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Fulltext Port assisted closure of laparoscopic wound: A safe and feasible technique

Leow VM, Faizah MS, Mohd Sharifudin S, Vasu Pillai L, Yang KF, Manisekar KS

Med J Malaysia, 2015 Oct;70(5):278-80.
PMID: 26556115 MyJurnal

OBJECTIVE: Various techniques and instruments have been developed to provide safe and secure closure of laparoscopic wounds. Herein we describe a simple method to close laparoscopic supraumbilical wounds with the aid of a laparoscopic port.
METHOD: This was a retrospective review of prospective data, which were from 151 patients who underwent laparoscopic cholecystectomy for symptomatic gallstone disease from December 2009 to December 2010 in Sultanah Bahiyah Hospital. A senior consultant hepato-pancreato-biliary (HPB) surgeon and two HPB trainee surgeons performed the operations. Postoperatively, all patients were followed up at 4 weeks.
RESULTS: All patients successfully underwent closure of the supraumbilical wound with the assistance of a 5mm laparoscopic port. None of the patients had incisional hernia on follow up.
CONCLUSION: Port assisted closure of supraumbilical laparoscopic wounds is a feasible and safe technique.
Study site: Sultanah Bahiyah Hospital, Kedah
Fulltext Antioxidant, antibacterial activity, and phytochemical characterization of Melaleuca cajuputi extract

Al-Abd NM, Mohamed Nor Z, Mansor M, Azhar F, Hasan MS, Kassim M

BMC Complement Altern Med, 2015;15:385.
PMID: 26497742 DOI: 10.1186/s12906-015-0914-y

The threat posed by drug-resistant pathogens has resulted in the increasing momentum in research and development for effective alternative medications. The antioxidant and antibacterial properties of phytochemical extracts makes them attractive alternative complementary medicines. Therefore, this study evaluated the phytochemical constituents of Melaleuca cajuputi flower and leaf (GF and GL, respectively) extracts and their antioxidant and antibacterial activities.
The investigation of the skin biophysical measurements focusing on daily activities, skin care habits, and gender differences

Hadi H, Awadh AI, Hanif NM, Md Sidik NF, Mohd Rani MR, Suhaimi MS

Skin Res Technol, 2016 May;22(2):247-54.
PMID: 26333416 DOI: 10.1111/srt.12257

Skin, as a protective barrier to exogenous substances, can be modulated by various internal and external factors that can affect its functional state. In order to prevent the early symptoms and signs of diseases of the skin, frequent skin health assessment should be performed. The aims of the study were to evaluate four skin properties of transepidermal water loss (TEWL), hydration, elasticity, and pigmentation using a non-invasive skin assessment tool, DermaLab Combo(®) , and also to determine possible factors that may influence skin condition.
Fulltext Monte Carlo dose calculation in dental amalgam phantom

Aziz MZ, Yusoff AL, Osman ND, Abdullah R, Rabaie NA, Salikin MS

J Med Phys, 2015 Jul-Sep;40(3):150-5.
PMID: 26500401 DOI: 10.4103/0971-6203.165080

It has become a great challenge in the modern radiation treatment to ensure the accuracy of treatment delivery in electron beam therapy. Tissue inhomogeneity has become one of the factors for accurate dose calculation, and this requires complex algorithm calculation like Monte Carlo (MC). On the other hand, computed tomography (CT) images used in treatment planning system need to be trustful as they are the input in radiotherapy treatment. However, with the presence of metal amalgam in treatment volume, the CT images input showed prominent streak artefact, thus, contributed sources of error. Hence, metal amalgam phantom often creates streak artifacts, which cause an error in the dose calculation. Thus, a streak artifact reduction technique was applied to correct the images, and as a result, better images were observed in terms of structure delineation and density assigning. Furthermore, the amalgam density data were corrected to provide amalgam voxel with accurate density value. As for the errors of dose uncertainties due to metal amalgam, they were reduced from 46% to as low as 2% at d80 (depth of the 80% dose beyond Zmax) using the presented strategies. Considering the number of vital and radiosensitive organs in the head and the neck regions, this correction strategy is suggested in reducing calculation uncertainties through MC calculation.
Fulltext Novel piperazine core compound induces death in human liver cancer cells: possible pharmacological properties

Samie N, Muniandy S, Kanthimathi MS, Haerian BS, Azudin RE

Sci Rep, 2016 Apr 13;6:24172.
PMID: 27072064 DOI: 10.1038/srep24172

The current study evaluates the cytotoxic mechanism of a novel piperazine derivate designated as PCC against human liver cancer cells. In this context, human liver cancer cell lines, SNU-475 and 243, human monocyte/macrophage cell line, CRL-9855, and human B lymphocyte cell line, CCL-156, were used to determine the IC50 of PCC using the standard MTT assay. PCC displayed a strong suppressive effect on SNU-475 and SNU-423 cells with an IC50 value of 6.98 ± 0.11 μg/ml and 7.76 ± 0.45 μg/ml respectively, after 24 h of treatment. Significant dipping in the mitochondrial membrane potential and elevation in the released of cytochrome c from the mitochondria indicated the induction of the intrinsic apoptosis pathway by PCC. Activation of this pathway was further evidenced by significant activation of caspase 3/7 and 9. PCC was also shown to activate the extrinsic pathways of apoptosis via activation of caspase-8 which is linked to the suppression of NF-ƙB translocation to the nucleus. Cell cycle arrest in the G1 phase was confirmed by flow cytometry and up-regulation of glutathione reductase expression was quantified by qPCR. This study suggests that PCC is a simultaneous inducer of intrinsic and extrinsic pathways of apoptosis in liver cancer cell lines.
Fulltext MH17: the Malaysian experience

Khoo LS, Hasmi AH, Abdul Ghani Aziz SA, Ibrahim MA, Mahmood MS

Malays J Pathol, 2016 Apr;38(1):1-10.
PMID: 27126658 MyJurnal

A disaster is a natural or man-made (or technological) hazard resulting in an event of substantial extent causing significant physical damage or destruction, loss of life, or drastic change to the environment. It is a phenomenon that can cause damage to life and property and destroy the economic, social and cultural life of the people; and overwhelms the capacity of the community to cope with the event. The recent tragic aviation accidents in 2014 involving Malaysia Airlines flights MH370 and MH17 shocked the world in an unprecedented manner. This paper focuses on the Malaysian experience in the MH17 mission in Ukraine as well as the first ever international Disaster Victim Identification (DVI) operation for the Malaysian DVI team. The DVI operations in Hilversum, the Netherlands were well described in stages. The Netherlands' Landelijk Team Forensische Opsporing as the lead DVI team in Hilversum operated systematically, ensuring the success of the whole mission. This paper discusses the lessons learned by the Malaysian team on proper DVI structure, inter- and intra-agency cooperation, facilities planning and set up, logistics and health and safety aspects, as well as effective communication and collaboration with other international delegates. Several issues and challenges faced by the Malaysian team were also documented. In addition, the authors shared views, opinions and recommendations for a more comprehensive DVI operation in the future.
Fulltext A case of chronic myeloid leukaemia in blast transformation with leukemic ascites

Mohd Ridzuan MS, Yap E, Wan Fariza WJ, Fadilah SA, Salwati S

Med J Malaysia, 2016 04;71(2):85-7.
PMID: 27326952 MyJurnal

Chronic Myeloid Leukaemia (CML) is a disease characterised by a distinctive marker that is the Philadelphia Chromosome and an ability to transform into blast phase, which confers a poor prognosis. The median survival was reported to be between three to six months in correlation to blast phase. Extramedullary involvement with CML to sites such as pleural, meningeal and bones have been reported. We report a case of 41-year-old man who was diagnosed with CML in blast phase and presented with ascites. Ultrasound of abdomen showed coarse echotexture of liver suggestive leukaemic infiltration to the liver. The liver profile was severely deranged and associated with coagulopathy. Flow cytometry analysis of the peritoneal fluid revealed presence of myeloblasts consistent with CML in blast crisis with leukaemic ascites. Bone marrow biopsy also confirmed disease transformation. He received standard induction chemotherapy for acute myeloid leukaemia with dose modifications based on liver enzymes performance. Our case highlights an unusual presentation of CML in blast crisis with leukaemic ascites and the challenges in managing cytotoxic treatments due to the liver infiltration.
LC-QTOF-MS identification of porcine-specific peptide in heat treated pork identifies candidate markers for meat species determination

Sarah SA, Faradalila WN, Salwani MS, Amin I, Karsani SA, Sazili AQ

Food Chem, 2016 May 15;199:157-64.
PMID: 26775957 DOI: 10.1016/j.foodchem.2015.11.121

The purpose of this study was to identify porcine-specific peptide markers from thermally processed meat that could differentiate pork from beef, chevon and chicken meat. In the initial stage, markers from tryptic digested protein of chilled, boiled and autoclaved pork were identified using LC-QTOF-MS. An MRM method was then established for verification. A thorough investigation of LC-QTOF-MS data showed that only seven porcine-specific peptides were consistently detected. Among these peptides, two were derived from lactate dehydrogenase, one from creatine kinase, and four from serum albumin protein. However, MRM could only detect four peptides (EVTEFAK, LVVITAGAR, FVIER and TVLGNFAAFVQK) that were consistently present in pork samples. In conclusion, meat species determination through a tandem mass spectrometry platform shows high potential in providing scientifically valid and reliable results even at peptide level. Besides, the specificity and selectivity offered by the proteomics approach also provide a robust platform for Halal authentication.
In vitro degradation and cell viability assessment of Zn-3Mg alloy for biodegradable bone implants

Dambatta MS, Murni NS, Izman S, Kurniawan D, Froemming GR, Hermawan H

Proc Inst Mech Eng H, 2015 May;229(5):335-42.
PMID: 25991712 DOI: 10.1177/0954411915584962

This article reports the in vitro degradation and cytotoxicity assessment of Zn-3Mg alloy developed for biodegradable bone implants. The alloy was prepared using casting, and its microstructure was composed of Mg2Zn11 intermetallic phase distributed within a Zn-rich matrix. The degradation assessment was done using potentiodynamic polarization and electrochemical impedance spectrometry. The cell viability and the function of normal human osteoblast cells were assessed using 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium and alkaline phosphatase extracellular enzyme activity assays. The results showed that the degradation rate of the alloy was slower than those of pure Zn and pure Mg due to the formation of a high polarization resistance oxide film. The alloy was cytocompatible with the normal human osteoblast cells at low concentrations (<0.5 mg/mL), and its alkaline phosphatase activity was superior to pure Mg. This assessment suggests that Zn-3Mg alloy has the potential to be developed as a material for biodegradable bone implants, but the toxicity limit must be carefully observed.
Fulltext Andrographolide effect on both Plasmodium falciparum infected and non infected RBCs membranes

Zaid OI, Abd Majid R, Sabariah MN, Hasidah MS, Al-Zihiry K, Yam MF, et al.

Asian Pac J Trop Med, 2015 Jul;8(7):507-12.
PMID: 26276279 DOI: 10.1016/j.apjtm.2015.06.007

OBJECTIVE: To explore whether its antiplasmodium effect of andrographolide is attributed to its plausible effect on the plasma membrane of both Plasmodium falciparum infected and non-infected RBCs.
METHODS: Anti-plasmodium effect of andrographolide against Plasmodium falciparum strains was screened using the conventional malaria drug sensitivity assay. The drug was incubated with uninfected RBCs to monitor its effect on their morphology, integrity and osmotic fragility. It was incubated with the plasmodium infected RBCs to monitor its effect on the parasite induced permeation pathways. Its effect on the potential of merozoites to invade new RBCs was tested using merozoite invasion assay.
RESULTS: It showed that at andrographolide was innocuous to RBCs at concentrations approach its therapeutic level against plasmodia. Nevertheless, this inertness was dwindled at higher concentrations.
CONCLUSIONS: In spite of its success to inhibit plasmodium induced permeation pathway and the potential of merozoites to invade new RBCs, its anti-plasmodium effect can't be attributed to these functions as they were attained at concentrations higher than what is required to eradicate the parasite. Consequently, other mechanisms may be associated with its claimed actions.
Fulltext Double-burden of malnutrition among the indigenous peoples (Orang Asli) of Peninsular Malaysia

Wong CY, Zalilah MS, Chua EY, Norhasmah S, Chin YS, Siti Nur'Asyura A

BMC Public Health, 2015;15:680.
PMID: 26194643 DOI: 10.1186/s12889-015-2058-x

Double-burden of malnutrition (DBM) is an emerging public health concern among the Orang Asli (indigenous peoples) of Peninsular Malaysia. This study aimed to identify the presence of DBM at the community and household levels in Orang Asli population and its associated demographic and socio-economic factors.
Measurement of radioactivity and heavy metal levels in edible vegetables and their impact on Kuala Selangor communities of Peninsular Malaysia

Asaduzzaman Kh, Khandaker MU, Amin YM, Zainuddin Z, Farook MS, Bradley DA

Radiat Prot Dosimetry, 2015 Nov;167(1-3):165-70.
PMID: 25935008 DOI: 10.1093/rpd/ncv237

Vegetable is an essential daily diet item for the people of Malaysia. This work addressed the radiation and heavy metal exposure scenarios through the consumption of vegetables. Kuala Selangor is located in Sungai Selangor estuary in the west coast of Peninsular Malaysia, which is susceptible to pollution load due to the presence of large-scale industrial and human activities. Radioactivity and heavy metals level in human diet is of particular concern for the assessment of possible radiological and chemical hazards to human health. Therefore, a comprehensive study was carried out to determine the radioactivity levels ((226)Ra, (228)Ra and (40)K) and heavy metal concentrations (Cr, As, Cd, Mn, Mg, Al, Sr, Rb, Sb, Ba, Hg, Fe, Ni, Zn, Cu, Bi and Pb) in 10 varieties of vegetable collected from different farmlands in Kuala Selangor region. The committed doses for (226)Ra, (228)Ra and (40)K due to consumption of vegetables were found 16.6±1.3, 23.6±1.7 and 58±5 µSv y(-1), respectively, with a total of 98±8 µSv y(-1). This dose imposes no significant threat to human health. The estimated cancer risk shows that probability of increase in cancer risk from daily intake of vegetables is only a minor fraction of International Commission on Radiological Protection values. The concentrations of heavy metal were below the daily intake recommended by the international organisations.
Fulltext Indoor solar thermal energy saving time with phase change material in a horizontal shell and finned-tube heat exchanger

Paria S, Sarhan AA, Goodarzi MS, Baradaran S, Rahmanian B, Yarmand H, et al.

ScientificWorldJournal, 2015;2015:291657.
PMID: 25879052 DOI: 10.1155/2015/291657

An experimental as well as numerical investigation was conducted on the melting/solidification processes of a stationary phase change material (PCM) in a shell around a finned-tube heat exchanger system. The PCM was stored in the horizontal annular space between a shell and finned-tube where distilled water was employed as the heat transfer fluid (HTF). The focus of this study was on the behavior of PCM for storage (charging or melting) and removal (discharging or solidification), as well as the effect of flow rate on the charged and discharged solar thermal energy. The impact of the Reynolds number was determined and the results were compared with each other to reveal the changes in amount of stored thermal energy with the variation of heat transfer fluid flow rates. The results showed that, by increasing the Reynolds number from 1000 to 2000, the total melting time decreases by 58%. The process of solidification also will speed up with increasing Reynolds number in the discharging process. The results also indicated that the fluctuation of gradient temperature decreased and became smooth with increasing Reynolds number. As a result, by increasing the Reynolds number in the charging process, the theoretical efficiency rises.
The isolation and characterization of microsatellites from Anopheles dirus mosquitoes

Walton C, Chang MS, Handley JM, Harbach RE, Collins FH, Baimai V, et al.

Mol Ecol, 2000 Oct;9(10):1665-7.
PMID: 11050564
Fulltext Clinical features of malaria in Orang Asli population in Pos Piah, Malaysia

Norhayati M, Rohani AK, Hayati MIN, Halimah AS, Sharom MY, Zainah Abidin AH, et al.

Med J Malaysia, 2001 Sep;56(3):271-4.
PMID: 11732070

A malaria survey was conducted to examine the presence of common clinical features of malaria in individuals living in an endemic area of malaria. The overall infection rate was 11.0% with 7.5% and 3.5% infected with Plasmodium vivax and Plasmodium falciparum respectively. The mean parasitaemia level of both species was 2905.9 parasites/microliter blood, with the mean parasitaemia level of P. vivax and P. falciparum at 682.7 parasites/microliter blood and 6981.7 parasites/microliter blood respectively. The infection rates were higher in the younger age group. Hepatomegaly, hepatosplenomegaly and clinical anaemia were significantly associated with malaria. None of the patients were febrile. In conclusion, in low endemic areas, the presence of clinical anaemia, hepatomegaly and hepatosplenomegaly in afebrile individuals could be considered as useful criteria for the presence of asymptomatic parasitaemia. It is important to carry out laboratory diagnostic investigations, to ensure all the asymptomatic parasitaemia which act as reservoirs are detected and treated.
Kimura's disease: a report of three cases with a brief review of literature

Madhavan M, Othman NH, Singh MS, Indudharan R, Sharma HS, Shamsuddin AR

Acta Otorhinolaryngol Ital, 2000 Aug;20(4):284-9.
PMID: 11234448

Kimura's disease (KD) is an uncommon chronic inflammatory condition of unknown aetiology involving subcutaneous tissue, presenting as a tumor like lesion with a predilection for the head and neck region. Clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnose before tissue biopsy. Fine needle aspiration cytology has only limited value. Unless the pathologists are aware of this entity, it might be misdiagnosed. Surgery, radiotherapy and steroid therapy have been tried but none is proved best and recurrence is common. Three cases of KD seen in our hospital and the problems encountered in them are presented.
Fulltext Crash simulation of lower limb with motorcycle basket

How CK, Megat Ahmad MMH, Radin Umar RS, Hamouda AMS, Harwant S

Med J Malaysia, 2001 Mar;56(1):77-81.
PMID: 11503301

Lower limb injuries are the main cause of temporary and permanent disability among motorcyclists in Malaysia. They cause non-fatal but serious injuries requiring hospitalisation. Detailed studies on factors influencing lower limb injuries are justified in an attempt to reduce the occurrence of these injuries. This study presents a computer simulation of the crash behaviour of the basket of a small-engined motorcycle with the lower limb using finite element (FE) methods. The results suggest that the extensive deformation of the motorcycle basket may reduce the risk of injury to the lower limb. The behaviour of the basket during collision is analogous to the crumple zone of automobiles.
Hypoxia during upper gastrointestinal endoscopy with and without sedation and the effect of pre-oxygenation on oxygen saturation

Wang CY, Ling LC, Cardosa MS, Wong AK, Wong NW

Anaesthesia, 2000 Jul;55(7):654-8.
PMID: 10919420

In Study A, the incidence of arterial oxygen desaturation was studied using pulse oximetry (SaO2) in 100 sedated and 100 nonsedated patients breathing room air who underwent diagnostic upper gastrointestinal endoscopy. Hypoxia (SaO2 92% or less of at least 15 s duration) occurred in 17% and 6% of sedated patients and nonsedated patients, respectively (p < 0.03). Mild desaturation (SaO2 94% or less and less than 15 s duration) occurred in 47% of sedated patients compared with 12% of nonsedated patients (p < 0.001). In Study B, the effects of supplementary oxygen therapy and the effects of different pre-oxygenation times on arterial oxygen saturation (SaO2) in sedated patients were studied using pulse oximetry. One hundred and twenty patients who underwent diagnostic upper gastrointestinal endoscopy with intravenous sedation were studied. Patients were randomly allocated to one of four groups: Group A (n = 30) received no supplementary oxygen while Groups B-D received supplementary oxygen at 4 1 x min(-1) via nasal cannulae. The pre-oxygenation time in Group B (n = 30) was zero minutes, Group C (n = 30) was 2 min and Group D (n = 30) was 5 min before sedation and introduction of the endoscope. Hypoxia occurred in seven of the 30 patients in Group A and none in groups B, C and D (p < 0.001). We conclude that desaturation and hypoxia is common in patients undergoing upper gastrointestinal endoscopy with and without sedation. Sedation significantly increases the incidence of desaturation and hypoxia. Supplementary nasal oxygen at 4 1 x min(-1) in sedated patients abolishes desaturation and hypoxia. Pre-oxygenation confers no additional benefit.
Molecular epidemiology and evolution of enterovirus 71 strains isolated from 1970 to 1998

Brown BA, Oberste MS, Alexander JP, Kennett ML, Pallansch MA

J Virol, 1999 Dec;73(12):9969-75.
PMID: 10559310

Enterovirus 71 (EV71) (genus Enterovirus, family Picornaviridae), a common cause of hand, foot, and mouth disease (HFMD), may also cause severe neurological diseases, such as encephalitis and poliomyelitis-like paralysis. To examine the genetic diversity and rate of evolution of EV71, we have determined and analyzed complete VP1 sequences (891 nucleotides) for 113 EV71 strains isolated in the United States and five other countries from 1970 to 1998. Nucleotide sequence comparisons demonstrated three distinct EV71 genotypes, designated A, B, and C. The genetic variation within genotypes (12% or fewer nucleotide differences) was less than the variation between genotypes (16.5 to 19.7%). Strains of all three genotypes were at least 94% identical to one another in deduced amino acid sequence. The EV71 prototype strain, BrCr-CA-70, isolated in California in 1970, is the sole member of genotype A. Strains isolated in the United States and Australia during the period from 1972 to 1988, a 1994 Colombian isolate, and isolates from a large HFMD outbreak in Malaysia in 1997 are all members of genotype B. Although strains of genotype B continue to circulate in other parts of the world, none have been isolated in the United States since 1988. Genotype C contains strains isolated in 1985 or later in the United States, Canada, Australia, and the Republic of China. The annual rate of evolution within both the B and C genotypes was estimated to be approximately 1.35 x 10(-2) substitutions per nucleotide and is similar to the rate observed for poliovirus. The results indicate that EV71 is a genetically diverse, rapidly evolving virus. Its worldwide circulation and potential to cause severe disease underscore the need for additional surveillance and improved methods to identify EV71 in human disease.
Nasopharyngeal carcinoma in Malaysian Chinese: occupational exposures to particles, formaldehyde and heat

Armstrong RW, Imrey PB, Lye MS, Armstrong MJ, Yu MC, Sani S

Int J Epidemiol, 2000 Dec;29(6):991-8.
PMID: 11101539 DOI: 10.1093/ije/29.6.991

BACKGROUND: During 1990-1992, 282 Chinese residents of Selangor and the Federal Territory, Malaysia with histologically confirmed nasopharyngeal carcinoma (NPC) were interviewed about occupational history, diet, alcohol consumption, and tobacco use, as were an equal number of Malaysian Chinese population controls, pair-matched to cases by age and sex.

METHODS: Exposures to 20 kinds of workplace substances, solar and industrial heat, and cigarette smoke, were analysed by univariate and multivariate methods.

RESULTS: Nasopharyngeal carcinoma was associated with occupational exposures to construction, metal and wood dusts; motor fuel and oil; paints and varnishes; certain other chemicals; industrial heat; solar heat from outdoor occupations; certain smokes; cigarette smoking; and childhood exposure to parental smoking. After adjustment for risk from diet and cigarette smoke, only wood dust (OR = 2.36; 95% CI : 1.33- 4.19), and industrial heat (OR = 2.21; 95% CI : 1.12-4.33) remained clearly associated. Wood dust remained statistically significant after further adjustment for social class. No significant crude or adjusted association was found between NPC and formaldehyde (adjusted OR = 0.71; 95% CI : 0.34-1.43).

CONCLUSIONS: This study supports previous findings that some occupational inhalants are risk factors for NPC. The statistical effect of wood dust remained substantial after adjustment for diet, cigarette smoke, and social class. Intense industrial heat emerged as a previously unreported risk factor, statistically significant even after adjustment for diet and cigarette smoke. No association was found between NPC and formaldehyde.

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