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Malignant germ cell tumour in an infant vagina

Saren MS, Ping EL, Ping WK

Med J Malaysia, 2020 11;75(6):752-753.
PMID: 33219193

The mother of a 9-month-old female infant complained that her child was unable to pass urine at the same time noticing a mass protruding from the vaginal orifice.The infant had a single episode of vaginal bleeding.The primary concern of the mother was the inability of the daughter to micturate. Malignant germ cell tumour arising from an infant vagina is rare and accounts for about 3% of all paedriatic malignancies. These are also referred to as endodermal sinus tumours or yolk sac tumours, and are mostly the commonest form of infant vaginal malignancies encountered. A diagnosis of endodermal sinus tumour was established based on the histology and raised α-fetoprotein levels.These tumours had Schiller-Duval bodies which are primarily blood vessels surrounded by primordial germ cells and were periodic acid shift (PAS) positive diastase resistant hyaline globules which also stain positive with α- fetoprotein which is an important diagnostic feature. Tumours with high α-fetoprotein levels have a poorer prognosis. However, they respond satisfactorily to chemotherapy.
Sudden cardiac death in a young adult man due to spontaneous coronary artery dissection

Subramaniam K, Siew SF, Mahmood MS

Malays J Pathol, 2019 Apr;41(1):51-54.
PMID: 31025638

Spontaneous coronary artery dissection is a rare event and commonly associated with pregnancy and female gender. This condition can reduce or completely obstruct the blood flow to the heart, causing a myocardial ischaemia, abnormalities in heart rhythm or sudden death. We present a case of a 28-year-old Indian male with no previous medical illness who complained sudden onset of chest pain prior to his death. Autopsy revealed a left anterior descending coronary artery dissection associated with plaque rupture. The anterior wall of left ventricle showed contraction band necrosis. There was also atheroma present in the right coronary artery which was insignificant. Histologically, dissection was associated with atherosclerosis. There was no evidence of vasculitis. The cause of death was given as coronary artery dissection due to coronary artery atherosclerosis.
Serum lipoprotein(A) profiles in a Singaporean population

Wong MS, Chew WL, Aw TC

Pathology, 1999 Aug;31(3):225-9.
PMID: 10503268

Lipoprotein(a) [Lp(a)] is formed when apolipoprotein(a) is linked to low density lipoprotein (LDL)-cholesterol via a single disulfide bond. It is an independent risk factor for myocardial infarction and raised concentrations are associated with an increased risk of developing coronary artery disease. Singapore has a multi-racial population of 77% Chinese, 14% Malays and 7% Indians. Studies have shown that the Indians have significantly higher standardised mortality ratios (SMR) compared to the Chinese and the Malays. We measured serum Lp(a) concentrations in 803 healthy individuals recruited from the Multiphasic Health Screening Programme, using the Macra Lp(a) sandwich enzyme immunoassay kit (Strategics Diagnostics, Delaware, USA). Lp(a) concentrations were skewed in all three groups. Our population mean was 9.0 mg/dl, with 50th, 75th and 95th percentile values of 10.2, 19.8 and 43.1 mg/dl, respectively, which are lower than values reported from Caucasian populations (15.0, 29.0 and 60.0 mg/dl, respectively). Males had lower Lp(a) concentrations than females (P < 0.05). The Indian group had significantly higher concentrations (median 12.3 mg/dl) compared to their Chinese (median 9.6 mg/dl) and Malay (median 8.4 mg/dl) counterparts (P < 0.05). This could partly account for the higher SMR seen in the Indian population in Singapore. As serum Lp(a) concentrations are method- and population-dependent, we recommend that laboratories determine their own reference ranges by their method to avoid misclassification of the coronary heart disease (CHD) risk of patients.
Microbial diversity dynamics during the self-acidification of dairy slurry

Bastami MS, Jones DL, Chadwick DR

Environ Technol, 2021 Jun;42(16):2562-2572.
PMID: 31868106 DOI: 10.1080/09593330.2019.1706644

Slurry acidification has been shown to be effective in reducing environmentally damaging gases. However, this involved the use of concentrated acids on farms. Therefore, due to the health and safety concerns, there is an interest in self-acidification of slurry technique. This study was designed to determine the microbial dynamics leading to self-acidification of slurry. A fresh cattle slurry was amended 10% brewing sugar and stored over 30 days. This fermentable carbon source promoted self-acidification of the slurry from pH 7.0 to 4.7 within four days, and was associated with the accumulation of lactic acid and a reduction in methane and relative ammonia emissions. A metagenomics approach through next generation sequencing (NGS) using an Illumina MiSeq platform was used to determine the microbial diversity and dynamics (bacteria and archaea) in the stored amended slurry. 16S ribosomal ribonucleic acid (rRNA) sequence data revealed the presence of the Order of Lactobacillales was associated with the lactic acid production. The operational taxonomic units (OTUs) abundance indicates that the methanogenic community was dominated by hydrogenotrophic methanogens from the member Order of Methanobacteriales, Methanomicrobiales, and Methanosarcinales. The decrease in tolerance by the methanogens in the self-acidified slurry was probably the main reason for the reduced methane emission. These results confirm, at the microbial level, the mechanism of inhibiting methane production via self-acidification during storage period.
Fulltext Development of demi-span equations for predicting height among the Malaysian elderly

Ngoh HJ, Sakinah H, Harsa Amylia MS

Malays J Nutr, 2012 Aug;18(2):149-59.
PMID: 24575663 MyJurnal

This study aimed to develop demi-span equations for predicting height in the Malaysian elderly and to explore the applicability of previous published demi-span equations derived from adult populations to the elderly.
Fulltext Relationship between family meals away from home and nutritional status of adolescents

Cynthia J, Zalilah MS, Lim MY

Malays J Nutr, 2013 Apr;19(1):25-35.
PMID: 24800382 MyJurnal

Despite the many benefits of family meals, data on association between family meals away from home (FMAFH) and nutritional status of adolescents is limited. This study determined the association between FMAFH with dietary intake and body mass index of adolescents (N = 408).
Fulltext A workplace email-linked website intervention for modifying cancer-related dietary and lifestyle risk factors: rationale, design and baseline findings

Ang YK, Mirnalini K, Zalilah MS

Malays J Nutr, 2013 Apr;19(1):37-51.
PMID: 24800383 MyJurnal

Introduction: The use of email and website as channels for workplace health
information delivery is not fully explored. This study aims to describe the
rationale, design, and baseline findings of an email-linked website intervention
to improve modifiable cancer risk factors. Methods: Employees of a Malaysian
public university were recruited by systematic random sampling and randomised
into an intervention (n=174) or control group (n=165). A website was developed
for the intervention and educational modules were uploaded onto the website.
The intervention group received ten consecutive weekly emails with hypertext
links to the website for downloading the modules and two individual phone
calls as motivational support whilst the control group received none. Diet,
lifestyle, anthropometric measurements, psychosocial factors and stages of change
related to dietary fat, fruit and vegetable intake, and physical activity were
assessed. Results: Participants were predominantly female and in non-academic
positions. Obesity was prevalent in 15% and 37% were at risk of co-morbidities.
Mean intake of fats was 31%, fruit was ~1 serving/day and vegetable was <1
serving/day. Less than 20% smoked and drank alcohol and about 40% were
physically inactive. The majority of the participants fell into the Preparation
stage for decreasing fat intake, eating more fruit and vegetables, and increasing
physical activity. Self-efficacy and perceived benefits were lowest among participants in the Precontemplation/Contemplation stage compared to the Preparation
and Action/Maintenance stages. Conclusion: Baseline data show that dietary and
lifestyle practices among the employees did not meet the international guidelines
for cancer prevention. Hence the findings warrant the intervention planned.
Keywords: Cancer, risk factors, email, website, worksite
Fulltext Relationship between Appetite, Food Intake and Body Composition among Elderly Malays from an Urban Residential Area in Kuala Lumpur, Malaysia

Mohamad HA, Suzana S, Noor Ibrahim MS, Norshafarina S

Malays J Nutr, 2010 Dec;16(3):339-48.
PMID: 22691987 MyJurnal

Loss of appetite, decrease in food intake and changes in body composition appear to be inter-related factors that can influence the well-being of older individuals. Therefore, a study was conducted to determine the level of appetite, food intake and its relation to body composition and functional status among noninstitutionalised elderly Malays in Cheras, Kuala Lumpur. The Council on Nutrition Appetite Questionnaire (CNAQ), Diet History Questionnaire (DHQ), Bio-impedance Analysis (BIA) and Instrumental Activity of Daily Living (IADL) questionnaire and handgrip dynamometer were used to measure appetite, food intake, body composition and functional status respectively. A total of 112 subjects (41.1% men and 58.9% women) participated with mean age being 66.0 ± 5.0 years for men and 66.3 ± 6.2 years for women. Prevalence of poor appetite was higher in elderly women (72.3%) than in men (52.3%) (p<0.05). Pearson's correlation test showed that CNAQ score correlated significantly with age (r=-0.255, p<0.01), energy intake (r=0.272, p<0.01), IADL score (r=0.408, p<0.01) and handgrip strength (r=0.263, p<0.05). Energy intake correlated significantly with fat free mass (r=0.424, p<0.05), muscle mass (r=0.456, p<0.05) and total body water (r=0.403, p<0.05). Multiple regression analysis showed that 27.0% of poor appetite could be explained by advanced age, low energy intake and decreased functional status. In conclusion, the study showed that poor appetite was prevalent among the subjects, especially women and this was influenced by aging, inadequate energy intake and decreased functional status.
Fulltext Relation of dietary fat intake perception to nutritional status and psychosocial factors

Yong HY, Zalilah MS, Yap LD

Malays J Nutr, 2009 Sep;15(2):195-204.
PMID: 22691817 MyJurnal

Excess dietary fat intake is associated with many chronic diseases. This cross-sectional study determines the differences in nutritional status and diet-related psychosocial factors by accuracy levels of dietary fat intake perceptions among adults. A total of 202 Universiti Putra Malaysia staff (20-55 years old) volunteered to participate in the study. Dietary fat accuracy levels (under-estimate, accurate and over-estimate) were determined by assessing actual fat intake through 24-hour diet recall and self-rated fat intake. Diet-related psychosocial factors assessed were perceived risks, intention to change, outcome expectancies and perceived barriers. About half (49.5%) of the respondents were classified as accurate estimators, while 35.6% and 14.9% were under-estimators and over-estimators, respectively. Dietary fat intake differed significantly between the dietary fat accuracy groups with under-estimators having the highest amount of dietary fat intake (F=17.10; p<0.001) and percentage of fat calories (F=103.99 + 0.533%, p<0.001). Over-estimators had the highest mean BMI (F=3.11, p<0.05) compared to other groups. Among the fat accuracy groups, under-estimators reported the least barriers to eating low fat foods (F= 3.671, p<0.05). There were no significant differences in waist circumference, energy intake, perceived disease risks, intention to change and outcome expectancies among the dietary fat accuracy groups. These findings suggest that inaccurate perceptions of dietary fat intake should not be overlooked as one of the cognitive barriers to dietary change and factors that influence nutritional status among adults.
Scrofuloderma: A diagnostic dilemma in primary care

Md Rifin S, Shalihin MSE, Mat Jidin M

Med J Malaysia, 2021 05;76(3):419-421.
PMID: 34031344

A 35-year-old lady presented at the Klinik Kesihatan Bandar 32 Bera, Pahang with a one-month history of multiple cervical swelling and ulcers over her neck area. The lesions began as papules and later progressively developed into nodules and pustules. She also had low grade fever associated with weight loss for one month duration. Chest xray revealed normal findings and sputum direct smear for acid fast bacilli was noted to be negative. Histopathologic finding of skin biopsy revealed central epidermal necrosis surrounded by granulomatous tissue forming an abscess and histiocyte infiltrates, confirming the diagnosis of Scrofuloderma. In view of the report of the fine needle aspiration cytology (FNAC) of the cervical lymph nodes suggestive for tuberculous lymphadenitis, the patient was given anti-tuberculosis therapy. Fortunately, six months later, the ulcers began to solve and heal gradually.
Development and validation of pelvic floor muscles exercise intervention for urinary incontinence among pregnant women

Parwathi A, Sherina MS, Rampal L, Ismail SIF

Med J Malaysia, 2021 05;76(3):332-339.
PMID: 34031331

INTRODUCTION: The prevalence of urinary incontinence among pregnant women is high in Malaysia. However, healthcare providers appear to pay little attention to it along with a limited local intervention that addresses the continence health during pregnancy. This study aims to develop and validate intervention with pelvic floor muscle exercise (PFME) for pregnant women.
MATERIALS AND METHODS: The development of PFME intervention was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention (MRC Framework). This involved four phases: identification of current research evidence, expert opinion, validation via focus group discussions with physiotherapists and pregnant women, and piloting the intervention using a single group pre-post design among 30 pregnant women at Maternity Hospital Kuala Lumpur to assess the feasibility of the intervention by evaluating changes in knowledge and attitude. The qualitative approach was used to analyse the first three phases, while non-parametric methods were used to analyse the pilot prepost test results.
RESULTS: Based on research evidence and guidelines found during the literature review, a PFME intervention was developed using a new paradigm incorporating two theories, the Health Belief Model and Motivational Interviewing that have been shown to be important in continence promotion and exercise adherence. The contribution of the panel of experts in refining the intervention to meet the local context, endorses the achievement of the intervention's content validity. While, the focus group discussion with pregnant women and physiotherapists revealed the face-validity of the intervention. The findings of the pilot pre-testing showed that PFME knowledge (p<0.001) and attitude (p=0.011) improved significantly immediately following the intervention.
CONCLUSIONS: Evidently, this is a pioneer study that illustrates the development of a Malaysian context-adapting PFME intervention on the basis of recommended steps using the MRC Framework. Incorporating a theory-based and rigorous validation approach into the development of the PFME intervention brought novel perspectives to the intervention. Given the promising preliminary results of the pre-testing pilot study, the PFME intervention could be implemented in the planned randomised control trial to validate the robustness of the results.
Fulltext Regulatory role of GSK3β in the activation of NF-κB and modulation of cytokine levels in Burkholderia pseudomallei-infected PBMC isolated from streptozotocin-induced diabetic animals

Maniam P, Nurul Aiezzah Z, Mohamed R, Embi N, Hasidah MS

Trop Biomed, 2015 Mar;32(1):36-48.
PMID: 25801253

Increased susceptibility of diabetics to melioidosis, a disease caused by the Burkholderia pseudomallei bacterium is believed to be attributed to dysfunction of the innate immune system. However, the underlying mechanism of the innate susceptibility is not well-understood. Glycogen synthase kinase-3β (GSK3β) plays an important role in the innate inflammatory response caused by bacterial pathogens. The present study was conducted to investigate the effects of GSK3β inhibition by LiCl on levels of pro- and anti-inflammatory cytokines; and the activity of transcription factor NF-κB in B. pseudomallei-infected peripheral blood mononuclear cells (PBMC) derived from diabetic-induced and normal Sprague Dawley rats. In addition, the effects of LiCl on intracellular bacterial counts were also investigated. Infection of PBMC from diabetic and normal rats with B. pseudomallei resulted in elevated levels of cytokines (TNF-α, IL-12 and IL-10) and phosphorylation of NF-κB in both cell types. Intracellular bacterial counts decreased with time in both cell types during infection. However bacterial clearance was less prominent in diabetic PBMC. Burkholderia pseudomallei infection also caused inactivation (Ser9 phosphorylation) of GSK3β in normal PBMC, an effect absent in infected diabetic PBMC. Inhibition of GSK3β by LiCl lowered the levels of pro-inflammatory cytokines (TNF-α and IL-12) in both normal and diabetic PBMC. Similarly, phosphorylated NF- κB (pNF-κB) levels in both cell types were decreased with LiCl treatment. Also, LiCl was able to significantly decrease the intracellular bacterial count in normal as well as diabetic PBMC. Interestingly, the levels of anti-inflammatory cytokine IL-10 in both normal and diabetic PBMC were further elevated with GSK3β inhibition. More importantly, GSK3β in infected diabetic PBMC was inactivated as in their non-diabetic counterparts upon LiCl treatment. Taken together, our results suggest that inhibition of dysregulated GSK3β in diabetic PBMC resulted in the inactivation of NF-κB and modulation of inflammatory cytokine levels. This is evidence that dysregulation of GSK3β is a contributing factor in the molecular basis of innate dysfunction and susceptibility of diabetic host to melioidosis infection.
Fulltext Evaluation of difference in the neurotoxicity produced by dermal application of chlorpyrifos on the neonatal and adult mice

Mitra NK, Lee MS, Nadarajah VD

Trop Biomed, 2010 Apr;27(1):19-29.
PMID: 20562809

Dermal exposure to organophosphate pesticide is important because of its popular use. This study planned to compare the changes in serum acetylcholinesterase, paraoxonase and neuronal density of hippocampus and iso-cortex between two age groups of Swiss albino mice (18-day-old and 150-day-old) after dermal application of (1/2) LD50 of chlorpyrifos for 14 days. Statistically significant reduction was observed in serum acetylcholinesterase (Mann-Whitney test, p<0.05) and neuronal density (Independent samples t-test, p<0.05) in exposed groups compared to the control. The reduction in serum AChE and neuronal density was more pronounced in exposed adult mice than in exposed neonatal mice. The paraoxonase level was insignificant in control neonatal mice, whereas it was 890-fold more in exposed neonatal mice. Upregulated paraoxonase levels may be extrapolated to produce relatively lower reduction of cholinesterase and neuronal density in neonatal mice.
Fulltext Microalgae associated with Leptoconops breeding sites in selected sandy beaches of Malaysia

Rohani A, Khadri MS, Lee HL

Trop Biomed, 2006 Dec;23(2):164-71.
PMID: 17322818 MyJurnal

A study was carried out to investigate correlation between presence of specific microalgal species and Leptoconops biting midge larvae in its breeding habitats. Sand samples containing microalgae were collected from the beach where the midges were most commonly biting and from sand beaches which are potential as breeding habitats of Leptoconops. The survey covered sand beaches from 12 seperate islands. At all sites, the Bacillariophyta constituted the largest representatives of the microalgae community with the majority from the Naviculaceae family. A total of 24 microalgal species were identified from the sand samples collected from the study sites. Sand samples from Kentot Kecil Island had the highest number of algal species (11.0) and the highest algae species diversity ( Shanon-Weiner Diversity Index, H' = 0.884). Besar Island (Johor) had the lowest number of algal species (2.0) whereas Tengol A Island had the lowest algae species diversity (H'=0.234). Highest similarity index was recorded between sand samples collected from Tengol A Island and Tengol B Island (75.0%) followed by Besar Island (Melaka) and Tengol B Island (62.0 %). The variation between other islands were relatively high. Virtually many kinds of algae were found where Leptoconops were breeding but Fragilaria intermedia, Mastigloia minuta and Navicula advena were particularly common.
Effect of the mannose-binding Artocarpus integer lectin on the cellular proliferation of murine lymphocytes

Lim SB, Kanthimathi MS, Hashim OH

Immunol Invest, 1998 Dec;27(6):395-404.
PMID: 9845424

The effect of the mannose-binding champedak (Artocarpus integer) lectin-M on the cellular proliferation of murine lymphocytes was investigated in this study. Our data demonstrated that the lectin was the main mitogenic component in the crude extract of the champedak seeds. It stimulated the proliferation of murine T cells at an optimal concentration of 2.5 microg/ml in a 3 day culture. Lectin-M appeared to be a T-cell mitogen as it does not induce significant DNA synthesis when cultured with spleen cells from the nude mouse. In the absence of T cells, the lectin was incapable of inducing resting B cells to differentiate into immunoglobulin secreting plasma cells.
Heavy metal contents in coastal water fishes of West Malaysia

Babji AS, Embong MS, Woon WW

Bull Environ Contam Toxicol, 1979 Dec;23(6):830-6.
PMID: 519067
The Morphometric Study of Degenerative Lateral Canal Stenosis at L4-L5 and L5-S1 Using Magnetic Resonance Imaging (MRI): Feasibility Analysis for Posterior Surgical Decompression

Yusof MI, Shif M, Abdullah MS

Malays Orthop J, 2015 Mar;9(1):4-10.
PMID: 28435587 MyJurnal DOI: 10.5704/MOJ.1503.015

This study was to evaluate the morphological features of degenerative spinal stenosis and adequacy of lateral canal stenosis decompression via unilateral and bilateral laminectomy. Measurements of facet joint angulation (FJA), mid facet point (MFP), mid facet point distance (MFPD), the narrowest point of the lateral spinal canal (NPLC) and the narrowest point of the lateral spinal canal distance (NPLCD) were performed. At L4L5 of the right and left side, the mean distance between the lateral border of the dura and MFP was 1.0 ± 0.2 cm and 1.0 ± 0.3cm respectively. The mean NPLC was seen at 0.7 ± 0.3 and 0.7 ± 0.3 cm cm from the dura. At L5S1 of the right and left side, the mean distance between the lateral border of the dura and MFP was 1.2± 0.2 and 1.3 ± 0.2 cm respectively. The mean NPLC was seen at 0.8 ± 0.4 and 0.9 ± 0.5 cm from the dura. Unilateral laminectomy may result in incomplete decompression.
Mosquito-borne haemorrhagic fever

George R, Kassim MS, Wah LT

Med J Malaysia, 1974 Sep;29(1):11-6.
PMID: 4282623
Fulltext The Relationship amongst Intervertebral Disc Vertical Diameter, Lateral Foramen Diameter and Nerve Root Impingement in Lumbar Vertebra

Yusof MI, Hassan MN, Abdullah MS

Malays Orthop J, 2018 Mar;12(1):21-25.
PMID: 29725508 MyJurnal DOI: 10.5704/MOJ.1803.004

Introduction: The vertical diameter of the foramen is dependent upon the vertical diameter of the corresponding intervertebral disc. A decrease in disc vertical diameter has direct anatomic consequences to the foraminal diameter and area available for the nerve root passing through it. This study is to establish the relationship amongst the intervertebral disc vertical diameter, lateral foramen diameters and nerve root compression in the lumbar vertebra. Materials and Methods: Measurements of the study parameters were performed using sagittal MRI images. The parameters studied were: intervertebral disc vertical diameter (DVD), foraminal vertical diameter (FVD), foraminal transverse diameter (FTD) and nerve root diameter (NRD) of both sides. The relationship between the measured parameters were then analyzed. Results: A total of 62 MRI images were available for this study. Statistical analysis showed moderate to strong correlation between DVD and FVD at all the lumbar levels except at left L23 and L5S1 and right L3L4 and L4L5. Correlation between DVD and FTD were not significant at all lumbar levels. Regression analysis showed that a decrease of 1mm of DVD was associated with 1.3, 1.7, 3.3, 3.3 and 1.3mm reduction of FVD at L1L2, L2L3, L3L4, L4L5 and L5S1 respectively. Conclusion: Reduction of DVD was associated with reduction of FVD. However, FVD was relatively wide for the nerve root even with complete loss of DVD. FTD was much narrower than the FVD making it more likely to cause nerve root compression at the exit foramina. These anatomical details should be given consideration in treating patients with lateral canal stenosis.
Ultrasound degradation of xanthan polymer in aqueous solution: Its scission mechanism and the effect of NaCl incorporation

Saleh HM, Annuar MSM, Simarani K

Ultrason Sonochem, 2017 Nov;39:250-261.
PMID: 28732944 DOI: 10.1016/j.ultsonch.2017.04.038

Degradation of xanthan polymer in aqueous solution by ultrasonic irradiation was investigated. The effects of selected variables i.e. sonication intensity, irradiation time, concentration of xanthan gum and molar concentration of NaCl in solution were studied. Combined approach of full factorial design and conventional one-factor-at-a-time was applied to obtain optimum degradation at sonication power intensity of 11.5Wcm-2, irradiation time 120min and 0.1gL-1xanthan in a salt-free solution. Molecular weight reduction of xanthan gum under sonication was described by an exponential decay function with higher rate constant for polymer degradation in the salt free solution. The limiting molecular weight where fragments no longer undergo scission was determined from the function. The incorporation of NaCl in xanthan solution resulted in a lower limiting molecular weight. The ultrasound-mediated degradation of aqueous xanthan polymer chain agreed with a random scission model. Side chain of xanthan polymer is proposed to be the primary site of scission action.

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