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Country perspective on medical tourism: the Malaysian experience

Abd Manaf NH, Hussin H, Jahn Kassim PN, Alavi R, Dahari Z

Leadersh Health Serv (Bradf Engl), 2015;28(1):43-56.
PMID: 25751248 DOI: 10.1108/LHS-11-2013-0038

The study seeks to explore the perception of international patients on Malaysia as a medical tourism destination country, as well as overall patient satisfaction, perceived value and future intention for repeat treatment and services.
Characterization of the first isolate of Klebsiella pneumoniae carrying New Delhi metallo-β-lactamase and other extended spectrum β-lactamase genes from Malaysia

Ahmad N, Hashim R, Shukor S, Mohd Khalid KN, Shamsudin F, Hussin H

J Med Microbiol, 2013 May;62(Pt 5):804-806.
PMID: 23449878 DOI: 10.1099/jmm.0.050781-0
In silico approach for Post-SELEX DNA aptamers: A mini-review

Ahmad NA, Mohamed Zulkifli R, Hussin H, Nadri MH

J Mol Graph Model, 2021 06;105:107872.
PMID: 33765525 DOI: 10.1016/j.jmgm.2021.107872

Aptamers are short oligonucleotides that possess high specificity and affinity against their target. Generated via Systematic Evolution of Ligands by Exponential Enrichment, (SELEX) in vitro, they were screened and enriched. This review covering the study utilizing bioinformatics tools to analyze primary sequence, secondary and tertiary structure prediction, as well as docking simulation for various aptamers and their ligand interaction. Literature was pooled from Web of Science (WoS) and Scopus databases until December 18, 2020 using specific search string related to DNA aptamers, in silico, structure prediction, and docking simulation. Out of 330 published articles, 38 articles were assessed in the analysis based on the predefined inclusion and exclusion criteria. It was found that Mfold and RNA Composer web server is the most popular tool in secondary and tertiary structure prediction of DNA aptamers, respectively. Meanwhile, in docking simulation, ZDOCK and AutoDock are preferred to analyze binding interaction in the aptamer-ligand complex. This review reports a brief framework of recent developments of in silico approaches that provide predictive structural information of ssDNA aptamer.
Fulltext The Role of ISL1 and LHX5 LIM Homeobox Genes in Bladder Tumourigenesis

Akhir MKAM, Choy CS, Abdullah MA, Ghani FA, Veerakumarasivam A, Hussin H

Malays J Med Sci, 2020 Feb;27(1):37-45.
PMID: 32158343 MyJurnal DOI: 10.21315/mjms2020.27.1.4

Introduction: Lin-11, Isl-1 and Mec-3 domains (LIM) homeobox genes are among the most important sub-families of homeobox genes. These genes are thought to play an important role in cancer. In this study, the protein expression of these genes was examined in urothelial carcinoma of the bladder. The expression pattern of Islet-1 (ISL1) and LIM homeobox 5 (LHX5) across different cancer stages and grades, as well as the association between the protein expression of these genes and patient demographics and clinicopathological features, were examined.
Methods: A total of 100 formalin-fixed paraffin-embedded urothelial carcinoma tissues were selected from the Department of Pathology, Hospital Kuala Lumpur and the protein expression of ISL1 and LHX5 was determined using immunohistochemistry.
Results: Positive expression of ISL1 and LHX5 was detected in 94% and 98% of the samples, respectively. There were no distinct LHX5 expression patterns associated with different cancer stages, but the proportion of high-expressing tumours was higher in high-grade tumours. In addition, there was a significant association between the expression of LHX5 and tumour grade. The proportion of tumours expressing high levels of ISL1 was found to be highest in later stage tumours.
Conclusion: The high percentage of tumours expressing both these genes suggests that ISL1 and LHX5 play an important role in bladder tumourigenesis across multiple stages.
Fulltext Palliative brachytherapy to axilla and hypopharynx in elderly patient with hypopharyngeal squamous cell carcinoma - case report

Appalanaido GK, Shukor SA, Fan AS, Chong SE, Hussin H, Karim NKA, et al.

Rep Pract Oncol Radiother, 2021;26(4):647-653.
PMID: 34434581 DOI: 10.5603/RPOR.a2021.0076

Brachytherapy (BT) is an important local treatment of tumor and it can be applied to different anatomical sites either in a curative or palliative setting. BT can deliver large dose of radiation to the tumor while sparing the surrounding normal tissue which translates into a better therapeutic ratio compared to external beam radiotherapy. However, the evidence for the use of brachytherapy in the palliative setting is lacking in the literature. In this case report, we describe the brachytherapy technique and outcome of a patient with squamous cell carcinoma of the hypopharynx who underwent palliative brachytherapy to the hypopharynx and metastatic tumor at the right axilla.
Fulltext Data for the potential gold mineralization mapping with the applications of Electrical Resistivity Imaging and Induced Polarization geophysical surveys

Arifin MH, Kayode JS, Izwan MK, Zaid HAH, Hussin H

Data Brief, 2019 Feb;22:830-835.
PMID: 30766903 DOI: 10.1016/j.dib.2018.12.086

To identify the potential zones for gold mineralization at the Felda Chiku 3, Gua Musang, Kelantan, East coast Malaysia, twenty-one (21) geophysical survey lines were conducted at the proposed mineral exploration site using the pole - dipole of the electrical resistivity and induced polarization arrays to get the maximum depth of 150 m with 400 m survey length. From the resistivity and chargeability concentration maps, the potential mineralized zones as delineated, was observed to be dominantly concentrated towards the southwest and northern part of the area. The 3D resistivity and chargeability slice model present low resistivity values and high chargeability values that are well correlated which is palpable especially at the depths of 25 m and 50 m respectively. The data showed that the potential mineralized zones are trending approximately north-south directions. Forty (40) drilling locations were proposed for follow-up drilling based on the resistivity and chargeability models.
Fulltext Comparison of Mast Cell Density and Prognostic Factors in Invasive Breast Carcinoma: A Single-Centre Study in Malaysia

Awang Ahmad N, Lai SK, Suboh R, Hussin H

Malays J Med Sci, 2023 Oct;30(5):81-90.
PMID: 37928785 DOI: 10.21315/mjms2023.30.5.7

BACKGROUND: Mast cells influence tumour growth, neo-angiogenesis and the propensity for metastasis by contributing to innate and adaptive immune responses in the tumour microenvironment. The number of mast cells has increased in various malignant tumours and their abundance has been associated with either a favourable or unfavourable prognosis. This study investigated the significant difference in stromal mast cell density among multiple prognostic factor groups in invasive breast carcinoma.
METHODS: CD117 (c-KIT) antibodies were used to stain 160 formalin-fixed and paraffin-embedded invasive breast carcinoma tissues to demonstrate the presence of mast cells. Then the labelled mast cells were counted in 10 fields at 400× magnification and the mean value was used to represent the mast cell density.
RESULTS: The demographic distribution revealed that most patients were 40 years old or older (92.5%) and of Malay ethnicity (66.3%). With regard to prognostic factors, the most prevalent subtype was invasive carcinoma of no special type (80.6%), followed by tumour grade 3 (41.3%), T2 tumour size (63.1%), N0 lymph node stage (51.3%), presence of lymphovascular invasion (59.4%), positive oestrogen (64.4%) and progesterone receptors (53.1%), and negative human epidermal growth factor receptor 2 (HER2) expression (75.0%). However, there was no significant difference in stromal mast cell density among the different demographic and prognostic factor groups in invasive breast carcinoma.
CONCLUSION: The findings from this study suggest that stromal mast cells do not play a significant role in preventing or promoting tumour growth in invasive breast carcinoma.
Differential Protein Expression Patterns of HOXA13 and HOXB13 Are Associated with Bladder Cancer Progression

Chin FW, Hussin H, Chau DM, Ong TA, Yunus R, Abdul Razack AH, et al.

Diagnostics (Basel), 2023 Aug 09;13(16).
PMID: 37627895 DOI: 10.3390/diagnostics13162636

Bladder cancer is a common urological cancer and has the highest recurrence rate of any cancer. The aim of our study was to profile and characterize the protein expression of homeobox A13 (HOXA13) and homeobox B13 (HOXB13) genes in Malaysian bladder cancer patients. The protein expression of HOXA13 and HOXB13 in formalin-fixed paraffin-embedded (FFPE) bladder cancer tissues was determined by immunohistochemistry (IHC) analysis. The association between HOXA13/HOXB13 protein expression and demographic/clinicopathological characteristics of the bladder cancer patients was determined by chi-square analysis. Approximately 63.6% of the bladder cancer tissues harbored high HOXA13 expression. High HOXA13 expression was significantly associated with non-muscle invasive bladder cancer, lower tumor grade, higher number of lymph node metastases, and recurrence risk. In contrast, low HOXB13 expression (including those with negative expression) was observed in 71.6% of the bladder cancer tissues analyzed. Low HOXB13 expression was significantly associated with muscle-invasive bladder cancer, higher tumor stage, tumor grade, and metastatic risk. Both HOXA13 and HOXB13 protein expression were found to be associated with bladder tumorigenesis. The putative oncogenic and tumor suppressive roles of HOXA13 and HOXB13, respectively, suggest their potential utility as biomarkers in bladder cancer.
Fulltext Myeloid sarcoma of the urinary bladder with cutaneous tumour seeding after percutaneous suprapubic catheterization

Geok Chin T, Masir N, Noor Hussin H, Mohd Sidik S, Boon Cheok L, Yean T

Malays J Pathol, 2011 Jun;33(1):47-51.
PMID: 21874752 MyJurnal

Myeloid sarcoma (MS) is a rare extramedullary myeloid tumour. It has been reported in various sites, including lymph node, bone, skin, soft tissue, various organs and the CNS. It may precede or occur concurrently with acute myeloid leukemia. Urinary bladder involvement is extremely uncommon. We report a 70-year-old female who had MS of the urinary bladder, presented with frank and persistent hematuria associated with lower abdominal pain. She subsequently had tumour seeding in the abdominal skin via percutaneous suprapubic catheter. Tumours from both the urinary bladder and skin showed immature cells that were immunoreactive toward LCA (focal), MPO (strong), CD99 (weak) and CD117 (weak). Summary of cases in the literature is presented. The potential of its misdiagnosis and the useful markers for the diagnosis of MS are discussed.
Fulltext Effects of gate stack structural and process defectivity on high-k dielectric dependence of NBTI reliability in 32 nm technology node PMOSFETs

Hussin H, Soin N, Bukhori MF, Hatta SW, Wahab YA

ScientificWorldJournal, 2014;2014:490829.
PMID: 25221784 DOI: 10.1155/2014/490829

We present a simulation study on negative bias temperature instability (NBTI) induced hole trapping in E' center defects, which leads to depassivation of interface trap precursor in different geometrical structures of high-k PMOSFET gate stacks using the two-stage NBTI model. The resulting degradation is characterized based on the time evolution of the interface and hole trap densities, as well as the resulting threshold voltage shift. By varying the physical thicknesses of the interface silicon dioxide (SiO2) and hafnium oxide (HfO2) layers, we investigate how the variation in thickness affects hole trapping/detrapping at different stress temperatures. The results suggest that the degradations are highly dependent on the physical gate stack parameters for a given stress voltage and temperature. The degradation is more pronounced by 5% when the thicknesses of HfO2 are increased but is reduced by 11% when the SiO2 interface layer thickness is increased during lower stress voltage. However, at higher stress voltage, greater degradation is observed for a thicker SiO2 interface layer. In addition, the existence of different stress temperatures at which the degradation behavior differs implies that the hole trapping/detrapping event is thermally activated.
Fulltext A study of negative bias temperature instability (NBTI) in p-MOSFET devices

Hussin, H., Zainudin, M.F.

Pertanika Journal of Science & Technology, 2017;25(101):257-266.
MyJurnal

Negative bias temperature instability (NBTI) is a common phenomenon in a p-channel MOSFET device
under a negative gate-to-source voltage at a high stress temperature. This paper presents the NBTI
characterisation based on different analysis methods and stress conditions on p-MOSFET devices. The
atomic hydrogen concentration is probed at interface, Poly-Si and channel of p-MOSFET under study
using SILVACO TCAD tool. In addition, the behaviour of the permanent and recoverable component
was investigated based on AC stress at different stress conditions using Modelling Interface Generation
(MIG) tool. The results show that increases in temperature, negative voltage stress gate and decreases
in frequency increase the threshold voltage shift, thus enhancing NBTI degradation.
Evaluation of two types of leukocyte removal filters on transfusion dependent thalassaemics

Jamal R, Mazeni NR, Hussin H

Malays J Pathol, 2000 Dec;22(2):79-83.
PMID: 16329539

The advent of leukocyte filters has enabled effective removal of leukocytes from certain blood products thus avoiding many adverse effects of blood transfusion. Many different materials have been incorporated into these filters to achieve >95% leukocyte removal. In this study we evaluated the efficacy of leukocyte removal of two different filters, using actual bedside transfusion settings involving patients with transfusion dependent thalassaemia. Fifty-one transfusion events were randomised to use either a polyurethane filter or a non-woven polyester filter. We found that the two filters achieved 98.4% and 96.2% leukocyte removal respectively (p = 0.022). We also found no significant correlation between pre-filtration white blood cell count and the volume transfused with the efficacy of leukodepletion. No untoward events or transfusion reactions were observed during the study.
Fulltext Development and Testing of a Community-Based Intervention to Address Intimate Partner Violence among Rohingya and Syrian Refugees: A Social Norms-Based Mental Health-Integrated Approach

James LE, Welton-Mitchell C, Michael S, Santoadi F, Shakirah S, Hussin H, et al.

Int J Environ Res Public Health, 2021 11 07;18(21).
PMID: 34770188 DOI: 10.3390/ijerph182111674

Intimate partner violence (IPV) is the leading form of gender-based violence globally and increases during times of conflict and displacement. To reduce IPV and encourage help-seeking, a two-phase community-based intervention was co-designed with Rohingya in Malaysia and Syrians in Lebanon. Three day workshops, utilizing a social norms-based mental health-integrated approach, were implemented for women and men in each country (n = 148). Pre- to post-measures indicated reductions in beliefs about acceptability of violence and rigid gender norms, and improvements in mental health, functioning, coping, and self-efficacy for women and men following workshop participation. Workshop participation was also associated with increased help-seeking intent, for both mental health and IPV (victims and perpetrators). Workshops included community design of poster campaigns to address IPV, which were then tested in each setting using a randomized controlled trial in Malaysia (n = 240) and a matched cluster comparison in Lebanon (n = 260). Women in both settings found IPV less acceptable in the poster condition. Help-seeking preferences were also influenced by the poster for women and men in both countries. This participatory intervention research can provide a roadmap for use in other settings, emphasizing the value of community-generated solutions to IPV among displaced populations.
Fulltext Grades of Poorly Differentiated Clusters are Associated with Lymph Node and the Tumour, Node and Metastasis Stages in Colorectal Carcinoma

Kerisnon Krishnan T, Mohtarrudin N, Wan Yaacob WA, Hussin H

Malays J Med Sci, 2023 Dec;30(6):70-78.
PMID: 38239248 DOI: 10.21315/mjms2023.30.6.8

BACKGROUND: Colorectal carcinoma (CRC) is the third most common cancer globally. In Malaysia, CRC is most prevalent among males and the second most common cancer among females. The CRC arises mainly from the adenocarcinoma sequence. Poorly differentiated clusters (PDCs) and tumour budding (TB) are believed to represent sequential steps in tumour growth. Therefore, this study analysed the association between PDC grades with clinicopathological and demographic characteristics of CRC.
METHODS: A total of 47 CRC cases previously diagnosed by histopathological examination were reviewed for the presence of PDCs and graded accordingly. The association between PDC grades with clinicopathological and demographic characteristics was statistically analysed.
RESULTS: Out of the 47 cases with PDCs, most of them were of grade 3 (G3) (n = 27, 57.4%), followed by grade 2 (G2) (n = 13, 27.7%) and grade 1 (G1) (n = 7, 14.9%). Higher PDC grades (G2 and G3) were mainly observed in higher tumour stage (T); T3 (n = 26, 83.9%), T4 (n = 12, 92.3%), N1 (n = 20, 86.9%), N2 (n = 15, 100%). In addition, there was a significant association between PDC grades with the nodal stage (N) (P = 0.013) and the tumour, node and metastasis (TNM) stages (P = 0.012).
CONCLUSION: The PDC grades are useful for assessing the disease prognosis in CRC. A statistically significant association between PDC grades with N and TNM stages suggested that PDC grades are potential predictive parameters for invasive and metastatic risks in CRC.
Fulltext Colesional cutaneous talaromycosis (penicilliosis) and Kaposi sarcoma in an HIV-infected patient

Lai SK, Tan LJ, Hussin H, Salleh AA, Bakrin IH

Clin Case Rep, 2021 Nov;9(11):e04639.
PMID: 34849222 DOI: 10.1002/ccr3.4639

HIV-infected patients are at high risk of multiple pathologies. Accurate identification of multiple colesional pathologies is critical for the patient management. We report a distinctive case of colesional cutaneous talaromycosis and Kaposi sarcoma. Prudent histopathological examination and judicious use of adjunct diagnostic test are essential for the diagnosis.
Fulltext Characterization of detergent compatible protease from halophilic Virgibacillus sp. CD6

Lam MQ, Nik Mut NN, Thevarajoo S, Chen SJ, Selvaratnam C, Hussin H, et al.

3 Biotech, 2018 Feb;8(2):104.
PMID: 29404232 DOI: 10.1007/s13205-018-1133-2

A halophilic bacterium, Virgibacillus sp. strain CD6, was isolated from salted fish and its extracellular protease was characterized. Protease production was found to be highest when yeast extract was used as nitrogen source for growth. The protease exhibited stability at wide range of salt concentration (0-12.5%, w/v), temperatures (20-60 °C), and pH (4-10) with maximum activity at 10.0% (w/v) NaCl, 60 °C, pH 7 and 10, indicating its polyextremophilicity. The protease activity was enhanced in the presence of Mg2+, Mn2+, Cd2+, and Al3+ (107-122% relative activity), and with retention of activity > 80% for all of other metal ions examined (K+, Ca2+, Cu2+, Co2+, Ni2+, Zn2+, and Fe3+). Both PMSF and EDTA inhibited protease activity, denoting serine protease and metalloprotease properties, respectively. High stability (> 70%) was demonstrated in the presence of organic solvents and detergent constituents, and the extracellular protease from strain CD6 was also found to be compatible in commercial detergents. Proteinaceous stain removal efficacy revealed that crude protease of strain CD6 could significantly enhance the performance of commercial detergent. The protease from Virgibacillus sp. strain CD6 could serve as a promising alternative for various applications, especially in detergent industry.
Immunohistochemical expression of NANOG in urothelial carcinoma of the bladder

Md Akhir MKA, Hussin H, Veerakumarasivam A, Choy CS, Abdullah MA, Abd Ghani F

Malays J Pathol, 2017 Dec;39(3):227-234.
PMID: 29279584 MyJurnal

Urothelial carcinoma is a common malignant neoplasm that has a poor prognosis and a high frequency of recurrence and metastasis. Constant disease surveillance with periodic and long term cystoscopy examination is necessary for management of the disease. However, the monitoring and therapy regimen is expensive, incurring a massive burden to patients and the government. Therefore, the development of specific biomarkers for urothelial carcinoma at an early stage and recurrence detection becomes a priority. Homeobox genes are a family of genes that are involved in tumourigenesis. They might be potential prognostic markers for urothelial carcinoma. The study investigated the expression pattern of NANOG which is one of a homeobox gene in different stages and grades of urothelial carcinoma. NANOG expressions were also correlated with patient demographic factors and clinicopathological parameters. The expression of NANOG in 100 formalin-fixed paraffin-embedded urothelial carcinoma tissues was determined by immunohistochemistry. Immunohistochemistry showed positive expression of NANOG in all specimens with detection in the cytoplasm, nuclei and the nuclear membrane of the cancer cells. The immunohistochemical expression of NANOG increased across stages and grades of the tumour. The expression of NANOG was not significantly associated with demographic factors; gender (p = 0.376), race (p = 0.718) and age (p = 0.058) as well as with most of the clinicopathological parameters; pathological stage (p = 0.144), grade (p = 0.625), lymph node involvement (p = 0.174) and distant metastasis (p = 0.228). However, NANOG expression showed significant correlation with tumour invasion (p = 0.019). We concluded that NANOG might be a potential biomarker for early diagnosis of urothelial carcinoma of the bladder.
Fulltext Distribution and Antifungal Susceptibility Pattern of Candida species at a Tertiary Hospital in Malaysia

Mohamed NA, Pathmanathan SG, Hussin H, Zaini AB

J Infect Dev Ctries, 2018 Feb 28;12(2):102-108.
PMID: 31825911 DOI: 10.3855/jidc.9634

INTRODUCTION: Invasive Candida infections cause significant mortality and morbidity worldwide. Information on recent trends in species distribution and antifungal resistance in local settings is essential.
METHODOLOGY: Yeast isolates identified through standard culture methods throughout 2014 and 2015 from Hospital Ampang, Malaysia were retrospectively studied. The antifungal susceptibility of Candida species was determined using colorimetric broth microdilution method and MIC values interpreted according to CLSI breakpoints.
RESULTS: Out of all the 149 yeast cultures collected, most were from blood (55.7%) and respiratory specimens (33.6%). Candida tropicalis was the most common (28.9%), followed by C. albicans (26.2%), C. parapsilosis (15.4%), C. glabrata (14.1%), Crytococcus neoformans (6.7%), Trichosporon asahi (3.4%), C. krusei (2.0%), C. famata, C. rugose, C. guilliermondii, C. dublinensis and Trichosporon spp. (0.7% each). Occurrence of C. tropicalis in candidaemia cases was significantly associated to presence of an underlying haematological disorder, while C. albicans isolates in blood were significantly found in absence of such disorders. The four most common Candida species isolated showed high susceptibility to amphotericin B (100%), anidulafungin (100%), micafungin (100%), caspofungin (98.4%), flucytosine (98.4%) and voriconazole (84.1%). However, drug susceptibility to itraconazole and fluconazole was comparatively lower (57.9% and 72.2%, respectively). C. glabrata and C. tropicalis were the least susceptible to these azoles.
CONCLUSION: Prevalence of the high number of non-albicans Candida species with slight predominance of C. tropicalis over C. albicans was observed. Low susceptibility to itraconazole among C. glabrata and C. tropicalis isolates and to fluconazole among C. glabrata isolates warrants for continued surveillance to monitor emerging antifungal resistance.
Development and validation of pan-Leptospira Taqman qPCR for the detection of Leptospira spp. in clinical specimens

Mohd Ali MR, Mohd Safee AW, Ismail NH, Abu Sapian R, Mat Hussin H, Ismail N, et al.

Mol Cell Probes, 2018 04;38:1-6.
PMID: 29524642 DOI: 10.1016/j.mcp.2018.03.001

BACKGROUND: Early diagnosis of leptospirosis is important for ensuring better clinical management and achieving better outcomes. Currently, serological assays suffer from inconsistent performance and are less useful for early diagnosis of leptospirosis. As an alternative, qPCR is more sensitive, specific and able to detect the presence of leptospiral DNA during the acute phase of the infection. Meanwhile, most molecular assays do not detect the non-pathogenic group of Leptospira, even though these groups may also infect humans, although less frequently and less severely.
METHODS: A set of primers and probe targeting rrs genes of 22 Leptospira spp. were designed and evaluated on 31 Leptospira isolates, 41 other organisms and 65 clinical samples from suspected patients.
RESULTS: The developed assay was able to detect as low as 20 fg Leptospira DNA per reaction (equivalent to approximately 4 copies) and showed high specificity against the tested leptospiral strains. No cross amplification was observed with the other organisms. During the evaluation of the confirmed clinical specimens, the developed assay was able to correctly identify all positive samples (n = 10/10). One amplification was observed in a negative sample (n = 1/55). The sequencing of the PCR product of the discordant sample revealed that the sequences were similar to those of L. interrogans and L. kirschneri.
CONCLUSION: The findings suggest that the developed Taqman qPCR assay is sensitive, specific and has potential to be applied in a larger subsequent study.
Hedgehog signalling molecule, SMO is a poor prognostic marker in bladder cancer

Mohd Ariffin K, Abd Ghani F, Hussin H, Md Said S, Yunus R, Veerakumarasivam A, et al.

Malays J Pathol, 2021 Apr;43(1):49-54.
PMID: 33903305

INTRODUCTION: Hedgehog (HH) pathway is an important signalling cascade for growth and patterning during embryonic development. Constitutive activation of Hedgehog pathway can be found in various types of malignancies including medulloblastoma, basal cell carcinoma, gastrointestinal, breast, pancreatic, prostate cancer and leukaemia. Little is known about the expression and role of Hedgehog signalling in bladder cancer.
MATERIALS AND METHODS: The purpose of this study was to investigate the immunohistochemical expression of SMO in 112 bladder cancer cases and determine their association with demographic and clinicopathological parameters. Bladder cancer tissues were obtained from the Hospital Kuala Lumpur.
RESULTS: SMO was expressed in the cytoplasm of all cases of bladder cancer. 6 cases (5.4%) showed low expression, while 106 cases (94.6%) showed high expression. Positive expression of SMO protein was correlated with a few variables which include grade and stage of tumour, lymph node metastasis and distant metastasis. SMO expression showed statistically significant association with higher grade (p=0.001) and higher stage (p=0.042) of bladder cancer. SMO expression also showed borderline association with lymph node metastasis (p=0.056).
CONCLUSION: These findings indicate that SMO expression may be a poor prognostic marker in bladder cancer.

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