Browse publications by year: 2018

  1. Sarina Md. Yusof, Maisarah Shari, Zulkifli Kadir, Suhana Aiman, Norizzati Mohd Idris, Aishah Adam, et al.
    Movement Health & Exercise, 2018;7(2):11-22.
    MyJurnal
    Background: Obesity is major contributor to diseases and mortality. Constant
    weight loss significantly reverses diseases related to obesity and helps
    prolong human life expectancy. To date, there has been limited scientific
    evidence comparing the effectiveness of the Aqua Zumba® Fitness program
    and conventional aqua jog among obese women. Thus, the purpose of this
    study is to compare the effects between 12 weeks of Aqua Zumba® Fitness
    and aqua jog on health parameters among middle-age women. Methods: A
    total of sixty sedentary obese women (BMI >30 kg/m2), aged 40-59 years old
    were randomized to either Aqua Zumba® Fitness (AZ, n=20), aqua jog (AJ,
    n=20) or control group (C, n=20). Exercise groups were involved in different
    12-week aqua exercise programs, 3 times per week, 60 minutes per session,
    with an intensity of 50-75% of maximum heart rate. Body mass (BM),
    skeletal muscle mass (SMM), body fat percentage (BF%), waist
    circumference (WC), upper and lower body strength (UBS and LBS),
    cardiorespiratory fitness (CRF), and flexibility were measured at baseline
    (week-0) and post-exercise intervention (week-13). Result: The AZ group
    demonstrated significant changes (p
  2. Siti Zulfa Zaidon, Ho, Yu Bin, Zailina Hashim, Praveena, Sarva Mangala, Nazamid Saari
    MyJurnal
    Pesticides application is essential in protecting crops and increases their productivity. However, this causes the pesticide residues to contaminate the crops and their surrounding environment that will eventually lead to exposure to human being. There is very little understanding on the human health effects of pesticides, thus many studies are being carried out for this purpose. In conjunction to this, there are various analytical methods on multi-residue pesticides analysis that have been developed over the years in various samples. This review provides an overview of the reported concentration of pesticides, the extraction and determination techniques of pesticides in environmental samples and the potential health effects they imposed on human in Malaysia from 2007 to 2017.
    MeSH terms: Crop Protection; Environment; Humans; Malaysia; Pesticide Residues; Pesticides; Crops, Agricultural
  3. Sharifah Norkhadijah Syed Ismail, Faridatul Hanim Salleh, Emilia Zainal Abidin, Nur Azlin Kather Mahiddin, Josfirin Uding Rangga
    MyJurnal
    Introduction: Cadmium (Cd) in urine and inhaled dust of the municipal waste operators was assessed. Methods: Urine spot samples were collected and analysed for Cd and creatinine of 60 municipal waste operators between April to June 2013. Respirable dust was collected using personal air sampling pump GilAir-3 and GilAir-5 for 8 working hours. Cd in urine and dust were analysed using the Flame Atomic Absorption Spectrometer (Perkin Elmer A Analyst 800) while urinary creatinine was measured using Reflotron® Plus creatinine. Results: The mean and standard deviation (SD) of Cd in the respirable dust (0.59 ± 50.27 µg/m3) was within the permissible exposure limit (PEL). The level of Cd in urine (0.015 ± 0.0097 µg/g Cr) was lower than the safe limit of 5 µg/g. The creatinine level (173.59 ± 50.27 mg/dl) was within the normal range (20 to 350 mg/dl). The multiple regression model shows smoking and years of smoking were the significant predictors for the Cd in the urine (R² = 0.216 F(3,56) = 5.150, p < 0.05). Conclusion: Municipal waste operators were exposed to minimal Cd exposure while handling waste and the accumulation of this metal urine was correlated with smoking habit.
  4. Asraa Faris, Hadri Hadi Md Yusof, Shahidee Zainal Abidin, Omar Habib, Cheah, Pike-See, Stanslas, Johnson, et al.
    MyJurnal
    Introduction: One of the commonly used techniques for mutation screening is High Resolution Melting (HRM) analysis. HRM is a post PCR method that relies on the detection of the fluorescent signals acquired due to the release of DNA intercalated dyes upon the melting of dsDNA to ssDNA. The method is simple, inexpensive and does not require post PCR-handling, making it suitable for high throughput screening. Methods: This study aimed to develop and validate HRM technique for the screening of two disease-associated single nucleotide polymorphisms (SNPs) namely BDNF rs6265 and DAT1 rs40184 using a total of 30 gDNA samples. The obtained results were confirmed and validated by sequencing. Results: HRM analysis showed that the predicted genotypes of BDNF rs6265 and DAT1 rs40184 among all the gDNA samples were in 100% concordance with the sequencing results, making it an accurate and sensitive method for the detection of SNPs. Conclusions: The application of HRM can accurately determine the genotype of BDNF rs6265 and DAT1 rs40184 SNPs, making it a promising tool for rapid and high-throughput screening of targeted SNPs in a large population study.
    MeSH terms: DNA; DNA, Single-Stranded; Coloring Agents; Genotype; Intercalating Agents; Mutation; Polymerase Chain Reaction; Brain-Derived Neurotrophic Factor; Polymorphism, Single Nucleotide
  5. Hazwanee Hamsan, Ho, Yu Bin, Vivien How, Zailina Hashim, Nazamid Saari
    MyJurnal
    Introduction: Tanjung Karang is a paddy growing town in Selangor, Malaysia. The paddy farmers in Tanjung Karang were using pesticides to control pests from invading the crops during agricultural activities with limited knowledge of its deleterious effects on their health. Objective: This study aims to (i) determine the respiratory health symptoms of paddy farmers due to occupational exposure of commonly used pesticides through inhalation and (ii) assess correlations between climatological conditions and the concentrations of pesticides in personal air samples among paddy farmers in Tanjung Karang, Malaysia. Methods: A cross-sectional study was carried out to assess the occupational exposures to pesticides among 83 paddy farmers in Kampung Sawah Sempadan. The data were collected with face-to-face interviews with the farmers based on a set of questionnaire. Results: The self-reported respiratory health symptoms of paddy farmers were as follows: breathing difficulty (16.9%), chest pain (15.7%), cough (41.0%), phlegm (39.8%), and wheezing (18.1%). Simple logistic regressions analysis indicated that exposure to azoxystrobin, buprofezin, chlorantraniliprole, fipronil, isoprothiolane, pretilachlor, propiconazole, tricyclazole and trifloxystrobin were contributing factors that affect self-reported respiratory health symptoms in this study. Spearman’s correlation coefficient test stated that the concentrations of chlorantraniliprole, fipronil and pymetrozine were affected by wind speed and temperature. Conclusion: The information obtained in this study is useful to understand the exposure of pesticides among paddy farmers and useful for risk management in the agricultural community.
  6. Sharifah Norkhadijah Syed Ismail, Josfirin Uding Rangga, Irniza Rasdi, Umi Raihana Abd Rahman, Mohd Armi Abu Samah
    MyJurnal
    Introduction: The application of M-learning or mobile application (app) as a tool to disseminate occupational safety and health (OSH) information among students and staff in the university, to replace the use of conventional noticeboard was assessed in this study. Materials and Methods: Study was conducted between February to March 2016 and involved 124 respondents from health sciences program in Universiti Putra Malaysia. OSH information was incorporated into a mobile-app using online software and respondents were requested to use the app for fourteen days. A self-administered questionnaire was used to assess the level of knowledge, attitude and practice of respondents before and after using the app. Results: The mobile app has significantly increased the knowledge score among respondents (z = -7.331, p
    MeSH terms: Learning; Malaysia; Surveys and Questionnaires; Students; Universities; Occupational Health; Knowledge; Mobile Applications
  7. Safiah Rohaizah Mazlan, Shamsul Bahri Md Tamrin, Guan, Ng Yee, Vivien How, Rozanah Ab Rahman, Johari Basri, et al.
    MyJurnal
    Background: Quality of Work Life (QWL) is a subset of the quality of life which expresses the interactions between workers and their total working environment with individual or human dimension. Objectives: The objective of this study was to determine the prevalence of QWL among Malaysian workers. Methods: 2740 respondents (1921 males and 819 females) were randomly selected from 11 different industries from all states of Malaysia. Respondents were aged between 18 to more than 55 years and were a local OSH Personnel and local general workers. Face to face interviews were conducted in all the selected industries using a structured questionnaire form adapted from Malaysian OSH Profile 2016. Respondents have completed the questionnaire under instructions and supervision of the research team. Results: Majority of the respondents were male (70.1%) and from manufacturing industries (76.3%). 50% of the respondents identified a high level of QWL in each component like not having a stress with the work load (85.5%), good work environment (78.4%), family life (83.1% and 83.6%), enough income and distribution (58.9%), good communication and harmonies relationship between colleagues and boss (93.4% and 88.7%), good facilities (88.6%), welfare at work (71.3%) and productive working condition (80.8%). There is a significant difference between QWL and type of industries [F(10)=12.897, p=0.001] where agriculture industry had the highest QWL. There is significant difference between QWL and gender (p=0.009) where male reported higher QWL compared to female. Conclusion: These findings could be used by the organizations in order to enhance its performance, productivity, employees’ commitment and satisfaction.
  8. Aida Soraya Shamsuddin, Sharifah Norkhadijah Syed Ismail, Emilia Zainal Abidin, Bin, Ho Yu
    MyJurnal
    Introduction: This study determined nitrate concentration and identify the classifying sources of nitrate pollution in the alluvial deposit aquifer system in Bachok, Kelantan. Materials and Methods: A total of 300 groundwater samples were collected in two different areas; agricultural area (150 samples) and non-agricultural area (150 samples). The samples were analyzed for nitrate and other parameters such as pH, EC, NH4+, TDS, turbidity and salinity. The multivariate analyses were used to identify factors that govern the groundwater quality and potential nitrate sources in the study area. Results: Samples in the agricultural area were slightly acidic (5.89 ± 0.67), contained high nitrate (15.10 ± 15.90 mg/L NO3-N), NH4+ (0.82 ± 1.24 mg/L) and turbidity (3.25 ± 2.78 NTU). The principal component analysis (PCA) have identified the groundwater quality in the study area was influenced by the natural processes and anthropogenic activities. Based on the hierarchal cluster analysis (HCA), Cluster II in the agricultural area was identified to be most heavily nitrate contamination, while Cluster III in the non-agricultural area was identified to be strongly affected by seawater intrusion. Conclusion: The findings of this study are useful for developing protection alternatives of private well waters to prevent further deterioration of groundwater quality by nitrate such as control of nitrogen fertilizer use, manure applications and other agricultural practices in the agricultural area. In order to reduce the health risk of nitrate, private well water users in this area should be advised to treat their water or find alternative sources for drinking.
  9. Zainal Adwin Zainal Abidin, Hazwan Zaini, Firdaus Hayati, Nornazirah Azizan, Aizat Tamlikha
    MyJurnal
    Obscure gastrointestinal bleeding is a surgical enigma of disastrous proportions. Patient’s haemodynamic status often dictates the path of management ranging from endoscopy, embolization and/or surgery. Minority of the cases has failed to identify the exact source of bleeding during endoscopic and imaging techniques. Emergency surgery is warranted in hypovolaemic shock which has failed to respond to fluid and blood resuscitation. We present a 72-year-old male with an obscure upper gastrointestinal bleeding due to ruptured cystic artery pseudoaneurysm and illustrate the rarity of the presentation with successful management.
  10. Ganapathy, Ganesh Kumar, Dharmalingam, T. Kumaravadivel, Sathival, Mugunthan M.
    MyJurnal
    Xylazine is an alpha-2agonist often used as a sedative, analgesic and muscle relaxant agent
    in animals. Xylazine was not accepted by Food and Drug Administration (FDA) for human use
    due to hazardous side effect such as hypotension, bradycardia, respiratory depression and coma.
    This is a rare case report of a 64-year-old farmer who accidentally injected himself with Xylazine
    which was supposed to be given to a fractious cow. He developed altered conscious level, hypotension, bradycardia and respiratory failure requiring mechanical ventilation. Fortunately, he
    recovered and was discharged home after three days. This occurred due to improper handling of
    Xylazine without standard operating procedures. Xylazine is regulated for animal use only. Therefore, effects of Xylazine toxicity in human must be emphasized for awareness on proper handling as well as for right management of its poisoning incident in future.
    MeSH terms: Farmers; Analgesics; Animals; Bradycardia; Cattle; Coma; Consciousness Disorders; Female; Humans; Hypnotics and Sedatives; Hypotension; Male; Respiration, Artificial; Respiratory Insufficiency; United States; United States Food and Drug Administration; Xylazine
  11. Low, Qin Jia, Huan, Nai Chien, Tan, Wei Lun
    MyJurnal
    Dandy-Walker syndrome is a rare congenital malformation of the brain that involves the cerebellum and the fourth ventricle. It is characterised by a classical triad of hydrocephalus, cystic dilatation of the fourth ventricle and complete or partial agenesis of the vermis. Majority of cases are diagnosed during neonatal or early infantile period. In this case report, a seven-year-old boy complained of recurrent headaches for the past one year. Physical examination was unremarkable. Examination of the fundus on the same day revealed bilateral papilloedema. His subsequent computed tomography scan of the brain done at a major district hospital demonstrated features in keeping with Dandy-Walker malformation. Our case highlighted the importance of embarking on a detailed and thorough approach when dealing with a child with chronic headache, especially in rural settings where advanced medical equipment is not readily available.
    MeSH terms: Brain; Cerebellum; Child; Dandy-Walker Syndrome; Dilatation; Headache; Hospitals, District; Humans; Hydrocephalus; Male; Papilledema; Physical Examination; Tomography; Fourth Ventricle; Headache Disorders; Cerebellar Vermis
  12. Haza Syakirin Mohamad Zin, Salmi Abdullah, Norazlah Bahari, Thandayathany, Vijayaletchumi, Hayati Abd Rahman, Nur Syahrina Rahim
    MyJurnal
    Intrauterine infection has emerged to be the main and frequent cause of premature delivery and foetal demise. Microorganisms gain entry into the amniotic cavity via ascending route, haematogenous dissemination, retrograde seeding from peritoneal cavity and accidental introduction during invasive procedures. This is a case of foetal loss in utero from a twin pregnancy due to intrauterine sepsis diagnosed through placenta examination. Both maternal and foetal evidences of inflammatory response were demonstrated in the placenta on histology. Microscopically, there were acute chorioamnionitis and villitis as well as abundant gram positive cocci in the foetal blood within placental villous capillaries. The presence of intravascular bacterial organism provides evidence for a conclusive diagnosis of intrauterine sepsis, particularly where the placenta or foetal blood microbiological cultures results are not available or equivocal. More attention should therefore be given when sampling, as pathological evidences of underlying foetal compromise or death could be provided by well-represented placental tissue samples.
    MeSH terms: Attention; Capillaries; Chorioamnionitis; Female; Fetal Blood; Fetal Death; Gram-Positive Cocci; Peritoneal Cavity; Placenta; Pregnancy; Sepsis; Pregnancy, Twin; Blood Culture
  13. Aslam M, Ahmad R, Yasin M, Khan AL, Shahid MK, Hossain S, et al.
    Bioresour Technol, 2018 Dec;269:452-464.
    PMID: 30145004 DOI: 10.1016/j.biortech.2018.08.050
    Biohydrogen as one of the most appealing energy vector for the future represents attractive avenue in alternative energy research. Recently, variety of biohydrogen production pathways has been suggested to improve the key features of the process. Nevertheless, researches are still needed to overcome remaining barriers to practical applications such as low yields and production rates. Considering practicality aspects, this review emphasized on anaerobic membrane bioreactors (AnMBRs) for biological hydrogen production. Recent advances and emerging issues associated with biohydrogen generation in AnMBR technology are critically discussed. Several techniques are highlighted that are aimed at overcoming these barriers. Moreover, environmental and economical potentials along with future research perspectives are addressed to drive biohydrogen technology towards practicality and economical-feasibility.
    MeSH terms: Fermentation; Hydrogen; Membranes, Artificial; Bioreactors*
  14. Alkhorayef M, Sulieman A, Mohamed-Ahmed M, Al-Mohammed HI, Alkhomashi N, Sam AK, et al.
    Appl Radiat Isot, 2018 Nov;141:270-274.
    PMID: 30145016 DOI: 10.1016/j.apradiso.2018.07.014
    With associated cure rates in excess of 90%, targeted 131I radioactive iodine therapy has clearly improved thyroid cancer survival. Thus said, potential radiation risks to staff represent a particular concern, current study seeking to determine the radiation exposure of staff from 131I patients during hospitalization, also estimating accumulated dose and related risk to staff during preparation of the radioactive iodine. In present study made over the three-month period 1st February to 1st May 2017, a total of 69 patient treatments were investigated (comprising a cohort of 46 females and 23 males), this being a patient treatment load typically reflective of the workload at the particular centre for such treatments. The patients were administered sodium iodide 131I, retained in capsules containing activities ranging from 370 to 5550 MBq at the time of calibration, radioiodine activity depends on many factors such as gender, clinical indication, body mass index and age. The staff radiation dose arising from each patient treatment was measured on three consecutive days subsequent to capsule administration. In units of µSv, the mean and dose-rates range at distances from the patients of 5 cm, 1 m and 2 m were 209 ± 73 (165-294), 6.8 ± 2 (5.3-9.5) and 0.9 ± 0.3 (0.7-1.2). The annual dose (also measured in units of µSv), based on annual records of doses, for medical physicists, technologists and nurses were 604, 680 and 1000 µSv respectively. In regard to current practice and workload, staff exposures were all found to be below the annual dose limit for radiation workers.
    MeSH terms: Radiation Exposure; Calibration; Capsules; Female; Hospitalization; Humans; Iodine Radioisotopes; Male; Radiation Dosage; Risk; Sodium Iodide; Thyroid Neoplasms; Cohort Studies; Body Mass Index; Workload
  15. Tan CY, Arumugam T, Razali SNO, Yahya MA, Goh KJ, Shahrizaila N
    J Clin Neurosci, 2018 Nov;57:198-201.
    PMID: 30145079 DOI: 10.1016/j.jocn.2018.08.031
    Diabetic patients with poor glycaemic control can demonstrate demyelinating distal sensorimotor polyneuropathy (D-DSP) on electrophysiology. Distinguishing D-DSP from chronic inflammatory demyelinating polyneuropathy (CIDP) can be challenging. In this study, we investigated the role of nerve ultrasound in differentiating the two neuropathies. Nerve ultrasound findings of D-DSP patients (fulfilling the electrophysiological but not clinical criteria for CIDP) were compared with non-diabetic CIDP patients (fulfilling both criteria). We studied 108 and 95 nerves from 9 D-DSP and 10 CIDP patients respectively. CIDP patients had significantly larger cross-sectional areas of the median nerve at the mid-arm (17.0 ± 12.5 vs 8.7 ± 2.6; p = 0.005), ulnar nerve at the wrist (7.3 ± 3.1 vs 4.1 ± 1.0; p = 0.001), mid forearm (8.8 ± 5.3 vs 5.5 ± 1.5; p = 0.002) and mid-arm (14.5 ± 14.1 vs 7.5 ± 1.9; p = 0.013), and radial nerve at mid forearm (4.1 ± 2.4 vs 1.2 ± 0.4; p 
    MeSH terms: Adult; Aged; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Ultrasonography/methods*
  16. Thent ZC, Froemming GRA, Ismail ABM, Fuad SBSA, Muid S
    Life Sci, 2018 Oct 01;210:214-223.
    PMID: 30145154 DOI: 10.1016/j.lfs.2018.08.057
    AIMS: Phytoestrogens and xenoestrogens act as agonists/antagonists in bone formation and differentiation. Strong bones are depending of the ability of osteoblasts to form new tissue and to mineralize the newly formed tissue. Dysfunctional or loss of mineralization leads to weak bone and increased fracture risk. In this study, we reported the effect of different types of phytoestrogens (daidzein, genistein and equol) on mineralization in hFOB 1.19 cells stimulated with bisphenol A (BPA).

    MAIN METHODS: Cell mineralization capacity of phytoestrogens was investigated by evaluating calcium, phosphate content and alkaline phosphatase activity. Bone related markers, osteocalcin and osteonectin, responsible in maintaining mineralization were also measured.

    KEY FINDINGS: BPA is significantly interfering with bone mineralization in hFOB 1.19 cells. However, the enhanced mineralization efficacy of daidzein and genistein (particularly at a dose of 5 and 40 μg/mL, respectively) was evidenced by increasing calcium and phosphate content, higher ALP activity, compared to the untreated BPA group. The quantitative analyses were confirmed through morphological findings. Osteocalcin and osteonectin levels were increased in phytoestrogens-treated cells. These findings revealed the potential effect of phytoestrogens in reverting the demineralization process due to BPA exposure in hFOB 1.19 cells.

    SIGNIFICANCE: We found that osteoblast differentiation and mineralization were maintained following treatment with phytoestrogens under BPA exposure.

    MeSH terms: Benzhydryl Compounds/pharmacology*; Calcification, Physiologic/drug effects*; Cell Differentiation/drug effects*; Cells, Cultured; Estrogens, Non-Steroidal/pharmacology; Humans; Isoflavones/pharmacology; Osteoblasts/cytology*; Osteoblasts/drug effects; Osteogenesis/drug effects*; Phenols/pharmacology*; Genistein/pharmacology; Phytoestrogens/pharmacology*; Equol/pharmacology
  17. Azhari NN, Ramli SNA, Joseph N, Philip N, Mustapha NF, Ishak SN, et al.
    Acta Trop, 2018 Dec;188:68-77.
    PMID: 30145261 DOI: 10.1016/j.actatropica.2018.08.020
    Leptospirosis is caused by the spirochetal bacterium Leptospira of which rodents are considered the most important reservoir. This study aims to determine and characterize virulent Leptospira species among rodents and small mammals found in human settlements and recreational spots within the Hulu Langat and Gombak districts of Selangor, Malaysia; regions that frequently report probable human leptospirosis cases. Molecular analysis revealed an overall Leptospira detection rate of 14.3% among the 266 small mammals captured, and the human settlements were found to have the highest number of isolates (15.1%), followed by recreational sites (14.5%). The molecular characterization conducted based on the lipL32, secY genes and MLST revealed that the strains belonged to four different species, including; Leptospira interrogans (29; 76.3%; ST50, ST238, ST243), L. kirschneri (5; 13.15%; ST110), L. borgpetersenii (3; 8%; ST143) and L. weilii (1; 2.63%; ST242). The study revealed genotypes of circulating strains among small mammals in Malaysia, which include Leptospira locus ST110 L. kirschneri, ST 50 L. interrogans, ST143 L. borgpetersenii and ST242 L. weilii. Among the small mammals studied, 17/105 (16.2%) Rattus norvegicus, 7/59 (11.9%) of Rattus rattus, 5/24 (20.8%) of Maxomys whiteheadi, 4/18 (22.2%) of Sundamys muelleri, 2/22 (9%), Tupaia gliss, 2/16 (12.5%) Rattus tiomanicus and 1/4 (25%) of Suncus murinus carried pathogenic leptospires. The data from the present study may imply that, in addition to rodents, other small mammals also serve as maintenance hosts for Leptospira. Hence, much remains unknown about Leptospira maintenance hosts, and there is need for further investigation to ascertain the prevailing serovars of pathogenic Leptospira in Malaysia. This will assist in the development of efficient diagnostic assays with improved microscopic agglutination test (MAT) panels, and in the implementation of suitable prevention and control measures.
    MeSH terms: Agglutination Tests; Animals; Humans; Leptospira/genetics*; Leptospira/isolation & purification; Leptospirosis/microbiology*; Malaysia; Mammals; Rodentia
  18. Kumarasamy G, Balasubramanian A, Abdullah B
    Gulf J Oncolog, 2018 May;1(27):73-77.
    PMID: 30145556
    Testicular cancer is an uncommon malignancy of the male reproductive organ, accounting for 1% of all cancers in men. Distant cervical metastasis from testicular cancer has been reported in 5% of patients. We present 2 cases of non-seminomatous testicular cancers that were diagnosed retrospectively in patients who presented with pure cervical lymph nodes. A comprehensive approach bearing in mind the possible differentials, pathogenesis and treatment options are discussed.
    MeSH terms: Adult; Head and Neck Neoplasms/secondary*; Head and Neck Neoplasms/therapy; Humans; Lymph Nodes/pathology*; Lymphatic Metastasis; Male; Prognosis; Testicular Neoplasms/pathology*; Testicular Neoplasms/therapy
  19. McDonald SA, Azzeri A, Shabaruddin FH, Dahlui M, Tan SS, Kamarulzaman A, et al.
    Appl Health Econ Health Policy, 2018 12;16(6):847-857.
    PMID: 30145775 DOI: 10.1007/s40258-018-0425-3
    INTRODUCTION: The World Health Organisation (WHO) has set ambitious goals to reduce the global disease burden associated with, and eventually eliminate, viral hepatitis.

    OBJECTIVE: To assist with achieving these goals and to inform the development of a national strategic plan for Malaysia, we estimated the long-term burden incurred by the care and management of patients with chronic hepatitis C virus (HCV) infection. We compared cumulative healthcare costs and disease burden under different treatment cascade scenarios.

    METHODS: We attached direct costs for the management/care of chronically HCV-infected patients to a previously developed clinical disease progression model. Under assumptions regarding disease stage-specific proportions of model-predicted HCV patients within care, annual numbers of patients initiated on antiviral treatment and distribution of treatments over stage, we projected the healthcare costs and disease burden [in disability-adjusted life-years (DALY)] in 2018-2040 under four treatment scenarios: (A) no treatment/baseline; (B) pre-2018 standard of care (pegylated interferon/ribavirin); (C) gradual scale-up in direct-acting antiviral (DAA) treatment uptake that does not meet the WHO 2030 treatment uptake target; (D) scale-up in DAA treatment uptake that meets the WHO 2030 target.

    RESULTS: Scenario D, while achieving the WHO 2030 target and averting 253,500 DALYs compared with the pre-2018 standard of care B, incurred the highest direct patient costs over the period 2018-2030: US$890 million (95% uncertainty interval 653-1271). When including screening programme costs, the total cost was estimated at US$952 million, which was 12% higher than the estimated total cost of scenario C.

    CONCLUSIONS: The scale-up to meet the WHO 2030 target may be achievable with appropriately high governmental commitment to the expansion of HCV screening to bring sufficient undiagnosed chronically infected patients into the treatment pathway.

    MeSH terms: Forecasting; Health Policy/economics; Hepatitis C/economics*; Hepatitis C/epidemiology; Hepatitis C/therapy; Humans; Malaysia/epidemiology; Hepacivirus/genetics; Health Care Costs/trends*; Cost of Illness*; Models, Economic; Quality-Adjusted Life Years
  20. Dalia AM, Loh TC, Sazili AQ, Jahromi MF, Samsudin AA
    BMC Vet Res, 2018 Aug 24;14(1):249.
    PMID: 30143038 DOI: 10.1186/s12917-018-1578-x
    BACKGROUND: Selenium (Se) and vitamin E (Vit E) can act synergistically and affect biological processes, mainly antioxidant and immunity. The use of excess dietary Vit E and Se in animals' feed could enhance immune response and induce disease resistance. Moreover, different Se sources may provide different alterations in the immune system. Accordingly, the aim of the current study was to assess the impact of dietary supplementation of Vit E, inorganic Se (sodium selenite, SS), bacterial organic Se of ADS18, and their different combinations on the plasma immunoglobulins, ceacum microbial population, and splenic cytokines gene expression in broiler chickens.

    RESULTS: Present results showed that, Se and Vit E synergistic effect was clear in plasma IgM level at day 42 and in splenic cytokines expression (TNF-α, IFN-γ, IL-2, IL-10). The combination of 0.3 mg/kg ADS18-Se with 100 mg/kg Vit E showed the highest IgM level compared to Vit E- SS complex. The combination of either SS or ADS18-Se with Vit E had no significant effect on IFN- γ and IL-10 compared to Vit E alone, while Vit E alone showed the significantly lowest TNF-α compared to the Se combinations. Supplementation of 100 mg/kg Vit E had no effect on microbial population except a slight reduction in Salmonella spp. The main effect of Se sources was that both sources increased the day 42 IgA and IgG level compared to NS group. ADS18-Se modulate the caecum microbial population via enhancing beneficial bacteria and suppressing the E-coli and Salmonella spp. while both Se and Vit E factors had no effect on lymphoid organ weights.

    CONCLUSIONS: The inclusion of 100 mg/kg Vit E with 0.3 mg/kg ADS18-Se, effectively could support the immune system through regulation of some cytokines expression and immunoglobulin levels more than using ADS18-Se alone, while no difference was observed between using SS alone or combined with Vit E.

    MeSH terms: Gastrointestinal Microbiome/drug effects; Animals; Antioxidants/metabolism; Cecum/microbiology; Chickens/immunology*; Diet/veterinary; Female; Immunoglobulins/blood; Klebsiella pneumoniae; Selenium/pharmacology*; Vitamin E/pharmacology*; Cytokines/genetics; Cytokines/metabolism; Sodium Selenite/pharmacology; Dietary Supplements
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