Browse publications by year: 2014

  1. Mohd Azri MS, Kunasegaran K, Azrina A, Siti Nadiah AK
    Indian J Hematol Blood Transfus, 2014 Sep;30(Suppl 1):405-8.
    PMID: 25332632 DOI: 10.1007/s12288-014-0439-4
    We report the first case of young woman with the p phenotype and anti-PP1P(k) antibody in the Malaysian population who was identified during a blood grouping and antibody screening procedure after her first miscarriage. Further family screening detected two other siblings who possessed the same rare phenotype and antibody. Because of difficulties in finding compatible units in the local population, the patient and her two siblings were advised to become regular blood donor. Their blood was frozen for future use. After she had two recurrent miscarriages, her third pregnancy was successfully managed using oral dydrogesterone, which was started from 10 weeks into the pregnancy. Her pregnancy was uneventful and she gave birth to a healthy term neonate.
    MeSH terms: Abortion, Habitual; Antibodies; Blood Donors; Blood Grouping and Crossmatching; Dydrogesterone; Female; Humans; Infant, Newborn; Phenotype; Pregnancy; Siblings; Parturition
  2. Kosuwin R, Putaporntip C, Tachibana H, Jongwutiwes S
    PLoS One, 2014;9(10):e110463.
    PMID: 25333779 DOI: 10.1371/journal.pone.0110463
    Thrombospondin-related adhesive protein (TRAP) of malaria parasites is essential for sporozoite motility and invasions into mosquito's salivary gland and vertebrate's hepatocyte; thereby, it is a promising target for pre-erythrocytic vaccine. TRAP of Plasmodium vivax (PvTRAP) exhibits sequence heterogeneity among isolates, an issue relevant to vaccine development. To gain insights into variation in the complete PvTRAP sequences of parasites in Thailand, 114 vivax malaria patients were recruited in 2006-2007 from 4 major endemic provinces bordering Myanmar (Tak in the northwest, n = 30 and Prachuap Khirikhan in the southwest, n = 25), Cambodia (Chanthaburi in the east, n = 29) and Malaysia (Yala and Narathiwat in the south, n = 30). In total, 26 amino acid substitutions were detected and 9 of which were novel, resulting in 44 distinct haplotypes. Haplotype and nucleotide diversities were lowest in southern P. vivax population while higher levels of diversities were observed in other populations. Evidences of positive selection on PvTRAP were demonstrated in domains II and IV and purifying selection in domains I, II and VI. Genetic differentiation was significant between each population except that between populations bordering Myanmar where transmigration was common. Regression analysis of pairwise linearized Fst and geographic distance suggests that P. vivax populations in Thailand have been isolated by distance. Sequence diversity of PvTRAP seems to be temporally stable over one decade in Tak province based on comparison of isolates collected in 1996 (n = 36) and 2006-2007. Besides natural selection, evidences of intragenic recombination have been supported in this study that could maintain and further generate diversity in this locus. It remains to be investigated whether amino acid substitutions in PvTRAP could influence host immune responses although several predicted variant T cell epitopes drastically altered the epitope scores. Knowledge on geographic diversity in PvTRAP constitutes an important basis for vaccine design provided that vaccination largely confers variant-specific immunity.
    MeSH terms: Amino Acid Sequence; Haplotypes; Humans; Mutation; Phylogeny; Plasmodium vivax/isolation & purification; Plasmodium vivax/metabolism*; Regression Analysis; Selection, Genetic; Genetic Variation; Protozoan Proteins/classification; Protozoan Proteins/genetics*; Protozoan Proteins/chemistry; Cluster Analysis; DNA, Protozoan/isolation & purification; DNA, Protozoan/metabolism; Malaria, Vivax/diagnosis; Malaria, Vivax/parasitology; Epitopes, T-Lymphocyte/chemistry
  3. Sim DS, Chong KW, Nge CE, Low YY, Sim KS, Kam TS
    J Nat Prod, 2014 Nov 26;77(11):2504-12.
    PMID: 25333996 DOI: 10.1021/np500589u
    Seven new indole alkaloids (1-7) comprising four vobasine, two tacaman, and one corynanthe-tryptamine bisindole alkaloid were isolated from the stem-bark extract of a Malayan Tabernaemontana. Two of the new vobasine alkaloids (1, 3), as well as 16-epivobasine (15) and 16-epivobasenal (17), showed appreciable cytotoxicity toward KB cells (IC50 ca. 5 μg/mL). The structure of the known Tabernaemontana alkaloid tronoharine (8) was revised based on newly acquired NMR data, as well as X-ray diffraction analysis.
    MeSH terms: Antineoplastic Agents, Phytogenic/isolation & purification*; Antineoplastic Agents, Phytogenic/pharmacology*; Antineoplastic Agents, Phytogenic/chemistry; Drug Screening Assays, Antitumor; Humans; Indoles/isolation & purification; Indoles/pharmacology; Indoles/chemistry; Malaysia; Molecular Conformation; Plants, Medicinal/chemistry*; Tryptamines/isolation & purification; Tryptamines/pharmacology; Tryptamines/chemistry; Molecular Structure; Crystallography, X-Ray; Nuclear Magnetic Resonance, Biomolecular; Indole Alkaloids/isolation & purification*; Indole Alkaloids/pharmacology*; Indole Alkaloids/chemistry; Tabernaemontana/chemistry*
  4. Tayyari F, Yusof F, Vymyslicky M, Tan O, Huang D, Flanagan JG, et al.
    Invest Ophthalmol Vis Sci, 2014 Dec;55(12):7716-25.
    PMID: 25335983 DOI: 10.1167/iovs.14-14430
    The purpose of this study was to determine the within-session variability and between-session repeatability of spectral Fourier-domain optical coherence tomography (Doppler FD-OCT) Doppler retinal blood flow measurements in young and elderly subjects.
    MeSH terms: Adult; Aged; Female; Fourier Analysis; Humans; Male; Middle Aged; Regional Blood Flow/physiology; Retinal Vessels/physiology*; Reproducibility of Results; Laser-Doppler Flowmetry/methods*; Tomography, Optical Coherence/methods*; Tomography, Optical Coherence/standards; Young Adult
  5. Kamarudin MN, Mohd Raflee NA, Hussein SS, Lo JY, Supriady H, Abdul Kadir H
    Drug Des Devel Ther, 2014;8:1765-80.
    PMID: 25336920 DOI: 10.2147/DDDT.S67980
    Alpha-lipoic acid, a potent antioxidant with multifarious pharmacological benefits has been reported to be neuroprotective in several neuronal models and used to treat neurological disorders such as Alzheimer's disease. Nonetheless, conclusive mechanisms of alpha-lipoic acid for its protective effects particularly in NG108-15 cells have never been investigated. In this study, the intricate neuroprotective molecular mechanisms by (R)-(+)-alpha-lipoic acid (R-LA) against H2O2-induced cell death in an in vitro model of neurodegeneration were elucidated. Pretreatment with R-LA (2 hours) significantly increased NG108-15 cell viability as compared to H2O2-treated cells and mitigated the induction of apoptosis as evidenced by Hoechst 33342/propidium iodide staining. R-LA (12.5-50 μM) aggrandized the reduced glutathione over glutathione disulfide ratio followed by a reduction in the intracellular reactive oxygen species level and an increase in mitochondrial membrane potential following H2O2 exposure. Moreover, pretreatment with R-LA stimulated the activation of PI3K-Akt through mTORC1 and mTORC2 components (mTOR, rictor and raptor) and production of antiinflammatory cytokine, IL-10 which led to the inactivation of glycogen synthase kinase-3β (GSK-3β) and reduction of both Bax/Bcl2 and Bax/Bcl-xL ratios, accompanied by inhibition of the cleaved caspase-3. Additionally, this observation was preceded by the suppression of NF-κβ p65 translocation and production of proinflammatory cytokines (IL-6 and TNF-α). The current findings accentuate new mechanistic insight of R-LA against apoptogenic and brain inflammatory factors in a neuronal model. These results further advocate the therapeutic potential of R-LA for the treatment of neurodegenerative diseases.
    MeSH terms: Cell Survival/drug effects; Cells, Cultured; Dose-Response Relationship, Drug; Humans; Hydrogen Peroxide/antagonists & inhibitors*; Hydrogen Peroxide/pharmacology; Thioctic Acid/pharmacology*; Thioctic Acid/chemistry; Molecular Conformation; Structure-Activity Relationship; Signal Transduction/drug effects; Cytokines/antagonists & inhibitors*; Cytokines/biosynthesis; NF-kappa B/antagonists & inhibitors*; NF-kappa B/metabolism; Cell Death/drug effects; Reactive Oxygen Species/metabolism; Phosphatidylinositol 3-Kinases/metabolism*; Glycogen Synthase Kinase 3/metabolism*; Proto-Oncogene Proteins c-akt/metabolism*; Glycogen Synthase Kinase 3 beta
  6. Eid AM, El-Enshasy HA, Aziz R, Elmarzugi NA
    Int J Nanomedicine, 2014;9:4685-95.
    PMID: 25336948 DOI: 10.2147/IJN.S66180
    There is an increasing trend among pharmaceutical industries to use natural bioactive materials as medicinal agents and to use new technologies such as self-nanoemulsifying systems. The solubility and bioavailability of poorly soluble drugs can be enhanced by self-nanoemulsifying systems. Swietenia oil is frequently used because of its antimicrobial, antimutagenic, and anticancer bioactive medical properties. This study was conducted to develop self-nanoemulsifying systems for Swietenia oil that will enhance the anti-inflammatory activity of the oil. The self-emulsifying systems developed for Swietenia oil in this study were constructed using ternary phase diagrams and contained the nonionic surfactants Labrasol(®), Tween 20, Capmul(®), and Labrafil(®). The effect of these surfactants on the formulation was examined. The mean droplet size of Swietenia oil as well as their distribution, appearance, viscosity, and spreading times were studied to find the optimum formula, which contained droplets that were less than 200 nm. The next step was to test the anti-inflammatory properties of the optimum formula using a carrageenan-induced rat paw edema test. The results from this test were compared to the oil solution. Different oil/surfactants mixtures had various emulsification properties that were related to the size of their droplets. Tween 20 is a good surfactant to use in self-emulsifying systems because it produces droplets of nano-size. Mixtures of Capmul/Labrasol at a ratio of 2:1 and Labrafil/Tween 20 at a ratio of 1:2 were able to produce self-nanoemulsifying formulations containing Swietenia oil concentrations that ranged from 20%-50%. Nanoemulsion occurred when the size of the droplets fell below 200 nm with low size distribution (<0.3) after being gently mixed with water. It was found that the hydrophilic/lipophilic balance value affected the ternary phase diagram behavior of Swietenia oil and surfactants. In addition, the anti-inflammatory properties of Swietenia oil were greater in the self-nanoemulsifying systems than in the oil solution.
    MeSH terms: Animals; Anti-Inflammatory Agents/pharmacology; Anti-Inflammatory Agents/therapeutic use*; Anti-Inflammatory Agents/chemistry*; Caprylates/chemistry; Edema/chemically induced; Edema/drug therapy; Edema/pathology; Emulsions/pharmacology; Emulsions/therapeutic use; Emulsions/chemistry*; Foot/pathology; Glycerides/chemistry; Male; Organic Chemicals/chemistry; Plant Oils/pharmacology; Plant Oils/therapeutic use*; Plant Oils/chemistry*; Polysorbates/chemistry; Surface-Active Agents/chemistry; Viscosity; Rats, Sprague-Dawley; Meliaceae/chemistry*; Rats
  7. Roy P, Das S, Auddy RG, Mukherjee A
    Int J Nanomedicine, 2014;9:4723-35.
    PMID: 25336950 DOI: 10.2147/IJN.S65262
    Andrographolide (AG) is one of the most potent labdane diterpenoid-type free radical scavengers available from plant sources. The compound is the principal bioactive component in Andrographis paniculata leaf extracts, and is responsible for anti-inflammatory, anticancer, and immunomodulatory activity. The application of AG in therapeutics, however, is severely constrained, due to its low aqueous solubility, short biological half-life, and poor cellular permeability. Engineered nanoparticles in biodegradable polymer systems were therefore conceived as one solution to aid in further drug-like applications of AG. In this study, a cationic modified poly(lactic-co-glycolic) acid nanosystem was applied for evaluation against experimental mouse hepatotoxic conditions. Biopolymeric nanoparticles of hydrodynamic size of 229.7 ± 17.17 nm and ζ-potential +34.4 ± 1.87 mV facilitated marked restoration in liver functions and oxidative stress markers. Superior dissolution for bioactive AG, hepatic residence, and favorable cytokine regulation in the liver tissues are some of the factors responsible for the newer nanosystem-assisted rapid recovery.
    MeSH terms: Animals; Antioxidants/metabolism; Carbon Tetrachloride/toxicity; Diterpenes/pharmacology*; Diterpenes/chemistry*; Liver/drug effects*; Liver/pathology; Male; Particle Size; Plant Extracts/chemistry; Polyglycolic Acid/chemistry; Lipid Peroxidation/drug effects; Cytokines/metabolism; Oxidative Stress/drug effects; Plant Leaves/chemistry; Lactic Acid/chemistry; Andrographis/chemistry; Nanotechnology; Mice; Nanoparticles/chemistry*; Drug-Induced Liver Injury/metabolism
  8. Saifullah B, Arulselvan P, El Zowalaty ME, Fakurazi S, Webster TJ, Geilich BM, et al.
    Int J Nanomedicine, 2014;9:4749-62.
    PMID: 25336952 DOI: 10.2147/IJN.S63608
    The primary challenge in finding a treatment for tuberculosis (TB) is patient non-compliance to treatment due to long treatment duration, high dosing frequency, and adverse effects of anti-TB drugs. This study reports on the development of a nanodelivery system that intercalates the anti-TB drug isoniazid into Mg/Al layered double hydroxides (LDHs). Isoniazid was found to be released in a sustained manner from the novel nanodelivery system in humans in simulated phosphate buffer solutions at pH 4.8 and pH 7.4. The nanodelivery formulation was highly biocompatible compared to free isoniazid against human normal lung and 3T3 mouse fibroblast cells. The formulation was active against Mycobacterium tuberculosis and gram-positive bacteria and gram-negative bacteria. Thus results show significant promise for the further study of these nanocomposites for the treatment of TB.
    MeSH terms: Aluminum Hydroxide/toxicity; Aluminum Hydroxide/chemistry*; Animals; Antitubercular Agents/pharmacokinetics*; Antitubercular Agents/pharmacology; Antitubercular Agents/toxicity; Antitubercular Agents/chemistry*; Cell Line; Cell Survival/drug effects; Drug Combinations; Humans; Isoniazid/pharmacokinetics*; Isoniazid/pharmacology; Isoniazid/toxicity; Isoniazid/chemistry*; Magnesium Hydroxide/toxicity; Magnesium Hydroxide/chemistry*; Mycobacterium tuberculosis/drug effects; Drug Delivery Systems/methods*; NIH 3T3 Cells; Mice; Nanocomposites/chemistry*
  9. Shahzad H, Giribabu N, Muniandy S, Salleh N
    Int J Clin Exp Pathol, 2014;7(9):5484-94.
    PMID: 25337190
    This study investigated the effect of 10 or 100 mg/kg/day quercetin on the uterus of ovariectomized adult female rats receiving sex-steroid replacement regime mimicking changes in hormonal profiles during the reproductive cycle. Following seven days of treatment with estrogen and progesterone with or without quercetin, uteri were harvested for histological and proliferative cell nuclear antigen (PCNA) protein and mRNA expression and PCNA protein distribution analyses. Our findings indicated that co-administration of 10 mg/kg/day quercetin with estrogen and progesterone caused a significant decrease in the size of uterine lumen and epithelial heights with lower PCNA protein and mRNA expression as compared to estrogen plus progesterone-only treatment (P < 0.05). Concomitant treatment with estrogen and progesterone with 100 mg/kg/day quercetin resulted in a marked increase in the number of glands with increased PCNA protein and mRNA expression. Significantly higher PCNA distribution was observed in the stroma and glands as compared to estrogen plus progesterone-only treatment (P < 0.05). In conclusion, at 10 mg/kg/day, quercetin affects uterine morphology but not proliferation, however at 100 mg/kg/day, quercetin induced significant stromal and glandular proliferation which could predispose the uterus towards neoplastic development.
    MeSH terms: Animals; Dose-Response Relationship, Drug; Epithelial Cells/drug effects; Epithelial Cells/metabolism; Epithelial Cells/pathology; Estrogen Antagonists/pharmacology*; Female; Ovariectomy; Progesterone/pharmacology*; Quercetin/pharmacology*; Quercetin/toxicity; RNA, Messenger/metabolism; Time Factors; Uterus/drug effects*; Uterus/metabolism; Uterus/pathology; Stromal Cells/drug effects; Stromal Cells/metabolism; Stromal Cells/pathology; Rats, Sprague-Dawley; Risk Assessment; Proliferating Cell Nuclear Antigen/genetics; Proliferating Cell Nuclear Antigen/metabolism; Phytoestrogens/pharmacology*; Phytoestrogens/toxicity; Cell Proliferation/drug effects*
  10. Yaacob MA, Hasan WA, Ali MS, Rahman RN, Salleh AB, Basri M, et al.
    Acta Biochim. Pol., 2014;61(4):745-52.
    PMID: 25337608
    Genome mining revealed a 1011 nucleotide-long fragment encoding a type I L-asparaginase (J15 asparaginase) from the halo-tolerant Photobacterium sp. strain J15. The gene was overexpressed in pET-32b (+) vector in E. coli strain Rosetta-gami B (DE3) pLysS and purified using two-step chromatographic methods: Ni(2+)-Sepharose affinity chromatography and Q-Sepharose anion exchange chromatography. The final specific activity and yield of the enzyme achieved from these steps were 20 U/mg and 49.2%, respectively. The functional dimeric form of J15-asparaginase was characterised with a molecular weight of ~70 kDa. The optimum temperature and pH were 25°C and pH 7.0, respectively. This protein was stable in the presence of 1 mM Ni(2+) and Mg(2+), but it was inhibited by Mn(2+), Fe(3+) and Zn(2+) at the same concentration. J15 asparaginase actively hydrolysed its native substrate, l-asparagine, but had low activity towards l-glutamine. The melting temperature of J15 asparaginase was ~51°C, which was determined using denatured protein analysis of CD spectra. The Km, Kcat, Kcat/Km of J15 asparaginase were 0.76 mM, 3.2 s(-1), and 4.21 s(-1) mM(-1), respectively. Conformational changes of the J15 asparaginase 3D structure at different temperatures (25°C, 45°C, and 65°C) were analysed using Molecular Dynamic simulations. From the analysis, residues Tyr₂₄ , His₂₂, Gly₂₃, Val₂₅ and Pro₂₆ may be directly involved in the 'open' and 'closed' lid-loop conformation, facilitating the conversion of substrates during enzymatic reactions. The properties of J15 asparaginase, which can work at physiological pH and has low glutaminase activity, suggest that this could be a good candidate for reducing toxic effects during cancer treatment.
    MeSH terms: Asparaginase/genetics; Asparaginase/metabolism*; Asparaginase/chemistry*; Bacterial Proteins/genetics; Bacterial Proteins/metabolism*; Bacterial Proteins/chemistry*; Photobacterium/enzymology*; Molecular Dynamics Simulation
  11. Rashid A, Manan AA, Yahya N, Ibrahim L
    PLoS One, 2014;9(10):e109429.
    PMID: 25338116 DOI: 10.1371/journal.pone.0109429
    This cross sectional survey was conducted to determine the support in making Penang UNESCO World Heritage Site (GTWHS) smoke free and to determine the influence of tolerance towards smoking on this support. This is the first phase in making Penang, Malaysia a smoke free state. A multistage sampling process was done to select a sample of respondents to represent the population of GTWHS. Attitude towards smoking was assessed using tolerance as a proxy. A total of 3,268 members of the community participated in the survey. A big majority (n = 2969; 90.9%) of the respondents supported the initiative. Support was lowest among the owners and residents/tenants, higher age groups, the Chinese, men, respondents who had poor knowledge of the places gazetted as smoke free, and respondents with poor knowledge of the health effects on smokers and on passive smokers. The odds (both adjusted and unadjusted) of not supporting the initiative was high among those tolerant to smoking in public areas. Tolerance towards smoking was associated with 80.3% risk of non-support in the respondents who were tolerant to smoking and a 57.2% risk in the population. Health promotion and education concerning the harm of tobacco smoke in Malaysia, which has mainly targeted smokers, must change. Health education concerning the risks of second hand smoke must also be given to non-smokers and efforts should be made to denormalize smoking.
    MeSH terms: Adult; Aged; Attitude to Health; Cross-Sectional Studies; Developing Countries; Female; Health Education; Humans; Malaysia; Male; Middle Aged; Smoking/epidemiology*; Tobacco Smoke Pollution*; Smoking Cessation; Smoke-Free Policy*
  12. Tan XT, Amran F, Chee Cheong K, Ahmad N
    BMC Infect Dis, 2014;14:563.
    PMID: 25338815 DOI: 10.1186/s12879-014-0563-7
    Leptospirosis is a zoonotic disease caused by Leptospira species and is distributed globally. Microscopic agglutination test (MAT) is the serological 'gold standard' for diagnosis of leptospirosis but it is time-consuming and labour-intensive. An alternative serological method that is rapid, sensitive and specific is important for early treatment to reduce morbidity and mortality. The use of local Leptospira isolation may improve the sensitivity and specificity of the test because it may varies from one geographical region to another region. The objective of this study was to determine the sensitivity, specificity and cut-off points for an in-house Immunoglobulin M (IgM) enzyme-linked immunosorbent assay (ELISA) using a locally isolated Leptospiral strain IMR/175 as the antigen for the detection of anti-Leptospiral IgM.
    MeSH terms: Agglutination Tests; Animals; Antibodies, Bacterial/blood; Enzyme-Linked Immunosorbent Assay; Humans; Immunoglobulin M/blood; Leptospira/isolation & purification; Leptospirosis/blood; Leptospirosis/diagnosis*; Leptospirosis/immunology; Malaysia; ROC Curve; Zoonoses; Area Under Curve
  13. Yusof A, Chia YC, Hasni YM
    Asian Pac J Cancer Prev, 2014;15(19):8095-9.
    PMID: 25338990
    BACKGROUND: Worldwide, over half a million women died of breast cancer in 2011 alone. Mammography screening is associated with a reduction of 20 to 35% in breast cancer mortality. The aim of this study was to determine the awareness and practice of mammography screening and predictors of its uptake in Malaysian women attending a primary care clinic.

    MATERIALS AND METHODS: A cross-sectional study was carried out among women aged 40 to 74 years attending a primary care clinic in Selangor, Malaysia. An assisted structured questionnaire included questions on socio-demography, source of information and level of knowledge. An adapted version of the revised Champion Health Belief Model Scale plus other associated factors for mammography screening up-take were also included as part of the questionnaire. Predictors for mammography screening uptake were only determined in those who were aware about mammography screening. Significant predictors were determined by logistic regression.

    RESULTS: 447 women were recruited for this study; 99.1% of them (n: 411) were aware about breast cancer. Only 50.1% (n: 206) had knowledge about mammography screening. Prevalence of clinical breast-examination (CBE) was 23.3% (n: 104) and mammography screening up-take was 13.2% (n: 59). The predictors for the latter were those who have had clinical breast-examination (aOR=17.58, 95%CI: 7.68-39.82) and those aged between 50 to 59 years (aOR=3.94, 95%CI: 1.61-9.66) as well as those aged 60 years and above (aOR=6.91, 95%CI: 2.28-20.94). Good knowledge and positive beliefs about mammography screening were not associated with mammography screening uptake.

    CONCLUSIONS: Half of our Malaysian women were aware about mammography screening. However, the uptake of mammography was low. Previous CBE and older age were significant predictors of mammography screening uptake. Increasing CBE services may increase compliance with guidelines.
    MeSH terms: Adult; Aged; Breast Neoplasms/diagnosis*; Breast Neoplasms/prevention & control; Breast Neoplasms/psychology*; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Mammography/statistics & numerical data*; Middle Aged; Neoplasm Staging; Prognosis; Surveys and Questionnaires; Health Behavior; Prevalence; Breast Self-Examination; Early Detection of Cancer/psychology*
  14. Loh SY, Lee SY, Murray L
    Asian Pac J Cancer Prev, 2014;15(19):8127-34.
    PMID: 25338995
    BACKGROUND: Qigong is highly favoured among Asian breast cancer survivors for enhancing health. This study examined the hypothesis that quality of life (QoL) in the Qigong group is better than the placebo (aerobic) or usual care group.

    MATERIALS AND METHODS: A total of 197 participants were randomly assigned to either the 8-week Kuala Lumpur Qigong Trial or control groups in 2010-2011. Measurement taken at baseline and post- intervention included QoL, distress and fatigue. Analysis of covariance (ANCOVA) and Kruskal Wallis were used to examine for differences between groups in the measurements.

    RESULTS: There were 95 consenting participants in this 8week trial. The adherence rates were 63% for Qigong and 65% for the placebo group. The Qigong group showed significant marginal improvement in Quality of life scores compared to placebo (mean difference=7.3 unit; p=0.036), compared to usual care (mean difference=6.7 unit; p=0.048) on Functional Assessment Cancer Therapy-Breast measure. There were no significant changes between the placebo and usual care groups in fatigue or distress at post intervention (8-week).

    CONCLUSIONS: Cancer survivors who participated in the Qigong intervention showed slightly better QOL. Follow up studies are greatly needed to evaluate which subgroups may best benefit from Qigong. With a steep rise of cancer survivors, there is an urgent need to explore and engage more cultural means of physical activity to fight side effects of treatment and for cancer control in developing countries.

    MeSH terms: Adult; Aged; Breast Neoplasms/mortality; Breast Neoplasms/psychology; Breast Neoplasms/rehabilitation*; Female; Follow-Up Studies; Humans; Middle Aged; Prognosis; Quality of Life*; Exercise*; Survival Rate; Case-Control Studies; Survivors/psychology*; Qigong*
  15. Athirajan V, Razak IA, Thurairajah N, Ghani WM, Ching HN, Yang YH, et al.
    Asian Pac J Cancer Prev, 2014;15(19):8183-9.
    PMID: 25339003
    BACKGROUND: A comparative cross-sectional study involving oral cancer patients and healthy individuals was designed to investigate associations between retinol, α-tocopherol and β-carotene with the risk of oral cancer.

    MATERIALS AND METHODS: This study included a total of 240 matched cases and controls where subjects were selected from the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS). Retinol, α-tocopherol and β-carotene levels and intake were examined by high-performance liquid chromatography (HPLC) and food frequency questionnaire (FFQ) respectively.

    RESULTS: It was found that results from the two methods applied did not correlate, so that further analysis was done using the HPLC method utilising blood serum. Serum levels of retinol and α-tocopherol among cases (0.177±0.081, 1.649±1.670μg/ml) were significantly lower than in controls (0.264±0.137, 3.225±2.054μg/ml) (p<0.005). Although serum level of β-carotene among cases (0.106±0.159 μg/ml) were lower compared to controls (0.134±0.131μg/ml), statistical significance was not observed. Logistic regression analysis showed that high serum level of retinol (OR=0.501, 95% CI=0.254-0.992, p<0.05) and α-tocopherol (OR=0.184, 95% CI=0.091-0.370, p<0.05) was significantly related to lower risk of oral cancer, whereas no relationship was observed between β-carotene and oral cancer risk.

    CONCLUSIONS: High serum levels of retinol and α-tocopherol confer protection against oral cancer risk.

    MeSH terms: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell/blood*; Carcinoma, Squamous Cell/ethnology*; Carcinoma, Squamous Cell/prevention & control; Chromatography, High Pressure Liquid; Female; Follow-Up Studies; Humans; Malaysia/ethnology; Male; Middle Aged; Mouth Neoplasms/blood*; Mouth Neoplasms/ethnology*; Mouth Neoplasms/prevention & control; Neoplasm Staging; Prognosis; Risk Factors; Vitamin A/blood*; Vitamins/metabolism*; Case-Control Studies; alpha-Tocopherol/blood*; Young Adult
  16. Wan Abdul Rahman WF, Fauzi MH, Jaafar H
    Asian Pac J Cancer Prev, 2014;15(19):8441-5.
    PMID: 25339043
    BACKGROUND: Paired-like homeodomain transcription factor 2 (PITX2) is another new marker in breast carcinoma since hypermethylation at P2 promoter of this gene was noted to be associated with poor prognosis. We investigated the expression of PITX2 protein using immunohistochemistry in invasive ductal carcinoma and its association with the established growth receptors such as estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth receptor 2 (HER2).

    METHODS: We conducted a cross sectional study using 100 samples of archived formalin-fixed paraffin embedded tissue blocks of invasive ductal carcinoma and stained them with immunohistochemistry for PITX2, ER, PR and HER2. All HER2 with scoring of 2+ were confirmed with chromogenic in-situ hybridization (CISH).

    RESULTS: PITX2 protein was expressed in 53% of invasive ductal carcinoma and lack of PITX2 expression in 47%. Univariate analysis revealed a significant association between PITX2 expression with PR (p=0.001), ER (p=0.006), gland formation (p=0.044) and marginal association with molecular subtypes of breast carcinoma (p=0.051). Combined ER and PR expression with PITX2 was also significantly associated (p=0.003) especially in double positive cases. Multivariate analysis showed the most significant association between PITX2 and PR (RR 4.105, 95% CI 1.765-9.547, p=0.001).

    CONCLUSION: PITX2 is another potential prognostic marker in breast carcinoma adding significant information to established prognostic factors of ER and PR. The expression of PITX2 together with PR may carry a very good prognosis.

    MeSH terms: Adult; Aged; Aged, 80 and over; Breast Neoplasms/metabolism*; Breast Neoplasms/pathology; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Immunoenzyme Techniques; Lymphatic Metastasis; Middle Aged; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Receptors, Estrogen/metabolism*; Receptors, Progesterone/metabolism*; Transcription Factors/metabolism*; Biomarkers, Tumor/metabolism; Carcinoma, Ductal, Breast/metabolism*; Carcinoma, Ductal, Breast/secondary; Homeodomain Proteins/metabolism*; Receptor, ErbB-2/metabolism*; DNA Methylation*; Neoplasm Grading
  17. Woodward M
    Asian Pac J Cancer Prev, 2014;15(19):8521-6.
    PMID: 25339057
    In many countries of the Association of Southeast Asian Nations (ASEAN), cancer is an increasing problem due to ageing and a transition to Western lifestyles. Governments have been slow to react to the health consequences of these socioeconomic changes, leading to the risk of a cancer epidemic overwhelming the region. A major limitation to motivating change is the paucity of high-quality data on cancer, and its socioeconomic repercussions, in ASEAN. Two initiatives have been launched to address these issues. First, a study of over 9000 new cancer patients in ASEAN - the ACTION study - which records information on financial difficulties, as well as clinical outcomes, subsequent to the diagnosis. Second, a series of roundtable meetings of key stakeholders and experts, with the broad aim of producing advice for governments in ASEAN to take appropriate account of issues relating to cancer, as well as to generate knowledge and interest through engagement with the media. An important product of these roundtables has been the Jakarta Call to Action on Cancer Control. The growth and ageing of populations is a global challenge for cancer services. In the less developed parts of Asia, and elsewhere, these problems are compounded by the epidemiological transition to Western lifestyles and lack of awareness of cancer at the government level. For many years, health services in less developed countries have concentrated on infectious diseases and mother-and-child health; despite a recent wake-up call (United Nations, 2010), these health services have so far failed to allow for the huge increase in cancer cases to come. It has been estimated that, in Asia, the number of new cancer cases per year will grow from 6.1 million in 2008 to 10.6 million in 2030 (Sankaranarayanan et al., 2014). In the countries of the Association of Southeast Asian Nations (ASEAN), corresponding figures are 770 thousand in 2012 (Figure 1), rising to 1.3 million in 2030 (Ferlay et al., 2012). ASEAN consists of Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. It, thus, includes low- and middle-income countries where the double whammy of infectious and chronic diseases will pose an enormous challenge in allocating limited resources to competing health issues. Cancer statistics, even at the sub-national level, only tell part of the story. Many individuals who contract cancer in poor countries have no medical insurance and no, or limited, expectation of public assistance. Whilst any person who has a family member with cancer can expect to bear some consequential burden of care or expense, in a poor family in a poor environment the burden will surely be greater. This additional burden from cancer is rarely considered, and even more rarely quantified, even in developed nations.
    MeSH terms: Asia, Southeastern; Cancer Care Facilities; Health Services Accessibility*; Health Services Needs and Demand/trends; Health Services Needs and Demand/statistics & numerical data; Humans; Neoplasms/prevention & control*; Societies, Medical; Consensus; Quality Improvement*
  18. Pok EH, Lee WJ
    World J Gastroenterol, 2014 Oct 21;20(39):14315-28.
    PMID: 25339819 DOI: 10.3748/wjg.v20.i39.14315
    Medical therapy for type 2 diabetes mellitus is ineffective in the long term due to the progressive nature of the disease, which requires increasing medication doses and polypharmacy. Conversely, bariatric surgery has emerged as a cost-effective strategy for obese diabetic individuals; it has low complication rates and results in durable weight loss, glycemic control and improvements in the quality of life, obesity-related co-morbidity and overall survival. The finding that glucose homeostasis can be achieved with a weight loss-independent mechanism immediately after bariatric surgery, especially gastric bypass, has led to the paradigm of metabolic surgery. However, the primary focus of metabolic surgery is the alteration of the physio-anatomy of the gastrointestinal tract to achieve glycemic control, metabolic control and cardio-metabolic risk reduction. To date, metabolic surgery is still not well defined, as it is used most frequently for less obese patients with poorly controlled diabetes. The mechanism of glycemic control is still incompletely understood. Published research findings on metabolic surgery are promising, but many aspects still need to be defined. This paper examines the proposed mechanism of diabetes remission, the efficacy of different types of metabolic procedures, the durability of glucose control, and the risks and complications associated with this procedure. We propose a tailored approach for the selection of the ideal metabolic procedure for different groups of patients, considering the indications and prognostic factors for diabetes remission.
    MeSH terms: Animals; Blood Glucose/metabolism*; Diabetes Mellitus, Type 2/blood; Diabetes Mellitus, Type 2/diagnosis; Diabetes Mellitus, Type 2/etiology; Diabetes Mellitus, Type 2/surgery*; Energy Metabolism; Homeostasis; Humans; Obesity/blood; Obesity/complications; Obesity/diagnosis; Obesity/surgery*; Remission Induction; Risk Factors; Biomarkers/blood; Weight Loss; Body Mass Index; Treatment Outcome; Patient Selection
  19. Chan WK, Azmi N, Mahadeva S, Goh KL
    World J Gastroenterol, 2014 Oct 21;20(39):14488-94.
    PMID: 25339836 DOI: 10.3748/wjg.v20.i39.14488
    To compare same-day whole-dose vs split-dose of 2-litre polyethylene glycol electrolyte lavage solution (PEG-ELS) plus bisacodyl for colon cleansing for morning colonoscopy.
    MeSH terms: Administration, Oral; Aged; Bisacodyl/administration & dosage; Colonoscopy/adverse effects; Colonoscopy/methods*; Drug Administration Schedule; Female; Humans; Therapeutic Irrigation/adverse effects; Therapeutic Irrigation/methods*; Malaysia; Male; Middle Aged; Polyethylene Glycols/administration & dosage*; Polyethylene Glycols/adverse effects; Predictive Value of Tests; Time Factors; Treatment Outcome; Patient Satisfaction; Laxatives/administration & dosage
  20. Ibrahim N, Amit N, Suen MW
    PLoS One, 2014;9(10):e110670.
    PMID: 25340331 DOI: 10.1371/journal.pone.0110670
    BACKGROUND: There has been a drastic increase in the rate of suicides over the past 45 years in Malaysia. The statistics show that adolescents aged between 16 and 19 years old are at high risk of committing suicide. This could be attributed to issues relating to the developmental stage of adolescents. During this stage, adolescents face challenges and are exposed to various stressful experiences and risk factors relating to suicide.

    METHOD: The present study examined psychological factors (i.e., depression, anxiety and stress) as predictors for suicidal ideation among adolescents. A cross-sectional study was conducted on 190 students (103 males and 87 females), aged 15 to 19 years old from two different schools in Kuala Lumpur. The Depression Anxiety Stress Scale 21-item version (DASS-21) was used to measure depression, anxiety and stress among the students, and the Beck Scale for Suicide Ideation (BSS) to measure suicidal ideation. The data were analysed using Pearson's correlation and multiple regression analysis.

    RESULTS: The results show that 11.10%, 10.00%, and 9.50% of the students reported that they were experiencing severe depression, anxiety and stress, respectively. There were significant correlations between depression, anxiety, and stress with suicidal ideation. However, only depression was identified as a predictor for suicidal ideation.

    CONCLUSION: Hence, this study extends the role of depression in predicting suicidal ideation among adolescents in the Malaysian context. The findings imply that teenagers should be assisted in strengthening their positive coping strategies in managing distress to reduce depression and suicidal ideation.

    MeSH terms: Adolescent; Anxiety/psychology; Demography; Depression/psychology; Female; Humans; Malaysia; Male; Regression Analysis; Stress, Psychological/psychology*; Young Adult; Suicidal Ideation*
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