Browse publications by year: 2018

  1. Dhand C, Balakrishnan Y, Ong ST, Dwivedi N, Venugopal JR, Harini S, et al.
    Int J Nanomedicine, 2018;13:4473-4492.
    PMID: 30122921 DOI: 10.2147/IJN.S159770
    Introduction: In search for cross-linkers with multifunctional characteristics, the present work investigated the utility of quaternary ammonium organosilane (QOS) as a potential cross-linker for electrospun collagen nanofibers. We hypothesized that the quaternary ammonium ions improve the electrospinnability by reducing the surface tension and confer antimicrobial properties, while the formation of siloxane after alkaline hydrolysis could cross-link collagen and stimulate cell proliferation.

    Materials and methods: QOS collagen nanofibers were electrospun by incorporating various concentrations of QOS (0.1%-10% w/w) and were cross-linked in situ after exposure to ammonium carbonate. The QOS cross-linked scaffolds were characterized and their biological properties were evaluated in terms of their biocompatibility, cellular adhesion and metabolic activity for primary human dermal fibroblasts and human fetal osteoblasts.

    Results and discussion: The study revealed that 1) QOS cross-linking increased the flexibility of otherwise rigid collagen nanofibers and improved the thermal stability; 2) QOS cross-linked mats displayed potent antibacterial activity and 3) the biocompatibility of the composite mats depended on the amount of QOS present in dope solution - at low QOS concentrations (0.1% w/w), the mats promoted mammalian cell proliferation and growth, whereas at higher QOS concentrations, cytotoxic effect was observed.

    Conclusion: This study demonstrates that QOS cross-linked mats possess anti-infective properties and confer niches for cellular growth and proliferation, thus offering a useful approach, which is important for hard and soft tissue engineering and regenerative medicine.

    MeSH terms: Quaternary Ammonium Compounds/pharmacology*; Animals; Anti-Infective Agents/pharmacology*; Cattle; Collagen/pharmacology*; Cross-Linking Reagents/pharmacology*; Fibroblasts/cytology; Fibroblasts/drug effects; Fibroblasts/metabolism; Fibroblasts/ultrastructure; Humans; Osteoblasts/cytology; Osteoblasts/drug effects; Osteoblasts/metabolism; Particle Size; Stress, Mechanical; Temperature; Wettability; Spectroscopy, Fourier Transform Infrared; Organosilicon Compounds/pharmacology*; Area Under Curve; Tissue Engineering/methods*; Cell Shape/drug effects; Tissue Scaffolds/chemistry*; Photoelectron Spectroscopy; Nanofibers/ultrastructure; Nanofibers/chemistry*
  2. Rahman HS
    Onco Targets Ther, 2018;11:4559-4572.
    PMID: 30122948 DOI: 10.2147/OTT.S170827
    BACKGROUND: The mastic gum resin has been used in traditional Kurdish medicine for treating various disorders such as topical wound and gastric ulcer. The study designed to evaluate the total polyphenol and flavonoid content, free radical scavenging activity, and anticancer effects of mastic gum resin derived from Pistacia atlantica subspecies kurdica.

    MATERIALS AND METHODS: Folin -Ciocalteau and the aluminum chloride colorimetric assays were used to determine the total phenol and flavonoid contents in the mastic gum resin respectively. Whereas, DPPH and ABTS+ assays were used to determine the antioxidant activities of mastic gum resin. Regarding anticancer activities, the MTT assay was used to study the effect of mastic gum resin on the proliferation of various cancer cells and the morphological changes were identified after Acridine Orange/Propidium Iodide staining. Flow cytometry was applied to determine the influence of mastic gum resin on the apoptosis rate by Annexin V double staining and to investigate the influence on cell cycle progression. Caspase colorimetric assay was used to estimate the hallmark enzyme of apoptosis, and finally RNA were obtained from COLO205 cells and analyzed by qRT-PCR analyses.

    RESULTS: The MTT results showed that the mastic gum resin at concentrations from 0.01 to 100 μM induced death of cancer cells in a dose and time-dependent manner. The mastic gum resin suppressed proliferation of human cancer cells with 72 h IC50 value of 15.34 ± 0.21, 11.52 ± 0.18, 8.11 ± 0.23 and 5.2 ± 0.8 μg/mL for bile duct cancer (cholangiocarcinoma) (KMBC), pancreatic carcinoma (PANC-1), gastric adenocarcinoma (CRL-1739), and colonic adenocarcinoma (COLO205) cells, respectively. Normal human colon fibroblast (CCD-18Co) cells were not adversely affected by resin treatment. Flow cytometry showed that the mastic gum resin significantly (P<0.05) arrested COLO205 cell proliferation at the G2/M phase of cell cycle. The resin caused apoptotic morphological changes in COLO205 cells. The apoptotic effect to mastic gum resin was via the mitochondrial as shown by the up-regulation of Bax, down-regulation of Bcl-2 genes, and activation of caspase-9 and -3 activities.

    CONCLUSION: It was confirmed that the antiproliferative efficacy of the resin is positively correlated with its polyphenolic contents, suggesting a causal link related to exudate content of phenolic acid and flavonoids. The results revealed that the mastic gum resin has potential to be developed as an anticancer and antioxidant product due to its high content of polyphenol compounds.

  3. Yee PTI, Poh CL
    Int J Med Sci, 2018;15(11):1143-1152.
    PMID: 30123051 DOI: 10.7150/ijms.26450
    Enterovirus 71 (EV-A71) is one of the major pathogens causing hand, foot and mouth disease (HFMD). Some strains can lead to neurological disease and fatality in children. Up to date, there is no FDA-approved vaccine to prevent severe HFMD and mortality. Although the inactivated vaccine has advanced to production in China, lack of long-term protection and the requirement of multiple boosters have necessitated the development of other types of vaccines. Recent studies indicate that cellular and not humoral immunity determines the clinical outcome of EV-A71 infections. High levels of cytokines such as IL-1β, IL-6, IL-10 and IFN-γ tend to correlate with clinical severity in patients with pulmonary edema and encephalitis. The live attenuated vaccine may serve as the preferred choice as it can induce excellent humoral and cellular immunity as well as live-long immunity. Expression of certain HLA alleles such as TNF-α promoter type II (-308 allele), HLA-A33 and HLA-DR17 responses have been linked to severe HFMD. However, the high variability of MHC genes could restrict T cell recognition and be a major obstacle in the design of peptide vaccines. Hence, the development of a T cell universal vaccine (incorporating both CD4+ and CD8+ T cell epitopes) that induces broad, multifunctional and cross-reactive CD8+ T cell responses maybe desirable.
    MeSH terms: Child; China; Enterovirus Infections/immunology*; Hand, Foot and Mouth Disease/immunology; Humans; T-Lymphocytes/immunology*; Enterovirus A, Human/immunology*
  4. Abu Bakar FI, Abu Bakar MF, Abdullah N, Endrini S, Rahmat A
    Adv Pharmacol Sci, 2018;2018:8603602.
    PMID: 30123256 DOI: 10.1155/2018/8603602
    This article aims to provide detailed information on Malaysian plants used for treating inflammation. An extensive search on electronic databases including PubMed, Google Scholar, Scopus, and ScienceDirect and conference papers was done to find relevant articles on anti-inflammatory activity of Malaysian medicinal plants. The keyword search terms used were "inflammation," "Malaysia," "medicinal plants," "mechanisms," "in vitro," and "in vivo." As a result, 96 articles on anti-inflammatory activity of Malaysian medicinal plants were found and further reviewed. Forty-six (46) plants (in vitro) and 30 plants (in vivo) have been identified to possess anti-inflammatory activity where two plants, Melicope ptelefolia (Tenggek burung) and Portulaca oleracea (Gelang pasir), were reported to have the strongest anti-inflammatory activity of more than 90% at a concentration of 250 µg/ml. It was showed that the activity was mainly due to the occurrence of diverse naturally occurring phytochemicals from diverse groups such as flavonoids, coumarins, alkaloids, steroids, benzophenone, triterpenoids, curcuminoids, and cinnamic acid. Hence, this current review is a detailed discussion on the potential of Malaysian medicinal plants as an anti-inflammatory agent from the previous studies. However, further investigation on the possible underlying mechanisms and isolation of active compounds still remains to be investigated.
  5. Tan SC, Chong CW, Teh CSJ, Ooi PT, Thong KL
    PeerJ, 2018;6:e5353.
    PMID: 30123701 DOI: 10.7717/peerj.5353
    Background: Enterococcus faecalis and Enterococcus faecium are ubiquitous opportunistic pathogens found in the guts of humans and farmed animals. This study aimed to determine the occurrence, antimicrobial resistance, virulence, biofilm-forming ability and genotypes of E. faecalis and E. faecium from swine farms. Correlations between the genotypes, virulotypes, antibiotic resistance, and the environmental factors such as locality of farms and farm hygiene practice were explored.

    Methods: E. faecalis and E. faecium strains were isolated from the oral, rectal and fecal samples of 140 pigs; nasal, urine and fecal samples of 34 farmers working in the farms and 42 environmental samples collected from seven swine farms located in Peninsular Malaysia. Antibiotic susceptibility test was performed using the disk diffusion method, and the antibiotic resistance and virulence genes were detected by Polymerase Chain Reaction. Repetitive Extragenic Palindromic-Polymerase Chain Reaction and Pulsed-Field Gel Electrophoresis were performed to determine the clonality of the strains. Crosstab/Chi-square test and DistLM statistical analyses methods were used to determine the correlations between the genotypes, virulence factors, antibiotic resistance, and the environmental factors.

    Results: A total of 211 E. faecalis and 42 E. faecium were recovered from 140 pigs, 34 farmers and 42 environmental samples collected from seven swine farms in Peninsular Malaysia. Ninety-eight percent of the strains were multidrug-resistant (resistant to chloramphenicol, tetracycline, ciprofloxacin and erythromycin). Fifty-two percent of the strains formed biofilms. Virulence genes efa, asaI, gelE, esp, cyl and ace genes were detected. Virulence genes efa and asaI were most prevalent in E. faecalis (90%) and E. faecium (43%), respectively. Cluster analyses based on REP-PCR and PFGE showed the strains were genetically diverse. Overall, the strains isolated from pigs and farmers were distinct, except for three highly similar strains found in pigs and farmers. The strains were regional- and host-specific.

    Discussion: This study revealed alarming high frequencies of multidrug-resistant enterococci in pigs and swine farmers. The presence of resistance and virulence genes and the ability to form biofilm further enhance the persistence and pathogenicity of the strains. Although the overall clonality of the strains were regionals and host-specific, strains with high similarity were found in different hosts. This study reiterates a need of a more stringent regulation to ensure the proper use of antibiotics in swine husbandry to reduce the wide spread of multidrug-resistant strains.

    MeSH terms: Farmers; Animals; Anti-Bacterial Agents; Chloramphenicol; Ciprofloxacin; Erythromycin; Humans; Malaysia; Enterococcus faecalis; Swine; Virulence; Chi-Square Distribution; Electrophoresis, Gel, Pulsed-Field; Enterococcus; Enterococcus faecium; Drug Resistance, Bacterial; Virulence Factors; Farms
  6. Tengku-Fatishah A, Besari AM, Tharakan J, Shatriah I
    Cureus, 2018 Jun 14;10(6):e2807.
    PMID: 30123729 DOI: 10.7759/cureus.2807
    Intracranial tuberculoma is a rare manifestation of tuberculosis involving the central nervous system. The involvement of the ventricular system is extremely uncommon. We describe a young woman with bilateral papilledema secondary to intraventricular tuberculoma with hydrocephalus. She was treated with anti-tuberculosis therapy and intravenous dexamethasone. Her visual acuity deteriorated after one month of treatment. We provide a literature review of this uncommon ocular sequelae.
    MeSH terms: Antitubercular Agents; Cerebral Ventricles; Dexamethasone; Female; Humans; Hydrocephalus; Papilledema; Tuberculosis; Visual Acuity; Tuberculoma, Intracranial
  7. Tong L, Htoon HM, Hou A, Acharya RU, Tan JH, Wei QP, et al.
    BMJ Open Ophthalmol, 2018;3(1):e000150.
    PMID: 30123846 DOI: 10.1136/bmjophth-2018-000150
    Objective: Dry eye is a common disease with great health burden and no satisfactory treatment. Traditional Chinese medicine, an increasingly popular form of complementary medicine, has been used to treat dry eye but studies have been inconclusive. To address this issue, we conducted a randomised investigator-masked study which included the robust assessment of disease mechanisms.

    Methods and analysis: Eligible participants (total 150) were treated with artificial tear (AT) alone, with added eight sessions of acupuncture (AC) or additional daily oral herb (HB) over a month.

    Results: Participants treated with AC were more likely to respond symptomatically than those on AT (88% vs 72%, p=0.039) with a difference of 16% (95% CI: 0.18 to 31.1). The number-to-treat with AC to achieve response in one person was 7 (3 to 157). Participants in the AC group also had reduced conjunctival redness (automatic grading with Oculus keratograph) compared with AT (p=0.043) and reduced tear T helper cell (Th1)-cytokine tumour necrosis factor α (p=0.027) and Th2-cytokine interleukin 4 concentrations (p=0.038). AC was not significantly superior to AT in other outcomes such as tear osmolarity, tear evaporation rates, corneal staining and tear break-up times. No significant adverse effects were encountered. HB was not significantly different in the primary outcome from AT (80% vs 72%, p=0.26).

    Conclusions: AC is safe and provides additional benefit in mild to moderate dry eye up to 1 month, compared with ATs alone. Treatment is associated with demonstrable molecular evidence of reduced inflammation. Provided that suitably qualified practitioners are available to implement standardised treatment, AC may be recommended as adjunctive therapy to AT.

    Trial registration number: ClinicalTrials.gov (NCT02219204)registered on 14 August 2014.
  8. Kundu SK, Chakraborty C, Yagihara S, Teoh SL, Das S
    Curr Drug Deliv, 2018;15(10):1381-1392.
    PMID: 30124152 DOI: 10.2174/1567201815666180820101255
    Surgical operations are impossible without administering proper analgesia. Advancement in the field of anesthesia has invariably resulted in the accomplishment of all surgical processes without any inconvenience. Admittedly, the use of noble gas is on the decline. The noble gases may not interact chemically with any other substance under normal temperature and pressure but they may interact with proteins and lipids. Different anesthetic molecules may stimulate either proteins or lipids in membrane. There is a connection between the anesthetic molecules and the hydrophobic region of the membrane. In the present review, we attempt to highlight the interaction between the anesthetic molecule with proteins and lipids and their effects. We sketched few noble gases and some other existing molecules such as halothane and alcohol which interacted with proteins and lipids.
    MeSH terms: Anesthetics/chemistry*; Animals; Noble Gases/chemistry*; Humans; Lipids/chemistry*; Proteins/chemistry*
  9. Singh OP, Ahmed IB, Malarvili MB
    Technol Health Care, 2018;26(5):785-794.
    PMID: 30124456 DOI: 10.3233/THC-181288
    BACKGROUND: Assessment of asthma outside of the hospital using a patient independent device is highly in demand due to the limitation of existing devices, which are manual and unreliable if patients are not cooperative.

    OBJECTIVE: The study aims to verify the use of newly developed human respiration, carbon dioxide (CO2) measurement device for the management of asthma outside of the hospital.

    METHOD: The data were collected from 60 subjects aged between 18-35 years via convenience sampling method reported in UTM Health Center using the device. Furthermore, the data were normalized and analyzed using descriptive statistics, t-test, and area (Az) under receiver operating characteristic curve (ROC).

    RESULT: Findings revealed that the normalized mean values of end-tidal carbon dioxide (EtCO2), Hjorth Activity (HA), and respiratory rate (RR) were lower in asthmatic compared with healthy subjects with minimum deviation from the mean. In addition, each parameter was found to significantly differ statistically for asthma and non-asthma with p< 0.05. Furthermore, the Az shows the strong association for the screening of asthma and non-asthma with an average of 0.71 (95% CI: 0.57-0.83), 0.77 (95% CI: 0.64-0.90), and 0.83 (95% CI: 0.73-0.94) for RR, EtCO2, and HA, respectively.

    CONCLUSIONS: This study demonstrates that the newly developed handheld human respiration CO2 measurement device may possibly be used as an effort-independent asthma management method outside of the hospital.
    MeSH terms: Adolescent; Adult; Ambulatory Care Facilities; Asthma/physiopathology*; Carbon Dioxide/analysis*; Female; Humans; Male; Respiratory Function Tests; Monitoring, Ambulatory/instrumentation*; Exhalation/physiology*; Young Adult; Respiratory Rate
  10. Song YL, Yap AU, Türp JC
    J Oral Rehabil, 2018 Dec;45(12):1007-1015.
    PMID: 30125394 DOI: 10.1111/joor.12704
    The aim of this systematic review (SR) was to determine the association between temporomandibular disorders (TMDs) and pubertal development. Due to the inadequacy of the conventional PICO (Population, Interventions, Comparisons and Outcome) format used for intervention-based SRs, the Joanna Briggs Institute's guidelines for synthesising evidence related to associations with a focus on aetiology were adopted. A search of the PubMed and LIVIVO databases covering the period from January 1980 to May 2018 yielded four publications, which fulfilled the inclusion criteria. Analysis of articles based on the Pubertal Development Scale showed that TMD prevalence increases with pubertal development. Although no sex difference in TMD prevalence and diagnosis was observed, more females reported TMD anamnestic variables, including accounts of temporomandibular pain during pubertal maturity. The higher prevalence of depression and somatisation during pubertal development may contribute to more TMD symptom reporting in females. More prospective studies incorporating standardised methods for diagnosing TMDs and detecting comorbid psychosocial and somatic problems are desired to further elucidate the relationship between TMDs and pubertal development.
    MeSH terms: Depression; Depressive Disorder; Female; Pain; Prospective Studies; Temporomandibular Joint Disorders; Comorbidity; Prevalence; PubMed
  11. Mohd Hassan FW, Muggundha Raoov, Kamaruzaman S, Sanagi MM, Yoshida N, Hirota Y, et al.
    J Sep Sci, 2018 Oct;41(19):3751-3763.
    PMID: 30125466 DOI: 10.1002/jssc.201800326
    This study describes a dispersive liquid-liquid microextraction combined with dispersive solid-phase extraction method based on phenyl-functionalized magnetic sorbent for the preconcentration of polycyclic aromatic hydrocarbons from environmental water, sugarcane juice, and tea samples prior to gas chromatography with mass spectrometry analysis. Several important parameters affecting the extraction efficiency were investigated thoroughly, including the mass of sorbent, type and volume of extraction solvent, extraction time, type of desorption solvent, desorption time, type and amount of salt-induced demulsifier, and sample volume. Under the optimized extraction and gas chromatography-mass spectrometric conditions, the method revealed good linearity (10-100000 ng/L) with coefficient of determination (R2 ) of ≥0.9951, low limits of detection (3-16 ng/L), high enrichment factors (61-239), and satisfactory analyte recoveries (86.3-109.1%) with the relative standard deviations 
    MeSH terms: Gas Chromatography-Mass Spectrometry; Sodium Chloride; Solvents; Tea; Water; Sodium Chloride, Dietary; Saccharum; Solid Phase Extraction; Limit of Detection; Liquid Phase Microextraction
  12. Paudel YN, Shaikh MF, Shah S, Kumari Y, Othman I
    Eur J Pharmacol, 2018 Oct 15;837:145-155.
    PMID: 30125565 DOI: 10.1016/j.ejphar.2018.08.020
    Epilepsy is a devastating condition affecting around 70 million people worldwide. Moreover, the quality of life of people with epilepsy (PWE) is worsened by a series of comorbidities. The neurobehavioral comorbidities discussed herein share a reciprocal and complex relationship with epilepsy, which ultimately complicates the treatment process in PWE. Understanding the mechanistic pathway by which these comorbidities are associated with epilepsy might be instrumental in developing therapeutic interventions. Inflammatory cytokine signaling in the brain regulates important brain functions including neurotransmitter metabolism, neuroendocrine function, synaptic plasticity, dopaminergic transmission, the kynurenine pathway, and affects neurogenesis as well as the neural circuitry of moods. In this review, we hypothesize that the complex relationship between epilepsy and its related comorbidities (cognitive impairment, depression, anxiety, autism, and schizophrenia) can be unraveled through the inflammatory mechanism that plays a prominent role in all these individual conditions. An ample amount of evidence is available reporting the role of inflammation in epilepsy and all individual comorbid condition but their complex relationship with epilepsy has not yet been explored through the prospective of inflammatory pathway. Our review suggests that epilepsy and its neurobehavioral comorbidities are associated with elevated levels of several key inflammatory markers. This review also sheds light on the mechanistic association between epilepsy and its neurobehavioral comorbidities. Moreover, we analyzed several anti-inflammatory therapies available for epilepsy and its neurobehavioral comorbidities. We suggest, these anti-inflammatory therapies might be a possible intervention and could be a promising strategy for preventing epileptogenesis and its related neurobehavioral comorbidities.
    MeSH terms: Autism Spectrum Disorder/etiology; Animals; Anti-Inflammatory Agents/therapeutic use*; Anxiety/etiology; Cognition; Depression/etiology; Epilepsy/drug therapy; Epilepsy/etiology*; Epilepsy/immunology; Epilepsy/psychology; Humans; Inflammation/complications*; Schizophrenia/etiology; Comorbidity; Cytokines/physiology; Inflammation Mediators/physiology
  13. Khan M, Alam A, Khan KM, Salar U, Chigurupati S, Wadood A, et al.
    Bioorg Chem, 2018 12;81:157-167.
    PMID: 30125730 DOI: 10.1016/j.bioorg.2018.07.038
    Novel derivatives of flurbiprofen 1-18 including flurbiprofen hydrazide 1, substituted aroyl hydrazides 2-9, 2-mercapto oxadiazole derivative 10, phenacyl substituted 2-mercapto oxadiazole derivatives 11-15, and benzyl substituted 2-mercapto oxadiazole derivatives 16-18 were synthesized and characterized by EI-MS, 1H and 13C NMR spectroscopic techniques. All derivatives 1-18 were screened for α-amylase inhibitory activity and demonstrated a varying degree of potential ranging from IC50 = 1.04 ± 0.3 to 2.41 ± 0.09 µM as compared to the standard acarbose (IC50 = 0.9 ± 0.04 µM). Out of eighteen compounds, derivatives 2 (IC50 = 1.69 ± 0.1 µM), 3 (IC50 = 1.04 ± 0.3 µM), 9 (IC50 = 1.25 ± 1.05 µM), and 13 (IC50 = 1.6 ± 0.18 µM) found to be excellent inhibitors while rest of the compounds demonstrated comparable inhibition potential. A limited structure-activity relationship (SAR) was established by looking at the varying structural features of the library. In addition to that, in silico study was conducted to understand the binding interactions of the compounds (ligands) with the active site of α-amylase enzyme.
    MeSH terms: alpha-Amylases; Carbon Isotopes; Flurbiprofen; Libraries; Ligands; Oxadiazoles; Structure-Activity Relationship; Inhibitory Concentration 50; Catalytic Domain; Acarbose; Carbon-13 Magnetic Resonance Spectroscopy
  14. Tang DKH, Md Dawal SZ, Olugu EU
    J Safety Res, 2018 Sep;66:9-19.
    PMID: 30121115 DOI: 10.1016/j.jsr.2018.05.003
    INTRODUCTION: This study establishes the correlations between performance of a set of key safety factors and the actual lagging performance of oil platforms in Malaysia, hence the relevance of the key safety factors in evaluating and predicting the safety performance of oil and gas platforms. The key factors are crucial components of a safety performance evaluation framework and each key safety factor corresponds to a list of underlying safety indicators.

    METHOD: In this study, participating industrial practitioners rated the compliance status of each indicator using a numbering system adapted from the traffic light system, based on the actual performance of 10 oil platforms in Malaysia. Safety scores of the platforms were calculated based on the ratings and compared with the actual lagging performance of the platforms. Safety scores of two platforms were compared with the facility status reports' findings of the respective platforms.

    RESULTS: The platforms studied generally had good performance. Total recordable incident rates of the platforms were found to show significant negative correlations with management and work engagement on safety, compliance score for number of incident and near misses, personal safety, and management of change. Lost time injury rates, however, correlated negatively with hazard identification and risk assessment. The safety scores generally agreed with findings of the facility status reports with substandard process containment found as a contributor of hydrocarbon leaks.

    CONCLUSIONS: This study proves the criterion validity of the safety performance evaluation framework and demonstrates its usability for benchmarking and continuous improvement of safety practices on the Malaysian offshore oil and gas platforms.

    PRACTICAL APPLICATIONS: This study reveals the applicability of the framework and the potential of extending safety reporting beyond the few conventional lagging safety performance indicators used. The study also highlights the synergy between correlating safety factors to streamline safety management on offshore platforms.

    MeSH terms: Oil and Gas Industry/statistics & numerical data*; Humans; Malaysia; Safety Management/organization & administration; Safety Management/statistics & numerical data*; Risk Assessment/statistics & numerical data
  15. NoorAni A, Rajini S, Balkish MN, Noraida MK, SMaria A, Fadhli MY, et al.
    Public Health, 2018 Aug 16;163:105-112.
    PMID: 30121437 DOI: 10.1016/j.puhe.2018.06.018
    OBJECTIVE: This article examines the trends in morbidities and healthcare utilisation in Malaysian older people aged 60 years and above.
    STUDY DESIGN: This is a repeated cross-sectional study.
    METHODS: Data from three nation-wide community-based surveys, which were conducted in 1996, 2006, and 2015 were analysed. Multivariate analysis was performed for 2015 data to identify factors associated with healthcare utilisation.
    RESULTS: Analysis noted increasing trends in the prevalence of diabetes, hypertension, hypercholesterolaemia and obesity from 1996 to 2015. Decreasing trends were noted in the prevalence of current smokers and drinkers over this 20-year period, whereas health service utilisation increased with age in all surveys. In 2015, both inpatient and outpatient care are significantly associated with increasing age and diabetes.
    CONCLUSIONS: Increasing trends of health problems and healthcare utilisation were observed among older people in Malaysia. Policymakers should plan for appropriate resources to meet the challenges of an ageing population in Malaysia.
    Study name: National Health and Morbidity Survey (NHMS-1996, NHMS-2006, NHMS-2015)
    MeSH terms: Aging; Ambulatory Care; Cross-Sectional Studies; Diabetes Mellitus; Hypercholesterolemia; Hypertension; Inpatients; Malaysia; Morbidity; Obesity; Surveys and Questionnaires; Prevalence; Multivariate Analysis
  16. Tan YF, Lim CY, Chong CW, Lim PKC, Yap IKS, Leong PP, et al.
    Intervirology, 2018;61(2):92-95.
    PMID: 30121676 DOI: 10.1159/000491602
    BACKGROUND: The giant amoebal viruses of Mimivirus and Marseillevirus are large DNA viruses and have been documented in water, soil, and sewage samples. The trend of discovering these giant amoebal viruses has been increasing throughout Asia with Japan, India, and Saudi Arabia being the latest countries to document the presence of these viruses. To date, there have been no reports of large amoebal viruses being isolated in South East Asia.

    OBJECTIVE: In this study, we aim to discover these viruses from soil samples in an aboriginal village (Serendah village) in Peninsular -Malaysia.

    METHOD AND RESULTS: We successfully detected and isolated both Mimivirus-like and Marseillevirus-like viruses using Acanthamoeba castellanii. Phylogeny analysis identified them as Mimivirus and Marseillevirus, respectively.

    CONCLUSION: The ubiquitous nature of both Mimivirus and Marseillevirus is further confirmed in our study as they are detected in higher quantity in soil that is near to water vicinities in an aboriginal village in Peninsular Malaysia. However, this study is limited by our inability to investigate the impact of Mimivirus and Marseillevirus on the aboriginal villagers. More studies on the potential impact of these viruses on human health, especially on the aborigines, are warranted.

    MeSH terms: DNA Viruses/classification*; DNA Viruses/genetics*; DNA Viruses/isolation & purification; Genes, Viral; Phylogeny; Soil Microbiology*; Genome, Viral; Mimiviridae/classification*; Mimiviridae/genetics*; Mimiviridae/isolation & purification
  17. Sultan S, Irfan SM, Zaidi SM
    Med J Malaysia, 2018 08;73(4):185-189.
    PMID: 30121679
    BACKGROUND: It is being increasingly recognised that thalassemia major patients, like intermedia, have increased propensity for thromboembolism. Deficiency of natural anticoagulants is more recently defined finding contributing to the hypercoagulable state. The aim this study is to determine natural anticoagulants levels and their correlation with maternal characteristics, haematological and biochemical markers.

    METHODS: This is a prospective case-control study. We registered 80 patients and 60 healthy controls from Jan 2009 to Dec 2013. Complete blood counts, prothrombin time, activated partial thromboplastin time, protein C, protein S, antithrombin, serum ferritin, liver enzymes; HbsAg and Anti- HCV were evaluated.

    RESULT: There were 42 males and 38 females with mean age of 12.30±5.50 years. The mean protein C, protein S and antithrombin in patients and control were 58.25±22.5 versus 110.67±22.60, 67.90±19.58 versus 98.70±21.54 and 89.73±18.09 versus 104.0±10.98 (p<0.001) respectively. Protein C was predominantly deficient in 65% followed by protein S and antithrombin in 35% and 20% respectively. Protein C deficiency divulged positive correlation with protein S deficiency (p = 0.035) and antithrombin deficiency with hemoglobin of ≤8gm% (p<0.0025). No significant correlation of prothrombotic markers was established with maternal characteristics, hepatic dysfunction, hepatitis and serum ferritin.

    CONCLUSION: Substantial decrement in prothrombotic markers, primarily protein C, may be implicated in elevated thrombosis; however follow-up data is required to establish definitive thromboembolic events.

    MeSH terms: Adolescent; Antithrombins/blood; Blood Cell Count; Child; Child, Preschool; Female; Ferritins/blood; Hepatitis B Surface Antigens/blood; Humans; Male; Partial Thromboplastin Time; Prospective Studies; Protein C/analysis; Prothrombin Time; Biomarkers/blood; Case-Control Studies; beta-Thalassemia/blood*; Protein S/analysis; Hepatitis C Antibodies/blood; Young Adult
  18. Syadwa AS, Anita ZB
    Med J Malaysia, 2018 08;73(4):190-196.
    PMID: 30121680 MyJurnal
    AIM: Symptomatic relief following palliative radiotherapy for advanced cancers may take a few weeks up to a few months to achieve. Thus, accurate prognostication is important to avoid harm to these patients with limited lifespan. We conducted a retrospective cohort study to determine the median survival and 30-day mortality (30-DM) and factors associated with these parameters in our centre.

    METHODS: Data from 585 eligible patients who received palliative radiotherapy between January 2012 and December 2014 were analysed. Median overall survival was calculated from the commencement of first fraction of the last course of radiotherapy to date of death or when censored. 30-DM was calculated as the proportion of patients who died within 30 days from treatment start date. Kaplan-Meier survival analysis was used to estimate survival. Chi-square test and logistic regression was used to assess the impact of potential prognostic factors on median survival and 30-DM.

    RESULTS: The most common diagnoses were lung and breast cancers and most common irradiated sites were bone and brain. Median survival and 30-DM were 97 days and 22.7% respectively. Primary cancer, age, treatment course, performance status, systemic treatment post radiotherapy and intended radiotherapy treatment completed had an impact on median survival whereas mainly the latter three factors had an impact on 30-DM.

    CONCLUSION: Median survival and factors affecting both survival and 30-DM in our study are comparable to others. However, a 30-DM rate of 22.7% is significantly higher compared to the literature. We need to better select patients who will benefit from palliative radiotherapy in our centre.

    MeSH terms: Breast Neoplasms/diagnosis; Breast Neoplasms/mortality; Breast Neoplasms/radiotherapy; Female; Humans; Lung Neoplasms/diagnosis; Lung Neoplasms/mortality; Lung Neoplasms/radiotherapy; Male; Middle Aged; Neoplasms/diagnosis; Neoplasms/mortality; Neoplasms/radiotherapy*; Palliative Care/methods*; Prognosis; Radiotherapy Dosage; Retrospective Studies; Time Factors; Logistic Models; Survival Analysis; Kaplan-Meier Estimate
  19. Rashid AA, Zuhra H, Tan CE
    Med J Malaysia, 2018 08;73(4):197-201.
    PMID: 30121681 MyJurnal
    INTRODUCTION: Social support and self-efficacy are factors that influence patients' health behaviour. However, the relationship between these two factors among patients with Type 2 Diabetes Mellitus (T2DM) has not been adequately explored. This study aims to report social support and selfefficacy of Malaysian T2DM patients, and their correlations.

    METHODS: This cross-sectional questionnaire study involved 329 patients with T2DM who received their follow up at a public primary care clinic. Patients were selected via systematic random sampling. Patients self-completed locally adapted versions of the Medical Outcomes Study (MOS) Social Support Survey and Diabetic Management Self Efficacy Scale (DMSES). The scores of both tools were analysed to determine the association and correlation between social support and self-efficacy.

    RESULTS: The mean score for overall social support was 72.7±21.40 score range (0-100). "Affectionate support" was rated the highest averaged mean score at 78.31±23.71 (score range: 0-100). The mean DMSES score was 147.6±35.5 (score range :0-200), of which "medications" subscale was rated the highest with averaged mean scores 9.07±1.67 (score range: 0-10). Overall social support and self-efficacy were found to be weakly correlated (r=0.197, p<0.001). However, all subscales of social support were moderately correlated with "medications" subscale of self-efficacy.

    CONCLUSION: Social support is significantly associated with patients' self-efficacy in handling their own medications.

    MeSH terms: Cross-Sectional Studies; Diabetes Mellitus, Type 2/psychology*; Diabetes Mellitus, Type 2/therapy; Female; Humans; Male; Middle Aged; Primary Health Care; Psychological Tests; Surveys and Questionnaires; Social Support; Self Efficacy
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