Cancer can be a major cause of poverty. This may be due either to the costs of treating and managing the illness as well as its impact upon people's ability to work. This is a concern that particularly affects countries that lack comprehensive social health insurance systems and other types of social safety nets. The ACTION study is a longitudinal cohort study of 10,000 hospital patients with a first time diagnosis of cancer. It aims to assess the impact of cancer on the economic circumstances of patients and their households, patients' quality of life, costs of treatment and survival. Patients will be followed throughout the first year after their cancer diagnosis, with interviews conducted at baseline (after diagnosis), three and 12 months. A cross-section of public and private hospitals as well as cancer centers across eight member countries of the Association of Southeast Asian Nations (ASEAN) will invite patients to participate. The primary outcome is incidence of financial catastrophe following treatment for cancer, defined as out-of-pocket health care expenditure at 12 months exceeding 30% of household income. Secondary outcomes include illness induced poverty, quality of life, psychological distress, economic hardship, survival and disease status. The findings can raise awareness of the extent of the cancer problem in South East Asia and its breadth in terms of its implications for households and the communities in which cancer patients live, identify priorities for further research and catalyze political action to put in place effective cancer control policies.
MeSH terms: Asia, Southeastern/epidemiology; Health Promotion; Humans; Neoplasms/economics*; Socioeconomic Factors; Health Care Costs*; Cost of Illness*
The use of manual stretching procedures has become more prevalent in cardiorespiratory physiotherapy to improve pulmonary functions. However, limited evidence exists regarding evaluation of their effectiveness. The study aimed to determine the impact of Intercostal (IC) stretch in improving the dynamic pulmonary function parameters (Forced Expiratory Volume in the first second (FEV1), Forced Vital Capacity (FVC) and FEV1/FVC % and respiratory rate among healthy adults. Thirty healthy male subjects were recruited based on inclusion and exclusion criteria. Subjects were assigned to the experimental group and the control group through random sampling method. In the experimental group, subjects underwent IC stretch for ten breaths on the inspiratory phase of the respiratory cycle with breathing control exercises in semi recumbent position, while in the control group, breathing control exercises alone were performed in the semi recumbent position. The results of the study showed, FEV1/FVC % in the experimental group significantly improved with P=0.017 (p<0.05) than the control group, which means IC stretch increased lung volume and lead to improved lung function. This study suggested the IC stretching with breathing control may be more effective in improving dynamic lung parameters especially FEV1/FVC % than breathing control alone.
The essential oils obtained by hydrodistillation from the fresh leaf and stem of Piper porphyrophyllum N.E. Br. were analyzed by GC and GC/MS. Thirty four constituents were identified in the leaf oil, while thirty eight constituents were identified in the stems oil. The most abundant components in the leaf oil included bicyclogermacrene (14.7 %), α-copaene (13.2 %) and β-phellandrene (9.5 %) while sabinene (15.5 %), bicyclogermacrene (12.3 %) and α-copaene (8.1 %) were the main constituents in the stem oil. The evaluation of antibacterial activity by using micro-dilution method revealed that both oils were moderately active against all the Gram-positive bacteria (Staphylococcus aureus, Bacillus subtilis) and Gram-negative bacteria (Pseudomonas aeruginosa, Pseudomonas putida and Escherichia coli) with minimum inhibitory concentration (MIC) values in the range 125-1000 µg/ml.
Interleukin-6 (IL6; proinflammatory marker), von Willebrand Factor (vWF; endothelial dysfunction marker) and P-selectin (platelet activation marker), may play important roles in defining the pathogenesis of vulnerable plaques in acute coronary syndrome (ACS). This study aims to investigate the expression and relationship of these markers in early phases of ACS in a young and multiethnic Malaysian population.
Alcohol dehydrogenase (Adh) is a versatile enzyme involved in many biochemical pathways in plants such as in germination and stress tolerance. Sago palm is plant with much importance to the state of Sarawak as one of the most important crops that bring revenue with the advantage of being able to withstand various biotic and abiotic stresses such as heat, pathogens, and water logging. Here we report the isolation of sago palm Adh cDNA and its putative promoter region via the use of rapid amplification of cDNA ends (RACE) and genomic walking. The isolated cDNA was characterized and determined to be 1464 bp long encoding for 380 amino acids. BLAST analysis showed that the Adh is similar to the Adh1 group with 91% and 85% homology with Elaeis guineensis and Washingtonia robusta, respectively. The putative basal msAdh1 regulatory region was further determined to contain promoter signals of TATA and AGGA boxes and predicted amino acids analyses showed several Adh-specific motifs such as the two zinc-binding domains that bind to the adenosine ribose of the coenzyme and binding to alcohol substrate. A phylogenetic tree was also constructed using the predicted amino acid showed clear separation of Adh from bacteria and clustered within the plant Adh group.
Cardiovascular mortality is the leading cause of death in end stage renal disease. Despite being on continuous ambulatory peritoneal dialysis (CAPD), blood pressure (BP) remains poorly controlled. A higher pulse pressure and non dipping are associated with increased cardiovascular mortality. We studied BP control and the prevalence of non dipping in CAPD patients.
Curcuma longa (turmeric) rhizomes contains curcumin, an active compound which possesses anti-inflammatory effects. Collagen-induced arthritis (CIA) is an accepted experimental animal model of rheumatoid arthritis. The present study aimed to observe the histological changes in the joints of experimental arthritic rats treated with curcumin. Twenty four male Sprague-Dawley (approximately 7 weeks-old) rats were randomly divided into four groups. Three groups were immunized with 150 µg collagen. All rats with established CIA, with arthritis scores exceeding 1, were orally treated with betamethasone (0.5 mg/ml/kg body weight), curcumin (110 mg/ml/kg body weight) or olive oil (1.0 ml/kg body weight) daily, for two weeks. One remaining group was kept as normal control. Treatment with 110 mg/ml/kg curcumin showed significant mean differences in the average white blood cell (WBC) count (p<0.05), cell infiltration, bone and cartilage erosion scores (p<0.05) compared to the olive oil treated group. Pannus formation scores showed that curcumin supplementation successfully suppressed the pannus formation process that occurred in the articular cartilage of the CIA joints. The mean difference for histological scores for the curcumin group was insignificant compared to the betamethasone treated group. It is concluded that supplementation of curcumin has protective effect on the histopathological and degenerative changes in the joints of CIA rats which was at par with betamethasone.
Previous research has shown the beneficial effects of aqueous extract of Piper sarmentosum (P.s) on atherosclerosis. The first stage in atherosclerosis is the formation of foam cell. The aim of this study was to investigate the effect of the methanol extract of P.s on fatty streaks by calculating neointimal foam cell infiltration in rabbits fed with high cholesterol diet. Thirty six male New Zealand white rabbits were divided equally into six groups: (i) C: control group fed normal rabbit chow; (ii) CH: cholesterol diet (1 % cholesterol); (iii) PM1: 1 % cholesterol with methanol extract of P.s (62.5 mg/kg); (iv) PM2: 1 % cholesterol with methanol extract of P.s (125 mg/kg); (v) PM3: 1 % cholesterol with methanol extract of P.s (250 mg/kg); (vi) SMV group fed 1 % cholesterol supplemented with Simvistatin drug (1.2 mg/kg). All animals were treated for 10 weeks. At the end of the treatment, the rabbits were fasted and sacrificed and the aortic tissues were collected for histological studies to measure the area of the neointimal foam cell infiltration using software. The thickening of intima ratio of atherosclerosis and morphological changes by scanning electron microscope were measured. The results showed that the atherosclerotic group had significantly bigger area of fatty streak compared to the control group. The area of fatty streak in the abdominal aorta was significantly reduced in the treatment groups which were similar with the SMV group. Similarly, there was a reduction in the number of foam cell in the treatment groups compared to the atherosclerotic group as seen under scanning microscope. In conclusion, histological study demonstrated that the methanol extract of the P.s could reduce the neointimal foam cell infiltration in the lumen of the aorta and the atherosclerotic lesion.
Tumor necrosis factor alpha (TNFα) is a multifunctional cytokine which plays a pivotal role in the pathogenesis of rheumatoid arthritis (RA). Apart from its well recognized proinflammatory properties, it is known to interfere with lipid metabolism and erythropoiesis. We evaluated the effects of adalimumab on hematologic, lipid and inflammatory parameters using data from patients on adalimumab 40 mg fortnightly from 2 centers in Malaysia. Mean changes in laboratory values from baseline to Weeks 4, 12 and 24 were compared using paired T test and Wilcoxon signed-rank test. We studied 18 patients with RA who were on adalimumab 40 mg fortnightly. The inflammatory markers i.e. erythrocyte sedimentation rate and C reactive protein showed significant changes as early as at week 4 compared to baseline with p values of 0.003 and 0.005, respectively. From a baseline of high disease activity with a mean Disease Activity Score using 28 joint counts (DAS 28) of 5.3, there was a steady improvement in the disease activity and remission was achieved at week 24 with a DAS 28 of 2.4. The hemoglobin level improved at week 12 (p=0.013) and this was sustained till week 24. As opposed to previous studies, the LDL level significantly decreased at week 12 (p=0.015) and this change persisted till week 24 (p=0.001). The total cholesterol showed a similar pattern as the LDL. The pharmacodynamics of adalimumab therapy in rheumatoid arthritis extend beyond the joints with favorable effects on haemoglobin and lipid profile.
Study site: Putrajaya Hospital and Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
A survey was conducted to investigate patterns of fruits and vegetables consumption among Malaysian adults residing in Selangor, Malaysia. Two hundred forty two subjects comprises of male (28%) and female (72%) of major ethnics (Malays-52.3%; Chinese-30.5%; Indians-16.9%) with the mean age of 43.5±18 years were studied from July to November 2002. Consumption data for vegetables were collected using 24 hours duplicate samples method while for fruits 24-hour diet record was used. The results showed that most frequently consumed leafy, leguminous, root, brassica and fruits vegetables were celery (Apium graveolens), spinach (Spinacia oleracea), water spinach (Ipomoea aquatic), long beans (Vigna sesquipedolis), French beans (Phaseolus vulgaris), carrot (Daucas carota), potato (Solanum tuberosum), Chinese mustard (Brassica juncea), round cabbage (Brassica reptans), cauliflower (Brassica oleracea var cauliflora), chilies (red, green, small or dried) (Capsicum sp.), tomato (Lycopersicum esculentum), cucumber (Cucumis sativus), long eggplant (Solanum melongena) and okra (Hibiscus esculentus). While most consumed ulam and traditional vegetables were petai (Parkia speciosa), sweet leaves (Sauropus andragynus) and Indian pennywor (Hydrocotyle asiatica). Other vegetables inclusive spices and flavorings that were preferred by subjects were shallot (Allium fistulosum), garlic(Allium sativum), onion (Alium cepa), green bean sprout (Phaseolus aureus) and curry leaves (Murraya koenigii). The most preferred fruits were banana (Musa spp.) and apples (.Malus domestica). A total consumption of fruits and vegetables among adults in Selangor was 173 g/day and the consumption among Malays (202 g/day) was significantly higher (P
Klebsiella pneumoniae (K. pneumoniae) is one of the most important members of Klebsiella genus in Enterobacteriacae family, which is responsible for pneumonia (the destructive lung inflammation disease). Vegetables are known as source of contamination with K. pneumonia. Raw vegetables are usually consumed in salads and other dishes. The aim of this study was to investigate the occurrence of K. pneumoniae in raw vegetables marketed in Malaysia. Two hundred commonly used salad vegetables (lettuces, parsley, cucumber, tomato and carrot) from hypermarkets and wet markets were investigated for presence of K. pneumoniae using Most Probable Number-Polymerase Chain Reaction (MPN-PCR). K. pneumoniae was found to be significantly more frequent (100%) and (82.5%) in lettuce and cucumbers, respectively. K. pneumoniae contamination was lowest in carrot samples (30%). All samples were contaminated with K. pneumoniae ranging from
A total of 112 burger patties (35 beef burger patties, 39 chicken burger patties and 38 fish burger patties) which are commercially available at retail level were investigated for the presence and number of Listeria monocytogenes. These samples were analyzed using MPN-PCR method and conventional culturing methods. L. monocytogenes was detected in 33.3% of chicken burger patties, 22.9% of beef patties, and 10.5% of fish patty samples. From all contaminated raw burger patties, the estimated count of L. monocytogenes was ranged from 3 to 75 MPN/g. The results suggest that burger act as a potential source of listeriosis if the contaminated burger patty is consumed without adequate cooking. The risk associated with consumption of these samples was found to be high particularly for processed food at retail level in Malaysia. Therefore, food manufacturers play an important role in monitoring the manufacturing process and conduct a periodical surveillance on microbiological quality assessment on the processing plants. Besides, there is a need to increase awareness of consumers and food handlers to practice proper cooking of the burger patties before the point of consumption, to reduce the risk of listeria infection.
Two high protein wheat flour samples of Red Horse (RH) and Bake with Yen (BY) were examined for predominant Lactobacillus spp. in fermented liquid sourdough. The identification of Lactobacillus spp. was based on biochemical tests of catalase test, gas carbon dioxide production, arginine test, the ability to grow at temperature of 15°C and 45°C and carbohydrate fermentation using API50CH kit. Those strains were identified as Lactobacillus spp. and confirmed using polymerase chain reaction (PCR) of 16S rRNA partial sequencing analysis. In the present study, we successfully isolated and identified the Lactobacillus plantarum and L. fermentum which were predominant bacteria in liquid sourdough of the sample RH and BY brand, respectively.
Chili shrimp paste (CSP) is a favorite condiment in Southeast Asia. Microbial spoilage makes CSP unsuitable for consumption within several days. Thermal treatment was applied to produce microbiologically safe CSP. The effect of heating process on physicochemical and sensorial properties of CSP was studied. Heating at the optimum condition (21.6 min, 80 ˚C) has been shown effective and reliable in controlling microorganisms in CSP. Complete inactivation of peroxidase activities could not be accomplished at the optimal point, and significant reduction of the total phenolic and capsaicinoids contents was observed. Sensorial evaluation indicated that thermally processed CSP was less preferred by panelists when compared to freshly prepared samples of dry weight respectively.
This research was conducted to evaluate the effects of supplementation of jackfruit puree on probiotic (Lactobacillus acidophilus FTDC 1295) in terms of cell count, viability and nutritional value of dadih. Four samples of dadih were prepared in this investigation; Control, Jackfruit dadih, Probiotic dadih and Jackfruit Probiotic dadih (Control, ConJD, ConPD and JPD respectively). Results revealed that dadih supplemented with jackfruit puree (JPD) directly improved the probiotic cell counts which are significantly higher than the dadih without jackfruit puree (ConPD). The high probiotic viability in dadih (ConPD 92%; JPD 96%) indicated that it can be an effective probiotic delivery vehicle. The chemical compositions (moisture, total solids, fat, protein, mineral, organic acid, and pH) showed variations in its pattern due to the differential in formulations and the incorporations of probiotic bacteria. In addition, the Total Phenolic Content and the antioxidant capacity were reported to be the highest in dadih supplemented with jackfruit puree and probiotic (JPD) as compared with other dadih samples. These are attributed by the presence of jackfruit puree and probiotic in the samples which effectively increased the total phenolic content which directly increase the antioxidant activity
The objective of this research is recovery of squalene from palm fatty acid distillate (PFAD) using supercritical fluid extraction (SFE). The extraction process was performed by using the SFE and recovered squalene was analyzed from total lipid extracts using HPLC. A central composite design was used to study the effect of SFE variables namely pressure (X₁) from 200 to 400 bar and temperature (X₂) from 40 to 60⁰C on the total lipid extracts (Y₁) and squalene concentration (Y₂) and optimize the SFE conditions. The nonlinear regression equations were significantly (p < 0.05) fitted for both responses with high R₂ (> 0.965), which had no indication of lack of fit. The results indicated that a combined pressure (200 bar) and temperature (50⁰C) was predicted to provide the optimum region in terms of total lipid extracts (13.84 ± 0.52%) and squalene concentration (418.31 ± 18.40 ppm) studied.
5'-Phosphodiesterase (5'-PDE) is an enzyme that hydrolyses RNA to form 5'-inosine monophosphate (5'-IMP) and 5'-guanosine monophosphate (5'-GMP), which function as flavour enhancers. Selection of the best producer of 5'-PDE was made by determining the activity of the enzyme in six seeds that have been germinated, namely mung bean (Vigna radiate), soybean (Glycine max), adzuki/red bean (Vigna angularis L.), chick pea (Cicer arietinum), black eye pea (Vigna unguiculata) and petai (Parkia speciosa). Seeds that were not germinated acted as the control. In order to ensure there is no contamination from potential 5'-PDE-producing microorganisms during germination, microbial growth was reduced by using different surface sterilizing treatments where the seeds were soaked in 100 mL solution containing different concentrations of sodium hypochlorite (with or without 0.05% sodium azide) for 5 minutes before rinsing it five times with sterilized distilled water (total 500 mL). The seeds were observed every day for 3 days and the best surface sterilizing treatment was selected based on absence of mold growth and the effects on hypocotyl length. Sodium hypochlorite at 0.3% (v/v) concentration was able to inhibit mold growth in adzuki bean, soybean and chickpea. On the other hand, only 0.1% (v/v) sodium hypochlorite was needed to inhibit mold growth in black eye pea and petai, while mung bean required 0.05% (v/v) sodium hypochlorite to inhibit mold growth. Under these conditions, the growth of hypocotyl (hypocotyls length) was only slightly affected compared to the control. 5'-PDE was extracted from seeds that have been germinated for 24 hours and their control (ungerminated seeds) by homogenization in a blender with 400 mL of 50 mM acetate buffer, pH 4.5. After that, the homogenates were stirred for 30 min and the centrifuged at 9000 rpm for 15 min at 10°C. 5'-PDE activity was determined using thymidine 5'-monophosphate p-nitrophenyl ester as substrate at pH 7.0 and 55°C. The formation of nucleotide monophosphates, the products of reaction, was determined at 405 nm. As a strong presence of phosphomonoesterase (PME) will reduce the yield of nucleotide monophosphates as the enzyme hydrolyzes these products into nucleosides and orthophosphate, PME activity was also determined using p-nitrophenyl phosphate as the substrate at 60°C and pH 5.0. Thus, the seed with the highest 5'-PDE activity and a low PME activity can be selected. Germinated adzuki bean was found to have the highest 5'-PDE activity (0.59 µmol p-nitrophenol/min/mg protein) among the germinated seeds. A time-course study indicated that the level of 5'-PDE in adzuki bean increased with time of germination until 15 hours (0.69 µmol p-nitrophenol/min/mg protein), after which the acitivity decreased until it reached the basal level (0.44 µmol p-nitrophenol/min/mg protein) at 72 hours. On the other hand, PME in the bean was the highest at 9 h germination (0.98 µmol p-nitrophenol/min/mg protein). In general, controls have very low basal level of 5'-PDE activity (0.18- 0.42 µmol p-nitrophenol/min/mg protein).
Watermelon waste materials remained one of the important food grade agro-wastes generated by most hospitality industries in Southeast Asia and particularly in Malaysia. Jam was prepared from watermelon rind with different flavours (vanilla, pineapple, strawberry, lemon and no flavour). Five different samples were prepared at various compositions T₁ (50-50), T₂ (80-20), T₃ (60-40), T₄ (40-60) and T₅ (20-80) of rind and sugar. T₁ (50-50) gave the best jam set. Ten man panel (trained) evaluated the jam for its sensory characteristics and physicochemical analysis. Sensory evaluation conducted among five flavours was significantly different at (p>0.05). Chemical analysis showed that ascorbic acid reduced greatly among all treatments during three month storage. Soluble sugar and pH also decreased gradually for T₁ (from 4.96 to 4.40), T₂ (from 4.92 to 4.21), T₃ (from 4.74 to 4.11), T₄ (from 4.62 to 4.51) and T₅ (from 4.52 to 4.25) upon storage. Strawberry flavoured jam was most acceptable by the panel.
This study was to investigate the effects of wheat flour substitution with legume flour (mung bean and chick pea) in cookies in terms of the physicochemical and organoleptic properties. Three formulations of cookies were prepared from (a) Control (100% wheat flour), (b) Mung bean (50% wheat flour + 35% mung bean flour + 15% corn flour) and (c) Chickpea (50% wheat flour + 35% chickpea flour + 15% corn flour). The physicochemical and organoleptic attributes of the three types of cookie were evaluated. Results showed significant different (p