Browse publications by year: 2017

Distribution of adeB and NDM-1 genes in multidrug resistant Acinetobacter baumannii isolated from infected wound of patients admitted in a tertiary care hospital in Bangladesh

Hasan MJ, Shamsuzzaman SM

Malays J Pathol, 2017 Dec;39(3):277-283.
PMID: 29279590

BACKGROUND: The adeB gene in Acinetobacter baumannii regulates the bacterial internal drug efflux pump that plays a significant role in drug resistance. The aim of our study was to determine the occurrence of adeB gene in multidrug resistant and New Delhi metallo-beta-lactamase-1 (NDM- 1) gene in imipenem resistant Acinetobacter baumannii isolated from wound swab samples in a tertiary care hospital of Bangladesh.
METHODS: A total of 345 wound swab samples were tested for bacterial pathogens. Acinetobacter baumannii was identified by culture and biochemical tests. Antimicrobial susceptibility pattern was determined by the disc diffusion method according to CLSI standards. Extended spectrum beta-lactamases were screened using the double disc synergy technique. Gene encoding AdeB efflux pump and NDM-1 were detected by Polymerase Chain Reaction (PCR).
RESULTS: A total 22 (6.37%) Acinetobacter baumannii were identified from 345 wound swab samples and 20 (91%) of them were multidrug resistant. High resistance rates to some antibiotics were seen namely, cefotaxime (95%), amoxyclavulanic acid (90%) and ceftriaxone (82%). All the identified Acinetobacter baumannii were sensitive to colistin and 82% to imipenem. Two (9%) ESBL producing Acinetobacter baumannii strains were detected. adeB gene was detected in 16 (80%) out of 20 multidrug resistant Acinetobacter baumannii. 4 (18%) of 22 Acinetobacter baumannii were imipenem resistant. NDM-1 gene was detected in 2 (50%) of the imipenem resistant strains of Acinetobacter baumannii.
CONCLUSION: The results of this study provide insight into the role of adeB gene as a potential regulator of drug resistance in Acinetobacter baumanni in Bangladesh. NDM-1 gene also contributes in developing such resistance for Acinetobacter baumannii.

MeSH terms: Acinetobacter Infections/genetics*; Bacterial Proteins/genetics*; Bangladesh; beta-Lactamases/genetics*; Cross-Sectional Studies; Humans; Microbial Sensitivity Tests; Wound Infection/genetics*; Drug Resistance, Multiple/genetics*; Membrane Transport Proteins/genetics*; Acinetobacter baumannii; Tertiary Care Centers
Transperineal template-guided prostate saturation biopsies in men with suspicion of prostate cancer: a pilot study from Pakistan

Mehmood K, Mubarak M, Dhar M, Rafi M, Kinsella J

Malays J Pathol, 2017 Dec;39(3):285-288.
PMID: 29279591

Traditionally, transrectal ultrasound (TRUS)-guided biopsies are done for the diagnosis of prostate cancer (PCa) in Pakistan. The transperineal template-guided saturation biopsy (TTSB) approach has been recently introduced in Pakistan and we share diagnostic yields and pathological findings of specimens taken for PCa diagnosis in men with elevated serum total prostate specific antigen (PSA) and negative TRUS-guided prostate biopsies. In all, 16 patients investigated at the Department of Urology, Sindh Institute of Urology and Transplantation (SIUT), underwent TTSB. The mean age of patients was 67.8 ± 8.8 (range: 55 - 84) years. The median PSA was 9.5 (IQR: 7.9 - 19.8) ng/ ml. The duration of symptoms before biopsy ranged from 1 month to 144 months. The prostate was enlarged with mean weight of 73.5 ± 55.5 g. Histopathology revealed PCa in 5 of 16 (31.2%) cases. The Gleason score was 6 (3+3), 7 (3+4) and 8 (4+4) in 1 case each (6.3%) and 10 (5+5) in 2 cases (12.5%). At least two cores were positive in all positive cases. None of the patients required antibiotics post-procedure. In conclusion, the TTSB technique is a promising option for patients with elevated PSA level and negative transrectal prostate biopsies for the detection of PCa in our setting.

MeSH terms: Adenocarcinoma/diagnosis*; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Pilot Projects; Prostatic Neoplasms/diagnosis*; Image-Guided Biopsy/methods*
Rapidly increasing liver progenitor cell numbers in human regenerating liver after portal vein ligation and liver partition

Lin KH, Hsu HT, Teng TH, Lin PY, Ko CJ, Hsieh CE, et al.

Malays J Pathol, 2017 Dec;39(3):289-291.
PMID: 29279592

BACKGROUND: Liver regeneration is dependent on the proliferation of hepatocytes. Hepatic progenitor cells are intra-hepatic precursor cells capable of differentiating into hepatocytes or biliary cells. Although liver progenitor cell proliferation during the regenerative process has been observed in animal models of severe liver injury, it has never been observed in vivo in humans because it is unethical to take multiple biopsy specimens for the purpose of studying the proliferation of liver progenitor cells and the roles they play in liver regeneration. Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a staged procedure for inducing remnant liver hypertrophy so that major hepatectomy can be performed safely. This staged procedure allows for liver biopsy specimens to be taken before and after the liver begins to regenerate.
CASE PRESENTATION: The liver progenitor cell proliferation is observed in a patient undergoing ALPPS for a metastatic hepatic tumour. Liver biopsy is acquired before and after ALPPS for the calculation of average number of liver progenitor cell under high magnification examination by stain of immunomarkers. This is the first in vivo evidence of growing liver progenitor cells demonstrated in a regenerating human liver.

MeSH terms: Adult; Hepatectomy/methods; Humans; Ligation; Liver/cytology*; Liver Neoplasms/surgery; Liver Regeneration/physiology*; Male; Portal Vein/surgery; Stem Cells/cytology*; Hepatocytes/cytology*; Cell Proliferation
Diagnostic conundrum of a perineal tumour: a rectal gastrointestinal stromal tumour mimic

Shi R, Chew MH, Leow WQ

Malays J Pathol, 2017 Dec;39(3):293-296.
PMID: 29279593

Gastrointestinal stromal tumour (GIST) is a common mesenchymal tumour arising in the gastrointestinal tract, but not frequently encountered in the rectum. Herein, we describe a case of a rectal GIST which mimicked histomorphological features of a schwannoma; thus, making intraoperative frozen section evaluation challenging. Although subsequent immunohistochemistry and molecular findings readily confirmed the diagnosis of a GIST, we wish to draw attention to three clues that will help the pathologist steer clear of this potential diagnostic pitfall. One, GISTs are relatively more common than schwannomas in the rectum. Two, schwannomas usually have very little mitoses. Three, rectal GISTs commonly exhibit nuclear palisades. We also discuss the diagnostic, prognostic and therapeutic functions of immunohistochemical and molecular investigations. As the surgical intent for rectal GISTs is for en-bloc excision with wide margins, we surmise that the intraoperative consult should include GIST as a possible differential diagnosis for rectal mesenchymal tumours. In view of the potential for neoadjuvant treatment with imatinib before surgical excision to preserve sphincter function, a multidisciplinary approach is recommended for establishing most effective treatment strategy in these rare complex cases.

MeSH terms: Diagnosis, Differential; Humans; Immunohistochemistry; Male; Middle Aged; Neurilemmoma/diagnosis*; Neurilemmoma/pathology; Perineum/pathology; Rectal Neoplasms/diagnosis*; Rectal Neoplasms/pathology; Biomarkers, Tumor/analysis; Gastrointestinal Stromal Tumors/diagnosis*; Gastrointestinal Stromal Tumors/pathology
Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma - a rare vascular neoplasm with deceptive morphology and distinctive immunophenotype

Cheo FF, Sittampalam K

Malays J Pathol, 2017 Dec;39(3):305-309.
PMID: 29279595

Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma is a rare, low grade vascular (endothelial) neoplasm typically presenting as multicentric, superficial to deep nodules in extremities with a slight tendency of affecting young adult males. We report a case of pseudomyogenic hemangioendothelioma in a 15-year-old boy presenting initially with a 1 cm right thigh painless cutaneous lump. The lump was excised with the clinical impression of a sebaceous cyst. On microscopy, a poorly circumscribed, mild to moderately atypical spindle cell lesion in fascicular and storiform patterns with strikingly myoid-like eosinophilic cytoplasm was identified. The spindle cells were highlighted by pancytokeratin AE1/AE3, CD31, and ERG with retained INI-1, while being negative for MNF116, S100, CD34, EMA, desmin, SMA, caldesmon, myogenin, MyoD1, HHV-8 and CD163. Following the first diagnostic report, a positron emission tomography-computed tomography (PET-CT) scan revealed another 4 cm ill-defined nodule accompanied by a smaller adjacent 0.7 cm ipsilateral satellite nodule within the right psoas muscle that displayed similar morphology and immunophenotype as the cutaneous lump, supporting the multicentric feature of this unique entity. It is an uncommon yet increasingly recognised neoplasm of endothelial origin possessing a misleading myoid morphology and distinctive immunophenotype worth notifying.

MeSH terms: Adolescent; Humans; Immunohistochemistry; Male; Soft Tissue Neoplasms/pathology*; Biomarkers, Tumor/analysis; Hemangioendothelioma, Epithelioid/pathology*
Solid pseudopapillary neoplasm of the pancreas with liver metastasis initially misinterpreted as benign haemorrhagic cyst

Jung MJ, Kim HK, Choi SY, Kim SG, Jin SY

Malays J Pathol, 2017 Dec;39(3):327-330.
PMID: 29279599

Solid pseudopapillary neoplasm (SPN) of the pancreas is considered a low-malignant neoplasm with a good prognosis. However, 5% to 15% of patients with SPNs develop metastatic disease, most commonly in the liver. Metastatic hepatic malignancies that show pseudocystic features are rare. Here we describe the case of a middle-aged female with a cystic liver metastasis from SPN. To the best of our knowledge, SPN with a single cystic liver metastasis has not been described, although these tumours frequently undergo haemorrhagic-cystic degeneration. Thus, in these patients the marked cystic change could be misinterpreted as a benign lesion.

MeSH terms: Carcinoma, Papillary/diagnosis*; Carcinoma, Papillary/secondary; Cysts/diagnosis*; Cysts/pathology; Diagnosis, Differential; Female; Humans; Liver Neoplasms/diagnosis*; Liver Neoplasms/secondary; Middle Aged; Pancreatic Neoplasms/diagnosis*; Pancreatic Neoplasms/pathology
Teaching Video NeuroImages: Purposeless groaning in progressive supranuclear palsy

Low SC, Tan AH, Lim SY

Neurology, 2017 01 03;88(1):e9.
PMID: 28025406 DOI: 10.1212/WNL.0000000000003465
MeSH terms: Humans; Male; Middle Aged; Supranuclear Palsy, Progressive/physiopathology*; Video Recording/methods*; Neuroimaging/methods*
Fulltext Escaping introns in COI through cDNA barcoding of mushrooms: Pleurotus as a test case

Avin FA, Subha B, Tan YS, Braukmann TWA, Vikineswary S, Hebert PDN

Ecol Evol, 2017 09;7(17):6972-6980.
PMID: 28904776 DOI: 10.1002/ece3.3049

DNA barcoding involves the use of one or more short, standardized DNA fragments for the rapid identification of species. A 648-bp segment near the 5' terminus of the mitochondrial cytochrome c oxidase subunit I (COI) gene has been adopted as the universal DNA barcode for members of the animal kingdom, but its utility in mushrooms is complicated by the frequent occurrence of large introns. As a consequence, ITS has been adopted as the standard DNA barcode marker for mushrooms despite several shortcomings. This study employed newly designed primers coupled with cDNA analysis to examine COI sequence diversity in six species of Pleurotus and compared these results with those for ITS. The ability of the COI gene to discriminate six species of Pleurotus, the commonly cultivated oyster mushroom, was examined by analysis of cDNA. The amplification success, sequence variation within and among species, and the ability to design effective primers was tested. We compared ITS sequences to their COI cDNA counterparts for all isolates. ITS discriminated between all six species, but some sequence results were uninterpretable, because of length variation among ITS copies. By comparison, a complete COI sequences were recovered from all but three individuals of Pleurotus giganteus where only the 5' region was obtained. The COI sequences permitted the resolution of all species when partial data was excluded for P. giganteus. Our results suggest that COI can be a useful barcode marker for mushrooms when cDNA analysis is adopted, permitting identifications in cases where ITS cannot be recovered or where it offers higher resolution when fresh tissue is. The suitability of this approach remains to be confirmed for other mushrooms.

MeSH terms: Agaricales; Animals; Electron Transport Complex IV; DNA; Humans; Introns; Reference Standards; Species Specificity; DNA Primers; DNA, Complementary; Pleurotus; DNA Barcoding, Taxonomic
Fulltext Logged peat swamp forest supports greater macrofungal biodiversity than large-scale oil palm plantations and smallholdings

Shuhada SN, Salim S, Nobilly F, Zubaid A, Azhar B

Ecol Evol, 2017 09;7(18):7187-7200.
PMID: 28944010 DOI: 10.1002/ece3.3273

Intensive land expansion of commercial oil palm agricultural lands results in reducing the size of peat swamp forests, particularly in Southeast Asia. The effect of this land conversion on macrofungal biodiversity is, however, understudied. We quantified macrofungal biodiversity by identifying mushroom sporocarps throughout four different habitats; logged peat swamp forest, large-scale oil palm plantation, monoculture, and polyculture smallholdings. We recorded a total of 757 clusters of macrofungi belonging to 127 morphospecies and found that substrates for growing macrofungi were abundant in peat swamp forest; hence, morphospecies richness and macrofungal clusters were significantly greater in logged peat swamp forest than converted oil palm agriculture lands. Environmental factors that influence macrofungi in logged peat swamp forests such as air temperature, humidity, wind speed, soil pH, and soil moisture were different from those in oil palm plantations and smallholdings. We conclude that peat swamp forests are irreplaceable with respect to macrofungal biodiversity. They host much greater macrofungal biodiversity than any of the oil palm agricultural lands. It is imperative that further expansion of oil palm plantation into remaining peat swamp forests should be prohibited in palm oil producing countries. These results imply that macrofungal distribution reflects changes in microclimate between habitats and reduced macrofungal biodiversity may adversely affect decomposition in human-modified landscapes.

MeSH terms: Agaricales; Agriculture; Asia, Southeastern; Hand; Humans; Humidity; Hydrogen-Ion Concentration; Industrial Oils; Microclimate; Soil; Temperature; Wind; Biodiversity; Wetlands; Forests
WEO position statement on hygiene in digestive endoscopy: Focus on endoscopy units in Asia and the Middle East

Murdani A, Kumar A, Chiu HM, Goh KL, Jang BI, Khor CJ, et al.

Dig Endosc, 2017 Jan;29(1):3-15.
PMID: 27696514 DOI: 10.1111/den.12745

The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures). These minimum requirements are mandatory for patient safety. Both advanced diagnostic and therapeutic endoscopies should be carried out in an environment that is safe for patients and staff. Particular attention is given to contaminants. Procedural errors in decontamination, defective equipment, and failure to follow disinfection guidelines are major factors contributing to transmission of infection during endoscopy. Other important risk factors include inadequate cleaning, use of older endoscopes with surface and working channel irregularities, and contamination of water bottles or irrigating solutions. Infections by multidrug-resistant organisms have become an increasing problem in health-care systems worldwide. Since 2010, outbreaks of multidrug-resistant bacteria associated with endoscopic retrograde cholangiopancreatography have been reported from the USA, France, Germany, and The Netherlands. In many endoscopy units in Asia and the Middle East, reprocessing procedures have lagged behind those of Western countries for cultural reasons or lack of financial resources. This inconsistency in standards is now being addressed, and the World Endoscopy Organization has prepared this position statement to highlight key points for quality assurance in any endoscopy unit in any country.

MeSH terms: Asia; Gastroenterology*; Humans; Hygiene/standards*; Middle East; Societies, Medical*; Endoscopy, Digestive System/standards*; Endoscopes*; Consensus*
Fulltext Effectiveness of Malaria intervention programmes among patent medicine vendors: a systematic review

Yahaya Mohammed Katagum, Hayati Kadir @ Shahar, Faisal Ibrahim

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):81-91.
MyJurnal

Poor diagnosis, treatment and prevention practices had characterised Patent Medicine Vendor (PMV) activities in malaria control despite expectations on their contributions to check the menace. Interventions reversing this situation reduces disease burden and legitimise PMV inclusion in basic healthcare delivery. This study seeks to identify and review studies addressing this priority problem. Steps outlined in PRISMA guidelines were adopted to search and conduct reviews via electronic databases. Randomized trials with intervention effects on PMVs were considered and thirteen articles were ultimately reviewed and narratively evaluated. Analysis of search outputs identified intervention types, methods used, sample sizes, intervention periods, knowledge, attitude and practice variables, other outcomes and listing of priority systematic review topics, using pre-determined criteria. All reviewed studies were found to be effective despite adopting different intervention approaches. Furthermore, identifying and prioritizing reviews greatly improves future malaria interventions and results thereof, thereby maximising opportunities to deliver appropriate and evidence-based healthcare.

MeSH terms: Commerce; Delivery of Health Care; Nonprescription Drugs; Malaria; Randomized Controlled Trials as Topic; Sample Size; Knowledge
Fulltext A cross-sectional study of ovarian cancer knowledge and its determinants among female employees in a Public University, Malaysia

Najat Milad Elmahdi, Latiffah A. Latiff, Mehrnoosh Akhtari-Zavare, Maimunah Ismail, Rosliza Abdul Manaf, Azrin Shah Abu Bakar

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):71-79.
MyJurnal

Introduction: Ovarian cancer is recognizable as the fourth leading cancer in Malaysia. Knowledge on ovarian cancer is low among Malaysian women, which may affect their interpretation of early symptoms and delay presentation of ovarian cancer cases. The aim of this study was to determine the level of ovarian cancer knowledge and its determinants among female nonacademic staff in Universiti Putra Malaysia, Serdang, Malaysia. Methods: A crosssectional study was designed to collect the data from 366 participants via a validated self-administered questionnaire, from April to July 2015. Results: The mean age of participants was 34 ± 7.89. Most of the sample was Malay (96.4%), married (61.5%). A total of 51.4% of respondents reported low knowledge level. Knowledge of ovarian cancer was significantly associated with marital status (p
Fulltext Adherence towards different vaccines of childhood immunization of under five year old children

Zamzaireen Zainal Abidin, Muhamad Hanafiah Juni, Faisal Ibrahim

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):61-69.
MyJurnal

Introduction: Adherence towards childhood immunization (completeness and timeliness), with consideration of age-dependent-seroconversion, is the basis for children protection. Despite high global and national immunization coverage, vaccine preventable diseases’ are rising. This study aimed to determine adherence (completeness and timeliness) towards different vaccines of childhood immunization and associated factors among mothers of under five children. Methods: Cross-sectional study design was conducted at a health clinic in Seremban. Total of 320 mothers of under five children attending child health clinic selected via systematic random sampling. Data collection was via validated self-administered questionnaires and proforma, analysed using SPSS version 22. Associations between categorical variables determined by chi-square tests. Results: Consented respondents were 314; resulting in response rate of 98.1%. Adherence (completeness) was 98.09% but only 56.5% - 97.1% of respondents adhered in terms of timeliness. Types of transportation was significantly associated with adherence (completeness), p=0.041. Employment status was significantly associated with adherence (timeliness) towards BCG (p=0.008), Hepatitis B dose one (p=0.018) and dose two (p=0.040) vaccines. Education level was significantly associated with adherence (timeliness) towards DTaP/IPV/HiB dose four (p=0.019). Maternal age and usage of government clinic were significantly associated with adherence (timeliness) of MMR dose one, p=0.030 and p=0.017 respectively. Conclusion: Adherence (completeness) was high but varying adherence towards vaccine timeliness. Transportation types associated with completeness. Employment status associated with BCG, first and second doses of Hepatitis B vaccines’ timeliness. Education level associated with fourth dose of DTaP/IPV/HiB. Maternal age and usage of government clinic associated with timeliness of first dose MMR.

MeSH terms: Adult; Ambulatory Care Facilities; Child; Cross-Sectional Studies; Female; Humans; Immunization*; Malaysia; Mothers; Vaccination*; Vaccines*
Fulltext Inadequate health literacy on childhood immunization and its predictors among antenatal mothers

Mohamad Yusof NY, Mohd Zulkefli NA, Ismail S, Abd Rashid MF

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):51-59.
MyJurnal

Introduction: Outbreak of vaccine preventable disease still persists despite good coverage of immunization in Malaysia. Health literacy on childhood immunization is one of essential factor for the outbreak to happen. Thus, this study determined the predictors of health literacy on childhood immunization among antenatal mother in Seremban, Negeri Sembilan.
Methodology: A cross sectional study was conducted among 424 antenatal women using a cluster sampling approach. Antenatal women who were Malaysian and not illiterate were chosen in this study. A selfadministered, validated and pretested questionnaire was used to collect data on sociodemographic, socio economic, awareness on immunization, utilization of health care services and health literacy on childhood immunization. The data was analyzed using SPSS version 22.0. Chi Square test was used in bivariate analysis and multiple logistic regression was used to determine the predictors of inadequate health literacy on childhood immunization.
Result: Out of 362 respondents, 81.2% were inadequate health literacy. The predictors were maternal education (AOR= 2.608, 95% CI 1.477-4.604), parity (AOR= 1.067, 95% CI 1.103-3.876), residential area (AOR= 2.344, 95% CI 1.184-4.641) and utilization of government hospital (AOR= 2.344, 95% CI 1.184-4.641).
Conclusion: Accessibility of health education with regard to immunization need to be strengthen among primigravida, low education and those staying in rural area. In addition, health education also needs to emphasize on the individual that is employed and low economic status with underutilization of government hospital. A simplified education material with interesting pictures and using visual aids help illiterate people for better understanding.
Study site: Klinik Kesihatan, Seremban district, Negeri Sembilan, Malaysia

MeSH terms: Ambulatory Care Facilities; Audiovisual Aids; Cross-Sectional Studies; Disease Outbreaks; Female; Government; Health Education; Humans; Immunization; Malaysia; Mothers; Parity; Pregnancy; Surveys and Questionnaires; Vaccination; Vaccines; Chi-Square Distribution; Logistic Models; Health Literacy
Fulltext The correlation of two nicotine dependence measurement methods: Fagerstrom Test for Nicotine Dependence (FTND) and Saliva Cotinine among a group of Muslim smoker in Malaysia

Nuraisyah Hani Zulkifley, Suriani Ismail, Rosliza Abdul Manaf, Zulkifley Hamid

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):43-50.
MyJurnal

Introduction: One of the known factors that hindered smoking cessation is nicotine dependence. Measurement of the nicotine dependence is important to better understand cigarette smoking addiction dependence and ways to overcome it. Among methods of nicotine dependence measurement are self-reported Fagerstrom Test for Nicotine Dependence (FTND) and biochemical assessment such as saliva cotinine. Biochemical assessment can be used to measure the accuracy of the self-reported measurement of nicotine dependence. Objective: To explore the correlation between the FTND and the saliva cotinine of the smokers in three different timeline. Methods: A total of 61 male smokers who currently smoke cigarette on daily basis were recruited. The study used the one-group pretest-posttest study design and the data were collected three times. The self-reported measurement were measured by using FTND and the biochemical assessment measured by using saliva cotinine from Saliva Bio oral swab (SOS) with the sensitivity of 0.15ng/ml. Data analysis was conducted by using Pearson correlation. Results: There was a significant association between the FTND score and saliva cotinine level of the smokers at baseline, second and third data collection (p=0.014, p=0.003, p

MeSH terms: Cotinine; Male; Saliva; Smoke; Tobacco; Tobacco Use Disorder; Smoking Cessation; Behavior, Addictive; Self Report
Fulltext Prevalence and predictors of pap smear practice among staff of a public university in Nilai, Negeri Sembilan

Nuurain Amirah Mohd Razi, Suriani Ismail, Rosliza Abdul Manaf

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):33-42.
MyJurnal

Introduction: The practice of Pap smear has long been an issue worldwide especially in the developing countries. Malaysia National Health and Morbidity Survey IV reported an uptake of 12.8% in 2011. It was found that Malay women has the lowest prevalence of uptake compared to other major ethnicities in the country. The objective of this study is to determine the prevalence of Pap smear practice and its predictors among staff in a public university with majority of Malay ethnicity. Methodology: A cross-sectional study was conducted among female staff in a public university in Nilai, Negeri Sembilan using a self-administered and validated questionnaire. All female staff from the seven faculties and the library were invited to participate. Data were analysed using SPSS version 22 for descriptive and inferential statistics, whereby Multiple Logistic Regression were performed to identify the predictors. Results: One-hundred-and eighty-seven respondents participated this study. The prevalence of Pap smear practice was 65.2%, of which, two-thirds (65.6%) had done it within the past three years. Predictors of the practice were higher parity, attending annual medical check-up, husband’s support and positive attitude towards the test. Conclusion: The prevalence of Pap smear uptake among this population is higher than other studies in Malaysia, however, not all of them have done it regularly within 3 yearly interval as suggested by the World Health Organisation.
Fulltext Sex and species specific isotopic niche specialisation increases with trophic complexity: evidence from an ephemeral pond ecosystem

Dalu T, Wasserman RJ, Vink TJ, Weyl OL

Sci Rep, 2017 02 24;7:43229.
PMID: 28233858 DOI: 10.1038/srep43229

It is generally accepted that organisms that naturally exploit an ecosystem facilitate coexistence, at least partially, through resource partitioning. Resource availability is, however, highly variable in space and time and as such the extent of resource partitioning must be somewhat dependent on availability. Here we test aspects of resource partitioning at the inter- and intra-specific level, in relation to resource availability in an atypical aquatic environment using an isotope approach. Using closely related key organisms from an ephemeral pond, we test for differences in isotopic signatures between two species of copepod and between sexes within each species, in relation to heterogeneity of basal food resources over the course of the ponds hydroperiod. We show that basal food resource heterogeneity increases over time initially, and then decreases towards the end of the hydroperiod, reflective of the expected evolution of trophic complexity for these systems. Resource partitioning also varied between species and sexes, over the hydroperiod with intra- and inter-specific specialisation relating to resource availability. Intra-specific specialisation was particularly evident in the omnivorous copepod species. Our findings imply that trophic specialisation at both the intra- and inter-specific level is partly driven by basal food resource availability.

MeSH terms: Animals; Carbon Isotopes; Feeding Behavior; Female; Male; Sex Characteristics*; Species Specificity; Ecosystem*; Copepoda/physiology*; Ponds*
Impulsiveness, postprandial blood glucose, and glucoregulation affect measures of behavioral flexibility

Riby LM, Lai Teik Ong D, Azmie NBM, Ooi EL, Regina C, Yeo EKW, et al.

Nutr Res, 2017 Dec;48:65-75.
PMID: 29246282 DOI: 10.1016/j.nutres.2017.10.011

Behavioral flexibility (BF) performance is influenced by both psychological and physiological factors. Recent evidence suggests that impulsivity and blood glucose can affect executive function, of which BF is a subdomain. Here, we hypothesized that impulsivity, fasting blood glucose (FBG), glucose changes (ie, glucoregulation) from postprandial blood glucose (PBG) following the intake of a 15-g glucose beverage could account for variability in BF performance. The Stroop Color-Word Test and the Wisconsin Card Sorting Test (WCST) were used as measures of BF, and the Barratt Impulsiveness Scale (BIS-11) to quantify participants' impulsivity. In Study 1, neither impulsivity nor FBG could predict performance on the Stroop or the WCST. In Study 2, we tested whether blood glucose levels following the intake of a sugary drink, and absolute changes in glucose levels following the intake of the glucose beverage could better predict BF. Results showed that impulsivity and the difference in blood glucose between time 1 (postprandial) and time 2, but not blood glucose levels at time 2 per se could account for variation in performance on the WCST but not on the Stroop task. More specifically, lower impulsivity scores on the BIS-11, and smaller differences in blood glucose levels from time 1 to time 2 predicted a decrease in the number of total and perseverative errors on the WCST. Our results show that measures of impulsivity and glucoregulation can be used to predict BF. Importantly our data extend the work on glucose and cognition to a clinically relevant domain of cognition.

MeSH terms: Adolescent; Adult; Blood Glucose/metabolism*; Cognition; Female; Glucose/administration & dosage*; Humans; Impulsive Behavior*; Male; Prospective Studies; Postprandial Period*; Young Adult; Stroop Test
Fulltext Predictors of preventive practices towards HFMD among mothers of preschool children in Klang District

Qudsiah Suliman, Salmiah Md. Said, Nor Afiah Mohd. Zulkefli

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):21-32.
MyJurnal

Introduction: During which HFMD epidemic has kept on recurring worldwide, effective vaccine and specific treatment for HFMD are still not available, calling attention to on preventive practices as the mainstay of the management. Therefore, it is timely to renew the assessment on maternal preventive practices and its predictors in Klang District, Selangor wherein the endemicity and upsurge of HFMD cases has been demonstrated. Methods: A cross-sectional study was conducted from 1st April 2017 until 15th May 2015 among mothers of Community Development Department (KEMAS) preschool children in Klang District. Respondents were selected based on probability proportional to size sampling, whereas data collection was facilitated by validated, and reliable self-administered questionnaire, that examine on the preventive practices towards HFMD. Results: A total of 353 mothers responded to questionnaire, resulting response rate of 80.2%. Most of the respondent were housewife, married and obtained educational level up to secondary school. Insufficient knowledge score (13.61 ± 4.04) was demonstrated, with health belief highlighted on low mean score for perceived severity and perceived barrier, which was 8.30(SD=1.36) and 7.80(SD=2.14) respectively. Simple linear regression revealed significant linear relationship between preventive practices with knowledge and all health belief subscales. Hierarchical multiple linear regression reported predictors of preventive practices towards HFMD, which include knowledge, (perceived susceptibility)2, perceived severity, and perceived barrier, with the group of variables was significantly predicting the (preventive practice)3 and accounted for 13.1% variance in the (preventive practices)3 (F[5,347]=11.588, p value=
Fulltext Biosocial background in the development of child overweight and obesity among preschoolers in Putrajaya: an observational study

Fatimah Ahmad Fauzi, Nor Afiah Mohd Zulkefli

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):11-20.
MyJurnal

Introduction: Childhood obesity becomes a global epidemic with the majority are living in developing countries. Obese children are at risk of becoming obese adults with non-communicable diseases, which may further lead to huge economic burden for the affected countries. The study objectives were to determine the biosocial background contributing overweight and obesity among preschoolers in Putrajaya (2017) - sociodemographic, pre-and perinatal factors, feeding and weaning practices. Methods: Cross-sectional study was performed using cluster random sampling among 897 preschoolers, whose anthropometric body weights and heights were measured. The calculated BMI was used to determine their obese status based on WHO Growth Standards 2006 and Reference 2007. Their mothers were distributed with self-administered, validated, and pre-tested questionnaires regarding their children’s first two-years-of-life experience. Chi Square test was used for bivariate categorical analysis, Independent T-test and Mann Whitney U test for continuous data analysis. Multivariate binary logistic regression was executed to determine predictors of child obesity. Results: The prevalence of obese children was 7.4%, which can be predicted by the increase in child’s age (Adjusted Odd Ratio: 2.619; 95%CI: 1.435 – 4.780), mothers with higher level of education (AOR: 3.896; 95%CI: 1.127 – 13.470), and higher maternal BMI (AOR: 1.132; 95%CI: 1.057 – 1.213). Conclusion: Three predictors of child obesity can be derived from sociodemographic and pre-and perinatal factors. Further application on these predictors in more targeted interventions and policies need to be considered to reduce the prevalence of obesity and related non-communicable diseases in the country.

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