Browse publications by year: 2019

  1. Senek MZF, Kong SY, Shin SD, Sun KM, Kim J, Ro YS
    Trans R Soc Trop Med Hyg, 2019 10 11;113(10):590-598.
    PMID: 31225621 DOI: 10.1093/trstmh/trz050
    BACKGROUND: Snakebite is a global public health crisis, but there are no nationwide data on snakebite in South Korea. The aim of this study was to describe the epidemiological profile and outcomes of snakebite cases in South Korea seasonally.

    METHODS: The selected subjects were patients of all ages with a chief complaint of snakebite who presented to participating emergency departments (EDs) between 1 January 2011 and 31 December 2016.

    RESULTS: A total of 1335 patients were eligible for the study. There were an average of 223 snakebite cases reported each year. Most snakebites occurred during the summer months (55.9%) in patients aged 40-59 y (36.3%) and males (61.5%). Snakebites occurred most frequently on Mondays (22.9%) between 12:00 and 17:59 h (42.0%) outdoors (57.9%) and in farm areas (20.7%). Over 82% of the bites were by venomous snakes across all seasons, and 66% of the patients visited EDs without using emergency medical services. Based on the excess mortality ratio-adjusted injury severity score, 88, 9.2 and 2.8% had mild, moderate and severe injuries, respectively. There were 10 fatalities during the study period.

    CONCLUSION: This study provides essential information to understand and assess the burden and distribution of snakebites in South Korea and provides valuable information for developing appropriate prevention and control interventions to address it.

    MeSH terms: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Risk Factors; Seasons; Sex Factors; Snake Bites/epidemiology*; Snake Bites/therapy; Treatment Outcome; Young Adult; Republic of Korea/epidemiology
  2. Khalilpourfarshbafi M, Devi Murugan D, Abdul Sattar MZ, Sucedaram Y, Abdullah NA
    PLoS One, 2019;14(6):e0218792.
    PMID: 31226166 DOI: 10.1371/journal.pone.0218792
    The increased prevalence of obesity and associated insulin resistance calls for effective therapeutic treatment of metabolic diseases. The current PPARγ-targeting antidiabetic drugs have undesirable side effects. The present study investigated the anti-diabetic and anti-obesity effects of withaferin A (WFA) in diet-induced obese (DIO) C57BL/6J mice and also the anti-adipogenic effect of WFA in differentiating 3T3- F442A cells. DIO mice were treated with WFA (6 mg/kg) or rosiglitazone (10 mg/kg) for 8 weeks. At the end of the treatment period, metabolic profile, liver function and inflammatory parameters were obtained. Expression of selective genes controlling insulin signaling, inflammation, adipogenesis, energy expenditure and PPARγ phosphorylation-regulated genes in epididymal fats were analyzed. Furthermore, the anti-adipogenic effect of WFA was evaluated in 3T3- F442A cell line. WFA treatment prevented weight gain without affecting food or caloric intake in DIO mice. WFA-treated group also exhibited lower epididymal and mesenteric fat pad mass, an improvement in lipid profile and hepatic steatosis and a reduction in serum inflammatory cytokines. Insulin resistance was reduced as shown by an improvement in glucose and insulin tolerance and serum adiponectin. WFA treatment upregulated selective insulin signaling (insr, irs1, slc2a4 and pi3k) and PPARγ phosphorylation-regulated (car3, selenbp1, aplp2, txnip, and adipoq) genes, downregulated inflammatory (tnf-α and il-6) genes and altered energy expenditure controlling (tph2 and adrb3) genes. In 3T3- F442A cell line, withaferin A inhibited adipogenesis as indicated by a decrease in lipid accumulation in differentiating adipocytes and protein expression of PPARγ and C/EBPα. The effect of rosiglitazone on physiological and lipid profiles, insulin resistance, some genes expression and differentiating adipocytes were markedly different. Our data suggest that WFA is a promising therapeutic agent for both diabetes and obesity.
    MeSH terms: Animals; Cell Differentiation/drug effects; Male; Mice, Inbred C57BL; Mice, Obese; Weight Loss/drug effects*; Down-Regulation/drug effects; 3T3 Cells; Anti-Obesity Agents/pharmacology; Adipogenesis/drug effects*; Mice; Withanolides/pharmacology*; Diet, High-Fat
  3. Sharma P, Mehta M, Dhanjal DS, Kaur S, Gupta G, Singh H, et al.
    Chem Biol Interact, 2019 Aug 25;309:108720.
    PMID: 31226287 DOI: 10.1016/j.cbi.2019.06.033
    Cancer is one of the major diseases that cause a high number of deaths globally. Of the major types of cancers, lung cancer is known to be the most chronic form of cancer in the world. The conventional management of lung cancer includes different medical interventions like chemotherapy, surgical removal, and radiation therapy. However, this type of approach lacks specificity and also harms the adjacent normal cells. Lately, nanotechnology has emerged as a promising intervention in the management and treatment of lung cancers. Nanotechnology has revolutionized the existing modalities and focuses primarily on reducing toxicity and improving the bioavailability of anticancer drugs to the target tumor cells. Nanocarrier systems are being currently used extensively to exploit and to overcome the obstructions induced by cancers in the lungs. The nano-carrier-loaded therapeutic drug delivery methods have shown promising potential in treating lung cancer as its target is to control the growth of tumor cells. In this review, various modes of nano drug delivery options like liposomes, dendrimers, quantum dots, carbon nanotubes and metallic nanoparticles have been discussed. Nano-carrier drug delivery systems emerge as a promising approach and thus is expected to provide newer and advanced avenues in cancer therapeutics.
    MeSH terms: Antineoplastic Agents/therapeutic use; Antineoplastic Agents/chemistry; Drug Carriers/chemistry*; Humans; Liposomes/chemistry; Lung Neoplasms/drug therapy*; Lung Neoplasms/pathology; Dendrimers/chemistry; Nanoparticles/chemistry
  4. Kamal A, Nazari V M, Yaseen M, Iqbal MA, Ahamed MBK, Majid ASA, et al.
    Bioorg Chem, 2019 09;90:103042.
    PMID: 31226469 DOI: 10.1016/j.bioorg.2019.103042
    Three benzimidazolium salts (III-V) and respective selenium adducts (VI-VIII) were designed, synthesized and characterized by various analytical techniques (FT-IR and NMR 1H, 13C). Selected salts and respective selenium N-Heterocyclic carbenes (selenium-NHC) adducts were tested in vitro against Cervical Cancer Cell line (Hela), Breast Adenocarcinoma cell line (MCF-7), Retinal Ganglion Cell line (RGC-5) and Mouse Melanoma Cell line (B16F10) using MTT assay and the results were compared with standard drug 5-Fluorouracil. Se-NHC compounds and azolium salts showed significant anticancer potential. Molecular docking studies of compounds (VI, VII and VIII) showed strong binding energies and ligand affinity toward following angiogenic factors: VEGF-A (vascular endothelial growth factor A), EGF (human epidermal growth factor), HIF (Hypoxia-inducible factor) and COX-1 (Cyclooxygenase-1) suggesting that the anticancer activity of adducts (VI, VII and VIII) may be due to their strong anti-angiogenic effect. In addition, compounds III-VIII were screened for their antibacterial and antifungal potential. Adduct VI was found to be potent anti-fungal agent against A. Niger with zone of inhibition (ZI) value 27.01 ± 0.251 mm which is better than standard drug Clotrimazole tested in parallel.
    MeSH terms: Animals; Antifungal Agents; Carbon Isotopes; Uterine Cervical Neoplasms; Clotrimazole; Epidermal Growth Factor; Female; Humans; Retinal Ganglion Cells; Salts; Selenium; Vascular Endothelial Growth Factor A; Angiogenesis Inducing Agents; Mice; Cyclooxygenase 1; MCF-7 Cells
  5. Rahnamaie-Tajadod R, Goh HH, Mohd Noor N
    J Plant Physiol, 2019 Sep;240:152994.
    PMID: 31226543 DOI: 10.1016/j.jplph.2019.152994
    Polygonum minus Huds. is a medicinal aromatic plant rich in terpenes, aldehydes, and phenolic compounds. Methyl jasmonate (MeJA) is a plant signaling molecule commonly applied to elicit stress responses to produce plant secondary metabolites. In this study, the effects of exogenous MeJA treatment on the composition of volatile organic compounds (VOCs) in P. minus leaves were investigated by using a metabolomic approach. Time-course changes in the leaf composition of VOCs on days 1, 3, and 5 after MeJA treatment were analyzed through solid-phase microextraction (SPME) and gas chromatography-mass spectrometry (GC-MS). The VOCs found in MeJA-elicited leaves were similar to those found in mock-treated leaves but varied in quantity at different time points. We focused our analysis on the content and composition of monoterpenes, sesquiterpenes, and green leaf volatiles (GLVs) within the leaf samples. Our results suggest that MeJA enhances the activity of biosynthetic pathways for aldehydes and terpenes in P. minus. Hence, the production of aromatic compounds in this medicinal herb can be increased by MeJA elicitation. Furthermore, the relationship between MeJA elicitation and terpene biosynthesis in P. minus was shown through SPME-GC-MS analysis of VOCs combined with transcriptomic analysis of MeJA-elicited P. minus leaves from our previous study.
    MeSH terms: Acetates/administration & dosage; Acetates/pharmacology*; Cyclopentanes/administration & dosage; Cyclopentanes/pharmacology*; Plant Growth Regulators/pharmacology*; Plant Leaves/drug effects; Plant Leaves/chemistry; Polygonum/drug effects*; Polygonum/chemistry; Oxylipins/administration & dosage; Oxylipins/pharmacology*; Volatile Organic Compounds/metabolism*
  6. Patoz A, Lussiana T, Gindre C, Hébert-Losier K
    Sports (Basel), 2019 Jun 17;7(6).
    PMID: 31212983 DOI: 10.3390/sports7060147
    Close to 90% of recreational runners rearfoot strike in a long-distance road race. This prevalence has been obtained from North American cohorts of runners. The prevalence of rearfoot strikers has not been extensively examined in an Asian population of recreational runners. Therefore, the aim of this study was to determine the prevalence of rearfoot, midfoot, and forefoot strikers during a long-distance road race in Asian recreational runners and compare this prevalence to reported values in the scientific literature. To do so, we classified the foot strike pattern of 950 recreational runners at the 10 km mark of the Singapore marathon (77% Asian field). We observed 71.1%, 16.6%, 1.7%, and 10.6% of rearfoot, midfoot, forefoot, and asymmetric strikers, respectively. Chi-squared tests revealed significant differences between our foot strike pattern distribution and those reported from North American cohorts (P < 0.001). Our foot strike pattern distribution was similar to one reported from elite half-marathon runners racing in Japan (Fisher exact test, P = 0.168). We conclude that the prevalence of rearfoot strikers is lower in Asian than North American recreational runners. Running research should consider and report ethnicity of participants given that ethnicity can potentially explain biomechanical differences in running patterns.
  7. Zakria NM, Tengku Ismail TA, Wan Mansor WNA, Sulaiman Z
    PMID: 31213022 DOI: 10.3390/ijerph16122147
    The validation of a new questionnaire is essential to improving its credibility in the assessment and collection of evidence. This study aimed to validate a newly developed infant and young child feeding questionnaire for child care providers (IYCF-CCPQ) to measure the knowledge, attitudes, and practices regarding infant and young child feeding among them. A cross-sectional study was conducted with 200 child care providers who were involved in handling children less than two years old in child care centers in the northeastern part of Peninsular Malaysia. The IYCF-CCPQ was self-administered and consists of three domains: Knowledge (104 items), attitude (90 items), and practice (42 items). The dichotomous-scale items in the knowledge domain were analyzed using a two-parameter logistic model of item response theory (2-PL IRT). The Likert-type-scale items in the attitude section were assessed using exploratory factor analysis (EFA). The items in the practice section were assessed descriptively. Internal consistency by marginal reliability was assessed in the knowledge domain, and Cronbach's alpha coefficient was used for the attitude domain. The marginal reliability values were 0.91 and 0.74 for the knowledge domains related to breastfeeding/formula feeding and complementary feeding, respectively, and the Cronbach's alpha values were 0.89 and 0.90 for the attitude domains related to breastfeeding/formula feeding and complementary feeding, respectively. The analysis showed good psychometric properties (discrimination, difficulty index, factor loading, and communalities) and good reliability. The IYCF-CCPQ is valid for use assessing the knowledge, attitudes, and practices among Malaysian child care providers regarding infant and young child feeding.
    MeSH terms: Adult; Child; Child Care/statistics & numerical data*; Child, Preschool; Cross-Sectional Studies; Factor Analysis, Statistical; Feeding Behavior/psychology*; Female; Humans; Infant; Infant, Newborn; Health Knowledge, Attitudes, Practice*; Malaysia; Male; Psychometrics; Surveys and Questionnaires/standards*; Reproducibility of Results; Caregivers/psychology*; Caregivers/statistics & numerical data*
  8. Chan WY, Selvarajah GT, Ajat M, Suzuki R, Tsukui T
    Vet Immunol Immunopathol, 2019 Jun;212:43-49.
    PMID: 31213251 DOI: 10.1016/j.vetimm.2019.05.002
    Canine atopic dermatitis (AD) is a chronic, inflammatory and pruritic allergic skin disease in dogs. House dust mites such as Dermatophagoides farinae are one of the known causative agents for the induction of canine AD worldwide. D. farinae protein Der f 2 is known as an important allergen involved in canine AD and recently, Zen-1 has also been identified as an allergenic protein. There is limited information on the prevalence and role of allergen sensitization to crude D. farinae extract (CDF), Der f 2 and Zen-1 among dogs diagnosed with AD in Malaysia. The aim of this study was to determine the proportion of CDF-, Der f 2- and Zen-1-specific reactive sera among dogs diagnosed with AD in Malaysia using an enzyme-linked immunosorbent assay (ELISA). Serum samples were collected from dogs diagnosed with AD from several veterinary clinics in Malaysia. The canine case records were retrieved and information on signalment, dermatological and non-dermatological histories, clinical presentation, food allergies, and exclusion of ectoparasitic, microbial and fungal skin infections were obtained through a survey form. All serum samples were evaluated to quantify the CDF-, Der f 2- and Zen-1-specific immunoglobulin E (IgE) levels. A total of 24.6%, 48.4% and 29.8% of dogs diagnosed with AD were positive for CDF-, Der f 2- and Zen-1-specific IgE, respectively. These results suggest that CDF-, Der f 2- and Zen-1 are important allergens that can contribute to AD in dogs in Malaysia, and serological testing can be performed to provide additional treatment options involving specific immunotherapies.
    MeSH terms: Allergens/immunology; Animals; Dermatitis, Atopic/immunology; Dermatitis, Atopic/parasitology; Dermatitis, Atopic/veterinary*; Dog Diseases/immunology*; Dog Diseases/parasitology; Dogs; Enzyme-Linked Immunosorbent Assay; Hospitals, Animal; Immunoglobulin E/blood*; Malaysia; Antigens, Dermatophagoides/blood; Antigens, Dermatophagoides/immunology*; Dermatophagoides farinae; Pets/immunology; Arthropod Proteins/blood; Arthropod Proteins/immunology*
  9. Goh CF, Ong ET
    Curr Pharm Teach Learn, 2019 06;11(6):621-629.
    PMID: 31213319 DOI: 10.1016/j.cptl.2019.02.025
    BACKGROUND AND PURPOSE: The flipped classroom has not been fully exploited to improve tertiary education in Malaysia. A transformation in pharmacy education using flipped classrooms will be pivotal to resolve poor academic performance in certain courses. This study aimed to investigate the effectiveness of the flipped classroom in improving student learning and academic performance in a course with a historically low pass rate.

    EDUCATIONAL ACTIVITY AND SETTING: A quasi-experimental pre- and posttest control group design was employed. The experimental group experienced the flipped classroom for selected topics while the control group learned in a traditional classroom. Analysis of covariance was utilized to compare the performance on the final exam using the grade point of a pre-requisite course as the covariate. Students' perceptions of their experience in the flipped classroom were gauged through a web-based survey.

    FINDINGS: Student performance on the final exam was significantly higher in the flipped classroom group. The lowest-scoring students benefitted the most in terms of academic performance. More than two-thirds of students responded positively to the use of the flipped classroom and felt more confident while participating in classes and tests.

    SUMMARY: The flipped classroom is academically beneficial in a challenging course with a historically low pass rate; it was also effective in stimulating learning interest. The current study identified that for the flipped classroom to be successful, the role of educators, the feasibility of the approach, and the acceptance of students were important.

    MeSH terms: Analysis of Variance; Curriculum/standards; Curriculum/trends; Education, Pharmacy/methods; Education, Pharmacy/standards; Educational Measurement/methods; Educational Measurement/standards*; Educational Measurement/statistics & numerical data; Educational Status*; Humans; Learning*; Malaysia; Surveys and Questionnaires; Teaching/standards*; Teaching/statistics & numerical data; Statistics, Nonparametric
  10. Chong LT, Chong MC, Tang LY, Ramoo V, Chui PL, Hmwe NTT
    J Pediatr Nurs, 2019 06 15;48:e15-e20.
    PMID: 31213340 DOI: 10.1016/j.pedn.2019.05.016
    STUDY PURPOSE: This study was conducted to examine the relationship between religious practice, religious coping methods and psychological distress among parents caring for children with transfusion-dependent thalassemia.

    DESIGN AND METHODS: This is a cross-sectional survey. Data were collected on 162 parents of children diagnosed with thalassemia aged 12 years and younger in thalassemia day care centers of three public hospitals in Sabah, Malaysia. Data were collected using questionnaires, including General Health Questionaire-12 (GHQ-12), Duke University Religion Index (DUREL) and Brief RCOPE.

    RESULTS: Forty-two percent of parents had psychological distress with GHQ score ≥ 3 (mean score of 2.85 ± 3.17). Ninety-five percent of parents used positive religious coping methods (mean P-COPE score 22.35 ± 2.33) more than negative religious coping methods (mean N-COPE score was 12.19 ± 5.23). They used Organized Religious Activities (mean ORA score of 4.20 ± 1.27), and Non-Organized Religious Activities (NORA, the mean was 4.17 ± 1.37). Positive and negative religious coping methods were significantly related to parents' psychological distress (P-COPE and GHQ-12 scores (rs (df) = 0.19, p 

    MeSH terms: Adaptation, Psychological; Adolescent; Adult; Anxiety/psychology; Child; Cross-Sectional Studies; Depression/psychology; Female; Humans; Male; Parents/psychology*; Quality of Life/psychology; Surveys and Questionnaires; Religion and Psychology*; Stress, Psychological/psychology*; Thalassemia/psychology*; Thalassemia/therapy
  11. Mubarak N, Hatah E, Khan TM, Zin CS
    J Asthma Allergy, 2019;12:109-153.
    PMID: 31213852 DOI: 10.2147/JAA.S202183
    Objective: This systematic review aims to investigate the impact of collaborative practice between community pharmacist (CP) and general practitioner (GP) in asthma management. Methods: A systematic search was performed across 10 databases (PubMed, Medline/Ovid, CINAHL, Scopus, Web of Science, Cochrane central register of controlled trials, PsycARTICLES®, Science Direct, Education Resource Information Centre, PRO-Quest), and grey literature using selected MeSH and key words, such as "community pharmacist", "general practitioner", and "medicine use review". The risk of bias of the included studies was assessed by Cochrane risk of bias tool. All studies reporting any of the clinical, humanistic, and economical outcomes using collaborative practice between CPs and GPs in management of asthma, such as CPs conducting medications reviews, patient referrals or providing education and counseling, were included. Results: A total of 23 studies (six RCTs, four C-RCT, three controlled interventions, seven pre-post, and three case control) were included. In total, 11/14 outcomes were concluded in favor of CP-GP collaborative interventions with different magnitude of effect size. Outcomes, such as asthma severity, asthma control, asthma symptoms, PEFR, SABA usage, hospital visit, adherence, and quality of life (QoL) (Asthma Quality-of-Life Questionnaire [AQLQ]; Living with Asthma Questionnaire [LWAQ]) demonstrated a small effect size (d≥0.2), while inhalation technique, ED visit, and asthma knowledge witnessed medium effect sizes (ES) (d≥0.5). In addition to that, inhalation technique yielded large ES (d≥0.8) in RCTs subgroup analysis. However, three outcomes, FEV, corticosteroids usage, and preventer-to-reliever ratio, did not hold significant ES (d<0.2) and, thus, remain inconclusive. The collaboration was shown to be value for money in the economic studies in narrative synthesis, however, the limited number of studies hinder pooling of data in meta-analysis. Conclusion: The findings from this review established a comprehensive evidence base in support of the positive impact of collaborative practice between CP and GP in the management of asthma.
    MeSH terms: Asthma*; Humans; Pharmacists*; General Practitioners*; Intersectoral Collaboration
  12. Krajewska-Kułak E, Kułak W, Cybulski M, Kowalczuk K, Guzowski A, Łukaszuk C, et al.
    Mater Sociomed, 2019 Mar;31(1):57-61.
    PMID: 31213958 DOI: 10.5455/msm.2019.31.57-61
    Introduction: Nursing care is one of the most important areas of health services, taking place in direct contact with the patient, constituting a subsystem deciding about the general level of services.

    Aim: The aim of the study was to construct the Trust in Nurse Scale on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick.

    Methods: The study included a group of 1,200 people selected at random, 600 each from surgical and medical treatment wards. Patients did not report any problems with understanding the statements on the scale.

    Results: The internal accuracy scores were excellent, all Cronbach's a values were well above 0.70. The Spearman's rank correlation coefficient values were highly statistically significant (p <0.001), and correlation strength was very high (for most items rs > 0.90).

    Conclusion: We suggest that The Trust in Nurse Scale, developed on the basis of the standardized Trust in Physician Scale by Anderson and Dedrick, can be used in studies on patient satisfaction with nursing care.

    MeSH terms: Health Services; Humans; Physicians; Patient Satisfaction; Statistics, Nonparametric; Trust
  13. Johar A, Thevarajah S, Heng A, Chan LC, Ch'ng CC, Mohd Safdar NA, et al.
    Dermatol Res Pract, 2019;2019:8923168.
    PMID: 31214257 DOI: 10.1155/2019/8923168
    Psoriasis is a chronic inflammatory skin disease affecting nearly 10% of dermatologic patients in Malaysia. Treatment options include topical agents and phototherapy as well as nonbiologic and biologic systemic therapy. Mild psoriasis can often be managed with topical agents. However, managing moderate to severe psoriasis is more challenging and may require systemic treatment with nonbiologics or biologics. Despite the availability of several biologics, there are many unmet clinical needs, which may be addressed by secukinumab, an IL-17A inhibitor. This position statement is based on an expert panel discussion and is intended to provide dermatologists an overview of existing options as well as to provide a better understanding of secukinumab and how it can be integrated into current practice. During the discussion, panel members examined current approaches and the role of secukinumab in plaque psoriasis management. Panel members estimated that up to 30% of patients have moderate to severe psoriasis but only 1-2% receive biologics. Highlights from the discussion were that (i) the threshold for biologic use should be lower, in line with international guidelines; (ii) studies have shown that secukinumab has several advantages over other biologics which are greater efficacy, sustained efficacy over time, rapid onset of action, and early evidence of possible disease-modifying potential; and (iii) ideal candidates for secukinumab are all patients of moderate to severe psoriasis, including those with history of treatment failure, difficult-to-treat patterns of psoriasis (nail, scalp, and palmoplantar psoriasis), psoriatic arthritis, and comorbidities and those aiming for clear skin. Panel members recommend that secukinumab be considered first line option among biologic therapies.
  14. Chinnappan SM, George A, Thaggikuppe P, Choudhary Y, Choudhary VK, Ramani Y, et al.
    PMID: 31214269 DOI: 10.1155/2019/4916519
    Paracetamol (PCM) is a well-known drug widely used for its analgesic and antipyretic properties. PCM is generally considered as safe but overdose of PCM can cause nephrotoxicity. Traditionally, herbs have been used for the treatment of drug or toxin-induced renal disorders and numerous medicinal plants were tested for nephroprotection effect in PCM-induced nephrotoxicity model. The aim of the present study was to evaluate the protective effect of the herbal extract Eurycoma longifolia (EL) against PCM-induced nephrotoxicity rat model. Forty Wistar rats were randomly divided into five groups of eight rats each: control (vehicle 10 ml/kg), PCM alone (200 mg/kg PCM), EL 100 (EL 100 mg/kg+200 mg/kg PCM), EL 200 (EL 200 mg/kg+200 mg/kg PCM), and EL 400 (EL 400 mg/kg+200 mg/kg PCM). All animals from control group received vehicle daily and animals from groups PCM alone, EL 100, EL 200, and EL 400 received repeated dose of PCM and the assigned treatment of EL daily for a period of 14 days. On the 15th day, serum creatinine, blood urea nitrogen, protein, and albumin were measured in blood and creatinine clearance was measured in urine collected over 24 hours. Kidney sections of all experimental groups underwent histopathological analysis. There was a significant (p<0.05) increase in serum creatinine and blood urea levels in the PCM alone group compared to the treatment groups due to nephrotoxicity. In the treatment groups, there was a dose-dependent protection against PCM-induced changes observed in serum total protein, albumin, urea, and creatinine. Significant (p<0.05) drop was seen in serum creatinine and blood urea content in EL 200 and EL 400 groups. Creatinine clearance significantly increased for EL 200 (p<0.01) and EL 400 (p < 0.001) groups. Serum total protein and serum albumin content were significantly increased (p<0.05) in EL 200 and EL 400 groups compared to PCM alone group. Histopathological examination (H&E staining) of the rat kidneys revealed severe degeneration in the PCM alone group, while there was evidence of significant dose-dependent protection in the treatment groups against PCM-induced changes. The serum and urine biochemical results and histopathology analysis of the kidney indicate the nephroprotective potential of EL extract against PCM-induced nephrotoxicity.
    MeSH terms: Acetaminophen; Analgesics; Animals; Blood Urea Nitrogen; Creatinine; Kidney; Kidney Diseases; Kidney Function Tests; Plants, Medicinal; Serum Albumin; Staining and Labeling; Urea; Rats, Wistar; Control Groups; Eurycoma; Rats; Antipyretics
  15. Yong HY, Shariff ZM, Mohd Yusof BN, Rejali Z, Bindels J, Tee YYS, et al.
    Nutr Res Pract, 2019 Jun;13(3):230-239.
    PMID: 31214291 DOI: 10.4162/nrp.2019.13.3.230
    BACKGROUND/OBJECTIVES: Little is known about the dietary patterns (DPs) of women during pregnancy. The present study aimed to identify the DPs of pregnant Malaysian women and their associations with socio-demographic, obstetric, and anthropometric characteristics.
    SUBJECTS AND METHODS: This prospective cohort study included 737 participants enrolled in Seremban Cohort Study between 2013 and 2015. Food consumption was assessed using a validated 126-food item semi-quantitative food frequency questionnaire (SFFQ) at four time-points, namely, pre-pregnancy and at each trimester (first, second, and third). Principal component analysis (PCA) was used to identify DPs.
    RESULTS: Three DPs were identified at each time point and designated DP 1-3 (pre-pregnancy), DP 4-6 (first trimester), DP 7-9 (second trimester) and DP 10-12 (third trimester). DP 1, 4, and 7 appeared to be more prudent diets, characterized by higher intakes of nuts, seeds & legumes, green leafy vegetables, other vegetables, eggs, fruits, and milk & dairy products. DP 2, 5, 8, and 11 had greater loadings of condiments & spices, sugar, spreads & creamer, though DP 2 had additional sweet foods, DP 5 and 8 had additional oils & fats, and DP 11 had additional tea & coffee, respectively. DP 3 and 6 were characterized by high protein (poultry, meat, processed, dairy, eggs, and fish), sugars (mainly as beverages and sweet foods), and energy (bread, cereal & cereal products, rice, noodles & pasta) intakes. DP 9 had additional fruits. However, DP 12 had greater loadings of energy foods (bread, cereal & cereal products, rice, noodles & pasta), sugars (mainly as beverages, and sweet foods), and good protein sources (eggs, nuts, seeds & legumes). Malays were more likely to have lower adherence (LA) for DP 1 and 10 than non-Malays. DP 2, 8, and 11 were more prevalent among Malays than non-Malays. Women with a higher education were more likely to have LA for DP 10, and women with a greater waist circumference at first prenatal visit were more likely to show LA for DP 11.
    CONCLUSIONS: DPs observed in the present study were substantially different from those reported in Western populations. Information concerning associations between ethnicity, waist circumference and education with specific DPs before and throughout pregnancy could facilitate efforts to promote healthy dietary behavior and the overall health and well-being of pregnant women.
    Study name: Seremban Cohort Study (SECOST)
    MeSH terms: Animals; Bread; Edible Grain; Coffee; Demography; Diet; Female; Fruit; Humans; Fabaceae; Malaysia; Meat; Milk; Nuts; Oils; Poultry; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Pregnancy Trimester, Third; Prospective Studies; Surveys and Questionnaires; Oryza; Tea; Vegetables; Cohort Studies; Spices; Principal Component Analysis; Waist Circumference
  16. Nayak SB, Soumya KV
    Surg Radiol Anat, 2019 Jun 18.
    PMID: 31214757 DOI: 10.1007/s00276-019-02268-x
    Vermiform appendix is considered as a vestigial organ, and it has minimal or no role to play in the digestion and absorption of food. It is an enigma to the clinicians due to its variable positions and symptoms caused by its inflammation. In the available literature, there are many reports on various positions, size and disease of appendix. However, there is no report on an anteriorly located appendicular attachment to the caecum. During dissection classes for medical undergraduates, an appendix with its base attached to the anterior wall of the caecum was noted. The entire appendix was attached to the ileum through a mesoappendix and was readily visible when the anterior abdominal wall was reflected. This position could be a boon to the clinicians and radiologists during diagnosis and surgery of the appendix.
    MeSH terms: Appendix; Digestion; Ileum; Inflammation; Abdominal Wall; Radiologists
  17. Yaacof N, Qamaruz Zaman N, Yusup Y, Yusoff S
    Environ Sci Pollut Res Int, 2019 Aug;26(23):24286-24299.
    PMID: 31214886 DOI: 10.1007/s11356-019-05517-z
    Malaysia is the second-largest producer and exporter of palm oil amounting to 39% of world palm oil production and 44% of world exports (MPOB, 2014). An enormous amount of palm oil mill effluent is released during palm oil milling, and the effluent causes a major odor problem. Many methods, such as biofiltering, can be adopted to manage the malodor. However, these methods are expensive and require high maintenance. The separation distance method can be used as an alternative due to its low cost and effectiveness. This research was conducted to verify the performance of three different methods, namely, in-field monitoring by using an olfactometer, CALPUFF model, and Gaussian plume model. Given that no research has compared the three methods, this study examined the effectiveness of the methods and determined which among them is suitable for use in Malaysia. The appropriate separation distances were 1.3 km for in-field monitoring, 1.2 km for the CALPUFF model, and 0.5 for the Gaussian plume model. These different values of separation distance were due to the various approaches involved in each method. This research determined an appropriate means to establish a proper separation distance for reducing odor nuisance in areas around palm oil mills.
    MeSH terms: Industrial Waste/analysis*; Malaysia; Odors/analysis*; Plant Oils; Waste Management/methods*
  18. Thomson DR, Linard C, Vanhuysse S, Steele JE, Shimoni M, Siri J, et al.
    J Urban Health, 2019 08;96(4):514-536.
    PMID: 31214975 DOI: 10.1007/s11524-019-00363-3
    Area-level indicators of the determinants of health are vital to plan and monitor progress toward targets such as the Sustainable Development Goals (SDGs). Tools such as the Urban Health Equity Assessment and Response Tool (Urban HEART) and UN-Habitat Urban Inequities Surveys identify dozens of area-level health determinant indicators that decision-makers can use to track and attempt to address population health burdens and inequalities. However, questions remain as to how such indicators can be measured in a cost-effective way. Area-level health determinants reflect the physical, ecological, and social environments that influence health outcomes at community and societal levels, and include, among others, access to quality health facilities, safe parks, and other urban services, traffic density, level of informality, level of air pollution, degree of social exclusion, and extent of social networks. The identification and disaggregation of indicators is necessarily constrained by which datasets are available. Typically, these include household- and individual-level survey, census, administrative, and health system data. However, continued advancements in earth observation (EO), geographical information system (GIS), and mobile technologies mean that new sources of area-level health determinant indicators derived from satellite imagery, aggregated anonymized mobile phone data, and other sources are also becoming available at granular geographic scale. Not only can these data be used to directly calculate neighborhood- and city-level indicators, they can be combined with survey, census, administrative and health system data to model household- and individual-level outcomes (e.g., population density, household wealth) with tremendous detail and accuracy. WorldPop and the Demographic and Health Surveys (DHS) have already modeled dozens of household survey indicators at country or continental scales at resolutions of 1 × 1 km or even smaller. This paper aims to broaden perceptions about which types of datasets are available for health and development decision-making. For data scientists, we flag area-level indicators at city and sub-city scales identified by health decision-makers in the SDGs, Urban HEART, and other initiatives. For local health decision-makers, we summarize a menu of new datasets that can be feasibly generated from EO, mobile phone, and other spatial data-ideally to be made free and publicly available-and offer lay descriptions of some of the difficulties in generating such data products.
    MeSH terms: Health Equity*; Cities/statistics & numerical data; Decision Making*; Developing Countries/statistics & numerical data; Health Status*; Humans; Residence Characteristics/statistics & numerical data*; Urban Health/statistics & numerical data*
  19. Saleem Z, Godman B, Hassali MA, Hashmi FK, Azhar F, Rehman IU
    Pathog Glob Health, 2019 Jun;113(4):191-205.
    PMID: 31215326 DOI: 10.1080/20477724.2019.1632070
    Health-care-associated infections (HAIs) are considered a serious public health issues that contribute substantially to the global burden of mortality and morbidity with respect to infectious diseases. The aim is to assess the burden of health-care-associated infections by collation of available data from published point prevalence surveys (PPS) on HAIs to give future guidance. Study protocol and methodology were designed according to preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Published research papers that conducted a point prevalence survey of HAIs in hospital settings by following the structured survey methodology employed by European Centre of Disease Prevention and Control (ECDC) were included. Of 1212 articles, 67 studies were included in the final analysis conducted across different countries. Overall, 35 studies were conducted in Europe, 21 in Asia, 9 in America, and 2 in Africa. The highest prevalence of HAIs was recorded in a study conducted in adult ICU settings of 75 regions of Europe (51.3%). The majority of the studies included HAI data on urinary tract infections, respiratory tract infections, and bloodstream infections. Klebsiella pneumonia, Pseudomonas aeruginosa and E. coli were the most frequent pathogens responsible for HAIs. PPS is an useful tool to quantify HAIs and provides a robust baseline data for policymakers. However, a standardize surveillance method is required. In order to minimize the burden of HAIs, infection prevention and control programs and antibiotic stewardship may be effective strategies to minimize the risk of HAIs.
    MeSH terms: Adolescent; Adult; Aged; Aged, 80 and over; Bacteria/classification; Bacteria/isolation & purification; Bacterial Infections/microbiology; Bacterial Infections/epidemiology; Child; Child, Preschool; Cross Infection/epidemiology*; Female; Fungi/classification; Fungi/isolation & purification; Hospitals; Humans; Infant; Infant, Newborn; Male; Middle Aged; Mycoses/microbiology; Mycoses/epidemiology; Respiratory Tract Infections/microbiology; Respiratory Tract Infections/epidemiology; Urinary Tract Infections/microbiology; Urinary Tract Infections/epidemiology; Global Health; Prevalence; Sepsis/microbiology; Sepsis/epidemiology; Young Adult
  20. Yadav H, Jegasothy R, Ramakrishnappa S, Mohanraj J, Senan P
    BMC Med Educ, 2019 Jun 18;19(1):218.
    PMID: 31215454 DOI: 10.1186/s12909-019-1662-3
    BACKGROUND: Ethical behavior and professionalism is an ideal characteristic required of medical students and included as 'must achieve' and critical aspect of medical students' curriculum. This study proposes to determine the perceived unethical and unprofessional behavior among medical students in a private medical university from year 1 to year 5 of the medical curriculum.

    METHODS: A cross-sectional study was conducted among year 1 to year 5 medical students in a private medical university. A self-administered questionnaire was used with the 3 major domains of professionalism and ethics i.e. discipline plagiarism and cheating.

    RESULTS: A total of 464 respondents responded to the survey and they included medical students from year 1 and year 2 (pre-clinical) and years 3-5 (clinical years). Majority of the students, 275 (59.2%) answered that they had not seen any form of unethical behavior among other students. The females seem to have a larger number 172(63%) among the same gender compared to the males. Majority 352 (75%) of them had not heard of the 'Code of Professional Conduct by the Malaysian Medical Council'. About fifty three (53.1%) of the students answered that the training was sufficient.

    CONCLUSIONS: This study showed that the perception of unethical behavior was 58.8% in the 1st year (pre-clinical) and it increased to 65.2% in the 5th year (clinical). The 3 main discipline issues were students do not show interest in class (mean 2.9/4), they are rude to other students (mean 2.8/4) and talking during class (mean 2.6/4). Despite the existence of unethical behavior among the students majority of them (71.7%) claimed that they had adequate training in ethics and professionalism. It is proposed that not only the teaching of ethics and professionalism be reviewed but an assessment strategy be introduced to strengthen the importance of professionalism and ethics.

    MeSH terms: Professionalism/ethics*; Cross-Sectional Studies; Education, Medical, Undergraduate/ethics*; Female; Humans; Malaysia; Male; Morals; Professional Competence; Students, Medical/psychology*; Students, Medical/statistics & numerical data; Universities*; Plagiarism; Professional Misconduct/statistics & numerical data; Professional Misconduct/ethics*; Young Adult
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