Browse publications by year: 2018

  1. Rosdi, N.H., Mohd Kanafi, N., Abdul Rahman, N.
    MyJurnal
    Cellulose acetate (CA) is an interesting material due to its wide spectrum of utilities across different domains ranging from absorbent to membrane filters. In this study, polystyrene (PS) nanofibres, and cellulose acetate/polystyrene (CA/PS) blend nanofibres with various ratios of CA: PS from 20: 80 to 80: 20 were fabricated by using electrospinning technique. The SEM images show that the nanofibres exhibited non-uniform and random orientation with the average fibre diameter in the range of 100 to 800 nm. It was found that the incorporation of PS had a great effect on the morphology of nanofibre. At high proportion of PS, no or less beaded CA/PS nanofibres were formed. Thermal properties of the composite nanofibres were investigated by using thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) techniques. The TGA results showed thermal stability of CA/PS nanofibres were higher than pristine CA.
    MeSH terms: Calorimetry, Differential Scanning; Cellulose; Dietary Fiber; Polystyrenes; Thermogravimetry; Nanofibers; Orientation, Spatial
  2. Ahmad Saad, F.F., Abdullah, N.S., Shaharuddin, S., Nordin, A.J.
    MyJurnal
    Chronic inflammation is associated with processes that contribute to the onset or progression of cancer. This study examined the correlation between dichotomised patients with malignant tumours and inflammatory markers based on the altered glucose metabolism measured by the FDG SUVmax that underpins the degree of tumour aggressiveness. Thirty-one patients underwent 18F-FDG PET/CT for various carcinoma along with blood inflammatory markers such as C-reactive protein (CRP), interleukin-6 (IL6), lipid profile and fasting blood glucose (FBG) levels were obtained in retrospective study. Patients were dichotomised by the cut-off SUVmax value of 6.0 dl/ml derived from curve analysis (P=-0.025). The mean age of the subjects were 53.16 ± 12.06 years and mean SUVmax of 8.80±6.27 g/ml. Significant correlation was noted between the SUVmax and CRP and IL6 (r=0.361; P
  3. Sumeet Kaur, Syaril Ezuan
    MyJurnal
    Objective: Suicide pacts are rare subsets of suicides amounting to less than 1% of suicides globally. Usually, there is one dominant participant to persuade the other by their shared experiences to agree to the suicide pact. There is also the perceived loss of a partner (which is a contributing factor in about 20% of cases) with the impending death of one member acting as a trigger.

    Methods: We report a 46-year-old Burmese lady who presented with deliberate self- poisoning immediately after the death of her husband to honour a suicide pact they made. She had no previous history of psychiatric illnesses. The pact, initiated by her husband, was well planned six months prior to his death.

    Result: She was discharged well after a thorough medical evaluation and supportive therapy. Input of family members knowledgeable in Buddhism helped allay her obligation to the pact citing religious reasons.

    Conclusion: The case highlights a suicide pact that was initially unrecognised in the ward. In a multicultural country, psychiatrists need to be more sensitive and aware of erroneous beliefs that may lead to a suicide pact.
    MeSH terms: Mental Disorders; Buddhism; Death; Female; Psychiatry; Suicide; Spouses
  4. Shamini Arasalingam, Mohamed Suhaib Peer, Shamini Rama, Puvaneswari Jeyapalan
    MyJurnal
    Objective: Bradycardia due to the combination of amisulpride and fluvoxamine is not commonly known in the literature.

    Methods: We report a case of asymptomatic sinus bradycardia that occurred when amisulpride and fluvoxamine were given concurrently and resolved after cessation of both these two medications. The Naranjo scale for Adverse Drug Reaction was used to determine the likelihood of medications’ in causing bradycardia. Other possible causes were also assessed and ruled out through medical consultations.

    Results: This case strongly suggests that the bradycardia occurred due to the combined effect of these medications’ independent risk in causing this potentially harmful cardiac event.

    Conclusion: Therefore, it is important to monitor for bradycardia whenever both these medications are prescribed even at therapeutic dosages.
  5. Mohammad Farris Iman Leong Abdullah, Darshan Singh, Vicknasingam Kasinather, B.
    MyJurnal
    Objective: Lysergic-acid-diethylamide (LSD) users are the hidden population of drug users as they do not present to medical personal for treatment. The method of transporting the drug is usually by-pass the law enforcers’ monitoring. We describe a rare case of LSD use in Malaysia Novel Psychoactive Substances (NPS) which is difficult to capture as LSD users remained as a hidden population of drug users in the country.

    Methods: We reported a 23-year-old male with chronic use of Lysergic-acid-diethylamide (LSD) presented with retrospective history of acute intoxication. Later, he presented with depressive symptoms, occasional flashbacks and physical complications such as premature ejaculation (PE), urinary incontinence, reduced sweating and headache despite abstinence from LSD and other drugs. The reported physical complications remitted after 4 months of abstinence.

    Result: Our case report suggested that LSD use not only causes acute intoxication but leads to several complications, which may persist even after cessation of LSD use.

    Conclusion: This case-report had pointed out the importance of future studies to look into the complications of LSD and the case-report as well demonstrated the harmful psychological and physical effects of LSD use, which would warrant proper surveillance and interventions curbing the emergence of LSD use in Malaysia.
  6. Loo, Jiann Lin, Eu, Choon Leng, Johari Khamis, Raba'iah Mohd Salleh, Suarn Singh Jasmit Singh
    MyJurnal
    Objective: Pritchard Criteria are adopted in a Malaysian criminal-justice system while assessing fitness to plead. There is limited data on the reason of unfitness to plead for female offenders in Malaysia.

    Methods: A case series of five patients hospitalized to Hospital Bahagia Ulu Kinta, Malaysia due to unfitness to plead was presented and discussed.

    Result: The offences include three homicides, one assault, and one stealing. All of them were diagnosed to have schizophrenia with prominent looseness of association. Four of them subsequently treated as Treatment-Resistant Schizophrenia (TRS) with a minimal response toward clozapine.

    Conclusion: Looseness of association may be a contributing factor for unfitness to plead among Malaysian female offenders, which can result in indeterminate hospitalization. This should be confirmed in a larger prospective study.
    MeSH terms: Clozapine; Female; Homicide; Hospitalization; Hospitals; Humans; Malaysia; Prospective Studies; Schizophrenia; Social Justice; Theft; Crime Victims; Criminals
  7. Mohamad Ayob Ismail, Hazli Zakaria, Hatta Sidi, Hajar Mohd Salleh Sahimi, Khairi Che Mat
    MyJurnal
    Objective: Long-term use of ecstasy is known to be a risk factor for structural brain damage and psychosis. Most patients suffering from ADHD in childhood will not develop psychosis during adulthood but the risk is increased when there is concomitant significant drug use. However, it is difficult to distinguish between substance-induced psychoses with schizophrenic psychosis.

    Method: We report a case of a patient with history of ADHD who was untreated, who later developed psychotic symptoms soon after initiation of ecstasy uses. The symptoms persisted despite in a ‘drug-free period’ and intensified while on the ecstasy.

    Results: Present case helps to understand common neurobiological mechanism behind psychosis and brain atrophy, and risk factors such as ADHD and ecstasy abuse.

    Conclusion: More research in this area is vital for management and further understanding on the importance of treating ADHD earlier and to be more vigilant in establishing the history of substance use.
  8. Azlina Wati Nikmat, Nurul Azreen Hashim, Muhammad Farid Saidi, Nur Suhailah Mohd Zaki, Nur Nabihah Hasan Shukri, Nur Basyariah Abdulla
    MyJurnal
    Objective: Smart phones have become an important part of human’s life, including the healthcare population and medical students. However, pathological use of smart phones could lead to smart phones addiction. The aim of this study is to observe a pattern of usage of smart phones among the medical students and staffs in the Faculty of Medicine Universiti Teknologi MARA (UiTM) and screen for smart phone addiction among the respondents.

    Methods: A cross sectional, quasi-experimental study design involving medical students and staffs in the Faculty of Medicine Universiti Teknologi MARA (UiTM) was employed. A total of 598 respondents was approached to participate, and all consented to this study. Measurements used in the study include a self-developed questionnaire to measure pattern of smart phone usage and Smart phone addiction scale (Malay version).

    Result: We found that 65.9% of the respondents were heavy users of the smart phone (more than 3 hours daily) and majority of them were using it for social networking. More than half of the respondents (52.2%) were at risk of developing smart phone addiction based on Smart phone Addiction Scale (Malay Version).

    Conclusion: This study revealed that medical students, and the faculty staffs were heavy users of smart phones, and they were at risk to develop smart phone addiction.
  9. Mohammad Farris Iman Leong Abdullah, Darshan Singh, Vicknasingam Kasinather, B., Nizuwan Azman
    MyJurnal
    Introduction: Kratom (Mitragyna speciosa Korth) dependence is a common psychiatric complication associated with regular kratom use in Malaysia. Hence, it is important to assess the severity of kratom dependence among regular kratom users. The Kratom Dependence Scale (KDS) was introduced to evaluate the degree of severity of kratom dependence among users. This study aimed to translate the original English version of the KDS into Malay and examine the psychometric properties of the KDS (Malay) among Malaysian kratom users.

    Methods: Initially, parallel translation and back translation of the original English version of the KDS was performed. The KDS (Malay) then was administered to 20 active Malaysian kratom users to assess face and content validities in a pilot study. Finally, the final version was administered to 150 active kratom users to evaluate its internal consistency (Cronbach’s α), face and content validities, discriminative validity, and construct validity, i.e. via exploratory factor analysis (EFA).

    Results: The KDS (Malay) Cronbach’s α of 0.94 exhibited excellent internal consistency. It also demonstrated construct validity, as EFA showed that all items of the KDS (Malay) fit into a single domain, similar to the original English version. Discriminative validity was also demonstrated by the KDS (Malay), as it could differentiate kratom dependent users from non-kratom dependent users.

    Conclusion: The KDS (Malay) has acceptable psychometric properties and is suitable to assess severity of kratom dependence in Malaysian kratom users.
  10. Tiong, Xun Ting, Nur Sara Shahira Abdullah, Mohamad Adam Bujang, Fatin Ellisya Sapri, Selvasingam Ratnasingam, Chong, Kok Joon, et al.
    MyJurnal
    Objective: A quick assessment tool for screening individuals with depression or anxiety is pertinent in mental-health set up. This study aims to validate the K10 and the K6 to screen patients with non-specific
    psychological distress in a Malaysian population.

    Methods: Translation of the questionnaire was done from English to Malay. Face validity was conducted on patients, and a pilot study was performed to assess the reliability of the K10 questionnaire. Fieldwork was conducted to determine the reliability and validity of the K10 questionnaire based on convenience sampling of healthy individuals and patients diagnosed with psychiatric illness. Malay version for K10 was administered to healthy participants (group without psychological distress) and patients on psychiatric clinic follow up (psychological distress). Data collection was done between August 2016 and September 2016.

    Result: A total of 94 subjects were recruited in the study, of which 32 formed the case group. The Cronbach’s alpha coefficients for K10
    were 0.837(control) and 0.885 (case), as for K6 were 0.716 (control) and 0.859 (case). The total score of the
    K10 and the K6 clearly differentiated between the control and case groups (p

    Study site: Sarawak General Hospital
    MeSH terms: Hospitals; Cohort Studies
  11. Mardiana Mansor, Afiqah Mat Zin, Aniza Abd Aziz, Shabbir Ahmad Sheikh
    MyJurnal
    Objective: The purpose of this study was to determine the level of psychosocial burden and its associated risk factors among women with abnormal Pap smear and post colposcopy.

    Methods: A cross-sectional study was conducted employing universal sampling of 218 respondents with abnormal Pap smear and post colposcopy. They fulfilled the specific inclusion and exclusion criteria. Three tertiary hospitals in the East Coast of Malaysia were participated. Self-administration of validated Malay-version Psychosocial Effect of Abnormal Pap smear Questionnaire was used to assess the psychosocial burden. The General Health Questionnaire-12 (GHQ-12) was applied to assess the general health factor. Data was analyzed using IBM-SPSS of version 22.

    Results: The results showed that respondents with an abnormal Pap smear and post-colposcopy women (43.1%) demonstrated a high level of psychosocial burden. The significant risk factor of psychosocial burden was living in an urban and semi-urban area of residence (p≤0.001) and distress condition (p≤0.001) respectively.

    Conclusions: A substantial number of women with abnormal Pap smear results were experiencing psychosocial burden. Women with an abnormal Pap-smear who were living in the urban and semi-urban and distressed were more likely to experience a higher psychosocial burden.
  12. Parra-Cruz R, Jäger CM, Lau PL, Gomes RL, Pordea A
    J Phys Chem B, 2018 09 13;122(36):8526-8536.
    PMID: 30114369 DOI: 10.1021/acs.jpcb.8b05926
    The stability of enzymes is critical for their application in industrial processes, which generally require different conditions from the natural enzyme environment. Both rational and random protein engineering approaches have been used to increase stability, with the latter requiring extensive experimental effort for the screening of variants. Moreover, some general rules addressing the molecular origin of protein thermostability have been established. Herein, we demonstrate the use of molecular dynamics simulations to gain molecular level understanding of protein thermostability and to engineer stabilizing mutations. Carbonic anhydrase (CA) is an enzyme with a high potential for biotechnological carbon capture applications, provided it can be engineered to withstand the high temperature process environments, inevitable in most gas treatment units. In this study, we used molecular dynamics simulations at 343, 353, and 363 K to study the relationship between structure flexibility and thermostability in bacterial α-CAs and applied this knowledge to the design of mutants with increased stability. The most thermostable α-CA known, TaCA from Thermovibrio ammonificans, had the most rigid structure during molecular dynamics simulations, but also showed regions with high flexibility. The most flexible amino acids in these regions were identified from root mean square fluctuation (RMSF) studies, and stabilizing point mutations were predicted based on their capacity to improve the calculated free energy of unfolding. Disulfide bonds were also designed at sites with suitable geometries and selected based on their location at flexible sites, assessed by B-factor calculation. Molecular dynamics simulations allowed the identification of five mutants with lower RMSF of the overall structure at 400 K, compared to wild-type TaCA. Comparison of free-energy landscapes between wild-type TaCA and the most promising mutants, Pro165Cys-Gln170Cys and Asn140Gly, showed an increased conformational stability of the mutants at 400 K.
    MeSH terms: Carbonic Anhydrases/genetics; Carbonic Anhydrases/chemistry*; Enzyme Stability; Humans; Mutation; Neisseria gonorrhoeae/enzymology; Protein Conformation; Temperature; Protein Engineering; Pliability; Catalytic Domain/genetics; Molecular Dynamics Simulation
  13. Takahashi S, Metcalf CJE, Arima Y, Fujimoto T, Shimizu H, Rogier van Doorn H, et al.
    J R Soc Interface, 2018 09 12;15(146).
    PMID: 30209044 DOI: 10.1098/rsif.2018.0507
    Outbreaks of hand, foot and mouth disease have been documented in Japan since 1963. This disease is primarily caused by the two closely related serotypes of Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16). Here, we analyse Japanese virologic and syndromic surveillance time-series data from 1982 to 2015. As in some other countries in the Asia Pacific region, EV-A71 in Japan has a 3 year cyclical component, whereas CV-A16 is predominantly annual. We observe empirical signatures of an inhibitory interaction between the serotypes; virologic lines of evidence suggest they may indeed interact immunologically. We fit the time series to mechanistic epidemiological models: as a first-order effect, we find the data consistent with single-serotype susceptible-infected-recovered dynamics. We then extend the modelling to incorporate an inhibitory interaction between serotypes. Our results suggest the existence of a transient cross-protection and possible asymmetry in its strength such that CV-A16 serves as a stronger forcing on EV-A71. Allowing for asymmetry yields accurate out-of-sample predictions and the directionality of this effect is consistent with the virologic literature. Confirmation of these hypothesized interactions would have important implications for understanding enterovirus epidemiology and informing vaccine development. Our results highlight the general implication that even subtle interactions could have qualitative impacts on epidemic dynamics and predictability.
    MeSH terms: Antigens, Viral; Computer Simulation; Disease Outbreaks; Enterovirus*; Hand, Foot and Mouth Disease/epidemiology*; Hand, Foot and Mouth Disease/virology*; Humans; Japan/epidemiology; Time Factors; Epidemics; Serogroup
  14. Aljaberi MA, Juni MH, Al-Maqtari RA, Lye MS, Saeed MA, Al-Dubai SAR, et al.
    BMJ Open, 2018 09 12;8(9):e021180.
    PMID: 30209153 DOI: 10.1136/bmjopen-2017-021180
    OBJECTIVE: The current study aimed to investigate the relationships among the perceived quality of healthcare services, satisfaction and behavioural intentions among international students in Kuala Lumpur, Malaysia.

    SETTING: A cross-sectional study on public universities in Kuala Lumpur, Malaysia.

    PARTICIPANTS: All participants in this study were international students joining public universities in Kuala Lumpur, Malaysia.

    PRIMARY INDEPENDENT VARIABLE: Perceived quality of healthcare services measured on a SERVQUAL scale.

    PRIMARY DEPENDENT VARIABLE: Participants' satisfaction of healthcare services assessed using five items.

    SECONDARY DEPENDENT VARIABLE: Behavioural intentions measured on six items.

    RESULTS: Of the 556 international students, 500 (90%) completed the survey. The study used structural equation modelling (SEM) through the AMOS (Analysis of Moment Structures) software to analyse the data. SEM analyses showed that the perceived quality of healthcare services significantly and directly affected satisfaction, with a value of 89% and an effect size of 0.78. It also had a significant indirect impact on the behavioural intentions (0.78) of international students. The results indicated that participants' satisfaction had a statistically significant impact on their behavioural intentions (0.77).

    CONCLUSION: Perceived quality of care is an important driver of international students' satisfaction and their behavioural intention with healthcare services. Such relations of effects among the three investigated factors were also positive and significant.

    MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Malaysia; Male; Middle Aged; Patient Acceptance of Health Care/statistics & numerical data*; Perception; Quality of Health Care*; Surveys and Questionnaires; Students/psychology; Students/statistics & numerical data*; Universities*; Patient Satisfaction/statistics & numerical data*; Intention; Internationality; Young Adult
  15. Jung D, Kim YB, Lee JB, Muhamed AMC, Lee JY
    Eur J Appl Physiol, 2018 Dec;118(12):2655-2667.
    PMID: 30209544 DOI: 10.1007/s00421-018-3988-7
    PURPOSE: We investigated the effects of humidity on regional sweating secretion and active sweat gland density on the scalp during passive heating in hot environments.

    METHODS: Eight male subjects shaved their heads prior to expose to dry (30%RH; H30%) and humid (85%RH; H85%) conditions at an air temperature of 32 °C. Total sweat rate, local sweat rates (frontal, vertex, temporal, and occipital regions), active sweat glands on the scalp (2 frontal, 2 parietal, 2 temporal, 1 occipital, and 1 vertex), and rectal and skin temperatures were measured during leg immersion in 42 °C water for 60 min.

    RESULTS: (1) Total sweat rates were greater for H30% (179.4 ± 35.6 g h-1) than for H85% (148.1 ± 27.2 g h-1) (P 

    MeSH terms: Adult; Age Factors; Environmental Exposure*; Hot Temperature*; Humans; Humidity*; Male; Scalp/physiology*; Sex Factors; Skin Temperature; Sweat Glands/physiology*; Sweating*; Time Factors; Young Adult
  16. Rahman IA, Mohamad N, Rohani JM, Zein RM
    Ind Health, 2018 Nov 21;56(6):492-499.
    PMID: 30210096 DOI: 10.2486/indhealth.2018-0043
    Prolonged standing can cause discomfort on the body of the workers and can lead to injury and occupational disease. One of the ergonomic intervention is through improving the work-rest scheduling. The purpose of this study are to identify the fatigue level from the perception of the worker and to investigate the impact of the work-rest scheduling to the standing workers for 12 h working time with a different gender. This study involved two methods which are self-assessment of the worker and direct measurement by using electromyography (EMG). For self-assessment, 80 workers have been interviewed using questionnaire in order to identify the fatigue level. For direct measurement, EMG was attached to the 15 selected workers at their respective leg and lower back to analyse the muscle efforts. In terms of perception, the results show the discomfort and fatigue level at the lower body region in the following order as foot ankle, lower back and leg. There is a significant difference between gender on discomfort pain for foot ankle and leg. The results show short frequent break by 10 min can reduce the fatigue at the leg and infrequent long break is preferable in order to reduce the fatigue at the lower back. In conclusion, it was found that prolonged standing affect the muscle fatigue and discomfort especially lower extremities such as foot ankle, lower back and leg. Besides that, different type of work rest scheduling and gender have significant result towards the muscle fatigue development.
    MeSH terms: Adult; Electromyography; Female; Humans; Human Engineering; Lumbosacral Region/physiology; Malaysia; Male; Middle Aged; Personnel Staffing and Scheduling; Posture/physiology; Rest/physiology*; Rest/psychology; Sex Factors; Occupational Health; Muscle Fatigue/physiology*; Lower Extremity/physiology; Young Adult
  17. Zun AB, Ibrahim MI, Hamid AA
    Oman Med J, 2018 Sep;33(5):416-422.
    PMID: 30210721 DOI: 10.5001/omj.2018.76
    Objectives: Implemented in 2010, 1 Malaysia Clinic (1MC) is the latest innovation in public primary healthcare services in Malaysia to serve the urban population. This study aimed to assess the level of satisfaction and its associated factors using the SERVQUAL (SERV-service, QUAL-quality) instrument. We also sought to compare the difference of mean score between expectation and perception of SERVQUAL dimension among patients attending 1MC in Kota Bharu district, Malaysia.

    Methods: This cross-sectional study included all nine 1MCs in the Kota Bharu district, Malaysia, and used the validated SERVQUAL questionnaire from Ministry of Health, Malaysia. The primary data was collected in January 2017. The sample size was proportionate to the average daily patient attendance for each clinic, and a simple random sampling method was applied to reduced selection bias. Satisfaction level was determined by the mean gap score of expectation and perception of the SERVQUAL dimension.

    Results: A total of 386 patients were involved in this study (184 male and 202 female). Most were from the low socioeconomic group. Less than half of the patients were satisfied with the clinic services. The tangible dimension (service quality (SQ) gap: -0.25) was the most critical dimension among all five SQ dimensions assessed. The factors included low education level (adjusted odds ratio (adj. OR) 1.87; 95% confidence interval (CI): 1.06, 2.67; p = 0.024), monthly household income less than RM 3000 (adj. OR 2.97; 95% CI: 1.72, 5.51; p < 0.001), and frequency 3 3 visits (adj. OR 2.23; 95% CI: 1.44, 3.45; p < 0.001) had significant association with high level of satisfaction.

    Conclusion: 1MC has achieved its objective to increase the accessibility of health services among the low-income population in urban settings. However, most patients were not satisfied with certain parts of the services. Thus, proper evaluation of the service gap is required for improvement of the service.
    MeSH terms: Ambulatory Care Facilities; Cross-Sectional Studies; Female; Health Services; Health Services Accessibility; Humans; Malaysia; Male; Perception; Personal Satisfaction; Poverty; Primary Health Care; Surveys and Questionnaires; Urban Population; Selection Bias; Confidence Intervals; Odds Ratio; Sample Size
  18. Zahari M, Sulaiman SA, Othman Z, Ayob Y, Karim FA, Jamal R
    Mediterr J Hematol Infect Dis, 2018;10(1):e2018056.
    PMID: 30210749 DOI: 10.4084/MJHID.2018.056
    Background: Haemophilia A (HA) and Haemophilia B (HB) are X-linked blood disorders that are caused by various mutations in the factor VIII (F8) and factor IX (F9) genes respectively. Identification of mutations is essential as some of the mutations are associated with the development of inhibitors. This study is the first comprehensive study of the F8 mutational profile in Malaysia.

    Materials and methods: We analysed 100 unrelated HA and 15 unrelated HB patients for genetic alterations in the F8 and F9 genes by using the long-range PCR, DNA sequencing, and the multiplex-ligation-dependent probe amplification assays. The prediction software was used to confirm the effects of these mutations on factor VIII and IX proteins.

    Results: 44 (53%) of the severe HA patients were positive for F8 intron 22 inversion, and three (3.6%) were positive for intron one inversion. There were 22 novel mutations in F8, including missense (8), frameshift (9), splice site (3), large deletion (1) and nonsense (1) mutations. In HB patients, four novel mutations were identified including the splice site (1), small deletion (1), large deletion (1) and missense (1) mutation.

    Discussion: The mutational spectrum of F8 in Malaysian patients is heterogeneous, with a slightly higher frequency of intron 22 inversion in these severe HA patients when compared to other Asian populations. Identification of these mutational profiles in F8 and F9 genes among Malaysian patients will provide a useful reference for the early detection and diagnosis of HA and HB in the Malaysian population.

    MeSH terms: Hemophilia B; Factor IX; Factor VIII; Hemophilia A; Humans; Introns; Malaysia; Mutation; Software; Polymerase Chain Reaction; Sequence Analysis, DNA
  19. Hamid ZA, Tan HY, Chow PW, Harto KAW, Chan CY, Mohamed J
    Sultan Qaboos Univ Med J, 2018 May;18(2):e130-e136.
    PMID: 30210840 DOI: 10.18295/squmj.2018.18.02.002
    Objectives: The ex vivo maintenance of haematopoietic stem/progenitor cells (HSPCs) is crucial to ensure a sufficient supply of functional cells for research or therapeutic applications. However, when exposed to reactive oxygen species (ROS) in a normoxic microenvironment, HSPCs exhibit genomic instability which may diminish their quantity and quality. This study aimed to investigate the role of N-acetylcysteine (NAC) supplementation on the oxidative stress levels, genotoxicity and lineage commitment potential of murine haematopoietic stem/progenitor cells (HSPCs).

    Methods: This study was carried out at the Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia, between June 2016 and July 2017. Bone marrow cells were isolated from nine mice and cultured in a growth medium. Various concentrations of NAC between 0.125-2 μM were added to the culture for 48 hours; these cells were then compared to non-supplemented cells harvested from the remaining three mice as the control group. A trypan blue exclusion test was performed to determine cell viability, while intracellular ROS levels and genotoxicity were determined by hydroethidine staining and comet assay, respectively. The lineage commitment potential of erythroid, myeloid and pre-B-lymphoid progenitor cells was evaluated via colony-forming cell assay.

    Results: NAC supplementation at 0.25, 0.5 and 2 μM significantly increased cell viability (P <0.050), while intracellular ROS levels significantly decreased at 0.25 and 0.5 μM (P <0.050). Moreover, DNA damage was significantly reduced at all NAC concentrations (P <0.050). Finally, the potential lineage commitment of the cells was not significantly affected by NAC supplementation (P >0.050).

    Conclusion: The findings of this study indicate that NAC supplementation may potentially overcome the therapeutic limitations of ex vivo-maintained HSPCs.

    MeSH terms: Acetylcysteine/pharmacology*; Animals; Cell Survival/drug effects; Cells, Cultured; Colony-Forming Units Assay; Hematopoietic Stem Cells/cytology; Hematopoietic Stem Cells/drug effects*; Hematopoietic Stem Cells/metabolism; Malaysia; Male; Free Radical Scavengers/pharmacology*; Reactive Oxygen Species/metabolism; Reactive Oxygen Species/toxicity; Oxidative Stress/drug effects*; Cell Lineage; Cell Proliferation; Mice
  20. Iqhbal M, Noor JM, Karim NA, Ismail I, Sanib H, Mokhtar MA, et al.
    Sultan Qaboos Univ Med J, 2018 May;18(2):e219-e222.
    PMID: 30210855 DOI: 10.18295/squmj.2018.18.02.017
    The use of ultrasonography in acute and critical care medicine is becoming increasingly common. However, use of an airway ultrasound as an adjunct to determine the type of intervention needed and assess complications is not common practice. We report a 56-year-old male who presented to the Emergency Department of the Sungai Buloh Hospital, Selangor, Malaysia, in 2015 with hoarseness, stridor and impending respiratory failure. A point-of-care ultrasound performed to assess the neck and vocal cords indicated a heterogeneous echogenic mass in the larynx, thus ruling out a cricothyroidotomy. The patient was therefore referred for an emergency tracheostomy. This case highlights the importance of point-of-care airway ultrasonography in the assessment of patients with stridor. This imaging technique not only helps to detect the cause of the stridor, but also to determine the feasibility of a cricothyroidotomy in emergency cases.
    MeSH terms: Airway Obstruction/etiology; Emergencies; Hoarseness/etiology; Humans; Malaysia; Male; Middle Aged; Respiratory Sounds/diagnosis*; Respiratory Sounds/etiology; Thyroid Cartilage/surgery; Tracheostomy; Ultrasonography*; Point-of-Care Systems*; Preoperative Period; Airway Management
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