Browse publications by year: 2020

Fulltext Preliminary phytochemical evaluation and vitamin c content of Tolidus (Hornstedtia havilandii (K. Schum) K. Schum) from Sabah

Nur Syafiqah Martang, Nadia Majitol, Farnidah Jasnie, Lo Chor-Wai

Borneo Akademika, 2020;4(4):15-20.
MyJurnal

Most of the plants in the ginger family Zingeberaceae are well-known for their medicinal properties. However, the genus Hornstedtia found in Sabah is less reported. This research aims to investigate the phytochemical constituent and vitamin C content of a fruit, locally known as the Tolidus fruit in Sabah. The dried fruit sample was extracted using three solvents which were water, ethanol and methanol. The phytochemical constituents were determined using standard Colour Test for the presence of alkaloid, flavonoid, saponin and tannin. Then, the content of Vitamin C was determined using the standard Colorimetric Titration and ascorbic acid as standard. The phytochemical evaluation revealed that all three targeted constituents were present in all extracts except for the alkaloid. The vitamin C content was determined in both dried and fresh sample of fruits, where 52.84 mg was quantified in the fresh fruit aqueous extract and 23.93 mg in the dried fruit aqueous extract respectively. These results are comparable to the content of vitamin C in orange and lime fruits. The phytochemical evaluation and vitamin C content of Tolidus suggested the potential of this underutilised fruit to be the natural and affordable source of vitamin C. Additionally, may protect the body against harmful free radicals. However, further analysis is needed to determine other constructive natural contents and evaluate the efficacy of this fruit as a natural source of antioxidant

MeSH terms: Ethanol; Methanol; Alkaloids; Antioxidants; Ascorbic Acid; Color; Colorimetry; Flavonoids; Free Radicals; Fruit; Malaysia; Reference Standards; Saponins; Solvents; Tannins; Water; Ginger; Citrus sinensis; Phytochemicals
Fulltext Colorectal Cancer Immunotherapy: Options and Strategies

Johdi NA, Sukor NF

Front Immunol, 2020;11:1624.
PMID: 33042104 DOI: 10.3389/fimmu.2020.01624

Colorectal cancer is the third most common cancer in the world with increasing incidence and mortality rates globally. Standard treatments for colorectal cancer have always been surgery, chemotherapy and radiotherapy which may be used in combination to treat patients. However, these treatments have many side effects due to their non-specificity and cytotoxicity toward any cells including normal cells that are growing and dividing. Furthermore, many patients succumb to relapse even after a series of treatments. Thus, it is crucial to have more alternative and effective treatments to treat CRC patients. Immunotherapy is one of the new alternatives in cancer treatment. The strategy is to utilize patients' own immune systems in combating the cancer cells. Cancer immunotherapy overcomes the issue of specificity which is the major problem in chemotherapy and radiotherapy. The normal cells with no cancer antigens are not affected. The outcomes of some cancer immunotherapy have been astonishing in some cases, but some which rely on the status of patients' own immune systems are not. Those patients who responded well to cancer immunotherapy have a better prognostic and better quality of life.

MeSH terms: Humans; Immune System; Immunotherapy; Neoplasm Recurrence, Local; Prognosis; Quality of Life; Reference Standards; Colorectal Neoplasms; Incidence; Radiation Oncology
Fulltext In vitro antileptospiral activity of trigona thoracia propolis and its synergistic effects with commonly prescribed antibiotics

Siti Radziah Ismail

IIUM Medical Journal Malaysia, 2020;19(1):13-22.
MyJurnal

Introduction: Trigona thoracica propolis is known to have antimicrobial properties, however its
antileptospiral properties and its synergistic effects with commonly prescribed antibiotics are scarcely
documented. This study aimed to evaluate the antileptospiral properties of Trigona thoracica against
pathogenic Leptospira species (spp.) and to study its synergistic effects with commonly prescribed
antibiotics. Materials and Methods: The tested Leptospira serovars were Australis, Bataviae, Canicola and
Javanica. Aqueous extract propolis (AEP) and ethanolic extracts propolis (EEP) were used. Broth dilution
methods were used to determine the Minimum Inhibitory Concentration (MIC), Minimum Bactericidal
Concentration (MBC) and the synergistic effects between the propolis and the tested antibiotics. The
synergistic effects was evaluated by using the fractional inhibitory concentration (FIC) index. Morphological
changes of the treated Leptospira were observed under a Scanning Electron Microscope (SEM). Results: The
AEP and EEP were found to have antileptospiral properties against the tested Leptospira spp. The synergy
result showed that only combination of AEP and penicillin G against serovar Australis has demonstrated
synergistic effect with the FIC index of 0.38. Morphological study using SEM showed significant structural
changes of the treated Leptospira spp. Conclusions: The result suggests that Trigona thoracica propolis could
potentially be used as either a complimentary or an alternative therapeutic agent against pathogenic
Leptospira spp.

MeSH terms: Ethanol; Animals; Anti-Infective Agents; Anti-Bacterial Agents; Thoracica; Bees; Leptospira; Microbial Sensitivity Tests; Microscopy, Electron, Scanning; Penicillin G; Propolis; Serogroup
Fulltext Prevalence of overweight and obesity among primary healthcare workers in Perak, Malaysia

Low, Pei Kit, Hazizi Abu Saad, Rosita Jamaluddin, Chee, Huei Phing

IIUM Medical Journal Malaysia, 2020;19(1):23-30.
MyJurnal

Introduction: Overweight and obesity has been emerging as one of the most common and preventable
nutritional problems worldwide. In 2016, 39% and 13% of the adult population worldwide was classified as
overweight and obese, respectively. Materials and Methods: We conducted a cross-sectional study at 12
selected health clinics in Perak, Malaysia, and we used multi-stage cluster random sampling to determine the
prevalence of overweight and obesity among the primary healthcare workers and the associate factors of
obesity indices. Each respondent was required to complete a self-administered questionnaire on their sociodemographic characteristics. In addition, we took anthropometric measurements, including height, weight,
BMI, waist circumference, and body fat percentage, of the participants. Results: We recruited 261 primary
healthcare workers. Overall, 49.9% of the healthcare workers were overweight or obese, 51.0% were at risk
of having abdominal obesity, and 79.6% had a high body fat percentages. Age and self-reported health status
were significantly associated with all the obesity indices. Educational level showed significant association
with BMI and waist circumference, while occupational status showed an association only with BMI. Older age
and professionals were predictors for high obesity indices. Conclusion: The prevalence of obesity among the
primary healthcare workers was higher than among the general population. An immediate intervention
programme is needed to reduce the prevalence of overweight and obesity among primary healthcare
workers.

MeSH terms: Adipose Tissue; Adult; Aged; Body Weight; Cross-Sectional Studies; Employment; Health Personnel; Health Status; Humans; Malaysia; Obesity; Primary Health Care; Body Mass Index; Prevalence; Overweight; Waist Circumference; Obesity, Abdominal; Self Report
Fulltext The impacts of climate variability on cholera cases in Malaysia

Noor Artika Hassan, Hashim JH, Wan Puteh SE, Wan Mahiyuddin WR, Faisal MS

IIUM Medical Journal Malaysia, 2020;19(1):75-83.
MyJurnal

Introduction: Altered weather patterns and changes in precipitation, temperature and humidity resulting
from climate change could affect the distribution and incidence of cholera. This study is to quantify climateinduced increase in morbidity rates of cholera. Material and Methods: Monthly cholera cases and monthly
temperature, precipitation, and relative humidity data from 2004 to 2014 were obtained from the Malaysian
Ministry of Health and Malaysian Meteorological Department, respectively. Poisson generalized linear models
were developed to quantify the relationship between meteorological parameters and the number of reported
cholera cases. Results: The findings revealed that the total number of cholera cases in Malaysia during the 11
year study period was 3841 cases with 32 deaths. Out of these, 45.1% of the cases were among children below
12 years old and 75% of the cases were from Sabah. Temperature and precipitation gave significant impact on
the cholera cases in Sabah, (p

MeSH terms: Child; Cholera; Humans; Humidity; Malaysia; Morbidity; Temperature; Weather; Causality; Incidence; Linear Models; Meteorology; Climate Change
Fulltext Predicting sexual intention to engage in premarital sex among late adolescent in Kuantan government secondary schools: an application of theory of planned behaviour

Abdullah F, Draman S, Abd. Aziz KH, Zainuddin NA, Muhammad NA

IIUM Medical Journal Malaysia, 2020;19(1):109-116.
MyJurnal

Introduction: Based on the Theory of Planned Behaviour (TPB), sexual intention is determined by three main
socio-cognitive factors which are permissive attitudes, social-norms and self-efficacy in performing
premarital sexual activity. Premarital sex associated with increased risk of sexually transmitted diseases and
detrimental social implications. The aim of this study was to explore the correlation of the socio-cognitive
factors in predicting intention to engage in premarital sex amongst late adolescents in Kuantan government
secondary schools. Method: This cross-sectional study was conducted among 466 pre-university students aged
18-19 years from nine government secondary schools in Kuantan district. A self-administered validated Youth
Sexual Intention Questionnaire (YSI-Q) was used. Statistical analyses were done using IBM SPSS version 22.0.
Results: Permissive attitude (r=0.579, p

MeSH terms: Adolescent; Adult; Aged; Attitude; Cognition; Cross-Sectional Studies; Government; Humans; Surveys and Questionnaires; Schools; Sexual Behavior; Sexually Transmitted Diseases; Students; Universities; Self Efficacy; Intention; Young Adult
Fulltext Knee pain during Islamic prayer after anterior cruciate ligament reconstruction using hamstring and bone patellar tendon autograft

Ahmed N, Shihabudin M.T, Ab Rahman S

IIUM Medical Journal Malaysia, 2020;19(1):31-36.
MyJurnal

Introduction: Hamstring tendon (HT) and bone patellar tendon bone (BPTB) are the commonly used
autograft in an anterior cruciate ligament reconstruction surgery. The BPTB is said to have more incidence of
anterior knee pain compared to HT. The study aimed to compare the severity of knee pain during Islamic
prayer kneeling. Methods: A cross sectional cohort analysis of patients undergoing ACL reconstruction surgery
using BPTB with HT autografts was conducted to determine differences in postoperative pain while kneeling
and ability to pray in normal position. Kneeling during prayer and the ability to sit while performing prayer
were assessed at 3rd, 4th, 5th and 6th month. Results: There were no significant differences in mean pain score
while kneeling at 3rd, 4th, 5th and 6th month. The mean difference of patient’s ability to perform normal
prayers for BPTB (3.56+1.16) and HT (3.30+1.05) was found insignificant. The average number of patients in
both groups was able to pray between 3 to 4 months post operatively as full range of motion of knee is
allowed within this period. Total 49 patients (BPTB 23, HT 26) out of 60 were able to pray normally within 4
months post-operation. Mostly delayed due to anterior knee pain. Conclusion: There is no different in term of
knee pain during kneeling while performing Islamic prayer between those who had their ACL reconstructed
either using BPTB or HT autograft.

MeSH terms: Cross-Sectional Studies; Humans; Knee; Knee Joint; Pain, Postoperative; Cohort Studies; Incidence; Range of Motion, Articular; Patellar Ligament; Anterior Cruciate Ligament Reconstruction; Autografts; Hamstring Tendons
Fulltext Surgical antibiotic prophylaxis: incidence and risk of surgical site infection

Fadzwani B, Raha A.R, Nadia M.N, Wan Rahiza WM, Razman J, Nordiah A.J

IIUM Medical Journal Malaysia, 2020;19(1):45-53.
MyJurnal

Introduction: This prospective cross sectional study assessed surgical antibiotic prophylaxis (SAP) practice,
the incidence of surgical site infection (SSI) and its associated risks in Universiti Kebangsaan Malaysia Medical
Centre. Methods: Patients for elective colorectal, hepatobiliary, upper gastrointestinal, breast and
endocrine surgery, who received SAP were included and followed up until day-30 postoperatively. Types of
antibiotic, preoperative–dose timing, intraoperative re-dosing and its duration were recorded. The incidence
of SSI was calculated and its associated risks expressed in odds ratio. Results: Out of 166 patients recruited,
121 (72.89%) patients received SAP preoperatively, and 91 (75.21%) of them were prescribed the appropriate
antibiotic as per our institutional guideline. Three patients who continued to receive therapeutic antibiotic
postoperatively were excluded from statistical analysis. Eleven (9.10%) patients received SAP beyond the
preoperative–dose timing of 60 minutes (p=0.001), which was an independent risk factor for SSI (adjusted OR
4.527, 95% CI; 1.058-19.367, p=0.042). The risk of SSI also remained in patients who continued to receive
SAP beyond 24 hours (OR 4.667, 95% CI; 1.527-14.259, p=0.007). The overall rate of SSI was 17.18%.
Conclusion: We found that the choice of antibiotic prescribed for SAP was in accordance to institutional
guideline and the relatively high SSI incidence was similar to a recent local report. Although the number of
patients receiving preoperative dose-timing of > 60 minutes was low, it was nonetheless an independent risk
factor for SSI. The postoperative continuation of SAP for more than 24 hours showed no benefit in reducing
SSI.

MeSH terms: Anti-Bacterial Agents; Breast Neoplasms; Cross-Sectional Studies; Humans; Malaysia; Prospective Studies; Research Design; Risk Factors; Endocrine Surgical Procedures; Surgical Wound Infection; Colorectal Neoplasms; Incidence; Odds Ratio; Elective Surgical Procedures; Antibiotic Prophylaxis
Fulltext Factors associated with postpartum family planning in a cohort of Kelantanese women with previous caesarean delivery in Malaysia

Hafizah I, Tengku Alina TI, Suhaily MH, Zaharah S

IIUM Medical Journal Malaysia, 2020;19(1):85-97.
MyJurnal

This community-based, cross-sectional study aimed to identify the factors associated with
postpartum family planning use among a cohort of women with recent caesarean delivery in a state with the
lowest contraceptive use in Malaysia. Materials and Methods: A total of 281 women aged between 18-49
years old who had caesarean delivery in government tertiary centres in Kelantan from January until April
2017 were enrolled in this study. The study was conducted from January until April 2018. Women were
selected through stratified random sampling with probability proportional to size. Data were collected
through a validated structured questionnaire. The main outcome was binary (postpartum family planning use
or non-use). The factors included socio-demographic details, reproductive history, previous contraceptive
use, contraceptive health education received, knowledge, and social support. Simple and multiple logistic
regression were conducted to identify significant determinants of postpartum family planning use. Results:
The factors associated with postpartum family planning use included a secondary and below education level
of women (AOR= 2.37, 95% CI (1.05, 5.34)), previous contraceptive use (AOR= 9.82, 95% CI (4.81, 20.06)),
individual health education (AOR= 4.19, 95% CI (1.23, 14.30)), higher knowledge score (AOR= 1.12, 95% CI
(1.03, 1.23)), and higher social support score (AOR= 1.09, 95% CI (1.03, 1.16)). Conclusions: here remains a
need to enhance personalised contraceptive counselling in the primary care setting as well as to promote
longer acting reversible contraceptive methods.

MeSH terms: Adolescent; Adult; Aged; Cesarean Section; Contraception; Contraception Behavior; Contraceptive Agents; Contraceptive Devices; Counseling; Cross-Sectional Studies; Demography; Family Planning Services; Female; Government; Health Education; Humans; Malaysia; Middle Aged; Pregnancy; Primary Health Care; Probability; Surveys and Questionnaires; Social Support; Reproductive History; Postpartum Period; Young Adult
Fulltext The neorectum reservoirs

Wong M.P.K

IIUM Medical Journal Malaysia, 2020;19(1):33-37.
MyJurnal

The incidence of rectal dissection is increasing with the rise of rectal cancer all over the world. This
technique has been used regularly to provide a reasonable quality of life for patients. The concern raised
was the functions of these neorectum to replace the original rectum. Several configurations have been
suggested namely the straight end-to-end coloanal anastomosis, side-to-end coloanal anastomosis, colonic Jpouch and the transverse coloplasty to suit the anatomy of the deep pelvis. Apparently, there was no
difference in terms of functional outcome among all these four types of reconstructions. However, these
configurations have seen the emergence of anterior resection syndrome or a pragmatic defaecatory
dysfunction as their complications. Furthermore, the neorectum functions are affected by many other
factors such as preoperative chemoradiotherapy, septic complications, and others more.

MeSH terms: Anastomosis, Surgical; Colon; Dissection; Humans; Pelvis; Quality of Life; Rectal Neoplasms; Rectum; Incidence; Chemoradiotherapy
Fulltext Effect of planting media on growth of pineapple CV. Madu seedlings by stem cutting technique

Mohd Miqdam Jubidin, Mohammed Selamat Madom, Nur Aainaa Hasbullah

Borneo Akademika, 2020;4(4):9-14.
MyJurnal

Generally, pineapple sucker is used as the main planting material for commercial cultivation
of pineapple. Pineapple sucker is usually obtained either from the stalk or the stem of a
pineapple plant. Research to study the effect of planting media using mineral soil as the main
component for the mixture on the growth of sucker by stem cutting technique was conducted. The objective of this research is to study the effects of mineral soil-based mixed planting
media on the growth of pineapple suckers produced cultivated via stem cutting of Madu
pineapple. The research was conducted at the Pineapple Nursery of the Faculty of Sustainable
Agriculture, UMS Sandakan, from March 2019 until September 2019. The treatments used in
this research were, soil as T1 (100%); Soil:coco peat as T2 (1:1,v/v); Soil:peat soil as T3
(1:1,v/v); Soil:sand as T4 (1:1,v/v). The data obtained showed there is a significant difference
in the number of a successfully germinated sucker. However, no significant difference was
detected for the sucker growth parameters. Planting media T3, soil: coco peat recorded the
highest number of successfully germinated suckers (12.25). Meanwhile, for growing media, suggested T2 soil: peat soil were recorded the highest for root length (15.53 cm), leaf number
(18.00), and stem diameter (2.18 cm) at 60 days after transplant (DAT).

MeSH terms: Agriculture; Cocos; Culture Media; Faculty; Humans; Minerals; Soil; Plant Leaves; Germination; Ananas
Fulltext Considering phrasal verbs and collocations for ESL vocabulary teaching

Weng, Brandon Chai An

Borneo Akademika, 2020;4(4):1-8.
MyJurnal

Words have a habit of appearing in recurrent patterns. These recurring patterns may take the
form of phrasal verbs, collocations, and other multi-word expressions (MWEs). Since these
patterns constantly re-occur in both speech and writing, it would seem prudent to teach
vocabulary to ESL learners in the manner in which words actually present themselves: in
typical chunks. A common example of such a chunk would be “to deal with the problem”, in
which “deal with” and “problem” are collocates. This paper contains three sections. The first
examines what phrasal verbs and collocates are in the first place, and why they are particularly
important for learners. The second part is a review of recent studies that support the teaching
of MWEs and chunking pedagogy. This paper concludes by discussing the potential of
incorporating chunking pedagogy in one’s own ESL vocabulary teaching.

MeSH terms: Habits; Learning; Memory; Speech; Vocabulary; Writing
Fulltext Antioxidant enzymes in tears among Malay age-related macular degeneration patients

Yi Ni Koh, Embong Zunaina, Ahmad Tajudin Liza-Sharmini, Che Badariah Abd-Aziz, Che Hussin Che-Maraina, Mei Fong Chong, et al.

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):149-156.
MyJurnal

Introduction: Age-related macular degeneration (ARMD) is an ocular degenerative disorder that associated with impairment of central vision. Oxidative stress plays an important role in the pathogenesis of ARMD. The aim of this study was to determine the level of antioxidant enzymes (catalase and glutathione peroxidase) in tears among Malay ARMD patients. Methods: A cross sectional study was conducted between September 2015 and November 2017 among Malay ARMD patients. Schirmer paper was used to collect the tear samples. The level of catalase and glu- tathione peroxidase level in tears was evaluated using commercially available oxidative stress marker kits. Results: A total of 136 Malay ARMD patients were recruited into the study with 68 controls. Mean tear catalase and gluta- thione peroxidase levels were significantly lower in ARMD patients (1348.97 SD 109.11 µM and 453.87 SD 41.96 U/L respectively) as compared to the control group (1453.38 SD 38.87 µM and 502.28 SD 34.29 U/L respectively) (P

MeSH terms: Antioxidants; Catalase; Cross-Sectional Studies; Eye; Eye Diseases; Glutathione Peroxidase; Humans; Macular Degeneration; Malaysia; Thiones; Oxidative Stress; Control Groups
A Cross-sectional Study to Evaluate Nuclear Changes in Buccal Mucosa Following Panoramic Radiography

Santhosh K, Manzoor S, Sushanth A, Seralathan S, Rajasekar V, Jacob A

J Contemp Dent Pract, 2020 Nov 01;21(11):1258-1261.
PMID: 33850072

AIM AND OBJECTIVE: To evaluate the possible genotoxic effect of X-rays on buccal mucosa while exposing to dental panoramic radiography using micronucleus test.
MATERIALS AND METHODS: The study group comprised of 30 healthy subjects, 15 males and 15 females, aged between 24 years and 65 years. Samples were obtained from the exfoliated oral mucosa cells of buccal mucosa before and 12 days after exposing the patients to panoramic radiography.
RESULTS: The study reported that there was no significant increase in the number of micronuclei cells present before and after panoramic radiography. Positive correlation existed between age with pre- and postexposure micronuclei.
CONCLUSION: Diagnostic dental panoramic radiograph does not induce micronuclei in the target buccal epithelium cells. A positive correlation between age and micronuclei frequency was established.
CLINICAL SIGNIFICANCE: Panoramic radiographs does not induce cytotoxicity but increase frequency may be vulnerable to genotoxic effects in buccal mucosal cells. Hence, dental radiographs should be prescribed only when necessary.

MeSH terms: Adult; Cell Nucleus*; Cross-Sectional Studies; Female; Humans; Male; Radiography, Panoramic; Micronucleus Tests; Young Adult
Fulltext Optimized aqueous extraction conditions for maximal phenolics, flavonoids and antioxidant capacity from Artocarpus heterophyllus (Jackfruit) leaves by response surface methodology (RSM)

Nor Hafiza Sayuti, ‘Ammar Akram Kamarudin, Nor Asma Ab. Razak, Norazalina Saad, Mohd Sabri Pak Dek, Norhaizan Mohd Esa

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):135-144.
MyJurnal

Introduction: There are numerous studies on the therapeutic properties of Artocarpus heterophyllus. However, stud- ies on the aqueous extraction of A. heterophyllus leaves are limited. This present study was conducted to optimize the extraction conditions of A. heterophyllus leaves to yield the highest phenolic, flavonoids and antioxidant contents. Methods: Response surface methodology (RSM) was employed to obtain a higher phenolic extraction parameter(s) of A. heterophyllus leaves using Central Composite Design (CCD). The antioxidant activity was then determined via ABTS (2,29-azinobis (3 ethylbenzothiazoline-6-sulfonic acid)) and DPPH (2,2-Diphenyl-1-picrylhydrazyl) assay and analysis of the individual phenolics was performed by high performance liquid chromatography (HPLC). Results: The optimum extraction conditions with higher phenolics content and antioxidant activity was achieved at 81°C, 100 min and 40 mL/g sample with a good desirability value of 0.87. Under these optimized parameters, total phenolics and flavonoids were 174.48 ± 4.05 mg GAE/g sample and 21.44 ± 0.05 mg RE/g sample, respectively. Meanwhile, antioxidant activity via ABTS and DPPH assays were 90.88% ± 0.09 and 87.22% ± 0.62, respectively. Finally, under optimal extraction conditions revealed 4 compounds identified as chlorogenic acid, quercetin, rutin and kaempferol. Conclusion: The optimisation are promising to improve phenolic yield and antioxidant activity in A. heterophyllus leaves. It also proved that A. heterophyllus leaves can be used as an alternative natural antioxidant especially in medicinal applications since all identified compound possess significant biological activities for human health.

MeSH terms: Antioxidants; Biphenyl Compounds; Chlorogenic Acid; Chromatography, High Pressure Liquid; Flavonoids; Humans; Phenols; Picrates; Quercetin; Rutin; Sulfonic Acids; Plant Leaves; Artocarpus; Kaempferols; Benzothiazoles
Fulltext Prevalence, sociodemographic and clinical characteristics of G6PD deficient blood donors in Terengganu and the effects of storage on their donated blood

Hayati Mansor, Eusni Rahayu Mohd. Tohit, Faridah Idris, Alawiyah Abdul Rahman

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):126-134.
MyJurnal

Introduction: Glucose-6-phosphate dehydrogenase (G6PD) deficiency causes red blood cell destruction due to oxi- dative stress. G6PD is essential for NADPH conversion; which is critical for glutathione reductase to prevent damage to cellular structures. In Malaysia, blood donors are not routinely screened for G6PD deficiency. We hypothesise that G6PD-deficient red blood cells are more likely to haemolyse during storage due to increased oxidative molecules. The objectives of this study were to determine the prevalence of G6PD deficiency among blood donors, describe their characteristics and to evaluate the effects of storage on G6PD-deficient donated blood. Methods: This study was conducted at selected mobile donation centres in Terengganu. Consented blood donors were screened for G6PD sta- tus using fluorescent spot tests (FST). G6PD enzyme activities were measured for donors who were G6PD deficient. Effects of storage on haemolysis from G6PD-deficient donors were compared with non G6PD-deficient group. Sixty ml of blood was collected from blood unit to transfer pouch for estimation of haemoglobin (Hb), plasma Hb, per- centage of haemolysis and plasma potassium. Serial sampling with a 7-day interval was done from Day 1 to Day 35. Statistical analysis was considered significant if p 0.05. Results: A total of 440 blood donors were screened and 12 male donors were found to be G6PD deficient by FST. Enzymatic activities were measured in 11 donors as one donor sample failed to be sent to the centre due to logistic problem. Their enzymatic activities ranged from 1.66-2.93 U/g Hb whereby 6 have severe deficiency and the other 5 were categorised as partial deficiency. Donors were asymp- tomatic for haemolytic episode. Serial sampling showed there was no significant difference of haemolytic parameters in blood units of G6PD-deficient donors as compared to control (p>0.05). Conclusion: Prevalence of G6PD blood donors in Terengganu mobile centres was 2.7%. G6PD enzyme activities did not correlate with clinical symptoms. Haemolytic parameters were not affected in blood units which were G6PD-deficient.

MeSH terms: Blood Donors; Erythrocyte Count; Erythrocytes; Glucosephosphate Dehydrogenase; Glucosephosphate Dehydrogenase Deficiency; Glutathione Reductase; Hematologic Tests; Hemoglobins; Hemolysis; Humans; Malaysia; Male; NADP; Plasma; Potassium; Prevalence; Oxidative Stress
Fulltext Diabetes-associated autoantibodies among young diabetes mellitus patients in Malaysia

Hasni Mahayidin, Siti Zulaikha Zakariah, Noor Ashidah Ishah, Xu Ann Wee, Masita Arip, Nurhanani Mohamed Nor

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):118-125.
MyJurnal

Introduction: Diabetes-associated autoantibodies (DAA) is the hallmark of T1DM and LADA which are frequently tested in young diabetes patients. It was noted that up to 10-15% of patients with initial diagnosis of T2DM also exhibit DAA. Regardless of the classification, the presence of DAA suggests an underlying islet autoimmunity which lead to progressive pancreatic β-cell failure. There is limited data reported on DAA in young diabetes patients in Malaysia. This study aims to determine the frequency of DAA positivity and its association with demographic and clinical characteristics among this cohort. Methods: A retrospective study using secondary data obtained from Al- lergy and Immunology Research Centre, Institute for Medical Research, Malaysia. This study included 194 diabetes patients who were diagnosed before the age of 40 years old and tested for GADA, ICA, IA2A and IAA. Results: From 194 patients, 91 (46.9%) were positive for least one of the following DAA: ICA (79, 40.7%), GADA (61, 31.4%), IA2A (37, 19.1%) and IAA (9, 4.6%). Multiple positivity was higher (73.6%) compared to single positivity. Highest com- bination of double positivity was ICA+GADA (54, 59.3%) and triple positivity was ICA+GADA+IA2A (25, 27.5%). Simultaneous positivity of four autoantibodies was seen in only one (1.1%) patient. ICA, GADA and IA2A were asso- ciated with age group and ethnicity (all p < 0.001). Only IA2A was associated with gender (p = 0.012). Conclusions: GADA, ICA ad IA2A are more significant in young Malaysian diabetes patients. IAA has a very low frequency in this studied population.

MeSH terms: Adult; Antiviral Agents; Autoantibodies; Diabetes Mellitus, Type 1; Diabetes Mellitus, Type 2; Ethnic Groups; Glutamate Decarboxylase; Humans; Insulin Antibodies; Malaysia; Retrospective Studies; Cohort Studies; Autoimmunity; Hepatitis C, Chronic; Biomedical Research; Insulin-Secreting Cells
Fulltext Forensic analysis of accelerant on different fabrics using Attenuated Total Reflectance-Fourier Transform Infrared Spectroscopy (ATR-FTIR) and chemometrics techniques

Farah Izza Jais, Sharifah Mastura, Naji Arafat Mahat, Dzulkiflee Ismail, Muhammad Naeim Mohamad Asri

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):112-117.
MyJurnal

Introduction: Accelerants and fabrics are commonly used to spread fire attributable to their highly flammable prop- erties. Hence, having the ability to discriminate the different types of accelerants on various types of fabrics after fire and/or arson using the non-destructive Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spec- troscopy coupled with chemometric techniques appears forensically relevant. Methods: Six types of fabrics viz. cotton, wool, silk, rayon, satin, and polyester, were burnt completely with RON95 and RON97 gasoline as well as diesel. Subsequently, the samples were analyzed by ATR-FTIR spectroscopy followed by Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA) for discriminating the different types of accelerants on such burned fabrics. Results: RON95 showed the fastest rate of burning on all fabric types. Results also revealed that while wool had the slowest burning rate for all the three different accelerants, polyester, cotton, and satin demon- strated the highest rate of burning in RON95, RON97, and diesel, respectively. FTIR spectra revealed the presence of alkane, alcohol, alkene, alkyne, aromatic, and amine compounds for all fabrics. The two dimensional PCA (PC1 versus PC2) demonstrated 71% of variance and it was improved by cross-validation through the three dimensional LDA technique with correct classification of 77.8%. Conclusion: ATR-FTIR spectroscopy coupled with chemometric techniques had enabled identification of the functional groups, as well as statistically supported discrimination of the different accelerants, a matter of relevance in forensic fire and arson investigations.

MeSH terms: Alkanes; Alkenes; Alkynes; Amines; Animals; Firesetting Behavior; Fourier Analysis; Gasoline; Polyesters; Textiles; Wool; Discriminant Analysis; Spectroscopy, Fourier Transform Infrared; Principal Component Analysis; Silk
Fulltext Lean public emergency department efficiency evaluation by Slack-based Measure Data Envelopment Analysis

Tiong Ngee-Wen, Suhaiza Zailani, Azmin Azliza Aziz, Rashidi Ahmad

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):105-111.
MyJurnal

Introduction: Lean healthcare outcome is usually measured with multiple key performance metrics but there is a lack of tools that enabled efficiency assessment. This research aimed to assess the efficiency among lean public emergen- cy departments (ED) through Slack-Based Measure Data Envelopment Analysis (SBM-DEA) and evaluate the impact of lean on the efficiency in public emergency departments. Methods: A retrospective observational study design using data on the number of support staff, number of doctors, number of discharge, arrival to consultant and length of stay. Efficiency scores of 20 Malaysian public EDs were computed using SBM-DEA modelling and compared be- tween before and after lean implementation. Results: A total of 13 out of 20 public EDs exhibited improvement in ar- rival to consultant and length of stay upon lean implementation. However, only 9 out of the 13 public EDs have had an improvement in efficiency score. Conclusion: Lean healthcare demonstrated a positive impact on the efficiency level of some public EDs. The SBM-DEA model offers the benchmarking capability and slack elimination information that may complement the lean continuous improvement philosophy.

MeSH terms: Consultants; Delivery of Health Care; Efficiency; Emergency Service, Hospital; Humans; Length of Stay; Patient Discharge; Philosophy; Polysorbates; Retrospective Studies; Benchmarking
Fulltext Computational prediction of novel broad-spectrum drug targets against Vibrio cholerae by integrated genomics and proteomics approach

Suresh Kumar, Meera Ramanujam

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):99-104.
MyJurnal

Introduction: Vibrio cholerae is a motile, Gram-negative curved rod belonging to the Vibrionaceae family. It is the causative agent of cholera. The acute diarrheal disease cholera causes about 120 000 casualties annually and has a significant effect on the health of young kids between the ages of 1 and 5. The main cause of death is due to resistance to antibiotics. As a result, new drug targets need to be identified immediately. The study’s goal is to identify Vibrio Cholerae’s putative drug target through an integrated approach to genomics and proteomics. Methods: Through this study, 2241 core protein sequence of Vibrio Cholerae were retrieved from the Panx tool. The sequence decreased to 173 druggable sequences by undergoing different phases of the process such as determining the non-homolo- gous sequence against human proteome by using the BlastP tool, identifying the essential genes by using the DEG database, and determining the sequence of virulent proteins by using Virulent prediction tool. Results: 11 potential drug targets were identified through molecular weight, and sub-cellular localization analysis. Conclusion: Through pan-genome analysis, we can able to find potential drug targets. This study also helps to identify the potential drug targets against Vibrio cholerae and to increase the efforts of drug and vaccine developments.

MeSH terms: Anti-Bacterial Agents; Cause of Death; Child, Preschool; Cholera; Diarrhea; Pharmaceutical Preparations; Goals; Humans; Infant; Molecular Weight; Motivation; Vaccines; Vibrio; Vibrio cholerae; Genes, Essential; Proteome; Genomics; Proteomics

External Links