Browse publications by year: 2018

  1. Kumar S, Thomas BS, Gupta K, Guddattu V, Alexander M
    Niger J Clin Pract, 2018 Aug;21(8):1029-1033.
    PMID: 30074006 DOI: 10.4103/njcp.njcp_341_17
    Aim and objectives: The aim and the objectives were. (1) to assess the efficacy of a desensitizing toothpaste containing 8.0% arginine-calcium carbonate (Colgate® Sensitive Pro-Relief™), (2) to assess the efficacy of a desensitizing toothpaste containing 8.0% arginine-calcium carbonate (Colgate® Sensitive Pro-Relief™) used in combination with iontophoresis, and (3) to compare the effectiveness of the above methods.

    Subjects and Methods: Two groups of 40 patients each having dentinal hypersensitivity were treated using 8% proarginine and iontophoresis. The patients were recalled after 1, 2, and 4 weeks. The scores were tabulated and the results were analyzed using SPSS statistical software.

    Results: Visual analog scale between the two groups showed a significant difference from the 1st week till the 4th week. ANOVA values showed the reduction in the dentinal hypersensitivity in Group 2 using the iontophoresis along with the 8.0% arginine-calcium carbonate toothpaste. The Cochran-Mantel-Haenszel correlation test of the Schiff's dentinal hypersensitivity cross-tabulation showed P < 0.001 which was statistically significant reduction after the 4th week following the application of 8.0% arginine-calcium carbonate along with iontophoresis.

    Conclusion: Iontophoresis, when used along with Colgate® Sensitive Pro-Relief™ toothpaste, can provide additional benefit as this provides a better sealing effect.

    MeSH terms: Adult; Aged; Arginine/administration & dosage; Arginine/therapeutic use*; Calcium Carbonate/therapeutic use*; Dentin Sensitivity/drug therapy*; Drug Combinations; Female; Humans; Iontophoresis*; Male; Middle Aged; Prospective Studies; Sodium Fluoride/administration & dosage; Sodium Fluoride/therapeutic use*; Toothbrushing; Toothpastes/therapeutic use*; Toothpastes/chemistry; Single-Blind Method; Treatment Outcome; Dentin Desensitizing Agents/therapeutic use*
  2. Chai YC, Mahadevan R, Ng CG, Chan LF, Md Dai F
    Int J Soc Psychiatry, 2018 09;64(6):578-588.
    PMID: 30074421 DOI: 10.1177/0020764018792585
    BACKGROUND: Depression has been well studied as part of caregiver burden among patients with severe mental illnesses. Curiously, though, there has been little data in terms of caregiver burden with specific focus on depression among caregivers of patients with major depressive disorder (MDD).

    AIM: This study aims to determine the rate of depression among caregivers of person with depression and its psychosocial correlates, which include stigma, perceived social support, religious commitment and the severity of the patient's symptoms.

    METHODS: A cross-sectional study was conducted among 165 patients diagnosed with MDD using the Mini-International Neuropsychiatric Interview (M.I.N.I.) together with their caregivers. Apart from gathering social demographic data, patients were administered the 16-item Quick Inventory of Depressive Symptomatology-Self-Rated Version (QIDS-SR 16), whereas the caregivers were required to answer Patient Health Questionnaire-9 (PHQ-9), Multidimensional Scale of Perceived Social Support (MSPSS), Duke University Religion Index (DUREL) and Depression Stigma Scale (DSS). Those who scored ⩾5 on PHQ-9 were further assessed with interviewer-rated M.I.N.I. to diagnose the presence of depression.

    RESULTS: A total of 47 (28.5%) caregivers were found to have depressive symptoms. Out of that total, 13 (7.9%) were diagnosed to have MDD using M.I.N.I. From univariate analysis, factors associated with depression in caregivers were the severity of symptoms in patients ( p 

    MeSH terms: Adaptation, Psychological; Cross-Sectional Studies; Demography; Depression; Depressive Disorder, Major; Humans; Social Support; Universities; Multivariate Analysis; Caregivers; Friends; Social Stigma
  3. Atan R, Peck L, Prowle J, Licari E, Eastwood GM, Storr M, et al.
    Crit Care Med, 2018 10;46(10):e988-e994.
    PMID: 30074491 DOI: 10.1097/CCM.0000000000003350
    OBJECTIVES: In critically ill patients with acute kidney injury receiving vasopressors, high cytokine levels may sustain the shock state. High cutoff hemofiltration achieves greater cytokine removal in ex vivo and in animal models and may reduce the duration of shock but may also increase albumin losses.

    DESIGN: This was a single-center double-blind randomized controlled trial comparing continuous venovenous hemofiltration-high cutoff to continuous venovenous hemofiltration-standard.

    SETTING: Tertiary care hospital in Australia.

    PATIENTS: Vasopressor-dependent patients in acute kidney injury who were admitted to the ICU.

    INTERVENTIONS: Norepinephrine-free time were calculated in critically ill vasopressor-dependent patients in acute kidney injury, randomized to either continuous venovenous hemofiltration-high cutoff or continuous venovenous hemofiltration-standard.

    MEASUREMENT AND MAIN RESULTS: A total of 76 patients were randomized with the following characteristics (continuous venovenous hemofiltration-high cutoff vs continuous venovenous hemofiltration-standard); median age of 65 versus 70 year, percentage of males 47% versus 68%, and median Acute Physiology and Chronic Health Evaluation scores of 25 versus 23.5. The median hours of norepinephrine-free time at day 7 were 32 (0-110.8) for continuous venovenous hemofiltration-high cutoff and 56 hours (0-109.3 hr) (p = 0.520) for continuous venovenous hemofiltration-standard. Inhospital mortality was 55.6% with continuous venovenous hemofiltration-high cutoff versus 34.2% with continuous venovenous hemofiltration-standard (adjusted odds ratio, 2.49; 95% CI, 0.81-7.66; p = 0.191). There was no significant difference in time to cessation of norepinephrine (p = 0.358), time to cessation of hemofiltration (p = 0.563), and filter life (p = 0.21). Serum albumin levels (p = 0.192) were similar and the median dose of IV albumin given was 90 grams (20-212 g) for continuous venovenous hemofiltration-high cutoff and 80 grams (15-132 g) for continuous venovenous hemofiltration-standard (p = 0.252).

    CONCLUSIONS: In critically ill patients with acute kidney injury, continuous venovenous hemofiltration-high cutoff did not reduce the duration of vasopressor support or mortality or change albumin levels compared with continuous venovenous hemofiltration-standard.

    MeSH terms: Aged; Australia; Critical Care/methods*; Dopamine/blood; Double-Blind Method; Epinephrine/blood; Female; Humans; Intensive Care Units; Male; Middle Aged; Outcome and Process Assessment (Health Care); Severity of Illness Index*; Critical Illness/therapy; Hemodiafiltration/methods; Hemodiafiltration/mortality*; Acute Kidney Injury/blood; Acute Kidney Injury/drug therapy*; Acute Kidney Injury/mortality*; Acute Kidney Injury/therapy
  4. Chew SC, Tan CP, Nyam KL
    J Food Sci, 2018 Sep;83(9):2288-2294.
    PMID: 30074623 DOI: 10.1111/1750-3841.14291
    Kenaf seed oil is prone to undergo oxidation due to its high content of unsaturated fatty acids, thus microencapsulation stands as an alternative to protect kenaf seed oil from the adverse environment. This study primarily aimed to evaluate the oxidative stability of microencapsulated refined kenaf seed oil (MRKSO) by the use of gum arabic, β-cyclodextrin, and sodium caseinate as the wall materials by spray drying. Bulk refined kenaf seed oil (BRKSO) and MRKSO were kept at 65 °C for 24 days to evaluate its oxidative stability, changes of tocopherol and tocotrienol contents, phytosterol content, and fatty acid profile. The results showed that the peroxide value, p-Anisidine value, and total oxidation value of BRKSO were significantly higher than the MRKSO at day 24. The total tocopherol and tocotrienol contents were reduced 66.1% and 56.8% in BRKSO and MRKSO, respectively, upon the storage. There was a reduction of 71.7% and 23.5% of phytosterol content in BRKSO and MRKSO, respectively, upon the storage. The degradation rate of polyunsaturated fatty acids in BRKSO was higher than that of MRKSO. This study showed that the current microencapsulation technique is a feasible way to retard the oxidation of kenaf seed oil.

    PRACTICAL APPLICATION: There is increasing research on the functional properties of crude kenaf seed oil, but the crude kenaf seed oil is not edible. This study offered in developing of microencapsulated refined kenaf seed oil by spray drying, which is suitable for food application. The microencapsulation of refined kenaf seed oil with healthier wall materials is beneficial in developing a diversity of functional food products and supplements.

    MeSH terms: Capsules; Caseins*; Desiccation; Drug Compounding/methods*; Fatty Acids, Unsaturated/analysis; Gum Arabic*; Oxidation-Reduction; Phytosterols/analysis; Plant Oils/administration & dosage; Plant Oils/chemistry*; Seeds/chemistry; Lipid Peroxidation/drug effects*; Oxidative Stress; Dietary Supplements; Tocopherols/analysis; Tocotrienols/analysis; Hibiscus/chemistry*; beta-Cyclodextrins*; Functional Food
  5. Jamil NAM, Rahmad N, Rosli NHM, Al-Obaidi JR
    Electrophoresis, 2018 12;39(23):2954-2964.
    PMID: 30074628 DOI: 10.1002/elps.201800185
    Wax apple is one of the underutilized fruits that is considered a good source of fibers, vitamins, minerals as well as antioxidants. In this study, a comparative analysis of the developments of wax fruit ripening at the proteomic and metabolomic level was reported. 2D electrophoresis coupled with MALDI-TOF/TOF was used to compare the proteome profile from three developmental stages named immature, young, and mature fruits. In general, the protein expression profile and the identified proteins function were discussed for their potential roles in fruit physiological development and ripening processes. The metabolomic investigation was also performed on the same samples using quadrupole LC-MS (LC-QTOF/MS). Roles of some of the differentially expressed proteins and metabolites are discussed in relation to wax apple ripening during the development. This is the first study investigating the changes in the proteins and metabolites in wax apple at different developmental stages. The information obtained from this research will be helpful in developing biomarkers for breeders and help the plant researchers to avoid wax apple cultivation problems such as fruit cracking.
    MeSH terms: Chromatography, Liquid; Plant Proteins/analysis; Plant Proteins/metabolism; Biomarkers; Proteomics/methods*; Tandem Mass Spectrometry; Metabolomics/methods*; Protein Interaction Maps
  6. Tan PJ, Khoo EM, Chinna K, Saedon NI, Zakaria MI, Ahmad Zahedi AZ, et al.
    PLoS One, 2018;13(8):e0199219.
    PMID: 30074996 DOI: 10.1371/journal.pone.0199219
    OBJECTIVE: To determine the effectiveness of an individually-tailored multifactorial intervention in reducing falls among at risk older adult fallers in a multi-ethnic, middle-income nation in South-East Asia.

    DESIGN: Pragmatic, randomized-controlled trial.

    SETTING: Emergency room, medical outpatient and primary care clinic in a teaching hospital in Kuala Lumpur, Malaysia.

    PARTICIPANTS: Individuals aged 65 years and above with two or more falls or one injurious fall in the past 12 months.

    INTERVENTION: Individually-tailored interventions, included a modified Otago exercise programme, HOMEFAST home hazards modification, visual intervention, cardiovascular intervention, medication review and falls education, was compared against a control group involving conventional treatment.

    PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was any fall recurrence at 12-month follow-up. Secondary outcomes were rate of fall and time to first fall.

    RESULTS: Two hundred and sixty-eight participants (mean age 75.3 ±7.2 SD years, 67% women) were randomized to multifactorial intervention (n = 134) or convention treatment (n = 134). All participants in the intervention group received medication review and falls education, 92 (68%) were prescribed Otago exercises, 86 (64%) visual intervention, 64 (47%) home hazards modification and 51 (38%) cardiovascular intervention. Fall recurrence did not differ between intervention and control groups at 12-months [Risk Ratio, RR = 1.037 (95% CI 0.613-1.753)]. Rate of fall [RR = 1.155 (95% CI 0.846-1.576], time to first fall [Hazard Ratio, HR = 0.948 (95% CI 0.782-1.522)] and mortality rate [RR = 0.896 (95% CI 0.335-2.400)] did not differ between groups.

    CONCLUSION: Individually-tailored multifactorial intervention was ineffective as a strategy to reduce falls. Future research efforts are now required to develop culturally-appropriate and affordable methods of addressing this increasingly prominent public health issue in middle-income nations.

    TRIAL REGISTRATION: ISRCTN Registry no. ISRCTN11674947.

    Study site: emergency department, medical outpatients and primary care clinic at a teaching hospital in Kuala Lumpur, Malaysia
    MeSH terms: Accidental Falls/prevention & control*; Accidental Falls/statistics & numerical data; Accidents, Home/prevention & control; Accidents, Home/statistics & numerical data; Aged; Aged, 80 and over; Cardiovascular Diseases/epidemiology; Cardiovascular Diseases/therapy; Emergency Service, Hospital; Environment Design/standards; Exercise Therapy; Female; Hospitals, University; Humans; Malaysia; Male; Outpatient Clinics, Hospital; Patient Admission/statistics & numerical data; Primary Prevention/methods*; Vision Disorders/diagnosis; Vision Disorders/epidemiology; Vision Disorders/therapy; Precision Medicine/methods*
  7. Mohamad Afifi Ismail, Gun Hean Chon, Mohammad Rashedi Ismail-Fitry
    MyJurnal
    Meat tenderness is an important quality attribute that influences consumer acceptance. The application of mechanical treatment by mean to reduce toughness of meat cuts has gained much interest recently, with an intention to make use the lower grade meat cuts. This review deliberates the function, mechanism and numerous types of mechanical work in meat tenderization. The mechanical work employs to make meat softer by loosening the muscle structure and disrupting muscle cell. Previous studies have thoroughly examined the use of mechanical treatment (such as massaging, tumbling, and grinding) as an effective meat tenderization technique. Besides that, current research on newly emerging processing technology such as highpressure process (HPP) also shows potential to be explored. The application of mechanical work has shown impressive outcomes by reducing the shear force value that represents hardness of meat. The present paper also described the physical, biochemical and the structural changes of the meat. Finally, the improvements in the meat tenderness by using various type of mechanical work are presented in this paper.
    MeSH terms: Drug Combinations; Hardness; Meat; Papain; Sodium, Dietary; Intention
  8. Muhammad Adil Khattak, Tuan Mohamad Hakimi Tuan Yahya, Muhammad Wazif Mohd Sallehhudin, Muhammad Izzuan Mohd Ghazali, Nur Awal Abdullah, Nur Athirah Nordin, et al.
    MyJurnal
    In this recent years, energy security has been actively studied. European vitality security challenges have changed significantly in the previous 20 years. From one viewpoint, the current strains amongst Russia and the EU are undermining heir verifiable organization on vitality; on the other, profound changes in the vitality scene at the worldwide level, activated by innovative advances and major geo-political changes, are driving the EU to revaluate its vitality security system. The point of this paper is to talk about Eastern Europe vitality security in a changing worldwide. Furthermore, this paper will give a review on the energy market and the energy security strategy in Eastern Europe country.
    MeSH terms: Ethnic Groups; Europe, Eastern; Humans; Organizations; Russia
  9. Rabihah Md. Sum
    MyJurnal
    Risk management requires human judgements, from risk identification, assessment to response. Although automated tools are useful in handling large amounts of data and in performing complex calculations rapidly, humans undertake the entire risk management process. They bring to the process their intuitions, insights, previous experiences and skills. Therefore, creating a rich source of information of risks faced by an organisation. Ignoring human factors may impoverish information and limit risk management to only measurable factors. This study contributes to the field of decision-making and risk assessment by investigating and discussing in detail how to quantify subjective judgements using the Analytic Hierarchy Process (AHP). AHP is used to assess risk of an insurance company. It discusses how to do risk assessment by combining both intuition and analytic in the decision-making process. The study defines intuition as knowledge and experience, and analytic as the mathematics or quantitative analysis to derive the result. It demonstrates how Analytic Hierarchy Process (AHP) - a flexible multi-attribute or multi-criteria decision making tool, enables risk managers to use both intuition and analytic to do risk assessment. Risk assessment using AHP produces global priority weights representing the overall risk ranking of an insurance company. The study develops a risk assessment problem and uses AHP to organise and structure risks and sub-risks of the problem. It uses formative evaluation method with open-ended questionnaires to obtain feedbacks from risk managers on AHP. Three employees of a risk management department in a government agency assesses the risks using AHP. AHP strengths are easy to use and understand, improves risk assessment and useful for risk assessment problems that have scarce or no data. AHP limitation are the numbers and repetitiveness of the pairwise comparisons. The participants either ignore some of the pairwise questions or they answer randomly instead of deliberate judgements.
    MeSH terms: Decision Making; Government Agencies; Humans; Mathematics; Problem Solving; Surveys and Questionnaires; Risk Assessment; Intuition
  10. Betantya Nugroho, Azli Yahya, Nor Hisham, Kamal Khalil, Abd. Rahim, Mohd Najeb Jamaluddin
    MyJurnal
    Electromagnetic pulse (EMP) is a sudden burst of wide-band, high-intensity electromagnetic radiation. EMP also called as a transient electromagnetic disturbance, a short burst of electromagnetic energy. Effect of EMP to automobile is classify as medium threats to vehicle attacks where EMP aims at damaging electronic devices such as on board sensors and processors, CPU which found in almost all models from 1990’s and forward. This paper presents a MATLAB simulation of EMP generator by means of Switch Mode Power Supply, thus the electrical shielding can be studied further. Theoretically, EMP generator is developed by implementing energy storage circuit and discharge control circuit. Sending a rapidly changing electrical current through a loop will create an electromagnetic field in the form of a pulse. The results show an increase in pulse voltage from 12 VDC to 758 VDC with a current of 1500 A. A MATLAB model on the coverage area affected by EMP pulse will be developed in the next phase of the research.
  11. Cheah HL, Raabe CA, Lee LP, Rozhdestvensky TS, Citartan M, Ahmed SA, et al.
    Crit Rev Biochem Mol Biol, 2018 08;53(4):335-355.
    PMID: 29793351 DOI: 10.1080/10409238.2018.1473330
    Over the past decade, RNA-deep sequencing has uncovered copious non-protein coding RNAs (npcRNAs) in bacteria. Many of them are key players in the regulation of gene expression, taking part in various regulatory circuits, such as metabolic responses to different environmental stresses, virulence, antibiotic resistance, and host-pathogen interactions. This has contributed to the high adaptability of bacteria to changing or even hostile environments. Their mechanisms include the regulation of transcriptional termination, modulation of translation, and alteration of messenger RNA (mRNA) stability, as well as protein sequestration. Here, the mechanisms of gene expression by regulatory bacterial npcRNAs are comprehensively reviewed and supplemented with well-characterized examples. This class of molecules and their mechanisms of action might be useful targets for the development of novel antibiotics.
    MeSH terms: Anti-Bacterial Agents; Bacteria; Drug Resistance, Microbial; Gene Expression Regulation; RNA; RNA, Messenger; Virulence; Sequence Analysis, RNA; RNA Stability; RNA, Untranslated; Host-Pathogen Interactions; High-Throughput Nucleotide Sequencing
  12. Priya K, Sulaiman J, How KY, Yin WF, Chan KG
    Arch Microbiol, 2018 Sep;200(7):1135-1142.
    PMID: 29796703 DOI: 10.1007/s00203-018-1526-y
    Quorum sensing (QS) is a term used to describe cell-to-cell communication that enables bacteria to orchestrate group behaviours according to density of bacterial cells. In Gram-negative bacteria, this signalling system is widely known to regulate a variety of different phenotypes such as antibiotic production and biofilm formation. In this study, we report the production of N-acyl homoserine lactones produced by Chromobacterium haemolyticum strain KM2, a bacterium isolated from a river water of a reserved tropical national park. Preliminary screening of QS activity using biosensor reporter assays indicated that C. haemolyticum strain KM2 produces both short- and long-chain AHLs. Analysis with high-resolution liquid chromatography-mass spectrometry (LC-MS/MS) analysis revealed the production of three AHLs by strain KM2: N-octanoyl-L-homoserine lactone (C8-HSL), N-dodecanoyl-L-homoserine lactone (C12-HSL), and N-3-oxo-dodecanoyl-L-homoserine lactone (OC12-HSL). This bacterial isolate also exhibited strong β-haemolytic activity. To the best of our knowledge, this is the first documentation of QS activity and multiple AHLs production by C. haemolyticum strain KM2.
    MeSH terms: Chromatography, Liquid; Chromobacterium/classification; Chromobacterium/isolation & purification; Chromobacterium/metabolism*; Chromobacterium/chemistry; Homoserine/analogs & derivatives; Homoserine/analysis; Homoserine/metabolism; Lactones/analysis; Lactones/metabolism; Malaysia; 4-Butyrolactone/analogs & derivatives*; 4-Butyrolactone/analysis; 4-Butyrolactone/metabolism; Rivers/microbiology*; Quorum Sensing; Tandem Mass Spectrometry
  13. Lee YI, Yap JW, Izan S, Leitch IJ, Fay MF, Lee YC, et al.
    BMC Genomics, 2018 Aug 02;19(1):578.
    PMID: 30068293 DOI: 10.1186/s12864-018-4956-7
    BACKGROUND: Satellite DNA is a rapidly diverging, largely repetitive DNA component of many eukaryotic genomes. Here we analyse the evolutionary dynamics of a satellite DNA repeat in the genomes of a group of Asian subtropical lady slipper orchids (Paphiopedilum subgenus Parvisepalum and representative species in the other subgenera/sections across the genus). A new satellite repeat in Paphiopedilum subgenus Parvisepalum, SatA, was identified and characterized using the RepeatExplorer pipeline in HiSeq Illumina reads from P. armeniacum (2n = 26). Reconstructed monomers were used to design a satellite-specific fluorescent in situ hybridization (FISH) probe. The data were also analysed within a phylogenetic framework built using the internal transcribed spacer (ITS) sequences of 45S nuclear ribosomal DNA.

    RESULTS: SatA comprises c. 14.5% of the P. armeniacum genome and is specific to subgenus Parvisepalum. It is composed of four primary monomers that range from 230 to 359 bp and contains multiple inverted repeat regions with hairpin-loop motifs. A new karyotype of P. vietnamense (2n = 28) is presented and shows that the chromosome number in subgenus Parvisepalum is not conserved at 2n = 26, as previously reported. The physical locations of SatA sequences were visualised on the chromosomes of all seven Paphiopedilum species of subgenus Parvisepalum (2n = 26-28), together with the 5S and 45S rDNA loci using FISH. The SatA repeats were predominantly localisedin the centromeric, peri-centromeric and sub-telocentric chromosome regions, but the exact distribution pattern was species-specific.

    CONCLUSIONS: We conclude that the newly discovered, highly abundant and rapidly evolving satellite sequence SatA is specific to Paphiopedilum subgenus Parvisepalum. SatA and rDNA chromosomal distributions are characteristic of species, and comparisons between species reveal that the distribution patterns generate a strong phylogenetic signal. We also conclude that the ancestral chromosome number of subgenus Parvisepalum and indeed of all Paphiopedilum could be either 2n = 26 or 28, if P. vietnamense is sister to all species in the subgenus as suggested by the ITS data.

    MeSH terms: Chromosome Mapping; DNA, Ribosomal/genetics; DNA, Satellite/genetics*; Phylogeny; RNA, Ribosomal/genetics; Species Specificity; In Situ Hybridization, Fluorescence/methods*; Sequence Analysis, DNA/methods*; DNA, Plant/genetics; Evolution, Molecular; Orchidaceae/genetics*; High-Throughput Nucleotide Sequencing/methods*
  14. Kaniappan K, Lim CTS, Chin PW
    BMC Cancer, 2018 Aug 02;18(1):779.
    PMID: 30068299 DOI: 10.1186/s12885-018-4702-1
    BACKGROUND: Cases of non-traumatic splenic rupture are rare and entails a potentially grave medical outcome. Hence, it is important to consider the differential diagnosis of a non-traumatic splenic rupture in patients with acute or insidious abdominal pain. The incidence of rupture in Diffuse B-cell non-Hodgkin Lymphoma is highly infrequent (Paulvannan and Pye, Int J Clin Pract 57:245-6, 2003; Gedik et el., World J Gastroenterol 14:6711-6716, 2008), despite reports of various non-traumatic splenic rupture in the literature (Orloff and Peksin, Int Abstr Surg 106:1-11, 1958; Paulvannan and Pye, Int J Clin Pract 57:245-6, 2003). In this article, we attempt to highlight the features of a rare cause of splenic rupture that might serve as a future reference point for the detection of similar cases during routine clinical practice.

    CASE PRESENTATION: A 40-year-old man presented with 1 week history of left hypochondriac pain associated with abdominal distention. There was no history of preceding trauma or fever. Clinical examination revealed signs of tachycardia, pallor and splenomegaly. He had no evidence of peripheral stigmata of chronic liver disease. In addition, haematological investigation showed anemia with leucocytosis and raised levels of lactate dehydrogenase enzyme. However, peripheral blood film revealed no evidence of any blast or atypical cells. In view of these findings, imaging via ultrasound and computed tomography of the abdomen was performed. The results of these imaging tests showed splenic collections that was suggestive of splenic rupture and hematoma. Patient underwent emergency splenectomy and the histopathological report confirmed the diagnosis as DLBCL.

    CONCLUSIONS: The occurrence of true spontaneous splenic rupture is uncommon. In a recent systematic review of 613 cases of splenic rupture, only 84 cases were secondary to hematological malignancy. Acute leukemia and non-Hodgkin lymphoma were the most frequent causes of splenic rupture, followed by chronic and acute myelogeneous leukemias. At present, only a few cases of diffuse large B-cell lymphoma (DLBCL) have been reported. The morbidity and mortality rate is greatly increased when there is a delay in the diagnosis and intervention of splenic rupture cases. Hence, there should be an increased awareness amongst both physicians and surgeons that a non-traumatic splenic rupture could be the first clinical presentation of a DLBCL.

    MeSH terms: Adult; Diagnosis, Differential; Humans; Male; Splenic Rupture/etiology
  15. Woon YL, Hor CP, Lee KY, Mohd Anuar SFZ, Mudin RN, Sheikh Ahmad MK, et al.
    BMC Public Health, 2018 08 02;18(1):946.
    PMID: 30068318 DOI: 10.1186/s12889-018-5849-z
    BACKGROUND: Epidemiologic measures of the dengue burden such as prevalence and incidence are important for policy-making and monitoring the progress of disease control. It is a common practice where epidemiologic and economic research estimate dengue burden based on notification data. However, a basic challenge in estimating the incidence of dengue is that a significant proportion of infected population are asymptomatic. It can be overcome by using mathematical models that relate observed prevalence and mortality to incidence. In this study, we estimate the trend of dengue incidence and hospitalization in Malaysia.

    METHODS: This study is based entirely on the available secondary data sources on dengue in Malaysia. The age-specific incidence of dengue between 2001 and 2013 was estimated using the prevalence and mortality estimates in an incidence-prevalence-mortality (IPM) model. Data on dengue prevalence were extracted from six sero-surveys conducted in Malaysia between 2001 and 2013; while statistics on dengue notification and Case Fatality Rate were derived from National Dengue Surveillance System. Dengue hospitalization data for the years 2009 to 2013 were extracted from the Health Informatics Centre and the volumes of dengue hospitalization for hospitals with missing data were estimated with Poisson models.

    RESULTS: The dengue incidence in Malaysia varied from 69.9 to 93.4 per 1000 population (pkp) between 2001 and 2013.The temporal trend in incidence rate was decreasing since 2001. It has been reducing at an average rate of 2.57 pkp per year from 2001 to 2013 (p = 0.011). The age-specific incidence of dengue decreased steadily with dengue incidence reaching zero by age > 70 years. Dengue notification rate has remained stable since 2001 and the number of notified cases each year was only a small fraction of the incident cases (0.7 to 2.3%). Similarly, the dengue hospitalization was larger but still a small fraction of the incident cases (3.0 to 5.6%).

    CONCLUSION: Dengue incidence can be estimated with the use of sero-prevalence surveys and mortality data. This study highlights a reducing trend of dengue incidence in Malaysia and demonstrates the discrepancy between true dengue disease burden and cases reported by national surveillance system. Sero-prevalence studies with representative samples should be conducted regularly to allow better estimation of dengue burden in Malaysia.

    MeSH terms: Cross-Sectional Studies; Dengue; Hospitalization; Humans; Malaysia; Models, Theoretical; Surveys and Questionnaires; Incidence; Prevalence; Information Storage and Retrieval
  16. Mahmuda A, Bande F, Abdulhaleem N, Abd Majid R, Awang Hamat R, Omar Abdullah W, et al.
    Iran J Parasitol, 2018 8 3;13(2):204-214.
    PMID: 30069204
    Background: Currently, most of the available serological diagnostic kits for strongyloidiasis are based on the use of the crude antigens of Strongyloides ratti, which are good, but with less sensitivity towards the infection. Hence, this study aimed to produce and evaluate monoclonal antibody for detecting soluble parasite antigen in animal sera.

    Methods: The study was conducted in the Department of Medical Microbiology and Parasitology, University Putra Malaysia in 2014-2017. Saline extract protein from the infective larvae of S. ratti was used to immunize BALB/c mice and subsequent fusion of the B-cells with myeloma cells (SP2/0) using 50% PEG. The hybridomas were cultured in HAT medium and cloned by limiting dilutions. Positive hybrids were screened by indirect ELISA. The ascites fluid from the antibody-secreting hybridoma was purified and the MAb was characterized by western-blots and evaluated in sandwich ELISA for reactivity against the homologous and heterologous antigens.

    Results: An IgG1 that recognizes a 30 and 34 kDa protein bands was obtained. The MAb was recognized by all S. ratti-related antigens and cross-reacted with only Toxocara canis antigens in both assays. The minimum antigen detection limit was found to be 5 ng/ml. All antibody-positive rat and dog sera evaluated have shown antigen-positive reactions in Sandwich-ELISA.

    Conclusion: The MAb produced, was able to detect antigens in strongyloidiasis and toxocariasis in animal models and may also be useful for the serological detection of active strongyloidiasis and visceral toxocariasis in human sera.

    MeSH terms: Animals; Antibodies, Monoclonal; Ascites; B-Lymphocytes; Dogs; Enzyme-Linked Immunosorbent Assay; Humans; Hybridomas; Immunoglobulin G; Immunization; Larva; Malaysia; Mice, Inbred BALB C; Parasites; Strongyloidiasis; Toxocariasis; Universities; Blotting, Western; Antigens, Heterophile; Toxocara canis; Strongyloides ratti; Models, Animal; Mice; Rats; Limit of Detection
  17. Hajissa K, Zakaria R, Suppian R, Mohamed Z
    Iran J Parasitol, 2018 8 3;13(2):215-224.
    PMID: 30069205
    Background: Toxoplasma gondii is a widely prevalent intracellular protozoan parasite which causes serious clinical and veterinary problems. Development of an effective vaccine for controlling toxoplasmosis is an extremely important aim. In the present study, the protective efficacy of recombinant multiepitope antigen (USM.TOXO1) expressing nine potential epitopes identified from SAG1, GRA2, and GRA7 of Toxoplasma gondii was evaluated in BALB/c mice.

    Methods: Mice were immunized subcutaneously with three doses of USM.TOXO1 antigen (10 μg/ml). Following the immunization, the IgG antibody, IgG subclass, IFN-γ and IL-4 production were evaluated using ELISA, the study was conducted at Animal Research and Service Center (ARASC), USM Health Campus in 2016.

    Results: Mice immunized with USM.TOXO1 significantly induced a mixed Th1/Th2 response polarized toward the IgG1 antibody isotype. While the cytokine analysis revealed a significant release of IFN-γ cytokines.

    Conclusion: USM.TOXO1 is a potential vaccine candidate that elicits strong immunity in BALB/c mice. The proven immunogenicity of the generated antigen can serve as a premise for further use of epitope-based vaccine in the immunoprevention of human and animal toxoplasmosis.

  18. Jayaraman J, Nagendrababu V, Pulikkotil SJ, Innes NP
    Int J Paediatr Dent, 2018 Nov;28(6):548-560.
    PMID: 30070003 DOI: 10.1111/ipd.12414
    OBJECTIVE: To systematically assess the methodological quality of Systematic Reviews (SRs) and Meta-Analyses (MA) published in Paediatric Dentistry journals and to analyse the relationship between the authors, journals, country, review topic, and the year of publication to the methodological quality of SRs and MA.

    DESIGN: Paediatric Dentistry journals ranked in the top five of the h5 index of Google Scholar Metrics were selected. SRs with MA were searched independently by two reviewers using PubMed and Scopus databases until December 2017. Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) tool. Statistical significance was set at P 

    MeSH terms: Evaluation Studies as Topic; Humans; Pediatric Dentistry*; Publications/statistics & numerical data; Databases, Factual; Statistics, Nonparametric; Journal Impact Factor*; Research Report
  19. Umapathi T, Kam YW, Ohnmar O, Ng BCJ, Ng Y, Premikha M, et al.
    J Peripher Nerv Syst, 2018 09;23(3):197-201.
    PMID: 30070025 DOI: 10.1111/jns.12284
    Although individuals with Zika virus (ZIKV) antibodies were reported in Malaya in mid-1950s, entomological and human surveillance in Singapore did not identify autochthonous transmission until the outbreak of August-November, 2016. A total of 455 cases from 15 separate clusters were identified. We asked if this ZIKV outbreak increased the incidence of Guillain-Barré syndrome (GBS) and aimed to characterize these cases. Eleven GBS cases, consecutively enrolled into our prospective GBS database from onset to 4 weeks after outbreak, and six controls, comprising three GBS patients enrolled before outbreak and three non-GBS patients, were examined for evidence of recent ZIKV infection. We performed serum, urine ZIKV RT-PCR, ZIKV serology, and virus neutralization assays, accounting for cross-reaction and co-infection with dengue (DENV). We found five GBS cases with only serological evidence of recent ZIKV infection (including one ZIKV-DENV co-infection). A temporal relationship with ZIKV outbreak was unlikely as two cases were GBS controls enrolled 3 months before outbreak. None reported symptoms of ZIKV infection. In addition, compared to last 10 years the national number of GBS hospitalizations did not increase during and immediately after outbreak. We conclude the 2016 Singapore ZIKV outbreak did not cause a change in GBS epidemiology.
    MeSH terms: Adult; Aged, 80 and over; Disease Outbreaks*; Female; Humans; Male; Middle Aged; Singapore/epidemiology; Incidence; Guillain-Barre Syndrome/epidemiology*
  20. Mittal P, Chan OY, Kanneppady SK, Verma RK, Hasan SS
    PLoS One, 2018;13(8):e0201776.
    PMID: 30071006 DOI: 10.1371/journal.pone.0201776
    Self-medication with analgesics in dental pain management is a common practice as most of these medicines are available over-the-counter (OTC). The study aims to examine the relationship between beliefs about medicines and self-medication with analgesics in dental pain management in Malaysia. This cross-sectional study was conducted among conveniently sampled patients attending dental clinics, located in Kuala Lumpur, Malaysia to assess association between self-medication with analgesics and patient's beliefs about medicines via Beliefs about Medicines Questionnaire. Participants were evaluated for their self-medication practices via 4 items. Further assessment was done via Quantitative Analgesic Questionnaire (QAQ) regarding the analgesics taken. Statistical analyses were performed using SPSS version 24, with 0.05 as level of significance. The prevalence of self-medication with analgesics was 29.4%, with 95.6% of the participants took analgesics when necessary. Participants practising self-medication for dental pain reported more positive beliefs in General-Necessity (13.04 vs. 9.98, p = 0.001) than those not practising self-medication. However, these participants had weaker beliefs in General-Harm (12.00 vs. 10.29, p = 0.006) and General-Overuse (11.38 vs. 10.31, p = 0.032) than those not practising self-medication. Participants beliefs in General-Harm (r = -0.243; p = 0.003) and General-Overuse (r = -0.203; p = 0.012) were negatively correlated with total QAQ point. The study found that individuals who practised self-medication had stronger beliefs about the benefits of medicines and weaker beliefs in viewing medicines as harmful and overused. Findings can guide public education to improve the safety aspects of self-medication with analgesics in dental practice.
    MeSH terms: Adult; Aged; Analgesics/therapeutic use*; Cross-Sectional Studies; Nonprescription Drugs/therapeutic use*; Female; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Male; Middle Aged; Self Medication/psychology*; Thiophenes; Toothache/drug therapy*; Toothache/epidemiology; Toothache/psychology*; Prevalence; Young Adult; Pain Management/psychology
External Links