Browse publications by year: 2017

  1. Kalid N, Zaidan AA, Zaidan BB, Salman OH, Hashim M, Muzammil H
    J Med Syst, 2017 Dec 29;42(2):30.
    PMID: 29288419 DOI: 10.1007/s10916-017-0883-4
    The growing worldwide population has increased the need for technologies, computerised software algorithms and smart devices that can monitor and assist patients anytime and anywhere and thus enable them to lead independent lives. The real-time remote monitoring of patients is an important issue in telemedicine. In the provision of healthcare services, patient prioritisation poses a significant challenge because of the complex decision-making process it involves when patients are considered 'big data'. To our knowledge, no study has highlighted the link between 'big data' characteristics and real-time remote healthcare monitoring in the patient prioritisation process, as well as the inherent challenges involved. Thus, we present comprehensive insights into the elements of big data characteristics according to the six 'Vs': volume, velocity, variety, veracity, value and variability. Each of these elements is presented and connected to a related part in the study of the connection between patient prioritisation and real-time remote healthcare monitoring systems. Then, we determine the weak points and recommend solutions as potential future work. This study makes the following contributions. (1) The link between big data characteristics and real-time remote healthcare monitoring in the patient prioritisation process is described. (2) The open issues and challenges for big data used in the patient prioritisation process are emphasised. (3) As a recommended solution, decision making using multiple criteria, such as vital signs and chief complaints, is utilised to prioritise the big data of patients with chronic diseases on the basis of the most urgent cases.
    MeSH terms: Smartphone; Algorithms; Computer Systems; Humans; Statistics as Topic*; Time Factors*; Telemedicine/organization & administration*; Monitoring, Ambulatory/statistics & numerical data*; Data Mining/methods*; Remote Sensing Technology/statistics & numerical data*
  2. Nor Fauziah Handar
    Medical Journal of Malaysia, 2017;72(5):324-326.
    MyJurnal
    A four-year-old Ibanese boy presented with subacute
    abdominal distension for two months duration. Ultrasound
    and computed tomography (CT) scan showed solid liver
    masses as well as bowel and intraperitoneal lesions. Initial
    diagnosis of intraperitoneal inflammatory process as in
    tuberculosis with non-liquefied liver abscess with
    differential diagnosis of neoplastic process was made. Liver
    biopsy and peritoneal fluid analysis revealed Burkitt’s
    lymphoma (BL). We aim to highlight the diagnostic
    challenge of BL in this young age group emphasizing on the
    ultrasound and CT features of intraabdominal BL. We would
    also want to stress the importance of early diagnosis of BL
    as it is known to be the most aggressive tumour within 24
    hours yet to have good survival if early diagnosis was made.
  3. Azmawati Mohammed Nawi, Dalila Roslan, Idayu Badilla Idris, Rozita Hod
    Medical Journal of Malaysia, 2017;72(5):298-305.
    MyJurnal
    Introduction: Adolescents’ involvement in sexual practices
    are becoming a major public health concern in Malaysia.
    This study aims to determine the prevalence of sexual
    practices among Malaysian school-going adolescents and
    its predictive factors.

    Methods: A cross-sectional study was carried out from April
    2012 till September 2012 among 16-year-old school
    adolescents from two different schools. They were selected
    through simple random sampling and these adolescents
    answered a self-administered questionnaire consisting of
    three sections i.e. socio-demography, risk-taking
    behaviours and family-adolescents relationship. Data were
    analysed using Pearson Chi-Square test while Simple
    Logistic Regression and Multiple Logistic Regression were
    applied to determine the predictive factors.

    Results: The prevalence of sexual practices among the
    adolescents was 30.1% in which they were either involved in
    pornography (26.8%), pre-sexual activities (8.5%) or premarital
    sex (2.9%). Six predictive factors associated with
    sexual practices among this age group were identified which
    were male (adjusted Odds Ratio (aOR) 2.7, 95% Confidence
    Interval (95%CI) 1.4 to 2.5), truancy (aOR 2.3, 95%CI 1.3 to
    4.2), bully (aOR 3.5, 95%CI 1.7 to 7.3), hanging out (aOR 2.8,
    95% 1.4 to 5.6), staying out late (aOR 3.2, 95%CI 1.5 to 6.8)
    and conflict with family (aOR 4.1, 95%CI 1.9 to 8.9).

    Discussion: Asian background differs from the western
    countries and findings of this study may suggest suitable
    intervention programmes that can prevent high-risk sexual
    practices among Asian school-going adolescents.
  4. Hajissa K, Zakaria R, Suppian R, Mohamed Z
    BMC Infect Dis, 2017 12 29;17(1):807.
    PMID: 29284420 DOI: 10.1186/s12879-017-2920-9
    BACKGROUND: The inefficiency of the current tachyzoite antigen-based serological assays for the serodiagnosis of Toxoplasma gondii infection mandates the need for acquirement of reliable and standard diagnostic reagents. Recently, epitope-based antigens have emerged as an alternative diagnostic marker for the achievement of highly sensitive and specific capture antigens. In this study, the diagnostic utility of a recombinant multiepitope antigen (USM.TOXO1) for the serodiagnosis of human toxoplasmosis was evaluated.

    METHODS: An indirect enzyme-linked immunosorbent assay (ELISA) was developed to evaluate the usefulness of USM.TOXO1 antigen for the detection of IgG antibodies against Toxoplasma gondii in human sera. Whereas the reactivity of the developed antigen against IgM antibody was evaluated by western blot and Dot enzyme immunoassay (dot-EIA) analysis.

    RESULTS: The diagnostic performance of the new antigens in IgG ELISA was achieved at the maximum values of 85.43% and 81.25% for diagnostic sensitivity and specificity respectively. The USM.TOXO1 was also proven to be reactive with anti- T. gondii IgM antibody.

    CONCLUSIONS: This finding makes the USM.TOXO1 antigen an attractive candidate for improving the toxoplasmosis serodiagnosis and demonstrates that multiepitope antigens could be a potential and promising diagnostic marker for the development of high sensitive and accurate assays.

    MeSH terms: Antibodies, Protozoan/blood; Epitopes/genetics; Epitopes/immunology*; Antigens, Protozoan/genetics; Antigens, Protozoan/immunology*; Cross Reactions; Enzyme-Linked Immunosorbent Assay/methods*; Humans; Immunoglobulin G/blood; Immunoglobulin M/blood; Recombinant Proteins/genetics; Recombinant Proteins/immunology; Recombinant Proteins/metabolism; Sensitivity and Specificity; Serologic Tests; Toxoplasma/immunology*; Toxoplasmosis/diagnosis*; Toxoplasmosis/immunology; Blotting, Western
  5. Nair VS, Nayak M, Ramya MK, Sivadas G, Ganesh C, Devi SL, et al.
    J Pharm Bioallied Sci, 2017 Nov;9(Suppl 1):S41-S44.
    PMID: 29284934 DOI: 10.4103/jpbs.JPBS_92_17
    AIM: The aim of this study is to detect in vitro adherence of Enterococcus faecalis to the infected dentinal tubules of human extracted teeth using confocal laser scanning microscope.

    SUBJECTS AND METHODS: Roots from human premolar teeth (n = 40) were infected with E. faecalis strain the American Type Culture Collection 29212 in brain heart infusion for 21 days. After the experimental period, specimens were divided into two groups, Group A (n = 20), Group B (n = 20), and Group A specimens were stained with fluorescein diacetate dye for the detection of viability and adherence Group B were stained with acridine orange dye for detection of metabolic activity and adherence. Samples were washed, thoroughly sectioned and examined by confocal laser scanning microscopy. Computer-assisted determinants of fluorescence, bacterial viability, metabolic activity, and adherence were compared statistically.

    RESULTS: E. faecalis was able to invade the dentinal tubules to a depth of 1-400 μm and adhere to 1-200 μm depth. Adherence (90%) was significantly higher in 1-100 μm using fluorescein diacetate and acridine orange dye.

    CONCLUSION: Adherence of E. faecalis as evaluated by confocal laser scanning microscope was highest at the depth of 1-100 μm which may have an impact on the shaping and cleaning procedures on the root canal.

  6. Ramesh M, Malathi N, Ramesh K, Aruna RM, Kuruvilla S
    J Pharm Bioallied Sci, 2017 Nov;9(Suppl 1):S88-S91.
    PMID: 29284943 DOI: 10.4103/jpbs.JPBS_77_17
    Background: High levels of fluoride in the drinking water, especially ground water, results in skeletal fluorosis which involves the bone and major joints. This study was conducted to assess the prevalence of skeletal fluorosis to compare with dental fluorosis in an endemically fluorosed population in the District of Salem, Tamil Nadu.

    Materials and Methods: Institutional ethical clearance was obtained. A total of 206 patients who reported to the Department of Hematology for blood investigations were the participants in this study. Age, sex, place, weight, height, dental fluorosis, and skeletal complaints were noted down. Body mass index was calculated, and statistical analysis was performed.

    Results: Dental fluorosis was present in 63.1% and absent in 36.9% of the samples reported. Skeletal fluorosis was present in 24.8% and was absent in 75.2%. A large number of the patients had knee pain and difficulty in bending. Chi-square test was used for statistical analysis. Skeletal fluorosis and age were compared and P value was 0.00 and was significant. Dental fluorosis and skeletal fluorosis were compared and P value was found to be 0.000 and significant.

    Discussion and Conclusion: There is a need to take measures to prevent dental and skeletal fluorosis among the residents of Salem district. Calcium balance should be maintained, and fluoride intake should be minimized to reduce the symptoms. The government should provide water with low fluoride level for drinking and cooking. Once the symptoms develop, treatment largely remains symptomatic, using analgesics and physiotherapy.

    MeSH terms: Analgesics; Body Weight; Calcium, Dietary; Cooking; Fluorides; Hematology; Humans; India; Fluorosis, Dental; Pain; Body Mass Index; Prevalence; Chi-Square Distribution; Physical Therapy Modalities; Groundwater; Drinking Water
  7. Yap E, Law ZK, Aslan Abdullah NM, Abdul Wahid SF
    EXCLI J, 2017;16:1233-1248.
    PMID: 29285019 DOI: 10.17179/excli2017-805
    Patients with advanced aggressive B-cell non-Hodgkin lymphomas (NHL) are usually treated with rituximab in combination with chemotherapy. However, disease relapse rates are high. Radiotherapy (RT) has been shown to be efficacious in treating early-stage NHL but its role in advanced stage diseases is unclear. We performed a systematic review of randomized controlled trials (RCTs) comparing chemotherapy with RT to chemotherapy alone in patients with newly diagnosed advanced aggressive NHL. We searched online databases and pooled similar outcome estimates. For time-to-event outcomes, we estimated hazard ratios (HR) for overall survival (OS) and event-free survival (EFS) using the fixed-effect model. Two RCTs involving 254 patients met inclusion criteria. The trials were single-centre RCTs with follow-up period of five and ten years. Both trials were conducted in the pre-rituximab era. Patients treated with consolidation RT had better OS (HR for mortality 0.61; 95 % CI 0.38 to 0.97) and EFS (HR for mortality 0.67; 95 % CI 0.46 to 0.98) compared to those who received no RT. There was an apparent benefit of RT on local control (OR 0.09; 95 % CI 0.04 to 0.20); although this was estimated as a dichotomous rather than time-to-event outcome. Limited evidence shows benefits of consolidation RT in advanced aggressive NHL. However, we were not able to estimate the effect size with confidence due to small number of trials and sample size. We cannot recommend routine consolidation RT in advanced aggressive NHL. More RCTs with the inclusion of rituximab and PET-CT monitoring are needed.
    MeSH terms: Rituximab; Aggression; B-Lymphocytes; Follow-Up Studies; Humans; Lymphoma, Non-Hodgkin; Neoplasm Recurrence, Local; Proportional Hazards Models; Randomized Controlled Trials as Topic; Sample Size; Disease-Free Survival; Positron Emission Tomography Computed Tomography
  8. Shaghayegh G, Alabsi AM, Ali-Saeed R, Ali AM, Vincent-Chong VK, Ismail NH, et al.
    Asian Pac J Cancer Prev, 2017 Dec 29;18(12):3333-3341.
    PMID: 29286228
    Cancer is one of the most common causes of death in the developed world, with one-third of people diagnosed with
    cancer during their lifetime. Oral cancer commonly occurs involving the buccal mucosa (cheeks), tongue, floor of the
    mouth and lip. It is one of the most devastating and disfiguring of malignancies. Morinda citrifolia L., commonly known
    as ‘noni’, belongs to the Rubiaceae family. It is native to the Pacific islands, Hawaii, Caribbean, Asia and Australia.
    The plant displays broad curative effects in pharmacological studies. Damnacanthal (DAM) and Nordamnacanthal
    (NDAM), anthraquinone compounds isolated from the roots of Morinda citrifolia L., has been used for the treatment
    of several chronic diseases including cancer. The objectives of this study were to evaluate cytotoxicity, morphological
    changes, cell death mode (apoptosis/necrosis), and cell migration induced by DAM and NDAM on the most common
    type of oral cancer, oral squamous cell carcinoma (OSCC)cells. Anti-proliferative effects of these compounds against
    OSCC cell lines were determined by MTT assay. The mode of cell death was analysed by phase contrast and fluorescent
    microscopy as well as flow cytometry. In addition, cell migration was assessed. The results showed that DAM and
    NDAM exerted cytotoxicity against OSCC cells with IC50 values of 1.9 to >30 μg/ml after 72 h treatment. Maximum
    growth inhibition among the tested cell lines for both compounds was observed in H400 cells, and thus it was selected
    for further study. The study demonstrated inhibition of H400 OSCC cell proliferation, marked apoptotic morphological
    changes, induction of early apoptosis, and inhibition of cell migration by DAM and NDAM. Therefore, this information
    suggests that these compounds from noni have potential for used as anti tumor agents for oral cancer therapy.
    MeSH terms: Aldehydes/pharmacology*; Anthraquinones/pharmacology*; Carcinoma, Squamous Cell/drug therapy; Carcinoma, Squamous Cell/pathology*; Cell Movement/drug effects*; Humans; Mouth Neoplasms/drug therapy; Mouth Neoplasms/pathology*; Plant Extracts/pharmacology; Tumor Cells, Cultured; Apoptosis/drug effects*; Morinda/chemistry; Cell Proliferation/drug effects*
  9. Sirunyan AM, Tumasyan A, Adam W, Ambrogi F, Asilar E, Bergauer T, et al.
    Phys Rev Lett, 2017 Dec 15;119(24):242001.
    PMID: 29286735 DOI: 10.1103/PhysRevLett.119.242001
    The first observation of top quark production in proton-nucleus collisions is reported using proton-lead data collected by the CMS experiment at the CERN LHC at a nucleon-nucleon center-of-mass energy of sqrt[s_{NN}]=8.16  TeV. The measurement is performed using events with exactly one isolated electron or muon candidate and at least four jets. The data sample corresponds to an integrated luminosity of 174  nb^{-1}. The significance of the tt[over ¯] signal against the background-only hypothesis is above 5 standard deviations. The measured cross section is σ_{tt[over ¯]}=45±8  nb, consistent with predictions from perturbative quantum chromodynamics.
    MeSH terms: Aircraft; Electrons; Elementary Particles; Mesons; Protons; United States; Physical Phenomena; Nucleons
  10. Sirunyan AM, Tumasyan A, Adam W, Ambrogi F, Asilar E, Bergauer T, et al.
    Phys Rev Lett, 2017 Dec 01;119(22):221802.
    PMID: 29286783 DOI: 10.1103/PhysRevLett.119.221802
    A search for a signal consistent with the type-III seesaw mechanism in events with three or more electrons or muons is presented. The data sample consists of proton-proton collisions at sqrt[s]=13  TeV collected by the CMS experiment at the LHC in 2016 and corresponds to an integrated luminosity of 35.9  fb^{-1}. Selection criteria based on the number of leptons and the invariant mass of oppositely charged lepton pairs are used to distinguish the signal from the standard model background. The observations are consistent with the expectations from standard model processes. The results are used to place limits on the production of heavy fermions of the type-III seesaw model as a function of the branching ratio to each lepton flavor. In the scenario of equal branching fractions to each lepton flavor, heavy fermions with masses below 840 GeV are excluded. This is the most sensitive probe to date of the type-III seesaw mechanism.
    MeSH terms: Electrons; Elementary Particles; Flavoring Agents; Mesons; Motivation; Protons; Taste; United States; Patient Selection
  11. Koh, Kwee Choy, Mahfuja Islam, Chan, Weng Kien, Lee, Wei Yi, Ho, Yong Wai, Syed Abdul Hannan Alsagoff, et al.
    Medical Journal of Malaysia, 2017;72(4):209-214.
    MyJurnal
    Introduction: In Malaysia, the prevalence of missed
    opportunities for HIV-testing is unknown. Missed
    opportunities have been linked to late diagnosis of HIV and
    poorer outcome for patients. We describe missed
    opportunities for earlier HIV-testing in newly-HIV-diagnosed
    patients.

    Methods: Cross sectional study. Adult patients diagnosed
    with HIV infection and had at least one medical encounter in
    a primary healthcare setting during three years prior to
    diagnosis were included. We collected data on sociodemographic
    characteristics, patient characteristics at
    diagnosis, HIV-related conditions and whether they were
    subjected to risk assessment and offered HIV testing during
    the three years prior to HIV diagnosis.

    Results: 65 newly HIV-diagnosed patients (male: 92.3%;
    Malays: 52.4%; single: 66.7%; heterosexual: 41%;
    homosexual 24.6%; CD4
  12. Cai S, Tan S, Gluckman PD, Godfrey KM, Saw SM, Teoh OH, et al.
    Sleep, 2017 Feb 01;40(2).
    PMID: 28364489 DOI: 10.1093/sleep/zsw058
    STUDY OBJECTIVES: To examine the influence of maternal sleep quality and nocturnal sleep duration on risk of gestational diabetes mellitus (GDM) in a multiethnic Asian population.

    METHODS: A cohort of 686 women (376 Chinese, 186 Malay, and 124 Indian) with a singleton pregnancy attended a clinic visit at 26-28 weeks of gestation as part of the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort study. Self-reported sleep quality and sleep duration were assessed using the Pittsburgh Sleep Quality Index (PSQI). GDM was diagnosed based on a 75-g oral glucose tolerance test administered after an overnight fast (1999 WHO criteria). Multiple logistic regression was used to model separately the associations of poor sleep quality (PSQI score > 5) and short nocturnal sleep duration (<6 h) with GDM, adjusting for age, ethnicity, maternal education, body mass index, previous history of GDM, and anxiety (State-Trait Anxiety Inventory score).

    RESULTS: In the cohort 296 women (43.1%) had poor sleep quality and 77 women (11.2%) were categorized as short sleepers; 131 women (19.1%) were diagnosed with GDM. Poor sleep quality and short nocturnal sleep duration were independently associated with increased risk of GDM (poor sleep, adjusted odds ratio [OR] = 1.75, 95% confidence interval [CI] 1.11 to 2.76; short sleep, adjusted OR = 1.96, 95% CI 1.05 to 3.66).

    CONCLUSIONS: During pregnancy, Asian women with poor sleep quality or short nocturnal sleep duration exhibited abnormal glucose regulation. Treating sleep problems and improving sleep behavior in pregnancy could potentially reduce the risk and burden of GDM.

    MeSH terms: Adult; China/ethnology; Darkness; Ethnic Groups; Female; Glucose/metabolism; Glucose Tolerance Test; Humans; India/ethnology; Malaysia/ethnology; Maternal Age; Pregnancy; Risk Factors; Singapore; Sleep/physiology*; Time Factors; Cohort Studies; Logistic Models; Odds Ratio; Diabetes, Gestational/diagnosis; Diabetes, Gestational/etiology*; Asian Continental Ancestry Group
  13. Mohd Nafi SN, Idris F, Jaafar H
    Asian Pac J Cancer Prev, 2017 Dec 28;18(12):3231-3238.
    PMID: 29281877
    Background: Angiogenic activity has been considered to reflect important molecular events during breast tumour
    development. The present study concerned cellular and molecular changes of MNU-induced breast tumours subjected
    to promotion and suppression of angiogenesis. Methods: Female Sprague Dawley rats at the age of 21 days received
    MNU at the dose 70 mg/kg of body weight by intraperitoneal injection. Three months post-carcinogen initiation,
    mammary tumours were palpated and their growth was monitored. When the tumour diameter reached 1.0 ± 0.05 cm,
    rats were given bFGF or PF4 intratumourally at a dose of 10 μg/tumour. Entire palpable tumour were subsequently
    excised and subjected to histology examination, IHC staining, and RT-PCR. Results: No critical morphological changes
    were observed between pro-angiogenic factor, bFGF, and control groups. However, increase of tumour size with more
    necrotic and diffuse areas was notable in tumours after anti-angiogenic PF4 intervention. ER and PR mRNA expression
    was significantly up- and down-regulated in bFGF and PF4 groups, respectively. The trends were significantly associated
    with peri- and intratumoural MVD counts. However, irrespective of whether we promoted or inhibited angiogenesis,
    the expression of EGFR and ERBB2 continued to be significantly increased but this was not significantly associated
    with the MVD score. No significant differences in E-cadherin and LR gene expression were noted between intervention
    and control groups. Conclusion: ER and PR receptor expression shows consistent responses when tumour angiogenesis
    is manipulated either positively or negatively. Our study adds to current understanding that not only do we need to
    target hormonal receptors, as presently practiced, but we also need to target endothelial receptors to successfully treat
    breast cancer.
    MeSH terms: Alkylating Agents/toxicity; Animals; Female; Mammary Neoplasms, Experimental/blood supply; Mammary Neoplasms, Experimental/chemically induced; Mammary Neoplasms, Experimental/pathology*; Mammary Neoplasms, Experimental/prevention & control*; Methylnitrosourea/toxicity*; Neovascularization, Pathologic/pathology; Neovascularization, Pathologic/prevention & control*; Platelet Factor 4/administration & dosage*; Injections, Intralesional; Fibroblast Growth Factor 2/administration & dosage*; Rats, Sprague-Dawley; Angiogenesis Inhibitors/administration & dosage*; Rats
  14. Salmasi S, Lee KS, Ming LC, Neoh CF, Elrggal ME, Babar ZD, et al.
    BMC Cancer, 2017 12 28;17(1):903.
    PMID: 29282008 DOI: 10.1186/s12885-017-3888-y
    BACKGROUND: Globally, cancer is one of the leading causes of mortality. High treatment cost, partly owing to higher prices of anti-cancer drugs, presents a significant burden on patients and healthcare systems. The aim of the present study was to survey and compare retail prices of anti-cancer drugs between high, middle and low income countries in the South-East Asia, Western Pacific and Eastern Mediterranean regions.

    METHODS: Cross-sectional survey design was used for the present study. Pricing data from ten counties including one from South-East Asia, two from Western Pacific and seven from Eastern Mediterranean regions were used in this study. Purchasing power parity (PPP)-adjusted mean unit prices for 26 anti-cancer drug presentations (similar pharmaceutical form, strength, and pack size) were used to compare prices of anti-cancer drugs across three regions. A structured form was used to extract relevant data. Data were entered and analysed using Microsoft Excel®.

    RESULTS: Overall, Taiwan had the lowest mean unit prices while Oman had the highest prices. Six (23.1%) and nine (34.6%) drug presentations had a mean unit price below US$100 and between US$100 and US$500 respectively. Eight drug presentations (30.7%) had a mean unit price of more than US$1000 including cabazitaxel with a mean unit price of $17,304.9/vial. There was a direct relationship between income category of the countries and their mean unit price; low-income countries had lower mean unit prices. The average PPP-adjusted unit prices for countries based on their income level were as follows: low middle-income countries (LMICs): US$814.07; high middle income countries (HMICs): US$1150.63; and high income countries (HICs): US$1148.19.

    CONCLUSIONS: There is a great variation in pricing of anticancer drugs in selected countires and within their respective regions. These findings will allow policy makers to compare prices of anti-cancer agents with neighbouring countries and develop policies to ensure accessibility and affordability of anti-cancer drugs.

    MeSH terms: Antineoplastic Agents/economics*; Antineoplastic Agents/therapeutic use; Asia, Southeastern/epidemiology; Cross-Sectional Studies; Developing Countries; Humans; Neoplasms/drug therapy*; Neoplasms/economics*; Neoplasms/epidemiology; Pacific Islands/epidemiology; Drug Costs/standards*; Mediterranean Region/epidemiology
  15. Ng SL, Nordin A, Abd Ghafar N, Suboh Y, Ab Rahim N, Chua KH
    Parasit Vectors, 2017 12 28;10(1):625.
    PMID: 29282148 DOI: 10.1186/s13071-017-2547-0
    BACKGROUND: In recent years, the concern of Acanthamoeba keratitis has increased since the infection is often associated with contact lens use. Partial 18S rRNA genotypic identification of Acanthamoeba isolates is important to correlate with pathophysiological properties in order to evaluate the degree of virulence. This is the first report of genotypic identification for clinical isolates of Acanthamoeba from corneal scrapings of keratitis in Malaysia. This study is also the first to correlate the mRNA expression of MBP and AhLBP as virulent markers for axenic strains of Acanthamoeba.

    RESULTS: In this study, ten clinical isolates were obtained from corneal scrapings. Rns genotype and intra-genotypic variation at the DF3 region of the isolates were identified. Results revealed that all clinical isolates belonged to the T4 genotype, with T4/6 (4 isolates), T4/2 (3 isolates), T4/16 (2 isolates) and one new genotype T4 sequence (T4/36), being determined. The axenic clinical isolates were cytopathogenic to rabbit corneal fibroblasts. MBP and AhLBP mRNA expression are directly correlated to Acanthamoeba cytopathic effect.

    CONCLUSIONS: All ten Malaysian clinical isolates were identified as genotype T4 which is predominantly associated with AK. Measuring the mRNA expression of Acanthamoeba virulent markers could be useful in the understanding of the pathogenesis of Acanthamoeba keratitis.

    MeSH terms: Acanthamoeba; Animals; Contact Lenses; Cornea; Fibroblasts; Genotype; Malaysia; Rabbits; RNA, Messenger; RNA, Ribosomal, 18S; Virulence; Acanthamoeba Keratitis
  16. Dashti S, Latiff LA, Zulkefli NABM, Baharom AB, Minhat HS, Hamid HA, et al.
    J Family Reprod Health, 2017 Jun;11(2):56-66.
    PMID: 29282412
    Objective: Polycystic ovarian syndrome (PCOS) is a common condition amongst women of reproductive age that can result in increased mortality and morbidity in women due to increased risk of diabetes mellitus and cardiovascular diseases. The aim of this systematic review was to assess the effectiveness of common treatments of PCOS on the predictors of diabetes in non-diabetic PCOS women. Materials and methods: An extensive search was performed on the publications in three medical databases including pubmed, scopus and google scholar from 1995 till 2017. The articles were screened based on their quality and included in this systematic review. A total of 25 articles including cohort, randomised controlled trial, review and meta-analysis were included in the review. Results: This systematic review revealed that the effect of lifestyle modification might be low in PCOS subjects due to high drop-out rate while the benefits of this intervention including weight and fat reduction may not be achieved by medical interventions. Metformin treatment may result in improvements in insulin sensitivity while its weight reduction effect is still not documented in PCOS subjects. Thiazolidendiones might be tolerated by the PCOS subjects and may result in similar effects as metformin but this effect should be documented by further studies. Conclusion: Combination of lifestyle modification with metformin or thiazolidinedions might improve the outcome of the prevention strategies. On the other hand this study revealed a different response to treatments in non-obese compared with obese PCOS subjects.
    MeSH terms: Body Weight; Cardiovascular Diseases; Diabetes Mellitus; Female; Humans; Insulin Resistance; Life Style; Metformin; Obesity; Polycystic Ovary Syndrome; Cohort Studies; Weight Loss; PubMed
  17. Sulaiman W, Abdullah AC, Tan JTC, Baba S, Karim N
    Cureus, 2017 Oct 25;9(10):e1802.
    PMID: 29282446 DOI: 10.7759/cureus.1802
    It is often a challenge and a dilemma for clinicians encountering patients with pyrexia of unknown origin. Numerous tests performed to determine the underlying cause often give inconclusive results. We present a 52-year-old man with undulating fever for more than 10 months with persistent hyperferritinaemia, and negative immunological and serological markers. Despite corticosteroids, disease modifying anti-rheumatic agents and immune-modulator therapy, he succumbed to the illness. A diagnosis of refractory Adult onset Still's disease complicated by haemophagocytic lymphohistiocytosis was made.
    MeSH terms: Adrenal Cortex Hormones; Adult; Brucellosis; Fever; Humans; Malaysia; Male; Middle Aged; Biomarkers; Still's Disease, Adult-Onset; Antirheumatic Agents; Lymphohistiocytosis, Hemophagocytic
  18. Janaydeh M, Ismail A, Omar H, Zulkifli SZ, Bejo MH, Aziz NAA
    Environ Monit Assess, 2017 Dec 27;190(1):47.
    PMID: 29282545 DOI: 10.1007/s10661-017-6416-2
    Heavy metal pollution has become a global concern due to accumulation in tissue and transferable effects to humans via the food chain. This study focused on monitoring the accumulation of cadmium (Cd) and lead (Pb) in surface soil and body content: bone, heart, brain, liver, lung, muscle, kidney, feathers, feces, and gizzard contents of house crow Corvus splendens in the Klang region, Malaysia. The results revealed the occurrence of Pb and Cd in all biological samples from house crows, food contents, and surface soil samples. Heart and kidney accrued high amounts of Cd, while high amounts of Pb were found to accumulate in bones and feathers. Major discrepancies were also discovered in the concentrations of metals between juvenile and adults, as well as female and male bird samples. Concentrations of Pb and Cd in house crow internal tissues correlated significantly with that of bird feathers, but none could be established with that of surface soil. In addition, a significant correlation was observed between Pb concentration in the internal tissues to that of the feces, but the same was not the case when compared with the surface soil concentration. Metal accrual in the house crows feathers and feces may be through a long-term transmission via the food chain, which are eliminated from feathers via molting. This may suggest the utility of molted breast feathers of house crow in the bio-monitoring of Cd and Pb contamination, whereas feces of house crow appear only to be suitable for the bio-monitoring of Pb contamination.
    MeSH terms: Animals; Birds; Cadmium/analysis; Cadmium/metabolism*; Environmental Monitoring*; Environmental Pollutants/analysis; Environmental Pollutants/metabolism*; Environmental Pollution/statistics & numerical data; Feathers/chemistry; Female; Humans; Lead/analysis; Lead/metabolism*; Malaysia; Male; Soil; Ecosystem*; Metals, Heavy/analysis; Food Chain; Crows/metabolism*
  19. Pilcher NJ, Adulyanukosol K, Das H, Davis P, Hines E, Kwan D, et al.
    PLoS One, 2017;12(12):e0190021.
    PMID: 29284017 DOI: 10.1371/journal.pone.0190021
    Fisheries bycatch is a widespread and serious issue that leads to declines of many important and threatened marine species. However, documenting the distribution, abundance, population trends and threats to sparse populations of marine species is often beyond the capacity of developing countries because such work is complex, time consuming and often extremely expensive. We have developed a flexible tool to document spatial distribution and population trends for dugongs and other marine species in the form of an interview questionnaire supported by a structured data upload sheet and a comprehensive project manual. Recognising the effort invested in getting interviewers to remote locations, the questionnaire is comprehensive, but low cost. The questionnaire has already been deployed in 18 countries across the Indo-Pacific region. Project teams spent an average of USD 5,000 per country and obtained large data sets on dugong distribution, trends, catch and bycatch, and threat overlaps. Findings indicated that >50% of respondents had never seen dugongs and that 20% had seen a single dugong in their lifetimes despite living and fishing in areas of known or suspected dugong habitat, suggesting that dugongs occurred in low numbers. Only 3% of respondents had seen mother and calf pairs, indicative of low reproductive output. Dugong hunting was still common in several countries. Gillnets and hook and line were the most common fishing gears, with the greatest mortality caused by gillnets. The questionnaire has also been used to study manatees in the Caribbean, coastal cetaceans along the eastern Gulf of Thailand and western Peninsular Malaysia, and river dolphins in Peru. This questionnaire is a powerful tool for studying distribution and relative abundance for marine species and fishery pressures, and determining potential conservation hotspot areas. We provide the questionnaire and supporting documents for open-access use by the scientific and conservation communities.
    MeSH terms: Animals; Documentation*; Fisheries*; Surveys and Questionnaires; Species Specificity; Endangered Species*
  20. Karwowski MP, Morman SA, Plumlee GS, Law T, Kellogg M, Woolf AD
    Environ Geochem Health, 2017 Oct;39(5):1133-1143.
    PMID: 27704308 DOI: 10.1007/s10653-016-9881-6
    Though most childhood lead exposure in the USA results from ingestion of lead-based paint dust, non-paint sources are increasingly implicated. We present interdisciplinary findings from and policy implications of a case of elevated blood lead (13-18 mcg/dL, reference level <5 mcg/dL) in a 9-month-old infant, linked to a non-commercial Malaysian folk diaper powder. Analyses showed the powder contains 62 % lead by weight (primarily lead oxide) and elevated antimony [1000 parts per million (ppm)], arsenic (55 ppm), bismuth (110 ppm), and thallium (31 ppm). These metals are highly bioaccessible in simulated gastric fluids, but only slightly bioaccessible in simulated lung fluids and simulated urine, suggesting that the primary lead exposure routes were ingestion via hand-mouth transmission and ingestion of inhaled dusts cleared from the respiratory tract. Four weeks after discontinuing use of the powder, the infant's venous blood lead level was 8 mcg/dL. Unregulated, imported folk remedies can be a source of toxicant exposure. Additional research on import policy, product regulation, public health surveillance, and culturally sensitive risk communication is needed to develop efficacious risk reduction strategies in the USA. The more widespread use of contaminated folk remedies in the countries from which they originate is a substantial concern.
    MeSH terms: Boston; Environmental Exposure*; Female; Humans; Infant; Lead/analysis; Lead/blood*; Malaysia; Medicine, Traditional/adverse effects*; Oxides/analysis; Powders; Hazardous Substances/analysis; Hazardous Substances/blood; Diapers, Infant*
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