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Genetic Association of Major Depression With Atypical Features and Obesity-Related Immunometabolic Dysregulations

Milaneschi Y, Lamers F, Peyrot WJ, Baune BT, Breen G, Dehghan A, et al.

JAMA Psychiatry, 2017 12 01;74(12):1214-1225.
PMID: 29049554 DOI: 10.1001/jamapsychiatry.2017.3016

Importance: The association between major depressive disorder (MDD) and obesity may stem from shared immunometabolic mechanisms particularly evident in MDD with atypical features, characterized by increased appetite and/or weight (A/W) during an active episode.
Objective: To determine whether subgroups of patients with MDD stratified according to the A/W criterion had a different degree of genetic overlap with obesity-related traits (body mass index [BMI] and levels of C-reactive protein [CRP] and leptin).
Design, Setting, and Patients: This multicenter study assembled genome-wide genotypic and phenotypic measures from 14 data sets of the Psychiatric Genomics Consortium. Data sets were drawn from case-control, cohort, and population-based studies, including 26 628 participants with established psychiatric diagnoses and genome-wide genotype data. Data on BMI were available for 15 237 participants. Data were retrieved and analyzed from September 28, 2015, through May 20, 2017.
Main Outcomes and Measures: Lifetime DSM-IV MDD was diagnosed using structured diagnostic instruments. Patients with MDD were stratified into subgroups according to change in the DSM-IV A/W symptoms as decreased or increased.
Results: Data included 11 837 participants with MDD and 14 791 control individuals, for a total of 26 628 participants (59.1% female and 40.9% male). Among participants with MDD, 5347 (45.2%) were classified in the decreased A/W and 1871 (15.8%) in the increased A/W subgroups. Common genetic variants explained approximately 10% of the heritability in the 2 subgroups. The increased A/W subgroup showed a strong and positive genetic correlation (SE) with BMI (0.53 [0.15]; P = 6.3 × 10-4), whereas the decreased A/W subgroup showed an inverse correlation (-0.28 [0.14]; P = .06). Furthermore, the decreased A/W subgroup had a higher polygenic risk for increased BMI (odds ratio [OR], 1.18; 95% CI, 1.12-1.25; P = 1.6 × 10-10) and levels of CRP (OR, 1.08; 95% CI, 1.02-1.13; P = 7.3 × 10-3) and leptin (OR, 1.09; 95% CI, 1.06-1.12; P = 1.7 × 10-3).
Conclusions and Relevance: The phenotypic associations between atypical depressive symptoms and obesity-related traits may arise from shared pathophysiologic mechanisms in patients with MDD. Development of treatments effectively targeting immunometabolic dysregulations may benefit patients with depression and obesity, both syndromes with important disability.

Matched MeSH terms: Genetic Predisposition to Disease
Fulltext Risk of Escherichia coli O157:H7 infection linked to the consumption of beef

Premarathne J.M.K.J.K., New, C.Y., Ubong, A, Nakaguchi, Y., Nishibuchi, M., Son, R.

Food Research, 2017;1(3):67-76.
MyJurnal

Escherichia coli O157:H7 is a major food-borne pathogen that has resulted in numerous
outbreaks around the world. Widespread distribution of the organism in various ecological
niches impedes the control measures. This study aimed to detect and quantify E. coli O157:H7
in beef sold in wet markets and hypermarkets in Malaysia and to determine the risk of E. coli
O157:H7 infection linked to consumption of beef. The rfbO157 and flicH7 primers targeted on
somatic antigen (O157) and flagellar antigen (H7) respectively of E. coli O157:H7 was used for
the MPN-PCR method. A total of 99 beef samples were collected from local wet markets and
hypermarkets. The highest E. coli O157:H7 contamination rate was observed in beef samples
collected from wet markets (89.50%), whereas the contamination rate in hyper market A and B
were compratively low (35.35 and 20% respectively). However, the microbial load was highest
in the beef samples from hypermarket A (1100 MPN/g) while E. coli O157:H7 bacterial load
in beef samples from hypermarket B and wet market ranged from 3 to 93 MPN/g and 3 to 240
MPN/g, respectively. Using the Quantitative Microbial Risk Assessment (QMRA) approach
the risk was estimated incorporating the findings of the prevalence study and predictions
based on home storage, cooking and consumption patterns. Three different exposure pathways
were investigated to estimate the risk associated with contaminated beef and Monte Carlo
simulation was used to determine the level of uncertainty. The developed model predicated that
consumption of contaminated beef can be accountable for 1.83E+06 E. coli O157:H7 cases per
year in Malaysia. The reliability of the model, data gaps and further research needs, is discussed.
Through continuous improvement Quantitative Microbial Risk Assessment provides valuable
insight into controlling and prevention strategies.

Matched MeSH terms: Disease Outbreaks
Fulltext Collaborative intervention between pharmacists and physicians on elderly patients: a randomized controlled trial

Shim YW, Chua SS, Wong HC, Alwi S

Ther Clin Risk Manag, 2018;14:1115-1125.
PMID: 29942134 DOI: 10.2147/TCRM.S146218

Background: The elderly population is the largest consumer of medications as this age group is at high risk for developing chronic diseases. However, medication use among elderly people is complicated by an increased risk of drug-related problems. Therefore, the present study was conducted to investigate the effects of collaborative interventions between pharmacists and physicians on health-related outcomes of elderly patients.
Patients and methods: This was a randomized controlled trial (RCT) conducted on elderly outpatients who sought treatment in the Medical Outpatient Department of a public tertiary hospital in Malaysia and who were taking at least five medications. The participants were randomly allocated to the intervention and control groups. The intervention group received pharmaceutical care from a pharmacist in collaboration with physicians and was followed-up for 6 months, while the control group received usual care in the outpatient pharmacy.
Results: A total of 73 participants in the intervention group and 79 participants in the control group completed the study. Participants in the intervention group had significantly better medication adherence (median =7.0 vs 5.0, U=1224.5, p<0.001, r=0.503) and better Medication Appropriateness Index (MAI) score (median =8.0 vs 20.0, U=749.5, p<0.001, r=0.639).
Conclusion: Collaborative interventions between pharmacists and physicians improved medication adherence and MAI scores of the elderly patients. Therefore, such services should be implemented in all hospitals, especially in countries where pharmacists are still not playing a substantial role in patient care.
Trial registration: NMRR-12-958-13020.
Study site: Outpatient clinic (MOPD), Duchess of Kent Hospital, Sandakan, Sabah, Malaysia

Matched MeSH terms: Chronic Disease
Fulltext Knowledge, attitude and practices of the risk for chronic kidney disease among patients in a tertiary teaching hospital

Dariah Mohd Yusoff, Junaiti Yusof, Kueh, Yee Cheng

The Malaysian Journal of Nursing, 2016;8(2):3-11.
MyJurnal

Patients with chronic diseases such as diabetes, hypertension and cardiovascular diseases are known as
high-risk groups for developing chronic kidney disease (CKD). Adequate related knowledge among them
helps to increase their awareness towards CKD and adapt healthy attitude and practices for CKD
prevention, which will result in better health outcomes. This study aimed to identify the patients'
knowledge, attitude, and practices (KAP) towards the risks for CKD. This cross-sectional study used a selfadministered
survey questionnaire on 103 adult male and female patients at four general surgical and
medical wards in a teaching hospital using convenient sampling method. The data were computed using
STATA version 12. Data on KAP were obtained through the Chronic Kidney Disease Screening Index
questionnaire. The majority of respondents had poor knowledge (69.9%, n=72), but most of them had good
attitude (68.9%, n=71) and good practices (88.3%, n=91) towards the risk of CKD. Significant associations
were indicated between education level, occupation and monthly family income with knowledge (p-value <
0.05). Significant associations were also indicated between age, sex, marital status and occupation with
their attitude (p-value < 0.05). Meanwhile, marital status was found to be significantly associated with the
practices towards the risk for CKD (p-value=0.008).
Poor knowledge on the risk of getting CKD among hospitalized adults in this study implied the need for
improvement in the public understanding towards the risk for CKD.

Matched MeSH terms: Chronic Disease
Expert opinion on the applicability of dyslipidemia guidelines in Asia and the Middle East

Alshamiri M, Ghanaim MMA, Barter P, Chang KC, Li JJ, Matawaran BJ, et al.

Int J Gen Med, 2018;11:313-322.
PMID: 30050317 DOI: 10.2147/IJGM.S160555

Cardiovascular disease (CVD) is a growing burden across the world. In Asia and the Middle East, in particular, CVD is among the most prevalent and debilitating diseases. Dyslipidemia is an important factor in the development of atherosclerosis and associated cardiovascular events, and so effective management strategies are critical to reducing overall cardiovascular risk. Multiple dyslipidemia guidelines have been developed by international bodies such as the European Society of Cardiology/European Atherosclerosis Society and the American College of Cardiology/American Heart Association, which all have similarities in practice recommendations for the optimal management of dyslipidemia. However, they differ in certain aspects including pharmacological treatment, lifestyle modification and the target levels used for low-density lipoprotein cholesterol. The evidence behind these guidelines is generally based on data from Western populations, and their applicability to people in Asia and the Middle East is largely untested. As a result, practitioners within Asia and the Middle East continue to rely on international evidence despite population differences in lipid phenotypes and CVD risk factors. An expert panel was convened to review the international guidelines commonly used in Asia and the Middle East and determine their applicability to clinical practice in the region, with specific recommendations, or considerations, provided where current guideline recommendations differ from local practice. Herein, we describe the heterogeneous approaches and application of current guidelines used to manage dyslipidemia in Asia and the Middle East. We provide consensus management recommendations to cover different patient scenarios, including primary prevention, elderly, chronic kidney disease, type 2 diabetes, documented CVD, acute coronary syndromes and family history of ischemic heart disease. Moreover, we advocate for countries within the Asian and Middle East regions to continue to develop guidelines that are appropriate for the local population.

Matched MeSH terms: Coronary Artery Disease
Can treatment of Brachiaria decumbens (signal grass) improve its utilisation in the diet in small ruminants?-a review

Chung ELT, Predith M, Nobilly F, Samsudin AA, Jesse FFA, Loh TC

Trop Anim Health Prod, 2018 Jun 20.
PMID: 29926360 DOI: 10.1007/s11250-018-1641-4

Brachiaria decumbens is an extremely productive tropical grass due to its aggressive growth habit and its adaptation to a varied range of soil types and environments. As a result of the vast availability, treated B. decumbens demonstrates as a promising local material that could be utilised as an improved diet for sheep and goats. Despite the fact that the grass significantly increases weight gains in grazing farm animals, there were many reports of general ill-thrift and sporadic outbreaks of photosensitivity in livestock due to the toxic compound of steroidal saponin found in B. decumbens. Ensiling and haymaking were found to be effective in removing toxin and undesirable compounds in the grass. Biological treatments using urea, activated charcoal, polyethylene glycol, and effective microorganisms were found to be useful in anti-nutritional factor deactivation and improving the nutritive values of feedstuffs. Besides, oral administration of phenobarbitone showed some degree of protection in sheep that fed on B. decumbens pasture. In this review, we aim to determine the effect of B. decumbens toxicity and possible treatment methods on the grass to be used as an improved diet for small ruminant.

Matched MeSH terms: Disease Outbreaks
Fulltext Perception of adult patient towards the importance of prevention of coronary artery disease in a private hospital in Malaysia

Leela Chellamuthu, Ho, Siew Eng, Joel Hoashea Munjan, Susanna Emmanuel Vijayan

The Malaysian Journal of Nursing, 2016;8(1):49-55.
MyJurnal

Aim: This study aims to determine the perception of adult patients towards the importance of prevention of coronary artery diseases (CAD) in order to raise awareness on the risk of CAD.
Method: 80 adults between 18-40 years old were enrolled in the out-patient department at a private hospital. The awareness and perception of the importance of preventing CAD were assessed using a questionnaire.
Result: The level of perception on the importance of prevention of CAD was quite good. 75% of the subjects (n = 60) recorded good level of perception meaning they are aware of the importance of prevention of CAD. 22.5% of the subjects (n = 18) recorded a satisfactory level of perception while only 2.5% of the subjects (n = 2) recorded a poor level of perception towards the importance of prevention of CAD. Majority of the subjects had good perception on importance of a balanced diet, exercise and active lifestyle.
Conclusion: In conclusion it can be said that although people are aware of the risk posed by CAD, recommendations such as proper health teachings and guide lines are still required to ensure that the community is able to understand the risk and take preventive measure in order to reduce the risk of obtaining the risk of heart disease.
Study site: Outpatient clinic, private hospital, Malaysia

Matched MeSH terms: Coronary Artery Disease
Fulltext The epidemiological characteristics and molecular phylogeny of the dengue virus in Guangdong, China, 2015

Sun J, Zhang H, Tan Q, Zhou H, Guan D, Zhang X, et al.

Sci Rep, 2018 07 02;8(1):9976.
PMID: 29967414 DOI: 10.1038/s41598-018-28349-2

In 2015, an unexpected multiple outbreak of dengue occurred in Guangdong, China. In total, 1,699 cases were reported, of which 1,627 cases were verified to have DENV infections by nucleic acid or NS1 protein, including 44 DENV-1, 1126 DENV-2, 18 DENV-3 and 6 DENV-4, and the other cases were confirmed by NS1 ELISA. Phylogenetic analyses of DENV-1 isolates identified two genotypes (I and V). The predominant DENV-2 outbreak isolates were the Cosmopolitan genotypes, which likely originated from Malaysia. The DENV-3 isolates were assigned into genotype I and genotype III. All 6 DENV-4 isolates from imported cases were likely originally from Cambodia, Thailand and the Philippines. The entomological surveillance showed a moderate risk for the BI index in Chaozhou and Foshan and a low risk in Guangzhou. The imported cases were mostly detected in Guangzhou and Foshan. Surprisingly, the most serious outbreak occurred in Chaozhou, but not in Guangzhou or Foshan. A combined analyses demonstrated the multiple geographical origins of this outbreak, and highlight the detection of suspected cases after the alerting of imported cases, early implementation of control policies and reinforce the vector surveillance strategies were the key points in the chain of prevention and control of dengue epidemics.

Matched MeSH terms: Disease Outbreaks
Fulltext Benzbromarone Attenuates Oxidative Stress in Angiotensin II- and Salt-Induced Hypertensive Model Rats

Muraya N, Kadowaki D, Miyamura S, Kitamura K, Uchimura K, Narita Y, et al.

Oxid Med Cell Longev, 2018;2018:7635274.
PMID: 29967665 DOI: 10.1155/2018/7635274

Oxidative stress induced by hyperuricemia is closely associated with the renin-angiotensin system, as well as the onset and progression of cardiovascular disease (CVD) and chronic kidney disease (CKD). It is therefore important to reduce oxidative stress to treat hyperuricemia. We previously found that benzbromarone, a uricosuric agent, has a direct free radical scavenging effect in vitro. The antioxidant effects of benzbromarone were evaluated in vivo via oral administration of benzbromarone for 4 weeks to model rats with angiotensin II- and salt-induced hypertension. Benzbromarone did not alter plasma uric acid levels or blood pressure but significantly reduced the levels of advanced oxidation protein products, which are oxidative stress markers. Furthermore, dihydroethidium staining of the kidney revealed a reduction in oxidative stress after benzbromarone administration. These results suggest that benzbromarone has a direct antioxidant effect in vivo and great potential to prevent CVD and CKD.

Matched MeSH terms: Disease Models, Animal
Fulltext Hepatocellular Carcinoma in Malaysia and Its Changing Trend

Raihan R, Azzeri A, H Shabaruddin F, Mohamed R

Euroasian J Hepatogastroenterol, 2018 05 01;8(1):54-56.
PMID: 29963463 DOI: 10.5005/jp-journals-10018-1259

Hepatocellular carcinoma (HCC) is one of the leading causes of death globally. In Malaysia liver cancer is the eighth most common cause of cancer for both gender and fifth most common cause of cancer for males. Liver cancer is a cause of premature death in Malaysia: The trend from 1990 to 2010 was observed upward. Since 1990, the annual years of life lost (YLLs) from liver cancer have increased by 31.5%. Older persons are at higher risk and there is male predominance observed. Curative surgical resection, liver transplantation, and supportive symptomatic care, including percutaneous ethanol injection and radiofrequency ablation (RFA), and noncurative transarterial chemoembolization (TACE) are among available treatment facilities. Yet the survival rate is very poor as majority of patients present at very advanced stage. Hepatitis B virus (HBV) remained the leading cause of HCC in Malaysia. Several studies showed cryptogenic causes, which are mainly nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) among the predominant causes of HCC in Malaysia than hepatitis C virus (HCV), alcohol, or any other reason. This mainly correlates with the increasing incidence of diabetes and obesity in Malaysia. How to cite this article: Raihan R, Azzeri A, Shabaruddin FH, Mohamed R. Hepatocellular Carcinoma in Malaysia and Its Changing Trend. Euroasian J Hepato-Gastroenterol 2018;8(1):54-56.

Matched MeSH terms: Non-alcoholic Fatty Liver Disease
Fulltext Parenting stress in Malaysian parents of children with thalassaemia

Mohamed M, Lau DSC, Loh CK, Syed Zakaria SZ, Alias H, A Jamal AR, et al.

Malaysian Journal of Paediatrics and Child Health, 2017;23(1):1-11.
MyJurnal

Introduction: Parents of children with chronic illness such as thalassaemia, experience parental anxiety as a result of multiple stressors; these parents will consequently undergo the process of coping and adjustment in order to overcome the situation. Identifying families who may require psychosocial intervention is an important step towards providing holistic management for these children.

Methodology: A cross-sectional study was conducted to determine the level of parenting stress amongst parents of children with thalassaemia. Risk factors associated with high parenting stress score were identified. Research instruments used were the Parenting Stress Index/Short Form and Coping Inventory for Stressful Situations.

Results: A total of 54 subjects were recruited. High total parenting stress score (TPSS, defined at 75th centile) for this cohort was 99.5 whereas the mean TPSS was 86.18. Overall, 24% of these parents have high TPSS. Chinese ethnicity, number of children, monthly income, task-oriented and emotion-oriented coping mechanisms were significantly associated with a high TPSS. Logistic regression analysis revealed that low task-oriented but high emotion-oriented scores were risk factors with the greatest predictive power.

Conclusion: Early recognition of parenting stress is important to identify at risk parents so that interventions such as counseling and social support may be given.

Matched MeSH terms: Chronic Disease
Fulltext NMR-based metabolomics Reveals Alterations of Electro-acupuncture Stimulations on Chronic Atrophic Gastritis Rats

Xu J, Zheng X, Cheng KK, Chang X, Shen G, Liu M, et al.

Sci Rep, 2017 03 30;7:45580.
PMID: 28358020 DOI: 10.1038/srep45580

Chronic atrophic gastritis (CAG) is a common gastrointestinal disease which has been considered as precancerous lesions of gastric carcinoma. Previously, electro-acupuncture stimulation has been shown to be effective in ameliorating symptoms of CAG. However the underlying mechanism of this beneficial treatment is yet to be established. In the present study, an integrated histopathological examination along with molecular biological assay, as well as 1H NMR analysis of multiple biological samples (urine, serum, stomach, cortex and medulla) were employed to systematically assess the pathology of CAG and therapeutic effect of electro-acupuncture stimulation at Sibai (ST 2), Liangmen (ST 21), and Zusanli (ST 36) acupoints located in the stomach meridian using a rat model of CAG. The current results showed that CAG caused comprehensive metabolic alterations including the TCA cycle, glycolysis, membrane metabolism and catabolism, gut microbiota-related metabolism. On the other hand, electro-acupuncture treatment was found able to normalize a number of CAG-induced metabolomics changes by alleviating membrane catabolism, restoring function of neurotransmitter in brain and partially reverse the CAG-induced perturbation in gut microbiota metabolism. These findings provided new insights into the biochemistry of CAG and mechanism of the therapeutic effect of electro-acupuncture stimulations.

Matched MeSH terms: Disease Models, Animal
Fulltext Growth and survival of Cronobacter species as measured by media performance

Ghassem, M., Babji, A. S., Forsythe, S. J.

International Food Research Journal, 2011;18(1):367-372.
MyJurnal

Cronobacter sakazakii is an emerging food borne pathogen which has been associated with outbreaks of a rare form of infant meningitis. Although the origin of the microorganism has not been established, several
infection cases have been associated with the consumption of contaminated powdered infant formula (PIF). In the present study, growth characteristics of three C. sakazakii strains isolated from PIF samples and C.
muytjensii strain ATCC 51329, which was formerly the ATCC Preceptrol™ strain for the quality control of
‘Enterobacter sakazakii’ prior to the taxonomic revision, were investigated in Tryptone Soya broth (TSB) and
reconstituted PIF at 4, 10, 25, 37, 45 and 50ºC. The viability of heat treated cells of Cronobacter strains was
evaluated by plating on Violet Red Bile Glucose agar (VRBGA) and the Druggan-Forsythe-Iversen (DFI)
chromogenic agar followed by incubation at 37ºC. These strains were also subjected to higher temperatures
between 52 to 60ºC to measure their thermal tolerance. The mean generation time of all Cronobacter strains
were slightly lower in PIF than in TSB. C. muytjensii ATCC 51329 showed lower generation time in all culture
media and all temperatures compared to the Cronobacter food isolates, but the results were not significantly
different (P>0.05). The results also indicated that combination of PIF: DFI culture media had higher recovery at
all temperatures compared to other combinations. Survival study also indicated that C. muytjensii ATCC 51329
had higher D-value compared to food isolates at all incubation temperatures.

Matched MeSH terms: Disease Outbreaks
Fulltext Antibiotic resistance and plasmid profiling of Vibrio parahaemolyticus isolated from cockles in Padang, Indonesia

Zulkifli, Y., Alitheen, N.B., Raha, A.R., Yeap, S.K., Marlina, Son, R., et al.

International Food Research Journal, 2009;16(1):53-58.
MyJurnal

Vibrio parahaemolyticus is one of the most widely recognized pathogenic Vibrio species due to numerous outbreaks and its’ wide occurrence in marine environment. In this study, 32 isolates of V. parahaemolyticus isolated from cockles were tested for sensitivity to 16 antibiotics and the presence of plasmids. All the isolates were multi-resistance, defined as resistant to atleast three different antibiotics with multiple antibiotic resistance indexes ranging from 0.31 to 0.69, indicating the isolates originate from high risk sources of contamination where antibiotics are often used. In the plasmid profiling test, only 15 isolates (47%) harbored plasmid DNA, which ranged in size from 2.7 to 56.2 kb, separating the isolates into 14 plasmid profiles. Hence, food contaminated with antibiotic resistant V. parahaemolyticus could be a major threat to public health due to the distinct possibility that they can be a significant reservoir of genes encoding antibiotic resistance determinants that can be transferred intra or interspecies. As in many developing countries, raw food hygiene and antimicrobial resistance epidemiology is still in the infancy stage in the locality of the study and thus our data provide a current baseline profile of antimicrobial resistance and plasmid of V. parahaemolyticusfrom cockles in Padang, Indonesia.

Matched MeSH terms: Disease Outbreaks
Fulltext Food security status: It’s association with inflammatory marker and lipid profile among young adult

Nur Atiqah, A., Norazmir, M.N., Khairil Anuar, M.I., Mohd Fahmi, M., Norazlanshah, H.

International Food Research Journal, 2015;22(5):1855-1863.
MyJurnal

Food insecurity, the inability to have sufficient, safe and nutritious food for an active and healthy life, was found to be closely associated with adverse health outcomes. However, limited studies can be found that clearly explains lipid profile and inflammatory events among food secure and insecure individuals, especially among young adults in university, thus creating the need for further research. This study investigated both groups including their gender distribution to determine lipid profile such as total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) and inflammatory marker, high sensitivity C reactive protein (hs-CRP), with waist circumference (WC), fat mass index (FMI) and waist-to-height-ratio (WHTR). A comparative cross-sectional study was carried out among participants aged between 18 to 25 years old (N=124) who were selected through the Adults Food Security Survey Module (AFSSM) and participated in blood draw procedures. Well-established blood markers of lipid profile and inflammatory marker were measured. Percentage of food secure individuals (56.5%) was slightly higher than food insecure (43.5%). Although mean (M) of Hs-CRP for male and female (M=1.000, M=0.645) was higher in food secure group, all other variables showed higher measurements among the food insecure groups. Lipid profiles, TC (M=5.175, M=5.062) and LDL (M=3.100, M=2.914) were high for both male and female respectively, while TG is high for male (M=0.817) (p=0.037) and HDL for female (M=1.826). For body composition such as FMI (M=4.494, M=5.452), WC (M=77.46, M=76.82) and WHtR (M=0.471, M=0.497), male and female respectively, in food insecure group showed higher results but only FMI showed a significant difference (p = 0.016). Statistics showed an association between food security status and lipid profile (TG) and with FMI. However, no significant association was found with inflammatory marker. This study will continue further in depth in gene expression of peroxisome proliferator activated receptor gamma (PPAR-y) and endothelial dysfunction to better understand this issue. Regardless, current data provides knowledge and understanding of food insecurity experienced by young adults in university campus and may help them in making healthier food choices and be appreciative of the risk of chronic illnesses.

Matched MeSH terms: Chronic Disease
Tocotrienol and Its Role in Chronic Diseases

Chin KY, Pang KL, Soelaiman IN

Adv Exp Med Biol, 2016;928:97-130.
PMID: 27671814

Tocotrienol is a member of vitamin E family and is well-known for its antioxidant and anti-inflammatory properties. It is also a suppressor of mevalonate pathway responsible for cholesterol and prenylated protein synthesis. This review aimed to discuss the health beneficial effects of tocotrienol, specifically in preventing or treating hyperlipidaemia, diabetes mellitus, osteoporosis and cancer with respect to these properties. Evidence from in vitro, in vivo and human studies has been examined. It is revealed that tocotrienol shows promising effects in preventing or treating the health conditions previously mentioned in in vivo and in vitro models. In some cases, alpha-tocopherol attenuates the biological activity of tocotrienol. Except for its cholesterol-lowering effects, data on the health-promoting effects of tocotrienol in human are limited. As a conclusion, the encouraging results on the health beneficial effects of tocotrienol should motivate researchers to explore its potential use in human.

Matched MeSH terms: Chronic Disease
Fulltext Personalising care of adults with asthma from Asia: a modified e-Dephi consensus study to inform management tailored to attitude and control profiles

Chisholm A, Price DB, Pinnock H, Lee TT, Roa C, Cho SH, et al.

NPJ Prim Care Respir Med, 2017 Jan 05;27:16089.
PMID: 28055000 DOI: 10.1038/npjpcrm.2016.89

REALISE Asia-an online questionnaire-based study of Asian asthma patients-identified five patient clusters defined in terms of their control status and attitude towards their asthma (categorised as: 'Well-adjusted and at least partly controlled'; 'In denial about symptoms'; 'Tolerating with poor control'; 'Adrift and poorly controlled'; 'Worried with multiple symptoms'). We developed consensus recommendations for tailoring management of these attitudinal-control clusters. An expert panel undertook a three-round electronic Delphi (e-Delphi): Round 1: panellists received descriptions of the attitudinal-control clusters and provided free text recommendations for their assessment and management. Round 2: panellists prioritised Round 1 recommendations and met (or joined a teleconference) to consolidate the recommendations. Round 3: panellists voted and prioritised the remaining recommendations. Consensus was defined as Round 3 recommendations endorsed by >50% of panellists. Highest priority recommendations were those receiving the highest score. The multidisciplinary panellists (9 clinicians, 1 pharmacist and 1 health social scientist; 7 from Asia) identified consensus recommendations for all clusters. Recommended pharmacological (e.g., step-up/down; self-management; simplified regimen) and non-pharmacological approaches (e.g., trigger management, education, social support; inhaler technique) varied substantially according to each cluster's attitude to asthma and associated psychosocial drivers of behaviour. The attitudinal-control clusters defined by REALISE Asia resonated with the international panel. Consensus was reached on appropriate tailored management approaches for all clusters. Summarised and incorporated into a structured management pathway, these recommendations could facilitate personalised care. Generalisability of these patient clusters should be assessed in other socio-economic, cultural and literacy groups and nationalities in Asia.

Matched MeSH terms: Disease Management
Fulltext Tualang Honey Protects the Rat Midbrain and Lung against Repeated Paraquat Exposure

Tang SP, Kuttulebbai Nainamohamed Salam S, Jaafar H, Gan SH, Muzaimi M, Sulaiman SA

Oxid Med Cell Longev, 2017;2017:4605782.
PMID: 28127418 DOI: 10.1155/2017/4605782

Paraquat (PQ) is a dopaminergic neurotoxin and a well-known pneumotoxicant that exerts its toxic effect via oxidative stress-mediated cellular injuries. This study investigated the protective effects of Tualang honey against PQ-induced toxicity in the midbrain and lungs of rats. The rats were orally treated with distilled water (2 mL/kg/day), Tualang honey (1.0 g/kg/day), or ubiquinol (0.2 g/kg/day) throughout the experimental period. Two weeks after the respective treatments, the rats were injected intraperitoneally with saline (1 mL/kg/week) or PQ (10 mg/kg/week) once per week for four consecutive weeks. After four weekly exposures to PQ, the glutathione peroxidase activity and the number of tyrosine-hydroxylase immunopositive neurons in the midbrain were significantly decreased in animals from group PQ (p < 0.05). The lungs of animals from group PQ showed significantly decreased activity of superoxide dismutase and glutathione-S-transferase. Treatment with Tualang honey ameliorated the toxic effects observed in the midbrain and lungs. The beneficial effects of Tualang honey were comparable to those of ubiquinol, which was used as a positive control. These findings suggest that treatment with Tualang honey may protect against PQ-induced toxicity in the rat midbrain and lung.

Matched MeSH terms: Disease Models, Animal
The Potential Role of Melatonin on Memory Function: Lessons from Rodent Studies

Zakaria R, Ahmad AH, Othman Z

Folia Biol. (Praha), 2016;62(5):181-187.
PMID: 27978412

Pineal melatonin biosynthesis is regulated by the circadian clock located in the suprachiasmatic nucleus of the hypothalamus. Melatonin has been found to modulate the learning and memory process in human as well as in animals. Endogenous melatonin modulates the process of newly acquired information into long-term memory, while melatonin treatment has been found to reduce memory deficits in elderly people and in various animal models. However, the mechanisms mediating the enhancing effect of melatonin on memory remain elusive. This review intends to explore the possible mechanisms by looking at previous data on the effects of melatonin treatment on memory performance in rodents.

Matched MeSH terms: Disease Models, Animal
Fulltext Inadequate health literacy on childhood immunization and its predictors among antenatal mothers

Mohamad Yusof NY, Mohd Zulkefli NA, Ismail S, Abd Rashid MF

Malaysian Journal of Medicine and Health Sciences, 2017;13(3):51-59.
MyJurnal

Introduction: Outbreak of vaccine preventable disease still persists despite good coverage of immunization in Malaysia. Health literacy on childhood immunization is one of essential factor for the outbreak to happen. Thus, this study determined the predictors of health literacy on childhood immunization among antenatal mother in Seremban, Negeri Sembilan.
Methodology: A cross sectional study was conducted among 424 antenatal women using a cluster sampling approach. Antenatal women who were Malaysian and not illiterate were chosen in this study. A selfadministered, validated and pretested questionnaire was used to collect data on sociodemographic, socio economic, awareness on immunization, utilization of health care services and health literacy on childhood immunization. The data was analyzed using SPSS version 22.0. Chi Square test was used in bivariate analysis and multiple logistic regression was used to determine the predictors of inadequate health literacy on childhood immunization.
Result: Out of 362 respondents, 81.2% were inadequate health literacy. The predictors were maternal education (AOR= 2.608, 95% CI 1.477-4.604), parity (AOR= 1.067, 95% CI 1.103-3.876), residential area (AOR= 2.344, 95% CI 1.184-4.641) and utilization of government hospital (AOR= 2.344, 95% CI 1.184-4.641).
Conclusion: Accessibility of health education with regard to immunization need to be strengthen among primigravida, low education and those staying in rural area. In addition, health education also needs to emphasize on the individual that is employed and low economic status with underutilization of government hospital. A simplified education material with interesting pictures and using visual aids help illiterate people for better understanding.
Study site: Klinik Kesihatan, Seremban district, Negeri Sembilan, Malaysia

Matched MeSH terms: Disease Outbreaks

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