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  1. Geographical Diversity of Proteomic Responses to Cold Stress in the Fungal Genus Pseudogymnoascus
    Abu Bakar N, Lau BYC, González-Aravena M, Smykla J, Krzewicka B, Karsani SA, et al.
    Microb Ecol, 2023 Dec 07;87(1):11.
    PMID: 38060022 DOI: 10.1007/s00248-023-02311-w
    In understanding stress response mechanisms in fungi, cold stress has received less attention than heat stress. However, cold stress has shown its importance in various research fields. The following study examined the cold stress response of six Pseudogymnoascus spp. isolated from various biogeographical regions through a proteomic approach. In total, 2541 proteins were identified with high confidence. Gene Ontology enrichment analysis showed diversity in the cold stress response pathways for all six Pseudogymnoascus spp. isolates, with metabolic and translation-related processes being prominent in most isolates. 25.6% of the proteins with an increase in relative abundance were increased by more than 3.0-fold. There was no link between the geographical origin of the isolates and the cold stress response of Pseudogymnoascus spp. However, one Antarctic isolate, sp3, showed a distinctive cold stress response profile involving increased flavin/riboflavin biosynthesis and methane metabolism. This Antarctic isolate (sp3) was also the only one that showed decreased phospholipid metabolism in cold stress conditions. This work will improve our understanding of the mechanisms of cold stress response and adaptation in psychrotolerant soil microfungi, with specific attention to the fungal genus Pseudogymnoascus.
  2. From generosity to gratitude: Exploring Islamic views on body donation, human dissection, and honoring the gift of life
    Hadie SNH, Gasmalla HEE, Wadi MM, Zainul Abidin MA, Yusoff MSB
    Anat Sci Educ, 2024 Feb 08.
    PMID: 38332675 DOI: 10.1002/ase.2393
    Human dissection is an ancient pedagogical method that is still relevant in modern anatomy curricula. The body procurement process for dissection purposes has undergone significant evolution from the medieval era until now, whereby body donation has become the main source for human bodies in medical education. The appreciation ceremony for body donors is an excellent way to promote a body donation program, whereby both dissection and appreciation ceremonies are effective in inculcating professional behaviors and altruism among medical students. Despite the benefits of dissection and such ceremonies, conflicting ideas about the acceptability of these methods exist among Muslim scholars and students. Hence, this article provides a theological Islamic interpretation of human dissection, body donation, and appreciation ceremonies from four sources of Islamic law-the Qur'an, Hadith, Idjmaa, and Qiyas-to justify Muslims' involvement in the aforementioned. It is important to note that the fundamentals of Islam are submission to the will of the one and only God, Allah Subhanahu wa ta'ala (SWT) and recognition of Prophet Muhamad (peace be upon him) as the last messenger of God. Therefore, the actions of a Muslim are strongly based on faith and virtue.
  3. Fulltext Solvent Dependence of the Rheological Properties in Hydrogel Magnetorheological Plastomer
    Hapipi NM, Mazlan SA, Ubaidillah U, Abdul Aziz SA, Ahmad Khairi MH, Nordin NA, et al.
    Int J Mol Sci, 2020 Mar 05;21(5).
    PMID: 32151055 DOI: 10.3390/ijms21051793
    Chemically crosslinked hydrogel magnetorheological (MR) plastomer (MRP) embedded with carbonyl iron particles (CIPs) exhibits excellent magnetic performance (MR effect) in the presence of external stimuli especially magnetic field. However, oxidation and desiccation in hydrogel MRP due to a large amount of water content as a dispersing phase would limit its usage for long-term applications, especially in industrial engineering. In this study, different solvents such as dimethyl sulfoxide (DMSO) are also used to prepare polyvinyl alcohol (PVA) hydrogel MRP. Thus, to understand the dynamic viscoelastic properties of hydrogel MRP, three different samples with different solvents: water, DMSO, and their binary mixtures (DMSO/water) were prepared and systematically carried out using the oscillatory shear. The outcomes demonstrate that the PVA hydrogel MRP prepared from precursor gel with water shows the highest MR effect of 15,544% among the PVA hydrogel MRPs. However, the samples exhibit less stability and tend to oxidise after a month. Meanwhile, the samples with binary mixtures (DMSO/water) show an acceptable MR effect of 11,024% with good stability and no CIPs oxidation. Otherwise, the sample with DMSO has the lowest MR effect of 7049% and less stable compared to the binary solvent samples. This confirms that the utilisation of DMSO as a new solvent affects the rheological properties and stability of the samples.
  4. Fulltext Migration and Proliferation Effects of Thymoquinone-Loaded Nanostructured Lipid Carrier (TQ-NLC) and Thymoquinone (TQ) on In Vitro Wound Healing Models
    Alexander HR, Syed Alwi SS, Yazan LS, Zakarial Ansar FH, Ong YS
    Evid Based Complement Alternat Med, 2019;2019:9725738.
    PMID: 31915456 DOI: 10.1155/2019/9725738
    Wound healing is a regulated biological event that involves several processes including infiltrating leukocyte subtypes and resident cells. Impaired wound healing is one of the major problems in diabetic patients due to the abnormal physiological changes of tissues and cells in major processes. Thymoquinone, a bioactive compound found in Nigella sativa has been demonstrated to possess antidiabetic, anti-inflammatory, and antioxidant effects. Today, the rapidly progressing nanotechnology sets a new alternative carrier to enhance and favour the speed of healing process. In order to overcome its low bioavailability, TQ is loaded into a colloidal drug carrier known as a nanostructured lipid carrier (NLC). This study aimed to determine the effect of TQ-NLC and TQ on cell proliferation and migration, mode of cell death, and the antioxidant levels in normal and diabetic cell models, 3T3 and 3T3-L1. Cytotoxicity of TQ-NLC and TQ was determined by MTT assay. The IC10 values obtained for 3T3-L1 treated with TQ-NLC and TQ for 24 hours were 4.7 ± 3.3 and 5.3 ± 0.6 μM, respectively. As for 3T3, the IC10 values obtained for TQ-NLC and TQ at 24 hours were 4.3 ± 0.17 and 3.9 ± 2.05 μM, respectively. TQ-NLC was observed to increase the number of 3T3 and 3T3-L1 healthy cells (87-95%) and gradually decrease early apoptotic cells in time- and dose-dependant manner compared with TQ. In the proliferation and migration assay, 3T3-L1 treated with TQ-NLC showed higher proliferation and migration rate (p < 0.05) compared with TQ. TQ-NLC also acted as an antioxidant by reducing the ROS levels in both cells after injury at concentration as low as 3 μM. Thus, this study demonstrated that TQ-NLC has better proliferation and migration as well as antioxidant effect compared with TQ especially on 3T3-L1 which confirms its ability as a good antidiabetic and antioxidant agent.
  5. Fulltext Systematic Review on the Effects, Roles and Methods of Magnetic Particle Coatings in Magnetorheological Materials
    Jamari SKM, Nordin NA, Ubaidillah, Aziz SAA, Nazmi N, Mazlan SA
    Materials (Basel), 2020 Nov 24;13(23).
    PMID: 33255343 DOI: 10.3390/ma13235317
    Magnetorheological (MR) material is a type of magneto-sensitive smart materials which consists of magnetizable particles dispersed in a carrier medium. Throughout the years, coating on the surface of the magnetic particles has been developed by researchers to enhance the performance of MR materials, which include the improvement of sedimentation stability, enhancement of the interaction between the particles and matrix mediums, and improving rheological properties as well as providing extra protection against oxidative environments. There are a few coating methods that have been employed to graft the coating layer on the surface of the magnetic particles, such as atomic transfer radical polymerization (ATRP), chemical oxidative polymerization, and dispersion polymerization. This paper investigates the role of particle coating in MR materials with the effects gained from grafting the magnetic particles. This paper also discusses the coating methods employed in some of the works that have been established by researchers in the particle coating of MR materials.
  6. Fulltext An Early Warning System for Flood Detection Using Critical Slowing Down
    Syed Musa SMS, Md Noorani MS, Abdul Razak F, Ismail M, Alias MA, Hussain SI
    Int J Environ Res Public Health, 2020 Aug 24;17(17).
    PMID: 32846870 DOI: 10.3390/ijerph17176131
    The theory of critical slowing down (CSD) suggests an increasing pattern in the time series of CSD indicators near catastrophic events. This theory has been successfully used as a generic indicator of early warning signals in various fields, including climate research. In this paper, we present an application of CSD on water level data with the aim of producing an early warning signal for floods. To achieve this, we inspect the trend of CSD indicators using quantile estimation instead of using the standard method of Kendall's tau rank correlation, which we found is inconsistent for our data set. For our flood early warning system (FLEWS), quantile estimation is used to provide thresholds to extract the dates associated with significant increases on the time series of the CSD indicators. We apply CSD theory on water level data of Kelantan River and found that it is a reliable technique to produce a FLEWS as it demonstrates an increasing pattern near the flood events. We then apply quantile estimation on the time series of CSD indicators and we manage to establish an early warning signal for ten of the twelve flood events. The other two events are detected on the first day of the flood.
  7. Fulltext Protective Effects of Nigella sativa on Metabolic Syndrome in Menopausal Women
    Ibrahim RM, Hamdan NS, Ismail M, Saini SM, Abd Rashid SN, Abd Latiff L, et al.
    Adv Pharm Bull, 2014;4(1):29-33.
    PMID: 24409406 DOI: 10.5681/apb.2014.005
    PURPOSE: This study was conducted in menopausal women to determine the metabolic impact of Nigella sativa.

    METHODS: Thirty subjects who were menopausal women within the age limit of 45-60 were participated in this study and randomly allotted into two experimental groups. The treatment group was orally administered with N. sativa seeds powder in the form of capsules at a dose of 1g per day after breakfast for period of two months and compared to control group given placebo. Anthropometric and biochemical parameters were measured at baseline, 1st month, 2nd month and a month after treatment completed to determine their body weight, serum lipid profile and fasting blood glucose (FBG).

    RESULTS: The treatment group showed slight reduction with no significant difference in body weight changes of the respondents. However, significant (p<0.05) improvement was observed in total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and blood glucose (p<0.05).

    CONCLUSION: These results suggested that treatment with N. sativa exert a protective effect by improving lipid profile and blood glucose which are in higher risk to be elevated during menopausal period.

  8. Fulltext Fabrication of Bilayer Nanofibrous-Hydrogel Scaffold from Bacterial Cellulose, PVA, and Gelatin as Advanced Dressing for Wound Healing and Soft Tissue Engineering
    Khan R, Aslam Khan MU, Stojanović GM, Javed A, Haider S, Abd Razak SI
    ACS Omega, 2024 Feb 13;9(6):6527-6536.
    PMID: 38371763 DOI: 10.1021/acsomega.3c06613
    Tissue engineering is currently one of the fastest-growing areas of engineering, requiring the fabrication of advanced and multifunctional materials that can be used as scaffolds or dressings for tissue regeneration. In this work, we report a bilayer material prepared by electrospinning a hybrid material of poly(vinyl alcohol) (PVA) and bacterial cellulose (BC NFs) (top layer) over a highly interconnected porous 3D gelatin-PVA hydrogel obtained by a freeze-drying process (bottom layer). The techniques were combined to produce an advanced material with synergistic effects on the physical and biological properties of the two materials. The bilayer material was characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and a water contact measurement system (WCMS). Studies on swelling, degradability, porosity, drug release, cellular and antibacterial activities were performed using standardized procedures and assays. FTIR confirmed cross-linking of both the top and bottom layers, and SEM showed porous structure for the bottom layer, random deposition of NFs on the surface, and aligned NFs in the cross section. The water contact angle (WCA) showed a hydrophilic surface for the bilayer material. Swelling analysis showed high swelling, and degradation analysis showed good stability. The bilayer material released Ag-sulfadiazine in a sustained and controlled manner and showed good antibacterial activities against severe disease-causing gram + ive and -ive (Escherichia coli, Staphylococcus aureus, and Pseudomonas aeruginosa) bacterial strains. In vitro biological studies were performed on fibroblasts (3T3) and human embryonic kidneys (HEK-293), which showed desirable cell viability, proliferation, and adhesion to the bilayer. Thus, the synergistic effect of NFs and the hydrogel resulted in a potential wound dressing material for wound healing and soft tissue engineering.
  9. Berberine and RNAi-Targeting Telomerase Reverse Transcriptase (TERT) and/or Telomerase RNA Component (TERC) Caused Oxidation in Colorectal Cancer Cell Line, HCT 116: An Integrative Approach using Molecular and Metabolomic Studies
    Samad MA, Saiman MZ, Abdul Majid N, Karsani SA, Yaacob JS
    Cell Biochem Biophys, 2024 Mar;82(1):153-173.
    PMID: 38198024 DOI: 10.1007/s12013-023-01210-8
    Colorectal cancer (CRC) is the most common cancer in both men and women and is associated with increased telomerase levels and activity. The potential downstream effects of TERT and/or TERC downregulation by berberine (a telomerase inhibitor) or RNA interference (RNAi) on various target RNAs, proteins, relative telomerase activity (RTA), relative telomere length (RTL), hydrogen peroxide concentration [H2O2], percentage of cell cycle distribution, cell size and granularity as well as cellular metabolites were explored in HCT 116 cell line. Knockdown of TERT decreased TERC. The downregulation of TERT and/or TERC caused increment of [H2O2], G0/G1 phase arrest in addition to decreased S and G2/M phases, as well as diminished cell size. RTL was later reduced as a result of TERT, TERT and/or TERC downregulation which decreased RTA. It was discovered that xanthine oxidase (XO) was significantly and positively correlated at FDR-adjusted p value 
  10. Fulltext Factors affecting test anxiety: a qualitative analysis of medical students' views
    Wadi M, Yusoff MSB, Abdul Rahim AF, Lah NAZN
    BMC Psychol, 2022 Jan 06;10(1):8.
    PMID: 34991718 DOI: 10.1186/s40359-021-00715-2
    BACKGROUND: Medical students are vulnerable to test anxiety (TA), which impacts their professional lives and jeopardizes the optimal health care of their patients. The qualitative exploration of TA among medical students is crucial to understanding the problem. Hence, this study examined medical students' insights into TA and their suggestions on how to reduce it.

    METHODS: We conducted a phenomenological study on medical students at a public university. We utilized focus group discussions (FGDs) to investigate their experiences of TA. The FGDs were transcribed verbatim, and these transcripts were analyzed using Atlas.ti software. The thematic analysis followed the recommended guidelines.

    RESULTS: Seven FGD sessions were conducted with 45 students. Three major themes emerged: the students, their academic resources, and the examiner. Each theme comprised mutually exclusive subthemes. The "students" theme was divided into negative vs. positive thoughts and self-negligence vs. self-care, "academic recources" into heavy curriculum vs. facilitative curricular aids, and "examiner" into criticism vs. feedback and strict vs. kind approaches.

    CONCLUSION: This study provides a solid foundation for policymakers and decision makers in medical education to improve current assessment practices and student well-being. Medical students will be able to significantly alter and reduce TA if they are provided with additional psychological support and their examiners are trained on how to deal with examinees.

  11. Fulltext Antibacterial and Hemocompatible pH-Responsive Hydrogel for Skin Wound Healing Application: In Vitro Drug Release
    Khan MUA, Razaq SIA, Mehboob H, Rehman S, Al-Arjan WS, Amin R
    Polymers (Basel), 2021 Oct 27;13(21).
    PMID: 34771258 DOI: 10.3390/polym13213703
    The treatment of successive skin wounds necessitates meticulous medical procedures. In the care and treatment of skin wounds, hydrogels produced from natural polymers with controlled drug release play a crucial role. Arabinoxylan is a well-known and widely available biological macromolecule. We produced various formulations of blended composite hydrogels (BCHs) from arabinoxylan (ARX), carrageenan (CG), and reduced graphene oxide (rGO) using and cross-linked them with an optimal amount of tetraethyl orthosilicate (TEOS). The structural, morphological, and mechanical behavior of the BCHs samples were determined using Fourier-transform infrared spectroscopy (FT-IR), Scanning electron microscope (SEM), mechanical testing, and wetting, respectively. The swelling and degradation assays were performed in phosphate-buffered saline (PBS) solution and aqueous media. Maximum swelling was observed at pH 7 and the least swelling in basic pH regions. All composite hydrogels were found to be hemocompatible. In vitro, silver sulfadiazine release profile in PBS solution was analyzed via the Franz diffusion method, and maximum drug release (87.9%) was observed in 48 h. The drug release kinetics was studied against different mathematical models (zero-order, first-order, Higuchi, Hixson-Crowell, Korsmeyer-Peppas, and Baker-Lonsdale models) and compared their regression coefficient (R2) values. It was observed that drug release follows the Baker-Lonsdale model, as it has the highest value (0.989) of R2. Hence, the obtained results indicated that, due to optimized swelling, wetting, and degradation, the blended composite hydrogel BCH-3 could be an essential wound dressing biomaterial for sustained drug release for skin wound care and treatment.
  12. Fulltext Medical Education e-Professionalism (MEeP) framework; from conception to development
    Guraya SS, Guraya SY, Harkin DW, Ryan Á, Mat Nor MZB, Yusoff MSB
    Med Educ Online, 2021 Dec;26(1):1983926.
    PMID: 34775927 DOI: 10.1080/10872981.2021.1983926
    BACKGROUND: Medical professionalism education intends to produce virtuous and humanistic healthcare professionals who demonstrate perseverance and professional integrity. However, today's medicine has embodied a mammoth transformation of medical practice towards sns and the digital realm. Such paradigm shift has challenged the medical professional's values, behaviors, and identities, and the distinct boundaries between personal and professional lives are blurred. This study aims to develop a framework for healthcare professionals coping with the challenges of medical professionalism in the digital realm.

    METHODS: We followed a systematic approach for the development of a framework about e-professionalism. Qualitative data was collected from a systematic review and a delphi study, while quantitative data was collected by administering a validated questionnaire social networking sites for medical education (snsme). Subsequently, categorization of the selected data and identifying concepts, deconstruction and further categorizing concepts (philosophical triangulation), integration of concepts (theoretical triangulation), and synthesis and resynthesis of concepts were performed.

    RESULTS: The initial process yielded six overlapping concepts from personal, professional, character (implicit) and characteristic (explicit) domains: environment, behavior, competence, virtues, identity, and mission. Further integration of data was done for the development of the medical education e-professionalism (meep) framework with a central concept of a commitment to mission. The mission showed deep connections with values (conformity, beneficence, universalism, and integrity), behaviours (communication, self-awareness, tolerance, power), and identity (reflection, conscientiousness, self-directed, self-actualization). The data demonstrated that all medical professionals require updated expertise in sns participation.

    CONCLUSION: The meep framework recognises a mission-based social contract by the medical community. This mission is largely driven by professional values, behaviors and identity. Adherence to digital standards, accountability, empathy, sensitivity, and commitment to society are essential elements of the meep framework.

  13. Fulltext Development of Biodegradable Bio-Based Composite for Bone Tissue Engineering: Synthesis, Characterization and In Vitro Biocompatible Evaluation
    Khan MUA, Razak SIA, Ansari MNM, Zulkifli RM, Ahmad Zawawi N, Arshad M
    Polymers (Basel), 2021 Oct 20;13(21).
    PMID: 34771168 DOI: 10.3390/polym13213611
    Several significant advancements in the field of bone regenerative medicine have been made in recent years. However, therapeutic options, such as bone grafts, have several drawbacks. There is a need to develop an adequate bone substitute. As a result, significant bone defects/injuries pose a severe challenge for orthopaedic and reconstructive bone tissue. We synthesized polymeric composite material from arabinoxylan (ARX), β-glucan (BG), nano-hydroxyapatite (nHAp), graphene oxide (GO), acrylic acid (AAc) through free radical polymerization and porous scaffold fabricated using the freeze-drying technique. These fabricated porous scaffolds were then coated with chitosan solution to enhance their biological activities. The complex structure of BG, nHAp, GO was studied through various characterization and biological assays. The structural, morphological, wetting and mechanical analyses were determined using FT-IR, XRD, XPS, SEM/EXD, water contact angle and UTM. The swelling (aqueous and PBS media) and degradation (PBS media) observed their behavior in contact with body fluid. The biological activities were conducted against mouse pre-osteoblast cell lines. The result found that BGH3 has desirable morphological, structural with optimum swelling, degradation, and mechanical behavior. It was also found to be cytocompatible against MC3T3-E1 cell lines. The obtained results confirmed that the fabricated polymeric scaffolds would be a potential bone substitute to regenerate defective bone with different loading bearing applications for bone tissue engineering.
  14. Fulltext A Study of Psychological Distress in Two Cohorts of First-Year Medical Students that Underwent Different Admission Selection Processes
    Yusoff MS, Rahim AF, Baba AA, Ismail SB, Esa AR
    Malays J Med Sci, 2012 Jul;19(3):29-35.
    PMID: 23610547 MyJurnal
    Medical training is often regarded as a stressful period. Studies have previously found that 21.6%-50% of medical students experience significant psychological distress. The present study compared the prevalence and levels of psychological distress between 2 cohorts of first-year medical students that underwent different admission selection processes.
  15. Proteomic characterization of Pseudogymnoascus spp. isolates from polar and temperate regions
    Abu Bakar N, Chung BLY, Smykla J, Karsani SA, Alias SA
    Mycologia, 2024;116(3):449-463.
    PMID: 38484286 DOI: 10.1080/00275514.2024.2313429
    Proteomics has been used extensively in the field of mycology, mainly in trying to understand the complex network of protein-protein interactions that has been implicated in the molecular functions of fungi. It is also a useful tool to compare metabolic differences within a genus. Species of Pseudogymnoascus, a genus under the phyla Ascomycota, have been shown to play an important role in the soil environment. They have been found in both polar and temperate regions and are a known producer of many extracellular hydrolases that contribute to soil decomposition. Despite the apparent importance of Pseudogymnoascus spp. in the soil ecosystem, investigations into their molecular functions are still very limited. In the present study, proteomic characterization of six Pseudogymnoascus spp. isolated from three biogeographic regions (the Arctic, Antarctic, and temperate regions) was carried out using tandem mass spectrometry. Prior to proteomic analysis, the optimization for protein extraction was carried out. Trichloroacetic acid‑acetone‑phenol was found to be the best extraction method to be used for proteomic profiling of Pseudogymnoascus spp. The proteomic analysis identified 2003 proteins that were successfully mapped to the UniProtKB database. The identified proteins were clustered according to their biological processes and molecular functions. The shared proteins found in all Pseudogymnoascus spp. (1201 proteins) showed a significantly close relationship in their basic cellular functions, despite differences in morphological structures. Analysis of Pseudogymnoascus spp. proteome also identified proteins that were unique to each region. However, a high number of these proteins belonged to protein families of similar molecular functions, namely, transferases and hydrolases. Our proteomic data can be used as a reference for Pseudogymnoascus spp. across different global regions and a foundation for future soil ecosystem function research.
  16. Fulltext Characteristics and Outcomes of Patients with Anterior Circulation Intracranial Aneurysm Managed with Clipping in Hospital Sungai Buloh
    Ab Ghani A, Nayan SA, Kandasamy R, Rosman AK, Ghani AR
    Malays J Med Sci, 2016 Nov;23(6):113-117.
    PMID: 28090185 MyJurnal DOI: 10.21315/mjms2016.23.6.12
    The annual incidence of intracranial aneurysm in Malaysia is estimated to be 1.1-1.7 per 100,000 population based on a study done conducted in 1988. Since then, little epidemiological research has been conducted in Malaysia, and the real incidence is therefore probably unreported despite advancements in the diagnosis and treatment of this disorder. Intracranial aneurysm may be treated by microsurgical clipping or embolisation depending on its location and the surgeon's preference. This study aims to report the characteristics and outcomes of patients with a clipped anterior circulation aneurysm in Hospital Sungai Buloh.
  17. Assessment of Pre- and Post-Operative Cerebral Perfusion in Anterior Circulation Intracranial Aneurysm Clipping Patients at Hospital Sungai Buloh Using CT Perfusion Scan and Correlations to Fisher, Navarro and WFNS Scores
    Ghani AA, Nayan SAM, Kandasamy R, Ghani ARI, Rosman AK
    Malays J Med Sci, 2017 Feb;24(1):47-58.
    PMID: 28461780 DOI: 10.21315/mjms2017.24.1.6
    BACKGROUND: Intracranial aneurysms may rupture and are typically associated with high morbidity and mortality, commonly due to vasospasm after rupture. Once the aneurysm ruptures, the patient's cerebral blood flow may be disturbed during the acute phase, affecting cerebral circulation and thus cerebral perfusion prior to the onset of vasospasm. Fisher and Navarro scores are used to predict vasospasm, while World Federation of Neurosurgical Societies (WFNS) scores are used to predict patient outcomes. Several score modifications are available to obtain higher sensitivity and specificity for the prediction of vasospasm development, but these scores are still unsuccessful. Alternatively, cerebral CT perfusion scan (CTP) is a non-invasive method for measuring cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in regions of interests (ROI) to obtain the cerebral perfusion status as well as detecting vasospasm.

    METHODS: A total of 30 patients' data with clipped anterior circulation intracranial aneurysms admitted to the hospital between 1 January 2013 and 30 June 2014, were collected from the hospital's electronic database. The data collected included patients' admissions demographic profiles, Fisher, Navarro and WFNS scores; and their immediate pre- and post-operative CTP parameters.

    RESULTS: This study found a significant increase in post-operative MTT (pre- and post-operative MTT) were 9.75 (SD = 1.31) and 10.44 (SD = 1.56) respectively, (P < 0.001)) as well as a significant reduction in post-operative CBF (pre- and post-operative mean CBF were 195.29 (SD = 24.92) and 179.49 (SD = 31.17) respectively (P < 0.001)). There were no significant differences in CBV. There were no significant correlations between the pre- and post-operative CTP parameters and Fisher, Navarro or WFNS scores.

    CONCLUSION: Despite the interest in using Fisher, Navarro and WFNS scores to predict vasospasm and patient outcomes for ruptured intracranial aneurysms, this study found no significant correlations between these scores in either pre- or post-operative CTP parameters. These results explain the disagreement in the field regarding the multiple proposed grading systems for vasospasm prediction. CTP measures more than just anatomical structures; therefore, it is more sensitive towards minor changes in cerebral perfusion that would not be detected by WFNS, Fisher or Navarro scores.

  18. Fulltext Achievement of LDL Cholesterol Goal and Adherence to Statin by Diabetes Patients in Kelantan
    Yudin ZM, Yaacob LH, Hassan NB, Ismail SB, Draman N, Yusoff SSM
    Malays J Med Sci, 2017 May;24(3):44-50.
    PMID: 28814932 MyJurnal DOI: 10.21315/mjms2016.24.3.6
    BACKGROUND: Statins are a class of potent drugs that can be used to reduce cholesterol, especially low-density lipoprotein cholesterol (LDL-C). However, their effectiveness is limited if adherence to treatment is poor. The objectives of the study are to estimate the proportion of diabetic patient who has achieved LDL-C goal and to determine the association of LDL-C achievement with socio demographic factors and statin therapy adherence.

    METHODS: This is a cross-sectional study involving 234 patients with type 2 diabetes mellitus (T2DM) and dyslipidaemia attending an outpatient clinic in a hospital in Kelantan. Interviews and self-administered questionnaires were used to determine their sociodemographic and clinical characteristics. Adherence to therapy was assessed using the Medication Compliance Questionnaire (MCQ). The associations between the achievement of LDL targets and sociodemographic/clinical factors, including adherence, were analysed with simple logistic regression.

    RESULTS: About 37.6% of patients achieved their LDL-C target. The percentage of patients who adhered to statin use was 98.3%, and 20.5% of these patients reported full adherence. There was no significant association between achievement of LDL-C targets with adherence or any other sociodemographic factors, such as age, gender and educational or economic status (all P-value < 0.05).

    CONCLUSION: Despite a high level of adherence, the majority of patients failed to achieve LDL-C targets. More concerted efforts are needed to improve this.

    Study site: primary
    care clinic in Hospital Universiti Sains Malaysia,
  19. Fulltext Correlations between subdural empyema and paraclinical as well as clinical parameters amongst urban malay paediatric patients
    Nayan SA, Abdullah MS, Naing NN, Haspani MS, Md Ralib AR
    Malays J Med Sci, 2008 Oct;15(4):19-27.
    PMID: 22589634 MyJurnal
    Paediatric subdural empyema is frequently seen in developing Asean countries secondary to rinosinusogenic origins. A cross-sectional analysis on the surgical treatment of intracranial subdural empyema in Hospital Kuala Lumpur (HKL), a major referral center, was done in 2004. A total number of 44 children who fulfilled the inclusion criteria were included into this study. The methods of first surgery, volume of empyema on contrasted CT brain, improvement of neurological status, re-surgery, mortality and morbidity, as well as the demographic data such as age, gender, sex, duration of illness, clinical presentation, probable origin of empyema, cultures and follow-up were studied. Chi-square test was performed to determine the association between surgical methods and the survival of the patients, neurological improvement, clearance of empyema on CT brain, re-surgery and long morbidity among the survivors. If the 20% or more of the cells were having expected frequency less than five, then Fisher's Exact test was applied. The level of significance was set at 0.05. SPSS version 12.0 was used for data entry and data analysis. There were 44 patients who were less than 18 years. Their mean age was 5.90 ± 6.01 years. There were 30 males (68.2%) and 14 females (31.8%) involved in the study. Malays were majority with 28 (63.6%) followed by Indian 8 (18.2%), Chinese 5 (11.4%) and others 3 (6.8%). The variables which were under interest were gender, race, headache, vomiting, seizures, sign of meningism, cranial nerve palsy, thickness site of abscess, first surgical treatment, improvement in neurological deficit, clearance of CT and whether re-surgery was necessary. All variables were found not to be associated with Henk W Mauser Score for PISDE grading. Comparison between this urban study and a rural setting study by the same corresponding author in the same period on subdural empyema was done. Common parameters were compared and it was found out that seizures were more prevalent in urban study where the patients are more than one year old (p=0.005). Mortality was much higher in urban study than the rural one (p=0.040). The larger proportion of urban group had volume of abscess less than or equal to 50 ml (p=< 0.001).
  20. dCas9 Tells Tales: Probing Gene Function and Transcription Regulation in Cancer
    Mohamad Zamberi NN, Abuhamad AY, Low TY, Mohtar MA, Syafruddin SE
    CRISPR J, 2024 Apr;7(2):73-87.
    PMID: 38635328 DOI: 10.1089/crispr.2023.0078
    Clustered regularly interspaced short palindromic repeats (CRISPR)-based genome editing is evolving into an essential tool in the field of biological and medical research. Notably, the development of catalytically deactivated Cas9 (dCas9) enzyme has substantially broadened its traditional boundaries in gene editing or perturbation. The conjugation of dCas9 with various molecular effectors allows precise control over transcriptional processes, epigenetic modifications, visualization of chromosomal dynamics, and several other applications. This expanded repertoire of CRISPR-Cas9 applications has emerged as an invaluable molecular tool kit that empowers researchers to comprehensively interrogate and gain insights into health and diseases. This review delves into the advancements in Cas9 protein engineering, specifically on the generation of various dCas9 tools that have significantly enhanced the CRISPR-based technology capability and versatility. We subsequently discuss the multifaceted applications of dCas9, especially in interrogating the regulation and function of genes that involve in supporting cancer pathogenesis. In addition, we also delineate the designing and utilization of dCas9-based tools as well as highlighting its current constraints and transformative potentials in cancer research.
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