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  1. Yeo JJP, Yeo LS, Tan SSN, Delailah DDRA, Lee SWH, Hu ATH, et al.
    Hypertens Res, 2024 Feb;47(2):352-357.
    PMID: 37673957 DOI: 10.1038/s41440-023-01418-4
    Resistant hypertension is a well-recognised clinical challenge. However, the definition and epidemiology of true resistant hypertension (RH) are less understood, especially in Asia. This cross-sectional study examined the prevalence of RH referred from primary care clinics based on various guidelines. RH was defined as blood pressure (BP) being above the threshold using ambulatory blood pressure monitoring despite adequate lifestyle measures and optimal treatment with ≥3 medications at maximally tolerated doses. Between one in four (n = 94, 24.0% using Malaysian guidelines) and up to two-thirds (n = 249, 63.7% using 2018 American guidelines) of adults referred for uncontrolled hypertension met the criteria of true RH. Of those with RH, a further one-quarter (n = 26, 26.6%) were deemed to have refractory hypertension (elevated BP despite treatment with at least 5 antihypertensive medications). Adults with RH were generally younger, more likely to be male, had a higher BMI and were more likely to have gout, CKD, and angina compared to those with controlled hypertension. The prevalence of RH amongst Asian adults with poor hypertension control is high. A concerted effort is needed to reduce the high burden of RH, especially among this population.
  2. Byrne I, William T, Chua TH, Patterson C, Hall T, Tan M, et al.
    Sci Rep, 2023 Aug 10;13(1):12998.
    PMID: 37563178 DOI: 10.1038/s41598-023-39670-w
    Malaysia has reported no indigenous cases of P. falciparum and P. vivax for over 3 years. When transmission reaches such low levels, it is important to understand the individuals and locations where exposure risks are high, as they may be at greater risk in the case of a resurgence of transmission. Serology is a useful tool in low transmission settings, providing insight into exposure over longer durations than PCR or RDT. We ran blood samples from a 2015 population-based survey in northern Sabah, Malaysian Borneo on a multiplex bead assay. Using supervised machine learning methods, we characterised recent and historic exposure to Plasmodium falciparum and P. vivax and found recent exposure to P. falciparum to be very low, with exposure to both species increasing with age. We performed a risk-factor assessment on environmental, behavioural, demographic and household factors, and identified forest activity and longer travel times to healthcare as common risk-factors for exposure to P. falciparum and P. vivax. In addition, we used remote-sensing derived data and geostatistical models to assess environmental and spatial associations with exposure. We created predictive maps of exposure to recent P. falciparum in the study area and showed 3 clear foci of exposure. This study provides useful insight into the environmental, spatial and demographic risk factors for P. falciparum and P. vivax at a period of low transmission in Malaysian Borneo. The findings would be valuable in the case of resurgence of human malarias in the region.
  3. Low VL, Azhar SS, Tan TK, Bathmanaban P, AbuBakar S, Chandrawathani P, et al.
    Vet Res Commun, 2022 Sep;46(3):979-983.
    PMID: 35190932 DOI: 10.1007/s11259-022-09904-9
    Rickettsioses is a group of emerging infectious diseases in Southeast Asia caused by Gram-negative obligate intracellular bacteria in the Rickettsiae tribe. However, there is limited information regarding the vertebrate hosts of Rickettsia spp. in this region. This study aims to detect and identify Rickettsia agents present in wildlife and domesticated animals in Malaysia using Polymerase Chain Reaction (PCR) and sequencing of citrate synthase gene (gltA), followed by genotyping and phylogenetic analysis. Rickettsia sp. was detected in 2 (0.67%) of 300 wildlife and domesticated animal blood samples. The positive samples were derived from a goat (5.56% of 18) and a sheep (2.22% of 45). Both sequences demonstrated 99.64% sequence similarity to Rickettsia asembonensis, a species that is known to infect humans and macaques. This study reported for the first time the detection of R. asembonensis in sheep and goats in Malaysian farms, suggesting this species may be adapting to a wider range of animals, specifically farm animals. Therefore, this bacterium may pose a zoonotic threat to the local community particularly to the farmworkers or animal handlers. The low infection rate of this pathogen across different animals highlighted the need of continuous surveillance of emerging and reemerging pathogens among animal populations.
  4. Lee CJ, Lai LL, See MH, Velayuthan RD, Doon YK, Lim PE, et al.
    World J Surg, 2023 Nov;47(11):2743-2752.
    PMID: 37491402 DOI: 10.1007/s00268-023-07108-z
    BACKGROUND: In recent years, the increase in antibiotics usage locally has led to a worrying emergence of multi-drug resistant organisms (MDRO), with the Malaysian prevalence rate of methicillin-resistant Staphylococcus aureus (MRSA) ranging from 17.2 to 28.1% between 1999 and 2017. A study has shown that 7% of all non-lactational breast abscesses are caused by MRSA. Although aspiration offers less morbidities compared to surgical drainage, about 20% of women infected by MRSA who initially underwent aspiration subsequently require surgical drainage. This study is conducted to determine the link between aetiology, antimicrobial resistance pattern and treatment modalities of breast abscesses.

    METHODS: Retrospective study of reviewing microbiology specimens of breast abscess patients treated at Universiti Malaya Medical Centre from 2015 to 2020. Data collected from microbiology database and electronic medical records were analysed using SPSS V21.

    RESULT: A total of 210 specimens from 153 patients were analysed. One-fifth (19.5%) of the specimens isolated were MDRO. Lactational associated infections had the largest proportion of MDR in comparison to non-lactational and secondary infections (38.5%, 21.7%, 25.7%, respectively; p = 0.23). Staphylococcus epidermidis recorded the highest number of MDR (n = 12) followed by S. aureus (n = 8). Adjusted by aetiological groups, the presence of MDRO is linked to failure of single aspirations (p = 0.554) and significantly doubled the risk of undergoing surgical drainage for resolution (p = 0.041).

    CONCLUSION: MDR in breast abscess should be recognised as an increasing healthcare burden due to a paradigm shift of MDRO and a rise of resistance cases among lactational associated infection that were vulnerable to undergo surgical incision and drainage for resolution.

  5. Zhang A, Muthanna A, Lee YZ, Yew XX, Selvanathan R, Gan ZSR, et al.
    Inflammopharmacology, 2026 Apr;34(4):2317-2335.
    PMID: 41863760 DOI: 10.1007/s10787-026-02191-9
    Cardamonin (2’,4’-dihydroxy-6’-methoxychalcone) is a naturally occurring chalcone primarily isolated from Boesenbergia rotunda and Alpinia species, which has gained considerable attention for its diverse pharmacological properties. This comprehensive review examines the preclinical evidence supporting cardamonin’s therapeutic potential in metabolic diseases, including obesity, diabetes, cardiovascular complications, and related disorders. Preclinical studies have demonstrated that cardamonin exerts anti-inflammatory, antioxidant, and metabolic regulatory effects through modulation of key signaling pathways including NF-κB, Nrf2, AMPK, mTOR, and PPAR pathways. In obesity models, cardamonin suppresses lipogenesis and promotes browning of adipocytes via PKA-mediated mechanisms. In diabetes, it enhances glucose uptake through GLUT4 translocation and improves insulin sensitivity by inhibiting mTOR/S6K1 feedback. Cardamonin also demonstrates cardioprotective effects against ischemia-reperfusion injury, pressure overload, and doxorubicin-induced cardiotoxicity. Additionally, it shows nephroprotective properties in models of renal injury and metabolic dysfunction. However, clinical studies remain limited, and the therapeutic translation of cardamonin requires further investigation of its bioavailability, pharmacokinetics, and safety profile in humans. This review synthesizes current preclinical evidence and identifies critical gaps that warrant future research to establish cardamonin as a potential therapeutic agent for metabolic diseases.
  6. Lim HC, Lee SK, Keng JW, Lee EQ, Tan ESS, Liew KB, et al.
    Drug Deliv Transl Res, 2025 Nov;15(11):4260-4276.
    PMID: 40783675 DOI: 10.1007/s13346-025-01939-0
    Plant oils play an important role in natural product-based dermatological formulations owing to their multifunctional therapeutic properties. Among these, sunflower seed oil (SSO) has gained prominence due to its dual role as a barrier-restoring emollient and skin penetration enhancer. Rich in unsaturated fatty acids, particularly linoleic acid (LA) and oleic acid (OA), SSO supports skin health by restoring lipid bilayer organization, modulating ceramide synthesis, and activating peroxisome proliferator-activated receptor-alpha (PPAR-α). These mechanisms reinforce barrier integrity while facilitating transdermal delivery of active agents. However, oils high in OA and/or containing protein allergens may compromise barrier function and promote allergen penetration, necessitating careful evaluation of chemical composition and structural characteristics. Ex vivo studies using porcine skin models have demonstrated SSO ability to enhance the permeation of both hydrophilic and lipophilic compounds. Clinically, SSO has shown efficacy in reducing transepidermal water loss (TEWL), improving hydration, and accelerating wound healing in conditions such as xerosis and atopic dermatitis. Its favourable safety profile, biocompatibility, and successful incorporation into various dermatological and cosmeceutical formulations underscore its versatility. This review critically examines the molecular interactions between SSO and the skin barrier, with specific focus on its roles in barrier restoration, inflammation modulation and transdermal enhancement. Mechanistic insights from its fatty acid composition are integrated with ex vivo findings, supported by clinical evidence, to evaluate its therapeutic potential and utility as a multifunctional, plant-based excipient in modern topical drug delivery systems for human skin health.
  7. Yam MF, Tew WY, Tan CS, Loh HW, Qiu Q, Yan CS, et al.
    Hypertens Res, 2025 Nov;48(11):2897-2910.
    PMID: 40968158 DOI: 10.1038/s41440-025-02298-6
    Orthosiphon stamineus Benth, commonly used in Southeast Asia for its medicinal properties, is traditionally employed to treat diabetes and hypertension. Scientific research has validated that O. stamineus extract exhibits significant vasodilatory action on rat aorta. This effect is primarily due to the synergistic interaction among key compounds: eupatorin, sinensetin and 3'-hydroxy-5,6,7,4'-tetramethoxyflavone (TMF). Our previous publication identified the optimum formulation, G28, which contains eupatorin, sinensetin and TMF in the ratio of EC20:EC15:EC5. Therefore, the aim of this study was to investigate the antihypertensive effect and mechanism of action of formulation G28. In this study, aortic rings from spontaneously hypertensive rats (SHRs) and Sprague-Dawley (SD) rats were used to examine the vasodilation mechanisms. The antihypertensive effect of G28 was also assessed through repeated-dose administration in SHRs. G28 exhibited stronger vasorelaxant effects in SHR versus SD rat aortic rings, indicating higher potency under hypertensive conditions. The effect was partially endothelium-dependent, as endothelium removal reduced responses in both aortic rings. G28 retained efficacy with Nω-Nitro-1-arginine methyl ester, methylene blue and 1H-[1,2,4]Ox-adiazolol[4,3-α]quinoxaline-1-one, suggesting involvement of the NO/sGC/cGMP pathway. Additionally, G28's effect diminished with glibenclamide, barium chloride, 4-aminopyrine and tetraethylammonium, indicating potassium channel involvements. The vasorelaxant effect was not significantly altered by indomethacin, atropine, or propranolol (in SD rats only), suggesting independence from the cyclooxygenase, beta-adrenergic (in SD rats only) and muscarinic pathways. G28 also reduced intracellular Ca²⁺ in vascular smooth muscle by antagonising voltage-gated calcium channel and Inositol triphosphate receptor. In vivo, G28 significantly reduced blood pressure in SHRs over 21 days of oral administration, underscoring its potential for hypertension control. G28 shows strong antihypertensive effects via NO/sGC/cGMP, potassium and calcium channels. Its sustained blood pressure reduction in SHRs highlights potential as a promising hypertension treatment option.
  8. Loh HH, Tay SP, Koa AJ, Yong MC, Said A, Chai CS, et al.
    J Hum Hypertens, 2026 Sep;40(9):755-762.
    PMID: 42570943 DOI: 10.1038/s41371-026-01195-w
    Although routine screening for primary aldosteronism (PA) is increasingly recognized among patients with obstructive sleep apnea (OSA), data regarding aldosterone-to-renin ratio (ARR) screening positivity among Southeast Asian OSA populations remain limited, particularly in resource-limited settings. This study aimed to determine the prevalence and clinical correlates of ARR positivity screening among obese hypertensive OSA patients. In this cross-sectional study, obese hypertensive adults with confirmed OSA were recruited. Blood samples were analyzed for plasma aldosterone concentration (PAC), plasma renin concentration (PRC), serum potassium, and standard metabolic indices. Therapeutic intensity score (TIS) was used to quantify antihypertensive burden. ARR-based categories were applied to stratify patients into (i) positive ARR (Group 1), (ii) low renin/negative ARR (Group 2), or (iii) negative ARR (Group 3). Among 160 patients, 11.9% were classified in Group 1 and 20.0% as Group 2. Serum potassium levels were significantly lower in Group 2 compared with Group 3. An inverse association between PRC and uric acid was observed in the overall cohort, although the model fit was weak. In males, serum potassium, uric acid, and TIS were significantly associated with RAAS activity and were associated with greater likelihood for ARR positive screen. A substantial proportion of obese hypertensive OSA patients demonstrated ARR positivity. However, routine clinical and metabolic parameters alone were insufficient to reliably identify affected individuals. These findings support maintaining a low threshold for PA screening in hypertensive OSA patients.
  9. Olson PS, Sawangjit R, Tan BK, Seesin T, Setiawan CH, Watcharadamrongkun S, et al.
    Sci Rep, 2025 Nov 20;15(1):40930.
    PMID: 41266400 DOI: 10.1038/s41598-025-24749-3
    Noncommunicable diseases (NCDs) are the leading cause of morbidity and mortality in ASEAN countries. However, consolidated evidence regarding the effectiveness of pharmacy practice interventions in ASEAN is still unclear. This study aimed to explore the scope and impact of pharmacy practice in managing NCDs in ASEAN countries. Systematic searches were conducted in 12 databases (PubMed™, Science Direct™, Scopus™, Springer Link™, Web of Science™, Cochrane Library™, and other databases) for studies published between 2001 and 2021. Of the 171 included studies from seven countries, seven focused on pharmacy education and showed improvements in students' knowledge and skills. Meta-analyses were performed on 47 randomized controlled trials using a random-effects models and risk of bias assessment. Pharmacists' interventions significantly improved fasting blood glucose, HbA1c, lipid parameters, blood pressure, and percent peak expiratory flow rates, compared to usual care. No significant improvements were found in blood pressure (particularly in diabetes subgroups), smoking cessation, or body weight. Positive humanistic outcomes, such as patient satisfaction, knowledge, and quality of life, were reported. While the studies in the meta-analyses were limited to Thailand, Malaysia, Indonesia, and Lao PDR, pharmacists' practice interventions in ASEAN countries demonstrated positive impacts on both clinical and humanistic outcomes. Due to a high overall risk of bias, the results should be interpreted with considerable caution. Further large-scale, long-term, and rigorous studies should be undertaken.Systematic review registration: The Prospective Registration of Systematic Review on April 10, 2022, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=316184 .
  10. Kuan, C.H., Rukayadi, Y., Ahmad, S. H., Wan Mohamed Radzi, C.W.J., Kuan, C.S., Yeo, S.K., et al.
    MyJurnal
    Listeriosis and salmonellosis are the major foodborne illnesses worldwide. Over the last decade,
    increasing reports about the antibiotic resistance of Listeria monocytogenes and Salmonella from diverse sources have prompted public health concerns, especially in developing countries with over reliance or misuse of antibiotic drugs in the treatment of humans and animals. In this study, antibiotic susceptibility profiles of 58 L. monocytogenes and 12 Salmonella Enteritidis strains from vegetable farms and retail markets in Malaysia were testedby the standard disk diffusion method. Listeria monocytogenes isolates were found to exhibit 100% resistance to penicillin G. Also, high resistance patterns were observed for meropenem (70.7%) and rifampicin (41.4%). The multiple antibiotic resistance (MAR) index of L. monocytogenes isolates ranged from 0.11 to 0.56. Besides, the antibiogram results revealed that multidrugresistant (MDR) S. Enteritidis were detected and all the S. Enteritidis isolates demonstrated resistance to at least four antibiotics. Ampicillin, amoxicillin, and trimethoprim failed to inhibit all the S. Enteritidis strains. Salmonella Enteritidis isolates also displayed high resistance to nalidixic acid (75.0%), trimethoprim-sulfamethoxazole (75.0%), and chloramphenicol (66.7%). Findings in this study indicated that vegetables could be potential sources of multidrug resistance of L. monocytogenes and S. Enteritidis, which can be a serious issue and a major concern for public health. Thus, there is a great need for surveillance programs in Malaysia to continuously monitor the antibiotic resistance profiles of important pathogens.
  11. Seah, B.H.A., Tow, S.L.C., Ong, K.C.B. Ong, Yang, C.C., Tsai, C.P., Lee, K.H., et al.
    Neurology Asia, 2017;22(4):341-348.
    MyJurnal
    Optic neuritis, which may be a precursor to multiple sclerosis (MS), is an uncommon disease in
    Asian patients. The Asian Collaborative Longitudinal Optic Neuritis Epidemiology (ACLONE) is
    an observational cohort study that assessed the risk of recurrent optic neuritis and/or progression
    of further neurologic events, either MS or neuromyelitis optica (NMO) in Asian patients with firstever
    optic neuritis. Secondary aims were to study the presenting characteristics and visual outcome,
    and to identify risk factors for development of either MS or NMO. A total of 112 patients (25 men
    and 87 women) aged from 12 to 61 years were recruited from Singapore, Taiwan, South Korea and
    Malaysia. Of these, 94 (84%) had unilateral optic neuritis, with the right eye involved in 45 patients
    and the left eye in 49 patients and the remaining 18 (16%) had bilateral optic neuritis. Follow up
    data was available for 104 patients, and patients were followed for a median duration of 25.9 months.
    Of these patients, 6 patients were adjudicated to have reached the primary endpoint (composite of
    MS/NMO and optic neuritis): 3 patients with recurrent optic neuritis also subsequently experienced
    neurologic symptoms, and 3 patients without recurrent eye involvement had neurologic symptoms.
    Only one patient was considered to have prototypical MS, the other 5 were diagnosed with NMO,
    all with subsequent antibody confirmation. Optic neuritis in Asian patients has significantly different
    presenting characteristics from the classic description. However, in the majority of the patients it is
    usually a benign disease, with good visual outcome and no further events.
  12. Thung, T.Y., Lee, E., Tan, C.W., Malcolm, T.T.H., New, C.Y., Ramzi, O.S.B., et al.
    Food Research, 2018;2(5):404-414.
    MyJurnal
    Bacteriophages are ubiquitous in our world, mainly in the oceans, soil, the water and food
    we consume. They can be used efficiently in modern biotechnology, as well as alternatives
    to antibiotics for many antibiotic resistant bacterial strains. Phages can be used as vehicles
    for vaccines both DNA and protein, for the detection of pathogenic bacterial strain, as biocontrol
    agents in agriculture and food industry. This review outlines the properties as well
    as the influence of different external physical and chemical factors like temperature and
    acidity on phage persistence. A better understanding of the complex problem of phage
    sensitivity to external factors may be useful for other researchers working with phages.
    Furthermore, the applications of bacteriophages were described in this paper as well.
  13. Najma Kori, Wan Asyraf Wan Zaidi, Rabani Remli, Azman Ali Raymond, Norlinah Mohamed Ibrahim, Tan, Hui Jan, et al.
    Neurology Asia, 2018;23(3):225-232.
    MyJurnal
    Background & Objectives: The National Institute of Health Stroke Scale (NIHSS) provides a valid and quick assessment of stroke severity in hyperacute stroke management. Stroke patients who are eligible for reperfusion therapy require prompt assessment. There is no validated Bahasa Malaysia (BM) version of the NIHSS that allows easier assessment by BM-speaking health professionals. This study aimed to translate and validate a BM version of the NIHSS.
    Methods: The English NIHSS was translated to BM, then back translated to ensure linguistic accuracy. We also adapted the language assessment of the NIHSS to be more culturally appropriate. Training and certification videos were downloaded from the NIH website and dubbed into BM. We determined intra-class correlation and unweighted kappa as the best measure of reliability. Median scores were used in the analysis for language items.
    Results: One hundred and one raters participated in the test-retest reliability study. Agreement between the original NIHSS and our translated version of the BM-NIHSS was good (ICC = 0.738, 95% CI: 0.611 to 0.823). Fair to moderate agreement was found on item-by-item analysis (unweighted κ=0.20-0.50) despite high observed agreement. Fifty patients participated in the language assessment arm. Scores were better in BM for reading, naming objects and repetition (Mdn = 100, p < 0.001). There was no difference in the median scores for the description component.
    Conclusions: The BM-NIHSS is a valid translation of the NIHSS, and may be used in clinical practice by BM-speaking healthcare professionals.
  14. George-Kodiseri E, Faridah K, George-Vadaketh R, Lau PS, Ong MS, Tan TY, et al.
    Family Physician, 1989;1:34-42.
  15. Chiu W, Too S, Daud S, Rashid N, Chia M, Rahman S, et al.
    Sains Malaysiana, 2014;43:941-945.
    In the present study, we report the size distribution study on the iron oxide (Fe304) magnetic nanocrystals (Ncs), which have been synthesized by using green chemistry approach with palm-oil based carboxylic compound (oleic acid) as capping ligands . The Fe304 Ncs were prepared by one pot reaction under non-hydrolytic approach. With the assistance of oleic acid that plays the role as effective capping-ligands , we showed that the Fe304 NCs that are highly monodispersed in size and shape can be synthesized by scrupulously controlling the reaction time. The diameter of Fe304 Ncs can be tuned within the range of 4.0-18.0 nm and exhibit very uniform morphology, which are spherical in shape. Current synthetic approach offers a cheap, environmentally benign and excellent repeatability route in large-scale production of high-quality magnetic Fe304 Ncs if compared to the preceding reports.
  16. Amir Hamzah A, Abu Bakar Z, Abdul Sani N, Tan JK, Ahmad Damanhuri M, Makpol S, et al.
    Sains Malaysiana, 2016;45:1371-1380.
    Higher level of education is associated with better cognitive performance and lower risk of developing dementia. However, the effect of education on cognitive performance varies across different cognitive domains and in different populations. The aim of this study was to determine the relationship between education and performance of different cognitive domains among healthy Malay adults. A total of 53 individuals aged 29 to 77 years participated in a battery of neurophysiological tests consisting of Mini-Mental State Examination, Montreal Cognitive Assessment, digit span, visual reproduction and digit symbol speed test (DSST). Blood test was performed for each participant to obtain their biochemical profile. Educational level was divided into level 1 (PMR), level 2 (SPM), level 3 (STPM), level 4 (Diploma) and level 5 (Degree). Simple linear regression indicated that years of education was positively associated with scores of delayed visual reproduction (b=1.348, p=0.002) and DSST (b=3.257, p=0.012). However, scores of all the tests were not significantly different among different levels of education after controlling for age, gender and blood test profile by ANCOVA. Multiple linear regression analysis showed that MMSE score was associated with red cell distribution width (b=-0.628, p=0.005), age (b=-0.119, p<0.001) and there was interaction between high density lipoprotein (HDL) with age (b=0.047, p<001). MoCA score was associated with age (b=-0.121, p<0.001), gender (male compared to female, b=1.870, p=0.020) and HDL (b=1.681, p=0.047). Age was associated with backward digit span (b=-0098, p<0.001) and immediate visual reproduction (b=-0.348, p<0.001), resp. Delayed visual reproduction was associated with age (b=-0.323, p<0.001) and potassium level (b=-4.471, p=0.016). DSST was associated with age (b=-0.911, p<0.001) and alanine aminotransferase (b=-0.754, p=0.002). The lack of association between educational level and cognitive performance after adjusting for confounders in this study maybe due to multiple factors influencing cognitive performance and further studies with a larger sample size are needed to further identify the factors involved.
    Keywords: Cognitive performance; education; healthy Malay adults
    ABSTRAK
    Tahap pendidikan yang tinggi telah dikaitkan dengan prestasi kognitif yang lebih baik dan risiko perkembangan dementia yang lebih rendah. Namun, kesan pendidikan terhadap prestasi kognitif berbeza antara domain kognitif dan populasi yang berlainan. Kajian ini bertujuan untuk menentukan hubungan antara pendidikan dengan prestasi pada domain kognitif yang berlainan pada individu dewasa Melayu yang sihat. Seramai 53 individu yang berumur antara 29 hingga 77 tahun telah menyertai ujian neuropsikologi yang terdiri daripada Pemeriksaan Keadaan Mental Mini, Penilaian Kognitif Montreal, digit span, penghasilan semula visual dan ujian kelajuan simbol digit (DSST). Tahap pendidikan dibahagikan kepada tahap 1 (PMR), tahap 2 (SPM), tahap 3 (STPM), tahap 4 (Diploma) dan tahap 5 (Ijazah Sarjana Muda). Regresi linear mudah menunjukkan bahawa tahap pendidikan berhubung kait secara positif dengan penghasilan semula visual tertunda (b=1.348, p=0.002) dan DSST (b=3.257, p=0.012). Namun, semua skor ujian menjadi tidak berbeza antara tahap pendidikan yang berbeza selepas mengambil kira kesan konpengasas dengan menggunakan ANCOVA. Regresi linear berganda menunjukkan bahawa skor MMSE berhubung kait dengan lebar taburan sel merah (b=-0.628, p=0.005), umur (b=-0.119, p<0.001) dan interaksi antara lipoprotein ketumpatan tinggi (HDL) dan umur (b=0.047, p<001). MoCA didapati berhubung kait dengan umur (b=-0.121, p<0.001), jantina (lelaki berbanding perempuan, b=1.870, p=0.020) dan HDL (b=1.681, p=0.047). Umur juga berhubung kait dengan digit span ke belakang (b=-0098, P<0.001) dan penghasilan semula visual segera (b=-0.348, p<0.001). Penghasilan semula visual tertunda berhubung kait dengan umur (b=-0.323, p<0.001) dan tahap kalium (b=-4.471, p=0.016). DSST berhubung kait dengan umur (b=-0.911, p<0.001) dan alanin aminotransferase (b=-0.754, p=0.002). Hubungan antara tahap pendidikan dan prestasi kognitif tidak dikesan selepas mengambil kira kesan konpengasas yang mencadangkan bahawa prestasi kognitif mungkin dipengaruhi oleh pelbagai faktor dan kajian lanjut dengan bilangan sampel yang lebih besar diperlukan untuk mengenal pasti faktor ini.
  17. Goh EML, Tan LC, Chow SK, Teh LK, Yeap SS
    DOI: 10.1046/j.0219-0494.2003.00021.x
    Aim: To determine the prevalence of the use of complementary medicine in patients with systemic lupus erythematosus (SLE)., Method: A prospective survey was conducted of 132 patients using a standard questionnaire., Results: Of the 132 patients, 15.2% were on alternative therapy and 56.7% were taking food supplements. The common types of alternative therapy taken were oral traditional herbs (50%) and noni juice (20%). Vitamin C, calcium, vitamin E, vitamin B, Spirulina, evening primrose oil, fish oil and multivitamins were the commonest food supplements. There was no significant relationships between taking alternative treatment and educational level (P = 0.16), income (P = 0.05) or race (P = 0.42) of the patients. The majority of these patients took these therapies or supplements for up to 1 year. Up to 70% of the patients had not consulted a doctor before taking these therapies, with immediate family members and friends being the main sources of recommendation. The majority of patients spent RM50-RM500 (US$13-US$132) for 2 months' supply of medications. In conclusion, 15.2% of SLE patients in our study were on alternative therapy and 57.6% on food supplements., Conclusion: Physicians should be aware of these practices which should be taken into account during the history-taking and subsequent management of the patients.
  18. Chellappan DK, Sze Ning QL, Su Min SK, Bin SY, Chern PJ, Shi TP, et al.
    Chem Biol Interact, 2019 Sep 01;310:108732.
    PMID: 31276660 DOI: 10.1016/j.cbi.2019.108732
    BACKGROUND: The human body is a home to thousands of microbiotas. It is defined as a community of symbiotic, commensal and pathogenic microorganisms that have existed in all exposed sites of the body, which have co-evolved with diet, lifestyle, genetic factors and immune factors. Human microbiotas have been studied for years on their effects with relation to health and diseases.

    METHODS: Relevant published studies, literature and reports were searched from accessible electronic databases and related institutional databases. We used keywords, viz; microbiome, microbiota, microbiome drug delivery and respiratory disease. Selected articles were carefully read through, clustered, segregated into subtopics and reviewed.

    FINDINGS: The traditional belief of sterile lungs was challenged by the emergence of culture-independent molecular techniques and the recently introduced invasive broncho-alveolar lavage (BAL) sampling method. The constitution of a lung microbiome mainly depends on three main ecological factors, which include; firstly, the immigration of microbes into airways, secondly, the removal of microbes from airways and lastly, the regional growth conditions. In healthy conditions, the microbial communities that co-exist in our lungs can build significant pulmonary immunity and could act as a barrier against diseases, whereas, in an adverse way, microbiomes may interact with other pathogenic bacteriomes and viromes, acting as a cofactor in inflammation and host immune responses, which may lead to the progression of a disease. Thus, the use of microbiota as a target, and as a drug delivery system in the possible modification of a disease state, has started to gain massive attention in recent years. Microbiota, owing to its unique characteristics, could serve as a potential drug delivery system, that could be bioengineered to suit the interest. The engineered microbiome-derived therapeutics can be delivered through BC, bacteriophage, bacteria-derived lipid vesicles and microbe-derived extracellular vesicles. This review highlights the relationships between microbiota and different types of respiratory diseases, the importance of microbiota towards human health and diseases, including the role of novel microbiome drug delivery systems in targeting various respiratory diseases.

  19. Jhi Biau Foo, Li Shan Ng, Ji Hui Lim, Pau Xien Tan, Yan Zhi Lor, Jason Siau Ee Loo, et al.
    MyJurnal
    Introduction: Copper complexes can be developed as targeted agent for cancer due to increased uptake of copper by cancer cells for angiogenesis. Our previous published data showed that copper complex Cu(SBCM)2 induced apoptosis towards triple-negative MDA-MB-231 breast cancer cells. However, its effect towards other breast cancer subtype remains unknown. Current study was performed to explore the cytotoxicity of Cu(SBCM)2 towards oestrogen- receptor positive MCF-7 breast cancer cells. Methods: MTT assay was employed to study the growth inhibition of Cu(SBCM)2 towards MCF-7 breast cancer cells and human non-cancerous MCF10A breast cells. Morphological changes of Cu(SBCM)2-treated MCF-7 cells was observed under inverted light microscope. Induction of cell cycle arrest and apoptosis were accessed by flow cytometry. The expression of wild-type p53 protein was evaluated by western blotanalysis. Intracellular reactive oxygen species of MCF-7 treated with Cu(SBCM)2 was detected using DCFHDA assay. The cells were then co-treated with Cu(SBCM)2 and antioxidants to evaluate the involvement of ROS in the cytotoxicity of Cu(SBCM)2. Molecular docking study was performed to determine the interaction of Cu(SBCM)2 with DNA, DNA topoisomerase I, and human ribonucleotide reductase. Results: Cu(SBCM)2 induced G2/M phase cell cycle arrest and apoptosis in MCF-7 cells possibly via upregulation of p53 wild-type protein. Cu(SBCM)2 was less toxic towards MCF10A cells. Increased level of intracellular ROS was not detected in MCF-7 cells after treatment with Cu(SBCM)2. However, N-acetylcysteine antioxidant enhance the cytotoxicity of Cu(SBCM)2 in MCF-7 cells. Cu(SBCM)2 showed the greatest affinity for DNA topoisomerase I in comparison to DNA and human ribonucleotide reductase. Conclusions: Cu(SBCM)2 has a potential to be developed as a targeted agent for breast cancer.
  20. Zhe, Kang Law, Wan Nur Nafisah, Saathevan, Ramesh, Jee, Yong Hing, Mohd Firdaus Zakaria, Nurul Munirah Mohd Shuhairi, et al.
    Neurology Asia, 2015;20(2):121-127.
    MyJurnal
    Background & Objectives: The burden of stroke is increasing, in part due to increasing prevalence of diabetes mellitus. Given the high prevalence of diabetes in the Malaysian population (22.6%), we aimed to determine the prevalence of diabetes in our stroke population. We also aimed to study the stroke subtype associated with diabetes. We hypothesized that lacunar infarction would be more prevalent in diabetics. Methods: We retrospectively reviewed data of consecutive patients with acute ischaemic stroke admitted from October 2004 to December 2010 from our stroke registry. Demographic data, risk factors profile and stroke subtypes were reviewed and analyzed. Results: Eight hundred and fifty eight patients were identified from the registry. As high as 59.3% (n=509) of our patients were diabetics, of which 49.2% (n=422) had pre-existing diabetes and 10.1% (n=87) were newly diagnosed. Lacunar infarction was the commonest stroke subtype, comprising 60.6% (n=519) of all strokes. Diabetes was significantly associated with lacunar infarction (OR 1.5, CI 95% 1.16-2.01, p=0.003), particularly in those aged ≤ 55 years (OR 2.29, 95% CI 1.12-4.67) and HbA1C ≥ 6.5% (χ2=8.77, p=0.003). Conclusions: The prevalence of diabetes in our stroke patients is amongst the highest reported. Diabetes mellitus, particularly those with poor glycaemic control is strongly associated with lacunar infarction.
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