Opportunities to prevent and manage undernutrition to amplify efforts to end TB

The bidirectional relationship between TB and nutrition is well recognized – primary undernutrition is a risk factor for developing TB disease, while TB results in wasting. Although nutrition support is acknowledged as an important intervention in TB programmes, it is seldom afforded commensurate priority for action. TB incidence and deaths worldwide are falling too slowly to meet WHO End TB Strategy milestones, and the number of undernourished people is increasing, likely to be further exacerbated by the ongoing COVID-19 pandemic. Undernutrition needs to be more urgently and intensively addressed. This is especially true for the WHO South-East Asia Region, where the high rates of undernutrition are a key driver of the TB epidemic. The evidence base has been sufficiently robust for clear and workable programmatic guidance to be formulated on assessment, counselling and interventions for TB patients. Many high-burden countries have developed policies addressing TB and nutrition. Gaps in research to date have frustrated the development of more refined programmatic approaches related to addressing TB and malnutrition. Future research can be shaped to inform targeted, actionable policies and programmes delivering dual benefits in terms of undernutrition and TB. There are clear opportunities for policy-makers to amplify efforts to end TB by addressing undernutrition.

HBV-HCC treatment with mRNA electroporated HBV-TCR T cells

Hepatocellular carcinoma is a significant global health challenge with steadily increasing incidence in the East Asia region. While both Hepatitis C and B virus infections account for the majority of HCC cases, the advent of potent antivirals against HCV infection have biased the aetiology towards chronic HBV infection that at the moment remains without an effective cure. For this reason, HBV-HCC remains a persistent global problem. Treatment options for intermediate to advance stages of HBV-HCC remains limited, hence novel therapeutic strategies are required to fulfil this medical need. Following the considerable success of adoptive T cell immunotherapy against B cell malignancies, it is conceivable to envision whether the same could be achieved against HBV-HCC. In this review, we describe the development of T cell therapy strategies for HBV-HCC and discuss the safety and the efficacy of the strategy in terms of the direct killing of tumour cells and the other alterations possibly induced by the action of the T cells.

Incidence and risk factors for dysglycaemia in Asian-Indians: a 10-year population-based prospective cohort study

BackgroundDiabetes prevalence estimates suggest an increasing trend in South-East Asia region, but studies on its incidence are limited. The current study aims to estimate the incidence of type 2 diabetes and pre-diabetes in a population-based cohort from India.MethodsA subset of Chandigarh Urban Diabetes Study cohort (n=1878) with normoglycaemia or pre-diabetes at baseline was prospectively followed after a median of 11 (0.5–11) years. Diabetes and pre-diabetes were diagnosed as per WHO guidelines. The incidence with 95% CI was calculated in 1000 person-years and Cox proportional hazard model was used to find the association between the risk factors and progression to pre-diabetes and diabetes.ResultsThe incidence of diabetes, pre-diabetes and dysglycaemia (either pre-diabetes or diabetes) was 21.6 (17.8–26.1), 18.8 (14.8–23.4) and 31.7 (26.5–37.6) per 1000 person-years, respectively. Age (HR 1.02, 95% CI 1.01 to 1.04), family history of diabetes (HR 1.56, 95% CI 1.09 to 2.25) and sedentary lifestyle (HR 1.51, 95% CI 1.05 to 2.17) predicted conversion from normoglycaemia to dysglycaemia, while obesity (HR 2.43, 95% CI 1.21 to 4.89) predicted conversion from pre-diabetes to diabetes.ConclusionA high incidence of diabetes and pre-diabetes in Asian-Indians suggests a faster conversion rate to dysglycaemia, which is partly explained by sedentary lifestyle and consequent obesity in these individuals. The high incidence rates call for a pressing need for public health interventions targeting modifiable risk factors.

The ASEAN “Crack”: Myanmar Conflict as The Warning Sign of Peace Stability in South East Asia Region

ASEAN currently facing a real strive to deal with their own internal humanitarian and peace stability related to the case of Myanmar conflict. This condition has put other ASEAN members in quandary to conduct a prompt and precise solution to bring back peace in Myanmar. This article examines the potential crack in the “ASEAN way” principle which is related to the various conflicts inside the region. Moreover, it also endorsed two possible proposals which can be considered to strengthen the role of ASEAN to take action towards their member states. The latest conflict inside Myanmar between military and democratic groups showed the warning sign that something is not working well within the system of ASEAN as a regional organization. This article investigates the potential crack that ASEAN has in their basic principle which harms the future peace stability within the region. The writer argues that the conflict in Myanmar has become a symptom that ASEAN must revisit their basic principle and reorganize their strategy to deal with potential conflict that might occur in the future.

Low Cost Plug and Abandonment with Hybrid Hydraulic Pulling Unit

Plug and Abandonment (P&A) operations with conventional Hydraulic Workover Unit (WHU) have an enormous benefit and impact on low-cost P&A campaign in Malaysia compare with using conventional drilling rig. Subsequently, this Hybrid Hydraulic Pulling Unit (HHPU) was the first successful deployed and safely delivered for P&A campaign together with conductor removal in offshore West Malaysia. This paper presents case study that showcase the capability of HHPU for low-cost permanent P&A campaign by eliminate requirement for additional bringing rigging-up and rigging-down of casing jack unit for conductor removal operation. The unit manage to cut and pull-out the existing completion strings, setting cement plugs, cut and pull-out multiple strings of casing along with retrieving the 24″ conductors delivering the most advantageous outcome for P&A campaign safely, efficiently and cost effectively. It was invented from 340K HWU with improvise features that capable of pull-out existing completion string and removal of the conductor with size up to 36″. This paper demonstrates a unique combination of techniques and equipment of a successfully low-cost P&A operation with excellent client satisfaction with no incident and accident were recorded. The end results may contradict traditional P&A methods, but the case history can be used for future reference or potential replication in South East Asia region.

Framework for planning and monitoring active TB case finding interventions to meet the global targets in the COVID-19 era and beyond: South-East Asia perspective

There was an estimated 20–40% decline in tuberculosis (TB) case detection in the South-East Asia Region (SEA Region) during 2020 due to COVID-19 outbreak. This is over and above a million people with TB who were missed each year, prior to the pandemic. Active case finding (ACF) for TB has been gaining considerable interest and investment in the SEA Region and will be even more essential for finding people with TB missed due to the COVID-19 pandemic. Many countries in the Region have incorporated ACF activities into national strategic plans and are conducting large scale activities with varying results. ACF can reach people with TB earlier than routine approaches, can lead to increases in the numbers of people diagnosed, and is often needed for certain key populations who face stigma, social, and economic barriers. However, ACF is not a one size fits all approach, and has higher costs than routine care. So, planning interventions in consultation with relevant stakeholders including the affected communities is critical. Furthermore, continuous monitoring during the intervention and after completion is crucial as national TB programmes review progress and decide on the effective utilization of limited resources. Planning and monitoring become more relevant in the COVID-19 era because of constraints posed by resource diversion towards pandemic control. Here, we summarize different aspects of planning and monitoring of ACF approaches to inform national TB programmes and partners based on experiences in the SEA Region, as programmes look to reach those who are missed and catch-up on progress towards ending TB.

A Critical Study of Kumpulan Militant Malaysia, its Wider Connections in the Region and the Implications of Radical Islam for the Stability of Southeast Asia

<p>This study analyzes the existence and political history of Kumpulan Militan Malaysia (Malaysia Militant Group-KMM); the most spectacular Muslim militant group to recently emerge from Malaysia. Using an interpretive framework derived from typology of radicalism, this study exposes the roots of the group and its transformation into a militant movement. Based on extensive fieldwork, numerous interviews and in-depth research of related documents, this study demonstrates that the existence of KMM cannot be dissociated from Afghanistan’s global Jihadist campaign. This study analyzes the activities of KMM in the context of radical Islam in the South East Asia region and its wider connection, particularly with the Jemaah Islamiyah (JI). Findings from fieldwork research conducted with active and ex-members of KMM and JI are presented to find the answer to the question pertaining the involvement of these two groups in terrorism activities in Southeast Asia. Southeast Asian contemporary social and political scenarios have been build-up from a long history of rebellious freedom fighters against colonial super-powers. In addition to nationalism, Islamization has also played a significant role in establishing freedom movements in the 1940s and 1950s. Systematic pressure under colonial powers and harsh policies implemented by ultra nationalists to these groups resulted in a series of rebellions and defiance such as what happened in Indonesia, Southern Thailand and the Southern Philippines. Historical facts led to radicalism in these countries, which are important for gaining a better knowledge about Muslim radicalism in Southeast Asia also presented in this thesis. The ‘typology of radicalism’ - the transformation from ‘nominal believers’ to activists, extremists, radicals and terrorists is explained in this research. Understanding Islam and their willingness to perform Jihad as was carried out in Afghanistan has had a significant impact on today’s militants. Finally, this research suggests the best methods for overcoming radicalism and diffusing KMM and JI’s threat in Southeast Asia.</p>