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  1. The Impact of Sociological and Environmental Factors for Dengue Infection in Kuala Lumpur, Malaysia
    Adnan RA, Ramli MF, Othman HF, Asha'ri ZH, Ismail SNS, Samsudin S
    Acta Trop, 2021 Apr;216:105834.
    PMID: 33485870 DOI: 10.1016/j.actatropica.2021.105834
    BACKGROUND: Dengue incidence has grown dramatically around the world in recent years. Vector control is the only method to reduce dengue incidence due to the lack of a vaccine available. By understanding the factors contributed to the vector densities such as environmental and sociological factors, dengue prevention and control may succeed.

    OBJECTIVE: This study is aimed at determining the impact of sociological and environmental factors contributing to dengue cases.

    METHODS: The study surveyed 379 respondents with dengue history. The socio-environmental factors were evaluated by chi-square and binary regression.

    RESULT: The chi-square results revealed sociological factors associated between family with dengue experience such as older age (p =0.012), fewer than four people in the household (p= 0.008), working people (p= 0.004) and apartment/terrace houses (p=0.023). Similarly, there is a significant association between respondent's dengue history and houses that are shaded with vegetation (p= 0.012) and the present of public playground areas near the residential (p = 0.011).

    CONCLUSION: The study identified socio-environmental factors that play an important role in the abundance of Aedes mosquitoes and also for the local dengue control measures.

  2. Relationship of psychological symptoms, antipsychotics and social data with psychosocial function in schizophrenia patients in Malaysia
    Norlelawati AT, Kartini A, Norsidah K, Ramli M, Wan Azizi WS, Tariq AR
    Asia Pac Psychiatry, 2015 Mar;7(1):45-53.
    PMID: 23857669 DOI: 10.1111/appy.12089
    INTRODUCTION: The present study investigated the relationship between psychological symptoms and psychosocial function and the role of relevant sociodemographic data and antipsychotic use in the prediction of psychosocial function among multiracial schizophrenia outpatients in Malaysia.
    METHODS: A total of 223 participants were recruited in this cross-sectional study conducted from December 2010 to April 2011. Psychological symptoms were assessed using the Positive and Negative Syndrome Scale whilst the psychosocial function was assessed using the Personal and Social Performance scale. Sociodemographic and treatment variables were gathered through interview or review of the medical records.
    RESULTS: All dimensions of psychosocial functions were inversely correlated with Positive and Negative Syndrome Scale sub-domains. Only the disorganization sub-domain significantly predicts all dimensions of psychosocial function. For social data, body mass index and employment status were significant predictors of all dimensions of psychosocial functions. Typical antipsychotics significantly predict social function negatively as compared to sulpiride (β = -0.152, P = 0.028).
    DISCUSSION: We found that the relationship between psychological symptoms and psychosocial functions were relatively consistent with the findings from the Caucasian population. Additionally, disorganization was the only significant predictor of all dimensions of psychosocial functions. This further emphasized the importance of cognition in psychosocial function. The roles of sulpiride, body mass index and employment status as predictors of psychosocial function were also discussed.
    KEYWORDS: antipsychotics; psychosocial function; schizophrenia; symptoms
    Study site: Psychiatric clinic, Hospital Tengku Ampuan Afzan, Kuantan, Pahang, Malaysia
  3. Fulltext A case of naturally occurring anti-Dia antibody in a young man
    Iberahim S, Noor NHM, Hassan MN, Bahar R, Yusoff SM, Ramli M, et al.
    Asian J Transfus Sci, 2022;16(2):276-279.
    PMID: 36687544 DOI: 10.4103/ajts.ajts_136_21
    The Diego (Di) blood group system comprises 22 antigens located on the band 3 protein, most of which are low-prevalence antigens. The majority of antibodies to Diego system antigens were of clinically insignificant; however anti-Dia, -Dib, -Wra, -ELO and-DISK may cause hemolytic disease of the fetus and newborn (HDFN) and transfusion reaction. We reported a case of naturally occurring of anti-Dia in a young man who presented to our hospital for wound debridement of fingers injury. His serological results were suggestive of anti-Dia antibody, and his molecular blood group showed he has Di (a-b+) antigen. Anti-Dia may be clinically significant. It can cause mild-to-severe HDFN, but there are only infrequent reports of it being clearly implicated in a hemolytic transfusion reaction. We suggest the need for reagent red blood cell panels to include Dia antigen-positive cells in antibody identification tests for our populations.
  4. Fulltext The first Malay database toward the ethnic-specific target molecular variation
    Halim-Fikri H, Etemad A, Abdul Latif AZ, Merican AF, Baig AA, Annuar AA, et al.
    BMC Res Notes, 2015;8:176.
    PMID: 25925844 DOI: 10.1186/s13104-015-1123-y
    The Malaysian Node of the Human Variome Project (MyHVP) is one of the eighteen official Human Variome Project (HVP) country-specific nodes. Since its inception in 9(th) October 2010, MyHVP has attracted the significant number of Malaysian clinicians and researchers to participate and contribute their data to this project. MyHVP also act as the center of coordination for genotypic and phenotypic variation studies of the Malaysian population. A specialized database was developed to store and manage the data based on genetic variations which also associated with health and disease of Malaysian ethnic groups. This ethnic-specific database is called the Malaysian Node of the Human Variome Project database (MyHVPDb).
  5. Haemolytic anaemia precipitated by dengue fever
    Abdullah NH, Mohammad N, Ramli M, Wan Ghazali WS
    BMJ Case Rep, 2019 Aug 28;12(8).
    PMID: 31466966 DOI: 10.1136/bcr-2018-226760
    We reported a case of a woman with no past medical illness who presented with a few days' history of fever, myalgia, arthralgia, hypochromic microcytic anaemia and thrombocytopaenia and who was nonstructural protein 1 antigen (NS1Ag)-positive. Haemolytic anaemia including full blood picture work-up revealed high reticulocyte count and haemolysis with positive direct Coombs test. She was started on prednisolone and was discharged well.
  6. Fulltext The Prevalence of TET2 Gene Mutations in Patients with BCR-ABL-Negative Myeloproliferative Neoplasms (MPN): A Systematic Review and Meta-Analysis
    Chia YC, Islam MA, Hider P, Woon PY, Johan MF, Hassan R, et al.
    Cancers (Basel), 2021 Jun 20;13(12).
    PMID: 34203097 DOI: 10.3390/cancers13123078
    Multiple recurrent somatic mutations have recently been identified in association with myeloproliferative neoplasms (MPN). This meta-analysis aims to assess the pooled prevalence of TET2 gene mutations among patients with MPN. Six databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science and Embase) were searched for relevant studies from inception till September 2020, without language restrictions. The eligibility criteria included BCR-ABL-negative MPN adults with TET2 gene mutations. A random-effects model was used to estimate the pooled prevalence with 95% confidence intervals (CIs). Subgroup analyses explored results among different continents and countries, WHO diagnostic criteria, screening methods and types of MF. Quality assessment was undertaken using the Joanna Briggs Institute critical appraisal tool. The study was registered with PROSPERO (CRD42020212223). Thirty-five studies were included (n = 5121, 47.1% female). Overall, the pooled prevalence of TET2 gene mutations in MPN patients was 15.5% (95% CI: 12.1-19.0%, I2 = 94%). Regional differences explained a substantial amount of heterogeneity. The prevalence of TET2 gene mutations among the three subtypes PV, ET and MF were 16.8%, 9.8% and 15.7%, respectively. The quality of the included studies was determined to be moderate-high among 83% of the included studies. Among patients with BCR-ABL-negative MPN, the overall prevalence of TET2 gene mutations was 15.5%.
  7. Platelet Additive Solutions as an Alternative Storage Medium of Apheresis Platelets to Reduce ABO Antibody Titer for ABO-Incompatibility Platelet Transfusion
    Adzahar S, Hassan MN, Zulkafli Z, Mohd Noor NH, Ramli M, Mohamed Yusoff S, et al.
    Cureus, 2023 Aug;15(8):e44012.
    PMID: 37746385 DOI: 10.7759/cureus.44012
    Introduction Platelet additive solutions (PASs) are nutrient media commonly used to replace and reduce the need for storage plasma. They are an alternative medium to maintain high-quality platelets lasting longer on the shelf for about seven days. Platelets with high titer of ABO antibody can pose a hemolytic transfusion reaction (HTR) risk if units are given across the ABO barrier. The risk of complication is greater when group O platelet is released to non-group O patients. The PAS has been known as a safe medium, where the titer of ABO antibodies is expected to be diluted. In this study, we compared the anti-A and anti-B antibody titers of apheresis platelets in PAS and non-PAS (plasma) as the suspending media. Methods A total of 20 apheresis platelet donors were selected, with seven from blood group A, eight from blood group B, and five from blood group O. The platelets were collected using an Amicus cell separator. They were suspended in PAS and plasma before being stored at a temperature range of 22-24º C. Anti-A (blood group B and O) and Anti-B (blood group A and O) antibody titers were measured and compared between the two suspending media. Wilcoxon signed-rank test is used for statistical analysis, and a p-value <0.05 is considered significant. Results The median titer of the anti-A antibody of apheresis platelets showed a significant difference between suspended in PAS (2.50) and plasma (4.00), p=0.002. Similar findings were also seen with the median titer of the anti-B antibody of apheresis platelet, in which it showed a significant difference between suspended in PAS (2.00) and plasma (4.00), p=0.004. It was observed that there was a significant reduction in both anti-A and anti-B antibody titers in the PAS as compared to the plasma group. Conclusion The decrease in ABO antibody titer in apheresis platelets stored with PAS can be beneficial for patients. This reduces the risk of HTRs if ABO-incompatible platelet units need to be issued. Thus, using PAS as a storage medium significantly improves platelet inventory management without compromising patient safety.
  8. The Blood Donor Deferral Rate and the Reasons for Deferral at a Tertiary Care Teaching Institute in Northeastern Malaysia
    Zahidin MA, Saidin NIS, Ibrahim NA, Mohd Nasir NNA, Abdul Razak NI, Ramli M, et al.
    Cureus, 2024 Feb;16(2):e54954.
    PMID: 38544652 DOI: 10.7759/cureus.54954
    A deferral takes place when donors fail to meet the eligibility criteria for donating blood during their visit to a blood collection site. Deferral periods, which can be either permanent or temporary, are implemented to protect the well-being of both the donor and the recipient. This study aimed to investigate the frequency of deferrals and the various factors contributing to them. A retrospective analysis was conducted at the Transfusion Medicine Unit of Hospital Universiti Sains Malaysia (USM), utilizing data obtained from blood donors during the period from January 2022 to June 2023. The research included a cohort of 18,751 donors who visited our transfusion unit for blood donation. Data, including gender, age, and reasons for deferral, were collected by reviewing the records of donors who were deferred. Descriptive statistics were employed to analyze the data of deferral blood donors. Out of 18,751 blood donors, 3,533 (18.84%) were deferred, consisting of 1,267 males (35.86%) and 2,266 females (64.14%). The age group of 18-25 years accounted for the highest number, comprising 1,875 donors (53.07%). Among the deferred cases, 53.33% were first-time donors, followed by 25.28% regular donors and 21.40% lapsed donors. The deferral of blood donors resulted from various reasons. The most common cause of overall deferral among blood donors was low hemoglobin (38.33%), followed by upper respiratory tract infections (8.38%), chronic medical illness (7.08%), and high blood pressure (7.02%). Temporary deferrals were more prevalent than permanent deferrals, accounting for 91.57% of cases compared to 8.43% for permanent deferrals. Voluntary non-remunerative blood donors constitute the backbone for a safe and reliable blood supply in transfusion services. Utilizing a comprehensive database will enable effective counseling of temporarily deferred donors, providing insights into the reasons for their deferral, the expected duration, and the appropriate treatments. This information is crucial for motivating these donors to recruit again in the donor pool. Public education initiatives aimed at raising awareness about the causes of deferral and promoting regular health check-ups can play a pivotal role in minimizing these deferrals.
  9. Hematological Profile of Hb Adana Among High School Students in Northeast Peninsular Malaysia
    Siti Asmaa MJ, Miin Phoon L, Zakaria NA, Hussin S, Bahar R, Hassan MN, et al.
    Cureus, 2024 Mar;16(3):e57353.
    PMID: 38694420 DOI: 10.7759/cureus.57353
    Background Hb Adana is a non-deletional alpha (α)-thalassaemia variant resulting from mutations in α1- or α2-globin codon 59 (αCD59), leading to the production of unstable α-globin. Clinical manifestations can vary from silent carrier status to dependence on blood transfusions, hepatosplenomegaly, skeletal deformities, and spinal cord compression. Despite the significance of Hb Adana inheritance, studying this variant poses challenges due to the scarcity of molecular tests and the potential for routine diagnoses to be overlooked. This study aims to investigate the prevalence of Hb Adana among local high school students and assess the hematological parameters and hemoglobin analysis of Hb Adana in Malaysia. Methodology This retrospective study analyzed 13,721 blood samples collected from high school students participating in Malaysia's National Thalassaemia Screening Program at Hospital Raja Perempuan Zainab II (HRPZ II). Deletional α-thalassaemia was detected using multiplex gap-polymerase chain reaction (PCR), while common non-deletional α-thalassaemia was identified using multiplex amplification refractory mutation system (ARMS) PCR. Data were extracted from the HRPZ II database for analysis. Results Among the participants, 2327 individuals were found to have either common deletional (n=1037, 44.6%) or non-deletional (n=1290, 55.4%) α-thalassaemia. Hb Constant Spring was the most prevalent non-deletional α-thalassaemia, accounting for 53.03% of cases. Thirty-one participants (1.33%) exhibited αCD59α/αα, and one (0.04%) had αCD59α/-α3.7. Among the 32 subjects with Hb Adana, 87.5% were Malay, and 12.5% were Orang Asli. Additionally, seven cases of HbE/Hb Adana co-inheritance were identified. Hemoglobin levels in heterozygous Hb Adana individuals ranged from mild anemia to normal, between 95 g/L and 153 g/L. Mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were approximately 73 fL and 23 pg, respectively. Conclusion This study delineates the distribution of α-thalassaemia mutation patterns among high school students in Kelantan, Northeast Peninsular Malaysia. Our findings indicate that Hb Adana is rare in our region and co-inheritance with an α-gene deletion results in α+-thalassaemia and with HbE, α0-thalassaemia. All heterozygous Hb Adana individuals exhibited low MCVs and MCHs.
  10. Fulltext Red Blood Cell Alloimmunization and Its Associated Factors among Chronic Liver Disease Patients in a Teaching Hospital in Northeastern Malaysia
    S Abdullah SZ, Hassan MN, Ramli M, Abdullah M, Mohd Noor NH
    Diagnostics (Basel), 2023 Feb 25;13(5).
    PMID: 36900030 DOI: 10.3390/diagnostics13050886
    Red blood cell (RBC) alloimmunization is an important complication of blood transfusion. Variations in the frequency of alloimmunization have been noted among different patient populations. We aimed to determine the prevalence of RBC alloimmunization and associated factors among chronic liver disease (CLD) patients in our center. This is a case-control study involving 441 patients with CLD who were being treated at Hospital Universiti Sains Malaysia and subjected to pre-transfusion testing from April 2012 until April 2022. Clinical and laboratory data were retrieved and statistically analyzed. A total of 441 CLD patients were included in our study, with the majority being elderly, with the mean age of patients 57.9 (SD ± 12.1) years old, male (65.1%) and Malays (92.1%). The most common causes of CLD in our center are viral hepatitis (62.1%) and metabolic liver disease (25.4%). Twenty-four patients were reported to have RBC alloimmunization, resulting in an overall prevalence of 5.4%. Higher rates of alloimmunization were seen in females (7.1%) and patients with autoimmune hepatitis (11.1%). Most patients developed a single alloantibody (83.3%). The most common alloantibody identified belonged to the Rh blood group, anti-E (35.7%) and anti-c (14.3%), followed by the MNS blood group, anti-Mia (17.9%). There was no significant factor association of RBC alloimmunization among CLD patients identified. Our center has a low prevalence of RBC alloimmunization among CLD patients. However, the majority of them developed clinically significant RBC alloantibodies, mostly from the Rh blood group. Therefore, phenotype matching for Rh blood groups should be provided for CLD patients requiring blood transfusions in our center to prevent RBC alloimmunization.
  11. Fulltext Obesity in multiracial schizophrenia patients receiving outpatient treatment in a regional tertiary hospital in malaysia
    Norlelawati AT, Kartini A, Ramli M, Norsidah K, Wan Azizi WS, Tariq AR
    East Asian Arch Psychiatry, 2012 Jun;22(2):49-56.
    PMID: 22714874
    OBJECTIVES. Obesity is an issue of concern among patients with schizophrenia as it is a co-morbid condition that is closely related to metabolic syndrome. The present study assessed the correlation of body mass index with antipsychotic use among multiracial schizophrenia outpatients. The study also compared the patients' body mass index with Malaysian Adult Nutrition Survey (MANS) data.
    METHODS. A total of 216 participants were recruited into a cross-sectional study conducted over 5 months, from December 2010 to April 2011. Body weight and height were measured using the standard methods. Demographic data and treatment variables were gathered through interview or review of the medical records.
    RESULTS. There were differences in mean body mass index between men and women (p = 0.02) and between Malay, Chinese and Indian races (p = 0.04). Stratified by sex, age, and race, the body mass index distributions of the patients were significantly different to those of the reference MANS population. The prevalence of obesity among patients was more than 2-fold greater than among the reference population in all variables. Although body mass index distribution was related to antipsychotic drugs (χ(2) = 33.42; p = 0.04), obesity could not be attributed to any specific drug.
    CONCLUSION. The prevalence of obesity among patients with schizophrenia was significantly greater than that in the healthy Malaysian population, and affects the 3 main races in Malaysia.
    Study site: Psychiatry Clinic, Tengku Ampuan Afzan Hospital, Kuantan, Pahang, Malaysia.
  12. Fulltext Psychosocial distress and blood pressure among young adults: role of cortisol as mediator.
    Wan Fatein Nabeila W.O., Sithu A., Aszrin A., Azarisman S.M.S., Jamalludin A.R., Norlelawati A.T., et al.
    IIUM Medical Journal Malaysia, 2019;18(2):69-76.
    MyJurnal
    Hypertension is the most prevalent risk factor of cardiovascular diseases in Malaysia. 17.3% of hypertension cases in Malaysia is attributed to adults aged 18 to 39 years. Psychosocial distress is a possible risk factor for elevated blood pressure in young adults, and cortisol could be the mediating factor. The aim of this study is to evaluate the mediating role of cortisol in hypertension and psychosocial distress in young adults. Methods and materials:A comparative cross-sectional study was conducted in 240 young adults aged 18 to 45 years. The body mass index, waist circumference and blood pressure parameters were recorded. Serum cortisol, creatinine, fasting blood glucose and lipid profile were measured following acute mental stress test. Psychosocial distress was assessed using the DASS-21 questionnaire. Results:Mean (standard deviation) values for SBP, DBP, MAP were 126.0(16.3), 84.1(12.2) and 98.1(13.1) mmHg respectively. Anxiety was significantly associated with systolic blood pressure (β=0.644), diastolic blood pressure (β=0.454) and mean arterial pressure (β=0.516) after adjusting for sex, age and cortisol. However, it was not mediated by cortisol. Depression and stress were not found to have any effect on blood pressure of the young adults studied. Conclusion:The data suggest that there is no elevated risk for psychosocial distress and hypertension that cortisol poses in young adults.
  13. Fulltext Knowledge and attitude towards HIV/AIDS among transsexuals in Kuantan, Pahang
    Ramli, M., Mohd Aznan, M.A., Maliya. S., Muhamad Shaiful Lizam, M.A., Muhammad Salman, M.H., Mohamad Faqihuddin, H., et al.
    International Medical Journal Malaysia, 2016;15(1):45-50.
    MyJurnal
    Introduction: Lack of knowledge and negative attitude towards HIV/AIDS may be the risk factors for HIV infection among transsexuals. Research on knowledge and attitude towards HIV infection in transsexual communities is very limited at both local and international levels. This study aimed to assess the knowledge and attitude towards HIV infection among the male-to-female transsexual community in Kuantan, Pahang.
    Methods: A cross-sectional study was carried out from July to August 2014 among 33 male-to-female transsexuals in Kuantan, Pahang. Convenience sampling was used. Participants who gave consent answered a self-administered questionnaire. Data obtained was analyzed with descriptive statistics, χ2-test, and independent sample t test.
    Results: The majority of the subjects in this study were 29 years and below (48.5%), Muslims (93.9%), and had completed up to secondary education (60.6%). Most of them were sex workers (60.6%), and had relatively low income (no income to RM 3000, mean of RM1528). A total of 87.9% of the subjects demonstrated good knowledge and also positive attitude towards HIV/AIDS. Level of education was significantly associated with scores in knowledge (p=0.01).
    Conclusions: Despite the positive outcome from this study, misconceptions towards HIV/AIDS still exist among transsexuals. Education and interventions from multiple directions on HIV/AIDS are essential to deliver the correct information to this population, so as to emphasize prevention, early detection, and holistic medical care. Transsexuals also require attention from religious bodies and non-governmental organizations to help them in employment, financial, spiritual, and psycho-social issues.
  14. Fulltext Medical Complications Among Type 2 Diabetes Mellitus Patients at a General Hospital in East Coast Malaysia
    Noor Hasimah, M., Nurhanani, M.N., Ramli, M.
    International Medical Journal Malaysia, 2010;9(1):15-19.
    MyJurnal
    Introduction: Diabetes Mellitus (DM) is a chronic metabolite disorder with high potential of multisystemic medical complications especially among poorly controlled patients. This study was conducted at Raja Perempuan Zainab II Hospital, Kota Bharu with objectives to explore the pattern of common diabetic mellitus type 2 complications and to compare between gender and races in relation to other risk factors during their hospitalization. Materials and Methods: This is a retrospective study based on patients’ record involving 215 patients (110 women and 105 men) who were admitted with diabetic complications in medical ward for a period of 6 months (January to June 2006) Results: Out of total 300 identifi ed subjects, 285 case notes were traceable. From 285, 84.6% (241 subjects) were diagnosed as DM type 2. 215 out of 241 subjects (89.2%) had one or more diabetic complications. In general the most common diabetic complication was diabetic nephropathy 34.9% (75 patients). When we compared between genders, diabetic foot ulcers was the most common diabetic complications among males (43.8%) and diabetic nephropathy for females (40.9%). A total of 199 patients (92.6%) had poor blood sugar control during their hospitalization and 103 patients (47.9%) had hypertension. Conclusion: Patients with DM type 2 had a high prevalence of complications. Common diabetic complications among genders were varied. Patients with diabetic complications had high prevalence of risk factors such as poor blood sugar control, concomitant hypertension and smoking habit.
  15. Fulltext Determinants of early postpartum psychological reaction among mothers in Kuala Lumpur Hospital
    Ramli M, Abdullah AAW, Saiful MIB, Fafiz MN, Fahmi AAZ
    International Medical Journal Malaysia, 2010;9(1):37-41.
    MyJurnal
    Introduction: Maternal psychological well-being determines early mother-infant relationship and babys health. Paying attention on this aspect is essential particularly in early postpartum period. This study aimed to determine early psychological reactions toward socioeconomic profi les, delivery methods and delivery outcomes among postpartum mothers in Kuala Lumpur Hospital. Materials and Methods: A total of 150 two week-postpartum mothers participated in this cross sectional study and their psychological perspective was measured by using the Depressive, Anxiety and Stress Scale (DASS). Results: 4%, 16% and 4.7% of respondents had significant depressive, anxiety and stress levels respectively. Conclusion: Socioeconomic variables such household income, level of education and presence of medical illness were statistically signifi cant to determine early postpartum psychological reactions but not the modes or outcomes of delivery.
  16. Fulltext Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience
    Mohd Noor NH, Saad NH, Khan M, Hassan MN, Ramli M, Bahar R, et al.
    Int J Environ Res Public Health, 2021 10 25;18(21).
    PMID: 34769712 DOI: 10.3390/ijerph182111194
    Blood transfusion is a fundamental and life-saving procedure where the consequence of errors can be fatal. Nurses' knowledge plays an essential role in ensuring quality and safety in blood transfusion. The objective of this study was to assess blood transfusion-associated knowledge of tertiary hospital nurses on the east coast of Malaysia. This was a cross-sectional study with 200 registered nurses involved in blood transfusion procedures at Hospital Universiti Sains Malaysia. The knowledge of the nurses was evaluated by using the routine blood transfusion knowledge questionnaire based on five parts, and <50%, 50-74%, or ≥75% of the knowledge was considered as poor, moderate, or high, respectively. Based on the scoring system, the overall knowledge of blood transfusion among Malaysian nurses (33.2 ± 8.4 years) was estimated to be 54.9 ± 7.6%. In individual items, the scoring was 81.0%, 45.4%, 49.2%, 63.0%, and 90.0% in knowledge prior to blood transfusion, on pre-transfusion, on post-transfusion, on complications, and on transfusion policy, respectively. The findings of this study indicated that most of the nurses' overall knowledge of blood transfusion was at a moderate level; therefore, training courses and continuous medical education are warranted to improve knowledge and skills of the nurses to ensure good practices of blood transfusion.
  17. Conformation sensitive gel electrophoresis for the detection of calreticulin mutations in BCR-ABL1-negative myeloproliferative neoplasms
    Zakaria NA, Rosle NA, Siti Asmaa MJ, Aziee S, Haiyuni MY, Samat NA, et al.
    Int J Lab Hematol, 2021 Dec;43(6):1451-1457.
    PMID: 34125992 DOI: 10.1111/ijlh.13628
    INTRODUCTION: Calreticulin (CALR) mutations in myeloproliferative neoplasms (MPN) have been reported to be key markers in the molecular diagnosis, particularly in patients lacking JAK2 V617F mutation. In most current reports, CALR mutations were analysed by either allele-specific PCR (AS-PCR), or the more expensive quantitative real-time PCR, pyrosequencing and next-generation sequencing. Hence, we report the use of an alternative method, the conformation sensitive gel electrophoresis (CSGE) for the detection of CALR mutations in BCR-ABL1-negative MPN patients.

    METHODS: Forty BCR-ABL1-negative MPN patients' DNA: 19 polycythemia vera (PV), 7 essential thrombocytosis (ET) and 14 primary myelofibrosis (PMF), were screened for CALR mutations by CSGE. PCR primers were designed to amplify sequences spanning between exons 8 and 9 to target the mutation hotspots in CALR. Amplicons displaying abnormal CSGE profiles by electrophoresis were directly sequenced, and results were analysed by BioEdit Sequence Alignment Editor v7.2.6. CSGE results were compared with AS-PCR and confirmed by Sanger sequencing.

    RESULTS: CSGE identified 4 types of mutations; 2 PMF patients with either CALR type 1 (c.1099_1150del52) or type 2 (c.1155_1156insTTGTC), 1 ET patient with nucleotide deletion (c.1121delA) and insertion (c.1190insA) and 1 PV patient with p.K368del (c.1102_1104delAAG) and insertion (c.1135insA) inframe mutations. Three patients have an altered KDEL motif at the C-terminal of CALR protein. In comparison, AS-PCR only able to detect two PMF patients with mutations, either type 1 and type 2.

    CONCLUSION: CSGE is inexpensive, sensitive and reliable alternative method for the detection of CALR mutations in BCR-ABL1-negative MPN patients.

  18. Fulltext Preparation and characterization of an anti-inflammatory agent based on a zinc-layered hydroxide-salicylate nanohybrid and its effect on viability of Vero-3 cells
    Ramli M, Hussein MZ, Yusoff K
    Int J Nanomedicine, 2013;8:297-306.
    PMID: 23345976 DOI: 10.2147/IJN.S38858
    A new organic-inorganic nanohybrid based on zinc-layered hydroxide intercalated with an anti-inflammatory agent was synthesized through direct reaction of salicylic acid at various concentrations with commercially available zinc oxide. The basal spacing of the pure phase nanohybrid was 15.73 Å, with the salicylate anions arranged in a monolayer form and an angle of 57 degrees between the zinc-layered hydroxide interlayers. Fourier transform infrared study further confirmed intercalation of salicylate into the interlayers of zinc-layered hydroxide. The loading of salicylate in the nanohybrid was estimated to be around 29.66%, and the nanohybrid exhibited the properties of a mesoporous-type material, with greatly enhanced thermal stability of the salicylate compared with its free counterpart. In vitro cytotoxicity assay revealed that free salicylic acid, pure zinc oxide, and the nanohybrid have a mild effect on viability of African green monkey kidney (Vero-3) cells.
  19. Fulltext Reticulocyte haemoglobin as a biomarker for the detection of iron deficiency anaemia in haemodialysis patients on recombinant human erythropoietin
    Jamian, E., Sanip, Z., Ramli, M., Mohd Daud, K., Mohamad, S., Hassan, R.
    Journal of Biomedical and Clinical Sciences, 2018;3(2):29-34.
    MyJurnal
    Iron deficiency anaemia (IDA) frequently occurs in haemodialysis
    (HD) patients undergoing recombinant human erythropoietin (rHuEPO)
    therapy and is commonly associated with rHuEPO hypo-responsiveness.
    However, the conventional iron indices are inadequate to exhibit the status or
    utilisation of iron during erythropoiesis. The aim of this study was to elucidate
    the accuracy and usefulness of the reticulocyte haemoglobin (RET-He) test
    for diagnosing IDA in HD patients undergoing rHuEPO therapy. Methods: In
    this cross-sectional study, fifty-five blood samples of HD patients on rHuEPO
    therapy were collected and analysed for haematological and biochemical
    parameters. A receiver operating characteristics curve was also plotted for
    sensitivity and specificity analysis. IDA detection rates by RET-He, soluble
    transferrin receptor (sTfR) and serum ferritin were 63.64%, 3.64% and 0%,
    respectively. RET-He level was significantly correlated with sTfR level, mean
    cell volume, mean cell haemoglobin level and the transferrin receptor-ferritin
    index. The sensitivity and specificity of RET-He in detecting IDA were 78.3%
    and 92.0%, respectively, with an area under the curve of 0.864. IDA was more
    frequently detected by RET-He than by ferritin or sTfR in HD patients
    undergoing rHuEPO therapy. The RET-He level also showed higher sensitivity
    and specificity for the iron status in these patients. Therefore, RET-He is a
    useful biomarker for the detection of IDA in HD patients undergoing rHuEPO
    therapy.
  20. Properties of high-oleic palm oils derived by fractional crystallization
    Ramli MR, Siew WL, Cheah KY
    J Food Sci, 2008 Apr;73(3):C140-5.
    PMID: 18387090 DOI: 10.1111/j.1750-3841.2007.00657.x
    High-oleic palm oil (HOPO) with an oleic acid content of 59.0% and an iodine value (IV) of 78.2 was crystallized in a 200-kg De Smet crystallizer with a predetermined cooling program and appropriate agitation. The slurry was then fractionated by means of dry fractionation at 4, 8, 10, 12, and 15 degrees C. The oil and the fractionated products were subjected to physical and chemical analyses, including fatty acid composition, triacylglycerol and diacylglycerol composition, solid fat content, cloud point, slip melting point, and cold stability test. Fractionation at 15 degrees C resulted in the highest olein yield but with minimal oleic acid content. Due to the enhanced unsaturation of the oil, fractionation at relatively lower crystallization temperature showed a considerable effect on fatty acid composition as well as triacylglycerol and diacylglycerol composition of liquid fractions compared to higher crystallization temperature. The olein and stearin fractionated at 4 degrees C had the best cold stability at 0 degrees C and sharper melting profile, respectively.
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