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Fulltext Recombinant Production and Characterization of an Extracellular Subtilisin-Like Serine Protease from Acinetobacter baumannii of Fermented Food Origin

Muhammed NS, Hussin N, Lim AS, Jonet MA, Mohamad SE, Jamaluddin H

Protein J, 2021 06;40(3):419-435.
PMID: 33870461 DOI: 10.1007/s10930-021-09986-5

Acinetobacter baumannii is a ubiquitous bacteria that is increasingly becoming a formidable nosocomial pathogen. Due to its clinical relevance, studies on the bacteria's secretory molecules especially extracellular proteases are of interest primarily in relation to the enzyme's role in virulence. Besides, favorable properties that extracellular proteases possess may be exploited for commercial use thus there is a need to investigate extracellular proteases from Acinetobacter baumannii to gain insights into their catalytic properties. In this study, an extracellular subtilisin-like serine protease from Acinetobacter baumannii designated as SPSFQ that was isolated from fermented food was recombinantly expressed and characterized. The mature catalytically active form of SPSFQ shared a high percentage sequence identity of 99% to extracellular proteases from clinical isolates of Acinetobacter baumannii and Klebsiella pneumoniae as well as a moderately high percentage identity to other bacterial proteases with known keratinolytic and collagenolytic activity. The homology model of mature SPSFQ revealed its structure is composed of 10 β-strands, 8 α-helices, and connecting loops resembling a typical architecture of subtilisin-like α/β motif. SPSFQ is catalytically active at an optimum temperature of 40 °C and pH 9. Its activity is stimulated in the presence of Ca2+ and severely inhibited in the presence of PMSF. SPSFQ also displayed the ability to degrade several tissue-associated protein substrates such as keratin, collagen, and fibrin. Accordingly, our study shed light on the catalytic properties of a previously uncharacterized extracellular serine protease from Acinetobacter baumannii that warrants further investigations into its potential role as a virulence factor in pathogenicity and commercial applications.
Efficacy of fasting and calorie restriction (FCR) on mood and depression among ageing men

Hussin NM, Shahar S, Teng NI, Ngah WZ, Das SK

J Nutr Health Aging, 2013;17(8):674-80.
PMID: 24097021 DOI: 10.1007/s12603-013-0344-9

OBJECTIVE: An intervention study on the FCR (Fasting and Calorie Restriction) dietary regime was carried out to determine its efficacy in improving mood states and depression status among ageing men.
SUBJECTS: A total of 32 healthy males (Mean±SD), aged 59.7±6.3 years, with a BMI of 26.7±2.2 kg/m2 were recruited to the study.
METHOD: Participants were randomized to either the FCR group (and were instructed to follow a calorie restricted dietary regime with intermittent fasting) or to the control group (in which individuals were asked to maintain their current lifestyle), for a 3 month period. Mood was assessed using the Profile of Mood States and depression was assessed using Beck Depression Inventory-II and Geriatric Depression Scale-15 at baseline, week 6 and week 12 of the intervention.
RESULTS: A total of 31 subjects completed the study (n=16, FCR and n=15, control). Significant decreases in tension, anger, confusion and total mood disturbance and improvements in vigor were observed in participants in the FCR group compared to the control group (p<0.05). No significant changes in mean depression scores were observed. Weight, BMI and percent body fat were reduced by 3.8%, 3.7% and 5.7% respectively in the FCR group.
CONCLUSIONS: Our findings show that a FCR dietary regime is effective in improving mood states and nutritional status among ageing men.
Fulltext A review of dengue fever incidence in Kota Bharu, Kelantan, Malaysia during the years 1998-2003

Hussin N, Jaafar J, Naing NN, Mat HA, Muhamad AH, Mamat MN

Southeast Asian J. Trop. Med. Public Health, 2005 Sep;36(5):1179-86.
PMID: 16438143

Dengue is the most common and widespread arthropod borne arboviral infection in the world today. It is estimated that there are at least 100 million cases of dengue fever (DF) annually and 500,000 cases of dengue hemorrhagic fever (DHF) which require hospitalization. In Malaysia, it has become a major public health problem. Malaysia recorded 19,544 dengue cases in 1997, the highest recorded since the disease was made notifiable in the country. Of 19,544 cases, 806 were DHF with 50 deaths. The objectives of this analysis were to describe the incidence of dengue fever and dengue hemorrhagic fever in Kota Bharu, Kelantan, Malaysia for the years 1998-2003 and to explore the characteristics of dengue fever and dengue hemorrhagic fever in Kota Bharu, Kelantan, Malaysia for years 1998-2003. A total of 4,716 dengue cases were notified involving 4,476 (94.9%) DF and 240 (5.1%) DHF cases, which increased though the years. The highest incidence was in January (701 or 14.9%), while the lowest was in May (188 or 4.0%). Forty percent of cases (n=1,890) were in the 15-29 year old group. The Majority were Malays (4,062 or 86.1%) and 2,602 or 55.2% were male. A total of 4,477 cases (95%) were local cases and 4,289 or 91% came from the urban area. For priority areas, 3,772 (80%) were from priority 1. More than half the cases had positive serology results. All symptoms occurred in more than 96% of cases and fever was the commonest (99.7%). The mean values for age, temperature, systolic and diastolic blood pressure (BP) were 27.8 +/- 15.4 years, 37.9 +/- 0.90 degrees C, 115 +/- 15.2 mmHg and 73 +/- 11.1 mmHg, respectively. The mean value for the time interval between the onset of symptoms and diagnosis, onset of symptoms and notification and time of diagnosis to notification were 5.1 +/- 2.3, 5.9 +/- 2.5 and 0.8 +/- 1.1 days, respectively. There were associations between the types of dengue and classification, area and priority area. Among the symptoms, the association was only seen in joint pain. The mean significant differences between DF and DHF were found in age and systolic blood pressure. The incidence of dengue in Kota Bharu is comparable to that in Malaysia. The increase in the number of cases needs to be addressed promptly with effective surveillance, prevention and control programs.
Fulltext Leptospirosis incidence and mortality in Malaysia

Tan WL, Soelar SA, Mohd Suan MA, Hussin N, Cheah WK, Verasahib K, et al.

Southeast Asian J. Trop. Med. Public Health, 2016 May;47(3):434-40.
PMID: 27405126

Leptospirosis is endemic in Southeast Asia, Central and South America, the Caribbean, and Oceania. Malaysia was categorized as a probable endemic country without any available data. Thus, this study was conducted to determine incidence, case fatality rate and mortality rate of leptospirosis. Leptospirosis is a notifiable disease in Malaysia since 2010 whereby probable or confirmed cases must be notified to relevant health district office. There were 3,665 and 4,457 probable and laboratory confirmed leptospirosis cases notified in 2012 and 2013, respectively. In the 2-year period, the most common age group of patients was 19 years old or less (23.3%) with male:female ratio of 2.61:1. Students consisted about 16.9% of patients, followed by agriculture-based or plantation workers (14.7%). Overall age-standardized incidence rate of leptospirosis in Malaysia for 2012 and 2013 was 29.02 per 100,000. Overall case fatality rate was 1.47% for 2-year period and overall age-standardized mortality rate was 0.45 per 100,000. Leptospirosis is an emerging public health concern in Malaysia and may pose a significant health impact and burden to the nation in the coming years if not well controlled.
Fulltext All trans-retinoic acid in the treatment of promyelocytic leukaemia--a case report

Hoe TS, Hussin NH, Chum KW, Cheong SK

Med J Malaysia, 1992 Sep;47(3):225-7.
PMID: 1491649

A six year old Chinese boy with relapsed Acute Promyelocytic Leukaemia (APML) failed to respond to reinduction with Daunorubicin and Cytarabine infusion. He was successfully treated with all trans-Retinoic Acid (45 mg/m2/day) orally. After four weeks of treatment, he was in complete remission. The side effects of all trans-Retinoic Acid were negligible.
Fulltext α-Thalassemia with Haemoglobin Adana mutation: prenatal diagnosis

Zainal NZ, Alauddin H, Ahmad S, Hussin NH

Malays J Pathol, 2014 Dec;36(3):207-11.
PMID: 25500521

Thalassaemia carriers are common in the Asian region including Malaysia. Asymptomatic patients can be undiagnosed until they present for their antenatal visits. Devastating obstetric outcome may further complicate the pregnancy if both parents are thalassaemia carriers leading to hydrophic fetus due to haemoglobin Bart's disease. However in certain cases where unexplained hydrops fetalis occur in parents with heterozygous thalassaemia carrier,mutated α genes should be suspected. We report a twenty-nine year old woman in her third pregnancy with two previous pregnancies complicated by early neonatal death at 21 and 28 weeks of gestation due to hydrops fetalis. DNA analysis revealed the patient to have heterozygous (--SEA) α-gene deletion, while her husband has a compound heterozygosity for α(3.7) deletion and codon 59 (GGC → GAC) mutation of the α-gene. This mutation, also known as hemoglobin Adana, can explain hydrops fetalis resulting from two alpha gene deletions from the patient (mother) and a single alpha gene deletion with mutation from the father. The third pregnancy resulted in a grossly normal baby boy with 3 α-gene deletions (HbH disease). We postulate that, in view of heterogenisity of the α-thalassaemia in this patient with severely unstable haemoglobin Adana chains from her husband, there will be a 25% possibility of fetal hydrops in every pregnancy.
Fulltext Bone marrow necrosis preceding infantile acute lymphoblastic leukaemia

Eusni RM, Hamidah Hussin N, Zarina AL, Rahman J

Malays J Pathol, 2007 Dec;29(2):113-7.
PMID: 19108404 MyJurnal

We report a case of bone marrow necrosis preceding infantile acute lymphoblastic leukaemia (ALL). Bone marrow necrosis is a rare antemortem event and has been known to be present in many conditions, notably in haematological malignancies like acute lymphoblastic leukaemia. This case was a 6-month-old Chinese boy who was referred to Hospital Universiti Kebangsaan Malaysia for further investigation of pancytopaenia, high-grade fever, bloody diarrhoea and petechial rashes for one week. His first bone marrow aspirate revealed bone marrow necrosis. His clinical condition improved after ten days. However, his full blood picture then revealed the presence of 5% blast cells. His subsequent marrow 2 weeks later revealed acute lymphoblastic leukaemia (FAB-L1) and immunophenotyping showed precursor B acute lymphoblastic leukaemia-null type. He was started on United Kingdom Acute Lymphoblastic leukaemia (UK ALL) Infantile Leukaemia protocol, however, he defaulted treatment after 3 days. Mode of presentation, mechanism of disease and laboratory investigations and outline of treatment will be discussed.
Characterisation of immunogenotypes of diffuse large B-cell lymphoma

Phang KC, Hussin NH, Abdul Rahman F, Tizen NMS, Mansoor A, Masir N

Malays J Pathol, 2019 Aug;41(2):101-124.
PMID: 31427546

INTRODUCTION: Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive type of non-Hodgkin lymphoma with variable clinical outcomes. The immunogenotypic features of this heterogeneous disease in Malaysia were not well characterized.
MATERIALS & METHODS: In total 141 local series of DLBCL cases from UKM Medical Centre were retrospectively studied.
RESULTS: Of these cases, we classified our patients into two subtypes: 32.7% (37/113) GCB and non-GCB 67.3% (76/113) by Hans algorithm and the results showed strong agreement with the results by Choi algorithm (κ = 0.828, P<0.001). Survival analysis indicated significant difference in between GCB and non-GCB subtypes (P=0.01), elevated serum LDH (P=0.016), age more than 60-year-old (P=0.021) and the presence of B symptoms (P=0.04). We observed 12% DLBCL cases were CD5 positive and 81.8% of them died of the disease (P=0.076). Analysis on the dual expression of MYC/BCL2 revealed that there is no significant difference in DE and non-DE groups (P=0.916). FISH study reported there were 9.22% (13/141) rearranged cases observed in our population at which highest frequency of BCL6 gene rearrangement (76.9%), followed by MYC (15.4%) and BCL2 (7.7%); no BCL10 and MALT-1 gene rearrangement found regardless of using TMAs or whole tissue samples. More cases of MYC protein overexpression observed compared to MYC translocation.
CONCLUSION: Relatively lower frequency of GCB tumours and low gene rearrangement rates were observed in Malaysian population. A national study is therefore warranted to know better the immunogenotypic characteristics of DLBCL in Malaysia and their implications on the survival.
Fulltext Detection of α-thalassaemia in neonates on cord blood and dried blood spot samples by capillary electrophoresis

Alauddin H, Langa M, Mohd Yusoff M, Raja Sabudin RZA, Ithnin A, Abdul Razak NF, et al.

Malays J Pathol, 2017 Apr;39(1):17-23.
PMID: 28413201 MyJurnal

INTRODUCTION: Haemoglobin Bart's (Hb Bart's) level is associated with α-thalassaemia traits in neonates, enabling early diagnosis of α-thalassaemia. The study aimed to detect and quantify the Hb Bart's using Cord Blood (CB) and CE Neonat Fast Hb (NF) progammes on fresh and dried blood spot (DBS) specimen respectively by capillary electrophoresis (CE).

METHODS: Capillarys Hemoglobin (E) Kit (for CB) and Capillarys Neonat Hb Kit (for NF) were used to detect and quantify Hb Bart's by CE in fresh cord blood and dried blood spot (DBS) specimens respectively. High performance liquid chromatography (HPLC) using the β-Thal Short Programme was also performed concurrently with CE analysis. Confirmation was obtained by multiplex ARMS Gap PCR.

RESULTS: This study was performed on 600 neonates. 32/600 (5.3%) samples showed presence of Hb Bart's peak using the NF programme while 33/600 (5.5%) were positive with CB programme and HPLC methods. The range of Hb Bart's using NF programme and CB programme were (0.5-4.1%) and (0.5-7.1%), respectively. Molecular analysis confirmed all positive samples possessed α-thalassaemia genetic mutations, with 23/33 cases being αα/--SEA, four -α3.7/-α3.7, two αα/-α3.7 and three αα/ααCS. Fifty Hb Bart's negative samples were randomly tested for α-genotypes, three were also found to be positive for α-globin gene mutations. Thus, resulting in sensitivity of 91.7% and 88.9% and specificity of 100% for the Capillarys Cord Blood programme and Capillarys Neonat Fast programme respectively.

CONCLUSION: Both CE programmes using fresh or dried cord blood were useful as a screening tool for α-thalassaemia in newborns. All methods show the same specificity (100%) with variable, but acceptable sensitivities in the detection of Hb Bart.
Staphylococcal aureus bacteraemia: Clinical characteristic & evaluation of Prolex Staph Xtra latex agglutination test in the rapid identification of Staphylococcus aureus

Nordin N, Hussin NS, Hanafiah A, Sulong A

Malays J Pathol, 2021 Dec;43(3):435-447.
PMID: 34958065

BACKGROUND: Staphylococcus aureus is a leading cause of community as well as healthcare-associated bacteraemia. This study aimed to describe clinical characteristics of S. aureus bacteraemia (SAB) and to evaluate the performance of the Prolex Staph Xtra Latex agglutination test in the identification of Staphylococcus aureus.
METHODS: Cross-sectional study was conducted from Jun 2018 to May 2019. Isolates from first-positive peripheral blood cultures were tested with Prolex Staph Xtra Latex agglutination test, together with routine tube coagulase and DNase test. All isolates were further confirmed with Vitek2 GP.
RESULTS: Hundred isolates were tested with Prolex Staph Xtra Latex. Twelve isolates were excluded due to incomplete medical records. Eighty-eight isolates were analysed, yielded sensitivities, specificities, positive and negative predictive values of 100%, 91.7%, 98.7%, and 100%, respectively. Of these, 76 were identified as S. aureus and 12 CoNS. Seventy-six patients were included in the SAB analysis. Fifty-nine out of 76 (78.6%) had underlying comorbidities. Thirty-four percent of the episodes were considered as primary SAB. Skin and soft tissue infection were accounted for the highest source of bacteraemia, 24(31.6%). Both MRSA and MSSA bacteraemia were seen mostly among healthcare-associated bacteraemia (HCA) (7/16, 43.8% and 28/60, 46.7%). Liver cirrhosis was significantly associated with MRSA bacteraemia (P=0.048). Metastatic infection & complicated SAB were identified in 13(17.1%) and 30(39.5%) of cases, respectively. All-cause mortality was 22.4%.
CONCLUSION: S. aureus bacteraemia is a serious infection associated with significant metastatic complications and mortality. Prolex Staph Xtra Latex agglutination test has excellent sensitivity and specificity with 100% and 91.7% respectively.
Epidemiology of bloodstream infections in the paediatric population in a Malaysian general hospital over a 2-year period

Subramaniam K, Khaithir TMN, Ding CH, Che Hussin NS

Malays J Pathol, 2021 Aug;43(2):291-301.
PMID: 34448793

BACKGROUND: Bloodstream infection (BSI) is a major cause of morbidity and mortality. The classification of infection into community-acquired, hospital-acquired, and healthcare-associated infection provides an educated guess on the possible aetiological agents and appropriate empirical antimicrobial therapy to be instituted. This study aims to determine the aetiological agents, the antimicrobial susceptibility patterns, and the classification of infections among the paediatric population.
MATERIALS & METHODS: This study was conducted in Hospital Kuala Lumpur, Malaysia from January 2016 to December 2017. A total of 303 isolates were included in this study which was obtained from 238 patients. The patients' microbiological worksheets and medical notes were reviewed to determine the antimicrobial susceptibility patterns, demographic data, classification of infection, and outcome (survival versus death).
RESULTS: Most of the patients were in the age group of one to less than five years old (41%) with 58% male and 85% Malay patients. Common causes of BSI were Staphylococcus aureus (17%), followed by Klebsiella pneumoniae (15%), Acinetobacter baumanii (10%), Pseudomonas aeruginosa (10%), and Escherichia coli (6%). Sixty percent of BSI episodes were caused by gram-negative bacteria, 34% by gram-positive bacteria, and 6% by fungi. Most of the infections were classified as hospital-acquired infections (72%), followed by healthcareassociated (20%) and community-acquired infections (8%). There were 33% of methicillin-resistant Staphylococcus aureus, 53% of extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae, and 33% ESBL producing Escherichia coli. The overall case fatality rate (CFR) was 27% with the highest CFR caused by Serratia marcescens (53.3%).
CONCLUSIONS: The majority of paediatric bloodstream infections are hospital-acquired. Improvement in prevention strategies and revisions in antibiotic policies are important to overcome it.
A Hospital-based Study on the Local Epidemiology of Pneumonia Including the Contribution of Legionella Pneumonia

Lourdesamy Anthony AI, Zam Z, Hussin N

Malays J Med Sci, 2020 Dec;27(6):79-88.
PMID: 33447136 DOI: 10.21315/mjms2020.27.6.8

Background: In real-life practice, only 20% of hospitalised pneumonia cases have an identified etiology. The usage of Legionella urine antigen test (LUAT) in developed nations revolutionised case detection rates. Accordingly, our objectives were to study the microbiological etiology for hospitalised pneumonia patients and the diagnosis of Legionella pneumonia.
Methods: A prospective, observational single-centre study was conducted where all 504 cases that were consecutively admitted for pneumonia were enrolled. Blood and sputum samples obtained were used to identify pathogens using standard microbiological culture methods. The urine samples collected were tested using the ImmunocatchTMLegionella immunochromatographic (ICT) urine antigen test.
Results: A microbiological diagnosis was only achieved in 104 cases (20.6%) and a Gram-negative infection predominance was observed. Culture-positive cases required longer hospitalisation (8.46 days versus 5.53 days; P < 0.001) and the higher usage of antipseudomonal antibiotics (23.1% versus 8.3%; P < 0.001). Only 3 cases (0.6%) were diagnosed with Legionella pneumonia.
Conclusion: The local pathogen distribution is diverse compared to other regions. Culture-negative pneumonia is common and significantly differs from culture-positive pneumonia. Legionella pneumophila serotype 1 is not a common cause of pneumonia and LUAT did not help demystify the cause of culture-negative pneumonia.
Fulltext Experience of short-term hydroxychloroquine and azithromycin in COVID-19 patients and effect on QTc trend

Hor CP, Hussin N, Nalliah S, Ooi WT, Tang XY, Zachariah S, et al.

J Infect, 2020 08;81(2):e117-e119.
PMID: 32474031 DOI: 10.1016/j.jinf.2020.05.058
Fulltext Proposal of a Clinical Decision Tree Algorithm Using Factors Associated with Severe Dengue Infection

Tamibmaniam J, Hussin N, Cheah WK, Ng KS, Muninathan P

PLoS One, 2016;11(8):e0161696.
PMID: 27551776 DOI: 10.1371/journal.pone.0161696

BACKGROUND: WHO's new classification in 2009: dengue with or without warning signs and severe dengue, has necessitated large numbers of admissions to hospitals of dengue patients which in turn has been imposing a huge economical and physical burden on many hospitals around the globe, particularly South East Asia and Malaysia where the disease has seen a rapid surge in numbers in recent years. Lack of a simple tool to differentiate mild from life threatening infection has led to unnecessary hospitalization of dengue patients.

METHODS: We conducted a single-centre, retrospective study involving serologically confirmed dengue fever patients, admitted in a single ward, in Hospital Kuala Lumpur, Malaysia. Data was collected for 4 months from February to May 2014. Socio demography, co-morbidity, days of illness before admission, symptoms, warning signs, vital signs and laboratory result were all recorded. Descriptive statistics was tabulated and simple and multiple logistic regression analysis was done to determine significant risk factors associated with severe dengue.

RESULTS: 657 patients with confirmed dengue were analysed, of which 59 (9.0%) had severe dengue. Overall, the commonest warning sign were vomiting (36.1%) and abdominal pain (32.1%). Previous co-morbid, vomiting, diarrhoea, pleural effusion, low systolic blood pressure, high haematocrit, low albumin and high urea were found as significant risk factors for severe dengue using simple logistic regression. However the significant risk factors for severe dengue with multiple logistic regressions were only vomiting, pleural effusion, and low systolic blood pressure. Using those 3 risk factors, we plotted an algorithm for predicting severe dengue. When compared to the classification of severe dengue based on the WHO criteria, the decision tree algorithm had a sensitivity of 0.81, specificity of 0.54, positive predictive value of 0.16 and negative predictive of 0.96.

CONCLUSION: The decision tree algorithm proposed in this study showed high sensitivity and NPV in predicting patients with severe dengue that may warrant admission. This tool upon further validation study can be used to help clinicians decide on further managing a patient upon first encounter. It also will have a substantial impact on health resources as low risk patients can be managed as outpatients hence reserving the scarce hospital beds and medical resources for other patients in need.

Study site: single ward, in Hospital Kuala Lumpur, Malaysia
Fulltext Seroprevalence of acute dengue in a Malaysian tertiary medical centre

Ding CH, Rashid ZZ, Rahman MM, Khang N, Low WN, Hussin N, et al.

Pak J Med Sci, 2016 Mar-Apr;32(2):495-8.
PMID: 27182269 DOI: 10.12669/pjms.322.9320

The aims of this study were to determine the seroprevalence of acute dengue in Universiti Kebangsaan Malaysia (UKM) Medical Centre and its correlation with selected haematological and biochemical parameters.
Fulltext A two-year review on epidemiology and clinical characteristics of dengue deaths in Malaysia, 2013-2014

Woon YL, Hor CP, Hussin N, Zakaria A, Goh PP, Cheah WK

PLoS Negl Trop Dis, 2016 05;10(5):e0004575.
PMID: 27203726 DOI: 10.1371/journal.pntd.0004575

BACKGROUND: Dengue infection is the fastest spreading mosquito-borne viral disease, which affects people living in the tropical and subtropical countries. Malaysia had large dengue outbreaks in recent years. We aimed to study the demographics and clinical characteristics associated with dengue deaths in Malaysia.

METHODS: We conducted a retrospective review on all dengue deaths that occurred nationwide between 1st January 2013 and 31st December 2014. Relevant data were extracted from mortality review reports and investigational forms. These cases were categorized into children (<15 years), adults (15-59 years) and elderly (≥60 years) to compare their clinical characteristics.

RESULTS: A total of 322 dengue deaths were reviewed. Their mean age was 40.7±19.30 years, half were females and 72.5% were adults. The median durations of first medical contact, and hospitalization were 1 and 3 days, respectively. Diabetes and hypertension were common co-morbidities among adults and elderly. The most common warning signs reported were lethargy and vomiting, with lethargy (p = 0.038) being more common in children, while abdominal pain was observed more often in the adults (p = 0.040). But 22.4% did not have any warning signs. Only 34% were suspected of dengue illness at their initial presentation. More adults developed severe plasma leakage (p = 0.018). More than half (54%) suffered from multi-organ involvement, and 20.2% were free from any organ involvement. Dengue deaths occurred at the median of 3 days post-admission. Dengue shock syndrome (DSS) contributed to more than 70% of dengue deaths, followed by severe organ involvement (69%) and severe bleeding (29.7%).

CONCLUSION: In Malaysia, dengue deaths occurred primarily in adult patients. DSS was the leading cause of death, regardless of age groups. The atypical presentation and dynamic progression of severe dengue in this cohort prompts early recognition and aggressive intervention to prevent deaths.

TRIAL REGISTRATION: National Medical Research Registry (NMRR, NMRR-14-1374-23352).
Resolution of Female Sexual Dysfunction (FSD) Among the Obese Multiethnic Malaysian Women Now a Reality with Bariatric Surgery: a Prospective Pilot Study in Malaysia

Lechmiannandan S, Panirselvam M, Muninathan P, Hussin N, Rajan R, Sidi H, et al.

Obes Surg, 2019 05;29(5):1571-1575.
PMID: 30706310 DOI: 10.1007/s11695-019-03722-w

INTRODUCTION: Female sexual dysfunction (FSD) among the obese women is often under diagnosed and ignored especially in Malaysia, a nation of conservative multiethnic society. There are only a few studies on FSD resolution post-bariatric surgery. The objective was to identify the rate and resolution or improvement of FSD, among obese multiethnic Malaysian women post-bariatric surgery.
MATERIAL AND METHODS: This is a prospective study of women undergoing bariatric surgery, between May 2017 and April 2018. FSD was diagnosed using the Malay version of Female Sexual Function Index (MVFSFI) questionnaire. Patients filled up the questionnaire before and 6 months after surgery. Association between BMI reduction and FSFI score improvement was measured using Fisher's exact test. Outcomes between types of surgery (sleeve gastrectomy and gastric bypass) was compared.
RESULTS: Fifty-two women completed the study. The mean age was 38.77 ± 6.7. There were 44 (84.6%) Malay patients, 7 (13.5%) Indian patients, and 1 (1.9%) Chinese patient. There was a significant reduction in mean BMI, 39.89 ± 6.9 pre-surgery to 30.32 ± 5.4 post-surgery (p value
Quantitative and physical evaluation of patchouli essential oils obtained from different sources of Pogostemon cablin

Hussin N, Mondello L, Costa R, Dugo P, Yusoff NI, Yarmo MA, et al.

Nat Prod Commun, 2012 Jul;7(7):927-30.
PMID: 22908584

Patchouli essential oil can be obtained from fresh, dried and fermented plant material. It is a highly valuable product in the fragrance industry and its quality changes depending upon raw material age and oil storage. In this work, patchouli essential oils derived from different treatments have been subjected to GC-FID quantitative analysis using an internal standard (ISTD) method with response factors (RF). Samples were obtained from i) fresh plants; ii) hydrodistillation of one year mature and fermented plants; iii) hydrodistillation of one year mature plants; iv) commercial products from Indonesia and Malaysia. Linear Retention Indices (LRI) for both polar and non-polar GC-MS analyses were also measured as a tool for qualitative analysis towards a homologous series of C7-C30 n-alkanes. The results obtained confirmed that, in all samples, patchouli alcohol was the main volatile constituent, with higher amount in lab-scale produced oils, compared with commercial samples. Other major compounds, in lab oils and commercial samples respectively, were: delta-guaiene, alpha-guaiene, pogostol, seychellene and alpha-patchoulene. Another 36 compounds were also found.
Fulltext The association between the use of complementary and alternative medicine (CAM) with health-related quality of life (HRQoL) and anthropometric indices among university’s staff

Halib H, Hamdan NA, Hussin N, Shafie N

Malaysian Journal of Public Health Medicine, 2017;17 Special(2):74-81.

Complementary Alternative Medicine (CAM) is broadly used as an adjunct treatment for patients to treat various kinds of disease, prevent disease and to sustain and enhance quality of life of the users. The study is aimed to investigate the association between CAM uses, Health-Related Quality of Life (HRQoL) and anthropometric indices among workers or staffs in Universiti Sultan Zainal Abidin (UniSZA) Gong Badak Campus, Kuala Terengganu. A total of 300 subjects participated in this study and completed the malay version of modified HRQol (SF-12) questionnaires. Anthropometric measurements among the subjects were done. Independent t-test, One-way ANOVA and Pearson correlation were used to test the association and the hypotheses. The prevalence of CAM users was 37.3%. The results showed that bodily pain score domain was significantly higher among non-CAM users. Overall, male had higher Mental Health Composite Score (MCS) score than female. Physical Health Composite Score (PCS) was only correlated negatively with BMI among non-CAM users but negative correlated with body fat percentage in both CAM and non-CAM users. As conclusion, HRQoL had significant negative correlation with body fat percentage among CAM users. No association was found between CAM use and HRQoL scores.
Fulltext Impak kesihatan mental terhadap anggota kesihatan yang juga mangsa banjir di daerah Segamat, Johor

Zaharah, M.S., Hussin, N., Roshelmi, D., Jamsiah, M.

Malaysian Journal of Community Health, 2009;15(3):35-40.
MyJurnal

Introduction : Major flooding that occurred in Segamat District at the end of 2006 and early 2007 was a natural disaster that has left impact on physical and mental well-being of the victims. The aim of this study is to see the impact of the major flooding to the mental health of the health staff in Segamat District.
Methodology : Cross sectional study was conducted among Segamat health staffs who were involved in the major floods. Structured questionnaire was used to assess the mental health status of the victims. Result : There were 119 health staffs from the district health office, Hospital Segamat, dental clinic and Community Nursing School were interviewed in this study. A total of 6.7% respondents claimed to have stress related symptoms with women were more effected than men. Nurses and married respondents were found to be more stressful in this study.
Conclusion : Based on findings, therefore, top management has to pay more attention to the welfare of the health staff, directly or indirectly, in particular on the psychological aspect. By giving emphasis on continuous in-service training and counseling as well as other relevant support, stress-related symptoms could be minimized which in turn lead to higher individual productivity.

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