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MyMedR (Malaysian Medical Repository) is an open access collection of Malaysian health and biomedical research. The materials are imported from PubMed and MyJurnal. We gratefully acknowledge the permission to reuse the materials from the National Library of Medicine of the United States and the Malaysian Citation Centre. This project is funded by Academy of Family Physicians of Malaysia. The project team members are: CL Teng, CJ Ng, EM Khoo, Mastura Ismail, Abrizah Abdullah, TK Chiew, Thanaletchumi Dharmalingam.

Please note that some citations are non-Malaysian publications. Common reasons are: (1) One or more authors had a Malaysian affiliation; (2) The article abstract mentioned Malaysia; (3) The study subjects included Malay ethnic group.

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  1. Khor CG, Kan SL, Tan BE
    Int J Rheum Dis, 2018 Jun;21(6):1322-1325.
    PMID: 24495523 DOI: 10.1111/1756-185X.12302
    We report a 29-year-old Malay man who had pulmonary manifestations as an initial presentation for systemic lupus erythematosus. He had prolonged hospitalization and was treated with intensive care therapy with immunosuppressants.
    MeSH terms: Adult; Critical Care; Hemorrhage/diagnosis; Hemorrhage/etiology*; Hemorrhage/therapy; Humans; Immunosuppressive Agents/therapeutic use; Length of Stay; Lupus Erythematosus, Systemic/complications*; Lupus Erythematosus, Systemic/diagnosis; Lupus Erythematosus, Systemic/drug therapy; Male; Pneumonia/diagnosis; Pneumonia/etiology*; Pneumonia/therapy; Tomography, X-Ray Computed; Treatment Outcome
  2. Yusuf S, Lonn E, Pais P, Bosch J, López-Jaramillo P, Zhu J, et al.
    N. Engl. J. Med., 2016 May 26;374(21):2032-43.
    PMID: 27039945 DOI: 10.1056/NEJMoa1600177
    BACKGROUND: Elevated blood pressure and elevated low-density lipoprotein (LDL) cholesterol increase the risk of cardiovascular disease. Lowering both should reduce the risk of cardiovascular events substantially.

    METHODS: In a trial with 2-by-2 factorial design, we randomly assigned 12,705 participants at intermediate risk who did not have cardiovascular disease to rosuvastatin (10 mg per day) or placebo and to candesartan (16 mg per day) plus hydrochlorothiazide (12.5 mg per day) or placebo. In the analyses reported here, we compared the 3180 participants assigned to combined therapy (with rosuvastatin and the two antihypertensive agents) with the 3168 participants assigned to dual placebo. The first coprimary outcome was the composite of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, and the second coprimary outcome additionally included heart failure, cardiac arrest, or revascularization. The median follow-up was 5.6 years.

    RESULTS: The decrease in the LDL cholesterol level was 33.7 mg per deciliter (0.87 mmol per liter) greater in the combined-therapy group than in the dual-placebo group, and the decrease in systolic blood pressure was 6.2 mm Hg greater with combined therapy than with dual placebo. The first coprimary outcome occurred in 113 participants (3.6%) in the combined-therapy group and in 157 (5.0%) in the dual-placebo group (hazard ratio, 0.71; 95% confidence interval [CI], 0.56 to 0.90; P=0.005). The second coprimary outcome occurred in 136 participants (4.3%) and 187 participants (5.9%), respectively (hazard ratio, 0.72; 95% CI, 0.57 to 0.89; P=0.003). Muscle weakness and dizziness were more common in the combined-therapy group than in the dual-placebo group, but the overall rate of discontinuation of the trial regimen was similar in the two groups.

    CONCLUSIONS: The combination of rosuvastatin (10 mg per day), candesartan (16 mg per day), and hydrochlorothiazide (12.5 mg per day) was associated with a significantly lower rate of cardiovascular events than dual placebo among persons at intermediate risk who did not have cardiovascular disease. (Funded by the Canadian Institutes of Health Research and AstraZeneca; ClinicalTrials.gov number, NCT00468923.).

    MeSH terms: Rosuvastatin Calcium/administration & dosage*; Rosuvastatin Calcium/adverse effects; Aged; Antihypertensive Agents/administration & dosage*; Antihypertensive Agents/adverse effects; Benzimidazoles/administration & dosage*; Cardiovascular Diseases/epidemiology; Cardiovascular Diseases/prevention & control*; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Hydrochlorothiazide/administration & dosage*; Hypertension/drug therapy*; Cholesterol, LDL/blood; Male; Middle Aged; Risk Factors; Tetrazoles/administration & dosage*; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage*; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects; Medication Adherence
  3. Sharma G, Vasanth Kumar S, Wahab HA
    J. Biomol. Struct. Dyn., 2018 01;36(1):233-242.
    PMID: 28013578 DOI: 10.1080/07391102.2016.1274271
    A series of dimeric naphthoquinones containing natural 2-hydroxy-1-4-naphthoquinone moiety was designed, synthesized, and evaluated against neuraminidase of H5N1 virus. p-hydroxy derivatives showed higher inhibition when compared to p-halogenated compounds. Molecular docking studies conducted with H5N1 neuraminidase clearly demonstrated different binding modes of the most active compound onto the open and closed conformations of loop 150. The results thus provide not only evidences of a novel scaffold evaluated as inhibitor, but also a rational explanation involving molecular modeling and the role of loop 150 in the binding.
    MeSH terms: Binding Sites; Enzyme Inhibitors/metabolism; Enzyme Inhibitors/pharmacology; Enzyme Inhibitors/chemistry; Humans; Naphthoquinones/metabolism; Naphthoquinones/pharmacology; Naphthoquinones/chemistry*; Neuraminidase/antagonists & inhibitors; Neuraminidase/metabolism; Neuraminidase/chemistry*; Molecular Structure; Influenza A Virus, H5N1 Subtype/enzymology*; Molecular Docking Simulation*; Protein Domains
  4. Irish AB, Viecelli AK, Hawley CM, Hooi LS, Pascoe EM, Paul-Brent PA, et al.
    JAMA Intern Med, 2017 02 01;177(2):184-193.
    PMID: 28055065 DOI: 10.1001/jamainternmed.2016.8029
    Importance: Vascular access dysfunction is a leading cause of morbidity and mortality in patients requiring hemodialysis. Arteriovenous fistulae are preferred over synthetic grafts and central venous catheters due to superior long-term outcomes and lower health care costs, but increasing their use is limited by early thrombosis and maturation failure. ω-3 Polyunsaturated fatty acids (fish oils) have pleiotropic effects on vascular biology and inflammation and aspirin impairs platelet aggregation, which may reduce access failure.

    Objective: To determine whether fish oil supplementation (primary objective) or aspirin use (secondary objective) is effective in reducing arteriovenous fistula failure.

    Design, Setting, and Participants: The Omega-3 Fatty Acids (Fish Oils) and Aspirin in Vascular Access Outcomes in Renal Disease (FAVOURED) study was a randomized, double-blind, controlled clinical trial that recruited participants with stage 4 or 5 chronic kidney disease from 2008 to 2014 at 35 dialysis centers in Australia, Malaysia, New Zealand, and the United Kingdom. Participants were observed for 12 months after arteriovenous fistula creation.

    Interventions: Participants were randomly allocated to receive fish oil (4 g/d) or matching placebo. A subset (n = 406) was also randomized to receive aspirin (100 mg/d) or matching placebo. Treatment started 1 day prior to surgery and continued for 12 weeks.

    Main Outcomes and Measures: The primary outcome was fistula failure, a composite of fistula thrombosis and/or abandonment and/or cannulation failure, at 12 months. Secondary outcomes included the individual components of the primary outcome.

    Results: Of 1415 eligible participants, 567 were randomized (359 [63%] male, 298 [53%] white, 264 [47%] with diabetes; mean [SD] age, 54.8 [14.3] y). The same proportion of fistula failures occurred in the fish oil and placebo arms (128 of 270 [47%] vs 125 of 266 [47%]; relative risk [RR] adjusted for aspirin use, 1.03; 95% CI, 0.86-1.23; P = .78). Fish oil did not reduce fistula thrombosis (60 [22%] vs 61 [23%]; RR, 0.98; 95% CI, 0.72-1.34; P = .90), abandonment (51 [19%] vs 58 [22%]; RR, 0.87; 95% CI, 0.62-1.22; P = .43), or cannulation failure (108 [40%] vs 104 [39%]; RR, 1.03; 95% CI, 0.83-1.26; P = .81). The risk of fistula failure was similar between the aspirin and placebo arms (87 of 194 [45%] vs 83 of 194 [43%]; RR, 1.05; 95% CI, 0.84-1.31; P = .68).

    Conclusions and Relevance: Neither fish oil supplementation nor aspirin use reduced failure of new arteriovenous fistulae within 12 months of surgery.

    Trial Registration: anzctr.org.au Identifier: CTRN12607000569404.

    MeSH terms: Administration, Oral; Adult; Arteriovenous Shunt, Surgical*; Aspirin/therapeutic use*; Constriction, Pathologic/prevention & control*; Double-Blind Method; Female; Fibrinolytic Agents/therapeutic use*; Fish Oils/therapeutic use*; Graft Occlusion, Vascular/prevention & control*; Renal Dialysis*; Humans; Kidney Failure, Chronic/therapy*; Male; Middle Aged; Vascular Patency/drug effects*; Treatment Outcome; Dietary Supplements
  5. Iwani NA, Jalaludin MY, Zin RM, Fuziah MZ, Hong JY, Abqariyah Y, et al.
    Sci Rep, 2017 01 06;7:40055.
    PMID: 28059134 DOI: 10.1038/srep40055
    The purpose of this study was to investigate the usefulness of triglyceride to hdl-c ratio (TG:HDL-C) as an insulin resistance (IR) marker for overweight and obese children. A total of 271 blood samples of obese and overweight children aged 9-16 years were analysed for fasting glucose, lipids and insulin. Children were divided into IR and non-insulin resistance, using homeostasis model assessment (HOMA). The children were then stratified by tertiles of TG: HDL-C ratio. The strength between TG:HDL-C ratio and other parameters of IR were quantified using Pearson correlation coefficient (r). Odds ratio was estimated using multiple logistic regression adjusted for age, gender, pubertal stages and IR potential risk factors. Children with IR had significantly higher TG:HDL-C ratio (2.48) (p = 0.01). TG:HDL-C ratio was significantly correlated with HOMA-IR (r = 0.104, p 
    MeSH terms: Adolescent; Blood Glucose/analysis; Child; Female; Humans; Insulin/blood; Insulin Resistance*; Cholesterol, HDL/blood*; Male; Triglycerides/blood*; Biomarkers/blood*; Overweight/complications*; Overweight/pathology*
  6. Lin HR, Heish CW, Liu CH, Muduli S, Li HF, Higuchi A, et al.
    Sci Rep, 2017 01 10;7:40069.
    PMID: 28071738 DOI: 10.1038/srep40069
    Human adipose-derived stem cells (hADSCs) are easily isolated from fat tissue without ethical concerns, but differ in purity, pluripotency, differentiation ability, and stem cell marker expression, depending on the isolation method. We isolated hADSCs from a primary fat tissue solution using: (1) conventional culture, (2) a membrane filtration method, (3) a membrane migration method where the primary cell solution was permeated through membranes, adhered hADSCs were cultured, and hADSCs migrated out from the membranes. Expression of mesenchymal stem cell markers and pluripotency genes, and osteogenic differentiation were compared for hADSCs isolated by different methods using nylon mesh filter membranes with pore sizes ranging from 11 to 80 μm. hADSCs isolated by the membrane migration method had the highest MSC surface marker expression and efficient differentiation into osteoblasts. Osteogenic differentiation ability of hADSCs and MSC surface marker expression were correlated, but osteogenic differentiation ability and pluripotent gene expression were not.
    MeSH terms: Adipose Tissue/cytology*; Cell Differentiation*; Cell Movement*; Cell Separation/methods*; Filtration/methods*; Humans; Stem Cells/physiology*; Biomarkers/analysis
  7. Wong TH, Gupta ED, Radhakrishnan AK, Gun SC, Chembalingam G, Yeap SS
    Int J Rheum Dis, 2018 May;21(5):992-1000.
    PMID: 28217867 DOI: 10.1111/1756-185X.13048
    AIM: Vitamin D3 [25(OH)D] has been shown to be important in bone health and can influence rheumatoid arthritis (RA) disease activity. Vitamin D-binding protein (VDBP) levels vary with race and may modulate 'bioavailable' levels of 25(OH)D. The aim of this study was to explore the relationships between 25(OH)D, VDBP and clinical factors on bone mineral density (BMD) in a group of multi-ethnic Malaysian RA patients and healthy controls.

    METHODS: A cross-sectional study of 77 female RA patients and 29 controls was performed. Serum 25(OH)D was measured using the Elecsys® Vitamin D total assay. Serum VDBP was measured using a Quantikine® enzyme-linked immunosorbent assay kit. BMD was assessed using dual-energy X-ray absorptiometry (DXA).

    RESULTS: Overall, mean 25(OH)D levels were 42.66 ± 21.75 nmol/L with no significant difference between RA patients and controls. 25(OH)D levels were significantly higher in Chinese, compared to Malay/Indian subjects. In RA patients, menopausal status and body mass index (BMI) were significantly associated with BMD but not 25(OH)D or RA Disease Activity Score of 28 joints (DAS28). There was no significant correlation between 25(OH)D and DAS28, even after correction for menopausal status and BMI. VDBP levels were not significantly different between the races and did not significantly correlate with BMD, 25(OH)D overall, or DAS28 in RA patients.

    CONCLUSIONS: In Malaysian RA patients, menopausal status and BMI were more important influences on BMD than 25(OH)D or RA disease activity. The utility of measuring VDBP levels in this population remains uncertain.

    MeSH terms: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid/blood*; Arthritis, Rheumatoid/ethnology; Arthritis, Rheumatoid/pathology*; Cross-Sectional Studies; Enzyme-Linked Immunosorbent Assay; Female; Humans; Malaysia; Menopause/blood; Menopause/ethnology; Middle Aged; Severity of Illness Index; Vitamin D/analogs & derivatives*; Vitamin D/blood; Vitamin D-Binding Protein/blood*; Biomarkers/blood; Absorptiometry, Photon; Bone Density*; Body Mass Index; Case-Control Studies; Asian Continental Ancestry Group
  8. Lee YK, Ng CJ, Low WY
    J Eval Clin Pract, 2017 Dec;23(6):1281-1288.
    PMID: 28585242 DOI: 10.1111/jep.12777
    RATIONALE, AIMS, AND OBJECTIVES: Patient concerns are often neglected in consultations, especially for chronic diseases where patients and providers fall into the routine of chronic disease management in consultations. One strategy to elicit patient concerns has been to ask patients to complete agenda lists before the consultation. This study aimed to explore the impact of a preconsultation agenda website in addressing patients' unmet needs during chronic disease consultations.

    METHODS: Patients entered their concerns into a website (Values In Shared Interactions Tool (VISIT)). Doctors accessed this information via the electronic medical records before consultations. Individual in-depth interviews were then conducted with patients and doctors on the website's impact on consultations. Interviews were transcribed verbatim and analysed thematically.

    RESULTS: The average age (years) was 65.7 for patients (n = 8) and 35.7 for doctors (n = 7). Patients in the study entered between 1 to 6 items in the website. From postconsultation interviews, we found that the website impacted the consultation in 5 ways: (1) It facilitated patients to communicate their full agenda to doctors; (2) it helped address unmet patient needs as it gave them opportunity to raise other issues besides their chronic condition; (3) it facilitated rapport between doctor and patient; (4) it facilitated doctors to organize their consultation around the concerns the patient had listed; and (5) it disrupted the doctor's usual consultation style if the list of concerns was lengthy.

    CONCLUSIONS: Integrating patient concerns into electronic health records helped to facilitate patient-centred consultations. Doctors found this information useful but felt uneasy if the agenda list was too long or too complex. Areas for future studies include training doctors to manage complex agendas and formal evaluation of the VISIT tool.

    MeSH terms: Adult; Aged; Chronic Disease/therapy*; Female; Humans; Male; Middle Aged; Patient Participation/methods*; Physician-Patient Relations*; Patient Satisfaction; Patient-Centered Care; Internet*
  9. Bin Sintang MD, Danthine S, Patel AR, Rimaux T, Van De Walle D, Dewettinck K
    J Colloid Interface Sci, 2017 Oct 15;504:387-396.
    PMID: 28586736 DOI: 10.1016/j.jcis.2017.05.114
    In order to modify the self-assembly of sucrose esters (SEs) in sunflower oil, we added sunflower lecithin (SFL) as co-surfactant. It is hypothesized that SFL modifies the self-assembly of SEs by interrupting the extensive hydrogen bonding between SEs monomers. The addition of SFL into SEs induced gelation of the mixed surfactant system oleogels at all studied ratios. The 7:3 SEs:SFL combination showed enhanced rheological properties compared to the other studied ratios, which suggests better molecular ordering induced by SFL. The modifications might have been caused by interference in the hydrogen bonding, connecting the polar heads of SEs molecules in the presence of SFL. This effect was confirmed by thermal behavior and small angle X-ray diffraction (SAXD) analysis. From the crystallization and melting analyses, it was shown that the peak temperature, shape and enthalpy decreased as the SFL ratio increases. Meanwhile, the bi-component oleogels exhibited new peaks in the SAXD profile, which imply a self-assembly modification. The microscopic study through polarized and electrons revealed a change in the structure. Therefore, it can be concluded that a synergistic effect between SEs and SFL, more particularly at 7:3 ratio, towards sunflower oil structuring could be obtained. These findings shed light for greater applications of SEs as structuring and carrier agent in foods and pharmaceutical.
    MeSH terms: Crystallization; Esters/chemistry; Gels/chemistry*; Hydrogen Bonding; Sucrose/chemistry*; Surface-Active Agents/chemistry*; X-Ray Diffraction; Lecithins/chemistry*
  10. Sadeghi M, Popov V, Guzman H, Phan TG, Vasilakis N, Tesh R, et al.
    Virus Res., 2017 10 15;242:49-57.
    PMID: 28855097 DOI: 10.1016/j.virusres.2017.08.012
    Eleven viral isolates derived mostly in albopictus C6/36 cells from mosquito pools collected in Southeast Asia and the Americas between 1966 and 2014 contained particles with electron microscopy morphology typical of reoviruses. Metagenomics analysis yielded the near complete genomes of three novel reoviruses, Big Cypress orbivirus, Ninarumi virus, and High Island virus and a new tetravirus, Sarawak virus. Strains of previously characterized Sathuvarachi, Yunnan, Banna and Parry's Lagoon viruses (Reoviridae), Bontang virus (Mesoniviridae), and Culex theileri flavivirus (Flaviviridae) were also characterized. The availability of these mosquito virus genomes will facilitate their detection by metagenomics or PCR to better determine their geographic range, extent of host tropism, and possible association with arthropod or vertebrate disease.
    MeSH terms: Animals; Asia, Southeastern; Culicidae/virology*; Reoviridae/classification; Reoviridae/genetics*; Reoviridae/isolation & purification*; Genome, Viral; Sequence Analysis, DNA; Flaviviridae/classification; Flaviviridae/genetics*; Flaviviridae/isolation & purification*; Nidovirales/classification; Nidovirales/genetics*; Nidovirales/isolation & purification*
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