Advances in neuroimaging techniques, particularly Magnetic Resonance Imaging (MRI), have proved invaluable in detecting structural brain lesions in patients with epilepsy in developed countries. In Malaysia, a few electroencephalography facilities available in rural district hospitals run by trained physician assistants have Internet connections to a government neurological center in Kuala Lumpur. These facilities are more commonly available than MRI machines, which require radiological expertise and helium replacement, which may problematic in Southeast Asian countries where radiologists are found in mainly big cities or towns. We conducted a cross-sectional study over a two year period begining January 2001 on rural patients, correlating EEG reports and MRI images with a clinical diagnosis of epilepsy to set guidelines for which rural patients need to be referred to a hospital with MRI facilities. The patients referred by different hospitals without neurological services were classified as having generalized, partial or unclassified seizures based on the International Classification of Epileptic Seizures proposed by the International League Against Epilepsy (ILAE). The clinical parameters studied were seizure type, seizure frequency, status epilepticus and duration of seizure. EEG reports were reviewed for localized and generalized abnormalities and epileptiform changes. Statistical analysis was performed using logistic regression and area under the curve. The association between clinical and radiological abnormalities was evaluated for sensitivity and specificity. Twenty-six males and 18 females were evaluated. The mean age was 20.7 +/- 13.3 years. Nineteen (43.2%) had generalized seizures, 22 (50.0%) had partial seizures and 3 (6.8%) presented with unclassified seizures. The EEG was abnormal in 30 patients (20 with generalized abnormalities and 10 localized abnormalities). The MRI was abnormal in 17 patients (38.6%); the abnormalities observed were cerebral atrophy (5), hippocampal sclerosis (4), infarct/gliosis (3), cortical dysgenesis (2) and tumors (2). One patient had an arachnoid cyst in the right occipital region. Of the 17 patients with an abnormal MRI, 14 had an abnormal EEG, this difference was not statistically significant. There was no significant associaton between epileptographic changes and MRI findings (p = 0.078). EEG findings were associated with MRI findings (p = 0.004). The association between an abnormal EEG and an abnormal MRI had a specificity of 82.4%, while epileptogenic changes had a specificity of 64.7% in relation to abnormal MRI findings. This meants that those patients in rural hospitals with abnormal EEGs should be referred to a neurology center for further workup and an MRI to detect causes with an epileptic focus.
There is very little data regarding the factors related to intima-media thickness (IMT) of the common carotid artery in normal individuals in those with non-insulin diabetes mellitus and perimenopausal women in Southeast Asian countries. Ultrasound imaging evaluating the carotid artery IMT in those with diabetes and those on hormone replacement therapy (HRT) was performed beginning in August 2000 for a period of nearly two years at the Department of Radiology, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. A total of 153 participants were included. Significant differences between the women on HRT and not on HRT were IMT and systolic blood pressure. When comparing those with non-insulin dependent diabetes mellitus (NIDDM) and normal individuals, the significant differences were IMT, total cholesterol level, systolic blood pressure and diastolic blood pressure. IMT was high in those with NIDDM but not in those on HRT. Both those with NIDDM and those on HRT had associated dyslipidemia and systolic hypertension.
A total of 31 adult patients with moderate and severe head injury were assessed clinically on admission for Glasgow Coma Scale (GCS) and short test of mental status (STMS) on follow-up and compared to their initial and follow up CT scan. Good predictors were admission GCS, midline shift, volume of subdural haemorrhage in the initial CT scan of the brain as well as the presence of post-traumatic hydrocephalus, gliosis and site of gliosis in the follow-up CT scan. There was no direct correlation between the significant predictors on the first CT scan and the follow-up CT scan of the brain.
Headache is a very common patient complaint but secondary causes for headache are unusual. Neuroimaging is both expensive and has a low yield in this group. Most patients with intracranial pathology have clinical features that would raise a "red flag". Appropriate selection of patients with headache for neuroimaging to look for secondary causes is very important. Red flags act as screening tools to help in identifying those patients presenting with headache who would benefit from prompt neuroimaging, and may increase the yield. The aim of this study is to evaluate clinical features in patients with headache using neuroimaging as a screening tool for intracranial pathology. 20 red flags were defined. A retrospective study of 111 patients was performed and the outcomes were divided into positive and negative. Abnormal neuroimaging was present in 39 patients. Results were analysed using the Logistic Regression model. Sensitivity and specificity of red flags were analysed to establish the cut-off point to predict abnormal neuroimaging and a receiver operating characteristic (ROC) curve plotted to show the sensitivity of the diagnostic test. Three red flag features proved to be statistically significant with the p-value of less than 0.05 on both univariate and multivariate analysis. These were: paralysis; papilloedema; and "drowsiness, confusion, memory impairment and loss of consciousness". In addition, if three or more red flags from the list were present, this showed strong indication of abnormal neuroimaging, from cut-off point of ROC curve (area under the curve =0.76).
There is an increasing interest in bioinspired dynamic materials. Abundant illustrations of protein domains exist in nature, with remarkable ligand binding characteristics and structures that undergo conformational changes. For example, calmodulin (CaM) can have three conformational states, which are the unstructured Apo-state, Ca2+-bound ligand-exposed binding state, and compact ligand-bound state. CaM's mechanical response to biological cues is highly suitable for engineering dynamic materials. The distance between CaM globular terminals in the Ca2+-bound state is 5 nm and in the ligand-bound state is 1.5 nm. CaM's nanoscale conformational changes have been used to develop dynamic hydrogel microspheres that undergo reversible volume changes. The current work presents the fabrication and preliminary results of layer-by-layer (LbL) self-assembled Dynamic MicroCapsules (DynaMicCaps) whose multilayered shell walls are composed of polyelectrolytes and CaM. Quasi-dynamic perfusion results show that the DynaMicCaps undergo drastic volume changes, with up to ∼1500% increase, when exposed to a biochemical ligand trifluoperazine (TFP) at pH 6.3. Under similar test conditions, microcapsules without CaM also underwent volume changes, with only up to ∼290% increase, indicating that CaM's bio-responsiveness was retained within the shell walls of the DynaMicCaps. Furthermore, DynaMicCaps exposed to 0.1 M NaOH underwent volume changes, with only up to ∼580% volume increase. Therefore, DynaMicCaps represent a new class of polyelectrolyte multilayer (PEM) capsules that can potentially be used to release their payload at near physiological pH. With over 200 proteins that undergo marked, well-characterized conformational changes in response to specific biochemical triggers, several other versions of DynaMicCaps can potentially be developed.
Computed tomography (CT) perfusion is a new method to diagnose ischaemic stroke especially in developing countries. It identifies the area and is useful to predict the size of final infarction. The aim of this study was to assess cerebral ischaemia with CT perfusion (CTP) among patients with acute ischaemic stroke in Hospital Universiti Sains Malaysia, a tertiary referral centre in a rural setting.
Like many other African countries, incidence of drought is increasing in Nigeria. In this work, spatiotemporal changes in droughts under different representative concentration pathway (RCP) scenarios were assessed; considering their greatest impacts on life and livelihoods in Nigeria, especially when droughts coincide with the growing seasons. Three entropy-based methods, namely symmetrical uncertainty, gain ratio, and entropy gain were used in a multi-criteria decision-making framework to select the best performing General Circulation Models (GCMs) for the projection of rainfall and temperature. Performance of four widely used bias correction methods was compared to identify a suitable method for correcting bias in GCM projections for the period 2010-2099. A machine learning technique was then used to generate a multi-model ensemble (MME) of the bias-corrected GCM projection for different RCP scenarios. The standardized precipitation evapotranspiration index (SPEI) was subsequently computed to estimate droughts from the MME mean of GCM projected rainfall and temperature to predict possible spatiotemporal changes in meteorological droughts. Finally, trends in the SPEI, temperature and rainfall, and return period of droughts for different growing seasons were estimated using a 50-year moving window, with a 10-year interval, to understand driving factors accountable for future changes in droughts. The analysis revealed that MRI-CGCM3, HadGEM2-ES, CSIRO-Mk3-6-0, and CESM1-CAM5 are the most appropriate GCMs for projecting rainfall and temperature, and the linear scaling (SCL) is the best method for correcting bias. The MME mean of bias-corrected GCM projections revealed an increase in rainfall in the south-south, southwest, and parts of the northwest whilst a decrease in the southeast, northeast, and parts of central Nigeria. In contrast, rise in temperature for entire country during most of the cropping seasons was projected. The results further indicated that increase in temperature would decrease the SPEI across Nigeria, which will make droughts more frequent in most of the country under all the RCPs. However, increase in drought frequency would be less for higher RCPs due to increase in rainfall.
This study aimed to investigate the association between socio-demographic factors and designated healthy lifestyle behaviours in a nationally-representative sample of Malaysian adults aged 18 years and above. Secondary data involving 7388 participants aged 18-96 years from the National Health and Morbidity Survey 2019, a national cross-sectional survey, was used in this study. A healthy lifestyle score (0-5 points) was calculated based on five modifiable lifestyle factors: non-smoker, body mass index
In this article, we developed a new higher-order implicit finite difference iterative scheme (FDIS) for the solution of the two dimension (2-D) time fractional Cable equation (FCE). In the new proposed FDIS, the time fractional and space derivatives are discretized using the Caputo fractional derivative and fourth-order implicit scheme, respectively. Moreover, the proposed scheme theoretical analysis (convergence and stability) is also discussed using the Fourier analysis method. Finally, some numerical test problems are presented to show the effectiveness of the proposed method.
Post-radiation large vessel injury has not received as much attention as microvascular irradiation injury. A few studies have shown that common carotid intima-media thickness (IMT) is increased after radiotherapy to the head and neck. However, in most of these studies, the irradiated subjects also had other major risk factors for atherosclerosis. In this study, irradiated subjects with major risk factors such as hypertension, diabetes, history of previous cerebrovascular accident and connective tissue disorder were excluded.
The possibility of achieving many electrons per absorbed photon of sufficient energy by quantum dots (QDs) drives the motivation to build high performance quantum dot solar cells (QDSCs). Although performance of dye-sensitized solar cells (DSCs), with similar device configuration as that of QDSCs, has significantly improved in the last two decades QDSCs are yet to demonstrate impressive device performances despite the remarkable features of QDs as light harvesters. We investigated the fundamental differences in the optical properties of QDs and dyes using DFT calculations to get insights on the inferior performance of QDSCs. The CdSe QDs and the ruthenium bipyridyl dicarboxylic acid dye (N3) were used as typical examples in this study. Based on a generalized equation of state correlating material properties and photoconversion efficiency, we calculated ground and excited state properties of these absorbers at the B3LYP/lanl2dz level of DFT and analyzed them on the basis of the device performance. Five missing links have been identified in the study which provides numerous insights into building high efficiency QDSCs. They are (i) fundamental differences in the emitting states of the QDs in the strong and weak confinement regimes were observed, which explained successfully the performance differences; (ii) the crucial role of bifunctional ligands that bind the QDs and the photo-electrode was identified; in most cases use of bifunctional ligands does not lead to a QD enabled widening of the absorption of the photo-electrode; (iii) wide QDs size distribution further hinders efficient electron injections; (iv) wide absorption cross-section of QDs favours photon harvesting; and (v) the role of redox potential of the electrolyte in the QD reduction process.
Arrays of TiO2 nanotubes (TiO2 NTs) with grassy surfaces were observed on titanium foil anodised at 60 V in fluorinated ethylene glycol (EG) with added hydrogen peroxide (H2O2). The grassy surface was generated by the chemical etching and dissolution of the surface of the TiO2 NTs walls, which was accelerated by the temperature increase on the addition of H2O2 . Upon annealing at 600 °C, the grassy part of the TiO2 NTs was found to consist of mostly anatase TiO2 whereas the bottom part of the anodic oxide comprised a mixture of anatase and rutile TiO2. The TiO2 NTs were then used to reduce hexavalent chromium (Cr(VI)) under ultraviolet radiation. They exhibited a rather efficient photocatalytic effect, with 100% removal of Cr(VI) after 30 min of irradiation. The fast removal of Cr(VI) was due to the anatase dominance at the grassy part of the TiO2 NTs as well as the higher surface area the structure may have. This work provides a novel insight into the photocatalytic reduction of Cr(VI) on grassy anatase TiO2 NTs.
This paper studies the effect of Quranic therapy on psychological diseases and spiritual diseases. The experiments have been conducted on a random sample with 121 patients from both genders. The procedures that have been followed were different sessions with the patients, who were given some verses from the Holy Quran to listen within a specific period of time. After that, each patient was given a remedy program. This study aimed to measure the effectiveness and responsiveness of patients to receive treatment through Quran. This study highlighted the employment of a quantitative research, which achieved its objective through validity and reliability. The results of the effectiveness factor came after ability and willingness and gave a result of 92.6% for those who support the contention that the Quran has a significant healing influence. Also, some of the patients who regularly attended Quranic therapy sessions have been successfully cured, 81.8% of the sample believe that Quranic therapy sessions support their health needs. This study has empirically proved that the sound of the Holy Quran is an effective treatment for those who suffer from spiritual and psychological issues. Folk medicine and other traditional methods of treatment are important field of study that require further investigation. The study also illustrates that it's highly important for patient to have confidence in his doctor or healer. Furthermore, our results show that the ability and willingness positively and significantly are related to the effectiveness and responsiveness, also effectiveness positively and significantly related to the responsiveness. Therefore, the patients satisfied to receive treatment through Quran and they have the ability and willingness to do so as they believe that Quran is an essential part of their life.
A chronology of mathematical models for heat and mass transfer equation is proposed for the prediction of moisture and temperature behavior during drying using DIC (Détente Instantanée Contrôlée) or instant controlled pressure drop technique. DIC technique has the potential as most commonly used dehydration method for high impact food value including the nutrition maintenance and the best possible quality for food storage. The model is governed by the regression model, followed by 2D Fick's and Fourier's parabolic equation and 2D elliptic-parabolic equation in a rectangular slice. The models neglect the effect of shrinkage and radiation effects. The simulations of heat and mass transfer equations with parabolic and elliptic-parabolic types through some numerical methods based on finite difference method (FDM) have been illustrated. Intel®Core™2Duo processors with Linux operating system and C programming language have been considered as a computational platform for the simulation. Qualitative and quantitative differences between DIC technique and the conventional drying methods have been shown as a comparative.
The validity of using rainfall characteristics as lumped parameters for investigating the pollutant wash-off process such as first flush occurrence is questionable. This research study introduces an innovative concept of using sector parameters to investigate the relationship between the pollutant wash-off process and different sectors of the runoff hydrograph and rainfall hyetograph. The research outcomes indicated that rainfall depth and rainfall intensity are two key rainfall characteristics which influence the wash-off process compared to the antecedent dry period. Additionally, the rainfall pattern also plays a critical role in the wash-off process and is independent of the catchment characteristics. The knowledge created through this research study provides the ability to select appropriate rainfall events for stormwater quality treatment design based on the required treatment outcomes such as the need to target different sectors of the runoff hydrograph or pollutant species. The study outcomes can also contribute to enhancing stormwater quality modelling and prediction in view of the fact that conventional approaches to stormwater quality estimation is primarily based on rainfall intensity rather than considering other rainfall parameters or solely based on stochastic approaches irrespective of the characteristics of the rainfall event.
Minor head injury in a developing country like Malaysia is managed by primary care physicians and/or medical assistants in district hospitals. These patients are seen initially in their local hospitals, which have at least an X-ray machine for the purpose of screening. This study aimed to guide these physicians to manage these patients at a primary care level. A cross-sectional study was conducted and the study revealed significant predictors of significant computed tomographic (CT) findings. The presence of a Glasgow coma scale (GCS) score of 14 or 13 was associated with the risk of developing significant CT findings compared to patients with a GCS of 15 (p<0.001). Thirty-seven out of 50 patients with GCS of 14 or 13 developed clinically significant brain injury on CT scan. Similarly, the presence of skull fracture was associated with the risk of developing CT abnormalities (p<0.001). Forty-two out of 51 patients with skull fracture developed clinically significant CT findings. Vomiting was associated with developing CT abnormalities (p=0.017). Twenty-seven out of 40 patients with vomiting showed significant CT findings. Soft tissue injury was also found to be associated with developing CT abnormalities (p=0.007). Therefore, we propose reclassifying minor head injury based on the GCS score. Patients with a GCS score of 15 were classified as having mild head injury, while patients with a GCS score of 13 or 14 were at higher risk of developing brain injury and therefore categorized as high risk mild head injury. This group requires emergency CT scan examination, especially when associated with non-motor vehicle accidents, abnormal central nervous system (CNS) examination, craniofacial injuries or skull fractures. They should be referred to a general surgical unit which can treat head injuries or a neurosurgical tertiary centre.
Hepcidin is a principal regulator of iron homeostasis and its dysregulation has been recognised as a causative factor in cancers and iron disorders. The strategy of manipulating the presence of hepcidin peptide has been used for cancer treatment. However, this has demonstrated poor efficiency and has been short-lived in patients. Many studies reported using minihepcidin therapy as an alternative way to treat hepcidin dysregulation, but this was only applied to non-cancer patients. Highly conserved fish hepcidin protein, HepTH1-5, was investigated to determine its potential use in developing a hepcidin replacement for human hepcidin (Hepc25) and as a therapeutic agent by targeting the tumour suppressor protein, p53, through structure-function analysis. The authors found that HepTH1-5 is stably bound to ferroportin, compared to Hepc25, by triggering the ferroportin internalisation via Lys42 and Lys270 ubiquitination, in a similar manner to the Hepc25 activity. Moreover, the residues Ile24 and Gly24, along with copper and zinc ligands, interacted with similar residues, Lys24 and Asp1 of Hepc25, respectively, showing that those molecules are crucial to the hepcidin replacement strategy. HepTH1-5 interacts with p53 and activates its function through phosphorylation. This finding shows that HepTH1-5 might be involved in the apoptosis signalling pathway upon a DNA damage response. This study will be very helpful for understanding the mechanism of the hepcidin replacement and providing insights into the HepTH1-5 peptide as a new target for hepcidin and cancer therapeutics.Communicated by Ramaswamy H. Sarma.
Many studies reported that the activation of tumour suppressor protein, p53 induced the human hepcidin expression. However, its expression decreased when p53 was silenced in human hepatoma cells. Contrary to Tilapia hepcidin TH1-5, HepTH1-5 was previously reported to trigger the p53 activation through the molecular docking approach. The INhibitor of Growth (ING) family members are also shown to directly interact with p53 and promote cell cycle arrest, senescence, apoptosis and participate in DNA replication and DNA damage responses to suppress the tumour initiation and progression. However, the interrelation between INGs and HepTH1-5 remains unknown. Therefore, this study aims to identify the mechanism and their protein interactions using in silico approaches. The finding revealed that HepTH1-5 and its ligands had interacted mostly on hotspot residues of ING proteins which involved in histone modifications via acetylation, phosphorylation, and methylation. This proves that HepTH1-5 might implicate in an apoptosis signalling pathway and preserve the protein structure and function of INGs by reducing the perturbation of histone binding upon oxidative stress response. This study would provide theoretical guidance for the design and experimental studies to decipher the role of HepTH1-5 as a potential therapeutic agent for cancer therapy. Communicated by Ramaswamy H. Sarma.
The COVID-19 pandemic affected everyone's lives and general well-being worldwide, including young adults. Young adulthood is marked by a shift in various social areas including acquiring financial independence. As the pandemic was an exceptional scenario in all nations, there is a research gap in analysing how it would affect financial experiences of young adults, particularly the Muslim young adults. These individuals may face financial stress as a result of the COVID-19 pandemic due to their high level of financial strain. Furthermore, little is still known about the role that religiosity may play in the relationship between the financial strain and financial stress, notably during the pandemic. The objectives of this study were to examine the level of financial strain and financial stress of Muslim young adults, assess the effect of financial strain on financial stress of Muslim young adults and investigate the moderating effect of religiosity on the relationship between Muslim young adults' financial strain and financial stress during the COVID-19 pandemic. A survey of 230 Muslim young adults was conducted in Malaysia. Results showed that thirty percent of Muslim young adults fell under high level of financial strain while majority of them fell under high level of financial stress. Additionally, financial strain had a significant positive effect on the financial stress of Muslim young adults. This means that the more financially strained, the more Muslim young adults experienced financial stress during the COVID-19 pandemic. Religiosity, however, did not moderate the relationship between financial strain and financial stress. These results highlighted the significance of comprehending the level of financial strain and financial stress experienced by Muslim young adults during the COVID-19 pandemic. The results provided relevant parties insights in developing strategies for Muslim young adults to manage financial strain and financial stress to reduce the negative effect of the COVID-19 pandemic.