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  1. Yeap TB, Shabani NS, Bong CP, Tan HS
    BMJ Case Rep, 2021 Jul 13;14(7).
    PMID: 34257132 DOI: 10.1136/bcr-2021-244358
    Intraoperative impending compartment syndrome (ICS) is an extremely rare but lethal occurrence that can involve the upper and/or lower limb(s). It commonly occurs in patients who undergo anaesthesia in various special positions such as lithotomy, lateral decubitus or prone. We present a patient who developed an ICS of his left forearm during a cervical spine surgery in prone position. This devastating condition was fortunately identified when the pulse oximetry, intra-arterial wave form and motor-evoked potentials signal disappeared abruptly from our monitors. We discuss our perioperative challenges and management for the patient which had eventually saved the patient's limb.
  2. Tan SJ, Baharin B, Nabil S, Mohd N, Zhu Y
    J Evid Based Dent Pract, 2021 Jun;21(2):101543.
    PMID: 34391557 DOI: 10.1016/j.jebdp.2021.101543
    OBJECTIVES: To comprehensively evaluate implant survival, clinical and biochemical parameters, as well as possible dose-response relationship with hemoglobin A1c (HbA1c) in patients with differing diabetic control.

    METHODOLOGY: Five electronic databases were searched for studies that compared implant outcomes in patients with differing HbA1c values. Research quality was evaluated using Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) tool. Narrative synthesis and meta-analysis were performed for survival rate, plaque index (PI), bleeding on probing (BOP), probing pocket depth, and marginal bone loss (MBL). Categorical dose-response meta-analysis (DRMA) was conducted according to length of follow-up.

    RESULTS: Twenty-two studies met the inclusion criteria. Prospective studies were mostly of moderate quality, but non-prospective papers had serious to critical risk of bias. Survival rate was high for the first 3 years (92.6%-100%) for patients with HbA1c less than 8%. Meta-analysis revealed worsening clinical parameters with increasing HbA1c. DRMA further established a significant dose-response relationship between glycemic control with BOP (10% more bleeding, 95% CI 0.05-0.16, P = .008) and MBL (0.05 mm more bone loss, 95% CI 0.01-0.09, P = .002) per HbA1c category, but no association with probing pocket depth. Osseointegration progressed at a slower rate, and inflammatory cytokines and bone biomarkers were adversely affected in patients with HbA1c above 8%.

    CONCLUSION: Moderate evidence suggests a high short-term survival but possible dose-response trend of worsening BOP and MBL in association with glycemic control. Clinically, HbA1c values must be considered for risk assessment before placement and throughout the lifespan of the implant placed in a patient with diabetes.

  3. Tan HJ, Ling WC, Chua AL, Lee SK
    Phytomedicine, 2021 Sep;90:153623.
    PMID: 34303263 DOI: 10.1016/j.phymed.2021.153623
    BACKGROUND: Concurrent use of epigallocatechin-3-gallate (EGCG) and medication may lead to botanical-drug interactions, subsequently therapeutic failure or drug toxicity. It has been reported that EGCG reduces plasma nadolol bioavailability in normotensive models. Nevertheless, evidence on the effects of EGCG on hypertensive model, and the possible underlying mechanism have not been elucidated.

    OBJECTIVES: This study aims (i) to investigate the effects of EGCG on nadolol pharmacokinetics (maximum plasma concentration, time to achieve maximum concentration, area under the time-plasma concentration curve, plasma half-life and total clearance) and subsequently its impact on blood pressure control; and (ii) to identify transcriptional regulatory roles of EGCG on the nadolol intestinal and hepatic drug-transporters in SHR.

    METHODS: Male SHR were pre-treated with a daily dose of EGCG (10 mg/kg body weight, i.g.) for 13 days. On day-14, a single dose of nadolol (10 mg/kg body weight) was given to the rats 30 min after the last dose of EGCG administration. Systolic blood pressure (SBP) was measured at 6-h and 22-h post-nadolol administration. Plasma and urinary nadolol concentrations were quantified using high-performance liquid chromatography, and pharmacokinetic parameters were analyzed by using non-compartmental analysis. Hepatic and ileal Oatp1a5, P-gp, and Oct1 mRNA expressions were determined by real-time PCR.

    RESULTS: SBP of SHR pre-treated with EGCG and received nadolol was significantly higher than those which were not pre-treated with EGCG but received nadolol. Pre-treatment of EGCG resulted in a marked reduction of plasma nadolol maximum concentration (Cmax) and area under the time-plasma concentration curve (AUC) by 53% and 51% compared to its control. The 14-day treatment with oral EGCG led to a significant downregulation of mRNA levels of ileal Oatp1a5, P-gp, and Oct1 genes by 4.03-, 8.01- and 4.03-fold; and hepatic P-gp, and Oct1 genes by 2.61- and 2.66-fold.

    CONCLUSION: These data concluded that exposure to EGCG could lead to reduced nadolol bioavailability and therefore, uncontrolled raised blood pressure and higher risks of cardiovascular events. Our data suggest that the reduced nadolol bioavailability is associated with the downregulation of ileal Oatp1a5 and Oct1 mRNA levels that subsequently lead to poor absorption of nadolol to the systemic circulation.

  4. Tan HL, Smith JG, Hoffmann J, Renton T
    Cephalalgia, 2022 Feb;42(2):128-161.
    PMID: 34404247 DOI: 10.1177/03331024211036152
    BACKGROUND: Burning mouth syndrome is a chronic idiopathic intractable intraoral dysaesthesia that remains a challenge to clinicians due to its poorly understood pathogenesis and inconsistent response to various treatments.

    AIM: This review aimed to study the short- (≤3 months) and long-term (>3 months) effectiveness and sustainable benefit of different burning mouth syndrome treatment strategies and the associated side effects.

    MATERIALS AND METHODS: Randomised controlled trials of burning mouth syndrome treatment compared with placebo or other interventions with a minimum follow up of 2 months were searched from the PubMed, Embase and Cochrane database (published to July 2020).

    RESULTS: Twenty-two studies were selected based on the inclusion and exclusion criteria and analysed. Nine categories of burning mouth syndrome treatment were identified: Anticonvulsant and antidepressant agents, phytomedicine and alpha lipoic acid supplements, low-level laser therapy, saliva substitute, transcranial magnetic stimulation, and cognitive behaviour therapy. Cognitive behaviour therapy, topical capsaicin and clonazepam, and laser therapy demonstrated favourable outcome in both short- and long-term assessment. Phytomedicines reported a short-term benefit in pain score reduction. The pooled effect of alpha lipoic acid (ALA) pain score improvement was low, but its positive effects increased in long term assessment.

    CONCLUSION: A more significant volume in terms of sample size, multi-centres, and multi-arm comparison of therapeutic agents with placebo and longitudinal follow-up studies is recommended to establish a standardised burning mouth syndrome treatment protocol. Further studies are required to assess the analgesic benefits of topical clonazepam and capsaicin, alternative medicines with neurodegenerative prevention capability and psychology support in treating burning mouth syndrome and reducing systemic adverse drug reactions.Registration International Prospective Register of Systematic Reviews (PROSPERO):Protocol ID - CRD42020160892.

  5. Ridzuan MH, Ali MF, Tan CE, Abdul Aziz AF
    Cureus, 2021 Jun;13(6):e15410.
    PMID: 34249557 DOI: 10.7759/cureus.15410
    Background and objective Despite the widespread use of traditional and complementary medicine (TCM) during pregnancy, very few studies have focused on the use of these practices during the postpartum period among women in Malaysia. This study aimed to evaluate users' profiles and factors associated with the use of TCM during the postpartum period among women attending a community clinic in rural Malaysia. Materials and methods A cross-sectional study was conducted among 210 women at a maternal and child health clinic in Bagan Serai, Perak, Malaysia from January to April 2019. A self-administered questionnaire was used to determine the prevalence, the different types, and reasons for the use of TCM and perceptions toward TCM. Factors associated with TCM use during the postpartum period were derived from multiple logistic regression analyses. Results The prevalence of TCM use during the postpartum period was 66.2% among the subjects. The most common type of TCM used was massage (88.3%), and the most common reason reported was to improve general well-being (72.1%). "Family belief" had the highest mean for influence toward TCM use (mean: 3.63). Malays (adj. OR: 4.52, 95% CI: 1.93-10.59, p=0.001) and those having a low monthly household income (adj. OR: 3.68, 95% CI: 1.24-10.91, p=0.019) were the groups that were more likely to use TCM. Conclusion TCM use during the postpartum period is highly prevalent among Malay women with low household monthly incomes. Further studies should be conducted to address the benefits and risks of using TCM during the postpartum period.
  6. Low SY, Tan JY, Ban ZH, Siwayanan P
    J Oleo Sci, 2021 Aug 05;70(8):1027-1037.
    PMID: 34248098 DOI: 10.5650/jos.ess21078
    Liquid detergent has an increasing demand in North America, Western Europe, and Southeast Asia countries owing to its convenience to use and efficiency to clean. Alpha methyl ester sulfonates (α-MES), an anionic surfactant derived from palm oil based methyl ester, was reported to have lower manufacturing cost, good detergency with less dosage, excellent biodegradability, higher tolerance to hard water, and lower eco-toxicity as compared to linear alkylbenzene sulfonates (LABS). LABS was known as the workhorse of the detergent industry in the 20th century. Although palm-based α-MES was successfully used as the sole surfactant in powder detergent, there are still some unsettled technical issues related to phase stability and viscosity when using this anionic surfactant in heavy-duty laundry liquid detergent formulations. This paper will review not only the market overview of detergents, the application and performance of green surfactants in laundry detergents but also will highlight the technical issues related to the application of palm-based α-MES in laundry liquid detergent and some of the possible methods to overcome the formulation adversities.
  7. Tan SY, Bastion MC, Mohd Khialdin S
    Cureus, 2021 Jul;13(7):e16275.
    PMID: 34373823 DOI: 10.7759/cureus.16275
    Orbital metastasis from renal cell carcinoma (RCC) is uncommon. Orbital tumor, as the first presentation of RCC, is rare as the majority of orbital metastases occur after a confirmed diagnosis of primary cancer. We report a case of the metastatic orbital tumor as the first manifestation of RCC, which presented with painless left eye proptosis for two months' duration, associated with blurring of vision and diplopia. Otherwise, the systemic review was unremarkable. Examination showed left eye non-axial proptosis with a pulsatile, multilobulated mass over the left supraorbital area extending to the left frontal region, limited ocular motility, and impaired optic nerve functions. CT of the orbit showed a mass arising from the left frontal and greater wing of the left sphenoid bone, with infiltration to the left lateral rectus, left superior oblique, and lacrimal gland. Further systemic investigation with CT thorax, abdomen, and pelvis revealed left RCC with para-aortic nodes, lungs, and bone metastases. The patient was planned for palliative care.
  8. Ibrahim N, Jamaluddin ND, Tan LL, Mohd Yusof NY
    Sensors (Basel), 2021 Jul 28;21(15).
    PMID: 34372350 DOI: 10.3390/s21155114
    The emergence of highly pathogenic and deadly human coronaviruses, namely SARS-CoV and MERS-CoV within the past two decades and currently SARS-CoV-2, have resulted in millions of human death across the world. In addition, other human viral diseases, such as mosquito borne-viral diseases and blood-borne viruses, also contribute to a higher risk of death in severe cases. To date, there is no specific drug or medicine available to cure these human viral diseases. Therefore, the early and rapid detection without compromising the test accuracy is required in order to provide a suitable treatment for the containment of the diseases. Recently, nanomaterials-based biosensors have attracted enormous interest due to their biological activities and unique sensing properties, which enable the detection of analytes such as nucleic acid (DNA or RNA), aptamers, and proteins in clinical samples. In addition, the advances of nanotechnologies also enable the development of miniaturized detection systems for point-of-care (POC) biosensors, which could be a new strategy for detecting human viral diseases. The detection of virus-specific genes by using single-stranded DNA (ssDNA) probes has become a particular interest due to their higher sensitivity and specificity compared to immunological methods based on antibody or antigen for early diagnosis of viral infection. Hence, this review has been developed to provide an overview of the current development of nanoparticles-based biosensors that target pathogenic RNA viruses, toward a robust and effective detection strategy of the existing or newly emerging human viral diseases such as SARS-CoV-2. This review emphasizes the nanoparticles-based biosensors developed using noble metals such as gold (Au) and silver (Ag) by virtue of their powerful characteristics as a signal amplifier or enhancer in the detection of nucleic acid. In addition, this review provides a broad knowledge with respect to several analytical methods involved in the development of nanoparticles-based biosensors for the detection of viral nucleic acid using both optical and electrochemical techniques.
  9. Tan YH, Lim CS, Wong KH, Sabaratnam V
    Int J Med Mushrooms, 2021;23(6):1-11.
    PMID: 34369729 DOI: 10.1615/IntJMedMushrooms.2021038578
    Neuritin is important in neuritogenesis, neurite arborization, and neurite extension. Lignosus rhinocerotis sclerotia extracts and nerve growth factor (NGF) have been well documented to possess positive neurite stimulatory effects. However, the correlation of neuritin expression with neurite outgrowth of L. rhinocerotis and NGF cotreatment of PC12 cells remains unknown. Thus, the present study investigated neuritin expression in PC12 cells treated with 5 ng/mL of NGF and L. rhinocerotis extracts (20-1280 μg/mL) concurrently for 48 h. The neurite outgrowth score was quantitated, and total protein was harvested for enzyme-linked immunosorbent assay. There was a significant difference (P = 0.051) in neuritin protein abundance in 640 μg/mL of L. rhinocerotis aqueous cotreatment with 5 ng/mL of NGF-treated cells (5 ± 0.39 ng/mL) and 50 ng/mL of NGF-treated PC12 cells (5 ± 0.48 ng/mL) compared to untreated cells (1.9 ± 0.65 ng/ mL), with an average neurite length of 98 ± 3.66, 106 ± 3.00, and 73 ± 4.79 μm, respectively. Expression of microtubule element β3 tubulin was increased in PC12 cells treated with 50 ng/mL of NGF (3.5 ± 0.21-fold) and also cells cotreated with 640 μg/mL of extract and 5 ng/mL of NGF (4.9 ± 0.29-fold) compared to untreated cells. Upregulation of β3 tubulin expression in this study confirmed the elongation of PC12 cell processes. Correlation analysis showed that neuritin protein abundance is positively proportional to the average neurite length in PC12 cells cotreated with L. rhinocerotis extract and 5 ng/mL of NGF. This study highlights that neuritin modulation is involved in neurite outgrowth induced by L. rhinocerotis treatment. To our knowledge, this is the first report to show that tiger milk mushroom extracts induce neuritin expression.
  10. Tan ML, Gassman PW, Liang J, Haywood JM
    Sci Total Environ, 2021 Nov 15;795:148915.
    PMID: 34328938 DOI: 10.1016/j.scitotenv.2021.148915
    Alternative climate products, such as gauge-based gridded data, ground-based weather radar, satellite precipitation and climate reanalysis products, are being increasingly applied for hydrological modelling. This review aims to summarize the studies that have evaluated alternative climate products within Soil and Water Assessment Tool (SWAT) applications and to propose future research directions, primarily for modelers who wish to study limited gauge, ungauged or transnational river basins. A total of 126 articles have been identified since 2004, the majority of which have been published within the last five years. About 58% of the studies were conducted in Asia, mostly in China and India, while another 14% were reported for United States studies. CFSR and TRMM are the most popular applied products in SWAT modelling, followed by PERSIANN, CMADS, APHRODITE, CHIRPS and NEXRAD. Generally, the performance of climate products is region-dependent; e.g., CFSR typically performs well in the United States and South America, but performs more poorly for Asia, Africa and mountainous basin conditions, as compared to other products. In contrast, the CMADS, TRMM, APRHODITE and NEXRAD have shown the strongest capability for supporting SWAT modelling in these regions. However, most of the evaluated products contain only precipitation input; therefore, merging reliable precipitation with CFSR-temperature is recommended for hydro-climatic modelling. Future research directions include: (1) examination of optimal combinations; e.g. CHIRPS-precipitation and CFSR-temperature, for simulating streamflow in different types of river basins; (2) development of a standardized validation scheme which incorporates the commonly accepted products, statistical approaches and temperature variables; (3) further evaluation of existing climate data products to accurately capture extreme events, pattern and indices as well as WGEN statistics; (4) improvement of climate data in terms of averaging approach, bias correction and additional factors or indices integration; and (5) bias correction of CMIP6 climate projections using the optimal climate data combinations.
  11. Habibullah MS, Din BH, Tan SH, Zahid H
    Environ Sci Pollut Res Int, 2022 Jan;29(1):1073-1086.
    PMID: 34341937 DOI: 10.1007/s11356-021-15702-8
    The present study investigates the impact of climate change on biodiversity loss using global data consisting of 115 countries. In this study, we measure biodiversity loss using data on the total number of threatened species of amphibians, birds, fishes, mammals, mollusks, plants, and reptiles. The data were compiled from the Red List published by the International Union for Conservation of Nature (IUCN). For climate change variables, we have included temperature, precipitation, and the number of natural disaster occurrences. As for the control variable, we have considered governance indicator and the level of economic development. By employing ordinary least square with robust standard error and robust regression (M-estimation), our results suggest that all three climate change variables - temperature, precipitation, and the number of natural disasters occurrences - increase biodiversity loss. Higher economic development also impacted biodiversity loss positively. On the other hand, good governance such as the control of corruption, regulatory quality, and rule of law reduces biodiversity loss. Thus, practicing good governance, promoting conservation of the environment, and the control of greenhouse gasses would able to mitigate biodiversity loss.
  12. Liew A, Lee CC, Lan BL, Tan M
    Comput Biol Med, 2021 09;136:104690.
    PMID: 34352452 DOI: 10.1016/j.compbiomed.2021.104690
    Convolutional neural networks (CNNs) have been used quite successfully for semantic segmentation of brain tumors. However, current CNNs and attention mechanisms are stochastic in nature and neglect the morphological indicators used by radiologists to manually annotate regions of interest. In this paper, we introduce a channel and spatial wise asymmetric attention (CASPIAN) by leveraging the inherent structure of tumors to detect regions of saliency. To demonstrate the efficacy of our proposed layer, we integrate this into a well-established convolutional neural network (CNN) architecture to achieve higher Dice scores, with less GPU resources. Also, we investigate the inclusion of auxiliary multiscale and multiplanar attention branches to increase the spatial context crucial in semantic segmentation tasks. The resulting architecture is the new CASPIANET++, which achieves Dice Scores of 91.19%, 87.6% and 81.03% for whole tumor, tumor core and enhancing tumor respectively. Furthermore, driven by the scarcity of brain tumor data, we investigate the Noisy Student method for segmentation tasks. Our new Noisy Student Curriculum Learning paradigm, which infuses noise incrementally to increase the complexity of the training images exposed to the network, further boosts the enhancing tumor region to 81.53%. Additional validation performed on the BraTS2020 data shows that the Noisy Student Curriculum Learning method works well without any additional training or finetuning.
  13. Tan DWH, Ng PK, Noor EEM
    F1000Res, 2021;10:392.
    PMID: 34354817 DOI: 10.12688/f1000research.51705.1
    Background: Elderly people with severe finger weakness may need assistive health technology interventions. Finger weakness impedes the elderly in executing activities of daily living such as unbuttoning shirts and opening clothes pegs. While studies have related finger weakness with ageing effects, there appears to be no research that uses an algorithmic problem-solving approach such as the theory of inventive problem-solving (TRIZ) to recommend finger grip assistive technologies that resolve the issue of finger weakness among the elderly. Using TRIZ, this study aims to conceptualise finger grip enhancer designs for elderly people. Methods: Several TRIZ tools such as the cause-and-effect chain (CEC) analysis, engineering contradiction, physical contradiction, and substance-field analysis are used to conceptualise solutions that assist elderly people in their day-to-day pinching activities. Results: Based on the segmentation principle, a finger assistant concept powered by a miniature linear actuator is recommended. Specific product development processes are used to further conceptualise the actuation system. The study concluded that the chosen concept should use a DC motor to actuate fingers through tendon cables triggered by a push start button. Conclusions: Finger pinch degradation worsens the quality of life of the elderly. A finger grip enhancer that assists in day-to-day activities may be an effective option for elderly people, not only for their physical but also their mental well-being in society.
  14. Mardiana O, Nor Afiah MZ, Ahmad N, Tan KA, Murallitharan M
    Med J Malaysia, 2021 07;76(4):480-487.
    PMID: 34305108
    BACKGROUND: Previous research has documented the benefits of physical activity (PA) for cancer survivors which include improved quality of life, physical, physiological, emotional and social functioning, reduced relapse of cancer and the mitigation of cancer mortality. This study aims to evaluate the effects of an independent PA programme based on PA level, quality of life, self-efficacy, outcome expectations, reinforcement, behavioural capability and observational learning amongst registered National Cancer Society Malaysia's (NCSM) cancer survivors.

    METHODS: A two-armed, parallel, double-blinded, randomized, controlled trial, intervention and wait-list control groups will be conducted amongst 106 NCSM's cancer survivors. The programme is developed based on a Social Cognitive Theory that combines both psychoeducation and social media approaches to behavioural intervention. The duration of intervention will be 2 months, in which data will be collected at baseline, 2- month (immediately post-intervention) and 4-month. The primary outcome of the study is to determine the PA level of the participant which will be measured as METminutes/ week of PA using the International Physical Activity Questionnaire (IPAQ). There are four measurements of PA that are measured which are moderate and vigorous PA (MVPA) MET-minutes/week, light PA MET-minutes/week, moderate PA MET-minutes/week and vigorous PA METminutes/ week. A Generalised Estimating Equation (GEE) analysis will be used to evaluate the effectiveness of the intervention, adjusted for baseline covariates on both continuous and categorical outcomes. This study will utilize a significance level of 0.05 with a confidence interval of 95% for means estimation in rejecting null hypothesis. The trial registered to the Australian New Zealand Clinical Trials (ANZCTR) with the Registration Number, ACTRN12620000039987.

    CONCLUSION: The programme will be useful as a supplementary prescription to assist policy makers to strengthen non-pharmacological cancer management options and to empower cancer survivors to be self-reliant and self-sufficient to include PA as part of their recovery process.

  15. Sabarudin NS, Tan SW, Phang YF, Omar AR
    J Vet Sci, 2021 Jul;22(4):e42.
    PMID: 34313038 DOI: 10.4142/jvs.2021.22.e42
    BACKGROUND: Inclusion body hepatitis (IBH) is an economically important viral disease primarily affecting broiler and breeder chickens. All 12 serotypes of fowl adenovirus (FAdV) can cause IBH.

    OBJECTIVES: To characterize FAdV isolates based on phylogenetic analysis, and to study the pathogenicity of FAdV-8b in specific-pathogen-free (SPF) chickens following virus inoculation via oral and intramuscular (IM) routes.

    METHODS: Suspected organ samples were subjected to virus isolation and polymerase chain reaction (PCR) for FAdV detection. Hexon gene sequencing and phylogenetic analysis were performed on FAdV-positive samples for serotype identification. One FAdV-8b isolate, UPM/FAdV/420/2017, was selected for fiber gene characterization and pathogenicity study and was inoculated in SPF chickens via oral and IM routes.

    RESULTS: The hexon gene phylogenetic analysis revealed that all isolates belonged to FAdV-8b. The fiber gene-based phylogenetic analysis of isolate UPM/FAdV/420/2017 supported the grouping of that isolate into FAdV species E. Pathogenicity study revealed that, chickens infected with UPM/FAdV/420/2017 via the IM route had higher clinical score values, higher percent mortality, higher degree of the liver lesions, higher antibody response (p < 0.05), and higher virus shedding amounts (p < 0.05) than those infected via the oral route. The highest virus copy numbers were detected in liver and gizzard.

    CONCLUSIONS: FAdV-8b is the dominant FAdV serotype in Malaysia, and pathogenicity study of the FAdV-8b isolate UPM/FAdV/420/2017 indicated its ability to induce IBH in young SPF chickens when infected via oral or IM routes.

  16. Samy AL, Awang Bono S, Tan SL, Low WY
    Asia Pac J Public Health, 2021 11;33(8):839-846.
    PMID: 34308673 DOI: 10.1177/10105395211025901
    The COVID-19 outbreak was declared a pandemic by the World Health Organization in March 2020 due to rapid intercontinental spread and high morbidity and mortality. Globally, the disease has had a major impact on human lives, including health, economic, employment, psychological, and overall well-being. The COVID-19, besides causing respiratory, neurological, and cardiovascular diseases, has had significant impact on mental health. Major mental health disorders, including depression, anxiety, and stress, have risen in parallel with increasing prevalence of COVID-19. Many population groups, including children, the elderly, those with chronic illnesses, and health care workers, have been affected. This review gives an overall assessment of the prevalence of COVID-19-associated psychological morbidity. In countries in the Asia-Pacific region, prevalence of depression ranged between 4.9% and 43.1%, anxiety from 7.0% to 43.0%, and stress from 3.4% to 35.7%. As COVID-19 continues to severely affect the psychosocial well-being of the population at large, countries have developed and revised policies, guidelines, and introduced new initiatives to curb mental health issues among their citizens. In the long run, pre-disaster preparedness is important to alleviate long-term post-pandemic psychiatric morbidity and to develop psychological resilience toward disasters and pandemic, alongside investment for better mental health coverage.
  17. Tan PP, Chang CT, Abdul Rahman J, Mohd Noor S
    Malays J Med Sci, 2021 Jun;28(3):86-96.
    PMID: 34285647 DOI: 10.21315/mjms2021.28.3.8
    Objective: To develop and validate a questionnaire which evaluates the blood donors' satisfaction.

    Background: In Malaysia, blood procurement relies mainly on voluntary non-remunerated donors. Hence, it is important to ensure the satisfaction of the blood donors in order to increase retention.

    Methods: This study was conducted among blood donors who attended blood donation and understood the Malay language. Non-Malaysian and illiterate donors were excluded. The questionnaire was developed by the transfusion medicine team. Content validity was established by content reviewers, while face validity was examined in the cognitive debriefing stage. For the 18-item questionnaire, 90 respondents were required based on the 1:5 ratio. A retest was performed in two weeks' time.

    Results: One hundred and thirty-seven participants responded in the first phase, while 103 responded after two weeks. The five domains were: technical, interpersonal, accessibility/ convenience, physical experience and overall satisfaction. The Kaiser-Meyer-Olkin (KMO) value was 0.896, with significant Bartlett's Test of Sphericity (P < 0.001). The factor loadings ranged from 0.729 to 0.953. The Cronbach alpha values of the five domains ranged from 0.814 to 0.955 and the intraclass correlation coefficient ranged from 0.663 to 0.847.

    Conclusion: The Malaysian blood donor's satisfaction (M-BDS) questionnaire is a reliable and valid tool suitable for the assessment of blood donor's satisfaction in blood donation centres.

  18. Tan CS, Tew WY, Jingying C, Yam MF
    Chem Biol Interact, 2021 Oct 01;348:109620.
    PMID: 34411564 DOI: 10.1016/j.cbi.2021.109620
    Naringenin is a naturally occurring flavanone (flavonoid) known to have bioactive effects on human health. It has been reported to show cardiovascular effects. This study aimed to investigate the possible vasorelaxant effect of naringenin and the mechanism behind it by using a Sprague Dawley rat aortic ring assay model. Naringenin caused significant vasorelaxation of endothelium-intact aortic rings precontracted with phenylephrine (pD2 = 4.27 ± 0.05; Rmax = 121.70 ± 4.04%) or potassium chloride (pD2 = 4.00 ± 0.04; Rmax = 103.40 ± 3.82%). The vasorelaxant effect decreased in the absence of an endothelium (pD2 = 3.34 ± 0.10; Rmax = 62.29 ± 2.73%). The mechanisms of the vasorelaxant effect of naringenin in the presence of antagonists were also investigated. Indomethacin, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one, atropine, 4-aminopyridine, Nω-nitro-l-arginine methyl ester, glibenclamide and propranolol significantly reduced the relaxation stimulated by naringenin in the presence of endothelium. Besides that, the effect of naringenin on the voltage-operated calcium channel (VOCC) in the endothelium-intact aortic ring was studied, as was intracellular Ca2+ release from the sarcoplasmic reticulum (SR) in the endothelium-denuded aortic ring. The results showed that naringenin also significantly blocked the entry of Ca2+ via the VOCC, SERCA/SOCC and suppressed the release of Ca2+ from the SR. Thus, the vasorelaxant effect shown by naringenin mostly involve the COX pathway, the endothelium-dependent pathway via NO/sGC/prostaglandin, calcium and potassium channels.
  19. Tan HH, Thomas NF, Inayat-Hussain SH, Chan KM
    Sci Rep, 2021 02 26;11(1):4773.
    PMID: 33637843 DOI: 10.1038/s41598-021-83163-7
    Cytoprotection involving the nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling pathway is an important preventive strategy for normal cells against carcinogenesis. In our previous study, the chemopreventive potential of (E)-N-(2-(3, 5-Dimethoxystyryl) phenyl) furan-2-carboxamide (BK3C231) has been elucidated through its cytoprotective effects against DNA and mitochondrial damages in the human colon fibroblast CCD-18Co cell model. Therefore this study aimed to investigate the molecular mechanisms underlying BK3C231-induced cytoprotection and the involvement of the Nrf2/ARE pathway. The cells were pretreated with BK3C231 before exposure to carcinogen 4-nitroquinoline N-oxide (4NQO). BK3C231 increased the protein expression and activity of cytoprotective enzymes namely NAD(P)H:quinone oxidoreductase 1 (NQO1), glutathione S-transferase (GST) and heme oxygenase-1 (HO-1), as well as restoring the expression of glutamate-cysteine ligase catalytic subunit (GCLC) back to the basal level. Furthermore, dissociation of Nrf2 from its inhibitory protein, Keap1, and ARE promoter activity were upregulated in cells pretreated with BK3C231. Taken together, our findings suggest that BK3C231 exerts cytoprotection by activating the Nrf2 signaling pathway which leads to ARE-mediated upregulation of cytoprotective proteins. This study provides new mechanistic insights into BK3C231 chemopreventive activities and highlights the importance of stilbene derivatives upon development as a potential chemopreventive agent.
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