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The nasocardiac reflex during nasoendoscopy: A commonly overlooked risk

Wong A, Abu Bakar MZ

Am J Otolaryngol, 2021 01 04;42(2):102869.
PMID: 33429183 DOI: 10.1016/j.amjoto.2020.102869

PURPOSE: The nasocardiac reflex is known but not well researched. We aimed to ascertain the electrocardiographic features of the reflex and to chronologically map the heart rhythm dynamics during nasoendoscopy. We also intended to identify variables that could potentially affect the occurrence of this reflex.
MATERIAL AND METHODS: A prospective, quasi-experimental physiological study. Selected healthy subjects were observed electrocardiographically for 60 s continuously in three equal phases of 20 s each - baseline phase, nasoendoscopic phase, and recovery phase (post-nasoendoscopy). Heart rate fluctuations were charted, followed by identification of a positive nasocardiac reflex group of subjects and a negative group. Analyses against multiple variables were done.
RESULTS: A total of 53 subjects were analysed. Heart rate during the baseline phase was 81.0 ± 9.9, nasoendoscopic phase was 72.7 ± 10.1, and recovery phase was 75.2 ± 9.6. Sixteen subjects (30.2%) had a positive nasocardiac reflex, and they remained in sinus rhythm with no occurrences of skipped beats, atrioventricular blocks or asystoles. One subject (1.9%) developed temporary ectopic premature ventricular contractions after nasoendoscopy. No variables were found affecting the incidence of a nasocardiac reflex in our study.
CONCLUSIONS: The pattern of heart rate dynamics was consistent as heart rates drop rapidly upon endoscope insertion and recover in some measure after its withdrawal. Although all our subjects remained asymptomatic, clinicians should not overlook the risks of a severe nasocardiac reflex when performing nasoendoscopy. We recommend that electrical cardiac monitoring be part of the management of vasovagal responses during in-office endonasal procedures.
Correlation between subjective and objective voice analysis pre- and post-shift among teleoperators in a tertiary hospital

Rahman M, Saniasiaya J, Abu Bakar MZ

J Laryngol Otol, 2023 Jul;137(7):789-793.
PMID: 36444560 DOI: 10.1017/S0022215122002493

OBJECTIVE: Teachers and singers have been extensively studied and are shown to have a greater tendency to voice disorders. This study aimed to investigate the correlation between subjective and objective voice analysis pre- and post-shift among teleoperators in a tertiary hospital.
METHODS: This was a prospective cohort study. Each patient underwent pre- and post-shift voice analysis.
RESULTS: Among 42 teleoperators, 28 patients (66.7 per cent) completed all the tests. Female predominance (62 per cent) was noted, with a mean age of 40 years. Voice changes during working were reported by 48.1 per cent. Pre- and post-shift maximum phonation time (p < 0.018) and Voice Handicap Index-10 (p < 0.011) showed significant results with no correlation noted between subjective and objective assessment.
CONCLUSION: Maximum phonation time and Voice Handicap Index-10 are good voice assessment tools. The quality of evidence is inadequate to recommend 'gold standard' voice assessment until a better-quality study has been completed.
Thermocatalytic treatment of biomass tar model compounds via radio frequency

Anis S, Zainal ZA, Bakar MZ

Bioresour Technol, 2013 May;136:117-25.
PMID: 23567671 DOI: 10.1016/j.biortech.2013.02.049

A new effective RF tar thermocatalytic treatment process with low energy intensive has been proposed to remove tar from biomass gasification. Toluene and naphthalene as biomass tar model compounds were removed via both thermal and catalytic treatment over a wide temperature range from 850 °C to 1200 °C and 450 °C to 900 °C, respectively at residence time of 0-0.7 s. Thermal characteristics of the new technique are also described in this paper. This study clearly clarified that toluene was much easier to be removed than naphthalene. Soot was found as the final product of thermal treatment of the tar model and completely removed during catalytic treatment. Radical reactions generated by RF non-thermal effect improve the tar removal. The study showed that Y-zeolite has better catalytic activity compared to dolomite on toluene and naphthalene removal due to its acidic nature and large surface area, even at lower reaction temperature of about 550 °C.
Combustion of chlorinated volatile organic compounds (VOCs) using bimetallic chromium-copper supported on modified H-ZSM-5 catalyst

Abdullah AZ, Bakar MZ, Bhatia S

J Hazard Mater, 2006 Feb 28;129(1-3):39-49.
PMID: 16310938

The paper reports on the performance of chromium or/and copper supported on H-ZSM-5(Si/Al = 240) modified with silicon tetrachloride (Cr1.5/SiCl4-Z, Cu1.5/SiCl4-Z and Cr1.0Cu0.5/SiCl4-Z) as catalysts in the combustion of chlorinated VOCs (Cl-VOCs). A reactor operated at a gas hourly space velocity (GHSV) of 32,000 h(-1), a temperature between 100 and 500 degrees C with 2500 ppm of dichloromethane (DCM), trichloromethane (TCM) and trichloroethylene (TCE) is used for activity studies. The deactivation study is conducted at a GHSV of 3800 h(-1), at 400 degrees C for up to 12 h with a feed concentration of 35,000 ppm. Treatment with silicon tetrachloride improves the chemical resistance of H-ZSM-5 against hydrogen chloride. TCM is more reactive compared to DCM but it produces more by-products due to its high chlorine content. The stabilization of TCE is attributed to resonance effects. Water vapor increases the carbon dioxide yield through its role as hydrolysis agent forming reactive carbocations and acting as hydrogen-supplying agent to suppress chlorine-transfer reactions. The deactivation of Cr1.0Cu0.5/SiCl4-Z is mainly due to the chlorination of its metal species, especially with higher Cl/H feed. Coking is limited, particularly with DCM and TCM. In accordance with the Mars-van Krevelen model, the weakening of overall metal reducibility due to chlorination leads to a loss of catalytic activity.
Fulltext Dietary (n-6 : n-3) fatty acids alter plasma and tissue fatty acid composition in pregnant Sprague Dawley rats

Kassem AA, Abu Bakar MZ, Yong Meng G, Mustapha NM

ScientificWorldJournal, 2012;2012:851437.
PMID: 22489205 DOI: 10.1100/2012/851437

The objective of this paper is to study the effects of varying dietary levels of n-6 : n-3 fatty acid ratio on plasma and tissue fatty acid composition in rat. The treatment groups included control rats fed chow diet only, rats fed 50% soybean oil (SBO): 50% cod liver oil (CLO) (1 : 1), 84% SBO: 16% CLO (6 : 1), 96% SBO: 4% CLO (30 : 1). Blood samples were taken at day 15 of pregnancy, and the plasma and tissue were analyzed for fatty acid profile. The n-3 PUFA in plasma of Diet 1 : 1 group was significantly higher than the other diet groups, while the total n-6 PUFA in plasma was significantly higher in Diet 30 : 1 group as compared to the control and Diet 1 : 1 groups. The Diet 1 : 1 group showed significantly greater percentages of total n-3 PUFA and docosahexaenoic acid in adipose and liver tissue, and this clearly reflected the contribution of n-3 fatty acids from CLO. The total n-6 PUFA, linoleic acid, and arachidonic acid were significantly difference in Diet 30 : 1 as compared to Diet 1 : 1 and control group. These results demonstrated that the dietary ratio of n-6 : n-3 fatty acid ratio significantly affected plasma and tissue fatty acids profile in pregnant rat.
Post-traumatic brain injury olfactory dysfunction: factors influencing quality of life

Ahmedy F, Mazlan M, Danaee M, Abu Bakar MZ

Eur Arch Otorhinolaryngol, 2020 May;277(5):1343-1351.
PMID: 32025786 DOI: 10.1007/s00405-020-05823-0

PURPOSE: To evaluate if and how post-traumatic brain injury (TBI) olfactory dysfunction affects the quality of life (QoL).
METHODS: In this case-control observational study, 32 adults with post-TBI olfactory dysfunction (cases) were matched with 32 TBI patients with intact olfactory function (controls). All subjects self-rated their olfactory function using the Visual Analogue Scale (VAS). Cases also underwent objective olfactory function assessment with the Sniffin' Sticks test, which generated a Threshold, Discrimination, and Identification (TDI) score. QoL was assessed with the Questionnaire for Olfactory Disorders (QOD). Factors evaluated included age, gender, smoking, TBI severity and duration, lesion localisation, and Disability Rating Scale (DRS) score.
RESULTS: Cases had a higher mean QOD score than controls at 26.31 ± 14.37 and 9.44 ± 8.30, respectively (F = 16.426, p
Computed tomography analysis of the anterior ethmoid genu of the frontal recess in non-diseased sinuses

Raman K, Govindaraju R, James K, Abu Bakar MZ, Patil N, Shah MN

J Laryngol Otol, 2023 Feb;137(2):169-173.
PMID: 34924062 DOI: 10.1017/S0022215121004175

OBJECTIVE: Knowledge of anatomical variations of the frontal recess and frontal sinus and recognition of endoscopic landmarks are vital for safe and effective endoscopic sinus surgery. This study revisited an anatomical landmark in the frontal recess that could serve as a guide to the frontal sinus.
METHOD: Prevalence of the anterior ethmoid genu, its morphology and its relationship with the frontal sinus drainage pathway was assessed. Computed tomography scans with multiplanar reconstruction were used to study non-diseased sinonasal complexes.
RESULTS: The anterior ethmoidal genu was present in all 102 anatomical sides studied, independent of age, gender and race. Its position was within the frontal sinus drainage pathway, and the drainage pathway was medial to it in 98 of 102 cases. The anterior ethmoidal genu sometimes extended laterally and formed a recess bounded by the lamina papyracea laterally, by the uncinate process anteriorly and by the bulla ethmoidalis posteriorly. Distance of the anterior ethmoidal genu to frontal ostia can be determined by the height of the posterior wall of the agger nasi cell rather than its volume or other dimensions.
CONCLUSION: This study confirmed that the anterior ethmoidal genu is a constant anatomical structure positioned within frontal sinus drainage pathway. The description of anterior ethmoidal genu found in this study explained the anatomical connection between the agger nasi cell, uncinate process and bulla ethmoidalis and its structural organisation.
Valproate-induced reversible sensorineural hearing loss: a case report with serial audiometry and pharmacokinetic modelling during a valproate rechallenge

Yeap LL, Lim KS, Lo YL, Bakar MZ, Tan CT

Epileptic Disord, 2014 Sep;16(3):375-9.
PMID: 25167568 DOI: 10.1684/epd.2014.0671

Hearing loss has been reported with valproic acid (VPA) use. However, this is the first case of VPA-induced hearing loss that was tested and confirmed with a VPA rechallenge, supported by serial audiometry and pharmacokinetic modelling. A 39-year-old truck driver with temporal lobe epilepsy was treated with VPA at 400 mg, twice daily, and developed hearing loss after each dose, but recovered within three hours. Hearing loss fully resolved after VPA discontinuation. Audiometry performed five hours after VPA rechallenge showed significant improvement in hearing thresholds. Pharmacokinetic modelling during the VPA rechallenge showed that hearing loss occurred at a level below the therapeutic range. Brainstem auditory evoked potential at three months after VPA discontinuation showed bilateral conduction defect between the cochlear and superior olivary nucleus, supporting a pre-existing auditory deficit. VPA may cause temporary hearing threshold shift. Pre-existing auditory defect may be a risk factor for VPA-induced hearing loss. Caution should be taken while prescribing VPA to patients with pre-existing auditory deficit.
Fulltext Development and characterization of novel porous 3D alginate-cockle shell powder nanobiocomposite bone scaffold

Bharatham BH, Abu Bakar MZ, Perimal EK, Yusof LM, Hamid M

Biomed Res Int, 2014;2014:146723.
PMID: 25110655 DOI: 10.1155/2014/146723

A novel porous three-dimensional bone scaffold was developed using a natural polymer (alginate/Alg) in combination with a naturally obtained biomineral (nano cockle shell powder/nCP) through lyophilization techniques. The scaffold was developed in varying composition mixture of Alg-nCP and characterized using various evaluation techniques as well as preliminary in vitro studies on MG63 human osteoblast cells. Morphological observations using SEM revealed variations in structures with the use of different Alg-nCP composition ratios. All the developed scaffolds showed a porous structure with pore sizes ideal for facilitating new bone growth; however, not all combination mixtures showed subsequent favorable characteristics to be used for biological applications. Scaffolds produced using the combination mixture of 40% Alg and 60% nCP produced significantly promising results in terms of mechanical strength, degradation rate, and increased cell proliferation rates making it potentially the optimum composition mixture of Alg-nCP with future application prospects.
Heterotopic implantation of autologous bone marrow in rock pigeons (Columba livia): possible applications in avian bone grafting

Sanaei MR, Abu J, Nazari M, Faiz NM, Bakar MZ, Allaudin ZN

J. Avian Med. Surg., 2011 Dec;25(4):247-53.
PMID: 22458179

Autologous bone marrow, alone or as a composite marrow graft, has received much attention in various species. To assess the potential osteogenicity of autologous, extramedullary bone marrow implants in an avian model, 24 adult pigeons (Columba livia) were given intramuscular implantations of autologous marrow aspirated from the medial tibiotarsus. Birds were euthanatized at 1, 4, 6, 8, 10, and 12 weeks after surgery to evaluate whether ectopic bone had formed at the implant sites. Primary evaluations by in situ radiography and postmortem histologic examinations showed no evidence of bone formation. Further evaluation with histologic scores and histomorphometry revealed a significantly increased rate of angiogenesis at the implant sites by the sixth and tenth week postimplantation (P < .05). No significant differences between the treatment and control sites were present at any other endpoints. Results of this study show that, although autologous bone marrow lacks heterotopic osteogenic potentials in this avian model, it could still function as a useful adjunct to routine bone grafting techniques because of its unique capabilities to promote early angiogenesis.
Combustion in porous media and its applications--a comprehensive survey

Mujeebu MA, Abdullah MZ, Bakar MZ, Mohamad AA, Muhad RM, Abdullah MK

J Environ Manage, 2009 Jun;90(8):2287-312.
PMID: 19299066 DOI: 10.1016/j.jenvman.2008.10.009

The rapid advances in technology and improved living standard of the society necessitate abundant use of fossil fuels which poses two major challenges to any nation. One is fast depletion of fossil fuel resources; the other is environmental pollution. The porous medium combustion (PMC) has proved to be one of the technically and economically feasible options to tackle the aforesaid problems to a remarkable extent. PMC has interesting advantages compared with free flame combustion due to the higher burning rates, the increased power dynamic range, the extension of the lean flammability limits, and the low emissions of pollutants. This article provides a comprehensive picture of the global scenario of research and developments in PMC and its applications that enable a researcher to decide the direction of further investigation. The works published so far in this area are reviewed, classified according to their objectives and presented in an organized manner with general conclusions. A separate section is devoted for the numerical modeling of PMC.
Modelling on the effect of diffusive and convective substrate transport for biofilm

Khabibor Rahman N, Bakar MZ, Hekarl Uzir M, Harun Kamaruddin A

Math Biosci, 2009 Apr;218(2):130-7.
PMID: 19563738 DOI: 10.1016/j.mbs.2009.01.007

A one-dimensional biofilm model was developed based on the basic principle of conservation of mass. Three simple, generic processes were combined in the model which includes microbial growth, diffusive and convective mass transport. The final model could generate a quantitative description of the relationship between the microbial growth and the consumption of substrate (oxygen) within the fixed biofilm thickness. Mass transfer resistance contributes large influence on the substrates and microbial concentration across the biofilm thickness due to the effect of biofilm structure.
Fulltext Development of nanoantibiotic delivery system using cockle shell-derived aragonite nanoparticles for treatment of osteomyelitis

Saidykhan L, Abu Bakar MZ, Rukayadi Y, Kura AU, Latifah SY

Int J Nanomedicine, 2016;11:661-73.
PMID: 26929622 DOI: 10.2147/IJN.S95885

A local antibiotic delivery system (LADS) with biodegradable drug vehicles is recognized as the most effective therapeutic approach for the treatment of osteomyelitis. However, the design of a biodegradable LADS with high therapeutic efficacy is too costly and demanding. In this research, a low-cost, facile method was used to design vancomycin-loaded aragonite nanoparticles (VANPs) with the aim of understanding its potency in developing a nanoantibiotic bone implant for the treatment of osteomyelitis. The aragonite nanoparticles (ANPs) were synthesized from cockle shells by a hydrothermal approach using a zwitterionic surfactant. VANPs were prepared using antibiotic ratios of several nanoparticles, and the formulation (1:4) with the highest drug-loading efficiency (54.05%) was used for physicochemical, in vitro drug release, and biological evaluation. Physiochemical characterization of VANP was performed by using transmission electron microscopy, Fourier transform infrared spectroscopy, X-ray powder diffraction, and Zetasizer. No significant differences were observed between VANP and ANP in terms of size and morphology as both samples were cubic shaped with sizes of approximately 35 nm. The Fourier transform infrared spectroscopy of VANP indicated a weak noncovalent interaction between ANP and vancomycin, while the zeta potential values were slightly increased from -19.4±3.3 to -21.2±5.7 mV after vancomycin loading. VANP displayed 120 hours (5 days) release profile of vancomycin that exhibited high antibacterial effect against methicillin-resistant Staphylococcus aureus ATCC 29213. The cell proliferation assay showed 80% cell viability of human fetal osteoblast cell line 1.19 treated with the highest concentration of VANP (250 µg/mL), indicating good biocompatibility of VANP. In summary, VANP is a potential formulation for the development of an LADS against osteomyelitis with optimal antibacterial efficacy, good bone resorbability, and biocompatibility.
Fulltext Acute and subacute dermal toxicity of ethanolic extract of Melastoma malabathricum leaves in Sprague-Dawley rats

Reduan FH, Shaari RM, Sayuti NSA, Mustapha NM, Abu Bakar MZ, Sithambaram S, et al.

Toxicol Res, 2020 Jul;36(3):203-210.
PMID: 32685424 DOI: 10.1007/s43188-019-00013-5

Melastoma malabathricum is a well-known herb in Malaysia where it being used in various ways for treatment of different diseases and ailments including skin problems. The study aims to investigate acute and subacute dermal toxicity of ethanolic extract of M. malabathricum leaves following to a single or repeated doses exposure. A total of 30 female Sprague-Dawley rats were grouped into 5 groups (n = 6 per group) for both acute and subacute toxicity study. The duration for each study was determined at 14 days for acute toxicity and 28 days for subacute toxicity. The rats were topically applied with the plant extract at three different doses; 2.5%, 5.0% and 10.0% on the shaved area of dorsal skin. For acute toxicity study, rats in all three groups received single application of the extract on the first day of the experimental period, while rats in subacute toxicity study were topically applied with the extract once daily for 28 days. Throughout the respective 14-day and 28-day study periods, all rats were monitored for any changes in their physical appearance and behavioural patterns that might develop due to toxic effects of the plant. There were no mortality or abnormal physical appearance, and physiological and behavioural changes observed in all rats in both studies. Body weights, kidney and liver weights, and both haematology and serum biochemistry results showed no significant (p > 0.05) differences between all groups in both studies. All of the findings were supported by normal macroscopic and microscopic architectures of liver, kidneys and skin of all rats applied topically with the extract. This study suggests that topical application of M. malabathricum leaf ethanolic extract at 2.5%, 5% and 10% does not induce acute and subacute adverse effects on the skin or systemic toxic reactions in rats.
A preliminary report on the role of endoscopic endonasal nasopharyngectomy in recurrent rT3 and rT4 nasopharyngeal carcinoma

Wong EHC, Liew YT, Abu Bakar MZ, Lim EYL, Prepageran N

Eur Arch Otorhinolaryngol, 2017 Jan;274(1):275-281.
PMID: 27520568 DOI: 10.1007/s00405-016-4248-2

Endoscopic endonasal nasopharyngectomy (EEN) has become increasingly used for recurrent nasopharyngeal carcinoma (rNPC) due to reduced functional and cosmetic morbidities compared to conventional external approach. Majority of the existing studies on EEN focused on patients with lower recurrent staging of rT1 and rT2. The aims of this study were to provide a preliminary report on the outcome of EEN performed in patients with advanced (rT3 and rT4) rNPC, and to determine the prognostic factors for patients' survival. All patients who underwent EEN for rNPC between January 2003 and December 2015 inclusive were analyzed. All surgeries were performed in University Malaya Medical Centre in Kuala Lumpur and Queen Elizabeth Hospital in Sabah, by a single surgeon. We reported the 2-year overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS) and any related complications and significant prognostic factors. Fifteen patients with recurrent NPC (2 rT3 and 13 rT4 tumours) underwent EEN over the 13 years period. The mean age was 50.4 years (range 30-65) and the mean follow-up period was 28.7 months (range 9-81 weeks). The 2-year OS, DFS and DSS were 66.7 % (mean 19.4 months), 40 % (mean 15.7 months) and 73.3 % (mean 20.2 months), respectively. No severe operative complications were encountered. No independent prognostic factors for survival outcome were identified. This is the first preliminary report in English that exclusively looked at the use of EEN in advanced rT3 and rT4 NPCs, showing favourable patient outcome. However, further long-term follow-up of patients is required.
Fulltext Congenital tongue base lipoblastoma causing neonatal airway compromise

Wan MH, Tengku Nun Ahmad TE, Naicker MS, Abu Bakar MZ

BMJ Case Rep, 2021 Jan 18;14(1).
PMID: 33462056 DOI: 10.1136/bcr-2020-239554

Lipoblastomas are benign tumours of immature fat cells presenting in infancy. A lipoblastoma within the airway lumen causing airway compromise is an extremely rare occurrence. We present a 6 hours of life girl who had airway compromise due to a lobulated mass at the base of the tongue. The mass was excised after emergency endotracheal intubation.
Fulltext Toxicity and Safety Evaluation of Doxorubicin-Loaded Cockleshell-Derived Calcium Carbonate Nanoparticle in Dogs

Danmaigoro A, Selvarajah GT, Mohd Noor MH, Mahmud R, Abu Bakar MZ

Adv Pharmacol Sci, 2018;2018:4848602.
PMID: 30079088 DOI: 10.1155/2018/4848602

Doxorubicin (DOX) is a potent anticancer agent with cytotoxic effects which limit its clinical usage. This effect is due to its nonselective nature causing injury to the cells as a result of reactive free oxygen radical's release. Cockleshell-derived calcium carbonate nanoparticle (CS-CaCO3NP) is a pH-responsive carrier with targeted delivery potentials. This study aimed at evaluating the toxicity effects of repeated dose administration of DOX-loaded CS-CaCO3NP in healthy dogs. Fifteen dogs with an average body weight of 15 kg were randomized equally into 5 groups. Dogs were subjected to 5 doses at every 3-week interval with (i) normal saline, (ii) DOX, 30 mg/m2, and the experimental groups: CS-CaCO3NP-DOX at (iii) high dose, 50 mg/m2, (iv) clinical dose, 30 mg/m2, and (v) low dose, 20 mg/m2. Radiographs, electrocardiography, and blood samples were collected before every treatment for haematology, serum biochemistry, and cardiac injury assessment. Heart and kidney tissues were harvested after euthanasia for histological and ultrastructural evaluation. The cumulative dose of DOX 150 mg/m2 over 15 weeks revealed significant effects on body weight, blood cells, functional enzymes, and cardiac injury biomarkers with alterations in electrocardiogram, myocardium, and renal tissue morphology. However, the dogs given CS-CaCO3NP-DOX 150 mg/m2 and below did not show any significant change in toxicity biomarker as compared to those given normal saline. The study confirmed the safety of repeated dose administration of CS-CaCO3NP-DOX (30 mg/m2) for 5 cycles in dogs. This finding offers opportunity to dogs with cancer that might require long-term administration of DOX without adverse effects.
Fulltext The Authentication and Grading of Edible Bird's Nest by Metabolite, Nutritional, and Mineral Profiling

Mohamad Ibrahim R, Mohamad Nasir NN, Abu Bakar MZ, Mahmud R, Ab Razak NA

Foods, 2021 Jul 07;10(7).
PMID: 34359444 DOI: 10.3390/foods10071574

Edible bird's nest (EBN) produced by Aerodramus fuciphagus has a high demand for nutritional and medicinal application throughout the world. The present study was to evaluate the authentication of a man-made house EBN, which are half cup and stripe-shaped by FTIR. Next, both samples were compared according to their metabolite, nutritional, and mineral composition. The results indicated that the FTIR spectra of both EBN samples were identical and similar to the reference, suggesting the authenticity of the EBN used. The metabolites that contribute to the possible medicinal properties of EBN were found by using GC-MS. The results of the proximate analysis, followed by the standard AOAC method, inferred that both EBN shapes to be rich in crude protein and carbohydrate contents. However, the proximate composition between the half cup and stripe-shaped EBN showed significant differences. Major mineral elements detected were calcium and sodium, and magnesium contents were significantly different between both EBN. Additionally, the half cup and stripe-shaped EBN had a low level of heavy metal content than the maximum regulatory limit as set by the Malaysian Food Act 1983. This study concludes that the nutritional composition varied between the samples and thus suggests that nutrient content should be considered as criteria for the grading requirement of commercialized EBN.
Determining weight-bearing tissue condition using peak reactive hyperemia response trend and ultrasonographic features: Implications for pressure ulcer prevention

Yapp JH, Raja Ahmad RMK, Mahmud R, Mohtarrudin N, Mohamad Yusof L, Abdul Rahim E, et al.

Wound Repair Regen, 2019 05;27(3):225-234.
PMID: 30667138 DOI: 10.1111/wrr.12698

Frequent repositioning is important to prevent pressure ulcer (PU) development, by relieving pressure and recovering damages on skin areas induced by repetitive loading. Although repositioning is the gold standard to prevent PU, there is currently no strategy for determining tissue condition under preventive approaches. In this study, the peak reactive hyperemia (RH) trends and ultrasonographic (US) features are compared with the tissue condition under histopathological examination to determine the potential use of these features in determining the tissue condition noninvasively. Twenty-one male Sprague-Dawley rats (seven per group), with body weight of 385-485 g, were categorized into three groups and subjected to different recovery times, each with three repetitive loading cycles at skin tissues above of right trochanter area. The first, second, and third groups were subjected to short (3 minutes), moderate (10 minutes), and prolonged (40 minutes) recovery, respectively, while applying fixed loading time and pressure (10 minutes and 50 mmHg, respectively), to provide different degree of recovery and tissue conditions (tissue damage and tissue recovery). Peak RH was measured in the three cycles to determine RH trend (increasing, decreasing, and inconsistent). All rat tissues were evaluated using ultrasound at pre- and post-experiment and rated by two raters to categorize the severity of tissue changes (no, mild, moderate, and severe). The tissue condition was also evaluated using histopathological examination to distinguish between normal and abnormal tissues. Most of the samples with increasing RH trend is related to abnormal tissue (71%); while inconsistent RH trends is more related to normal tissue (82%). There is no relationship between the tissue conditions evaluated under ultrasonographic and histopathological examination. Peak RH trend over repetitive loading may serve as a new feature for determining the tissue condition that leading to pressure ulcer.
Fulltext Effects of Concentrate and Bypass Fat Supplementations on Growth Performance, Blood Profile, and Rearing Cost of Feedlot Buffaloes

Mohd Azmi AF, Ahmad H, Mohd Nor N, Meng GY, Saad MZ, Abu Bakar MZ, et al.

Animals (Basel), 2021 Jul 15;11(7).
PMID: 34359233 DOI: 10.3390/ani11072105

This study investigates the effects of supplementation of the basal diet with concentrate and rumen bypass fat on the dry matter intake (DMI), growth performance, blood metabolites and hormonal changes, and the feeding cost of feedlot water buffaloes. Thirty-six healthy, three- to four-month-old male Murrah crossbred (n = 18) and Swamp (n = 18) buffaloes with a similar average initial body weight of 98.64 ± 1.93 kg were each randomly allocated into three dietary experimental groups. Buffaloes were fed with Diet A, which consisted of 100% Brachiaria decumbens, Diet B, consisting of 70% Brachiaria decumbens and 30% concentrate, and Diet C, consisting of 70% Brachiaria decumbens, 26% concentrate, and 4% rumen bypass fat for a period of 730 days. Feed intake was measured daily, while blood samples were collected for every eight months. Furthermore, body scores were noted prior to and at the end of the experimental period. The results showed that the average daily gain for buffaloes fed with Diet C was the highest. The DMI, BCS, FI, and FCR for the three groups showed significant (p < 0.05) differences, in the following order: Diet C > Diet B > Diet A. At the end of the two-year feeding trial, buffaloes fed with Diet B had significantly (p < 0.05) higher cholesterol levels than Diet A and Diet C. In addition, buffaloes fed with Diet C had significantly (p < 0.05) higher levels of serum total protein, growth hormone, and insulin-like growth factor-I hormone compared to Diet A and Diet B. On the other hand, buffaloes fed with Diet B and Diet C showed significant (p < 0.05) decrease in glucose levels. Supplemented diet improved the buffalos' weight gain to achieve the market weight in a shorter period of time, thus, giving farmers a greater return. In conclusion, concentrate and bypass fat supplementations in the diet of water buffaloes improved the growth performance without adverse effect on the blood metabolites, which enabled better farmer profitability.

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