Important bioactive molecules are molecules that are pharmacologically active derived from natural sources and through chemical synthesis. Over the years many of such molecules have been discovered through bioprospective endeavours. The discovery of taxol from the pacific yew tree bark that has the ability in stabilising cellular microtubules represents one of the hallmarks of success of such endeavours. In recent years, the discovery process has been aided by the rapid development
of techniques and technologies in chemistry and biotechnology. The progress in advanced genetics and computational biology has also transformed the way hypotheses are formulated as well as the strategies for drug discovery. Of equal importance is the use of advanced drug delivery vehicles in enhancing the efficacy and bioavailability of bioactive molecules. The availability of suitable animal models for testing and validation is yet another major determinant in increasing the prospect for
clinical trials of bioactive molecules.
Cancer research is an extremely broad topic covering many scientific disciplines including biology (e.g. biochemistry and signal transduction), chemistry (e.g. drug discover and development), physics (e.g. diagnostic devices) and even computer science (e.g. bioinformatics). Some would argue that
cancer research will continue in much the same way as it is by adding further layers of complexity to the scientific knowledge that is already complex and almost beyond measure. But we anticipate that cancer research will undergo a dramatic paradigm shift due to the recent explosion of new discoveries in cancer biology. This review article focuses on the latest horizons in cancer research concerning cancer epigenetics, cancer stem cells, cancer immunology and cancer metabolism.
There have been significant achievements in research at IMU as indicated by the increasing amount of external funds obtained, and number of publications and postgraduate students produced since it started its research activities in the year 2000. However, it is a great challenge indeed to ensure sustainability of our research, which is currently heavily dependent on internal funding. There is a need to realign our strategies to further enhance our competitiveness in securing external funding for research. In line with this, the Institute for Research, Development and Innovation (IRDI) was officially established on 18 September 2012. The Institute will serve as a platform to support all research activities at IMU. There are four Centres of Excellence based on the identified thrust areas under
IRDI, namely 1) Centre for Bioactive Molecules and Drug Discovery; 2) Centre for Environmental and
Population Health; 3) Centre for Cancer and Stem Cell Research, and 4) Centre for Health Professional Education Research. Major findings based on research in these four thrust areas are reviewed in this paper. With the strategic planning and establishment of IRDI, it is our aspiration to bring research at IMU to a higher level.
MeSH terms: Academies and Institutes; Achievement; Education, Professional; Financial Management; Neoplasms; Publications; Students; Drug Discovery; Stem Cell Research
Healthcare investment is critically important for the health and well-being of the population, and different health systems are developed to meet the needs and priorities of each country. What has become clear has been that despite major advances in medicine, science and technology, there are major issues related to access and equity as well as quality and patient safety in healthcare services. The issue of patient safety was highlighted by the reports of the Institute of Medicine, USA1,2 and this had received worldwide attention. It is also an irony that despite being in an age of major advances in medicine, science and technology, with the acceptance of evidence-based medicine, so much of medicine and healthcare delivered is of little or no proven value. This poses a major challenge on health policy, and on how this can be addressed in any health reform process that focuses on improving access, equity, efficiency and effectiveness in healthcare services.
MeSH terms: Attention; Delivery of Health Care; Health Policy; Health Services; Humans; Investments; Technology; United States; Institute of Medicine (U.S.); Health Care Reform; Evidence-Based Medicine; Patient Safety
Hairy polyps are rare developmental malformations. They are benign lesions presented as a pedunculated mass that may arise from the naso-oropharyngeal region. Larger mass can cause upper respiratory obstruction causing respiratory distress or feeding difficulty, while smaller mass will present as intermittent respiratory distress due to a ball-valve type of obstruction. They are commonly seen in female, with ratio of 6:1 and majority of the cases occur in the infantile period. We are reporting a case of hairy polyp in a female infant that causing intermittent respiratory distress.
In this study, we report an extremely rare case of liposarcoma which arises primarily in mediastinum. The patient appeared to have progressive dyspnoea and prolonged cough for a duration of one year. Chest radiograph and Computed Tomography (CT) of the thorax revealed a large right mediastinal mass with fatty component. It was confirmed to be primary liposarcoma on histopathological examination.
Cervico-aural [collaural fistula] fistula is rare and it accounts for less than 5% of branchial cleft anomalies. In this paper, we report one such case of a 9 year old girl who was presented to us with two discharging cutaneous openings on the right side; one in the floor of the external auditory canal and another in the neck at the junction of the upper 2/3rd and lower third of the sternomastoid muscle along its anterior border.
In this paper, we report three cases of orbital rhabdomyosarcoma in different age groups with different histopathologic types. Case 1 is a 10-year old Malay boy who presented with painless proptosis of the left eye. Magnetic resonance imaging (MRI) showed soft tissue mass arising from the lateral rectus muscle. Tissue biopsy revealed rhabdomyosarcoma of embryonal type. Case 2 is a 32-year old Malay man who presented with a progressive left eye proptosis associated with pain and redness. Computed Tomography (CT) scan showed a retrobulbar mass extending medially in the left orbit. Meanwhile, biopsy showed rhabdomyosarcoma of pleomorphic type. Case 3 is a 67-year old Malay woman who presented with proptosis and fungating growth of left orbital region, epistaxis and nasal blockage. CT scan revealed an ill-defined mass filling up the left orbital cavity. Biopsy showed rhabdomyosarcoma of alveolar type. Rhabdomyosarcoma is the most common in childhood but it should be considered as a differential diagnosis of orbital tumours irrespective of age.
Routine diagnosis of intestinal microsporidiosis in clinical diagnostic laboratories relies mostly on detection of microsporidial spores via special staining and microscopic techniques. This paper describes the comparative evaluation of Calcofluor White M2R method, with modified Gram-chromotrope Kinyoun method as the reference standard. One hundred and six stool samples were examined for the presence of microsporidial spores. Sensitivity, specificity, positive and negative predictive values of the Calcofluor White M2R method compared to the reference technique were 95.2%, 4.3%, 78.2% and 20.0%, respectively. The positive predictive value (PPV) was 78.2% and the negative predictive value (NPV) was 20.0%. Despite low specificity of the CFW method due to its ability to stain chitinous wall of microorganisms, the presence of distinct deep-blue horizontal or equitorial stripes in microsporidial spores in modified Gram-chromotrope Kinyoun would likely reduce the false positive results obtained in the Calcofluor White M2R. Hence, the simultaneous use of these two methods would give better performance and accuracy for the detection of microsporidial spores in patients with intestinal microsporidiosis.
Major Depressive Disorder (MDD) in gynaecological cancer patients is a disabling illness with significant mental and physical suffering. Determining the risk factors of MDD in cancer patients enables us to pay more attention to those who are vulnerable and to device effective strategies for prevention, early detection, and treatment. The objective of the study is to determine the prevalence of MDD and its associated risk factors in gynaecological cancer patients at Hospital Sultanah Bahiyah, Alor Star. This is a hospital-based cross-sectional descriptive study of 120 gynaecological cancer patients in Gynae-Oncology Unit in Hospital Sultanah Bahiyah, Alor Star. Mini International Neuropsychiatry Interview (MINI) was used for diagnosis of MDD. Socio-demographic data and clinical variables were collected. MVFSFI (Malay version Female Sexual Function Index) was used to determine sexual dysfunction, and WHOQOL-BREF (World Health Organization – Quality of Life-26) was performed to assess quality of life. The prevalence of MDD in gynaecological cancer patients in the study was 18%. The variables found to be significantly associated with MDD were lack of perceived social support, greater physical pain perception, presence of past psychiatric history, and poorer quality of life. Meanwhile, sexual dysfunction was not associated with MDD. Logistic regression analysis revealed that only the psychological health domain of QOL was significantly associated with MDD, and contributed to 60% of the variation in MDD. The prevalence of MDD in gynaecological cancer patients is higher than those in the general population. In view that MDD can compromise cancer prognosis and patient’s well-being, psychosocial intervention is recommended as a part of multi- disciplinary and comprehensive management of gynaecological cancer.
MeSH terms: Attention; Cross-Sectional Studies; Depressive Disorder, Major; Female; Health Services; Humans; Mental Health; Pain; Physical Examination; Prognosis; Quality of Life; Risk Factors; Social Support; Prevalence; Logistic Models; Early Detection of Cancer; Neuropsychiatry; Pain Perception
Globally, one person dies every six seconds as a result of tobacco use. This makes tobacco use the cause of every one out of 10 deaths in adults and the single largest and leading cause of preventable death in the world. The objective of this study was to determine the prevalence of smoking among staff of Universiti Putra Malaysia. For the purpose of this study an analytical cross sectional study design was used and a standardized, pre-tested, while a validated well-structured questionnaire was used for data collection. The prevalence of smoking was found to be 10.0% (26.5% among males and 0.5% among females). In addition, significant associations were found between smoking and gender, religion, marital status, highest educational level, occupation, and family income (p < 0.05). In particular, gender and educational level were significant predictors of smoking. In conclusion, the prevalence of smoking among university staff was shown to be considerably lower than that stated for the national level. However, the University could aim at achieving zero prevalence in the years to come.
MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Occupations; Surveys and Questionnaires; Smoking; Tobacco Use Disorder; Universities; Prevalence; Marital Status; Tobacco Use
Maternal depression has been linked to the development of adolescents’ emotional and behavioural problems. The main objective of this study was to determine the association between maternal depressive disorders and externalizing and internalizing problems among their adolescent children. This was a cross-sectional, comparison study of 35 mothers with depression and their adolescents, matched with 35 healthy mothers and their adolescents as controls. The mothers completed Quick Inventory Depressive Symptomatology (QIDS) for assessment of current depression. The emotional and behavioural problems in the adolescents were assessed independently by the mothers and their adolescents off-springs using Child Behavioral Checklist (CBCL) and Youth Self-Report (YSR), respectively. SPSS version 12.0 was used for statistical analysis. The findings showed that adolescents who have mothers with depressive disorders had significantly higher scores of externalizing (mean difference = 4.686 + 10.887, p = 0.016) and total emotional and behavioural problems (mean difference = 10.171 + 23.007, p = 0.013) than controls. The cases also scored higher than the controls in the following CBCL syndrome scales: aggressive behaviour (mean difference = 3.200 + 6.773, p = 0.008), social problem (mean difference = 1.286 + 2.865, p = 0.012), and attention problem (mean difference = 1.543 + 4.435, p = 0.047). Mothers with depressive disorders reported that their adolescents have greater emotional and behavioural problems than the controls. The findings suggested a need for preventive strategies to curb problematic behaviour focusing on this vulnerable group.
The National Health and Morbidity Survey 2011 was a nationally representative household survey of non-institutionalized Malaysian population who were residing in Malaysia for at least 2 weeks prior to data collection. The aim of the survey was to provide health related community–based data and information to support Ministry of Health, Malaysia, in reviewing health priorities, programme strategies and activities, and planning for allocation of resources. There were twelve research scopes included in the survey. The sample size was calculated based on the requirement for each scope. A two-stage stratified sampling was adopted in the survey. The methods for data collection were via the questionnaire, clinical examination, and biochemical analysis. Quality controls were also instituted to ensure collection of high quality data. The National Health and Morbidity Survey 2011 (NHMS 2011) adopted an appropriate methodology for a population survey and all the necessary steps were taken to ensure valid and reliable findings.
Study name: National Health and Morbidity Survey (NHMS-2011)
MeSH terms: Health Priorities; Health Surveys; Malaysia; Morbidity; Quality Control; Surveys and Questionnaires; Sample Size; Resource Allocation
Palmaris longus is tendon of choice in reconstructive, plastic and cosmetic surgeries. Thus, a suitable length is required and it would be more convenient if the length of the tendon of the palmaris longus could be estimated before harvesting. This study was carried out to determine the relationship between the length and width of the palmaris longus tendon and the length of forearm and hand, the relationship between the length and the width of the palmaris longus tendon and wrist width and wrist circumference, as well as to identify a technique to estimate the length of the tendinous part of palmaris longus before harvesting it. A standardized proforma was used to collect the data of each of the 31 cadavers upper limbs. These data were analysed using SPSS software version 17. It is important to note that p value less than 0.05 is considered as statistically significant in this study. Out of the 31 upper limbs, palmaris longus tendon was absent in 3 (9.68%). Meanwhile, the mean length and width of the palmaris longus tendon was found to be 16.20 cm and 0.48 cm, respectively. The mean length of the forearm and hand was 26.6 cm and 21.2 cm, respectively. The mean width of the wrist and wrist circumference was 8.2 cm and 14.82 cm, respectively. These indicate a significant and moderate relationship between the length of palmaris longus tendon and the length of forearm (r = 0.49, r2 = 0.24, p < 0.01). In addition, there was also a significant relationship between the length of palmaris longus tendon and the length of hand (r = 0.56, p < 0.01). This paper presents the technique used to estimate the length and width of the tendinous part of palmaris longus before harvesting. The length of palmaris longus can be estimated pre-operatively by measuring the length of the hand by using the technique explained in this paper.
HbA1c is an established index of glycaemic control and correlates strongly with risk of chronic diabetic complications. However, the accuracy of HbA1c measurement can be affected by many factors, among which is the presence of haemoglobin (Hb) variants. The aim of the study was to determine the percentage of Hb variant detected during HbA1c monitoring in Hospital Kuala Lumpur. The study also analysed non-reportable HbA1c results in the presence of Hb variants. A cross-sectional study using retrospective data of HbA1c results over five months’ period was analysed on Biorad Variant II Turbo, a high performance liquid chromatography (HPLC) assay. The Hb variants were grouped either as HbS, HbC, others (Hb variant apart from HbS or C), and a combination of HbS or C with Others. A total of 11,904 patients were included. Only 2.3% (273) had Hb variants; HbS trait (10.3%), others (89%), and the combination of HbS trait with others (0.7%). No patient with HbC variant or its combination was found. Only 2.2% of those with Hb variant had non-reportable HbA1c. Although the percentage of Hb variants detected during HbA1c analysis and non-reportable HbA1c results were low, their presence should be noted.
Management of Beta (β)-thalassaemia intermedia in contrast to β-thalassaemia major patients has no clear guidelines as to indicators of adequate transfusion. Regular blood transfusion suppresses bone marrow erythropoietic activity. Serum soluble transferrin receptor (sTfR) concentration is a marker for erythropoietic activity, with increased sTfR being associated with functional iron deficiency and increased erythropoietic activity. This study aimed to determine the use of sTfR as an indicator of adequate transfusion in adult β-thalassaemia intermedia patients. A cross-sectional study was conducted at Hospital Ampang, Malaysia, for six months. Patient group included six β-thalassaemia intermedia and 34 HbE-β-thalassaemia transfused patients. None of the patients were on regular monthly blood transfusions as in β-thalassaemia major. The control group comprised of 16 healthy subjects with normal haematological parameters. Haemoglobin (Hb) analysis, sTfR and ferritin assays were performed. Hb and HbA percentages (%) were found to be significantly lower in patients compared to the controls, while HbE%, HbF%, sTfR and ferritin were significantly higher in patients. An inverse relationship was found in the controls between HbF% with Hb (r = -0.515, p < 0.05) and HbA% (r = -0.534, p < 0.05). In patients, sTfR showed an inverse relationship with HbA% (r = -0.618, p = 0.000) and a positive correlation with HbE% (r = 0.418, p = 0.007) and HbF% (r = 0.469, p = 0.002). Multivariate analysis showed that HbA% (r = 2.875, p = 0.048), HbE% (r = 2.872, p = 0.020) and HbF% (r = 2.436, p = 0.013) best predicted sTfR independently in patients. Thus, sTfR is a useful marker for erythropoiesis. The elevated sTfR in these patients indicate that the transfusion regimen used was inadequate to suppress ineffective erythropoiesis. Hb levels may not be the best target for monitoring transfusion treatment in β-thalassaemia intermedia patients, but the use of sTfR is helpful in individualising transfusion regimens.
MeSH terms: Adult; Blood Transfusion; Bone Marrow; Clinical Protocols; Cross-Sectional Studies; Erythropoiesis; Ferritins; Hemoglobins; Humans; Iron; Malaysia; Receptors, Transferrin; Multivariate Analysis; beta-Thalassemia; Iron Metabolism Disorders; Control Groups; Healthy Volunteers
Clinical vampirism in psychiatric practice is very rare and usually associated with schizophrenia, antisocial personality disorder or paraphilia. An Asian case of clinical vampirism is described. It is about a 24-year-old Malay female, paramedic student, who craved for blood since childhood. She injured her sister and herself so that she could access and drink blood. There was no associated psychosis or medical problems. The craving for blood may represent her underlying craving for parental love and attention.
Military personnel who are deployed for peace-keeping missions are exposed to many hazards, including infectious diseases. One of the most common and fatal infectious disease is Malaria. Although well controlled in Malaysia, this deadly disease is still widely endemic in many other countries especially Africa. We would like to report the case of a military personnel who was infected with Malaria during a peace-keeping mission in Sudan and subsequently died after returning home. We hope that by reporting this case in depth, strategic actions can be taken to avoid similar unfortunate events in future.
MeSH terms: Africa; Communicable Diseases; Immunologic Tests; Malaria; Malaysia; Military Personnel; Religious Missions; Sudan
Intracranial germinomas belong to the class of germ cell tumors which are relatively rare intracranial tumors. Early recognition of this neoplasm is vital as germinomas are highly radiosensitive and effective/ early radiation therapy can result in relatively favourable overall prognosis. In this article we describe a 19 years old man who presented with pituitary tumor in the suprasellar region for which transsphenoidal decompression and biopsy was done. The histopathological examination confirmed it to be germinoma and he underwent craniospinal radiotherapy.
Discrepancies between tooth sizes can cause orthodontic problems such as crowding and improper occlusion. By identifying these problems, better orthodontic treatment outcome can be achieved. The aim of this study is to identify anterior tooth size discrepancies among 4 different types of malocclusion i.e. Class I; Class II division 1 (II/1); Class II division 2 (II/2); and Class III. Methods: A retrospective study was carried out using 200 orthodontic study models where 50 study models were taken for each of the 4 malocclusion groups. The samples were selected using random sampling technique based on the orthodontic waiting list in the Orthodontic Department, Dental Faculty, UKM. All anterior teeth were measured by the same examiner at the largest mesio-distal dimension, using a digital caliper recorded up to 0.01 mm. Comparison between the 4 groups of malocclusion were made intra-arch using individual tooth size measurement and inter-arch using Anterior Bolton Index (ABI). Results: For the intra-arch assessment, Class II/1 had significantly the largest upper and lower anterior tooth size except for its upper canine and lower central incisor. Class III group had insignificantly the smallest mandibular anterior teeth compared to other malocclusion groups. For inter-arch assessment, Anterior Bolton Index (ABI) of all samples was 79.2 ± 3.94%. The highest ABI was noted in Class II / 2 of 80.3 ± 4.71%. However, no significant differences were found among the 4 malocclusion groups (p>0.05). Conclusion: Most of the anterior teeth in Class II division 1 were the largest of all. No significant difference in the inter-arch tooth size discrepancies were detected among all malocclusion
groups.