Browse publications by year: 2012

  1. Rothan HA, Abdulrahman AY, Sasikumer PG, Othman S, Rahman NA, Yusof R
    J Biomed Biotechnol, 2012;2012:251482.
    PMID: 23093838 DOI: 10.1155/2012/251482
    Dengue diseases have an economic as well as social burden worldwide. In this study, the antiviral activity of protegrin-1 (PG-1, RGGRLCYCRRRFCVCVGR) peptide towards dengue NS2B-NS3pro and viral replication in Rhesus monkey kidney (MK2) cells was investigated. The peptide PG-1 was synthesized by solid-phase peptide synthesis, and disulphide bonds formation followed by peptide purification was confirmed by LC-MS and RPHPLC. Dengue NS2B-NS3pro was produced as a single-chain recombinant protein in E. coli. The NS2B-NS3pro assay was carried out by measuring the florescence emission of catalyzed substrate. Real-time PCR was used to evaluate the inhibition potential of PG-1 towards dengue serotype-2 (DENV-2) replication in MK2 cells. The results showed that PG-1 inhibited dengue NS2B-NS3pro at IC(50) of 11.7 μM. The graded concentrations of PG-1 at nontoxic range were able to reduce viral replication significantly (P < 0.001) at 24, 48, and 72 hrs after viral infection. However, the percentage of inhibition was significantly (P < 0.01) higher at 24 hrs compared to 48 and 72 hrs. These data show promising therapeutic potential of PG-1 against dengue infection, hence it warrants further analysis and improvement of the peptide features as a prospective starting point for consideration in designing attractive dengue virus inhibitors.
    MeSH terms: Animals; Cell Line; Dengue Virus/drug effects*; Dengue Virus/enzymology*; Enzyme Inhibitors/pharmacology; Kidney/virology*; Macaca mulatta; Serine Endopeptidases/metabolism*; Virus Replication/drug effects*; Virus Replication/physiology*; Viral Nonstructural Proteins/metabolism*; Antimicrobial Cationic Peptides/pharmacology*
  2. Jamshed SQ, Ibrahim MI, Hassali MA, Masood I, Low BY, Shafie AA, et al.
    South Med Rev, 2012 Jul;5(1):22-30.
    PMID: 23093896
    OBJECTIVES: In developing countries out-of-pocket payments (OOP) are as high as 80% of healthcare spending. Generic medicines can be instrumental in reducing this expenditure. The current study is aimed to explore the knowledge, perception, and attitude of general practitioners towards generic medicines in Karachi, Pakistan.
    METHODS: This exploratory, descriptive study was conducted on a sample of 289 randomly selected general practitioners who were dispensing at their private clinics in Karachi, Pakistan. The questionnaires were distributed and collected by hand. Data was entered to SPSS version 17. Fischer's exact test was applied to see the association between variables.
    RESULTS: A total of 206 questionnaires were included in the study. A response rate of 71.3% was achieved. Out of 206 respondents, 139 (67.5%) were male while 67 (32.5%) respondents were female. Close to three quaters of the respondents (n= 148; 71.8%) showed correct knowledge about generic medicines being a 'copy of the brand name medicines' and 'interchangeable with brand name medicines' (n= 148; 71.8%). In terms of safety, the majority of respondents (n=85; 41.26%) incorrectly understood that the generic medicines are less safe than brand name medicines. The total percentage of correct responses was seen in 53% of the respondents. More than half of the respondents agreed that locally manufactured medicines are of the same effectiveness as brand name medicines (n=114; 55.4%). Male practitioners with practice experience of 11-15 years showed positive perception towards the quality of multinational products. The Majority of respondents believed that their prescribing decision is influenced by medical representatives (n=117; 56.8%). More than three-quarters of the respondents expressed their wish to prescribe low cost medicines in their practice (n=157; 76.2%). More than one third of the respondents expressed their uneasiness to prescribe products from all local manufacturers (n=72; 35%).
    CONCLUSION: There were gaps identified in the knowledge of respondents. Although good perception and attitude were noted among the respondents, dissemination of information regarding generic medicines may perhaps strengthen generic prescribing. There is a need to introduce 'Quality by Design' concept in local manufacturing units. This, in turn, can inculcate confidence in prescribers towards locally manufactured generic medicines.
    KEYWORDS: Karachi; Pakistan; attitude; dispensing doctor; general practitioner; generic medicines; perception
    MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Developing Countries; Health Expenditures; Female; Humans; Male; Pakistan; Perception; Surveys and Questionnaires; Drug Costs; Drugs, Generic; General Practitioners; Private Facilities
  3. Saleem F, Hassali MA, Shafie AA, Atif M, Ul Haq N, Aljadhey H
    South Med Rev, 2012 Jul;5(1):47-52.
    PMID: 23093899
    This study aims to evaluate association between Health related quality of lifeand disease state knowledge among hypertensive population of Pakistan.
  4. Trang PH, Ooi PT, Zuki AB, Noordin MM
    ScientificWorldJournal, 2012;2012:894952.
    PMID: 23093914 DOI: 10.1100/2012/894952
    It is hypothesized that despite sharing a similar habitat, the Muong indigenous and Vietnamese wild pigs may reveal different gastric morphology. Due to the protective nature of procuring these pigs, a total of 12 Muong indigenous pigs and nine Vietnamese wild pigs stomach collected post mortem were analysed for selected biometric parameters and histology. The result indicated that the stomach of the Vietnamese wild pig is broader with a bigger capacity and greater proportion of proper gastric glands. Interestingly, the stomach mass correlated well with live body weight in both breeds apart from possessing similar histomorphometry of the gastric gland regions. On the other hand, the thicker (P < 0.05) submucosa in the Vietnamese wild pig is attributed to the presence of numerous loose connective tissues, abundant blood vessels, adipose tissues and nerve plexus. The appearance of lymphoid follicles underneath the tubular gastric glands in the Vietnamese wild pig exceeded that of Muong indigenous pigs. This finding suggested that the difference in feeding behavior as well as immunity. In conclusion, adaptations found in the Vietnamese wild pig indicated that this breed is equipped with a bigger and effectively functional stomach to suit its digestive physiology and immunity in the wild.
    MeSH terms: Animals; Animals, Wild*; Species Specificity; Stomach/anatomy & histology*; Vietnam
  5. Midi M, Kanagasundram S, Sidi H, Asmidar D, Naing L, Guan NC
    Int J Psychiatry Med, 2012;43(4):405-18.
    PMID: 23094470
    To compare the risk of sexual arousal difficulties between two groups of depressed female patients in remission who were treated with either escitalopram or fluoxetine. Associated factors were also examined.
    MeSH terms: Adult; Antidepressive Agents/adverse effects*; Antidepressive Agents/therapeutic use; Cross-Sectional Studies; Depressive Disorder, Major/diagnosis; Depressive Disorder, Major/drug therapy*; Depressive Disorder, Major/epidemiology; Depressive Disorder, Major/psychology; Dose-Response Relationship, Drug; Female; Fluoxetine/adverse effects*; Fluoxetine/therapeutic use; Humans; Malaysia; Middle Aged; Surveys and Questionnaires; Citalopram/adverse effects*; Citalopram/therapeutic use; Sexual Dysfunctions, Psychological/chemically induced*; Sexual Dysfunctions, Psychological/diagnosis; Sexual Dysfunctions, Psychological/epidemiology
  6. Ansari M, Ibrahim MI, Hassali MA, Shankar PR, Koirala A, Thapa NJ
    BMC Res Notes, 2012 Oct 24;5:576.
    PMID: 23095352 DOI: 10.1186/1756-0500-5-576
    BACKGROUND: In developing countries, mothers usually manage diarrhea at home with the pattern of management depending on perceived disease severity and beliefs. The study was carried out with the objective of determining mothers' beliefs and barriers about diarrhea and its management.

    METHODS: Qualitative methods involving two focus group discussions and eight in-depth interviews were used to collect the data. The study was conducted at the following places: Tankisinuwari, Kanchanbari and Pokhariya of Morang district, Nepal during the months of February and March 2010. Purposive sampling method was adopted to recruit twenty mothers based on the inclusion criteria. A semi-structured interview guide was used to conduct the interviews. Written informed consent was obtained from all of the participants before conducting the interviews. The interviews were moderated by the main researcher with the support of an expert observer from Nobel Medical College. The interviews were recorded with the permission of the participants and notes were written by a pre trained note-taker. The recordings were transcribed verbatim. All the transcribed data was categorized and analyzed using thematic content analysis.

    RESULTS: Twenty mothers participated in the interviews and most (80%) of them were not educated. About 75% of the mothers had a monthly income of up to 5000 Nepalese rupees (US$ 60.92). Although a majority of mothers believed diarrhea to be due to natural causes, there were also beliefs about supernatural origin of diarrhea. Thin watery diarrhea was considered as the most serious. There was diversity in mothers' beliefs about foods/fluids and diarrhea management approaches. Similarly, several barriers were noted regarding diarrhea prevention and/or management such as financial weakness, lack of awareness, absence of education, distance from healthcare facilities and senior family members at home. The elderly compelled the mothers to visit traditional healers.

    CONCLUSIONS: There were varied beliefs among the mothers about the types, causes and severity of diarrhea, classification of foods/fluids and beliefs and barriers about preventing or treating diarrhea.

    MeSH terms: Adult; Child; Data Collection/methods; Data Collection/statistics & numerical data; Diarrhea/prevention & control*; Diarrhea/therapy*; Educational Status; Female; Health Services Accessibility/statistics & numerical data; Humans; Interviews as Topic/methods; Health Knowledge, Attitudes, Practice*; Mothers/education*; Mothers/psychology; Nepal; Social Class
  7. Rafii MY, Jalani BS, Rajanaidu N, Kushairi A, Puteh A, Latif MA
    Genet. Mol. Res., 2012;11(4):3629-41.
    PMID: 23096688 DOI: 10.4238/2012.October.4.10
    We evaluated 38 dura x pisifera (DP) oil palm progenies in four locations in Malaysia for genotype by environment interaction and genotypic stability studies. The DP progenies derived from crosses between pisifera palms of AVROS, Serdang S27B, Serdang 29/36, and Lever Cameroon were chosen to be the males' parent and Deli dura palms designated as females' parent. All the locations differed in terms of soil physical and chemical properties, and the soil types ranged from coastal clay to inland soils. The genotype by environment interaction and stability of the individual genotypes were analyzed for oil yield trait using several stability techniques. A genotype by environment interaction was detected for oil yield and it had a larger variance component than genotypic variance (σ(2)(gl)/σ(2)(g) = 139.7%). Genotype by environment interaction of oil yield was largely explained by a non-linear relationship between genotypic and environmental values. Overall assessment of individual genotypic stability showed that seven genotypes were highly stable and had consistent performance over the environments for the oil yield trait [total individual genotype stability scored more than 10 and mean oil yielded above the average of the environment (genotype means are more than 34.37 kg·palm(-1)·year(-1))]. These genotypes will be useful for oil palm breeding and tissue culture programs for developing high oil yielding planting materials with stable performance.
    MeSH terms: Analysis of Variance; Crosses, Genetic; Environment*; Genotype; Plant Oils/chemistry*; Regression Analysis; Arecaceae/genetics; Arecaceae/metabolism*; Gene-Environment Interaction
  8. Lin TS, Abd Latiff A, Abd Hamid NA, Wan Ngah WZ, Mazlan M
    PMID: 23097676 DOI: 10.1155/2012/491027
    Diabetes is a common cause of delayed wound healing. The aim of the study was to determine the effect of topical administration of tocopherol cream on the wound healing process in diabetic rats. The study was conducted using 18 male Sprague Dawley rats which were divided into three groups: (I) diabetic rats receiving control cream (n = 6), (II) diabetic rats receiving 0.06% tocopherol cream (n = 6), and (III) diabetic rats receiving 0.29% tocopherol cream (n = 6). Four cutaneous wounds were created at the dorsal region of the rats. Wound healing was assessed by total protein content, rate of wound closure estimation, and histological studies on the tenth day after wounding. Tocopherol treatment enhanced the wound healing process by increasing rate of wound closure and total protein content significantly (P < 0.05) compared to the control group. Histological observation also showed better organized epithelium and more collagen fibers in the tocopherol treated groups. Application of tocopherol cream enhances wound healing process in diabetic condition which is known to cause delay in wound healing.
    MeSH terms: Administration, Topical; Animals; Collagen; Diabetes Mellitus, Experimental; Male; Ointments; Vitamin E; Wound Healing; Rats, Sprague-Dawley; Tocopherols; Control Groups; Rats
  9. Dhanoa A, Singh VA, Mansor A, Yusof MY, Lim KT, Thong KL
    BMC Infect Dis, 2012;12:270.
    PMID: 23098162 DOI: 10.1186/1471-2334-12-270
    Methicillin-resistant Staphylococcus aureus (MRSA) has of late emerged as a cause of community-acquired infections among immunocompetent adults without risk factors. Skin and soft tissue infections represent the majority of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clinical presentations, whilst invasive and life-threatening illness like necrotizing pneumonia, necrotizing fasciitis, pyomyositis, osteomyelitis and sepsis syndrome are less common. Although more widely described in the pediatric age group, the occurrence of CA-MRSA osteomyelitis in adults is an uncommonly reported entity.
    MeSH terms: Adult; Genotype; Humans; Male; Osteomyelitis/diagnosis*; Osteomyelitis/microbiology; Osteomyelitis/pathology; Staphylococcal Infections/diagnosis*; Staphylococcal Infections/microbiology; Staphylococcal Infections/pathology; Bacteremia/diagnosis*; Bacteremia/microbiology; Bacteremia/pathology; Community-Acquired Infections/diagnosis*; Community-Acquired Infections/microbiology; Community-Acquired Infections/pathology; Virulence Factors/genetics; Methicillin-Resistant Staphylococcus aureus/classification; Methicillin-Resistant Staphylococcus aureus/genetics; Methicillin-Resistant Staphylococcus aureus/isolation & purification*; Multilocus Sequence Typing
  10. Chin KY, Soelaiman IN, Naina Mohamed I, Shahar S, Teng NI, Suhana Mohd Ramli E, et al.
    Aging Male, 2012 Dec;15(4):240-5.
    PMID: 23098182 DOI: 10.3109/13685538.2012.724740
    OBJECTIVE: Variations in testosterone levels are associated with several outcomes of aging. The present study aimed to examine the relationship between age-related decline of testosterone levels and changes in bone health status, handgrip strength, body fat percentage and fat-free mass.
    MATERIALS AND METHODS: A total of 335 Malaysian Chinese and Malay men aged 40 years and above were recruited for this study. Their body compositions, calcaneal speed of sound and handgrip strength were measured and their blood was collected. Linear regression analysis was done to examine the relationship among age, testosterone levels and outcomes of aging.
    RESULTS: The results indicated significant changes in all testosterone measurements, sex hormone binding globulin level, calcaneal speed of sound, handgrip strength, body fat percentage and fat-free mass with age (p < 0.05). Age-dependent decline in bioavailable and free testosterone levels were significantly associated with reduction in calcaneal speed of sound, fat-free mass and handgrip strength (p < 0.05). Age-dependent decline in the total testosterone level was significantly associated with an increase in body fat percentage among the elderly men (p < 0.05).
    CONCLUSION: Testosterone levels are associated with changes in outcome of aging such as bone health status, muscle strength and body composition, and the relationships are age-dependent.
    MeSH terms: Adult; Aging/physiology*; Body Composition/physiology*; China/ethnology; Health Status*; Humans; Malaysia; Male; Middle Aged; Testosterone/blood*; Testosterone/deficiency; Bone Density/physiology*; Muscle Strength/physiology*
  11. Al-Naggar RA, Bobryshev YV
    Asian Pac J Cancer Prev, 2012;13(8):3595-600.
    PMID: 23098439
    OBJECTIVE: The objective of this study was to determine the practice and barriers of mammography and associated factors among Malaysian women in the general population.

    METHODOLOGY: A cross-sectional study was conducted among 200 women in Shah Alam, Selangor; Malaysia. The questionnaire contained 27 questions and was comprised of two sections; socio-demographic characteristics and practices, knowledge and barriers of mammography. All the data were analyzed using the Statistical Package for the Social Sciences (SPSS) 13.0.

    RESULTS: Of the 200 Malaysian women who participated in this study, the majority were under the age of 50 years (65.5%), Malay (86%), and married (94.5%). Regarding any family history of cancer in general, the majority of the participants had none (78%). However, some did report a close relative with breast cancer (16.5%). While the majority of them knew about mammography (68%), 15% had had a mammogram once in their life and only 2% had the procedure every two or three years. Univariate analysis showed that age, family history of cancer, family history of breast cancer, regular supplement intake, regular medical check-up and knowledge about mammogram were significantly associated with mammogram practice among the general population (p=0.007, p=0.043, P=0.015, p=0.01, p=0.001, p<0.001; respectively). Multivariate analysis using multiple linear regression test showed that age, regular medical check-up and knowledge about mammography testing were statistically associated with the practice of mammography among the general population in Malaysia (p=0.035, p=0.015 and p<0.001; respectively). Lack of time, lack of knowledge, not knowing where to go for the test and a fear of the test result were the most important barriers (42.5%, 32%, 21%, 20%; respectively).

    CONCLUSION: The practice of mammogram screening is low among Malaysian women.

    MeSH terms: Adult; Breast Neoplasms/diagnosis; Breast Neoplasms/epidemiology; Breast Neoplasms/prevention & control*; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia/epidemiology; Mammography/statistics & numerical data*; Mass Screening*; Middle Aged; Prognosis; Surveys and Questionnaires; Health Behavior*; Breast Self-Examination/trends; Breast Self-Examination/statistics & numerical data*; Early Detection of Cancer
  12. Norsa'adah B, Rahmah MA, Rampal KG, Knight A
    Asian Pac J Cancer Prev, 2012;13(8):3723-30.
    PMID: 23098462
    Delay in help-seeking behaviour which is potentially preventable has a major effect on the prognosis and survival of patients with breast cancer. The objective of this study was to explore reasons for delay in seeking help among patients with breast cancer from the East Coast of peninsular Malaysia. A qualitative study using face- to-face in-depth interview was carried out involving 12 breast cancer patients who had been histo-pathologically confirmed and were symptomatic on presentation. Respondents were selected purposely based on their history of delayed consultation, diagnosis or treatment. All were of Malay ethnicity and the age range was 26-67 years. Three were in stage ll, seven in stage lll and two in stage lV. At the time of interview, all except one respondent had accepted treatment. The range of consultation time was 0.2-72.2 months with a median of 1.7 months, diagnosis time was 1.4-95.8 months( median 5.4 months )and treatment time was 0-33.3 months (median 1.2 months). The themes derived from the study were poor knowledge or awareness of breast cancer, fear of cancer consequences, beliefs in complementary alternative medicine, sanction by others, other priorities, denial of disease, attitude of wait and see and health care system weakness. Help-seeking behaviour was influenced by a complex interaction of cognitive, environmental, beliefs, culture and psycho-social factors. Breast cancer awareness and psychological counselling are recommended for all patients with breast symptoms to prevent delay in seeking clinical help.
    MeSH terms: Adult; Aged; Awareness; Breast Neoplasms/diagnosis; Breast Neoplasms/epidemiology; Breast Neoplasms/psychology*; Female; Humans; Interview, Psychological; Health Knowledge, Attitudes, Practice*; Malaysia/epidemiology; Middle Aged; Patient Acceptance of Health Care/psychology*; Prognosis; Health Behavior*; Breast Self-Examination/psychology*; Comprehension; Qualitative Research; Delayed Diagnosis
  13. Al-Naggar RA, Bobryshev YV, Al-Jashamy K
    Asian Pac J Cancer Prev, 2012;13(8):3829-33.
    PMID: 23098479
    OBJECTIVES: The objective of this study was to examine the practice and associated factors of breast self- examination (BSE) among Malaysian women.

    METHODS: For this cross-sectional study 250 women were selected by a simple random sampling technique. The questionnaire was consisted of three parts: socio-demographic characteristics, knowledge about BSE, and practice of BSE. Obtained data was analyzed using SPSS version 13. T-test and ANOVA test were used to explore the relation between socio-demographic characteristics and the practice of BSE.

    RESULTS: About 32% of the participants reported that they have had family history of cancer and about 20% of the participants reported that they have had family history of breast cancer. The majority of the participants (88.8%) have heard about breast cancer and 78.4% of the participants have heard about BSE. Race, marital status, residency, regular exercise, awareness about breast cancer, belief that breast cancer can be detected early, belief that early detection improves the chance of survival, family history of cancer, family history of breast cancer, awareness about BSE, and belief that BSE is necessary, significantly influenced the practice of BSE among women. Practice of BSE on monthly basis was found to be 47.2% among the study participants.

    CONCLUSION: The socio-demographic characteristics significantly influence the practice of BSA among women in Malaysia. The findings of this study might not only influence the planning of specific screening interventions and strategies in Malaysia but might also be important for the relevant international communities, interested in the peculiarities of BSE incidence in different countries.
    MeSH terms: Adolescent; Adult; Aged; Breast Neoplasms/diagnosis; Breast Neoplasms/epidemiology; Breast Neoplasms/prevention & control*; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia/epidemiology; Mass Screening*; Middle Aged; Prognosis; Surveys and Questionnaires; Health Behavior*; Breast Self-Examination/trends*; Breast Self-Examination/statistics & numerical data; Early Detection of Cancer; Young Adult
  14. Al-Naggar RA, Bobryshev YV, Al-Jashamy K, Al-Musli M
    Asian Pac J Cancer Prev, 2012;13(8):3835-40.
    PMID: 23098480
    OBJECTIVE: The objective of this study is to determine the practice and associated factors of HPV vaccine among school girls in Melaka, Malaysia.

    METHODOLOGY: A total number of 612 secondary school girls participated in this study. The questionnaire consists of 38 questions which included 3 sections. The first section is about socio- demography. The Second section is about knowledge and awareness of HPV vaccines. The third section is about practices with associated barriers of HPV vaccination. Verbal consent was obtained from all participants, and data were analyzed using SPSS 13.

    RESULTS: A total number of 612 secondary school girl students participated in this study. The mean age was 13.93 ± SD (1.09); minimum age was 13 years old and maximum was 17 years old. The majority of them was Malay, from rural areas and had a family monthly income of RM 3000 or less (91.8%, 53.1%, 69.6%; respectively). The majority of the parents of the school girls were with secondary education level (56.4%). The majority of the participants did not have a family history of cervical cancer (99.0%). The prevalence of HPV vaccination was 77.9% among school girls in Melaka. The majority of the participants were vaccinated in their schools (77.0%). About 69% knew about cervical cancer and 77.6% had ever heard about HPV vaccine. Regarding the factors that influence the practice of uptake HPV vaccine, they were age, race, income, parents' education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccine (p<0.001).

    CONCLUSION: The prevalence of HPV vaccine among school girls is high. Age, race, income, parents' education, knowledge about cervical cancer, heard about HPV vaccine and place of getting the vaccine were the significant factors that influence the practice of uptake HPV vaccine among school girls.

    MeSH terms: Adolescent; Awareness; Uterine Cervical Neoplasms/etiology; Uterine Cervical Neoplasms/epidemiology; Uterine Cervical Neoplasms/prevention & control*; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia/epidemiology; Patient Acceptance of Health Care; Prognosis; Surveys and Questionnaires; Schools; Health Behavior*; Prevalence; Papillomaviridae/pathogenicity*; Papillomavirus Infections/complications; Papillomavirus Infections/prevention & control*; Papillomavirus Infections/virology; Papillomavirus Vaccines/therapeutic use*
  15. Al-Naggar RA, Bobryshev YV, Abdulghani MA, Rammohan S, Al-Jashamy K
    Asian Pac J Cancer Prev, 2012;13(8):3841-50.
    PMID: 23098481
    OBJECTIVE: The objective of this study was to explore the knowledge and perceptions of Malaysian tradition healers towards cancer and cancer prevention.

    METHODOLOGY: A total of 25 participants agreed to participate in this qualitative study during the period from 20th July 2011 until 24th of September 2011. The proposal of this study was approved by the Ethics Committee of Management and Science University (MSU). Once the participant agreed to be interviewed, date, time and place of the interviews were determined. Consent form was obtained from participants before the interview began. Participants were briefed about the study and its purpose, and after asking their permission, their replies were recorded. The data was organized into themes and analyzed manually.

    RESULTS: Twenty-five Malaysian traditional healers participated in this qualitative study. The age of participants ranged between 26 to 78 years old. The majority were in the age group of 31-60 years old, male, Chinese, degree holders with a monthly income ranging from 1,000-5,000 Ringgit Malaysia (RM) and were married (56%, 80%, 48%, 52%, 68%, 84% respectively). The majority defined cancer as having high cholesterol or abscess accumulation. A few of them defined cancer as a type of cell growth. The majority mentioned that food and unhealthy lifestyles are the primary causes of cancer. Surprisingly some of them mentioned that cancer is caused by interference by ghosts. Regarding the diagnosis of cancer, the majority mentioned that they refer their patients to modern physicians' medical report when it comes to diagnosing or treating patients with cancer. The most common cancers that many patients came to seek treatment were breast cancers, followed by colon cancers, liver and lung cancers.

    CONCLUSION: Despite good knowledge about the causes of cancer among traditional healers, misconceptions still exist. Insufficient knowledge about the definition of cancer was noted among the traditional healers. This urges immediate action by the Ministry of Health of Malaysia to set up a strict regulation and regular monitoring of the traditional healers nationally. Traditional and Complementary Medicine may be integrated into the healthcare system and need to have sustained cooperation for the benefit of patients since about 80% of patients use traditional medicines.

    MeSH terms: Adult; Complementary Therapies*; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia/epidemiology; Male; Medicine, Traditional*; Middle Aged; Neoplasms/diagnosis; Neoplasms/epidemiology; Neoplasms/prevention & control*; Perception; Prognosis; Surveys and Questionnaires; Health Behavior*; Qualitative Research
  16. Jaafar H, Abdullah S, Murtey MD, Idris FM
    Asian Pac J Cancer Prev, 2012;13(8):3857-62.
    PMID: 23098483
    A total of 96 cases of invasive breast ductal carcinoma were examined for immunohistochemical expression of Bax and Bcl-2 in the epithelial tumor cells and endothelial cells of the blood vessels. We also investigated the association between both proteins in the epithelium in relation to tumor characteristics such as tumor size, grade, lymph node involvement, microvessel density (MVD), hormonal receptors expression and c-erbB-2 overexpression. Bax expression showed a significant association between tumor and endothelial cells (p<0.001) while Bcl-2 expression in tumor cells was inversely associated with that in the endothelial cells (p<0.001). Expression of Bcl-2 in tumor cells was strongly associated with expression of estrogen and progesterone receptors (p=0.003 and p=0.004, respectively). In addition, intratumoral MVD was significantly higher than peritumoral MVD (p<0.001) but not associated with Bax or Bcl-2 expression and other tumor characteristics. We concluded that the number of endothelial cells undergoing apoptosis was in direct linkage with the number of apoptotic tumor cells. Anti-apoptotic activity of the surviving tumor cells appears to propagate cancer progression and this was influenced by the hormonal status of the cells. Tumor angiogenesis was especially promoted in the intratumoral region and angiogenesis was independent of anti-apoptotic activity.
    MeSH terms: Adult; Aged; Aged, 80 and over; Breast Neoplasms/blood supply; Breast Neoplasms/metabolism*; Breast Neoplasms/pathology; Endothelium, Vascular/metabolism*; Endothelium, Vascular/pathology; Female; Humans; Immunoenzyme Techniques; Middle Aged; Neovascularization, Pathologic/metabolism*; Prognosis; Receptors, Estrogen/metabolism*; Receptors, Progesterone/metabolism*; Biomarkers, Tumor/metabolism; Apoptosis; Carcinoma, Ductal, Breast/blood supply; Carcinoma, Ductal, Breast/metabolism; Carcinoma, Ductal, Breast/pathology; Receptor, ErbB-2/metabolism*; Proto-Oncogene Proteins c-bcl-2/metabolism*; bcl-2-Associated X Protein/metabolism*; Microvessels/metabolism; Microvessels/pathology; Neoplasm Grading
  17. Ulaganathan V, Kandiah M, Zalilah MS, Faizal JA, Fijeraid H, Normayah K, et al.
    Asian Pac J Cancer Prev, 2012;13(8):3873-7.
    PMID: 23098486
    OBJECTIVE: Colorectal cancer (CRC) and the metabolic syndrome (MetS) are both on the rise in Malaysia. A multi-centric case-control study was conducted from December 2009 to January 2011 to determine any relationship between the two.

    METHODS: Patients with confirmed CRC based on colonoscopy findings and cancer free controls from five local hospitals were assessed for MetS according to the International Diabetes Federation (IDF) definition. Each index case was matched for age, gender and ethnicity with two controls (140: 280).

    RESULTS: MetS among cases was highly prevalent (70.7%), especially among women (68.7%). MetS as an entity increased CRC risk by almost three fold independently (OR=2.61, 95%CI=1.53-4.47). In men MetS increased the risk of CRC by two fold (OR=2.01, 95%CI, 1.43-4.56), demonstrating an increasing trend in risk with the number of Mets components observed.

    CONCLUSION: This study provides evidence for a positive association between the metabolic syndrome and colorectal cancer. A prospective study on the Malaysian population is a high priority to confirm these findings.

    MeSH terms: Adult; Aged; Colonoscopy; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Prognosis; Risk Factors; Colorectal Neoplasms/etiology*; Colorectal Neoplasms/epidemiology; Prevalence; Case-Control Studies; Metabolic Syndrome X/complications*; Metabolic Syndrome X/epidemiology
  18. Yusoff HM, Daud N, Noor NM, Rahim AA
    Asian Pac J Cancer Prev, 2012;13(8):3983-7.
    PMID: 23098504
    In Malaysia, colorectal cancer is the most common cancer in males and the third most common in females. Mortality due to colorectal cancer can be effectively reduced with early diagnosis. This study was designed to look into colorectal cancer screening participation and its barriers among average risk individuals in Malaysia. A cross sectional study was conducted from August 2009 till April 2010 involving average risk individuals from 44 primary care clinics in West Malaysia. Each individual was asked whether they have performed any of the colorectal cancer screening methods in the past five years. The barrier questions had three domains: patient factors, test factors and health care provider factors. Descriptive analysis was achieved using Statistical Program for Social Sciences (SPSS) version 12.0. A total of 1,905 average risk individuals responded making a response rate of 93.8%. Only 13 (0.7%) respondents had undergone any of the colorectal cancer screening methods in the past five years. The main patient and test factors for not participating were embarrassment (35.2%) and feeling uncomfortable (30.0%), respectively. There were 11.2% of respondents who never received any advice to do screening. The main reason for them to undergo screening was being advised by health care providers (84.6%). The study showed that participation in colorectal cancer screening in Malaysia is extremely low and multiple factors contribute to this situation. Given the importance of the disease, efforts should be made to increase colorectal cancer screening activities in Malaysia.
    MeSH terms: Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia/epidemiology; Male; Middle Aged; Patient Participation*; Prognosis; Surveys and Questionnaires; Colorectal Neoplasms/diagnosis*; Colorectal Neoplasms/prevention & control; Health Behavior*; Early Detection of Cancer*
  19. Balasundram S, Mustafa WM, Ip J, Adnan TH, Supramaniam P
    Asian Pac J Cancer Prev, 2012;13(8):4045-50.
    PMID: 23098514
    OBJECTIVE: The impact of ablative oral cancer surgery was studied, with particular reference to recurrence and nodal metastasis, to assess survival probability and prognostic indicators and to elucidate if ethnicity influences the survival of patients.

    METHODS: Patients who underwent major ablative surgery of the head and neck region with neck dissection were identified and clinical records were assessed. Inclusion criteria were stage I-IV oral and oropharyngeal malignancies necessitating resection with or without radiotherapy from 2004 to 2009. All individuals had a pre-operative assessment prior to the surgery. The post operative assessment period ranged from 1 year to 5 years. Survival distributions were analyzed using Kaplan-Meier curves.

    RESULTS: 87 patients (males:38%; females:62%) were included in this study, with an age range of 21-85 years. Some 78% underwent neck dissections while 63% had surgery and radiotherapy. Nodal recurrence was detected in 5.7% while 20.5% had primary site recurrence within the study period. Kaplan-Meier survival analysis revealed that the median survival time was 57 months. One year overall survival (OS) rate was 72.7% and three year overall survival rate dropped to 61.5%. On OS analysis, the log-rank test showed a significant difference of survival between Malay and Chinese patients (Bonferroni correction p=0.033). Recurrence-free survival (RFS) analysis revealed that 25% of the patients have reached the event of recurrence at 46 months. One year RFS rate was 85.2% and the three year survival rate was 76.1%. In the RFS analysis, the log-rank test showed a significant difference in the event of recurrence and nodal metastasis (p<0.001).

    CONCLUSION: Conservative neck is effective, in conjunction with postoperative radiotherapy, for control of neck metastases. Ethnicity appears to influence the survival of the patients, but a prospective trial is required to validate this.

    MeSH terms: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell/mortality; Carcinoma, Squamous Cell/pathology; Carcinoma, Squamous Cell/surgery*; Female; Humans; Lymphatic Metastasis; Malaysia; Male; Middle Aged; Mouth Neoplasms/mortality; Mouth Neoplasms/pathology; Mouth Neoplasms/surgery*; Neoplasm Recurrence, Local/mortality; Neoplasm Recurrence, Local/pathology; Neoplasm Recurrence, Local/surgery*; Neoplasm Staging; Prognosis; Retrospective Studies; Salivary Gland Neoplasms/mortality; Salivary Gland Neoplasms/pathology; Salivary Gland Neoplasms/surgery*; Survival Rate; Neck Dissection*; Young Adult
  20. Saibul N, Shariff ZM, Rahmat A, Sulaiman S, Yaw YH
    Asian Pac J Cancer Prev, 2012;13(8):4081-6.
    PMID: 23098520
    Complementary and alternative medicine (CAM) use is prevalent among individuals with cancer, especially breast cancer survivors. This study was conducted among 394 breast cancer survivors in selected regions of Peninsular Malaysia to identify the pattern and factors associated with CAM use. About 51% of the respondents reported CAM use as complementary treatment. Vitamins (47.2%), spiritual activities (33.2%) and other dietary supplements (30.7%) were the most commonly used CAM therapies. Common reasons for CAM use were to increase the body's ability to perform daily activities (70.9%), enhance immune function (58.3%) and improve emotional well-being (31.7%). Users obtained CAM information mainly from friends and family members (62.5%), physicians (25.0%) and mass media (13.9%). Ethnicity and years of education were significantly associated with CAM use. Although no adverse effects of CAM were reported, breast cancer survivors should discuss their CAM use with health professionals to prevent potential adverse effects of these therapies.
    MeSH terms: Adult; Aged; Complementary Therapies/statistics & numerical data*; Breast Neoplasms/immunology; Breast Neoplasms/psychology; Breast Neoplasms/therapy*; Cross-Sectional Studies; Female; Humans; Middle Aged; Prognosis; Survivors/psychology*; Dietary Supplements*; Young Adult
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