Thisstudy aim tocharacterize melt-derivedbioactive glass and to determinethe bioactive glass (BG) suitability for dental usagethrough proliferative activity assessment of stem cells from human exfoliated deciduous teeth (SHED)when exposed to bioactive glass conditioned medium. Bioglass 45S5 in mole percentages (46.13% SiO2, 26.91% CaO, 24.35% Na2O and 2.60% P2O5)was synthesizedthrough melt-derived and characterized usingX-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR)to confirm and identify its properties.SHEDwere used to evaluate the biocompatibility of 45S5 by exposing the cells to various concentration of BG-conditioned medium (1-10 mg/ml) using alamarBlue assay. The BG produced has an amorphous structureas shown by XRD analysis. TheSi-O-Si bending, asymmetric Si-O stretching and asymmetricSi-O-Si stretchingbands were observed in the BG structure supporting the presenceof silicate network. For alamarBlue assay, SHED cultured in BG-conditioned medium showed high proliferation rate when subjected to minimal powder content in the DMEM cell culture medium.Hence, it can be concluded that SHED cultured in lower powder content of the BG-conditioned media showedhigh proliferative activity suggesting the potential of the BG for dental usage.
Total immunoglobulin E (IgE) has been an indicator for early diagnosis of allergic diseases due the important role of IgE in the sensitization towards allergens. Although total IgE is a common diagnostic test that screens for possible allergic diseases, reports are still lacking on the profile of total IgE levels of allergic patients from the north-east region of Peninsular Malaysia. Hence, this study aimed to investigate the association of total IgE levels with clinico-demographic parameters and whether increasing total IgE levels were associated with certain allergic manifestations in this study cohort. A local cohort of allergic patients (n=71) diagnosed in between 2009 and 2016 in Hospital Universiti Sains Malaysia (HUSM) were evaluated for the relevance of total IgE levels in allergy diagnosis. Our study did not demonstrate significant association between total IgE with age (p=0.75) or gender (p=0.65). However, we showed that elevated total IgE levels were associated with disease severity. Our data suggests that increasing total IgE levels beyond the conventional cutoff used to define abnormal IgE levels were more commonly associated with patients presenting allergic asthma and skin allergy manifestations. Total IgE level is a useful indicator for diagnosis of allergic diseases. Although total IgE level might not be sufficient to confirm the sensitization status of an individual, it may reflect the severity of the allergic disease suffered and it has a high correlation with positive sIgE values.
Neurofibromatosis (NF) is a genetic neurological disorder which can lead to abnormal tumour suppression. Neurofibromatosis associated neurological tumour is usually benign in nature, only occasionally can become malignant. Gastrointestinal involvement is reported to be infrequent with only up to 25% of patients with neurofibromatosis showing involvement. Solitary gastrointestinal neurofibroma is very rare, with most cases involving the stomach or small bowel. We report here a case of solitary small intestinal neurofibroma with no other associated systemic signs, causing intussusception and intestinal obstruction.
The molecular biology knowledge in β-thalassaemia is limited due to the involvement of various erythropoeitic processes where the genetic information is lack due to nucleus ejection throughout the maturation of red blood cell activities concurrence with the accumulation of haemoglobin. Nucleated red blood cells (NRBCs) are typically found in peripheral blood (PB) of β-thalassaemia transfusion dependent patients and abundant in post splenectomy (Fig. 1A) [1]. The presence of NRBCs will provide further understanding on the molecular aspect of ineffective erythropoiesis in β-thalassaemia patients. Therefore, the objectives of this study were to isolate the NRBCs using CD71 magnetic beads from PB of β-thalassaemia patients and to compare the quantity of NRBCs enriched between non-splenectomised transfusion dependent and post-splenectomised transfusion dependent β-thalassaemia patients.
The large clinical spectrum of Haemoglobin E (HbE)/β-thalassaemia leads to identification of modifiers that cause the complexity1. IGSF4, a member of the immunoglobulin superfamily 4 is known as a thalassaemia-related gene that plays an important role in globin synthesis. Methylation of IGSF4 was reported to interrupt the process of globin synthesis through its interaction with other genes in the regulation network of globin expression2. Specific cells isolation is needed in order to study the methylation profile as the interaction between various haematopoietic cells including nucleated red blood cells (NRBCs) in whole blood could impact the methylation results3. Therefore, the objective of this study was to describe the pattern of DNA methylation at the promoter region of IGSF4 gene that may involve in the alteration of globin synthesis in HbE/β-thalassaemia patients.
Azacytidine (5-Aza) is a chemotherapeutic drug that has been known to restore the expression of Tumour suppressor genes by de-methylation and shown clinical efficacy inMyelodysplastic syndrome (MDS) [1-3]. Currently, 5-Aza is being used in UK for the treatment of some adults with MDS, chronic myelocytic leukemia (CML) and acute myelocytic leukemia (AML) [4]. Majority of CML patients treated with imatinib, a BCR/ABL inhibitor would develop resistance under prolonged therapy. Signal transducer and activator of transcription 3 (STAT3) is an oncogenic transcription factor that is constitutively activated in various human cancers including hematological malignancies. Activation of STAT3 represents an important mechanism of imatinib resistant [5]. Methylation of SHP-1is involved in the constitutive activation of STAT3 [6], and a low level of SHP-1is not sufficient to inhibit activated STAT3 [7]. Epigenetic silencing of SHP-1also plays a role in the development of resistance to imatinib in BCR/ABL positive CML cells.
Haemolytic Disease of Foetus and Newborn (HDFN) and Haemolytic Transfusion Reaction (HTR) may occur due to antibodies against Kidd antigen. In Malaysia, the prevalence of RBC alloimmunization due to Kidd antibody for cases of HDFN and HTR have been reported [1-2] however there is insufficient data in Hospital Umum Sarawak (HUS).The aim of this study is to determine whether Kidd alloimmunization causes HDFN and HTR. Indirectly categorize Kidd phenotype blood in regular blood donors.
HRQOL is referring to patients' perceptions that is related to physical and mental of thalessemia patients. HRQOL measurement is crucial in assessing the extent of impact that this chronic disease has affected the thalassaemia patients’ lives. HRQOL measurement also includes identifying the effects of the treatment and disease towards wellbeing of the patients. Quality of Life (QOL) of individuals with thalassaemia major are affected by many influence factors such as the effect of diagnosis and treatment, chronic conditions state, appearances, treatment’s components such as frequent hospital visits for the transfusion, nightly mixture of subcutaneous, late arrival or absence, sexual development and complications from the disease[1-2].
The study aims to assess the Health Related Quality of Life (HRQoL) among thalassaemia patients and identify the significant factors that contribute to HRQoL in thalassaemia patients in Malaysia. A cross sectional based study was conducted at Kedah Thalassaemia Society Club in Kedah, Malaysia. The HRQoL was measured using a Short form survey version 2 (SF-36). Descriptive study was used to describe the demographic and disease related to the thalassaemia patients. The HRQoL was compared using the Mann-Whitney and Kruskal-Wallis test. The analyses were performed using the Quality Metric Health Outcomes Scoring software for SF-36 and SPSS v 22. Three hundred and ninety thalassaemia patients were enrolled in the study. The majority of the participants (n = 221, 58.5%) were categorized in the age group of 18-27 years (25.40 ± 10.2). The HRQoL measure of less than 50 for the physical component summary (PCS) and mental component summary (MCS) among thalassaemia patients were rated as poor. Patients with higher education levels were significantly associated with PCS (p=0.002) and showed higher mean scores for PCS (52.0) compared to the others. Age, marital status, employment status, monthly income, health check-ups before screening of thalassaemia and medical insurance was associated with PCS levels compare to the others. The type of thalassaemia, the medical treatment received and the side effects of the conventional treatment were significantly associated with p-values of less than 0.001 and PCS and MCS scores of below 50.
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.
Lung cancer is the second most common contributor to overall cancer–associated death in Malaysia after breast cancer. Many cases of late diagnosis are due to patient’s failure in recognizing the signs and symptoms of this disease. Objective: The aim of this research was to evaluate the knowledge on lung cancer and perception on its screening among IIUM Kuantan students. Method: This was a cross-sectional study whereby convenient sampling was used as the sampling method strategy. A total of 186 students participated, whereby majority was female students, single, and aged between 21 to 29 years old. Knowledge and perception scores were analyzed using descriptive statistics by denoting it in terms of frequency and percentages. Independent t-test, as well as one-way ANOVA, Mann-Whitney and Pearson correlation tests was used to find the association of gender, faculty, marital status, age and year of study (respectively) with knowledge and perception of students. Association between knowledge of lung cancer with perception of its screening was also evaluated using Pearson correlation test. Results: Most of IIUM Kuantan students portrayed good level of knowledge and perception. Socio-demographic factors that were significantly associated with students’ knowledge were age (p=0.001), year of study (p=
Clinacanthus nutans or locally known as Belalai Gajah in Malaysia has been used in China in various manners to treat inflammatory conditions like hematoma, contusion, strains and rheumatism. Recently, C. nutans has become popular for the treatment of cancer among Malaysian. Thus, the aim of this present study is to prove the anti cancer activity of C. nutans extracts in a treatment of cervical cancer as claimed by local people. Aqueous and methanol extracts were extracted from the leaves of C. nutans and phytochemical screening was performed for determination of secondary metabolites. The cytotoxic activities of both aqueous and methanol extracts were investigated against HeLa cell by using MTT assay. The mode of cell death was examined by Hoechst 33258 nuclear staining. The secondary metabolite constituents detected in C. nutans aqueous extract are terpenoids and flavonoids, whereas methanol extract contains terpernoids, alkaloids and flavonoids. Results also showed that C. nutans aqueous extract exerted a significant cytotoxic effect on HeLa cells (IC50=13±0.82 μg/ml) but no IC50 was detected by methanol extract. No significant cytotoxic activities (IC50 = not detected) were observed in normal kidney cell line, Vero, treated with both aqueous and methanol extracts of C. nutans which showed the cytoselective property of the extracts. However, HeLa and Vero cells treated with control drug, tamoxifen showed a significant cytotoxicity effects with IC50 values of 3.8±0.19 μg/ml and 2.2±0.029 μg/ml respectively. Hoechst 33258 stained showed the aqueous extract of C. nutans induced cell death on HeLa cells via apoptosis. Thus, suggesting C. nutans aqueous extract as a potential promising alternate therapeutic substance for cancer prevention and treatment especially for cervical cancer treatment.
Medicinal plants have healing properties and are able to synthesize various chemical compounds. These chemicals (also known as phytochemical compounds) play vital roles in determining the pharmacological properties existing in certain plants. The phytochemical compounds present in plants are associated with primary and secondary constituents. Most of the time, the secondary constituents exhibit the bioactivities in plants such as antimicrobial, antioxidant, antidiabetic, antibacterial and anti-inflammatory properties. Some common medicinal plants that have been used in curing various diseases by traditional practitioners in Malaysia are Ficus deltoidea Jack, Andrographis paniculata, Curcuma longa, Clinacanthus nutans and Eurycoma longifolia Jack. This review discusses the morphology, phytochemical compounds and phytochemical properties of selected medicinal plants in Malaysia. The plants of focus have been found to possess anti-cancer and anti-diabetic effects. This review, it is hoped will enable Malaysian researchers to explore further on the potential of these plants in investigating new and novel drugs in the future.
Globally, α-thalassaemia is a highly prevalent disease. In Malaysia, this disorder is a well-known public health problem [1]. The three most common deletional α-thalassaemia found in this region include --SEA deletion, -α3.7 and -α4.2 deletions [2]. The prevalence rate of triplication alpha cases such as αααanti3.7 and αααanti4.2 is unknown in Malaysia although it plays a pivotal role in exacerbating the clinical phenotypes in beta thalassaemia carriers [3]. Therefore, the purpose of this study was to design an assay for the detection of triplications and common deletional alpha thalassaemia using droplet digital PCR (ddPCR). Copy number changes were analysed using Quanta-SoftTM software version 1.6.6 after performing ddPCR. Sensitivity and validation analysis were also performed on the DNA samples. The changes in copy number changes (common deletions, duplications and triplications) in the alpha globin gene has been quantitatively detected using ddPCR. For the samples validation as determined by ddPCR, the mean copy number values for αα/αα are 2.0275±0.0177 (HS-40), 1.8175±0.0389 (HBA2), 2.0450±0.0848 (HB 3.7), 2.0050±0.0000 (HBA1). For -α3.7 /--SEA, the mean copy number values are 2.0225±0.2180 (HS-40), 0.9325±0.1213 (HBA2), 0 (HB 3.7), 0.9984±0.1333 (HBA1). As for –α4.2 /--SEA, the mean copy number values are 1.9350 (HS-40), 0 (HBA2), 0.7945 (HB 3.7), 0.8480 (HBA1). The mean copy number values for --SEA/αα samples are 1.9067±0.1327 (HS-40), 0.8164±0.0364 (HBA2), 0.8920±0.0434 (HB 3.7), 0.9148±0.0338 (HBA1) respectively. This study has found that the use of ddPCR is convenient as it allows direct quantification without the requirement of a calibration curve unlike qPCR [4]. Secondly, this study also showed that ddPCR is accurate and precise in the detection of alpha thalassaemia deletions and triplications based on the gene dosages using absolute quantification. In addition, the non-requirement of post-PCR work has minimised the risk of PCR carryover contamination. Thirdly, ddPCR saves time with less turnaround time and minimise the labour work required as compared to techniques such as MLPA which requires DNA denaturation and hybridisation reaction on day 1 while ligation and PCR reaction on day 2. Fourthly, this study found that the detection of α-thalassaemia using ddPCR is sensitive. DNA samples with low concentration as low as 1 ng were able to be detected for α-thalassaemia using ddPCR. The ability to detect minute amount of DNA concentration is crucial particularly in the diagnosing of the lethal HbH hydrops foetalis during the neonatal stage in α-thalassaemia. In conclusion, this is an alternative method (ddPCR) that can be employed for rapid detection of alpha thalassaemia variants in Malaysia.
Conventional anticoagulant therapy is the mainstay of medical treatment for deep vein thrombosis disorders. However,there are many complications associated with these agents such as bleeding. Hence, the search for novel anticoagulant derived from natural substances such as plants origin is in high demand nowadays. Ocimum sanctum(O.sanctum) also known as Ocimum tenuiform (OT), tulsi or holy basil from the family of Lamiaceae has been widely used for thousands of years in Ayurveda and Unani systems to cure or prevent a number of illnessessuch as headache, malaria, ulcers, bronchitis, cough, flu, sore throat and asthma. The objective is to investigate theeffect ofO. sanctum(Tulsi) aqueous leaf extract on prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) in human plasma. Coagulation activity of O. sanctum was measured via PT, APTT and TT assay in citrated plasma collected from thirty-six healthy regular blood donors. The plasma was tested against different concentrations of O. sanctum aqueous extract as follows: 0.1mg/ml, 0.5 mg/ml and 1.0 mg/ml. Result shows the aqueous extract of O. sanctum prolonged the PT and APTT assays (p0.05). The gas chromatography-mass spectrometry (GC-MS) analysis had identified the linolenic acid at 1-10% of ethanol and aqueousconcentration at different retention time which was responsible for the coagulation activities of O. sanctumin human plasma. This study suggests that O. sanctum does affect coagulation activity in human plasma and can be potentially used as naturally derived anticoagulant products in the future.
Trisomy 8 is a condition where every cell of an individual presents with an extra copy (three copies of chromosome 8. This disorder occurs when a pair of chromosomes fails to divide evenly, which results in cells containing more than two of this chromosome. Here, we report a case of mosaic trisomy 8 in a Malaysian Malay boy.Although patient in this case confirmed with T8M, he exhibited few of the characteristic features that previously were reported to be associated with T8M. However, the patient’s very young age might explain the lack of clinical presentation of these features.
Hospital-acquired infections (HAIs) are responsible for over 40% of cases in acute-care hospitals and commonly associated with catheter-sassociated urinary tract infections (CAUTIs). Current nanotechnology approach focus on improving the aseptic procedures for medical devices and manage the HAIs risk. TiO2 and ZnO nanoparticles (NPs) have been widely reported independently, to have a photocatalytic killing potential. The present study evaluates the antibacterial activity of heterojunction between TiO2 and ZnO NPs on several types bacterial pathogens model including Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. The antibacterial screening test on TiO2/ZnO nanoparticles (NPs) were done under dark and light conditions with different molar ratio 25T75Z, 50T50Z and 75T25Z according to Clinical Laboratory Standards Institute (CLSI) guidelines MO2-A11. ZnO and TiO2/ZnO (25T75Z and 50T50Z) NPs at the highest concentration (1000µg/µL) showed mean diameters of the zones of inhibition (mm); (12.5 ± 0.58), (12.13 ± 0.85), and (7.25 ± 1.44) in dark condition. Increment in inhibition zones was obtained under light condition; (21.38 ± 0.48), (17.50 ± 1.0), and (12.38 ± 1.80). Findings from this study highlights the heterogeneous TiO2 and ZnO NPs could become a promising bacteriostatic and/or bactericidal agent to combat against the HAIs.
The National Blood Center, Kuala Lumpur interprets laboratory results for the von Willebrand factor (vWF) profile based on guidelines provided by the U.S. National Heart, Lung, and Blood Institute, which were established based on the Caucasian population [1-2]. The vWF profiles among the Malay population has not yet been established.
The goals of this study were to determine the vWF profiles of the different ABO blood types among Malays and to evaluate their association with demographic characteristics and smoking habits.
One hundred and forty Malay donors participated in this study. Factor VIII (FVIII), vWF antigen, and ristocetin cofactor (RiCof) levels and collagen binding activity (CBA) were measured by coagulometric clot detection, latex agglutination, and enzyme-linked immunosorbent assay.
Screening for Tuberculosis (TB) using Chest X-Rays (CXR) among high-risk individuals is essential to help reach the End TB Strategy goal in reduction of 90% in TB incidence by 2035. Even though Ministry of Health Malaysia has made screening compulsory, the number of cases detected is not encouraging. Therefore, it is essential to identify factors contributing to positive screening that would improve case detection. High-risk groups are individuals that are compulsory to be screened using chest x-ray, regardless of presence or absence of TB symptoms. A cross sectional study was done in 2016 involving individuals belonging to TB high-risk groups who underwent screening in Kedah, Malaysia. Data was obtained from the TB information system (TBIS) 104 A, an information system used for TB screening monitoring and chest x-ray report of the selected individuals. It involved 1417 individuals who were randomly selected from various health facilities in six districts of Kedah. Among all 1417 study samples, 1036 (73.1%) individuals were asymptomatic. Among the asymptomatic individuals, only 91 (8.8%) had positive CXR findings. Smokers were found to have almost 3 times the odds of having positive CXR findings compared to non-smokers [Adjusted OR (95% CI): 2.71 (1.03, 7.15), p-value
Alpha thalassemia is a common genetic disorder with more than 20% of the world population to be a carrier of some form of α–thalassemia, as estimated by The World Health Organization [1]. It has heterogeneity in its presentation and inheritance and characterised according to their deficient or absent in alpha globin chain involved [2]. The affected individuals may be asymptomatic with hypochromic microcytic anemia or in silent alpha thalassemia may have no clinical signs with normal to mild haematological changes [3]. Current voluntary thalassemia screening programme in Malaysia is mainly based on MCH level of less than 27 before molecular study for alpha thalassemia is done if Hb analysis showed normal results, to exclude alpha thalassemia. Accurate characterization of hematologic parameters is important for selection of appropriate molecular test to determine the carrier genotype, as the test is expensive, time-consuming and not always available. This study was aimed to evaluate the correlation of hematological parameters (Hb, RBC, MCV, MCH, RDW and platelet) with various types of deletional alpha-thalassemia among patients in HUSM.
Hb Malay was first described in 1989 following an investigation of anaemia in a 22-year-old Malay gentleman who was homozygous for this chain variant. This Hb variant is caused by AAC AGC mutation at codon 19 of the globin gene resulting in the substitution of serine for asparagine [1]. The mutation creates cryptic RNA splice site in exon 1 of the -globin gene leading to an abnormal RNA processing. Thus, this mutation not only produces variant haemoglobin but also a mild + thalassemia phenotype [2].