Browse publications by year: 2019

  1. Amidzic J, Vuckovic N, Capo I, Levakov AF
    Malays J Pathol, 2019 Apr;41(1):75-78.
    PMID: 31025643
    We report a case of congenital cytomegalovirus and Herpes simplex virus infection suspected via ultrasound indicated by the presence of fetal cerebral abnormalities. The pregnancy was electively terminated at 31 weeks of gestation. The postmortem examination of the foetus showed brain with lissencephaly. The histopathological examination revealed numerous enlarged cells containing cytomegalic inclusions and multinucleated giant cells in multiple fetal organs and placenta. Documented evidence of histopathological detection of cytomegalovirus inclusions in multiple organs are very sparse in literature. This case highlights the causal relationship of viral infections in early pregnancy and abnormalities of the central nervous system.
    MeSH terms: Autopsy; Brain; Cytomegalovirus Infections; Cytomegalovirus; Female; Fetus; Herpes Simplex; Placenta; Pregnancy; Giant Cells; Lissencephaly
  2. Handra-Luca A
    Malays J Pathol, 2019 Apr;41(1):79-81.
    PMID: 31025644
    No abstract available.
    MeSH terms: Humans
  3. Wan Mohd Yunus WMA, Musiat P, Brown JS
    JMIR Ment Health, 2019 Apr 26;6(4):e11401.
    PMID: 31025943 DOI: 10.2196/11401
    BACKGROUND: Depression in the workplace is a very common problem that exacerbates employees' functioning and consequently influences the productivity of organizations. Despite the commonness of the problem and the currently available interventions, a high proportion of employees do not seek help. A new intervention, a webinar (Web-based seminar), was developed, which integrated the use of technology and the traditional guided therapist support to provide accessible help for the problem of depression in the workplace.

    OBJECTIVE: The aim of this study was to explore the feasibility, preliminary outcome, and acceptability of the webinar intervention conducted in organizations.

    METHODS: In total, 2 organizations were invited to participate, and 33 employees participated in this proof-of-concept study. The webinar intervention consisted of 6 1-hour sessions conducted via the Adobe Connect platform, developed by Adobe Inc. The intervention was developed based on a systematic review, focus group studies, and face-to-face self-confidence workshops that utilized cognitive behavior therapy (CBT). The final webinar intervention used CBT and the coping flexibility approach. The structure of the intervention included PowerPoint presentations, animation videos, utilization of chat panels, and whiteboard features. The intervention was conducted live and guided by a consultant psychologist assisted by a moderator. Study outcomes were self-assessed using self-reported Web surveys. The acceptability of the intervention was assessed using self-reported user experience Web surveys and open-ended questions.

    RESULTS: The findings showed: (1) evidence of feasibility of the intervention: the webinar intervention was successfully conducted in 3 groups, with 6 1-hour sessions for each group, with 82% (23/28) participants completing all 6 sessions; (2) positive improvements in depression: the linear mixed effects modeling analysis recorded a significant overall effect of time primarily for depression (F2, 48.813=31.524; P

    MeSH terms: Consultants; Depression; Depressive Disorder; Follow-Up Studies; Surveys and Questionnaires; Cognitive Therapy; Outcome Assessment (Health Care); Workplace; Focus Groups; Internet; Self Report
  4. Ryan S, Bacon H, Endenburg N, Hazel S, Jouppi R, Lee N, et al.
    J Small Anim Pract, 2019 05;60(5):E1-E46.
    PMID: 31026337 DOI: 10.1111/jsap.12998
    MeSH terms: Animals; Animal Husbandry; Animal Welfare*; Vaccination/veterinary*
  5. Theint HT, Walsh JE, Wong ST, Voon K, Shitan M
    Spectrochim Acta A Mol Biomol Spectrosc, 2019 Jul 05;218:348-358.
    PMID: 31026712 DOI: 10.1016/j.saa.2019.04.008
    A laboratory prototype system that correlates murine blood absorbance with degree of infection for Plasmodium berghei and Trypanosoma avensi has been designed, constructed and tested. A population (n = 6) of control uninfected, Plasmodium infected and Trypanosoma infected BALB/c mice were developed and spectral absorption measurements pre and post infection were made every 3 days. A fibre optic spectrometer set-up was used as the basis of a laboratory prototype biosensor that uses the Beer Lambert Law to relate Ultraviolet-Visible-Near-infrared absorbance data to changes in murine blood chemistry post infection. Spectral absorption results indicate a statistically relevant correlation at a 650 nm with infection for Plasmodium from between 4 and 7 sampling days' post infection, in spite of significant standard deviations among the sample populations for control and infected mice. No significant spectral absorption change for Trypanosoma infection was been detected from the current data. Corresponding stained slides of control and infected blood at each sampling date were taken with related infected cell counts determined and these correlate well for Plasmodium absorbance at 650 nm.
    MeSH terms: Animals; Equipment Design; Female; Malaria/blood*; Malaria/diagnosis; Malaria/parasitology; Mice, Inbred BALB C; Plasmodium berghei/isolation & purification*; Spectrophotometry, Ultraviolet/instrumentation; Trypanosoma/isolation & purification*; Trypanosomiasis/blood*; Trypanosomiasis/diagnosis; Trypanosomiasis/parasitology; Biosensing Techniques/instrumentation*; Spectroscopy, Near-Infrared/instrumentation
  6. Wang J, Yi X, Cui J, Chang Y, Yao D, Zhou D, et al.
    Sci Total Environ, 2019 Jun 20;670:1060-1067.
    PMID: 31018421 DOI: 10.1016/j.scitotenv.2019.03.245
    With the population growth, urbanization and industrialization, China has become a hotspot of atmospheric deposition nitrogen (ADN), which is a threat to ecosystem and food safety. However, the impacts of increased ADN on rice growth and grain metal content are little studied. Based on previous long-term ADN studies, greenhouse experiment was conducted with four simulated ADN rates of 0, 30, 60 and 90 kg N ha-1 yr-1 (CK, N1, N2 and N3 as δ15N, respectively) to assess rice growth and metal uptake in a red soil ecosystem of southeast China during 2016-2017. Results showed that simulated ADN could promote rice growth and increase yields by 15.68-24.41% (except N2) and accumulations of cadmium (Cd) or copper (Cu) in organs. However, there was no linear relationship between ADN rate and rice growth or Cd or Cu uptake. The 15N-ADN was mainly accumulated in roots (21.31-67.86%) and grains (25.26-49.35%), while Cd and Cu were primarily accumulated in roots (78.86-93.44% and 90.00-96.24%, respectively). 15N-ADN and Cd accumulations in roots were significantly different between the two growing seasons (p 
    MeSH terms: Industrial Development; Cadmium; Edible Grain; China; Copper; Longitudinal Studies; Metals; Nitrogen; Population Growth; Oryza; Seasons; Soil; Urbanization; Ecosystem; Plant Roots; Food Safety
  7. Erdiwansyah, Mamat R, Sani MSM, Sudhakar K
    Sci Total Environ, 2019 Jun 20;670:1095-1102.
    PMID: 31018425 DOI: 10.1016/j.scitotenv.2019.03.273
    Southeast Asian countries stand at a crossroads concerning their shared energy future and heavily rely on fossil fuels for transport and electricity. Within Asia, especially India and China lead the world renewable energy generation undergoing a period of energy transition and economic transformation. Southeast Asian countries have huge potentials for sustainable energy sources. However they are yet to perform globally in renewable energy deployment due to various challenges. The primary objective of the study is to examine the renewable energy growth and analyse the government policies to scale up the deployment of renewables for power generation substantially. The study also offers policy recommendations to accelerate renewable energy exploitation sustainably across the region. To achieve the ambitious target of 23% renewables in the primary energy mix by 2025, ASEAN Governments should take proactive measures like removal of subsidies of fossil fuels, regional market integration and rapid implementation of the existing project. Eventually, each of this strategy will necessitate sustained leadership, political determination, and concrete actions from stakeholders, in particular, increased cooperation across the region.
    MeSH terms: Asia; China; Electricity; Fossil Fuels; Government; India; Leadership; Renewable Energy
  8. Koyama M, Nagao N, Syukri F, Yusoff FM, Toda T, Quyen TNM, et al.
    Sci Total Environ, 2019 Jun 20;670:1133-1139.
    PMID: 31018429 DOI: 10.1016/j.scitotenv.2019.03.320
    The primary biological treatment method for organic sludge is composting and/or anaerobic digestion, but their product (compost or biogas) is of little economic benefit; therefore, an improved process to produce a high-value product is required to make sludge management more sustainable. Maximizing NH3 gas recovery during composting processes has the potential benefit of producing high-value microalgal biomass. However, the majority of produced ammonia does not evaporate as NH3 gas but retains as NH4+-N in the compost after fermentation. The present study investigates the effects of the timing of Ca(OH)2 dosing (on days 2, 5, and 9), and the Ca(OH)2 dose (1.1-2.6 mmol/batch), on lab-scale thermophilic composting of anaerobic sludge. The effects on NH3 recovery, organic matter degradability, and microbial activity are evaluated. Ca(OH)2 dosing immediately improved the emission of NH3, with yields 50-69% higher than those under control conditions. The timing of the dosing did not influence NH3 recovery or organic matter degradability. Higher Ca(OH)2 doses resulted in higher NH3 recovery, while microbial activity was temporarily and marginally inhibited. The pH of the compost reached 10-11.5 but quickly dropped to 8-8.5 within a day, probably because of neutralization of Ca(OH)2 by the emitted CO2 and release of NH3, which maintained the microbial activity. The present study indicated that Ca(OH)2 dosing would be useful to apply during thermophilic composting for NH3 recovery to cultivate high-value microalgal biomass, which enables this process to obtain a more economic benefit.
    MeSH terms: Ammonia; Carbon Dioxide; Digestion; Fermentation; Sewage; Soil; Biomass; Biofuels; Microalgae
  9. Filho WL, Havea PH, Balogun AL, Boenecke J, Maharaj AA, Ha'apio M, et al.
    Sci Total Environ, 2019 Jun 20;670:181-187.
    PMID: 31018438 DOI: 10.1016/j.scitotenv.2019.03.181
    Plastic debris is a worldwide problem. This is particularly acute in the Pacific region, where its scale is a reason for serious concerns. There is an obvious need for studies to assess the extent to which plastic debris affects the Pacific. Therefore, this research aims to address this need by undertaking a systematic assessment of the ecological and health impacts of plastic debris on Pacific islands. Using pertinent historical qualitative and quantitative data of the distribution of plastic debris in the region, this study identified pollution and contamination trends and risks to ecosystems, and suggests some measures which may be deployed to address the identified problems. The study illustrates the fact that Pacific Island States are being disproportionately affected by plastic, and reiterates that further studies and integrated strategies are needed, involving public education and empowerment, governmental action, as well as ecologically sustainable industry leadership. It is also clear that more research is needed in respect of developing alternatives to conventional plastic, by the production of bio-plastic, i.e. plastic which is produced from natural (e.g. non-fossil fuel-based sources) materials, and which can be fully biodegradable.
    MeSH terms: Animals; Environmental Monitoring*; Humans; Pacific Islands; Plastics/adverse effects*; Waste Products/adverse effects*; Water Pollutants/adverse effects*
  10. Ikram S, Shah JA, Zubair S, Qureshi IM, Bilal M
    Sensors (Basel), 2019 Apr 23;19(8).
    PMID: 31018597 DOI: 10.3390/s19081918
    The application of compressed sensing (CS) to biomedical imaging is sensational since it permits a rationally accurate reconstruction of images by exploiting the image sparsity. The quality of CS reconstruction methods largely depends on the use of various sparsifying transforms, such as wavelets, curvelets or total variation (TV), to recover MR images. As per recently developed mathematical concepts of CS, the biomedical images with sparse representation can be recovered from randomly undersampled data, provided that an appropriate nonlinear recovery method is used. Due to high under-sampling, the reconstructed images have noise like artifacts because of aliasing. Reconstruction of images from CS involves two steps, one for dictionary learning and the other for sparse coding. In this novel framework, we choose Simultaneous code word optimization (SimCO) patch-based dictionary learning that updates the atoms simultaneously, whereas Focal underdetermined system solver (FOCUSS) is used for sparse representation because of a soft constraint on sparsity of an image. Combining SimCO and FOCUSS, we propose a new scheme called SiFo. Our proposed alternating reconstruction scheme learns the dictionary, uses it to eliminate aliasing and noise in one stage, and afterwards restores and fills in the k-space data in the second stage. Experiments were performed using different sampling schemes with noisy and noiseless cases of both phantom and real brain images. Based on various performance parameters, it has been shown that our designed technique outperforms the conventional techniques, like K-SVD with OMP, used in dictionary learning based MRI (DLMRI) reconstruction.
    MeSH terms: Brain; Learning; Magnetic Resonance Imaging; Artifacts; Phantoms, Imaging; Mathematical Concepts; Neuroimaging
  11. Gendeh HS, Abdullah AB, Goh BS, Hashim ND
    Ear Nose Throat J, 2019 Aug;98(7):416-419.
    PMID: 31018687 DOI: 10.1177/0145561319840166
    Intracranial complications secondary to chronic otitis media (COM) include otogenic brain abscess and sinus thrombosis. Intravenous antibiotics and imaging have significantly reduced the incidence of intracranial complications secondary to COM. However, the same does not apply to a developing country like Malaysia, which still experiences persisting otogenic complications. This case series describes 3 patients with COM and intracranial complications. All 3 patients had COM with mastoiditis, with 1 of the 3 having a cholesteatoma. Postulated reasons for the continued occurrence include poor access to health care, poor compliance with medication, and the lack of pneumococcal vaccination during childhood. In conclusion, public awareness and a timely specialty referral can reduce the incidence of intracranial complications of COM.
    MeSH terms: Anti-Bacterial Agents; Brain Abscess; Cholesteatoma; Developing Countries; Health Services Accessibility; Humans; Malaysia; Mastoiditis; Otitis Media; Referral and Consultation; Sinus Thrombosis, Intracranial; Vaccination; Incidence
  12. Rasudin NS, Ahmad MAI, Hussain N, Che Hamah MSS
    Int J Health Care Qual Assur, 2019 Apr 15;32(3):653-658.
    PMID: 31018797 DOI: 10.1108/IJHCQA-07-2018-0169
    PURPOSE: The purpose of this paper is to validate the Press Ganey Questionnaire (PGQ) (Bahasa Melayu version) using Hospital Universiti Sains Malaysia (HUSM) patients.

    DESIGN/METHODOLOGY/APPROACH: This cross-sectional study comprised 252 patients visiting HUSM. Patients were selected using the convenience sampling method. The PGQ (Bahasa Melayu version) had three main factors: during your visit; your care provider and overall assessment. Data were analyzed using the structural equation modeling.

    FINDINGS: The exploratory factor analysis resulted in item reduction from 21 to 17, which contained four factors with eigenvalues greater than 1. Meanwhile, confirmatory factor analysis results showed that data fitted the model: χ2/df at 1.764, comparative fit index at 0.952, Tucker-Lewis index at 0.941 and root mean square error of approximation at 0.073. The average variance extracted value for the four factors was greater than 0.50, which indicated that PGQ convergent validity was met. Overall, PGQ produced good reliability with composite reliability score equals to 0.966. Four factors were reclassified as "during your registration," "hospital staff attitude," "doctor's attitude" and "overall assessment."

    RESEARCH LIMITATIONS/IMPLICATIONS: Patient satisfaction is an important and frequently used indicator for measuring healthcare quality; hence, a validated and reliable instrument is important for measuring patient satisfaction that leads to healthcare service quality assessment.

    PRACTICAL IMPLICATIONS: Validated PGQ provides some useful information for doctors, medical assistants, nurses and staff in the emergency department to help them become more prominent and efficient in their role as healthcare providers.

    SOCIAL IMPLICATIONS: Validated PGQ will help healthcare providers to deliver the best and exceptional care toward emergency patient, and thus improve their quality of work life. The findings in this study can be used as a guide or as baseline data for further research in this area.

    ORIGINALITY/VALUE: The PQG (Bahasa Melayu version) was confirmed as a reliable and valid instrument for measuring patient satisfaction. This research is the first PGQ validation study in Southeast Asia, specifically focusing on Malaysian respondents.

    MeSH terms: Adolescent; Adult; Attitude of Health Personnel; Cross-Sectional Studies; Factor Analysis, Statistical; Female; Humans; Malaysia; Male; Middle Aged; Psychometrics; Surveys and Questionnaires/standards*; Socioeconomic Factors; Translating; Reproducibility of Results; Patient Satisfaction*; Young Adult
  13. Fun WH, Sararaks S, Tan EH, Tang KF, Chong DWQ, Low LL, et al.
    BMC Health Serv Res, 2019 Apr 24;19(1):248.
    PMID: 31018843 DOI: 10.1186/s12913-019-4072-7
    BACKGROUND: Health Research Priority Setting (HRPS) in the Ministry of Health (MOH) Malaysia was initiated more than a decade ago to drive effort toward research for informed decision and policy-making. This study assessed the impact of funded prioritised research and identified research gaps to inform future priority setting initiatives for universal access and quality healthcare in Malaysia.

    METHODS: Research impact of universal access and quality healthcare projects funded by the National Institutes of Health Malaysia were assessed based on the modified Payback Framework, addressing categories of informing policy, knowledge production, and benefits to health and health sector. For the HRPS process, the Child Health and Nutrition Research Initiative methodology was adapted and adopted, with the incorporation of stakeholder values using weights and monetary allocation survey. Workshop discussions and interviews with stakeholders and research groups were conducted to identify research gaps, with the use of conceptual frameworks to guide the search.

    RESULTS: Seventeen ongoing and 50 completed projects were identified for research funding impact analysis. Overall, research fund allocation differed from stakeholders' expectation. For research impact, 48 out of 50 completed projects (96.0%) contributed to some form of policy-making efforts. Almost all completed projects resulted in outputs that contributed to knowledge production and were expected to lead to health and health sector benefits. The HRPS process led to the identification of research priority areas that stemmed from ongoing and new issues identified for universal access and quality healthcare.

    CONCLUSION: The concerted efforts of evaluation of research funding impact, prioritisation, dissemination and policy-maker involvement were valuable for optimal health research resource utilisation in a resource constrained developing country. Embedding impact evaluation into a priority setting process and funding research based on national needs could facilitate health research investment to reach its potential.

    MeSH terms: Administrative Personnel; Decision Making; Developing Countries; Health Priorities*; Health Services Research/economics*; Humans; Malaysia; Policy Making; Quality of Health Care*; Research Design; Research Support as Topic*; Resource Allocation
  14. Tahir AA, Mohd Barnoh NF, Yusof N, Mohd Said NN, Utsumi M, Yen AM, et al.
    Microbes Environ, 2019 Jun 27;34(2):161-168.
    PMID: 31019143 DOI: 10.1264/jsme2.ME18117
    Oil palm empty fruit bunches (OPEFB) are the most abundant, inexpensive, and environmentally friendly lignocellulosic biomass in Malaysia. Investigations on the microbial diversity of decaying OPEFB may reveal microbes with complex enzymes that have the potential to enhance the conversion of lignocellulose into second-generation biofuels as well as the production of other value-added products. In the present study, fungal and bacterial diversities in decaying OPEFB were identified using Illumina MiSeq sequencing of the V3 region of the 16S rRNA gene and V4 region of the 18S rRNA gene. Fungal diversity in decaying OPEFB was dominated by the phylum Ascomycota (14.43%), while most of the bacterial sequences retrieved belonged to Proteobacteria (76.71%). Three bacterial strains isolated from decaying OPEFB, designated as S18, S20, and S36, appeared to grow with extracted OPEFB-lignin and Kraft lignin (KL) as the sole carbon source. 16S rRNA gene sequencing identified the 3 isolates as Paenibacillus sp.. The molecular weight distribution of KL before and after degradation showed significant depolymerization when treated with bacterial strains S18, S20, and S36. The presence of low-molecular-weight lignin-related compounds, such as vanillin and 2-methoxyphenol derivatives, which were detected by a GC-MS analysis, confirmed the KL-degrading activities of isolated Paenibacillus strains.
    MeSH terms: Bacteria/classification; Bacteria/genetics; Bacteria/isolation & purification*; Bacteria/metabolism*; Biodegradation, Environmental; Fruit/microbiology; Fungi/classification; Fungi/genetics; Fungi/isolation & purification; Fungi/metabolism; Lignin/metabolism*; Malaysia; RNA, Ribosomal, 16S/genetics; Tropical Climate; Sequence Analysis, DNA; Biomass; Arecaceae/microbiology*; Biodiversity*; Biofuels/microbiology
  15. Takeda K, Yamauchi J, Miki A, Kim D, Leong XY, Doggett SL, et al.
    Sci Rep, 2019 04 24;9(1):6500.
    PMID: 31019205 DOI: 10.1038/s41598-019-42844-0
    The insect male accessory gland (MAG) is an internal reproductive organ responsible for the synthesis and secretion of seminal fluid components, which play a pivotal role in the male reproductive strategy. In many species of insects, the effective ejaculation of the MAG products is essential for male reproduction. For this purpose, the fruit fly Drosophila has evolved binucleation in the MAG cells, which causes high plasticity of the glandular epithelium, leading to an increase in the volume of seminal fluid that is ejaculated. However, such a binucleation strategy has only been sporadically observed in Dipteran insects, including fruit flies. Here, we report the discovery of binucleation in the MAG of the common bed bug, Cimex lectularius, which belongs to hemimetabolous Hemiptera phylogenetically distant from holometabolous Diptera. In Cimex, the cell morphology and timing of synchrony during binucleation are quite different from those of Drosophila. Additionally, in Drosophila, the position of the two nuclei in the adult stage changes as a result of the mating history or the nutrient conditions; however, it remains stable in Cimex. These differences suggest that binucleation in the Cimex MAG plays a unique role in the male reproductive system that is distinct from that of Drosophila.
    MeSH terms: Animals; Bedbugs; Drosophila; Ejaculation; Genitalia, Male; Male; Reproduction; Bodily Secretions
  16. Singh V, Haque S, Kumari V, El-Enshasy HA, Mishra BN, Somvanshi P, et al.
    Sci Rep, 2019 04 24;9(1):6482.
    PMID: 31019210 DOI: 10.1038/s41598-019-42740-7
    Arterial/venous thrombosis is the major cardiovascular disorder accountable for substantial mortality; and the current demand for antithrombotic agents is extensive. Heparinases depolymerize unfractionated heparin (UFH) for the production of low molecular-weight heparins (LMWHs; used as anticoagulants against thrombosis). A microbial strain of Streptomyces sp. showing antithrombotic activity was isolated from the soil sample collected from north India. The strain was characterized by using 16S rRNA homology technique and identified as Streptomyces variabilis MTCC 12266 capable of producing heparinase enzyme. This is the very first communication reporting Streptomyces genus as the producer of heparinase. It was observed that the production of intracellular heparinase was [63.8 U/mg protein (specific activity)] 1.58 folds higher compared to extracellular heparinase [40.28 U/mg protein]. DEAE-Sephadex A-50 column followed by Sepharose-6B column purification of the crude protein resulted 19.18 folds purified heparinase. SDS-PAGE analysis of heparinase resulted an estimated molecular-weight of 42 kDa. It was also found that intracellular heparinase has the ability to depolymerize heparin to generate LMWHs. Further studies related to the mechanistic action, structural details, and genomics involved in heparinase production from Streptomyces variabilis are warranted for large scale production/purification optimization of heparinase for antithrombotic applications.
    MeSH terms: Anticoagulants; Electrophoresis, Polyacrylamide Gel; Fibrinolytic Agents; Heparin; Heparin, Low-Molecular-Weight; RNA, Ribosomal, 16S; Sepharose; Streptomyces; Thrombosis; Veins; Heparin Lyase; Venous Thrombosis; Genomics
  17. Alrubaiee G, Baharom A, Faisal I, Hayati KS, Daud SM, Basaleem HO
    BMC Nurs, 2019;18:15.
    PMID: 31019377 DOI: 10.1186/s12912-019-0340-4
    [This corrects the article DOI: 10.1186/s12912-019-0333-3.].
  18. Arabi Z, Md Monoto EM, Bojeng A
    Int Breastfeed J, 2019;14:17.
    PMID: 31019544 DOI: 10.1186/s13006-019-0210-4
    Background: Pre-pubescent girls with chest burns are at risk of complication associated with scarring and impairment in breast development. This case illustrates how burn injuries in childhood in a first-time mother have affected her in terms of breastfeeding.

    Case presentation: In May 2015, a 20 year old first-time mother at 36 weeks gestation was seen in a district health clinic in Kuching, Sarawak in regards to her ability to breastfeed. She had a history of a flame burn at the age of 5 years old to her chest, abdomen, upper limb and part of her trunk. A skin graft was done on her whole chest and abdomen. Despite the injuries, she had pubertal and antenatal breast development. Her abdomen was able to stretch to accommodate her pregnancy. Physical examination showed a pregnancy which corresponded to date. The skin over her chest and abdomen appeared tight with areas of hyperpigmentation and hypopigmentation due to scarring from the skin graft. Breast tissues were palpable over her chest. The areola and nipple tissue were completely absent with complete scarring of the nipple-areolar complex. There was no duct opening to the areola for milk expression or leakage. Counselling regarding her breastfeeding issues was done. She delivered her baby at full term via spontaneous vaginal delivery with no complication. Oral cabergoline 1 mg was given on the first day postpartum. The baby was given infant formula via bottle feeding as the feeding method of choice.

    Conclusion: Counselling plays an important part in the management of a mother with breastfeeding difficulty. Allaying the possible guilty feelings of not being able to breastfeed will fulfil the emotional gap which may arise in a mother with these challenges.

    MeSH terms: Breast Feeding*; Burns/physiopathology*; Feeding Methods; Female; Humans; Infant, Newborn; Thoracic Injuries/physiopathology*; Young Adult
  19. Bullo S, Buskaran K, Baby R, Dorniani D, Fakurazi S, Hussein MZ
    Pharm Res, 2019 Apr 24;36(6):91.
    PMID: 31020429 DOI: 10.1007/s11095-019-2621-8
    BACKGROUND: The chemotherapy of cancer has been complicated by poor bioavailability, adverse side effects, high dose requirement, drug resistance and low therapeutic indices. Cancer cells have different ways to inhibit the chemotherapeutic drugs, use of dual/multiple anticancer agents may be achieve better therapeutic effects in particular for drug resistant tumors. Designing a biocompatible delivery system, dual or multiple drugs could addressing these chemotherapy drawbacks and it is the focus of many current biomedical research.

    METHODS: In the present study, graphene oxide-polyethylene glycol (GOPEG) nanocarrier is designed and loaded with two anticancer drugs; Protocatechuic acid (PCA) and Chlorogenic acid (CA). The designed anticancer nanocomposite was further coated with folic acid to target the cancer cells, as their surface membranes are overexpressed with folate receptors.

    RESULTS: The particle size distribution of the designed nanocomposite was found to be narrow, 9-40 nm. The release profiles of the loaded drugs; PCA and CA was conducted in human body simulated PBS solutions of pH 7.4 (blood pH) and pH 4.8 (intracellular lysosomal pH). Anticancer properties were evaluated against cancerous cells i.e. liver cancer, HEPG2 and human colon cancer, HT-29 cells. The cytocompatbility was assessed on normal 3T3 fibroblasts cells.

    CONCLUSION: The size of the final designed anticancer nanocomposite formulation, GOPEG-PCACA-FA was found to be distributed at 9-40 nm with a median of 8 nm. The in vitro release of the drugs PCA and CA was found to be of sustained manner which took more than 100 h for the release. Furthermore, the designed formulation was biocompatible with normal 3T3 cells and showed strong anticancer activity against liver and colon cancer cells.

    MeSH terms: Animals; Antineoplastic Agents/chemistry; Cell Survival/drug effects; Chlorogenic Acid/pharmacology; Chlorogenic Acid/chemistry*; Drug Carriers/chemistry*; Folic Acid/metabolism; Graphite/chemistry*; Humans; Hydrogen-Ion Concentration; Particle Size; Polyethylene Glycols/chemistry*; Surface Properties; Cell Line, Tumor; Nanoparticles/chemistry*; Nanocomposites/chemistry; Hydroxybenzoates/pharmacology; Hydroxybenzoates/chemistry*; Drug Liberation
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