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  1. Chekima K, Yan SW, Lee SWH, Wong TZ, Noor MI, Ooi YB, et al.
    Cochrane Database Syst Rev, 2023 Jun 22;6(6):CD005105.
    PMID: 37345841 DOI: 10.1002/14651858.CD005105.pub3
    BACKGROUND: The prevalence of obesity is increasing worldwide, yet nutritional management remains contentious. It has been suggested that low glycaemic index (GI) or low glycaemic load (GL) diets may stimulate greater weight loss than higher GI/GL diets or other weight reduction diets. The previous version of this review, published in 2007, found mainly short-term intervention studies. Since then, randomised controlled trials (RCTs) with longer-term follow-up have become available, warranting an update of this review.

    OBJECTIVES: To assess the effects of low glycaemic index or low glycaemic load diets on weight loss in people with overweight or obesity.

    SEARCH METHODS: We searched CENTRAL, MEDLINE, one other database, and two clinical trials registers from their inception to 25 May 2022. We did not apply any language restrictions.

    SELECTION CRITERIA: We included RCTs with a minimum duration of eight weeks comparing low GI/GL diets to higher GI/GL diets or any other diets in people with overweight or obesity.

    DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. We conducted two main comparisons: low GI/GL diets versus higher GI/GL diets and low GI/GL diets versus any other diet. Our main outcomes included change in body weight and body mass index, adverse events, health-related quality of life, and mortality. We used GRADE to assess the certainty of the evidence for each outcome.

    MAIN RESULTS: In this updated review, we included 10 studies (1210 participants); nine were newly-identified studies. We included only one study from the previous version of this review, following a revision of inclusion criteria. We listed five studies as 'awaiting classification' and one study as 'ongoing'. Of the 10 included studies, seven compared low GI/GL diets (233 participants) with higher GI/GL diets (222 participants) and three studies compared low GI/GL diets (379 participants) with any other diet (376 participants). One study included children (50 participants); one study included adults aged over 65 years (24 participants); the remaining studies included adults (1136 participants). The duration of the interventions varied from eight weeks to 18 months. All trials had an unclear or high risk of bias across several domains.  Low GI/GL diets versus higher GI/GL diets Low GI/GL diets probably result in little to no difference in change in body weight compared to higher GI/GL diets (mean difference (MD) -0.82 kg, 95% confidence interval (CI) -1.92 to 0.28; I2 = 52%; 7 studies, 403 participants; moderate-certainty evidence). Evidence from four studies reporting change in body mass index (BMI) indicated low GI/GL diets may result in little to no difference in change in BMI compared to higher GI/GL diets (MD -0.45 kg/m2, 95% CI -1.02 to 0.12; I2 = 22%; 186 participants; low-certainty evidence)at the end of the study periods. One study assessing participants' mood indicated that low GI/GL diets may improve mood compared to higher GI/GL diets, but the evidence is very uncertain (MD -3.5, 95% CI -9.33 to 2.33; 42 participants; very low-certainty evidence). Two studies assessing adverse events did not report any adverse events; we judged this outcome to have very low-certainty evidence. No studies reported on all-cause mortality.    For the secondary outcomes, low GI/GL diets may result in little to no difference in fat mass compared to higher GI/GL diets (MD -0.86 kg, 95% CI -1.52 to -0.20; I2 = 6%; 6 studies, 295 participants; low certainty-evidence). Similarly, low GI/GL diets may result in little to no difference in fasting blood glucose level compared to higher GI/GL diets (MD 0.12 mmol/L, 95% CI 0.03 to 0.21; I2 = 0%; 6 studies, 344 participants; low-certainty evidence).  Low GI/GL diets versus any other diet Low GI/GL diets probably result in little to no difference in change in body weight compared to other diets (MD -1.24 kg, 95% CI -2.82 to 0.34; I2 = 70%; 3 studies, 723 participants; moderate-certainty evidence). The evidence suggests that low GI/GL diets probably result in little to no difference in change in BMI compared to other diets (MD -0.30 kg in favour of low GI/GL diets, 95% CI -0.59 to -0.01; I2 = 0%; 2 studies, 650 participants; moderate-certainty evidence). Two adverse events were reported in one study: one was not related to the intervention, and the other, an eating disorder, may have been related to the intervention. Another study reported 11 adverse events, including hypoglycaemia following an oral glucose tolerance test. The same study reported seven serious adverse events, including kidney stones and diverticulitis. We judged this outcome to have low-certainty evidence. No studies reported on health-related quality of life or all-cause mortality. For the secondary outcomes, none of the studies reported on fat mass. Low GI/GL diets probably do not reduce fasting blood glucose level compared to other diets (MD 0.03 mmol/L, 95% CI -0.05 to 0.12; I2 = 0%; 3 studies, 732 participants; moderate-certainty evidence).  AUTHORS' CONCLUSIONS: The current evidence indicates there may be little to no difference for all main outcomes between low GI/GL diets versus higher GI/GL diets or any other diet. There is insufficient information to draw firm conclusions about the effect of low GI/GL diets on people with overweight or obesity. Most studies had a small sample size, with only a few participants in each comparison group. We rated the certainty of the evidence as moderate to very low. More well-designed and adequately-powered studies are needed. They should follow a standardised intervention protocol, adopt objective outcome measurement since blinding may be difficult to achieve, and make efforts to minimise loss to follow-up. Furthermore, studies in people from a wide range of ethnicities and with a wide range of dietary habits, as well as studies in low- and middle-income countries, are needed.

  2. Noor-Hassim MB, Ng CL, Teo HM, Azmi WA, Muhamad-Zalan NB, Karim NB, et al.
    BioTechnologia (Pozn), 2023;104(2):209-216.
    PMID: 37427028 DOI: 10.5114/bta.2023.127209
    As the global human population continues to grow, the demand for food rises accordingly. Unfortunately, anthropogenic activities, climate change, and the release of gases from the utilization of synthetic fertilizers and pesticides are causing detrimental effects on sustainable food production and agroecosystems. Despite these challenges, there remain underutilized opportunities for sustainable food production. This review discusses the advantages and benefits of utilizing microbes in food production. Microbes can be used as alternative food sources to directly supply nutrients for both humans and livestock. Additionally, microbes offer higher flexibility and diversity in facilitating crop productivity and agri-food production. Microbes function as natural nitrogen fixators, mineral solubilizers, nano-mineral synthesizers, and plant growth regulator inducers, all of which promote plant growth. They are also active organisms in degrading organic materials and remediating heavy metals and pollution in soils, as well as soil-water binders. In addition, microbes that occupy the plant rhizosphere release biochemicals that have nontoxic effects on the host and the environment. These biochemicals could act as biocides in controlling agricultural pests, pathogens, and diseases. Therefore, it is important to consider the use of microbes for sustainable food production.
  3. Abd Rahman NA, Noor SK, Ibrahim IM, Yasin MNM, Ismail AM, Osman MN, et al.
    Micromachines (Basel), 2023 Apr 13;14(4).
    PMID: 37421074 DOI: 10.3390/mi14040841
    This paper presents the generation of orbital angular momentum (OAM) vortex waves with mode +1 using dielectric resonator antenna (DRA) array. The proposed antenna was designed and fabricated using FR-4 substrate to generate OAM mode +1 at 3.56 GHz (5G new radio band). The proposed antenna consists of 2 × 2 rectangular DRA array, a feeding network, and four cross slots etched on the ground plane. The proposed antenna succeeded in generating OAM waves; this was confirmed by the measured radiation pattern (2D polar form), simulated phase distribution, and intensity distribution. Moreover, mode purity analysis was carried out to verify the generation of OAM mode +1, and the purity obtained was 53.87%. The antenna operates from 3.2 to 3.66 GHz with a maximum gain of 7.3 dBi. Compared with previous designs, this proposed antenna is low-profile and easy to fabricate. In addition, the proposed antenna has a compact structure, wide bandwidth, high gain, and low losses, thus meeting the requirements of 5G NR applications.
  4. Ibraheem ZO, Majid RA, Sidek HM, Noor SM, Yam MF, Abd Rachman Isnadi MF, et al.
    PMID: 31915453 DOI: 10.1155/2019/7967980
    The emergence of drug-resistant strains of Plasmodium falciparum is the worst catastrophe that has ever confronted the dedicated efforts to eradicate malaria. This urged for searching other alternatives or sensitizers that reverse chloroquine resistance. In this experiment, the potential of andrographolide to inhibit plasmodial growth and reverse CQ resistance was tested in vitro using the SYBRE green-1-based drug sensitivity assay and isobologram technique, respectively. Its safety level toward mammalian cells was screened as well against Vero cells and RBCs using MTT-based drug sensitivity and RBC hemolysis assays, respectively. Its effect against hemozoin formation was screened using β-hematin formation and heme fractionation assays. Its molecular characters were determined using the conventional tests for the antioxidant effect measurement and the in silico molecular characterization using the online free chemi-informatic Molinspiration software. Results showed that andrographolide has a moderate antiplasmodium effect that does not entitle it to be a substituent for chloroquine. Furthermore, andrographolide ameliorated the sensitivity of the parasite to chloroquine. Besides, it showed an indirect inhibitory effect against hemozoin formation within the parasite and augmented the chloroquine-induced inhibition of hemozoin formation. The study suggests that its chloroquine resistance reversal effect may be due to inhibition of chloroquine accumulation or due to its impact on the biological activity of the parasite. Overall, this in vitro study is a clue for the reliability of andrographolide to be added with chloroquine for reversal of chloroquine resistance and tolerance, but further in vivo studies are recommended to confirm this notion. In spite of its prominent and safe in vitro and in vivo growth inhibitory effect and its in vitro chloroquine resistance reversing effect, it is inapplicable to implement it in malaria chemotherapy to substitute chloroquine or to reverse its resistance.
  5. Bahar R, Zulkafli Z, Zulkeflee RH, Hassan MN, Rahman Wan SWA, Noor NM, et al.
    Balkan J Med Genet, 2024 Jun;27(1):65-67.
    PMID: 39263647 DOI: 10.2478/bjmg-2024-0001
    Haemoglobin (Hb) Malay is variant haemoglobin with a β++ thalassemia phenotype. The prevalence of Hb Malay in the Malaysian population was 5.5%. We describe a 58-year-old male who presented with symptomatic anaemia to the Hospital Universiti Sains Malaysia. Further history revealed that the patient had anaemia since the age of 28, and on regular follow-up at other hospital. Physical examination revealed pallor, jaundice and hepatosplenomegaly. The full blood count and peripheral blood smear showed hypochromic microcytic anaemia with anisopoikilocytosis, and many target cells. High-performance liquid chromatography results showed a β thalassemia trait. However, the diagnosis does not alight with the patient's condition. Bone marrow aspirate was completed and showed reactive changes and erythroid hyperplasia. A molecular test was then performed for β globin gene mutation detection using Multiplex Amplification Refractory Mutation System (M-ARMS) PCR method. This revealed the result as homozygous codon 19 mutation or Hb Malay. Therefore, in this case report we would like to highlight the laboratory approaches, the challenges faced by the usual haematological investigations and the importance role of molecular testing in the diagnosis of severe anaemia.
  6. Mohd Noor MN, Cockburn JG, Foong CC, Thiam CN, Abdul Aziz YF, Hong WH, et al.
    PLoS One, 2024;19(11):e0313332.
    PMID: 39509428 DOI: 10.1371/journal.pone.0313332
    Current feedback models advocate learner autonomy in seeking, processing, and responding to feedback so that medical students can become feedback-literate. Feedback literacy improves learners' motivation, engagement, and satisfaction, which in turn enhance their competencies. However, there is a lack of an objective method of measuring medical student feedback literacy in the empirical literature. Such an instrument is required to determine the level of feedback literacy amongst medical students and whether they would benefit from an intervention. Therefore, this research protocol addresses the methodology aimed at the development of a comprehensive instrument for medical student feedback literacy, which is divided into three phases, beginning with a systematic review. Available instruments in health profession education will be examined to create an interview protocol to define medical students' feedback literacy from the perspectives of medical students, educators, and patients. A thematic analysis will form the basis for item generation, which will subsequently undergo expert validation and cognitive interviews to establish content validity. Next, we will conduct a national survey to gather evidence of construct validity, internal consistency, hypothesis testing, and test-retest reliability. In the final phase, we will distribute the instrument to other countries in an international survey to assess its cross-cultural validity. This protocol will help develop an instrument that can assist educators in assessing student feedback literacy and evaluating their behavior in terms of managing feedback. Ultimately, educators can identify strengths, and improve communication with students, as well as feedback literacy and the feedback process. In conclusion, this study protocol outlined a systematic, evidence-based methodology to develop a medical student feedback literacy instrument. This study protocol will not only apply to medical and local cultural contexts, but it has the potential for application in other educational disciplines and cross-cultural studies.
  7. Zubir MZ, Noor AA, Mohd Rizal AM, Harith AA, Abas MI, Zakaria Z, et al.
    PLoS One, 2024;19(8):e0293694.
    PMID: 39141630 DOI: 10.1371/journal.pone.0293694
    The efficiency and productivity evaluation process commonly employs Data Envelopment Analysis (DEA) as a performance tool in numerous fields, such as the healthcare industry (hospitals). Therefore, this review examined various hospital-based DEA articles involving input and output variable selection approaches and the recent DEA developments. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was utilised to extract 89 English articles containing empirical data between 2014 and 2022 from various databases (Web of Science, Scopus, PubMed, ScienceDirect, Springer Link, and Google Scholar). Furthermore, the DEA model parameters were determined using information from previous studies, while the approaches were identified narratively. This review grouped the approaches into four sections: literature review, data availability, systematic method, and expert judgement. An independent single strategy or a combination with other methods was then applied to these approaches. Consequently, the focus of this review on various methodologies employed in hospitals could limit its findings. Alternative approaches or techniques could be utilised to determine the input and output variables for a DEA analysis in a distinct area or based on different perspectives. The DEA application trend was also significantly similar to that of previous studies. Meanwhile, insufficient data was observed to support the usability of any DEA model in terms of fitting all model parameters. Therefore, several recommendations and methodological principles for DEA were proposed after analysing the existing literature.
  8. Jagaba AH, Lawal IM, Ghfar AA, Usman AK, Yaro NSA, Noor A, et al.
    Chemosphere, 2023 Oct;339:139620.
    PMID: 37524265 DOI: 10.1016/j.chemosphere.2023.139620
    Agro-industrial biorefinery effluent (AIBW) is considered a highly polluting source responsible for environmental contamination. It contains high loads of chemical oxygen demand (COD), and phenol, with several other organic and inorganic constituents. Thus, an economic treatment approach is required for the sustainable discharge of the effluent. The long-term process performance, contaminant removal and microbial response of AIBW to rice straw-based biochar (RSB) and biochar-based geopolymer nanocomposite (BGC) as biosorbents in an activated sludge process were investigated. The adsorbents operated in an extended aeration system with a varied hydraulic retention time of between 0.5 and 1.5 d and an AIBW concentration of 40-100% for COD and phenol removal under standard conditions. Response surface methodology was utilised to optimize the process variables of the bioreactor system. Process results indicated a significant reduction of COD (79.51%, 98.01%) and phenol (61.94%, 74.44%) for BEAS and GEAS bioreactors respectively, at 1 d HRT and AIBW of 70%. Kinetic model analysis indicated that the Stover-Kincannon model best describes the system functionality, while the Grau model was better in predicting substrate removal rate and both with a precision of between R2 (0.9008-0.9988). Microbial communities examined indicated the abundance of genera, following the biosorbent addition, while RSB and BGC had no negative effect on the bioreactor's performance and bacterial community structure of biomass. Proteobacteria and Bacteroidetes were abundant in BEAS. While the GEAS achieved higher COD and phenol removal due to high Nitrosomonas, Nitrospira, Comamonas, Methanomethylovorans and Acinetobacter abundance in the activated sludge. Thus, this study demonstrated that the combination of biosorption and activated sludge processes could be promising, highly efficient, and most economical for AIBW treatment, without jeopardising the elimination of pollutants or the development of microbial communities.
  9. Harun AM, Awang H, Noor NFM, Makhatar NM, Yusoff ME, Affandi NDN, et al.
    Biomed Res Int, 2021;2021:6173143.
    PMID: 34859102 DOI: 10.1155/2021/6173143
    BACKGROUND: Potential antibacterial substances, such as titanium dioxide (TiO2), are being extensively studied throughout the research world. A modified hydrothermal nanotitania extraction was shown to inhibit Staphylococcus aureus growth in the laboratory. However, the toxicity effect of the extract on rats is unknown. In this study, we observed the effects of a modified hydrothermal nanotitania extraction on the skin and behavior of Sprague-Dawley rats.

    METHODS: Sprague-Dawley (Rattus norvegicus) rats were used as the experimental animals. The skin around the dorsum of the tested animals was shaved and pasted with 0.1 mg and 0.5 mg of the nanotitania extraction. The color and condition of the pasted area and the behavior of the animals were observed.

    RESULTS: 0.1 mg nanotitania extraction application on the dorsum of the rat produced no skin color changes at day 1, day 3, day 5, or day 7 postapplication. There were no changes in their behavior up to day 7 with no skin rashes or skin scratches seen or fur changes. However, 0.5 mg of nanotitania extraction resulted in redness and less fur regrowth at day 7.

    CONCLUSIONS: A 0.1 mg modified nanotitania extraction was observed to have no effect on the skin of Sprague-Dawley rats.

  10. Ransing R, Koh EBY, Ramalho R, de Filippis R, Pinto da Costa M, Pereira-Sanchez V, et al.
    Front Psychiatry, 2023;14:1230059.
    PMID: 37692313 DOI: 10.3389/fpsyt.2023.1230059
  11. Harun AM, Noor NFM, Zaid A, Yusoff ME, Shaari R, Affandi NDN, et al.
    Antibiotics (Basel), 2021 Aug 10;10(8).
    PMID: 34439011 DOI: 10.3390/antibiotics10080961
    Titanium dioxide (TiO2) is an antimicrobial agent which is considered of potential value in inhibiting the growth of multiple bacteria. Klebsiella pneumonia and Haemophilus influenza are two of the most common respiratory infection pathogens, and are the most. Klebsiella pneumonia causes fatal meningitis, while Haemophilus influenza causes mortality even in younger patients. Both are associated with bacteremia and mortality. The purpose of this study was to test a new antibacterial material, namely nanotitania extract combined with 0.03% silver that was developed at Universiti Malaysia Sabah (UMS) and tested against K. pneumonia and H. influenza. The nanoparticles were synthesized through a modified hydrothermal process, combined with molten salt and proven to have excellent crystallinity, with the band-gap energy falling in the visible light spectrum. The nanoparticle extract was tested using a macro-dilutional method, which involved combining it with 0.03% silver solution during the process of nanoparticle synthesis and then introducing it to the bacteria. A positive control containing the bacteria minus the nanoparticles extract was also prepared. 25 mg/mL, 12.5 mg/mL, and 6.25 mg/mL concentrations of the samples were produced using the macro dilution method. After adding the bacteria to multiple concentrations of nanoparticle extract, the suspensions were incubated for 24 h at a temperature of 37 °C. The suspensions were then spread on Mueller-Hinton agar (K. pneumonia) and chocolate blood agar (H. influenza), where the growth of bacteria was observed after 24 h. Nanoparticle extract in combination with silver at 0.03% was proven to have potential as an antimicrobial agent as it was able to inhibit H. influenza at all concentrations. Furthermore, it was also shown to be capable of inhibiting K. pneumonia at concentrations of 25 mg/mL and 50 mg/mL. In conclusion, the nanoparticle extract, when tested using a macro-dilutional method, displayed antimicrobial properties which were proven effective against the growth of both K. pneumonia and H. influenza.
  12. Ekeuku SO, Chin KY, Qian J, Zhang Y, Qu H, Ahmad F, et al.
    Int J Med Sci, 2023;20(13):1711-1721.
    PMID: 37928881 DOI: 10.7150/ijms.84604
    Background: Menopause is accompanied by increased oxidative stress, partly contributing to weight gain and bone marrow adiposity. Traditional Chinese medication, E'Jiao, has been demonstrated to reduce excessive bone remodelling during oestrogen deprivation, but its effects on body composition and bone marrow adiposity during menopause remain elusive. Objective: To determine the effects of E'Jiao on body composition, bone marrow adiposity and skeletal redox status in ovariectomised (OVX) rats. Methods: Seven groups of three-month-old female Sprague Dawley rats were established (n=6/group): baseline, sham, OVX control, OVX-treated with low, medium or high-dose E'Jiao (0.26, 0.53, 1.06 g/kg, p.o.) or calcium carbonate (1% in tap water, ad libitum). The supplementation was terminated after 8 weeks. Whole-body composition analysis was performed monthly using dual-energy X-ray absorptiometry. Analysis of bone-marrow adipocyte numbers and skeletal antioxidant activities were performed on the femur. Results: Increased total mass, lean mass, and bone marrow adipocyte number were observed in the OVX control versus the sham group. Low-dose E'Jiao supplementation counteracted these changes. Besides, E'Jiao at all doses increased skeletal catalase and superoxide dismutase activities but lowered glutathione levels in the OVX rats. Skeletal malondialdehyde level was not affected by ovariectomy but was lowered with E'Jiao supplementation. However, peroxisome proliferator-activated receptor gamma protein expression was not affected by ovariectomy or any treatment. Conclusion: E'Jiao, especially at the low dose, prevented body composition changes and bone marrow adiposity due to ovariectomy. These changes could be mediated by the antioxidant actions of E'Jiao. It has the potential to be used among postmenopausal women to avoid adiposity.
  13. Al-Wajeeh NS, Hajrezaie M, Al-Henhena N, Kamran S, Bagheri E, Zahedifard M, et al.
    Drug Des Devel Ther, 2017;11:995-1009.
    PMID: 28408799 DOI: 10.2147/DDDT.S107018
    Cibotium barometz is a pharmaceutical plant customarily used in traditional medicine in Malaysia for the treatment of different diseases, such as gastric ulcer. The gastroprotective effect of C. barometz leaves against ethanol-induced gastric hemorrhagic abrasions in Sprague Dawley rats has been evaluated in terms of medicinal properties. Seven groups of rats (normal control and ulcerated control groups, omeprazole 20 mg/kg, 62.5, 125, 250, and 500 mg/kg of C. barometz correspondingly) were used in antiulcer experiment and pretreated with 10% Tween 20. After 1 hour, the normal group was orally administered 10% Tween 20, whereas absolute alcohol was fed orally to ulcerated control, omeprazole, and experimental groups. Gastric's homogenate were assessed for endogenous enzymes activities. Stomachs were examined macroscopically and histologically. Grossly, the data demonstrated a significant decrease in the ulcer area of rats pretreated with plant extract in a dose-dependent manner with respect to the ulcerated group. Homogenates of the gastric tissue exhibited significantly increased endogenous enzymes activities in rats pretreated with C. barometz extract associated with the ulcerated control group. Histology of rats pretreated with C. barometz extract group using hematoxylin and eosin staining exhibited a moderate-to-mild disruption of the surface epithelium with reduction in submucosal edema and leucocyte infiltration in a dose-dependent manner. In addition, it showed heat shock protein70 protein up-expression and BCL2-associated X protein downexpression. These outcomes might be attributed to the gastroprotective and antioxidative effects of the plant.
  14. Rahman MSA, Khor KH, Khairani-Bejo S, Lau SF, Mazlan M, Roslan MA, et al.
    J Vet Res, 2023 Jun;67(2):187-195.
    PMID: 38143826 DOI: 10.2478/jvetres-2023-0024
    INTRODUCTION: Canine leptospirosis has always been a differential diagnosis in dogs presenting with clinical signs and blood profiles associated with kidney and/or liver disease. The conventional polymerase chain reaction (PCR) provides diagnoses, but real-time PCR-based tests provide earlier confirmation and determine the severity of infection, especially in the acute stage, allowing early detection for immediate treatment decisions. To our knowledge, real-time PCR has not been routinely adopted for clinical investigation in Malaysia. This study evaluated TaqMan real-time PCR (qPCR) assays diagnosing leptospirosis and compared their applicability to clinical samples from dogs with kidney and/or liver disease against a conventional PCR reference.

    MATERIAL AND METHODS: The qPCR assays were validated using existing leptospiral isolates. Whole blood and urine samples were analysed using a conventional PCR, LipL32(1) and LipL32(2) qPCRs and a microscopic agglutination test. The sensitivity and specificity of the qPCRs were determined.

    RESULTS: The LipL32(1) qPCR assay had more diagnostic value than the LipL32(2) qPCR assay. Further evaluation of this assay revealed that it could detect as low as five DNA copies per reaction with high specificity for the tested leptospiral strains. No cross-amplification was observed with other organisms. Analysing the clinical samples, the LipL32(1) qPCR assay had 100.0% sensitivity and >75.0% specificity.

    CONCLUSION: The LipL32(1) qPCR assay is sensitive, specific and has the potential to be applied in future studies.

  15. Bal PK, Nah SA, Wan Mohamad Noor WMR, Md Nor MT, Singaravel S, Tan WS, et al.
    Malays J Pathol, 2023 Dec;45(3):457-462.
    PMID: 38155386
    Hirschsprung's Disease (HD) is a congenital disorder causing severe constipation in infants and children. Suction rectal biopsy (SRB) is the preferred technique for obtaining tissue samples for histopathological evaluation. In low-resource settings like Malaysia, cost-effective diagnostic approaches are necessary, making single sample SRB valuable. This study evaluates the diagnostic accuracy and sufficiency of a single macroscopically adequate sample in suction rectal biopsies for the histopathological confirmation of HD. We conducted a retrospective study of children who underwent suction rectal biopsies for the diagnosis of HD at Hospital Raja Perempuan Zainab II (HRPZII), Kota Bharu, Kelantan. A total of 68 patients were included in the study. The inadequacy rate for bedside SRB was 14%, comparable to current literature. Our study found no statistically significant association between sample inadequacy and gestational age, gender, birth weight, or weight at biopsy. Complication rates were 0%, consistent with literature reports. Calretinin staining, an additional technique, was performed in 23 biopsy episodes, with a 4.3% inadequacy rate, compared to 20% in specimens not subjected to calretinin staining. The cost of SRB almost doubled with each additional sample taken, significant in low-resource environments. In conclusion, single sample SRBs can be adequately diagnostic and cost-effective in low-resource settings, providing valuable insights for healthcare facilities in Malaysia and other developing countries. The use of adjunctive techniques such as calretinin staining may improve diagnostic accuracy while maintaining cost-effectiveness. Further prospective studies with larger sample sizes are needed to validate these findings.
  16. Elhefnawy M, Noor Harun S, Leykhim T, Tangiisuran B, Zainal H, Looi I, et al.
    Cureus, 2023 Dec;15(12):e50794.
    PMID: 38239519 DOI: 10.7759/cureus.50794
    Objectives Compared with the first stroke, neurological impairment caused by stroke recurrence is more serious, more difficult to treat, and has a higher mortality rate, especially among ischemic stroke (IS) patients with diabetes mellitus (DM). Although there are established correlations between factors and IS recurrence, there were some issues regarding the naive hazard of IS recurrence with no risk factor influence, and how does the baseline hazard differ among patients with DM and non-DM? To answer all these questions, two time-to-event (TTE) models of recurrent IS after the index IS were developed among IS patients with DM and non-DM. Method A total of 7697 patients with an index IS attack were extracted from the Malaysian Registry of Neurology and stratified according to DM status. Several parametric survival models were evaluated using nonlinear mixed-effect modeling software (NONMEM 7.5). The final model was determined according to the lowest objective function value, graphical evaluation, numerical diagnostics, and clinical plausibility. Additionally, the final model was validated internally and temporally using Kaplan-Meier visual predictive checks (KM-VPCs). Results One hundred ninety-five (5.82%) of 3493 DM patients and 138 (3.28%) of 4204 non-DM patients developed a recurrent IS with a maximum follow-up of 7.37 years. Gompertz's model best fitted the data. With no influence on risk factors, the index IS attack was predicted to contribute to the hazard of recurrent IS by 0.356 and 0.253 within the first six months after the index IS among patients with and without DM, respectively. Even after six months of index IS, the recurrent IS baseline hazard was not equal to zero among both groups (0.0023, 0.0018). Moreover, after incorporating the time and risk factors, the recurrent hazards increased exponentially during the first three years after the index IS followed by an exponential reduction afterward. The recurrent IS predictors among DM patients were ischemic heart disease (IHD) and hyperlipidemia (HPLD). IHD and HPLD increased the hazard of recurrent IS by 2.40 and 1.88 times, respectively, compared to those without IHD and HPLD before index IS (HR, 2.40 (1.79-3.20)), and (HR, 1.88 (1.44-2.45)) respectively. Conclusion The baseline hazard was the highest during the first six months after the index IS. Moreover, receiving medications for secondary prevention failed to demonstrate a significant association with reducing IS recurrence among IS patients with DM, suggesting a need for more intensive patient screening and new strategies for secondary prevention among IS patients with DM.
  17. Vijian D, Wan Ab Rahman WS, Kannan TP, Zulkafli Z, Mohd Noor NH, Bahar R, et al.
    Malays J Pathol, 2024 Aug;46(2):321-324.
    PMID: 39207010
    INTRODUCTION: Haemoglobin (Hb) Quong Sze is a non-deletional α-thalassaemia subtype that occurs due to missense mutation at codon 125 of the HBA2 gene. Interaction between Hb QS with Southeast Asian double α-globin gene deletion results in non-deletional HbH disease, which is more severe than deletional HbH.

    CASE REPORT: A 3-month-old baby boy was presented with neonatal anaemia and mild hepatomegaly. Full blood count revealed severe hypochromic microcytic anaemia. There was an abundance of HbH inclusion bodies in his red blood cells. High-performance liquid chromatography showed a reduced HbA2 level with the presence of pre-run peak. Capillary electrophoresis showed the presence of HbH and Hb Barts. Molecular analysis found a common α0-thalassaemia (--SEA) in one allele and mutation in codon 125 in the other allele.

    DISCUSSION: Non-deletional HbH disease due to a combination of deletional and non-deletional mutations may present with severe clinical manifestations than those with deletion mutations, which warrants accurate diagnosis using molecular techniques.

  18. Zayet TMA, Ismail MA, Varathan KD, Noor RMD, Chua HN, Lee A, et al.
    Scientometrics, 2021;126(8):6383-6421.
    PMID: 34188335 DOI: 10.1007/s11192-021-04046-2
    Social media is a pool of users' thoughts, opinions, surrounding environment, situation and others. This pool can be used as a real-time and feedback data source for many domains such as transportation. It can be used to get instant feedback from commuters; their opinions toward the transportation network and their complaints, in addition to the traffic situation, road conditions, events detection and many others. The problem is in how to utilize social media data to achieve one or more of these targets. A systematic review was conducted in the field of transportation-related research based on social media analysis (TRR-SMA) from the years between 2008 and 2018; 74 papers were identified from an initial set of 703 papers extracted from 4 digital libraries. This review will structure the field and give an overview based on the following grounds: activity, keywords, approaches, social media data and platforms and focus of the researches. It will show the trend in the research subjects by countries, in addition to the activity trends, platforms usage trend and others. Further analysis of the most employed approach (Lexicons) and data (text) will be also shown. Finally, challenges and future works are drawn and proposed.

    SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11192-021-04046-2.

  19. Kaur J, Cheong SM, Mahadir Naidu B, Kaur G, Manickam MA, Mat Noor M, et al.
    Asia Pac J Public Health, 2014 Sep;26(5 Suppl):53S-62S.
    PMID: 25070697 DOI: 10.1177/1010539514544356
    Depression among adolescents has been recognized as a major public health issue. The objective of this study was to determine the prevalence and correlates of depression among school-going adolescents in Malaysia. Data from the Malaysia Global School-based Health Survey (GSHS) 2012 were analyzed with additional data from the validated DASS21 (Depression, Anxiety, and Stress) questionnaire. The study revealed that 17.7% of respondents had depressive symptoms. Multivariate analysis further showed that feeling lonely (adjusted odds ratio [aOR] = 2.99; 95% CI = 2.57-3.47), Indian ethnicity (aOR = 2.00; 95% CI = 1.63-2.44), using drugs (aOR = 1.85; 95% CI = 1.21-2.82), and being bullied (aOR = 1.79; 95% CI = 1.60-1.99) were significantly associated with depressive symptoms. Lack of parental supervision, alcohol use, and tobacco use were also significant risk factors. Addressing depressive symptoms among adolescents may have implications for managing their risks of being bullied and substance use. This study also highlights the need to further investigate depressive symptoms among adolescents of Indian ethnicity.
    Study name: Global School-Based Student Health Survey (GSHS)
  20. Suzana S, Kee CC, Jamaludin AR, Noor Safiza MN, Khor GL, Jamaiyah H, et al.
    Asia Pac J Public Health, 2012 Mar;24(2):318-29.
    PMID: 20833669 DOI: 10.1177/1010539510380736
    Obesity is an emerging public health threat in the elderly population in developing countries. Hence, the Third National Health and Morbidity Survey has assessed 4746 individuals aged 60 years and older recruited through a household survey to determine the prevalence of adiposity using body mass index and waist circumference. The national's prevalence of overweight and obesity in men was 29.2% (95% confidence interval [CI] = 27.2-31.3) and 7.4% (95% CI = 6.4-8.6), respectively. However, the prevalence decreased with age. The figures in women were 30.3% (95% CI = 28.5-32.1) and 13.8% (95% CI = 12.5-15.2), respectively. The prevalence of abdominal obesity was 21.4% (95%CI = 20.2-22.6), with 7.7% (95% CI = 6.7-9.0) in men and 33.4% (95% CI = 31.4-35.3) in women. Predictors of adiposity include the following: Malay and Indian ethnicity, higher education level, higher household income, from urban area, and being married. In conclusion, adiposity affects about one third of the Malaysian elderly population, especially those of the younger age group, women, and those with higher socioeconomic status.
    Study name: National Health and Morbidity Survey (NHMS-2006)
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