Displaying publications 1 - 20 of 32 in total

Abstract:
Sort:
  1. Woon LSC, Zakaria H
    East Asian Arch Psychiatry, 2019 Dec;29(4):118-123.
    PMID: 31871308 DOI: 10.12809/eaap1851
    OBJECTIVE: To determine the prevalence of adult attention deficit hyperactivity disorder (ADHD) and comorbid mental disorders in a Malaysian forensic mental hospital.

    METHODS: All adult patients admitted to the forensic wards who were able to understand Malay or English language and give written informed consent were included. Participants were assessed using the Conners Adult Attention-Deficit Diagnostic Interview for DSM-IV (for presence of adult ADHD and a history of childhood ADHD) and the Mini International Neuropsychiatric Interview (for psychiatric comorbidities). Sociodemographic and offence-related data were also collected.

    RESULTS: Of 199 patients admitted, 120 were included for analysis. The mean age of participants was 36.3 years. 94.2% were men. 81.7% were single, divorced, or separated. 25% had a history of childhood ADHD. The prevalence of adult ADHD was 15.8%. The persistence rate was 63%. Among the 19 participants with adult ADHD, the most common psychiatric comorbidities were substance dependence (68.4%), lifetime depression (63.2%), and generalised anxiety disorder (47.4%). Compared with participants without ADHD, participants with adult ADHD were less likely to be married (0% vs 21.8%, p = 0.022) and more likely to have alcohol abuse (15.8% vs 2%, p = 0.028), lifetime manic/hypomanic episodes (42.1% vs 7.9%, p = 0.001), and generalised anxiety disorder (47.4% vs 19.8%, p = 0.017), and were of younger age at first offence (21.8 years vs 26.9 years, p = 0.021).

    CONCLUSIONS: Adult ADHD is common in a Malaysian forensic mental hospital and is associated with unmarried status, alcohol abuse, lifetime manic/hypomanic episodes, generalised anxiety disorder, and younger age at first offence.

  2. Woon LS, Kanapathy A, Zakaria H, Alfonso CA
    Psychodyn Psychiatry, 2017;45(2):237-257.
    PMID: 28590207 DOI: 10.1521/pdps.2017.45.2.237
    Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder that often runs a chronic unremitting course. Treatment outcomes can be unsatisfactory despite the availability of various somatic and psychological therapies. Psychodynamic psychotherapy in combination with cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) could help patients with treatment-resistant OCD achieve better outcomes. An integrative approach can help patients gain insight, strengthen the therapeutic alliance, improve treatment adherence, and provide symptomatic relief when other treatments seem insufficient or have failed. We describe the treatment process of a person with treatment-resistant OCD who received pharmacotherapy, concurrent CBT/ERP, and a brief course of psychodynamic psychotherapy. Case formulations from cognitive behavioral and psychodynamic perspectives are presented. The authors discuss the advantages of doing a psychodynamic assessment and formulation in treatment refractory cases and the wisdom of integrating psychotherapy interventions for OCD, as well as the unique clinical features of cases that warrant a multimodal treatment approach.
  3. Tang SS, Prodhan ZH, Biswas SK, Le CF, Sekaran SD
    Phytochemistry, 2018 Oct;154:94-105.
    PMID: 30031244 DOI: 10.1016/j.phytochem.2018.07.002
    Antimicrobial peptides (AMPs), the self-defence products of organisms, are extensively distributed in plants. They can be classified into several groups, including thionins, defensins, snakins, lipid transfer proteins, glycine-rich proteins, cyclotides and hevein-type proteins. AMPs can be extracted and isolated from different plants and plant organs such as stems, roots, seeds, flowers and leaves. They perform various physiological defensive mechanisms to eliminate viruses, bacteria, fungi and parasites, and so could be used as therapeutic and preservative agents. Research on AMPs has sought to obtain more detailed and reliable information regarding the selection of suitable plant sources and the use of appropriate isolation and purification techniques, as well as examining the mode of action of these peptides. Well-established AMP purification techniques currently used include salt precipitation methods, absorption-desorption, a combination of ion-exchange and reversed-phase C18 solid phase extraction, reversed-phase high-performance liquid chromatography (RP-HPLC), and the sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS-PAGE) method. Beyond these traditional methods, this review aims to highlight new and different approaches to the selection, characterisation, isolation, purification, mode of action and bioactivity assessment of a range of AMPs collected from plant sources. The information gathered will be helpful in the search for novel AMPs distributed in the plant kingdom, as well as providing future directions for the further investigation of AMPs for possible use on humans.
  4. Selamat Din SH, Nik Jaafar NR, Zakaria H, Mohamed Saini S, Ahmad SN, Midin M
    Asian Pac J Cancer Prev, 2017 Feb 01;18(2):465-471.
    PMID: 28345831
    Background: Anxiety is recognized as a normal psychological reaction of those caring for cancer patients. However, anxiety disorders in caregivers may interfere with their care-giving role and require further clinical attention. Objectives: To determine the prevalence and associated factors of anxiety disorders among caregivers of breast cancer patients receiving oncologic treatment in Kuala Lumpur Hospital. Methodology: A cross-sectional study was conducted on 130 caregiver-patient dyads, recruited by non-random sampling at Kuala Lumpur Hospital. Data were collected in 2 stages: 1) the caregivers were screened for psychological distress using the Depression, Anxiety, Stress, Scale (DASS-21) while other related factors for the patients and their caregivers were obtained; 2) the identified distressed caregivers (n=64) were then administered the Mini International Neuropsychiatric Interview (MINI) to diagnose anxiety disorders. Results: A total of 11.5% (n=15) of the caregivers reported suffering from anxiety disorders. Bivariate analysis found duration of caregiving (OR=3.31; CI=2.21-11.93), shared caregiving (OR=4.07; CI=1.34-12.36), and patients’ treatment type (OR=3.42; CI=1.92-12.76) were significantly associated with anxiety disorders (p value <0.05), with shared caregiving and patient’s treatment type remaining significant using logistic regression (p value < 0.05, R2 = 0.255). Conclusions: Every one in ten of the caregivers in this study had a diagnosable anxiety disorder, associated with certain care-giving factors and patients’ treatment. This should alert clinicians to such risk and indicates psychological support needs for family caregivers.
  5. Lee SC, Sidi H, Zakaria H, Loo JL, Yahaya R
    MyJurnal
    Exhibitionism is a distressing condition which may have a link with the increasing availability and usage of online sexual activities (OSA). We highlight a 42-year-old man who presented with a constant craving for OSA to achieve his sexual satisfaction which included exposing his genitalia to virtual partners, unsuspected strangers, and colleagues in public areas. His sexual behaviours were further reinforced by an online video chatting with genitalia exposure, which ended commonly with an exchange of masturbatory acts. He denied any problem with his erection and able to achieve orgasm via common sexual acts. There was no past psychiatric history nor family history of mental disorder. He volunteered to seek psychiatric help and subsequently given a psycho education on his illness and how to cope with the distress associated with his sexual acts. He was scheduled for an intensive psychotherapy to instil insight and hope to deal with his sexual difficulties.
  6. Assa'edah Mahmud A, Zakaria H, Zaliman Mohd Yusoff M, Ruzyanei Nik Jaafar N, Baharudin A, Mohd Tamil A
    Alpha Psychiatry, 2022 Sep;23(5):223-229.
    PMID: 36426271 DOI: 10.5152/alphapsychiatry.2022.21781
    BACKGROUND: The primary purpose of this study is to examine the feasibility of a short-term virtual reality exposure therapy among healthy working adults sample. The secondary aim is to measure the effect of virtual reality exposure therapy on negative and positive emotions by comparing it to the standard stress management program and the wait-list groups.

    METHODS: We enrolled 67 participants allocated into 3 groups to receive virtual reality exposure therapy, standard stress management, or wait-list group. The virtual reality exposure therapy group received a total of a 30-minute exposure to a virtual reality environment over 2 weeks. The standard stress management group received a stress management program once during the study period.

    RESULTS: The results showed a heterogeneous sample, whereby a significantly younger, less-working years, and higher anxiety baseline score were found in the virtual reality exposure therapy group compared to standard stress management and wait-list groups. Nonetheless, the virtual reality exposure therapy group showed a reduction in depression, anxiety, and stress score (P < .001). The standard stress management group showed a reduction in anxiety score only (P = .002), whereas no significant changes were observed in the wait-list group. For positive emotion, all 3 groups showed significant improvement.

    CONCLUSION: Short-term virtual reality exposure therapy is a feasible intervention for the negative and positive emotions; however, cautious interpretation is needed due to significant heterogeneous sample. Replication of study with comparable groups is recommended.

  7. Hanim BS, Rahim RA, Mohd Salleh MF, Zakaria H, Abd Shukor N
    Malays J Pathol, 2023 Dec;45(3):463-471.
    PMID: 38155387
    INTRODUCTION: Chorioamnionitis is the inflammation of the placenta and is histologically defined as the presence of neutrophilic infiltration into the chorio-amnion membrane with and without involvement of the umbilical cord. Currently, the inflammatory mediators involved in the eliciting of inflammatory response is still largely under investigation. CD47 and CD36 are pro-inflammatory molecules that are still under investigation. The aim of this study was to determine the expressions of CD47 and CD36 in the placenta of mothers with chorioamnionitis.

    MATERIALS AND METHODS: This was a cross-sectional study, involving a total of 100 cases that comprised of acute subchorionitis (stage I, n=20), acute chorioamnionitis (stage II, n=20), acute necrotising chorioamnionitis (stage III, n=20) and non-chorioamnionitis placenta as control (n=40). All tissue blocks were retrieved from the archived pathology record over a period of 4 years. CD36 and CD47 immunohistochemistry were performed on all cases and their expression in various cell types on the placenta were analysed.

    RESULTS: CD36 was expressed only on the foetal vascular endothelial cells. Interestingly, CD47 showed positive staining on the neutrophils and its expression was significantly different between maternal inflammatory response stage II chorioamnionitis (n=13/20, p<0.001) with stage I and stage III chorioamnionitis.

    DISCUSSION: Our study showed CD47 was expressed in the neutrophils and it was associated with poorer perinatal outcomes and it may have a role in the pathogenesis of chorioamnionitis.

  8. Lila MA, Siew JS, Zakaria H, Saad SM, Ni LS, Abdullah JM
    Malays J Med Sci, 2004 Jan;11(1):9-23.
    PMID: 22977356 MyJurnal
    Gene therapy is a promising approach towards cancer treatment. The main aim of the therapy is to destroy cancer cells, usually by apoptotic mechanisms, and preserving others. However, its application has been hindered by many factors including poor cellular uptake, non-specific cell targeting and undesirable interferences with other genes or gene products. A variety of strategies exist to improve cellular uptake efficiency of gene-based therapies. This paper highlights advancements in gene therapy research and its application in relation to anti-cancer treatment.
  9. Midin M, Razali R, Zamzam R, Fernandez A, Hum LC, Shah SA, et al.
    Int J Ment Health Syst, 2011 May 30;5:14.
    PMID: 21624111 DOI: 10.1186/1752-4458-5-14
    BACKGROUND: Gainful employment is one major area of functioning which is becoming an important goal in psychiatric rehabilitation of patients with schizophrenia. Studies in western countries are pointing to evidence that certain sociodemographic and clinical factors may contribute to employment outcomes in this group of people. However, the area is still largely unexplored in Malaysia. The aim of this study was to examine the sociodemographic, clinical and cognitive correlates of employment status among patients with Schizophrenia.

    METHODS: This was a cross-sectional study. All participants who fulfilled the requirements of the study according to the inclusion and exclusion criteria were enrolled. Study instruments included a demographic data questionnaire, Positive and Negative Symptom Scale (PANSS), Trail Making Tests, Rey's Auditory Verbal Learning Test (RAVLT) and Digit Span. Bivariate analyses were done using chi-square for categorical data and t-test for continuous data and multiple logistic regression analysis was done to identify predictors of employment status.

    RESULTS: A total of 95 participants who fulfilled the inclusion criteria were enrolled into the study. Among the sociodemographic, clinical and cognitive variables studied marital status, educational level, mean scores of negative symptoms, Digit Span and RAVLT and Trail Making Tests were found to show significant association with employment status on bivariate analyses. However, when entered into a logistic regression model, only cognitive variables ie. Trail A and B, Digit Span and RAVLT were significant predictors of employment status.

    CONCLUSIONS: The results from this study support the role of cognitive function, particularly, attention, working memory and executive functioning on attaining and maintaining employment in persons with schizophrenia as measured by the RAVLT, Digit Span and Trail Making Tests. These findings may act as preliminary evidence suggesting the importance of integrating cognitive rehabilitation in the psychosocial rehabilitation program for patients with schizophrenia in Malaysia.

  10. Biswal BM, Sulaiman SA, Ismail HC, Zakaria H, Musa KI
    Integr Cancer Ther, 2013 Jul;12(4):312-22.
    PMID: 23142798 DOI: 10.1177/1534735412464551
    Hypothesis. Withania somnifera is an herb with antioxidant, anti-inflammatory, anticancer, antistress, and adaptogenic properties. Previous studies have shown its antistress effects in animals. Traditional Indian medicine has used it for centuries to alleviate fatigue and improve general well-being.
  11. Lim JTY, Cheng Q, Ng YP, Pheh KS, Panirselvam RR, Tay KW, et al.
    Front Psychol, 2021;12:666027.
    PMID: 34975604 DOI: 10.3389/fpsyg.2021.666027
    Background: Suicide remains an important cause of premature deaths and draws much media attention. However, unsafe reporting and portrayal of suicides by the media have been associated with increased risk of suicidal behavior. Current evidence suggests that media capacity-building could potentially prevent suicide. However, there are still knowledge gaps in terms of a lack of data on effective strategies for improving awareness and safe reporting of suicide-related media content. This study aims to investigate the effectiveness of a workshop conducted with members of the media community on the safe reporting of suicide-related content. Methods: An interventional single-arm pre and post pilot study was conducted on a sample of the Malaysian media community recruited through purposive and snowball sampling. The media safe reporting workshop was conducted by a suicide prevention expert with a media industry background. Thirty participants completed a self-reported evaluation questionnaire on their awareness and knowledge of reporting on suicide-related media content; before and after the interventional workshop. Results: There was a significant difference between the total scores before and after the intervention, with a large effect size. Post-intervention scores were significantly improved in 8 items, namely those related to the reporting of: (i) the content of any suicide note; (ii) headlines with methods of suicide; (iii) headlines with the location of suicide; (iv) cases of suspected suicide despite the unconfirmed cause of death; (v) suicide news to cater to readers' interests; (vi) cause of suicide; (vii) details of the location of suicide; and (viii) the negative impact to media community when reporting suicide stories. In particular, there was an improvement in the majority of items for people from the media community with no lived experience of suicidal behavior. Conclusion: The media safe reporting workshop is a potentially effective intervention for improving awareness and knowledge measures relating to safe reporting on suicide among the media community, with a more pronounced effect in those without lived experience of suicidal behavior. Limitations in the sample size, generalizability, short-term evaluation, and lack of a control group warrant future larger, longer-term controlled, and more representative studies.
  12. Nordin AS, Kadir RA, Yahya NA, Zakaria H, Rashid RA, Habil MH
    Int Dent J, 2014 Aug;64(4):206-12.
    PMID: 24835463 DOI: 10.1111/idj.12110
    As a signatory to the World Health Organisation 2003 Framework Convention on Tobacco Control, Malaysia has policies in place and funded 300 public Quit clinics. Unfortunately, government dentists are not included to run tobacco dependence treatment. A cross-sectional exploratory survey was carried out to seek Malaysian dentists' opinion on their knowledge, perception and willingness to conduct tobacco dependence treatment. Participation was voluntary from those who attended a specially designed one-day, four-module workshop on tobacco cessation intervention. Data were collected using the Audience-Response-System equipment which tracked immediate responses covering four domains namely: smoking as a public health problem, smoking as an addiction, the role of dentists in the programme and confidence in conducting smoking cessation in the clinic. Sample comprised more female dentists (73.5%), mean age 33.6 (SD 8.99) years and with more than 3 years working experience. Findings indicated that the majority agreed Malaysia has a rising problem in the prevalence of smoking (71.6%) and predicted that it will affect mostly the young (81.9%). Only half of the dentists surveyed (58.9%) routinely recorded their patients' smoking habits. The majority (71.6%) believed that dentists are effective in helping their patient to stop smoking and 76.3% agreed that dentists should discuss the smoking habit with their patients; however, 60% agreed that doing so is too time consuming. In addition, only 24.7% knew of more ways to treat a smoking habit. The majority felt comfortable giving advice to patients about changing their habits (76.5%) or discussing treatment options (60.5%): 75% would opt for a combined programme of counselling and use of medication if they have to do, 15% would choose to go on counselling only, while 8% did not want to treat. In conclusion, the findings suggest that dentists have a strong potential to contribute significantly to providing smoking cessation treatment if adequately trained.
  13. Agatonovic-Kustrin S, Morton DW, Adam A, Mizaton HH, Zakaria H
    J Chromatogr A, 2017 Dec 29;1530:192-196.
    PMID: 29132827 DOI: 10.1016/j.chroma.2017.11.012
    The steady increase of diabetes is becoming a major burden on health care systems. As diabetic complications arise from oxidative stress, an antioxidant therapy along with anti-diabetic drugs is recommended. Myrmecodia or ant plant is highly valued as a traditional medicine in West Papua. It is used as an alternative treatment for diabetes, as the substances produced by ants can reduce blood sugar levels. The aim of this study was to develop and establish high-performance thin-layer chromatographic (HPTLC)-bioautographic methods to measure the antioxidant and hypoglycemic effects in different extracts from Myrmecodia platytyrea and to compare them with sterol content. Antioxidant activity in methanol, ethanol, dichloromethane (DCM) and ethyl acetate (EA) extracts were measured with a direct HPTLC-2,2-diphenyl-1-picrylhydrazyl free radical (DPPH) assay, while hypoglycemic effects were assessed using a newly developed α-amylase inhibitory activity assay. Stigmasterol is observed, after derivatization with anisaldehyde, as purple colored zones under visible light at hRF values of 0.66. The highest antioxidant activity was observed in the ethanol extract which is rich in polyphenols and flavonoids, while the DCM extract did not show antioxidant activity, but had significant α-amylase inhibitory activity. The highest α-amylase inhibitory activity was observed in the EA and DCM extracts and was related to their stigmasterol content.
  14. Alfonso CA, Michael MC, Elvira SD, Zakaria H, Kalayasiri R, Adlan ASA, et al.
    Psychiatr. Clin. North Am., 2018 06;41(2):305-318.
    PMID: 29739528 DOI: 10.1016/j.psc.2018.01.010
    Psychodynamic psychiatry remains a challenging subject to teach in underserved areas, where enthusiasm to learn is substantial. Besides logistical and psychiatric workforce shortcomings, sensible cultural adaptations to make psychodynamic psychiatry relevant outside of high-income countries require creative effort. Innovative pedagogical methods that include carefully crafted mentoring and incorporate videoconferencing in combination with site visits can be implemented through international collaborations. Emphasis on mentoring is essential to adequately train future psychodynamic psychotherapy supervisors. Examples of World Psychiatric Association initiatives in countries such as Indonesia, Iran, Malaysia, and Thailand are presented as possible models to emulate elsewhere.
  15. Zakaria H, Hussain I, Zulkifli NS, Ibrahim N, Noriza NJ, Wong M, et al.
    PLoS One, 2023;18(7):e0283862.
    PMID: 37506072 DOI: 10.1371/journal.pone.0283862
    BACKGROUND AND AIMS: There is growing evidence on the contribution of psychological factors to internet addiction; yet it remains inconsistent and deserves further exploration. The aim of this study was to determine the relationship between the psychological symptoms (Attention Deficit Hyperactivity Disorder (ADHD) symptoms, stress, depression, anxiety and loneliness) and internet addiction (IA) among the university students in Malaysia.

    MATERIALS AND METHODS: A total of 480 students from different faculties in a Malaysian public university participated in this study. They were selected by simple random sampling method. They completed self-administered questionnaires including the Malay Version of Internet Addiction Test (MVIAT)) to measure internet addiction and Adult Self-Report Scale (ASRS) Symptom Checklist, Depression Anxiety Stress Scales (DASS) and UCLA Loneliness Scale (Version 3) to assess for ADHD symptoms, depression, anxiety, stress, and loneliness respectively.

    RESULTS: The prevalence of IA among university students was 33.33% (n = 160). The respondents' mean age was 21.01 ± 1.29 years old and they were predominantly females (73.1%) and Malays (59.4%). Binary logistic regression showed that gender (p = 0.002; OR = 0.463, CI = 0.284-0.754), ADHD inattention (p = 0.003; OR = 2.063, CI = 1.273-3.345), ADHD hyperactivity (p<0.0001; OR = 2.427, CI = 1.495-3.939), stress (p = 0.048; OR = 1.795, CI = 1.004-3.210) and loneliness (p = 0.022; OR = 1.741, CI = 1.084-2.794) were significantly associated with IA.

    CONCLUSION: A third of university students had IA. In addition, we found that those who were at risk of IA were males, with ADHD symptoms of inattention and hyperactivity, who reported stress and loneliness. Preventive strategy to curb internet addiction and its negative sequelae may consider these factors in its development and implementation.

  16. Golam F, Prodhan ZH
    J Sci Food Agric, 2013 Feb;93(3):449-56.
    PMID: 23238771 DOI: 10.1002/jsfa.5983
    Kernel elongation after cooking is an important character of fine rice and most rice consumers prefer length-wise elongation. Although improvement of aromatic rice began early in the 1970s, until now the mechanisms and genetics of kernel elongation has remained unrevealed. Kernel elongation is considered as a physical phenomenon and is influenced by several physicochemical and genetic factors, including genotypes, aging temperature, aging time, water uptake, amylose content and gelatinization temperature. Recently the complete genetic map of fine rice has been created and the gene responsible for kernel length identified; moreover, this gene is tightly linked with the cooked kernel elongation trait. Several molecular markers linked with cooked kernel elongation have been developed. These tools will be helpful for the improvement of this important trait. For the proper study of cooked kernel elongation of rice, this review paper will provide the basis and directional materials for further studies.
  17. Sidi H, Loh SF, Mahadevan R, Puteh SE, Musa R, Wong CY, et al.
    Asia Pac Psychiatry, 2013 Apr;5 Suppl 1:103-9.
    PMID: 23857845 DOI: 10.1111/appy.12053
    INTRODUCTION: The objective of this study was to determine the relationship between clinical/socio-demographic factors with knowledge and attitude on sex among medical students of the National University of Malaysia (UKM).
    METHODS: A cross-sectional study assessing 452 students using a self-administered questionnaire of knowledge and attitude was performed and had a response rate of 80%.
    RESULTS: The majority of respondents were Malays (56%), females (57.5%), lived in urban areas (66.4%), had a median family income of RM3000 and perceived themselves as moderately religious (60%). The overall score on knowledge about sex was 21.7 of 35 (a higher score indicates better knowledge about sex). It was noted that 73.2% of students felt that they did not receive adequate training in medical school to deal with patients' sexuality and sexual problems, while 51.5% felt uncomfortable talking to patients about these issues. Students in the clinical year were more knowledgeable than those in pre-clinical years (22.67 versus 20.71, P 22 marks [median score]).
    DISCUSSION: The students' attitude on sex was considered conservative as the majority of them disagreed on premarital sex, masturbation, abortion, homosexuality and oral sex. Gender and religiosity have a large influence on attitudes on controversial sexual issues, whereas clinical status plays a small role. Knowledge on sex among UKM medical students is inadequate and their attitudes on sex are considered conservative. Integration of sexual medicine and health modules in the medical curriculum is crucial for students to more effectively address patients' sexual problems and promote non-judgmental attitudes towards patients.
    KEYWORDS: attitude; knowledge; medical student; sex
  18. Loo JL, Ang JK, Subhas N, Ho BK, Zakaria H, Alfonso CA
    Psychodyn Psychiatry, 2017;45(1):45-57.
    PMID: 28248565 DOI: 10.1521/pdps.2017.45.1.45
    The subjective nature of psychodynamic psychotherapy (PP) makes training and supervision more abstract compared to other forms of psychotherapy. The issues encountered in the learning and supervision process of PP of Malaysian psychiatry trainees are discussed in this article. Issues of preparation before starting PP, case selection, assessment of patients, dynamic formulations, supervision, anxieties in the therapy, countertransference, termination of therapy, the treatment alliance, transfer of care, the therapeutic setting, and bioethical considerations are explored. Everyone's experience of learning PP is unique and there is no algorithmic approach to its practice. With creative thinking, effort, and "good enough" supervision, a trainee can improve PP skills, even in underserved areas of the world.
  19. Wong YP, Wagiman N, Tan JW, Hanim BS, Rashidan MSH, Fong KM, et al.
    Diagnostics (Basel), 2022 Apr 01;12(4).
    PMID: 35453930 DOI: 10.3390/diagnostics12040882
    Background: Chorioamnionitis complicates about 1−5% of deliveries at term and causes about one-third of stillbirths. CXC-chemokine receptor 1 (CXCR1) binds IL-8 with high affinity and regulates neutrophil recruitment. We aimed to determine the immunoexpression of CXCR1 in placentas with chorioamnionitis, and its association with adverse perinatal outcomes. Methods: A total of 101 cases of chorioamnionitis and 32 cases of non-chorioamnionitis were recruited over a period of 2 years. CXCR1 immunohistochemistry was performed, and its immunoexpression in placentas was evaluated. The adverse perinatal outcomes included intrauterine death, poor APGAR score, early neonatal death, and respiratory complications. Results: Seventeen cases (17/101, 16.8%) with chorioamnionitis presented as preterm deliveries. Lung complications were more common in mothers who were >35 years (p = 0.003) and with a higher stage in the foetal inflammatory response (p = 0.03). Notably, 24 cases (23.8%) of histological chorioamnionitis were not detected clinically. Interestingly, the loss of CXCR1 immunoexpression in the umbilical cord endothelial cells (UCECs) was significantly associated with foetal death (p = 0.009). Conclusion: The loss of CXCR1 expression in UCECs was significantly associated with an increased risk of adverse perinatal outcomes and could be used as a biomarker to predict adverse perinatal outcomes in chorioamnionitis. Further study is warranted to study the pathophysiology involved in the failure of CXCR1 expression in these cells.
  20. Castillo-Carandang NT, Buenaventura RD, Chia YC, Do Van D, Lee C, Duong NL, et al.
    Risk Manag Healthc Policy, 2020;13:803-819.
    PMID: 32765135 DOI: 10.2147/RMHP.S256165
    Introduction: Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in the Association of Southeast Asian Nations (ASEAN) member states. Progress has been slow despite the World Health Organization action plan for the prevention and control of NCDs in the region. This paper presents recommendations focused on practical strategies for optimizing NCD management in the ASEAN region.

    Methods: A multidisciplinary group of experts from six ASEAN member states convened for two face-to-face meetings to discuss barriers and possible recommendations for optimizing NCD management, focused on cardiovascular diseases and mental disorders, in the region. Multiple approaches, ie, analysis of insights from the meetings and a review of existing literature on NCD programs in the ASEAN region were followed. The proposed recommendations were also based on selected successful interventions in ASEAN member states, thus providing actionable strategies.

    Results: The gaps identified in NCD management for cardiovascular diseases and mental disorders in the ASEAN region were classified into gaps relating to policies and to clinical and public health practice. The proposed solutions addressing policy gaps include fostering multisectoral public-private partnerships, employing "whole-of-government" and "whole-of-society" approaches and promoting "health-in-all policies approach" to manage issues with financing, accessibility, efficiency and quality of health services. Whereas proposed solutions to bridge clinical and public health practice gaps entail strengthening primary care services, building the capacity of trained healthcare workers and employing collaborative care for holistic management of patients.

    Conclusion: The scale of premature and preventable deaths from NCDs in the ASEAN region remains a serious public health concern and requires a "whole-of-system approach". The interventions proposed in this paper build on regional collaborations and knowledge sharing to help develop a concerted and targeted response to NCDs.

Related Terms
Filters
Contact Us

Please provide feedback to Administrator (afdal@afpm.org.my)

External Links