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  1. Fulltext A potential epigenetic marker mediating serum folate and vitamin B12 levels contributes to the risk of ischemic stroke
    Wei LK, Sutherland H, Au A, Camilleri E, Haupt LM, Gan SH, et al.
    Biomed Res Int, 2015;2015:167976.
    PMID: 25705649 DOI: 10.1155/2015/167976
    Stroke is a multifactorial disease that may be associated with aberrant DNA methylation profiles. We investigated epigenetic dysregulation for the methylenetetrahydrofolate reductase (MTHFR) gene among ischemic stroke patients. Cases and controls were recruited after obtaining signed written informed consents following a screening process against the inclusion/exclusion criteria. Serum vitamin profiles (folate, vitamin B12, and homocysteine) were determined using immunoassays. Methylation profiles for CpGs A and B in the MTHFR gene were determined using a bisulfite-pyrosequencing method. Methylation of MTHFR significantly increased the susceptibility risk for ischemic stroke. In particular, CpG A outperformed CpG B in mediating serum folate and vitamin B12 levels to increase ischemic stroke susceptibility risks by 4.73-fold. However, both CpGs A and B were not associated with serum homocysteine levels or ischemic stroke severity. CpG A is a potential epigenetic marker in mediating serum folate and vitamin B12 to contribute to ischemic stroke.
    Matched MeSH terms: Folic Acid/blood*; Vitamin B 12/blood*; Stroke/blood*
  2. Fulltext Validity and reliability of the Malay version of the Hill-Bone compliance to high blood pressure therapy scale for use in primary healthcare settings in Malaysia: A cross-sectional study
    Cheong AT, Sazlina SG
    Malays Fam Physician, 2015;10(2):36-44.
    PMID: 27099659 MyJurnal
    INTRODUCTION: Hill-Bone compliance to high blood pressure therapy scale (HBTS) is one of the useful scales in primary care settings. It has been tested in America, Africa and Turkey with variable validity and reliability. The aim of this paper was to determine the validity and reliability of the Malay version of HBTS (HBTS-M) for the Malaysian population.
    MATERIALS AND METHODS: HBTS comprises three subscales assessing compliance to medication, appointment and salt intake. The content validity of HBTS to the local population was agreed through consensus of expert panel. The 14 items used in the HBTS were adapted to reflect the local situations. It was translated into Malay and then back-translated into English. The translated version was piloted in 30 participants. This was followed by structural and predictive validity, and internal consistency testing in 262 patients with hypertension, who were on antihypertensive agent(s) for at least 1 year in two primary healthcare clinics in Kuala Lumpur, Malaysia. Exploratory factor analyses and the correlation between HBTS-M total score and blood pressure were performed. The Cronbach's alpha was calculated accordingly.
    RESULTS: Factor analysis revealed a three-component structure represented by two components on medication adherence and one on salt intake adherence. The Kaiser-Meyer-Olkin statistic was 0.764. The variance explained by each factors were 23.6%, 10.4% and 9.8%, respectively. However, the internal consistency for each component was suboptimal with Cronbach's alpha of 0.64, 0.55 and 0.29, respectively. Although there were two components representing medication adherence, the theoretical concepts underlying each concept cannot be differentiated. In addition, there was no correlation between the HBTS-M total score and blood pressure.
    CONCLUSION: HBTS-M did not conform to the structural and predictive validity of the original scale. Its reliability on assessing medication and salt intake adherence would most probably to be suboptimal in the Malaysian primary care setting.
    Matched MeSH terms: Blood Pressure
  3. Fulltext Food insecurity and the metabolic syndrome among women from low income communities in Malaysia
    Shariff ZM, Sulaiman N, Jalil RA, Yen WC, Yaw YH, Taib MN, et al.
    Asia Pac J Clin Nutr, 2014;23(1):138-47.
    PMID: 24561982 DOI: 10.6133/apjcn.2014.23.1.05
    This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/ obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.
    Matched MeSH terms: Blood Glucose/analysis; Lipids/blood
  4. Fulltext Lipopolysaccharide, immune activation, and liver abnormalities in HIV/hepatitis B virus (HBV)-coinfected individuals receiving HBV-active combination antiretroviral therapy
    Crane M, Avihingsanon A, Rajasuriar R, Velayudham P, Iser D, Solomon A, et al.
    J Infect Dis, 2014 Sep 1;210(5):745-51.
    PMID: 24585898 DOI: 10.1093/infdis/jiu119
    We investigated the relationship between microbial translocation, immune activation, and liver disease in human immunodeficiency virus (HIV)/hepatitis B virus (HBV) coinfection. Lipopolysaccharide (LPS), soluble CD14, CXCL10, and CCL-2 levels were elevated in patients with HIV/HBV coinfection. Levels of LPS, soluble CD14, and CCL-2 declined following receipt of HBV-active combination antiretroviral therapy (cART), but the CXCL10 level remained elevated. No markers were associated with liver disease severity on liver biopsy (n = 96), but CXCL10, interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor α, and interferon γ (IFN-γ) were all associated with elevated liver enzyme levels during receipt of HBV-active cART. Stimulation of hepatocyte cell lines in vitro with IFN-γ and LPS induced a profound synergistic increase in the production of CXCL10. LPS may contribute to liver disease via stimulating persistent production of CXCL10.
    Matched MeSH terms: Lipopolysaccharides/blood*; Cytokines/blood; Antigens, CD14/blood
  5. Managing post stroke hyperglycaemia: moderate glycaemic control is better? An update
    Wan Sulaiman WA, Hashim HZ, Che Abdullah ST, Hoo FK, Basri H
    EXCLI J, 2014;13:825-33.
    PMID: 26417305
    Post stroke hyperglycaemia (PSH) is prevalent in acute ischaemic stroke (AIS) patients and it has been associated with a dismal outcome of death and disability. Insulin has been proven to attenuate glucose effectively in stroke patients, thus many trials over the years had studied the efficacy of intensive treatment aiming at normalization of blood sugar level in order to improve the bleak outcomes of PSH. However, tight glycaemic control failed to be translated into clinical benefits and the outcomes are no different from the conventional approach, despite the costly healthcare expenditure invested. On the contrary, it brings more significant harm than the intended benefit, as 1 in every 9 treated patients had symptomatic hypoglycaemia. Thus, the benefits of tight glucose control, if any, are overshadowed by this potential risk of hypoglycaemia causing permanent neurological injury. Therefore, international practice guidelines recommend for less aggressive treatment to maintain blood glucose level within an appropriate range in AIS patients. However, there are limited details for stroke-specific glycaemic management and this made management of PSH particularly difficult. This review is to discuss and provide suggestions concerning glycaemic control in acute ischaemic stroke; the direction of its future prospective clinical trials and the treatment strategy required based on recent literature.
    Matched MeSH terms: Blood Glucose
  6. Nutritional status and dietary intakes of children aged 6 months to 12 years: findings of the Nutrition Survey of Malaysian Children (SEANUTS Malaysia)
    Poh BK, Ng BK, Siti Haslinda MD, Nik Shanita S, Wong JE, Budin SB, et al.
    Br J Nutr, 2013 Sep;110 Suppl 3:S21-35.
    PMID: 24016764 DOI: 10.1017/S0007114513002092
    The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.
    Matched MeSH terms: Ferritins/blood; Vitamin A/blood; Vitamin D/blood
  7. Fulltext A report on an unusual presentation of autonomic dysreflexia
    Suhaida SS, Engkasan JP
    Med J Malaysia, 2012 Dec;67(6):616-7.
    PMID: 23770957 MyJurnal
    A 48-year-old male with complete tetraplegia C6 presented with sweating and flushing of the right half of the face and neck that recurred when lying in supine and left lateral positions. The symptoms subsided immediately upon sitting upright or lying in a right lateral position. The symptoms were associated with occasional mild head discomfort rather than headache and were accompanied by marked elevation of blood pressure, which was 190-200/120-130 mmHg compared to his previous baseline blood pressure of 80-90/50-70 mmHg, and he had a heart rate of 60-70 beats per minute. We believe that post-traumatic syringomyelia, found upon further investigation, was the cause of the Autonomic dysreflexia (AD) in this patient. He was advised to avoid the positions causing the symptoms and the progression of symptoms was monitored regularly. AD might not have been diagnosed in this patient because of the atypical and unusual presentations. Therefore, knowledge and a heightened level of awareness of this possible complication are important when treating individuals with spinal cord injury (SCI).
    Matched MeSH terms: Blood Pressure
  8. Insulin secreted from genetically engineered intestinal cells reduces blood glucose levels in diabetic mice
    Rasouli M, Allaudin ZN, Omar AR, Ahmad Z
    Curr Gene Ther, 2013 Aug;13(4):229-39.
    PMID: 23721205 DOI: 10.2174/15665232113139990002
    Poorly controlled diabetes mellitus can result in serious complications. Gene therapy is increasingly being considered as an alternative approach to treat diabetes, because of its ability to induce physiological insulin secretion and it allows patients to escape insulin injections. The properties of gut K and L-cells, including glucose sensitivity, the ability to process insulin and a regulated secretion pathway support their use as surrogate β-cells. Previous in vitro studies have provided sufficient evidence supporting the use of these cells for gene therapy studies. Therefore, we examined the ability of K and L-cells to produce insulin in diabetic mice. Chitosan nanoparticles were used to transfer the insulin gene into intestinal cells via oral administration. The efficiency of chitosan as a gene vehicle was investigated through the use of reporter gene. Insulin mRNA and protein expression levels were measured by RT-PCR and ELISA, respectively. Blood glucose testing revealed that this treatment reduced glucose levels in diabetic mice. The decrease in blood glucose level in the first week of treatment was greater in mice with K-cell specific insulin expression compared with mice with L-cell-specific insulin expression. These results indicate that inducing insulin secretion in K-cells conferred a quicker response to gene therapy.
    Matched MeSH terms: Blood Glucose/genetics; Diabetes Mellitus/blood
  9. Metabolic and biochemical changes in streptozotocin induced obese-diabetic rats treated with Phyllanthus niruri extract
    Mediani A, Abas F, Maulidiani M, Khatib A, Tan CP, Ismail IS, et al.
    J Pharm Biomed Anal, 2016 Sep 05;128:302-312.
    PMID: 27318080 DOI: 10.1016/j.jpba.2016.06.003
    Herbal medicine has been proven to be an effective therapy offering a variety of benefits, such as moderate reduction in hypoglycemia, in the treatment and prevention of obesity and diabetes. Phyllanthus niruri has been used as a treatment for diabetes mellitus. Herein, the induction of type 2 diabetes in Sprague-Dawley rats was achieved by a low dose of streptozotocin (STZ) (25mg/kgbw). Here, we evaluated the in vivo antidiabetic properties of two concentrations (250 and 500mg/kg bw) of P. niruri via metabolomics approach. The administration of 500mg/kgbw of P. niruri extract caused the metabolic disorders of obese diabetic rats to be improved towards the normal state. The extract also clearly decreased the serum glucose level and improved the lipid profile in obese diabetic rats. The results of this study may contribute towards better understanding the molecular mechanism of this medicinal plant in managing diabetes mellitus.
    Matched MeSH terms: Blood Glucose/metabolism; Lipids/blood
  10. Review: the Multiple Roles of Monocytic Microparticles
    Halim AT, Ariffin NA, Azlan M
    Inflammation, 2016 Aug;39(4):1277-84.
    PMID: 27216803 DOI: 10.1007/s10753-016-0381-8
    Monocytic microparticles (mMP) are microparticles derived from human monocytes either under in vivo or in vitro conditions. The size of mMP is between 0.1 and 1.0 μm. Apart from the size range, mMPs are also identified based on phosphatidylserine and CD14 expression on their surface, though this is not always the case. Monocytic MP are critical players in inflammation, endothelial cell function, and blood coagulation. They exhibit dual function by either helping the progression of such conditions or limiting it, depending on certain factors. Furthermore, the numbers of mMP are elevated in some autoimmune diseases, infectious diseases, and metabolic disorders. However, it is unknown whether mMP play an active role in these diseases or are simply biomarkers. The mechanism of mMP modulation is yet to be identified. In this review, we highlight the mechanism of mMP formation and the roles that they play in inflammation, blood coagulation, and different disease settings.
    Matched MeSH terms: Blood Coagulation
  11. Fulltext Augmentation of Autoantibodies by Helicobacter pylori in Parkinson's Disease Patients May Be Linked to Greater Severity
    Suwarnalata G, Tan AH, Isa H, Gudimella R, Anwar A, Loke MF, et al.
    PLoS One, 2016;11(4):e0153725.
    PMID: 27100827 DOI: 10.1371/journal.pone.0153725
    Parkinson's disease (PD) is the second most common chronic and progressive neurodegenerative disorder. Its etiology remains elusive and at present only symptomatic treatments exists. Helicobacter pylori chronically colonizes the gastric mucosa of more than half of the global human population. Interestingly, H. pylori positivity has been found to be associated with greater of PD motor severity. In order to investigate the underlying cause of this association, the Sengenics Immunome protein array, which enables simultaneous screening for autoantibodies against 1636 human proteins, was used to screen the serum of 30 H. pylori-seropositive PD patients (case) and 30 age- and gender-matched H. pylori-seronegative PD patients (control) in this study. In total, 13 significant autoantibodies were identified and ranked, with 8 up-regulated and 5 down-regulated in the case group. Among autoantibodies found to be elevated in H. pylori-seropositive PD were included antibodies that recognize Nuclear factor I subtype A (NFIA), Platelet-derived growth factor B (PDGFB) and Eukaryotic translation initiation factor 4A3 (eIFA3). The presence of elevated autoantibodies against proteins essential for normal neurological functions suggest that immunomodulatory properties of H. pylori may explain the association between H. pylori positivity and greater PD motor severity.
    Matched MeSH terms: Autoantibodies/blood; Parkinson Disease/blood; Helicobacter Infections/blood
  12. Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial
    Firouzi S, Majid HA, Ismail A, Kamaruddin NA, Barakatun-Nisak MY
    Eur J Nutr, 2017 Jun;56(4):1535-1550.
    PMID: 26988693 DOI: 10.1007/s00394-016-1199-8
    AIM: Evidence of a possible connection between gut microbiota and several physiological processes linked to type 2 diabetes is increasing. However, the effect of multi-strain probiotics in people with type 2 diabetes remains unclear. This study investigated the effect of multi-strain microbial cell preparation-also refers to multi-strain probiotics-on glycemic control and other diabetes-related outcomes in people with type 2 diabetes.

    DESIGN: A randomized, double-blind, parallel-group, controlled clinical trial.

    SETTING: Diabetes clinic of a teaching hospital in Kuala Lumpur, Malaysia.

    PARTICIPANTS: A total of 136 participants with type 2 diabetes, aged 30-70 years, were recruited and randomly assigned to receive either probiotics (n = 68) or placebo (n = 68) for 12 weeks.

    OUTCOMES: Primary outcomes were glycemic control-related parameters, and secondary outcomes were anthropomorphic variables, lipid profile, blood pressure and high-sensitivity C-reactive protein. The Lactobacillus and Bifidobacterium quantities were measured before and after intervention as an indicator of successful passage of the supplement through gastrointestinal tract.

    STATISTICAL ANALYSIS: Intention-to-treat (ITT) analysis was performed on all participants, while per-protocol (PP) analysis was performed on those participants who had successfully completed the trial with good compliance rate.

    RESULTS: With respect to primary outcomes, glycated hemoglobin decreased by 0.14 % in the probiotics and increased by 0.02 % in the placebo group in PP analysis (p 

    Matched MeSH terms: Blood Glucose/metabolism*; Insulin/blood
  13. Fulltext Vitamin Status among Breastfed Infants in Bhaktapur, Nepal
    Ulak M, Chandyo RK, Thorne-Lyman AL, Henjum S, Ueland PM, Midttun Ø, et al.
    Nutrients, 2016 Mar 08;8(3):149.
    PMID: 27005657 DOI: 10.3390/nu8030149
    Vitamin deficiencies are known to be common among infants residing in low- and middle-income countries but relatively few studies have assessed several biochemical parameters simultaneously. The objective of the study was to describe the status of vitamins (A, D, E, B₆, B12 and folate) in breastfed infants. We measured the plasma concentrations of trans retinol, 25 hydroxy vitamin D, α-tocopherol, pyridoxal 5'-phosphate, cobalamin, folate, methylmalonic acid, homocysteine, hemoglobin and C-reactive protein from 467 randomly selected infants. One in five (22%) was deficient in at least one vitamin. Mean (SD) plasma folate concentration was 73 (35) nmol/L, and no infant in the sample was folate deficient. Vitamin B₆ deficiency and vitamin B12 deficiency was found in 22% and 17% of the infants, respectively. Elevated plasma methylmalonic acid or total homocysteine concentration was found in 82% and 62% of infants, respectively. Fifteen percent of infants were vitamin A deficient and 65% were marginally deficient in vitamin A. Fewer than 5% of infants had low plasma vitamin D concentration or vitamin E concentration (α-tocopherol <9.3 µmol/L). Our results illustrate the importance of continued supplementation campaigns and support the expansion of food fortification and dietary diversification programs that target children and women in Nepal.
    Matched MeSH terms: Avitaminosis/blood; Vitamins/blood*; Biomarkers/blood
  14. Glycaemic control and associated factors among patients with diabetes at public health clinics in Johor, Malaysia
    Mahmood MI, Daud F, Ismail A
    Public Health, 2016 Jun;135:56-65.
    PMID: 26976488 DOI: 10.1016/j.puhe.2015.07.043
    OBJECTIVES: To determine the prevalence of glycaemic control and factors associated with poor glycaemic control [glycosylated haemoglobin (HbA1c) ≥6.5%] among patients with type 2 diabetes treated in public health clinics in Johor, Malaysia.

    STUDY DESIGN: Cross-sectional study.

    METHODS: A review of all patients aged over 18 years and with a diagnosis of type 2 diabetes for >1 year. The National Diabetic Registry was used as the database for attendees at public health clinics in Johor Bahru between January and December 2013. A required sample of 660 was calculated, and a random sampling method was applied to acquire patient information across the 13 public health clinics in Johor Bahru. All relevant information (e.g. HbA1c, type of treatment and other parameters for glycaemic control) were abstracted from the registry.

    RESULTS: Sixty-eight percent of 706 patients had HbA1c >6.5%, and mean HbA1c was 7.8%. Younger patients (72.3%) had poorer glycaemic control than older patients (63.0%), and most patients with poor glycaemic control were obese (79.2%). Approximately 31.7% of patients did not achieve the target blood pressure <130/80 mmHg, and 58.5% did not achieve the target lipid profile. Multiple logistic regression analysis revealed that age (<60 years), sex (male), duration of diabetes (>5 years), body mass index (obese), type of treatment (diet therapy vs combination therapy) and abnormal lipid profile were significantly associated with increased odds of HbA1C >6.5%.

    CONCLUSIONS: More than half (68%) of the patients with diabetes had HbA1c >6.5%. This highlights the importance of providing organized care to manage patients with diabetes in the primary care setting, such as weight reduction programmes, proper prescribing treatment, and age- and gender-specific groups to ensure good glycaemic control.
    Matched MeSH terms: Blood Glucose/metabolism*; Diabetes Mellitus, Type 2/blood*
  15. Fulltext Dietary macronutrients and the aging liver sinusoidal endothelial cell
    Cogger VC, Mohamad M, Solon-Biet SM, Senior AM, Warren A, O'Reilly JN, et al.
    Am J Physiol Heart Circ Physiol, 2016 05 01;310(9):H1064-70.
    PMID: 26921440 DOI: 10.1152/ajpheart.00949.2015
    Fenestrations are pores within the liver sinusoidal endothelial cells (LSECs) that line the sinusoids of the highly vascularized liver. Fenestrations facilitate the transfer of substrates between blood and hepatocytes. With pseudocapillarization of the hepatic sinusoid in old age, there is a loss of fenestrations. LSECs are uniquely exposed to gut-derived dietary and microbial substrates delivered by the portal circulation to the liver. Here we studied the effect of 25 diets varying in content of macronutrients and energy on LSEC fenestrations using the Geometric Framework method in a large cohort of mice aged 15 mo. Macronutrient distribution rather than total food or energy intake was associated with changes in fenestrations. Porosity and frequency were inversely associated with dietary fat intake, while fenestration diameter was inversely associated with protein or carbohydrate intake. Fenestrations were also linked to diet-induced changes in gut microbiome, with increased fenestrations associated with higher abundance of Firmicutes and reduced abundance of Bacteroidetes Diet-induced changes in levels of several fatty acids (C16:0, C19:0, and C20:4) were also significantly inversely associated with fenestrations, suggesting a link between dietary fat and modulation of lipid rafts in the LSECs. Diet influences fenestrations and these data reflect both the key role of the LSECs in clearing gut-derived molecules from the vascular circulation and the impact these molecules have on LSEC morphology.
    Matched MeSH terms: Liver/blood supply*; Biomarkers/blood
  16. Fulltext A case series of acquired haemophilia in a Malaysian hospital: unpredictably rare medical emergency
    Lee CP, Khalid BB
    Oxf Med Case Reports, 2015 Oct;2015(10):330-2.
    PMID: 26568837 DOI: 10.1093/omcr/omv055
    Acquired haemophilia (AH) is a rare bleeding disorder characterized by the presence of acquired inhibitors against Factor VIII causing disruption of coagulation cascade. It has no known genetic inheritance, and diagnosis remains a challenge. The peculiar presentations are later age of onset as acute pain in weight-bearing joints and spontaneous muscle haematoma with isolated prolonged activated partial thrombin time (APTT). Prevalence is 1 per million per year affecting both genders equally where blood product transfusion is seen in almost 87% of cases. The direct cause of AH is still unknown, and autoimmune dysregulation has been postulated, which predisposes to the development of the factor inhibitors. Being extremely rare, we are reporting two consecutive patients diagnosed by unusual bleeding episodes with isolated prolonged APTT due to Factor VIII inhibitors. AH deserves a special mention as high index of suspicion is required. More studies are required to provide better guidance in diagnosis and management of this condition.
    Matched MeSH terms: Blood Coagulation
  17. Fulltext High fat diet-induced inflammation and oxidative stress are attenuated by N-acetylneuraminic acid in rats
    Yida Z, Imam MU, Ismail M, Ismail N, Ideris A, Abdullah MA
    J Biomed Sci, 2015;22:96.
    PMID: 26498218 DOI: 10.1186/s12929-015-0211-6
    Serum sialic acid levels are positively correlated with coronary artery disease and inflammation. Although sialic acid is a non-specific marker, it is considered sensitive likely due to its influence in sialylation of glycoprotein structures all over the body.
    Matched MeSH terms: Hyperlipidemias/blood; Obesity/blood; Biomarkers/blood
  18. Fulltext What's next after metformin? focus on sulphonylurea: add-on or combination therapy
    Lim PC, Chong CP
    Pharm Pract (Granada), 2015 Apr-Jun;13(3):606.
    PMID: 26445623 DOI: 10.18549/PharmPract.2015.03.606
    The pathophysiology of type 2 diabetes (T2DM) mainly focused on insulin resistance and insulin deficiency over the past decades. Currently, the pathophysiologies expanded to ominous octet and guidelines were updated with newer generation of antidiabetic drug classes. However, many patients had yet to achieve their target glycaemic control. Although all the guidelines suggested metformin as first line, there was no definite consensus on the second line drug agents as variety of drug classes were recommended.
    Matched MeSH terms: Blood Glucose
  19. Fulltext Poor blood pressure control and its associated factors among older people with hypertension: A cross-sectional study in six public primary care clinics in Malaysia
    Cheong AT, Sazlina SG, Tong SF, Azah AS, Salmiah S
    Malays Fam Physician, 2015;10(1):19-25.
    PMID: 26425291 MyJurnal
    INTRODUCTION: Hypertension is highly prevalent in the older people. Chronic disease care is a major burden in the public primary care clinics in Malaysia. Good blood pressure (BP) control is needed to reduce the morbidity and mortality of cardiovascular disease (CVD). This study aimed to determine the status of BP control and its associated factors among older people with hypertension in public primary care clinics.
    MATERIALS AND METHODS: A cross-sectional study on hypertensive patients aged 18 years and above was conducted in six public primary care clinics in Federal Territory, Malaysia. A total of 1107 patients were selected via systematic random sampling. Data from 441 (39.8%) patients aged 60 years and more were used in this analysis. BP control was determined from the average of two BP readings measured twice at an interval of 5 min. For patients without diabetes, poor BP control was defined as BP of ≥140/90 mm Hg and ≥150/90 for the patients aged 80 years and more. For patients with diabetes, poor control was defined as BP of ≥140/80 mm Hg.
    RESULTS: A total of 51.7% (n = 228) of older patients had poor BP control. The factors associated with BP control were education level (p = 0.003), presence of comorbidities (p = 0.015), number of antihypertensive agents (p = 0.001) and number of total medications used (p = 0.002). Patients with lower education (less than secondary education) (OR = 1.7, p = 0.008) and the use of three or more antihypertensive agents (OR = 2.0, p = 0.020) were associated with poor BP control.
    CONCLUSION: Among older people with hypertension, those having lower education level, or using three or more antihypertensive agents would require more attention on their BP control.
    Matched MeSH terms: Blood Pressure
  20. Mature Erythrocyte Surface Antigen Protein Identified in the Serum of Plasmodium falciparum-Infected Patients
    Zainudin NS, Othman N, Muhi J, Abdu Sani AA, Noordin R
    Am J Trop Med Hyg, 2015 Dec;93(6):1268-73.
    PMID: 26392156 DOI: 10.4269/ajtmh.15-0333
    This study was performed to identify circulating Plasmodium falciparum proteins in patient serum, which may be useful as diagnostic markers. Depletion of highly abundant proteins from each pooled serum sample obtained from P. falciparum-infected patients and healthy individuals was performed using the Proteoseek Antibody-Based Albumin/IgG Removal Kit (Thermo Scientific, Rockford, IL). In analysis 1, the depleted serum was analyzed directly by NanoLC-MS/MS. In analysis 2, the depleted serum was separated by two-dimensional electrophoresis followed by western blot analysis. Subsequently, the selected band was analyzed by NanoLC-MS/MS. The result of analysis 1 revealed the presence of two mature erythrocyte surface antigen (MESA) proteins and chloroquine resistance transporter protein (PfCRT). In addition, analysis 2 revealed an antigenic 75-kDa band when the membrane was probed with purified IgG from the pooled serum obtained from P. falciparum-infected patients. MS/MS analysis of this protein band revealed fragments of P. falciparum MESA proteins. Thus, in this study, two different analyses revealed the presence of Plasmodium MESA protein in pooled serum from malaria patients; thus, this protein should be further investigated to determine its usefulness as a diagnostic marker.
    Matched MeSH terms: Immunoglobulin G/blood; Protozoan Proteins/blood; Malaria, Falciparum/blood
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