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Fulltext Enhancing food waste biodegradation rate in a food waste biodigester with the synergistic action of hydrolase-producing Bacillus paralicheniformis GRA2 and Bacillus velezensis TAP5 co-culture inoculation

Roslan MAM, Jefri NQUA, Ramlee N, Rahman NAA, Chong NHH, Bunawan H, et al.

Saudi J Biol Sci, 2021 May;28(5):3001-3012.
PMID: 34012331 DOI: 10.1016/j.sjbs.2021.02.041

Food waste (FW) minimization at the source by using food waste biodigester (FWBs) has a vast potential to lower down the impact of increasing organic fraction in municipal solid waste generation. To this end, this research sought to check the performance of locally isolated hydrolase-producing bacteria (HPB) to improve food waste biodegradation rate. Two under-explored HPB identified as Bacillus paralicheniformis GRA2 and Bacillus velezensis TAP5 were able to produce maximum amylase, cellulase, protease and lipase activities, and demonstrated a significant hydrolase synergy in co-culture fermentation. In vitro biodegradation analysis of both autoclaved and non-autoclaved FW revealed that the HPB inoculation was effective to degrade total solids (>62%), protein (>19%), total fat (>51), total sugar (>86%), reducing sugar (>38%) and starch (>50%) after 8-day incubation. All co-culture treatments were recorded superior to the respective monocultures and the uninoculated control. The results of FW biodegradation using batch-biodigester trial indicated that the 1500 mL and 1000 mL inoculum size of HPB inoculant reached a plateau on the 4th day, with gross biodegradation percentage (GBP) of >85% as compared to control (66.4%). The 1000 mL inoculum was sufficient to achieve the maximum GBP (>90%) of FW after an 8-day biodigestion in a FWB.
Detection of mobile colistin-resistance gene variants (mcr-1 and mcr-2) in urinary tract pathogens in Bangladesh: the last resort of infectious disease management colistin efficacy is under threat

Ara B, Urmi UL, Haque TA, Nahar S, Rumnaz A, Ali T, et al.

Expert Rev Clin Pharmacol, 2021 Apr;14(4):513-522.
PMID: 33691556 DOI: 10.1080/17512433.2021.1901577

Background: Currently, colistin-resistant pathogens emerged has become a global health concern. This study assessed the distribution of mcr-1 to mcr-5 variants with the phenotypic colistin-resistance in bacterial isolates from urinary tract infection (UTI) patients in Bangladesh.Methods: A cross-sectional study was conducted between April 2017 and March 2018 to enroll uncomplicated UTI patients, and 142 urine samples were analyzed. Uropathogens were identified using the API-20E biochemical panel and 16s rRNA gene sequencing. Polymerase chain reactions detected the mcr gene variants in the UTI isolates. The phenotypic colistin-susceptibility was determined by the Kirby-Bauer disc-diffusion method and the minimal inhibitory concentration (MIC) measurement.Results: The combined carriage of mcr-1 and mcr-2 genes in 11.4% (14/123) of urinary tract pathogens. The mcr-positive pathogens include five Escherichia coli, three Klebsiella pneumoniae, three Pseudomonas putida, two Enterobacter cloacae, and one Enterobacter hormaechei. The mcr-positive variant showed significantly higher phenotypic colistin resistance with MIC between >16 µg/mL and >128 µg/mL (p
A cross-sectional study evaluating the knowledge and beliefs about, and the use of antibiotics amongst Malaysian university students

Haque M, Rahman NAA, McKimm J, Binti Abdullah SL, Islam MZ, Zulkifli Z, et al.

Expert Rev Anti Infect Ther, 2019 04;17(4):275-284.
PMID: 30761920 DOI: 10.1080/14787210.2019.1581607

BACKGROUND: The introduction of antibiotics into modern medicine has changed clinical care by saving millions of lives. However, misuse of antibiotics has led to their benefits being overshadowed by the development of antimicrobial resistance.
AIMS OF STUDY: This study aimed to assess university students' knowledge and beliefs about and their use of antibiotics.
METHODS: This cross-sectional study was conducted among 674 medical and non-medical students of the National Defence University of Malaysia, using universal and convenience sampling methods. The data was collected using a validated questionnaire and analyzed using IBM SPSS 24, and the MANOVA test and Logistic Regression were used to explore the associated factors.
RESULTS: More than half of the respondents' knowledge was low and their health beliefs outdated. Age, race and program were significantly associated with up-to-date knowledge and beliefs about antibiotic use, factors associated with finishing a course of antibiotics were studying medicine, personal health, and ethnicity. The significant factors associated with antibiotic self-prescribing were beliefs having been prescribed antibiotics during the last one year, and trusting the doctors who did not prescribe antibiotics.
CONCLUSION: This study has identified a concerning low knowledge about antibiotics amongst some Malaysian university students, reflected in use of un-prescribed antibiotics and a lack of adherence to treatment. There is a need for educational interventions for students regarding antibiotic usage and resistance issues.
Fulltext Tocilizumab in COVID-19: a study of adverse drug events reported in the WHO database

Charan J, Dutta S, Kaur R, Bhardwaj P, Sharma P, Ambwani S, et al.

Expert Opin Drug Saf, 2021 Sep;20(9):1125-1136.
PMID: 34162299 DOI: 10.1080/14740338.2021.1946513

BACKGROUND: Elevated inflammatory cytokines in Coronavirus disease 2019 (COVID-19) affect the lungs leading to pneumonitis with a poor prognosis. Tocilizumab, a type of humanized monoclonal antibody antagonizing interleukin-6 receptors, is currently utilized to treat COVID-19. The present study reviews tocilizumab adverse drug events (ADEs) reported in the World Health Organization (WHO) pharmacovigilance database.
RESEARCH DESIGN AND METHODS: All suspected ADEs associated with tocilizumab between April to August 2020 were analyzed based on COVID-19 patients' demographic and clinical variables, and severity of involvement of organ system.
RESULTS: A total of 1005 ADEs were reported among 513 recipients. The majority of the ADEs (46.26%) were reported from 18-64 years, were males and reported spontaneously. Around 80%, 20%, and 64% were serious, fatal, and administered intravenously, respectively. 'Injury, Poisoning, and Procedural Complications' remain as highest (35%) among categorized ADEs. Neutropenia, hypofibrinogenemia were common hematological ADEs. The above 64 years was found to have significantly lower odds than of below 45 years. In comparison, those in the European Region have substantially higher odds compared to the Region of Americas.
CONCLUSION: Neutropenia, superinfections, reactivation of latent infections, hepatitis, and cardiac abnormalities were common ADEs observed that necessitate proper monitoring and reporting.
Fulltext The Incidence of Nasopharyngeal Carcinoma in Pahang State of Malaysia from 2012 to 2017

Ahmad A, Yassin WM, Rahman NAA, Leman WI, Rosla L, Paul M, et al.

Malays J Med Sci, 2021 Feb;28(1):66-74.
PMID: 33679222 DOI: 10.21315/mjms2021.28.1.9

Background: Nasopharyngeal carcinoma (NPC) is the fifth most common cancer among Malaysians. While several studies have reported the trend of NPC in other states in Malaysia, no studies have reported the trend of NPC in Pahang state. This study was designed to report the number and distribution of newly diagnosed NPC cases in Pahang.
Methods: NPC cases that were diagnosed between 2012 and 2017 in two referral hospitals in Pahang were traced. The crude incidence rate (CR) and age-standardised rate (ASR) were calculated to investigate the NPC incidence.
Results: There were 143 new cases of NPC reported from the two hospitals. The mean age at diagnosis was 52.0 ± 13.7 years old. The majority of cases involved males (74.1%) with a male to female ratio of 2.9:1. Chinese males were found to have the highest incidence with a mean ASR of 4.7 per 100,000 population. Overall, the mean ASR for Pahang was 2.4 per 100,000 population for males and 0.9 per 100,000 population for females.
Conclusion: The total number of NPC cases reveals an increasing trend from 2012 to 2014 and then a slightly decreasing trend from 2015 to 2017. The incidence of NPC in Pahang was intermediate in males and low in females.
Fulltext Self-medication of antibiotics: investigating practice among university students at the Malaysian National Defence University

Haque M, Rahman NAA, McKimm J, Kibria GM, Azim Majumder MA, Haque SZ, et al.

Infect Drug Resist, 2019;12:1333-1351.
PMID: 31190922 DOI: 10.2147/IDR.S203364

Background: Self-medication of drugs to alleviate symptoms is a common global behavior, helping relieve burdens on health services, but many drugs eg, antibiotics are prescription-only. Self-medication of antibiotics (SMA) is an irrational use of drugs, contributing to microbial resistance increasing health care costs and higher mortality and morbidity. This study aimed to assess SMA among university students. Methods: This was a cross-sectional study conducted among medical and non-medical students of the National Defence University of Malaysia. A validated instrument was used to gather data. Ethics approval was obtained. Random and universal sampling was adopted, and SPSS 21 was used for data analysis. Results: A total of 649 students participated in the study: 48.5% male and 51.5% female, 39.3% reported self-medicating with antibiotics. Penicillin, doxycycline, clarithromycin were the antibiotics most used with the majority reporting no adverse drug reactions. Cost savings and convenience were the principal reasons for SMA which were mainly obtained from local retail pharmacies. Despite medical students (particularly the more senior) having better knowledge of antibiotic use than non-medical students, 89% of all research participants responded that practicing SMA was a good/acceptable practice. Conclusion: SMA is common amongst Malaysian students and, despite understanding why SMA is unwise, even medical students self-medicate.