Introduction: The National Blood Center, Kuala Lumpur interprets laboratory results for the von Willebrand factor (VWF) profile based on guidelines which were established based on the Caucasian population. The VWF profiles among the Malay population has not yet been established. The current study aims to determine the VWF profiles of the different ABO blood types among Malays and to evaluate their association with demographic characteristics and smoking habits. Methods: One hundred and forty Malay donors were involved. Factor VIII (FVIII:C), VWF antigen (VWF:Ag), and ristocetin cofactor (VWF:RiCof) levels and collagen binding activity (VWF:CBA) were measured by coagulometric clot detection, latex agglutination, and enzyme-linked immunosorbent assay. Results: The majority of donors (59.3%) were 30–49 years old, male (81.43%), non-smokers (74.3%), and overweight (71.4%). The Malay VWF:Ag were slightly higher than those of Caucasians, Indians, Thais, and Chinese, but the average ratios of VWF activity (i.e., VWF:RiCof level and VWF:CBA) to VWF:Ag were slightly lower than those of the other populations. The highest level of VWF:Ag was found among those with the B blood group, followed by types A and O. Conclusion: Malays with type O blood had lower values of the components of the VWF profile compared to subjects with non-O blood. The higher levels of these elements and lower VWF activity to VWF:Ag ratio in Malays compared to other populations suggest that ethnicity impacts the plasma VWF levels and their interaction with collagen and platelets.
MicroRNAs (miRNAs) are small noncoding RNAs that involved in various normal and cancer-related cellular pro-cesses. Studies on expression profiling of miRNAs have been performed and the data showed that some miRNAs are up-regulated or down-regulated in cancer. miRNAs play a crucial role in HNSCC development, metastasis, prognosis and survival rate. Several studies have been conducted previously to investigate that use of miRNAs as the biomark-ers in disease diagnostic/prognostic and potential therapeutic targets management that may improve the outcomes of HNSCC. Our previous study revealed that upregulation of oncogenic miRNAs including hsa-miR-181a-2*, hsa-miR-29b-1*, hsa-miR-181a, hsa-miR-181b, hsa-miR-744, hsa-miR-1271 and hsa-miR-221* were able to distinguish HNSCC from normal samples. These miRNAs may contribute in a simple profiling strategy to identify individuals at higher risk of developing head and neck cancers, thus helping in the elucidation of the molecular mechanisms involved in head and neck cancer pathogenesis.
Introduction: The mortality rate of glioma patients particularly with glioblastoma multiforme (GBM) remains high even with advancements in the multimodality treatment. This is partly due to chemoresistance of the glioma cells towards drug treatment which finally reduced the survival of GBM patients. In this study, we determined the chemosensitisation and oncogenic characteristics of ZFP36L2 in LN18 GBM cells using RNA interference (RNAi). Methods: Meta-analysis of microarray datasets was used to identify the druggable genes responsive to GBM chemosensitivity. Subsequently, the genes were validated using RNAi screening [pooled small interference RNA (siRNA)]. Temozolomide- resistant LN18 cells were used to evaluate the effects of gene silencing on chemosensitisation to the sub-lethal dose (1/10 of IC50) of temozolomide. Assays such as cell viability, proliferation, migration and invasion and apoptosis assays were carried out. The apoptosis pathway underlying chemosensitisation by ZFP36L2 siRNA was determined using a human apoptosis array kit. Statistical analyses were performed using one-way analysis of variance. Results: ZFP36L2 was identified as a potential marker of GBM based on the meta-analysis and RNAi screening. ZFP36L2 knockdown lead to 1) Apoptosis induction (p < 0.05) 2) Reduced cell migration (p < 0.05) 3) Reduced up to 82% of cell invasion (p < 0.01) and 4) Decreased cellular proliferation in siZFP36L2-treated LN18 cells. Downstream analysis showed that the sub-lethal dose of temozolomide caused major upregulation of BCL2-associated X, apoptosis regulator (BAX). Conclusion: ZFP36L2 is oncogenic and chemosensitive thus may contribute to gliomagenesis through cell proliferation, migration, invasion and apoptosis. RNAi therapy in combination with chemotherapy treatment such as temozolomide may serve as potential therapeutic approach in the future.
Introduction: Work-related road traffic crashes (RTC) are a significant global public health challenge due to the seriousness of its consequences. Injured workers who have survived work-related RTC are advised to go for reha- bilitation after they have been treated physically by healthcare providers. Reintegrate as soon as possible into the working community able avoid long periods of sick leave. Return to work (RTW) rate have been used extensively in many previous studies as an indicator of rehabilitation outcomes on the working capacity of injured workers. The objective of this study was to compare RTW rate after rehabilitation for injured workers who received physical re- habilitation only (control group) and physical rehabilitation plus outcome-focused intervention (intervention group). Methods: Eligible 200 workers who were involved in work-related RTC and agreed to participate in SOCSO RTW Program were identified and invited to be part of this study. Sociodemographic, employment and injury-related questions were distributed. Results: This study finding showed majority (79.5%) of the respondents were aged 25 years old or older, male (86.0%), married or divorced (63.5%), and attained secondary and below education level at secondary or below (66.0%). More than half of injured workers consisted of blue-collar workers (69%), had fracture injury (93.0%), and had injury to their lower limbs (48.5%). RTW rate was higher in the intervention group (received physical rehabilitation and outcome-focused intervention) compared to the control group (received physical rehabil- itation only). Conclusion: RTW rate for work-related RTC was higher with outcome-focused intervention, in addition to physical rehabilitation.
Work-Related Hand Injuries (WRHIs) may result in disability and diminished productivity and cause economic impacts not only to the individual, worker’s families and industries, but to the local community as well.
Objectives: To determine the prevalence of severe Work-Related Hand Injuries (WRHIs) and factors associated at a tertiary hospital.
Methods: A pre-tested validated questionnaire was used to obtain data. All patients 18 years and above with WRHIs seen at a tertiary hospital between January 2010 and June 2010 were included in the study. Data was analysed using SPSS version 18.
Results: Out of the 297 industrial accidents, 74 (24.9%) were WRHIs. Among those with WRHIs, (47.3%) of them had severe hand injuries. The overall mean age of the respondents was 30.36 (± 9.54 SD) years. Majority (82.5%) of the injuries occurred between Mondays to Friday. Majority (70.1%) of hand injuries were caused by machine and 48.6% of the hand injuries occurred when the hand was caught in the operating part of the machine. Majority (62.1%) of the respondents had fingers’ injuries and 32.4% had open fracture. Bivariate analysis showed that there was significant association between severity of WRHIs and locations of injury, mechanisms of injury, sources of injury and sectors of industry (p < 0.05). Logistic regression analysis showed that WRHIs was significantly associated with source of injury and sector of industry. Respondents with hand injury resulted while operating on mechanical machine was 26 times more likely to report severe WRHIs than those with other sources of their hand injury like (sharp tool, heavy door, and wet floor). Respondents working in metal-machinery industries were eight times more likely to report severe WRHIs than those who working in other sectors of industry like (wood-furniture, constriction, food preparing, service and automotive).
Conclusions: WRHIs contributed to 24.9% of all industrial accidents seen at the emergency department and orthopaedic clinic and 47.3% of the respondents with WRHIs had severe hand injuries. Severity of WRHIs was significantly associated with sources of injury and sectors of industry.
Study site: emergency room, orthopaedic ward, general surgery ward and the orthopaedic outpatient clinic of a tertiary hospital
This study aimed to identify the exposure levels of traffic air pollutants specifically PM10, benzene, toluene, and xylene (BTX) among traffic policemen and the risks to their respiratory health. A cross-sectional comparative study was conducted among 42 traffic policemen and 42 desk-bound policemen as the exposed and comparative groups respectively. Methods: The questionnaire adapted from the American Thoracic Society for Adult Respiratory Health Disease (ATS-DLD) to obtain socio-demographic and respiratory symptoms data. A spirometer (Chestgraph Hi-105) was used to perform lung function test. A personal air sampling pump was used to measure the personal exposure level to PM10. A Ppbrae 3000 was used to measure the outdoor and indoor concentration of BTX during morning and afternoon peak hours respectively. Results: The mean personal exposure level of PM10 among the traffic policemen was 150.14 ± 130.66 μg/m3 compared to only 84.14 ± 94.11 μg/m3 in the comparative group. The short exposures to BTX at the roadsides were found to be slightly higher in the afternoons than in the mornings. Indoor offices air concentrations were only detectable for benzene while the mornings and afternoons values for toluene and xylene were below the detection limits. A median concentration of benzene documented significantly higher at the selected of sampling roadsides areas (median=0.157 ppm) than indoor office areas (median=0.071 ppm). Conclusion: The respiratory symptoms were significantly higher in the exposed group compared to the comparative group which they were 3.9, 4.1, and 3.5 times more likely to develop cough, wheezing, and breathlessness respectively.
Introduction: The magnitude of drowning as one of the leading causes of death among children in Malaysia may have been underestimated. Little is known on the level of awareness on water safety among parents as it might be associated with appropriateness and adequacy of the supervision. This study aims to describe perceptions of water safety among parents of primary school children. Methods: A cross-sectional survey with 719 respondent conduct- ed to obtain information on parents self-reported on their children’s water-involved activity and swimming ability, self-estimated ability to rescue their child and perceptions of the risk of drowning and water safety for their children. Results: The result revealed that about 21.6% of respondents did not perceive drowning as one of the unintentional injury leading causes of death among children. Parents reported that their children had experienced a near- drown- ing incident (16.1%), and only 12.2% of the child had attended a formal swimming lesson. Majority of the parents did not involve in any water safety program (98.7%), can’t swim (61.6%), not been certified in CPR (87.3%) and not confident (87.3%) to perform resuscitation (CPR). Respondents also perceived their children could swim (42.1%), and they felt confident when their child in the water (45.6%). There were statistical differences between parents who reported their child had a near-drowning experience with their perception of children’s swimming ability. Conclu- sion: An exploration of parent’s perception of water safety provided an overview of the need for promoting aware- ness on drowning risk and water safety education in this country.
Introduction: The use of crude herbs for well-being as well as curation and prevention of ailments is evident globally, including Malaysia. To understand the effectiveness and reliability, the presence of phytochemical compounds as the factor influencing the use of crude herbs shall be determined. This study was conducted to screen the presence of phytochemical compounds in the local crude herbs consumed by patients with chronic diseases. This is part of
a larger study, where a cross-sectional study was conducted and reported elsewhere. Methods: In total, 15 types of crude herbs were reported by the patients with chronic diseases attending government health clinic at Kampar, Perak. The herbs were extracted using hot and standard cold methods respectively. Results: All the 15 crude herbs’ hot and cold extracts revealed the presence of eight phytochemical compounds, namely, phenols, quinones, tannins, terpenoids, saponins, flavonoids, glycosides, and alkaloids at varying intensity. Saponins, alkaloids, and glycosides were present in all the crude herbs extracts. However, terpenoids, tannins, and phenols were absent in Orthosiphon stamineus, Clinacanthus nutans, and Pandanus amaryllifolius extracts respectively. However, the cold extracts exhibited a higher intensity of phytochemicals compared to hot extracts. The present study confirms the presence of
phytochemicals in the local crude herbs consumed by patients with chronic diseases. The screened phytochemicals are bioactive compounds that possess medicinal properties that may trigger the patients to treat their diseases’ underlying conditions. However, the use of prescribed medicine, particularly among aging patients must be taken into account while consuming crude herbs. Conclusion: The findings of this study indicate that structured-evidence based crude herbs use interventions for patients with chronic diseases is warranted.
Introduction: The obesity rate in Malaysia is increasing exponentially. This is alarming as obesity in a population is likely to lead to health complications and negatively impact national economic productivity. The quality of health of our country is of paramount importance to a sustainable nation. To safeguard the health of our population in this country, there are current laws and potential laws to be implemented to combat obesity. In Malaysia, the government have introduced ‘soft policies’ approach such as Healthy life style programmes and campaigns as means to curb obesity yet its impact is questionable. ‘Hard policies’, such as regulations (e.g. imposing a tax, removal of subsidies, reduction of operational hours of eateries, menu-labelling, curbing of marketing of unhealthy food, implementation of pedestrian and bicycle paths, metabo laws) may be used as legitimate interventions to combat obesity in Malaysia. The aims of this paper is to (i) analyse the legal justifications for implementation of obesity prevention regulations, (ii) to compare and contrast the pros and cons of current and potential obesity prevention regulations to reduce obesity. Results and Conclusion: The law could be used to facilitate promotion of public health. In light of new scientific advances, gaps in the current regulatory framework, and the increasingly obesogenic environment, this paper proposes
potential legal approaches to address obesity in Malaysia. It is important for legal scholars to devise innovative strategies to address obesity from new perspectives. The great potential for the law to rectify the status quo has yet to be fully explored. With reduction of obesity, the fiscal burden of the nation on medical bills could be reduced and productivity could be increased.
Introduction: Kidney transplantation (KT) is the preferred end-stage renal disease (ESRD) treatment because it pro-vides a better survival rate, quality of life as well as a cheaper alternative. However, Malaysia’s KT rates is consis-tently low considering that ESRD rates have been increasing exponentially. With only four hospitals performing KT, there’s a gap to indicate a lack of evaluation in KT system of Malaysia. Qualitative study was undertaken to explore and describe the barriers and solutions improve the rates and service of KT in Malaysia. Methods: Semi-structured interviews adopted as qualitative methodological approach to explore current KT policy and service in Malaysia be-tween March – May 2018 in Kuala Lumpur. Eight key-informants selected using stakeholder analysis and informed consent were obtained. Interviews were digitally audio-recorded, transcribed verbatim and analysed using thematic analysis. Results: Barriers and solutions of Malaysia’s KT are the results of complex interplay of personal, cultural, and environmental factors that can be categorized and described using the five levels of influence conceptualized by the socio-ecological model (SEM). Guidance for developing culturally appropriate and sensitive interventional strategies was elicited from the key informants’ experiences to improve KT rate and services in Malaysia. Conclusion:Malaysia is experiencing very low rate of KT compared to other countries. The use of SEM provided a framework to foster a better understanding of current practice, barriers and solutions to KT in Malaysia. Implications of these find-ings could prompt policy change for better KT service delivery model. Further stakeholder engagement and evalua-tion is required to align best practices to improve KT rates and service in Malaysia that is comparable to high-income countries.
Wandering spleen is renowned as a surgical enigma due to its diverse presentations. Due to lack of its attaching ligaments which would usually place it at the left hypochondrium region, the spleen ‘wanders’ and may be located anywhere within the abdominal cavity. This condition has been associated with many complications such as splenic torsion, pancreatitis and portal hypertension. We report a case of a wandering spleen presenting as acute appen- dicitis in an 18-year-old young active sportsman. The patient developed post-operative ileus and later intestinal obstruction which necessitated exploratory laparatomy onto which the final diagnosis of splenic and small bowel infarct due to splenic torsion with small bowel volvulus was made. Splenectomy, small bowel resection and primary anastomosis were performed and the patient made a full recovery.
With the availability of the Internet, pornographic materials are readily accessible. Pornographic materials may have a link to addiction and other deviant sexual behaviour. In this case report, we highlighted a link between voyeuristic disorder and internet sex addiction. Mr. SK is a 22-year-old single gentleman who was referred for psychiatric assessment due to voyeuristic acts. He had been watching pornographic materials since 16 years old and became addicted to it.
More studies are now focusing on vitamin E as an anticancer agent for its good effects in many in-vitro studies. Current studies proposed that vitamin E might be a suitable candidate as an alternative treatment for cancer due to its antioxidant properties. Vitamin E act as an antioxidant by their long-chain polyunsaturated fatty acids, and thus the integrity of membranes in the cells is maintained and consequently retain the bioactivity of the cells. This mini review will focus on the activity of vitamin E as an antioxidant to protect against cancer in in-vitro, in-vivo, and clin- ical studies. Although most studies reported great outcomes for the anticancer activity of vitamin E, there were some conflicting data. To date, studies on effects of vitamin E are still undergoing where researchers are still debating on the positive and negative effects of vitamin E as an anticancer therapeutic action.
Vitamin D plays an important role in maintaining the physical health as well as the performance of athletes. This cross-sectional analytical study was conducted to determine vitamin D intake, sun exposure and skin types of both indoor and outdoor Malaysian athletes in the National Sports Institute, Bukit Jalil. Method: A total of 28 indoor (badminton, shooting, wushu and fencing) and 36 outdoor (athletics, football and hockey) athletes were recruited for this study. The dietary vitamin D intake was estimated using Vitamin D-specific Food Frequency Questionnaire (FFQ). The Sun Exposure Index (SEI) was calculated from Seven-day Sun Exposure Record while the skin types of athletes were determined using Fitzpatrick Skin Typing Questionnaire. Results: The mean age of the athletes was 21.02±4.11 years and their mean Body Mass Index (BMI) was 22.20±2.22 kg/m2. The mean body fat percentage of outdoor athletes was significantly lower than indoor athletes (p
Introduction: A hospital based case control study was
conducted in government hospitals on contact lens patients
diagnosed with microbial keratitis. Methods: The objective of
this study is to determine the visual outcomes of contact lens
related microbial keratitis. The visual outcomes which
comprised of visual acuity, keratometry readings, corneal
topography findings and contrast sensitivity examinations was
determined after three months from the first presentation at the
hospitals. Results: The mean LogMAR visual acuity during
presentation was 0.96 ± 0.73 or a Snellen equivalent 6/60 (n=76)
and mean LogMAR visual acuity after three months was 0.10 ±
0.48 or a Snellen equivalent 6/7.5 (n=76) with a significant
difference (t=11.22, df=78, p=0.001). Best fit curve for the cases
had a regression coefficient, r=0.350 ± 0.063 (95% CI = 0.224,
0.447, df=78, p=0.001. The visual acuity in cases and controls
was 0.10 ± 0.48 and -0.10 ± 0.14 respectively (t= -3.61, df=154
p=0.001) after three months which showed improvement. There
was a reduction in the corneal uniformity index and corneal
asphericity in the cases. The Corneal Uniformity Index (CU
index) in cases was 63.03 ± 26.38 (n=76) and in controls, 80.13
± 11.30 (n=77), (t= -5.22, df=151, p=0.001). There was also a
reduction in the contrast sensitivity function at all spatial
frequencies in the cases which was significantly different.
Conclusion: Microbial keratitis reduced the vision, corneal
uniformity index, asphericity and contrast sensitivity after three
months in eyes of patients diagnosed with the condition.
Introduction: Inflammation is one of the major cause of cardiovascular disease, obesity, cancer and stroke. Many dietary compounds containing kernel oil or coconut oil with anti-inflammatory effect can delay the onset of these chronic diseases however the underlying mechanism is unclear. Methods: This study compares the effects of 5% virgin palm kernel oil (VPKO), virgin coconut oil (VCO) and refined, bleached, deodorized olive oil (RBDOO) on selected immune markers in healthy sprague dawley (SD) rats (n=16 per treatment) across 8 weeks. Sera were obtained for four major immunological analyses including cluster of differentiation 4 (CD 4), cluster of differentiation 8 (CD 8), interleukin 6 (IL 6), and c reactive protein (CRP). Results were expressed in mean ± standard error of the mean (mean±SE). Results: Eight weeks fat feeding had no significant difference in weight gain across treatments. Interestingly, we observe significant different on the concentration of CD 4 (p=0.001) with the lowest CD 4 level in rats fed with VPKO 3.87±0.65 ng/ml. The concentration of CD 8 in rats fed with VPKO 8.19±0.25 (p=0.001) ng/ml was comparable to VCO fed rats but was found lower than the control group, RBDOO fed rats. Lower T cell count (CD 4 or CD 8) indicates suppression in inflammation. IL-6 and CRP concentration in rat fed with VPKO 10.89±0.22 pg/ml and 118.39±7.13 ng/ml were slightly higher than that of VCO fed rats but were lower than RBDOO fed rats. Conclusion: We postulate that VPKO could be a potential supplement as an alternative to VCO for relieving inflammation and enhancing body immune system.
Renal cell carcinoma (RCC) is the most common renal malignancies. In advanced stage, it is highly resistant to systemic therapies. RCC is a highly vascular tumour and angiogenesis pathway has been postulated in its carcinogenesis. Novel drug targeting Vascular Endothelial Growth Factor (VEGF) and advanced surgical interventions have shown to increase the overall patients’ survival. In this study, we evaluated the VEGF expression of RCC using immunohistochemistry technique and its potential correlation with the tumour grades. Methods: 40 RCC cases that underwent nephrectomy were selected. The archived samples of formalin fixed, paraffin-embedded (FFPE) were retrieved. The tumour tissue blocks were carefully chosen, sectioned and stained with VEGF using immunohistochemistry technique. The intensity of VEGF expression was scored as 0 (negative), 1+ (weak), 2+ (moderate) or 3+ (strong). Results: Majority of the RCC cases were male, with male to female ratio of 2.1:1. Mean patient age was 56.2 years (age ranged between 16 to 74 years). Most of the cases were Malays (42.5 %). VEGF was expressed in 36 (90%) of RCC cases. Among the 36 cases that were immunopositive, 8 (16.7%) were grade 1, 20 (55.6%) grade 2 and 8 (16.7%) grade 3. There was no significant association between VEGF expressions score and grades of RCC (p=0.39). Conclusion: VEGF was expressed in majority of RCC cases although there was no significant association with tumour grades.
The consequence of post-operative infection can be devastating despite its rare incidence. Common organisms caus- ing post-operative infection are normal flora of the skin: Staphylococcus aureus and Staphylococcus epidermidis. Early diagnosis followed by arthroscopic debridement and antibiotic therapy with graft retention remains the main aim of treatment. However, there are certain cases where the infection persists despite early intervention. Vancomy- cin-loaded bone cement bullet inserted into bone tunnel can provide a high local concentration of vancomycin with bactericidal effect and low systemic complications to treat deep-seated infection.
Introduction: The aim of this study was to assess the validity and reproducibility of a food frequency questionnaire (FFQ) specifically developed for the assessment of riboflavin intake among Malaysian women in Selangor. Methods: The study was carried out in Universiti Putra Malaysia (UPM), which consisted of 204 healthy women (102 Chinese and 102 Malay) aged between 19 and 45 years. The FFQs were interviewer-administered, which were completed twice; at the beginning of the study (FFQ-1) and two weeks thereafter (FFQ-2). A two-day 24-hour dietary recall (24DR) was interviewer-administered as the standard criteria method. Data were analyzed using Wilcoxon signed ranks test, Spearman correlation coefficient (SCC), intra-class correlation coefficient (ICC) and Bland-Altman plots to determine the validity and reproducibility. Results: Median riboflavin intake derived from 24DRs was significantly higher than FFQ-2 (p
Introduction: There has been a resurgence of vaccine-preventable diseases in Malaysia over the recent years. In overcoming this issue, parents as the main caregiver of their children play a major role, which is to protect their children against diseases via vaccinations. This study aimed to examine the parents’ vaccine knowledge, aware-ness, and hesitancy in relation to their children’s immunisation status and to determine the association between the parents’ vaccine knowledge, awareness, and hesitancy. Methods: A cross-sectional study with a sample size of 405 parents was conducted in the Sandakan health clinics from February 2018 to April 2018 by employing validated questionnaires adapted from two studies. Results: The median ± IQR of the total vaccine knowledge and awareness scores (ranging from 0-10) were 7.00±3.00 and 8.00±4.00, respectively. Meanwhile, the median ± IQR of the total vaccine hesitancy scores (ranging from 0-100) was 16.67±20.00, with only 27 (6.8%) parents being vaccine-hesitant (scores >50). Most of the children (n=376, 92.8%) were immunised in the study. It observed a significant association between the children’s immunisation status and the parents’ vaccine knowledge scores (p = 0.005). Nevertheless, the children’s immunisation status was not significantly associated with the parents’ vaccine awareness and hesitancy scores. The positive Spearman correlation value (r = 0.551) signified that the parents’ vaccine knowledge was posi-tively associated with their vaccine awareness. On the other hand, both the vaccine knowledge and awareness were negatively correlated to the vaccine hesitancy as indicated by the negative Spearman correlation value (r = -0.397 and r = -0.351 respectively). Conclusion: The study established that the parents with a better understanding about vaccinations were more likely to keep their children’s immunisation up-to-date. It was also revealed that improving the parents’ knowledge and raising their awareness about the importance of vaccination are vital in reducing their vaccine hesitancy.