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Fulltext An association of myasthenia gravis with Hashimoto's thyroiditis in a patient with a multinodular goitre

Mohamed N, Mohd Zin F, Mohd Yusoff SS

Malays Fam Physician, 2017;12(2):29-31.
PMID: 29423128

Introduction: The association of myasthenia gravis (MG) with other autoimmune diseases including autoimmune thyroid disease (ATD) is well recognised, although rare. The occurrence of both diseases can occur in two ways: either disease preceding the other, or concurrently. The presentation of MG in association with ATD can range from ocular to generalised disease.

Case Summary: A 26-year-old Malay female with persistent hyperthyroidism secondary to Hashimoto's thyroiditis in multinodular goitre was diagnosed with generalised MG after 2 years. She presented with right eye ptosis (ocular) and difficulty in swallowing and chewing (bulbar). The diagnosis of MG was confirmed by fatigability testing, electromyography and the presence of AChR antibodies. Her symptoms showed improvement with pyridostigmine (Mestinon) 60 mg 6-hourly. Her antithyroid drug was tapered down according to her thyroid function test. Throughout a year of follow-ups, her hyperthyroidism and fatigability symptoms improved with treatment. She was later counselled for total thyroidectomy and thymectomy.

Conclusion: Myasthenia gravis and hyperthyroidism may present with similar symptoms such as dysphagia due to neuromuscular weakness or fatigue. When the diseases occur together, one of the diagnoses may be missed. Therefore, the occurrence of new symptoms in a patient with underlying ATD should should trigger the early identification of other autoimmune diseases by primary care doctors.
Benefits of clean development mechanism application on the life cycle assessment perspective: a case study in the palm oil industry

Chuen OC, Yusoff S

J Air Waste Manag Assoc, 2012 Mar;62(3):299-306.
PMID: 22482288

This study performed an assessment on the beneficial of the Clean Development Mechanism (CDM) application on waste treatment system in a local palm oil industry in Malaysia. Life cycle assessment (LCA) was conducted to assess the environmental impacts of the greenhouse gas (GHG) reduction from the CDM application. Calculations on the emission reduction used the methodology based on AM002 (Avoided Wastewater and On-site Energy Use Emissions in the Industrial Sector) Version 4 published by United Nations Framework Convention on Climate Change (UNFCC). The results from the studies showed that the introduction of CDM in the palm oil mill through conversion of the captured biogas from palm oil mill effluent (POME) treatment into power generation were able to reduce approximate 0.12 tonnes CO2 equivalent concentration (tCO2e) emission and 30 kW x hr power generation per 1 tonne of fresh fruit bunch processed. Thus, the application of CDM methodology on palm oil mill wastewater treatment was able to reduce up to 1/4 of the overall environment impact generated in palm oil mill.
Dexamethasone-induced stress exacerbates shedding, tissue antigen distribution, and pathology of caprine Brucellosis

Tanko P, Mohd Yusoff S, Emikpe BO, Onilude OM, Abdullateef A

J Immunoassay Immunochem, 2021 May 04;42(3):265-284.
PMID: 33577382 DOI: 10.1080/15321819.2020.1862862

This study investigated dexamethasone-treatment, shedding routes, tissue antigen distribution, and pathology of caprine Brucellosis. Eighteen non-pregnant goats were randomly grouped into A, B, and C. Group A was administered dexamethasone for 7 days at 2 mg/kg before inoculating 0.5 mL B. melitensis at 107 CFU ocularly while group B was inoculated 0.5 mL B. melitensis only, and C as control negative. Blood samples, ocular, nasal, and vaginal swabs were obtained for evaluation. Three goats were sacrificed from each group at days 21 and 42 post-inoculation (pi) and selected tissues collected for PCR, histopathology, and immunohistochemistry. Brucella melitensis was detected in the ocular swabs of group A significantly higher than group B. Shedding was prolonged in group A compared to B. The overall shedding was 22.2% in group A and 9.4% in group B. The uterus of both groups A and B revealed mild inflammation and microgranuloma, extensive necrotic lesions in lymph nodes. Liver showed multifocal necrosis predominantly in group A. Lesion scoring showed significantly higher scores in A compared to B. Strong immunostaining was observed in the liver, lungs, and spleen, predominantly at day 21 pi. This study demonstrated dexamethasone prolonged shedding, tissue antigen distribution, and pathology in dexamethasone-treated goats.
Effects of resveratrol on shedding and pathological dynamics in experimental B. melitensis infection in dexamethasone-treated nonpregnant Boer goats

Tanko PN, Mohd Yusoff S, Emikpe BO, Bejo SK, Salisi S

J Immunoassay Immunochem, 2019;40(4):419-438.
PMID: 31154897 DOI: 10.1080/15321819.2019.1620766

Brucellosis constitutes an infectious re-emerging zoonosis. Spread of diseases could be exacerbated by stress-induced immunosuppression. This study evaluated relationship between Brucella melitensis infection, shedding dynamics, dexamethasone-induced stress, pathological alterations and resveratrol ameliorative effects in goats. Twelve nonpregnant goats were divided into four groups A, B, C, and D of three animals each. Groups A and B were administered 107 CFU/mL of B. melitensis ocularly, 21 days prior to 7 days consecutive administration of dexamethasone (2 mg/kg). Group A was further administered resveratrol (5 mg/kg) intravenously for 5 consecutive days from day 31 post B. melitensis inoculation. Group C was administered similar dose of B. melitensis while group D was inoculated normal saline. Blood, nasal, ocular, and vaginal swabs were collected at intervals for analysis. The does were sacrificed at day 42 post inoculation (pi). Tissues were collected for tissue bacterial load determination, histopathology, and immunohistochemistry. Dexamethasone administration from day 21 pi increased the frequency in the shedding dynamics, tissue bacterial load, pathological alterations (frequency of microgranuloma and intensity of immunostaining) in group B while 5 days treatment with resveratrol following dexamethasone administration significantly reduced tissue bacterial load, decline in shedding dynamics, and ameliorate damage by dexamethasone administration/B. melitensis infection.
Development and application of dot-enzyme-linked immunosorbent (dot-ELISA) assay for detection of Brucella melitensis and evaluation of the shedding pattern in infected goats

Onilude OM, Mohd Yusoff S, Emikpe BO, Tanko P, Shahrom SM, Effendy M

J Immunoassay Immunochem, 2017;38(1):82-99.
PMID: 27494045 DOI: 10.1080/15321819.2016.1220395

Early and accurate diagnosis of Brucella melitensis is essential for the treatment and control of brucellosis both in animals and humans. The thrust for the development of a rapid diagnostic technique to overcome the limitations of conventional microbiological and serological tests brought about this investigation on the development and application of dot-ELISA for antigen and antibody detection in infected goats. Fifteen apparently healthy Boer aged 2-3 years which tested negative for brucellosis using PCR and ELISA, were grouped into A (10 goats infected intraocularly with 10(7) CFU of B. melitensis) and B (5 goats) as control. Discharges (ocular, nasal, and vaginal) and blood were collected at days 3, 7, 10, 14, weekly until 42 post-infection (pi) for dot-ELISA, PCR, and RBPT. Dot-ELISA detected B. melitensis antigen and antibody in group A at day 3 and 7 pi, respectively with adequate sensitivity and specificity relative to PCR and RBPT. The bacteria shedding detected from discharges at day 3 pi in the nasal and ocular route with dot-ELISA. Group B were consistently negative. Values such as speed, simplicity, field adaptability, high sensitivity, and specificity make dot-ELISA a rapid and adequate technique for diagnosis of brucellosis in B. melitensis infected goats within few hours.
Loneliness as a risk factor for hypertension in later life

Momtaz YA, Hamid TA, Yusoff S, Ibrahim R, Chai ST, Yahaya N, et al.

J Aging Health, 2012 Jun;24(4):696-710.
PMID: 22422758 DOI: 10.1177/0898264311431305

The present study aims to determine the impact of loneliness on hypertension in later life.
Fulltext A minireview of CYP2C9 and CYP2C19 single nucleotide polymorphisms (SNPs) among Malaysian populations

Rosdi R.A., Yusoff S., Mohd Yusoff N., Ismail R., Tan, C.S., Musa N.

Journal of Biomedical and Clinical Sciences, 2017;2(1):47-52.
MyJurnal

It has been recognized extensively that studies of pharmacogenetics provide massive examples of causal relationship between genotypes and drug effectiveness to account for interindividual phenotypic variations in drug therapy. In most cases, cytochrome P450 (CYP) polymorphisms are one of the major variables that affecting those drug plasma concentration, drug detoxification and drug activation in humans. Thus, understanding of CYP polymorphisms can be crucially valuable in order to allow early and more accurate drug dosage prediction and improve the drug response accordingly. Despite the high level of homologous amino acid sequences, CYP2C9 and CYP2C19 genes are among the most important CYP genes which metabolize a wide range of clinically therapeutic drugs. Several critical reviews have been published relating to the aforementioned genes. However, this minireview aims to systematically merge reported studies on the SNPs frequencies of both genes concentrating only on Malaysian population. It is hoped that, the minireview can be an opener for new opportunities to reevaluate the evidence on the prevalence of CYP2C genes as a potential genetic factor influencing a particular drug efficacy and safety among Malaysian. Such evaluation can be developed to the next level of early prediction of better and specific drug treatment, thereby improving the drug response while helping the government in minimising the drug expenditures.
Conformation sensitive gel electrophoresis for the detection of calreticulin mutations in BCR-ABL1-negative myeloproliferative neoplasms

Zakaria NA, Rosle NA, Siti Asmaa MJ, Aziee S, Haiyuni MY, Samat NA, et al.

Int J Lab Hematol, 2021 Dec;43(6):1451-1457.
PMID: 34125992 DOI: 10.1111/ijlh.13628

INTRODUCTION: Calreticulin (CALR) mutations in myeloproliferative neoplasms (MPN) have been reported to be key markers in the molecular diagnosis, particularly in patients lacking JAK2 V617F mutation. In most current reports, CALR mutations were analysed by either allele-specific PCR (AS-PCR), or the more expensive quantitative real-time PCR, pyrosequencing and next-generation sequencing. Hence, we report the use of an alternative method, the conformation sensitive gel electrophoresis (CSGE) for the detection of CALR mutations in BCR-ABL1-negative MPN patients.
METHODS: Forty BCR-ABL1-negative MPN patients' DNA: 19 polycythemia vera (PV), 7 essential thrombocytosis (ET) and 14 primary myelofibrosis (PMF), were screened for CALR mutations by CSGE. PCR primers were designed to amplify sequences spanning between exons 8 and 9 to target the mutation hotspots in CALR. Amplicons displaying abnormal CSGE profiles by electrophoresis were directly sequenced, and results were analysed by BioEdit Sequence Alignment Editor v7.2.6. CSGE results were compared with AS-PCR and confirmed by Sanger sequencing.
RESULTS: CSGE identified 4 types of mutations; 2 PMF patients with either CALR type 1 (c.1099_1150del52) or type 2 (c.1155_1156insTTGTC), 1 ET patient with nucleotide deletion (c.1121delA) and insertion (c.1190insA) and 1 PV patient with p.K368del (c.1102_1104delAAG) and insertion (c.1135insA) inframe mutations. Three patients have an altered KDEL motif at the C-terminal of CALR protein. In comparison, AS-PCR only able to detect two PMF patients with mutations, either type 1 and type 2.
CONCLUSION: CSGE is inexpensive, sensitive and reliable alternative method for the detection of CALR mutations in BCR-ABL1-negative MPN patients.
Fulltext Blood Transfusion Knowledge among Nurses in Malaysia: A University Hospital Experience

Mohd Noor NH, Saad NH, Khan M, Hassan MN, Ramli M, Bahar R, et al.

Int J Environ Res Public Health, 2021 10 25;18(21).
PMID: 34769712 DOI: 10.3390/ijerph182111194

Blood transfusion is a fundamental and life-saving procedure where the consequence of errors can be fatal. Nurses' knowledge plays an essential role in ensuring quality and safety in blood transfusion. The objective of this study was to assess blood transfusion-associated knowledge of tertiary hospital nurses on the east coast of Malaysia. This was a cross-sectional study with 200 registered nurses involved in blood transfusion procedures at Hospital Universiti Sains Malaysia. The knowledge of the nurses was evaluated by using the routine blood transfusion knowledge questionnaire based on five parts, and <50%, 50-74%, or ≥75% of the knowledge was considered as poor, moderate, or high, respectively. Based on the scoring system, the overall knowledge of blood transfusion among Malaysian nurses (33.2 ± 8.4 years) was estimated to be 54.9 ± 7.6%. In individual items, the scoring was 81.0%, 45.4%, 49.2%, 63.0%, and 90.0% in knowledge prior to blood transfusion, on pre-transfusion, on post-transfusion, on complications, and on transfusion policy, respectively. The findings of this study indicated that most of the nurses' overall knowledge of blood transfusion was at a moderate level; therefore, training courses and continuous medical education are warranted to improve knowledge and skills of the nurses to ensure good practices of blood transfusion.
N,N-dimethylhexadecyl carboxymethyl chitosan as a potential carrier agent for rotenone

Kamari A, Aljafree NF, Yusoff SN

Int J Biol Macromol, 2016 Jul;88:263-72.
PMID: 27041651 DOI: 10.1016/j.ijbiomac.2016.03.071

In this study, an amphiphilic chitosan derivative namely N,N-dimethylhexadecyl carboxymethyl chitosan (DCMC) was synthesised and applied for the first time as a carrier agent for rotenone. The physical and chemical properties of DCMC were characterised by using Fourier Transform Infrared Spectrometer (FTIR), Proton Nuclear Magnetic Resonance Spectrometer ((1)H NMR), CHN-O Elemental Analyser, Thermogravimetric Analyser (TGA) and Differential Scanning Calorimeter (DSC). DCMC was soluble in acidic (except pH 4), neutral and basic media with percent of transmittance (%T) values ranged from 67.2 to 99.4%. The critical micelle concentration (CMC) was determined as 0.095mg/mL. Transmission Electron Microscopy (TEM) analysis confirmed that DCMC has formed self-aggregates and exhibited spherical shape with the size of 65.5-137.0nm. The encapsulation efficiency (EE) and loading capacity (LC) of DCMC micelles with different weight ratios (DCMC:rotenone; 5:1, 50:1 and 100:1) were determined by using High Performance Liquid Chromatography (HPLC). The weight ratio of 100:1 gave the best EE with the value of more than 95.0%. DCMC micelles performed an excellent ability to control the release of rotenone, of which 99.0% of rotenone was released within 48h. Overall, DCMC has several key features to be an effective carrier agent for pesticide formulations.
Do depression and educational attainment mediate the association between ethnicity and dementia?

Momtaz YA, Hamid TA, Yusoff S, Ibrahim R

Gerontology, 2013;59(3):206-12.
PMID: 23147388 DOI: 10.1159/000342254

Research shows marked differences in the prevalence of dementia among different ethnic groups. However, there is a relative dearth of studies focusing on how ethnicity may influence dementia. The main aim of the current study is to test potential mediating effects of depression and level of education on the association between ethnicity and dementia.
Fulltext High resolution melting analysis of the NR1I3 genetic variants: Is there an association with neonatal hyperbilirubinemia?

Cheung TP, Van Rostenberghe H, Ismail R, Nawawi NN, Abdullah NA, Ramli N, et al.

Gene, 2015 Dec 1;573(2):198-204.
PMID: 26188155 DOI: 10.1016/j.gene.2015.07.045

Constitutive androstane receptor (CAR) encoded by the nuclear receptor subfamily 1, group I, member 3 (NR1I3) gene regulates the elimination of bilirubin through activating the components of the bilirubin clearance pathway. Hence, NR1I3 genetic variants may affect bilirubin metabolism and result in neonatal hyperbilirubinemia. Thus far, research which investigates the association between NR1I3 variants and neonatal hyperbilirubinemia has not been undertaken in any population. The present study aimed to evaluate the influence of MPJ6_1I3008 (rs10157822), IVS8+116T>G (rs4073054) and 540A>G (rs2307424) on neonatal hyperbilirubinemia development in the Malay population. Buccal swabs were collected from 232 hyperbilirubinemia and 277 control term newborns with gestational age ≥37weeks and birth weight ≥2500g. The NR1I3 variants were genotyped by using high resolution melting (HRM) assays and verified by DNA sequencing. Gender, mode of delivery and birth weight did not differ between hyperbilirubinemia and control groups. The genotypic and allelic frequencies of MPJ6_1I3008, IVS8+116T>G and 540A>G were not significantly different between the groups. However, stratification by gender revealed a significant inverse association between homozygous variant genotype of MPJ6_1I3008 and risk of neonatal hyperbilirubinemia in the females (OR, 0.44; 95% CI, 0.20-0.95; p=0.034). This study demonstrates that the homozygous variant genotype of MPJ6_1I3008 was associated with a significant reduced risk of neonatal hyperbilirubinemia in the females.
Global trends of textile waste research from 2005 to 2020 using bibliometric analysis

Kasavan S, Yusoff S, Guan NC, Zaman NSK, Fakri MFR

Environ Sci Pollut Res Int, 2021 Sep;28(33):44780-44794.
PMID: 34235692 DOI: 10.1007/s11356-021-15303-5

Researchers have broadly studied textile waste, but the research topics development and performance trends in this study area are still unclear. A bibliometric analysis was conducted to explore the global scientific literature to determine state of the art on textile waste over the past 16 years. Data of publications output are identified based on the Web of Science (from 2015 to 2020). This study used VOSviewer to analyse collaboration networks among authors, countries, institutions, and author's keywords in identifying five main clusters. A total of 3296 papers in textile waste research were identified. In this study, a total of 10451 authors were involved in textile waste research, and 36 authors among them published more than ten research publications in the period of this study. China has been in a top position in textile waste research moving from 3 output publications in 2005 to 91 output publications in 2020. Indian Institute of Technology System IIT System was ranked first in terms of the total publication number (85 publications, 2.45%). Textile wastewater and adsorption are the most commonly used keywords that reflect the current main research direction in this field and received more attention in recent years. Based on keyword cluster analysis outputs, textile waste research can be categorized into five types of clusters, namely (1) pollutant compositions, (2) component of textile wastewater, (3) treatment methods for textile wastewater, (4) effect mechanism of textile wastewater, and (5) recyclability of textile waste.
Establishment of suitable separation distance by using different methods for malodor mitigation from palm oil mill

Yaacof N, Qamaruz Zaman N, Yusup Y, Yusoff S

Environ Sci Pollut Res Int, 2019 Aug;26(23):24286-24299.
PMID: 31214886 DOI: 10.1007/s11356-019-05517-z

Malaysia is the second-largest producer and exporter of palm oil amounting to 39% of world palm oil production and 44% of world exports (MPOB, 2014). An enormous amount of palm oil mill effluent is released during palm oil milling, and the effluent causes a major odor problem. Many methods, such as biofiltering, can be adopted to manage the malodor. However, these methods are expensive and require high maintenance. The separation distance method can be used as an alternative due to its low cost and effectiveness. This research was conducted to verify the performance of three different methods, namely, in-field monitoring by using an olfactometer, CALPUFF model, and Gaussian plume model. Given that no research has compared the three methods, this study examined the effectiveness of the methods and determined which among them is suitable for use in Malaysia. The appropriate separation distances were 1.3 km for in-field monitoring, 1.2 km for the CALPUFF model, and 0.5 for the Gaussian plume model. These different values of separation distance were due to the various approaches involved in each method. This research determined an appropriate means to establish a proper separation distance for reducing odor nuisance in areas around palm oil mills.
Optimal implementation of low impact development for urban stormwater quantity and quality control using multi-objective optimization

Rezaei AR, Ismail Z, Niksokhan MH, Dayarian MA, Ramli AH, Yusoff S

Environ Monit Assess, 2021 Mar 31;193(4):241.
PMID: 33791871 DOI: 10.1007/s10661-021-09010-4

Stormwater runoff is a major concern in urban areas which is mostly the result of vast urbanization. To reduce urban stormwater runoff and improve water quality, low impact development (LID) is used in urban areas. Therefore, it is vital to find the optimal combination of LID controls to achieve maximum reduction in both stormwater runoff and pollutants with optimal cost. In this study, a simulation-optimization model was developed by linking the EPA Storm Water Management Model (SWMM) to the Multi-Objective Particle Swarm Optimization (MOPSO) using MATLAB. The coupled model could carry out multi-objective optimization (MOO) and find potential solutions to the optimization objectives using the SWMM simulation model outputs. The SWMM model was developed using data from the BUNUS catchment in Kuala Lumpur, Malaysia. The total suspended solids (TSS) and total nitrogen (TN) were selected as pollutants to be used in the simulation model. Vegetated swale and rain garden were selected as LID controls for the study area. The LID controls were assigned to the model using the catchment characteristics. The target objectives were to minimize peak stormwater runoff, TSS, and TN with the minimum number of LID controls applications. The LID combination scenarios were also tested in SWMM to identify the best LID types and combination to achieve maximum reduction in both peak runoff and pollutants. This study found that the peak runoff, TSS, and TN were reduced by 13%, 38%, and 24%, respectively. The optimal number of LID controls that could be used at the BUNUS catchment area was also found to be 25.
Fulltext Initial evaluation of the training programme for health care professionals on the use of Malaysian clinical practice guidelines for management of dementia

Yusoff S, Koh CT, Mohd Aminuddin MY, Krishnasamy M, Suhaila MZ

East Asian Arch Psychiatry, 2013 Sep;23(3):91-101.
PMID: 24088402

The Malaysian Clinical Practice Guidelines (CPG) for Management of Dementia (second edition) was launched in April 2010 by the Ministry of Health Malaysia. A training programme for the management of dementia, involving all categories of staff working at primary and secondary centres, was implemented to ensure that care delivery for people with dementia was in accordance with the guidelines. The study aimed to look into improving knowledge and understanding of dementia following training, and to evaluate the effectiveness of the training programme using a clinical audit indicator recommended in the guidelines.
Platelet Additive Solutions as an Alternative Storage Medium of Apheresis Platelets to Reduce ABO Antibody Titer for ABO-Incompatibility Platelet Transfusion

Adzahar S, Hassan MN, Zulkafli Z, Mohd Noor NH, Ramli M, Mohamed Yusoff S, et al.

Cureus, 2023 Aug;15(8):e44012.
PMID: 37746385 DOI: 10.7759/cureus.44012

Introduction Platelet additive solutions (PASs) are nutrient media commonly used to replace and reduce the need for storage plasma. They are an alternative medium to maintain high-quality platelets lasting longer on the shelf for about seven days. Platelets with high titer of ABO antibody can pose a hemolytic transfusion reaction (HTR) risk if units are given across the ABO barrier. The risk of complication is greater when group O platelet is released to non-group O patients. The PAS has been known as a safe medium, where the titer of ABO antibodies is expected to be diluted. In this study, we compared the anti-A and anti-B antibody titers of apheresis platelets in PAS and non-PAS (plasma) as the suspending media. Methods A total of 20 apheresis platelet donors were selected, with seven from blood group A, eight from blood group B, and five from blood group O. The platelets were collected using an Amicus cell separator. They were suspended in PAS and plasma before being stored at a temperature range of 22-24º C. Anti-A (blood group B and O) and Anti-B (blood group A and O) antibody titers were measured and compared between the two suspending media. Wilcoxon signed-rank test is used for statistical analysis, and a p-value <0.05 is considered significant. Results The median titer of the anti-A antibody of apheresis platelets showed a significant difference between suspended in PAS (2.50) and plasma (4.00), p=0.002. Similar findings were also seen with the median titer of the anti-B antibody of apheresis platelet, in which it showed a significant difference between suspended in PAS (2.00) and plasma (4.00), p=0.004. It was observed that there was a significant reduction in both anti-A and anti-B antibody titers in the PAS as compared to the plasma group. Conclusion The decrease in ABO antibody titer in apheresis platelets stored with PAS can be beneficial for patients. This reduces the risk of HTRs if ABO-incompatible platelet units need to be issued. Thus, using PAS as a storage medium significantly improves platelet inventory management without compromising patient safety.
Hematological Profile of Hb Adana Among High School Students in Northeast Peninsular Malaysia

Siti Asmaa MJ, Miin Phoon L, Zakaria NA, Hussin S, Bahar R, Hassan MN, et al.

Cureus, 2024 Mar;16(3):e57353.
PMID: 38694420 DOI: 10.7759/cureus.57353

Background Hb Adana is a non-deletional alpha (α)-thalassaemia variant resulting from mutations in α1- or α2-globin codon 59 (αCD59), leading to the production of unstable α-globin. Clinical manifestations can vary from silent carrier status to dependence on blood transfusions, hepatosplenomegaly, skeletal deformities, and spinal cord compression. Despite the significance of Hb Adana inheritance, studying this variant poses challenges due to the scarcity of molecular tests and the potential for routine diagnoses to be overlooked. This study aims to investigate the prevalence of Hb Adana among local high school students and assess the hematological parameters and hemoglobin analysis of Hb Adana in Malaysia. Methodology This retrospective study analyzed 13,721 blood samples collected from high school students participating in Malaysia's National Thalassaemia Screening Program at Hospital Raja Perempuan Zainab II (HRPZ II). Deletional α-thalassaemia was detected using multiplex gap-polymerase chain reaction (PCR), while common non-deletional α-thalassaemia was identified using multiplex amplification refractory mutation system (ARMS) PCR. Data were extracted from the HRPZ II database for analysis. Results Among the participants, 2327 individuals were found to have either common deletional (n=1037, 44.6%) or non-deletional (n=1290, 55.4%) α-thalassaemia. Hb Constant Spring was the most prevalent non-deletional α-thalassaemia, accounting for 53.03% of cases. Thirty-one participants (1.33%) exhibited αCD59α/αα, and one (0.04%) had αCD59α/-α3.7. Among the 32 subjects with Hb Adana, 87.5% were Malay, and 12.5% were Orang Asli. Additionally, seven cases of HbE/Hb Adana co-inheritance were identified. Hemoglobin levels in heterozygous Hb Adana individuals ranged from mild anemia to normal, between 95 g/L and 153 g/L. Mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were approximately 73 fL and 23 pg, respectively. Conclusion This study delineates the distribution of α-thalassaemia mutation patterns among high school students in Kelantan, Northeast Peninsular Malaysia. Our findings indicate that Hb Adana is rare in our region and co-inheritance with an α-gene deletion results in α+-thalassaemia and with HbE, α0-thalassaemia. All heterozygous Hb Adana individuals exhibited low MCVs and MCHs.
Fulltext Increase in tumour-infiltrating lymphocytes with regulatory T cell immunophenotypes and reduced zeta-chain expression in nasopharyngeal carcinoma patients

Yip WK, Abdullah MA, Yusoff SM, Seow HF

Clin Exp Immunol, 2009 Mar;155(3):412-22.
PMID: 19220831 DOI: 10.1111/j.1365-2249.2008.03793.x

The pathological significance of the mechanisms of tumour immune-evasion and/or immunosuppression, such as loss of T cell signalling and increase in regulatory T cells (T(regs)), has not been well established in the nasopharyngeal carcinoma (NPC) microenvironment. To evaluate the T(reg) immunophenotypes in tumour-infiltrating lymphocytes (TILs), we performed a double-enzymatic immunostaining for detection of forkhead box P3 (FoxP3) and other markers including CD4, CD8, and CD25 on 64 NPC and 36 non-malignant nasopharyngeal (NP) paraffin-embedded tissues. Expression of CD3 zeta and CD3 epsilon was also determined. The prevalence of CD4(+)FoxP3(+) cells in CD4(+) T cells and the ratio of FoxP3(+)/CD8(+) were increased significantly in NPC compared with those in NP tissues (P < 0.001 and P = 0.025 respectively). Moreover, the ratio of FoxP3(+)/CD25(+)FoxP3(-) in NPC was significantly lower than that in NP tissues (P = 0.005), suggesting an imbalance favouring activated phenotype of T cells in NPC. A significant negative correlation between the abundance of FoxP3(+) and CD25(+)FoxP3(-) cells (P < 0.001) was also identified. When histological types of NPC were considered, a lower ratio of FoxP3(+)/CD25(+)FoxP3(-) was found in non-keratinizing and undifferentiated carcinomas. Increased CD4(+)FoxP3(+)/CD4(+) proportion and FoxP3(+)/CD8(+) ratio were associated with keratinizing squamous cell carcinoma. A reduced expression of CD3 zeta in TILs was found in 20.6% of the NPC tissues but none of the NP tissues. These data provide evidence for the imbalances of T(reg) and effector T cell phenotypes and down-regulation of signal-transducing molecules in TILs, supporting their role in suppression of immune response and immune evasion of NPC.
Profile of a low vision clinic population

Mohidin N, Yusoff S

Clin Exp Optom, 2002 12 17;81(5):198-202.
PMID: 12482319

BACKGROUND: Causes of low vision and types of low vision devices (LVDs) prescribed in other low vision clinics have been studied extensively. Similar studies have not been conducted in Malaysia. This paper reports the results of a retrospective study of 573 patients seen at the Universiti Kebangsaan Malaysia-Malaysian Association for the Blind (UKM-MAB) low vision clinic in Kuala Lumpur. METHODS: The record cards of 573 patients seen at the UKM-MAB clinic over 10 years were examined and the following information extracted: date of first consultation, age, sex, cause of visual impairment as diagnosed by an ophthalmologist and types of low vision devices (LVDs) prescribed. RESULTS: The majority of patients were from the younger age groups with 423 (73.8 per cent) less than 50 years of age. Three hundred and ninety-five (68.9 per cent) of the subjects were males and 178 (31.1 per cent) female. The main causes of low vision were congenital structural defects including nystagmus among patients in the zero to 29 years age group, retinitis pigmentosa among the 30 to 59 years age group and age-related macular degeneration (ARM) among those over 60 years of age. CONCLUSIONS: Since the majority of the patients were from the younger age group the main causes of low vision were congenital and hereditary diseases. Three hundred and forty-one (59.5 per cent) patients seen at the low vision clinic accepted the use of LVDs.

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