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  1. Mohd Noor MNZ, Alauddin AS, Wong YH, Looi CY, Wong EH, Madhavan P, et al.
    Asian Pac J Cancer Prev, 2023 Jan 01;24(1):37-47.
    PMID: 36708550 DOI: 10.31557/APJCP.2023.24.1.37
    BACKGROUND: Cancer remains a challenging target to cure, with present therapeutic methods unable to exhibit restorative outcomes without causing severe negative effects. Molecular hydrogen (H2) has been reported to be a promising adjunctive therapy for cancer treatment, having the capability to induce anti-proliferative, anti-oxidative, pro-apoptotic and anti-tumoural effects. This review summarises the findings from various articles on the mechanism, treatment outcomes, and overall effectiveness of H2 therapy on cancer management.

    METHODS: Using Cochrane, PubMed, and Google Scholar as the search engines, full-text articles in the scope of the study, written in English and within 10 years of publication were selected.

    RESULTS: Out of the 677 articles, 27 articles fulfilled the eligibility criteria, where data was compiled into a table, outlining the general characteristics and findings. Throughout the different forms of H2 administration, study design and types of cancers reported, outcomes were found to be consistent.

    CONCLUSION: From our analysis, H2 plays a promising therapeutic role as an independent therapy as well as an adjuvant in combination therapy, resulting in an overall improvement in survivability, quality of life, blood parameters, and tumour reduction. Although more comprehensive research is needed, given the promising outcomes, H2 is worth considering for use as a complement to current cancer therapy.

    Matched MeSH terms: Humans
  2. Chong SSF, Kanno M, Chee ASM, Long SM, Ong SHM, Harnpramukkul U, et al.
    Ther Innov Regul Sci, 2023 Jan;57(1):12-25.
    PMID: 36175790 DOI: 10.1007/s43441-022-00435-8
    PURPOSE: Asia Partnership Conference of Pharmaceutical Associations (APAC) promote regulatory agility of four important best practices i.e. reliance, digital platform, accepting electronic document and process integration. Dialogues and strong partnership witnessed reforms and efficiencies amidst the pandemic. In tracking the progress of regulatory agility, APAC identifies areas for improvement and recommends prioritizing these areas for change.

    METHODS: As one voice, 13 main industry associations under the umbrella of APAC sent joint letters to our National Regulatory Authorities (NRAs) with a call to maintain regulatory agility and consider new ways of working. Consequently, APAC surveyed its member associations to measure regulatory agilities implemented by the NRAs during 2020 and 2021 in view of the pandemic.

    RESULTS: This paper reports progress in implementing regulatory agility, e.g. the number of economies that can accept electronic Certificate of Pharmaceutical Products (eCPP) has reached 100% for the economies that require CPP and more than 90% can waive onsite inspection in the presence of Good Manufacturing Practice (GMP) certificate and/or inspection report. The paper also features the progress made in Malaysia, the Philippines, and the ASEAN (Association of South East Asian Nations) regional reliance initiative to reduce inefficiencies and duplications.

    CONCLUSIONS: We have demonstrated the power of working together to enable regulatory agilities and efficiencies. APAC will continue to track the progress of all economies including India within the areas for improvement prioritized and discussed in this paper. APAC is also committed to working with key stakeholders including our NRAs in Asia to sustain and enable a new era of innovation ushered in by COVID-19 to benefit patients.

    Matched MeSH terms: Humans
  3. Asmuje NF, Mat S, Goh CH, Myint PK, Tan MP
    Am J Hypertens, 2022 Dec 08;35(12):998-1005.
    PMID: 36153737 DOI: 10.1093/ajh/hpac107
    BACKGROUND: Emerging evidence has linked visit-to-visit, day-to-day and 24-h ABPM blood pressure variability (BPV) with cognitive impairment. Few studies have, however, considered beat-to-beat BPV. This study, therefore, evaluated the relationship between beat-to-beat BPV and cognitive function among community-dwellers aged 55 years and over.

    METHODS: Data was obtained from the Malaysian Elders Longitudinal Research (MELoR) study, which employed random stratified sampling from three parliamentary constituencies within the Klang Valley. Beat-to-beat blood pressure (BP) was recorded using non-invasive BP monitoring (TaskforceTM, CNSystems). Low frequency (LF), high frequency (HF) and low-to-high frequency (LF:HF) ratio for BPV were derived using fast Fourier transformation. Cognition was evaluated using the Montreal Cognitive Assessment (MoCA) test, and categorized into normal aging, mild impairment and moderate-to-severe impairment.

    RESULTS: Data from 1,140 individuals, mean age (SD) 68.48 (7.23) years, were included. Individuals with moderate-to-severe impairment had higher HF-BPV for systolic (SBP) and diastolic (DBP) blood pressure compared to individuals within the normal aging group [OR (95% CI) = 2.29 (1.62-3.24)] and [OR (95% CI) = 1.80 (1.32-2.45)], while HF-SBPV [OR (95% CI) = 1.41 (1.03-1.93)] but not HF-DBPV was significantly higher with mild impairment compared to normal aging after adjustments for potential confounders. Moderate-to-severe impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.29 (0.18-0.47)] and LF:HF-DBPV [OR (95% CI) = 0.49 (0.34-0.72)], while mild impairment was associated with significantly lower LF:HF-SBPV [OR (95% CI) = 0.52 (0.34-0.80)] but not LF:HF-DBPV [OR (95% CI) = 0.81 (0.57-1.17)], compared to normal aging with similar adjustments.

    CONCLUSION: Higher HF-BPV, which indicates parasympathetic activation, and lower LF:HF-BPV, which addresses sympathovagal balance, were observed among individuals with moderate-to-severe cognitive impairment. Future studies should determine whether BPV could be a physiological marker or modifiable risk factor for cognitive decline.

    Matched MeSH terms: Humans
  4. Kow CS, Ramachandram DS, Hasan SS
    Acta Diabetol, 2022 Feb;59(2):285-286.
    PMID: 34648089 DOI: 10.1007/s00592-021-01810-x
    Matched MeSH terms: Humans
  5. Padma Priya S, Higuchi A, Abu Fanas S, Pooi Ling M, Kumari Neela V, Sunil PM, et al.
    Lab Invest, 2015 Dec;95(12):1344-52.
    PMID: 26367485 DOI: 10.1038/labinvest.2015.108
    The ultimate goal of dental stem cell research is to construct a bioengineered tooth. Tooth formation occurs based on the well-organized reciprocal interaction of epithelial and mesenchymal cells. The dental mesenchymal stem cells are the best explored, but because the human odontogenic epithelium is lost after the completion of enamel formation, studies on these cells are scarce. The successful creation of a bioengineered tooth is achievable only when the odontogenic epithelium is reconstructed to produce a replica of natural enamel. This article discusses the untapped sources of odontogenic epithelial stem cells in humans, such as those present in the active dental lamina in postnatal life, in remnants of dental lamina (the gubernaculum cord), in the epithelial cell rests of Malassez, and in reduced enamel epithelium. The possible uses of these stem cells in regenerative medicine, not just for enamel formation, are discussed.
    Matched MeSH terms: Humans
  6. Manoharan S, Ying LY
    Int J Clin Pract, 2023;2023:1068000.
    PMID: 36793928 DOI: 10.1155/2023/1068000
    Epstein-Barr virus (EBV) reactivation in acute-phase of COVID-19 disease was recently discovered but it is not clear in terms of degree of mortality caused, and this was the aim of the current study. Six databases and three non-databases were thoroughly searched, independently. The articles related to non-human study (abstract, in vitro, in vivo, in silico, case study, poster, and review articles) were excluded for main analysis. Four articles related to mortality linked to EBV reactivation were systematically identified and included in the qualitative and quantitative analyses. Based on proportional meta-analysis of 4 studies, 34.3% or 0.343 (95% CI: 0.189-0.516; I 2 = 74.6) mortality related to EBV reactivation was identified. To address high heterogeneity, subgroup meta-analysis was carried out. Based on subgroup analysis, 26.6% or 0.266 (95% CI: 0.191-0.348; I 2 = 0) with no heterogeneity was identified. Interestingly, in comparative meta-analysis, EBV(-)/SARS-CoV-2(+) patients had statistically lesser mortality (9.9%) than EBV(+)/SARS-CoV-2(+) patients (23.6%) where RR = 2.31 (95% CI: 1.34-3.99; p = 0.003; I 2 = 6%). This finding is equivalent to the absolute mortality effect of 130 more per 1000 COVID-19 patients (95% CI: 34-296). Furthermore, based on statistical analysis, D-dimer was not statistically significantly different (p > 0.05) between the groups although studies have shown that D-dimer was statistically significantly different (p < 0.05) between these groups. Based on the inclusion and analysis of low risk of bias and high quality of articles graded with Newcastle-Ottawa Scale (NOS), when COVID-19 patients' health state is gradually worsening, EBV reactivation needs to be suspected because EBV reactivation is a possible marker for COVID-19 disease severity.
    Matched MeSH terms: Humans
  7. Govindarajan KK, Arasappan M
    J Coll Physicians Surg Pak, 2023 Feb;33(2):232-233.
    PMID: 36797637 DOI: 10.29271/jcpsp.2023.02.232
    Ingested foreign bodies (Fb) in children usually pass out in stools without any sequels. However, Fbs like open safety pins, button batteries, and super absorbent polymer (SAP) / jelly toys are associated with complications such as intestinal obstruction, and bowel perforation. Intestinal obstruction in children of uncertain nature should raise a suspicion of foreign body ingestion such as SAP, which may not be obvious at the initial presentation. The study reports two such children, outlining the presentation and management. Key Words: Children, Intestinal obstruction, Foreign body, Health hazard, Bilious vomit, Super absorbent polymer beads.
    Matched MeSH terms: Humans
  8. Shamsher S, Suhaimi NHI, Noor Ali R, Zulkifli K
    Med J Malaysia, 2023 Jan;78(1):126-127.
    PMID: 36715203
    Chlorhexidine is labelled as hidden allergen as the health care professionals (HCPs) are unaware of the wide range of products containing chlorhexidine. Adverse events from chlorhexidine allergy can be reduced by appropriate perioperative management especially heeding on positive history during preoperative assessment, awareness regarding this hidden allergen, and educating HCPs on possible chlorhexidine-containing products. The regulatory agencies all over the world have issued recommendations regarding safety and risk of hypersensitivity reactions with chlorhexidine-containing products. The onus lies on HCPs to disseminate this knowledge to the stakeholders. We present a brief update to combat chlorhexidine allergy in perioperative setting.
    Matched MeSH terms: Humans
  9. Ab Hamid J, Juni MH, Rosliza AM, Syed Ismail SN, Lim PY
    Med J Malaysia, 2023 Jan;78(1):109-117.
    PMID: 36715200
    INTRODUCTION: The floating catchment area (FCA) method has emerged as the most comprehensive and accurate method for quantifying the spatial accessibility of health care services. There were variants of the FCA-based method that was continuously improvised by the researchers to suit specific local contexts and the different nature of healthcare service delivery. This scoping review identifies factors associated with the spatial accessibility of healthcare services that were specifically measured using the FCAbased method.

    MATERIALS AND METHODS: This scoping review was performed through electronic databases (PubMed and ScienceDirect) using keywords: 'spatial accessibility', 'floating catchment area' and 'factors'. Google Scholar and Mendeley Network were also used as additional sources to obtain relevant studies.

    RESULTS: A total of 32 articles were included in this review. Factors identified can be distinguished into two broad categories, which are spatial and non-spatial factors. Spatial factors were remoteness or distance from the urban centre, areas in close proximity to main roads, and some specific geographical characteristics such as mountainous and deltaic regions, whereas non-spatial factors were the degree of urbanisation, population density and various demographic profiles of the population such as socioeconomic status, health need, and minority ethnic composition.

    CONCLUSION: This study adds to the body of literature pertinent to the factors associated with spatial accessibility to healthcare services. These findings could give insight for researchers to consider and incorporate those additional variables to further improve the FCA-based method calculations.

    Matched MeSH terms: Humans
  10. Sim SK, Myo N, Sohail M
    Med J Malaysia, 2023 Jan;78(1):61-67.
    PMID: 36715193
    INTRODUCTION: To evaluate the effectiveness of team-based self-directed learning (SDL) in the teaching of the undergraduate Year 5 surgical posting.

    MATERIALS AND METHODS: A quasi-experimental study was conducted to develop and administer a team-based SDL versus a conventional SDL to teach undergraduate surgical topics. One hundred and seventy-four medical students who underwent the Year 5 surgical posting were recruited. They were assigned to two groups receiving either the teambased SDL or the conventional SDL. Pre- and post-SDL assessments were conducted to determine students' understanding of selected surgical topics. A selfadministered questionnaire was used to collect student feedback on the team-based SDL.

    RESULTS: The team-based SDL group scored significantly higher than the conventional SDL group in the post-SDL assessment (74.70 ± 6.81 vs. 63.77 ± 4.18, t = -12.72, p < 0.01). The students agreed that the team-based SDL method facilitated their learning process.

    CONCLUSION: The study demonstrated that the use of a teambased SDL is an effective learning strategy for teaching the Year 5 surgical posting. This method encouraged peer discussion and promoted teamwork in completing task assignments to achieve the learning objectives.

    Matched MeSH terms: Humans
  11. Amrina MA, Shahidah M, Sofiah HR, Mirlia SCM, Thilakaveni R, Chong ZL, et al.
    Med J Malaysia, 2023 Jan;78(1):20-24.
    PMID: 36715186
    INTRODUCTION: Healthcare workers (HCWs) were among the first to be fully vaccinated against SARS-CoV-2. However, the antibody responses to the vaccines and potential decline among Malaysian HCW are still unclear. The objective of this study is to follow-up anti-S antibody levels among HCW vaccinated with mRNA vaccine (BTN162b2) and inactivated vaccine (CoronaVac).

    MATERIALS AND METHODS: Plasma samples were collected prevaccination, 2 weeks and 6 months post-vaccination and tested for total immunoglobulin levels using ELISA method.

    RESULTS: A small percentage of HCW (2.2%, 15/677) had elevated anti-S antibody levels in their pre-vaccination plasma samples (median 20.4, IQR 5.8), indicating that they were exposed to SARS-CoV-2 infection prior to vaccination. The mRNA vaccine significantly increased anti-S levels of both previously infected and uninfected individuals to saturation levels (median 21.88, IQR.0.88) at 2 weeks postsecond dose of the vaccine. At 6 months post-vaccination, the antibody levels appeared to be maintained among the recipients of the mRNA vaccine. However, at this time point, anti-S antibody levels were lower in individuals given inactivated vaccine (median 20.39, IQR 7.31, n=28), and interestingly, their antibody levels were similar to anti-S levels in pre-vaccination exposed individuals. Antibody levels were not different between the sexes.

    CONCLUSION: Anti-S levels differ in individuals given the different vaccines. While further study is required to determine the threshold level for protection against SARSCoV- 2, individuals with low antibody levels may be considered for boosters.

    Matched MeSH terms: Humans
  12. Ng GH, Philip Ding HL, Leow YC, Umasangar R, Ang CW
    Med J Malaysia, 2023 Jan;78(1):32-34.
    PMID: 36715188
    INTRODUCTION: The COVID-19 pandemic has led to major changes in the provision of surgical services and also affected patients' health-seeking behaviour. This contributes to delayed presentation of many surgical conditions resulting in poorer outcomes. Colorectal cancer (CRC) patients who present with acute surgical emergencies such as complete bowel obstruction, perforation, bleeding or sepsis often require immediate intervention. This study aimed to assess the impact of COVID-19 pandemic on the proportion of emergency surgery in CRC patients.

    MATERIALS AND METHODS: This is a retrospective cohort study. All CRC patients who underwent elective and emergency surgery from January until December 2019 (pre-COVID era) and September 2020 until August 2021 (COVID era) were included. Patient demographics, presentation, tumour stage, surgery performed and waiting time for surgery were collected. Data were then compared.

    RESULTS: Seventy-seven and 76 new cases of CRC underwent surgery before and during COVID-19, respectively. The proportions of emergency surgery before and during COVID-19 are 29% vs 33% (p=0.562). Of those who required emergency surgery, the proportions of patients who required stoma formation are 59% vs 72% (p= 0.351). There was no difference in median waiting time for patients requiring elective surgery (p= 0.668).

    CONCLUSION: The proportion of emergency surgery for CRC patients is not statistically higher during the pandemic.

    Matched MeSH terms: Humans
  13. Binns C, Low WY, Shunnmugam B
    Asia Pac J Public Health, 2023 Jan;35(1):5-6.
    PMID: 36694949 DOI: 10.1177/10105395221150836
    Matched MeSH terms: Humans
  14. Kua KP, Chongmelaxme B, Lee SWH
    J Infect Dis, 2023 Feb 14;227(4):471-482.
    PMID: 35512129 DOI: 10.1093/infdis/jiac179
    BACKGROUND: Tuberculosis is one of the leading causes of mortality worldwide from an infectious disease. This review aimed to investigate the association between prior cytomegalovirus infection and tuberculosis disease.

    METHODS: Six bibliographic databases were searched from their respective inception to 31 December 2021. Data were pooled using random-effects meta-analysis.

    RESULTS: Of 5476 identified articles, 15 satisfied the inclusion criteria with a total sample size of 38 618 patients. Pooled findings showed that individuals with cytomegalovirus infection had a higher risk of tuberculosis disease compared to those not infected with cytomegalovirus (odds ratio [OR], 3.20; 95% confidence interval [CI], 2.18-4.70). Age was the only covariate that exerted a significant effect on the result of the association. Meta-analysis of risk estimates reported in individual studies showed a marked and significant correlation of cytomegalovirus infection with active tuberculosis (adjusted hazard ratio, 2.92; 95% CI, 1.34-4.51; adjusted OR, 1.14; 95% CI, .71-1.57). A clear dose-response relation was inferred between the levels of cytomegalovirus antibodies and the risks of tuberculosis events (OR for high levels of cytomegalovirus antibodies, 4.07; OR for medium levels of cytomegalovirus antibodies, 3.58).

    CONCLUSIONS: The results suggest an elevated risk of tuberculosis disease among individuals with a prior cytomegalovirus infection.

    Matched MeSH terms: Humans
  15. Chu SY, Kassim SNZB, Gan CH, Fierro V, Chan CMH, Hersh D
    J Autism Dev Disord, 2023 Feb;53(2):795-807.
    PMID: 34247302 DOI: 10.1007/s10803-021-05184-5
    Sibling relationships remain understudied in typically developing adolescents who have siblings with autism spectrum disorder (ASD). This study explored the lived experiences and perceptions of adolescents who have a brother or a sister with a diagnosis of ASD using semi-structured interviews. Using thematic analysis, the participants reported having difficulties communicating with their siblings. Feeling a mixture of emotions was common when interacting with their siblings with ASD and emotional self-regulation was a typical coping strategy utilized by these adolescents. Despite the challenges, having a sibling with ASD led to closer relationships between the siblings. These findings offer insights into these adolescents' needs and how they may be best supported, informing the practice of speech-language pathology and other health professions.
    Matched MeSH terms: Humans
  16. Jamil J, Wan Hassan WMN, Ghani AR, Yeap TB
    BMJ Case Rep, 2023 Feb 16;16(2).
    PMID: 36796871 DOI: 10.1136/bcr-2022-250640
    Acromegaly is a progressive systemic disorder which is common among middle-aged women. A functioning growth hormone-secreting pituitary adenoma is the most common cause. Anaesthesia for pituitary surgery in patients with acromegaly is challenging. Rarely, these patients may develop thyroid lesions that may compromise the airway. We present the case of a young man with newly diagnosed acromegaly caused by a pituitary macroadenoma complicated by a large multinodular goitre. The aim of this report is to discuss the perianaesthetic approach in patients with acromegaly with a high risk of airway compromise undergoing pituitary surgery.
    Matched MeSH terms: Humans
  17. Chan YK, Ng KP, Chiu CL
    Int J Obstet Anesth, 2002 Jul;11(3):176-9.
    PMID: 15321544 DOI: 10.1054/ijoa.2002.0954
    Available data for obstetric care in the University Malaya Medical Centre, Kuala Lumpur from 1987 to 1999 were reviewed. Despite incomplete data, we were able to determine fairly well the practice of obstetric anaesthesia and analgesia in the unit, and the changes over the years. There was a decline in the use of general anaesthesia for both elective and emergency caesarean sections from 41.3% and 69.4% respectively in 1995 to 21.6% and 26.9% respectively in 1999. By 1999, regional anaesthesia had become the most common method of anaesthesia administered in both elective (14.3% epidural and 63.5% spinal) and emergency (30.2% epidural and 42.6% spinal) caesarean sections. The percentage of patients delivering vaginally who received epidural analgesia appeared to have stabilised at about 8 to 9% in the last few years, with a gradual decline in the total instrumental delivery rate from a high of about 12% to the pre-epidural rate of 7%.
    Matched MeSH terms: Humans
  18. ELKarazle K, Raman V, Then P, Chua C
    Sensors (Basel), 2023 Jan 20;23(3).
    PMID: 36772263 DOI: 10.3390/s23031225
    Given the increased interest in utilizing artificial intelligence as an assistive tool in the medical sector, colorectal polyp detection and classification using deep learning techniques has been an active area of research in recent years. The motivation for researching this topic is that physicians miss polyps from time to time due to fatigue and lack of experience carrying out the procedure. Unidentified polyps can cause further complications and ultimately lead to colorectal cancer (CRC), one of the leading causes of cancer mortality. Although various techniques have been presented recently, several key issues, such as the lack of enough training data, white light reflection, and blur affect the performance of such methods. This paper presents a survey on recently proposed methods for detecting polyps from colonoscopy. The survey covers benchmark dataset analysis, evaluation metrics, common challenges, standard methods of building polyp detectors and a review of the latest work in the literature. We conclude this paper by providing a precise analysis of the gaps and trends discovered in the reviewed literature for future work.
    Matched MeSH terms: Humans
  19. Wong YY, Chiew AZJ, Eaton V, Ferris FD, Kremzier M, Lim BL, et al.
    JCO Glob Oncol, 2023 Jan;9:e2200351.
    PMID: 36630666 DOI: 10.1200/GO.22.00351
    PURPOSE: Palliative care in Sarawak is mainly provided by health care professionals with limited formal training in palliative care. Therefore, in 2020, collaborative work between Sarawak General Hospital, University Malaysia Sarawak, and ASCO began. This study reports on the outcome of this collaboration.

    METHODS: The collaboration was initiated with the first ASCO Palliative Care e-course, Train the Trainer program, International Development and Education Award-Palliative Care and translation of ASCO Palliative Care Interdisciplinary Curriculum resources.

    RESULTS: This collaboration has resulted in the change of practice of palliative care among the oncology team of Sarawak General Hospital.

    CONCLUSION: It encourages more timely palliative care referrals to ensure that patients with complex physical, psychosocial, and spiritual needs have the necessary input and support from the palliative care team throughout the course of patients' illnesses.

    Matched MeSH terms: Humans
  20. Ismanto A, Hadibarata T, Widada S, Indrayanti E, Ismunarti DH, Safinatunnajah N, et al.
    Bioprocess Biosyst Eng, 2023 Mar;46(3):467-482.
    PMID: 36520279 DOI: 10.1007/s00449-022-02826-5
    Groundwater is defined as water that exists underground in voids or gaps in sediments and is extracted for human consumption from aquifers. It is critical to our daily lives because it contributes to the sustainability of our natural ecosystem while also providing economic benefits. Heavy metals are metallic compounds with a relatively high atomic weight and density compared to water. In Malaysia, heavy metal contamination of groundwater has become a concern due to rapid population growth, economic development, and a lack of environmental awareness. Environmental factors or their behaviors, such as density, viscosity, or volume, affect the distribution and transportation of heavy metals. The article discusses the difficulties created by the presence of heavy metals in groundwater supplies and the resulting health problems. Additionally, remediation methods are discussed for managing contaminated water to preserve the ecological environment for current and future generations, as well as their advantages and disadvantages.
    Matched MeSH terms: Humans
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