Browse publications by year: 2018

  1. Duangjai A, Nuengchamnong N, Suphrom N, Trisat K, Limpeanchob N, Saokaew S
    Kobe J Med Sci, 2018 Oct 15;64(3):E84-E92.
    PMID: 30666038
    This study was to assess the impact of different colors of coffee fruit (green, yellow and red) on adipogenesis and/or lipolysis using 3T3-L1 adipocytes. Characterization of chemical constituents in different colors of coffee fruit extracts was determined by ESI-Q-TOF-MS. The cytotoxicity of the extracts in 3T3-L1 preadipocytes were evaluated by MTT assay. Oil-red O staining and amount of glycerol released in 3T3-L1 adipocytes were measured for lipid accumulation and lipolysis activity. All coffee fruit extracts displayed similar chromatographic profiles by chlorogenic acid > caffeoylquinic acid > caffeic acid. Different colors of raw coffee fruit possessed inhibitory adipogenesis activity in 3T3-L1 adipocytes, especially CRD decreased lipid accumulation approximately 47%. Furthermore, all extracts except CYF and their major compounds (malic, quinic, and chlorogenic acid) increased glycerol release. Our data suggest that different colors of coffee fruit extract have possessed anti-adipogenic and lipolytic properties and may contribute to the anti-obesity effects.
    MeSH terms: Caffeic Acids; Chlorogenic Acid; Coffee; Color; Fruit; Glycerol; Lipids; Lipolysis; Obesity; Quinic Acid; Staining and Labeling; Adipocytes; Adipogenesis
  2. Lee YY, Saba E, Irfan M, Kim M, Chan JY, Jeon BS, et al.
    Phytomedicine, 2018 Sep 18;54:169-181.
    PMID: 30668366 DOI: 10.1016/j.phymed.2018.09.186
    BACKGROUND: Different processing conditions alter the ginseng bioactive compounds, promoting or reducing its anti-inflammatory effects. We compared black ginseng (BG) - that have been steamed 5 times - with red ginseng (RG).

    HYPOTHESIS/ PURPOSE: To compare the anti-inflammatory activities and the anti-nociceptive properties of RG and BG.

    METHODS: Nitric Oxide (NO) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay, quantitative Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR), western blot, xylene-induced ear edema, carrageenan-induced paw edema RESULTS: The ginsenoside contents were confirmed using high-performance liquid chromatography (HPLC) and has been altered through increased processing. The highest concentration of these extracts inhibited NO production to near-basal levels in lipopolysaccharide (LPS)-stimulated RAW 264.7 without exhibiting cytotoxicity. Pro-inflammatory cytokine expression at the mRNA level was investigated using qRT-PCR. Comparatively, BG exhibited better inhibition of pro-inflammatory mediators, iNOS and COX-2 and pro-inflammatory cytokines, IL-1β, IL-6 and TNF-α. Protein expression was determined using western blot analysis and BG exhibited stronger inhibition. Xylene-induced ear edema model in mice and carrageenan-induced paw edema in rats were carried out and tested with the effects of ginseng as well as dexamethasone and indomethacin - commonly used drugs. BG is a more potent anti-inflammatory agent, possesses anti-nociceptive properties, and has a strong potency comparable to the NSAIDs.

    CONCLUSION: BG has more potent anti-inflammatory and anti-nociceptive effects due to the change in ginsenoside component with increased processing.

  3. Haque MA, Jantan I, Harikrishnan H, Ghazalee S
    Phytomedicine, 2018 Sep 18;54:195-205.
    PMID: 30668369 DOI: 10.1016/j.phymed.2018.09.183
    BACKGROUND: Zingiber zerumbet rhizome has been used as spices and in traditional medicine to heal various immune-inflammatory related ailments. Although the plant was reported to have potent anti-inflammatory and immunosuppressive properties by several studies, the molecular mechanisms underlying the effects have not been well justified.

    PURPOSE: The study was carried out to investigate the molecular mechanisms underlying the anti-inflammatory properties of the standardized 80% ethanol extract of Z. zerumbet through its effect on mitogen-activated protein kinase (MyD88)-dependent nuclear factor-kappa B (NF-кB), mitogen activated protein kinase (MAPK) and phosphatidylinositol 3-kinase/Akt (PI3K-Akt) signaling pathways in lipopolysaccharide (LPS)-induced U937 human macrophages.

    METHODS: Standardization of the 80% ethanol extract of Z. zerumbet was performed by using a validated reversed-phase HPLC method, while LC-MS/MS was used to profile the secondary metabolites. The release of pro-inflammatory markers, tumor necrosis factor (TNF)-α, interleukin (IL)-1β and prostaglandin E2 (PGE2) was evaluated by enzyme-linked immunosorbent assay (ELISA), while the Western blot technique was executed to elucidate the expression of mediators linked to MyD88-dependent respective signaling pathways. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) assay was carried out to quantify the relative gene expression of cyclooxygenase (COX)-2 and pro-inflammatory mediators at the transcriptional level.

    RESULTS: The quantitative and qualitative analyses of Z. zerumbet extract showed the presence of several compounds including the major chemical marker zerumbone. Z. zerumbet extract suppressed the release of pro-inflammatory mediators, COX-2 protein expression and downregulated the mRNA expression of pro-inflammatory markers. Z. zerumbet-treatment also blocked NF-κB activation by preventing the phosphorylation of IKKα/β and NF-κB (p65) as well as the phosphorylation and degradation of IκBα. Z. zerumbet extract concentration-dependently inhibited the phosphorylation of respective MAPKs (JNK, ERK, and p38) as well as Akt. Correspondingly, Z. zerumbet extract suppressed the upstream signaling adaptor molecules, TLR4 and MyD88 prerequisite for the NF-κB, MAPKs, and PI3K-Akt activation.

    CONCLUSION: The findings suggest that Z. zerumbet has impressive role in suppressing inflammation and related immune disorders by inhibition of various pro-inflammatory markers through the imperative MyD88-dependent NF-κB, MAPKs, and PI3K-Akt activation.

  4. Sidahmed HMA, Vadivelu J, Loke MF, Arbab IA, Abdul B, Sukari MA, et al.
    Phytomedicine, 2018 Aug 03;55:31-39.
    PMID: 30668441 DOI: 10.1016/j.phymed.2018.06.036
    BACKGROUND: Clausena excavata Burm.f. (Rutaceae) has been used for the treatment of stomach disorders including peptic ulcer.

    PURPOSE: In this study, we aimed to investigate dentatin isolated from C. excavata Burm.f., for anti-ulcer activity against ethanol ulcer model in rats.

    METHODS: Gastric acid output, ulcer index, serum profile, histological evaluation using Hematoxylin and eosin (HE), periodic acid Schiff base stainings and immunohistochemical localization for heat shock proteins 70 (HSP70) were all investigated. Possible involvement of reduced glutathione (GSH), lipid peroxidation, prostaglandin E2 (PGE2), superoxide dismutase (SOD) enzymes, radical scavenging, and anti-Helicobacter pylori activity were investigated.

    RESULTS: Dentatin showed anti-secretory activity against the pylorus ligature model and protected the gastric mucosa from ethanol ulceration, as revealed by the improved macroscopic and histological appearance. Dentatin significantly increased the gastric homogenate content of PGE2 GSH and SOD. Dentatin inhibited the lipid peroxidation as revealed by the reduced gastric content of malondialdehyde (MDA). Moreover, dentatin up-regulated HSP70 expression. However, dentatin showed insignificant anti-H. pylori activity.

    CONCLUSION: Dentatin possesses gastro-protective activity, which could be attributed to the anti-secretory, mucus production, anti-oxidant, and HSP70 activities.

    MeSH terms: Ethanol; Animals; Eosine Yellowish-(YS); Gastric Acid; Gastric Mucosa; Glutathione; Hematoxylin; Heterocyclic Compounds, 3-Ring; Malondialdehyde; Mucus; Peptic Ulcer; Periodic Acid; Pylorus; Schiff Bases; Staining and Labeling; Superoxide Dismutase; Ulcer; Lipid Peroxidation; Dinoprostone; Helicobacter pylori; Oxidants; HSP70 Heat-Shock Proteins; Rutaceae; Rats; Clausena
  5. Qurash MT, Yaacob NY, Azuan N, Khaleel YS, Zakaria R
    J Med Ultrasound, 2018 06 18;26(4):210-214.
    PMID: 30662153 DOI: 10.4103/JMU.JMU_40_18
    Interventional radiology procedures are becoming more challenging over time; thus, there is a need for excellent and reliable training methods. Training on live patients is neither safe nor an ethical solution. Alternatives are many and varied, but the most popular is ultrasound guided simulators. This report shows how a simple, homemade, low-cost phantom material, and construction modules can provide several advantages over ordinary gelatin phantoms. A new layering technique and target synthesis are described for the biopsy phantom, including tips on decreasing the needle pass artifact as well as controlling the mixture echogenicity.
    MeSH terms: Biopsy; Gelatin; Humans; Needles; Ultrasonography; Radiology, Interventional; Artifacts; Phantoms, Imaging
  6. Ralib AM, Nanyan S, Ramly NF, Har LC, Cheng TC, Mat Nor MB
    Indian J Crit Care Med, 2018 Dec;22(12):831-835.
    PMID: 30662220 DOI: 10.4103/ijccm.IJCCM_193_18
    Introduction: Acute kidney injury (AKI) is common in the intensive care unit (ICU) with a high risk of morbidity and mortality. The high incidence of AKI in our population may be attributed to sepsis. We investigated the incidence, risk factors, and outcome of AKI in four tertiary Malaysian ICUs. We also evaluated its association with sepsis.

    Materials and Methods: This retrospective cohort study extracted de-identified data from the Malaysian Registry of Intensive Care in four Malaysian tertiary ICUs between January 2010 and December 2014. The study was registered under the NMRR and approved by the ethics committee. AKI was defined as twice the baseline creatinine or urine output <0.5 ml/kg/h for 12 h.

    Results: Of 26,663 patients, 24.2% had AKI within 24 h of admission. Patients with AKI were older and had higher severity of illness compared to those without AKI. AKI patients had a longer duration of mechanical ventilation, length of ICU, and hospital stay. Age, Simplified Acute Physiological II Score, and the presence of sepsis and preexisting hypertension, chronic cardiovascular disease independently associated with AKI. About 32.3% had sepsis. Patients with both AKI and sepsis had the highest risk of mortality (relative risk 3.43 [3.34-3.53]).

    Conclusions: AKI is common in our ICU, with higher morbidity and mortality. Independent risk factors of AKI include age, the severity of illness, sepsis and preexisting hypertension, and chronic cardiovascular disease. AKI independently contributes to mortality. The presence of AKI and sepsis increased the risk of mortality by three times.

    MeSH terms: Cardiovascular Diseases; Creatinine; Critical Care; Humans; Hypertension; Intensive Care Units; Length of Stay; Registries; Respiration, Artificial; Retrospective Studies; Risk Factors; Incidence; Ethics Committees; Sepsis; Acute Kidney Injury
  7. Foead AI, Mathialagan A, Varadarajan R, Larvin M
    Indian J Crit Care Med, 2018 Dec;22(12):870-874.
    PMID: 30662227 DOI: 10.4103/ijccm.IJCCM_379_18
    Symmetrical peripheral gangrene (SPG) is a rare, debilitating disease that deserves more widespread concern among the medical fraternities. The objective of this review is to outline the etiology, pathology findings, and management practices of SPG. About 18%-40% mortality rate was reported, and survivors have high frequency of multiple limb amputations. SPG is the hallmark of disseminated intravascular coagulation (DIC). The main pathogenesis theory, to date, is microthrombosis associated with disturbed procoagulant-anticoagulant balance. The treatment of SPG is largely anecdotal and theoretically involves heparin-based anticoagulation and substitution of natural anticoagulants. Early recognition, prompt management of DIC, and underlying conditions may halt the progression of the disease. The multicenter randomized controlled trial should be set up to formulate the proper treatment guidelines.
    MeSH terms: Amputation; Anticoagulants; Blood Coagulation; Disseminated Intravascular Coagulation; Gangrene; Hematologic Agents; Heparin; Humans; Thrombosis; Survivors; Physical Therapy Modalities
  8. Choo QQ, Chiu CK, Lisitha KA, Chan CYW, Kwan MK
    J Orthop, 2018 12 21;16(1):74-79.
    PMID: 30662243 DOI: 10.1016/j.jor.2018.12.004
    Objective: This study analyses the quantity of local bone graft obtained from different anatomical parts of the posterior elements during corrective surgery for Adolescent Idiopathic Scoliosis patients.

    Summary of background data: Locally harvested autogenous bone graft eliminates possible donor site morbidity and has all the important basic bone graft properties such as osteoinductivity, osteogenicity and osteoconductivity. Its usage was reported to be adequate to achieve fusion but none had quantifies the amount of local bone graft harvested.

    Methods: Total of 40 AIS patients were recruited in the study. All posterior spinal fusion surgeries were performed by the same dual surgeons and same anesthetist with a single observer collecting and measuring bone grafts harvested. The bone grafts harvested from each respective posterior element (spinous processes, laminas, facets and transverses processes) and measured accordingly.

    Results: There were 36 females and 4 males. Amongst cases recruited, there were 32% Lenke 1, 28% Lenke 2, 8%Lenke 3, 22%Lenke 5 and 10% Lenke 6. Total thoracic levels involved were 333, whereas lumbar levels were 81. The mean total weight of bone graft obtained per case was 36.5 ± 13.7 g. The total weight of lumbar bone graft to the number of lumbar fusion levels (4.5 ± 1.2 g/fusion level) was significantly higher than the total weight of thoracic bone graft to the number of thoracic fusion levels (3.2 ± 1.2 g/fusion level). The amount of bone graft was obtained was highest from lumbar spinous process (42%), followed by thoracic spinous process (32%), lumbar lamina (29%), lumbar facet (28%), thoracic lamina (25%), thoracic facet (22%), and thoracic transverse process (21%).

    Conclusions: Lumbar vertebra provided more bone graft than thoracic vertebra. Spinous processes contributed the highest amount of local bone graft in the thoracic and lumbar spine.

  9. Ghaffar ZA, Chong SE, Tan KL, Appalanaido GK, Musa MY, Hussin HB, et al.
    J Contemp Brachytherapy, 2018 Dec;10(6):573-576.
    PMID: 30662482 DOI: 10.5114/jcb.2018.79856
    The practice of brachytherapy in unresectable tongue carcinoma is gaining popularity. However, this procedure poses specific anesthetic challenges, particularly challenges of airway sharing and a higher rate of difficult airway. We report a 74-year-old chronic smoker, chronic alcoholic with history of stroke, who had undergone brachytherapy for tongue carcinoma. Apart from a huge tongue tumor, he had an epiglottic mass but refused elective tracheostomy. This had led to a few critical states throughout the process of treatment, including a metabolic crisis due to thiamine deficiency and difficult airway crisis. To our best knowledge, there have been no reported case on a patient with vocal cord mass undergoing tongue brachytherapy. We hope sharing of this experience may aid the management of similar patients in future.
    MeSH terms: Anesthetics; Beriberi; Brachytherapy; Epiglottis; Humans; Male; Thiamine Deficiency; Tongue Neoplasms; Tracheostomy; Vocal Cords; Stroke
  10. Lee CL, H'ng PS, Paridah MT, Chin KL, Rashid U, Maminski M, et al.
    R Soc Open Sci, 2018 Dec;5(12):180775.
    PMID: 30662718 DOI: 10.1098/rsos.180775
    In the present study, agricultural biomass-palm kernel shell (PKS) and coconut shell (CS)-was used to produce high porosity bioadsorbent using two-stage continuous physical activation method with different gas carrier (air and N2) in each stage. The activation temperature was set constant at 600, 700, 800 or 900°C for both activation stages with the heating rate of 3°C min-1. Two parameters, the gas carrier and activation temperature, were determined as the significant factors on the adsorption properties of bioadsorbent. BET, SEM, FTIR, TGA, CHNS/O and ash content were used to elucidate the developed bioadsorbent prepared from PKS and CS and its capacity towards the adsorption of methylene blue and iodine. The novel process of two-stage continuous physical activation method was able to expose mesopores and micropores that were previously covered/clogged in nature, and simultaneously create new pores. The synthesized bioadsorbents showed that the surface area (PKS: 456.47 m2 g-1, CS: 479.17 m2 g-1), pore size (PKS: 0.63 nm, CS: 0.62 nm) and pore volume (PKS: 0.13 cm3 g-1, CS: 0.15 cm3 g-1) were significantly higher than that of non-treated bioadsorbent. The surface morphology of the raw materials and synthesized bioadsorbent were accessed by SEM. Furthermore, the novel process meets the recent industrial adsorbent requirements such as low activation temperature, high fixed carbon content, high yield, high adsorption properties and high surface area, which are the key factors for large-scale production of bioadsorbent and its usage.
  11. Phang ZH, Chew JJ, A/P Thurairajasingam J, Ibrahim SB
    PMID: 30656250 DOI: 10.5435/JAAOSGlobal-D-18-00059
    Spontaneous spinal epidural hematoma is a rare condition defined by bleeding in the epidural space of the spine with no identifiable causes such as trauma, vascular malformation, or bleeding disorders. This is a case of a 79-year-old woman with a medical history of diabetes mellitus, dyslipidemia, and hypertension presented with the sudden onset of severe thoracolumbar back pain associated with weakness and numbness in her bilateral lower limb. Examination of the lower limb showed bilateral lower limb motor and sensory deficits. Laboratory investigations showed normal results. MRI showed posterior extradural intraspinal hematoma from T11 to L3 vertebrae. Patient underwent right hemilaminectomy and posterior decompression of T12 and L1 vertebrae to evacuate the hematoma. Postoperatively, her neurologic complications improved gradually. Decision was made not to restart aspirin. On follow-up at 1 year, the patient had complete recovery of neurologic complications of both lower limb and had no recurrence of bleeding. In short, this is a case of spontaneous spinal epidural hematoma associated with long-term use of low-dose aspirin in an elderly patient requiring surgical evacuation of hematoma with good functional outcome after the surgery. Therefore, aspirin should be prescribed cautiously especially to elderly patients.
    MeSH terms: Aged; Aspirin; Back Pain; Diabetes Mellitus; Epidural Space; Female; Follow-Up Studies; Hematoma, Epidural, Cranial; Humans; Hypertension; Hypesthesia; Laminectomy; Magnetic Resonance Imaging; Lower Extremity; Hematoma, Epidural, Spinal; Dyslipidemias; Vascular Malformations
  12. Chan, Yoke Mun, Rahimah Abdul Kadir, Tengku Aizan Abdul Hamid, Tanti Irawati Rosli
    Loss of teeth can affect masticatory efficiency in older adults. This may result in avoidance or modifications in food
    choices and lead to lower intake of important nutrients among older individuals. The aim of this study was to determine
    the association between tooth loss and body mass index, BMI, among older adults in Kuala Pilah, Negeri Sembilan. A
    cross-sectional study was carried out on 428 older adults aged 50 years and above from selected villages in district of
    Kuala Pilah. Respondents were interviewed to collect information on their demographic characteristics. Number of tooth
    loss was determined through oral assessment, followed by anthropometric assessment to calculate the BMI of respondents.
    Findings showed that majority of the respondents were overweight and obese, 40.4% and 19.9% respectively, while only
    a small proportion was underweight, 3.9%. The proportion of edentulism (total tooth loss) was 18.3% and majority of
    the older adults had lost more than 12 teeth (77.1%) and less than 4 pairs of occluding posterior teeth (86.0%). Total
    and partial tooth loss was found to be not significantly associated with BMI. In relation to the arrangement of teeth,
    older adults with reduced number of posterior occluding pairs of teeth were more likely to experience unsatisfactory
    BMI (OR = 3.61, 95% CI: 1.48, 8.76). This may suggest that functional arrangement of the tooth in the oral cavity is more
    important than the number of tooth loss alone. Thus, maintaining an optimum number of teeth for chewing is essential
    for maintenance of ideal BMI.
    MeSH terms: Adult; Anthropometry; Cross-Sectional Studies; Demography; Food; Humans; Mastication; Obesity; Surveys and Questionnaires; Thinness; Body Mass Index; Tooth Loss; Overweight
  13. Roziah Arabi, Rohani Mamat, Noraini Abd Rashid, Rufina Bakri
    Jurnal Sains Kesihatan Malaysia, 2018;16(1):163-168.
    Exclusive breastfeeding (EBF) is very crucial for the health of infant as well as mother. However, the prevalence of
    exclusive breastfeeding is very low especially among working mother. Since the prevalence of EBF might be influenced by
    the level of knowledge on EBF, researcher comes to critical thinking to conduct this study to evaluate level of knowledge
    on EBF among working mother. A cross sectional design study was carried out to determine knowledge level on exclusive
    breastfeeding among working mother, and its relationship with demographic data in Hospital Canselor Tuanku Muhriz
    (HCTM). A total 283 respondents were recruited to participate in this study. The respondents’ knowledge level on exclusive
    breastfeeding was identified using Kim & Chapman (2013) Questionnaire on Knowledge and Practice about Exclusive
    Breastfeeding. The result showed that majority of the respondents (56.9%) had high knowledge on exclusive breastfeeding.
    For demographic data, factors such as age, level of education, and family income had shown a significant association (p
    < 0.05) with level of knowledge on exclusive breastfeeding. In conclusion, the level of knowledge of EBF was identified
    among working mother, yet it has been influenced by mother’s sociodemographic background
  14. Syed Mohamed Al Junid, Azimatun Noor Aizuddin
    Jurnal Sains Kesihatan Malaysia, 2018;16(1):145-153.
    Health care services are not often accessible and available for all people in one country due to multiple reasons such as
    the geographical barrier, affordability, etc. The aim of this study was to analyse willingness to pay (WTP) for healthcare
    services user fees among Malaysian population and determine its’ influencing factors. Structured interviews were
    conducted involving 774 households in 4 states represents Peninsular Malaysia. Validated questionnaires with open
    ended, followed by bidding games were applied to elicit maximum amount of WTP. The study was analysed descriptively
    and with multivariate regression method to adjust for potential confounding factors. More than half of respondents WTP
    more than current fee for the government clinic outpatient registration fee with mean MYR3.76 (SD2.71). Majority of
    respondents not WTP more than usual for private clinic simple outpatient treatment charges with the mean MYR38.76
    (SD5.45). Factors that were found to have significant associations with WTP for both government and private clinic were
    income and having health insurance. Community willing to pay for healthcare services user fees and charges but at
    certain amount. The healthcare services user fees and charges can be increased up to community WTP level to avoid
    from catastrophic expenditure.
  15. Rohayu Hami, Noorsuzana Mohd Shariff, Siti Shahanis Md Sharif, Appalanaido, Gokula Kumar, Nizuwan Azman, Mohammad Farris Iman Leong Abdullah
    Hope leads to lower depression and anxiety and is associated with improved quality of life of cancer patients. In this
    study, Hope Scale (HS) was translated into Malay, and the psychometric properties of the Malay version of the Hope
    Scale were investigated among Malaysian cancer patients. Concurrent translation and back translation of the original
    English version of the Hope Scale were performed, and the Malay version was administered to 195 cancer patients
    with different cancer diagnoses at baseline assessment and 2 months later at follow-up. The Hope Scale (Malay) total
    score (Cronbach’s α = 0.72; intraclass correlation coefficient (ICC) = 0.67) and its domains (Cronbach’s α [pathway] =
    0.7; Cronbach’s α [agency] = 0.7; ICC[Pathway] = 0.64; ICC[Agency] = 0.70) demonstrated acceptable internal consistencies and
    test-retest reliability. Convergent and discriminant validities were also achieved by the Hope Scale (Malay). The Hope
    Scale (Malay) demonstrated construct validity, as confirmatory factor analysis demonstrated that the items in the Hope
    Scale (Malay) best fit into two domains, which was true for the original English version. The Hope Scale (Malay) had
    acceptable psychometric properties and thus is suitable for assessing hope in Malaysian cancer patients.
  16. Shamshimah Samsuddin, Noriszura Ismail
    Occupational injury is an issue that needs to be considered in reducing the problems of disability and death in the
    workplace. Healthy and high-productivity workers are one of the important factors that are important to the economic
    growth of a country. This study aims to identify the trend of disability for employees covered by the Employment Injury
    Scheme under the Social Security Organization Malaysia (SOCSO) for the years 2009-2013. Based on the descriptive
    analysis, 80% of the total numbers of workers who suffer injury or death in the workplace are male employees. In
    addition, workers aged 25 and above are more prone to injury and death associated with work. The results showed that
    socio-demographic factors such as gender and age, as well as level of disability are several important factors that need
    to be considered in identifying the trend of disability among employees.
    MeSH terms: Work Performance; Demography; Employment; Disabled Persons; Malaysia; Male; Social Security; Workplace; Occupational Injuries
  17. Muhamad Nur Fariduddin Abdul Aziz, Wee, Lei Hum, Lilia Halim, Mohd Johar Jaafar
    The importance of nontechnical skills among healthcare professionals is gaining widespread recognition as critical
    elements complementing technical skills that are used to improve patients’ safety. These skills are typically acquired
    through simulation training which has emerged as an effective way to complement clinical training. Effective simulation
    requires structure and effective debriefing methods to enhance its learning outcome. In previous literature, evidence of the
    effectiveness of healthcare simulation was available but studies evaluating debriefing method(s) remain sparse. In this
    paper, the effectiveness of debriefing methods in eight studies on the acquisition of nontechnical skills among healthcare
    professionals is reviewed. Articles published from 1st January 2016 across three different databases were referred to. The
    results of the review show a statistically significant improvement in the performance of nontechnical and technical skills
    across different professionals through various methods of debriefing. Nontechnical skills such as teamwork, effective
    communication, decision-making, and situational awareness have improved significantly. In addition, integration of
    realism in simulation learning has begun to emerge as an effective technique of providing a real world experience.
    However, there was lack of detailed information on the length and type of debriefing conducted in the studies. These
    methods clearly require further research since the key to successful simulation learning is through debriefing which is
    the heart of simulation.
  18. Lam, Kok Wai, Kamal Rullah, Mohd Fadhlizil Fasihi Mohd Aluwi
    Jurnal Sains Kesihatan Malaysia, 2018;16(1):135-143.
    Inhibition of xanthine oxidase (XO) activity is an effective therapeutic approach for the treatment of diseases such as gout
    and hyperuricemia. Additionally, the use of XO inhibitors can further be extended to injury treatments such as ischemic
    reperfusion in various organs such as heart, liver and kidney. In this study, 7 aurone compounds were synthesized and
    tested on XO and compared with the positive control allopurinol. Compound 5e was identified as the most potent compound
    and was able to inhibit half of XO activity at 33.23 μM followed by compounds 5f and 5d at 210.22 μM and 302.0 μM,
    respectively. Finally, molecular docking
  19. Hartini Yusof, Mohamed Kamel Abd. Ghani
    One hundred seventy-one patients suffering from chronic renal diseases at Kuala Lumpur Hospital participated in a crosssectional study with purposive sampling to ascertain prevalence rates of Cryptosporidium parvum (C. parvum), Giardia
    intestinalis (G. intestinalis), Blastocystis hominis (B. hominis) and Strongyloides stercoralis (S. stercoralis). The patients
    were divided into 2 groups: post-transplant group (138 patients) and pre-transplant group (33 patients). In this study, the
    parasite infection is linked to the aspects of race, gender, renal patient’s group and the postrenal transplantation period.
    Immunofluorescence staining was performed on fecal slides for the detection of C. parvum oocysts and G. intestinalis cysts.
    Sand charcoal culture technique was also used to detect the presence of S. strongyloides in fecal samples. The findings
    showed that the prevalence of C. parvum, G. intestinalis dan B. hominis among post-transplant patients was 18.1%,
    10.9% and 22.5%, respectively but none of the pretransplant patient was infected. Meanwhile, both patient groups were
    free of S. stercoralis infection. Furthermore, there was no significant association between post-transplantation period
    and pattern in prevalence of the studied parasites, however, it was noted that the prevalence rates of C. parvum and G.
    intestinalis had declined after 6 months post transplantati
  20. Yee, Fun Chow, Rahayu Mustaffa Kamal, Shobha, Sharma, Joginder Singh, Susheel Kaur Dhillon, Hua, Nong Ting
    Jurnal Sains Kesihatan Malaysia, 2018;16(1):169-176.
    Knowledge of normal anatomy and physiology of swallowing is fundamental in the identification of individuals with or
    at risk for swallowing disorders. Learning anatomy and physiology however, is not an easy task thus, computer-assisted
    learning (CAL) approaches have been incorporated into the learning of the topics to enhance understanding. Although
    evidence exists on the benefits of using CAL in education, more studies are necessary in the field of swallowing. While
    courseware for the learning of anatomy and physiology of swallowing exist, they are not comprehensive. Therefore, this
    study aimed to develop a comprehensive CAL courseware for anatomy and physiology of swallowing. The current study
    used a designed-based research following the ADDIE (analysis, design, development, implementation, and evaluation)
    model to create a multimedia courseware, incorporating the use of text, still images, animations, audio narrations,
    and presented on a simple graphical user interface. The courseware was evaluated by 27 undergraduate students in
    terms of its usefulness, ease of use, and users’ satisfaction. Results indicate that the participants were satisfied with the
    courseware and that they perceived the courseware as useful, easy to learn and easy to use. The study represents an
    initiative to investigate the use of CAL in the subject and to establish the basis for further work which includes assessment
    on the learning outcomes from the usage of the CAL courseware. It is hoped that the use of this courseware in teaching
    and learning of anatomy and physiology of swallowing can enhance students’ knowledge and understanding of the area
    efficiently and effectively.
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