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This study offers a comprehensive morpho-histological analysis of the gastrointestinal tract (GIT) of the Malabar red snapper. A comparison of its GIT morphology with that of the Asian seabass reveals similarities and differences between the two species. Additionally, the moisture content, crude protein, and ash in the fillets of Malabar red snapper and Asian seabass were slightly different, with Malabar red snapper exhibiting higher levels of essential fatty acids. Furthermore, higher levels of the polyunsaturated fatty acid (PUFA)/saturated fatty acid (SFA) ratio and docosahexaenoic acid (DHA)/eicosapentaenoic acid (EPA) ratio, and a lower omega-6/omega-3 ratio, were observed in Malabar red snapper compared to Asian seabass. The Malabar red snapper's esophagus featured protective mechanisms such as simple columnar epithelial cells, mucous-secreting glands, and goblet cells that were predominantly stained for acid and neutral mucosubstances. Furthermore, its stomach, with mucus cells that were weakly stained for acid mucosubstances, exhibited distinct regions with varying glandular densities, with the pyloric region featuring few glands. The pyloric caeca of the fish were composed of five finger-like structures and few goblet cells. Several goblet cells gradually increased from the anterior to the posterior region of the intestine. These findings provide useful insights for the aquaculture sector, focusing on Malabar red snapper.

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Presenting new molecular and scanning electron microscope (SEM) features, this study gives additional data to the better knowledge of Thaparocleidus vistulensis (Siwak, 1932) (Monopisthocotyla, Ancylodiscoididae), a parasite of the European catfish Silurus glanis Linnaeus, 1758 (Siluriformes, Siluridae) cultured in a commercial fish farm in Hungary. In addition, notes on the early development of sclerotized anchors are also provided. The main morphological difference of T. vistulensis compared to other congeneric species is associated with the male copulatory organ, which exhibits 5-7 loops in the middle of the penis length and a long open V-shaped sclerotized accessory piece, dividing terminally into two parts, securing the terminal part of the penis tube. The present study provides for the first time molecular characterization data based on the 2694 bp long nucleotide sequence of rDNA (ITS1, 5.8S, ITS2, and flanked with partial 18S and partial 28S) submitted in GenBank with the accession number OR916383. A phylogenetic tree based on ITS1 sequences supports a well-defined clade including T. vistulensis, forming a sister group with T. siluri, a species-specific monopisthocotylan parasite to S. glanis. The morphological characterization of T. vistulensis, especially for the male copulatory organ, together with the molecular data in the present study, extends knowledge about this monopisthocotylan species and provides new information for future phylogeny studies.

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Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disorder with various systemic and ocular clinical manifestations. In patients with SLE, central retinal vein and artery occlusion, choroidopathy, and occlusive vasculitis are among the most significant and clinically relevant ocular manifestations, although they do not commonly occur. We present a case series of three SLE patients of different races and genders who developed ocular-related clinical features of SLE during the course of their systemic disease. The clinical outcomes of each patient were different, affecting their vision in bilateral eyes, with some patients having better visual recovery while others having permanently poor vision. These outcomes were not significantly related to the patients' age, gender, or race.

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Chronic cerebral hypoperfusion (CCH) is a common mechanism of acute brain injury due to impairment of blood flow to the brain. Moreover, a prolonged lack of oxygen supply may result in cerebral infarction or global ischemia, which subsequently causes long-term memory impairment. Research on using Clitoria ternatea root extract for treating long-term memory has been studied extensively. However, the bioactive compound contributing to its neuroprotective effects remains uncertain. In the present study, we investigate the effects of clitorienolactone A (CLA) and B (CLB) from the roots of Clitoria ternatea extract on hippocampal neuroplasticity in rats induced by CCH. CLA and CLB were obtained using column chromatography. The rat model of CCH was induced using two-vessel occlusion surgery (2VO). The 2VO rats were given 10 mg/kg of CLA and CLB orally, followed by hippocampal neuroplasticity recording using in vivo electrophysiological. Rats received CLA and CLB (10 mg/kg) significantly reversed the impairment of long-term potentiation following 2VO surgery. Furthermore, we investigate the effect of CLA and CLB on the calcium channel using the calcium imaging technique. During hypoxia, CLA and CLB sustain the increase in intracellular calcium levels. We next predict the binding interactions of CLA and CLB against NMDA receptors containing GluN2A and GluN2B subunits using in silico molecular docking. Our result found that both CLA and CLB exhibited lower binding affinity against GluN2A and GluN2B subunits. Our findings demonstrated that bioactive compounds from Clitoria ternatea improved long-term memory deficits in the chronic cerebral hypoperfusion rat model via calcium uptake. Hence, CLA and CLB could be potential therapeutic tools for treating cognitive dysfunction.

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@#Introduction: Malaysia has not legalized CPR teaching in the national curriculum, leaving it to school principals to implement the teaching of CPR who may have limited knowledge. This study aims to investigate Malaysian secondary school principals’ level of readiness, defined as knowledge, attitude, willingness to teach CPR, and barriers to implementation. Methods: Malaysian secondary school principals were invited to complete a survey that consisted of five parts: (1) demographics, (2) CPR knowledge, (3) attitude towards CPR, (4) willingness to teach CPR, and (5) barriers to implementing CPR teaching. Results: A total of 54 secondary school principals responded to the survey. Three (5.6%) principals passed the CPR test. More than 80% agreed CPR course is important for students, mandatory to be taken before graduation and best taught by certified teachers. Principals are willing to qualify themselves and teachers with CPR certification and to provide funding to support and hire an outsider to teach CPR courses. Funding, teachers’ readiness for skills and knowledge proficiency, and curriculum burden are perceived as potential barriers to successful CPR teaching. One-way MANOVA analysis showed that gender (p = .257), age (p = .108), qualifications (p = .321), teaching experience (p = .194), and administrative experience (p = .193) did not have a significant effect on the combined dependent variables. Conclusion: Malaysian secondary school principals are aware of the importance of CPR and were willing to acquire the knowledge, skills, funds, equipment, and support in ensuring its implementation in the national curriculum.

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The life cycle of Thaparocleidus vistulensis (Siwak, 1932), a host-specific monogenean parasite of European catfish (Silurus glanis Linnaeus, 1758), was investigated by detailed observation of infection dynamics, egg development, hatching rate and in vitro survival rates of the parasite at different life stages at 23 °C. A total of 30 naive fingerlings were infected in three exposure trials by co-habitation with donor fish carrying adult parasites. Two fish were dissected every two days during the 10-day experimental period to explore the development of larvae and juvenile parasites on the host gills. Freshly laid eggs by adult monogeneans were collected and observed daily under a light microscope until hatching. A total of 445 eggs were collected and distributed into wells of 96-well microtiter plates containing filtered fish tank water to determine their hatching rates. A similar method was used to investigate the survival rates of isolated parasites at different developmental stages (larvae, juveniles, and adults). T. vistulensis populations on the European catfish in fish tanks increased markedly within ten days, dependent on the severity of the initial infection levels of the donor fish. The first eggs hatched three to four days after oviposition, and the hatching rate peaked on the fifth day (89.7%). The survival rate for freely swimming oncomiracidia without host was 7.4% after five days, whereas isolated juvenile and adult parasites showed a higher dependence of host contact (survival rates three days post-isolation of 0.9% and 1.6%, respectively). The data allows prediction of parasite-host dynamics and may improve control of gill-disease in cultured European catfish stocks in fish farms.

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Background: The advancement of biomedical research generates myriad healthcare-relevant data, including medical records and medical device maintenance information. The COVID-19 pandemic significantly affects the global mortality rate, creating an enormous demand for medical devices. As information technology has advanced, the concept of intelligent healthcare has steadily gained prominence. Smart healthcare utilises a new generation of information technologies, such as the Internet of Things (loT), big data, cloud computing, and artificial intelligence, to completely transform the traditional medical system. With the intention of presenting the concept of smart healthcare, a predictive model is proposed to predict medical device failure for intelligent management of healthcare services. Methods: Present healthcare device management can be improved by proposing a predictive machine learning model that prognosticates the tendency of medical device failures toward smart healthcare. The predictive model is developed based on 8,294 critical medical devices from 44 different types of equipment extracted from 15 healthcare facilities in Malaysia. The model classifies the device into three classes; (i) class 1, where the device is unlikely to fail within the first 3 years of purchase, (ii) class 2, where the device is likely to fail within 3 years from purchase date, and (iii) class 3 where the device is likely to fail more than 3 years after purchase. The goal is to establish a precise maintenance schedule and reduce maintenance and resource costs based on the time to the first failure event. A machine learning and deep learning technique were compared, and the best robust model for smart healthcare was proposed. Results: This study compares five algorithms in machine learning and three optimizers in deep learning techniques. The best optimized predictive model is based on ensemble classifier and SGDM optimizer, respectively. An ensemble classifier model produces 77.90%, 87.60%, and 75.39% for accuracy, specificity, and precision compared to 70.30%, 83.71%, and 67.15% for deep learning models. The ensemble classifier model improves to 79.50%, 88.36%, and 77.43% for accuracy, specificity, and precision after significant features are identified. The result concludes although machine learning has better accuracy than deep learning, more training time is required, which is 11.49 min instead of 1 min 5 s when deep learning is applied. The model accuracy shall be improved by introducing unstructured data from maintenance notes and is considered the author's future work because dealing with text data is time-consuming. The proposed model has proven to improve the devices' maintenance strategy with a Malaysian Ringgit (MYR) cost reduction of approximately MYR 326,330.88 per year. Therefore, the maintenance cost would drastically decrease if this smart predictive model is included in the healthcare management system.

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Infection by the microsporidian parasite Enterocytozoon hepatopenaei (EHP) has become a significant problem in the shrimp cultivation industry in Asian countries like Thailand, China, India, Vietnam, Indonesia, and Malaysia. The outbreak of this microsporidian parasite is predominantly related to the existence of macrofauna-carriers of EHP. However, information about potential macrofauna-carriers of EHP in rearing ponds is still limited. In this study, the screening of EHP in potential macrofauna-carriers was conducted in farming ponds of Penaeus vannamei in three states in Malaysia, namely Penang, Kedah, and Johor. A total of 82 macrofauna specimens (phyla: Arthropoda, Mollusca, and Chordata) were amplified through a polymerase chain reaction (PCR) assay targeting genes encoding spore wall proteins (SWP) of EHP. The PCR results showed an average prevalence of EHP (82.93%) from three phyla (Arthropoda, Mollusca and Chordata). The phylogenetic tree generated from the macrofauna sequences was revealed to be identical to the EHP-infected shrimp specimens from Malaysia (MW000458, MW000459, and MW000460), as well as those from India (KY674537), Thailand (MG015710), Vietnam (KY593132), and Indonesia (KY593133). These findings suggest that certain macrofauna species in shrimp ponds of P. vannamei are carriers of EHP spores and could be potential transmission vectors. This study provides preliminary information for the prevention of EHP infections that can be initiated at the pond stage by eradicating macrofauna species identified as potential vectors.

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Catching and crating may elicit stress and fear reactions in poultry because the procedures involve human contact and exposure to a novel environment. This study determined the effects of dietary probiotic supplementation on physiological stress, underlying fear, and growth performance of Pekin ducks subjected to catching and 4 h of crating. The study used a 2 × 2 factorial arrangement; the main factors were diet (basal or basal + probiotic) and crating durations (0 or 4 h). From 1 to 21 days of age (doa), birds were fed a basal or basal + probiotic (CLOSTAT® (Bacillus subtilis) (Kemin Industries, Inc., Des Moines, IA, USA), 1 g/kg) diet. At 21 doa, an equal number of ducklings from each dietary group were caught and crated for 4 h or left undisturbed in the home pens. Birds were examined for serum corticosterone (CORT), heat shock protein (HSP) 70, creatine kinase (CK), triglyceride (TG), glucose (GLU), cholesterol (CHOL), and lactate (LAC) concentrations, heterophil to lymphocyte ratios (HLR), tonic immobility (TI) duration, open-field (OF) test, body weight (BW), and feed conversion ratios (FCR). Diet had no significant (p > 0.05) effect on CORT among the non-crated ducks. However, after catching and crating, birds fed the control diet had significantly (p < 0.05) higher CORT than their probiotic-supplemented counterparts. Catching and crating significantly (p < 0.05) elevated HSP70, HLR, GLU, and CHOL but reduced TG in ducks. Birds fed the probiotic-supplemented diet showed significantly (p < 0.05) lower HSP70, HLR, TG, and CK than those fed the control diet. Probiotic-supplemented ducks showed reduced fear-related behaviours, including TI durations, ambulation latency, and body shaking. Diet had a negligible effect on body weights and FCR of ducks at 21 doa. In brief, catching and crating for 4 h augmented Pekin ducks' physiological stress and fear reactions, and supplementing birds with probiotics was beneficial in ameliorating these detrimental effects.

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Necrotizing sarcoid granulomatosis (NSG) is a rare disease that shares similarities with pulmonary vasculitides and sarcoidosis. This is a report of two cases of NSG with a review of literature. The first case is a 33-year-old black female with a one-year history of malaise and cough. Lung imaging revealed scattered pulmonary nodules. Histopathology showed multiple necrotizing granulomas without prominent neutrophilic infiltrates. The second case is a 58-year-old white female with a one-year history of fatigue, dyspnea, and ophthalmoplegia on the left eye. Imaging showed multiple pulmonary nodules. Lung biopsy was consistent with NSG. The challenge of the NSG diagnosis is to distinguish it from other mimickers. Pathology often shows necrotizing granulomatous vasculitis, distinguishing it from classical sarcoid. Laboratory markers for vasculitis like neutrophil cytoplasmic antibodies and antibodies against myeloperoxidase and proteinase 3 are negative or only low titers. NSG responds well to immune-suppression, most commonly with glucocorticoids.

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The microsporidian parasite Enterocytozoon hepatopenaei (EHP) is an emerging problem in the marine shrimp industry, primarily in Asian countries such as China, Thailand, India, Malaysia, Indonesia, and Vietnam. A screening was conducted to investigate the prevalence of EHP after a fixed period of culturing for 1 rearing cycle in 3 states of Malaysia. The screening stages covered Penaeus vannamei post larvae (PL) and after 14-30, 31-50, 51-70, and 71-90 d of culture in 1 production cycle. A total of 279 samples were amplified using a PCR assay targeting the gene encoding a spore wall protein (SWP) of EHP. The EHP infection was initially detected in the hatchery and increased to 96.6% after the shrimp were transferred to the pond. The positive EHP sequence showed 91 to 100% similarity to sequences from India, Thailand, Vietnam, Indonesia, and Latin America. EHP infection increased throughout 1 rearing cycle due to factors such as the cannibalistic feeding habits of shrimp and the presence of unknown vectors or carriers of EHP in the culture ponds. Hence, the finding from the current study will be fundamental for other studies concerning EHP.

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INTRODUCTION: The use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation. MATERIAL AND METHOD: A prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients' aged 7-11-years old used 1 spray in each nostril once daily, while patients aged 12-17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12). RESULTS: A total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms' score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms' score (p < 0.001). AH significantly reduced in size from week 0 (2.89±.87) to week 12 (1.88±.83) (p < 0.001). CONCLUSION: MF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered

INTRODUCCIÓN: El papel del aerosol nasal de mometasona furoato (MF) para tratar la hipertrofia adenoidea (HA) tiene un resultado variable, debido a los diferentes métodos de evaluación del tamaño de las adenoides. El objetivo de nuestro estudio fue evaluar el efecto del aerosol nasal de MF en niños y adolescentes con HA, utilizando una evaluación endoscópica fiable y consistente. MATERIAL Y MÉTODO: Se llevó a cabo un estudio prospectivo intervencionista. La evaluación se realizó durante la primera visita (semana 0) y la segunda visita (semana 12). Se valoraron los síntomas de obstrucción nasal, rinorrea, tos y ronquidos, obteniéndose una puntuación de síntomas totales globales. Se realizó un examen nasoendoscópico rígido utilizando un sistema de clasificación del tamaño adenoideo, con valores de 1 a 4. Los pacientes fueron tratados con aerosol intranasal de MF durante 12 semanas. Los pacientes con edades comprendidas entre 7 y 11 años utilizaron 1 pulverización en cada fosa nasal una vez al día, mientras que los pacientes de 12 a 17 años utilizaron 2 pulverizaciones en cada fosa nasal una vez al día. La re-evaluación se realizó durante la segunda visita (semana12). RESULTADOS: Reunimos a un total de 74 pacientes. Se produjeron mejoras significativas de la semana 0 a la 12 en cuanto a puntuación de los síntomas de obstrucción nasal, rinorrea, tos y ronquidos, incluyendo la puntuación total de síntomas nasales (p < 0,001). Se redujo significativamente el tamaño de HA de la semana 0 (2,89 ±0,87) a la semana 12 (1,88 ±0,83) (p < 0,001). CONCLUSIÓN: El aerosol intranasal de MF es efectivo para mejorar los síntomas atribuidos a HA, así como reducir el tamaño de las adenoides. Se propone el uso de dicho aerosol intranasal como opción de tratamiento, antes de considerarse la adenoidectomía

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INTRODUCTION: The use of mometasone furoate (MF) intranasal spray in treating adenoid hypertrophy (AH) has a variable outcome due the different methods of adenoid size evaluation. The aim of our study was to evaluate the effect of MF intranasal spray in children and adolescents with AH using a reliable and consistent endoscopic evaluation. MATERIAL AND METHOD: A prospective interventional study was conducted. Evaluation took place during the first visit (week 0) and second visit (week 12). Symptoms of nasal obstruction, rhinorrhoea, cough and snoring were assessed, and an overall total symptoms score was obtained. A rigid nasoendoscopic examination using a four-grading system of adenoid size from 1 to 4 was performed. Patients were treated with MF intranasal spray for 12 weeks. Patients' aged 7-11-years old used 1 spray in each nostril once daily, while patients aged 12-17 used two sprays in each nostril once daily. Reassessment was carried out during the second visit (week 12). RESULTS: A total of 74 patients was recruited. There were significant improvements from week 0 to week 12 in the symptoms' score for nose obstruction, rhinorrhoea, cough, snoring including the total nasal symptoms' score (p<0.001). AH significantly reduced in size from week 0 (2.89±.87) to week 12 (1.88±.83) (p<0.001). CONCLUSION: MF intranasal spray is effective in improving the symptoms attributed to AH as well as reducing the adenoid size. MF intranasal spray is advocated as a treatment option before adenoidectomy is considered.

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This study determines the median lethal dose, and describes the clinico-pathological changes and disease development following Streptococcus agalactiae infection in Javanese medaka model. Javanese medakas were infected with S. agalactiae via intraperitoneal (IP) from 104 to 108 CFU/mL, and immersion (IM) route from 103 to 107 CFU/mL. The LD50-240h and clinico-pathological changes of the fish was determined until 240 h post infection (hpi). Next, the disease development was determined for 96 hpi in the fish following IP and IM infection at 103 CFU/mL and 104 CFU/mL, respectively. The LD50-240h of S. agalactiae in Javanese medaka was lower following IP injection (4.5 × 102 CFU/mL), compared to IM route (3.5 × 103 CFU/mL). The clinical signs included separating from the schooling group, swimming at the surface of water column, lethargy, erratic swimming pattern, corneal opacity and exophthalmia. Histopathological examinations revealed generalized congestion in almost all internal organs, particularly in liver and brain, while the kidney displayed tubular necrosis. Both IP and IM routes showed significant positive correlation (p < 0.05) between the CFU/g of S. agalactiae in the fish tissue and fish deaths. Moreover, the lesions for histopathological scoring in selected organs following IP and IM challenges were also reflecting the CFU/g and fish deaths. This study indicates the capability of Javanese medaka as a model organism in study of streptococcosis development.

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Background: Lymphangiomas are congenital malformations of the lymphatic system with characteristic dilated endothelium-lined spaces. It is vulnerability to infection or chemical irritants cause spontaneous reduction in size and in some cases complete resolution. Intralesional injection of OK-432 or Picibanil (lyophilized incubation mixture of Group A Streptococcus pyogenes of human origin) is slowly gaining recognition as its safety and efficacy standards have shown to avoid complications resulting from surgical interventions. The objective of this study was to evaluate the clinical outcomes of cystic hygroma patients who received OK-432 injections. Methods: In between 2011 and 2013, six patients with cystic hygroma received intralesional injection of OK-432. All the patients were assessed clinically and radiologically either via ultrasound, computer tomography (CT) or magnetic resonant imaging (MRI) prior to and after receiving the injections. Patients’ response towards treatment was classified as total shrinkage, marked shrinkage (greater than 50% reduction in size), slight shrinkage (less than 50% reduction in size) or non-responsive to treatment. Results: Mean duration of follow-up was 12 months. Total shrinkage was achieved in one patient, marked shrinkage in three patients and one patient experienced mild shrinkage. Only one out of the six patients showed no response to treatment. None of the patients in this study experienced serious complications or adverse effects post intralesional injection of OK-432. Conclusions: Intralesional OK-432 injection is an effective and safe alternative in treating cystic hygroma.