The t(14;18)(q32;q21) chromosomal translocation induces BCL2 protein expression in most follicular lymphomas. However, a small number of cases lack BCL2 expression despite carrying the t(14;18)(q32;q21) translocation. This study aims to explore the mechanism accounting for the lack of BCL2 protein expression when the t(14;18) translocation is present.
We investigated the role of renal sympathetic innervation in the deterioration of renal haemodynamic and excretory functions during the early post-ischaemic phase of renal ischaemia/reperfusion injury.
The development of novel therapeutic agents is essential for combating the increasing number of cases of dengue fever in endemic countries and among a large number of travelers from non-endemic countries. The dengue virus has three structural proteins and seven non-structural (NS) proteins. NS3 is a multifunctional protein with an N-terminal protease domain (NS3pro) that is responsible for proteolytic processing of the viral polyprotein, and a C-terminal region that contains an RNA triphosphatase, RNA helicase and RNA-stimulated NTPase domain that are essential for RNA replication. The serine protease domain of NS3 plays a central role in the replicative cycle of dengue virus. This review discusses the recent structural and biological studies on the NS2B-NS3 protease-helicase and considers the prospects for the development of small molecules as antiviral drugs to target this fascinating, multifunctional protein.
Urinary incontinence is a common but poorly understood problem in the elderly population. The aim of this study was to determine the prevalence of urinary incontinence and its associated factors among the elderly in a community setting.
Blunt abdominal trauma can cause multiple internal injuries. However, these injuries are often difficult to accurately evaluate, particularly in the presence of more obvious external injuries. Computed tomography (CT) imaging is currently used to assess clinically stable patients with blunt abdominal trauma. CT can provide a rapid and accurate appraisal of the abdominal viscera, retroperitoneum and abdominal wall, as well as a limited assessment of the lower thoracic region and bony pelvis. This paper presents examples of various injuries in trauma patients depicted in abdominal CT images. We hope these images provide a resource for radiologists, surgeons and medical officers, as well as a learning tool for medical students.
Necrotizing fasciitis of the head and neck is a rare, rapidly progressive infection involving the skin, subcutaneous tissue and fascia. We report three cases of necrotizing fasciitis that differ in their presentation and outcome. The first case involves a patient who presented with progressively enlarging anterior neck swelling that was later complicated by dehydration and reduced consciousness. The second case is a patient with neck swelling and ipsilateral otorrhea. The third case concerns a patient with a buccal ulcer complicated by ipsilateral facial swelling. All of them underwent a fasciotomy with wound debridement with the addition of a cortical mastoidectomy in the second case. Two of these patients recovered well. Unfortunately, the third case succumbed to death due to airway compromise and septicaemia. We advocate the importance of eradicating the source of infection followed by frequent, meticulous wound dressing and strict blood sugar control to obtain better outcomes in managing necrotizing fasciitis of the head and neck. However, involvement of the airway carries a grave prognosis despite aggressive treatment.
Bilateral vocal cord palsy is almost always caused by neck surgery, particularly surgery of the thyroid. We report a case of bilateral vocal cord palsy requiring emergency surgery to relieve the airway obstruction as the sole presentation of acquired syphilis. As the incidence of syphilis worldwide is rising, this unusual presentation may give clinicians a different perspective on the disease.
Ketamine can be abused as a recreational drug, and there has been a recent surge in its usage. The effects of ketamine on the urinary system were unknown until the recent publication of a few case reports. Many doctors are still unaware of this new clinical entity, termed ketamine-associated ulcerative cystitis. We report a case that we encountered and discuss the diagnosis and disease management in addition to a review of the literature.
It is universally known that breastfeeding provides a broad spectrum of nutritional and non-nutritional advantages to the developing infant. Nonnutritive protecting potentials of breast milk towards different infections and non-infectious diseases are still attracting the attention of researchers in different specialties. The neonate, who is suddenly exposed to a wide variety of organisms, is in dire need of protection, enhancement and education of his immature immune system to encounter these organisms. The lactating mammary gland is an integral part of the common mucosal immune system which stands as a sentinel in combating pathogens that enter the body via the mucosal route. The common mucosal immune system also competently controls tolerance mechanisms to innocent proteins and is involved in surveillance of carcinogensis. The diverse roles of general mucosal immunity are nearly well established but the specialised functions of breast tissue and breast milk in boosting the immune responses need more emphasis and highlighting. The detailed understanding and evaluation of breast milk as an immunological tool is reviewed within the domain of the diverse activities of the common mucosal immune system.
Understanding the experiences of household food insecurity is essential for better measurement and assessment of its nutritional, physical and psychological consequences. This qualitative study explored coping strategies and their perceived severity in relation to household food insecurity. Women (n=57; 20-50 years old) from rural and urban areas in Selangor and Negeri Sembilan participated in this study. These women were interviewed using a semi-structured questionnaire. The questionnaire was divided into two parts, that is, demographic and socio-economic information and women's experiences of coping with household food insecurity. Women were chosen since they were primarily responsible for food acquisition and preparation for the all household members. Thematic analysis was utilized in data analysis. Thematic analysis is a method for identifying, analysing and reporting patterns and themes of the qualitative data. Themes capture something important related to the study objectives and describe an integrating as well as relational idea from the data. Results showed that households displayed a variety of non-food related coping strategies and food-related coping strategies. Women's descriptions of non-food related coping strategies to food insecurity were categorised into five themes i.e. cloth purchasing behaviors, reduce school-going children's expenditure, delay the payment of bills, adjust lifestyle and increase cash and income earning. Food related coping strategies were categorised into four themes i.e. food stretching, food rationing, food seeking and food anxiety. Food stretching is a strategy of food insecurity that affects the quality of diet. Food rationing comprises coping strategies of food insecurity related to the quantity of food available for household's consumption. Food seeking is a strategy of acquiring food through socially unacceptable ways and food anxiety is a strategy that indicates households allocating money to buy staple food in order to prevent food insecurity. Each coping strategy showed a different level of perceived severity, that is, less severe, quite severe, severe and very severe. In conclusion, the qualitative data provide valuable information for understanding the experiences of food insecurity that can be used as a basis to develop direct indicators that can capture the core behaviours and their level of severity to measure household food insecurity.
This is a descriptive study on nutritional status of Orang Asli (Che Wong tribe) adults in Krau Wildlife Reserve. Twenty-six households, comprising 29 men and 28 women,participated in the study. Dietary diversity was assessed using food frequency questionnaire with 37 food groups. Weight, height and waist circumference were measured using standard instruments. The mean age for men and women was 39.9 ± 17.1 years and 33.7 ± 16.1 years, respectively. Most (89.5%) of the adults had no formal education and about 89.5% of households were categorised as poor. There were 13.8% underweight, 72.4% normal, 10.3% overweight and 3.3% obese men. For women, 25.0%, 46.4%, and 28.6% were underweight, normal and overweight, respectively. While none of the men had at-risk waist circumference (men >90 cm), about 21.4% of women had waist circumference of >80 cm. The mean dietary diversity score was 9.47 ± 4.15 with men (9.48 ± 3.70) and women (9.46 ± 4.63) having similar scores. There was a significant correlation between waist circumference and household income (r=0.36, p< 0.01); however, the association was only significant in women (r=0.50, p< 0.01). Although under-nutrition still prevails, there are emerging cases of overweight and obesity in this rural Orang Asli community undergoing nutrition transition especially among the females.
The main objective of this study was to determine the motives underlying the selection of foods between husbands and wives in an urban community. Thiscross-sectional study was carried out in Bandar Baru Bangi, Selangor, Malaysia among 150 married couples aged 20 and above, who voluntarily agreed to participate and were not on any special diet. Data were collected using the Food Choice Questionnaire (FCQ) which measured the health-related and non health related factor that influence people's food choices. It consisted of 36 items designed to assess the reported importance of nine factors: health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity, and ethical concern. In this study, the FCQ was adapted and a new factor, religion (religious guidelines), was included. Demographic characteristics including age, occupation, education, household income and household size were also collected. Data were analysed using SPSS version 16. Results showed that 40.7% of husbands (mean age= 43.33 + 11.16 years) and 55.3% of wives (mean age= 41.28 + 10.93 years) perceived themselves as the main food shopper while 12.0% of the husbands and 85.3% of the wives perceived themselves as the main meal planner. Husbands rated religion as the most prominent factor in food choice motives with a mean average rating of 4.56 + 0.59 on a 5-point rating scale, followed by health and convenience factor. Meanwhile, the wives rated health as the most essential factor with mean average rating of 4.49 + 0.58, followed by religion and convenience factor. Sensory appeal, ethical concerns and familiarity were rated as the bottom three factors of food choice motives among these two groups. Price of foods was not considered as an important factor in making food choices for the subjects in this study. In conclusion, the husbands and wives of this urban community rated religion, health and convenience as the three most important food choice motives in food selection.
Dental caries are attributed to various factors including diet. The present crosssectional study determined the frequency of sugary food and drink consumption and defined its relationship to dental caries among preschool children. A total of 50 preschoolers (aged 5-6 years) in three kindergartens of the Department of Community Development (KEMAS) in Titiwangsa, Kuala Lumpur participated in this study. A set of structured questionnaires was used to assess the frequency of sugary food and drink consumption. Dental check ups were performed by a dentist. The dft index (decayed, filled teeth) was used to describe incidence of caries in subjects. Results showed that 62% of the subjects had dental caries. with the mean dft score being 3.72. The frequency of sugary food consumption by the majority of subjects was 2 times a day, while the frequency of sugary drink consumption was more than 3 times a day. There was no significant relationship between frequency of sugary food and drink consumption with incidence of caries. Subjects with high dft scores were more likely to report dental pain. The prevalence of dental caries in preschoolers in this study was high, indicating a need for effective dental health promotion to improve dental health status of this age group.
A cross-sectional study was carried out to assess the physical activity levels among patients with type 2 diabetes mellitus (DM) at Cheras Health Clinic in Kuala Lumpur. A total of 132 subjects (62 men and 70 women) aged 30 years and above participated in this study. Data was collected using an interview based questionnaire to obtain socio-demographic and health profile information. Physical activity was assessed using a shortened version of the International Physical Activity Questionnaire (IPAQ). Anthropometric measurements and body fat were also taken. Glycaemic status, that is, HbA1c, fasting blood sugar (FBS) and 2 hours post-prandial (2-HPP) were obtained from medical records. Results showed that the mean age of the patients was 51.9 + 5.8 years. The majority of patients had poor glycaemic control based on HbA1c (70.7%), FBS (71.9%) and 2HPP (85.4%). Patients who were unmarried and aged(60 years and above had a lower physical activity level (p< 0.05). In the older age group, low physical activity was associated with poor glycaemic control (p< 0.05). Patients in the moderate and high physical activity level were motivated to perform physical activity so as to be healthy (68.1%). Low physical activity level among patients was due to lack of time (54.5%) and lack of energy (21.2%). In conclusion, physical activity levels of the patients were unsatisfactory and associated with poor glycaemic control, especially in the elderly. There is a need to encourage diabetic patients to undertake regular physical activity in order to achieve optimal glycaemic control.
Study site: Klinik Kesihatan Cheras, Kuala Lumpur, Malaysia
MeSH terms: Adult; Aged; Ambulatory Care Facilities; China/ethnology; Cross-Sectional Studies; Diabetes Mellitus, Type 2*; Female; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Male; Motor Activity; Exercise*
The Malaysian Dietary Guidelines (MDG) with eight key messages were first published in 1999. An updated version consisting of 14 key messages is being developed. The objective of this study was to evaluate the understanding of five key messages of the updated MDG among adults aged 18-59 years in Kuala Lumpur. A total of 773 adults comprising 330 Malays, 364 Chinese and 79 Indians were included in the study. A self-administrated questionnaire was used to obtain demographic data and to determine the level of understanding of key words and messages to be included in the new MDG. The results showed that 63% of the subjects were not aware of the existence of the MDG published in 1999. Overall, the understanding of the five messages in the updated MDG was moderate with a mean score of 60.0 ± 16.5. Between 52% to 93% of the subjects did not understand such key words as serving size, sedentary habits, blended vegetable oil and shortenings. The mean scores of understanding were significantly higher (p< 0.05) among the Chinese subjects (61.3 ± 17.8) than Malays (58.6 ± 14.2) and Indians (60.0 ± 18.9). The younger subjects (61.2 + 16.0) scored significantly (p< 0.05) higher than the older (58.7 ± 17.0) counterparts. There was also a significant association between the level of understanding of MDG with education level (p< 0.001) and occupational status (p< 0.001), respectively. This study suggests that some key words and messages in the updated MDG should be simplified to ensure that they are understood by Malaysians.
The teaching and research tool called 'DietPLUS', developed by the present author at an institution of higher learning in 2007, contains nutrient information of 840 food items in Excel format. DietPLUS functions as a '2-in-1' food composition database plus a rapid calculator of nutrient intakes, with the option of 'collapsing' the food composition face leaving only the nutrient calculator face. The macronutrients featured in the programme are energy, protein, fat, carbohydrates, dietary fibre, sugars (intrinsic + added), polyunsatuared omega-6 fatty acids (mainly linoleic acid, LA) and polyunsaturated omega-3 fatty acids [alphalinolenic acid (ALA) or eicosapentaenic acid (EPA) + docosahexaenolic acid (DHA)]. The micronutrients in the programme are vitamin A (as retinol equivalents, RE), vitamin C, thiamin (vitamin B1), riboflavin (vitamin B2), and niacin. Cholesterol content was included to complete the list of food components tabled. Food items consumed are converted into gram quantities (edible portion) and are entered in one column in the Excel programme which emphasises the simplicity and user-friendliness of the present nutrient calculator. DietPLUS instantaneously sums up the macronutrients and micronutrients consumed with each subsequent entry. Macronutrients (protein, fat, carbohydrate, sugars and dietary fibre) consumed are presented as gram quantities and a percentage of the Recommended Nutrient Intakes for Malaysia 2005. An approximate number of servings are also provided for vegetables, fruits, legumes, fish and meat, which may be useful in meal planning and nutrition/dietetic counselling.
The aims of this study are to determine and compare the antioxidant levels and activities (i.e. primary and secondary) between selected seeds of Malaysian tropical fruits - guava (Psidium guajava), mango (Mangifera indica L.) and papaya (Carica papaya L.). Seeds are among byproducts from the processing of fruitsbased products. Instead of discarding seeds as waste, seeds with high potential as antioxidants could be utilised for commercial purposes. Accordingly, the selected seeds of Malaysian tropical fruits were tested in this study for total phenolic content (TPC), free radical scavenging activity by 1, 1- diphenyl-2-picrylhydrazyl (DPPH) assay and metal ion chelating effect by ferrous ion chelating (FIC) assay. Extraction of antioxidant compounds from sample was done with 70% ethanol. TPCs of the seeds were expressed as gallic acid equivalents (GAE) in mg per 100 g fresh seed weight. TPC assay showed that mango seeds had the highest TPC (i.e. 32 ± 0.001 mg GAE) followed by guava seeds (i.e. 20 ± 0.001 mg GAE) and papaya seeds (8 ± 0.003 mg GAE). For DPPH assay, IC50 data showed that mango seed extract scavenged 50% DPPH radicals at the lowest concentration (0.11 ± 0.01 mg/mL) followed by the positive control BHA (0.13 ± 0.01 mg/mL), guava seed extract (0.26 ± 0.01 mg/mL) and papaya seed extract (0.34 ± 0.01 mg/mL). Interestingly, all seed extracts showed higher free radical scavenging activities than BHA after sample concentration of 0.60 mg/mL. However, FIC assay indicated that metal ion chelating effects of all seed extracts were weaker than BHA suggesting that the fruit seeds are not sources of good metal ion chelators. Overall, present results suggest that TPC of the seeds show strong negative correlation with their primary antioxidant activity (r= -0.985, R2= 0.970), and not all compounds in extracts which could scavenge DPPH radicals are good metal ion chelators. Mango seeds relatively showed the highest antioxidant level and primary antioxidant activity followed by guava seeds and papaya seeds.