Androgen ablation therapy using gonadotropin-releasing hormone agonists is reported to be associated with metabolic abnormalities. Annatto tocotrienol (AnTT) is reported to reduce the expression of genes related to adipogenesis but the mechanism remains elusive. This study sought to determine the effects of annatto tocotrienol on body composition (lean and fat mass), serum adiponectin, leptin, and glucose levels in male rats treated with buserelin, a testosterone ablation agent. Three-month-old male Sprague Dawley rats (n=32) were randomly divided into four groups. The normal control (n=8) was given corn oil orally daily and normal saline subcutaneously daily. The remaining groups were injected with buserelin subcutaneously (75μg/kg/day). The buserelin group (n=8) was given corn oil orally, while the treatment groups were supplemented orally with AnTT at 60 or 100 mg/ kg (n = 8/group). After treatment of 12 weeks, rats were euthanized. Dual-energy x-ray absorptiometry was performed to determine the lean and fat mass of the rats. Blood was collected for the evaluation of adiponectin, leptin and glucose levels. After 12 weeks, the lean mass, fat mass, adiponectin and leptin levels for all groups increased significantly compared to their respective baseline levels irrespective of their treatment (P
Pain is an unpleasant sensation that can cause physical and psychological problems for the patient. Despite the pharmacological intervention for reducing pain, it remains as an issue after surgery. Music therapy as non-pharmacological intervention can effect post-operative pain and patients’ requirement of analgesics. The purpose of this study was to determine effect of music therapy on pain after elective total knee replacement (TKR) surgery. This study compared analgesics consumption by patients post-operatively for five days. A Quasi-experimental design with convenience sample of patient with a mean of 64.35 (49-76) who underwent TKR in UKM Medical Centre from May to December 2012 was used. Forty patients were randomly assigned in one of the two groups using a sealed-envelope technique. The experimental group listened to music for five days post-operatively and were on analgesics and control group were treated with pharmacological intervention only. Pain was measured by McGill Pain Questionnaire-Short Form (MPQ-SF) for patient on bed rest on day one, day three and day five post-operatively. Statistical (Mann- Whitney) findings between groups showed the experimental group significantly had less pain on day one and day five rather than the control group at 0.05 level using Pain Rating Intensity (PRI), Visual Analogue Scale (VAS) and Present Pain Intensity (PPI). Statistical (Friedman) tests within group showed that the patient had significantly decreased pain over time at level 0.05 using PRI, VAS and PPI. Statistical (Mann- Whitney) tests revealed that there was no significant difference when using analgesics between the two groups in five days post-operatively at milligram but comparing median showed experimental group used less analgesic than control group. Music therapy is simple, available, save and cheap effective intervention for pain management post-operatively. Pain management is one of the key roles of nursing and nurses can use music therapy as a simple intervention to reduce pain.
Penuaan ovari telah dikaitkan dengan tekanan oksidatif dan kehilangan fungsi ovari. Tokotrienol telah dibuktikan dapat memberi kesan yang baik terhadap sistem pembiakan wanita. Walau bagaimanapun, peranan tokotrienol ke atas metabolisma ovari dan seterusnya peningkatan kualiti oosit dalam mencit tua masih tidak diketahui. Oleh itu, hubungan antara perubahan aktiviti metabolik dalam ovari dan kualiti oosit dalam mencit tua selepas suplementasi fraksi kaya tokotrienol (TRF) telah dikaji. Mencit betina berusia enam minggu digunakan sebagai kumpulan Muda. Mencit betina berusia enam bulan dibahagikan kepada empat kumpulan iaitu kumpulan pertama yang diberikan minyak jagung-bebas tokoferol (kawalan) manakala tiga kumpulan yang lain diberi suplimen TRF pada dos 90, 120, dan 150 mg/kg. Rawatan diberikan secara oral selama dua bulan. Pada akhir rawatan, mencit dari semua kumpulan disuperovulasi dan kemudian dikorbankan. Kualiti oosit dinilai dan analisis metabolomik secara tidak disasarkan, pada tisu ovari dijalankan dengan menggunakan 'liquid chromatography tandem mass spectrometry of quadrupole time-of-flight' (LC-MS Q-TOF). Peratusan oosit normal adalah lebih tinggi (p
Piper betle (PB) leaves have been traditionally used in many Asian countries for the healing of wounds and other ailments. The aim of this study was to examine the wound healing effect of PB on skin injury-inflicted Sprague-Dawley rats. Eighteen male Sprague-Dawley rats were inflicted with wounds and then divided into three groups consisting of a control (normal wound healing without dressing), saline (wound healing aided by gauze soaked in saline) and PB (gauze impregnated with PB paste) dressings. Wounds were created on the back of rats with 6-mm sterilized punch biopsy needle. Wounds were examined on days 3, 5, 7, 9, 11 and 13 for dryness, exudation, and scar formation. Rats were sacrificed on day 14 and the granulation tissue formed on the wound was then excised for histological examination using Hematoxylin and Eosin staining. The formation of granulation tissue in rats treated with PB showed higher progress to wound closure with shorter days (on day 3) compared to the control and saline group (on day 5). PB dressing minimized the formation of scar tissue significantly (p
Pulse wave velocity (PWV), augmentation index (AI) and finger photoplethysmography fitness index (PPGF) are non-invasive markers of vascular function and may predict future cardiovascular disease (CVD) risk. In women, the changes from both oestrogen and progesterone levels during menstrual cycle may give significant impact on vascular function. Thus, this study was designed to investigate the variation of vascular function during follicular and luteal phase in healthy young women. Twenty-two healthy young women with regular menstrual cycle were recruited. Blood pressure (BP), body mass index (BMI), PWV, AI, PPGF, estradiol (Es) and progesterone (Prog) level were measured during follicular (F) and mid-luteal (L) phase. Data was analyzed via SPSS version 20 and P value < 0.05 was considered to be significant. The mean age of the subjects was 22.73 ± 0.60 years. There was significant variations of estradiol and progesterone levels during menstrual cycle whereby the level of estradiol (EsF = 107.6 ± 52.56 pmol/L vs. EsL = 555.16 ± 152.79 pmol/L, P
Two new vascular health markers which are derived from finger
photoplethysmography (PPG) waveform have been introduced based on Malaysian
population, namely PPG fitness index (PPGF) and vascular risk prediction index
(VRPI). The objectives of this study were to investigate the associations between
PPGF and other cardiovascular disease (CVD) markers such as carotid femoral pulse
wave velocity (PWVCF), to compare PPGF between those with and without CVD risk
factors and to determine the sensitivity of VRPI in identifying young subjects with
CVD risk factors. A total of 114 men age 20 to 40 yrs with and without CVD risk
factors were recruited. Risk factors included hypertension, smoking, dyslipidemia,
abdominal obesity and family history of premature CVD. Subjects were divided
into healthy, those with one risk factor and those with at least two risk factors. Their
weight, height, peripheral and central blood pressure (BP), PWVCF and PPGF were
measured and the sensitivity of VRPI in predicting subjects with CVD risk factor was
calculated. Data was analyzed via SPSS version 15 and p < 0.05 was considered
significant. The mean age of the subjects was 28.94 ± 4.86 yrs. No differences in
PPGF was observed between groups (p > 0.05). The independent variables for
PPGF were forward pressure (Beta = 0.35, p < 0.01), PWVCF (Beta = -0.26, p < 0.01),
systolic BP (Beta = -0.26, p = 0.04) and height (Beta = 0.24, p < 0.01). The sensitivity
of VRPI was 82.02%. In conclusion, PPGF was correlated to PWVCF and may be a
potential marker of arterial stiffness. In addition, VRPI is sensitive to be used as an
early screening of CVD risk factors.
Euphorbia tirucalli dilaporkan mempunyai aktiviti antibakteria terhadap pelbagai
mikroorganisma. Kajian in vitro ini bertujuan untuk menilai ciri-ciri antibakteria
ekstrak (metanol, etanol dan ekstrak akueus) batang Euphorbia tirucalli terhadap
bakteria yang berkaitan dengan karies gigi, iaitu Streptococcus mutans (S. mutans)
dan Streptococcus sobrinus (S. sobrinus). Sifat-sifat antibakteria telah ditentukan
menggunakan ujian resapan agar berlubang pada kepekatan ekstrak yang berbeza
(10, 20 dan 30 mg/ml). Komersial amoxicillin (10 µg) telah digunakan sebagai
kawalan positif manakala pelarut yang sesuai telah digunakan sebagai kawalan
negatif. Ekstrak metanol dan ethanol daripada batang Euphorbia tirucalli didapati
berkesan terhadap S. mutans dan S. sobrinus. Walau bagaimanapun, ekstrak akueus
batang Euphorbia tirucalli tidak menunjukkan aktiviti terhadap kedua-dua strain
bakteria. Perbezaan dalam ciri-ciri antibakteria dalam perbezaan ekstrak Euphorbia
tirucalli mungkin disebabkan oleh perbezaan dalam juzuk fitokimia.
Psychophysiological effect associated to an event is inseparable with regard to the human’s mental health (Celik 2010; Cannon 1987; Roxo et al. 2011; Laird & Lacasse 2014). The manifestation of psychophysiological phenomenon in relation to an event has been observed during pre-modern era and inspired physician like Avicenna from the influence of the great thinker of Aristotle and Plato. Avicenna or IbnuSina, the Persian-born philosopher and physician from the Greco-Islamic era, has made his standpoint on the clinical importance of pulsology (Celik 2010). In his earlier concepts on pulse patterns, it was found that pulse would rise when he or she is anticipating an event, especially if an event is meaningful and related to him or her. Avicenna documented in dealing with such events, the psychophysiological changes that were observed, i.e. increased pulse from normal pulse. For example, a man who is approaching a house with a lady that he loved, started to experience tachycardia and palpitation. Sphygmology, a study of pulses is based on the contribution by Ibnu-Sina (Zarshenas et al. 2013). It is a relatively simple, practical and inexpensive means, having a significant diagnosis yield (Zarshenas et al. 2013). It has been recognised through the history of medicine, over the centuries, that we have a better understanding on the fundamental concept of coping with stress by observing our own pulses. Using this modest physiological approach, it has contributed to the modern way in dealing with distressed situation-the psychophysiology of biofeedback therapy and instilling the Buddhist teaching of mindfulness. For example in the former, biofeedback is a simple way of overcoming stress. Biofeedback therapy is a method that trains people to enhance their health by regulating certain bodily processes that normally happen involuntarily (Abgrall-Barbry & Consoli 2006). Once we are in a stressful state, our pulse and blood pressure will increase. Meditating, or self-dialogueand telling our brain that, “I am in control and can dictate my pulse from the highest to lowest possible beat,” can be helpful in dealing with our stress level via higher mental function coordination. Indeed, regulation of basic physiological phenomena and psychological input-“calming the mind” has both anatomical and neurophysiological explanation via the reticular activating system and thalamic integration. Understanding a simple way in managing with stress, especially during the difficult and stressful time can be gratifying and rewarding. This is especially true when it comes to inconveniences, hassle and problems due to coronavirus disease 2019 (COVID-19) pandemic, and during the movement control order (MCO).
Acute myeloid leukaemia (AML) is the most common subtype of acute leukaemias with a poor outcome. Msi2 protein is a newly discovered prognostic marker and it has been considered as a new target for therapy in AML. The study of Msi2
protein expression in AML cases has not been performed in Malaysia, to date. The main aim of the present study was to observe the expression of Msi2 protein in AML patients by immunohistochemistry (IHC) and to correlate its expression
with the well-established prognostic and clinical parameters in AML as well as the overall survival (OS). Sixty four bone marrow trephine biopsy sections were immunostained for Msi2 protein. The percentage of blasts with positive reaction
and the intensity of the cytoplasmic and nuclear staining were evaluated. The expression of Msi2 protein was found in 95.3% cases with Msi2 pattern varying between the cases. In 71.9% of cases, the blasts showed total cellular positivity and 23.4% cases showed only cytoplasmic positivity. Majority showed high expression of Msi2 for cytoplasmic staining. Interestingly, there was significant correlation between total cellular staining and the intermediate cytogenetic subgroup (P=0.04). In conclusion, the results showed that the majority of the patients had high expression of Msi2 but this did not correlate to OS. However, the Msi2 expression correlated to the cytogenetic findings. The results suggest future extensive research to be conducted in order to ascertain the exact role of Msi2 positive blast cells in AML in our population and their association with prognosis and outcome.
Keywords: AML, cytogenetics, immunohistochemistry, Msi2 protein
Pengetahuan mengenai pendedahan plumbum (Pb) di kalangan kanak-kanak masih kurang baik di kalangan ibu bapa di Malaysia. Tujuan utama kajian ini adalah untuk menterjemahkan versi Bahasa Inggeris Chicago Lead Knowledge Test (CLKT) yang asal ke dalam Bahasa Melayu (bahasa tempatan) dan disesuaikan dengan latar belakang budaya negara ini. Langkah-langkah terjemahan adalah sistematik dan berdasarkan ‘International Society for Pharmacoeconomics and Outcome Research’ (ISPOR) iaitu persediaan, terjemahan ke depan, perangkuman, terjemahan mundur, penilaian terjemahan mundur, penyelarasan, pembahasan kognitif, penilaian pembahasan kognitif dan semakan akhir, pembacaan pruf, dan laporan akhir. Jumlah item adalah kekal 24, di mana satu item dihapus, satu item disemak semula, dan satu item ditambah ke dalam borang soalan kaji selidik. Keempat-empat tema iaitu pengetahuan umum, pendedahan, pencegahan dan pemakanan dalam soal selidik ini dikekalkan. Skala respon, skema jawapan, dan sistem pemarkahan adalah tetap sama. Sebilangan besar item mempunyai terjemahan langsung ke bahasa Melayu kecuali item 5, 7, 12, 20, dan 22. Purata (+SD) dan julat interkuartil (IQR) untuk skor keseluruhan pengetahuan adalah 9.50 + 2.45 markah dan 5 markah masing-masing. Skor terendah adalah 4 markah dan skor tertinggi ialah 13 markah. Ini merupakan satu-satunya kajian yang menggunakan pendekatan sistematik dan standard dalam terjemahan dan penyesuaian budaya di Malaysia. Terjemahan CLKT dan penyesuaian budaya di Malaysia akan menyumbang kepada penyelidikan semasa yang lain terutamanya mengenai pendedahan Pb di kalangan kanak-kanak.
In this study, functional magnetic resonance imaging (fMRI) is used to investigate func-tional specialisation in human auditory cortices during listening. A silent fMRI paradigm was used to reduce the scanner sound artefacts on functional images. The subject was instructed to pay attention to the white noise stimulus binaurally given at an inten-sity level of 70 dB higher than the hearing level for normal people. Functional speciali-sation was studied using the Matlab-based Statistical Parametric Mapping (SPM5) software by means of fixed effects (FFX), random effects (RFX) and conjunction analyses. Individual analyses on all subjects indicated asymmetrical bilateral activation of the left and right hemispheres in Brodmann areas (BA) 22, 41 and 42, involving the primary and secondary auditory cortices. The percentage of signal change is larger in the BA22, 41 and 42 on the right as compared to the ones on the left (p>0.05). The average number of activated voxels in all the respective Brodmann areas are higher in the right hemisphere than in the left (p>0.05). FFX results showed that the point of maximum intensity was in the right BA41 whereby 599±1 activated voxels were ob-served in the right temporal lobe as compared to 485±1 in the left temporal lobe. The RFX results were consistent with that of FFX. The analysis of conjunction which fol-lowed, showed that the right BA41 and left BA22 as the common activated areas in all subjects. The results confirmed the specialisation of the right auditory cortices in pro-cessing non verbal stimuli.
Sepsis causes high mortality and morbidity. Static lactate concentration and early lactate clearance are cited to be a predictor for sepsis survival. This study examined the clinical utility of static lactate concentration and early lactate clearance within the first six hours of admission in Emergency Department (ED) to predict 28-day mortality rate in sepsis patients. Patients who presented with sepsis, severe sepsis or septic shock and admitted to ED of Universiti Kebangsaan Malaysia Medical Centre were recruited. Blood lactate concentrations were measured upon admission (H0), at 1st hour (H1) and 6th hour (H6), respectively. Either standard treatment of sepsis or early goal directed therapy was initiated according to sepsis severity. A follow-up report was conducted at 28 days via telephone call, e-mail or case notes. Patients were later classified into survivor and non-survivor as final outcome. Static lactate concentration appeared to be significantly higher for non-survivor as compared to the survival group at H0, H1 and H6 (p
Thalassaemia screening programme has been conducted in Malaysia since 2004. The aim of the programme was to reduce the burden of the disease by identifying thalassaemia carriers. However, the response towards the screening activities was unsatisfactory as there was lack of public awareness against the importance of thalassaemia screening. An alternative approach is to screen blood donors. The purpose of this study was to observe the prevalence of thalassaemia carriers among healthy blood donors. Seven hundred and thirty eight healthy blood donors were screened in Hospital Tengku Ampuan Rahimah, Klang from July to September 2010 using cation-exchange high performance liquid chromatography (HPLC). Cases with haemoglobin variants were further analyzed by gel electrophoresis at alkaline pH. Result shows that the blood donors consisted of 413 Malays (56%), 162 Indians (22%), 148 Chinese (20%) and 15 others (2%). There were 19 (2.6%) individuals with haemoglobin E trait, six (0.8%) with co-inheritance of haemoglobin E and αα- thalassaemia and five (0.7%) with β-thalassaemia trait. Haemoglobin Constant Spring and haemoglobin A2 prime were observed in two (0.3%); and Haemoglobin Lepore and alpha chain variant in one (0.2%). αα-thalassaemia and normal haemoglobin A2 β-thalassaemia could not be excluded in 190 cases (26%), as they required deoxyribonucleic acid (DNA) studies for identification. Thalassaemia screening in blood donors is more feasible and effective. Therefore, a wider scale population screening including blood donors could benefit the existing thalassaemia screening programme in Malaysia.
Human papillomavirus (HPV) plays an important role in the pathogenesis of cervical cancer. HPV has been found in 99.7% of cervical cancers worldwide. In Malaysia, it is the second most common cancer among women in all major ethnic groups. The main purpose of this study was to establish the method of SyBrGreen Real-Time PCR and apply it for identification of multiple infections of the two high risk HPV subtypes. In this study, 57 positive samples for HPV 16 and HPV 18 were used to establish a simple
and sensitive method to detect and identify HPV infection in the cervical neoplasia at different stages of the disease by using real-time ABICycler SyBrGreen 1 technology. The results showed 67 HPV genomes in 57 samples. HPV 16 genome was detected in 55/67 (82%) cases while HPV 18 was detected in 8/67 (12%) cases with 4 cases showing multiple infections of HPV 16 and HPV 18. HPV 16 was the most prevalent followed by HPV 18. Using SyBr Green Real-Time PCR techniques, the results
showed that DNA melting curve for HPV 16 had a peak around 80.2ºC and Ct value of 20 cycles whereas the DNA melting curve for HPV 18 around 79.2ºC and Ct value of 22 cycles. In conclusion, a SyBr Green Real-Time PCR method has the potential for clinical usage in detection and identification of HPV infection in cervical neoplasia at different stages of the disease.
Susceptibility to smoking, which is defined as a lack of cognitive commitment not to smoke in the future, has been shown to be a predictor for adolescent smoking initiation in developed countries. This study aims to evaluate the utility of a susceptibility-tosmoke measure as a predictor of smoking initiation among adolescents in Kota Tinggi district, Johor Malaysia. Susceptibility to smoking was evaluated among 1763 adolescents at baseline using a two-item construct. At follow-up 12 months later, 1288 of the 1763 adolescents (73.1%) responded. Results showed 14.9% (n=188/1260) of the respondents were susceptible to smoking at baseline. Among the susceptible adolescents, 31.9% initiated smoking after one year. Respondents who were identified as susceptible to smoking by the measure were 3.7 times (95%; CI: 2.17- 6.30) more likely to initiate smoking compared to non-susceptible respondents after adjusting for gender, school locality, percentage of friends who smoke, father smoking, parental acceptance of smoking, and belief in the positive and negative consequences of smoking. The findings suggest that the susceptibility measure is a reliable predictor and can be used as a screening tool to identify adolescents who are at risk of initiating smoking.
Post operative pain is an expected adverse outcome following surgery and it often delays mobilization and overall recovery. Acute post operative pain is subjective and cannot be measured directly. The objective of this study was to determine nurses’ knowledge and attitude towards post operative pain management. A cross sectional study was conducted in surgical wards and the Intensive Care Unit of Universiti Kebangsaan Malaysia Medical Centre from February to April 2008. A 28 item questionnaire which comprised of two domains: knowledge and attitude towards post operative pain management was used. Eighty four respondents successfully responded to the study. Twenty respondents (25%) possessed high level, 58 respondents (69%) possessed moderate level and 5 respondents (6%) had low knowledge level of post operative pain management. Positive attitude towards post operative pain management was reported by 66 respondents (78.5%). There was a significant relationship between nurses’ academic qualifications and attitude towards post operative pain management (χ² =29.96, p
Tujuan kajian ini adalah untuk menerokai kaedah pembantu penanda permukaan terhadap implan orbital untuk pembedahan tulang orbit. Enam tengkorak manusia dewasa kering telah digunakan dalam kajian ini. Implan orbital aluminium yang disediakan secara individu, dengan ketebalan 0.4 mm disediakan untuk lantai orbit secara bilateral. Empat penanda permukaan implan fizikal dari aspek anterior dan posterior implan yang disediakan dan diimbas secara optik. Pemeriksaan pra-pembedahan tomografi berkomputer ‘cone-beam’ (CBCT) diperolehi untuk semua lantai orbit. Data 'Digital Imaging and Communications in Medicine' (DICOM) tengkorak diambil, diimport dan direka bentuk dengan format data stereolithografi (STL) implan orbital masing-masing menggunakan iPlan CMF (Versi 3.0, BrainLab, Jerman). Teknik gabungan imej dilakukan untuk setiap tengkorak selepas pembinaan semula dengan pengambilan pos-pembedahan CBCT. Pengukuran berasaskan daripada data tomografi terhadap posisi implant kemudian dinilai di antara kedudukan implan yang direncanakan dan yang direalisasikan dalam satah sagittal dan coronal. Analisa statistik dijalankan menggunakan Statistik Statistik PASW® 18. Hasil kajian menunjukkan bahawa 38 daripada 48 penanda permukaan yang dinilai menunjukkan peningkatan ketinggian kedudukan dalam skala kecil pasca-pembedahan berbanding dengan kedudukan implan orbital maya. Semakan metrik Euclidean menunjukkan perbezaan yang kurang daripada 1.00 mm dalam semua penanda permukaan kecuali pada kawasan lej posterior dan anterior dalam penilaian satah sagittal. Kajian ini menunjukkan bahawa penempatan penanda permukaan terhadap implant orbit dalam pembedahan navigasi orbit menyumbang kepada kedudukan implan orbital secara konsisten.
Kejuruteraan tisu merupakan satu bidang perubatan baru yang membolehkan tisu
manusia dibentuk secara in vitro sebelum pemindahan tisu dilakukan. Sel stem
mesenkima daripada sum sum tulang (BMSCs) adalah sumber sel yang sesuai
dalam kejuruteraan tisu tulang rawan, ekoran kebolehannya untuk membentuk
rawan hialin. Kajian ini telah dijalankan untuk mengkaji potensi BMSCs untuk
membentuk sel rawan secara in vitro dan in vivo. BMSCs dipencilkan daripada
kambing dan dibahagikan kepada dua kumpulan; iaitu kumpulan kajian dan
kumpulan kawalan. Sel di dalam kumpulan kawalan disemai di dalam medium
yang mengandungi 10% serum anak lembu (FBS). Manakala, sel di dalam kumpulan
kajian telah dikultur di dalam medium yang diperkaya dengan 1% FBS, 1% ITS, 5
ng/mL TGF-ß3, 50 ng/mL IGF-1, 40 ng/mL L-proline, 100 nM dexamethasone dan
50 μg / fosfat. Analisis pembentukan sel rawan telah dijalankan secara in vivo pada
model mencit gondol atimus. Sel didapati beragregasi di dalam kumpulan kajian
dan menunjukkan permulaannya kondrogenesis telah berlaku dalam pengkulturan
sel. Kerangka fibrin yang telah disemai bersama sel yang telah atau tidak diaruh
disediakan dan ditanamkan di dalam lapisan subkutaneus mencik gondol atimus
selama 5 minggu. Eksplan tersebut kemudiannya dikeluarkan daripada lokasi
penempelan untuk pemeriksaan histologi. Berdasarkan pewarnaan Safranin O dan
pengekspresan GAG, eksplan daripada kumpulan kajian didapati menghasilkan
matriks rawan pada kadar yang tinggi berbanding eksplan di dalam kumpulan
kawalan. Hasil kajian ini menunjukkan keberkesanan medium rendah serum yang mengandungi TGF-ß3 merangsang pembezaan sel stem mesenkima daripada
sum-sum tulang untuk menjadi sel rawa
Pengesanan awal risiko kanser payudara menggunakan mammografi dapat
mengurangkan kos pengurusan rawatan dan prognosis penyakit ini. Paras
ketumpatan payudara yang dikesan menggunakan mammogram memberi
potensi faktor penyebab kepada risiko kanser payudara. Penghasilan sel epitelial
pada mamari dapat ditentukan oleh faktor genetik. Gen transforming growth
factor-beta (TGF-ß) telah dikenalpasti terlibat di dalam regulasi proliferasi sel dan
pembahagian sel. Kajian ini bertujuan untuk mengukur hubung kait polimorfisme
TGF-ß1 dengan ketumpatan payudara di kalangan wanita yang menjalani saringan
mamografi. Pengesanan genotip bagi tiga polimorfisme TGF-ß1 yang dikenali
sebagai rs1800469, rs1800470 dan rs4803455 dilakukan dengan teknik PCR-RFLP.
Frekuensi alel dan genotip dikira bagi kumpulan kawalan yang terdiri dari kalangan
wanita yang telah dikelaskan BIRADS 1 dan BIRADS 2, manakala kumpulan kes
terdiri dari kalangan wanita yang telah dikelaskan BIRADS 3 dan BIRADS 4.Dua
polimorfisme (rs1800469 dan rs1800470) telah menunjukkan hubung kait yang
signifikan dengan ketumpatan payudara dengan nilai P= 0.004 dan 0.003. Namun
begitu polimorfisme yang ketiga iaitu rs4803455 tidak menunjukkan hubung kait
(nilai P=0.090). Analisa hubung kait haplotaip mencadangkan haplotaip GAA
berupaya memberi kecenderungan ketumpatan payudara (nilai P=0.02, OR=2.21
[1.07-4.55]) berbanding haplotaip AAC yang berupaya untuk memberi kesan
perlindungan dari penghasilan ketumpatan payudara (nilai P=0.004, OR=0.40 [0.21-0.77]). Data asas hubung kait dan haplotaip ini memberi penjelasan kaitan
polimorfisme TGF-ß1 dengan ketumpatan payudara dan memberi maklumat fungsi
polimorfisme di dalam mempengaruhi pembentukan ketumpatan payudara.
Despite evidence showing that structured rehabilitation after stroke improves functional outcomes, providing seamless rehabilitation from hospital to community has been elusive. The service provided should be able to accommodate variable degree of impairments and needs of the stroke survivors. This study aimed to assess the outcome of a multidisciplinary-based outpatient rehabilitation service for stroke patients living in the community. Patients who were discharged from Universiti Kebangsaan Malaysia Medical Centre after an acute stroke were referred to the Combined Stroke Rehabilitation Clinic (CSRC). Post stroke patients were assigned individually designed programs which were problem based and used task specific activities to achieve desired goals. Patients were reviewed on a regular basis either up to completion of the 2 year program, or are able to be discharged to the community, whichever is earlier. Modified Barthel Index (MBI) and Berg Balance Scores (BBS) were used for monitoring. A total of 68 patients were managed in CSRC for two years since its initiation, with mean age of 62.4 years (SD 12.4) with the mean duration of stroke when first reviewed in CSRC was 11.5 months (SD 11.9). Majority of patients (64.7%) received either two or three types of intervention. Both MBI and BBS demonstrated significant improvement over 12-months period (p value of 0.006 and 0.017 respectively). CSRC proved that structured rehabilitation intervention was beneficial in terms of functional status and improvement in balance to post-stroke patients.
Study site: Combined Stroke Rehabiltation clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia