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Objectives: This study was performed to identify and characterize circulating Plasmodium species in three provinces of Mindanao approaching malaria elimination., Methods: Rapid diagnostic tests (RDT), microscopic examination, and PCR were used to detect malaria parasites. PCR-positive isolates were genotyped for polymorphisms in loci of interest., Results: A total of 2639 participants were surveyed in Mindanao between 2010 and 2013. Malaria prevalence by PCR was 3.8% (95% confidence interval (CI): 2.7-5.2%) in Sarangani, 10% (95% CI: 7.7-12.7%) in South Cotabato, and 4.2% (95% CI: 3.2-5.6%) in Tawi-Tawi. P. falciparum and P. vivax were identified in all three provinces, and there was one case of P. malariae in South Cotabato. RDT was inferior to PCR for detecting asymptomatic P. falciparum and P. vivax. In Tawi-Tawi, microscopy failed to identify 46 PCR-positive malaria infections. The presence of pfcrt haplotypes CVMNK, CVIET, and SMNT (codons 72-76), pfmdr1 haplotype NFSND (codons 86, 184, 1034, 1042, 1246), and pvmdr1 haplotype NFL (codons 91, 976, 1076) was confirmed in Mindanao., Conclusions: Asymptomatic Plasmodium infections persisted in local communities between 2010 and 2013. PCR successfully identified subpatent malaria infections, and can better characterize malaria epidemiology in communities seeking malaria control and elimination at the local level., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: One-lung ventilation (OLV) is commonly used during thoracic surgery. At this time, hypoxemia is considered one of the remarkable consequences of the anesthesia management. Hypoxic pulmonary vasoconstriction (HPV) is the defense mechanism against hypoxia., Objectives: The aim of the present study was to investigate the effect of infusion of dexmedetomidine on improving the oxygenation during OLV among the adult patients undergoing thoracic surgery., Methods: A total of 42 patients undergoing OLV by general anesthesia with isoflurane inhalation were randomly assigned into two groups: IV infusion of dexmedetomidine at 0.3 microgram/kg/h (DISO) and IV infusion of normal saline (NISO). Three Arterial Blood Gas (ABG) samples were obtained throughout the surgery. Hemodynamic parameters, PaO 2 , PaCO 2 , and complications at recovery phase were recorded. The collected information was analyzed using SPSS software version 22., Results: In the dexmedetomidine group, the mean hemodynamic parameters had a significant reduction at 30 and 60 minutes following OLV. Administration of dexmedetomidine resulted in a significant increase in the PaCO 2 and a reduction in the PaO 2 when changing from two-lung ventilation to OLV, where PaO 2 reached its maximum value within 10 minutes after OLV in the DISO group, and it began to gradually increase to the end of operation. The duration of the recovery phase, also complications at the recovery phase decreased significantly in DISO group., Conclusions: The results of the study showed that, dexmedetomidine may improve arterial oxygenation during OLV in adult patients undergoing thoracic surgery, and can be a suitable anesthetic agent for thoracic surgery., Competing Interests: Conflict of Interests: The authors declared no conflict of interest., (Copyright © 2020, Author(s).)

Context Lumbar puncture (LP) is still an important modality in the diagnosis of subarachnoid hemorrhage (SAH). Rapid and correct fluid analysis can provide patients with a better prognosis by appropriate intervention. Objective To determine the value of cerebrospinal fluid lactate dehydrogenase level in differentiation between SAH and traumatic LP. Design This was a cross-sectional observational study. Patients with a diagnostic suspicion of SAH who were admitted to the emergency department were enrolled in our study based on the inclusion criteria. All patients underwent head computed tomography scan without contrast. Patients with SAH confirmed on computed tomography scan and those who needed surgical intervention underwent LP by the neurosurgical service in the operation room (group 1). Other patients who fulfilled the inclusion criteria but had a traumatic LP in the emergency setting were also enrolled in our study (group 2). The fluid samples of all LPs were sent to the laboratory to be analyzed. Finally, we compared the results of the 2 groups with each other. Results Fifty-two patients were enrolled in our study, 26 patients (50%) from each group. The cerebrospinal fluid lactate dehydrogenase level was significantly higher in group 1 than it was in group 2 ( P < .001), and based on receiver operating characteristic curve analysis, the significant level of cerebrospinal fluid lactate dehydrogenase to differentiate SAH from traumatic LP was estimated to be 185. The red blood cell and white blood cell counts were significantly higher in group 1 than they were in group 2 ( P < .001). Conclusions Cerebrospinal fluid lactate dehydrogenase can effectively differentiate SAH from traumatic tap in LP samples.

Background: Patients undergoing elective percutaneous coronary intervention (PCI) with drug-eluting stents (DES) who have impaired clopidogrel response, have a higher risk of subsequent major adverse cardiovascular events (MACE)., Aim of the Study: To establish the relationship between CYP2C19 genotype, clopidogrel responsiveness and 1-year MACE., Materials & Methods: Aspirin/clopidogrel responses were assessed with Multiplate Analyzer and CYP2C19*2 allele by SpartanRx., Results: A total of 42.0% carried ≥1 CYP2C19*2 allele. Prevalences of aspirin and clopidogrel high on-treatment platelet reactivity (HPR; local cutoffs: 300 AU*min for aspirin and 600 AU*min for clopidogrel) were 11.5% and 19.8% respectively. In multivariate ana-lysis, clopidogrel HPR was found to be an independent predictor for 1-year MACE (adj HR: 3.48, p = 0.022 )., Conclusion: Having clopidogrel HPR could be a potentially modifiable risk factor guided by phenotyping.

Introduction: Carotid intima media thickness (CIMT) being a cost effective and easily performed technique is useful in the detection of subclinical atherosclerosis and has been shown to be a prognosticator of cardiovascular events. The primary objective of this study was to obtain the distribution of CIMT measurements, highly sensitive C reactive protein (hs-CRP) and assessing health awareness and attitudes of the Malaysian population at cardiovascular disease (CVD) risk and not receiving lipid lowering agents. Secondarily the study sought to assess the significance of the relationship between these measurements against various patient characteristics., Methods: Measurements of CIMT are obtained by ultrasonography of 12 sites within the common carotid artery was recorded for 123 subjects from a single centre tertiary hospital of Malaysia who had two or more CVD risk factors but were not receiving lipid lowering therapy. CVD risk factors and lipid and glucose profiles were analyzed with respect to distribution of CIMT and high-sensitivity Creactive protein (hs-CRP) values., Results: The mean-max CIMT was 0.916±0.129mm (minimum 0.630mm, maximum 1.28mm) and the mean-mean CIMT was 0.743±0.110mm (minimum 0.482mm, maximum 1.050mm) and mean hs-CRP was 0.191mg/dL (minimum 0.030mg/dL, maximum 5.440mg/dL). Multivariate analyses confirmed a significant association between increasing CIMT and increasing age, total and low density lipoprotein cholesterol while log-transformed hs-CRP levels showed significant association with increasing body mass index, waist circumference, high blood glucose and triglyceride levels. Our patients had good health awareness on CVD., Conclusion: Newly defined CIMT measurements and hs-CRP levels may be useful adjunctive tools to screen for atherosclerosis in the Malaysian population. It may help in refining risk stratification on top of traditional clinical assessment.

Organofunctionalized apatite nanoparticles were prepared using a one step process involving dissolution/precipitation of natural phosphate rock and covalent grafting of nitrilotris(methylene)triphosphonate (NTP). The synthesized materials were characterized by Brunauer-Emmett-Teller (BET) surface measurement, thermogravimetry, inductively coupled plasma emission spectroscopy (ICP-ES), elemental analysis, multinuclear solid state cross-polarization/magic angle spinning (CP/MAS) and single-pulse NMR spectroscopy, transmission electron microscopy (TEM) and energy dispersive x-ray analysis (EDXA). After grafting BET measurements yielded particle specific surface areas ranging from 88 to 193 m(2) g(-1) depending on the grafted phosphonate. The results show that the surfaces of the nanoapatite particles can be covered with functional groups bound through a variable number of R-P-O-Ca bonds to render them organoapatites.

A natural phosphate rock and two synthetic mesoporous hydroxyapatites were evaluated for the removal of pyridine and phenol from aqueous solutions. Experiments performed by the batch method showed that the sorption process occurs by a first order reaction for both pyridine and phenol. In contrast, the Freundlich model was able to describe sorption isotherms for phenol but not for pyridine. In parallel, the three apatites exhibit similar pyridine sorption capacities whereas phenol loading was in agreement with their respective specific surface area. This was attributed to the strong interaction arising between pyridine and apatite surface that hinders further inter-particular diffusion. This study suggests that, despite its low specific surface area, natural phosphate rock may be used as an efficient sorbent material for specific organic pollutants, with comparable efficiency and lower processing costs than some activated carbons., (Copyright 2010 Elsevier B.V. All rights reserved.)