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Fulltext Rationale and design of a cluster randomized trial of a multifaceted intervention in people with hypertension: The Heart Outcomes Prevention and Evaluation 4 (HOPE-4) Study

Schwalm JR, McCready T, Lamelas P, Musa H, Lopez-Jaramillo P, Yusoff K, et al.

Am Heart J, 2018 09;203:57-66.
PMID: 30015069 DOI: 10.1016/j.ahj.2018.06.004

BACKGROUND: Cardiovascular disease is the leading cause of death throughout the world, with the majority of deaths occurring in low- and middle-income countries. Despite clear evidence for the benefits of blood pressure reduction and availability of safe and low-cost medications, most individuals are either unaware of their condition or not adequately treated.
OBJECTIVE: The primary objective of this study is to evaluate whether a community-based, multifaceted intervention package primarily provided by nonphysician health workers can improve long-term cardiovascular risk in people with hypertension by addressing identified barriers at the patient, health care provider, and health system levels.
METHODS/DESIGN: HOPE-4 is a community-based, parallel-group, cluster randomized controlled trial involving 30 communities (1,376 participants) in Colombia and Malaysia. Participants ≥50 years old and with newly diagnosed or poorly controlled hypertension were included. Communities were randomized to usual care or to a multifaceted intervention package that entails (1) detection, treatment, and control of cardiovascular risk factors by nonphysician health workers in the community, who use tablet-based simplified management algorithms, decision support, and counseling programs; (2) free dispensation of combination antihypertensive and cholesterol-lowering medications, supervised by local physicians; and (3) support from a participant-nominated treatment supporter (either a friend or family member). The primary outcome is the change in Framingham Risk Score after 12 months between the intervention and control communities. Secondary outcomes including change in blood pressure, lipid levels, and Interheart Risk Score will be evaluated.
SIGNIFICANCE: If successful, the study could serve as a model to develop low-cost, effective, and scalable strategies to reduce cardiovascular risk in people with hypertension.
Fulltext Infant & Child Mortality in Pakistan and its Determinants: A Review

Tharwani ZH, Bilal W, Khan HA, Kumar P, Butt MS, Hamdana AH, et al.

Inquiry, 2023;60:469580231167024.
PMID: 37085986 DOI: 10.1177/00469580231167024

Over the years, several developing countries have been suffering from high infant and child mortality rates, however, according to the recent statistics, Pakistan falls high on the list. Our narrative review of copious research on this topic highlights that several factors, such as complications associated with premature births, high prevalence of birth defects, lack of vaccination, unsafe deliveries, poor breastfeeding practices, complications during delivery, sudden infant death syndrome (SIDS), poor socioeconomic conditions, and a struggling healthcare system, have influenced these rates. Bearing in mind the urgency of addressing the increased infant and child mortality rate in Pakistan, multiple steps must be taken in order to prevent unnecessary deaths. An effective initiative could be spreading awareness and education among women, as a lack of education among women has been indirectly linked to increased child mortality in Pakistan across many researches conducted on the issue. Furthermore, the government should invest in healthcare by hiring more physicians and providing better supplies and improving infrastructure, especially in underdeveloped areas, to decrease child mortality due to lack of clean water and poor hygiene. Lastly, telemedicine should be made common in order to provide easy access to women who cannot visit the hospital.
Fulltext Monkeypox Virus and Other Emerging Outbreaks: An Overview and Future Perspective

Hamdana AH, Mohsin H, Habib Tharwani Z, Masood W, Furqana AQ, Sohail A, et al.

Inquiry, 2023;60:469580231175437.
PMID: 37190997 DOI: 10.1177/00469580231175437

Monkeypox (MPX) is a zoonotic disease caused by the MPX virus from the poxviridae family of orthopoxviruses. Typically, endemic in central and west Africa, it has now become a matter of concern since cases have been reported in non-endemic countries around mid-June 2022, especially in the European region, with the transmission not related to travel. The diagnosis is made by PCR testing of the skin lesions. Even though treatment is symptomatic, antiretrovirals, such as tecovirimat, are used in severe cases. Vaccination with second and third generation vaccines is approved for prophylaxis in high risk individuals. Unfortunately, these options of treatment and prevention are only available in high income countries at the moment. This review, through a thorough literature search of articles from 2017 onward, focuses on epidemiology, clinical manifestations, challenges, treatment, prevention and control of MPX virus and how they can be corelated with other viral outbreaks including COVID-19, Acute Hepatitis of unknown origin, Measles and Dengue, to better predict and therefore prevent its transmission. The previous COVID-19 pandemic increased the disease burden on healthcare infrastructure of low-middle income countries, therefore, this recent MPX outbreak calls for a joint effort from healthcare authorities, political figures, and NGOs to combat the disease and prevent its further spread not only in high income but also in middle- and low-income countries.
Fulltext Frequency, clinical characteristics and outcomes of Tropidolaemus species bite envenomations in Malaysia

Ismail AK, Abd Hamid MNH, Ariff NA, Frederic Ng VER, Goh WC, Abdul Samat NS, et al.

PLoS Negl Trop Dis, 2023 Jan;17(1):e0010983.
PMID: 36598885 DOI: 10.1371/journal.pntd.0010983

Pit vipers from the genus Tropidolaemus are identified as one of the common causes of snake bite from venomous species in Malaysia. All Tropidolaemus species bite cases referred to the Remote Envenomation Consultation Services (RECS) between 2015-2021 were included. A total of 4,718 snake-related injuries cases consulted to RECS with 310 (6.6%) involved Tropidolaemus species; of these 190 (61.3%) were T. subannulatus and 120 (38.7%) T. wagleri. All the T. subannulatus cases occurred in Sabah and Sarawak while all cases of T. wagleri occurred in Peninsular Malaysia. The majority of patients were male (74.8%) and adults between 18-59 years old (61.2%). The upper limb (56.6%) was the most frequent anatomical region involved. Most cases were non-occupationally related (75.4%). Bites from both species caused local pain (77.1%) and swelling (27.2%). Most patients complained of mild pain (48.0%). Paracetamol (40.0%) was the most common analgesic prescribed. Antivenom was not indicated in all cases. Two patients were given antivenom inappropriately before RECS consultation. Most patients (54.7%) needed hospital observation for less than 24 hours. No deaths occurred in the group studied.
Fulltext Author Correction: Insights into isotherms, kinetics, and thermodynamics of adsorption of acid blue 113 from an aqueous solution of nutraceutical industrial fennel seed spent

Taqui SN, Syed AA, Mubarak NM, Farade RA, Khan MAM, Kalam MA, et al.

Sci Rep, 2024 Jan 30;14(1):2474.
PMID: 38291216 DOI: 10.1038/s41598-024-53033-z
Fulltext Insights into isotherms, kinetics, and thermodynamics of adsorption of acid blue 113 from an aqueous solution of nutraceutical industrial fennel seed spent

Taqui SN, Syed AA, Mubarak NM, Farade RA, Khan MAM, Kalam MA, et al.

Sci Rep, 2023 Dec 19;13(1):22665.
PMID: 38114620 DOI: 10.1038/s41598-023-49471-w

Research studies have been carried out to accentuate Fennel Seed Spent, a by-product of the Nutraceutical Industry, as an inexpensive, recyclable and operational biosorbent for bioremediation of Acid Blue 113 (AB113) in simulated water-dye samples and textile industrial effluent (TIE). The physical process of adhesion of AB113 on the surface of the biosorbent depends on various parameters, such as the initial amount of the dye, amount and expanse of the biosorbent particles, pH of the solution and temperature of the medium. The data obtained was analyzed using three two-parameter and five three-parameter adsorption isotherm models to glean the adsorbent affinities and interaction mechanism of the adsorbate molecules and adsorbent surface. The adsorption feature study is conducted employing models of Weber-Morris, pseudo 1st and 2nd order, diffusion film model, Dumwald-Wagner and Avrami model. The study through 2nd order pseudo and Avrami models produced complementary results for the authentication of experimental data. The thermodynamic features, ΔG0, ΔH0, and ΔS0 of the adsorption process are acclaimed to be almost spontaneous, physical in nature and endothermic in their manifestation. Surface characterization was carried out using Scanner Electron Microscopy, and identification and determination of chemical species and molecular structure was performed using Infrared Spectroscopy (IR). Maximum adsorption evaluated using statistical optimization with different combinations of five independent variables to study the individual as well as combined effects by Fractional Factorial Experimental Design (FFED) was 236.18 mg g-1 under optimized conditions; pH of 2, adsorbent dosage of 0.500 g L-1, and an initial dye concentration of 209.47 mg L-1 for an adsorption time of 126.62 min with orbital shaking of 165 rpm at temperature 49.95 °C.
Graphene-edge-supported iron dual-atom for oxygen reduction electrocatalysts

Sumbowo JF, Ihsan FA, Fathurrahman F, Amalia N, Akbar FT, Yudistira HT, et al.

Phys Chem Chem Phys, 2023 Dec 06;25(47):32637-32647.
PMID: 38009535 DOI: 10.1039/d3cp03642a

Pyrolyzed Fe-N-C-based catalysts, particularly FeN4, are reported to show enhanced catalytic activity for some chemical reactions, particularly for the oxygen reduction reaction (ORR). Here, we present a computational study to investigate another pyrolyzed Fe-N-C-based catalyst, i.e. Fe2N6, adsorbed on graphene with special emphasis on the edges of graphene nanoribbons (both zig-zag and armchair configurations) as a candidate for Fe dual-atom catalysts (Fe-DACs). Utilizing density functional theory calculations along with microkinetic simulations, we investigate the influence of graphitic edges on the stability and ORR activity of Fe-DAC active sites. Our findings indicate that the presence of graphitic edges, particularly the zig-zag configuration, significantly lowers the formation energy of Fe-DAC active sites, making them more likely to form at the edges. Furthermore, several Fe-DAC active sites at graphitic edges exhibit exceptional ORR performance, surpassing the commonly employed FeN4 active site in SAC systems and even exceeding the benchmark Pt(111) surface. Notably, the (Fe2N6)o@z1 active site demonstrates outstanding performance in both associative and dissociative mechanisms. These results highlight the role of graphitic nanopores in enhancing the catalytic behavior of Fe-DAC active sites, providing valuable insights for designing efficient non-precious metal catalysts for ORR applications.
Evaluation of in vitro corrosion behavior and biocompatibility of poly[xylitol-(1,12-dodecanedioate)](PXDD)-HA coated porous iron for bone scaffolds applications

Md Yusop AH, Wan Ali WFF, Jamaludin FH, Szali Januddi F, Sarian MN, Saad N, et al.

Biotechnol J, 2024 Mar;19(3):e2300464.
PMID: 38509814 DOI: 10.1002/biot.202300464

The present study evaluates the corrosion behavior of poly[xylitol-(1,12-dodecanedioate)](PXDD)-HA coated porous iron (PXDD140/HA-Fe) and its cell-material interaction aimed for temporary bone scaffold applications. The physicochemical analyses show that the addition of 20 wt.% HA into the PXDD polymers leads to a higher crystallinity and lower surface roughness. The corrosion assessments of the PXDD140/HA-Fe evaluated by electrochemical methods and surface chemistry analysis indicate that HA decelerates Fe corrosion due to a lower hydrolysis rate following lower PXDD content and being more crystalline. The cell viability and cell death mode evaluations of the PXDD140/HA-Fe exhibit favorable biocompatibility as compared to bare Fe and PXDD-Fe scaffolds owing to HA's bioactive properties. Thus, the PXDD140/HA-Fe scaffolds possess the potential to be used as a biodegradable bone implant.
Fulltext The Effect of 4-hydroxybenzaldehyde on the γ-aminobutyric Acid Type A Receptor

Zhang J, Mohamad H, Wong JH, Bilal M, Ismail AHB, Lloyd AJ, et al.

Malays J Med Sci, 2017 Mar;24(2):94-99.
PMID: 28894409 DOI: 10.21315/mjms2017.24.2.12

The α1β2γ2 subtype of GABAA receptors is the most commonly found GABAA receptor subtype in the mammalian cortex and hippocampus. It is expressed heterologously in the Xenopus laevis oocyte as a α1β2γ2S/L subtype for application as an in vitro model for the screening of compounds that modulate receptor activities. In fact, 4-hydroxybenzaldehyde (4-HB) has been identified as one of the major components in Dendrocalamus asper bamboo shoots in our previous study, and the current study showed that at 101.7 μM, 4-HB significantly reduced the GABA-induced chloride current of GABAA receptors expressed on Xenopus oocytes, indicating a possible GABAergic antagonistic effect at high concentrations.
Fulltext Author Correction: A map of the extent and year of detection of oil palm plantations in Indonesia, Malaysia and Thailand

Danylo O, Pirker J, Lemoine G, Ceccherini G, See L, McCallum I, et al.

Sci Data, 2021 May 05;8(1):129.
PMID: 33953193 DOI: 10.1038/s41597-021-00917-8
Fulltext A map of the extent and year of detection of oil palm plantations in Indonesia, Malaysia and Thailand

Danylo O, Pirker J, Lemoine G, Ceccherini G, See L, McCallum I, et al.

Sci Data, 2021 03 30;8(1):96.
PMID: 33785753 DOI: 10.1038/s41597-021-00867-1

In recent decades, global oil palm production has shown an abrupt increase, with almost 90% produced in Southeast Asia alone. To understand trends in oil palm plantation expansion and for landscape-level planning, accurate maps are needed. Although different oil palm maps have been produced using remote sensing in the past, here we use Sentinel 1 imagery to generate an oil palm plantation map for Indonesia, Malaysia and Thailand for the year 2017. In addition to location, the age of the oil palm plantation is critical for calculating yields. Here we have used a Landsat time series approach to determine the year in which the oil palm plantations are first detected, at which point they are 2 to 3 years of age. From this, the approximate age of the oil palm plantation in 2017 can be derived.
Data on diet and growth by giant panda in zoo Negara, Malaysia

Yung DTC, Jani R, Azizi R, Ramli MN, Haidi Y, Zainudin AN, et al.

Data Brief, 2020 Apr;29:105082.
PMID: 31993462 DOI: 10.1016/j.dib.2019.105082

In this data article we present the determinations of the diet preference and growth of a pair of the giant panda, Ailuropoda melanoleuca (David, 1869) from Zoo Negara Malaysia. Once considered as endangered, the captive giant pandas were given with nine species of local bamboo in separate indoor enclosures. We recorded data between May 25, 2014 and December 31, 2016 and analysed it based on food preference, the pattern toward food consumption and body weights using SPSS v25.0 (IBM, USA). Data on the bamboo preference, daily average bamboo provided and consumed, and factors predicting of body weight per individual are reported in this article. The data highlight correlation between panda growth (kg) to the part of bamboo consumed (kg) and exhibit the pattern of preferred part of food (i.e.: either the leaf, culm or shoots of bamboo variety) for panda consumptions. The food consumption toward the body weight was modelled using logistic regression analysis to help determine the pattern of food consumption and body weight of giant panda in the future and based on regression model 1, only consumed variable is significance to the model.
Changing predominant SARS-CoV-2 lineages drives successive COVID-19 waves in Malaysia, February 2020 to March 2021

Sam IC, Chong YM, Abdullah A, Fu JYL, Hasan MS, Jamaluddin FH, et al.

J Med Virol, 2021 Nov 10.
PMID: 34757638 DOI: 10.1002/jmv.27441

Malaysia has experienced three waves of coronavirus disease 2019 (COVID-19) as of March 31, 2021. We studied the associated molecular epidemiology and SARS-CoV-2 seroprevalence during the third wave. We obtained 60 whole-genome SARS-CoV-2 sequences between October 2020 and January 2021 in Kuala Lumpur/Selangor and analyzed 989 available Malaysian sequences. We tested 653 residual serum samples collected between December 2020 to April 2021 for anti-SARS-CoV-2 total antibodies, as a proxy for population immunity. The first wave (January 2020) comprised sporadic imported cases from China of early Pango lineages A and B. The second wave (March-June 2020) was associated with lineage B.6. The ongoing third wave (from September 2020) was propagated by a state election in Sabah. It is due to lineage B.1.524 viruses containing spike mutations D614G and A701V. Lineages B.1.459, B.1.470, and B.1.466.2 were likely imported from the region and confined to Sarawak state. Direct age-standardized seroprevalence in Kuala Lumpur/Selangor was 3.0%. The second and third waves were driven by super-spreading events and different circulating lineages. Malaysia is highly susceptible to further waves, especially as alpha (B.1.1.7) and beta (B.1.351) variants of concern were first detected in December 2020/January 2021. Increased genomic surveillance is critical.
Fulltext Propolis efficacy on SARS-COV viruses: a review on antimicrobial activities and molecular simulations

Ghosh S, Al-Sharify ZT, Maleka MF, Onyeaka H, Maleke M, Maolloum A, et al.

Environ Sci Pollut Res Int, 2022 Aug;29(39):58628-58647.
PMID: 35794320 DOI: 10.1007/s11356-022-21652-6

This current study review provides a brief review of a natural bee product known as propolis and its relevance toward combating SARS-CoV viruses. Propolis has been utilized in medicinal products for centuries due to its excellent biological properties. These include anti-oxidant, immunomodulatory, anti-inflammatory, anti-viral, anti-fungal, and bactericidal activities. Furthermore, studies on molecular simulations show that flavonoids in propolis may reduce viral replication. While further research is needed to validate this theory, it has been observed that COVID-19 patients receiving propolis show earlier viral clearance, enhanced symptom recovery, quicker discharge from hospitals, and a reduced mortality rate relative to other patients. As a result, it appears that propolis could probably be useful in the treatment of SARS-CoV-2-infected patients. Therefore, this review sought to explore the natural properties of propolis and further evaluated past studies that investigated propolis as an alternative product for the treatment of COVID-19 symptoms. In addition, the review also highlights the possible mode of propolis action as well as molecular simulations of propolis compounds that may interact with the SARS-CoV-2 virus. The activity of propolis compounds in decreasing the impact of COVID-19-related comorbidities, the possible roles of such compounds as COVID-19 vaccine adjuvants, and the use of nutraceuticals in COVID-19 treatment, instead of pharmaceuticals, has also been discussed.
Fulltext Development, Testing, and Implementation of a Training Curriculum for Nonphysician Health Workers to Reduce Cardiovascular Disease

Khan M, Lamelas P, Musa H, Paty J, McCready T, Nieuwlaat R, et al.

Glob Heart, 2018 Jun;13(2):93-100.e1.
PMID: 29331282 DOI: 10.1016/j.gheart.2017.11.002

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide. The need to address CVD is greatest in low- and middle-income countries where there is a shortage of trained health workers in CVD detection, prevention, and control.
OBJECTIVES: Based on the growing evidence that many elements of chronic disease management can be shifted to nonphysician health care workers (NPHW), the HOPE-4 (Heart Outcomes Prevention and Evaluation Program) aimed to develop, test, and implement a training curriculum on CVD prevention and control in Colombia, Malaysia, and low-resource settings in Canada.
METHODS: Curriculum development followed an iterative and phased approach where evidence-based guidelines, revised blood pressure treatment algorithms, and culturally relevant risk factor counseling were incorporated. Through a pilot-training process with high school students in Canada, the curriculum was further refined. Implementation of the curriculum in Colombia, Malaysia, and Canada occurred through partner organizations as the HOPE-4 team coordinated the program from Hamilton, Ontario, Canada. In addition to content on the burden of disease, cardiovascular system pathophysiology, and CVD risk factors, the curriculum also included evaluations such as module tests, in-class exercises, and observed structured clinical examinations, which were administered by the local partner organizations. These evaluations served as indicators of adequate uptake of curriculum content as well as readiness to work as an NPHW in the field.
RESULTS: Overall, 51 NPHW successfully completed the training curriculum with an average score of 93.19% on module tests and 84.76% on the observed structured clinical examinations. Since implementation, the curriculum has also been adapted to the World Health Organization's HEARTS Technical Package, which was launched in 2016 to improve management of CVD in primary health care.
CONCLUSIONS: The robust curriculum development, testing, and implementation process described affirm that NPHW in diverse settings can be trained in implementing measures for CVD prevention and control.
Fulltext Targeted Photodynamic Therapy using a Vectorized Photosensitizer coupled to Folic Acid Analog induces Ovarian Tumor Cell Death and inhibits IL-6-mediated Inflammation

Boidin L, Moinard M, Moussaron A, Merlier M, Moralès O, Grolez GP, et al.

J Control Release, 2024 Jul;371:351-370.
PMID: 38789088 DOI: 10.1016/j.jconrel.2024.05.033

Ovarian cancer (OC) is one of the most lethal cancers among women. Frequent recurrence in the peritoneum due to the presence of microscopic tumor residues justifies the development of new therapies. Indeed, our main objective is to develop a targeted photodynamic therapy (PDT) treatment of peritoneal carcinomatosis from OC to improve the life expectancy of cancer patients. Herein, we propose a targeted-PDT using a vectorized photosensitizer (PS) coupled with a newly folic acid analog (FAA), named PSFAA, in order to target folate receptor alpha (FRα) overexpressed on peritoneal metastasis. This PSFAA was the result of the coupling of pyropheophorbide-a (Pyro-a), as the PS, to a newly synthesized FAA via a polyethylene glycol (PEG) spacer. The selectivity and the PDT efficacy of PSFAA was evaluated on two human OC cell lines overexpressing FRα compared to fibrosarcoma cells underexpressing FRα. Final PSFAA, including the synthesis of a newly FAA and its conjugation to Pyro-a, was obtained after 10 synthesis steps, with an overall yield of 19%. Photophysical properties of PSFAA in EtOH were performed and showed similarity with those of free Pyro-a, such as the fluorescence and singlet oxygen quantum yields (Φf = 0.39 and ΦΔ = 0.53 for free Pyro-a, and Φf = 0.26 and ΦΔ = 0.41 for PSFAA). Any toxicity of PSFAA was noticed. After light illumination, a dose-dependent effect on PS concentration and light dose was shown. Furthermore, a PDT efficacy of PSFAA on OC cell secretome was detected inducing a decrease of a pro-inflammatory cytokine secretion (IL-6). This new PSFAA has shown promising biological properties highlighting the selectivity of the therapy opening new perspectives in the treatment of a cancer in a therapeutic impasse.
Fulltext Acute lymphoblastic leukemia with clonal evolution due to delay in chemotherapy: A report of a case

Haidary AM, Saadaat R, Abdul-Ghafar J, Rahmani S, Noor S, Noor S, et al.

EJHaem, 2022 Aug;3(3):1013-1017.
PMID: 36051042 DOI: 10.1002/jha2.483

Clonal evolution in acute leukemias is one of the most important factors that leads to therapeutic failure and disease relapse. Delay in therapeutic intervention is one of the reasons that leads toward clonal evolution. In this report, we present a case of acute lymphoblastic leukemia in which therapeutic delay resulted in clonal evolution that was detected by conventional karyotyping and was responsible for non-responsiveness of the disease to conventional chemotherapy. A 17-year-old boy presented with generalized body aches, rapidly progressive pallor and lethargy. Bone marrow analysis was consistent with the diagnosis of B-cell ALL. Karyotypic analysis revealed 46, XY male karyotype. The patient left the hospital due to financial reasons and after 40 days came back to the hospital. Repeated bone marrow analysis including cytogenetic studies revealed presence of three different clones of blast cells: one clone showed 46, XY with del(9p) and t (11;14), second clone showed 46, XY with del(7q) and del(9p), and the third clone showed 46, XY normal karyotype. The patient did not respond to chemotherapy and died within 1 week of induction chemotherapy (HyperCVAD-A). Timely diagnosis and institution of chemotherapy in acute leukemias patients is the key to prevent clonal evolution and thus resistance of the disease to therapeutic interventions.
Fulltext Molecular detection of pathogens in ticks and fleas collected from companion dogs and cats in East and Southeast Asia

Nguyen VL, Colella V, Greco G, Fang F, Nurcahyo W, Hadi UK, et al.

Parasit Vectors, 2020 Aug 15;13(1):420.
PMID: 32799914 DOI: 10.1186/s13071-020-04288-8

BACKGROUND: Ticks and fleas are considered amongst the most important arthropod vectors of medical and veterinary concern due to their ability to transmit pathogens to a range of animal species including dogs, cats and humans. By sharing a common environment with humans, companion animal-associated parasitic arthropods may potentially transmit zoonotic vector-borne pathogens (VBPs). This study aimed to molecularly detect pathogens from ticks and fleas from companion dogs and cats in East and Southeast Asia.
METHODS: A total of 392 ticks and 248 fleas were collected from 401 infested animals (i.e. 271 dogs and 130 cats) from China, Taiwan, Indonesia, Malaysia, Singapore, Thailand, the Philippines and Vietnam, and molecularly screened for the presence of pathogens. Ticks were tested for Rickettsia spp., Anaplasma spp., Ehrlichia spp., Babesia spp. and Hepatozoon spp. while fleas were screened for the presence of Rickettsia spp. and Bartonella spp.
RESULT: Of the 392 ticks tested, 37 (9.4%) scored positive for at least one pathogen with Hepatozoon canis being the most prevalent (5.4%), followed by Ehrlichia canis (1.8%), Babesia vogeli (1%), Anaplasma platys (0.8%) and Rickettsia spp. (1%) [including Rickettsia sp. (0.5%), Rickettsia asembonensis (0.3%) and Rickettsia felis (0.3%)]. Out of 248 fleas tested, 106 (42.7%) were harboring at least one pathogen with R. felis being the most common (19.4%), followed by Bartonella spp. (16.5%), Rickettsia asembonensis (10.9%) and "Candidatus Rickettsia senegalensis" (0.4%). Furthermore, 35 Rhipicephalus sanguineus ticks were subjected to phylogenetic analysis, of which 34 ticks belonged to the tropical and only one belonged to the temperate lineage (Rh. sanguineus (sensu stricto)).
CONCLUSION: Our data reveals the circulation of different VBPs in ticks and fleas of dogs and cats from Asia, including zoonotic agents, which may represent a potential risk to animal and human health.
Human social conditions predict the risk of exposure to zoonotic parasites in companion animals in East and Southeast Asia

Colella V, Wongnak P, Tsai YL, Nguyen VL, Tan DY, Tong KBY, et al.

Commun Med (Lond), 2022 Nov 15;2(1):144.
PMID: 36380151 DOI: 10.1038/s43856-022-00210-8

BACKGROUND: A recent dramatic surge in pet ownership has been observed across metropolitan areas in Asia. To date, there is a dearth of information on the risk associated with pet ownership for the transmission of parasites on a large scale in Asia, despite this continent giving rise to the largest burden of zoonotic infections worldwide.
METHODS: We explored the nature and extent of zoonotic internal (endo-) and external (ecto-) parasites and arthropod-borne pathogens in 2381 client-owned dogs and cats living in metropolitan areas of eight countries in East and Southeast Asia using reliable diagnostic tests and then undertook extensive statistical analyses to define predictors of exposure to zoonotic pathogens.
RESULTS: The estimated ORs for overall parasite infections are 1.35 [95% CIs 1.07;1.71] in young animals and 4.10 [1.50;11.2] in the animal group older than 15 years as compared with adult animals, 0.61 [0.48;0.77] in neutered animals as compared to unneutered animals, 0.36 [0.26;0.50] in animals living in urban areas as compared with rural areas, 1.14 [1.08;1.21] for each 1 °C increase of annual mean temperature which varies from 12.0 to 28.0 °C, and 0.86 [0.78;0.95] for each year of life expectancy which varies from 70.9 to 83.3 years.
CONCLUSIONS: Here we highlight the influence of human life expectancy and the neutering status of the animals, which reflect increased living standards through access to education and human and veterinary health care, to be both strongly associated with exposure to zoonotic parasites. An integrated approach of local and international authorities to implement and manage educational programs will be crucial for the control of zoonotic infections of companion animals in Asia.
Fulltext Presentation of Breast Cancer and Impact of Patient Navigation on Timeliness of Diagnosis and Treatment and on Adherence to Treatment Recommendations in a Multicenter Network in Malaysia

Jaganathan M, Ang BH, Ali A, Sharif SZ, Mohamad M, Mohd Khairy A, et al.

JCO Glob Oncol, 2024 Mar;10:e2300297.
PMID: 38484197 DOI: 10.1200/GO.23.00297

PURPOSE: Breast cancer deaths disproportionately affect women living in low- and middle-income countries (LMICs). Patient navigation has emerged as a cost-effective and impactful approach to enable women with symptoms or suspicious mammogram findings to access timely diagnosis and patients with breast cancer to access timely and appropriate multimodality treatment. However, few studies have systematically evaluated the impact of patient navigation on timeliness of diagnosis and treatment in LMICs.
METHODS: We established a nurse- and community-navigator-led navigation program in breast clinics of four public hospitals located in Peninsular and East Malaysia and evaluated the impact of navigation on timeliness of diagnosis and treatment.
RESULTS: Patients with breast cancer treated at public hospitals reported facing barriers to accessing care, including having a poor recognition of breast cancer symptoms and low awareness of screening methods, and facing financial and logistics challenges. Compared with patients diagnosed in the previous year, patients receiving navigation experienced timely ultrasound (84.0% v 65.0%; P < .001), biopsy (84.0% v 78.0%; P = .012), communication of news (63.0% v 40.0%; P < .001), surgery (46% v 36%; P = .008), and neoadjuvant therapy (59% v 42%, P = .030). Treatment adherence improved significantly (98.0% v 87.0%, P < .001), and this was consistent across the network of four breast clinics.
CONCLUSION: Patient navigation improves access to timely diagnosis and treatment for women presenting at secondary and tertiary hospitals in Malaysia.

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