Browse publications by year: 2018

  1. Gorgey, Annie, Nor Azian Aini Mat
    MATEMATIKA, 2018;34(1):1-2.
    MyJurnal
    Symmetric methods such as the implicit midpoint rule (IMR), implicit trapezoidal
    rule (ITR) and 2-stage Gauss method are beneficial in solving Hamiltonian problems
    since they are also symplectic. Symplectic methods have advantages over non-symplectic
    methods in the long term integration of Hamiltonian problems. The study is to show
    the efficiency of IMR, ITR and the 2-stage Gauss method in solving simple harmonic
    oscillators (SHO). This study is done theoretically and numerically on the simple harmonic
    oscillator problem. The theoretical analysis and numerical results on SHO problem
    showed that the magnitude of the global error for a symmetric or symplectic method
    with stepsize h is linearly dependent on time t. This gives the linear error growth when
    a symmetric or symplectic method is applied to the simple harmonic oscillator problem.
    Passive and active extrapolations have been implemented to improve the accuracy of the
    numerical solutions. Passive extrapolation is observed to show quadratic error growth
    after a very short period of time. On the other hand, active extrapolation is observed to
    show linear error growth for a much longer period of time.
    MeSH terms: Biological Phenomena; Problem Solving
  2. Minhat Halimatus Sakdiah, Liyana Najwa Inche Mat, Abdul Syafiq A. Radzis, Ng, Yiet Fai, Nur Syazwany Nasir Khan
    Int J Public Health Res, 2018;8(1):894-898.
    MyJurnal
    Introduction Parkinson’s disease (PD) is the second most common neurodegenerative disease after Alzheimer’s disease (AD) and the most frequent sub-cortical degenerative disease, characterized by universal progressive disorder of the
    nervous system that affects movement. This cross sectional study aimed to determine the prevalence and correlates of PD among elderly attending the neurology clinic in Serdang Hospital.
    Methods A total of 150 records of patients attended the clinic from January to December 2016 were randomly selected. Data was collected using a proforma form seeking information related to age, gender, race, locality, and presence of comorbidity particularly diabetes mellitus. The data was analysed using the Statistical Package for Social Science (IBM SPSS) version 22.0.
    Results The prevalence of PD among the elderly involved in the study was 34%. Majority of the respondents were aged 60 to 70 years old (54.7%), male (53.3%), Chinese (56.7%), from urban locality (93.0%) and were not diabetic (69.3%). The inferential statistics showed no significant association between all the factors with PD. However, the associations between age and diabetes mellitus with PD were almost significant with p values of 0.07 and 0.08 respectively.
    Conclusions Overall, the prevalence of PD among elderly who attended the neurology clinic in year 2016 was less than half with none of the factors under study were significantly associated with PD. However with bigger sample size, possible significant association may be obtained between age and diabetes mellitus.

    Study site: neurology clinic in Hospital Serdang
    MeSH terms: Aged; Cross-Sectional Studies; Hospitals; Humans; Malaysia; Outpatient Clinics, Hospital; Parkinson Disease*; Prevalence*
  3. Fah, Then Ru, Jun, Tan Yi, Lim, Christopher Thiam Seong
    MyJurnal
    Minimal Change Disease (MCD) and Focal Segmental Glomerulosclerosis (FSGS) are common causes of nephrotic syndrome. These two conditions are similar in their presentations but differentiated via their histopathological features and responsiveness to corticosteroids. There are ongoing debates whether MCD and FSGS are at the same spectrum of disease rather than separate entities. FSGS has been postulated to be the severe end of the spectrum of MCD. We have reported a case that has primary FSGS after years of poorly controlled MCD, which supports both conditions are the same spectrum of disease.
    MeSH terms: Adrenal Cortex Hormones; Cell Differentiation; Glomerulosclerosis, Focal Segmental; Nephrosis, Lipoid; Nephrotic Syndrome
  4. Ikmal Hisyam Bakrin, Hasni Mahayidin, Khairul Shakir Ab Rahman, Wan Irnawati Wan Ab Rahman, Sazali Satari, Asrul Fahmi Azizan
    MyJurnal
    Lipoma arborescens is a non-neoplastic, reactive condition due to chronic synovial inflammation and irritation, characterized by frond-like or villous proliferation of mature adipose tissue covered by hyperplastic synovium. The knee is the most commonly affected site particularly the suprapatellar pouch. We report a case of lipoma arborescens affecting the right knee of an elderly Chinese gentleman associated with bilateral knee and hand osteoarthritis. He presented with progressive worsening of right knee swelling and pain. Partial synovectomy of the right knee was performed and no lesion recurrence was noted at one year post-operation. The clinical and imaging findings, pathological features, together with differential diagnoses were discussed.
    MeSH terms: Adipose Tissue; Aged; China/ethnology; Diagnosis, Differential; Edema; Hand; Humans; Inflammation; Joint Diseases; Knee Joint; Lipoma; Male; Neoplasm Recurrence, Local; Osteoarthritis; Pain; Synovial Membrane; Osteoarthritis, Knee; Cell Proliferation
  5. Siti Zulaikha Zakariah, Syafinaz Amin Nordin, Khairul Anuar Zainun, Asyraff Md Najib
    MyJurnal
    Group B streptococcus (GBS) is generally known to cause severe disease in the neonate and immunocompromised adults. GBS in the pregnant mother is rare and can potentially be fatal. Clinical presentation can be as mild as an uncomplicated urinary tract infection or serious invasive disease in the form of bacteremia, chorioamnionitis, endometritis and septic abortion. We report a case of a 46-year-old Para 3 lady, post-partum day 12, whom was found dead at home. Prior to her death, she had intermittent fever and abnormal lochia. Autopsy findings indicate GBS endometritis and bacteraemia. She was never screened for GBS. The cost-effectiveness of universal GBS screening needs to be explored to reduce maternal and neonatal morbidity due to GBS.
    MeSH terms: Abortion, Septic; Adult; Autopsy; Chorioamnionitis; Cost-Benefit Analysis; Death; Endometritis; Female; Humans; Infant, Newborn; Mothers; Pregnancy; Streptococcus agalactiae; Urinary Tract Infections; Bacteremia; Postpartum Period
  6. Wong DTL, Sidi H, Salleh H, Tajjudin I
    MyJurnal
    With the availability of the Internet, pornographic materials are readily accessible. Pornographic materials may have a link to addiction and other deviant sexual behaviour. In this case report, we highlighted a link between voyeuristic disorder and internet sex addiction. Mr. SK is a 22-year-old single gentleman who was referred for psychiatric assessment due to voyeuristic acts. He had been watching pornographic materials since 16 years old and became addicted to it.
    MeSH terms: Problem Behavior; Erotica; Humans; Malaysia; Male; Sexual Behavior; Voyeurism*; Behavior, Addictive; Internet; Young Adult
  7. Lee SC, Sidi H, Zakaria H, Loo JL, Yahaya R
    MyJurnal
    Exhibitionism is a distressing condition which may have a link with the increasing availability and usage of online sexual activities (OSA). We highlight a 42-year-old man who presented with a constant craving for OSA to achieve his sexual satisfaction which included exposing his genitalia to virtual partners, unsuspected strangers, and colleagues in public areas. His sexual behaviours were further reinforced by an online video chatting with genitalia exposure, which ended commonly with an exchange of masturbatory acts. He denied any problem with his erection and able to achieve orgasm via common sexual acts. There was no past psychiatric history nor family history of mental disorder. He volunteered to seek psychiatric help and subsequently given a psycho education on his illness and how to cope with the distress associated with his sexual acts. He was scheduled for an intensive psychotherapy to instil insight and hope to deal with his sexual difficulties.
    MeSH terms: Adult; Coitus; Erotica; Exhibitionism; Genitalia; Humans; Malaysia; Malaysia/ethnology; Male; Orgasm; Penile Erection; Psychotherapy; Sexual Behavior; Sexual Partners; Craving
  8. Ezamin Abdul Rahim, Ahmad Sobri Muda, Hariati Jamil
    MyJurnal
    Bronchial artery embolization (BAE) is the mainstay treatment for massive haemoptysis. Herein we briefly discuss the tips and tricks of super-selective embolization of bronchial artery using N-butyl-2 cyanoacrylate (NBCA). Based on our experience, this technique produces a better resolution and exhibit high non- recurrence rate in the treatment of massive haemoptysis.
    MeSH terms: Bronchi; Bronchial Arteries; Embolization, Therapeutic; Enbucrilate; Hemoptysis; Vascular Surgical Procedures
  9. Nadzirah Mohamad Radzi, Farah Wahida Ahmad Zaiki
    MyJurnal
    The application of ultrasound technology has been widely accepted in clinical settings, particularly in Obstetrics and Gynaecology. This is in light of its ability to detect early foetal malformations apart from enabling foetal monitoring throughout gestation. While ultrasonography is an imaging method that is regularly used in Obstetrics, it is questionable as to whether it is safe for foetuses. The purpose of this paper was to review the evidence regarding the thermal effects of ultrasound exposure on foetal development, particularly. It is hoped that the importance of prudent usage of prenatal ultrasonography will be impressed on clinicians and the public in order to avoid the unnecessary usage of ultrasonography when it is not medically indicated. This is so that the welfare of pregnant women will be looked after, besides contributing to the better health of the next generation by ensuring that the benefits outweigh the known risks or potential harms.
    MeSH terms: Female; Fetal Monitoring; Fetus; Gynecology; Humans; Obstetrics; Pregnancy; Ultrasonography; Ultrasonography, Prenatal; Fetal Development
  10. Edre Mohammad Aidid, Hayati Kadir@Shahar, Salmiah Md Said, Sharifah Norkhadijah Syed Ismail
    MyJurnal
    Introduction: Leptospirosis is a preventable zoonosis of public health importance. Due to increasing incidence of leptospirosis and seasonal floods affecting Kuantan community, a study was conducted to identify the determinants of leptospirosis preventive practices. Methods: A cross-sectional study was carried out in Perkampungan Sungai Isap, Kuantan, Pahang, Malaysia, which obtained 568 respondents by stratified proportionate random sampling technique. Data was collected using a modified guided questionnaire and analysed using IBM SPSS version 22.0. Results: Majority of the respondents were females (52.6%), Malay ethnicity (98.8%), attended up to secondary school (57.2%), worked in low-risk occupational group (96.0%) and reside in moderate-risk stratum (55.6%). Overall, majority (68%) of the respondents had good knowledge. However, only 38% of the respondents had satisfactory attitude and 18% had satisfactory practice. There were significant associations between stratum and leptospirosis preventive practices (χ2=11.84, df=2, p=0.003), age group and leptospirosis preventive practices (χ2=7.41, df=2, p=0.03) and personal income and leptospirosis preventive practices (χ2=6.32, df=1, p=0.01). Multivariate logistic regression showed that the predictors of satisfactory leptospirosis preventive practices were high-risk stratum (aOR: 3.69, 95% CI: 1.71-8.00, p=0.001) and monthly personal income of less than RM1000 (aOR: 1.65, 95% CI: 1.05-2.59, p=0.03). Conclusions: Leptospirosis can be prevented by having adequate awareness regarding the disease through health promotional activities especially before, during and after flooding, targeting more on those in low to moderate risk areas and higher income group to prevent potential outbreaks.
  11. Chin, Wong Lok, Norazirah Md Nor, Adawiyah Jamil
    MyJurnal
    Introduction: Sun exposure is a risk for skin cancer but is beneficial for multiple other diseases. Recommendations for photoprotection are well defined, guidelines for optimal sun exposure is not clear. We determined sun exposure in healthy adults, considering their skin phototype and amount of skin exposed. Methods: A cross sectional study was performed involving healthy adults working in a tertiary health facility. Fitzpatrick skin phototype quiz was used to determine skin phototype. Sun exposure was quantified as an index (SEI); body surface area exposed times duration of exposure. Results: We recruited 167 volunteers, 110(66%) women and 56(34%) men. Mean age was 29.77±6.58 years, 124(74.7%) were Malay, 27(16.3%) Chinese, 14(8.4%) Indians and 1(0.6%) of other ethnicity. Fitzpatrick skin phototypes were 30(18.1%) type III, 109(65.7%) type IV and 27(16.3%) type V. Exposed body surface area was 13.96±8.33% in males and 14.55±9.58% in females. The duration of sun exposure per week in males was 11.52±6.11hours and 10.71±5.75 hours in females. Mean SEI was 160 ±144. The SEI in females was 158 ±151, 164 ±130 in males, p value =0.81. There were no significant differences in SEI between gender and skin phototypes. Conclusion: SEI was very low in our study population due to limited body surface area exposed and duration of sun exposure. SEI was higher in darker skin and males, however these were not statistically significant.
  12. Nurhaliza Zakariah, Ragunath, Priya, Feisul Idzwan Mustapha, Huda Zainuddin
    MyJurnal
    Introduction: Physical inactivity has been recognised as the fourth leading risk factor for mortality worldwide. Individuals who are physically inactive have an increased risk of 20% to 30% of dying prematurely. Individuals who fulfil the minimum recommendations of physical activity can reduce the development of Non-Communicable Diseases. In 2015, 33.5% of Malaysian adults were reported to be physically inactive. Various factors were found to be associated with physical activity participation and these factors need to be explored. Methods: A cross-sectional study using proportionate simple random sampling was conducted. A total of 310 health staff were sampled according to the proportion from five divisions and data were collected using a self-administered questionnaire. IBM SPSS version 22.0 were used to analyse the data. Predictors for physical activity were also determined. Results: The response rate was 97.7% (303 out of 310). The prevalence of physical inactivity among respondents was 37.6%. The predictors for physical inactivity were smoker/ex-smoker (aOR=2.308, p=0.027), certificate/diploma education (aOR=2.135, p=0.008), personal barrier (aOR=1.055, p=0.017) and social environment barrier (aOR=1.106, p =0.025). Conclusion: People that have a higher possibility of being physically inactive were those with certificate or diploma education and smokers or ex-smokers. Those with personal barriers and social environment barriers likewise have higher probability of being physically inactive. Thus, appropriate health interventions should be developed by taking these factors into consideration to promote physical activity among the health staff.
    MeSH terms: Adult; Cross-Sectional Studies; Humans; Motor Activity; Surveys and Questionnaires; Risk Factors; Social Environment; Exercise; Prevalence
  13. Ismail WI, Ahmad Hassali MA, Farooqui M, Saleem F, Roslan MNF
    Complement Ther Clin Pract, 2018 Nov;33:71-76.
    PMID: 30396630 DOI: 10.1016/j.ctcp.2018.06.004
    BACKGROUND AND PURPOSE: This study investigated the disclosure of complementary and alternative medicine (CAM) use to health care providers by Malaysian thalassemia patients.

    METHODS: The semi-structured interviews were audio taped, transcribed verbatim, and translated into English.

    RESULTS: Thematic analysis identified four themes: 1) reason for CAM disclosure, 2) attempt to disclose CAM, 3) withdrawal from CAM disclosure, and 4) non-disclosure of CAM use. The reason for patients' disclosure of CAM use to healthcare providers is because they wanted to find information about CAM and were afraid of the interaction between the conventional medicine and CAM. Patients also disclosed the use of CAM because they were not satisfied with the conventional medicine that had caused them harm.

    CONCLUSION: Effective communication between patients and health care providers is important, especially for patients who are undergoing conventional thalassemia treatment, for fear that there is an interaction between conventional treatment and CAM use.

    MeSH terms: Complementary Therapies*; Health Personnel*; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Physician-Patient Relations*; Thalassemia/therapy*; Cohort Studies; Disclosure*
  14. Majid A, Roberts SG, Cilissen L, Emmorey K, Nicodemus B, O'Grady L, et al.
    Proc Natl Acad Sci U S A, 2018 Nov 06;115(45):11369-11376.
    PMID: 30397135 DOI: 10.1073/pnas.1720419115
    Is there a universal hierarchy of the senses, such that some senses (e.g., vision) are more accessible to consciousness and linguistic description than others (e.g., smell)? The long-standing presumption in Western thought has been that vision and audition are more objective than the other senses, serving as the basis of knowledge and understanding, whereas touch, taste, and smell are crude and of little value. This predicts that humans ought to be better at communicating about sight and hearing than the other senses, and decades of work based on English and related languages certainly suggests this is true. However, how well does this reflect the diversity of languages and communities worldwide? To test whether there is a universal hierarchy of the senses, stimuli from the five basic senses were used to elicit descriptions in 20 diverse languages, including 3 unrelated sign languages. We found that languages differ fundamentally in which sensory domains they linguistically code systematically, and how they do so. The tendency for better coding in some domains can be explained in part by cultural preoccupations. Although languages seem free to elaborate specific sensory domains, some general tendencies emerge: for example, with some exceptions, smell is poorly coded. The surprise is that, despite the gradual phylogenetic accumulation of the senses, and the imbalances in the neural tissue dedicated to them, no single hierarchy of the senses imposes itself upon language.
    MeSH terms: Africa; Asia; Auditory Perception/physiology*; Cross-Cultural Comparison; Humans; Language*; Latin America; Phonetics; Psycholinguistics*; Semantics; Sign Language; Visual Perception/physiology*; Cultural Diversity; Olfactory Perception/physiology*; Taste Perception/physiology*; Touch Perception/physiology*
  15. Matejcic M, Saunders EJ, Dadaev T, Brook MN, Wang K, Sheng X, et al.
    Nat Commun, 2018 Nov 05;9(1):4616.
    PMID: 30397198 DOI: 10.1038/s41467-018-06863-1
    Chromosome 8q24 is a susceptibility locus for multiple cancers, including prostate cancer. Here we combine genetic data across the 8q24 susceptibility region from 71,535 prostate cancer cases and 52,935 controls of European ancestry to define the overall contribution of germline variation at 8q24 to prostate cancer risk. We identify 12 independent risk signals for prostate cancer (p 
    MeSH terms: Chromosome Mapping; Chromosomes, Human, Pair 8/genetics*; Disease Susceptibility; Genetic Markers; Genotype; Haplotypes; Humans; Male; Prostatic Neoplasms/genetics*; Prostatic Neoplasms/epidemiology; Prostatic Neoplasms/pathology; Risk Factors; Case-Control Studies; Risk Assessment; European Continental Ancestry Group/genetics*
  16. Takeuchi H, Savitzky AH, Ding L, de Silva A, Das I, Nguyen TT, et al.
    Ecol Evol, 2018 Oct;8(20):10219-10232.
    PMID: 30397460 DOI: 10.1002/ece3.4497
    A large body of evidence indicates that evolutionary innovations of novel organs have facilitated the subsequent diversification of species. Investigation of the evolutionary history of such organs should provide important clues for understanding the basis for species diversification. An Asian natricine snake, Rhabdophis tigrinus, possesses a series of unusual organs, called nuchal glands, which contain cardiotonic steroid toxins known as bufadienolides. Rhabdophis tigrinus sequesters bufadienolides from its toad prey and stores them in the nuchal glands as a defensive mechanism. Among more than 3,500 species of snakes, only 17 Asian natricine species are known to possess nuchal glands or their homologues. These 17 species belong to three nominal genera, Balanophis, Macropisthodon, and Rhabdophis. In Macropisthodon and Rhabdophis, however, species without nuchal glands also exist. To infer the evolutionary history of the nuchal glands, we investigated the molecular phylogenetic relationships among Asian natricine species with and without nuchal glands, based on variations in partial sequences of Mt-CYB, Cmos, and RAG1 (total 2,767 bp). Results show that all species with nuchal glands belong to a single clade (NGC). Therefore, we infer that the common ancestor of this clade possessed nuchal glands with no independent origins of the glands within the members. Our results also imply that some species have secondarily lost the glands. Given the estimated divergence time of related species, the ancestor of the nuchal gland clade emerged 19.18 mya. Our study shows that nuchal glands are fruitful subjects for exploring the evolution of novel organs. In addition, our analysis indicates that reevaluation of the taxonomic status of the genera Balanophis and Macropisthodon is required. We propose to assign all species belonging to the NGC to the genus Rhabdophis, pending further study.
  17. Md Zoqratt MZH, Eng WWH, Thai BT, Austin CM, Gan HM
    PeerJ, 2018;6:e5826.
    PMID: 30397546 DOI: 10.7717/peerj.5826
    Aquaculture production of the Pacific white shrimp is the largest in the world for crustacean species. Crucial to the sustainable global production of this important seafood species is a fundamental understanding of the shrimp gut microbiota and its relationship to the microbial ecology of shrimp pond. This is especially true, given the recently recognized role of beneficial microbes in promoting shrimp nutrient intake and in conferring resistance against pathogens. Unfortunately, aquaculture-related microbiome studies are scarce in Southeast Asia countries despite the severe impact of early mortality syndrome outbreaks on shrimp production in the region. In this study, we employed the 16S rRNA amplicon (V3-V4 region) sequencing and amplicon sequence variants (ASV) method to investigate the microbial diversity of shrimp guts and pond water samples collected from aquaculture farms located in Malaysia and Vietnam. Substantial differences in the pond microbiota were observed between countries with the presence and absence of several taxa extending to the family level. Microbial diversity of the shrimp gut was found to be generally lower than that of the pond environments with a few ubiquitous genera representing a majority of the shrimp gut microbial diversity such as Vibrio and Photobacterium, indicating host-specific selection of microbial species. Given the high sequence conservation of the 16S rRNA gene, we assessed its veracity at distinguishing Vibrio species based on nucleotide alignment against type strain reference sequences and demonstrated the utility of ASV approach in uncovering a wider diversity of Vibrio species compared to the conventional OTU clustering approach.
    MeSH terms: Gastrointestinal Microbiome; Animals; Crustacea; Disease Outbreaks; Malaysia; Nucleotides; Photobacterium; RNA, Ribosomal, 16S; Vibrio; Vietnam; Seafood; Aquaculture; Ponds; Microbiota; Farms
  18. Iqbal U, Wah TY, Habib Ur Rehman M, Mujtaba G, Imran M, Shoaib M
    J Med Syst, 2018 Nov 05;42(12):252.
    PMID: 30397730 DOI: 10.1007/s10916-018-1107-2
    Electrocardiography (ECG) sensors play a vital role in the Internet of Medical Things, and these sensors help in monitoring the electrical activity of the heart. ECG signal analysis can improve human life in many ways, from diagnosing diseases among cardiac patients to managing the lifestyles of diabetic patients. Abnormalities in heart activities lead to different cardiac diseases and arrhythmia. However, some cardiac diseases, such as myocardial infarction (MI) and atrial fibrillation (Af), require special attention due to their direct impact on human life. The classification of flattened T wave cases of MI in ECG signals and how much of these cases are similar to ST-T changes in MI remain an open issue for researchers. This article presents a novel contribution to classify MI and Af. To this end, we propose a new approach called deep deterministic learning (DDL), which works by combining predefined heart activities with fused datasets. In this research, we used two datasets. The first dataset, Massachusetts Institute of Technology-Beth Israel Hospital, is publicly available, and we exclusively obtained the second dataset from the University of Malaya Medical Center, Kuala Lumpur Malaysia. We first initiated predefined activities on each individual dataset to recognize patterns between the ST-T change and flattened T wave cases and then used the data fusion approach to merge both datasets in a manner that delivers the most accurate pattern recognition results. The proposed DDL approach is a systematic stage-wise methodology that relies on accurate detection of R peaks in ECG signals, time domain features of ECG signals, and fine tune-up of artificial neural networks. The empirical evaluation shows high accuracy (i.e., ≤99.97%) in pattern matching ST-T changes and flattened T waves using the proposed DDL approach. The proposed pattern recognition approach is a significant contribution to the diagnosis of special cases of MI.
    MeSH terms: Atrial Fibrillation/diagnosis*; Atrial Fibrillation/pathology; Electrocardiography/methods*; Female; Humans; Image Processing, Computer-Assisted/methods*; Male; Myocardial Infarction/diagnosis*; Myocardial Infarction/pathology; Pattern Recognition, Automated/methods*; Neural Networks (Computer); Internet
  19. Yeoh ZY, Jaganathan M, Rajaram N, Rawat S, Tajudeen NA, Rahim N, et al.
    J Glob Oncol, 2018 11;4:1-13.
    PMID: 30398950 DOI: 10.1200/JGO.17.00229
    PURPOSE: Late stage at presentation and poor adherence to treatment remain major contributors to poor survival in low- and middle-income countries (LMICs). Patient navigation (PN) programs in the United States have led to improvement in diagnostic or treatment timeliness, particularly for women in lower socioeconomic classes or minority groups. To date, studies of PN in Asia have been limited. We aimed to assess the feasibility of PN in a state-run hospital in an LMIC and to report the impact on diagnostic and treatment timeliness for patients in its first year of implementation.

    METHODS: We established PN in a dedicated breast clinic of a Malaysian state-run hospital. We compared diagnostic and treatment timeliness between navigated patients (n = 135) and patients diagnosed in the prior year (n = 148), and described factors associated with timeliness.

    RESULTS: Women with PN received timely mammography compared with patients in the prior year (96.4% v 74.4%; P < .001), biopsy (92.5% v 76.1%; P = .003), and communication of news (80.0% v 58.5%; P < .001). PN reduced treatment default rates (4.4% v 11.5%; P = .048). Among navigated patients, late stage at presentation was independently associated with having emotional and language barriers ( P = .01). Finally, the main reason reported for delay, default, or refusal of treatment was the preference for alternative therapy.

    CONCLUSION: PN is feasible for addressing barriers to cancer care when integrated with a state-run breast clinic of an LMIC. Its implementation resulted in improved diagnostic timeliness and reduced treatment default. Wider adoption of PN could be a key element of cancer control in LMICs.

    MeSH terms: Breast Neoplasms/pathology; Breast Neoplasms/therapy*; Feasibility Studies; Female; Humans; Malaysia; Patient Navigation/methods*
  20. Ravi R, Zulkrnin NSH, Rozhan NN, Nik Yusoff NR, Mat Rasat MS, Ahmad MI, et al.
    PLoS One, 2018;13(11):e0206982.
    PMID: 30399167 DOI: 10.1371/journal.pone.0206982
    BACKGROUND: The resistance problem of dengue vectors to different classes of insecticides that are used for public health has raised concerns about vector control programmes. Hence, the discovery of alternative compounds that would enhance existing tools is important for overcoming the resistance problem of using insecticides in vectors and ensuring a chemical-free environment. The larvicidal effects of Azolla pinnata extracts by using two different extraction methods with methanol solvent against Aedes in early 4th instar larvae was conducted.

    METHODS: The fresh Azolla pinnata plant from Kuala Krai, Kelantan, Malaysia was used for crude extraction using Soxhlet and maceration methods. Then, the chemical composition of extracts and its structure were identified using GCMS-QP2010 Ultra (Shimadzu). Next, following the WHO procedures for larval bioassays, the extracts were used to evaluate the early 4th instar larvae of Aedes mosquito vectors.

    RESULTS: The larvicidal activity of Azolla pinnata plant extracts evidently affected the early 4th instar larvae of Aedes aegypti mosquito vectors. The Soxhlet extraction method had the highest larvicidal effect against Ae. aegypti early 4th instar larvae, with LC50 and LC95 values of 1093 and 1343 mg/L, respectively. Meanwhile, the maceration extraction compounds were recorded with the LC50 and LC95 values of 1280 and 1520 mg/L, respectively. The larvae bioassay test for Ae. albopictus showed closely similar values in its Soxhlet extraction, with LC50 and LC95 values of 1035 and 1524 mg/L, compared with the maceration extraction LC50 and LC95 values of 1037 and 1579 mg/L, respectively. The non-target organism test on guppy fish, Poecilia reticulata, showed no mortalities and posed no toxic effects. The chemical composition of the Azolla pinnata plant extract has been found and characterized as having 18 active compounds for the Soxhlet method and 15 active compounds for the maceration method.

    CONCLUSIONS: Our findings showed that the crude extract of A. pinnata bioactive molecules are effective and have the potential to be developed as biolarvicides for Aedes mosquito vector control. This study recommends future research on the use of active ingredients isolated from A. pinnata extracts and their evaluation against larvicidal activity of Aedes in small-scale field trials for environmentally safe botanical insecticide invention.

    MeSH terms: Aedes/drug effects*; Animals; Biological Assay; Insecticides/pharmacology*; Insecticides/chemistry*; Larva/drug effects*; Gas Chromatography-Mass Spectrometry; Plant Extracts/pharmacology*; Plant Extracts/chemistry*; Toxicity Tests; Ferns/chemistry*; Phytochemicals/pharmacology; Phytochemicals/chemistry
External Links