Displaying publications 301 - 320 of 372 in total

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  1. Ramdzan AR, Manaf MRA, Aizuddin AN, Latiff ZA, Teik KW, Ch'ng GS, et al.
    PMID: 34444091 DOI: 10.3390/ijerph18168330
    Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths worldwide. Approximately 3-5% of CRCs are associated with hereditary cancer syndromes. Individuals who harbor germline mutations are at an increased risk of developing early onset CRC, as well as extracolonic tumors. Genetic testing can identify genes that cause these syndromes. Early detection could facilitate the initiation of targeted prevention strategies and surveillance for CRC patients and their families. The aim of this study was to determine the cost-effectiveness of CRC genetic testing. We utilized a cross-sectional design to determine the cost-effectiveness of CRC genetic testing as compared to the usual screening method (iFOBT) from the provider's perspective. Data on costs and health-related quality of life (HRQoL) of 200 CRC patients from three specialist general hospitals were collected. A mixed-methods approach of activity-based costing, top-down costing, and extracted information from a clinical pathway was used to estimate provider costs. Patients and family members' HRQoL were measured using the EQ-5D-5L questionnaire. Data from the Malaysian Study on Cancer Survival (MySCan) were used to calculate patient survival. Cost-effectiveness was measured as cost per life-year (LY) and cost per quality-adjusted life-year (QALY). The provider cost for CRC genetic testing was high as compared to that for the current screening method. The current practice for screening is cost-saving as compared to genetic testing. Using a 10-year survival analysis, the estimated number of LYs gained for CRC patients through genetic testing was 0.92 years, and the number of QALYs gained was 1.53 years. The cost per LY gained and cost per QALY gained were calculated. The incremental cost-effectiveness ratio (ICER) showed that genetic testing dominates iFOBT testing. CRC genetic testing is cost-effective and could be considered as routine CRC screening for clinical practice.
  2. Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.
    Value Health Reg Issues, 2014 May;3:117-123.
    PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012
    OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.
    METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.
    RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.
    CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.
  3. Surendra NK, Abdul Manaf MR, Hooi LS, Bavanandan S, Mohamad Nor FS, Firdaus Khan SS, et al.
    PLoS One, 2019;14(10):e0218422.
    PMID: 31644577 DOI: 10.1371/journal.pone.0218422
    OBJECTIVES: In Malaysia, there is exponential growth of patients on dialysis. Dialysis treatment consumes a considerable portion of healthcare expenditure. Comparative assessment of their cost effectiveness can assist in providing a rational basis for preference of dialysis modalities.

    METHODS: A cost utility study of hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) was conducted from a Ministry of Health (MOH) perspective. A Markov model was also developed to investigate the cost effectiveness of increasing uptake of incident CAPD to 55% and 60% versus current practice of 40% CAPD in a five-year temporal horizon. A scenario with 30% CAPD was also measured. The costs and utilities were sourced from published data which were collected as part of this study. The transitional probabilities and survival estimates were obtained from the Malaysia Dialysis and Transplant Registry (MDTR). The outcome measures were cost per life year (LY), cost per quality adjusted LY (QALY) and incremental cost effectiveness ratio (ICER) for the Markov model. Sensitivity analyses were performed.

    RESULTS: LYs saved for HD was 4.15 years and 3.70 years for CAPD. QALYs saved for HD was 3.544 years and 3.348 for CAPD. Cost per LY saved was RM39,791 for HD and RM37,576 for CAPD. The cost per QALY gained was RM46,595 for HD and RM41,527 for CAPD. The Markov model showed commencement of CAPD in 50% of ESRD patients as initial dialysis modality was very cost-effective versus current practice of 40% within MOH. Reduction in CAPD use was associated with higher costs and a small devaluation in QALYs.

    CONCLUSIONS: These findings suggest provision of both modalities is fiscally feasible; increasing CAPD as initial dialysis modality would be more cost-effective.

  4. Razali RH, Noorizhab MNF, Jamari H, James RJ, Teh KH, Ibrahim HM, et al.
    Pediatr Hematol Oncol, 2020 Apr;37(3):185-197.
    PMID: 31870219 DOI: 10.1080/08880018.2019.1705949
    Studies had shown that genetic polymorphism plays a significant role in the pharmacokinetics and pharmacodynamics variation of high dose methotrexate (MTX), 5000 mg/m2 regimen. The objective of this study was to investigate the genetic variations associated with the serum level and toxicity of MTX in Malaysian children with acute lymphoblastic leukemia (ALL). Thirty-eight patients were genotyped for rs717620 (ABCC2), rs4948496 (ARID5B), rs1801133 (MTHFR) and rs4149056 (SLCO1B1). Serum levels of MTX at 48 h post 24 h of intravenous infusion were analyzed by high-performance liquid chromatography-mass spectrometry. The ABCC2 genotype was significantly associated with the serum levels of MTX at 48 h after treatment (p = 0.017). Patients with CT and TT of rs717620 (ABCC2) and TC and CC of rs4948496 (ARID5B) were significantly associated with leukopenia grade I-IV (Fisher Exact Test; p = 0.03 and 0.02, respectively). The three most common MTX related toxicities were leukopenia (60.5%), increased alanine aminotransferase enzyme (47.4%), and thrombocytopenia (47.4%). Our results demonstrate that by prescreening of patients for ABCC2 and ARID5B associated with the serum levels and adverse effects of MTX would identify patients at risk and therefore help a pediatric oncologist to personalize chemotherapy drugs for precision health.
  5. Sulaiman S, Chowdhury SR, Fauzi MB, Rani RA, Yahaya NHM, Tabata Y, et al.
    Int J Mol Sci, 2020 Apr 13;21(8).
    PMID: 32294921 DOI: 10.3390/ijms21082688
    Recent advancement in cartilage tissue engineering has explored the potential of 3D culture to mimic the in vivo environment of human cartilaginous tissue. Three-dimensional culture using microspheres was described to play a role in driving the differentiation of mesenchymal stem cells to chondrocyte lineage. However, factors such as mechanical agitation on cell chondrogenesis during culture on the microspheres has yet to be elucidated. In this study, we compared the 2D and 3D culture of bone-marrow-derived mesenchymal stem cells (BMSCs) on gelatin microspheres (GMs) in terms of MSC stemness properties, immune-phenotype, multilineage differentiation properties, and proliferation rate. Then, to study the effect of mechanical agitation on chondrogenic differentiation in 3D culture, we cultured BMSCs on GM (BMSCs-GM) in either static or dynamic bioreactor system with two different mediums, i.e., F12: DMEM (1:1) + 10% FBS (FD) and chondrogenic induction medium (CIM). Our results show that BMSCs attached to the GM surface and remained viable in 3D culture. BMSCs-GM proliferated faster and displayed higher stemness properties than BMSCs on a tissue culture plate (BMSCs-TCP). GMs also enhanced the efficiency of in-vitro chondrogenesis of BMSCs, especially in a dynamic culture with higher cell proliferation, RNA expression, and protein expression compared to that in a static culture. To conclude, our results indicate that the 3D culture of BMSCs on gelatin microsphere was superior to 2D culture on a standard tissue culture plate. Furthermore, culturing BMSCs on GM in dynamic culture conditions enhanced their chondrogenic differentiation.
  6. C Thambiah S, Meor Anuar Shuhaili MFR, Chew BH, Samsudin IN, Abdul Rahman H, Stanslas J, et al.
    Biomarkers, 2019 Nov;24(7):659-665.
    PMID: 31342800 DOI: 10.1080/1354750X.2019.1648554
    Introduction: Statin, the first-line treatment for dyslipidaemia, may have suboptimal adherence due to its associated muscle adverse events. These data, however, remain limited. Aim: To determine the association of serum creatine kinase (CK) and SLCO1B1 rs4363657 polymorphism with statin-associated muscle adverse events (SAMAE) among dyslipidaemia participants.
    Methods: This was a prospective cohort study at government health clinics involving newly diagnosed adults with dyslipidaemia. SAMAE were recorded based on the patient's complaint after a month on statin. CK was taken at baseline and follow-up. Genetic profiling was performed for SLCO1B1 rs4363657 polymorphism.
    Results: Among 118 participants, majority were Malay (72%) males (61%) with a mean age of 49 ± 12.2 years old and prescribed lovastatin (61.9). There was a significant association between statin types (lovastatin and simvastatin) and SAMAE (p = 0.0327); no significant association noted between CK and SAMAE (p = 0.5637). The SLCO1B1 rs4363657 polymorphism was significantly associated SAMAE (p 
  7. Teoh BY, Lim YM, Chong WY, Subramaniam M, Tan ZZ, Misran M, et al.
    Biomed Microdevices, 2022 Jan 26;24(1):12.
    PMID: 35080702 DOI: 10.1007/s10544-022-00609-z
    Isolation of exosome from culture medium in an effective way is desired for a less time consuming, cost saving technology in running the diagnostic test on cancer. In this study, we aim to develop an inertial microfluidic channel to separate the nano-size exosome from C666-1 cell culture medium as a selective sample. Simulation was carried out to obtain the optimum flow rate for determining the dimension of the channels for the exosome separation from the medium. The optimal dimension was then brought forward for the actual microfluidic channel fabrication, which consisted of the stages of mask printing, SU8 mould fabrication and ended with PDMS microchannel curing process. The prototype was then used to verify the optimum flow rate with polystyrene particles for its capabilities in actual task on particle separation as a control outcome. Next, the microchip was employed to separate the selected samples, exosome from the culture medium and compared the outcome from the conventional exosome extraction kit to study the level of effectiveness of the prototype. The exosome outcome from both the prototype and extraction kits were characterized through zetasizer, western blot and Transmission electron microscopy (TEM). The microfluidic chip designed in this study obtained a successful separation of exosome from the culture medium. Besides, the extra benefit from this microfluidic channels in particle separation brought an evenly distributed exosome upon collection while the exosomes separated through extraction kit was found clustered together. Therefore, this work has shown the microfluidic channel is suitable for continuous separation of exosome from the culture medium for a clinical study in the future.
  8. Yusoff J, Ismail A, Abd Manaf MR, Ismail F, Abdullah N, Muhammad R, et al.
    Health Qual Life Outcomes, 2022 Jan 29;20(1):15.
    PMID: 35093066 DOI: 10.1186/s12955-022-01921-1
    BACKGROUND: Quality of life (QoL) is one of the treatment outcome measures in patients with breast cancer. In this study, we measured the QoL of women with breast cancer at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and identified the associated factors.

    METHODOLOGY: This cross-sectional study was conducted from October 2017 to December 2017 and involved female patients with breast cancer. The QoL scores and domains were determined using the EuroQol EQ-5D-5L, and were presented as the utility value and visual analog scores, respectively.

    RESULTS: We recruited a total of 173 women, aged 33-87 years. The median VA score was 80.00 (interquartile range [IQR] 70.00-90.00); the median utility value was 0.78 (interquartile range [IQR] 0.65-1.00. Women who did not take traditional medicine had a higher utility index score of 0.092 (95% CI 0.014-0.171), and women with household income of RM3000-5000 had a higher utility index score of 0.096 (95% CI 0.011-0.180).

    CONCLUSION: Traditional medicine consumption and household income were significantly associated with lower QoL. The pain/discomfort domain was the worst affected QoL domain and was related to traditional medicine use and household income. Addressing pain management in patients with breast cancer and the other factors contributing to lower QoL may improve the QoL of breast cancer survivors in the future.

  9. Tan SK, Yeong CH, Raja Aman RRA, Ng KH, Abdul Aziz YF, Chee KH, et al.
    Br J Radiol, 2018 Jul;91(1088):20170874.
    PMID: 29493261 DOI: 10.1259/bjr.20170874
    OBJECTIVE: This study aimed (1) to perform a systematic review on scanning parameters and contrast medium (CM) reduction methods used in prospectively electrocardiography (ECG-triggered low tube voltage coronary CT angiography (CCTA), (2) to compare the achievable dose reduction and image quality and (3) to propose appropriate scanning techniques and CM administration methods.

    METHODS: A systematic search was performed in PubMed, the Cochrane library, CINAHL, Web of Science, ScienceDirect and Scopus, where 20 studies were selected for analysis of scanning parameters and CM reduction methods.

    RESULTS: The mean effective dose (HE) ranged from 0.31 to 2.75 mSv at 80 kVp, 0.69 to 6.29 mSv at 100 kVp and 1.53 to 10.7 mSv at 120 kVp. Radiation dose reductions of 38 to 83% at 80 kVp and 3 to 80% at 100 kVp could be achieved with preserved image quality. Similar vessel contrast enhancement to 120 kVp could be obtained by applying iodine delivery rate (IDR) of 1.35 to 1.45 g s-1 with total iodine dose (TID) of between 10.9 and 16.2 g at 80 kVp and IDR of 1.08 to 1.70 g s-1 with TID of between 18.9 and 20.9 g at 100 kVp.

    CONCLUSION: This systematic review found that radiation doses could be reduced to a rate of 38 to 83% at 80 kVp, and 3 to 80% at 100 kVp without compromising the image quality. Advances in knowledge: The suggested appropriate scanning parameters and CM reduction methods can be used to help users in achieving diagnostic image quality with reduced radiation dose.

  10. Abdul Hadi MFR, Abdullah AN, Hashikin NAA, Ying CK, Yeong CH, Yoon TL, et al.
    Med Phys, 2022 Dec;49(12):7742-7753.
    PMID: 36098271 DOI: 10.1002/mp.15980
    PURPOSE: Monte Carlo (MC) simulation is an important technique that can help design advanced and challenging experimental setups. GATE (Geant4 application for tomographic emission) is a useful simulation toolkit for applications in nuclear medicine. Transarterial radioembolization is a treatment for liver cancer, where microspheres embedded with yttrium-90 (90 Y) are administered intra-arterially to the tumor. Personalized dosimetry for this treatment may provide higher dosimetry accuracy compared to the conventional partition model (PM) calculation. However, incorporation of three-dimensional tomographic input data into MC simulation is an intricate process. In this article, 3D Slicer, free and open-source software, was utilized for the incorporation of patient tomographic images into GATE to demonstrate the feasibility of personalized dosimetry in hepatic radioembolization with 90 Y.

    METHODS: In this article, the steps involved in importing, segmenting, and registering tomographic images using 3D Slicer were thoroughly described, before importing them into GATE for MC simulation. The absorbed doses estimated using GATE were then compared with that of PM. SlicerRT, a 3D Slicer extension, was then used to visualize the isodose from the MC simulation.

    RESULTS: A workflow diagram consisting of all the steps taken in the utilization of 3D Slicer for personalized dosimetry in 90 Y radioembolization has been presented in this article. In comparison to the MC simulation, the absorbed doses to the tumor and normal liver were overestimated by PM by 105.55% and 20.23%, respectively, whereas for lungs, the absorbed dose estimated by PM was underestimated by 25.32%. These values were supported by the isodose distribution obtained via SlicerRT, suggesting the presence of beta particles outside the volumes of interest. These findings demonstrate the importance of personalized dosimetry for a more accurate absorbed dose estimation compared to PM.

    CONCLUSION: The methodology provided in this study can assist users (especially students or researchers who are new to MC simulation) in navigating intricate steps required in the importation of tomographic data for MC simulation. These steps can also be utilized for other radiation therapy related applications, not necessarily limited to internal dosimetry.

  11. Yi Liang T, Zakaria NF, Kasjoo SR, Shaari S, Mohamad Isa M, Md Arshad MK, et al.
    Sensors (Basel), 2022 Dec 11;22(24).
    PMID: 36560080 DOI: 10.3390/s22249712
    The rapid growth of wireless technology has improved the network's technology from 4G to 5G, with sub-6 GHz being the centre of attention as the primary communication spectrum band. To effectively benefit this exclusive network, the improvement in the mm-wave detection of this range is crucial. In this work, a silicon self-switching device (SSD) based full-wave bridge rectifier was proposed as a candidate for a usable RF-DC converter in this frequency range. SSD has a similar operation to a conventional pn junction diode, but with advantages in fabrication simplicity where it does not require doping and junctions. The optimized structure of the SSD was cascaded and arranged to create a functional full-wave bridge rectifier with a quadratic relationship between the input voltage and outputs current. AC transient analysis and theoretical calculation performed on the full-wave rectifier shows an estimated cut-off frequency at ~12 GHz, with calculated responsivity and noise equivalent power of 1956.72 V/W and 2.3753 pW/Hz1/2, respectively. These results show the capability of silicon SSD to function as a full-wave bridge rectifier and is a potential candidate for RF-DC conversion in the targeted 5G frequency band and can be exploited for future energy harvesting application.
  12. Ibrahim AA, Ahmad Zamzuri M'I, Ismail R, Ariffin AH, Ismail A, Muhamad Hasani MH, et al.
    Medicine (Baltimore), 2022 Jul 29;101(30):e29627.
    PMID: 35905245 DOI: 10.1097/MD.0000000000029627
    The Teleprimary Care-Oral Health Clinical Information System (TPC-OHCIS) is an updated electronic medical record (EMR) that has been applied in Malaysian primary healthcare. Recognizing the level of patient satisfaction following EMR implementation is crucial for assessing the performance of health care services. Hence, the main objective of this study was to compare the level of patient satisfaction between EMR-based clinics and paper-based clinics. The study was a quasi-experimental design that used a control group and was conducted among patients in 14 public primary healthcare facilities in the Seremban district of Malaysia from May 10, to June 30, 2021. Patient satisfaction was assessed using the validated Short-Form Patient Satisfaction Questionnaire, which consisted of 7 subscales. All data were analyzed using the IBM Statistical Package for Social Sciences version 21. A total of 321 patients consented to participate in this study, and 48.9% of them were from EMR clinics. The mean score for the communication subscale was the highest at 4.08 and 3.96 at EMR-adopted clinics and paper-based record clinics. There were significant differences in general satisfaction and communication subscales, with higher patient satisfaction found in clinics using EMR. With the utilization of EMR, patient satisfaction and communication in delivering healthcare services have improved.
  13. Salvaraji L, Shamsudin SB, Avoi R, Saupin S, Kim Sai L, Asan SB, et al.
    Int J Environ Res Public Health, 2022 Dec 19;19(24).
    PMID: 36554980 DOI: 10.3390/ijerph192417099
    INTRODUCTION: Persistent exposure to indoor hazards in a healthcare setting poses a risk of SBS. This study determines the prevalence of and risk factors for SBS among healthcare workers in health clinics.

    METHODS: A cross-sectional study was conducted across four health clinics from February 2022 to May 2022. As part of the study, self-administered questionnaires were completed to determine symptoms related to SBS. An indoor air quality (IAQ) assessment was conducted four times daily for fifteen minutes at five areas in each clinic (laboratory, lobby, emergency room, pharmacy, and examination room).

    RESULT: Most of the areas illustrated poor air movement (<0.15 m/s), except for the laboratory. The total bacterial count (TBC) was above the standard limit in both the lobby and emergency room (>500 CFU/m3). The prevalence of SBS was 24.84% (77) among the healthcare workers at the health clinics. A significant association with SBS was noted for those working in the examination room (COR = 2.86; 95% CI = 1.31; 6.27) and those experiencing high temperature sometimes (COR = 0.25; 95% CI = 0.11; 0.55), varying temperature sometimes (COR = 0.31; 95% CI = 0.003), stuffy air sometimes (COR = 0.17; 95% CI = 0.005; 0.64), dry air sometimes (COR = 0.20; 95% CI = 0.007; 0.64), and dust sometimes (COR = 0.25; 95% CI = 0.11; 0.60) and everyday (COR = 0.34; 95% CI = 0.14; 0.81). Only healthcare workers in the examination room (AOR = 3.17; 95% CI = 1.35; 7.41) were found to have a significant risk of SBS when controlling for other variables.

    CONCLUSION: SBS is prevalent among healthcare workers at health clinics.

  14. Kow RY, Abdul Rani R, Mohamad Nazarallah MH, Leong JF, Hayyun MF, Low CL, et al.
    Cureus, 2024 Mar;16(3):e56617.
    PMID: 38646377 DOI: 10.7759/cureus.56617
    Robotic-assisted hip and knee arthroplasty represents cutting-edge advancements in orthopedic surgery, harnessing robotic technology to enhance precision, improve clinical outcomes, and facilitate intra-operative procedures. In these robotic-assisted surgeries, the robotic systems assist surgeons in planning and executing joint replacement surgeries, thereby facilitating personalized implant positioning and optimizing the fit and alignment of hip and knee implants. Despite the increasing attention garnered by robotic-assisted hip and knee arthroplasty in recent years, a comprehensive bibliometric analysis using the Scopus database has yet to be conducted. This bibliometric analysis reviews the Scopus database from 1961 until 2022 to investigate the literature on the field of robotic-assisted hip and knee arthroplasty. A total of 577 articles that satisfied the selection criteria were included in this review. The majority of the articles focus more on total knee replacement, compared to total hip replacement and unicompartmental knee arthroplasty. The overwhelming majority of the articles were authored by researchers and clinicians from the United States of America (USA) and the United Kingdom (UK). Similarly, most of the articles with the highest number of citations were authored by researchers and clinicians from these regions. This comprehensive bibliometric analysis using Scopus in the domain of robotic-assisted hip and knee replacement has the potential to act as a roadmap for researchers, clinicians, and policymakers, facilitating informed decision-making, promoting collaborative initiatives, and guiding the development of future studies to further advance the field of robotic-assisted hip and knee arthroplasty.
  15. Ooi ECW, Isa ZM, Manaf MRA, Fuad ASA, Ahmad A, Mustapa MN, et al.
    Sci Rep, 2024 Apr 30;14(1):9926.
    PMID: 38688966 DOI: 10.1038/s41598-024-60439-2
    The transition of ICD has never been a straightforward initiative. As nations transition to ICD-11, ensuring its acceptance among the users is essential. To our knowledge, there are limited studies about the instrument and ICD-11 adoption. Therefore, the purpose of this study was to design an instrument and investigate the factors influencing the intention to use the ICD-11 among medical record officers (MROs) and assistant medical record officers (AMROs) at Ministry of Health (MOH) Malaysia facilities. Based on the current literature, a model based on the decomposed theory of planned behaviour (DTPB) was proposed. The model consisted of 13 dimensions and 12 hypotheses identified from previous studies. Using PLS-SEM, 185 survey data points were analysed. The study findings showed that ten factors have a significant impact on the suggested model. Users' subjective norm was the most influential factor in their intention to use ICD-11. Unexpectedly, perceived usefulness and was found to have no significant influence. This study is important for policymakers in strategising ICD-11 implementation efforts. This study's novelty lies in applying a DTPB theory model in the context of the intention to use ICD-11.
  16. Surendra NK, Abdul Manaf MR, Hooi LS, Bavanandan S, Mohamad Nor FS, Shah Firdaus Khan S, et al.
    BMC Nephrol, 2019 04 30;20(1):151.
    PMID: 31039745 DOI: 10.1186/s12882-019-1326-x
    BACKGROUND: Health related quality of life (HRQOL) is an important predictor of clinical outcomes for End Stage Renal Disease (ESRD) patients and to establish quality adjusted life years (QALYs) for economic evaluation studies. This study aims to measure the health utilities and to identify socio-demographic and clinical factors associated with HRQOL for haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) in Malaysia.

    METHODS: A total of 141 patients (77 HD and 64 CAPD) from 1 federal and four state hospitals participated in this cross-sectional study. Patients were randomly selected from the National Renal Registry (NRR) using a stratified random sampling. The EQ-5D-3 L questionnaire was used to measure HRQOL. Variables investigated include dialysis modalities, sociodemographic characteristics, co-morbidities and biochemical markers. Utilities are measured on an ordinal scale of 0-1, where 1 indicates full health and 0 indicates death.

    RESULTS: The mean utility scores were 0.854 ± 0.181 and 0.905 ± 0.124 (p > 0.05) and the mean Visual Analogue Scale (VAS) scores were 76.2 ± 12.90 and 77.1 ± 10.26 (p > 0.05) for HD and CAPD patients respectively. There was a significant difference in problems reported between HD (35.1%) and CAPD (15.6%) on usual activities dimension (p = 0.009). The proportion of patients having problems in the pain/discomfort domain in both modalities was high (34.0%). Haemoglobin (

  17. Tok PSK, Kamarudin N', Jamaludin M, Ab Razak MF, Ahmad MAS, Abu Bakar FA, et al.
    Infect Dis (Lond), 2022 Mar;54(3):235-237.
    PMID: 34772327 DOI: 10.1080/23744235.2021.2000636
  18. Haron NH, Mohamad Hanif EA, Abdul Manaf MR, Yaakub JA, Harun R, Mohamed R, et al.
    Asian Pac J Cancer Prev, 2019 Feb 26;20(2):509-517.
    PMID: 30803214
    Introduction: Microsatellite instability (MSI) is a hallmark of defective DNA mismatch repair (MMR) of genes especially MLH1 and MSH2. It is frequently involved in the carcinogenesis of various tumours including gastric cancer (GC). However, MSI in GCs have not been reported in Malaysia before. Objective: This study was conducted to determine the microsatellite instability (MSI) status in gastric cancer by microsatellite analysis, sequencing, its association with MLH1 and MSH2 protein expression and H.pylori infection by immunohistochemistry. Method: A total of 60 gastric cancer cases were retrieved. DNA was extracted from paired normal and tumour tissues while MLH1 and MSH2 protein expression as well as H. pylori status were determined by IHC staining. For microsatellite analysis, polymerase chain reaction (PCR) was performed for paired tissue samples using a panel of five microsatellite markers. MSI-positive results were subjected for DNA sequencing to assess mutations in the MLH1 and MSH2 genes. Results: Microsatellite analysis identified ten MSI positive cases (16.7%), out of which only six cases (10.3%) showed absence of MLH1 (n=3) or MSH2 (n=3) protein expression by IHC. The most frequent microsatellite marker in MSI positive cases was BAT26 (90%). Nine of ten MSI positive cases were intestinal type with one diffuse and all were located distally. H. pylori infection was detected in 13 of 60 cases (21.7%) including in three MSI positive cases. All these results however were not statistically significant. Our sequencing data displayed novel mutations. However these data were not statistically correlated with expression levels of MLH1 and MSH2 proteins by IHC. This may be due to small sample size to detect small or moderately sized effects. Conclusion: The frequency of MSI in this study was comparable with published results. Determination of affected MMR genes by more than two antibodies may increase the sensitivity of IHC to that of MSI analysis.
  19. Mohamad N, Pahrol MA, Shaharudin R, Md Yazin NKR, Osman Y, Toha HR, et al.
    Front Public Health, 2022;10:878396.
    PMID: 35923958 DOI: 10.3389/fpubh.2022.878396
    Healthcare workers (HCWs) are at risk of contracting coronavirus disease-2019 (COVID-19) in their workplace. Infection prevention guidelines and standard operating procedures were introduced to reduce risk of exposure and prevent transmission. Safe practices during interaction with patients with COVID-19 are crucial for infection prevention and control (IPC). This study aimed to assess HCWs' compliance to IPC and to determine its association with sociodemographic and organizational factors. A cross-sectional study was conducted between March and April 2021 at public healthcare facilities in the east coast of Peninsular Malaysia. HCWs who were involved with COVID-19-related works were invited to participate in the online survey. The questionnaire was adapted from the World Health Organization (WHO) Interim Guidance: WHO Risk Assessment and Management of Exposure of Healthcare Workers in the Context of COVID-19. Respondents were categorized as compliant or non-compliant to IPC. A total of 600 HCWs involved in COVID-19-related works participated in the survey. Most of them (63.7%) were compliant to IPC as they responded to all items as "always, as recommended" during interaction with patients with COVID-19. The multivariate analysis showed that non-compliance was significantly associated with working in the emergency department (AOR = 3.16; 95% CI = 1.07-9.31), working as laboratory personnel (AOR = 15.13; 95% CI = 1.36-168.44), health attendant (AOR = 4.42; 95% CI = 1.74-11.24), and others (AOR = 3.63; 95% CI = 1.1-12.01), as well as work experience of more than 10 years (AOR = 4.71; 95% CI = 1.28-17.27). The odds of non-compliance among respondents without adequate new norms and personal protective equipment training were 2.02 (95% CI = 1.08-3.81) more than those with adequate training. Although most of the respondents complied to IPC protocols, compliance status differed according to department, work category, and years of service. Ensuring adequate training that will hopefully lead to behavioral change is crucial to prevent breach in IPC and thus minimize the risk of exposure to and transmission of COVID-19 in healthcare facilities.
  20. Lokman EF, Bugam SH, Ibrahim AS, Yunus N, Mansor F, Balasubramaniam V, et al.
    Nutr Health, 2023 Feb 08.
    PMID: 36755355 DOI: 10.1177/02601060231152060
    Introduction: The beneficial effects of resistant starch (RS) consumption on health in terms of reducing postprandial hyperglycaemia are evident. However, the potential of local Sarawak sago RS in regulating glucose has not been extensively studied. Objectives: This study aims to identify glucose-lowering effects of Sarawak sago RS, namely native (RS2) and chemically modified (RS4). Methodology: An oral glucose tolerance test (OGTT) was performed before and after 1 month treatment with sago RS2 and RS4 in spontaneously type 2 diabetes (T2D), Goto-Kakizaki (GK) rat. The mechanisms involved were further explored by screening the in vitro inhibitory activities of α-glucosidase and dipeptidyl peptidase (DPP)-IV. Histopathology examination for pancreas, kidney and liver tissues was done in response to sago RS intake using haematoxylin and eosin (H&E) staining. Results and discussion: The incremental area under the curve (iAUC) for blood glucose in RS-treated groups was decreased and significant in RS2-treated group (p 
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