Browse publications by year: 2013

  1. Kua VF, Ismail F, Chee Ee Phua V, Aslan NM
    Asian Pac J Cancer Prev, 2013;14(2):1121-6.
    PMID: 23621198
    BACKGROUND: Palliative chemotherapy with cisplatin/5-fluorouracil (5FU) is the commonest regimen employed for metastatic and recurrent head and neck squamous cell carcinoma (SCCHN) and nasopharyngeal carcinoma (NPC). However, this regimen is cumbersome requiring 5 days of admission to hospital. Carboplatin/5FU may be an alternative regimen without compromising survival and response rates. This study aimed to compare the efficacy and toxicity of carboplatin/5FU regimen with the cisplatin/5FU regimen.

    MATERIALS AND METHODS: This retrospective study looked at patients who had palliative chemotherapy with either cisplatin/5FU or carboplatin/5FU for metastatic and recurrent SCCHN and NPC. It included patients who were treated at UKMMC from 1st January 2004 to 31st December 2009 with either palliative IV cispaltin 75 mg/m2 D1 only plus IV 5FU 750 mg/m2 D1-5 infusion or IV Carboplatin AUC 5 D1 only plus IV 5FU 500 mg/m2 D1-2 infusion plus IV 5FU 500 mg/m2 D1-2 bolus. The specific objectives were to determine the efficacy of palliative chemotherapy in terms of overall response rate (ORR), median progression free survival (PFS) and median overall survival (OS) and to evaluate the toxicities of both regimens.

    RESULTS: A total of 41 patients were eligible for this study. There were 17 in the cisplatin/5FU arm and 24 in the carboplatin/5FU arm. The ORR was 17.7 % for cisplatin/5FU arm and 37.5 % for carboplatin/5FU arm (p-value=0.304). The median PFS was 7 months for cisplatin/5FU and 9 months for carboplatin/5FU (p-value=1.015). The median OS was 10 months for cisplatin/5FU arm and 12 months for carboplatin/5FU arm (p-value=0.110). There were 6 treatment-related deaths (6/41=14.6%), four in the carboplatin/5FU arm (4/24=16.7%) and 2 in the cisplatin/5FU arm (2/17=11.8%). Grade 3 and 4 hematologic toxicity was also more common with carboplatin/5FU group, this difference being predominantly due to grade 3-4 granulocytopenia (41.6% vs. 0), grade 3-4 anemia (37.5% vs. 0) and grade 3-4 thrombocytopenia (16.6% vs. 0).

    CONCLUSIONS: Carboplatin/5FU is not inferior to cisplatin/5FU with regard to its efficacy. However, there was a high rate of treatment-related deaths with both regimens. A better alternative needs to be considered.

    MeSH terms: Adult; Antineoplastic Combined Chemotherapy Protocols/adverse effects; Antineoplastic Combined Chemotherapy Protocols/therapeutic use; Carcinoma; Carcinoma, Squamous Cell/drug therapy; Carcinoma, Squamous Cell/mortality; Cisplatin/adverse effects; Cisplatin/therapeutic use*; Female; Fluorouracil/adverse effects; Fluorouracil/therapeutic use*; Head and Neck Neoplasms/drug therapy*; Head and Neck Neoplasms/mortality; Humans; Male; Middle Aged; Nasopharyngeal Neoplasms/drug therapy*; Nasopharyngeal Neoplasms/mortality; Neoplasm Metastasis/drug therapy; Neoplasm Recurrence, Local/drug therapy; Neoplasm Recurrence, Local/mortality; Palliative Care/methods; Retrospective Studies; Survival; Carboplatin/adverse effects; Carboplatin/therapeutic use*; Treatment Outcome; Disease-Free Survival
  2. Ghazali SM, Othman Z, Cheong KC, Hock LK, Wan Mahiyuddin WR, Kamaluddin MA, et al.
    Asian Pac J Cancer Prev, 2013;14(2):1141-5.
    PMID: 23621202
    Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.
    MeSH terms: Adult; Aged; Aged, 80 and over; Breast Neoplasms/diagnosis*; Breast Neoplasms/epidemiology; Cross-Sectional Studies; Female; Humans; Malaysia; Middle Aged; Patient Compliance*; Surveys and Questionnaires; Socioeconomic Factors; Breast Self-Examination/methods*; Marital Status; Early Detection of Cancer/methods*
  3. Yusof AS, Isa ZM, Shah SA
    Asian Pac J Cancer Prev, 2013;14(2):1151-4.
    PMID: 23621204
    BACKGROUND: Changes in dietary practices are known to be associated with changes in the health and disease pattern of a population. This study aimed to qualitatively explore the perception of colorectal cancer patients regarding causes of colorectal cancer and the influence of diet.

    MATERIALS AND METHODS: Twelve respondents from three major ethnicities in Malaysia were selected from the quantitative study on dietary pattern and colorectal cancer carried out earlier in this study. In-depth interviews (IDI), conducted from April until June 2012, were mainly in the Malay language with additional use of English and continued until the saturation point was reached. All interviews were autorecorded so that verbatim transcriptions could be created.

    RESULTS: Causes of colorectal cancer were categorized into internal and external factors. The majority of respondents agreed that there is an association between Western foods and colorectal cancer. Malaysian traditional diet was not related to colorectal cancer as less preservative agents were used. Malaysian diet preparation consisting of taste of cooking (spicy, salty and sour foods) plus type of cooking (fry, grilled and smoked) were considered causes of colorectal cancer. All respondents changed their dietary pattern to healthy food after being diagnosed with colorectal cancer. Advice from doctors regarding suitable food for colorectal cancer was useful in this regard.

    CONCLUSIONS: Eating outside, use of food flavoring ingredients and preservative agents were considered to be the main factors causing colorectal cancer. All respondents admitted that they changed to a healthy diet after being diagnosed with colorectal cancer.

    MeSH terms: Adult; Diet/adverse effects*; Eating; Feeding Behavior*; Female; Food Preservatives/adverse effects; Humans; Health Knowledge, Attitudes, Practice; Life Style; Malaysia; Male; Middle Aged; Perception; Surveys and Questionnaires; Colorectal Neoplasms/etiology*; Health Behavior*
  4. Nizam ZM, Abdul Aziz AA, Kaur G, Abu Hassan MR, Mohd Sidek AS, Yeh LY, et al.
    Asian Pac J Cancer Prev, 2013;14(2):619-24.
    PMID: 23621208
    BACKGROUND: Colorectal cancer (CRC) exists in a more common sporadic form and less common hereditary forms, associated with the Lynch syndrome, familial adenomatous polyposis (FAP) and other rare syndromes. Sporadic CRC is believed to arise as a result of close interaction between environmental factors, including dietary and lifestyle habits, and genetic predisposition factors. In contrast, hereditary forms such as those related to the Lynch syndrome result from inheritance of germline mutations of mismatch repair (MMR) genes. However, in certain cases, the influence of low penetrance alleles in familial colorectal cancer susceptibility is also undeniable.

    AIM: To investigate the genotype frequencies of MLH1 promoter polymorphism -93G>A and to determine whether it could play any role in modulating familial and sporadic CRC susceptibility risk.

    METHODS: A case-control study comprising of 104 histopathologically confirmed CRC patients as cases (52 sporadic CRC and 52 Lynch syndrome patients) and 104 normal healthy individuals as controls was undertaken. DNA was extracted from peripheral blood and the polymorphism was genotyped employing PCR-RFLP methods. The genotypes were categorized into homozygous wild type, heterozygous and homozygous variants. The risk association between these polymorphisms and CRC susceptibility risk was calculated using binary logistic regression analysis and deriving odds ratios (ORs).

    RESULTS: When risk association was investigated for all CRC patients as a single group, the heterozygous (G/A) genotype showed a significantly higher risk for CRC susceptibility with an OR of 2.273, (95%CI: 1.133-4.558 and p-value=0.021). When analyzed specifically for the 2 types of CRC, the heterozygous (G/A) genotype showed significantly higher risk for sporadic CRC susceptibility with and OR of 3.714, (95%CI: 1.416-9.740 and p-value=0.008). Despite high OR value was observed for Lynch syndrome (OR: 1.600, 95%CI: 0.715-3.581), the risk was not statistically significant (P=0.253).

    CONCLUSION: Our results suggest an influence of MLH1 promoter polymorphism -93G>A in modulating susceptibility risk in Malaysian CRC patients, especially those with sporadic disease.

    MeSH terms: Colorectal Neoplasms, Hereditary Nonpolyposis/genetics*; Female; Gene Frequency; Genotype; Humans; Malaysia; Male; Middle Aged; Nuclear Proteins/genetics*; Promoter Regions, Genetic/genetics; Risk; Case-Control Studies; Risk Assessment; Genetic Predisposition to Disease; Polymorphism, Single Nucleotide; Adaptor Proteins, Signal Transducing/genetics*; MutL Protein Homolog 1
  5. Lim KH, Ibrahim N, Ghazali SM, Kee CC, Lim KK, Chan YY, et al.
    Asian Pac J Cancer Prev, 2013;14(2):805-10.
    PMID: 23621242
    Increasing the rate of smoking cessation will reduce the burden of diseases related to smoking, including cancer. Understanding the process of smoking cessation is a pre-requisite to planning and developing effective programs to enhance the rate of smoking cessation.The aims of the study were to determine the demographic distribution of smokers across the initial stages of smoking cessation (the pre-contemplation and contemplation stages) and to identify the predictors of smoking cessation among Malaysian adult smokers. Data were extracted from a population-based, cross-sectional survey carried out from April 2006 to July 2006. The distribution of 2,716,743 current smokers across the pre-contemplation stage (no intention to quit smoking in the next six months) or contemplation stage (intended to quit smoking in the next six months) was described. Multivariable logistic regression analysis was used to examine the relationship between socio-demographic variables and the stages of smoking cessation. Of the 2,716,743 current smokers, approximately 30% and 70% were in the pre-contemplative and contemplative stages of smoking cessation respectively. Multivariable analysis showed that male gender, low education level, older age group, married and those from higher income group and number of cigarettes smoked were associated with higher likelihood of pre-contemplation to cease smoking in the next six months. The majority of current smokers in Malaysia were in the contemplative stage of smoking cessation. Specific interventions should be implemented to ensure the pre-contemplative smokers proceed to the contemplative stage and eventually to the preparation stage.
    MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Data Collection; Female; Health Surveys*; Humans; Malaysia/epidemiology; Male; Middle Aged; Surveys and Questionnaires; Smoking/adverse effects; Smoking/epidemiology*; Socioeconomic Factors; Tobacco Use Disorder/epidemiology*; Smoking Cessation/statistics & numerical data*; Intention; Young Adult
  6. Razak NA, Mn K, Zubairi YZ, Naing NN, Zaki NM
    Asian Pac J Cancer Prev, 2013;14(2):825-8.
    PMID: 23621246
    OBJECTIVE: The objective of this study was to determine the five-year survival among patients with cervical cancer treated in Hospital Universiti Sains Malaysia.

    METHODS: One hundred and twenty cervical cancer patients diagnosed between 1st July 1995 and 30th June 2007 were identified. Data were obtained from medical records. The survival probability was determined using the Kaplan-Meier method and the log-rank test was applied to compare the survival distribution between groups.

    RESULTS: The overall five-year survival was 39.7% [95%CI (Confidence Interval): 30.7, 51.3] with a median survival time of 40.8 (95%CI: 34.0, 62.0) months. The log-rank test showed that there were survival differences between the groups for the following variables: stage at diagnosis (p=0.005); and primary treatment (p=0.0242). Patients who were diagnosed at the latest stage (III-IV) were found to have the lowest survival, 18.4% (95%CI: 6.75, 50.1), compared to stage I and II where the five-year survival was 54.7% (95%CI: 38.7, 77.2) and 40.8% (95%CI: 27.7, 60.3), respectively. The five-year survival was higher in patients who received surgery [52.6% (95%CI: 37.5, 73.6)] as a primary treatment compared to the non-surgical group [33.3% (95%CI: 22.9, 48.4)].

    CONCLUSION: The five-year survival of cervical cancer patients in this study was low. The survival of those diagnosed at an advanced stage was low compared to early stages. In addition, those who underwent surgery had higher survival than those who had no surgery for primary treatment.

    MeSH terms: Adult; Carcinoma, Squamous Cell/mortality*; Carcinoma, Squamous Cell/surgery; Carcinoma, Squamous Cell/therapy; Uterine Cervical Neoplasms/mortality*; Uterine Cervical Neoplasms/surgery; Uterine Cervical Neoplasms/therapy; Female; Hospitals, University; Humans; Malaysia; Middle Aged; Neoplasm Staging; Prognosis; Retrospective Studies; Survival
  7. Daud R, Abdul Kadir MR, Izman S, Md Saad AP, Lee MH, Che Ahmad A
    J Foot Ankle Surg, 2013 Jul-Aug;52(4):426-31.
    PMID: 23623302 DOI: 10.1053/j.jfas.2013.03.007
    The trapezium shape of the talar dome limits the use of 2-dimensional plain radiography for morphometric assessment because only 2 of the 4 required parameters can be measured. We used computed tomography data to measure the 4 morphologic parameters of the trochlea tali: anterior width, posterior width, trochlea tali length, and angle of trapezium shape. A total of 99 subjects underwent computed tomography scanning, and the left and right talus bones were both virtually modeled in 3 dimensions. The 4 morphologic parameters were measured 3 times each to obtain the intraclass correlation, and analysis of variance was used to check for any significant differences between the repeated measurements. The average intraclass correlation coefficient for the measurements for 2 to 3 trials was 0.94 ± 0.04. Statistical analyses were performed on the data from all 198 talus bones using SAS software, comparing male and female and left and right bones. All 4 morphometric values were greater in the male group. No significant differences were found between the left and right talus bones. A strong positive correlation was observed between the trochlea tali length and the anterior width. The angle of trapezium shape showed no correlation with the other 3 parameters. The measurements were compared with the dimensions of the current talar components of 4 total ankle arthroplasty implants. However, most of them did not perfectly match the trapezium shape of the talus from our population. We successfully analyzed the trapezium shape of the trochlea tali using reliable virtual 3-dimensional measurements. Compared with other published reports, our study showed a relatively smaller dimension of the trochlea tali than the European counterparts.
    MeSH terms: Adult; Biomechanical Phenomena; Female; Follow-Up Studies; Humans; Male; Talus/physiopathology; Talus/radiography*; Tomography, X-Ray Computed/methods*; Imaging, Three-Dimensional/methods*; Young Adult
  8. Robson N, Bond A, Wolff K
    Prev Med, 2013;57 Suppl:S8-10.
    PMID: 23624111 DOI: 10.1016/j.ypmed.2013.04.010
    OBJECTIVES: There is evidence that smoking behaviour differs by ethnicity. This study aims to compare smoking behaviour characteristics between Caucasian and Malay smokers.
    METHODS: A cross sectional survey, involving 175 smokers attending smoking cessation clinics at the Institute of Psychiatry, London, United Kingdom and University Malaya, Kuala Lumpur, Malaysia between May 2005 and February 2007. Data on demographics, smoking history, nicotine dependence and smoking behaviour were collected.
    RESULTS: All participants were males, mean age 30.7 ± 10.3 years. Caucasians initiated smoking significantly earlier (mean age 14.8 ± 2.8 years) (p = 0.001) and smoked regularly significantly earlier (mean age 17.3 ± 3.5) (p = 0.003) than Malays (mean starting age 16.9 ± 4.4 years and mean age regular use 19.5 ± 4.5 years), respectively. Caucasians smoked less for social integration than Malays (p = 0.03) but smoked more for regulation of negative affect than Malays (p = 0.008) and smoked more for hedonism than Malays (p < 0.001).
    CONCLUSION: Malays smoke as a means of socially integrating. This has important public health implications. Social reasons and the social environment play a role in smoking uptake, smoking maintenance and smoking cessation and this should be borne in mind for strategies planning to promote smoking cessation.
    KEYWORDS: Behaviour; Caucasian; Character; Cigarette; Malay; Nicotine; Smoking
    MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Female; Great Britain/epidemiology; Humans; Malaysia/epidemiology; Male; Middle Aged; Smoking/ethnology*; Smoking/epidemiology; Smoking/psychology; Social Behavior; Smoking Cessation/ethnology; Smoking Cessation/psychology; Smoking Cessation/statistics & numerical data; Age of Onset; European Continental Ancestry Group/psychology*; European Continental Ancestry Group/statistics & numerical data; Asian Continental Ancestry Group/psychology*; Asian Continental Ancestry Group/statistics & numerical data; Young Adult
  9. Huey CS, Mahdy MA, Al-Mekhlafi HM, Nasr NA, Lim YA, Mahmud R, et al.
    Infect Genet Evol, 2013 Jul;17:269-76.
    PMID: 23624189 DOI: 10.1016/j.meegid.2013.04.013
    Giardia duodenalis is considered the most common intestinal parasite in humans worldwide. In Malaysia, many studies have been conducted on the epidemiology of giardiasis. However, there is a scarcity of information on the genetic diversity and the dynamics of transmission of G. duodenalis. The present study was conducted to identify G. duodenalis assemblages and sub-assemblages based on multilocus analysis of the glutamate dehydrogenase (gdh), beta-giardin (bg) and triose phosphate isomerase (tpi) genes. Faecal specimens were collected from 484 Orang Asli children with a mean age of 7 years and examined using light microscopy. Specimens positive for Giardia were subjected to PCR analysis of the three genes and subsequent sequencing in both directions. Sequences were edited and analysed by phylogenetic analysis. G. duodenalis was detected in 17% (84 of 484) of the examined specimens. Among them, 71 were successfully sequenced using at least one locus. Genotyping results showed that 30 (42%) of the isolates belonged to assemblage A, 32 (45%) belonged to assemblage B, while discordant genotype results were observed in 9 specimens. Mixed infections were detected in 43 specimens using a tpi-based assemblage specific protocol. At the sub-assemblages level, isolates belonged to assemblage A were AII. High nucleotide variation found in isolates of assemblage B made subtyping difficult to achieve. The finding of assemblage B and the anthroponotic genotype AII implicates human-to-human transmission as the most possible mode of transmission among Malaysian aborigines. The high polymorphism found in isolates of assemblage B warrants a more defining tool to discriminate assemblage B at the sub-assemblage level.
    MeSH terms: Adolescent; Child; Child, Preschool; Female; Genotype*; Giardiasis/epidemiology*; Humans; Malaysia/epidemiology; Male; Molecular Sequence Data; Phylogeny; Giardia lamblia/classification*; Giardia lamblia/genetics*; Giardia lamblia/isolation & purification; Genes, Protozoan; Multilocus Sequence Typing
  10. Su TT, Bulgiba AM, Sampatanukul P, Sastroasmoro S, Chang P, Tharyan P, et al.
    Prev Med, 2013;57 Suppl:S5-7.
    PMID: 23624253 DOI: 10.1016/j.ypmed.2013.04.009
    Clinical Epidemiology (CE) and Evidence-Based Medicine (EBM) have become increasingly important in an era of rising costs, patient safety concerns and evidence-based health care. CE and EBM research in the Asia Pacific region have grown significantly. However, there are three main challenges such as linking evidence to practice and policy; developing a strong collaborative network; and a need for resources and technical expertise to produce evidence. The Cochrane Collaboration is a possible solution to resolve above challenges identified, particularly the challenge of transforming evidence to practice. In addition, training can be carried out to enhance technical expertise in the region and there is also the promising potential that collaborations could extend beyond systematic reviews. To improve the adoption of evidence-based health policy, selection of the best evidence for the right audience and focusing on the relevant issues through appropriate methodology are essential. Information on effectiveness and cost effectiveness needs to be highlighted for policy makers. The way forward to strengthen research and capacity building is to establish the Asia Pacific Consortium for CE and EBM. The consortium would help to create mutually rewarding scientific research and collaborations that will augur well for advances in CE and EBM.
    MeSH terms: Epidemiology/organization & administration*; Epidemiology/standards; Health Policy; Humans; Indonesia; International Cooperation; Malaysia; Taiwan; Thailand; Evidence-Based Medicine/organization & administration*; Evidence-Based Medicine/standards
  11. Cheang HK, Wong HT, Ho SC, Chew KS, Lee WS
    Singapore Med J, 2013 Apr;54(4):224-6.
    PMID: 23624451
    INTRODUCTION: This study aimed to assess the immune response in infants who received the three-shot hepatitis B vaccine in Malaysia.

    METHODS: Consecutive infants born between March 2002 and April 2010 who received three doses of hepatitis B vaccine at a community clinic in Malaysia were enrolled in the study. Screening for hepatitis B surface antigen (HBsAg) and antibody against HBsAg (anti-HBs) was performed after the completion of primary immunisation, at approximately one year of age.

    RESULTS: A total of 572 infants (median age 9.3 ± 2.7 months; range 6.3-48 months) were screened for immune response to hepatitis B vaccination - 553 (96.7%) infants had adequate levels of anti-HBs (≥ 10 IU/L). Of the 440 mothers whose HBsAg status was known, 14 (3.2%) were positive for HBsAg. None of the 14 infants who were born to HBsAg-positive mothers were positive for HBsAg, and all but one infant had anti-HBs level ≥ 10 IU/L. Gender, gestational age and maternal HBsAg status were not found to significantly affect the subsequent immune response in infants following vaccination.

    CONCLUSION: The proportion of Malaysian mothers who are positive for HBsAg remains high. The three-shot hepatitis B vaccine, given as part of universal vaccination against hepatitis B, provides adequate anti-HBs in the vast majority of infants in a community setting in Malaysia.
    MeSH terms: Ambulatory Care Facilities; Antibodies, Viral/blood; Child, Preschool; Female; Hepatitis B/prevention & control; Hepatitis B Surface Antigens/immunology; Humans; Infant; Malaysia; Male; Hepatitis B Vaccines/administration & dosage*; Hepatitis B Vaccines/immunology*; Infectious Disease Transmission, Vertical/prevention & control; Maternal Exposure
  12. Jie Y, Isa ZM, Jie X, Ju ZL, Ismail NH
    PMID: 23625129 DOI: 10.1007/978-1-4614-6898-1_2
    In this review, our aim was to examine the influence of geographic variations on asthma prevalence and morbidity among adults, which is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity. Asthma is a complex inflammatory disease of multifactorial origin, and is influenced by both environmental and genetic factors. The disparities in asthma prevalence and morbidity among the world's geographic locations are more likely to be associated with environmental exposures than genetic differences. In writing this article, we found that the indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke in both urban and rural areas. Asthma and asthma-related symptoms occurred more frequently in urban than in rural areas, and that difference correlated with environmental risk exposures, SES, and healthcare access. Environmental risk factors to which urban adults were more frequently exposed than rural adults were dust mites,high levels of vehicle emissions, and a westernized lifestyle.Exposure to indoor biological contaminants in the urban environment is common.The main risk factors for developing asthma in urban areas are atopy and allergy to house dust mites, followed by allergens from animal dander. House dust mite exposure may potentially explain differences in diagnosis of asthma prevalence and morbidity among adults in urban vs. rural areas. In addition, the prevalence of asthma morbidity increases with urbanization. High levels of vehicle emissions,Western lifestyles and degree of urbanization itself, may affect outdoor and thereby indoor air quality. In urban areas, biomass fuels have been widely replaced by cleaner energy sources at home, such as gas and electricity, but in most developing countries, coal is still a major source of fuel for cooking and heating, particularly in winter. Moreover, exposure to ETS is common at home or at work in urban areas.There is evidence that asthma prevalence and morbidity is less common in rural than in urban areas. The possible reasons are that rural residents are exposed early in life to stables and to farm milk production, and such exposures are protective against developing asthma morbidity. Even so, asthma morbidity is disproportionately high among poor inner-city residents and in rural populations. A higher proportion of adult residents of nonmetropolitan areas were characterized as follows:aged 55 years or older, no previous college admission, low household income, no health insurance coverage, and could not see a doctor due to healthcare service availability, etc. In rural areas, biomass fuels meet more than 70% of the rural energy needs. Progress in adopting modern energy sources in rural areas has been slow. The most direct health impact comes from household energy use among the poor, who depend almost entirely on burning biomass fuels in simple cooking devices that are placed in inadequately ventilated spaces. Prospective studies are needed to assess the long-term effects of biomass smoke on lung health among adults in rural areas.Geographic differences in asthma susceptibility exist around the world. The reason for the differences in asthma prevalence in rural and urban areas may be due to the fact that populations have different lifestyles and cultures, as well as different environmental exposures and different genetic backgrounds. Identifying geographic disparities in asthma hospitalizations is critical to implementing prevention strategies,reducing morbidity, and improving healthcare financing for clinical asthma treatment. Although evidence shows that differences in the prevalence of asthma do exist between urban and rural dwellers in many parts of the world, including in developed countries, data are inadequate to evaluate the extent to which different pollutant exposures contribute to asthma morbidity and severity of asthma between urban and rural areas.
    MeSH terms: Allergens/immunology; Asthma/etiology*; Asthma/epidemiology; Coal/adverse effects; Environmental Exposure/adverse effects; Humans; Morbidity; Rural Health; Tobacco Smoke Pollution/adverse effects; Urban Health; Prevalence
  13. Abdualkader AM, Ghawi AM, Alaama M, Awang M, Merzouk A
    Pak J Pharm Sci, 2013 May;26(3):525-35.
    PMID: 23625426
    The medicinal Malaysian leeches have been used in traditional medicine to treat many different ailments. In this study, leech saliva extract (LSE) was collected from the medicinal Malaysian leech Hirudinaria manillensis. Gel electrophoresis of LSE was carried out to estimate the peptide and protein molecular weights of its content. Results showed that LSE contains more than 60 peptides and proteins with molecular masses ranging from 1.9-250kDa. Thrombin time assay in vitro was employed to assess the collected LSE antithrombin activity. First, to study its stability, LSE was lyophilized under the following different conditions: pre-freezing temperature, type of container and lyophilization cycle. Pre-freezed LSE sample at -20°C and lyophilized for 24 hours retained about 100-95% of its original biological activities. Second, the LSE antithrombin activity was monitored for a period of six months. Storage temperature, type of the container and photosensitivity effects on antithrombin activity of the lyophilized (solid state) and non-lyophilized (liquid state) were investigated. Results showed that storage temperature drastically affected the biological activity of LSE with -20 °C as the optimum temperature. Samples stored at ambient temperature and +4 °C were light photosensitive and adversely affected when stored in polypropylene tubes. Lyophilized samples were more stable than non-lyophilized ones over the period of study. To sum up, in order to have a biologically active stock of LSE, it has to be lyophilized for no more than 24 hours following freezing at -20°C and has to be stored at -20°C in glass tubes protected from light.
    MeSH terms: Animals; Biological Products/pharmacology*; Biological Products/chemistry*; Drug Storage; Fibrinolytic Agents/pharmacology; Fibrinolytic Agents/chemistry; Freeze Drying/methods; Leeches/chemistry*; Materia Medica/pharmacology; Materia Medica/chemistry; Molecular Weight; Peptides/pharmacology; Peptides/chemistry; Saliva/chemistry*; Temperature
  14. Rodzian MN, Aziz Ibrahim IA, Nur Azlina MF, Nafeeza MI
    Pol J Pathol, 2013 Apr;64(1):52-8.
    PMID: 23625601
    Stress has been implicated as a risk factor of various major health problems, such as stress-induced gastric mucosal injury. This study was performed to investigate the action of a pure preparation of tocotrienol (T3) concentrate, made up of 90% δ-tocotrienol and 10% γ-tocotrienol, on gastric injury of rats induced by water-immersion restraint stress (WIRS). Fourteen male Sprague-Dawley rats (200-250 g) were divided into two equal groups: a control group and a treated group. The treatment group received T3 concentrate at 60 mg/kg body weight daily for 28 days. The body weights of rats were recorded daily before the treatment was given. At the end of the treatment period, all rats were subjected to WIRS for 3.5 hours, following which the rats were euthanized. The stomachs were isolated and opened along the greater curvature for the examination of lesions and measurements of gastric malondialdehyde (MDA) and prostaglandin E₂ (PGE₂) contents. The mean gastric mucosal lesion index in the treated rats was significantly lower than that in the control rats. This suggests that the T3 concentrate has the ability to confer protection to the gastric mucosa against gastric injury induced by acute stress. No significant difference was observed for changes in body weight before and after the treatment. The gastric PGE2 content in both groups was comparable. However, the gastric MDA content was significantly higher in the treated group compared to the control group, indicating that the T3 supplementation was not able to reduce the lipid peroxidation process. This study concludes that the T3 concentrate has the ability to protect the gastric mucosa from stress-induced injury by a non-antioxidant mechanism.
    MeSH terms: Animals; Body Weight/drug effects; Chromans/pharmacology; Gastric Mucosa/drug effects*; Gastric Mucosa/pathology; Male; Malondialdehyde/analysis; Malondialdehyde/metabolism*; Stress, Physiological; Vitamin E/analogs & derivatives*; Vitamin E/pharmacology; Lipid Peroxidation; Dinoprostone/analysis; Dinoprostone/metabolism*; Rats, Sprague-Dawley; Oxidative Stress/drug effects; Rats
  15. Chwen LT, Foo HL, Thanh NT, Choe DW
    Asian-Australas J Anim Sci, 2013 May;26(5):700-4.
    PMID: 25049841 DOI: 10.5713/ajas.2012.12561
    A study was conducted to investigate the effects of feeding medium chain triacylglycerol (MCT) on growth performance, plasma fatty acids, villus height and crypt depth in preweaning piglets. A total of 150 new born piglets were randomly assigned into one of three treatments: i) Control (no MCT); ii) MCT with milk (MCT+milk); iii) MCT without milk (MCT+fasting). Body weight, plasma fatty acid profiles, villus height and crypt depth were measured. Final BW for the Control and MCT+fasting was lower (p<0.05) than MCT+milk. The piglets fed with MCT regardless of milk provision or fasting had greater medium chain fatty acids (MCFA) than the Control. In contrast, the Control had greater long chain fatty acid (LCFA) and unsaturated fatty acid (USFA) than the MCT piglets. The piglets fed with MCT regardless of milk provision or fasting had higher villus height for the duodenum and jejunum after 6 h of feeding. Similar observations were found in piglets fed with MCT after 6 and 8 days of treatment. This study showed that feeding MCT to the piglets before weaning improved growth performance, with a greater concentration of MCT in blood plasma as energy source and a greater height of villus in duodenum, jejunum and ileum.
    MeSH terms: Animals; Body Weight; Duodenum; Fasting; Fatty Acids; Fatty Acids, Unsaturated; Ileum; Jejunum; Milk; Triglycerides; Weaning
  16. Sazili AQ, Norbaiyah B, Zulkifli I, Goh YM, Lotfi M, Small AH
    Asian-Australas J Anim Sci, 2013 May;26(5):723-31.
    PMID: 25049845 DOI: 10.5713/ajas.2012.12563
    This study provides a comparative analysis of the effects of pre-slaughter penetrative and non-penetrative stunning and post-slaughter stunning on meat quality attributes in longissimus lumborum (LL) and semitendinosus (ST) muscles in heifers. Ten animals were assigned to each of four treatment groups: i) animals were subjected to conventional Halal slaughter (a clean incision through the structures at the front of the upper neck - the trachea, oesophagus, carotid arteries and jugular veins) and post-cut penetrating mechanical stun within 10 to 20 s of the neck cut (Unstunned; US); ii) high power non-penetrating mechanical stunning followed by the neck cut (HPNP); iii) low power non-penetrating mechanical stunning followed by the neck cut (LPNP); and iv) penetrative stunning using a captive bolt pistol followed by the neck cut (P). For each carcass, muscle samples were removed within 45 min of slaughter, portioned and analysed for pH, cooking loss, water holding capacity (WHC), tenderness (WBS), lipid oxidation (TBARS) and color, over a two week storage period. Stunning did not affect pH and cooking loss. Significant differences in water holding capacity, tenderness, lipid oxidation and color were present at different storage time points. HPNP stunning resulted in lower WHC and color values, particularly lightness (L*), higher TBARS values and peak force values compared with those stunned using LPNP, P and US. These adverse effects on quality were mostly encountered in the ST muscle. In conclusion, the meat quality achieved using P, LPNP and US treatments was comparable, and no treatment stood out as considerably better than another.
    MeSH terms: Animals; Carotid Arteries; Cattle; Color; Cooking; Esophagus; Female; Hydrogen-Ion Concentration; Jugular Veins; Lipids; Meat; Trachea; Water; Thiobarbituric Acid Reactive Substances; Hamstring Muscles
  17. Shoeb Ahmad S, Abdul Ghani S, Hemalata Rajagopal T
    J Curr Glaucoma Pract, 2013 May-Aug;7(2):49-53.
    PMID: 26997782 DOI: 10.5005/jp-journals-10008-1137
    Glaucoma is now regarded as a neurodegenerative disorder. A number of theories including the mechanical and vascular models have been used to explain the pathogenesis of glaucoma. However, there is now increasing evidence of biochemical molecules which may play a part in it's causation. These biochemical mechanisms include the role of excitatory aminoacids, caspases, protein kinases, oxygen free radicals, nitric oxide, TNF-alpha, neurotrophins and metalloproteins. This paper reviews these new developments which form the biochemical basis of glaucomatous neural degeneration. How to cite this article: Ahmad SS, Ghani SA, Rajagopal TH. Current Concepts in the Biochemical Mechanisms of Glaucomatous Neurodegeneration. J Current Glau Prac 2013;7(2):49-53.
    MeSH terms: Free Radicals; Glaucoma; Metalloproteins; Nerve Growth Factors; Nitric Oxide; Oxygen; Protein Kinases; Tumor Necrosis Factor-alpha; Tetrahymenina; Neurodegenerative Diseases; Caspases
  18. Zandi K, Lim TH, Rahim NA, Shu MH, Teoh BT, Sam SS, et al.
    BMC Complement Altern Med, 2013 Apr 29;13:91.
    PMID: 23627436 DOI: 10.1186/1472-6882-13-91
    BACKGROUND: Scutellaria baicalensis (S. baicalensis) is one of the traditional Chinese medicinal herbs that have been shown to possess many health benefits. In the present study, we evaluated the in vitro antiviral activity of aqueous extract of the roots of S. baicalensis against all the four dengue virus (DENV) serotypes.

    METHODS: Aqueous extract of S. baicalensis was prepared by microwave energy steam evaporation method (MEGHE™), and the anti-dengue virus replication activity was evaluated using the foci forming unit reduction assay (FFURA) in Vero cells. Quantitative real-time polymerase chain reaction (qRT-PCR) assay was used to determine the actual dengue virus RNA copy number. The presence of baicalein, a flavonoid known to inhibit dengue virus replication was determined by mass spectrometry.

    RESULTS: The IC(50) values for the S. baicalensis extract on Vero cells following DENV adsorption ranged from 86.59 to 95.19 μg/mL for the different DENV serotypes. The IC(50) values decreased to 56.02 to 77.41 μg/mL when cells were treated with the extract at the time of virus adsorption for the different DENV serotypes. The extract showed potent direct virucidal activity against extracellular infectious virus particles with IC(50) that ranged from 74.33 to 95.83 μg/mL for all DENV serotypes. Weak prophylactic effects with IC(50) values that ranged from 269.9 to 369.8 μg/mL were noticed when the cells were pre-treated 2 hours prior to virus inoculation. The concentration of baicalein in the S. baicalensis extract was ~1% (1.03 μg/gm dried extract).

    CONCLUSIONS: Our study demonstrates the in vitro anti-dengue virus replication property of S. baicalensis against all the four DENV serotypes investigated. The extract reduced DENV infectivity and replication in Vero cells. The extract was rich in baicalein, and could be considered for potential development of anti-DENV therapeutics.

    MeSH terms: Animals; Antiviral Agents/pharmacology*; Antiviral Agents/chemistry; Cell Line; Dengue/virology*; Dengue Virus/drug effects*; Dengue Virus/genetics; Dengue Virus/physiology; Humans; Plant Extracts/pharmacology*; Plant Extracts/chemistry; Virus Replication/drug effects*; Scutellaria baicalensis/chemistry*
  19. Malihi Z, Kandiah M, Chan YM, Hosseinzadeh M, Sohanaki Azad M, Zarif Yeganeh M
    J Hum Nutr Diet, 2013 Jul;26 Suppl 1:123-31.
    PMID: 23627676 DOI: 10.1111/jhn.12043
    The primary objective of the present study was to assess changes in the nutritional status and quality of life in acute leukaemia patients, aged ≥15 years, who had undergone induction chemotherapy.
    MeSH terms: Acute Disease; Adolescent; Adult; Female; Humans; Iran/epidemiology; Leukemia/complications*; Leukemia/drug therapy; Male; Nutritional Status*; Prospective Studies; Quality of Life*; Surveys and Questionnaires; Nutrition Assessment; Malnutrition/etiology*; Malnutrition/epidemiology; Young Adult; Induction Chemotherapy/adverse effects*
  20. Mansoor MA, Ismail A, Yahya R, Arifin Z, Tiekink ER, Weng NS, et al.
    Inorg Chem, 2013 May 20;52(10):5624-6.
    PMID: 23627942 DOI: 10.1021/ic302772b
    Perovskite-structured lead titanate thin films have been grown on FTO-coated glass substrates from a single-source heterometallic molecular complex, [PbTi(μ2-O2CCF3)4(THF)3(μ3-O)]2 (1), which was isolated in quantitative yield from the reaction of tetraacetatolead(IV), tetrabutoxytitanium(IV), and trifluoroacetic acid from a tetrahydrofuran solution. Complex 1 has been characterized by physicochemical methods such as melting point, microanalysis, FTIR, (1)H and (19)F NMR, thermal analysis, and single-crystal X-ray diffraction (XRD) analysis. Thin films of lead titanate having spherical particles of various sizes have been grown from 1 by aerosol-assisted chemical vapor deposition at 550 °C. The thin films have been characterized by powder XRD, scanning electron microscopy, and energy-dispersive X-ray analysis. An optical band gap of 3.69 eV has been estimated by UV-visible spectrophotometry.
    MeSH terms: Aerosols; Furans; Lead; Microscopy, Electron, Scanning; Oxides; Titanium; Trifluoroacetic Acid; X-Ray Diffraction; X-Rays; Spectroscopy, Fourier Transform Infrared; Calcium Compounds
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