Displaying publications 1 - 20 of 110 in total

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  1. Choon SE, De La Cruz C, Wolf P, Jha RK, Fischer KI, Goncalves-Bradley DC, et al.
    J Eur Acad Dermatol Venereol, 2024 Feb;38(2):265-280.
    PMID: 37750484 DOI: 10.1111/jdv.19530
    Generalized pustular psoriasis (GPP) is a rare, chronic, neutrophilic inflammatory skin disease characterized by episodes of widespread eruption of sterile, macroscopic pustules that can be accompanied by systemic inflammation and symptoms. A systematic literature review and narrative synthesis were conducted to determine the impact of GPP on patients' health-related quality of life (HRQoL) and patient-reported severity of symptoms and to compare its impact to patients with plaque psoriasis (plaque PsO). Searches were undertaken in Embase, MEDLINE and the Cochrane Library from 1 January 2002 to 15 September 2022. Screening was carried out by two reviewers independently. Outcome measures included generic (e.g. EQ-5D, SF-36) and dermatology-specific (e.g. DLQI) clinical outcome assessments, and other relevant patient-reported outcome measures (PROMs) (e.g. severity of pain measured by a numerical rating scale). Overall, 20 studies were found to be eligible for inclusion, of which seven also had data for plaque PsO. The DLQI was the most frequently reported outcome measure (16 out of 20 studies). When reported, mean DLQI (SD) scores varied from 5.7 (1.2) to 15.8 (9.6) across the studies, indicating a moderate to very large effect on HRQoL; the wide range of scores and large SDs were explained by the small population sizes (n ≤ 12 for all studies except two). Similar ranges and large SDs were also observed for other measures within individual studies. However, in general, people with GPP reported a greater impact of their skin condition on HRQoL, when compared to people with plaque PsO (i.e. higher DLQI scores) and higher severity for itch, pain and fatigue. This systematic review highlighted the need for studies with a larger population size, a better understanding of the impact of cutaneous and extracutaneous symptoms and comorbidities on HRQoL during and between GPP flares, and outcome measures specifically tailored to the unique symptoms and the natural course/history of GPP.
  2. Aad G, Abbott B, Abeling K, Abicht NJ, Abidi SH, Aboulhorma A, et al.
    Phys Rev Lett, 2024 Jan 12;132(2):021803.
    PMID: 38277607 DOI: 10.1103/PhysRevLett.132.021803
    The first evidence for the Higgs boson decay to a Z boson and a photon is presented, with a statistical significance of 3.4 standard deviations. The result is derived from a combined analysis of the searches performed by the ATLAS and CMS Collaborations with proton-proton collision datasets collected at the CERN Large Hadron Collider (LHC) from 2015 to 2018. These correspond to integrated luminosities of around 140  fb^{-1} for each experiment, at a center-of-mass energy of 13 TeV. The measured signal yield is 2.2±0.7 times the standard model prediction, and agrees with the theoretical expectation within 1.9 standard deviations.
  3. Subejano MSE, Penuliar G
    Trop Biomed, 2023 Dec 01;40(4):422-429.
    PMID: 38308829 DOI: 10.47665/tb.40.4.007
    Campylobacteriosis is a human infection primarily caused by Campylobacter jejuni and Campylobacter coli. Consumption of contaminated chicken and poultry products is the main mode of transmission. These bacteria possess virulence factors, including adhesins and toxins, which contribute to their pathogenesis. Moreover, their large genomes undergo frequent genetic recombination, resulting in a high degree of genetic diversity. However, limited information is available regarding the virulence and genotypic diversity profiles of these microorganisms in the Philippines. The objective of this study was to address this knowledge gap by characterizing Campylobacter isolates obtained from chicken offal sold in wet markets in Metro Manila, Philippines. Multilocus Sequence Typing (MLST) analysis was performed to determine the sequence types, resulting in the identification of 13 unique sequence types, including nine previously unreported ones, and three clonal complexes. Notably, the widespread sequence type ST-305 was found in samples from different markets. Furthermore, six isolates deposited in the Campylobacter PubMLST database were identified as C. coli based on allele profiles. Profiling using 10 selected virulence genes revealed that more than half of the isolates carried these genes. The most prevalent virulence gene was cadF (100%), followed by flaA (95%), racR, cdtA, cdtB, and cdtC (85%). The genes dnaJ and ceuE were also present in 75% of the isolates. Despite the limited sample size, the findings of this study reveal a significant level of genotypic diversity among the Campylobacter isolates. This diversity has important implications for source attribution studies and the identification of strains involved in campylobacteriosis outbreaks. Furthermore, the investigation of virulence factors associated with colonization and invasion of the avian gut can provide insights for the development of practical applications in Campylobacter control strategies. Understanding and addressing these factors are crucial steps toward mitigating the risk of Campylobacter infections and enhancing public health efforts.
  4. Shalihin MSE, Suhaimi NAN, Hamzah HA, Abidin S, Aidid ME, Musa R
    Med J Malaysia, 2023 Nov;78(6):830-844.
    PMID: 38031228
    INTRODUCTION: Mounting evidence has shown the significant correlation between periodontitis and the development of other comorbidities, such as cardiovascular disease due to periodontopathogenic bacterial migration and colonisation. As the main etiologic agent of periodontitis, the role of Porphyromonas gingivalis (P. gingivalis) has been widely explored as the main culprit and its early detection is crucial to control the exacerbation of diseases. This review aims to identify and summarise all clinical diseases that potentially developed due to the presence of P. gingivalis and discover all its detection methods that have been developed.

    MATERIALS AND METHODS: Full-text articles of case report, case control, cohort and cross-sectional studies that were published from 1st January 2012 until 30th June 2022, were searched using PubMed, CINAHL and Scopus. Periodontal related diseases were excluded in this review due to its wellknown associated disease with P. gingivalis. A comparison studies of detection methods were also excluded in this review.

    RESULTS: Out of 612 articles that were screened, only 106 met the eligibility criteria to be selected for further review. Risk of bias was performed using FEAT principles and reviewers' discussion. A total of 21 final articles that were reviewed showed significant correlation with P. gingivalis and were classified into several clinical domains. Twelve out of 13 detection methods showed high sensitivity and specificity with short duration analysis.

    CONCLUSION: Due to asymptomatic periodontal disease and the high prevalence of P. gingivalis-associated clinical diseases, this review suggests the need for oral public health awareness and early screening for the bacterium detection especially among elderly groups to maintain their quality of life.

  5. Ng HL, Sellappans R, Loo JSE
    Int J Pharm Pract, 2023 Sep 30;31(5):489-495.
    PMID: 37526297 DOI: 10.1093/ijpp/riad042
    OBJECTIVES: To determine the adoption and perception of mobile health (mHealth) applications among community pharmacists in Malaysia.

    METHODS: A cross-sectional survey using a self-administered questionnaire was conducted with 300 community pharmacists in the Klang Valley, Malaysia using a stratified sampling approach. The questionnaire consisted of 36 questions with three sections: demographic data, adoption of mHealth applications and perception towards mHealth applications. Descriptive and inferential tests as well as exploratory factor analysis were used to analyse the data.

    KEY FINDINGS: Adoption of mHealth applications by community pharmacists for both professional and personal use was relatively high at 79.7%. Utilised mHealth applications were primarily from the medical references category, while applications for patient monitoring, personal care and fitness were used to a lesser degree. Among mHealth application users, only 65.7% recommended them to their patients. Overall perception towards mHealth applications was positive, but perception towards the benefits and favour of mHealth applications for their patients was lower. This was corroborated by the factor analysis, which identified four main factors explaining 59.9% of variance in the dataset. These factors were perception towards use in their own professional practice, perception on benefits and use in their patients, perception on specific features of mHealth applications, and reliability of mHealth applications.

    CONCLUSIONS: Adoption of mHealth applications among community pharmacists in Malaysia is high. Community pharmacists are more likely to use mHealth applications professionally and personally but less likely to recommend them to patients due to less favourable perceptions on how patients will benefit from mHealth applications.

  6. Tan CY, Thanawongnuwech R, Arshad SS, Hassan L, Lee CY, Low SE, et al.
    Trop Biomed, 2023 Sep 01;40(3):301-306.
    PMID: 37897162 DOI: 10.47665/tb.40.3.005
    Porcine circovirus type 4 (PCV4) is the newest member in the porcine circovirus family, first reported in 2020. To date, the presence of PCV4 has only been reported in China, South Korea and most recently in Thailand. Detection of PCV4 have been reported in various production stages of pigs from piglets, finishers to sows; associated with a myriad of clinical manifestations including porcine dermatitis and nephropathy syndrome (PDNS), postweaning multisystemic wasting syndrome (PMWS), respiratory, enteric and neurological diseases. While successful virus isolation and culture has yet to be reported, pathogenicity of PCV4 has been demonstrated through infectious clone studies. The objective of this study is to investigate the presence of PCV4 in Malaysian porcine population to update the epidemiology of porcine circoviruses in Malaysia. A total of 49 samples from commercial intensive pig farms, abattoir and wild boar population were subjected to conventional polymerase chain reaction assay to detect PCV4 capsid (cap) genome. Resulting cap nucleotide sequences were analyzed for maximum likelihood phylogeny relationship. Results revealed that PCV4 is present in Peninsular Malaysia at a molecular prevalence of 4.08% (2 / 49 samples). Both PCV4 positive samples originated from clinically healthy finishers. Malaysian PCV4 strains were classified as genotype PCV4b, and were found to be phylogenetically distinct from the China, South Korea and Thailand strains. With this latest update of the novel PCV4 in Malaysia, it is clear that more attention needs to be given to the investigation of novel porcine circoviruses (PCV) and management of PCV diseases.
  7. Lam SE, Bradley DA, Mat Nawi SN, Khandaker MU, Abdul Sani SF
    Appl Radiat Isot, 2023 Sep;199:110920.
    PMID: 37419002 DOI: 10.1016/j.apradiso.2023.110920
    The present study continues research into the utilisation of carbonaceous media for medical radiation dosimetry, focusing on the effects of surface area-to-volume ratio and carbon content on structural interaction alterations and dosimetric properties in sheet- and bead-type graphitic materials (with the respective carbon content of ∼98 wt% and ∼90 wt%). Using 60Co gamma-rays and doses from 0.5 Gy to 20 Gy, the study has been made of the response of commercially available graphite in the form of 0.1 mm, 0.2 mm, 0.3 mm and 0.5 mm thick sheets, also of activated carbon beads. Confocal Raman and photoluminescence spectroscopy have been employed, examining radiation-induced structural interaction alterations. Dose-dependent variation in the Raman intensity ratio ID/IG relates to the varying dominance of defect generation and dose-driven defect annealing. Of the various thickness graphite sheets, the 0.1 mm thick medium possesses the greatest surface area-to-volume ratio. Perhaps unsurprisingly, it also exhibits the greatest thermoluminescence (TL) yield compared to that of the other carbonaceous sheet foils used herein. Moreover, the second greatest mass-normalised TL yield has been observed to be that of the porous beads, reflected in the greater defect density (ID/IG > 2) when compared to the other media, due in part to their inherent feature of large internal surface area. Considering the challenge posed in matching skin thickness with skin dose, the near tissue equivalent graphite sheets show particular promise as a skin dosimeter, sensitive as a function of depth.
  8. Tsan SEH, Viknaswaran NL, Cheong CC, Cheah S, Ng KT, Mong SXY, et al.
    Anaesthesia, 2023 Sep;78(9):1153-1161.
    PMID: 37314744 DOI: 10.1111/anae.16058
    Tranexamic acid is an antifibrinolytic drug that is widely used during surgery, but there are concerns about its thromboembolic effects. We aimed to investigate the effect of prophylactic intravenous tranexamic acid on thromboembolic outcomes in patients undergoing non-cardiac surgery. The MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials were searched. Randomised controlled trials comparing intravenous tranexamic acid with placebo or no treatment in patients undergoing non-cardiac surgery were included. The primary outcome was a composite of peri-operative cardiovascular thromboembolic events, defined as any deep vein thrombosis, pulmonary embolism, myocardial ischaemia/infarction or cerebral ischaemia/infarction. A total of 191 randomised controlled trials (40,621 patients) were included in the review. The primary outcome occurred in 4.5% of patients receiving intravenous tranexamic acid compared with 4.9% of patients in the control group. Our analysis showed that there was no difference between groups for composite cardiovascular thromboembolic events (risk ratio 1.02, 95%CI 0.94-1.11, p = 0.65, I2 0%, n = 37,512). This finding remained robust when sensitivity analysis was performed with continuity correction and in studies with a low risk of bias. However, in trial sequential analysis, our meta-analysis only achieved 64.6% of the required information size. There was no association between intravenous tranexamic acid and seizure rate or mortality rate within 30 days. Intravenous tranexamic acid was associated with a reduced blood transfusion rate compared with control (9.9% vs. 19.4%, risk ratio 0.46, 95%CI 0.41-0.51, p 
  9. Khandaker MU, Abuzaid MM, Mohamed IA, Yousef M, Jastaniah S, Alshammari QT, et al.
    Radiat Phys Chem Oxf Engl 1993, 2023 Sep;210:111023.
    PMID: 37206369 DOI: 10.1016/j.radphyschem.2023.111023
    Radiological staff, especially radiographers, work as front liners against the COVID-19 outbreak. This study aims to assess compliance with radiation protection and infection control practices during COVID-19 mobile radiography procedures. This cross-sectional study included 234 radiographers (females, 56%, n = 131; males, 44%, n = 103) who were asked to complete an online questionnaire consisting of demographic data, radiation protection and infection control practices during COVID-19 portable cases, and knowledge and awareness. After informed consent was completed, SPSS statistical software was used for the data analysis. The most common age group of participants ranged from 18 to 25 years old (30.3%, n = 71). Bachelor's degree holders were 74.4% (n = 174). Most radiographers (39.7%, n = 93) had a working experience of 1-5 years, followed by 27.8% (n = 65) with more than 16 years of experience. Most respondents (62.4%, n = 146) handled approximately 1-5 cases daily, the majority of them (56%, n = 131) stated affirmatively they had obtained special training to handle COVID-19, and when inquired if they had received any special allowances for handling COVID-19 suspected/confirmed cases most of them stated negative (73.9%, n = 173). Most participants stated that they always wear a TLD during portable cases (67.1%, n = 157) and a lead apron (51.7%, n = 121). Around 73% (n = 171) knew the latest information on COVID-19 and attended the COVID-19 awareness course. A significant association was found between the work experience of the radiographers and their responses to following the best practices (p = 0.018, α = 0.05). Radiographers who had COVID-19 training (μ = 48.78) tend to adhere more to best practices than those who have not (p = 0.04, α = 0.05). Further, respondents who handled more than 16/more COVID-19 suspected/confirmed cases followed the best practices more (μ = 50.38) than those who handled less (p = 0.04, α = 0.05). This study revealed detailed information on radiation protection and infection control practices during COVID-19 mobile radiography. It has been observed that the participants/radiographers have good knowledge and awareness of radiation protection and infection-control practices. The present results may be used to plan future requirements regarding resources and training to ensure patient safety.
  10. Burden AD, Okubo Y, Zheng M, Thaçi D, van de Kerkhof P, Hu N, et al.
    Exp Dermatol, 2023 Aug;32(8):1279-1283.
    PMID: 37140190 DOI: 10.1111/exd.14824
    Effisayil 1 was a multicentre, randomized, double-blind, placebo-controlled study of the anti-interleukin (IL)-36 receptor monoclonal antibody, spesolimab, in patients presenting with a generalized pustular psoriasis (GPP) flare. Previously published data from this study revealed that within 1 week, rapid pustular and skin clearance were observed in patients receiving spesolimab versus placebo. In this pre-specified subgroup analysis, the efficacy of spesolimab was evaluated according to patient demographic and clinical characteristics at baseline in patients receiving spesolimab (n = 35) or placebo (n = 18) on Day 1. Efficacy was by assessed by achievement of primary endpoint (Generalized Pustular Psoriasis Physician Global Assessment [GPPGA] pustulation subscore of 0 at Week 1) and key secondary endpoint (GPPGA total score of 0 or 1 at Week 1). Safety was assessed at Week 1. Spesolimab was found to be efficacious and had a consistent and favourable safety profile in patients presenting with a GPP flare, regardless of patient demographics and clinical characteristics at baseline.
  11. Pertiwi H, Rochmy SE, Chwen LT
    Arch Razi Inst, 2023 Aug;78(4):1269-1275.
    PMID: 38226375 DOI: 10.32592/ARI.2023.78.4.1269
    Restriction of antibiotic growth promoters (AGP) in Indonesia reduces broiler production due to bacterial diseases. Some poultry farmers have attempted to replace AGP with phytogenic compounds, such as tannin as an in-feed additive. Therefore, this study was carried out to investigate the effects of tannin administration on the production performance, viscera weight, and lipoprotein levels of tropically-raised broiler chickens. Cobb Strain broiler chicks aged one day were used in an experiment with a completely random design, three treatments, and four replicate pens, each containing nine birds. Three dietary treatments were assigned to the birds: basal diet (negative control), basal diet+0.03% Zn Bacitracyn (positive control), and basal diet+0.05% tannin for the starter phase of 1-21 days and the grower phase of 22-42 days, respectively. Tannin supplementation significantly increased the feed conversion ratio in all phases relative to the control group. Tannin supplementation in the diet significantly reduced daily feed intake during the grower phase, final body weight, carcass weight, intestine weight, liver weight, and total visceral weight, compared to the control group. Tannin had lower levels of aspartate aminotransferase but higher levels of low-density lipoprotein and alanine aminotransferase. Tannin addition in broiler diets might not improve growth performance and health. Therefore, it is not suggested as a substitute for AGPs in broiler diets.
  12. Khandaker MU, Nawi SNM, Lam SE, Sani SFA, Islam MA, Islam MA, et al.
    Appl Radiat Isot, 2023 Jun;196:110771.
    PMID: 36933313 DOI: 10.1016/j.apradiso.2023.110771
    Thermoluminescence (TL) materials have a broad variety of uses in various fields, such as clinical research, individual dosimetry, and environmental dosimetry, amongst others. However, the use of individual neutron dosimetry has been developing more aggressively lately. In this regard, present study establishes a relationship between the neutron dosage and the optical property changes of graphite-rich materials caused by high doses of neutron radiation. This has been done with the intention of developing a novel, graphite-based radiation dosimeter. Herein, the TL yield of commercially graphite-rich materials (i.e. graphite sheet, 2B and HB grade pencils) irradiated by neutron radiation with doses ranging from 250 Gy to 1500 Gy has been investigated. The samples were bombarded with thermal neutrons as well as a negligible amount of gamma rays, from the nuclear reactor TRIGA-II installed at the Bangladesh Atomic Energy Commission. The shape of the glow curves was observed to be independent of the given dosage, with the predominant TL dosimetric peak maintained within the region of 163 °C-168 °C for each sample. By studying the glow curves of the irradiated samples, some of the most well theoretical models and techniques were used to compute the kinetic parameters such as the order of kinetics (b), activation energy (E) or trap depth, frequency factor (s) or escape probability, and trap lifetime (τ). All of the samples were found to have a good linear response over the whole dosage range, with 2B grade of polymer pencil lead graphite (PPLGs) demonstrating a higher level of sensitivity than both HB grade and graphite sheet (GS) samples. Additionally, the level of sensitivity shown by each of them is highest at the lowest dosage that was given, and it decreases as the dose increases. Importantly, the phenomenon of dose-dependent structural modifications and internal annealing of defects has been observed by assessing the area of deconvoluted micro-Raman spectra of graphite-rich materials in high-frequency areas. This trend is consistent with the cyclical pattern reported in the intensity ratio of defect and graphite modes in previously investigated carbon-rich media. Such recurrent occurrences suggest the idea of employing Raman microspectroscopy as a radiation damage study tool for carbonaceous materials. The excellent responses of the key TL properties of the 2B grade pencil demonstrate its usefulness as a passive radiation dosimeter. As a consequence, the findings suggest that graphite-rich materials have the potential to be useful as a low-cost passive radiation dosimeter, with applications in radiotherapy and manufacturing.
  13. Mohammad Aidid E, Shalihin MSE, Md Nor A, Hamzah HA, Ab Hamid NF, Saipol Bahri NAN, et al.
    Med J Malaysia, 2023 May;78(3):404-410.
    PMID: 37271851
    INTRODUCTION: World Health Organization (2019) has declared colorectal cancer (CRC) as the second most common cancer in females and third in males, where the incidence seems to rise year by year. One of the very few potential pathogens specifically associated with malignant colonic diseases is Streptococcus gallolyticus (Sg). Sg is a part of the intestinal flora which formerly known as biotype I of Streptococcus bovis, belongs to Group D streptococci. Owing to only a few researches done in determining evidence to support Sg as a determinant of CRC, a systematic review is constructed.

    MATERIALS AND METHODS: Full-text articles on case-control and cohort studies published from 1st January 2010 to 1st October 2020 were searched using Google Scholar, PubMed and JSTOR. People of all age groups and Sg bacteraemia or colonisation were the type of participant and exposure used for the search strategy, respectively. Data collection was done by three reviewers and checked by two reviewers for discrepancies. All the papers were critically appraised using the STROBE statement. Qualitative synthesis was done by descriptive comparison, distribution of Sg according to stage comparison, method used for Sg detection comparison and risk of bias comparison.

    RESULT: Seven out of 11 articles that fulfil the eligibility criteria were selected. Four papers have low overall risk of bias due to low confounding or selection bias. Sg is found to be a risk factor for CRC from three papers studied, whereas the other four papers did not include the strength of association. Only two papers studied the association between the distribution of Sg and stages of CRC, where the results were contradictory from each other, making it to be inconclusive. The most common method used for Sg detection is a culturing technique, followed by molecular and biochemical techniques.

    CONCLUSION: There is insufficient evidence to prove the association between Sg bacteraemia as the risk factor for CRC as well as the association between the Sg distribution and stages of CRC. Culturing technique is the most common method used for the detection of bacteria, but it requires subsequent investigations to confirm the presence of Sg. Thus, it is recommended that more studies need to be done using strong statistical analysis to control for most of the confounders with comprehensive explanation and use of more methods in the detection of Sg.

  14. Mashor M, Wong KW, Tey KE, Choon SE
    Med J Malaysia, 2022 Nov;77(6):689-695.
    PMID: 36448386
    INTRODUCTION: Limited information exists regarding drug survival of biologics among psoriasis patients in Malaysia. This study aimed to determine the drug survival of biologics in Malaysian psoriasis patients, the reasons for drug discontinuation and to identify the predictor of drug survival.

    MATERIALS AND METHODS: A retrospective review of case notes on adult psoriasis patients treated with biologics in Hospital Sultanah Aminah Johor Bahru Malaysia, between January 2006 and December 2020. Drug survival was analysed using the Kaplan-Meier method.

    RESULTS: By December 2020, 100 patients with 154 treatment courses of biologics were included in the study. Male to female ratio was 1:1. The mean age at onset was 31.36 ± 11.72 years. Ustekinumab was the most frequently prescribed biologics (39%), followed by adalimumab (29.2%), secukinumab (14.9%), etanercept (13%), and infliximab (3.2%). Overall median drug survival for biologics was 25 months (interquartile range [IQR]= 12.0-.0). The median drug survival for ustekinumab was 35 months (IQR, 12-93); followed by 25 months (IQR, 12.0-), 18 months (IQR, 7-85), 17 months (IQR, 11-43), and 8 months (IQR, 1-10) for secukinumab, adalimumab, etanercept, and infliximab, respectively. The main reason for drug discontinuation was loss of efficacy (26%), inadequate funding (14.3%), loss to follow-up (10.4%), adverse events (4.5%), and patients' request (1.3%).

    CONCLUSION: Our study shows ustekinumab has the best long-term drug survival among biologics in Malaysian patients with psoriasis in real-life setting. Further study is required to evaluate the long-term drug survival for newer biologics.

  15. Yoon SY, Wong SW, Lim J, Ahmad S, Mariapun S, Padmanabhan H, et al.
    J Med Genet, 2022 Mar;59(3):220-229.
    PMID: 33526602 DOI: 10.1136/jmedgenet-2020-107416
    BACKGROUND: Identifying patients with BRCA mutations is clinically important to inform on the potential response to treatment and for risk management of patients and their relatives. However, traditional referral routes may not meet clinical needs, and therefore, mainstreaming cancer genetics has been shown to be effective in some high-income and high health-literacy settings. To date, no study has reported on the feasibility of mainstreaming in low-income and middle-income settings, where the service considerations and health literacy could detrimentally affect the feasibility of mainstreaming.

    METHODS: The Mainstreaming Genetic Counselling for Ovarian Cancer Patients (MaGiC) study is a prospective, two-arm observational study comparing oncologist-led and genetics-led counselling. This study included 790 multiethnic patients with ovarian cancer from 23 sites in Malaysia. We compared the impact of different method of delivery of genetic counselling on the uptake of genetic testing and assessed the feasibility, knowledge and satisfaction of patients with ovarian cancer.

    RESULTS: Oncologists were satisfied with the mainstreaming experience, with 95% indicating a desire to incorporate testing into their clinical practice. The uptake of genetic testing was similar in the mainstreaming and genetics arm (80% and 79%, respectively). Patient satisfaction was high, whereas decision conflict and psychological impact were low in both arms of the study. Notably, decisional conflict, although lower than threshold, was higher for the mainstreaming group compared with the genetics arm. Overall, 13.5% of patients had a pathogenic variant in BRCA1 or BRCA2, and there was no difference between psychosocial measures for carriers in both arms.

    CONCLUSION: The MaGiC study demonstrates that mainstreaming cancer genetics is feasible in low-resource and middle-resource Asian setting and increased coverage for genetic testing.

  16. Su WS, Thum CM, Loo JSE
    Int J Pharm Pract, 2022 Jan 07;30(1):59-66.
    PMID: 34962576 DOI: 10.1093/ijpp/riab075
    OBJECTIVES: To determine the prescribing patterns and identify potentially inappropriate prescribing practices among general practitioners in the private primary care sector by analysing a large electronic health insurance claims database.

    METHODS: Medical claims records from February 2019 to February 2020 were extracted from a health insurance claims database. Data cleaning and data analysis were performed using Python 3.7 with the Pandas, NumPy and Matplotlib libraries. The top five most common diagnoses were identified, and for each diagnosis, the most common medication classes and medications prescribed were quantified. Potentially inappropriate prescribing practices were identified by comparing the medications prescribed with relevant clinical guidelines.

    KEY FINDINGS: The five most common diagnoses were upper respiratory tract infection (41.5%), diarrhoea (7.7%), musculoskeletal pain (7.6%), headache (6.7%) and gastritis (4.0%). Medications prescribed by general practitioners were largely as expected for symptomatic management of the respective conditions. One area of potentially inappropriate prescribing identified was inappropriate antibiotic choice. Same-class polypharmacy that may lead to an increased risk of adverse events were also identified, primarily involving multiple paracetamol-containing products, non-steroidal anti-inflammatory drugs (NSAIDs), and antihistamines. Other areas of non-adherence to guidelines identified included the potential overuse of oral corticosteroids and oral salbutamol, and inappropriate gastroprotection for patients receiving NSAIDs.

    CONCLUSIONS: While prescribing practices are generally appropriate within the private primary care sector, there remain several areas where some potentially inappropriate prescribing occurs. The areas identified should be the focus in continuing efforts to improve prescribing practices to obtain the optimal clinical outcomes while reducing unnecessary risks and healthcare costs.

  17. Mohamed Juhan NAKF, Shalihin MSE
    Med J Malaysia, 2021 Nov;76(6):941-945.
    PMID: 34806692
    Hyperprolactinemia is a condition of elevated serum prolactin, which usually occurs in women as compared to men. Most patients present to primary care clinics with a history of galactorrhoea, oligomenorrhea, amenorrhoea or infertility. Literature search reveals that there were few idiopathic causes of hyperprolactinemia, which resolved by itself without specific pharmacological or surgical treatment. This case is of a 39-year-old woman presented with amenorrhea for four months after Implanon removal and concomitantly noted to have galactorrhoea for four years without any medical attention. The condition persisted after cessation of breastfeeding. After undergoing several investigations including imaging studies, the underlying cause of hyperprolactinemia was noted to be idiopathic. Due to the unclear cause of its aetiology, this case caused various challenges to the primary care. Exhaustive physiological and pathological causes of hyperprolactinemia have been ruled out. Nevertheless, with adequate treatment, she gained her normal menstrual and resolved galactorrhoea symptoms.
  18. Vilizzi L, Copp GH, Hill JE, Adamovich B, Aislabie L, Akin D, et al.
    Sci Total Environ, 2021 Sep 20;788:147868.
    PMID: 34134389 DOI: 10.1016/j.scitotenv.2021.147868
    The threat posed by invasive non-native species worldwide requires a global approach to identify which introduced species are likely to pose an elevated risk of impact to native species and ecosystems. To inform policy, stakeholders and management decisions on global threats to aquatic ecosystems, 195 assessors representing 120 risk assessment areas across all six inhabited continents screened 819 non-native species from 15 groups of aquatic organisms (freshwater, brackish, marine plants and animals) using the Aquatic Species Invasiveness Screening Kit. This multi-lingual decision-support tool for the risk screening of aquatic organisms provides assessors with risk scores for a species under current and future climate change conditions that, following a statistically based calibration, permits the accurate classification of species into high-, medium- and low-risk categories under current and predicted climate conditions. The 1730 screenings undertaken encompassed wide geographical areas (regions, political entities, parts thereof, water bodies, river basins, lake drainage basins, and marine regions), which permitted thresholds to be identified for almost all aquatic organismal groups screened as well as for tropical, temperate and continental climate classes, and for tropical and temperate marine ecoregions. In total, 33 species were identified as posing a 'very high risk' of being or becoming invasive, and the scores of several of these species under current climate increased under future climate conditions, primarily due to their wide thermal tolerances. The risk thresholds determined for taxonomic groups and climate zones provide a basis against which area-specific or climate-based calibrated thresholds may be interpreted. In turn, the risk rankings help decision-makers identify which species require an immediate 'rapid' management action (e.g. eradication, control) to avoid or mitigate adverse impacts, which require a full risk assessment, and which are to be restricted or banned with regard to importation and/or sale as ornamental or aquarium/fishery enhancement.
  19. Francis J, Toh LS, Sellappans R, Loo JSE
    Int J Clin Pharm, 2021 Jun;43(3):604-612.
    PMID: 33507463 DOI: 10.1007/s11096-020-01169-z
    Background The incidence of osteoporosis in Malaysia is increasing due to a fast-ageing population. Because of its silent nature, various osteoporosis risk assessment tools exist to detect high-risk patients and facilitate referrals for bone mineral density measurements. As an accessible point of contact, community pharmacists would benefit from the utilization of these tools and familiarity with guideline recommendations for osteoporosis screening. Aim This study aimed to investigate the awareness of osteoporosis risk assessment tools, practice behaviour towards osteoporosis, and knowledge of guideline recommendations among community pharmacists in the Klang Valley, Malaysia. Setting Community pharmacies. Methods This study was a cross-sectional study which sampled 284 community pharmacists practicing in the Klang Valley, using a stratified sampling approach. The study was conducted using a self-administered questionnaire which was divided into three sections: demographic data, knowledge of osteoporosis risk assessment tools and guideline recommendations, and practice behaviour towards osteoporosis. Practice behaviour was assessed with 15 items using a 5-point Likert scale. Main outcome measure. Proportion of respondents aware of osteoporosis risk assessment tools and respondent knowledge on guideline recommendations for osteoporosis screening. Results A total of 284 community pharmacists participated in the study. 84.1% of the respondents were aware of at least one risk assessment tool. However, only a small proportion of pharmacists (14.9%) regularly used these tools in their practice. Respondents perceived these tools to be relevant and beneficial, but perception towards their accessibility, ease-of-use, and administration time was mixed, suggesting unfamiliarity. Respondents preferred to conduct clinical assessments based on risk factors, with respondents identifying a mean of 10.1 ± 3.4 out of 15 risk factors. However, several clinically relevant risk factors were frequently unidentified. Knowledge of guideline recommendations among respondents was low. Conclusion There is some awareness of osteoporosis risk assessment tools but use in practice remains low among community pharmacists in Malaysia. There is potential to increase the use of these tools and knowledge of recommendations for osteoporosis screening and referral among community pharmacists.
  20. S E, G A, A F I, P S G, Y LT
    Environ Res, 2021 06;197:111177.
    PMID: 33864792 DOI: 10.1016/j.envres.2021.111177
    Membrane technology, especially nanofiltration (NF) has great attention to provide an imperative solution for water issues. The membrane is considered to be the heart in the separation plant. Understanding the membrane characteristics could allow predicting and optimizing the membrane performance namely flux, rejection and reduced fouling. The membrane development using biomaterials and nanomaterials provides a remarkable opportunity in the water application. This review focuses on the membrane characteristics of biomaterials and nanomaterials based nanofiltration. In this review, recent researches based on biomaterials and nanomaterials loaded membrane for salt rejection have been analyzed. Membrane fouling depends on the membrane characteristics and this review defined fouling as a ubiquitous bottleneck challenge that hampers the NF blooming applications. Fouling mitigation strategies via membrane modification using biomaterial (chitosan, curcumin and vanillin) and various other nanomaterials are critically reviewed. This review also highlights the membrane cleaning and focuses on concentrates disposal methods with zero liquid discharge system for resource recovery. Finally, the conclusion and future prospects of membrane technology are discussed. From this current review, it is apparent that the biomaterial and various other nanomaterials acquire exclusive properties that facilitate membrane advancement with improved capability for water treatment. Regardless of membrane material developments, still exist considerable difficulties in membrane commercialization. Thus, additional studies related to this field are needed to produce membranes with better performance for large‒scale applications.
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