Browse publications by year: 2024

  1. Wong PL, Zolkeflee NKZ, Ramli NS, Tan CP, Azlan A, Abas F
    J Tradit Complement Med, 2024 Jul;14(4):456-466.
    PMID: 39035686 DOI: 10.1016/j.jtcme.2024.02.001
    BACKGROUND AND AIM: Interest in the safety of herbal medicine is growing rapidly regarding knowledge and challenges in natural products. Hence, this study aimed to reveal the toxicological profile of Ardisia elliptica, a traditional medicinal plant used in the treatment of various illnesses.

    EXPERIMENTAL PROCEDURE: Acute toxicity study was performed on female and male Sprague Dawley rats with a single oral administration of 2000 mg/kg BW of 70% ethanolic A. elliptica leaf extract, using a combination of conventional investigations and 1H-NMR-based metabolomics approaches.

    RESULTS: Physical, hematological, biochemical, and histopathological assessments demonstrated the usual rat profile, with no mortality and delayed toxicity 14 days after administration. 1H NMR serum metabolomics depicted similar metabolites between normal and treated groups. Nevertheless, 1H NMR of urinary metabolomics revealed perturbation in carbohydrate, amino acid, and energy metabolism within 24h after extract administration, while no accumulation of toxic biomarkers in the collected biological fluids on Day 14. A minor gender-based difference revealed the influence of sex hormones and different energy expenditure on response to extract treatment.

    CONCLUSION: This study suggested that 2000 mg/kg BW of 70% ethanolic A. elliptica leaf extract is considered as safe for consumption and offered a comprehensive overview of the response of physiological and metabolic aspects applicable to food and herbal product development.

  2. Jerada R, Er-Rakibi A, Cherkani Hassani A, Benzeid H, El Ouardi A, Harhar H, et al.
    J Tradit Complement Med, 2024 Jul;14(4):355-380.
    PMID: 39035692 DOI: 10.1016/j.jtcme.2024.03.012
    Dittrichia viscosa is a perennial herb that has been used for generations in traditional medicine to address a variety of diseases, including diabetes, hypertension, cancer, microbial disorders, inflammatory conditions, and wound healing. The objective of this review is to provide an overview of existing knowledge on D. viscosa with regards to its botanical description, ethnomedicinal uses, and pharmacological properties. Databases such as Scopus, Wiley-Online, PubMed, Springer, Google Scholar, and ScienceDirect were used to select relevant articles based on their title and abstract. The reviewed studies found a strong correlation between D. viscosa's traditional uses and its observed biological effects. Pharmacological research has shown that the essential oils and extracts from D. viscosa possess a variety of biological activities, such as anti-inflammatory, anticancer, antibacterial, antifungal, analgesic, and antioxidant properties. The chemical compounds found in D. viscosa include sesquiterpenes, monoterpenes, flavonoids, and phenolic acids; some of these compounds, such as tometosin and inuviscolide, have been isolated and displayed promising cytotoxic and anti-inflammatory activity. The present review suggests that the pharmacological properties of D. viscosa align well with its ethnomedicinal uses. These findings support the traditional use of D. viscosa in treating various illnesses. Additionally, toxicological examinations of D. viscosa extracts and essential oil have demonstrated the plant's safety, which supports the need for comprehensive pharmacological studies, in vivo studies, and clinical trials to evaluate the best doses for optimal medicinal effects. This work underscores the medicinal value of D. viscosa and its potential in developing new pharmacological agents to address major health challenges like antibiotic resistance and cancers.
  3. Gunasegaran J, Teh YY, Lim CK, Ng SF
    Saf Health Work, 2024 Jun;15(2):129-138.
    PMID: 39035803 DOI: 10.1016/j.shaw.2024.02.005
    The COVID-19 pandemic has led to a significant surge in glove usage, as recommended by the World Health Organization. Despite efforts to ensure the quality and safety of gloves, glove-associated skin diseases such as hand dermatitis have become ubiquitous, particularly among health care workers. This review discusses the prevalence, causes, and risk factors of hand dermatitis, as well as research efforts in medical gloves in the past decade to overcome glove-related hand dermatitis. Research papers from 2013 to 2022 were reviewed, selecting only 49 relevant papers from the Ovid, PubMed, and Scopus databases. The average prevalence of hand dermatitis among health care workers increased from 21.08% to 37.24% upon the impact of the COVID-19 pandemic. The cases are likely due to allergies to latex proteins, rubber additives, and accelerators commonly found in gloves. Using alternatives to latex gloves, such as accelerator-free and latex-free glove options, can help reduce allergy-induced hand dermatitis. Strict hand hygiene practices, such as frequent hand washing and the use of sanitizers, are also contributing factors in contracting hand dermatitis. Over the past decade, glove research advancements have focused mainly on reducing or immobilizing latex proteins. These include the use of biodegradable dialdehyde, sodium alginate, arctigenin, bromelain, papain, UV-LED, prototype photoreactors, and structure-modified nanosilica with silane A174. Two effective hand dermatitis preventive measures, i.e. an additional layer of glove liners and the use of gentle alcohol-based hand sanitizer, were recommended. These advancements represent promising steps towards mitigating hand dermatitis risks associated with glove usage.
  4. Mir SA, Nayak B, Aljarba NH, Kumarasamy V, Subramaniyan V, Dhara B
    ACS Omega, 2024 Jul 16;9(28):30665-30674.
    PMID: 39035919 DOI: 10.1021/acsomega.4c02671
    This study employs a comprehensive approach combining protein retrieval, sequence alignment, and molecular dynamics simulations to investigate the structural dynamics and stability of wild-type KRas and its mutated variants (G12C, G12D, G12V, and G13D). The selected protein structures were retrieved from the Protein Data Bank (PDB) and prepared by using visual molecular dynamics (VMD) software. Sequence alignment using Clustal Omega provided a detailed comparison of the amino acid sequences, focusing on key mutation sites. Molecular dynamics simulations, performed with Gromacs, revealed distinct conformational changes and stability patterns in the wild-type and mutated KRas proteins over 100 ns. Clustering analysis identified higher conformational changes in the second α-helix of the mutated variants. The root-mean-square deviation (RMSD) distribution analysis showed variant-specific conformational dynamics, with G12V and G12D exhibiting slightly higher average RMSD values. Furthermore, clustering and RMSD analyses of specific amino acid residues (12, 13, 51, and 118) highlighted their roles in maintaining overall stability and influencing structural dynamics. The results indicate that mutations at positions 12 and 13 disrupt normal cycling between wild and mutated variants, leading to the persistent activation of KRas. Additionally, principal component analysis (PCA) elucidated unique conformational dynamics in mutated variants. Free energy landscape (FEL) analysis revealed alterations in the thermodynamic stability of mutated variants compared with the wild type. Overall, this study provides a detailed understanding of the structural changes associated with oncogenic mutations in KRas, offering insights crucial for targeted therapeutic strategies in KRas-driven cancers.
  5. Jabeen S, Siddiqui VU, Bala S, Mishra N, Mishra A, Lawrence R, et al.
    ACS Omega, 2024 Jul 16;9(28):30190-30204.
    PMID: 39035949 DOI: 10.1021/acsomega.3c10179
    Green synthesis methods offer a cost-effective and environmentally friendly approach to producing nanoparticles (NPs), particularly metal-based oxides. This study explores the green synthesis of copper oxide nanoparticles using Aloe vera (Aloe barbadensis Miller) leaf extract. The characterization revealed a unique sago-shaped morphology revealed by field-emission scanning electron microscopy and X-ray diffraction analysis. Distinctive metal-oxygen bonds at 521 and 601 cm-1 were confirmed by Fourier-transform infrared (FT-IR) spectroscopy. Furthermore, UV-visible spectroscopy revealed absorbance at 248 nm, suggesting electron transitions across energy bands and varying surface conduction electrons. The band gap value indicated the presence of quantum confinement effects, which were probably caused by the distinctive morphology and surface structure of the biogenic NPs. Additionally, molecular docking studies were carried out against key proteins of Salmonella typhi and Listeria monocytogenes, namely, listeriolysin O (PDB ID: 4CDB), internalin (InlA) (PDB ID: 1O6T), Salmonella effector protein (SopB) (PDB ID: 4DID), and YfdX (PDB ID: 6A07) using AutoDock 4.2. The results revealed binding energies against S. typhi and L. monocytogenes proteins, indicating potential interactions establishing the foundation for further in-depth understanding of the molecular basis underlying the observed antibacterial effects in vitro against S. typhi, Klebsiella pneumoniae, Pseudomonas aeruginosa, and L. monocytogenes. Antibacterial activity evaluation yielded impressive results, with CuO NPs displaying significant activity against S. typhi and L. monocytogenes, exhibiting zones of inhibition values of 13 ± 0.02 and 15 ± 0.04 mm, respectively. Moreover, the CuO NPs demonstrated remarkable photocatalytic efficacy, resulting in the degradation of 77% of the methylene blue dye when exposed to UV irradiation. This study highlighted the potential of green-synthesized CuO NPs derived from A. vera with their unique morphology, interesting spectroscopic properties, and promising antibacterial and photocatalytic activities.
  6. Nazar M, Ahmad A, Hussain SMS, Moniruzzaman M
    ACS Omega, 2024 Jul 16;9(28):30636-30644.
    PMID: 39035979 DOI: 10.1021/acsomega.4c02742
    The use of chemical dispersants to remove oil spills in aquatic environments raises serious concerns, including heightened toxicity and limited biodegradability, which diminish their effectiveness. This study aimed to develop an environmentally friendly formulation by combining two nonionic surfactants (Tween 80, Span 80) with two surface-active ionic liquids (SAILs): 1-butyl-3-methylimidazolium lauroyl sarcosinate [Bmim][Lausar] and choline myristate [Cho][Mys], to remediate crude oil spill. The performance of the formulation was evaluated by its emulsion stability, surface tension, interfacial tension (IFT), and effectiveness. The toxicity and biodegradability of the formulation were also assessed to ensure their safe application in aquatic environments. The formulation (F9) exhibited the most stable emulsion, maintaining stability even after 5 h with a critical micelle concentration (CMC) of 3.52 mM. The efficiency of the formulation in dispersing various crude oils (Arab, Ratawi, and Doba) ranged from 70.12 to 93.72%. Acute toxicity tests conducted on zebrafish demonstrated that the formulation, with an LC50 value of 450 mg L-1, exhibited practically nontoxicity after 96 h. The formulation showed rapid biodegradability, exceeding 60% within a 28-day testing period. This research presents a promising approach for synthesizing the green formulation which can contribute to mitigating the environmental impacts of oil spills and enhancing the efficiency of cleanup operations.
  7. Zainudin NA, Muhamad Ariffin MH
    Cureus, 2024 Jun;16(6):e62754.
    PMID: 39036121 DOI: 10.7759/cureus.62754
    Basilar invagination in a Chiari malformation associated with osteogenesis imperfecta in the pediatric population is a rare entity. We report a case of a seven-year-old female who presented with sudden-onset bilateral spastic quadriplegia and evidence of a basilar invagination on MRI. She underwent emergency decompression of the impinging odontoid via transoral approach followed by posterior wiring and fusion of the C1 and C2 vertebrae. Imaging modalities such as dynamic CT and MRI play a major role in delineating any craniovertebral anomalies and neural impingement not easily identified in plain radiographs. Understanding the complex craniovertebral junction (CVJ) anatomy and the possible causes of such deformities is vital for ensuring proper diagnosis and management of these patients.
  8. Lan X, Sulaiman N
    Cureus, 2024 Jun;16(6):e62758.
    PMID: 39036243 DOI: 10.7759/cureus.62758
    As a complex and multifactorial health problem, obesity results from the interaction of genetic, environmental, dietary, and lifestyle factors. Globally, the increase in obesity and related chronic diseases has been associated with global trade liberalization, rapid urbanization, and economic growth. This article is a narrative literature review on the global obesity problem and explores the global challenges of obesity and strategies to address them. The research methodology included a retrieval of peer-reviewed articles, including PubMed, ScienceDirect, and Google Scholar. Specific search terms like "obesity", "policy", "nutrition", and "global", outline the impact of obesity on global health and social systems, as well as policy effectiveness and gaps that exist. The outcome reveals regional differences in obesity rates and provides an analysis of the policies that countries have implemented to address obesity and their effectiveness, in particular concerning improving the quality of diets and limiting the intake of added sugars. Despite some policies proving effective, the challenge of obesity is far from being fully addressed, necessitating robust international efforts and strategies.
  9. Kamaruzaman F, Ibrahim R, Nik Mohd NK, Mohd Shakri N
    Cureus, 2024 Jun;16(6):e62734.
    PMID: 39036277 DOI: 10.7759/cureus.62734
    The most common benign laryngeal neoplasm in children is a papilloma. Laryngeal papillomatosis is a chronic disease and is rare in children. We report the case of a four-year-old Malay girl in whom chronic laryngeal papillomatosis, most likely acquired vertically during labor, was detected. She presented with hoarseness of voice for three years, and a flexible laryngoscopy examination revealed features of papilloma in the glottis area. The patient underwent direct laryngoscopy followed by excision of mass using the cold instrument. Surgical intervention is the primary treatment modality for laryngeal papillomatosis to maintain airway patency and voice quality.
  10. Hussain S, Gupta G, Shahwan M, Bansal P, Kaur H, Deorari M, et al.
    Noncoding RNA Res, 2024 Dec;9(4):1222-1234.
    PMID: 39036600 DOI: 10.1016/j.ncrna.2024.05.007
    Ferroptosis, a form of regulated cell death, has emerged as a crucial process in diverse pathophysiological states, encompassing cancer, neurodegenerative ailments, and ischemia-reperfusion injury. The glutathione (GSH)-dependent lipid peroxidation pathway, chiefly governed by glutathione peroxidase 4 (GPX4), assumes an essential part in driving ferroptosis. GPX4, as the principal orchestrator of ferroptosis, has garnered significant attention across cancer, cardiovascular, and neuroscience domains over the past decade. Noteworthy investigations have elucidated the indispensable functions of ferroptosis in numerous diseases, including tumorigenesis, wherein robust ferroptosis within cells can impede tumor advancement. Recent research has underscored the complex regulatory role of non-coding RNAs (ncRNAs) in regulating the GSH-GPX4 network, thus influencing cellular susceptibility to ferroptosis. This exhaustive review endeavors to probe into the multifaceted processes by which ncRNAs control the GSH-GPX4 network in ferroptosis. Specifically, we delve into the functions of miRNAs, lncRNAs, and circRNAs in regulating GPX4 expression and impacting cellular susceptibility to ferroptosis. Moreover, we discuss the clinical implications of dysregulated interactions between ncRNAs and GPX4 in several conditions, underscoring their capacity as viable targets for therapeutic intervention. Additionally, the review explores emerging strategies aimed at targeting ncRNAs to modulate the GSH-GPX4 pathway and manipulate ferroptosis for therapeutic advantage. A comprehensive understanding of these intricate regulatory networks furnishes insights into innovative therapeutic avenues for diseases associated with perturbed ferroptosis, thereby laying the groundwork for therapeutic interventions targeting ncRNAs in ferroptosis-related pathological conditions.
  11. Senin MH, Sopian MM, Shaharuddin B, Nasir MJM
    Asian J Transfus Sci, 2024;18(1):35-44.
    PMID: 39036701 DOI: 10.4103/ajts.ajts_176_21
    INTRODUCTION: Blood transfusion warrants written informed consent from the patient. However, patients have poor knowledge regarding blood transfusions as evidenced by nonstandardized information retained by patients from the informed consent discussion. The problem stems from suboptimal patient knowledge on the elements of informed consent. This study describes the development and validation of a new questionnaire to assess the knowledge on informed consent for blood transfusion from the patients' perspective.

    SUBJECTS AND METHODS: The development phase consisted of literature review, small group discussion, expert review meeting, content, and face validity. We evaluated the psychometric properties of Informed Consent for Blood Transfusion Questionnaire (ICBTQ) using reliability test and item response theory among a sample of 95 patients in Hospital Universiti Sains Malaysia.

    RESULTS: ICBTQ was formulated to include sociodemographic and knowledge sections. ICBTQ possessed excellent content validity. The face validity index (FVI) of clarity and comprehension were both 0.97. Thus, the universal FVI was 0.96. One item was added following the advice given by one of the content experts. ICBTQ had excellent face validity. For the validation phase, ICBTQ demonstrated an acceptable Cronbach's Alpha value. One item was omitted in view of low corrected item-total correlation. In the item response theory (IRT) analysis, ICBTQ exhibited good difficulty and discriminatory indexes. Assessments of item-fit indicated that all items of the model were well-fitted.

    CONCLUSIONS: Based on the IRT and reliability analysis, the knowledge section of the ICBTQ was psychometrically valid to be used among patients.

  12. Yuan Y, Shang J, Gao C, Sommer W, Li W
    Eur J Neurosci, 2024 Jul;60(2):4078-4094.
    PMID: 38777332 DOI: 10.1111/ejn.16422
    Although the attractiveness of voices plays an important role in social interactions, it is unclear how voice attractiveness and social interest influence social decision-making. Here, we combined the ultimatum game with recording event-related brain potentials (ERPs) and examined the effect of attractive versus unattractive voices of the proposers, expressing positive versus negative social interest ("I like you" vs. "I don't like you"), on the acceptance of the proposal. Overall, fair offers were accepted at significantly higher rates than unfair offers, and high voice attractiveness increased acceptance rates for all proposals. In ERPs in response to the voices, their attractiveness and expressed social interests yielded early additive effects in the N1 component, followed by interactions in the subsequent P2, P3 and N400 components. More importantly, unfair offers elicited a larger Medial Frontal Negativity (MFN) than fair offers but only when the proposer's voice was unattractive or when the voice carried positive social interest. These results suggest that both voice attractiveness and social interest moderate social decision-making and there is a similar "beauty premium" for voices as for faces.
    MeSH terms: Adolescent; Adult; Brain/physiology; Electroencephalography/methods; Female; Humans; Male; Young Adult
  13. Hatipoğlu Ö, Martins JFB, Karobari MI, Taha N, Aldhelai TA, Ayyad DM, et al.
    J Dent, 2024 Sep;148:105096.
    PMID: 38796090 DOI: 10.1016/j.jdent.2024.105096
    OBJECTIVES: When dental practitioners encounter a defective restoration, they are faced with a crucial decision whether to repair or replace it. This study aims to explore international preferences for repair procedures and the clinical steps taken during the repair process.

    METHOD: An 11-question survey was distributed to dentists across 21 countries via different platforms. The survey comprised two sections: the first included five questions aimed at gathering demographic information, while the second consisted of six questions focusing on participants' practices related to the repair of composite or amalgam restorations A meta-analysis was employed to ascertain the pooled odds ratio of repairing versus replacement. The statistical analysis was carried out using the RevMan 5.3 program and forest plots were generated using the same program to visualize the results.

    RESULTS: The survey was completed by 3680 dental practitioners. The results indicated a strong tendency to repair defective composite restorations (OR: 14.23; 95 % CI: 7.40, 27.35, p < 0.001). In terms of amalgam, there was a significant tendency to replace the restorations (OR: 0.19; 95 % CI: 0.12, 0.30, p < 0.001). When repairing restorations, the most common protocols were etching with orthophosphoric acid and creating an enamel bevel, regardless of the restorative material used.

    CONCLUSION: The findings of this study indicate that there exists a knowledge gap among dental practitioners regarding restoration repair. It is imperative that dental practitioners receive proper education and training on restoration repair, to ensure the usage of adequate protocols and restoration survival.

    CLINICAL SIGNIFICANCE: A significant portion of dental practitioners lack the necessary knowledge and education required for the repair of restorations. Therefore, it is imperative to establish guidelines aimed at enhancing the management of defective restorations, along with protocols for clinical interventions. This includes the incorporation of proper courses in undergraduate, graduate, and continuing education programs.

    MeSH terms: Adult; Cross-Sectional Studies; Dental Amalgam*; Dentists; Female; Humans; Male; Surveys and Questionnaires; Dental Restoration Failure; Practice Patterns, Dentists'/statistics & numerical data; Dental Restoration Repair*
  14. Subramaniam S, Piozzi GN, Kim SH, Khan JS
    Colorectal Dis, 2024 Jul;26(7):1447-1455.
    PMID: 38812078 DOI: 10.1111/codi.17046
    The robotic approach is rapidly gaining momentum in colorectal surgery. Its benefits in pelvic surgery have been extensively discussed and are well established amongst those who perform minimally invasive surgery. However, the same cannot be said for the robotic approach for colonic resection, where its role is still debated. Here we aim to provide an extensive debate between selective and absolute use of the robotic approach for colonic resection by combining the thoughts of experts in the field of robotic and minimally invasive colorectal surgery, dissecting all key aspects for a critical view on this exciting new paradigm in colorectal surgery.
    MeSH terms: Colon/surgery; Colorectal Surgery/methods; Humans; Laparoscopy/methods; Minimally Invasive Surgical Procedures/methods
  15. Shah R, Loo CE, Hanna NM, Hughes S, Mafra A, Fink H, et al.
    J Cancer Policy, 2024 Jun 01;41:100486.
    PMID: 38830535 DOI: 10.1016/j.jcpo.2024.100486
    During the COVID-19 pandemic, countries adopted mitigation strategies to reduce disruptions to cancer services. We reviewed their implementation across health system functions and their impact on cancer diagnosis and care during the pandemic. A systematic search was performed using terms related to cancer and COVID-19. Included studies reported on individuals with cancer or cancer care services, focusing on strategies/programs aimed to reduce delays and disruptions. Extracted data were grouped into four functions (governance, financing, service delivery, and resource generation) and sub-functions of the health system performance assessment framework. We included 30 studies from 16 countries involving 192,233 patients with cancer. Multiple mitigation approaches were implemented, predominantly affecting sub-functions of service delivery to control COVID-19 infection via the suspension of non-urgent cancer care, modified treatment guidelines, and increased telemedicine use in routine cancer care delivery. Resource generation was mainly ensured through adequate workforce supply. However, less emphasis on monitoring or assessing the effectiveness and financing of these strategies was observed. Seventeen studies suggested improved service uptake after mitigation implementation, yet the resulting impact on cancer diagnosis and care has not been established. This review emphasizes the importance of developing effective mitigation strategies across all health system (sub)functions to minimize cancer care service disruptions during crises. Deficiencies were observed in health service delivery (to ensure equity), governance (to monitor and evaluate the implementation of mitigation strategies), and financing. In the wake of future emergencies, implementation research studies that include pre-prepared protocols will be essential to assess mitigation impact across cancer care services.
  16. Hasan MS, Jamaludin MA, Mohd Azman SA, Atan R, Yap MH, Lee ZY, et al.
    Nephrology (Carlton), 2024 Aug;29(8):528-536.
    PMID: 38830816 DOI: 10.1111/nep.14330
    AIM: Despite the superiority of regional citrate anticoagulation (RCA) in continuous renal replacement therapy (CRRT), its application is limited in resource-limited settings. We aim to explore the cost and safety of RCA for CRRT in critically ill patients, compared to usual care.

    METHODS: This prospective observational study included patients requiring CRRT in a tertiary intensive care unit (ICU) from February 2022 to January 2023. They were classified to either the RCA or usual care groups based on the anticoagulation technique chosen by the treating physician, considering contraindications. The CRRT prescription follows the institutional protocol. All relevant data were obtained from the ICU CRRT-RCA charts and electronic medical records. A cost analysis was performed.

    RESULTS: A total of 54 patients (27 per group) were included, with no demographic differences. Sequential Organ Failure Assessment score and lactate levels were significantly higher in the usual care group. The number of filters used were comparable (p = .108). The median filter duration in the RCA group was numerically longer (35.00 [15.50-56.00] vs. 23.00 [17.00-29.00] h), but not statistically significant (p = .253). The duration of mechanical ventilation, vasopressor requirement, and mortality were similar, but the RCA group had a significantly longer ICU stay. The rate of adverse events was similar, with four severe metabolic alkalosis cases in the RCA group. The RCA group had higher total cost per patient per day (USD 611 vs. 408; p = .013).

    CONCLUSION: In this resource-limited setting, RCA for CRRT appeared safe and had clinically longer filter lifespan compared with usual care, albeit the increased cost.

    MeSH terms: Aged; Female; Health Resources/economics; Health Resources/statistics & numerical data; Humans; Intensive Care Units/economics; Male; Middle Aged; Prospective Studies; Acute Kidney Injury/economics; Acute Kidney Injury/therapy
  17. Raman P, Sagadevan Y, Dhanapalan S, Fernandez BJ, Tan SY, Appalasamy JR, et al.
    J Prev (2022), 2024 Aug;45(4):579-609.
    PMID: 38839738 DOI: 10.1007/s10935-024-00782-2
    Cardiovascular diseases are the leading cause of death in middle-income countries such as Malaysia. There is a significant gap in knowledge between cardiovascular disease-related risk assessments and interventions in the Malaysian population. In this scoping review, we have determined the status of cardiovascular research in Malaysia by prioritising lifestyle-related risk assessments and interventions. We searched five electronic databases (Ovid MEDLINE, Cochrane Central Register of Controlled Trials, APA PsychINFO, Embase and Scopus) to identify relevant research articles that had been published. The Joanna Briggs Institute and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews served as a guide for the scoping review. Study selection was made using the Covidence platform, screened, and extracted. Thirty-one studies were included in this review. Studies reviewed reported a significant positive association between physical inactivity, smoking, poor dietary patterns, working hours, clustering of lifestyle risk, and cardiovascular disease risk. Most interventions focused on physical activity and a multimodal lifestyle approach, significantly improving primary and secondary cardiovascular disease-related outcomes. The findings suggest improving lifestyle-related risk assessments and interventions to prevent cardiovascular diseases in this population. It is unclear if these outcomes can translate to higher effectiveness in preventing cardiovascular disease. Nevertheless, intervention using the multifaceted lifestyle approach can improve cardiovascular disease-related outcomes.
    MeSH terms: Humans; Life Style*; Malaysia/epidemiology; Risk Factors; Exercise; Risk Assessment
  18. Noor Mohamad NA, Omar J
    J Obstet Gynaecol Res, 2024 Jul 19.
    PMID: 39030916 DOI: 10.1111/jog.16031
    Cervical cancer is preventable due to effective screening to detect pre-malignant lesion, and vaccination against its causative organism namely human papillomavirus (HPV). This review article described current situation of cervical cancer in Malaysia. There is decreasing cervical cancer incidence in the country, with age-standardized rate of 10.3, versus 14.1 and 7.5 per 100 000 for worldwide and high-income countries, respectively. School-based HPV vaccination is part of national immunization since 2010, with yearly coverage rate of 83%-91%. The figure declined during coronavirus disease-19 pandemic due to scarce vaccine supply and movement-control order, resulting in about 500 000 students missing their course, with catch-up program currently onboard. Opportunistic cervical screening program started in 1960s with cervical smear cytology, which is succeeded by HPV DNA screening since 2020. Cervical cytology remains indispensable  screening method in healthcare facility without access to HPV test kit, and used to triage high-risk HPV positive with abnormal cytology that require urgent colposcopy. Computed tomography is the main imaging modality to assess local and distal extent of cervical cancer. Primary surgical treatment for early-stage cancer is performed by trained gynecologic oncologist, with long waiting list for radiation therapy in locally advanced disease due to limited available public facility. There is restricted access to targeted therapy due to high treatment cost. In conclusion, Malaysia is heading toward cervical cancer elimination through rigorous investment in primary and secondary prevention, and increase in public engagement with the support of government policy enforcement.
  19. Windyga J, Apte S, Frei-Jones M, Fujii T, Lyu CJ, Villarreal Martinez L, et al.
    Eur J Haematol, 2024 Nov;113(5):631-640.
    PMID: 39030946 DOI: 10.1111/ejh.14277
    OBJECTIVES: We aimed to characterise baseline disease and treatment burden in a large population with haemophilia A/B, both with (HAwI/HBwI) and without (HA/HB) inhibitors.

    METHODS: The prospective, non-interventional explorer6 study included patients ≥12 years old with severe HA, severe/moderate HB or HAwI/HBwI of any severity, treated according to local standard of care (excluding previous/current exposure to concizumab or emicizumab). Baseline characteristics and historical clinical data were collected and patient-reported outcomes, including treatment burden, were assessed.

    RESULTS: The explorer6 study enrolled 231 patients with haemophilia (84 HAwI/HBwI) from 33 countries. At baseline, patients with HA/HB treated with prophylaxis had the lowest median annualised bleeding rates (ABRs; 2.0), irrespective of haemophilia type; of these patients, 27.5% (HA) and 31.4% (HB) had target joints. Patients with HAwI/HBwI treated episodically reported the highest treatment burden. Of these patients, 28.5% (HAwI) and 25.1% (HBwI) performed sports activities in the month before screening.

    CONCLUSION: Despite receiving routine clinical care, historical and baseline information from patients enrolled in explorer6 showed that patients with HA/HB treated episodically and patients with HAwI/HBwI had higher ABRs, higher treatment burden and participated in sports less than those with HA/HB treated with prophylaxis. Emerging treatments could be beneficial in addressing these unmet medical needs.

    MeSH terms: Adolescent; Adult; Child; Hemophilia B/complications; Hemophilia B/diagnosis; Hemophilia B/drug therapy; Hemophilia B/epidemiology; Hemophilia B/therapy; Factor VIII/therapeutic use; Female; Hemorrhage/etiology; Hemorrhage/epidemiology; Humans; Male; Middle Aged; Prospective Studies; Severity of Illness Index; Cost of Illness; Disease Management; Young Adult
  20. Rekhi B, Dermawan JK, Fritchie KJ, Zimpfer A, Mohammad TM, Ali FS, et al.
    Virchows Arch, 2024 Dec;485(6):995-1005.
    PMID: 39031200 DOI: 10.1007/s00428-024-03879-5
    With the increasing use of next generation sequencing in soft tissue pathology, particularly in neoplasms not fitting any World Health Organization (WHO) category, the spectrum of EWSR1 fusion-associated soft tissue neoplasms has been expanding significantly. Although recurrent EWSR1::ATF1 fusions were initially limited to a triad of mesenchymal neoplasms including clear cell sarcoma of soft tissue, angiomatoid fibrous histiocytoma and malignant gastrointestinal neuroectodermal tumor (MGNET), this family has been expanding. We herein describe 4 unclassified extra-abdominal soft tissue (n = 3) and bone (n = 1) neoplasms displaying epithelioid and round cell morphology and carrying an EWSR1::ATF1 fusion. Affected were 3 males and 1 female aged 20-56 years. All primary tumors were extra-abdominal and deep-seated (chest wall, mediastinum, deltoid, and parapharyngeal soft tissue). Their size ranged 4.4-7.5 cm (median, 6.2). One patient presented with constitutional symptoms. Surgery with (2) or without (1) neo/adjuvant therapy was the treatment. At last follow-up (8-21 months), 2 patients developed progressive disease (1 recurrence; 1 distant metastasis). The immunophenotype of these tumors is potentially misleading with variable expression of EMA (2 of 3), pankeratin (2 of 4), synaptophysin (2 of 3), MUC4 (1 of 3), and ALK (1 of 3). All tumors were negative for S100 and SOX10. These observations point to the existence of heretofore under-recognized group of epithelioid and round cell neoplasms of soft tissue and bone, driven by EWSR1::ATF1 fusions, but distinct from established EWSR1::ATF1-associated soft tissue entities. Their overall morphology and immunophenotype recapitulate that of the emerging EWSR1/FUS::CREB fusion associated intra-abdominal epithelioid/round cell neoplasms. Our cases point to a potentially aggressive clinical behavior. Recognizing this tumor type is mandatory to delineate any inherent biological and/or therapeutic distinctness from other, better-known sarcomas in the differential diagnosis including sclerosing epithelioid fibrosarcoma.
    MeSH terms: Adult; Bone Neoplasms/genetics; Bone Neoplasms/pathology; Female; Fibrosarcoma/genetics; Fibrosarcoma/pathology; Humans; Male; Middle Aged; Phenotype; Biomarkers, Tumor/analysis; Biomarkers, Tumor/genetics; Activating Transcription Factor 1/genetics; Young Adult
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