Browse publications by year: 2021

  1. Yoshida N, Fukumoto K, Hasegawa D, Inagaki Y, Inoue K, Hirose R, et al.
    J Gastroenterol Hepatol, 2021 Dec;36(12):3337-3344.
    PMID: 34260116 DOI: 10.1111/jgh.15625
    BACKGROUND AND AIM: High-grade dysplasia (HGD) and T1 lesions are accidentally resected by cold snare polypectomy (CSP) and the characteristics, and follow-up of them has not been reported. In this study, we analyzed the histopathological findings and recurrence of them.

    METHODS: This was a multicenter retrospective-cohort study. We collected HGD and T1 lesions of ≤ 10 mm resected by CSP among 15 520 patients receiving CSP from 2014 to 2019 at nine related institutions, and we extracted only cases receiving definite follow-up colonoscopy after CSP of HGD and T1 lesions. We analyzed these tumor's characteristics and therapeutic results such as R0 resection and local recurrence and risk factors of recurrence.

    RESULTS: We collected 103 patients (0.63%) and extracted 80 lesions in 74 patients receiving follow-up colonoscopy for CSP scar. Mean age was 68.4 ± 12.0, and male rate was 68.9% (51/80). The mean tumor size (mm) was 6.6 ± 2.5, and the rate of polypoid morphology and rectum location was 77.5% and 25.0%. The rate of magnified observation was 53.8%. The rates of en bloc resection and R0 resection were 92.5% and 37.5%. The local recurrence rate was 6.3% (5/80, median follow-up period: 24.0 months). The recurrence developed within 3 months after CSP for four out of five recurrent cases. Comparing five recurrent lesions to 75 non-recurrent lesions, a positive horizontal margin was a significant risk factor (60.0% vs 10.7%, P 

    MeSH terms: Aged; Aged, 80 and over; Colonoscopy/adverse effects; Colonoscopy/methods*; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local/etiology; Neoplasm Recurrence, Local/pathology; Neoplasm Staging; Retrospective Studies
  2. Moy FM, Ng YH
    Sci Prog, 2021;104(3):368504211029812.
    PMID: 34260295 DOI: 10.1177/00368504211029812
    The COVID-19 pandemic has disrupted the lives of all including university students. With the preventive measures to reduce the transmission of COVID-19, all face-to-face teaching and learning are converted to e-learning. The COVID-19 pandemic and the implementation of e-learning may influence these students' mental conditions. This study aimed to determine the association of factors with mental health status (depression, anxiety and stress) among university students in Malaysia. Study participants were tertiary education students from both the private and public universities in Malaysia. Participants were recruited via university emails and social media. The survey was administered via the online REDCap platform, from April to June 2020, during the movement control order period in the country. The questionnaire captured data on socio-demographic characteristics, academic information, implementation of e-learning, perception towards e-learning and COVID-19; as well as DASS 21 to screen for depression, anxiety and stress. The levels of stress, anxiety and depression were 56.5% (95% CI: 50.7%, 62.1%), 51.3% (95% CI: 45.6%, 57.0%) and 29.4% (95% CI: 24.3%, 34.8%) respectively. Most participants had good perception towards e-learning but negative perception on COVID-19. From the multivariate analysis, participants with positive perception on COVID-19 were protective towards stress (aOR: 0.96; 95% CI: 0.92, 0.99), anxiety (aOR: 0.94, 95% CI: 0.90, 0.98) and depression (aOR: 0.95; 95% CI: 0.91, 0.99). Older students were 14% (aOR: 0.86, 95% CI: 0.79, 0.94) and 11% (aOR: 0.89: 95% CI: 0.80, 0.99) less likely for anxiety and depression, respectively. Students originated from the Malay ethnicity had higher odds (aOR: 1.93; 95% CI: 1.05, 3.56) for depression. These findings demonstrated that the mental status of university students was greatly affected during the COVID-19 pandemic. Timely and credible information should be disseminated to alleviate their negative perception towards COVID-19.
    MeSH terms: Adolescent; Adult; Anxiety/epidemiology*; Anxiety/psychology; Computer-Assisted Instruction/methods; Depression/epidemiology*; Depression/psychology; Ethnic Groups; Female; Humans; Malaysia/epidemiology; Male; Mental Health/ethnology; Mental Health/statistics & numerical data; Surveys and Questionnaires; Social Isolation/psychology*; Stress, Psychological/epidemiology*; Students/psychology; Universities; Multivariate Analysis; Education, Distance/organization & administration; Pandemics*
  3. Nakamaru M, Onuma A
    Ecol Appl, 2021 Oct;31(7):e02413.
    PMID: 34260776 DOI: 10.1002/eap.2413
    A major challenge in biodiversity management is overharvesting by unsustainable harvesters. If a scenario could be created where sustainable harvesters benefit more than the unsustainable ones, even in the short term, the issue of overharvesting would be solved. Everyone would then follow the lead of sustainable harvesters. However, creating such a scenario is not an easy task; the difficulty is intensified if the habitat is open access and there is no property rights system. Swiftlets in Sarawak, Malaysia, present a special case where sustainable harvesters are believed to be more beneficial than unsustainable harvesters. Edible nests built by adult Swiftlets are used as ingredients for a traditional luxurious soup in Chinese cuisine. A rise in nest prices has increased the instances of unsustainable harvesters wrongfully collecting nests along with the eggs and fledglings, which are then abandoned. Swiftlets live in caves and build nests on cave ceilings. It is known that Swiftlets escape from cave ceilings when these harvesters take the nests, never to return to the same place. This ecological feature appears to work as the Swiftlet's indirect punishment against unsustainable harvesters. This study constructs a stage-structured population model and examines the effect of property rights and the indirect punishment by Swiftlets on the population dynamics of the bird, and on the economic return of both sustainable and unsustainable harvesters. Our findings are as follows: the indirect punishment by Swiftlets provides sustainable harvesters a higher short-term return than unsustainable harvesters under the property rights system, as long as Swiftlets return to their original cave after escaping from the unsustainable harvesters. While previous studies regarding the management of the commons have stressed the importance of rules and regulations for sustainable harvesting without considering the ecological uniqueness of each species, this study suggests that ecological exploration and the discovery of ecological features are also essential for designing a sustainable framework.
  4. Poh PK, Ong YH, Arumugam K, Nittami T, Yeoh HK, Bessarab I, et al.
    Water Environ Res, 2021 Nov;93(11):2598-2608.
    PMID: 34260796 DOI: 10.1002/wer.1611
    Temperature is known to influence the operational efficiency of enhanced biological phosphorus removal (EBPR) systems. This study investigated the impact of thermal stress above 30°C on the properties of an EBPR community established with tropical inoculum. The results confirmed the stability of the 30°C EBPR system with high P-removal efficiency over 210 days. Accumulibacter was abundant in the community. When the EBPR sludge was subjected to a sudden temperature increase to 35°C under multiple cycles of anaerobic-aerobic phases, each lasting 4 h, high P-removal was maintained over 2 days, before gradually failing when the Competibacter appeared to outcompete Accumulibacter. These data suggested that the EBPR capacity is robust when subjected to occasional thermal stress. However, it could not be maintained even for a short time under temperature stress at 40°C. Thus, the threshold temperature for tropical EBPR failure is between 35°C and 40°C. PRACTITIONER POINTS: EBPR was stably maintained at 30°C with Accumulibacter being dominant. Good EBPR activities persisted for a short period at 35°C. EBPR was deteriorated at 40°C. The threshold temperature for tropical EBPR failure is between 35°C and 40°C.
    MeSH terms: Phosphorus*; Polyphosphates; Sewage; Temperature; Bioreactors; Microbiota*
  5. Zainal SFFS, Aziz HA, Omar FM, Alazaiza MYD
    Chemosphere, 2021 Dec;285:131484.
    PMID: 34261011 DOI: 10.1016/j.chemosphere.2021.131484
    Stabilised leachate usually contains lower concentration of organic compounds than younger leachate; it has low biodegradability and generally unsuitable for biological treatment. The effectiveness of tetravalent metal salts in a coagulation-flocculation (C-F) process is still inclusive. Application of natural coagulants as an alternative to the chemical could reduce chemical usage, is less costly, and environmentally friendly. Hence, the objective of the current research is to examine the possibility of reducing the amount of Tin (IV) chloride (SnCl4) as a primary coagulant by adding Jatropha curcas (JC) as a flocculant as a sole treatment through the C-F process in treating concentrated suspended solids (SS) (547 mg/L), colour (19,705 Pt-Co) and chemical oxygen demand (COD) (4202 mg/L) in stabilised landfill leachate. The work also aims to evaluate the sludge properties after treatment. Functional groups, such as carboxylic acids, hydroxyl and amine/amino compounds (protein contents), were detected in the JC seed to facilitate the C-F process by neutralising the charge pollutant in water and cause the possibility of hydrogen bonding interaction between molecules. The combination of JC seed (0.9 g/L) as a flocculant reduced the dosage of SnCl4 as a coagulant from 11.1 g/L to 8.5 g/L with removals of 99.78%, 98.53% and 74.29% for SS, colour and COD, respectively. The presence of JC improved the sludge property with good morphology; the particles were in a rectangular shape, had clumps and strong agglomeration. These properties of sludge proved that JC seed could enhance the adsorption and bridging mechanism in the C-F procedure.
    MeSH terms: Chlorides; Flocculation; Tin; Jatropha*
  6. Ngoo QZ, A NF, A B, Wh WH
    Korean J Ophthalmol, 2021 06;35(3):223-230.
    PMID: 34120421 DOI: 10.3341/kjo.2020.0019
    PURPOSE: To study the retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters in obstructive sleep apnoea (OSA) patients and their relationship with severity of the disease.

    METHODS: A cross-sectional, hospital-based study. Fifty-four OSA subjects and 54 controls were recruited. Candidate that fulfil the criteria with normal ocular examinations then proceed with spectrum domain Cirrus optical coherence tomography examinations. ONH parameters and RNFL thickness were evaluated. Apnoea-hypopnoea index (AHI) of the OSA group were obtained from the medical record.

    RESULTS: In OSA, mean of average RNFL thickness was 93.87 µm, standard deviation (SD) = 9.17, p = 0.008 (p < 0.05) while superior RNFL thickness was 113.59 µm, SD = 16.29, p ≤ 0.001 (p < 0.05). RNFL thickness fairly correlate with severity of the disease (AHI), superior RNFL with R = 0.293, R2 = 0.087, p = 0.030 (p < 0.05), and nasal RNFL R = 0.292, R2 = 0.085, p = 0.032. No significant difference and correlation observed on ONH parameters. In control group, mean of average RNFL thickness was 98.96 µm, SD = 10.50, p = 0.008 (p < 0.05) while superior RNFL thickness was 125.76 µm, SD = 14.93, p ≤ 0.001 (p < 0.05).

    CONCLUSIONS: The mean of the average and superior RNFL thickness were significantly lower in the OSA group compare to control. Regression analysis showed RNFL thickness having significantly linear relationship with the AHI, specifically involving the superior and nasal quadrant.

    MeSH terms: Cross-Sectional Studies; Humans; Nerve Fibers; Optic Disk*; Retinal Ganglion Cells; Tomography, Optical Coherence
  7. Murphy JK, Khan A, Sun Q, Minas H, Hatcher S, Ng CH, et al.
    Int J Equity Health, 2021 07 12;20(1):161.
    PMID: 34253198 DOI: 10.1186/s12939-021-01484-5
    BACKGROUND: The COVID-19 pandemic is expected to have profound mental health impact, including in the Asia Pacific Economic Cooperation (APEC) region. Some populations might be at higher risk of experiencing negative mental health impacts and may encounter increased barriers to accessing mental health care. The pandemic and related restrictions have led to changes in care delivery, including a rapid shift to the use of e-mental health and digital technologies. It is therefore essential to consider needs and opportunities for equitable mental health care delivery to the most at-risk populations. This rapid scoping review: 1) identifies populations in the APEC region that are at higher risk of the negative mental health impacts of COVID-19, 2) identifies needs and gaps in access to standard and e-mental health care among these populations, and 3) explores the potential of e-mental health to address these needs.

    METHODS: We conducted a rapid scoping review following the PRISMA Extension for Scoping Reviews (PRISMA-ScR). We searched Medline, Embase and PsychInfo databases and Google Scholar using a search strategy developed in consultation with a biomedical librarian. We included records related to mental health or psychosocial risk factors and COVID-19 among at-risk groups; that referred to one or more APEC member economies or had a global, thus generalizable, scope; English language papers, and papers with full text available.

    RESULTS: A total of 132 records published between December 2019 and August 2020 were included in the final analysis. Several priority at-risk populations, risk factors, challenges and recommendations for standard and e-mental health care were identified. Results demonstrate that e-mental health care can be a viable option for care delivery but that specific accessibility and acceptability considerations must be considered. Options for in-person, hybrid or "low-tech" care must also remain available.

    CONCLUSIONS: The COVID-19 pandemic has highlighted the urgent need for equitable standard and e-mental health care. It has also highlighted the persistent social and structural inequities that contribute to poor mental health. The APEC region is vast and diverse; findings from the region can guide policy and practice in the delivery of equitable mental health care in the region and beyond.

    MeSH terms: Asia/epidemiology; Mental Disorders/epidemiology; Mental Disorders/therapy*; Health Services Needs and Demand*; Humans; Pacific Islands/epidemiology; Risk Factors; Telemedicine*; Pandemics*
  8. Foo CH, Hii BYS, Wong CC, Ohn KM
    BMJ Case Rep, 2021 Jul 12;14(7).
    PMID: 34253529 DOI: 10.1136/bcr-2021-243788
    Postoperative pseudomeningocele usually has a benign course. We report a rare presentation of postoperative acute neurological deficit caused by compressive thoracic pseudomeningocele. This patient had posterior spinal fusion and decompression surgery for thoracic ossification of posterior longitudinal ligament and ligamentum flavum. Intraoperative incidental durotomy was covered with hydrogel dural sealant. She developed acute neurological deterioration 1 week after index surgery. Emergency decompression surgery was performed. One year after the surgery, she showed good neurological recovery.
    MeSH terms: Female; Humans; Thoracic Vertebrae/surgery; Treatment Outcome; Decompression, Surgical
  9. Azman A, Singh PSJ, Isahaque A
    Qual Soc Work, 2021 Mar;20(1-2):553-560.
    PMID: 34253996 DOI: 10.1177/1473325020973308
    The global lockdown due to COVID-19 is a major concern as all higher educational institutions face disruption in teaching, learning and assessment. Social work educators in Malaysia's higher educational institutions are not spared of this disruption. Conventional teaching methods are now being replaced by non-conventional modes of teaching, which include online teaching and assessment using various platforms such as Zoom, WebEx and others. In embarking on online methods of teaching, social work educators will have to undergo many changes. It is particularly so as social work has a practice component that involves field training, which will be a different challenge to educators and students in this new and unexpected environment. This paper aims to discuss the implications of COVID-19 on the changes that have taken place in social work teaching and learning in Malaysia and potential responses.
  10. Lee CY, Jenq CC, Chandratilake M, Chen J, Chen MM, Nishigori H, et al.
    Adv Health Sci Educ Theory Pract, 2021 Dec;26(5):1555-1579.
    PMID: 34254202 DOI: 10.1007/s10459-021-10060-z
    Clinical reasoning is the thought process that guides practice. Although a plethora of clinical reasoning studies in healthcare professionals exists, the majority appear to originate from Western cultures. A scoping review was undertaken to examine clinical reasoning related research across Asian cultures. PubMed, SciVerse Scopus, Web of Science and Airiti Library databases were searched. Inclusion criteria included full-text articles published in Asian countries (2007 to 2019). Search terms included clinical reasoning, thinking process, differential diagnosis, decision making, problem-based learning, critical thinking, healthcare profession, institution, medical students and nursing students. After applying exclusion criteria, n = 240 were included in the review. The number of publications increased in 2012 (from 5%, n = 13 in 2011 to 9%, n = 22) with a steady increase onwards to 12% (n = 29) in 2016. South Korea published the most articles (19%, n = 46) followed by Iran (17%, n = 41). Nurse Education Today published 11% of the articles (n = 26), followed by BMC Medical Education (5%, n = 13). Nursing and Medical students account for the largest population groups studied. Analysis of the articles resulted in seven themes: Evaluation of existing courses (30%, n = 73) being the most frequently identified theme. Only seven comparative articles showed cultural implications, but none provided direct evidence of the impact of culture on clinical reasoning. We illuminate the potential necessity of further research in clinical reasoning, specifically with a focus on how clinical reasoning is affected by national culture. A better understanding of current clinical reasoning research in Asian cultures may assist curricula developers in establishing a culturally appropriate learning environment.
    MeSH terms: Delivery of Health Care; Health Personnel; Humans; Learning; Students, Nursing*
  11. Mahendran R, Lim SK, Ong KC, Chua KH, Chai HC
    Clin Exp Nephrol, 2021 Nov;25(11):1163-1172.
    PMID: 34254206 DOI: 10.1007/s10157-021-02111-x
    BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is a monogenic kidney disorder that impairs renal functions progressively leading to kidney failure. The disease affects between 1:400 and 1:1000 ratio of the people worldwide. It is caused by the mutated PKD1 and PKD2 genes which encode for the defective polycystins. Polycystins mimic the receptor protein or protein channel and mediate aberrant cell signaling that causes cystic development in the renal parenchyma. The cystic development is driven by the increased cyclic AMP stimulating fluid secretion and infinite cell growth. In recent years, natural product-derived small molecules or drugs targeting specific signaling pathways have caught attention in the drug discovery discipline. The advantages of natural products over synthetic drugs enthusiast researchers to utilize the medicinal benefits in various diseases including ADPKD.

    CONCLUSION: Overall, this review discusses some of the previously studied and reported natural products and their mechanisms of action which may potentially be redirected into ADPKD.

    MeSH terms: Antioxidants/pharmacology; Curcumin/pharmacology; Diterpenes/pharmacology; Emodin/pharmacology; Epoxy Compounds/pharmacology; Estrogen Antagonists/pharmacology; Humans; Hypoglycemic Agents/pharmacology; Metformin/pharmacology*; Phenanthrenes/pharmacology; Plant Extracts/pharmacology*; Plant Extracts/therapeutic use; Quercetin/pharmacology*; Polycystic Kidney, Autosomal Dominant/drug therapy*; Flavanones/pharmacology*; Diterpenes, Kaurane/pharmacology; Chalcones/pharmacology*; Protein Kinase Inhibitors/pharmacology
  12. Wong JHD, Zaili Z, Abdul Malik R, Bustam AZ, Saad M, Jamaris S, et al.
    J Appl Clin Med Phys, 2021 Aug;22(8):139-147.
    PMID: 34254425 DOI: 10.1002/acm2.13338
    PURPOSE: This study aims to evaluate in vivo skin dose delivered by intraoperative radiotherapy (IORT) and determine the factors associated with an increased risk of radiation-induced skin toxicity.

    METHODOLOGY: A total of 21 breast cancer patients who underwent breast-conserving surgery and IORT, either as IORT alone or IORT boost plus external beam radiotherapy (EBRT), were recruited in this prospective study. EBT3 film was calibrated in water and used to measure skin dose during IORT at concentric circles of 5 mm and 40 mm away from the applicator. For patients who also had EBRT, the maximum skin dose was estimated using the radiotherapy treatment planning system. Mid-term skin toxicities were evaluated at 3 and 6 months post-IORT.

    RESULTS: The average skin dose at 5 mm and 40 mm away from the applicator was 3.07 ± 0.82 Gy and 0.99 ± 0.28 Gy, respectively. Patients treated with IORT boost plus EBRT received an additional skin dose of 41.07 ± 1.57 Gy from the EBRT component. At 3 months post-IORT, 86% of patients showed no evidence of skin toxicity. However, the number of patients suffering from skin toxicity increased from 15% to 38% at 6 months post-IORT. We found no association between the IORT alone or with the IORT boost plus EBRT and skin toxicity. Older age was associated with increased risk of skin toxicities. A mathematical model was derived to predict skin dose.

    CONCLUSION: EBT3 film is a suitable dosimeter for in vivo skin dosimetry in IORT, providing patient-specific skin doses. Both IORT alone and IORT boost techniques resulted in similar skin toxicity rates.

    MeSH terms: Aged; Female; Humans; Neoplasm Recurrence, Local; Prospective Studies; Radiation Injuries*; Mastectomy, Segmental
  13. Al-Samet MA, Goto M, Mubarak NM, Al-Muraisy SA
    Environ Sci Pollut Res Int, 2021 Dec;28(47):67632-67645.
    PMID: 34255262 DOI: 10.1007/s11356-021-15287-2
    The ever-increasing organic waste generation in Malaysia is a significant contributor to greenhouse gas (GHG) emissions. However, organic wastes can be utilized to produce biogas by anaerobic digestion, which is a promising option for both energy and material recovery from organic wastes with high moisture content. Therefore, this study was formulated to investigate the feasibility of anaerobic co-digestion of three types of organic wastes generated in significantly huge quantities in Malaysia, namely palm oil mill effluent (POME), food waste (FW), and sewage sludge (SWS). The biomethane potential (BMP) test was used to evaluate the biomethane potential from these organic wastes under mesophilic conditions to establish a stable and balanced microbial community, which may lack in mono-digestion, to improve biogas production. Comparative performance was made at different food to microorganism (F/M) ratios to investigate methane production in three groups of assays, namely A, B, and C. In groups A and B, the effect of F/M ratio variation on methane production was investigated, while in group C, the effect of varying the co-substrate mixture on methane yield was examined. The findings showed that the highest methane yields achieved for mono-digestion of POME and SWS in group A were 164.44 mL-CH4/g-CODadded and 65.34 mL-CH4/g-CODadded, respectively, at an F/M ratio of 0.8 and 197.90 mL-CH4/g-CODadded for FW in group B at an F/M ratio of 0.5. In addition, the highest methane yield achieved from the anaerobic co-digestion was at 151.47 mL-CH4/g-CODadded from the co-digestion of the POME and SWS (50:50) at an F/M ratio of 1.7 in group A. Both AD and AcoD were tested to fit into two kinetic models: the modified Gompertz and the transfer function models. The results showed that the modified Gompertz model had a better fit and was more adjusted to the experimental results for both AD and AcoD. The importance of this research lies in the economics of anaerobically co-digesting these abundance feedstocks and the variations in their characteristics which were found to increase their methane yield and process efficiency in anaerobic co-digestion.
  14. Teng XJ, Ng WM, Chong WH, Chan DJC, Mohamud R, Ooi BS, et al.
    Langmuir, 2021 08 03;37(30):9192-9201.
    PMID: 34255525 DOI: 10.1021/acs.langmuir.1c01345
    The changes in the transport behavior of a microswimmer before and after cargo loading are crucial to understanding and control of the motion of a biohybrid microbot. In this work, we show the change in swimming behavior of biflagellated microalgae Chlamydomonas reinhardtii picking up a 4.5 μm polystyrene microbead upon collision. The microswimmer changed from linear forward motion into helical motion upon the attachment of the cargo and swam with a decreased swimming velocity. We revealed the helical motion of the microswimmer upon cargo loading due to suppression of flagella by image analysis of magnified time-lapse images of C. reinhardtii with one microbead attached at the anterior end (between the flagella). Furthered suppression on the flagellum imposed by the loading of the second cargo has led to increased oscillation per displacement traveled and decreased swimming velocity. Moreover, the microswimmer with a microbead attached at the posterior end swam with swimming velocity close to free swimming microalgae and did not exhibit helical swimming behavior. The experimental results and analysis showed that the loading location of the cargo has a great influence over the swimming behavior of the microswimmer. Furthermore, the work balance calculation and mathematical analysis based on Lighthill's model are well consistent with our experimental findings.
    MeSH terms: Flagella*; Humans; Motion; Swimming; Chlamydomonas reinhardtii*
  15. Jikal M, Mori D, Yusoff AF, Rai SB, Mukhsam MH, Ali I, et al.
    Am J Trop Med Hyg, 2021 07 12;105(3):777-782.
    PMID: 34255740 DOI: 10.4269/ajtmh.21-0036
    Foodborne outbreaks of hepatitis A virus (HAV) are most commonly associated with fresh and frozen produce and with various types of shellfish. Alcoholic beverage-borne outbreaks of hepatitis A are extremely rare. Here, we report an outbreak of hepatitis A associated with the consumption of a traditional wine at a funeral ceremony in the Sabah state of Malaysian Borneo. Confirmed cases were determined by serum anti-HAV immunoglobulin M and/or for fecal HAV by reverse transcription polymerase chain reaction (RT-PCR). The amplicons of RT-PCR were subjected to nucleotide sequencing followed by phylogenetic analysis. We conducted a 1:2 case-control study to identify the possible exposure that led to the outbreak. Sixteen patients met the case definition, they were 18 to 58 years old and 90% of them were males. The case-control study showed that the consumption of nipa palm wine during the ceremony was significantly associated (P = 0.0017) with hepatitis A infection (odds ratio, 5.44; 95% CI, 1.80-16.43). Untreated river water was used to dilute the traditional wine, which was assumed to be the source of the infection. Phylogenetically, these viruses belonged to genotype IA and formed an independent cluster with strains from Taiwan, Japan, and the Philippines. This strain might be an emerging HAV in Asian countries. Environmental assessments were performed and environmental samples were negative for HAV. The incidence of hepatitis A in Sabah was also determined and it was 0.795/100,000 population. Strict monitoring of traditional wine production should be implemented by the local authority to prevent future outbreaks.
    MeSH terms: Adolescent; Adult; Ceremonial Behavior*; Disease Outbreaks; Female; Funeral Rites*; Hepatitis A/etiology; Hepatitis A/epidemiology*; Humans; Malaysia/epidemiology; Male; Middle Aged; Wine/virology*; Viral Structural Proteins/genetics; Arecaceae; Rivers/virology*; Young Adult
  16. Bongiovanni T, Yin MOL, Heaney L
    Int J Sports Med, 2021 Dec;42(13):1143-1158.
    PMID: 34256388 DOI: 10.1055/a-1524-2095
    Short-chain fatty acids (SCFAs) are metabolites produced in the gut via microbial fermentation of dietary fibers referred to as microbiota-accessible carbohydrates (MACs). Acetate, propionate, and butyrate have been observed to regulate host dietary nutrient metabolism, energy balance, and local and systemic immune functions. In vitro and in vivo experiments have shown links between the presence of bacteria-derived SCFAs and host health through the blunting of inflammatory processes, as well as purported protection from the development of illness associated with respiratory infections. This bank of evidence suggests that SCFAs could be beneficial to enhance the athlete's immunity, as well as act to improve exercise recovery via anti-inflammatory activity and to provide additional energy substrates for exercise performance. However, the mechanistic basis and applied evidence for these relationships in humans have yet to be fully established. In this narrative review, we explore the existing knowledge of SCFA synthesis and the functional importance of the gut microbiome composition to induce SCFA production. Further, changes in gut microbiota associated with exercise and various dietary MACs are described. Finally, we provide suggestions for future research and practical applications, including how these metabolites could be manipulated through dietary fiber intake to optimize immunity and energy metabolism.
    MeSH terms: Gastrointestinal Microbiome*; Anti-Inflammatory Agents; Dietary Fiber; Fatty Acids, Volatile/administration & dosage*; Humans; Exercise; Athletes*; Performance-Enhancing Substances/administration & dosage*
  17. Mohamad Akmal Bin Harun, Nurul Fateeha Binti Ahmad, Cheah, Huey Miin
    MyJurnal
    Chronic pain has a significant impact on sufferers’ quality of life. Furthermore, treatment inadequacies are often reported in the literatures. This study aims to investigate the prevalence of the different dosing behaviors in analgesics use in chronic, non-cancer pain and their correlation to pain control. This is a cross-sectional study and a convenience sampling method was applied. Brief Pain Inventory- Short Form and Pain Management Index was computed to assess pain control. Statistical analysis was performed with Pearson chi-square test and alpha value was set at 0.05. A total of 127 patients were analyzed. 70.9% of the patients reported inadequate pain control with their prescribed analgesic(s). 88.2% patients only took oral analgesics whenever they felt the pain while 11.8% patients took around-the-clock despite the absence of pain. Among them, 11.8-34.7% of patients did not follow their prescriber’s instruction for oral and topical analgesic use respectively. However, no statistically significant result was found between the dosing behaviors and pain control (p>0.95). It was also reported that 98% of patients were not aware of the maximum daily dose of their prescribed analgesic(s). The prevalence of ‘as needed’ dosing is higher than around-the-clock dosing in the management of chronic, non-cancer pain, with deviation from the prescribed instructions between 11.8-34.7%. However, those differences were not significantly associated with the pain control.
  18. Chung, Emily Shin Ni, Sim, Shin Mei, Wong, Sui Fern, Chai, Shirlie, Kamarudin Ahmad
    MyJurnal
    The Pharmacy value-added services (PVAS) has been implemented in Malaysian public hospitals to facilitate the collection of follow-up medications. In specific, PVAS include Integrated Drug Dispensing System, Medicine by Post, Drive-Through Pharmacy, and many more. While past studies examined the satisfaction towards PVAS and its impact on patients’ waiting time, little explored the awareness and the experience of patients towards each type of PVAS. This study aims to explore the patient’s awareness on PVAS, adoption of PVAS, their satisfaction towards PVAS, and willingness to adopt PVAS. This was a cross-sectional study conducted in January 2020. We invited the eligible patients or their family members to participate in the study. Respondents recruited at the Outpatient Pharmacy Department of Miri Hospital using convenient sampling. A questionnaire in the Malay language was developed and content validated to gather information on the demographic data, awareness on PVAS, adoption of PVAS, satisfaction towards PVAS, and willingness to adopt PVAS. A list of PVAS was included for the respondents to select the types they were aware of and used before. Results were presented as frequencies, percentages, mean and standard deviation. A total of 398 respondents participated in the study. Majority of the respondents (70.1%) were aware that PVAS offered in Miri Hospital. However, about a third of the respondents (31.4%) had experience using PVAS. The most commonly used PVAS was Appointment Card Dispensing System (49.6%) and that with the least usage was Local Partial Medication Supply Service (2.4%). The Drive-Through Pharmacy has the greatest satisfaction score, 4.40 (SD=0.70), whereas Call-and-Collect Service was the least satisfied, 3.88 (SD=0.91). Majority of the respondents (86.2%), specifically 95.8% of the experienced PVAS user and 90.1% of inexperienced group, were willing to adopt PVAS to collect their follow-up medications. The Drive-thru Pharmacy, which has the greatest awareness and satisfaction yet low usage, should be further promoted for greater adoption. Besides, such PVAS should be expanded to other healthcare facilities.
  19. Chen, Tze Seong
    MyJurnal
    Medication errors are more likely to occur during patient’s transition of care. There was very little information about impact of medication reconciliation activities done for patients with chronic kidney disease (CKD) Stage IV-V during admission stage in Malaysian Primary Hospitals. The objective of this study is to evaluate the impact of clinical pharmacist’s medication reconciliation activities during hospital admission of patients with CKD stage IV-V. This cross-sectional study was carried out in two multidisciplinary wards (male & female ward) in Hospital Raub, Pahang over 12 months with ethical approval. A clinical pharmacist was assigned to enroll potential study subjects in both wards. Patients over 18 years old who had previous history of CKD Stage IV-V were included in the study after obtaining informed consent. Medication reconciliation was carried out by the clinical pharmacist within 24 working hours during the admission of study subjects. All detected medication discrepancies were further classified as “intended” or “unintended” after discussion with the prescribing medical officer. The Severity Level of each unintended medication discrepancy was rated by a visiting medical specialist. Twelve patients with CKD stage V were recruited to the study. A total of 49 medication discrepancies were identified and most (89.8%) were found to be unintended. The most common unintended medication discrepancy identified was omission error. Most of the unintended medication discrepancies (59.1%) was rated as “No potential harm”, while 40.9% were rated as “Potential for monitoring and/or Intervention to preclude harm”. None of the unintended medication discrepancy was rated as “Potential harm”. In conclusion, medication discrepancies were common during admission of patients with late-stage chronic kidney disease in a primary hospital. Medication reconciliation performed by clinical pharmacist during admission has a potential role in preventing potential harms that may arise from unintentional medication discrepancies.
  20. Najiyatu,Nazihah,Zakaria,, Saraswathy,Devi,Sinniah,
    Compendium of Oral Science, 2021;8(1):98-109.
    MyJurnal
    ABSTRACT
    Background: Crowding, rotation and impaction of teeth are some of the complications of supernumeraries. This
    article aims to discuss the orthodontic treatment of a severely rotated upper left central incisor (UL1) secondary
    to an erupted mesiodens. An 18-year old Malay male presented with Class I malocclusion with severely crowded
    upper arch, presence of erupted mesiodens, severely rotated upper left central incisor, displaced upper left lateral
    incisor and upper left canine and centreline discrepancy. Methods: He had a combination of segmented arch
    and couple force mechanics to correct severely rotated central incisors. Following anchorage reinforcement, the
    upper mesiodens and the upper right first premolar was extracted. Subsequently, treatment was continued with
    conventional straight wire mechanics. Results: The severely rotated upper left central incisor was successfully
    corrected, and the upper arch crowding was resolved. The fixed appliances were debonded and he was provided
    with upper dual retention. He had gingival recession Type 1 at UL2 due to the bony defect. Conclusion: Severe
    crowding can be managed with segmented arch mechanics without any detrimental effects using low forces and
    good planning. Further periodontal consultation and management were required for the treatment of UL2.
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