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Fulltext Diagnostic Accuracy of Lactate Dehydrogenase/Adenosine Deaminase Ratio in Differentiating Tuberculous and Parapneumonic Effusions: A Systematic Review

Nyanti LE, Rahim MAA, Huan NC

Tuberc Respir Dis (Seoul), 2024 Jan;87(1):91-99.
PMID: 37726943 DOI: 10.4046/trd.2023.0107

BACKGROUND: Tuberculous pleural effusion (TPE) and parapneumonic effusion (PPE) are often difficult to differentiate owing to the overlapping clinical features. Observational studies demonstrate that the ratio of lactate dehydrogenase to adenosine deaminase (LDH/ADA) is lower in TPE compared to PPE, but integrated analysis is warranted.
METHODS: We conducted a systematic review to evaluate the diagnostic accuracy of the LDH/ADA ratio in differentiating TPE and PPE. We explored the PubMed and Scopus databases for studies evaluating the LDH/ADA ratio in differentiating TPE and PPE.
RESULTS: From a yield of 110 studies, five were included for systematic review. The cutoff value for the LDH/ADA ratio in TPE ranged from <14.2 to <25. The studies demonstrated high heterogeneity, precluding meta-analysis. Quality Assessment of Diagnostic Accuracy Studies Tool 2 assessment revealed a high risk of bias in terms of patient selection and index test.
CONCLUSION: LDH/ADA ratio is a potentially useful parameter to differentiate between TPE and PPE. Based on the limited data, we recommend an LDH/ADA ratio cutoff value of <15 in differentiating TPE and PPE. However, more rigorous studies are needed to further validate this recommendation.
Fulltext Inverse changes in plasma tetranectin and titin levels in patients with type 2 diabetes mellitus: a potential predictor of acute myocardial infarction?

Rahim MAA, Rahim ZHA, Ahmad WAW, Bakri MM, Ismail MD, Hashim OH

Acta Pharmacol Sin, 2018 Jul;39(7):1197-1207.
PMID: 29417940 DOI: 10.1038/aps.2017.141

An early intervention using biomarkers to predict acute myocardial infarction (AMI) will effectively reduce global heart attack incidence, particularly among high-risk patients with type 2 diabetes mellitus (T2DM). This study attempted to identify potential biomarkers by detecting changes in the levels of plasma proteins in T2DM patients following onset of AMI in comparison with those without AMI. Volunteer T2DM patients without AMI (control; n=10) and T2DM patients with AMI (n=10) were recruited. Plasma samples from these patients were evaluated via two-dimensional gel electrophoresis (2DE) to screen for proteins with level changes between the two groups. The abundance of spots on gel images was analyzed using Progenesis SameSpots and subjected to false discovery rate (FDR) analysis. Protein spots with statistically significant changes of at least 1.5 fold were selected for mass spectrometry (MS) analysis. Due to strong cardiac connections, tetranectin and titin were evaluated by enzymelinked immunosorbent assay (ELISA). The adjusted P-values and fold changes between the two groups resulted in identification of 34 protein spots with significantly altered abundance. Upon MS analysis, 17 plasma proteins were identified: tetranectin, titin, clusterin, haptoglobin, myosin-13, zinc fnger protein 445, DNA repair protein RAD50, serum albumin, apolipoprotein A-IV, caspase-6, aminoacyl tRNA synthase complex-interacting multifunctional protein 1, serotransferrin, retinol-binding protein 4, transthyretin, alpha-1-antitrypsin, apolipoprotein A-I and serum amyloid A. Comparable patterns of changes in tetranectin and titin between the control and AMI groups were confirmed using ELISA. In summary, tetranectin and titin in plasma appeared to be closely associated with the onset of AMI among T2DM patients and can be used as potential biomarkers for prediction of a cardiac event, though this requires validation in a prospective cohort study.
Local and transboundary factors' impacts on trace gases and aerosol during haze episode in 2015 El Niño in Malaysia

Samsuddin NAC, Khan MF, Maulud KNA, Hamid AH, Munna FT, Rahim MAA, et al.

Sci Total Environ, 2018 Jul 15;630:1502-1514.
PMID: 29554768 DOI: 10.1016/j.scitotenv.2018.02.289

Southeast Asian haze is a semi-natural phenomenon that chokes the region each year during the dry monsoon season. Smoke-haze episodes caused by the vegetation and peat fires in Indonesia severely affected large parts of Malaysia during the 2015 El Niño phenomenon. This study aimed to evaluate the factors that influenced the concentrations of aerosol and trace gases during the 2015 haze and non-haze period on a semi-urban site in the southern part of Malaysian peninsula that facing Sumatra (Muar, Site A), and on an urban site near to Kuala Lumpur, influenced by the city centre (Cheras, Site B). Local land use data and the cluster of air mass weighted backward trajectory were used to identify the potential factors from local sources and the transboundary region, respectively. The annual median concentrations of PM10 for semi-urban and urban sites were 45.0μg/m3 and 47.0μg/m3, respectively for the study period (Jan-Dec 2015) from the hourly observation dataset. The highest PM10 concentrations during the haze were 358μg/m3 and 415μg/m3 for the two sites, respectively, representing absolutely unhealthy air. However, the trace gases were within the safe threshold. The average concentrations of PM10 and carbon monoxide were two fold higher during the haze than the non-haze episodes on both sites. Nitrogen dioxide was more influenced by haze compared with sulphur dioxide and ozone. The results of the land use change suggest that the local factor can also partially affect the air pollution on the urban area (Site B) but more visible in 2015. The results of the backward trajectory and the wildfire radiative power showed that the smoke-haze episodes that affected Malaysia in 2015 were mainly initiated in the Indonesian Sumatra and Kalimantan regions. This study provides a very useful information towards the impacted region during El Niño haze episode.
Fulltext Determinants of Willingness to Undergo Lung Cancer Screening among High-Risk Current and Ex-smokers in Sabah, Malaysia: A Cross-Sectional Pilot Study

Nyanti LE, Chua CZ, Loo HC, Khor CZ, Toh ESY, Gill RS, et al.

Tuberc Respir Dis (Seoul), 2023 Oct;86(4):284-293.
PMID: 37643812 DOI: 10.4046/trd.2023.0051

BACKGROUND: Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer.
METHODS: A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCOm2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening.
RESULTS: A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening.
CONCLUSION: Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.