Browse publications by year: 2021

  1. Ahmed A, Saqlain M, Tanveer M, Blebil AQ, Dujaili JA, Hasan SS
    BMC Health Serv Res, 2021 Aug 23;21(1):859.
    PMID: 34425816 DOI: 10.1186/s12913-021-06897-0
    BACKGROUND: The pharmacist's role shifts from dispensing to bedside care, resulting in better patient health outcomes. Pharmacists in developed countries ensure rational drug use, improve clinical outcomes, and promote health status by working as part of a multidisciplinary team of healthcare professionals. However, clinical pharmacist services on healthcare utilization in low-and middle-income countries (LMICs) like Pakistan are unclear. As a result, we aim to systematically review pharmacists' clinical roles in improving Pakistani patients' therapeutic, safety, humanistic, and economic outcomes.

    METHODS: We searched PubMed, Scopus, EMBASE, CINAHL, and Cochrane Library for relevant articles published from inception to 28th February 2021. All authors were involved in the screening and selection of studies. Original studies investigating the therapeutic, humanistic, safety, and economic impact of clinical pharmacists in Pakistani patients (hospitalised or outpatients) were selected. Two reviewers independently assessed the risk of bias in studies, and discrepancies were resolved through mutual consensus. All of the included studies were descriptively synthesised, and PRISMA reporting guidelines were followed.

    RESULTS: The literature search found 751 articles from which nine studies were included; seven were randomized controlled trials (RCTs), and two were observational studies. Three RCTs included were having a low risk of bias (ROB), two RCTs were having an unclear ROB, while two RCTs were having a high ROB. The nature of clinical pharmacist interventions included one or more components such as disease-related education, lifestyle changes, medication adherence counselling, medication therapy management, and discussions with physicians about prescription modification if necessary. Clinical pharmacist interventions reduce medication-related errors, improve therapeutic outcomes such as blood pressure, glycemic control, lipid control, CD4 T lymphocytes, and renal functions, and improve humanistic outcomes such as patient knowledge, adherence, and health-related quality of life. However, no study reported the economic outcomes of interventions.

    CONCLUSIONS: The findings of the studies included in this systematic review suggest that clinical pharmacists play important roles in improving patients' health outcomes in Pakistan; however, it should be noted that the majority of the studies have a high risk of bias, and more research with appropriate study designs is needed.

    MeSH terms: Humans; Pakistan; Pharmacists*; Outcome Assessment (Health Care); Professional Role*; Medication Adherence
  2. Saniasiaya J, Prepageran N
    J Laryngol Otol, 2021 Aug 24.
    PMID: 34425929 DOI: 10.1017/S0022215121002279
    OBJECTIVE: To outline the impact on quality of life in coronavirus disease 2019 patients with olfactory dysfunction.

    METHODS: Five databases were searched for articles referring to the impact on quality of life in coronavirus disease 2019 patients with olfactory dysfunction. The search was conducted for the period from November 2019 to April 2021. The search was conducted over one month (May 2021).

    RESULTS: Four studies that met the objective were included. Altogether, there were 1045 patients. Various questionnaires were used to assess quality of life. Overall, the quality of life deficit affected 67.7 per cent of patients. Quality of life domains investigated include overall quality of life (four studies), food and taste dysfunction (two studies), mental health (two studies), cognitive function (one study), functional outcome (one study) and safety domains (one study).

    CONCLUSION: Quality of life deficit was reported to be 67.7 per cent among coronavirus disease 2019 patients with olfactory dysfunction. The high prevalence of persistent olfactory dysfunction prompts more serious research, as the long-standing consequences of olfactory dysfunction are detrimental.

  3. Thite N, Desiato A, Shinde L, Wolffsohn JS, Naroo SA, Santodomingo-Rubido J, et al.
    Cont Lens Anterior Eye, 2021 12;44(6):101496.
    PMID: 34426063 DOI: 10.1016/j.clae.2021.101496
    AIM: To understand the views of contact lens (CL) practitioners across the globe regarding what they perceive as opportunities and threats in CL practice.

    METHODS: A self-administered anonymised questionnaire, constructed in English and translated in six more languages, was distributed through reputed international professional bodies and academic institutions worldwide. The questionnaire included items on demographic characteristics, type of practice, and questions designed to explore practitioners' perspective on the future of their CL practice over the next five years.

    RESULTS: A total of 2408 valid responses were analysed. Multifocal CLs for presbyopia, CLs for myopia control, use of daily disposable (DD) CLs for occasional wear, and biocompatible materials to improve comfort were identified as promising areas of opportunities by practitioners (all 8/10). Respondents from North America, and Europe valued DDCLs for occasional wear moderately more favourable (Median: 9/10 for all) as compared to colleagues in Asia (Median: 8/10, p 

    MeSH terms: Contact Lenses*; Humans; Myopia*; Presbyopia*; Surveys and Questionnaires; Universities
  4. Safaei M, Sundararajan EA, Driss M, Boulila W, Shapi'i A
    Comput Biol Med, 2021 09;136:104754.
    PMID: 34426171 DOI: 10.1016/j.compbiomed.2021.104754
    Obesity is considered a principal public health concern and ranked as the fifth foremost reason for death globally. Overweight and obesity are one of the main lifestyle illnesses that leads to further health concerns and contributes to numerous chronic diseases, including cancers, diabetes, metabolic syndrome, and cardiovascular diseases. The World Health Organization also predicted that 30% of death in the world will be initiated with lifestyle diseases in 2030 and can be stopped through the suitable identification and addressing of associated risk factors and behavioral involvement policies. Thus, detecting and diagnosing obesity as early as possible is crucial. Therefore, the machine learning approach is a promising solution to early predictions of obesity and the risk of overweight because it can offer quick, immediate, and accurate identification of risk factors and condition likelihoods. The present study conducted a systematic literature review to examine obesity research and machine learning techniques for the prevention and treatment of obesity from 2010 to 2020. Accordingly, 93 papers are identified from the review articles as primary studies from an initial pool of over 700 papers addressing obesity. Consequently, this study initially recognized the significant potential factors that influence and cause adult obesity. Next, the main diseases and health consequences of obesity and overweight are investigated. Ultimately, this study recognized the machine learning methods that can be used for the prediction of obesity. Finally, this study seeks to support decision-makers looking to understand the impact of obesity on health in the general population and identify outcomes that can be used to guide health authorities and public health to further mitigate threats and effectively guide obese people globally.
    MeSH terms: Machine Learning; Adult; Humans; Life Style; Risk Factors; Metabolic Syndrome X*
  5. Bee SL, Bustami Y, Ul-Hamid A, Lim K, Abdul Hamid ZA
    J Mater Sci Mater Med, 2021 Aug 23;32(9):106.
    PMID: 34426879 DOI: 10.1007/s10856-021-06590-y
    Combination of bioactive material such as hydroxyapatite (HAp) with antibacterial agents would have great potential to be used as bone implant materials to avert possible bacterial infection that can lead to implant-associated diseases. The present study aimed to develop an antibacterial silver nanoparticle-decorated hydroxyapatite (HAp/AgNPs) nanocomposite using chemical reduction and thermal calcination approaches. In this work, natural HAp that was extracted from chicken bone wastes is used as support matrix for the deposition of silver nanoparticles (AgNPs) to produce HAp/AgNPs nanocomposite. XRD, FESEM-EDX, HRTEM, and XPS analyses confirmed that spherical AgNPs were successfully synthesized and deposited on the surface of HAp particles, and the amount of AgNPs adhered on the HAp surface increased with increasing AgNO3 concentration used. The synthesized HAp/AgNPs nanocomposites demonstrated strong antibacterial activity against Staphylococcus aureus bacteria, where the antibacterial efficiency is relied on the amount and size of deposited AgNPs. In addition, the in vitro bioactivity examination in Hank's balanced salt solution showed that more apatite were grown on the surface of HAp/AgNPs nanocomposite when AgNO3 concentration used >1 wt.%. Such nanocomposite with enhanced bioactivity and antibacterial properties emerged as a promising biomaterial to be applied for dentistry and orthopedic implantology.
    MeSH terms: Animals; Chickens; Materials Testing; Microbial Sensitivity Tests; Silver/pharmacology; Silver/chemistry*; Staphylococcus aureus/drug effects; Staphylococcus aureus/growth & development; Durapatite/pharmacology; Durapatite/chemistry; Bone Substitutes/chemical synthesis; Bone Substitutes/pharmacology; Bone Substitutes/chemistry; Prostheses and Implants; Coated Materials, Biocompatible/chemical synthesis*; Coated Materials, Biocompatible/pharmacology; Coated Materials, Biocompatible/chemistry; Microscopy, Electron, Transmission; Nanocomposites/chemistry; Metal Nanoparticles/chemistry*
  6. Elbestawy AR, Ellakany HF, Abd El-Hamid HS, Gado AR, Geneedy AM, Noreldin AE, et al.
    Avian Dis, 2021 09;65(3):407-413.
    PMID: 34427415 DOI: 10.1637/0005-2086-65.3.407
    Despite the vast Egyptian poultry production, scanty information is available concerning the infection of haemprotozoan parasites as pathogens in commercial broilers. In the present study, we provided the first detection of leucocytozoonosis in five broiler chicken flocks in El-Beheira Egyptian governorate. Despite the low mortality rates in the affected flocks (0.3%-1% as a 5-day mortality), severe postmortem (hemorrhagic spots and scars) and histopathologic lesions appeared in different organs including skeletal muscles, liver, kidney, pancreas, abdominal cavity, and bursa of Fabricius. Evaluation of blood smears revealed gametocytes in erythrocytes and leukocytes. Conventional reverse transcriptase-PCR and partial sequence analysis of mitochondrial cytochrome oxidase b gene detected Leucocytozoon caulleryi. GenBank accession numbers of the five Egyptian L. caulleryi isolates were obtained. The five L. caulleryi were 99.9% identical to each other and 99.14% similar to the L. caulleryi mitochondrial DNA gene of Asian strains from India, Japan, Malaysia, South Korea, Taiwan, and Thailand.
    MeSH terms: Animals; Chickens; Poultry Diseases*; Protozoan Infections, Animal*; Cytochromes b/genetics
  7. Lau G, Yu ML, Wong G, Thompson A, Ghazinian H, Hou JL, et al.
    Hepatol Int, 2021 Oct;15(5):1031-1048.
    PMID: 34427860 DOI: 10.1007/s12072-021-10239-x
    BACKGROUND & AIM: Hepatitis B reactivation related to the use of immunosuppressive therapy remains a major cause of liver-related morbidity and mortality in hepatitis B endemic Asia-Pacific region. This clinical practice guidelines aim to assist clinicians in all disciplines involved in the use of immunosuppressive therapy to effectively prevent and manage hepatitis B reactivation.

    METHODS: All publications related to hepatitis B reactivation with the use of immunosuppressive therapy since 1975 were reviewed. Advice from key opinion leaders in member countries/administrative regions of Asian-Pacific Association for the study of the liver was collected and synchronized. Immunosuppressive therapy was risk-stratified according to its reported rate of hepatitis B reactivation.

    RECOMMENDATIONS: We recommend the necessity to screen all patients for hepatitis B prior to the initiation of immunosuppressive therapy and to administer pre-emptive nucleos(t)ide analogues to those patients with a substantial risk of hepatitis and acute-on-chronic liver failure due to hepatitis B reactivation.

    MeSH terms: Antiviral Agents; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Immunosuppressive Agents/adverse effects; Virus Activation
  8. Azemi NFH, Misnan R, Keong BP, Mokhtar M, Kamaruddin N, Fah WC, et al.
    Mol Biol Rep, 2021 Oct;48(10):6709-6718.
    PMID: 34427887 DOI: 10.1007/s11033-021-06661-x
    BACKGROUND: Tropomyosin is a major allergen in crustaceans, including mud crab species, but its molecular and allergenic properties in Scylla olivacea are not well known. Thus, this study aimed to produce the recombinant tropomyosin protein from S. olivacea and subsequently investigate its IgE reactivity.

    METHODS AND RESULTS: The tropomyosin gene was cloned and expressed in the Escherichia coli system, followed by SDS-PAGE and immunoblotting test to identify the allergenic potential of the recombinant protein. The 855-base pair of tropomyosin gene produced was found to be 99.18% homologous to Scylla serrata. Its 284 amino acids matched the tropomyosin of crustaceans, arachnids, insects, and Klebsiella pneumoniae, ranging from 79.03 to 95.77%. The tropomyosin contained 89.44% alpha-helix folding with a tertiary structure of two-chain alpha-helical coiled-coil structures comprising a homodimer heptad chain. IPTG-induced histidine tagged-recombinant tropomyosin was purified at the size of 42 kDa and confirmed as tropomyosin using anti-tropomyosin monoclonal antibodies. The IgE binding of recombinant tropomyosin protein was reactive in 90.9% (20/22) of the sera from crab-allergic patients.

    CONCLUSIONS: This study has successfully produced an allergenic recombinant tropomyosin from S. olivacea. This recombinant tropomyosin may be used as a specific allergen for the diagnosis of allergy.

    MeSH terms: Amino Acid Sequence; Animals; Base Sequence; Brachyura/immunology*; Humans; Immunoglobulin E/metabolism; Male; Models, Molecular; Phylogeny; Recombinant Proteins/genetics*; Recombinant Proteins/immunology*; Tropomyosin/genetics*; Tropomyosin/immunology*; Tropomyosin/chemistry; Cluster Analysis; Molecular Sequence Annotation
  9. Al-Shamali Y, M Ali Y, Al-Shamali RA, Al-Melahi M, Al-Shammari FR, Alsaber A, et al.
    PLoS One, 2021;16(8):e0254379.
    PMID: 34428204 DOI: 10.1371/journal.pone.0254379
    PURPOSE: This cross-sectional observational study aims to report preliminary data from the first experience using tocilizumab for patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in three of Kuwait's largest public hospitals City.

    PATIENTS AND METHODS: This chart review study examined the benefits of tocilizumab treatment among 127 patients diagnosed with severe coronavirus disease of 2019 (COVID-19) pneumonia.

    RESULTS: 90 of 127 patients (71%) survived. Mortality was highest in the elderly with multiple medical conditions.

    CONCLUSION: Despite the small sample size and retrospective nature of the work, our findings are consistent with recent studies suggesting tocilizumab administration in patients presenting with severe COVID pneumonia with associated hyperinflammatory features conferred mortality benefit.

    MeSH terms: Aged; Cross-Sectional Studies; Female; Humans; Kuwait/epidemiology; Male; Middle Aged; Pneumonia/drug therapy*; Retrospective Studies; Antibodies, Monoclonal, Humanized/therapeutic use*
  10. Pai S, Patil V, Kamath R, Mahendra M, Singhal DK, Bhat V
    PLoS One, 2021;16(8):e0256663.
    PMID: 34428247 DOI: 10.1371/journal.pone.0256663
    BACKGROUND: The Coronavirus disease (COVID-19) outbreak in 2019, has shocked the entire world. As an effort to control the disease spread, the Indian government declared a nationwide lockdown on March 25th, 2020. As dental treatment was considered high risk in the spread of COVID-19, dentistry became one of the most vulnerable professions during this time. Dental professionals had to face job layoffs, salary cuts in professional colleges, closure of private clinics resulting in huge psychological, moral, and financial crises. Studies during the previous and present pandemics have shown mental issues among health care workers necessitating institutional reforms, along with early care and support. A balance in the work-life amongst professionals is the key to better efficiency and, was majorly affected during the COVID-19 pandemic lockdown due to sudden unexpected changes. Hence this study was conducted to understand the changes they underwent both at home and professional front with a hypothesis that physical and mental health, activities, relationship status, and workplace influence the work-life balance.

    METHODS: A pre-validated questionnaire survey was done on dentists across India. Structural Equation Modelling and path analysis were applied to the data collected.

    RESULTS: The results of the study supported the hypothesis that factors like physical and mental health, activities, relationship status, and workplace influenced the work-life balance directly. A significant imbalance was seen amongst the female dentists.

    CONCLUSION: The present study proved the unpreparedness among dental professionals. Hence an evolutionary phase in every field with better working protocols, robust mental health support, and a focus on strategies to face future such emergencies is required.

    MeSH terms: Cross-Sectional Studies; Dentists/psychology*; Female; Humans; India; Male; Surveys and Questionnaires; Workplace/psychology; Work-Life Balance*
  11. Zamzuri M'IA, Jamhari MN, Faisal Ghazi H, Muhamad Hasani MH, Mohd Ali NK, Abd Rashid MF, et al.
    PLoS One, 2021;16(8):e0256636.
    PMID: 34428257 DOI: 10.1371/journal.pone.0256636
    INTRODUCTION/BACKGROUND: Dengue fever remains a public health threat despite being preventable. A solution to the constant problem of dengue infection will require active intervention and a paradigm shift. Assessing perceived risk and correlating it with the attitude and practice of the community will help in designing appropriate measures. However, possible instruments for these assessments come with limitations.

    OBJECTIVE: The aim is to develop and validate a new scoring-based questionnaire, using dual statistical approaches to measure risk perception, attitude, and practices (RPAP) related to dengue in the community.

    METHODS: The RPAP questionnaire was developed bilingually using the International Society for Pharmacoeconomics and Outcome Research (ISPOR) guidelines. Content analysis was reviewed scrupulously by four expert panels. The initial 35-item scale was tested among 253 Malaysian respondents recruited non-probabilistically via multiple online platforms. Two statistical methods were employed to measure the construct validity: Exploratory Factor Analysis (EFA) as part of the Classical Test Theory (CTT) measurement, while Rasch Measurement Analysis (Rasch) was performed for the Item Response Theory (IRT) measurement. All results were cross-validated with their counterpart to ensure stability. Confirmatory Factor Analysis (CFA) was used to obtain a model fit index.

    RESULTS: 29 questions were retained after the final analysis. Both EFA and Rasch analysis detect multidimensionality. Nine latent factors were extracted from EFA, while only eight factors remained in the final model following CFA: 1) perceived susceptibility; 2) perceived severity; 3) perceived barrier; 4) perceived benefit; 5) cues to action; 6) self-efficacy; 7) attitude; and 8) practice. All items had adequate factor loadings and showed good internal consistency. The final model after CFA achieved a good fit with an RMSEA value of 0.061, SRMR of 0.068, PNFI of 0.649, and GFI of 0.996.

    CONCLUSION: The RPAP questionnaire contains 29 items and is a reliable and accurate psychometric instrument for measuring the risk perception of dengue fever, attitude, and practice of the community in dengue prevention. The Rasch measurement provides additional rigour to complement the CTT analysis. This RPAP questionnaire is suitable for use in studies related to dengue prevention in the community.

  12. Godinho MA, Murthy S, Ali Mohammed C
    Health Promot Int, 2021 Aug 24;36(3):731-740.
    PMID: 34428296 DOI: 10.1093/heapro/daaa087
    The South Asian region is predicted to be among the most severely affected by the health impacts of climate change and warrants regional health policy leadership to tackle the same. Model World Health Organization (WHO) simulations offer the academic opportunity to build this leadership. This study describes the conceptualization and conduct of the 'Manipal Model World Health Organization' 2018 debate simulation, where a multi-professional group of students at an Indian university deliberated approaches to address the regional health impacts of climate change in South Asia. We contextualized the Model WHO debate model for a multi-professional classroom. Multi-sectoral stakeholders were engaged to draw participants from health and non-health disciplines. Participants were trained in health research literacy, policy politics, bloc politics, writing and public speaking for Model WHO. Mock sessions provided training in navigating parliamentary procedures. The debate event consisted of 22 participants and a four-member panel from diverse academic disciplines who independently assessed the deliberations. All delegations demonstrated competent written and verbal contributions. Content analysis of resolutions reaffirmed international agreements and addressed the Climate Change Health Risk Framework, and objectives of the WHO Secretariat Action Plan. Besides presenting a stratified typology of academic health policy debate simulations in global, regional, and subnational contexts, we also propose a 'theory of change', illustrating how academic policy discourse platforms can nurture critical thinking, research/policy literacy and leadership skills. Such initiatives help build the health policy leadership required for addressing global health challenges such as climate change.
    MeSH terms: Health Policy; Humans; Leadership*; Global Health*; World Health Organization; Climate Change
  13. Daphne Teh AL, Jayapalan JJ, Loke MF, Wan Abdul Kadir AJ, Subrayan V
    Exp Eye Res, 2021 10;211:108734.
    PMID: 34428458 DOI: 10.1016/j.exer.2021.108734
    This study aimed to investigate the metabolite differences between patients with keratoconus and control subjects and identify potential serum biomarkers for keratoconus using a non-targeted metabolomics approach. Venous blood samples were obtained from patients with keratoconus (n = 20) as well as from age-, gender- and race-matched control subjects (n = 20). Metabolites extracted from serum were separated and analyzed by liquid chromatography/quadrupole time-of-flight mass spectrometer. Processing of raw data and analysis of the data files was performed using Agilent Mass Hunter Qualitative software. The identified metabolites were subjected to a principal component and hierarchical cluster analysis. Appropriate statistical tests were used to analyze the metabolomic profiling data. Together, the analysis revealed that the dehydroepiandrosterone sulfate from the steroidal hormone synthesis pathway was significantly upregulated in patients with keratoconus (p 
    MeSH terms: Adolescent; Adult; Chromatography, High Pressure Liquid; Chromatography, Liquid; Dehydroepiandrosterone/blood; Female; Humans; Hydroxyeicosatetraenoic Acids/blood*; Keratoconus/blood*; Keratoconus/diagnosis; Male; Middle Aged; Prostaglandins A/blood; Dinoprostone/blood; Dinoprost/blood; Biomarkers/blood*; Tandem Mass Spectrometry; Metabolomics/methods*; Metabolome/physiology; Young Adult
  14. Vaezzadeh V, Yi X, Rais FR, Bong CW, Thomes MW, Lee CW, et al.
    Mar Pollut Bull, 2021 Nov;172:112871.
    PMID: 34428623 DOI: 10.1016/j.marpolbul.2021.112871
    Concentrations, sources and interactions between black carbon (BC) and polycyclic aromatic hydrocarbons (PAHs) were investigated in 42 sediment samples collected from riverine, coastal and shelf areas in Peninsular Malaysia. The concentrations of BC measured by benzene polycarboxylic acid (BPCA) method and PAHs showed broad spatial variations between the relatively pristine environment of the East coast and developed environment of the West and South coast ranging from 0.02 to 0.36% dw and 57.7 ng g-1 dw to 19,300 ng g-1 dw, respectively. Among diagnostic ratios of PAHs, the ratios of Ant/(Ant+Phe) and LMW/HMW drew the clearest distinctions between the East coast versus the West and South coast sediments indicating the predominance of petrogenic sources in the former versus pyrogenic sources in the latter. PAHs significantly correlated with BC and total organic carbon (TOC) in the sediments (p 
    MeSH terms: Carbon/analysis; Environmental Monitoring; Malaysia; Geologic Sediments
  15. Choong WS, Hadibarata T, Yuniarto A, Tang KHD, Abdullah F, Syafrudin M, et al.
    Mar Pollut Bull, 2021 Nov;172:112880.
    PMID: 34428625 DOI: 10.1016/j.marpolbul.2021.112880
    The Baram River is one of the largest rivers in Sarawak, where many large industries, such as plywood, sawmills, shipyards, interisland ports, and other wood-based industries are located along the river. Microplastic contamination has become a widespread and growing concern worldwide because of the small sizes of microplastics and their presence in seafood such as fish, squid, scallop, crabs, shrimp, and mussels. In this study, microplastics were found in all sampling stations. Out of the 4017 microplastics found in the water and sediment, microplastics fragment accounted for 67.8% of total microplastics, followed by fiber, film, pellet, and foam. Five microplastic polymer types were detected by ATR-FTIR, including polyethylene (PE), polyester (PET) fibers, silicon polymer, nitrile, and polystyrene (PS). The most common microplastics size range in Baram River was 0.3-1 mm, with blue as the highly abundant color.
  16. Siva Dharma D, Abu Bakar N, Mustafa BE
    Eur J Dent, 2021 Oct;15(4):647-652.
    PMID: 34428845 DOI: 10.1055/s-0041-1727552
    OBJECTIVE: The aim of this study was to assess and compare the salivary leptin hormone levels between different classes of facial skeletal pattern (Class I, II, and III).

    MATERIALS AND METHODS: A sample of 62 patients were selected prior to the orthodontic treatment from a population that attended the International Islamic University Malaysia Specialist Orthodontic Clinic. Based on the lateral cephalometric analysis, the subjects were grouped into Class I, Class II, and Class III facial skeletal patterns, according to Eastman and Wits appraisal. Subsequently, unstimulated saliva samples were taken and purified to undergo leptin enzyme-linked immunosorbent assay analysis to determine the levels of leptin hormone. Statistical analysis using the Kruskal-Wallis test was used to analyze the data obtained.

    RESULTS: The results showed that there was a significant difference between the levels of leptin hormone between Class I and Class II skeletal patterns and between Class I and Class III facial skeletal patterns. No statistical difference was noted between the levels of leptin of Class II and Class III facial skeletal patterns.

    CONCLUSION: Salivary leptin hormone levels are higher in patients with Class II and Class III facial skeletal patterns compared with Class I.

  17. Lip, Henry Tan Chor, Huei, Tan Jih, Kannan, Ballan
    JUMMEC, 2021;24(1):50-52.
    MyJurnal
    Inferior vena cava agenesis (IVCA) is an uncommon congenital anomaly which was first described in the seventeenth century. The detection of such an anomaly is often incidental and patients are asymptomatic until the third to fourth decade of life. Due to the scarcity of these cases, there is no consensus on the subsequent treatment and surveillance of incidental asymptomatic IVC anomalies. Herein, we report on a young male with incidental findings of suprarenal IVC agenesis identified on contrast enhanced computed tomography (CT) scan of the abdomen in the course of treatment for acute appendicitis.
  18. Farahnaz Amini, Hou, Wong Fu, Chye, Edmond Ng Siah, Roslina Omar, Shafinaz Mohd Rejab, Izyan Wajiha Mohd Noor, et al.
    JUMMEC, 2021;24(1):37-44.
    MyJurnal
    Background: Breast cancer (BC) is the most common cancer in women globally. In low- and middle-income countries, the use of appropriate breast cancer genetics services for screening and personalized treatments is severely lacking. This review is aimed to assess and summarize the reported mutation profiles of Malaysian BC patients.

    Methods: A literature search was performed in PubMed and Google Scholar from 2002 to 2019 using a set of keywords and MESH terms.

    Results: Data from 14 eligible studies are presented here. A total of 28 genes were studied in Malaysian BC patients in which 445 genetic alterations (229 deleterious, 209 variants with unknown clinical significance (VUC), and seven protective variants) have been reported, with 73 being novel (16% novel). The frequency ranged from 0.2% to 76% for VUC and 2.1 to 15% for deleterious variations. Only BRCA1, BRCA2, PALB2, APOBEC3B, and P53 have been associated with BC risk in Malaysian patients. Nine of these studies were conducted using the overlapped source of patients, which may limit the generalizability of the findings to the whole population of Malaysia.

    Conclusion: Information on the genetic basis of BC in the Malaysian population is scant. Multidisciplinary efforts with appropriate sample selection techniques and study design with multicenter collaboration are needed to address this issue. Out of thirteen high- and moderated-penetrance pathogenic mutations for BC, only five have been linked to Malaysians’ BC susceptibility. The findings from this review is valuable for decision-makers, researchers, and physicians, to enhance the research plans and utility of genetic services for screening and prevention.
  19. Seong, Lim Ghee, Buzayan, Muaiyed Mahmoud Ali, Elkezza, Aeman
    JUMMEC, 2021;24(1):23-29.
    MyJurnal
    Introduction: Flexible denture is an alternative treatment modality for removable partial denture (RPD) that aid the retention by ensuring seal around the entire border of the denture. It is also referred as hypoallergenic denture especially for those who are allergic towards conventional acrylic denture which is the poly-methylmethacrylate monomer (PMMA) and metal (cobalt chromium). The flexible material exhibits lower flexural modulus than conventional type of baseplate material denture that makes it nearly unbreakable. Nowadays, there are a handful of different flexible materials in the dental market for the general dental practitioners to choose but somehow the studies on the properties of these different types of flexible materials are sparse.

    Objectives: The present study is to study the development of the flexible materials, the different type of flexible materials and their physical properties.

    Methods: From the limited article journals available, the authors have summarized the history, development and constituents of different type of flexible materials used in fabricating denture. Besides that, the authors also discussed about the indications, contraindications, advantages and disadvantages of the materials in denture constructions based on all the published researches available on this topic using published materials available in the dental library, University of Malaya and the databases (Science Direct, PubMed).

    Conclusion: Each flexible material has its pros and cons. Therefore, careful selection of material and understanding of the flexible dentures’ indications and contraindications are utmost importance to make sure the best treatment outcome. Hence, patients’ best interest and quality of life can be upheld.
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