Browse publications by year: 2023

  1. Li B, He Z, Peters R, Allender S, Zou Y, Zhou W, et al.
    Int J Behav Nutr Phys Act, 2023 Sep 18;20(1):111.
    PMID: 37723534 DOI: 10.1186/s12966-023-01510-5
    BACKGROUND: Group Model Building (GMB) is a participatory system dynamics method increasingly used to address complex public health issues like obesity. GMB represents a set of well-defined steps to engage key stakeholders to identify shared drivers and solutions of a given problem. However, GMB has not yet been applied specifically to develop multi-duty interventions that address multiple inter-related issues such as malnutrition in all its forms (MIAIF). Moreover, a recent systematic review of empirical applications of a systems approach to developing obesity interventions found no published work from non-western, low- and middle-income countries (LMICs). In this paper we describe adaptations and innovations to a common GMB process to co-develop systemic MIAIF interventions with Chinese decision-makers.

    METHODS: We developed, piloted and implemented multiple cultural adaptations and two methodological innovations to the commonly used GMB process in Fang Cheng Gang city, China. We included formal, ceremonial and policy maker engagement events before and between GMB workshops, and incorporated culturally tailored arrangements during participant recruitment (officials of the same seniority level joined the same workshop) and workshop activities (e.g., use of individual scoring activities and hand boards). We made changes to the commonly used GMB activities which enabled mapping of shared drivers of multiple health issues (in our case MIAIF) in a single causal loop diagram. We developed and used a 'hybrid' GMB format combining online and in person facilitation to reduce travel and associated climate impact.

    RESULTS: Our innovative GMB process led to high engagement and support from decision-makers representing diverse governmental departments across the whole food systems. We co-identified and prioritised systemic drivers and intervention themes of MIAIF. The city government established an official Local Action Group for long-term, inter-departmental implementation, monitoring and evaluation of the co-developed interventions. The 'hybrid' GMB format enabled great interactions while reducing international travel and mitigating limitations of fully online GMB process.

    CONCLUSIONS: Cultural and methodological adaptations to the common GMB process for an Asian LMIC setting were successful. The 'hybrid' GMB format is feasible, cost-effective, and more environmentally friendly. These cultural adaptations could be considered for other Asian settings and beyond to address inter-related, complex issues such as MIAIF.

    MeSH terms: China; Humans; Obesity; Asian Continental Ancestry Group
  2. Sii HL, Ng SH, Wong VF, Law WC
    Acta Neurol Taiwan, 2023 Dec 30;32(4):207-211.
    PMID: 37723913
    PURPOSE: Guillain-Barré Syndrome (GBS) associated with SARS-CoV-2 vaccine administration is very rare. Early recognition of GBS at early stage could prevent extensive nerve damage with potential respiratory and autonomic failure.

    CASE REPORT: We report a case of paraparetic spectrum of GBS in a 53-year-old lady who presented with rapidly progressive acute flaccid paralysis involving both lower extremities with areflexia eight days after the first dose of Sinovac vaccine for SARS-CoV-2 in Malaysia. Cerebrospinal fluid (CSF) albuminocytological dissociation was seen and nerve conduction study (NCS) revealed sensory neuropathy. The diagnosis of GBS was made based on the Brighton criteria. Patient responded well to intravenous immunoglobulin (IVIG).

    CONCLUSION: Though there is currently no convincing evidence of any causation between GBS and SARS- CoV-2 vaccination, clinicians should remain vigilant and consider GBS in the differential diagnosis for patient who presents with weakness with reduced or absent deep tendon reflex after vaccination against SARS-CoV-2.

    MeSH terms: Female; Humans; Malaysia; Middle Aged; Vaccination
  3. Halim SA, Bahar R, Abdullah WZ, Zon EM, Yusoff SM
    Oman Med J, 2023 Jul;38(4):e524.
    PMID: 37724319 DOI: 10.5001/omj.2023.86
    OBJECTIVES: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most common enzymopathy worldwide. The fluorescent spot test (FST) is the conventional method for screening neonates for G6PD. However, it has limitations and quantitative assays such as the CareStart Biosensor 1 are being increasingly recommended. This study aimed to compare FST and CareStart Bioensor 1 in their ability to detect G6PD levels in neonates.

    METHODS: This cross-sectional study involved 455 neonates between June and December 2020. Two milliliters of cord blood were analyzed with CareStart Biosensor 1 and dried cord blood spots with FST. Data was recorded and statistically analyzed. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated to determine the performance of FST at specific G6PD cut-off values; Cohen's kappa analysis assessed the agreement between the two methods.

    RESULTS: The sensitivity of FST at 30% cut-off G6PD activity level was 91.0%, (95% CI: 57.0-100) and specificity of 97.0% (95% CI: 95.0-98.0). At 60% cut-off, the FST sensitivity sharply declined to 29.0% (95% CI: 19.0-40.0) with a specificity of 100% (95% CI: 98.0-100). The overall prevalence of G6PD deficiency was 5.1% as measured by FST and 17.8% by Biosensor 1 (p < 0.001).

    CONCLUSIONS: In this study, FST missed a significant proportion of cases of intermediate G6PD levels. FST also misclassified several G6PD intermediate individuals as normal, rendering them susceptible to oxidative stress. Biosensor 1 reported a significantly higher prevalence of G6PD deficiency.

  4. Chew SH, Achmad Sankala HB, Chew E, Md Arif MHB, Mohd Zain NR, Hashim H, et al.
    Mult Scler Relat Disord, 2023 Nov;79:104992.
    PMID: 37717306 DOI: 10.1016/j.msard.2023.104992
    BACKGROUND: Differentiating tumefactive demyelinating lesions (TDL) from neoplasms of the central nervous system continues to be a diagnostic dilemma in many cases.

    OBJECTIVE: Our study aimed to examine and contrast the clinical and radiological characteristics of TDL, high-grade gliomas (HGG) and primary CNS lymphoma (CNSL).

    METHOD: This was a retrospective review of 66 patients (23 TDL, 31 HGG and 12 CNSL). Clinical and laboratory data were obtained. MRI brain at presentation were analyzed by two independent, blinded neuroradiologists.

    RESULTS: Patients with TDLs were younger and predominantly female. Sensorimotor deficits and ataxia were more common amongst TDL whereas headaches and altered mental status were associated with HGG and CNSL. Compared to HGG and CNSL, MRI characteristics supporting TDL included relatively smaller size, lack of or mild mass effect, incomplete peripheral rim enhancement, absence of central enhancement or restricted diffusion, lack of cortical involvement, and presence of remote white matter lesions on the index scan. Paradoxically, some TDLs may present atypically or radiologically mimic CNS lymphomas.

    CONCLUSION: Careful evaluation of clinical and radiological features helps in differentiating TDLs at first presentation from CNS neoplasms.

    MeSH terms: Female; Glioma*; Humans; Magnetic Resonance Imaging; Male; Neuroimaging
  5. Pani SK, Huang HY, Wang SH, Holben BN, Lin NH
    Sci Total Environ, 2023 Dec 20;905:167113.
    PMID: 37717748 DOI: 10.1016/j.scitotenv.2023.167113
    The South China Sea (SCS) is a receptor of pollution sources from various parts of Asia and is heavily impacted by strong meteorological systems, which thus dictate aerosol variability over the region. This study analyzes long-term aerosol optical properties observed at Dongsha Island (a representative site in northern SCS) from 2009 to 2021 and Taiping Island (a representative site in southern SCS) from 2012 to 2021 to better apprehend the temporal evolution of columnar aerosols over the SCS. The noticeable difference in loadings, optical properties, and compositions of aerosols between northern and southern SCS was due to the influence of dissimilar emission sources and transport mechanisms. Column-integrated aerosol optical depth (AOD) over northern SCS (range of monthly mean at 500 nm; 0.12-0.51) was significantly greater than southern SCS (0.09-0.21). The maximum AOD in March (0.51 ± 0.28) at Dongsha was attributed to westerlies coupled with biomass-burning (BB) emissions from peninsular Southeast Asia, whereas the maximum AOD at Taiping in September (0.21 ± 0.25) was owing to various pollution from the Philippines, Malaysia, and Indonesia. Fine-mode aerosol dominated over northern SCS (range of monthly mean Angstrom exponent for 440-870 nm: 0.85-1.36) due to substantial influence from continental sources including anthropogenic and BB emissions while coarse-mode particles dominated over southern SCS (0.54-1.28) due to relatively more influence from marine source. More absorbing columnar aerosols prevailed over northern SCS (range of monthly mean single scattering albedo at 675 nm: 0.92-0.99) compared to southern SCS (0.95-0.98) owing to differences in aerosol composition with respect to sources. Special pollution events showcased possible significant impacts on marine ecosystems and regional climate. This study encourages the establishment of more ground-based aerosol monitoring networks and the inclusion of modeling simulations to comprehend the complex nature of aerosol over this vast marginal sea.
  6. Bapat RA, Bedia SV, Bedia AS, Yang HJ, Dharmadhikari S, Abdulla AM, et al.
    Environ Res, 2023 Dec 01;238(Pt 1):116971.
    PMID: 37717805 DOI: 10.1016/j.envres.2023.116971
    Curcumin is a natural herb and polyphenol that is obtained from the medicinal plant Curcuma longa. It's anti-bacterial, anti-inflammatory, anti-cancer, anti-mutagenic, antioxidant and antifungal properties can be leveraged to treat a myriad of oral and systemic diseases. However, natural curcumin has weak solubility, limited bioavailability and undergoes rapid degradation, which severely limits its therapeutic potential. To overcome these drawbacks, nanocurcumin (nCur) formulations have been developed for improved biomaterial delivery and enhanced treatment outcomes. This novel biomaterial holds tremendous promise for the treatment of various oral diseases, the majority of which are caused by dental biofilm. These include dental caries, periodontal disease, root canal infection and peri-implant diseases, as well as other non-biofilm mediated oral diseases such as oral cancer and oral lichen planus. A number of in-vitro studies have demonstrated the antibacterial efficacy of nCur in various formulations against common oral pathogens such as S. mutans, P. gingivalis and E. faecalis, which are strongly associated with dental caries, periodontitis and root canal infection, respectively. In addition, some clinical studies were suggestive of the notion that nCur can indeed enhance the clinical outcomes of oral diseases such as periodontitis and oral lichen planus, but the level of evidence was very low due to the small number of studies and the methodological limitations of the available studies. The versatility of nCur to treat a diverse range of oral diseases augurs well for its future in dentistry, as reflected by rapid pace in which studies pertaining to this topic are published in the scientific literature. In order to keep abreast of the latest development of nCur in dentistry, this narrative review was undertaken. The aim of this narrative review is to provide a contemporaneous update of the chemistry, properties, mechanism of action, and scientific evidence behind the usage of nCur in dentistry.
    MeSH terms: Anti-Inflammatory Agents/pharmacology; Biocompatible Materials; Dental Caries*; Dentistry; Humans; Periodontitis*; Lichen Planus, Oral*
  7. Mansor M, Chong MC, Chui PL, Hamdan M, Basha MAMK
    Saudi Med J, 2023 Sep;44(9):933-939.
    PMID: 37717967 DOI: 10.15537/smj.2023.44.9.20230228
    OBJECTIVES: To validate and determine the psychometric properties of the Malay version of the endometriosis health profile-30 (EHP-30) by confirmatory factor analysis.

    METHODS: A cross-sectional study was carried out in the main city of Malaysia at a tertiary teaching hospital between January to April 2021. A total of 218 women diagnosed with endometriosis symptoms were recruited using the universal sampling method to answer the questionnaire.

    RESULTS: The revised Malay version of the EHP-30 with 28 items demonstrated that the factor loading of the 28 items had an acceptable value range between 0.60-0.90. The model fit was acceptable after the inclusion of 28 items correlated errors of the root mean square of error approximation: 0.072, 90% confidence interval: [0.065-0.080], comparative fit index (0.939), Tucker-Lewis index (0.932), and Chi-square/degrees of Freedom (2.135). The Cronbach's alpha ranged from 0.89-0.97. Concurrent validity for the composite reliability was between 0.88-0.96, while the average variance extracted was between 0.65-0.74.

    CONCLUSION: This revised Malay version of the EHP-30 is a reliable and valid tool that can be used for the next study.

    MeSH terms: Cross-Sectional Studies; Female; Hospitals, Teaching; Humans; Malaysia; Psychometrics; Reproducibility of Results
  8. Gunawardena SA, Abeyratne P, Jayasena A, Rajapaksha S, Senadhipathi H, Siriwardana D, et al.
    Sci Justice, 2023 Sep;63(5):638-650.
    PMID: 37718011 DOI: 10.1016/j.scijus.2023.08.001
    Estimating the post mortem interval (PMI) in skeletonized cases is an extremely challenging exercise. Sri Lanka lacks adequate taphonomic research which is a serious limitation when assessing PMI in forensic death investigations. Methods that have been proposed to estimate PMI using the total body score (TBS) and accumulated degree days (ADD) are mainly based on data from continental and temperate climates and have shown less reliability in tropical climates. With the intention of developing a region-specific, evidence-based guide which would be applicable to tropical climates like Sri Lanka, we selected thirteen skeletonized remains with known PMIs from forensic case records and analysed their taphonomy in relation to selected weather data. We also compared the ADD values within our dataset with reference ranges calculated using published formula. All except one were found from outdoor locations. The TBS ranged from 24 to 32 and had a weak positive correlation with the PMI. The earliest appearance of skeletonization was 15 days in a body found indoors. The highest rate of skeletonization was seen in a body with a TBS of 32 and a PMI of 23 days. The average daily temperature and relative humidity were similar across all the cases however, the amount of rainfall varied. Bodies exposed to monsoon rains (n = 6) had a lower mean rate of skeletonization compared to those that were not exposed (n = 4) suggesting lower rates of decomposition during periods of heavy rainfall. No correlation was found between ADD and TBS. In 9 (69.2%) cases, the actual ADD was much lower than reference ADD ranges for TBS values, indicating poor applicability of TBS and ADD based formulae in estimating PMI within the Sri Lankan climate. Our study shows a strong need for taphonomic and entomological research in tropical climates to further explore the impact of monsoons on biotic and abiotic factors affecting skeletonization.
    MeSH terms: Autopsy; Humans; Rain*; Retrospective Studies; Sri Lanka; Time Factors; Tropical Climate*; Reproducibility of Results; Forensic Anthropology*; Asian Continental Ancestry Group*
  9. Arifin K, Ali MXM, Abas A, Ahmad MA, Ahamad MA, Sahimi AS
    J Safety Res, 2023 Sep;86:376-389.
    PMID: 37718065 DOI: 10.1016/j.jsr.2023.07.017
    INTRODUCTION: The electrical utility industry, which plays a vital role in sustaining other sectors, contributes to high occupational accident rates in the utility industries. The high accident rate shows that there has been insufficient effort made to control unsafe actions and conditions in the workplace. This study aims to examine the influence of hazard control and prevention as leading indicators of safety behaviors and outcomes in coal-fired power plants in Malaysia.

    METHODS: This quantitative research was conducted by distributing survey questionnaires randomly to five coal-fired power plants in Peninsular Malaysia. A total of 340 respondents were involved in this research. Partial least squares structural equation modeling (PLS-SEM) analysis was performed using SmartPLS to validate and examine the relationship of the proposed model.

    RESULTS: The results validate the construct of hazard control and prevention consisting of planning, action, managing, and verifying, while the safety outcomes construct consists of occupational accidents, fatal accidents, near misses, and lost time injuries. The results indicate that hazard control and prevention significantly relate to safety compliance, safety participation, safety motivation, and safety knowledge. Moreover, safety outcomes were influenced negatively by hazard control and prevention through safety compliance.

    CONCLUSION: The model provides a better understanding of the influence of hazard control and prevention on safety behavior and outcomes.

    PRACTICAL APPLICATIONS: The model can be used as guidance for practitioners and researchers in planning and implementing hazard control and prevention to improve health and safety in the workplace.

    MeSH terms: Coal; Humans; Power Plants*; Least-Squares Analysis; Safety Management*
  10. Fahmy O, Kochergin M, Asimakopoulos AD, Gakis G
    Semin Oncol, 2023;50(3-5):102-104.
    PMID: 37718162 DOI: 10.1053/j.seminoncol.2023.09.001
    For many decades, extended pelvic lymph node dissection has been an integral part during radical cystectomy for patients with muscle invasive bladder cancer. This practice was based on large retrospective meta-analyses suggesting an oncologic benefit to an extended dissection. This mini review and meta-analysis includes the two available randomized trials in the current literature. Therefore, it can be considered as the strongest level of evidence regarding the prognostic benefit of an extended pelvic lymphadenectomy. Based on current randomized data, standard pelvic lymph node dissection up to the level of iliac bifurcation is sufficient, and extension of the dissection above this level does not provide any additional oncologic benefit.
  11. Supee AH, Zaini MAA
    Environ Monit Assess, 2023 Sep 17;195(10):1218.
    PMID: 37718332 DOI: 10.1007/s10661-023-11866-7
    This study presents the kinetics and thermodynamics of biomass pyrolysis. The kinetics of the pyrolysis process was estimated using ten kinetic models from three different mechanisms, namely chemical reaction, diffusion, and nucleation and growth. Results showed that each pyrolysis subdivision was described by a different reaction model, signifying the complex nature of the pyrolysis process. The average values of activation energy determined from the kinetic models for empty fruit bunch, coconut shell, bamboo, and cardboard are 10.2-64.6 kJ/mol, 18.7-186.2 kJ/mol, 8.0-70.8 kJ/mol, and 13.1-277.3 kJ/mol, respectively. The biomass pyrolysis is endothermic and non-spontaneous and would require external energy to initiate the degradation process. The findings are helpful in characterizing the thermal degradation of biomass in exploring its potential as a source of alternative solid fuel.
    MeSH terms: Cocos*; Environmental Monitoring; Fruit*; Kinetics; Thermodynamics
  12. Rajan N, Debnath S, Perveen K, Khan F, Pandey B, Srivastava A, et al.
    Front Plant Sci, 2023;14:1238870.
    PMID: 37719210 DOI: 10.3389/fpls.2023.1238870
    INTRODUCTION: This study explored the molecular characterization of 14 eggplant (brinjal) genotypes to evaluate their genetic diversity and the impact of heterosis. As eggplant is a vital horticultural crop with substantial economic and nutritional value, a comprehensive understanding of its genetic makeup and heterosis effects is essential for effective breeding strategies. Our aim was not only to dissect the genetic diversity among these genotypes but also to determine how genetic distance impacts heterotic patterns, which could ultimately help improve hybrid breeding programs.

    METHODS: Genetic diversity was assessed using 20 SSR markers, and the parental lines were grouped into five clusters based on the Unweighted Pair Group Method of Arithmetic Means (UPGMA). Heterosis was examined through yield and yield-related traits among parents and hybrids.

    RESULTS: Polymorphisms were detected in eight out of the twenty SSR markers across the parental lines. Notably, a high genetic distance was observed between some parents. The analysis of yield and yield-related traits demonstrated significant heterosis over mid, superior, and standard parents, particularly in fruit yield per plant. Two crosses (RKML-26 X PPC and RKML1 X PPC) displayed substantial heterosis over mid and better parents, respectively. However, the positive correlation between genetic distance and heterosis was only up to a certain threshold; moderate genetic distance often resulted in higher heterosis compared to very high genetic distance.

    DISCUSSION: These findings emphasize the critical role of parental selection in hybrid breeding programs. The results contribute to the understanding of the relationship between genetic distance and heterosis, and it is suggested that future research should delve into the genetic mechanisms that drive heterosis and the effect of genetic distance variance on heterosis. The insights drawn from this study can be harnessed to enhance crop yield and economic value in breeding programs.

  13. Siti Kaamilah MZ, Wong YS, Bushra J, Nik Ahmad Fadhil NM, Aisya Natasya M
    Breathe (Sheff), 2023 Sep;19(3):230052.
    PMID: 37719237 DOI: 10.1183/20734735.0052-2023
    Can you diagnose this woman with a history of uterine fibroids in the previous year and a recent finding of intrathoracic mass on chest radiography? https://bit.ly/44mQ9Jj.
  14. Thuraisingham C, Nalliah S
    Malays Fam Physician, 2023;18:49-100.
    PMID: 37719692 DOI: 10.51866/cm.264
    Menopause is an important phase in the life of older women. Women's life expectancy has increased worldwide. As women experience and perceive menopause differently depending on their personal, family and sociocultural backgrounds, perimenopausal symptoms can often go unnoticed and missed by general practitioners. General practitioners are uniquely placed in the healthcare delivery pyramid to close this gap and improve patients' quality of life by identifying perimenopausal signs and symptoms early. This article shares knowledge about continuing medical education for general practitioners to close the existing gap. As there is great variability within each menopausal woman's experience as well as among individual women, there is a need to individualise and render personalised care. By being able to discuss accepted and safe standards of care and by advocating for a holistic approach incorporating both non-pharmacological and pharmacological strategies, general practitioners would be able to improve the confidence of their patients for better health outcomes.
  15. Abdullah F, Abd Razak AA, Mohd Idris UK
    Malays Fam Physician, 2023;18:46-100.
    PMID: 37719694 DOI: 10.51866/cr.348
    A 37-year-old married, right-handed active firefighter presented to the primary care clinic with a self-report of difficulties in memorising and recalling information associated with declining work performance. Collaborative history-taking revealed that he also experienced emotional and social withdrawal, apathy, irritability and distractibility. He was initially diagnosed with major depressive disorder but showed no improvement with an antidepressant. This young man with no history of hereditary neurodegenerative disorder had further deterioration in cognitive function, predominantly executive behaviours, with progressive aphasia. Brain magnetic resonance imaging revealed cerebral atrophy predominant over the frontotemporal lobe. Positron emission tomography showed fluorodeoxyglucose hypometabolism at the bifrontal and left parietal and temporal cortices, consistent with frontotemporal dementia. He required institutionalisation with full nursing care less than 24 months after the onset of the symptoms. This case highlights the need for diagnostic consideration of dementia in young individuals presenting with cognitive impairment among other symptoms. It also emphasises the importance of obtaining collateral information from close relatives to avoid misdiagnosis and addresses the psychosocial impact of dementia at a young age.
  16. Majorie Ensayan AJ, Cheah WL, Helmy H
    Malays Fam Physician, 2023;18:48-100.
    PMID: 37719695 DOI: 10.51866/oa.167
    INTRODUCTION: Most working women experience poor physical and mental health during their postpartum period. This prospective study aimed to describe the physical and mental health issues faced by working mothers during their postpartum period.

    METHODS: Respondents were recruited using the proportional sampling method among mothers who attended the Maternal and Child Health Clinic in the Kuching division in Sarawak, Malaysia. Face-to-face interview was conducted using a questionnaire that consisted of items on socio-demographic data as well as perinatal, prenatal and postpartum factors, and the Edinburgh Postnatal Depression Scale and a checklist of 28 specific postpartum symptoms were used during the first 6 weeks and after 12 weeks of childbirth.

    RESULTS: A total of 281 respondents participated in this study. Fatigue (42.7%), back or neck pain (36.3%), breast discomfort (16.4%), dizziness (13.5%) and nipple irritation (11.0%) were among the most common symptoms experienced by the mothers during the first 6 weeks after childbirth. There was a significant decrease in the physical symptom scores of the respondents from the first 6 weeks to after 12 weeks of childbirth (1.73±1.96 vs 0.16±0.42; P<0.0005). A significant decrease was also found in the depression scores (6.26±4.26 vs 1.35±1.85, P<0.0005).

    CONCLUSION: The prevalence of postnatal depression was higher during the first 6 weeks of postpartum than after 12 weeks of postpartum. Screening and treatment of poor postpartum mental health among working women are essential owing to the impacts on occupational outcomes.

  17. Ng BZ, Peter JS, Chua SH
    Malays Fam Physician, 2023;18:45-100.
    PMID: 37719696 DOI: 10.51866/cr.287
    Brain tumours often present with a variety of early subtle, non-specific symptoms. This can obscure an organic origin of the illness, which deters timely referral and management. We report a rare case of psychosis in a patient with a left frontal lobe tumour, preceded by 2 months of lethargy and word- finding difficulty with minimal neurological deficits, who was referred to our psychiatric unit from a primary care facility. Blood investigation findings including tumour marker levels were normal. Prompt neuroimaging revealed a left frontal lobe lesion with findings indicating a glioblastoma. The patient was subsequently referred to the neurosurgical team for surgical resection of the tumour. A high index of suspicion is paramount among atypical sociodemographic groups of patients with atypical psychiatric presentations. The primary care setting, which is often the first point of contact for patients, provides an avenue for early detection of such cases and timely referral to the appropriate healthcare system to ensure an optimal outcome.
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