Introduction: Overweight and obesity among adolescents are not caused by a single factor, and evidence indicates that the food environment is one of the driving forces behind the current escalating obesity epidemic. Therefore, it is imperative to explore any perceived factors related to food choices and quality of food in the school food environ- ment among adolescents. Methods: A qualitative study based on the Socio-Ecological Model (SEM) was conducted on a purposive, multi-ethnic sample of 51 adolescents from different localities. The semi-structured and in-depth in- terviews were fully transcribed and analyzed qualitatively using Atlas.Ti. The transcribed texts were coded into simi- lar and related themes such as food choices, quality of food, social-peers’ influence, cost of food and self-awareness. Results: The findings revealed that there is a clustering of barriers to practising a healthy dietary intake within the school food environment. Accessibility to low cost snacks and fried foods, influence by parents and peers, as well as the autonomous character of informants in making their own purchases are the contributing factors to healthy eating practice among adolescents. Conclusions: The study highlights that the barriers to practicing healthy eating consid- erably outweighs the enabling factors. Therefore, the findings will help facilitate the construction of policy-driven environmental changes as well as strategies in designing effective and multilevel interventions that raise awareness in helping adolescents navigate healthy food in their school’s compound.
Introduction: Growing evidence highlighting the physical health risks linked with adolescent obesity and yet little is known on the role of psychosocial factors on the body weight status of adolescents. A cross sectional study was conducted to ascertain the associations between psychosocial factors (operationalised as weight teasing by peers, self-esteem and academic related stressor) with body weight status of adolescents in Hulu Langat District, Selangor, Malaysia. Methods: A total of 455 adolescents aged 13-16 years (50.3% male and 49.7% female) were recruited from five randomly selected schools through a multistage cluster sampling. Body weight and height were assessed and body mass index (BMI) was computed. Weight teasing by peers, self-esteem and academic related stressor were assessed using self-administered questionnaire of Perception of Teasing Scale (POTS), Rosenberg Self esteem Scale (RSE) and Secondary School Stressor (SSS) respectively. Results: The prevalence of overweight and obesity were 17.1% and 12.2%. Binary logistic regression revealed that adolescents who experienced weight teasing by their peers had 12 times higher odds to be overweight and obese. However, low self-esteem and high academic stressor were associated with a reduction in the likelihood of being overweight and obese. This rather contradictory results may be due to various factors that may affect the adolescents’ self-esteem and academic related stressor. Conclusion: Intervention programmes need to consider the peer environment of adolescents, increasing awareness on the effect of weight teasing by peers and further well designed study is crucial to stimulate the central understanding of psy- chosocial correlates to the adolescent obesity.
Introduction: Parents play significant roles in developing the behaviour of their children towards food. However, mothers usually represent the parents of the children in previous studies, while fathers were left out and their con- tribution remained unknown. This study compared paternal and maternal feeding practices and parenting styles between overweight or obese (OW/OB) and normal weight (NW) primary school children. Methods: There were 419 children aged 10 to 11 from four randomly selected national primary schools being screened for their body weight and height. There were 105 children identified as OW/OB and matched with 105 NW children based on sex, age and ethnicity, whose both their parents were then recruited as study subjects. Parents reported their personal body weight and height, and completed a questionnaire on parenting styles and feeding practices. Results: There were 34.9% of children overweight and obese, and more than half of their fathers (66.5%) and mothers (52.5%) were over- weight and obese. Both fathers and mothers of the OW/OB children perceived their children to be slightly heavier, but a majority of them perceived their children’s body weight status less accurately and applied less pressure to eat. Fathers of the OW/OB children were more in the obese category, performed indulgent parenting style, perceived less feeding responsibility and applied less monitoring on their children, but not mothers. Conclusion: There were distinct differences in paternal and maternal feeding practices and parenting styles between OW/OB and NW chil- dren. Researchers should encourage fathers to involve in childhood obesity research instead of focusing on mothers.
Rectal foreign body is not an uncommon encounter in current medical practice. It reported occurs due to sexual erot- icism, sexually abuse, assault or involuntary insertion. This condition possesses significant challenge among general surgeons on handling these cases. Diagnosis usually made by history taking, physical and radiological examination. We presented a case of a 43years old mentally challenge gentleman with retained rectal foreign body of three-week duration whom presented with non-specific abdominal pain, abdominal mass and loose stool. Due to low suspicion of rectal foreign body, the management flow skid from the norm. Attempt of removing rectal foreign body by various method was unsuccessful and his had to undergone exploratory laparotomy. Hence, propose flow of management in rectal foreign body is also included in this report.
Primitive neuroectodermal tumours (PNETs) occurring directly from the lung parenchyma without involvement of the chest wall or pleura are particularly unusual. We describe a 16-year-old male who presented with severe chest and back pain following a fall during high jump competition. Incidental finding of an opacity at the right lung upper lobe was seen on his chest radiograph. Computed tomography of the thorax demonstrated a lobulated hypodense lesion in the anterior segment of right upper lobe and subsequent biopsy confirmed the diagnosis of Ewing Sarcoma/ PNET following histologic and immunohistochemical examination. Whole-body positron emission computed to- mography/computed tomography (PET/CT) revealed mild, homogenous F18-fluorodeoxyglucose (FDG) uptake in the lung lesion with no evidence of metastasis. He eventually underwent right thoracotomy and right upper lobectomy. Indeed, F18-FDG PET/CT is a valuable imaging method in demonstrating active focus of glucose metabolism in lung parenchymal lesion, for preoperative evaluation and as baseline scan for patient’s monitoring.
Panoramic radiograph is a routine investigation tool in orthodontic diagnosis and treatment planning however the limitation of two-dimensional image in assessing the position of impacted canine and surrounding tissues had cause unnecessary treatment options and complications during treatment. This report highlights the differences in investi- gation outcome and orthodontic treatment planning of two similar cases of patients with impacted upper canine, in which one only had panoramic radiograph and another case supplemented with Cone Beam Computed Tomography (CBCT). The case supported only by panoramic radiograph had changes in treatment planning during canine remov- al surgery as prevention from oro-antral fistula. This event could have been prevented if CBCT was taken where the canine can be assessed for proximity towards maxillary sinus. It is recommended for CBCT in orthodontic assessment for canine impaction especially for cases where canine is positioned higher than root apex of adjacent teeth and when root resorption is suspected.
The current focus of perioperative management of anaemia has shifted from allogeneic transfusion to optimising and conserving the patient’s blood through the implementation of patient blood management (PBM) strategies. We here- by report a case to illustrate the success of applying PBM strategies in managing a surgical patient with an extremely rare red blood cells (RBC) phenotype. An 80-year-old Malay man was planned for urgent major abdominal surgery following diagnosis of intestinal obstruction secondary to an advanced rectosigmoid tumour. A request of two units packed RBC was made given anticipated blood loss intraoperatively. His pre-operative haemoglobin was 135 g/L. His previous immunohaematological record showed that he had an extremely rare P k (P1-, P-, Pk+) phenotype with clinically significant anti-P, anti-PX2, and anti-P1. The elements of PBM strategies were explored and applied. Even- tually, the patient successfully underwent a surgical operation without any allogeneic RBC transfusion.
Metastasis is a process of tumour cells escaping from the primary site and form a new lesion in other organs. It is a common phenomenon where bone is the frequent metastatic site. Bone scan using 99m-Techetium-Methylenedi- phosphate (99mTc-MDP) is used to diagnose bone pathologies such as bone metastases. 99mTc-MDP specifically binds to calcium which present in bone. This study aimed to validate 99mTc-MDP in breast cancer-induced to bone rat model and to determine calcium presence in the progression of metastasis. The rats were divided into two groups (normal and cancer-induced groups). For cancer-induced group, the left femur was induced with breast cancer cell line, MDA-MB-231. After 21 days, all rats were subjected to SPECT-CT scan. Our finding suggests that the kidney uptake of 99mTc-MDP is due to the calcium crystal presence caused by hypercalcemia. This is only a preliminary data, and further analysis will be conducted.
More studies are now focusing on vitamin E as an anticancer agent for its good effects in many in-vitro studies. Current studies proposed that vitamin E might be a suitable candidate as an alternative treatment for cancer due to its antioxidant properties. Vitamin E act as an antioxidant by their long-chain polyunsaturated fatty acids, and thus the integrity of membranes in the cells is maintained and consequently retain the bioactivity of the cells. This mini review will focus on the activity of vitamin E as an antioxidant to protect against cancer in in-vitro, in-vivo, and clin- ical studies. Although most studies reported great outcomes for the anticancer activity of vitamin E, there were some conflicting data. To date, studies on effects of vitamin E are still undergoing where researchers are still debating on the positive and negative effects of vitamin E as an anticancer therapeutic action.
The lysyl oxidase family has five family members which are; Lysyl Oxidase (LOX), Lysyl Oxidase Like-1 (LOXL1), Lysyl Oxidase Like-2 (LOXL2), Lysyl Oxidase Like-3 (LOXL3), and Lysyl Oxidase Like-4 (LOXL4). These are amine oxidases which are copper (Cu) dependent. The main function of these secreted enzymes is covalently crosslinking extracellular collagens and elastins, making the extracellular matrix (ECM) stable. Association with LOX family en- zymes has been found in various diseases including tumours, suggesting that it may be involved in the pathogenesis of the lesions. To add to the complexity, some of the LOX family members have been linked with tumour suppression while the other members were associated with tumour promotion, progression and metastasis. Thus, this review will explore further insight into the role of LOX family in tumour formation.
Apolipoprotien E (apoE) polymorphism is a human genetic risk factor and has been well-established to be associated with Alzheimer’s disease, lipid abnormalities, and cardiovascular disease (CVD). ApoE gene polymorphism is re- ported to correlate with lipid metabolism disturbances and coronary artery stenosis. Furthermore, ε4 allele carriers were found to have poor prognosis in survival rates of post-myocardial infarction. The purpose of the review is to distinguish the possible of apoE gene polymorphism as a determinant for CVD and its association. Preliminary data suggest ε4 allele carrier identification could be beneficial for risk stratification of CVD and initiation of statin therapy as primary intervention. Numerous studies have been done, however, results varied between studies as well as in different population. The evidence presented herein can help describe the risk prediction based on apoE gene poly- morphism.
In the past few years, compelling data have shown the potential crosstalk between dysbiosis of gut microbiota (GM) and impairment of systemic immune system. Since then, ideas on how GM partake in autoimmune conditions was put forward. Although genetic variability have been proven to contribute towards the pathogenesis of autoimmune conditions, epigenetics control have gained interest among researchers. Current review highlights the crosstalk be- tween autoimmune conditions and GM and its potential regulatory mechanisms. Convincing data from existing literature help in paving ways for more well-defined species in the future studies. The studies should focus on identi- fying the distinct species involve in different types of autoimmune diseases and their definitive role in autoimmunity. Ultimately, these data can be used for the advancement of therapeutic approach in personalized medicine.
Introduction: Resistance towards treatment is one of the challenges in breast cancer therapy. Recent studies show the link between lipoprotein with cancer resistance and progression. Clinical data indicates that oxidized low-density lipoprotein (oxLDL) and very low-density lipoprotein (VLDL) play roles the progression of breast cancer. Therefore, purpose of this study was to determine the roles of lipoproteins on migration of breast cancer cell and compare the effects of oxLDL and VLDL. Methods: Parent MCF-7 cells were purchased from ATCC, while the Tamoxifen-resistant MCF-7 (Tam-R MCF-7) was developed by pulse treatment method. Tam-R cells were treated with gradual increase in tamoxifen concentration for 72 hours in Dulbecco’s Modified Eagle’s medium (DMEM) without phenol red. Cell vi- ability test was done to measure the fold changes of Tam-R MCF-7 cells. Migration characteristics was studied using wound healing assay. Cells were treated with 10 μg/mL of oxLDL and VLDL up to 72 hours. Results: From the cell viability test, Tam-R MCF-7 cells had 4-fold increase of resistance than parental cells. Tam-R MCF-7 had acquired resistance to Tamoxifen and achieved a clinically relevant level of resistance. Lipoproteins were found to cause morphological changes, where cells exhibited elongation and dendritic-like growth compared to control cells. Both MCF-7 parental cells and Tam-R MCF-7 cells showed higher percentage of wound closure when treated with oxLDL. In contrast, VLDL treatment caused reduction in cell migration compared to oxLDL. Conclusion: Findings suggest that oxLDL may further promote resistant breast cancer cell migration compared to VLDL.
Introduction: The interpretations of printed panoramic radiographs film frequently depend on personal judgements analysis by observers. The findings correlations between more than two observers must consider statistical tool which can determine that sometimes the observers will agree or disagree merely by chance. Intraclass Correlation Coefficient (ICC) generally measures the degree of similarity among individuals within a cluster. Kappa statistic is the most frequently applied statistical analysis for this reason. This study aims to determine the validity of utilising printed panoramic radiographs for assessing dental anomalies and inter-examiner reliability in detecting dental anomalies observed within the panoramic radiographs. Methods: Twenty samples of printed versions of orthopantomogram (OPG) were arbitrarily selected from the AMDI Dental Clinic. Radiographic analyses were conducted twice, Trial 1 and Trial 2, with two-week intervals in between. Ten (10) printed OPG films were used in each session. During both assessments, incidence of dental anomalies was determined. All twenty OPGs were examined and analysed by the principal investigator and two independent examiners according to the inclusion and exclusion criterias. The data analysis was carried out using SPSS version 23. Results: The results of ICC for Trials 1 and 2 were 0.961 and 0.984, respectively. Conclusion: The outcomes demonstrated that the printed OPG films can be used to detect dental anomalies and inter-examiner dependability was in very good assertion for both trials, hence printed OPG films that satisfy the inclusion and exclusion criterias can be utilised for assessing dental anomalies as shown by the reliable ICC values in this study.
Introduction: OTULIN, OTUB1 and OTUB2 are deubiquitinases, the enzymes responsible for reversing ubiquitina- tion process that occupies key roles in numerous cellular processes. The ubiquitination protein-protein interaction (PPI) network has been extensively explored in order to unravel the complexity of ubiquitin pathway. However, many significant challenges remain to develop a network-based understanding of the ubiquitination complexity including incompleteness of human interactome. Therefore, we aim to construct a pair of yeast two-hybrid (Y2H) vectors using pDEST32/pDEST22 vector system as a preparation for screening OTULIN-, OTUB1- and OTUB2-inter- acting proteins from human cDNA library, with ultimate aim of expanding the PPI network in human ubiquitome. Methods: OTULIN, OTUB1 and OTUB2 were cloned into entry vector using pCR™8/GW/TOPO® TA Cloning® system and shuttled into pDEST™32 bait vector by LR recombination reaction. To generate Y2H prey library clones, cDNA library was synthesized from HEK293 cells and cloned into donor vector pDONR™222 before transferred into destination vector pDEST™22. Results: DNA sequencing analysis confirmed the correct sequence of OTULIN, OTUB1 and OTUB2 inserts in pDEST32. Meanwhile, generation of cDNA library in pDEST22 produced 5.2 x 106 clones. Randomly picked pDEST22-cDNA clones showed that the recombination rate was 83% and gel electro- phoresis indicated that the inserts length ranged from 0.45 to 3.4 kb. Conclusion: OTULIN, OTUB1, OTUB2 and cDNA library were successfully cloned into Y2H bait and prey vectors. The clones have been transfected into com- petent yeast Saccharomyces cerevisiae strain MaV203 and Y2H experiment to screen novel OTULIN-, OTUB1- and OTUB2-interacting protein from human cDNA library is underway.
Introduction: Breast cancer is the most common cause of cancer death among women. The purpose of this study is to determine the 5-years survival rate and prognostic factors among breast cancer patients in a tertiary oncological centre in Penang, Malaysia. Methods: A retrospective cohort study was conducted at the Advanced Medical and Dental Institute, Universiti Sains Malaysia. All 214 cases of breast cancer diagnosed from 1st January 2008 until 31st December 2012 were selected and retrospectively followed-up until 31st December 2017. The survival status for this study was referring to the record of the National Registration of Malaysia. Kaplan-Meier with Log-rank test and Cox regression were used for the univariable and multivariable analysis, respectively. Results: The mean (SD) age at diagnosis was 50.98 (±10.75) years. The majority of the patients were Malay (55.7%) and married (96.5%). After controlling for the effect of underlying comorbidities, lymph nodes involvement, marital status, vascular involvement and adjuvant therapy; it was found that marital status (adj HR= 3.63, 95% CI 1.17-11.24) and lymph nodes involve- ment (adj HR=2.36, 95% CI 1.17-4.76) were the significant prognostic factors. Conclusion: This study re-emphasizes the role of marital status and lymph nodes involvement as independent predictors of the long-term survival of breast cancer patients. Further studies are needed to assess the promising benefit of personalized treatment and specific supportive care given to the patients with these risk factors for better cancer experience and survival.
Introduction: Exergames is defined as a technology-driven physical activity, which is an innovative way of physical activity that integrates interactive gameplay in the exercise process. The exergames may provide enjoyable expe- riences that could motivate people to participate and continue playing the game play, while also exercising at the same time. Methods: This article presents a treasure hunt-based walking exergames on android platform with the implementation of intelligence-based image recognition. The exergame, termed USM ExerHunt uses images of Universiti Sains Malaysia buildings as the hints. The participant of the game supposes to find a building shown in the hint, and once reaching the destination captures the image of the building. Then, the application will calculate the total steps taken and calories burnt by the participant using an implementation of accelerometer from the mobile phone. Results: The developed USM ExerHunt application is able to achieve accurate image recognition of USM building, with the accuracy rate of 92%. Besides that, the application is capable of calculating the number of total steps and calories burnt after an exercise routine is completed. Conclusion: This android application has shown a proof of concept in incorporating machine intelligence into an exergame application, with pilot study within the USM community.
Introduction: Transfusion Medicine is an evolving filed which integrates multidisciplinary science in providing safe blood and blood products for patients. With an increasing demand for Transfusion Medicine training in Malaysia, a formal survey is needed to evaluate the postgraduate Transfusion Medicine programme offered by Advanced Med- ical and Dental Institute, Universiti Sains Malaysia to identify areas of deficiency based on the alumni experiences. Methods: An English language survey form was developed specifically to assess the programme contents (overall contents, learning experience in each year, and support in research), the alumni perception on soft-skills gained during the study, and the outcome of the programme. The survey forms were distributed to all alumni between March 2018 and October 2018 via e-mail or hand-delivered. Results: The survey response rate was 79% (37 of 47). A ma- jority (97%) of the transfusion medicine specialists (TMS) in this study reported that the course offered in the program was relevant to their current job. The learning experience which includes course content, student’s placement, facili- ties, and support in research) were rated between satisfactory and good. Communicating effectively through speaking was the highest reported soft-skill gained during the programme, whereas communicating effectively in writing was the lowest soft-skill gained. On the programme outcome, all TMS agreed that this programme will produce qualified and well trained specialists for current working market. Conclusion: Some improvement in the programme contents and teaching activities are needed to equip the future TMS for the nation.
Introduction: CRISPR/Cas9 nuclease has gained popularity as a genome editing tool due to its straight-forward mechanism. However, there are concerns that CRISPR nuclease would cause off-target and toxicity. The CRISPR/ Cas9 D10A nickase was designed to enhance genome editing. Nevertheless, this raised the question of whether the efficiency of nickase is compromised compared to CRISPR/Cas9 nuclease. Targeting HIV genes, we investigated if CRISPR nuclease performed better than the nickase in efficacy and safety. Methods: CRISPR nucleases and nickases were designed to target Gag, Pol, Rev, Vif, Tat and LTR. HIV latently infected cell line, ACH-2, was transfected with the nucleases and nickases. Changes to viral load after CRISPR treatment was measured using p24 ELISA. Safety of nuclease and nickase was monitored using GFP expression with fluorescence microscopy and flow cytometry. Targeting two sites within the same gene, and targeting multiple genes concurrently were also studied to determine efficacy of CRISPR in reducing viral load. Results: A 44.9 to 68.1% and a 34.4 to 49.7% decrease in viral load was seen in CRISPR nuclease and nickase respectively. Microscopy and flow cytometry results showed that the nickase system was slightly toxic with a 0.31 to 0.7-fold cell death. There was a 34% decrease in viral load when two sites were targeted within a gene, and the largest decrease was seen when all the nucleases were combined, giving a 75.4% decrease in viral load at day 5. Conclusion: The knowledge gained from this study will be employed to im- prove genome editing in other disease models.
Introduction: Nasopharyngeal cancer is known to be a rare malignancy that effects the head and neck region in- volving the nasopharynx. It has a 0.8% occurrence rate among all types of cancer and has many risk factors ranging from viral infections to dietary intake habits. This study aims in determining the geographical variations across the world and its associated risk factors with nasopharyngeal cancer. Methods: The study was initiated by extracting relevant literature articles from electronic databases such as PubMed, Science Direct and SEER from 2008-2018. Search strategy also included key terms; nasopharyngeal cancer, nasopharyngeal carcinoma, prevalence, risk fac- tors, geographic variation, distribution, incidences, epidemiology and mortality. Results: Nasopharyngeal cancer is most common in Asia and China had the most number of new cases diagnosed in 2018. The standard incidence rate of nasopharyngeal cancer globally in 2018 was 1.5 per 100,000. The standardized mortality rate for nasopharyn- geal cancer globally in 2018 was 0.84 per 100,000. The 5 identified countries with the highest mortality rates were China, Indonesia, Vietnam, India and Philippines accordingly. Among the risk factors attributing to the incidences of nasopharyngeal cancer are Epstein Barr Virus (EBV) infection, salted and preserved food consumption and tobac- co smoking. Conclusion: Nasopharyngeal cancer is strongly associated with the variation of geographical regions therefore adequate knowledge, early detection, immediate administration of treatment and rapid detection is vital in reducing the global incidence burden.