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  1. Fulltext Synthesis, spectroscopic and Hirshfeld surface analysis and fluorescence studies of (2E,2'E)-3,3'-(1,4-phenyl-ene)bis-[1-(4-hy-droxy-phen-yl)prop-2-en-1-one] N,N-di-methyl-formamide disolvate
    Kwong HC, Sim AJ, Chidan Kumar CS, Quah CK, Chantrapromma S, Naveen S, et al.
    Acta Crystallogr E Crystallogr Commun, 2018 Jun 01;74(Pt 6):835-839.
    PMID: 29951241 DOI: 10.1107/S2056989018007429
    In the bis-chalcone mol-ecule of the title compound, C24H18O4·2C3H7NO, the central benzene and terminal hy-droxy-phenyl rings form a dihedral angle of 14.28 (11)° and the central C=C double bond adopts a trans configuration. In the crystal, the bis-chalcone and solvate mol-ecules are inter-connected via O-H⋯O hydrogen bonds, which were investigated by Hirshfeld surface analysis. Solid-state fluorescence was measured at λex = 4400 Å. The emission wavelength appeared at 5510 Å, which corresponds to yellow light and the solid-state fluorescence quantum yield (Ff) is 0.18.
  2. Fulltext Crystal structure and Hirshfeld surface analysis of a pyridiniminium bromide salt: 1-[2-(adamantan-1-yl)-2-oxoeth-yl]pyridin-4-iminium bromide
    Kwong HC, Mahmud Pathi I, Chidan Kumar CS, Quah CK, Arafath MA
    Acta Crystallogr E Crystallogr Commun, 2018 Jul 01;74(Pt 7):1030-1034.
    PMID: 30002910 DOI: 10.1107/S2056989018009131
    In the cation of the title salt, C17H23N2O+·Br-, the adamantyl moiety and the pyridiniminium ring are inclined to the ketone bridge by torsion angles of -78.1 (2) (C-C-C=O) and 58.3 (2)° (C-C-N-C), respectively, and the ketone bridge has a C-C-C-N torsion angle of 174.80 (15)°. In the crystal, the cations are connected into chains parallel to the c axis by C-H⋯O hydrogen bonds. The chains are further linked into layers parallel to the bc plane by N-H⋯Br and C-H⋯Br hydrogen bonds, C-H⋯π inter-actions and π-π stacking inter-actions [centroid-to-centroid distance = 3.5657 (11) Å]. A Hirshfeld surface analysis, which comprises the dnorm surface, electrostatic potential map and two-dimensional fingerprint plots, was carried out to verify the contribution of the various inter-molecular inter-actions.
  3. Fulltext Crystal structure and Hirshfeld surface analysis of (2E)-3-(3-chloro-phen-yl)-1-(3,4-di-meth-oxy-phen-yl)prop-2-en-1-one
    Sheshadri SN, Atioğlu Z, Akkurt M, Chidan Kumar CS, Quah CK, Siddaraju BP, et al.
    Acta Crystallogr E Crystallogr Commun, 2018 Jul 01;74(Pt 7):935-938.
    PMID: 30002889 DOI: 10.1107/S205698901800837X
    In title compound, C17H15ClO3, the dihedral angle between the benzene and chloro-phenyl rings is 18.46 (7)°. In the crystal, mol-ecules are linked by C-H⋯O hydrogen contacts, enclosing an R22(14) ring motif, and by a further C-H⋯O hydrogen contact, forming a two-dimensional supra-molecular structure extending along the direction parallel to the ac plane. Hirshfeld surface analysis shows that van der Waals inter-actions constitute the major contribution to the inter-molecular inter-actions, with H⋯H contacts accounting for 36.2% of the surface.
  4. Fulltext Crystal structure and Hirshfeld surface analysis of (2E)-3-(2,4-di-chloro-phen-yl)-1-(2,5-di-chloro-thio-phen-3-yl)prop-2-en-1-one
    Murthy TNS, Atioğlu Z, Akkurt M, Chidan Kumar CS, Veeraiah MK, Quah CK, et al.
    Acta Crystallogr E Crystallogr Commun, 2018 Sep 01;74(Pt 9):1201-1205.
    PMID: 30225099 DOI: 10.1107/S2056989018010976
    The mol-ecular structure of the title compound, C13H6Cl4OS, consists of a 2,5-di-chloro-thio-phene ring and a 2,4-di-chloro-phenyl ring linked via a prop-2-en-1-one spacer. The dihedral angle between the 2,5-di-chloro-thio-phene ring and the 2,4-di-chloro-phenyl ring is 12.24 (15)°. The mol-ecule has an E configuration about the C=C bond and the carbonyl group is syn with respect to the C=C bond. The mol-ecular conformation is stabilized by intra-molecular C-H⋯Cl contacts, producing S(6) and S(5) ring motifs. In the crystal, the mol-ecules are linked along the a-axis direction through face-to-face π-stacking between the thio-phene rings and the benzene rings of the mol-ecules in zigzag sheets lying parallel to the bc plane along the c axis. The inter-molecular inter-actions in the crystal packing were further analysed using Hirshfield surface analysis, which indicates that the most significant contacts are Cl⋯H/ H⋯Cl (20.8%), followed by Cl⋯Cl (18.7%), C⋯C (11.9%), Cl⋯S/S⋯Cl (10.9%), H⋯H (10.1%), C⋯H/H⋯C (9.3%) and O⋯H/H⋯O (7.6%).
  5. ALK-positive anaplastic large-cell lymphoma with primary bone involvement: A rare case and review of the literature
    Noh BJ, Han CS, Park JS, Lee J, Kim YW, Park YK
    Malays J Pathol, 2018 Aug;40(2):161-167.
    PMID: 30173234
    Primary bone lymphoma (PBL) is an uncommon type of extranodal lymphoma involvement. An anaplastic large-cell lymphoma (ALCL) is an extremely rare type of PBL, and it remains unclear whether ALCLs that primarily involve the bone exhibit favourable or unfavourable biological behaviour, and whether they are similar to ALCLs in general, or not. We reported a case of ALK-positive ALCL with primary bone involvement, and reviewed the clinicopathological features of 22 previously reported cases. An ALCL with primary bone involvement mostly affects younger patients with a preponderant towards the involvement of axial-bone. The prognosis of an ALCL that primarily involves bone is unfavourable, compared with PBL generally. The ALK-positive ALCLs in PBLs had less decedents than the ALK-negative ALCLs with a statistical non-significance (p=0.198).
  6. Fulltext Crystal structure and Hirshfeld surface analysis of (E)-3-(2-chloro-4-fluoro-phen-yl)-1-(2,5-di-chloro-thio-phen-3-yl)prop-2-en-1-one
    Sanjeeva Murthy TN, Naveen S, Chidan Kumar CS, Veeraiah MK, Quah CK, Siddaraju BP, et al.
    Acta Crystallogr E Crystallogr Commun, 2018 Aug 01;74(Pt 8):1134-1137.
    PMID: 30116578 DOI: 10.1107/S2056989018010216
    In the title chalcone-thio-phene derivative, C13H6Cl3FOS, the aromatic rings are inclined to one another by 12.9 (2)°, and the thio-phene ring is affected by π-conjugation. In the crystal, mol-ecules are linked by C-H⋯F hydrogen bonds, forming an R22(8) ring motif. A Hirshfeld surface analysis was conducted to verify the contribution of the different inter-molecular inter-actions. The shape-index surface clearly shows that the two sides of the mol-ecules are involved in the same contacts with neighbouring mol-ecules and the curvedness plots show flat surface patches characteristic of planar stacking.
  7. Fulltext Crystal structure and Hirshfeld surface analysis of (2E)-3-(3-bromo-4-fluoro-phen-yl)-1-(3,4-di-meth-oxy-phen-yl)prop-2-en-1-one
    Sheshadri SN, Atioğlu Z, Akkurt M, Veeraiah MK, Quah CK, Chidan Kumar CS, et al.
    Acta Crystallogr E Crystallogr Commun, 2018 Aug 01;74(Pt 8):1063-1066.
    PMID: 30116562 DOI: 10.1107/S2056989018009416
    In the mol-ecule of the title compound, C17H14BrFO3, the aromatic rings are tilted with respect to the enone bridge by 13.63 (14) and 4.27 (15)°, and form a dihedral angle 17.91 (17)°. In the crystal, centrosymmetrically related mol-ecules are linked by pairs of C-H⋯O hydrogen bonds into dimeric units, forming rings of R22(14) graph-set motif. The dimers are further connected by weak C-H⋯O hydrogen inter-actions, forming layers parallel to (10). Hirshfeld surface analysis shows that van der Waals inter-actions constitute the major contribution to the inter-molecular inter-actions, with H⋯H contacts accounting for 29.7% of the surface.
  8. Fulltext Crystal structure and Hirshfeld surface analysis of a chalcone derivative: (E)-3-(4-fluoro-phen-yl)-1-(4-nitro-phen-yl)prop-2-en-1-one
    Wong QA, Chia TS, Kwong HC, Chidan Kumar CS, Quah CK, Arafath MA
    Acta Crystallogr E Crystallogr Commun, 2019 Jan 01;75(Pt 1):53-57.
    PMID: 30713733 DOI: 10.1107/S2056989018017450
    The mol-ecular structure of the title chalcone derivative, C15H10FNO3, is nearly planar and the mol-ecule adopts a trans configuration with respect to the C=C double bond. The nitro group is nearly coplanar with the attached benzene ring, which is nearly parallel to the second benzene ring. In the crystal, mol-ecules are connected by pairs of weak inter-molecular C-H⋯O hydrogen bonds into inversion dimers. The dimers are further linked by another C-H⋯O hydrogen bond and a C-H⋯F hydrogen bond into sheets parallel to (104). π-π inter-actions occur between the sheets, with a centroid-centroid distance of 3.8860 (11) Å. Hirshfeld surface analysis was used to investigate and qu-antify the inter-molecular inter-actions.
  9. Diffuse hepatic haemangiomatosis: A case report and review of literature
    Rao R, Naidu J, Muhammad Nawawi KN, Wong ZQ, Ngiu CS, Mohammed F, et al.
    Med J Malaysia, 2018 12;73(6):436-438.
    PMID: 30647226
    Hepatic haemangioma is a solitary liver lesion and prevalent among the female patients. We report a case of diffuse hepatic haemangiomatosis in a 62-year-old man, who was referred for an incidental finding of multiple liver nodules. History and physical examinations were unremarkable. Computed tomography and magnetic resonance imaging of the liver were performed and showed multiple haemangiomatosis. In view of the rarity of this condition in men, a liver biopsy was done and confirmed haemangiomas. Available published literature on diffuse hepatic haemangiomatosis was reviewed.
  10. Fulltext Crystal structure and Hirshfeld surface analysis of a bromo-chalcone: (E)-1-(3-bromo-phen-yl)-3-(2,6-di-chloro-phen-yl)prop-2-en-1-one
    Bindya S, Chidan Kumar CS, Naveen S, Siddaraju BP, Quah CK, Raihan MA
    Acta Crystallogr E Crystallogr Commun, 2019 Feb 01;75(Pt 2):264-267.
    PMID: 30800464 DOI: 10.1107/S205698901900104X
    In the title chalcone derivative, C15H9BrCl2O, the aryl rings are inclined to each by 14.49 (17)°, and the configuration about the C=C bond is E. There is a short intra-molecular C-H⋯Cl contact present resulting in the formation of an S(6) ring motif. In the crystal, the shortest inter-molecular contacts are Cl⋯O contacts [3.173 (3) Å] that link the mol-ecules to form a 21 helix propagating along the b-axis direction. The helices stack up the short crystallographic a axis, and are linked by offset π-π inter-actions [inter-centroid distance = 3.983 (1) Å], forming layers lying parallel to the ab plane. A qu-anti-fication of the inter-molecular contacts in the crystal were estimated using Hirshfeld surface analysis and two-dimensional fingerprint plots.
  11. Fulltext Crystal structure and Hirshfeld surface analysis of (E)-3-(2-chloro-phen-yl)-1-(2,5-di-chloro-thio-phen-3-yl)prop-2-en-1-one
    Murthy TNS, Atioğlu Z, Akkurt M, Veeraiah MK, Quah CK, Chidan Kumar CS, et al.
    Acta Crystallogr E Crystallogr Commun, 2019 Feb 01;75(Pt 2):124-128.
    PMID: 30800435 DOI: 10.1107/S2056989018018066
    The mol-ecular structure of the title compound, C13H7Cl3OS, consists of a 2,5- di-chloro-thio-phene ring and a 2-chloro-phenyl ring linked via a prop-2-en-1-one spacer. The dihedral angle between the 2,5-di-chloro-thio-phene and 2-chloro-phenyl rings is 9.69 (12)°. The mol-ecule has an E configuration about the C=C bond and the carbonyl group is syn with respect to the C=C bond. The mol-ecular conformation is stabilized by two intra-molecular C-H⋯Cl contacts and one intra-molecular C-H⋯O contact, forming S(5)S(5)S(6) ring motifs. In the crystal, the mol-ecules are linked along the a-axis direction through van der Waals forces and along the b axis by face-to-face π-stacking between the thio-phene rings and between the benzene rings of neighbouring mol-ecules, forming corrugated sheets lying parallel to the bc plane. The inter-molecular inter-actions in the crystal packing were further analysed using Hirshfield surface analysis, which indicates that the most significant contacts are Cl⋯H/ H⋯Cl (28.6%), followed by C⋯H/H⋯C (11.9%), C⋯C (11.1%), H⋯H (11.0%), Cl⋯Cl (8.1%), O⋯H/H⋯O (8.0%) and S⋯H/H⋯S (6.6%).
  12. A web-based educational intervention module to improve knowledge and attitudes towards thalassaemia prevention in Malaysian young adults
    Ngim CF, Ibrahim H, Abdullah N, Lai NM, Tan RKM, Ng CS, et al.
    Med J Malaysia, 2019 Jun;74(3):219-225.
    PMID: 31256177
    BACKGROUND: Thalassaemia is a public health burden in Malaysia and its prevention faces many challenges. In this study, we aimed to assess the effectiveness of a web-based educational module in improving knowledge and attitudes about thalassaemia prevention amongst Malaysian young adults.

    METHODS: We designed an interactive web-based educational module in the Malay language wherein videos were combined with text and pictorial visual cues. Malaysians aged 18-40 years old who underwent the module had their knowledge and attitudes assessed at baseline, post-intervention and at 6-month follow-up using a selfadministered validated questionnaire.

    RESULTS: Sixty-five participants: 47 Malays (72.3%), 15 Chinese (23.1%), three Indians (4.6%) underwent the module. Questionnaires were completed at baseline (n=65), postintervention (n=65) and at 6-month follow-up (n=60). Out of a total knowledge score of 21, significant changes were recorded across three time-points- median scores were 12 at pre-intervention, 19 at post-intervention and 16 at 6-month follow-up (p<0.001). Post-hoc testing comparing preintervention and 6-month follow-up scores showed significant retention of knowledge (p<0.001). Compared to baseline, attitudes at 6-month follow-up showed an increased acceptance for "marriage avoidance between carriers" (pre-intervention 20%, 6-month follow-up 48.3%, p<0.001) and "prenatal diagnosis" (pre-intervention 73.8%, 6-month follow-up 86.2%, p=0.008). Acceptance for selective termination however, remained low without significant change (pre-intervention 6.2%, 6-month follow-up 16.7%, p=0.109).

    CONCLUSION: A web-based educational module appears effective in improving knowledge and attitudes towards thalassaemia prevention and its incorporation in thalassaemia prevention programs is potentially useful in Malaysia and countries with a high internet penetration rate.

  13. Phenotypic variation among siblings with arrhythmogenic right ventricular cardiomyopathy
    Oon YY, Koh KT, Khaw CS, Mohd Amin NH, Ong TK
    Med J Malaysia, 2019 08;74(4):328-330.
    PMID: 31424042
    Arrhythmogenic right ventricular cardiomyopathy (ARVC) is primarily a familial disease with autosomal dominant inheritance. Incomplete penetrance and variable expression are common, resulting in broad disease spectrum. Three patterns of phenotypic expression have been described: (1) "classic" subtype, with predominant right ventricle involvement, (2) "left dominant" subtype, with early and dominant left ventricle involvement, and (3) "biventricular" subtype, with both ventricles equally affected. Genotypephenotype associations have been described, but there are other genetic and non-genetic factors that can affect disease expression. We describe two different phenotypic expressions of ARVC in a family.
  14. Comparing the outcome of monitored anaesthesia care and local anaesthesia for carpal tunnel syndrome surgery by neurosurgeons
    Goh CH, Lau BL, Teong SY, Law WC, Tan CS, Vasu R, et al.
    Med J Malaysia, 2019 12;74(6):499-503.
    PMID: 31929475
    INTRODUCTION: Carpal tunnel syndrome (CTS) is the commonest median nerve entrapment neuropathy of the hand, up to 90% of all nerve compression syndromes. The disease is often treated with conservative measures or surgery. The senior author initially intended to treat his own neurosurgical patients concurrently diagnosed with carpal tunnel syndrome in 2014, subsequently, he began to pick up more referrals from the primary healthcare group over the years. This has led to the setup of a peripheral and spine clinic to act as a hub of referrals.

    OBJECTIVE: Department of Neurosurgery Sarawak aimed to evaluate the surgical outcome of carpal tunnel release done over five years.

    METHODS: The carpal tunnel surgeries were done under local anaesthesia (LA) given by neurosurgeons (Bupivacaine 0.5% or Lignocaine 2%). Monitored anaesthesia care (MAC) was later introduced by our hospital neuroanaesthetist in the beginning of 2018 (Target-controlled infusion propofol and boluses of fentanyl). We looked into our first 17 cases and compared these to the two anaesthesia techniques (LA versus MAC + LA) in terms of patient's pain score based on visual analogue scale (VAS).

    RESULTS: Result showed MAC provided excellent pain control during and immediately after the surgery. None experienced anaesthesia complications. There was no difference in pain control at post-operation one month. Both techniques had equal good clinical outcome during patients' clinic follow up.

    CONCLUSION: Neurosurgeons provide alternative route for CTS patients to receive surgical treatment. Being a designated pain free hospital, anaesthetist collaboration in carpal tunnel surgery is an added value and improves patients overall experience and satisfaction.

  15. Could bacteriophages isolated from the sewage be the solution to methicillin-resistant Staphylococcus aureus?
    Tan CS, Aqiludeen NA, Tan R, Gowbei A, Mijen AB, Santhana Raj L, et al.
    Med J Malaysia, 2020 03;75(2):110-116.
    PMID: 32281590
    INTRODUCTIONS: The emergence of multidrug-resistant bacteria such as Methicillin-Resistant Staphylococcus aureus (MRSA) complicates the treatment of the simplest infection. Although glycopeptides such as vancomycin still proves to be effective in treating MRSA infections, the emergence of vancomycin-resistant strains limits the long term use of this antibiotic. Bacteriophages are ubiquitous bacterial viruses which is capable of infecting and killing bacteria including its antibiotic-resistant strains. Bactericidal bacteriophages use mechanisms that is distinct from antibiotics and is not affected by the antibioticresistant phenotypes.

    OBJECTIVES: The study was undertaken to evaluate the possibility to isolate bacteriolytic bacteriophages against S.aureus from raw sewage water and examine their efficacy as antimicrobial agents in vitro.

    METHODS: Bacteriophages were isolated from the raw sewage using the agar overlay method. Isolated bacteriophages were plaque purified to obtain homogenous bacteriophage isolates. The host range of the bacteriophages was determined using the spot test assay against the 25 MRSA and 36 MSSA isolates obtained from the Sarawak General Hospital. Staphylococcus saprophyticus, Staphylococcus sciuri and Staphylococcus xylosus were included as non-SA controls. The identity of the bacteriophages was identified via Transmission Electron Microscopy and genomic size analysis. Their stability at different pH and temperature were elucidated.

    RESULTS: A total of 10 lytic bacteriophages infecting S.aureus were isolated and two of them namely ΦNUSA-1 and ΦNUSA-10 from the family of Myoviridae and Siphoviridae respectively exhibited exceptionally broad host range against >80% of MRSA and MSSA tested. Both bacteriophages were specific to S.aureus and stable at both physiologic pH and temperature.

    CONCLUSION: This study demonstrated the abundance of S.aureus specific bacteriophages in raw sewage. Their high virulence against both MSSA and MRSA is an excellent antimicrobial characteristic which can be exploited for bacteriophage therapy against MRSA.

  16. A randomized controlled trial of mindfulness breathing exercise in patients with advanced lung cancer
    Chai CS, Tan SB, Ng DLC, Liam CK, Pang YK
    Ann Oncol, 2018 Nov;29 Suppl 9:ix110-ix111.
    PMID: 32177731 DOI: 10.1093/annonc/mdy440.005
  17. Psychological and work-related factors predicting work engagement in Malaysian employees
    Chan CMH, Wong JE, Wee LH, Jamil NA, Yeap LLL, Swarna Nantha Y, et al.
    Occup Med (Lond), 2020 Sep 09;70(6):400-406.
    PMID: 32537649 DOI: 10.1093/occmed/kqaa107
    BACKGROUND: Past research on work engagement has focused almost exclusively on either psychological or work-related factors in almost wholly separate literature. There is therefore a need to examine how these factors collectively influence work engagement.

    AIMS: To determine levels of work engagement and to identify psychological and work-related characteristics predicting work engagement in employees in Malaysia.

    METHODS: We recruited 5235 employees from 47 public and private organizations in Malaysia who responded to an online health survey. We assessed work engagement with the 9-item Utrecht Work Engagement Scale (UWES-9) and psychological distress using the 6-item Kessler scale. We performed multiple linear regression to determine predictors of work engagement.

    RESULTS: Employee mean age was 33.8 years (standard deviation [SD] ± 8.8). The mean work engagement score on the UWES-9 was 3.53 (SD ± 0.94). Eleven of 18 variables on multiple regression predicted work engagement, F(18, 4925) = 69.02, P < 0.001, R2 = 0.201. Factors that predicted higher work engagement were age, marital status, education level, job type, job permanency, longer sleep duration, lower psychological distress and no history of workplace bullying.

    CONCLUSIONS: Key factors associated with poorer work engagement in Malaysian employees include inadequate sleep, psychological distress and a history of workplace bullying. These are modifiable factors that individuals and employers can target to improve work engagement, ideally tailored according to occupational type.

  18. Fulltext Population Genomic Structure and Recent Evolution of Plasmodium knowlesi, Peninsular Malaysia
    Hocking SE, Divis PCS, Kadir KA, Singh B, Conway DJ
    Emerg Infect Dis, 2020 08;26(8):1749-1758.
    PMID: 32687018 DOI: 10.3201/eid2608.190864
    Most malaria in Malaysia is caused by Plasmodium knowlesi parasites through zoonotic infection from macaque reservoir hosts. We obtained genome sequences from 28 clinical infections in Peninsular Malaysia to clarify the emerging parasite population structure and test for evidence of recent adaptation. The parasites all belonged to a major genetic population of P. knowlesi (cluster 3) with high genomewide divergence from populations occurring in Borneo (clusters 1 and 2). We also observed unexpected local genetic subdivision; most parasites belonged to 2 subpopulations sharing a high level of diversity except at particular genomic regions, the largest being a region of chromosome 12, which showed evidence of recent directional selection. Surprisingly, we observed a third subpopulation comprising P. knowlesi infections that were almost identical to each other throughout much of the genome, indicating separately maintained transmission and recent genetic isolation. Each subpopulation could evolve and present a broader health challenge in Asia.
  19. Tuberculous meningitis mimicking Creutzfeldt-Jakob disease
    Khoo CS, Krishnan L, Ng CF, Teh PC, Norlinah MI, Tan HJ
    Rev Neurol (Paris), 2021 03;177(3):319-321.
    PMID: 32747046 DOI: 10.1016/j.neurol.2020.05.013
  20. Fulltext Assessing dehydration status in dengue patients using urine colourimetry and mobile phone technology
    Chew N, Noor Azhar AM, Bustam A, Azanan MS, Wang C, Lum LCS
    PLoS Negl Trop Dis, 2020 09;14(9):e0008562.
    PMID: 32881914 DOI: 10.1371/journal.pntd.0008562
    BACKGROUND: Dengue is a systemic and dynamic disease with symptoms ranging from undifferentiated fever to dengue shock syndrome. Assessment of patients' severity of dehydration is integral to appropriate care and management. Urine colour has been shown to have a high correlation with overall assessment of hydration status. This study tests the feasibility of measuring dehydration severity in dengue fever patients by comparing urine colour captured by mobile phone cameras to established laboratory parameters.

    METHODOLOGY/PRINCIPAL FINDINGS: Photos of urine samples were taken in a customized photo booth, then processed using Adobe Photoshop to index urine colour into the red, green, and blue (RGB) colour space and assigned a unique RGB value. The RGB values were then correlated with patients' clinical and laboratory hydration indices using Pearson's correlation and multiple linear regression. There were strong correlations between urine osmolality and the RGB of urine colour, with r = -0.701 (red), r = -0.741 (green), and r = -0.761 (blue) (all p-value <0.05). There were strong correlations between urine specific gravity and the RGB of urine colour, with r = -0.759 (red), r = -0.785 (green), and r = -0.820 (blue) (all p-value <0.05). The blue component had the highest correlations with urine specific gravity and urine osmolality. There were moderate correlations between RGB components and serum urea, at r = -0.338 (red), -0.329 (green), -0.360 (blue). In terms of urine biochemical parameters linked to dehydration, multiple linear regression studies showed that the green colourimetry code was predictive of urine osmolality (β coefficient -0.082, p-value <0.001) while the blue colourimetry code was predictive of urine specific gravity (β coefficient -2,946.255, p-value 0.007).

    CONCLUSIONS/SIGNIFICANCE: Urine colourimetry using mobile phones was highly correlated with the hydration status of dengue patients, making it a potentially useful hydration status tool.

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