Browse publications by year: 2024

  1. Yaacob NLC, Loganathan M, Hisham NA, Kamaruzzaman H, Isa KAM, Ibrahim MIM, et al.
    Korean J Fam Med, 2024 Jul;45(4):235.
    PMID: 39054839 DOI: 10.4082/kjfm.23.0220.R
  2. Fournier L, Bőthe B, Demetrovics Z, Koós M, Kraus SW, Nagy L, et al.
    Assessment, 2024 Jul 26.
    PMID: 39054862 DOI: 10.1177/10731911241259560
    The UPPS-P Impulsive Behavior Model and the various psychometric instruments developed and validated based on this model are well established in clinical and research settings. However, evidence regarding the psychometric validity, reliability, and equivalence across multiple countries of residence, languages, or gender identities, including gender-diverse individuals, is lacking to date. Using data from the International Sex Survey (N = 82,243), confirmatory factor analyses and measurement invariance analyses were performed on the preestablished five-factor structure of the 20-item short version of the UPPS-P Impulsive Behavior Scale to examine whether (a) psychometric validity and reliability and (b) psychometric equivalence hold across 34 country-of-residence-related, 22 language-related, and three gender-identity-related groups. The results of the present study extend the latter psychometric instrument's well-established relevance to 26 countries, 13 languages, and three gender identities. Most notably, psychometric validity and reliability were evidenced across nine novel translations included in the present study (i.e., Croatian, English, German, Hebrew, Korean, Macedonian, Polish, Portuguese-Portugal, and Spanish-Latin American) and psychometric equivalence was evidenced across all three gender identities included in the present study (i.e., women, men, and gender-diverse individuals).
  3. Tufail T, Saeed F, Tufail T, Bader Ul Ain H, Hussain M, Noreen S, et al.
    Food Sci Nutr, 2024 Jul;12(7):4944-4951.
    PMID: 39055199 DOI: 10.1002/fsn3.4141
    Cell wall polysaccharides (dietary fiber) in cereal grains contribute to health benefits. The novelty of the current study was an effort to explore the in vivo therapeutic potential of different cereal bran cell walls against hypercholesterolemia. For this purpose, the cell walls were isolated from different cereal brans (wheat, maize, oats, and barley), and the intake of these cereal bran cell walls was evaluated for their anti-lipidemic activity in normal and hypercholesterolemic rats. The serum taken from the rats was tested for cholesterol, lipid, and triglyceride profiles before and after treatment. The outcomes of the current study have shown that the cereal cell wall has a significant hypercholesterolemia effect. The biochemical parameters of the control animals were within the normal clinical ranges, indicating that the experimental diets were safe. Among cereal bran cell walls, barley bran significantly decreased cholesterol (56.35 ± 1.35 mg/dL), low-density lipoprotein (56.35 ± 1.05 mg/dL), triglycerides (105.29 ± 1.95 mg/dL), and increased high-density lipoprotein level (48.35 ± 1.35 mg/dL). These findings provide conclusive evidence that the cereal cell wall is beneficial in the treatment of hypercholesterolemia and may potentially provide protection against other acute, recurring, or chronic illnesses.
  4. Soltanieh S, Salavatizadeh M, Gaman MA, Kord Varkaneh H, Tan SC, Prabahar K, et al.
    Food Sci Nutr, 2024 Jul;12(7):4581-4593.
    PMID: 39055215 DOI: 10.1002/fsn3.4146
    Hepcidin has a crucial role in iron homeostasis upon inflammatory conditions such as inflammatory bowel disease (IBD). Thus, we conducted a systematic review and meta-analysis to determine the overall association between serum hepcidin concentrations and IBD. Based on the preferred reporting items for systematic review and meta-analysis (PRISMA) protocols, an electronic literature search was conducted on PubMed/MEDLINE, Scopus, and Web of Science until June 2020. Studies were deemed eligible for inclusion if they met the following criteria: (1) diagnosis of IBD, (2) observational design, and (3) measured serum hepcidin and prohepcidin concentrations in IBD patients and control group. Overall, 10 studies including 1184 participants were evaluated. Random-effects meta-analysis revealed that subjects with IBD had 7.22 ng/mL (95% CI: 2.10, 12.34; p = .006) higher serum hepcidin concentrations compared to control groups. A nonsignificantly lower serum prohepcidin concentration (0.522 ng/mL, 95% CI: -1.983 to 0.939; p = .484) was found for IBD patients compared to healthy subjects. However, there was significant heterogeneity among the studies regarding both hepcidin (I 2 = 98%, p 
  5. Abd Malek K, Ariffin F, Taher SW, Abd Aziz NA, Chew BH, Wong PF, et al.
    Cureus, 2024 Jun;16(6):e63147.
    PMID: 39055414 DOI: 10.7759/cureus.63147
    Introduction The COVID-19 pandemic has changed the working environment for general practitioners (GPs). GPs had to adapt quickly when care mitigation for mild COVID-19 in the community began. We assessed Malaysian GPs' knowledge and preparedness to manage COVID-19. Method A cross-sectional online survey was conducted between May and October 2022 among the GPs. Emails were sent to GPs affiliated with the main GP organizations in Malaysia, such as the Academy of Family Physicians of Malaysia (AFPM). Additionally, participation was sought through social media groups, including the Association of Malaysian Islamic Doctors, the Federation of Private Medical Practitioners' Associations Malaysia, and the Primary Care Network. Data was collected using a self-administered questionnaire on items related to knowledge and preparedness to manage COVID-19. The content was validated by six experts. Multiple logistic regression was used to determine the predictors for preparedness. Results A total of 178 GPs participated in this study. The mean age of the GPs was 41.8 (SD 12.37) years, 54.5% were males, 47.8% had a postgraduate qualification, and 68% had up to 10 years of general practice experience. Their practices are commonly solo (55.1%), located within an urban area (56.2%) and 47.2% operate 7 days a week. A majority of GPs (n = 124, 69.7%) had a good level of knowledge of COVID-19. In contrast, about a third (n = 60, 33.7%) had a good level of preparedness to manage COVID-19. GPs with a good level of knowledge of COVID-19 had 1.96 times the odds of having a good level of preparedness as compared to GPs with lower knowledge (OR = 2.11 (95% CI: 1.06, 4.18, p = 0.03)). Conclusion A good level of knowledge is a predictor for preparedness to manage COVID-19. Relevant and targeted measures to enhance knowledge for better preparedness among the GPs to respond to future pandemics are needed.
  6. Ismail S, Sutan R, Ibrahim R, Mohd Rathi FZ
    Cureus, 2024 Jun;16(6):e63064.
    PMID: 39055416 DOI: 10.7759/cureus.63064
    Background The Tele Primary Care Oral Health Clinical Information System (TPC-OHCIS) was implemented in Malaysia to digitalize health care and reduce numerous ground-level manual tasks. This study measures the psychometric properties of the TPC-OHCIS questionnaire among healthcare workers (HCWs) at primary healthcare clinics (PHC). Method A pilot study was conducted at PHC, which implemented the TPC-OHCIS application for service delivery. The questionnaire contained 65 items with four response categories, grouped into four scales: technology, organization, external support, and human resource. The questionnaire items were analyzed using the Rasch model in Winsteps 3.72.3. Results There were 319 respondents who participated (98.8%). The Cronbach alpha was 0.93. The construct validity was determined by a positive point measure correlation (PMC) value, with an infit and outfit mean square (MNSQ) range of 0.4-1.5 and a Z-standardized (ZSTD) range of -2.0 to 2.0. The person and item reliability were 0.93 and 0.97, respectively, indicating excellent reliability. The questionnaire was unidimensional, where the raw variance explained by measures was >40%. Conclusion The questionnaire was deemed fit for an actual survey after 18 items had been deleted. It has good psychometric properties and is practically applicable for evaluating HCWs on the TPC-OHCIS application implementation process monitoring using the local Malay language. High reliability and unidimensionality were achieved, supporting its use in digital healthcare. With this validated questionnaire, it will enhance digital healthcare implementation and streamline manual tasks.
  7. Nasir A, Chong Sian N, Abdullah A
    Cureus, 2024 Jun;16(6):e63113.
    PMID: 39055449 DOI: 10.7759/cureus.63113
    Hematohidrosis is a rare disease and should be treated as a diagnosis of exclusion. Its pathogenesis remains unclear, though several theories have been proposed. It is often associated with psychological stress and anxiety, with the most commonly affected areas being the ears, nose, and oral mucosa. There is no specific management modality for hematohidrosis yet, as it is generally self-limiting. Enhanced monitoring and surveillance are required to avoid complications and determine the severity of the condition.
  8. Pan Y, Motevalli S, Yu L
    Iran J Psychiatry, 2024 Jul;19(3):274-284.
    PMID: 39055523 DOI: 10.18502/ijps.v19i3.15804
    Objective: With the increase of game addiction, the problem of aggression as one of the most serious issues confronting today's society is affecting the mental health of the young generation. While available research has clarified the relationship between game addiction and aggression, this research contributes to future literature through examining the mediating role of narcissism and self-control in this relationship. Method : This study is a quantitative, cross-sectional, correlational research conducted in 2023 on Malaysian adolescents aged 12 to 18 years. Volunteer adolescents completed self-report questionnaires including the Buss and Perry Aggression Questionnaire, Gaming Addiction Scale, Childhood Narcissism Scale, and Brief Self-Control Scale. All questionnaires were prepared through a Sojump link posted on social media platforms. Descriptive statistics, Pearson correlation analysis, and path analysis were used for statistical analysis. Results: N = 595 adolescents were participated in this survey. According to correlation analysis, there were significant positive correlations between game addiction and aggression (r = 0.777, P < 0.001), game addiction and narcissism (r = 0.785, P < 0.001) as well as a significant negative correlation between game addiction and self-control (r = -0.668, P < 0.001). Besides, narcissism and self-control could significantly partially mediate the relationship between game addiction and aggression. The mediation model discovered a significant path from game addiction to narcissism (β = 0.785, CI = [0.7692, 1.0293], P < 0.001) and from narcissism to aggression (β = 0.442, CI [0.7731, 1.7244], P < 0.001). The total effect of game addiction on aggression was found to be statistically significant (β = 0.777, P < 0.001). Conclusion: The findings of this research reveal a captivating profile, indicating that specific psychological attributes such as aggression, self-control, and narcissistic tendencies might make certain individuals more susceptible to developing an addiction to online games.
  9. Van Coillie S, Prévot J, Sánchez-Ramón S, Lowe DM, Borg M, Autran B, et al.
    Front Immunol, 2024;15:1430678.
    PMID: 39055704 DOI: 10.3389/fimmu.2024.1430678
    The International Patient Organisation for Primary Immunodeficiencies (IPOPI) held its second Global Multi-Stakeholders' Summit, an annual stimulating and forward-thinking meeting uniting experts to anticipate pivotal upcoming challenges and opportunities in the field of primary immunodeficiency (PID). The 2023 summit focused on three key identified discussion points: (i) How can immunoglobulin (Ig) therapy meet future personalized patient needs? (ii) Pandemic preparedness: what's next for public health and potential challenges for the PID community? (iii) Diagnosing PIDs in 2030: what needs to happen to diagnose better and to diagnose more? Clinician-Scientists, patient representatives and other stakeholders explored avenues to improve Ig therapy through mechanistic insights and tailored Ig preparations/products according to patient-specific needs and local exposure to infectious agents, amongst others. Urgency for pandemic preparedness was discussed, as was the threat of shortage of antibiotics and increasing antimicrobial resistance, emphasizing the need for representation of PID patients and other vulnerable populations throughout crisis and care management. Discussion also covered the complexities of PID diagnosis, addressing issues such as global diagnostic disparities, the integration of patient-reported outcome measures, and the potential of artificial intelligence to increase PID diagnosis rates and to enhance diagnostic precision. These proceedings outline the outcomes and recommendations arising from the 2023 IPOPI Global Multi-Stakeholders' Summit, offering valuable insights to inform future strategies in PID management and care. Integral to this initiative is its role in fostering collaborative efforts among stakeholders to prepare for the multiple challenges facing the global PID community.
    MeSH terms: Humans; Global Health*
  10. Nik Azis NM, Abdul Shukor SN, Razali M, Zakaria HY, Zabarulla NZ
    Digit Health, 2024;10:20552076241264154.
    PMID: 39055786 DOI: 10.1177/20552076241264154
    BACKGROUND AND OBJECTIVE: Digital computerized assessment can provide objective values for the measurement of gingival pigmentation. This study aims to compare the Commission Internationale de l'Eclairage Lab color space (CIELAB) values and the computerized intensity values (CIVs) from digital imaging with clinical evaluations using the Dummett-Gupta Oral Pigmentation Index (DOPI) for assessing gingival pigmentation in a multi-ethnic population.

    METHODOLOGY: Digital photographs of 188 participants were taken using standardized parameters. The buccal gingival pigmentation was evaluated using three methods (a) a clinical evaluation by two independent assessors using the DOPI, (b) the CIELAB values using the Adobe Photoshop® software (Version 23.1.1) and (c) the CIV calculated using the ImageJ software (Version 1.53k). A hierarchical clustering analysis was used to identify colour groups that clustered together. Agreement between the clinical and digital categorization of the pigmentation was carried out using weighted kappa analysis. Agreements between CIELAB and CIV were compared using intra-class correlation coefficient.

    RESULTS: There was a statistically significant difference in the DOPI, the L*, a*, and b* coordinates, and the CIV between the different ethnic groups of the participants. Cluster analysis for the CIELAB and CIV both identified four clusters. The gingival pigmentation categorization using the L*, a*, and b* values moderately agreed with the clinical evaluation using the DOPI index while the categorization with the CIV was in slight agreement with the clinical evaluations.

    CONCLUSION: This study identified four clusters of gingival pigmentation in 188 multi-ethnic participants. The clusters, determined by CIELAB values, align with the clinical assessment of gingival pigmentation. Digital measurements derived from clinical photographs can serve as an effective means of pigmentation measurement in dental clinics.

  11. Zhao W, Zhu Y, Wong SK, Muhammad N, Pang KL, Chin KY
    Heliyon, 2024 Jul 15;10(13):e34064.
    PMID: 39055794 DOI: 10.1016/j.heliyon.2024.e34064
    BACKGROUND AND OBJECTIVE: Osteoarthritis (OA) is the most common age-related disease of joints with increasing global prevalence. Persistent inflammation within the joint space is speculated to be the cause of OA. Resveratrol is an anti-inflammatory and antioxidant compound which can influence cartilage metabolism through multiple signalling pathways. This systematic review and meta-analysis aimed to summarize the therapeutic effects of resveratrol in animal models of OA.

    METHODS: A comprehensive literature search was performed using PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, China Wanfang and VIP databases in May 2023. Studies on the effects of resveratrol in animal models of OA written in English or Mandarin, published from the inception of databases until the date of the search were considered.

    RESULTS: Fifteen eligibility studies were included and analysed. Resveratrol was shown to inhibit the secretion of interleukin-1β, tumour necrosis factor-α, interleukin-6, nitric oxide, and apoptosis of articular chondrocytes. Joint structure as indicated by Mankin scores was restored with resveratrol in animal OA models.

    CONCLUSION: Resveratrol is a potential therapeutic agent for OA based on animal studies. Further evidence from well-planned human studies would be required to validate its clinical efficacies.

  12. Qu Y, Chen Y, Tan Z, Han B
    Heliyon, 2024 Jul 15;10(13):e33804.
    PMID: 39055834 DOI: 10.1016/j.heliyon.2024.e33804
    Terrorism refers to the claims and acts that create social panic, endanger public security, infringe upon persons and property, or threaten state organs and organizations to achieve political and ideological goals through violence, sabotage, intimidation and other means. According to the survey, 92 % of the world's countries have been subjected to terrorist attacks to varying degrees, involving South America, the Middle East and North Africa. Since 1970, there have been about 200,000 terrorist incidents worldwide. Global terrorist attacks have a wide range of targets, involving nearly 20 groups, resulting in up to 280,000 deaths and 360,000 injuries. Based on the GTD database, this paper selects the relevant data from 1998 to 2017, and uses the factor analysis model to establish the evaluation index system of terrorist attack harm from the perspective of terrorist attack harm. At the same time, GIS is used for quantitative analysis of the data, and time series model is used for correlation prediction. The results show that the comprehensive evaluation model of terrorist attacks has objectively and accurately evaluated the terrorist attacks in the past 20 years, among which 9/11 incident has the highest degree of harm, followed by the Salam Embassy bombing. The ranking of the harmfulness of the incident is basically consistent with the reports of mainstream media at home and abroad. From the perspective of the global spatial scope of terrorist attacks, terrorist attacks are shifting from North Africa and the Arabian Peninsula to the eastern front, and the Middle East has continued to gather, and the situation of terrorist attacks in the Middle East is not optimistic. At present and for some time to come, international terrorism will remain at a high level, and terrorist attacks will remain concentrated in the Middle East and the Arabian Peninsula.
  13. Mustapha S, Magaji RA, Magaji MG, Gaya IB, Umar B, Yusha'u Y, et al.
    Iran J Basic Med Sci, 2024;27(9):1077-1084.
    PMID: 39055875 DOI: 10.22038/IJBMS.2024.76605.16573
    Interest in naturally occurring phytochemicals has been on the increase, they are believed to reduce the risk of brain disorders. Hispidulin (HN) is a phenolic flavonoid compound with various pharmacological and biological effects on the central nervous system. It belongs to the flavone class of flavonoids. It can be found in different plant materials, especially fruits and vegetables. The literature used in this review was collected from credible scientific databases including ScienceDirect, Scopus, PubMed, Google Scholar, and Hindawi without time restriction, using relevant keywords, such as HN, brain, central nervous system, flavonoids, and flavones. HN was discovered to possess pro-apoptotic properties, act as an antioxidant, inhibit cytokine production and toll-like receptor 4 expression, as well as impede nuclear factor kappa beta and mitogen-activated protein kinase B. HN was also found to inhibit lipid peroxidation in vitro and reduce brain edema in mice. These pharmacological potentials suggest that HN is a promising candidate for neuroprotection in CNS disorders like depression and epilepsy. This review provides an update on the scientific literature concerning how these activities could help provide various forms of neuroprotection in the CNS. Additional experimental data on the effects of HN in models of neurological disorders and neuroprotection should be explored further. Based on the current study, HN is a promising candidate for neuroprotection of the CNS.
  14. Almasri AMH, Hajeer MY, Ajaj MA, Almusawi AOA, Jaber ST, Zakaria AS, et al.
    Cureus, 2024 Jul;16(7):e65339.
    PMID: 39055972 DOI: 10.7759/cureus.65339
    Patient-reported outcome measures (PROMs) have become increasingly important in orthodontic treatment as they reflect patients' perceptions of treatment outcomes. Understanding patient satisfaction with orthodontic treatment is crucial for improving healthcare delivery and patient-centered care. This systematic review aimed to critically appraise the evidence regarding patient satisfaction after orthodontic treatment, exploring the effects of different treatment types, patient demographics, and other factors on satisfaction levels. Eight electronic bibliographic databases were searched without publication time or language restrictions, including PubMed®, Scopus®, the Cochrane Central Register of Controlled Trials, Web of Science™, Embase®, Google™ Scholar, Trip, and OpenGrey. A manual search was conducted on the references in the included papers. Eligibility criteria were established based on the Population, Intervention, Comparison, Outcomes, and Study (PICOS) framework. Studies were included if they reported patient satisfaction levels following orthodontic treatment using standardized questionnaires. Two reviewers independently collected and analyzed the data. The risk of bias was assessed using Cochrane's risk of bias tool (RoB2) for randomized clinical trials, and the methodologic quality for cohort and cross-sectional studies was assessed using the modified version of the Newcastle-Ottawa scale. Fourteen studies employed various questionnaires and timings to gauge post-orthodontic treatment satisfaction. Patient satisfaction levels were generally high, with most studies reporting satisfaction rates above 91%. Fixed orthodontic appliances were associated with higher satisfaction levels compared to removable appliances. While age and gender did not significantly influence satisfaction, the quality of care and doctor-patient relationships were crucial factors in patient satisfaction. This systematic review proves that patient satisfaction with orthodontic treatment is generally high, with fixed appliances and positive doctor-patient relationships contributing to higher satisfaction levels. However, the quality of the evidence was moderate to low, highlighting the need for further high-quality clinical studies in this area.
  15. Gunasekaran K, Singh P, Ng DX, Koh EYL, Lee HY, Tan R, et al.
    Front Public Health, 2024;12:1359929.
    PMID: 39056076 DOI: 10.3389/fpubh.2024.1359929
    OBJECTIVES: Early smoking initiation has been associated with a higher risk of developing long-term smoking habit. There is a growing global consensus that demands raising the minimum legal age (MLA) for smoking as an approach to address this problem. Singapore successfully raised the MLA from 18 to 21 years in 2021. This study aimed to evaluate the awareness and attitude of multi-ethnic Asian youth (aged 15-24) on raising MLA to 21 and passive smoking.

    METHODS: A cross-sectional survey comprising of 23 items was circulated via a secure internet-based platform, FORMSG between September and November 2022. Data were analyzed for descriptive statistics. Categorical variables were compared for association with receptivity toward change in MLA using Chi-Squared test and multivariable logistic regression analysis using Rstudio. Post-hoc Bonferroni correction were further utilized for pairwise comparison.

    RESULTS: Majority (80.3%) of the 608 participants expressed their support for MLA 21 implementation. Participants' age was a significant variable as those aged 15-17 years old (OR = 2.1, 95%CI = 1.01-4.32, p = 0.048) showed a higher likelihood of supporting MLA implementation compared to those aged 21 and above. In addition, majority (89.8%) of them were also aware of the harmful effects of passive smoking. When it came to discouraging smoking among youth, family influence (64%) and school education (55.6%) emerged as the top strategies.

    CONCLUSION: Most of the youth express strong support for raising the MLA to 21, with over 80% in favor of such change, reflects a significant harmony among youth in favor of tobacco-free environment.

    MeSH terms: Adolescent; Age Factors; Cross-Sectional Studies; Female; Humans; Health Knowledge, Attitudes, Practice*; Male; Surveys and Questionnaires; Singapore; Smoking/psychology; Young Adult
  16. Kulin D, Shah A, Fairlie T, Wong RK, Fang X, Ghoshal UC, et al.
    PMID: 39056447 DOI: 10.1111/nmo.14878
    BACKGROUND: This SRMA reviewed and assessed the changes in the severity of disorders of gut-brain interaction (DGBI) symptoms during the COVID-19 pandemic, and evaluated factors associated with symptom severity changes.

    METHODS: Electronic databases were searched until February 2024, for articles reporting on changes in symptom severity in DGBI patients during the COVID-19 pandemic. The proportion of DGBI patients who reported a change in their symptom severity were pooled using a random-effects model, and subgroup analyses were conducted to assess the effect of socio-cultural modifiers on symptom severity in DGBI.

    KEY RESULTS: Twelve studies including 3610 DGBI patients found that 31.4% (95% CI, 15.9-52.5) of DGBI patients experienced symptom deterioration, while 24.3% (95% CI, 10.2-47.5) experienced improvement. Countries with high gross domestic product (GDP) had a 43.5% (95% CI, 16.3-75.2) likelihood of symptom deterioration, compared to 9.2% (95% CI, 1.4-42.2) in lower GDP countries. Similarly, countries with low COVID fatality rates had a 60.1% (95% CI, 19.7-90.3) likelihood of symptom deterioration, compared to 18.3% (95% CI, 7.8-36.9) in higher fatality rate countries. Countries with lenient COVID policies had a 58.4% (95% CI, 14.1-92.3) likelihood of symptom deterioration, compared to 19% (95% CI, 8.2-38.1) in countries with stricter policies. Patients in high vaccine hesitancy countries had a 51.4% (95% CI, 19.5-82.2) likelihood of symptom deterioration, compared to 10.6% (95% CI, 2.7-33.4) in low vaccine hesitancy countries.

    CONCLUSIONS & INFERENCES: This meta-analysis reveals that a significantly higher proportion of DGBI patients experienced deterioration of symptoms during the COVID-19 pandemic. Various sociocultural, economic and environmental factors potentially modify the effects of the COVID-19 pandemic on DGBI.

  17. Sundaraj Y, Abdullah H, Nezhad NG, Rasib AAA, Othman R, Rodrigues KF, et al.
    Curr Issues Mol Biol, 2024 Jul 04;46(7):6960.
    PMID: 39057102 DOI: 10.3390/cimb46070415
    Afiq Adham Abd Rasib and Roohaida Othman were not included as authors in the original publication [...].
  18. Lim MSH, Voon PJ, Ali A, Mohamad FS, Jong LL, Chew LP, et al.
    PLoS One, 2024;19(7):e0296954.
    PMID: 39058692 DOI: 10.1371/journal.pone.0296954
    BACKGROUND: The state of Sarawak on the island of Borneo in East Malaysia, in working towards developing and strengthening cancer services through a holistic patient-centred approach, must focus on the comprehensive needs of cancer patients by taking into account the psycho-social, cultural and spiritual aspects of Sarawak's multi-ethnic, multi-cultural population.

    METHODS: A 42-item survey questionnaire was developed and validated with a total of 443 patients. The perceived importance of information provided and level of patient satisfaction were assessed with a 5-point Likert scale in 10 domains (Diagnosis, Surgery, Radiotherapy, Systemic therapy, Clinical trials, Pain management, Treatment monitoring, Psychosocial support, Sexual care and fertility issues, and Financial support). A Spearman's rank correlation test was applied to determine the correlation between response in both item and domain categories for perceived importance and satisfaction.

    RESULTS: Overall, patients were more satisfied with information related to cancer diagnosis, treatment and surgery but less satisfied with information pertaining to sexual aspects of care and family planning, psycho-social support and financial support. The majority of patients were satisfied with the level of treatment-related information received but preferred the information to be delivered in more easily comprehendible formats. Sexual aspects of care and family planning, psychosocial support and treatment monitoring post-discharge were perceived as important but seldom addressed by health care professionals due to lack of professional counsellors, social workers and clinical nurse specialists. Many patients face financial toxicity following a cancer diagnosis, particularly when diagnosed with advanced cancer requiring complex multi-modality treatment.

    CONCLUSION: Cancer patients in Sarawak have various unmet information needs. Written information and educational videos in local indigenous languages may be more suitable for Sarawak's multi-ethnic population. Sexual aspects of care and family planning are challenging but essential topics to discuss, in particular due to the high prevalence of breast and cervical cancer amongst young women of reproductive age in Sarawak. Financial assessment and information on support services offered by government and non-government organisations should be provided to eligible patients. A holistic needs assessment of each patient at time of diagnosis and support through their cancer journey requires a multi-disciplinary team of medical, nursing and allied health professionals including clinical nurse specialists, pharmacists, counsellors, physiotherapists, occupational therapists, speech and language therapists, dieticians and social workers.

    MeSH terms: Adult; Aged; Borneo; Ethnic Groups; Female; Humans; Male; Middle Aged; Surveys and Questionnaires; Referral and Consultation; Patient Satisfaction*; Young Adult
  19. Low ZX, Teo MYM, Juliana Nordin F, Palanirajan VK, Morak-Młodawska B, Saleem Qazi A, et al.
    PLoS One, 2024;19(7):e0305171.
    PMID: 39058699 DOI: 10.1371/journal.pone.0305171
    Curcuminoids originating from turmeric roots are renowned for their diverse pharmacological applications, particularly as a natural anticancer agent. Unfortunately, harnessing the full potential of curcumin derivatives in cancer therapy has been impeded by its inherent limitations, specifically instabilities owing to poor solubility, leading to low systemic bioavailability under normal physiological circumstances. To circumvent this, a novel organic-based drug delivery system employing physically adsorbed β-cyclodextrin (βCD) as an excipient was developed in this study. This resulted in improved aqueous dispersion coupled with anticancer enhancements of tetrahydrocurcumin (THC) at a molar ratio of 2:1. Encapsulation of this agent was confirmed by physicochemical characterisation using UV-vis spectroscopy, differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and both in vitro and in vivo approaches. Through the presence of an inclusion complex, a higher aqueous dispersion (65-fold) resulting in a higher drug content and an elevated release profile was achieved. Athymic nude (Nu/Nu) mice exposed to this treatment displayed improvements in tumour regression compared to stand-alone agents, consistent with in vitro cytotoxicity assays with an SI value > 10. The inclusion complex further enhanced apoptosis, as well as anti-migration and anti-invasion rates. Mechanistically, this formulation was consistent in terms of caspase 3 activation. Furthermore, the inclusion complex exhibited reduced systemic toxicity, including reduced inflammation in vital organs as examined by hematoxylin and eosin (H&E) staining. This study also revealed a notable sequential reduction in serum levels of tumour markers, including carcinoembryonic antigen (CEA) and mouse Cytochrome P450 1A2 (CYP1A2), correlating with a significant decrease in tumour bulk volume upon treatment commencement. These compelling findings highlight the potential of this formulation to empower insoluble or poorly soluble hydrophobic agents, thus offering promising prospects for their effective utilisation in colorectal cancer (CRC) chemotherapy.
    MeSH terms: Animals; Humans; Mice, Nude; Solubility*; Apoptosis/drug effects; Xenograft Model Antitumor Assays; Cell Line, Tumor; Mice
  20. Cheah MH, Lai PSM, Ong T
    PLoS One, 2024;19(7):e0307919.
    PMID: 39058713 DOI: 10.1371/journal.pone.0307919
    This study aimed to explore the views of healthcare professionals regarding the barriers and facilitators for a Fracture Liaison Service (FLS) in Malaysia. The qualitative study was conducted from February to December 2021 at a tertiary hospital in Malaysia. Doctors, nurses, pharmacists, and policymakers were recruited via purposive sampling. Semi-structured in-depth interviews were conducted until thematic saturation was achieved. Data were transcribed verbatim and analysed using thematic analysis. Thirty participants [doctors (n = 13), nurses (n = 8), pharmacists (n = 8), and policymakers (n = 1)] with 2-28 years of working experience were recruited. Three themes emerged: 1) Current delivery of secondary fracture prevention; 2) Importance of secondary fracture prevention, and 3) FLS sustainability. Some participants reported that the current post-hip fracture care was adequate, whilst some expressed concerns about the lack of coordination and continuity of care, especially in non-hip fragility fracture care. Most participants recognised the importance of secondary fracture prevention as fracture begets fracture, highlighting the need for a FLS to address this care gap. However, some were concerned about competing priorities. To ensure the sustainability of a FLS, cost-effectiveness data, support from relevant stakeholders, increased FLS awareness among patients and healthcare professionals, and a FLS coordinator were required. Training and financial incentives may help address the issue of low confidence and encourage the nurses to take on the FLS coordinator role. Overall, all participants believed that there was a need for a FLS to improve the delivery of secondary fracture prevention. Addressing concerns such as lack of confidence among nurses and lack of awareness can help improve FLS sustainability.
    MeSH terms: Adult; Attitude of Health Personnel; Female; Hip Fractures/prevention & control; Humans; Malaysia; Male; Middle Aged; Qualitative Research; Fractures, Bone; Secondary Prevention
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