffy CR, Zhang R, How SE, Lilienkampf A, De Sousa PA, Bradley M

Biomaterials, 2014 Jul;35(23):5998-6005.
PMID: 24780167 DOI: 10.1016/j.biomaterials.2014.04.013

Mesenchymal stems cells (MSCs) are currently the focus of numerous therapeutic approaches in tissue engineering/repair because of their wide multi-lineage potential and their ability to modulate the immune system response following transplantation. Culturing these cells, while maintaining their multipotency in vitro, currently relies on biological substrates such as gelatin, collagen and fibronectin. In addition, harvesting cells from these substrates requires enzymatic or chemical treatment, a process that will remove a multitude of cellular surface proteins, clearly an undesirable process if cells are to be used therapeutically. Herein, we applied a high-throughput 'hydrogel microarray' screening approach to identify thermo-modulatable substrates which can support hES-MP and ADMSC growth, permit gentle reagent free passaging, whilst maintaining multi-lineage potential. In summary, the hydrogel substrate identified, poly(AEtMA-Cl-co-DEAA) cross-linked with MBA, permitted MSCs to be maintained over 10 passages (each time via thermo-modulation), with the cells retaining expression of MSC associated markers and lineage potency. This chemically defined system allowed the passaging and maintenance of cellular phenotype of this clinically important cell type, in the absence of harsh passaging and the need for biological substrates.
Adolescents as perpetrators of aggression within the family

Kuay HS, Lee S, Centifanti LC, Parnis AC, Mrozik JH, Tiffin PA

Int J Law Psychiatry, 2016 Jul-Aug;47:60-7.
PMID: 27016774 DOI: 10.1016/j.ijlp.2016.02.035

Although family violence perpetrated by juveniles has been acknowledged as a potentially serious form of violence for over 30years, scientific studies have been limited to examining the incidence and form of home violence. The present study examined the prevalence of family aggression as perpetrated by youths; we examined groups drawn from clinic-referred and forensic samples. Two audits of case files were conducted to systematically document aggression perpetrated by referred youths toward their family members. The purpose of the first audit was fourfold: i) to identify the incidence of the perpetration of family aggression among clinical and forensic samples; ii) to identify whether there were any reports of weapon use during aggressive episodes; iii) to identify the target of family aggression (parents or siblings); and iv) to identify the form of aggression perpetrated (verbal or physical). The second audit aimed to replicate the findings and to show that the results were not due to differences in multiple deprivation indices, clinical diagnosis of disruptive behavior disorders, and placement into alternative care. A sampling strategy was designed to audit the case notes of 25 recent forensic Child and Adolescent Mental Health Service (CAMHS) cases and 25 demographically similar clinic-referred CAMHS cases in the first audit; and 35 forensic cases and 35 demographically similar clinic-referred CAMHS cases in the second audit. Using ordinal chi-square, the forensic sample (audit 1=64%; audit 2=82.9%) had greater instances of family violence than the clinical sample (audit 1=32%; audit 2=28.6%). They were more likely to use a weapon (audit 1=69%; audit 2=65.5%) compared to the clinical sample (audit 1 and 2=0%). Examining only the aggressive groups, there was more perpetration of aggression toward parents (audit 1, forensic=92%, clinical=75%; audit 2, forensic=55.17%, clinical=40%) than toward siblings (audit 1, forensic=43%, clinical=50%; audit 2, forensic=27.58%, clinical=30%). Based on these findings, we would urge professionals who work within the child mental health, particularly the forensic area, to systematically collect reports of aggression perpetrated toward family members.

Study conducted in England
Fulltext Comparable outcomes for β-lactam/β-lactamase inhibitor combinations and carbapenems in definitive treatment of bloodstream infections caused by cefotaxime-resistant Escherichia coli or Klebsiella pneumoniae

Harris PN, Yin M, Jureen R, Chew J, Ali J, Paynter S, et al.

Antimicrob Resist Infect Control, 2015;4:14.
PMID: 25932324 DOI: 10.1186/s13756-015-0055-6

Extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae are often susceptible in vitro to β-lactam/β-lactamase inhibitor (BLBLI) combination antibiotics, but their use has been limited by concerns of clinical inefficacy. We aimed to compare outcomes between patients treated with BLBLIs and carbapenems for bloodstream infection (BSI) caused by cefotaxime non-susceptible (likely ESBL- or AmpC β-lactamase-producing) Escherichia coli and Klebsiella pneumoniae.
Reagentless Affimer- and antibody-based impedimetric biosensors for CEA-detection using a novel non-conducting polymer

Shamsuddin SH, Gibson TD, Tomlinson DC, McPherson MJ, Jayne DG, Millner PA

Biosens Bioelectron, 2021 Apr 15;178:113013.
PMID: 33508539 DOI: 10.1016/j.bios.2021.113013

Polyoctopamine (POct), an amine-functionalised non-conducting polymer, as the transducer layer in an electrochemical biosensor, is presented. This polymer offers versatile covalent coupling either through thiol linker conjugation, carboxyl or aldehyde functional groups without the requirement of pre- or post-surface activation. The colorectal cancer biomarker carcinoembryonic antigen (CEA) was selected as the target analyte, whilst an antibody and a synthetic binding protein, an Affimer, were used as distinct bioreceptors to demonstrate the versatility of polyoctopamine as a transducer polymer layer for oriented immobilisation of the bioreceptors. The electrodeposited polymer layer was characterised using cyclic voltammetry, electrochemical impedance spectroscopy, and on-sensor chemiluminescent blotting. The performance of optimised POct-based biosensors were tested in spiked human serum. Results showed that the electropolymerisation of octopamine on screen printed gold electrode generates a thin polymer film with low resistance. Close proximity of the immobilised bioreceptors to the transducer layer greatly enhanced the sensitivity detection. The sensitivity of the smaller monomeric bioreceptor (Affimer, 12.6 kDa) to detect CEA was comparable to the dimeric antibody (150 kDa) with limit of detection at 11.76 fM which is significantly lower than the basal clinical levels of 25 pM. However, the Affimer-based sensor had a narrower dynamic range compared to the immunosensor (1-100 fM vs. 1 fM - 100 nM, respectively). All electrochemical measurements were done in less than 5 min with small sample volumes (10 μl). Hence, polyoctopamine features a simple fabrication of impedimetric biosensors using amine-functionalisation technique, provides rapid response time with enhanced sensitivity and label-free detection.
Caffeic acid phenethyl ester (CAPE) reverses fibrosis caused by chronic colon inflammation in murine model of colitis

Tambuwala MM, Kesharwani P, Shukla R, Thompson PD, McCarron PA

Pathol Res Pract, 2018 Nov;214(11):1909-1911.
PMID: 30170869 DOI: 10.1016/j.prp.2018.08.020

Fibrosis is known to be the hallmarks of chronic inflammation of the bowel. Epithelial damage due to inflammation compromises the barrier function of the gastrointestinal tract. This barrier dysfunction leads to further spread of inflammation resulting in a chronic state of inflammation. This chronic inflammation leads to development of fibrosis, which has very limited therapeutic options and usually requires surgical removal of the affected tissue. Our previous work has shown that Caffeic acid phenethyl ester (CAPE) is a naturally occurring anti-inflammatory agent, found in propolis, has been found to be protective in experimental colitis via enhancement of epithelial barrier function. However, the impact of CAPE on resolution of fibrosis in the long-term is unknown. The aim of this follow up study was to investigate the effect of CAPE on colon fibrosis in a chronic model of Dextran sulphate sodium induced colitis in mice. Dextran sulphate sodium (DSS) 2.5% w/v was administered in drinking water to induce colitis in C57/BL6 mice for 5 days on the 6th day DSS was stopped and test group mice were treated with intraperitoneal administration of CAPE (30 mg kg-1 day-1) for a further 7 days. Disease activity index (DAI) score, colon length and tissue histology and level of tissue fibrosis was observed. CAPE-treated mice had significantly lower levels of DAI, tissue inflammation scores and fibrosis as compared with control group. Our results show that CAPE is effective in resolving colon fibrosis in chronic inflammation. Thus, we can conclude CAPE could be a potential therapeutic agent for further clinical investigations for treatment of fibrosis in inflammatory bowel diseases in humans.
Fulltext Selection and characterisation of Affimers specific for CEA recognition

Shamsuddin SH, Jayne DG, Tomlinson DC, McPherson MJ, Millner PA

Sci Rep, 2021 01 12;11(1):744.
PMID: 33436840 DOI: 10.1038/s41598-020-80354-6

Carcinoembryonic antigen (CEA) is the only blood based protein biomarker at present, used for preoperative screening of advanced colorectal cancer (CRC) patients to determine the appropriate curative treatments and post-surveillance screening for tumour recurrence. Current diagnostics for CRC detection have several limitations and development of a highly sensitive, specific and rapid diagnostic device is required. The majority of such devices developed to date are antibody-based and suffer from shortcomings including multimeric binding, cost and difficulties in mass production. To circumvent antibody-derived limitations, the present study focused on the development of Affimer proteins as a novel alternative binding reagent for CEA detection. Here, we describe the selection, from a phage display library, of Affimers specific to CEA protein. Characterization of three anti-CEA Affimers reveal that these bind specifically and selectively to protein epitopes of CEA from cell culture lysate and on fixed cells. Kinetic binding analysis by SPR show that the Affimers bind to CEA with high affinity and within the nM range. Therefore, they have substantial potential for used as novel affinity reagents in diagnostic imaging, targeted CRC therapy, affinity purification and biosensor applications.
Callous-Unemotional Traits are Associated With Child-to-Parent Aggression

Kuay HS, Boothroyd LG, Towl GJ, Tiffin PA, Muñoz LC

Int J Offender Ther Comp Criminol, 2021 Oct 04.
PMID: 34605308 DOI: 10.1177/0306624X211049190

This study examined the relations between callous-unemotional traits and perpetration of aggression toward parents in two separate studies, while also considering motivation for aggression and parenting styles experienced among young people. Study 1 involved 60 parents of children aged between 11 and 17 years old. The online study found high callous-unemotional traits, as reported by parents, to be associated with aggression toward both parents. Both types of motivation (proactive and reactive, as reported by parents) were associated with aggression toward parents. Study 2 involved 42 youths from an alternative education sample (between 11 and 16 years old). Youths with higher self-reported callous-unemotional traits reported more aggression toward both parents. Both studies, which had different reporters and different samples, showed youths with higher callous-unemotional traits were more aggressive toward their parents. In discussing the results, we note the importance of including callous-unemotional traits in future research on parent-directed aggression and in studies on domestic violence more broadly.
Collinear facilitation and contour integration in autistic adults: Examining lateral and feedback connectivity

Gowen E, Jachim S, Subri S, Dickinson C, Hamblin-Pyke B, Warren PA

Vision Res, 2020 12;177:56-67.
PMID: 32977182 DOI: 10.1016/j.visres.2020.08.004

Alongside difficulties with communication and social interaction, autism is often accompanied by unusual sensory and perceptual experiences including enhanced visual performance on tasks that involve separating local parts from global context. This superiority may be the result of atypical integrative processing, involving feedback and lateral connections between visual neurons. The current study investigated the integrity of these connections in autistic adults by examining two psychophysics tasks that rely on these processes - collinear facilitation and contour integration. The relative contribution of feedback and lateral connectivity was studied by altering the timing of the target relative to the flankers in the collinear facilitation task, in 16 autistic and 16 non-autistic adults. There were no significant differences in facilitation between the autistic and non-autistic groups, indicating that for this task and participant sample, lateral and feedback connectivity appear relatively intact in autistic individuals. Contour integration was examined in a different group of 20 autistic and 18 non-autistic individuals, for open and closed contours to assess the closure effect (improved detection of closed compared to open contours). Autistic individuals showed a reduced closure effect at both short (150 ms) and longer (500 ms) stimulus presentation durations that was driven by better performance of the autistic group for the open contours. These results suggest that reduced closure in a simple contour detection paradigm is unlikely to be due to slower global processing. Reduced closure has implications for understanding sensory overload by contributing to reduced figure-ground segregation of salient visual features.
Fulltext Gender disparities in HIV treatment outcomes following release from jail: results from a multicenter study

Meyer JP, Zelenev A, Wickersham JA, Williams CT, Teixeira PA, Altice FL

Am J Public Health, 2014 Mar;104(3):434-41.
PMID: 24432878 DOI: 10.2105/AJPH.2013.301553

We assessed gender differences in longitudinal HIV treatment outcomes among HIV-infected jail detainees transitioning to the community.
Fulltext Strong and widespread cycloheximide resistance in Stichococcus-like eukaryotic algal taxa

Syuhada NH, Merican F, Zaki S, Broady PA, Convey P, Muangmai N

Sci Rep, 2022 Jan 20;12(1):1080.
PMID: 35058560 DOI: 10.1038/s41598-022-05116-y

This study was initiated following the serendipitous discovery of a unialgal culture of a Stichococcus-like green alga (Chlorophyta) newly isolated from soil collected on Signy Island (maritime Antarctica) in growth medium supplemented with 100 µg/mL cycloheximide (CHX, a widely used antibiotic active against most eukaryotes). In order to test the generality of CHX resistance in taxa originally identified as members of Stichococcus (the detailed taxonomic relationships within this group of algae have been updated since our study took place), six strains were studied: two strains isolated from recent substrate collections from Signy Island (maritime Antarctica) ("Antarctica" 1 and "Antarctica" 2), one isolated from this island about 50 years ago ("Antarctica" 3) and single Arctic ("Arctic"), temperate ("Temperate") and tropical ("Tropical") strains. The sensitivity of each strain towards CHX was compared by determining the minimum inhibitory concentration (MIC), and growth rate and lag time when exposed to different CHX concentrations. All strains except "Temperate" were highly resistant to CHX (MIC > 1000 µg/mL), while "Temperate" was resistant to 62.5 µg/mL (a concentration still considerably greater than any previously reported for algae). All highly resistant strains showed no significant differences in growth rate between control and treatment (1000 µg/mL CHX) conditions. Morphological examination suggested that four strains were consistent with the description of the species Stichococcus bacillaris while the remaining two conformed to S. mirabilis. However, based on sequence analyses and the recently available phylogeny, only one strain, "Temperate", was confirmed to be S. bacillaris, while "Tropical" represents the newly erected genus Tetratostichococcus, "Antarctica 1" Tritostichococcus, and "Antarctica 2", "Antarctica 3" and "Arctic" Deuterostichococcus. Both phylogenetic and CHX sensitivity analyses suggest that CHX resistance is potentially widespread within this group of algae.
Fulltext Phalangeal Osteosarcoma Mistaken for Tuberculosis: A Case Report

Mohd-Ariff MA, Ali-Noor I, Paul AG, Abdullah S

Malays Orthop J, 2015 Mar;9(1):38-40.
PMID: 28435596 MyJurnal DOI: 10.5704/MOJ.1503.011

We report a 21-year old female patient who presented with an 18-month history of a swelling in the distal phalanx of her right little finger. Although the history, clinical features and MRI were suggestive of a benign tumour or a tuberculous lesion, the histo-pathological examination of the swelling was reported as a conventional osteosarcoma. Osteosarcoma of the hand is very rare. This article highlights the possibility of a seemingly benign lesion seen in a routine clinic could well turn out to be malignant, and the need to maintain a high index of suspicion.
Fulltext Phosphorylation of interferon regulatory factor 9 (IRF9)

Paul A, Ismail MN, Tang TH, Ng SK

Mol Biol Rep, 2023 Apr;50(4):3909-3917.
PMID: 36662450 DOI: 10.1007/s11033-023-08253-3

BACKGROUND: IRF9 is a transcription factor that mediates the expression of interferon-stimulated genes (ISGs) through the Janus kinase-Signal transducer and activator of transcription (JAK-STAT) pathway. The JAK-STAT pathway is regulated through phosphorylation reactions, in which all components of the pathway are known to be phosphorylated except IRF9. The enigma surrounding IRF9 regulation by a phosphorylation event is intriguing. As IRF9 plays a major role in establishing an antiviral state in host cells, the topic of IRF9 regulation warrants deeper investigation.
METHODS: Initially, total lysates of 2fTGH and U2A cells (transfected with recombinant IRF9) were filter-selected and concentrated using phosphoprotein enrichment assay. The phosphoprotein state of IRF9 was further confirmed using Phos-tag™ assay. All protein expression was determined using Western blotting. Tandem mass spectrometry was conducted on immunoprecipitated IRF9 to identify the phosphorylated amino acids. Finally, site-directed mutagenesis was performed and the effects of mutated IRF9 on relevant ISGs (i.e., USP18 and Mx1) was evaluated using qPCR.
RESULTS: IRF9 is phosphorylated at S252 and S253 under IFNβ-induced condition and R242 under non-induced condition. Site-directed mutagenesis of S252 and S253 to either alanine or aspartic acid has a modest effect on the upregulation of USP18 gene-a negative regulator of type I interferon (IFN) response-but not Mx1 gene.
CONCLUSION: Our preliminary study shows that IRF9 is phosphorylated and possibly regulates USP18 gene expression. However, further in vivo studies are needed to determine the significance of IRF9 phosphorylation.
Fulltext Determinants of blood pressure control among hypertensive patients of rural areas in a South Indian State: A community based cross sectional study

Paul A, Kini SB, Kumar A, Mallya SD

Malays Fam Physician, 2023;18:40.
PMID: 37449276 DOI: 10.51866/oa.308

INTRODUCTION: Optimum blood pressure (BP) control is essential to prevent complications and improve the quality of life of patients with hypertension. This study aimed to explore the determinants of BP control in patients with hypertension on treatment without any other comorbidities.
METHOD: The study was conducted among 429 patients with essential hypertension aged > 30 years residing in four villages of a taluk/tahsil in a South Indian state. A pre-tested semi-structured questionnaire was used to collect data on socio-demographic characteristics, diagnosis and treatment of hypertension, lifestyle factors (e.g. diet and substance use), facilitators and barriers of BP control and anthropometric measurements. BP was measured using World Health Organization standards and classified using the Joint National Committee 8 Guidelines. Descriptive statistics were measured in terms of numbers and percentages. Univariate and multivariate logistic regression analyses were used to determine the significant determinants of BP control.
RESULTS: Approximately 64.3% of the participants had their BP under control. The participants aged 46-59 years were more likely to have uncontrolled BP than those aged ≥60 years. The participants with <80% adherence to medication (non-adherent) had a five fold higher odds of having uncontrolled BP than those with >80% adherence.
CONCLUSION: Adherence to medication was the only significant factor for BP control in the present study. Hence, adherence to medication should be addressed with interventions targeted to improve BP control in patients with hypertension.
Objective cough frequency, airway inflammation, and disease control in asthma

Marsden PA, Satia I, Ibrahim B, Woodcock A, Yates L, Donnelly I, et al.

Chest, 2016 06;149(6):1460-6.
PMID: 26973014 DOI: 10.1016/j.chest.2016.02.676

BACKGROUND: Cough is recognized as an important troublesome symptom in the diagnosis and monitoring of asthma. Asthma control is thought to be determined by the degree of airway inflammation and hyperresponsiveness but how these factors relate to cough frequency is unclear. The goal of this study was to investigate the relationships between objective cough frequency, disease control, airflow obstruction, and airway inflammation in asthma.

METHODS: Participants with asthma underwent 24-h ambulatory cough monitoring and assessment of exhaled nitric oxide, spirometry, methacholine challenge, and sputum induction (cell counts and inflammatory mediator levels). Asthma control was assessed by using the Global Initiative for Asthma (GINA) classification and the Asthma Control Questionnaire (ACQ). The number of cough sounds was manually counted and expressed as coughs per hour (c/h).

RESULTS: Eighty-nine subjects with asthma (mean ± SD age, 57 ± 12 years; 57% female) were recruited. According to GINA criteria, 18 (20.2%) patients were classified as controlled, 39 (43.8%) partly controlled, and 32 (36%) uncontrolled; the median ACQ score was 1 (range, 0.0-4.4). The 6-item ACQ correlated with 24-h cough frequency (r = 0.40; P < .001), and patients with uncontrolled asthma (per GINA criteria) had higher median 24-h cough frequency (4.2 c/h; range, 0.3-27.6) compared with partially controlled asthma (1.8 c/h; range, 0.2-25.3; P = .01) and controlled asthma (1.7 c/h; range, 0.3-6.7; P = .002). Measures of airway inflammation were not significantly different between GINA categories and were not correlated with ACQ. In multivariate analyses, increasing cough frequency and worsening FEV1 independently predicted measures of asthma control.

CONCLUSIONS: Ambulatory cough frequency monitoring provides an objective assessment of asthma symptoms that correlates with standard measures of asthma control but not airflow obstruction or airway inflammation. Moreover, cough frequency and airflow obstruction represent independent dimensions of asthma control.

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