Browse publications by year: 2018

  1. Jee SL, Amin-Tai H, Fathi NQ, Jabar MF
    ACG Case Rep J, 2018;5:e21.
    PMID: 29577055 DOI: 10.14309/crj.2018.21
    Perianal mucinous adenocarcinoma (PMA) is an oncologic rarity that poses a diagnostic and therapeutic dilemma for treating clinicians because there are few reported cases and an absence of definitive guidelines. We report a patient who had been treated with local surgery for recurrent perianal abscess with fistula for 3 years. Biopsy of the indurated tissue overlying his surgical scars revealed PMA. Neoadjuvant concurrent chemoradiotherapy followed by abdominoperineal resection was planned to address the locally advanced disease and ongoing sepsis. Our case is unique in that the fistula preceded carcinoma by only 3 years instead of the typical 10 years.
    MeSH terms: Abscess; Anus Diseases; Biopsy; Adenocarcinoma, Mucinous; Cicatrix; Fistula; Humans; Rectal Neoplasms; Sepsis; Neoadjuvant Therapy; Chemoradiotherapy
  2. Le DQ, Satyanarayana B, Fui SY, Shirai K
    Biol Trace Elem Res, 2018 Dec;186(2):538-545.
    PMID: 29577182 DOI: 10.1007/s12011-018-1313-2
    The present study, aimed at observing the total concentration of mercury (Hg) in edible finfish species with an implication to human health risk, was carried out from the Setiu mangrove wetlands on the east coast of Peninsular Malaysia. Out of 20 species observed, the highest Hg concentrations were found among carnivores-fish/invertebrate-feeders, followed by omnivores and carnivores-invertebrate-feeders, while the lowest concentrations in herbivores. The Hg concentrations varied widely with fish species and body size, from 0.12 to 2.10 mg/kg dry weight. A positive relationship between body weight and Hg concentration was observed in particular for Toxotes jaculatrix and Tetraodon nigroviridis. Besides the permissible range of Hg concentration up to 0.3 mg/kg (cf. United States Environmental Protection Agency (USEPA)) in majority of species, the carnivore feeders such as Acanthopagrus pacificus, Gerres filamentosus, and Caranx ignobilis have shown excess amounts (> 0.40 mg/kg flesh weight) that raising concerns over the consumption by local people. However, the weekly intake of mercury-estimated through the fish consumption in all three trophic levels-suggests that the present Hg concentrations are still within the range of Provisional Tolerable Weekly Intake (PTWI) reported by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). Perhaps, a multi-species design for Hg monitoring at Setiu wetlands would be able to provide further insights into the level of toxicity transfer among other aquatic organisms and thereby a strong health risk assessment for the local communities.
    MeSH terms: Animals; Environmental Monitoring; Fishes*; Food Contamination/analysis; Geography; Humans; Malaysia; Mercury/analysis*; Perciformes/classification; Tropical Climate; Water Pollutants, Chemical/analysis; Water Pollutants, Chemical/metabolism; Seafood/analysis*; Risk Assessment; Food Chain; Wetlands*
  3. Putteeraj M, Lim WL, Teoh SL, Yahaya MF
    Curr Drug Targets, 2018;19(14):1710-1720.
    PMID: 29577854 DOI: 10.2174/1389450119666180326125252
    Brain ischemia is among the leading cause of death with majority of the cases are associated with ischemic strokes. It can occur in two forms of either focal or global ischemia. Neurodegenerative disorder such as Alzheimer and Parkinson diseases is also on the rise worldwide. These disorders have common similarities; i.e. they all affecting the central nervous system with debilitating effect to the patient. In this review, we look into the promising role of flavonoids, a natural bioactive compound found abundant in vegetables, fruits and traditional herbs. Treatment with flavonoids such as curcumin, lycopene, ginsenoside, vitexin and baicalin have shown promising neuroprotective effects against ischemic-induced injury. Besides anticancer, antioxidant and immunomodulation properties, flavonoid also exerts neuroprotective effects by increases neuronal viability, increases tissue perfusion and cerebral blood flow and reduce ischemic-related apoptosis. In addition, flavonoid also exerts anti-amyloidogenic effect and reduces loss of dopaminergic neurons in the brain. These results suggesting flavonoids might be able to serve as a potential therapeutic agent in brain disorders.
    MeSH terms: Animals; Cell Survival; Brain Ischemia/drug therapy*; Flavonoids/pharmacology; Flavonoids/therapeutic use*; Humans; Neurons/cytology; Neurons/drug effects; Neurodegenerative Diseases/drug therapy*; Phytochemicals/pharmacology; Phytochemicals/therapeutic use
  4. Elias N, Chandren S, Razak FIA, Jamalis J, Widodo N, Wahab RA
    Int J Biol Macromol, 2018 Jul 15;114:306-316.
    PMID: 29578010 DOI: 10.1016/j.ijbiomac.2018.03.095
    The contribution of chitosan/nanocellulose (CS-NC) to the enzymatic activity of Candida rugosa lipase covalently bound on the surface of CS-NC (CRL/CS-NC) was investigated. Cellulosic material from oil palm frond leaves (OPFL) were bleached, alkaline treated and acid hydrolyzed to obtain the purified NC and used as nano-fillers in CS. XRD, Raman spectroscopy and optical fluorescence microscopic analyses revealed existence of strong hydrogen bonds between CS and the NC nanofillers. The CRLs were successfully conjugated to the surface of the CS-NC supports via imine bonds that occurred through a Schiff's based mechanism. Process parameters for the immobilization of CRL were assessed for factors temperature, concentration of glutaraldehyde and pH, to afford the highest enzyme activity to achieve maximum conversion of butyl butyrate within 3h of incubation. Conversion as high as 88% was reached under an optimized condition of 25°C, 0.3% glutaraldehyde concentration and buffer at pH7. Thermal stability of CRL/CS-NCs was 1.5-fold greater than that of free CRL, with biocatalysts reusability for up to 8 successive esterification cycles. This research provides a promising approach for expanding the use of NC from OPFL for enhancing enzyme activity in favour of an alternative eco-friendly means to synthesize butyl butyrate.
    MeSH terms: Candida/enzymology*; Cellulose/chemistry*; Enzyme Stability; Enzymes, Immobilized/chemistry*; Fungal Proteins/chemistry*; Poaceae/chemistry*; Lipase/chemistry*; Biomass*; Chitosan/chemistry*
  5. Ahamad NA, Kamangar S, Badruddin IA
    Biomed Mater Eng, 2018;29(3):319-332.
    PMID: 29578467 DOI: 10.3233/BME-181734
    The current study investigates the curvature effect due to various angles of curvature on the blood flow in human artery. The stenosis is considered to have three sizes 70%, 80% and 90% blockage before the curve section of artery. Numerical study of four different angle of curvature was considered to understand the flow behavior of artery having various curvatures, on the hemodynamics factors that includes drop in arterial pressure, flow velocity as well as wall shear stress. It was found that, the augmentation of the flow resistance due to the curvature increases in presence of stenosis. It was also noted that the wall shear is higher at the outer wall as compared to the inside wall in four models considered. Results showed that both the curvature of artery and size of the stenosis have significant impact. These two factors should be considered by cardiologist to assess the complexity of stenosis.
    MeSH terms: Blood Flow Velocity*; Computer Simulation*; Coronary Vessels/pathology; Coronary Vessels/physiopathology*; Hemodynamics; Humans; Models, Cardiovascular*; Stress, Mechanical; Coronary Stenosis/pathology; Coronary Stenosis/physiopathology*
  6. Mohamad NA, Ramachandran V, Ismail P, Mohd Isa H, Chan YM, Ngah NF, et al.
    Bosn J Basic Med Sci, 2018 Aug 01;18(3):260-267.
    PMID: 29579408 DOI: 10.17305/bjbms.2018.2493
    Pharmacogenetic studies indicate that a variable response to anti-vascular endothelial growth factor (VEGF) therapy in patients with neovascular form of AMD (nAMD) may be due to polymorphisms in the complement factor H gene (CFH). This study is the first to investigate the association between CFH Y402H polymorphism and the response to ranibizumab therapy in Malaysian patients with nAMD. We included 134 patients with nAMD, examined between September 2014 and February 2016. The diagnosis of nAMD was confirmed by ophthalmologic examination, before ranibizumab therapy was started. Each patient received an intravitreal injection of 0.5 mg/0.05 ml ranibizumab following a treat-and-extend (TE) regimen. Best-corrected visual acuity (BCVA) and central retinal thickness (CRT) were recorded after 3 and 6 months following the first injection and compared with the baseline values. Genotyping of Y402H (rs1061170) polymorphism was performed using PCR-RFLP and the amplified product was digested with MluCI restriction enzyme. Association between the Y402H genotypes and response to treatment was determined by a logistic regression analysis of responder (n = 49) and non-responder (n = 84) group. Significantly worse mean BCVA was observed for the CC genotype compared to the TT + CT genotype in the total sample after 6-month follow-up (p = 0.018). Comparing the baseline and 6-month point measurements, improved mean BCVA was observed in responder group, while worse mean BCVA was recorded for non-responder group. However, our regression analysis, adjusted for confounding factors, showed no significant association between the Y402H genotypes and response to treatment in nAMD patients under the recessive model (p > 0.05). Overall, our results suggest that factors other than Y402H polymorphism may be involved in the progression of nAMD after treatment with anti-VEGF agents, in Malaysian population.
    MeSH terms: Ranibizumab/therapeutic use*; Aged; Female; Genotype; Humans; Macular Degeneration/drug therapy*; Macular Degeneration/genetics*; Malaysia; Male; Middle Aged; Pharmacogenetics; Prospective Studies; Regression Analysis; Polymorphism, Restriction Fragment Length; Retina/pathology; Visual Acuity; Treatment Outcome; Complement Factor H/genetics; Polymorphism, Single Nucleotide*; Vascular Endothelial Growth Factor A/antagonists & inhibitors*; Intravitreal Injections
  7. Khalik WF, Ho LN, Ong SA, Voon CH, Wong YS, Yusuf SY, et al.
    Chemosphere, 2018 Jul;202:467-475.
    PMID: 29579681 DOI: 10.1016/j.chemosphere.2018.03.113
    The role of azo dye Reactive Black 5 (RB5) as an electron donor and/or electron acceptor could be distinguished in dual chamber of photocatalytic fuel cell (PFC). The introduction of RB5 in anode chamber increased the voltage generation in the system since degradation of RB5 might produce electrons which also would transfer through external circuit to the cathode chamber. The removal efficiency of RB5 with open and closed circuit was 8.5% and 13.6%, respectively and removal efficiency for open circuit was low due to the fact that recombination of electron-hole pairs might happen in anode chamber since without connection to the cathode, electron cannot be transferred. The degradation of RB5 in cathode chamber with absence of oxygen showed that electrons from anode chamber was accepted by dye molecules to break its azo bond. The presence of oxygen in cathode chamber would improve the oxygen reduction rate which occurred at Platinum-loaded carbon (Pt/C) cathode electrode. The Voc, Jsc and Pmax for different condition of ultrapure water at cathode chamber also affected their fill factor. The transportation of protons to cathode chamber through Nafion membrane could decrease the pH of ultrapure water in cathode chamber and undergo hydrogen evolution reaction in the absence of oxygen which then increased degradation rate of RB5 as well as its electricity generation.
    MeSH terms: Azo Compounds/chemistry; Bioelectric Energy Sources*; Electricity; Electrons*; Naphthalenesulfonates/chemistry*; Oxygen/chemistry; Sunlight*
  8. Hanafi MA, Hashim SN, Chay SY, Ebrahimpour A, Zarei M, Muhammad K, et al.
    Food Res Int, 2018 04;106:589-597.
    PMID: 29579964 DOI: 10.1016/j.foodres.2018.01.030
    As a protein-rich, underutilized crop, green soybean could be exploited to produce hydrolysates containing angiotensin-I converting enzyme (ACE) inhibitory peptides. Defatted green soybean was hydrolyzed using four different food-grade proteases (Alcalase, Papain, Flavourzyme and Bromelain) and their ACE inhibitory activities were evaluated. The Alcalase-generated green soybean hydrolysate showed the highest ACE inhibitory activity (IC50: 0.14 mg/mL at 6 h hydrolysis time) followed by Papain (IC50: 0.20 mg/mL at 5 h hydrolysis time), Bromelain (IC50: 0.36 mg/mL at 6 h hydrolysis time) and Flavourzyme (IC50: 1.14 mg/mL at 6 h hydrolysis time) hydrolysates. The Alcalase-generated hydrolysate was profiled based on its hydrophobicity and isoelectric point using reversed phase high performance liquid chromatography (RP-HPLC) and isoelectric point focusing (IEF) fractionators. The Alcalase-generated green soybean hydrolysate comprising of peptides EAQRLLF, PSLRSYLAE, PDRSIHGRQLAE, FITAFR and RGQVLS, revealed the highest ACE inhibitory activity of 94.19%, 99.31%, 92.92%, 101.51% and 90.40%, respectively, while their IC50 values were 878 μM, 532 μM, 1552 μM, 1342 μM and 993 μM, respectively. It can be concluded that Alcalase-digested green soybean hydrolysates could be exploited as a source of peptides to be incorporated into functional foods with antihypertensive activity.
    MeSH terms: Angiotensin-Converting Enzyme Inhibitors/isolation & purification; Angiotensin-Converting Enzyme Inhibitors/pharmacology*; Antihypertensive Agents/isolation & purification; Antihypertensive Agents/pharmacology*; Bromelains/chemistry; Food Handling/methods*; Hydrolysis; Papain/chemistry; Endopeptidases/chemistry; Peptides/isolation & purification; Peptides/pharmacology*; Protein Hydrolysates/isolation & purification; Protein Hydrolysates/pharmacology*; Soybeans/chemistry*; Subtilisins/chemistry*; Time Factors; Soybean Proteins/isolation & purification; Soybean Proteins/pharmacology*
  9. Norizzah AR, Nur Azimah K, Zaliha O
    Food Res Int, 2018 04;106:982-991.
    PMID: 29580013 DOI: 10.1016/j.foodres.2018.02.001
    Interesterification reaction involves rearrangement of the fatty acid radicals on the glycerol backbone, either randomly (chemical interesterification) or regioselectivity (enzymatic interesterification). Refined, bleached and deodourised palm oil (RBDPO) and palm kernel oil (RBDPKO) were blended in ratios from 25:75 to 75:25 (wt/wt). All blends were subjected to enzymatic (EI) and chemical interesterification (CI) using Lipozyme TL IM (4% w/w) and sodium methoxide (0.2% m/m) as the catalysts, respectively. The effect of EI and CI on the triacylglycerol (TAG) composition, thermal behaviour, polymorphism, crystal morphology and crystallisation kinetics were studied. The aim of this research is to characterise the nature of crystals in food product for certain desired structure. The crystallisation behaviour discussed in this study involves microstructure (PLM), polymorphism (XRD), thermal properties and crystallisation kinetics by DSC. The alteration in TAG composition was greater after CI as compared to EI with the reduction of LaLaLa (from 11.00% to 5.15%) and POO (from 14.28% to 4.87%). The DSC complete melting and crystallisation temperature of blend with 75% PO increased after CI, from 39.58 °C to 41.67 °C and from -30.84 °C to -28.33 °C, respectively. EI contributed to finer crystals than CI. However, the β' and β polymorph mixture and crystallisation kinetics (n = 2) of PO-PKO blends did not change after CI and EI. The knowledge on controlling crystallisation of RBDPO and RBDPKO blends is vital for proper processing condition like margarine production.
    MeSH terms: Crystallization; Esterification; Food Handling/methods*; Hot Temperature; Triglycerides/analysis; Triglycerides/chemistry
  10. Lian BSX, Yek AEH, Shuvas H, Abdul Rahman SF, Muniandy K, Mohana-Kumaran N
    BMC Res Notes, 2018 Mar 27;11(1):197.
    PMID: 29580266 DOI: 10.1186/s13104-018-3302-0
    OBJECTIVE: There are number of studies which report that BCL-2 anti-apoptotic proteins (e.g. BCL-2, BCL-XL, and MCL-1) are highly expressed in cervical cancer tissues compared to the normal cervical epithelia. Despite these reports, targeting these proteins for cervical cancer treatment has not been explored extensively. BH3-mimetics that inhibit specific BCL-2 anti-apoptotic proteins may hold encouraging treatment outcomes for cervical cancer management. Hence, the aim of this pilot study is to investigate the sensitivity of cervical cancer cell lines to combination of two BH3-mimetics namely ABT-263 which selectively inhibits BCL-2, BCL-XL and BCL-w and A-1210477, a selective MCL-1 inhibitor.

    RESULTS: We report that combination of A-1210477 and ABT-263 exhibited synergistic effects on all cervical cancer cell lines tested. Drug sensitization studies revealed that A-1210477 sensitised the cervical cancer cell lines SiHa and CaSki to ABT-263 by 11- and fivefold, respectively. Sensitization also occurred in the opposite direction whereby ABT-263 sensitised SiHa and CaSki to A-1210477 by eightfold. This report shows that combination of ABT-263 and A-1210477 could be a potential treatment strategy for cervical cancer. Extensive drug mechanistic studies and drug sensitivity studies in physiological models are necessary to unleash the prospect of this combination for cervical cancer therapy.

    MeSH terms: Aniline Compounds/pharmacology*; Antineoplastic Agents/pharmacology; Uterine Cervical Neoplasms/metabolism; Uterine Cervical Neoplasms/pathology; Drug Synergism; Female; Humans; Indoles/pharmacology*; Sulfonamides/pharmacology*; Proto-Oncogene Proteins c-bcl-2/antagonists & inhibitors; Proto-Oncogene Proteins c-bcl-2/metabolism; Cell Line, Tumor; Cell Proliferation/drug effects*; bcl-X Protein/antagonists & inhibitors; bcl-X Protein/metabolism; Myeloid Cell Leukemia Sequence 1 Protein/antagonists & inhibitors*; Myeloid Cell Leukemia Sequence 1 Protein/metabolism
  11. Teerawattanapong N, Panich P, Kulpokin D, Na Ranong S, Kongpakwattana K, Saksinanon A, et al.
    Infect Control Hosp Epidemiol, 2018 05;39(5):525-533.
    PMID: 29580299 DOI: 10.1017/ice.2018.58
    OBJECTIVETo summarize the clinical burden (cumulative incidence, prevalence, case fatality rate and length of stay) and economic burden (healthcare cost) of healthcare-associated infections (HAIs) due to multidrug-resistant organisms (MDROs) among patients in intensive care units (ICUs) in Southeast Asia.DESIGNSystematic review.METHODSWe conducted a comprehensive literature search in PubMed, EMBASE, CINAHL, EconLit, and the Cochrane Library databases from their inception through September 30, 2016. Clinical and economic burdens and study quality were assessed for each included study.RESULTSIn total, 41 studies met our inclusion criteria; together, 22,876 ICU patients from 7 Southeast Asian countries were included. The cumulative incidence of HAI caused by A. baumannii (AB) in Southeast Asia is substantially higher than has been reported in other regions, especially carbapenem-resistant AB (CRAB; 64.91%) and multidrug-resistant AB (MDR-AB) (58.51%). Evidence of a dose-response relationship between different degrees of drug resistance and excess mortality due to AB infections was observed. Adjusted odds ratios were 1.23 (95% confidence interval [CI], 0.51-3.00) for MDR-AB, 1.72 (95% CI, 0.77-3.80) for extensively drug-resistant AB (XDR-AB), and 1.82 (95% CI, 0.55-6.00) for pandrug-resistant AB (PDR-AB). There is, however, a paucity of published data on additional length of stay and costs attributable to MDROs.CONCLUSIONSThis review highlights the challenges in addressing MDROs in Southeast Asia, where HAIs caused by MDR gram-negative bacteria are abundant and have a strong impact on society. With our findings, we hope to draw the attention of clinicians and policy makers to the problem of antibiotic resistance and to issue a call for action in the management of MDROs.Infect Control Hosp Epidemiol 2018;39:525-533.
    MeSH terms: Acinetobacter Infections/drug therapy; Acinetobacter Infections/epidemiology; Anti-Bacterial Agents/economics; Anti-Bacterial Agents/therapeutic use*; Asia, Southeastern; Bacterial Infections/drug therapy*; Bacterial Infections/economics; Bacterial Infections/epidemiology*; Cross Infection/drug therapy; Cross Infection/economics; Cross Infection/microbiology*; Cross Infection/epidemiology*; Humans; Intensive Care Units; Length of Stay; Drug Resistance, Multiple, Bacterial; Acinetobacter baumannii/isolation & purification
  12. Arunachalam K, Lakshmanan S, Maan A, Kumar N, Dominic P
    J Clin Med Res, 2018 May;10(5):384-390.
    PMID: 29581800 DOI: 10.14740/jocmr3338w
    Background: Drug induced long QT syndrome is quite common in daily clinical practice but its impact is unknown.

    Methods: PubMed and EMBASE databases (until May 2, 2017) were searched to identify studies reporting drug induced long QT syndrome and followed the PRISMA guidelines. The main outcomes measured in these studies were QTc prolongation, ventricular arrhythmias, torsade de pointes (TdP) and death.

    Results: Out of 176 non-duplicate reports, 36 studies satisfied inclusion criteria and provided data on patients exposed to drugs that can potentially cause long QT. Totally, 14,756 patients were exposed and 930 patients (6.3%) were found to have QTc prolongation. The number of males was 6,400 and females were 5,723 patients. The mean age of the patients was 43.8 ± 9.36 years. Ventricular arrhythmias were found in 379 patients (2.6%), 26 patients were found to have premature atrial contractions (PACs) and premature ventricular contractions (PVCs). TdP was found in 49 patients (0.33 %), sudden cardiac death (SCD) was found in five patients and 586 patients were found to have all-cause mortality.

    Conclusions: Around 6% of patients have risk of QT prolongation when exposed but only 0.3% developed TdP and 2.6% developed ventricular arrhythmias. Risk of developing arrhythmias is higher with concomitant use of multiple QT prolonging drugs.

  13. M P Sockalingam SN, Kong Loh Seu K, Mohamed Noor H, Irfani Zakaria AS
    Case Rep Dent, 2018;2018:8715647.
    PMID: 29581902 DOI: 10.1155/2018/8715647
    Complicated crown-root fractures account for a small percentage of traumatic dental injuries seen in children; however, management of these injuries can be very challenging to clinicians. Factors such as complexity of the injury, patient's age and dentition stage, patient's cooperation, and parental demands may have some bearing on the type of treatment undertaken and its outcomes. In some children, these injuries may have significant impact on their quality of life. The purpose of this article is to describe two cases of complicated crown-root fracture which were successfully managed through orthodontic extrusion using a sectional fixed orthodontic technique. The basis for the treatment technique and its favourable outcomes were highlighted with its advantages and drawbacks.
    MeSH terms: Child; Crowns; Dentition; Humans; Patient Compliance; Quality of Life; Tooth Fractures; Tooth Root; Orthodontic Extrusion
  14. Chong SY, Fhun LC, Tai E, Chong MF, Sonny Teo KS
    Cureus, 2018 Jan 24;10(1):e2109.
    PMID: 29581921 DOI: 10.7759/cureus.2109
    Yoga has recently been touted as a means to improve physical and mental well-being. However, no form of exercise is without its risks. A 32-year-old Chinese female with moderate myopia complained of right eye sudden onset of floaters and mild blurring of vision after the head-down posture. The visual acuity was 6/12 in the right eye and 6/9 in the left eye. A right eye fundus examination showed posterior vitreous detachment, with a small blood clot located at the inferior margin of the optic disc. The patient was diagnosed with right eye vitreous hemorrhage secondary to acute posterior vitreous detachment and was managed conservatively. Acute changes in posture, especially between an upright and a head-down position, may cause acute posterior vitreous detachment. As yoga practitioners may be required to assume this head-down position, myopic patients should be warned of the possible ocular complications of this exercise.
    MeSH terms: Female; Humans; Myopia; Optic Disk; Posture; Thrombosis; Vision, Ocular; Visual Acuity; Vitreous Hemorrhage; Yoga; Vitreous Detachment
  15. Venkatason P, Zaharan NL, Ismail MD, Wan Ahmad WA, Mahmood Zuhdi AS
    Eur J Clin Pharmacol, 2018 Jul;74(7):953-960.
    PMID: 29582106 DOI: 10.1007/s00228-018-2451-3
    PURPOSE: Information is lacking on prescribing of preventative cardiovascular pharmacotherapies for patients with non-ST elevation myocardial infarction (NSTEMI) in the Asian region. This study examined the prescribing rate of these pharmacotherapies, comparing NSTEMI to STEMI, and variations across demographics and clinical factors within the NSTEMI group in the multi-ethnic Malaysian population.

    METHODS: This is a retrospective analysis of the Malaysian National Cardiovascular Disease Database-Acute Coronary Syndrome registry from year 2006 to 2013 (n = 30,873). On-discharge pharmacotherapies examined were aspirin, ADP-antagonists, statins, ACE-inhibitors, angiotensin-II-receptor blockers, and beta-blockers. Multivariate logistic regression was used to calculate adjusted odds ratio of receiving individual pharmacotherapies according to patients' characteristics in NSTEMI patients (n = 11,390).

    RESULTS: Prescribing rates for cardiovascular pharmacotherapies had significantly increased especially for ADP-antagonists (76%) in NSTEMI patients. More than 85% were prescribed statins and antiplatelets but rates remained significantly lower compared to STEMI. Women and those over 65 years old were less likely to be prescribed these pharmacotherapies compared to men and younger NSTEMI patients. Chinese and Indians were more likely to receive selected pharmacotherapies compared to Malays (main ethnicity). Geographical variations were observed; East Malaysian (Malaysian Borneo) patients were less likely to receive these compared to Western region of Malaysian Peninsular. Underprescribing in patients with risk factors such as diabetes were observed with other co-morbidities influencing prescribing selectively.

    CONCLUSION: This study uncovers demographic and clinical variations in cardiovascular pharmacotherapies prescribing for NSTEMI. Concerted efforts by policy makers, specialty societies, and physicians are required focusing on elderly, women, Malays, East Malaysians, and high-risk patients.

    MeSH terms: Adenosine Diphosphate; Adrenergic beta-Antagonists; Aged; Angiotensin-Converting Enzyme Inhibitors; Aspirin; Borneo; Demography; Diabetes Mellitus; Female; Humans; Malaysia; Male; Registries; Retrospective Studies; Risk Factors; Comorbidity; Logistic Models; Odds Ratio; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Asian Continental Ancestry Group; Acute Coronary Syndrome; Angiotensin Receptor Antagonists; ST Elevation Myocardial Infarction
  16. Bahrampour Juybari K, Kamarul T, Najafi M, Jafari D, Sharifi AM
    Cell Tissue Res, 2018 08;373(2):407-419.
    PMID: 29582166 DOI: 10.1007/s00441-018-2825-y
    Strategies based on mesenchymal stem cell (MSC) therapy for restoring injured articular cartilage are not effective enough in osteoarthritis (OA). Due to the enhanced inflammation and oxidative stress in OA microenvironment, differentiation of MSCs into chondrocytes would be impaired. This study aims to explore the effects of diallyl disulfide (DADS) on IL-1β-mediated inflammation and oxidative stress in human adipose derived mesenchymal stem cells (hADSCs) during chondrogenesis. MTT assay was employed to examine the effects of various concentrations of DADS on the viability of hADSCs at different time scales to obtain non-cytotoxic concentration range of DADS. The effects of DADS on IL-1β-induced intracellular ROS generation and lipid peroxidation were evaluated in hADSCs. Western blotting was used to analyze the protein expression levels of IκBα (np), IκBα (p), NF-κB (np) and NF-κB (p). Furthermore, the gene expression levels of antioxidant enzymes in hADSCs and chondrogenic markers at days 7, 14 and 21 of differentiation were measured using qRT-PCR. The results showed that addition of DADS significantly enhanced the mRNA expression levels of antioxidant enzymes as well as reduced ROS elevation, lipid peroxidation, IκBα activation and NF-κB nuclear translocation in hADSCs treated with IL-1β. In addition, DADS could significantly increase the expression levels of IL-1β-induced impaired chondrogenic marker genes in differentiated hADSCs. Treatment with DADS may provide an effective approach to prevent the pro-inflammatory cytokines and oxidative stress as catabolic causes of chondrocyte cell death and enhance the protective anabolic effects by promoting chondrogenesis associated gene expressions in hADSCs exposed to OA condition.
    MeSH terms: Adipose Tissue/cytology*; Allyl Compounds/pharmacology*; Antioxidants/metabolism*; Cell Nucleus/drug effects; Cell Nucleus/metabolism; Cell Survival/drug effects; Disulfides/pharmacology*; Gene Expression Regulation/drug effects; Glycosaminoglycans/metabolism; Humans; Malondialdehyde/metabolism; Phosphorylation/drug effects; RNA, Messenger/genetics; RNA, Messenger/metabolism; NF-kappa B/metabolism*; Reactive Oxygen Species/metabolism*; Protein Transport/drug effects; Intracellular Space/metabolism; Cell Shape/drug effects; Interleukin-1beta/metabolism*; Mesenchymal Stromal Cells/drug effects; Mesenchymal Stromal Cells/metabolism*; NF-KappaB Inhibitor alpha/metabolism
  17. Nwabichie CC, Manaf RA, Ismail SB
    Asian Pac J Cancer Prev, 2018 Mar 27;19(3):825-831.
    PMID: 29582641
    Introduction: Cervical cancer is a health concern among women worldwide, presently ranking as the second to fourth common cancer type among women in different parts of the world. Human papillomaviruses (HPV) 16 and 18 are the main causative agents of cervical cancer. However, prevention is possible with early and regular cervical cancer screening.
    Objective: This study aimed to identify the cervical cancer screening practices and factors affecting the screening status of African immigrant women attending selected church services in Klang Valley, Malaysia.
    Methodology: A cross-sectional study among 320 randomly selected respondents between ages 18-69 was conducted in three different churches with high numbers of African participants. A self-administered questionnaire was distributed among the respondents. To ensure a good understanding, the questionnaire was written and self-explained in English language, because English is the general spoken language among the study population. Three levels of analysis were conducted using SPSS 21, involving descriptive analysis, chi square and multiple logistic regression.
    Results: The response rate was 98.2%, the majority (68.1%) of the respondents being aged 31-50 years and married. The prevalence of screening among the respondents over the past 3 years was 27.2%. Using a p-value of 0.05 as the significance level, the final model showed that marital status (p=0.004), knowledge (p=0.035), perceived barriers (p=0.003), and having a regular health care provider (p<0.001) were the only significant predicting factors of uptake of cervical screening among African immigrant women in Klang Valley, Malaysia.
    Conclusion: The findings revealed that the uptake of cervical cancer screening among the African women was very low. Marital status, knowledge, perceived barriers and having a regular health care provider were the predictive factors. Specific awareness programs to increase uptake should be designed and implemented by the relevant authorities.
    MeSH terms: Adolescent; Adult; Aged; Uterine Cervical Neoplasms/diagnosis*; Uterine Cervical Neoplasms/epidemiology; Uterine Cervical Neoplasms/psychology*; Cross-Sectional Studies; Female; Follow-Up Studies; Humans; Health Knowledge, Attitudes, Practice*; Malaysia; Malaysia/epidemiology; Mass Screening; Middle Aged; Perception; Prognosis; Surveys and Questionnaires; Risk Factors; Vaginal Smears/psychology*; Early Detection of Cancer/psychology*; Young Adult; Papanicolaou Test/psychology*
  18. Tromp J, Tay WT, Ouwerkerk W, Teng TK, Yap J, MacDonald MR, et al.
    PLoS Med, 2018 03;15(3):e1002541.
    PMID: 29584721 DOI: 10.1371/journal.pmed.1002541
    BACKGROUND: Comorbidities are common in patients with heart failure (HF) and complicate treatment and outcomes. We identified patterns of multimorbidity in Asian patients with HF and their association with patients' quality of life (QoL) and health outcomes.

    METHODS AND FINDINGS: We used data on 6,480 patients with chronic HF (1,204 with preserved ejection fraction) enrolled between 1 October 2012 and 6 October 2016 in the Asian Sudden Cardiac Death in Heart Failure (ASIAN-HF) registry. The ASIAN-HF registry is a prospective cohort study, with patients prospectively enrolled from in- and outpatient clinics from 11 Asian regions (Hong Kong, Taiwan, China, Japan, Korea, India, Malaysia, Thailand, Singapore, Indonesia, and Philippines). Latent class analysis was used to identify patterns of multimorbidity. The primary outcome was defined as a composite of all-cause mortality or HF hospitalization within 1 year. To assess differences in QoL, we used the Kansas City Cardiomyopathy Questionnaire. We identified 5 distinct multimorbidity groups: elderly/atrial fibrillation (AF) (N = 1,048; oldest, more AF), metabolic (N = 1,129; obesity, diabetes, hypertension), young (N = 1,759; youngest, low comorbidity rates, non-ischemic etiology), ischemic (N = 1,261; ischemic etiology), and lean diabetic (N = 1,283; diabetic, hypertensive, low prevalence of obesity, high prevalence of chronic kidney disease). Patients in the lean diabetic group had the worst QoL, more severe signs and symptoms of HF, and the highest rate of the primary combined outcome within 1 year (29% versus 11% in the young group) (p for all <0.001). Adjusting for confounders (demographics, New York Heart Association class, and medication) the lean diabetic (hazard ratio [HR] 1.79, 95% CI 1.46-2.22), elderly/AF (HR 1.57, 95% CI 1.26-1.96), ischemic (HR 1.51, 95% CI 1.22-1.88), and metabolic (HR 1.28, 95% CI 1.02-1.60) groups had higher rates of the primary combined outcome compared to the young group. Potential limitations include site selection and participation bias.

    CONCLUSIONS: Among Asian patients with HF, comorbidities naturally clustered in 5 distinct patterns, each differentially impacting patients' QoL and health outcomes. These data underscore the importance of studying multimorbidity in HF and the need for more comprehensive approaches in phenotyping patients with HF and multimorbidity.

    TRIAL REGISTRATION: ClinicalTrials.gov NCT01633398.
    MeSH terms: Aged; Aged, 80 and over; Asia/epidemiology; Atrial Fibrillation/complications; Female; Geography; Heart Failure/complications*; Heart Failure/epidemiology*; Hospitals; Humans; Hypertension/complications; Hypertension/epidemiology; Malaysia; Male; Middle Aged; Obesity/complications; Obesity/epidemiology; Outpatient Clinics, Hospital; Phenotype; Prospective Studies; Quality of Life; Surveys and Questionnaires; Registries; Severity of Illness Index; Comorbidity; Asian Continental Ancestry Group; Diabetes Complications/epidemiology; Kaplan-Meier Estimate
  19. Lim JH, Lee CW, Bong CW, Affendi YA, Hii YS, Kudo I
    Mar Pollut Bull, 2018 Mar;128:415-427.
    PMID: 29571392 DOI: 10.1016/j.marpolbul.2018.01.037
    Particulate phosphorus was the dominant phosphorus species and accounted for 72 ± 5% of total phosphorus in coastal habitats, 63 ± 4% in estuaries, 58 ± 6% in lakes and 80 ± 7% in aquaculture farms whereas dissolved inorganic phosphorus (DIP) and dissolved organic phosphorus (DOP) were minor components. Correlation analyses (DIP vs Chl a; R2 = 0.407, df = 31, p 
    MeSH terms: Alkaline Phosphatase/analysis; Environmental Monitoring/methods*; Malaysia; Phosphorus/analysis*; Seawater/chemistry*; Solubility; Temperature; Ecosystem; Aquaculture; Salinity; Lakes/chemistry*; Estuaries*
  20. Showen R, Dunson C, Woodman GH, Christopher S, Lim T, Wilson SC
    Mar Pollut Bull, 2018 Mar;128:496-507.
    PMID: 29571401 DOI: 10.1016/j.marpolbul.2018.01.029
    Results are presented of a demonstration of real-time fish blast location in Sabah, Malaysia using a networked hydroacoustic array based on the ShotSpotter gunshot location system. A total of six acoustic sensors - some fixed and others mobile - were deployed at ranges from 1 to 9 km to detect signals from controlled test blasts. This allowed the blast locations to be determined to within 60 m accuracy, and for the calculated locations to be displayed on a map on designated internet-connected computers within 10 s. A smaller three-sensor system was then installed near Semporna in Eastern Sabah that determined the locations of uncontrolled blasts set off by local fishermen. The success of these demonstrations shows that existing technology can be used to protect reefs and permit more effective management of blast fishing activity through improved detection and enforcement measures and enhanced community engagement.
    MeSH terms: Animals; Computer Communication Networks; Conservation of Natural Resources/methods*; Environmental Monitoring/methods*; Malaysia; Software; Law Enforcement; Bombs; Coral Reefs*
External Links