Browse publications by year: 2020

  1. Fulltext The neurological exam of a comatose patient: an essential practical guide
    Zaitun Zakaria, Mohamad Muhaimin Abdullah, Sanihah Abdul Halim, Abdul Rahman Izaini Ghani, Zamzuri Idris, Jafri Malin Abdullah
    Malaysian Journal of Medical Sciences, 2020;27(5):108-123.
    MyJurnal
    A thorough examination of a comatose patient is essential given the spectrum of clinical diagnoses. The most immediate threat to patients is airway, breathing and circulation. All attending physician should employ a structured and focused approach in dealing with a comatose patient. It is important to recognise the urgent steps needed at the time to prevent further deterioration, followed by the final diagnosis of patient’s neurologic status. Here we provide the essential practical guide to the neurological exam of a comatose patient that would assist to determine the aetiology, location and nature of the neurological lesion.
    MeSH terms: Coma; Humans; Neurologic Examination; Physicians; Physiological Phenomena; Respiration; Respiratory System
  2. Fulltext Can we use peer-assisted learning to teach basic surgical skills?
    Ong, Mang Ning, Kar, Min Lew, Yih, Jeng Cheong, Ting, Evelyn Wan Xuan, Bakri Bohari, Tang, Yita, et al.
    Malaysian Journal of Medical Sciences, 2020;27(5):101-107.
    MyJurnal
    Background: It is reported that medical students do not receive adequate opportunities to learn surgical skill and are at risk of being unable to perform simple surgical procedures safely. The usefulness of peer-assisted learning (PAL) as a tool to assist in delivering surgical skills training is worth exploring. Methods: This is a randomised single blinded controlled trial. Fourth-year students from the university’s Surgical Society were asked to volunteer as peer tutors and those in 3rd-year were asked to undertake surgical skills training. A cohort of 35 students were selected and randomised to receive basic surgical skills training conducted either by faculty members or peers. The students’ performance of basic suturing skills was assessed using a checklist, through directly observed procedural skills (DOPS) technique. The assessment was conducted by faculty blinded to the training. Students’ perception to surgical skills training was assessed using a questionnaire survey. Results: The suturing and knotting skills of students learned from their peers was comparable to that acquired from faculty. The students’ perceived that their peers could conduct surgical skills training similar to their faculty. Conclusion: PAL approach for basic surgical skills training is as effective as faculty-led training. PAL has the potential to optimise the delivery of surgical skills training in undergraduate medical education.
    MeSH terms: Education, Medical, Undergraduate; Faculty; Humans; Learning; Peer Group; Perception; Surveys and Questionnaires; Students, Medical; Universities; Volunteers; Cohort Studies; Checklist
  3. Fulltext Six months guided exercise therapy improves motor abilities and white matter connectivity in children with cerebral palsy
    Md Safwan Samsir, Rahimah Zakaria, Salmi Abdul Razak, Mohamed Saat Ismail, Mohd Zulkifli Abdul Rahim, Lin, Chia-Shu, et al.
    Malaysian Journal of Medical Sciences, 2020;27(5):90-100.
    MyJurnal
    Background: Diffusion magnetic resonance imaging (dMRI) provides the state of putative connectivity from lesioned areas to other brain areas and is potentially beneficial to monitor intervention outcomes. This study assessed the effect of a 6 months guided exercise therapy on motor abilities and white matter diffusivity in the brains of cerebral palsy (CP) children. Methods: This is a single arm pre- and post-test research design involving 10 spastic CP children, aged 8–18 years and whose Gross Motor Function Classification System Expanded and Revised (GMFCS-E & R) at least Level 21 with the ability to ambulate independently. They were recruited from Paediatric Neurology Clinic, Hospital Universiti Sains Malaysia (HUSM) from December 2015–December 2016. All participants underwent 6 months of therapist-guided exercise session comprising progressive strength training at a frequency of twice a week, 1 h duration per session. The effect of exercise on motor abilities was assessed using the Gross Motor Function Measures (GMFM)-88. Six out of the 10 children consented for dMRI. Probabilistic tractography of the corticospinal tract (CST) was performed to determine the connectivity index of the tracts preand post-intervention. Results: All the participants displayed statistically significant increment in GMFM88 scores pre- to post-exercise intervention. This improvement was concurrent with increased connectivity index in the CST of upper limbs and lower limbs in the brain of these children.
    MeSH terms: Adolescent; Aged; Brain; Cerebral Palsy; Child; Exercise Therapy; Hospitals; Humans; Malaysia; Muscle Spasticity; Neurology; Pyramidal Tracts; Research Design; Exercise; Upper Extremity; Lower Extremity; Diffusion Magnetic Resonance Imaging; Resistance Training; White Matter
  4. Fulltext First parental concerns and age at diagnosis of autism spectrum disorder: a retrospective review from Malaysia
    Jayanath, Subhashini, Ozonoff, Sally
    Malaysian Journal of Medical Sciences, 2020;27(5):78-89.
    MyJurnal
    Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder. This is the first study to examine first parental concerns in ASD in Malaysia. We examined: i) age and type of first parental concerns (AOC); ii) association between AOC and severity; iii) time lag between AOC and diagnosis; and iv) factors associated with diagnostic delay. Methods: Medical records of 366 patients (aged 1–18 years) with ASD, at the Developmental Paediatrics Clinic of University of Malaya Medical Centre (UMMC), Kuala Lumpur, were reviewed for this 16-month retrospective cohort study. A validated coding system was used for initial parent concerns. Severity was classified via the Diagnostic and Statistical Manual of Mental Disorders-5th edition (DSM-5) criteria. Time lag between AOC and age at diagnosis (AOD) was calculated. Potential predictors of delayed diagnosis were extracted. Results: Three-quarters (75.1%) of parents had concerns by 36 months. Speech/language/ communication concerns were most frequent (60.1%). Number of first concerns was significantly correlated with severity (social communication/interaction, SCI [P = 0.019] and restricted, repetitive patterns of behaviours and/or interests/activities, RRB [P < 0.001]). AOC and AOD were significantly negatively correlated with SCI and RRB (P < 0.001). Medians; AOC: 24 months, AOD: 46 months and time lag: 17 months. Higher initial screen time was associated with diagnostic delay (P = 0.031). Conclusion: First parental concerns and AOD were comparable to studies across countries. Speech/communication delays may represent universal first parental recognition of ASD.
    MeSH terms: Autism Spectrum Disorder; Adolescent; Aged; Child; Child, Preschool; Communication; Communication Disorders; Humans; Infant; Language; Malaysia; Medical Records; Parents; Pediatrics; Retrospective Studies; Speech; Diagnostic and Statistical Manual of Mental Disorders; Delayed Diagnosis; Neurodevelopmental Disorders
  5. Fulltext Relapsed/progressive disease and its prognostic factors among multiple myeloma patients receiving novel agent treatment in north east peninsular malaysia: a single centre experience
    Hany Haqimi Wan Hanafi, Azlan Husin, Najib Majdi Yaacob, Abu Dzarr Abdullah
    Malaysian Journal of Medical Sciences, 2020;27(5):62-77.
    MyJurnal
    Background: Some multiple myeloma (MM) patients still relapse/progress despite novel agent therapy and relapse/progression in MM is therefore a vital area of ongoing research in the novel treatment era. This retrospective cohort study aimed to evaluate the time to relapse/ progression (TTP) among MM patients who received novel agents and to determine the associated prognostic factors. Methods: This study included 89 MM patients treated at Hospital Universiti Sains Malaysia. We analysed the TTP and the type of relapse/progression (biochemical versus clinical), and a Cox proportional hazard model was used to identify the significant prognostic factors. Results: Sixty-four percent of patients had biochemical relapse/progression. The overall median TTP among MM patients who received the novel agent(s) was 29.33 months (95% CI: 21.36–37.29). The type of paraprotein at diagnosis (P = 0.026, P = 0.228), International Staging System (ISS) score (P = 0.036, P = 0.067) and autologous stem cell transplant (ASCT) (P = 0.002) were prognostic factors for relapse/progression by simple Cox regression, but ASCT was the only significant predictor detected by multiple Cox regression (P = 0.003). Conclusion: Our study reflects the importance of paraprotein monitoring to detect early features of relapse/progression. ASCT is the most prognostic factor that may lengthen the TTP.
    MeSH terms: Hospitals; Humans; Longitudinal Studies; Malaysia; Multiple Myeloma; Myeloma Proteins; Neoplasm Recurrence, Local; Paraproteins; Prognosis; Retrospective Studies; Transplantation, Autologous; Proportional Hazards Models; Hematopoietic Stem Cell Transplantation
  6. Fulltext Pre-operative percutaneous nephrolithotripsy characterisation of kidney stones with second-generation dual-source dual-energy computed tomography
    DK Mella Mohd Ali, Mohd Hafizi Mahmud, Noor Shafini Mohamad
    Malaysian Journal of Medical Sciences, 2020;27(5):43-52.
    MyJurnal
    Background: The current clinical practice to manage kidney stone requires knowledge of the stone composition. However, it is often difficult to determine the actual stone composition before a stone is operatively removed from the patient. Dual-energy computed tomography (DECT) can predict urinary stone composition, but it is not widely adopted. The purpose of the study was to investigate the use of a second-generation DECT with tin or stannum (Sn) filter for characterising the kidney stones composition. Methods: Thirty-three kidney stones were scanned ex vivo using a dual-source (DS)- DECT scanner with dual-energy (DE) mode of 80/140 kVp with and without 4 mm Sn filtration. DE ratio was calculated to determine the kidney stones composition (uric acid, calcium oxalate, calcium phosphate and cystine). The median DE ratio of the stones was compared using Wilcoxon signed rank test and the results were further correlated with semi-quantitative Fourier transform infrared (FTIR) spectroscopy analysis using Kendall’s Tau test with P < 0.05 deemed to be statistically significant. Results: Second-generation DS-DECT could significantly discriminate the stones composition with and without Sn filtration (P < 0.001). The median DE ratio of uric acid, calcium oxalate and cystine stones were significantly higher with Sn filtration than those without filtration (P < 0.05). DECT results revealed significant correlation with FTIR spectroscopy analysis (r = 0.716, P < 0.001). DECT with Sn filtration showed increased performance (100% sensitivity, 0% specificity) than those without filtration (48.5% sensitivity, 0% specificity) in the detection of the kidney stone subtypes. Conclusion: In the second-generation DECT with additional Sn filtration, DECT has shown a significant performance in characterising and discriminating the kidney stone composition. This may improve diagnostic and therapy management in kidney stones cases.
    MeSH terms: Calcium Oxalate; Calcium Phosphates; Cystine; Family Characteristics; Fourier Analysis; Humans; Kidney; Kidney Calculi; Tin; Tomography; Uric Acid; Urinary Calculi; Spectroscopy, Fourier Transform Infrared
  7. Fulltext sLORETA source localisation of visual mismatch negativity in dyslexic children during Malay orthographical lexicon stimulations
    Siti Atiyah Ali, Begum, Tahamina, Faruque Reza, Nor Asyikin Fadzil, Faiz Mustafar
    Malaysian Journal of Medical Sciences, 2020;27(5):36-42.
    MyJurnal
    Background: While there are studies on visual lexical processing in other languages among dyslexics, no studies were done in the Malay language. The origin of visual lexical processing might be different in the Malay language. We aimed to detect the source localisation of visual mismatch negativity (vMMN) during Malay orthographic lexicon stimulations, employing an event-related potential (ERP) study. Methods: Twelve dyslexic and twelve non-dyslexic children participated in this study. They pushed button ‘1’ when they saw real (meaningful) Malay words and button ‘2’ for pseudowords (meaningless). The source localisation of vMMN was performed in the grand average waveform by applying the standardised low-resolution brain electromagnetic tomography (sLORETA) method using Net Station software. Results: Left occipital (BA17) and left temporal (BA37) lobes were activated during real words in the non-dyslexic and dyslexic children, respectively. During pseudowords, BA18 and BA17 areas of the left occipital lobe were activated in the non-dyslexic and dyslexic children, separately. vMMN sources were found at the left temporal (BA37) and right frontal (BA11) lobes in nondyslexic and dyslexic children, respectively. Conclusion: Right frontal lobe is the decision-making area where vMMN source was found in dyslexic children. We concluded that dyslexic children required the decision-making area to detect Malay real and pseudowords.
    MeSH terms: Child; Dyslexia; Evoked Potentials; Frontal Lobe; Humans; Language; Malaysia; Occipital Lobe; Software; Tomography; Electromagnetic Phenomena
  8. Fulltext Acquiring advanced laparoscopic colectomy skills – the issues
    Amin-Tai, Hizami, Elnaim, Abdel Latif Khalifa, Wong, Michael Pak Kai, Sagap, Ismail
    Malaysian Journal of Medical Sciences, 2020;27(5):24-35.
    MyJurnal
    Colorectal surgery has been revolutionised towards minimally invasive surgery with the emergence of enhanced recovery protocol after surgery initiatives. However, laparoscopic colectomy has yet to be widely adopted, due mainly to the steep learning curve. We aim to review and discuss the methods of overcoming these learning curves by accelerating the competency level of the trainees without compromising patient safety. To provide this mini review, we assessed 70 articles in PubMed that were found through a search comprised the keywords laparoscopic colectomy, minimal invasive colectomy, learning curve and surgical education. We found England’s Laparoscopic Colorectal National Training Programme (LAPCO-NTP) England to be by far the most structured programme established for colorectal surgeons, which involves preclinical and clinical phases that end with an assessment. For budding colorectal trainees, learning may be accelerated by simulator-based training to achieve laparoscopic dexterity coupled with an in-theatre proctorship by field experts. Task-specific checklists and video recordings are essential adjuncts to gauge progress and performance. As competency is established, careful case selections with the proctor are essential to maintain motivation and ensure safe performances. A structured programme to establish competency is vital to help both the proctor and trainee gauge real-time progress and performance. However, training systems both inside and outside the operating theatre (OT) are equally useful to achieve the desired performance.
    MeSH terms: Colectomy; Colorectal Surgery; Educational Status; England; Humans; Motivation; Laparoscopy; Video Recording; Colorectal Neoplasms; PubMed; Checklist; Learning Curve; Patient Safety; Surgeons
  9. Fulltext Exercise interventions as the primary treatment for depression: evidence from a narrative review
    Nur Fatin Nabilah Md Zemberi, Muhammad Mokhzani Ismail, Mohammad Farris Iman Leong Abdullah
    Malaysian Journal of Medical Sciences, 2020;27(5):5-23.
    MyJurnal
    There is an increasing evidence supporting the efficacy of exercise interventions in the treatment of depression, which is a growing global health concern. However, data on the efficacy of exercise as the primary treatment for depression are scarce. This narrative review explored the efficacy of exercise interventions as the primary treatment for depressive disorders. A comprehensive search for English-language literature published between January 1965 and November 2019 was conducted via PubMed, Google Scholar, Scopus, Web of Science, PsycINFO, EMBASE, Cochrane database and Medline. Thirteen randomised control trials (RCTs) were included in the final analysis. Their results indicated that supervised aerobic exercise and highintensity progressive resistance training (PRT) were effective in ameliorating depressive symptoms as the primary treatment compared with control groups, but they were not superior to other active treatments, such as antidepressants and cognitive behavioural therapy. Aerobic exercise and high-intensity PRT may be a promising primary treatment for depression as they may induce biopsychosocial effects (effects on neurotrophic factor, pro-inflammatory cytokines, monoamine, the hypothalamic-pituitary-adrenal axis, self-efficacy, mastery experience, adaptive coping and social interaction), which may ameliorate the severity of depressive symptoms. However, future RCTs with more comprehensive and well-designed methodologies are warranted to confirm our findings.
    MeSH terms: Adaptation, Psychological; Antidepressive Agents; Depression; Depressive Disorder; Humans; Hypothalamo-Hypophyseal System; Language; Nerve Growth Factors; Pituitary-Adrenal System; Global Health; Exercise; Bibliometrics; Cytokines; Self Efficacy; Control Groups; PubMed; Resistance Training
  10. Fulltext Post-attentive integration and topographic map distribution during audiovisual processing in dyslexia: a P300 eventrelated component analysis
    Siti Atiyah Al, Begum, Tahamina, Mohammed Faruque Reza, Nor Asyikin Fadzil, Faiz Mustafar
    Malaysian Journal of Medical Sciences, 2020;27(4):130-138.
    MyJurnal
    Background: Research on audiovisual post-attentive integration has been carried out using a variety of experimental paradigms and experimental groups but not yet studied in dyslexia. We investigated post-attentive integration and topographic voltage distribution in children with dyslexia by analysing the P300 event-related potential (ERP) component. Methods: We used a 128-child ERP net for the ERP experiment. Two types of stimuli were presented as either congruent or incongruent stimuli. Congruent stimuli included a matching auditory sound with an animal image, whereas incongruent stimuli included unmatched animal sounds. A total of 24 age-matched children were recruited in the control (n = 12) and dyslexia (n = 12) groups. Children pressed button ‘1’ or ‘2’ when presented with congruent or incongruent stimuli, respectively. The P300 amplitudes and latencies with topographic voltage distribution were analysed for both groups. Results: The dyslexia group evoked significantly higher P300 amplitudes at the T4 area than the control group. No significant differences were found in cases of P300 latency. Moreover, the dyslexia group demonstrated a higher intensity of P300 voltage distribution in the right parietal and left occipital areas than the control group. Conclusion: Post-attentive integration for children with dyslexia is higher and that this integration process implicated the parietal and occipital areas.
    MeSH terms: Animals; Cerebral Cortex; Child; Dyslexia; Humans; Sound; Event-Related Potentials, P300; Control Groups
  11. Fulltext Analysis of octamer-binding transcription factor-4 expression in oral leukoplakia
    Tegginamani AS, Shivakumar VH, Kallarakkal TG, Ismail SM, Abraham MT, Bin Zamzuri AT
    J Oral Maxillofac Pathol, 2020 09 09;24(2):400.
    PMID: 33456258 DOI: 10.4103/jomfp.JOMFP_272_19
    Background: Oral potentially malignant disorders have a risk for malignant transformation but are difficult to reliably identify and predict which patients are at the risk for malignant transformation. OCT4 has been hypothesized to play a key oncogenic driver in a variety of solid tumors. A deeper understanding of the aberrant molecular pathways which lead to carcinogenesis needs to be identified by the potential markers.

    Aims: To assess the OCT4 stemness factor in oral leukoplakia for its potential risk to malignant transformation.

    Settings and Design: 20 cases of oral leukoplakia were obtained from archives at Oral Cancer Research & Coordinating center (OCRCC) Malaysia Subjects and Methods: 20 cases of oral leukoplakia were assessed by OCT4 immunohistochemically. Oral squamous cell carcinoma was used as a control.

    Result: no expression of OCT 4 was observed in any cases of oral leukoplakia.

    Conclusion: The molecular mechanisms of Oct4 regulation and in particular of its switch on and off in tissues depends upon its microenvironment, which makes it challenging in fundamental and applied research fields of regenerative medicine and cancer therapy. It's better that patients should undergo multiple biopsies for the early detection of malignant transformation with close follow-up during the first two to three years, a large amount of work remains to be done with multi-marker panel investigation, as cure rates have remained constant over three decades.

    MeSH terms: Biopsy; Carcinoma, Squamous Cell; Cell Transformation, Neoplastic; Follow-Up Studies; Head and Neck Neoplasms; Humans; Leukoplakia, Oral; Malaysia; Mouth Neoplasms; Oncogenes; Regenerative Medicine; Early Detection of Cancer; Tumor Microenvironment
  12. Fulltext The Influence of Ficus deltoidea in Preserving Alveolar Bone in Ovariectomized Rats
    Omar NI, Baharin B, Lau SF, Ibrahim N, Mohd N, Ahmad Fauzi A, et al.
    Vet Med Int, 2020;2020:8862489.
    PMID: 33456747 DOI: 10.1155/2020/8862489
    Ficus deltoidea has been shown to possess antioxidant properties that could prevent the development of chronic inflammatory bone diseases. In this study, the efficacy of F. deltoidea in preventing alveolar bone resorption in osteoporotic rats induced by ovariectomy (OVX) was investigated. Twenty-four female Wistar rats were divided into four groups (n = 6) consisting of sham-operated (SO), ovariectomized control (OVXN), ovariectomized treated with estrogen (OVXP), and ovariectomized treated with F. deltoidea extract (OVXF). At the beginning of the study, two nonovariectomized, healthy rats were sacrificed to serve as baseline (BL). Treatment of the rats commenced two weeks after ovariectomy-the OVXP rats that served as positive control received Premarin® (64.5 μg/kg body weight), while OVXF rats were given F. deltoidea (800 mg/kg body weight); both agents were administered orally for two months. The negative control group of rats (OVXN) and the SO group received deionized water, also administered via oral gavage. At necropsy, morphometric assessment of the interradicular bone of the first molar was carried out using a micro-CT scanner, while quantification of osteoclasts and osteoblasts was performed histologically. The results showed that no statistically significant differences among the groups (p > 0.05) for bone morphometric assessment. However, trabecular thickness in the OVXF group was similar to BL, while trabecular separation and alveolar bone loss height were lower than those of the OVXN group. Histologically, the OVXF group demonstrated a significantly lower number of osteoclasts and a higher number of osteoblasts compared with OVXN (p=0.008 and p=0.019, respectively; p < 0.05). In conclusion, F. deltoidea has the capacity to prevent alveolar bone loss in ovariectomy-induced osteoporosis rats by potentially preserving trabecular bone microarchitecture and to decrease osteoclast and increase osteoblast cell count.
    MeSH terms: Animals; Antioxidants; Body Weight; Bone and Bones; Cell Count; Estrogens, Conjugated (USP); Estrogens; Female; Humans; Molar; Osteoblasts; Osteoclasts; Osteoporosis; Ovariectomy; Plant Extracts; Water; Alveolar Bone Loss; Rats, Wistar; Ficus; Control Groups; Rats; X-Ray Microtomography; Cancellous Bone
  13. Fulltext Redirecting Metabolic Flux towards the Mevalonate Pathway for Enhanced β-Carotene Production in M. circinelloides CBS 277.49
    Naz T, Nazir Y, Nosheen S, Ullah S, Halim H, Fazili ABA, et al.
    Biomed Res Int, 2020;2020:8890269.
    PMID: 33457420 DOI: 10.1155/2020/8890269
    Carotenoids produced by microbial sources are of industrial and medicinal importance due to their antioxidant and anticancer properties. In the current study, optimization of β-carotene production in M. circinelloides strain 277.49 was achieved using response surface methodology (RSM). Cerulenin and ketoconazole were used to inhibit fatty acids and the sterol biosynthesis pathway, respectively, in order to enhance β-carotene production by diverting metabolic pool towards the mevalonate pathway. All three variables used in screening experiments were found to be significant for the production of β-carotene. The synergistic effect of the C/N ratio, cerulenin, and ketoconazole was further evaluated and optimized for superior β-carotene production using central composite design of RSM. Our results found that the synergistic combination of C/N ratios, cerulenin, and ketoconazole at different concentrations affected the β-carotene productions significantly. The optimal production medium (std. order 11) composed of C/N 25, 10 μg/mL cerulenin, and 150 mg/L ketoconazole, producing maximum β-carotene of 4.26 mg/L (0.43 mg/g) which was 157% greater in comparison to unoptimized medium (1.68 mg/L, 0.17 mg/g). So, it was concluded that metabolic flux had been successfully redirected towards the mevalonate pathway for enhanced β-carotene production in CBS 277.49.
    MeSH terms: Antifungal Agents/chemistry; Biochemical Phenomena; Carbon/chemistry; Carotenoids/metabolism*; Cerulenin/chemistry; Culture Media/metabolism; Escherichia coli/metabolism; Fatty Acids/chemistry; Fermentation; Industrial Microbiology; Ketoconazole/chemistry; Lipids/chemistry; Mevalonic Acid/metabolism*; Mucor*; beta Carotene/biosynthesis*
  14. Fulltext Molecular identification and phylogenetic analysis of a Callosciurus notatus complete mitogenome from Peninsular Malaysia
    Jahari PNS, Mohd Azman S, Munian K, Ahmad Ruzman NH, Shamsir MS, Richter SR, et al.
    Mitochondrial DNA B Resour, 2020 Aug 26;5(3):3004-3006.
    PMID: 33458034 DOI: 10.1080/23802359.2020.1797583
    The mitogenome of a plantain squirrel, Callosciurus notatus, collected from Bukit Tarek Forest Reserve (Extension), Selangor, Malaysia was sequenced using BGISEQ-500RS technology. The 16,582 bp mitogenome consists of 13 protein-coding genes, 22 transfer RNA genes, 2 ribosomal RNA genes, and 1 control region. A phylogenetic and BLASTn analysis against other available datasets showed that the mitogenome matched with 99.49% similarity to a previously published C. notatus mitogenome from Peninsular Malaysia. However, it also diverged by nearly 8% (92.24% match) from a second previously published mitogenome for the same species, sampled in East Kalimantan, Indonesia. This suggests a difference in landscape features between both localities might affect its genetic connectivity.
    MeSH terms: Animals; Base Sequence; Indonesia; Malaysia; Phylogeny; Plantago; RNA, Transfer; Sciuridae; Technology; Genes, rRNA; Genome, Mitochondrial; Forests
  15. Fulltext The first complete mitochondrial genome data of Geoffroy's rousette, Rousettus amplexicaudatus originating from Malaysia
    Jahari PNS, Mohd Azman S, Munian K, M Fauzi NF, Shamsir MS, Richter SR, et al.
    Mitochondrial DNA B Resour, 2020 Sep 01;5(3):3262-3264.
    PMID: 33458132 DOI: 10.1080/23802359.2020.1812449
    The increasing interest in understanding the evolutionary relationship between members of the Pteropodidae family has been greatly aided by genomic data from the Old World fruit bats. Here we present the complete mitogenome of Geoffroy's rousette, Rousettus amplexicaudatus found in Peninsular Malaysia . The mitogenome constructed is 16,511bp in length containing 37 genes; 13 protein-coding genes (PCGs), 22 tRNA genes, two rRNA genes, and a D-loop region. The overall base composition is estimated to be 32.28% for A, 25.64% for T, 14.09% for G and 27.98% for C, indicating a slightly AT rich feature (57.93%). A phylogenetic and BLASTn analysis against other available mitogenomes showed Malaysian R. amplexicaudatus matched 98% similarity to the same species in Cambodia and Vietnam. However, it differed considerably (92.53% similarity) with the same species in the Philippines. This suggests flexibility in Rousettus sp. with regards to adapting to mesic and dry habitats, ability for long-distance dispersal and remarkably precise lingual echolocation thus supporting its wide-range distribution and colonization. Further taxonomical and mitogenomic comparatives are required in resolving the evolutionary relationship between Rousettus spp.
    MeSH terms: Animals; Base Composition; Cambodia; Chiroptera; Echolocation; Biological Evolution; Malaysia; Philippines; Phylogeny; RNA, Transfer; Vietnam; Ecosystem; Genes, rRNA; Genomics; Genome, Mitochondrial
  16. Fulltext Complete chloroplast genome sequence and phylogenetic analysis of Syzygium malaccense
    Tao L, Shi ZG, Long QY
    Mitochondrial DNA B Resour, 2020 Oct 09;5(3):3549-3550.
    PMID: 33458237 DOI: 10.1080/23802359.2020.1829132
    Syzygium malaccense is native to Malaysia. It is sometimes called the malay apple, malay rose-apple, mountain rose-apple, mountain apple, water apple, or French cashew. The tree is very popular in many tropical and subtropical regions for its fruit and traditional medicine. The first complete chloroplast genome of Syzygium malaccense has been reported in this study. The complete chloroplast genome of Syzygium malaccense is 158,954 bp, composed of four regions: a large single-copy region with a size of 87,991 bp, a small single copy region with a size of 18,793 bp, and two inverted repeat regions with a size of 26,085 bp. The GC content is 36.97%. A total of 132 genes were annotated, including 84 encoding proteins, eight encoding rRNA genes, 37 encoding tRNA genes, and three encoding pseudo genes. Phylogenetic analysis showed that Syzygium aromaticum, Syzygium cumini, and Syzygium forrestii are closely related to Syzygium malaccense.
    MeSH terms: Base Composition; Fruit; Malaysia; Medicine, Traditional; Phylogeny; Repetitive Sequences, Nucleic Acid; RNA, Transfer; Water; Genes, rRNA; Rosa; Syzygium; Anacardium; Genome, Chloroplast
  17. Oxygen-Releasing Scaffolds for Accelerated Bone Regeneration
    Touri M, Moztarzadeh F, Abu Osman NA, Dehghan MM, Brouki Milan P, Farzad-Mohajeri S, et al.
    ACS Biomater Sci Eng, 2020 05 11;6(5):2985-2994.
    PMID: 33463293 DOI: 10.1021/acsbiomaterials.9b01789
    Hypoxia, the result of disrupted vasculature, can be categorized in the main limiting factors for fracture healing. A lack of oxygen can cause cell apoptosis, tissue necrosis, and late tissue healing. Remedying hypoxia by supplying additional oxygen will majorly accelerate bone healing. In this study, biphasic calcium phosphate (BCP) scaffolds were fabricated by robocasting, an additive manufacturing technique. Then, calcium peroxide (CPO) particles, as an oxygen-releasing agent, were coated on the BCP scaffolds. Segmental radial defects with the size of 15 mm were created in rabbits. Uncoated and CPO-coated BCP scaffolds were implanted in the defects. The empty (control) group received no implantation. Repairing of the bone was investigated via X-ray, histological analysis, and biomechanical tests at 3 and 6 months postoperatively, with immunohistochemical examinations at 6 months after operation. According to the radiological observations, formation of new bone was augmented at the interface between the implant and host bone and internal pores of CPO-coated BCP scaffolds compared to uncoated scaffolds. Histomorphometry analysis represented that the amount of newly formed bone in the CPO-coated scaffold was nearly two times higher than the uncoated one. Immunofluorescence staining revealed that osteogenic markers, osteonectin and octeocalcin, were overexpressed in the defects treated with the coated scaffolds at 6 months of postsurgery, demonstrating higher osteogenic differentiation and bone mineralization compared to the uncoated scaffold group. Furthermore, the coated scaffolds had superior biomechanical properties as in the case of 3 months after surgery, the maximal flexural force of the coated scaffolds reached to 134 N, while it was 92 N for uncoated scaffolds. The results could assure a boosted ability of bone repair for CPO-coated BCP scaffolds implanted in the segmental defect of rabbit radius because of oxygen-releasing coating, and this system of oxygen-generating coating/scaffold might be a potential for accelerated repairing of bone defects.
    MeSH terms: Animals; Bone and Bones; Bone Regeneration; Osteogenesis*; Oxygen; Rabbits; Tissue Scaffolds*
  18. Fulltext Interventional Pulmonology and COVID-19: Experience from a Malaysian Tertiary Hospital
    Huan NC, Ng KL, Tang JT, Kua HN, Daut UN, Muhammad NA, et al.
    Ann Acad Med Singap, 2020 12;49(12):1013-1017.
    PMID: 33463660 DOI: 10.47102/annals-acadmedsg.2020364
    The ongoing pandemic of COVID-19 has presented multiple challenges to global healthcare services, dictating changes in almost every aspect of daily medical practice. Performing aerosol generating procedures (AGPs) in the field of interventional pulmonology can lead to profound formation of aerosols, leading to a high risk of infection among healthcare workers (HCWs). We share our experiences on performing AGPs in the midst of a COVID-19 pandemic by focusing on changes in AGP practices. In a pandemic, HCWs ought to adapt to the ever-changing situation and use available resources to provide the best possible healthcare to patients, ensure safety of staff, and continue medical education of future pulmonologists.
    MeSH terms: Aerosols; Bronchoscopy/methods*; Bronchoscopy/trends; Humans; Malaysia; Practice Patterns, Physicians'/trends; Thoracoscopy/methods*; Thoracoscopy/trends; Infection Control/methods*; Infection Control/trends; Infectious Disease Transmission, Patient-to-Professional/prevention & control*; Tertiary Care Centers
  19. Comparative Neuroprotective, Anti-Inflammatory and Neurite Outgrowth Activities of Extracts of King Oyster Mushroom, Pleurotus eryngii (Agaricomycetes)
    Kushairi N, Phan CW, Sabaratnam V, Vidyadaran S, Naidu M, David P
    Int J Med Mushrooms, 2020;22(12):1171-1181.
    PMID: 33463934 DOI: 10.1615/IntJMedMushrooms.2020036938
    Pleurotus eryngii (king oyster mushroom) is a renowned culinary mushroom with various medicinal properties that may be beneficial for health maintenance and disease prevention. However, its effect on the nervous system remains elusive. In this study, hot water (PE-HWA) and ethanol (PE-ETH) extracts of P. eryngii were investigated and compared for their neuroprotective, anti-inflammatory, and neurite outgrowth activities in vitro. Based on the results, both extracts up to 400 μg/mL were nontoxic to PC12 cells and BV2 microglia (p > 0.05). Treatment with 250 μM hydrogen peroxide (H2O2) markedly (p < 0.0001) reduced the PC12 cell viability to 67.74 ± 6.47%. Coincubation with 200 μg/mL and 400 μg/mL of PE-ETH dose-dependently increased the cell viability to 85.34 ± 1.91% (p < 0.001) and 98.37 ± 6.42% (p < 0.0001) respectively, while PE-HWA showed no activity. Nitric oxide (NO) released by BV2 microglia was notably (p < 0.0001) increased by 1 μg/mL lipopolysaccharides (LPS) from 7.46 ± 0.73 μM to 80.00 ± 3.78 μM indicating an inflammatory reaction. However, coincubation with 200 and 400 μg/mL of PE-ETH significantly (p < 0.0001) reduced the NO level to 58.57 ± 6.19 μM and 52.86 ± 3.43 μM respectively, while PE-HWA was noneffective. PE-ETH and PE-HWA at 40 μg/mL significantly increased the neurite-bearing cells from 4.70 ± 3.36% to 13.12 ± 2.82% (p < 0.01) and 20.93 ± 5.37% (p < 0.0001) respectively. Pleurotus eryngii, particularly the ethanol extract (PE-ETH) and its potentially bioactive compounds, could be explored as a neurohealth promoting agent, due to its collective neuroprotective, anti-inflammatory, and neurite outgrowth activities.
    MeSH terms: Animals; Anti-Inflammatory Agents/isolation & purification; Anti-Inflammatory Agents/pharmacology*; Hydrogen Peroxide/toxicity; Plant Extracts/isolation & purification; Plant Extracts/pharmacology*; Neurites/drug effects*; Neurites/physiology; PC12 Cells; Microglia/drug effects; Neuroprotective Agents/isolation & purification; Neuroprotective Agents/pharmacology*; Pleurotus/chemistry*; Rats; Neuronal Outgrowth/drug effects
  20. Lipids in an Ethyl Acetate Fraction of Caterpillar Medicinal Mushroom, Cordyceps militaris (Ascomycetes), Reduce Nitric Oxide Production in BV2 Cells via NRF2 and NF-κB Pathways
    Nallathamby N, Malek SNA, Vidyadaran S, Phan CW, Sabaratnam V
    Int J Med Mushrooms, 2020;22(12):1215-1223.
    PMID: 33463938 DOI: 10.1615/IntJMedMushrooms.2020037001
    Cordyceps militaris is known for its curative properties. The present study was undertaken to evaluate the reduction of nitric oxide production by BV2 cells by the bioactive fraction of stroma powder of C. militaris, and to deduce the potential chemical components and pathways that may be responsible. The CE2 fraction from ethyl acetate extract did not exert any cytotoxic effects toward the BV2 cells at concentrations 0.1 to 100 μg/mL. The CE2 fraction also showed a significant (p < 0.05) reduction in nitric oxide production at 1-100 μg/mL. At 10 μg/mL, the CE2 fraction attenuated 85% of the NO production in BV2 cells. Further, the CE2 fraction (10 μg/mL) downregulated inflammatory genes, iNOS and COX-2, and upregulated anti-inflammatory genes, HO-1 and NQO-1. The CE2 fraction reduced NO production via activation of NRF2 and NF-κB transcriptions. The chemical constituents of the bioactive CE2 fraction were identified via GCMS. Eleven lipid components were identified including fatty acids, fatty acid esters, and sterols.
    MeSH terms: Acetates; Animals; Lipids/isolation & purification; Lipids/pharmacology*; Nitric Oxide/metabolism*; Plant Extracts/isolation & purification; Plant Extracts/pharmacology*; NF-kappa B/genetics; NF-kappa B/metabolism*; Microglia/drug effects*; Microglia/metabolism; Cordyceps/chemistry*; NF-E2-Related Factor 2/genetics; NF-E2-Related Factor 2/metabolism*; Mice
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