Browse publications by year: 2017

Influence of trace elements on dental enamel properties: A review

Qamar Z, Haji Abdul Rahim ZB, Chew HP, Fatima T

J Pak Med Assoc, 2017 Jan;67(1):116-120.
PMID: 28065967

Dental enamel, an avascular, irreparable, outermost and protective layer of the human clinical crown has a potential to withstand the physico-chemical effects and forces. These properties are being regulated by a unique association among elements occurring in the crystallites setup of human dental enamel. Calcium and phosphate are the major components (hydroxyapatite) in addition to some trace elements which have a profound effect on enamel. The current review was planned to determine the aptitude of various trace elements to substitute and their influence on human dental enamel in terms of physical and chemical properties.

MeSH terms: Humans; Saliva/chemistry; Trace Elements/analysis; Trace Elements/chemistry; Durapatite/analysis; Durapatite/chemistry; Metals, Heavy/analysis; Metals, Heavy/chemistry
Clinical Characteristics, Pain, and Quality of Life Experiences of Trigeminal Neuralgia in a Multi-Ethnic Asian Cohort

Tan CY, Shahrizaila N, Goh KJ

J Oral Facial Pain Headache, 2017 10 27;31(4):e15-e20.
PMID: 29073667 DOI: 10.11607/ofph.1793

AIMS: To describe the clinical characteristics of trigeminal neuralgia (TN) in a multi-ethnic Malaysian population and to relate them to standardized measures of pain severity, anxiety, depression, and quality of life (QoL).
METHODS: Patients fulfilling the International Headache Society (IHS) criteria for TN were prospectively interviewed for their demographic and clinical data. Pain intensity was rated with a visual analog scale (VAS), anxiety and depression were determined by the Hospital Anxiety and Depression Scale (HADS), and QoL was assessed by the Short-Form 36 (SF-36) questionnaire. Chi-square, Mann-Whitney U, and Spearman correlation tests were used to test for differences considering a significance level of P < .05.
RESULTS: Of the 75 included patients, 52 (69.3%) were women with a mean ± standard deviation (SD) onset age of 52.0 ± 12.7 years, and 57.3% were Chinese, 24.0% Malay, and 18.7% Indian. Pain was more common on the right side (69.3%) and in the maxillary and mandibular divisions. VAS scores for pain at its worst were higher in anxious/borderline anxious patients compared to non-anxious patients (89.5 ± 15.9 vs 80.9 ± 17.2, respectively; P < .05), and VAS scores for pain at its least were higher in depressed/borderline depressed subjects compared to non-depressed subjects (38.4 ± 25.8 vs 23.0 ± 19.2, respectively; P < .05). Chinese patients had lower VAS scores for pain at its least compared to Indian patients (19.7 ± 16.1 vs 39.9 ± 24.7; P < .01). TN patients scored lower in all eight domains of the SF-36 compared to the general population. Indian patients had lower scores in role limitations due to physical health (8.9 ± 23.2 vs 49.4 ± 43.8; P < .01) and social function (56.3 ± 13.6 vs 76.5 ± 23.6; P < .01) than Chinese patients, and Malay patients had lower mental health scores compared to Chinese patients (59.1 ± 19.5 vs 73.0 ± 21.0; P < .01).
CONCLUSION: Clinical characteristics of TN patients were similar to those of other populations. There were differences in pain ratings and QoL between TN patients of different ethnicities, as well as between those with anxiety and depression.

MeSH terms: Adult; Aged; Aged, 80 and over; Anxiety/etiology; Cross-Sectional Studies; Depression/etiology; Ethnic Groups; Female; Humans; Malaysia; Male; Middle Aged; Pain Measurement; Prospective Studies; Quality of Life*; Trigeminal Neuralgia/ethnology*; Trigeminal Neuralgia/physiopathology; Trigeminal Neuralgia/psychology*; Asian Continental Ancestry Group/psychology*; Young Adult; Visual Analog Scale
Fulltext National Health and Morbidity Survey (NHMS) 2017: Adolescent Mental Health Survey

ISBN: 978-983-2387-38-1

Citation: National Health Morbidity Survey 2017: Adolescent Mental Health Survey. Kuala Lumpur: Institute for Public Health, Ministry of Health, Malaysia, 2017
Study name: National Health and Morbidity Survey (NHMS-2017)

MeSH terms: Adolescent; Health Surveys; Humans; Malaysia; Mental Health
Cigarette consumption by individuals in Malaysia: a zero-inflated ordered probability approach

Tan AKG, Yen ST

Journal of Public Health (Germany), 2017;25:87-94.
DOI: 10.1007/s10389-016-0754-3

Aim: To investigate cigarette consumption patterns exhibited by non-smokers, occasional smokers, and daily smokers in Malaysia.
Subjects and methods: A sample of 4204 individuals from the 2011 Malaysian Global Adult Tobacco Survey is analyzed. A zero-inflated ordered probit model is used to accommodate the ordinal nature of smoking outcomes with excessive zero observations of non-smokers.
Results: Socio-demographic characteristics are closely associated with consumption patterns of non-smokers, occasional smokers, and daily smokers. Specifically, urbanites, government employees, and Malays exhibit greater tendencies to be daily smokers and lower propensities to be non-smokers than others. Education is a deterring factor in cigarette smoking as higher education up to the tertiary level raises the propensity of being a non-smoker by 8.16 percentage points. The role of ethnicity is highlighted as individuals of Malay and other ethnic backgrounds are more likely to smoke daily, while exhibiting lower propensities of being non-smokers. Males are more likely to engage in occasional or daily smoking than females. Employment in government or non-government sectors increases the probability of daily smoking.
Conclusions: Our results suggest the need to include measures to cope with internal or external cues among smokers with specific socio-demographic characteristics. Cessation interventions should focus on daily smokers in urban surroundings with low education levels and those of Malay ethnic origins. Anti-smoking measures in line with occasional smoking may include ameliorating the male attitude toward smoking and policies to prohibit workplace indulgence.
Study name: Global Adults Tobacco Survey (GATS-2011)

MeSH terms: Adult; Cross-Sectional Studies; Education; Employment; Ethnic Groups; Female; Humans; Malaysia; Malaysia/ethnology; Male; Smoking; Urban Population; Workplace
Fulltext The Assessment, Evaluation, and Management of the Critically Ill Child When Resources are Limited-Southeast Asian Perspective

Tang SF, Lum L

J Pediatr Intensive Care, 2017 Mar;6(1):6-11.
PMID: 31073420 DOI: 10.1055/s-0036-1584672

The Southeast Asia region comprises 10 independent countries with highly divergent health systems and health status. The heterogeneity in infant and child mortality rates suggests that there is still scope for improvement in the care of critically ill children. There is, however, a paucity of published data on outcomes and processes of care that could affect planning and implementation of intervention programs. Significant challenges in the delivery of care for the critically ill child remain, especially in pre-hospital and in-hospital triaging and emergency care and inpatient hospital care. Potential areas for continued improvement include strengthening of health systems through sustained commitment by local governments, capacity building, and sharing of research output. Simple, low cost, locally available, and effective solutions should be sought. The introduction of standards and auditing tools can assist in determining effectiveness and outcomes of intervention packages that are adapted to local settings. Recognition and acknowledgment of shortfalls between expectations and outcomes is a first step to overcoming some of these obstacles necessary to achieve a seamless interface among pre-hospital, emergency, inpatient, and critical care delivery processes that would improve survival of critically ill children in this region.
Fulltext Smoking prevalence and attributable disease burden in 195 countries and territories, 1990-2015: a systematic analysis from the Global Burden of Disease Study 2015

GBD 2015 Tobacco Collaborators

Lancet, 2017 May 13;389(10082):1885-1906.
PMID: 28390697 DOI: 10.1016/S0140-6736(17)30819-X

BACKGROUND: The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and national progress toward achieving smoking-related targets can be assessed.
METHODS: We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed 38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the Socio-demographic Index (SDI).
FINDINGS: Worldwide, the age-standardised prevalence of daily smoking was 25·0% (95% uncertainty interval [UI] 24·2-25·7) for men and 5·4% (5·1-5·7) for women, representing 28·4% (25·8-31·1) and 34·4% (29·4-38·6) reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11·5% of global deaths (6·4 million [95% UI 5·7-7·0 million]) were attributable to smoking worldwide, of which 52·2% took place in four countries (China, India, the USA, and Russia). Smoking was ranked among the five leading risk factors by DALYs in 109 countries and territories in 2015, rising from 88 geographies in 1990. In terms of birth cohorts, male smoking prevalence followed similar age patterns across levels of SDI, whereas much more heterogeneity was found in age patterns for female smokers by level of development. While smoking prevalence and risk-deleted DALY rates mostly decreased by sex and SDI quintile, population growth, population ageing, or a combination of both, drove rises in overall smoking-attributable DALYs in low-SDI to middle-SDI geographies between 2005 and 2015.
INTERPRETATION: The pace of progress in reducing smoking prevalence has been heterogeneous across geographies, development status, and sex, and as highlighted by more recent trends, maintaining past rates of decline should not be taken for granted, especially in women and in low-SDI to middle-SDI countries. Beyond the effect of the tobacco industry and societal mores, a crucial challenge facing tobacco control initiatives is that demographic forces are poised to heighten smoking's global toll, unless progress in preventing initiation and promoting cessation can be substantially accelerated. Greater success in tobacco control is possible but requires effective, comprehensive, and adequately implemented and enforced policies, which might in turn require global and national levels of political commitment beyond what has been achieved during the past 25 years.
FUNDING: Bill & Melinda Gates Foundation and Bloomberg Philanthropies.
Malaysian Collaborators: Southern University College, Skudai, Malaysia (Y J Kim PhD); University of Science Malaysia, Kubang Kerian, Malaysia (K I Musa MD); International Medical University, Kuala Lumpur, Malaysia (C T Sreeramareddy MD)

MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Retrospective Studies; Risk Factors; Smoking/epidemiology*; Socioeconomic Factors; Global Health*; Prevalence; Normal Distribution; Age Distribution; Sex Distribution; Quality-Adjusted Life Years; Internationality*; Young Adult; Global Burden of Disease*
Determining Spatial Resolution of Gamma Cameras Using MATLAB

Velo P, Zakaria A

J Med Imaging Radiat Sci, 2017 Mar;48(1):39-42.
PMID: 31047208 DOI: 10.1016/j.jmir.2016.10.010

It is important to monitor the spatial resolution of a gamma camera on a weekly basis to acquire medical images with accurate quantitative information. A simple and fast computer program with a graphical user interface to analyze spatial resolution was successfully developed using MATLAB. The results were compared with those obtained from the standard processing system available in our gamma camera. The spatial resolution calculated using MATLAB was 1.24% lower than using the standard processing system. The developed program is cost effective, faster, and provides an easy platform for the physicists and technologists to analyze the spatial resolution based on the image of the line source.

MeSH terms: Cost-Benefit Analysis; Monitoring, Physiologic; Software; Gamma Cameras; Program Development
Fulltext Pore formation in lipid membrane II: Energy landscape under external stress

Akimov SA, Volynsky PE, Galimzyanov TR, Kuzmin PI, Pavlov KV, Batishchev OV

Sci Rep, 2017 10 02;7(1):12509.
PMID: 28970526 DOI: 10.1038/s41598-017-12749-x

Lipid membranes are extremely stable envelopes allowing cells to survive in various environments and to maintain desired internal composition. Membrane permeation through formation of transversal pores requires substantial external stress. Practically, pores are usually formed by application of lateral tension or transmembrane voltage. Using the same approach as was used for obtaining continuous trajectory of pore formation in the stress-less membrane in the previous article, we now consider the process of pore formation under the external stress. The waiting time to pore formation proved a non-monotonous function of the lateral tension, dropping from infinity at zero tension to a minimum at the tension of several millinewtons per meter. Transmembrane voltage, on the contrary, caused the waiting time to decrease monotonously. Analysis of pore formation trajectories for several lipid species with different spontaneous curvatures and elastic moduli under various external conditions provided instrumental insights into the mechanisms underlying some experimentally observed phenomena.

MeSH terms: Biomechanical Phenomena; Cell Membrane Permeability; Dimyristoylphosphatidylcholine/chemistry*; Elasticity; Kinetics; Lipid Bilayers/chemistry*; Phosphatidylcholines/chemistry*; Thermodynamics; Porosity; Molecular Dynamics Simulation
The first molecular survey of theileriosis in Malaysian cattle, sheep and goats

Kho KL, Amarajothi ADG, Koh FX, Panchadcharam C, Hassan Nizam QN, Tay ST

Vet Parasitol Reg Stud Reports, 2017 12;10:149-153.
PMID: 31014589 DOI: 10.1016/j.vprsr.2017.08.003

This study reports the molecular detection of Theileria spp. from six cattle farms, a sheep farm and a goat farm located at different states in Peninsular Malaysia. Animal blood samples were screened for the presence of Theileria DNA using a conventional polymerase chain reaction (PCR) assay. A total of 155 (69.2%) of 224 cattle investigated were PCR-positive for Theileria DNA. The occurrences of Theileria spp. ranged from 17.5% to 100.0% across six cattle farms. Theileria DNA was detected from 90.0% of 40 sheep but none of 40 goats examined in this study. Sequence analyses of amplified 18S rRNA partial fragments (335-338bp) confirmed the identification of Theileria buffeli, Theileria sergenti, and Theileria sinensis in representative samples of cattle and ticks. T. luwenshuni was identified in the infected sheep. The high occurrences of Theileria spp. in our farm animals highlight the needs for appropriate control and preventive measures for theileriosis.

MeSH terms: Animals; Cattle; Cattle Diseases/blood; Cattle Diseases/epidemiology; Cattle Diseases/parasitology*; Goats; Malaysia/epidemiology; Sheep; Sheep Diseases/blood; Sheep Diseases/epidemiology; Sheep Diseases/parasitology*; Theileriasis/blood; Theileriasis/epidemiology*; Goat Diseases/blood; Goat Diseases/epidemiology; Goat Diseases/parasitology*; Seroepidemiologic Studies; Theileria/isolation & purification
Fulltext Treatment of intracerebral haemorrhage with tranexamic acid - A review of current evidence and ongoing trials

Law ZK, Meretoja A, Engelter ST, Christensen H, Muresan EM, Glad SB, et al.

Eur Stroke J, 2017 Mar;2(1):13-22.
PMID: 31008298 DOI: 10.1177/2396987316676610

Purpose: Haematoma expansion is a devastating complication of intracerebral haemorrhage (ICH) with no established treatment. Tranexamic acid had been an effective haemostatic agent in reducing post-operative and traumatic bleeding. We review current evidence examining the efficacy of tranexamic acid in improving clinical outcome after ICH.
Method: We searched MEDLINE, EMBASE, CENTRAL and clinical trial registers for studies using search strategies incorporating the terms 'intracerebral haemorrhage', 'tranexamic acid' and 'antifibrinolytic'. Authors of ongoing clinical trials were contacted for further details.
Findings: We screened 268 publications and retrieved 17 articles after screening. Unpublished information from three ongoing clinical trials was obtained. We found five completed studies. Of these, two randomised controlled trials (RCTs) comparing intravenous tranexamic acid to placebo (n = 54) reported no significant difference in death or dependency. Three observational studies (n = 281) suggested less haematoma growth with rapid tranexamic acid infusion. There are six ongoing RCTs (n = 3089) with different clinical exclusions, imaging selection criteria (spot sign and haematoma volume), time window for recruitment and dosing of tranexamic acid.
Discussion: Despite their heterogeneity, the ongoing trials will provide key evidence on the effects of tranexamic acid on ICH. There are uncertainties of whether patients with negative spot sign, large haematoma, intraventricular haemorrhage, or poor Glasgow Coma Scale should be recruited. The time window for optimal effect of haemostatic therapy in ICH is yet to be established.
Conclusion: Tranexamic acid is a promising haemostatic agent for ICH. We await the results of the trials before definite conclusions can be drawn.

MeSH terms: Antifibrinolytic Agents; Cerebral Hemorrhage; Hematoma; Hemostatics; Humans; Longitudinal Studies; Tranexamic Acid; Glasgow Coma Scale; MEDLINE; Patient Selection
Fulltext Effects of neuroactive amino acids derivatives on cardiac and cerebral mitochondria and endothelial functions in animals exposed to stress

T. A. Popova, I.Prokofiev, I. S. Mokrousov, V. N. Perfilova, A. V. Borisov, S. A. Lebedeva, et al.

Journal of Clinical and Health Sciences, 2017;2:34-45.

To study the effects of glufimet, a new derivative of glutamic acid, and
phenibut, a derivative of γ-aminobutyric acid (GABA), on cardiac and cerebral mitochondria
and endothelial functions in animals following exposure to stress and inducible nitric oxide
synthase (iNOS) inhibition. Methods: Rats suspended by their dorsal cervical skin fold for 24
hours served as the immobilization and pain stress model. Arterial blood pressure was
determined using a non-invasive blood pressure monitor. Mitochondrial fraction of heart and
brain homogenates were isolated by differential centrifugation and analysed for mitochondrial
respiration intensity, lipid peroxidation (LPO) and antioxidant enzyme activity using
polarographic method. The concentrations of nitric oxide (NO) terminal metabolites were
measured using Griess reagent. Hemostasis indices were evaluated. Platelet aggregation
was estimated using modified version of the Born method described by Gabbasov et al.,
1989. Results: The present study demonstrated that stress leads to an elevated
concentration of NO terminal metabolites and LPO products, decreased activity of antioxidant
enzymes, reduced mitochondrial respiratory function, and endothelial dysfunction. Inhibition of
iNOS by aminoguanidine had a protective effect. Phenibut and glufimet inhibited a rise in
stress-induced nitric oxide production. This resulted in enhanced coupling of substrate
peroxidation and ATP synthesis. The reduced LPO processes caused by glufimet and
phenibut normalized the endothelial function which was proved by the absence of average
daily blood pressure (BP) elevation episodes and a significant increase in platelet aggregation
level. Conclusion: Glufimet and phenibut restrict the harmful effects of stress on the heart
and brain possibly by modulating iNOS activity
Fulltext Antiretroviral treatment-associated labia majora lipohypertrophy: A rare case and plastic surgical treatment options

Akmal Hisham, Devananthan Ilenghoven, Wan Syazli Wan Ahmad Kamal, Salina Ibrahim, Shah Jumaat Mohd Yussof

Journal of Clinical and Health Sciences, 2017;2:43-47.

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

MeSH terms: Abdomen; Activities of Daily Living; Adipose Tissue; Buttocks; Follow-Up Studies; HIV Seropositivity; Humans; Lipodystrophy; Prognosis; Pubic Bone; Lipectomy; HIV Infections; Antiretroviral Therapy, Highly Active
Fulltext Prevalence of urinary incontinence, its risk factors and effect on the quality of life in women after their first delivery

Bahiyah Abdullah, Siti Hajar Ayub, Akmal Zulayla Mohd Zahid, Noorneza Abd Rahman, Mohamad Rodi Isa

Journal of Clinical and Health Sciences, 2017;2:21-28.

Introduction: Although urinary incontinence is commonly associated with increasing parity, there is however a lack of published data on urinary incontinence among primiparous women. This study aims to determine its prevalence among primiparous women at 6-8 weeks postpartum, its risk factors and effects to their quality of life. Methods: This is a crosssectional study involving primiparous women at 6-8 weeks postpartum. Women in their third trimester were recruited using convenience sampling. Data were obtained using a study proforma, and International Consultation on Incontinence Questionnaire – Short Form (ICIQSF) over a face-to-face interview. The same questionnaire with additional enquiries on delivery was completed over a telephone interview at 6-8 week postpartum. Data were analysed using chi-square and simple logistic regression tests contained in the Statistical Package for Social Science version 20.0. Results: Three hundred and six women participated in this study. The prevalence of urinary incontinence in the third trimester of pregnancy was 34.3% (95%CI: 29.0, 39.7) and dropped to 5.2% (95% CI: 2.7, 7.7) at 6-8 weeks postpartum. Childhood enuresis and postpartum body mass index were the two factors that showed significant association with postpartum urinary incontinence. Urinary incontinence in 95 (31%) women had resolved by 6-8 weeks postpartum, whereas 10 (3.3%) women still had persistent symptom. A small proportion of women (2.0%) developed urinary incontinence in the postpartum period. Majority of women with urinary incontinence did not feel it significantly affected their quality of life. The ICIQ- SF mean score was 6.13 (range 2- 12). Conclusions: Postpartum urinary incontinence is rather uncommon among primiparous women and does not seem to affect their quality of life. Childhood enuresis and postpartum BMI were risk factors associated with postpartum urinary incontinence.
Fulltext The inhibitory effect of lemon juice (citrus limon) on vibrio parahaemolyticus in raw oyster (crassostrea virginica)

Siti Farah Alwani Mohd Nawi, Zaini Mohd Zain, Muhammad Zarif Zahari, Anis Amalina Abdul Hamid, Nur Fakhriah Ahmad Afandi, Siti Nur Fathihah Azmi

Journal of Clinical and Health Sciences, 2017;2:31-33.

Serving raw oysters with lemon juice is a delicacy in many restaurants in
Malaysia. Oysters (Crassostrea virginica) live in the seacoast and they share the same
environment as Vibrio parahaemolyticus. Consumption of raw oysters contaminated with V.
parahaemolyticus can lead to severe gastroenteritis. A study was performed to determine
whether lemon (Citrus limon) juice is able to inhibit the growth of V. parahaemolyticus after
being inoculated in raw oysters. Methods: Frozen oysters bought from a local supplier
weighing 6 g each were minced and placed in two bottles using sterile technique.
Approximately 1 ml of 107 CFU of V. parahaemolyticus (ATCC strain 17802) was added and
mixed in both bottles. The mixture was treated with 1 ml of lemon juice in only one of the
bottles and the other bottle served as a control. At every 30 s intervals for 2 min, 1 g of the
sample was taken for enumeration of viable cells onto thiosulphate citrate bile salt sucrose
(TCBS). Results: After 30 s of treatment with the lemon juice, it was observed that the
number of colonies in the treated samples reduced from 7 Log to 3 Log. Subsequently, no
viable V. parahaemolyticus was seen. It was also observed that there were 3 Log reductions
of V. parahaemolyticus after 30 s in untreated samples, however the number of colonies
remained stable until the end of the experiment. Conclusion: This study therefore shows
that lemon juice has some antimicrobial effect on V. parahaemolyticus in raw oysters.

MeSH terms: Animals; Anti-Infective Agents; Bile Acids and Salts; Biological Phenomena; Citrates; Citrus; Freezing; Gastroenteritis; Malaysia; Restaurants; Sucrose; Thiosulfates; Vibrio parahaemolyticus; Citric Acid; Crassostrea
Fulltext Outcome of chiropractic therapy in idiopathic scoliosis – a preliminary study

Mohd Nizam Haron, Syahirah Zeti Azham, Lyanna Annura Sallehudin, Nur Firzanie Kamaruddin, Ezreen Elia Izzaty Afindi

Journal of Clinical and Health Sciences, 2017;2:26-30.

The purpose of this study is to retrospectively report the results of scoliosis patients who underwent chiropractic therapy and to evaluate their outcome by looking at the potential to alter the natural progression of scoliosis after therapy.
Methods: Retrospective data collection was conducted at a private chiropractic centre in Kuala Lumpur. The data was collected from patients between the ages of 16 to 19 years old. A total of eight patients with 14 scoliotic curvatures (six thoracic, six lumbar and two thoracolumbar), who met the inclusion criteria, were selected as subjects for this study. All subjects received the same chiropractic therapy program. The outcome of the therapy was assessed by measuring the Cobb’s angle on the erect spine as captured on an x-ray. The Cobb’s angle was measured at the first presentation (to establish a baseline) after 6 and 24 months of therapy.
Results: The mean baseline Cobb’s angle for thoracic, lumbar and thoracolumbar scoliosis were 30.7o ± 19.4o, 31.7o ± 12.3o and 25.0o ± 18.4o respectively. After 24 months of chiropractic therapy, there was no discernible effect on the magnitude of the Cobb’s angles on the subjects overall.
Conclusion: Our study showed no significant reduction in spine curvature in patients with scoliosis using chiropractic therapy after 24 months.
Fulltext Selected recommendations from international guidelines on obstructive sleep apnoea

Nurul Yaqeen Mohd Esa

Journal of Clinical and Health Sciences, 2017;2:19-25.

Obstructive sleep apnoea (OSA) is increasingly seen as a major health threat globally.
However, it is still underdiagnosed mainly among Asian population partly due to lack of
understanding on the pathophysiology, and limited access to the diagnostic and management
aspect of the disease. Recurring complete and/or partial collapses of the upper airways define
OSA. Based on the number of apnoeas and/or hypopnoeas per hour of sleep, OSA is
categorized as mild, moderate and severe. Both the American Association of Sleep Medicine
(AASM) and American College of Physicians (ACP) has published guidelines regarding the
management of OSA in adults. Three recommendations have been suggested by the
guidelines which can be used to tailor the management of OSA. The aim of this article is to
select relevant recommendations from these guidelines in epidemiology, pathophysiology,
diagnostic procedures and treatment for proper management of OSA, while considering
specific patient populations, such as hypertensive, diabetic, obese and Asian patients.

MeSH terms: Adult; Diabetes Mellitus; Humans; Obesity; Sleep; United States; Sleep Apnea, Obstructive; Asian Continental Ancestry Group
Fulltext Development of folliculitis in a patient with recalcitrant pustular psoriasis following acitretin treatment: A case report

Nur Ashikin Ahmad, Tarita Taib, Meera Kuppusamy

Journal of Clinical and Health Sciences, 2017;2:48-51.

Oral retinoids are among the drugs of choice for pustular psoriasis. Therapy with retinoids, including acitretin, is potent teratogens with other common side effects such as mucocutaneous involvement. Mucocutaneous side effects including dry lips (cheilitis), skin peeling, hair loss (alopecia), dry skin, or rhinitis are dose-related, with cheilitis occurring in more than 75% of patients receiving the highest doses of acitretin (75 mg/day). We report on a 37-year-old woman who developed folliculitis with acitretin which is a rare cutaneous side effect. She presented with eruptions pruritic papules with follicular pattern on anterior thigh and forearms after almost 1 year of treatment with acitretin (50mg OD) for pustular psoriasis. The skin lesion was treated successfully with skin dressing and antibiotic treatment and skin biopsy is suggestive of folliculitis. Several treatments for pustular psoriasis including topical steroids, methotrexate and oral prednisolone were ineffective or not tolerated. Treatment with acitretin which are 50mg OD provided partial resolution of skin lesions. The case is hereby reported because of its rarity and folliculitis must be considered in the differential diagnosis of a popular eruption, especially in patients with high dose acitretin.

MeSH terms: Adult; Alopecia; Anti-Bacterial Agents; Bandages; Biopsy; Cheilitis; Diagnosis, Differential; Female; Folliculitis; Forearm; Humans; Lip; Methotrexate; Prednisolone; Psoriasis; Rhinitis; Skin Diseases; Teratogens; Thigh; Acitretin
Fulltext Assessment of obesity and body image satisfaction amongst students of AMC MET Medical College, Ahmedabad, Gujarat

Sheetal Vyas, Chitra Pandya, Rishita Mehta, Dhwani Mehta, Mohak Mankad, Aneri Modh

Journal of Clinical and Health Sciences, 2017;2:14-20.

Introduction: Body image satisfaction (BIS) may have an effect on body weight, which in turn contributes to healthier lifestyle practices. The present study aimed to measure the BMI of students, and to relate this to the students’ own perceptions of their body image and assessing body image satisfaction using the Stunkard figure rating scale. Methods: A cross sectional study was carried out on 200 students selected by stratified random sampling technique. Variables that were used in the current study are perception of self-body size, ideal body size, and body size satisfaction. The assessment was carried out using the Stunkard figure rating scale. Results: Mean age of the students was 20.4 years. Mean BMI of the boys was 25.63 and of the girls was 25.09. There was a significant difference between perceived body size and body size as per BMI. Overall the girls had significantly more satisfaction with their body image as compared to boys. The body image satisfaction and BMI had positive correlation. Most of the time students thought they were thinner than they actually were, with obvious implications for health and health seeking behaviour. Conclusions: Correct perception of the body size may become the motivation to lose weight and contribute to high success rate in attaining it. A wholesome community approach is needed to change weight status perceptions and improve exercise and dietary behaviour.
Fulltext Tocotrienols and oxidative stress in ocytes and developing embryos

Yuhaniza Shafinie Kamsani, Mohd Hamim Rajikin

Journal of Clinical and Health Sciences, 2017;2:8-18.

This review summarizes the impact of tocotrienols (TCTs) as antioxidants in minimizing
oxidative stress (OS), particularly in embryos exposed to OS causing agents. OS level is
increased, for example, by nicotine, a major alkaloid content in cigarette, which is also a source
of exogenous reactive oxygen species (ROS). Increased nicotine-induced OS increases cell
stress response, which is a common trigger leading to embryonic cell death. Having more
profound anti-oxidative stress effects than its counterpart tocopherol, TCTs improve blastocyst
implantation, foetal growth, pregnancy outcome and survival of the neonates affected by
nicotine. In reversing cell developmental arrest caused by nicotine-induced OS, TCTs enhances
PDK-1 expression in the P13K/Akt pathway and permit embryonic development beyond the 4-
cell stage with the production of more morulae. At the cytoskeletal level, TCTs increase the
number of nicotine-induced apoptotic cells, through caspase 8 activation in the mitochondria.
TCTs facilitate rough endoplasmic reticulum (rER) stress-mediated apoptosis and autophagy,
resulting from nicotine-induced OS. Reduced vesicular population in TCT supplemented
oocytes on the other hand may suggest reduced secretion of apoptotic cell bodies thus probably
minimizing vesicular apoptosis during oocyte maturation. Further extensive research is
required to develop TCTs as a tool in specific therapeutic approaches to overcome the
detrimental effects of OS.

MeSH terms: Animals; Antioxidants; Autophagy; Blastocyst; Female; Mitochondria; Nicotine; Oocytes; Pregnancy; Pregnancy Outcome; Vitamin E; Apoptosis; Reactive Oxygen Species; Oxidative Stress; Endoplasmic Reticulum, Rough; Tocopherols; Tocotrienols; Fetal Development; Proto-Oncogene Proteins c-akt; Caspase 8; Cell Body
Fulltext Shrinking lung syndrome – a rare cause of recurrent dyspnoea in SLE

Baharuddin H, Mohd Zim MA, Rosman A, Mohd Zain M

Journal of Clinical and Health Sciences, 2017;2(1):35-38.

Here we present a 24-year-old lady with systemic lupus erythematosus (SLE) whom we diagnosed with shrinking lung syndrome (SLS), a rare manifestation of SLE. The initial SLE manifestation was alopecia, thrombocytopenia, serositis and vasculitis. Anti-nuclear antibody (ANA), anti-double stranded DNA (dsDNA) antibody, anti-ribonucleic (RNP) and anti-Ro antibody were positive. A year after diagnosis, she started to develop intermittent dyspnea and was hospitalised on three occasions. Lung examinations revealed reduced breath sounds at both bases and dullness at the right base. Multiple chest radiographs showed bilateral raised hemi-diaphragms. Other investigations including CT pulmonary angiogram, high resolution CT of the thorax, ventilation-perfusion scan and echocardiogram were not significant. On the third hospital admission, we noticed bilateral small lung volumes in the previous high resolution CT scan. Inspiratory and expiratory chest radiographs were performed and showed minimal change in lung volumes and a diagnosis of shrinking lung syndrome (SLS) was made. Her SLE remained active with lupus nephritis despite multiple immunosuppression and she passed away two years later due to sepsis with multi-organ failure.

MeSH terms: Alopecia; Angiography; Antibodies, Antinuclear; Diaphragm; Dyspnea; Female; Humans; Lung Diseases; Lupus Erythematosus, Systemic; Lupus Nephritis; Malaysia; Serositis; Thrombocytopenia; Tomography, X-Ray Computed; Vasculitis; Sepsis

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