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Fulltext Creating an engaging and stimulating anatomy lecture environment using the Cognitive Load Theory-based Lecture Model: Students' experiences

Hadie SNH, Abdul Manan Sulong H, Hassan A, Mohd Ismail ZI, Talip S, Abdul Rahim AF

J Taibah Univ Med Sci, 2018 Apr;13(2):162-172.
PMID: 31435319 DOI: 10.1016/j.jtumed.2017.11.001

OBJECTIVE: There is a need to create a standard interactive anatomy lecture that can engage students in their learning process. This study investigated the impact of a new lecturing guideline, the Cognitive Load Theory-based Lecture Model (CLT-bLM), on students' cognitive engagement and motivation.
METHODS: A randomised controlled trial involving 197 participants from three institutions was conducted. The control group attended a freestyle lecture on the gross anatomy of the heart, delivered by a qualified anatomist from each institution. The intervention group attended a CLT-bLM-based lecture on a similar topic, delivered by the same lecturer, three weeks thereafter. The lecturers had attended a CLT-bLM workshop that allowed them to prepare for the CLT-bLM-based lecture over the course of three weeks. The students' ratings on their cognitive engagement and internal motivation were evaluated immediately after the lecture using a validated Learners' Engagement and Motivation Questionnaire. The differences between variables were analysed and the results were triangulated with the focus group discussion findings that explored students' experience while attending the lecture.
RESULTS: The intervention group has a significantly higher level of cognitive engagement than the control group; however, no significant difference in internal motivation score was found. In addition, the intervention group reported having a good learning experience from the lectures.
CONCLUSION: The guideline successfully stimulated students' cognitive engagement and learning experience, which indicates a successful stimulation of students' germane resources. Stimulation of these cognitive resources is essential for successful cognitive processing, especially when learning a difficult subject such as anatomy.
Gastrointestinal Parasites in Asian and African Elephants: A Systematic Review

Qurratul-Saadah Z, Che-Amat A, Syed-Hussain SS, Kamaludden J, Ariffin SMZ, Basripuzi NH, et al.

Trop Biomed, 2023 Mar 01;40(1):55-64.
PMID: 37356004 DOI: 10.47665/tb.40.1.012

Gastrointestinal parasites (GIPs) in elephants have been reported in several studies over the last decades. Nonetheless, comprehensive data on clinicopathology of elephant GIPs, parasite burden threshold value, and the effectiveness of conventional anthelmintic drugs are still lacking. Herein, we have systematically reviewed the available knowledge on elephant GIPs identified among different parts of the world based on their prevalence, epidemiology, pathology, diagnosis, treatment, and control. Two electronic databases were searched for publications that met the inclusion criteria. About19 English journal articles published between year of 2011- 2021 were included. The main GIPs reported in elephants were Cyathostomidae (at least 14 species), Ancylostomidae, Haemonchus contortus, Trichostrongylus colubriformis, Oesophagostomum columbianum, Oesophagostomum aceleatum, Ascarids, Trichurids, Strongyloides, Anophlocephalidae, flukes, and Coccidia across different parts of the world, including Malaysia, Indonesia, Thailand, Myanmar, Sri Lanka, India, Kenya, Nigeria, and South Africa. Most elephants show no clinical signs until the equilibrium between parasite and host is disturbed. The common diagnostic methods for GIPs are traditional direct smear, faecal floatation, sedimentation, and McMaster egg counting technique, all involving morphological identification. However, some articles described the use of molecular detection to characterise common GIPs of elephants. Although benzimidazoles and macrocyclic lactones group of anthelmintic are the most conventional GIPs treatment and control for captive and semi-captive elephants, there is limited data on the threshold value of faecal egg count as the baseline for treatment decision. Over the last decades, various studies regarding elephant GIPs have been conducted. However, more focused and systematic studies are required to enhance our knowledge in multiple aspects of elephant parasitology to find effective solutions and improve elephant health.
Fulltext Unlocking the Potential of Lignocellulosic Biomass Dragon Fruit (Hylocereus polyrhizus) in Bioplastics, Biocomposites and Various Commercial Applications

Taharuddin NH, Jumaidin R, Mansor MR, Hazrati KZ, Tarique J, Asyraf MRM, et al.

Polymers (Basel), 2023 Jun 12;15(12).
PMID: 37376300 DOI: 10.3390/polym15122654

Dragon fruit, also called pitaya or pitahaya, is in the family Cactaceae. It is found in two genera: 'Selenicereus' and 'Hylocereus'. The substantial growth in demand intensifies dragon fruit processing operations, and waste materials such as peels and seeds are generated in more significant quantities. The transformation of waste materials into value-added components needs greater focus since managing food waste is an important environmental concern. Two well-known varieties of dragon fruit are pitaya (Stenocereus) and pitahaya (Hylocereus), which are different in their sour and sweet tastes. The flesh of the dragon fruit constitutes about two-thirds (~65%) of the fruit, and the peel is approximately one-third (~22%). Dragon fruit peel is believed to be rich in pectin and dietary fibre. In this regard, extracting pectin from dragon fruit peel can be an innovative technology that minimises waste disposal and adds value to the peel. Dragon fruit are currently used in several applications, such as bioplastics, natural dyes and cosmetics. Further research is recommended for diverging its development in various areas and maturing the innovation of its usage.
Fulltext Synchronous Primary Parosteal Osteosarcoma and Primary Mediastinal Germ Cell Tumour with Atypical Mycobacterial Infection - A Rare Phenomenon: A Case Report

Lim CH, Mohamed-Haflah NH, Abdullah-Sani MH, Loh CK, Abdul-Rahman MR

Malays Orthop J, 2023 Mar;17(1):188-192.
PMID: 37064628 DOI: 10.5704/MOJ.2303.023

Mediastinal germ cell tumours are a rare group of extragonadal germ cell tumours with less than 5% prevalence of all germ cell tumours. Primary mediastinal germ cell tumours themselves account for 16-36% of the extragonadal germ cell tumours. Along the spectrum of osteosarcoma, parosteal osteosarcoma is a well-differentiated surface osteosarcoma with a prevalence of 4% of all osteosarcoma. As such synchronous primary parosteal osteosarcoma and primary mediastinal germ cell tumour are exceedingly rare. This leads to complexity in determining the most appropriate chemotherapy for two different types of tumours and its potential side effects of reduced immunity leading to potential secondary infection. Here we report a case of a 16-year-old boy who presented with synchronous primary osteosarcoma and primary mediastinal germ cell tumour, complicated with atypical mycobacterial infection post-operatively. Additionally, we discuss our choice of chemotherapy and the management of the atypical mycobacterial infection.
Fulltext Pre-operative Factors Predicting Mortality in Six Months and Functional Recovery in Elderly Patients with Hip Fractures

Nam NH, Minh ND, Hai TX, Sinh CT, Loi CB, Anh LT

Malays Orthop J, 2023 Mar;17(1):10-17.
PMID: 37064636 DOI: 10.5704/MOJ.2303.002

INTRODUCTION: This study aimed to determine on-admission and perioperative factors predicting six-month mortality and functional recovery in Vietnamese patients with hip fracture.
MATERIALS AND METHODS: Between April 2020 and July 2021, 118 patients participated in this prospective study. Patients' data were collected from medical records. Harris hip score (HHS) was used to evaluate the functional recovery six months after fractures. The obtained data were analysed using a univariate and multivariate model.
RESULTS: The mean age of the participants was 79.5±9.4 years and 68.6% of the patients were female. The six-month mortality rate was 5.9% and independently associated with age (odds ratio (OR): 3.512, 95% confidence interval (CI) 1.538 - 8.019; P<0.001, patients aged >80 years vs those aged ≤80 years) and hypoproteinemia (OR: 2.859, 95% CI: 1.001 - 8.166, P=0.049). Among 111 survivors there were 66 (59.5%) of patients with a good functional recovery. Patients aged >80 years had a higher risk of poor functional outcome (OR: 3.167, 95% CI: 1.386 - 7.235, P: 0.006) compared to those aged ≤ 80 years. No significant correlations between other clinical (gender, body mass index, comorbidities, type of fractures or surgery, time until surgery) or laboratory parameters (anaemia, hyperglycemia, marked elevation of C reactive protein level, electrolyte abnormalities, elevated urea) and mortality or functional outcome were found.
CONCLUSION: Advanced age is the most important factor affecting both mortality and functional outcome while hypoproteinemia is associated with a higher risk of mortality in elderly patients with hip fractures.
Validation study of AR Gynae endotrainer - a new mobile laparoscopic simulator

Omar AA, Zon EM, Ismail MP, Mahdi M, Ibrahim A, Engku-Husna EI, et al.

Med J Malaysia, 2023 Nov;78(6):711-716.
PMID: 38031211

INTRODUCTION: In gynaecology, laparoscopy is the choice of treatment for a lot of procedures as it is considered safe and effective. However, laparoscopic surgery requires skills that are different from those required for open surgery. In order to acquire the skills, a surgeon needs specific training. The aim of this study was to validate the AR Gynae endotrainer, a new mobile laparoscopic simulator, as a comparable box trainer for gynaecology laparoscopic training, comparing it with the well-established Karl Storz SZABO-BERCISACKIER laparoscopic trainer.
MATERIALS AND METHODS: A randomised prospective crossover study was designed to compare the AR Gynae endotrainer versus Karl Storz SZABO-BERCI-SACKIER laparoscopic trainer as a tool for training gynaecology laparoscopic skills. Participants were assigned to perform two specially designed tasks used for laparoscopic training using both endotrainers. All subjects evaluated both simulators concerning their performance by the use of a questionnaire comparing: design, ports placement, visibility, ergonomics, triangulation of movement, fulcrum effect, depth perception, ambidexterity, resources for training, and resources for teaching. The overall score was defined as the median value obtained. The ability and time taken for participants to complete the tasks using both endotrainers were also compared. A total of 26 participants were enrolled in this study, including 13 Masters's students from the Department of Obstetrics & Gynaecology and 13 Masters's students from the Department of Surgery, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia.
RESULTS: A better performance was observed with AR Gynae as compared to Karl Storz endotrainer in five out of ten items evaluated in the questionnaire. Additionally, the overall score of AR Gynae endotrainer (median of 3.98) was comparable to that of Karl Storz endotrainer (median of 3.91) with p=0.519. For the items design and resources for teaching, the evaluation for AR Gynae endotrainer was significantly higher with p-values of 0.003 and 0.032, respectively. All participants were able to complete both tasks using both endotrainers. The time taken to complete both tasks was comparable on both endotrainers. Also, the AR Gynae endotrainer was cheaper.
CONCLUSIONS: The AR Gynae endotrainer was found to be a convenient and cost-effective laparoscopic simulator for gynaecology laparoscopic training and was comparable to the established Karl Storz SZABO-BERCI-SACKIER laparoscopic trainer.
Fulltext Lung disease recognition methods using audio-based analysis with machine learning

Sabry AH, I Dallal Bashi O, Nik Ali NH, Mahmood Al Kubaisi Y

Heliyon, 2024 Feb 29;10(4):e26218.
PMID: 38420389 DOI: 10.1016/j.heliyon.2024.e26218

The use of computer-based automated approaches and improvements in lung sound recording techniques have made lung sound-based diagnostics even better and devoid of subjectivity errors. Using a computer to evaluate lung sound features more thoroughly with the use of analyzing changes in lung sound behavior, recording measurements, suppressing the presence of noise contaminations, and graphical representations are all made possible by computer-based lung sound analysis. This paper starts with a discussion of the need for this research area, providing an overview of the field and the motivations behind it. Following that, it details the survey methodology used in this work. It presents a discussion on the elements of sound-based lung disease classification using machine learning algorithms. This includes commonly prior considered datasets, feature extraction techniques, pre-processing methods, artifact removal methods, lung-heart sound separation, deep learning algorithms, and wavelet transform of lung audio signals. The study introduces studies that review lung screening including a summary table of these references and discusses the literature gaps in the existing studies. It is concluded that the use of sound-based machine learning in the classification of respiratory diseases has promising results. While we believe this material will prove valuable to physicians and researchers exploring sound-signal-based machine learning, large-scale investigations remain essential to solidify the findings and foster wider adoption within the medical community.
Respirable dust exposure impact on respiratory symptoms among cleaners in a Selangor Public University, Malaysia

Aziz NAI, Feisal NAS, Ibrahim TNBT, Cheah WY, Kamaludin NH

Med J Malaysia, 2024 Mar;79(Suppl 1):110-116.
PMID: 38555894

INTRODUCTION: Cleaners perform a vital role in environmental health by keeping the place clean, but they are also exposed to various hazards. Yet, there is a lack of effective and accessible occupational safety standard measures, thus making this to be difficult to monitor the long-term health effects of cleaners. This study aims to determine the respirable dust exposure on respiratory symptoms among cleaners in a public university in Selangor.
MATERIALS AND METHODS: A cross-sectional study was carried out among 51 cleaners. The respondents' background information and respiratory symptoms were gathered using a series of standardised questionnaires validated by the American Thoracic Society (ATS-DLD-78-A). The 8- hour respirable dust exposure to cleaners was measured using an air sampling pump (Gillian & Sensodyne Gil Air 3).
RESULTS: The mean of respirable dust was lower than permissible exposure limit with 0.63±0.57mg/m3. The respiratory symptoms among the cleaners showed no significant association between cough, phlegm, and breathing difficulties with working tenure. Meanwhile, wheezing and coughing with phlegm have an almost significant association with working tenure among cleaners with (Χ2=1.00, p=0.08) and (Χ2=1.00, p=0.07) respectively. Exposure to respirable dust has exhibited 6 times the prevalence of coughing with phlegm among cleaners (PR=6.28, 95% CI: 0.44, 89.38).
CONCLUSION: The findings of this study demonstrated that the cleaners were significantly affected by the respirable dust. The cleaners' working environment has caused them to be exposed to respirable dust.
Fulltext Benzylidene derivatives of andrographolide inhibit growth of breast and colon cancer cells in vitro by inducing G(1) arrest and apoptosis

Jada SR, Matthews C, Saad MS, Hamzah AS, Lajis NH, Stevens MF, et al.

Br J Pharmacol, 2008 Nov;155(5):641-54.
PMID: 18806812 DOI: 10.1038/bjp.2008.368

BACKGROUND AND PURPOSE: Andrographolide, the major phytoconstituent of Andrographis paniculata, was previously shown by us to have activity against breast cancer. This led to synthesis of new andrographolide analogues to find compounds with better activity than the parent compound. Selected benzylidene derivatives were investigated for their mechanisms of action by studying their effects on the cell cycle progression and cell death.
EXPERIMENTAL APPROACH: Microculture tetrazolium, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) and sulphorhodamine B (SRB) assays were utilized in assessing the in vitro growth inhibition and cytotoxicity of compounds. Flow cytometry was used to analyse the cell cycle distribution of control and treated cells. CDK1 and CDK4 levels were determined by western blotting. Apoptotic cell death was assessed by fluorescence microscopy and flow cytometry.
KEY RESULTS: Compounds, in nanomolar to micromolar concentrations, exhibited growth inhibition and cytotoxicity in MCF-7 (breast) and HCT-116 (colon) cancer cells. In the NCI screen, 3,19-(2-bromobenzylidene) andrographolide (SRJ09) and 3,19-(3-chloro-4-fluorobenzylidene) andrographolide (SRJ23) showed greater cytotoxic potency and selectivity than andrographolide. SRJ09 and SRJ23 induced G(1) arrest and apoptosis in MCF-7 and HCT-116 cells, respectively. SRJ09 downregulated CDK4 but not CDK1 level in MCF-7 cells. Apoptosis induced by SRJ09 and SRJ23 in HCT-116 cells was confirmed by annexin V-FITC/PI flow cytometry analysis.
CONCLUSION AND IMPLICATIONS: The new benzylidene derivatives of andrographolide are potential anticancer agents. SRJ09 emerged as the lead compound in this study, exhibiting anticancer activity by downregulating CDK4 to promote a G(1) phase cell cycle arrest, coupled with induction of apoptosis.
Fulltext The Antiproliferative Activity of Sclerotia of Lignosus rhinocerus (Tiger Milk Mushroom)

Lee ML, Tan NH, Fung SY, Tan CS, Ng ST

Evid Based Complement Alternat Med, 2012;2012:697603.
PMID: 22454675 DOI: 10.1155/2012/697603

Lignosus rhinocerus, the tiger milk mushroom, is one of the most important medicinal mushrooms used by the indigenous people of Southeast Asia and China. It has been used to treat breast cancer. A cold water extract (LR-CW) prepared from the sclerotia of L. rhinocerus cultivar was found to exhibit antiproliferative activity against human breast carcinoma (MCF-7) and human lung carcinoma (A549), with IC(50) of 96.7 μg/mL and 466.7 μg/mL, respectively. In comparison, LR-CW did not show significant cytotoxicity against the two corresponding human normal cells, 184B5 (human breast cell) and NL 20 (human lung cell). DNA fragmentation studies suggested that the cytotoxic action of LR-CW against cancer cells is mediated by apoptosis. Sephadex G-50 gel filtration fractionation of LR-CW yielded a high-molecular-weight and a low-molecular-weight fraction. The high-molecular-weight fraction contains mainly carbohydrate (68.7%) and small amount of protein (3.6%), whereas the low-molecular-weight fraction contains 31% carbohydrate and was devoid of protein. Only the high-molecular-weight fraction exhibited antiproliferative activity against cancer cells, with IC(50) of 70.0 μg/mL and 76.7 μg/mL, respectively. Thus, the cytotoxic action of the LR-CW is due to the high-molecular-weight fraction, either the proteins or protein-carbohydrate complex.
Fulltext Tetraalkylammonium salts (TAS) in solar energy applications - A review on in vitro and in vivo toxicity

Mustafa NM, Jumaah FN, Ludin NA, Akhtaruzzaman M, Hassan NH, Ahmad A, et al.

Heliyon, 2024 Apr 15;10(7):e27381.
PMID: 38560257 DOI: 10.1016/j.heliyon.2024.e27381

Tetraalkylammonium salt (TAS) is an organic salt widely employed as a precursor, additive or electrolyte in solar cell applications, such as perovskite or dye-sensitized solar cells. Notably, Perovskite solar cells (PSCs) have garnered acclaim for their exceptional efficiency. However, PSCs have been associated with environmental and health concerns due to the presence of lead (Pb) content, the use of hazardous solvents, and the incorporation of TAS in their fabrication processes, which significantly contributes to environmental and human health toxicity. As a response, there is a growing trend towards transitioning to safer and biobased materials in PSC fabrication to address these concerns. However, the potential health hazards associated with TAS necessitate a thorough evaluation, considering the widespread use of this substance. Nevertheless, the overexploitation of TAS could potentially increase the disposal of TAS in the ecosystem, thus, posing a major health risk and severe pollution. Therefore, this review article presents a comprehensive discussion on the in vitro and in vivo toxicity assays of TAS as a potential material in solar energy applications, including cytotoxicity, genotoxicity, in vivo dermal, and systemic toxicity. In addition, this review emphasizes the toxicity of TAS compounds, particularly the linear tetraalkyl chain structures, and summarizes essential findings from past studies as a point of reference for the development of non-toxic and environmentally friendly TAS derivatives in future studies. The effects of the TAS alkyl chain length, polar head and hydrophobicity, cation and anion, and other properties are also included in this review.
Effectiveness of Pamidronate Infusion in the Treatment of Charcot Arthropathy

Bajuri MY, Md-Noorpi NH, Yin MK, Azman I, Adib-Adham NS

Malays Orthop J, 2024 Mar;18(1):66-72.
PMID: 38638656 DOI: 10.5704/MOJ.2403.009

INTRODUCTION: The objective of this case series is to investigate the efficacy and safety of intravenous infusion of Pamidronate, a second generation bisphosphonate, in the treatment of active Charcot arthropathy.
MATERIALS AND METHODS: All patients with active Charcot arthropathy treated at the medical centre from 1 January 2013 to 30 June 2020 were included in the study. Efficacy outcome was evaluated based on time to consolidate findings observed through radiographic examination, while safety outcome was evaluated based on the incidence of adverse event (AE) occurrence.
RESULTS: A total of 81 patients (37 male, 44 female) diagnosed with active Charcot arthropathy were included. 64.2% of patients were at stage 1 of Charcot arthropathy whereas 35.8% were at stage 2. The mean time to consolidate for stage 1 and stage 2 was 6.50 ± 4.21 months and 3.63 ± 2.92 months respectively (p-value = 0.139). No significant association was observed between gender, ethnicity and disease stage with the consolidation time (p-value >0.05). The rate of AE incidence was 2.5%, observed in 2 patients who developed a fever during the treatment. No other serious AE was observed in the study.
CONCLUSION: Intravenous Pamidronate infusion is a safe and effective treatment option for Charcot arthropathy.
Novel Vibrio vulnificus sequence type 540 infection in a hepatitis patient

Chua HS, Soh YH, Ibrahim S, Abdullah NH, Che Mat Seri NAA, AbuBakar S, et al.

Trop Biomed, 2024 Jun 01;41(2):220-223.
PMID: 39154277 DOI: 10.47665/tb.41.2.014

Vibrio vulnificus infection is associated with high morbidity and mortality in high-risk patients. Poor prognoses could lead to >50% mortality rate. The present report describes a case of V. vulnificus bacteremia in a cirrhotic patient with underlying hepatitis C. He presented with generalised abdominal pain associated with distention and could not ambulate for one week. He also complained of fever for six days and pruritus for 10 days. Tea-coloured urine was noted in continuous bag drainage. The abdomen was distended but soft, with mild tenderness palpated over the left lumbar and iliac region. Blood investigation indicated ongoing infection and inflammation. The aerobic blood culture was identified using the matrix-assisted laser desorption/ionisation-time of flight mass spectrometry and confirmed via 16S rDNA sequencing as V. vulnificus. Multilocus sequence typing of the isolated V. vulnificus revealed a novel sequence type, ST540. The patient responded well to the intravenous cefoperazone and was then discharged with a four day-course of oral ciprofloxacin, 500 mg twice daily after completing the intravenous cefoperazone for 10 days. Clinical history and physical examination are important for early antibiotic therapy initiation and appropriate surgical intervention. Furthermore, bacterial strain typing is also essential for epidemiological surveillance and potentially anticipating the pathogen's virulence traits, which are vital in controlling and preventing the spread of infection.
Factors influencing final year radiography students' intention to pursue postgraduate education in medical imaging

Mohamed A, Mat Sanusi NSA, Azman NS, Zailani NS, Jasmin NH, Che Isa IN

Radiography (Lond), 2024 Jan;30(1):388-393.
PMID: 38159357 DOI: 10.1016/j.radi.2023.12.006

INTRODUCTION: Postgraduate education in medical imaging is an important platform that can support in preparing radiographers for the role extension and advancement in radiography. Thus, this study aims to identify the factors influencing final year radiography students' intention to pursue postgraduate education in medical imaging.
METHODS: An online cross-sectional survey was conducted among final year students in medical imaging programs from six institutions in Malaysia. Purposive convenience sampling has been employed. Data collection was related to students' interest in postgraduate study and possible factors that may affect students' intention to pursue postgraduate education after study degree completion. The questionnaire was a combination of a Likert Scale and open-ended question.
RESULTS: A total of 148 (female, n = 132 and male, n = 16) responses were included in the analysis. Among the participants, n = 93 (62.8 %) of students intended to pursue study. The highest choice of study was mixed mode (41.9 %) and cardiac imaging was the field of choice by the students (22.3 %). Five factors have been found to significantly correlate with the students' intention to pursue postgraduate study in medical imaging which were student attributes, being an academician, remuneration, finance, and social influences (p 0.05).
CONCLUSION: Five out of seven factors tested were found to significantly influence students' decision to pursue postgraduate education in medical imaging. Effective strategies based on the influencing factors should be strategized to encourage more students to pursue postgraduate education in medical imaging.
IMPLICATIONS FOR PRACTICE: Implementation of effective strategies based on the influencing factors will improve access to education among radiography students, ultimately enhancing future radiographers' capability and competency.
Family study of haemoglobin Arya in a Malaysian family

Nahanthiran S, Nik Mustapha NH, Yasin N, Idris FB, Md Noor SB

Malays J Pathol, 2024 Aug;46(2):315-320.
PMID: 39207009

INTRODUCTION: Thalassemia and haemoglobinopathies are relatively common among Malaysians. One of the rare haemoglobinopathies reported is Haemoglobin (Hb) Arya, which occurs due to substitution of aspartic acid at residue 47 of the alpha chain by asparagine. Here, we report the detection of Hb Arya in a Malaysian family, which was detected incidentally during family screening.
CASE REPORT: A 16 years-old girl, clinically asymptomatic was noted to have low mean corpuscular haemoglobin (MCV) with normal Hb level. Hb analysis using capillary electrophoresis (CE) showed reduced Hb A of 76.5%, Hb A2 of 1.6% with presence of small peak at Zone 1 likely A2'. There was also a small peak noted at Hb D zone and Hb S zones which quantified as 1.5% and 20% respectively. Supplementary test by high performance liquid chromatography (HPLC) showed a prominent peak at D-window (19.6%) and a small peak at S-window (0.6%). DNA analysis revealed a heterozygous state of α2 codon 47 Hb Arya mutation. Subsequent family study showed a similar mutation in the father and sister of the index case.
CONCLUSION: Very few reports are available up to date regarding Hb Arya. This report highlights the rare haemoglobinopathy in a Malay family in Malaysia that contributes to the growing literature of this rare haemoglobin variant.
Nutritional evaluation of working Malay women in Kuala Lumpur as studied by total food duplicate method

Shimbo S, Moon CS, Zhang ZW, Watanabe T, Ismail NH, Ali RM, et al.

Tohoku J Exp Med, 1996 Oct;180(2):99-114.
PMID: 9111760

Nutrient intake was surveyed by the total food duplicate method in 49 adult ethnically Malay women (at the ages of 18 to 47 years and mostly at 30-39 years) working in Kuala Lumpur, Malaysia. Simultaneously, hematological examinations, serum biochemistry, anthropometry and clinical examination were conducted. Nutrient intakes were estimated in reference to the weight of each food item and the standard food composition tables. Lunch was the most substantial meal of the day with rice as a staple food. Compared with the Recommended Dietary Allowance (RDA) values, daily intakes of energy (1,917 kcal as an arithmetic mean), protein (62.2 g), vitamin B1 (0.83 mg) and vitamin B2 (1.18 mg) were sufficient, but intakes of minerals [i.e., calcium (347.8 mg) and iron (12.5 mg)] and some vitamins [i.e., vitamin A (equivalent to 627 micrograms retinol) and niacin (7.84 mg)] were less than RDA. When evaluated on an individual basis, the prevalence of those who took less than 80% RDA was highest for iron (92%), followed by niacin (80%), calcium (57%) and vitamin A (57%). The presence of 7 hypohemoglobinemia cases may be related to the insufficient iron intake. Overweight cases (14 women) were also detected, the prevalence of which increased at advanced ages. Lipid intake was rather high (28% of total food on energy basis), for which the major source was plants with limited contribution from fish/shellfish.
In vitro evaluation of cytotoxicity and genotoxicity of porous nickel titanium dental implants produced by metal injection molding technique

N W N A M, R A, N H KA, E S, M A A K, M H I, et al.

J Biomed Mater Res B Appl Biomater, 2024 Jan;112(1):e35306.
PMID: 37522375 DOI: 10.1002/jbm.b.35306

Porous NiTi (pNiTi) is a promising biomaterial for functional long-term implantation that has been produced using various manufacturing techniques and tested for biocompatibility. pNiTi produced using a more recent technology of Metal Injection Molding (MIM) has shown better physical and mechanical properties than those produced by earlier manufacturing methods, but its biocompatibility has yet to be determined. Hence, extracts from pNiTi dental implants produced by MIM were tested for cytotoxicity and genotoxicity in this work. Its toxicity was evaluated at the cellular and in vitro levels using elution and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assays. Short-term testing revealed that pNiTi extract was cytocompatible with L-929 fibroblast and V79-4 lung cells, with no cell lysis or reactivity observed, respectively (USP grade 0). Following exposure to varied extract concentrations, good cell viability was observed where the lowest concentration showed the highest optical density (OD) and cell viability (2.968 ± 0.117 and 94%, respectively), and the highest concentration had the least OD and cell viability (2.251 ± 0.054 and 71%, respectively). pNiTi extracts demonstrated genocompatibility in two independent assays: mutagenic potential using a bacterial reverse mutation test and a clastogenic effect on chromosomes using the micronucleus test. Similar to the negative control reactions, there was no significant increase in revertant colonies following exposure to 100% pNiTi extract with and without metabolic activation (p = .00). No DNA clastogenic activity was caused by pNiTi at varied extract concentrations as compared to the negative control when tested with and without metabolic activation (p = .00). As a result, both cytotoxic and genotoxic investigations have confirmed that pNiTi dental implants utilizing the MIM process are cytocompatible and genocompatible in the short term, according to the International Standard, ISO 10993 - Parts 3, 5, and 33.
Fulltext Factors influencing pregnancy planning of multi-ethnic Asian women with diabetes: A qualitative study

Z I I, C J N, P Y L, N H

PLoS One, 2020;15(12):e0242690.
PMID: 33270663 DOI: 10.1371/journal.pone.0242690

INTRODUCTION: Pregnancy planning varies among women with diabetes. Observing that the literature examining the factors affecting diabetic women's pregnancy intentions in multi-ethnic Asian populations is limited, we sought to explore these factors to give a better perspective on these women's pregnancy planning.
METHODS: This qualitative study used individual in-depth interviews to capture the views and experiences of non-pregnant diabetic women of reproductive age in four public health clinics in a southwestern state of peninsular Malaysia from May 2016 to February 2017. The participants were purposively sampled according to ethnicity and were interviewed using a semi-structured topic guide. Interviews were audio-recorded, and transcripts were analysed using thematic analysis.
RESULTS: From the 33 interviews that were analysed, four important factors influencing participants' decisions regarding pregnancy planning were identified. Participants' perception of poor pregnancy outcomes due to advanced age and medical condition was found to have an impact. However, despite these fears and negative relationships with doctors, personal, family and cultural influences supported by religious 'up to God' beliefs took centre stage in the pregnancy intention of some participants. Participants demonstrated a variety of understandings of pregnancy planning. They outlined some activities for pregnancy preparation, although many also reported limited engagement with pre-pregnancy care.
CONCLUSIONS: This study emphasised the known dilemma experienced by diabetic women considering their desire for an ideal family structure against their perceived pregnancy risks, heterogeneous religious beliefs and the impact of cultural demands on pregnancy intention. This study urges healthcare providers to increase their engagement with the women in pregnancy planning in a more personalised approach.
Fulltext Tobacco & E-cigarette Survey Among Malaysian Adolescent (TECMA) 2016

Aris T, Abd Ghani AA, Mohd Yusoff MF, Robert TG, Tee GH, Mohd Hasri NH, et al.

ISBN: 978-983-2387-30-5

Citation: Aris T, Abd Ghani AA, Mohd Yusoff MF, Robert TG, Tee GH, Mohd Hasri NH, et al. Tobacco & E-cigarette Survey Among Malaysian Adolescent (TECMA) 2016. Kuala Lumpur: Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia; 2016
Prevalence of iron deficiency anaemia and thalassaemia trait among undergraduate medical students

Azma RZ, Ainoon O, Azlin I, Hamenuddin H, Hadi NA, Tatt WK, et al.

Clin Ter, 2012 Jul;163(4):287-91.
PMID: 23007811

Anaemia is a global health problem including Malaysia. In adults, anaemia may affect work productivity. Iron deficiency anaemia and thalassaemia are common causes of anaemia in Malaysia. However, there is scarcity of data on national prevalence of iron deficiency anaemia and thalassaemia, especially in young adults. This cross sectional study was performed to determine the prevalence of iron deficiency anaemia and thalassaemia among medical students of Universiti Kebangsaan Malaysia Medical Centre (UKMMC).

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