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Fulltext Elliptical metallic rings-shaped fractal metamaterial absorber in the visible regime

Bilal RMH, Saeed MA, Choudhury PK, Baqir MA, Kamal W, Ali MM, et al.

Sci Rep, 2020 Aug 20;10(1):14035.
PMID: 32820192 DOI: 10.1038/s41598-020-71032-8

Achieving the broadband response of metamaterial absorbers has been quite challenging due to the inherent bandwidth limitations. Herein, the investigation was made of a unique kind of visible light metamaterial absorber comprising elliptical rings-shaped fractal metasurface using tungsten metal. It was found that the proposed absorber exhibits average absorption of over 90% in the visible wavelength span of 400-750 nm. The features of perfect absorption could be observed because of the localized surface plasmon resonance that causes impedance matching. Moreover, in the context of optoelectronic applications, the absorber yields absorbance up to ~ 70% even with the incidence obliquity in the range of 0°-60° for transverse electric polarization. The theory of multiple reflections was employed to further verify the performance of the absorber. The obtained theoretical results were found to be in close agreement with the simulation results. In order to optimize the results, the performance was analyzed in terms of the figure of merit and operating bandwidth. Significant amount of absorption in the entire visible span, wide-angle stability, and utilization of low-cost metal make the proposed absorber suitable in varieties of photonics applications, in particular photovoltaics, thermal emitters and sensors.
Fulltext Functional Outcome and Complications in Management of Proximal Humerus Fractures Operated with Proximal Humerus Locking Plate

George PK, Dasgupta B, Bhaladhare SM, Reddy B, Jain A, Jogani AD

Malays Orthop J, 2021 Jul;15(2):47-54.
PMID: 34429822 DOI: 10.5704/MOJ.2107.008

Introduction: Controversies exist in treatment of proximal humerus fractures as treatment options vary greatly from conservative management, closed pinning, stacked intramedullary nails, plating and hemi-arthroplasty. The purpose of this study is to study the fracture patterns of each case and document the functional outcome and complications post-operative in the management of proximal humerus fractures operated with proximal humerus plate.
Material and Methods: Thirty five patients with closed proximal humerus fractures, above 18 years old, admitted in our tertiary care hospital during the study period were enrolled. Patients underwent open reduction internal fixation with proximal humerus locking plate under general anaesthesia. Post-operative patients were assessed using Constant and DASH scores. Complications were recorded.
Results: In our study the absolute Constant score of the study population increases at three months and six months and was found to be significant. Mean Constant score for 4-part fractures was 45.6 which were inferior as compared to 2-part and 3-part fractures (43.1 and 44.6, respectively). The mean Constant score at six months was 51.80 +/- 6.71. All three types of proximal humerus fractures showed significant improvement in the mean DASH score over our study period of six months and was found to be significant. Mean DASH score at six months was 27.97+/-12.84. Out of the 35 cases in the study two had complications. One had implant failure (Neer's type 3, 60-year-old female) and one had varus collapse (Neer's type 3, 45-year-old male).
Conclusion: Due to angular stability and effective maintenance of the intraoperative fracture reduction during follow-up period, early post-operative mobilisation is possible which helps the patient to attain better shoulder range of motion and return to activity faster.
Characteristics of ovarian malignancy in Bali province, Indonesia

Budiana ING, Prayudi PKA, Saspriyana KY, Darmayasa IM, Wiradnyana AAG, Suwiyoga K

Med J Malaysia, 2021 05;76(3):326-331.
PMID: 34031330

INTRODUCTION: The aim of this study was to describe the characteristics of ovarian cancer (OC) diagnosed in a tertiary referral centre in Bali, Indonesia, according to several risk factors.
MATERIALS AND METHODS: This is a descriptive retrospective study using data from the medical records of patients diagnosed with primary OC who underwent surgery at the Department of Obstetrics and Gynecology, Sanglah General Hospital Denpasar, Bali from January 2018 to December 2019.
RESULTS: A total of 94 OC or 19.4% from total gynecologic cancer (484 cases) were diagnosed. The characteristics of the majority of OC were as follows: 1. Socio demography: median age 46.5 years (interquartile range: 16.5) and 47.9% (45/94) had low educational level; 2. Hormonal factor: 48.9% (46/94) were multiparous, 59.6% (56/94) were premenopausal, and 97.9% (92/94) had never used oral contraceptive pills; 3. Genetic: all patients did not have a family history of ovarian cancer; 4. Clinical characteristics: 76.6% (72/94) with histologic type of epithelial tumors, 61.7% (58/94) with advanced stage, 74.5% (70/94) with unilateral tumor, and 44.7% (42/94) with mass sized 11-20 cm. In advanced OC, 63.8% (37/58) presented with ascites and omental carcinomatosis, 87.9% (51/58) without liver metastasis; and 5. Surgical outcome: 55.3% (52/94) underwent primary cytoreductive surgery and 78.8% (41/52) had suboptimal surgical outcome.
CONCLUSIONS: The characteristics of OC in the study population were different compared with the developed countries and the global population, i.e. the incidence of OC was most common among younger and premenopausal women. The majority of patients with advance OC had suboptimal surgical outcome.
Evaluation of Effectiveness of Two Different Endodontic Retreatment Systems in Removal of Gutta-percha: An in vitro Study

Raj PKT, Mudrakola DP, Baby D, Govindankutty RK, Davis D, Sasikumar TP, et al.

J Contemp Dent Pract, 2018 Jun 01;19(6):726-731.
PMID: 29959303

AIM: To determine the effectiveness of two different endodontic retreatment systems for the removal of laterally compacted gutta-percha (GP).
MATERIALS AND METHODS: Sixty-three freshly extracted human maxillary central incisors were used for the study. The teeth were instrumented with K-flex files and obturated using lateral condensation technique with GP and AH Plus sealer. The teeth were divided into three retreatment groups, each group consisting of 21 teeth. Group I: D-RaCe desobturation files (D-RaCe); group II: ProTaper Universal retreatment files (PTUR); group III: Hedstrom files (H-file). After removal of GP, the teeth were split longitudinally and divided into three equal parts: Cervical, middle, and apical third. The middle and apical thirds of all root halves were examined using scanning electron microscope (SEM). The total surface area covered by the residual debris was evaluated using Motic Image plus 2.0 software. Statistical analysis was done by one-way analysis of variance (ANOVA) test with a p-value <0.05 used to determine significance and Tukey's multiple post hoc tests used for comparison between the groups, and 't' test was done for comparison between the thirds within the same group.
RESULTS: The PTUR retreatment files showed overall better performance compared with D-RaCe files and H-files. The PTUR files performed better at middle third compared with others. The PTUR files and D-RaCe files performed equally at apical third better than H-files.
CONCLUSION: ProTaper retreatment files are better compared with D-RaCe files and H-files for the retreatment of the previously endodontically treated teeth.
CLINICAL SIGNIFICANCE: Highest efficacy for the removal of GP was shown by ProTaper Universal System followed by D-RaCe and H-file.
PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration

Nagendrababu V, Chong BS, McCabe P, Shah PK, Priya E, Jayaraman J, et al.

Int Endod J, 2020 Jul;53(7):922-947.
PMID: 32221975 DOI: 10.1111/iej.13300

Case reports play a key role in showcasing new, unusual or rare disease(s), and the impact of newer therapeutic approaches or interventions. The Preferred Reporting Items for Case reports in Endodontics (PRICE) 2020 guidelines are being introduced exclusively for Endodontics by adapting and integrating the CAse REport (CARE) guidelines and Clinical and Laboratory Images in Publications principles. The PRICE 2020 guidelines have been developed to help authors improve the completeness, accuracy and transparency of case reports in Endodontics and thus enhance the standard of manuscripts submitted for publication. The aim of this document is to provide a comprehensive explanation for each item in the PRICE 2020 checklist along with examples from the literature that demonstrate compliance with these guidelines. This information will highlight the importance of each item and provide practical examples to help authors understand the necessity of providing comprehensive information when preparing case reports. A link to this PRICE 2020 explanation and elaboration document is available on the Preferred Reporting Items for study Designs in Endodontology website at http://www.pride-endodonticguidelines.org.
Reassortment and evolutionary dynamics of tilapia lake virus genomic segments

Verma DK, Sood N, Paria A, Swaminathan TR, Mohan CV, Rajendran KV, et al.

Virus Res, 2021 Nov 12;308:198625.
PMID: 34780882 DOI: 10.1016/j.virusres.2021.198625

The tilapia lake virus (TiLV), a highly infectious negative-sense single-stranded segmented RNA virus, has caused several outbreaks worldwide since its first report from Israel in 2014, and continues to pose a major threat to the global tilapia industry. Despite its economic importance, little is known about the underlying mechanisms in the genomic evolution of this highly infectious viral pathogen. Using phylogenomic approaches to the genome sequences of TiLV isolates from various geographic regions, we report on the pervasive role of reassortment, selection, and mutation in TiLV evolution. Our findings provided the evidence of genome-wide reassortment in this newly discovered RNA virus. The rate of non-synonymous (dN) to synonymous (dS) substitutions was less than one (dN/dS = 0.076 to 0.692), indicating that each genomic segment has been subjected to purifying selection. Concurrently, the rate of nucleotide substitution for each genomic segment was in the order of 1-3 × 10-3 nucleotide substitutions per site per year, which is comparable to the rate of other RNA viruses. Collectively, in line with the results of the previous studies, our results demonstrated that reassortment is the dominant force in the evolution and emergence of this highly infectious segmented RNA virus.
Fulltext Mapping sustainability reporting research with the UN's sustainable development goal

Raman R, Nair VK, Shivdas A, Bhukya R, Viswanathan PK, Subramaniam N, et al.

Heliyon, 2023 Aug;9(8):e18510.
PMID: 37576319 DOI: 10.1016/j.heliyon.2023.e18510

Non-financial reporting (NFR) has become crucial to corporate sustainability strategies as companies demonstrate their commitment to the environmental, social, and governance actions outlined in the United Nations Sustainable Development Goals (SDGs) Agenda 2030. Among the various mandatory NFR initiatives, Sustainability Reporting (SR) has emerged as a widely adopted practice by companies worldwide. A gap that the study addresses is the theoretical perspectives on SR in the context of SDG. Then we conduct a bibliometric and science mapping analysis of research trends on SR and precisely map SR research to SDGs which is also a gap in the current literature. We find an exponential increase in the number of publications and citations on SR, particularly after 2015, which coincides with increased public awareness and scrutiny of the SDGs. At the country level, Australia leads with a total of 13 SDGs, followed by the UK, Spain, and Italy, which each address 12 SDGs. Emerging economies such as Indonesia, Malaysia, and India have also increased their contributions since 2019. A keyword co-occurrence analysis identified three main clusters: stakeholder engagement, corporate governance, and accountability; sustainable development goals and climate change; and sustainability reporting and global reporting initiatives. All three clusters had highly cited publications related to SDG 8 (decent work), SDG 9 (industry innovation), and SDG 12 (responsible consumption). This highlights the interdisciplinary nature of SR and its relevance to multiple SDGs. The study is distinctive in that we utilized social network analysis to examine the SDG network based on SR publications, which also affirmed the centrality of SDG 9 and 12. We utilized the prominence percentile, which indicates the momentum of a particular topic, to identify future topics in SR that align with the SDGs. These include cause-related marketing, environmentally preferable purchasing decisions, environmental management systems, education for sustainability, and green computing.
Bisphenol A (BPA) toxicity assessment and insights into current remediation strategies

Ighalo JO, Kurniawan SB, Khongthaw B, Buhari J, Chauhan PK, Georgin J, et al.

RSC Adv, 2024 Oct 29;14(47):35128-35162.
PMID: 39529868 DOI: 10.1039/d4ra05628k

Bisphenol A (BPA) raises concerns among the scientific community as it is one of the most widely used compounds in industrial processes and a component of polycarbonate plastics and epoxy resins. In this review, we discuss the mechanism of BPA toxicity in food-grade plastics. Owing to its proliferation in the aqueous environment, we delved into the performance of various biological, physical, and chemical techniques for its remediation. Detailed mechanistic insights into these removal processes are provided. The toxic effects of BPA unravel as changes at the cellular level in the brain, which can result in learning difficulties, increased aggressiveness, hyperactivity, endocrine disorders, reduced fertility, and increased risk of dependence on illicit substances. Bacterial decomposition of BPA leads to new intermediates and products with lower toxicity. Processes such as membrane filtration, adsorption, coagulation, ozonation, and photocatalysis have also been shown to be efficient in aqueous-phase degradation. The breakdown mechanism of these processes is also discussed. The review demonstrates that high removal efficiency is usually achieved at the expense of high throughput. For the scalable application of BPA degradation technologies, removal efficiency needs to remain high at high throughput. We propose the need for process intensification using an integrated combination of these processes, which can solve multiple associated performance challenges.
Fulltext The occurrence of dihydrofolate reductase (DHFR) point mutation (SER-108-->ASN-108) in Malaysian isolates of Plasmodium falciparum

Lim PK, Tan SK, Khoo AS, Noor Rain A, Nagappan S, Mak JW

Southeast Asian J Trop Med Public Health, 1998 Mar;29(1):27-30.
PMID: 9740263
Diffusion-in-gel enzyme-linked immunosorbent assay, ELISA and IFA test in the detection of malarial antibodies

Kumar GS, Mak JW, Lam PL, Tan MA, Lim PK

Southeast Asian J Trop Med Public Health, 1987 Dec;18(4):502-6.
PMID: 3129797

Malarial antibodies in 80 patients were measured using the diffusion-in-gel enzyme linked immunosorbent assay (DIG-ELISA), enzyme-linked immunosorbent assay (ELISA) and the indirect fluorescent antibody (IFA) test. Good correlations were obtained between all three tests in terms of sensitivity and reliability. DIG-ELISA has the advantage of being a rapid diagnostic tool for the detection of malarial antibodies.
Fulltext Epidemiology and control of malaria in Malaysia

Mak JW, Jegathesan M, Lim PK, Hakim SL, Rain AN, Ambu S, et al.

Southeast Asian J Trop Med Public Health, 1992 Dec;23(4):572-7.
PMID: 1298064

In spite of more than 30 years of control activities, malaria continues to be the most important parasitic infection in Malaysia, accounting for 39,189 confirmed cases in 1991, giving an annual parasite incidence rate of 2.2 per 1,000 population. Some factors contributing to the continued transmission of malaria are the development of drug resistant Plasmodium falciparum, changes in vector behavior, and ecological changes due to socio-economic reasons. Malaria parasite rates are higher among the Aborigines, land scheme settlers and those in intimate contact with the jungle, like loggers. There has been no substantial change in the proportion of the three common malaria species responsible for infections, P. falciparum, P. vivax, P. malariae and mixed infections accounting for about 70%, 28%, 1% and 1%, respectively of all infections. Drug resistant P. falciparum is unevenly distributed in Malaysia, but based on clinical experience and in vitro drug sensitivity studies, chloroquine resistance is frequently encountered. There has been clinical and laboratory evidence of resistance to sulfadoxine/pyrimethamine combination as well as quinine, but all these have so far been successfully treated with a combination of quinine and tetracycline. The eradication of the disease is impossible in the near future but there is confidence that with better surveillance techniques and the use of alternative control measures like permethrin impregnated bed-nets to complement existing ones, the target of bringing down the annual parasite incidence to 2 per 1,000 population during the Sixth Malaysian Plan period (1991-1995) can be achieved.
Replication of 13 obesity loci among Singaporean Chinese, Malay and Asian-Indian populations

Dorajoo R, Blakemore AI, Sim X, Ong RT, Ng DP, Seielstad M, et al.

Int J Obes (Lond), 2012 Jan;36(1):159-63.
PMID: 21544081 DOI: 10.1038/ijo.2011.86

Recent genome-wide association studies (GWAS) have identified 38 obesity-associated loci among European populations. However, their contribution to obesity in other ethnicities is largely unknown.
Surface properties of Indonesian-made narrow dynamic compression plates

Dewo P, Sharma PK, van der Tas HF, van der Houwen EB, Timmer M, Magetsari R, et al.

Med J Malaysia, 2008 Jul;63 Suppl A:21-2.
PMID: 19024964

The enormous need of orthopaedic (surgical) implants such as osteosynthesis plates is difficult to be fulfilled in developing countries commonly rely on imported ones. One of the alternatives is utilization of local resources, but only after they have been proven safe to use, to overcome this problem. Surface properties are some of the determining factors of safety for those implants. We have succeeded in developing prototype of osteosynthesis plate and the results indicate that Indonesian-made plates need improvement with regards to the surface quality of physical characterization.
A study of work injuries in eight Asian countries

Ong CN, Phoon WO, Tan TC, Jeyaratnam J, Cho SC, Suma'mur PK, et al.

Ann Acad Med Singap, 1984 Apr;13(2 Suppl):429-34.
PMID: 6497348

This study is based on a survey conducted in Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore, Sri Lanka and Thailand on occupational injuries during the years 1975-1980. The number of work accidents have risen rapidly during this period in all of the 8 countries studied. In the case of Thailand, the total number of work injuries increased four fold from 1975-1978, whereas, in Singapore it has almost doubled in 6 years. The number of permanent disablement nearly trebled in Korea, and the Philippines for the year 1967-1980. The largest percentage of accidents are lost-time injuries in all of the 8 countries. Thailand had a three fold increase in lost-time injuries whilst in Hong Kong the figure doubled. Six out of the 8 countries indicated that the building construction industry had the largest number of fatal accidents, followed by the manufacturing industry.
The effect of diethylcarbamazine citrate on incidence and recovery rates of Brugia malayi microfilaremia in Sabah, Malaysia

Hiil JL, Kan SK, Parmar SS, Chan MK, Mak JW, Lim PK, et al.

Am J Trop Med Hyg, 1988 May;38(3):582-8.
PMID: 3275137

Mass drug administration via 3 modes of delivery reduced the incidence and prevalence rates and intensity of Brugia malayi infection in 3 rural villages in the Bengkoka Peninsula, Sabah, in 1982-1983. A dosage of 6 mg diethylcarbamazine citrate (DEC-C)/kg body weight was administered either daily or weekly (total of 6 doses, 36 mg/kg body weight), and impact on B. malayi cases were comparable in the 3 villages. A total of 384 people participated in the DEC-C regimens, and all pregnant women and children under 2 years were excluded from the study. Bekessy's method of estimation of incidence and recovery rates was applied to data on B. malayi microfilaremia before drug administration. Treatment with DEC-C by any of the 3 modes of delivery drastically reduced the number of episodes of patent microfilaremia, incidence and prevalence, and median microfilarial density. Reduction was sustained for at least 18 to 24 months after treatment.
Parasites in soil samples from Signy island, Antarctica

Lim PKC, Lee XC, Mohd Nazmi NMA, Tang YY, Wong SF, Mak JW, et al.

Trop Biomed, 2018 Dec 01;35(4):1007-1016.
PMID: 33601848

Studies on parasite populations in Antarctic soils are scarce and thus little is known about the threat of these parasites towards either the natural fauna or human visitors. However, human presence in Antarctica, mainly through research and tourism, keeps increasing over time, potentially exposing visitors to zoonotic infections from Antarctic wildlife and environment. Most available literature to date has focused on faecal samples from Antarctic vertebrates. Therefore, this study addressed the possible presence of parasites in Antarctic soil that may be infectious to humans. Soil samples were obtained from five locations on Signy Island (South Orkney Islands, maritime Antarctic), namely North Point and Gourlay Peninsula (penguin rookeries), Pumphouse (relic coal-powered pump house), Jane Col (barren high altitude fellfield) and Berntsen Point (low altitude vegetated fellfield close to current research station). Approximately 10% of the soil samples (14/135) from 3 out of the 5 study sites had parasites which included Diphyllobotridae spp. eggs, Cryptosporidium sp., an apicomplexan protozoa (gregarine), Toxoplasma gondii, helminths (a cestode, Tetrabothrius sp., and a nematode larva) and mites. The presence of parasites in the 3 sites are most likely due to the presence of animal and human activities as two of these sites are penguin rookeries (North Point and Gourlay Peninsula) while the third site (Pumphouse Lake) has human activity. While some of the parasite species found in the soil samples appear to be distinctive, there were also parasites such as Cryptosporidium and Toxoplasma gondii that have a global distribution and are potentially pathogenic.
Bioefficacy Evaluation of Commercial Mosquito Coils Containing Metofluthrin, d-Allethrin, d-Trans Allethrin, and Prallethrin Against Aedes albopictus (Diptera: Culicidae) in Malaysia

Chen CD, Chin AC, Lau KW, Low VL, Lee HL, Lee PKY, et al.

J Med Entomol, 2018 10 25;55(6):1651-1655.
PMID: 30085203 DOI: 10.1093/jme/tjy130

The bioefficacy of commercial mosquito coils containing four different active ingredients, namely metofluthrin, d-allethrin, d-trans allethrin, and prallethrin against Aedes albopictus (Skuse) (Diptera: Culicidae) from 10 states in Malaysia, was evaluated using the glass chamber method. In this study, Ae. albopictus exhibited various knockdown rates (50% knockdown time, KT50), ranging from 2.50 to 5.00 min, 2.50 to 7.00 min, 3.00 to 8.00 min, and 5.00 to 17.00 min for metofluthrin, d-trans allethrin, d-allethrin, and prallethrin, respectively. Overall, all strains of Ae. albopictus were most susceptible to metofluthrin, with mortality rates >80%. On the other hand, mortality rates ranging from 5.0 to 100% were observed from all populations exposed to d-trans allethrin, d-allethrin, and prallethrin. In addition, significant correlations between KT50 of metofluthrin and d-allethrin (r = 0.758, P = 0.011), metofluthrin and prallethrin (r = 0.676, P = 0.032), d-allethrin and d-trans allethrin (r = 0.832, P = 0.003), d-allethrin and prallethrin (r = 0.921, P = 0.000), and d-trans allethrin with prallethrin (r = 0.941, P = 0.000) were detected, suggesting some levels of cross-resistance within the pyrethroid insecticides. This study demonstrated that metofluthrin can induce high insecticidal activity in Ae. albopictus in Malaysia, followed by d-trans allethrin, d-allethrin, and prallethrin.
PRICE 2020 guidelines for reporting case reports in Endodontics: a consensus-based development

Nagendrababu V, Chong BS, McCabe P, Shah PK, Priya E, Jayaraman J, et al.

Int Endod J, 2020 May;53(5):619-626.
PMID: 32090342 DOI: 10.1111/iej.13285

Case reports can provide early information about new, unusual or rare disease(s), newer treatment strategies, improved therapeutic benefits and adverse effects of interventions or medications. This paper describes the process that led to the development of the Preferred Reporting Items for Case reports in Endodontics (PRICE) 2020 guidelines through a consensus-based methodology. A steering committee was formed with eight members (PD, VN, BC, PM, PS, EP, JJ and SP), including the project leaders (PD, VN). The steering committee developed an initial checklist by combining and modifying the items from the Case Report (CARE) guidelines and Clinical and Laboratory Images in Publications (CLIP) principles. A PRICE Delphi Group (PDG) and PRICE Face-to-Face Meeting Group (PFMG) were then formed. The members of the PDG were invited to participate in an online Delphi process to achieve consensus on the wording and utility of the checklist items and the accompanying flow chart that was created to complement the PRICE 2020 guidelines. The revised PRICE checklist and flow chart developed by the online Delphi process was discussed by the PFMG at a meeting held during the 19th European Society of Endodontology (ESE) Biennial Congress in Vienna, Austria, in September 2019. Following the meeting, the steering committee created a final version of the guidelines, which were piloted by several authors during the writing of a case report. In order to help improve the clarity, completeness and quality of case reports in Endodontics, we encourage authors to use the PRICE 2020 guidelines.
Valorization of food waste and poultry manure through co-composting amending saw dust, biochar and mineral salts for value-added compost production

Ravindran B, Karmegam N, Awasthi MK, Chang SW, Selvi PK, Balachandar R, et al.

Bioresour Technol, 2022 Feb;346:126442.
PMID: 34848334 DOI: 10.1016/j.biortech.2021.126442

The present study proposes a system for co-composting food waste and poultry manure amended with rice husk biochar at different doses (0, 3, 5, 10%, w/w), saw dust, and salts. The effect of rice husk biochar on the characteristics of final compost was evaluated through stabilization indices such as electrical conductivity, bulk density, total porosity, gaseous emissions and nitrogen conservation. Results indicated that when compared to control, the biochar amendment extended the thermophilic stage of the composting, accelerated the biodegradation and mineralization of substrate mixture and helped in the maturation of the end product. Carbon dioxide, methane and ammonia emissions were reduced and the nitrogen conservation was achieved at a greater level in the 10% (w/w) biochar amended treatments. This study implies that the biochar and salts addition for co-composting food waste and poultry manure is beneficial to enhance the property of the compost.
Suction rectal biopsy (SRB) in Hirschsprung's Disease: Is a single macroscopically adequate sample sufficient?

Bal PK, Nah SA, Wan Mohamad Noor WMR, Md Nor MT, Singaravel S, Tan WS, et al.

Malays J Pathol, 2023 Dec;45(3):457-462.
PMID: 38155386

Hirschsprung's Disease (HD) is a congenital disorder causing severe constipation in infants and children. Suction rectal biopsy (SRB) is the preferred technique for obtaining tissue samples for histopathological evaluation. In low-resource settings like Malaysia, cost-effective diagnostic approaches are necessary, making single sample SRB valuable. This study evaluates the diagnostic accuracy and sufficiency of a single macroscopically adequate sample in suction rectal biopsies for the histopathological confirmation of HD. We conducted a retrospective study of children who underwent suction rectal biopsies for the diagnosis of HD at Hospital Raja Perempuan Zainab II (HRPZII), Kota Bharu, Kelantan. A total of 68 patients were included in the study. The inadequacy rate for bedside SRB was 14%, comparable to current literature. Our study found no statistically significant association between sample inadequacy and gestational age, gender, birth weight, or weight at biopsy. Complication rates were 0%, consistent with literature reports. Calretinin staining, an additional technique, was performed in 23 biopsy episodes, with a 4.3% inadequacy rate, compared to 20% in specimens not subjected to calretinin staining. The cost of SRB almost doubled with each additional sample taken, significant in low-resource environments. In conclusion, single sample SRBs can be adequately diagnostic and cost-effective in low-resource settings, providing valuable insights for healthcare facilities in Malaysia and other developing countries. The use of adjunctive techniques such as calretinin staining may improve diagnostic accuracy while maintaining cost-effectiveness. Further prospective studies with larger sample sizes are needed to validate these findings.

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