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Fulltext The study of broken hearts: A pragmatic case report on takotsubo cardiomyopathy in Malaysia

Syeda Humayra, Abd. Rahim Mohamad, Ab. Kahar Ab. Ghapar, L Mohamed

JUMMEC, 2020;23(2):5-7.
MyJurnal

The Takotsubo syndrome is an acquired, non-ischemic stress-induced cardiomyopathy popularly known as the ‘broken heart syndrome’. It is an acute left ventricular dysfunction presenting mostly in older women after an intensely stressful event. The exact pathophysiology remains elusive. The term came into existence in the early 1990s in Japan, where the distinctive change in the shape of the left ventricle with apical ballooning during systole, resembled the Takotsubo, an octopus pot used bythe Japanese fisherman. From a rare underrecognized syndrome, it has been increasingly recognised as a form of acute cardiac failure. Clinical diagnosis of the syndrome may be unidentified due to its similarity with the acute coronary syndrome, but without the narrowing of coronary vessels in angiographic imaging. There is a substantial elevation of the cardiac biomarkers, troponin and the natriuretic peptides which helps in differentiating the Takotsubo syndrome from myocardial infarction. A case report of a 59-year old Malaysian lady with typical, recurrent episodes of the Takotsubo syndrome is presented.
Fulltext Concentrations of Mn and Fe in the sediment cores of Sarawak and Sabah coastal waters. [Kepekatan Mn dan Fe dalam teras sedimen di perairan Sarawak dan Sabah.]

Wan Mahmood ZU, Ahmad Z, Mohamed CAR

Sains Malaysiana, 2010;39(1):13-20.

Sediment cores were taken at eight stations along Sarawak and Sabah coastal waters using a gravity box corer on July 2004. The sediment cores were cut into 2 cm interval for measurement of Mn and Fe concentration using the Inductive Couple Plasma-Mass Spectrometer (ICP-MS). Overall, the sediment cores contained much mud which include a mixture of silt (46 – 67%) and clay (18 – 53%) compared to sand (0.4 – 16%). The concentrations of Mn and Fe were in the range of 154 – 366 µg/g and 0.9 – 3.4%, respectively. The variation was studied by ANOVA, which showed a significant difference (p = 0.000) for both of Mn and Fe concentrations at all sampling stations. In those ranges, Fe concentration was higher compared to Mn. It is believed that dissolving and diluting process influenced the concentration of Mn in the water column and sediment. Fe showed a significant correlation (r > 0.5, p < 0.01) with Mn at all stations except SR 03, indicating the natural occurrence of Mn and Fe in the water column. Meanwhile, Müller classification proved that sediment cores taken at 8 stations along Sarawak and Sabah coastal waters were not polluted with Fe and Mn with geoaccumulation index, Igeo < 1 and classification 0 – 1.
Keywords: Fe; Mn; Müller classification; organic carbon; particle size; sediment core
Fulltext Epigenetic changes of DRD2 gene in Pathogenesis of Schizophrenia

Nour El Huda Abd Rahim, Mohd Nabil Fikri Rahim, Norsidah Ku Zaifah, Hanisah Mohd Noor, Kartini Abdullah, Norlelawati A. Talib

International Medical Journal Malaysia, 2017;16(11):3-3.
MyJurnal

The dopamine hypothesis has earlier dominated the theories for the
development of schizophrenia based on the early pharmacologic evidence. The
antipsychotic drugs, among others, is thought to interfere with the function of the
dopamine D2 receptor (DRD2) resulting in clinical improvement. Accumulating evidence
suggest the role of epigenetic mechanisms in the pathophysiology of schizophrenia.
Despite this, specific evidence linking the DRD2 DNA methylation with schizophrenia is
insufficient mainly due to the poor accessibility and limited brain samples. Of late, new
data has suggested the global impact of DNA methylation in the development of
schizophrenia, thus methylation in the peripheral blood could infer changes in the brain.
The aim of this study was to assess the DRD2 DNA methylation in the peripheral blood of
schizophrenia.
Fulltext Prediction of clinical symptoms of Schizophrenia based on COMT Methylation marker

Nour El Huda Abd Rahim, Mohd Nabil Fikri Rahim, Norsidah Ku Zaifah, Hanisah Mohd Noor, Kartini Abdullah, Norlelawati A. Talib

International Medical Journal Malaysia, 2017;16(11):19-19.
MyJurnal

The dopamine hypothesis of schizophrenia is based on the fact that hyperdopaminergic
state is involved in causing psychosis and antipsychotic drugs block the
dopamine receptor. COMT regulates the homeostatic levels of neurotransmitter
dopamine in the synapses and plays a role in the neurocognitive function. The
dysregulation of dopamine in the prefrontal cortex influences the cognitive function and
the severity of the psychotic symptoms in schizophrenia. During epigenetic event,
methylated COMT gene may cause reduction in its expression and contribute to the
clinical presentation of schizophrenia. Therefore, the aim of this study was to assess the
feasibility of using COMT DNA methylation for the prediction of specific psychotic
presentation of schizophrenia. (Copied from article).
Fulltext Assessment of selected herbicides and chelating agents in water using Gas Chromatography-Electron Capture Detector (GC-ECD)

Siti Fadhilah Abd. Rahim, Normala Masrom, Muhamad Cyrill Kamal, Noor Azmi Shaharuddin, Khairul Basyar Baharudin, Norliza Abu Bakar

Bioremediation Science and Technology Research, 2015;3(1):27-31.
MyJurnal

Water contamination by herbicides and chelating agents is increasing mainly due to the
increasing agricultural activities. Water contamination by these compounds has become a
concern due to their adverse effects to the environment and humans. Seven sampling sites of
water sources in Selangor and Johor were chosen for the study. Contamination level of
Mecoprop (MCCP), Nitrilotriacetic acid (NTA) and Ethylenediaminetetraacetic acid (EDTA) in
these water body areas was determined by using Gas Chromatography-Electron Capture
Detector (GC-ECD). Our results indicated that water samples of Sungai Melot in Selangor
showed the highest presence of EDTA. MCCP was detected at a high level at Sungai Sarang
Buaya, Johor while NTA showed similar level of concentration at three different sites, Ladang
10, Ladang Sayur and Mardi, Selangor.
Pengambilan Fe, Mn dan Cu oleh Nepenthes sp. dalam tanih bekas lombong Pelepah Kanan Kota Tinggi, Johor

Sahibin Abd. Rahim, Tukimat Lihan, Zulfahmi Ali Rahman, Wan Mohd. Razi Idris, Azman Hashim, Sharilnizam M. Yusof, et al.

Sains Malaysiana, 2007;36:9-13.

Kandungan logam berat Fe, Cu dan Mn dalam tanih serta tumbuhan Nepenthes sp yang diambil daripada kawasan bekas lombong bijih timah dan besi di Lombong Pelepah Kanan, Kota Tinggi, Johor telah dikaji. Kandungan logam berat telah ditentukan di dalam empat bahagian tumbuhan Nepenthes sp. iaitu di dalam akar, batang, daun dan periuk. Sebanyak 15 sampel tumbuhan Nepenthes sp dan tanih dikumpul untuk dianalisis. Komposisi logam-logam berat dalam sampel tanih diekstrak dengan menggunakan campuran asid nitrik dan asid perklorik. Kandungan logam berat dalam tumbuhan pula diekstrak melalui kaedah penghadaman basah. Kandungan logam berat di dalam larutan ekstrak tanih dan tumbuhan ditentukan dengan menggunakan alat Spektrofotometer Serapan Atom Kaedah Nyalaan (FAAS). Nilai Koefisien Penyerapan Biologi (BAC) dikira sebagai nisbah kandungan logam berat dalam tumbuhan kepada kandungan logam berat dalam tanih. Analisis tanih menunjukkan kawasan bekas lombong didominasi oleh pasir dan bersifat asid. Ia juga mempunyai kandungan bahan organik dan nilai kekonduksian elektrik yang rendah. Logam Fe mencatatkan kepekatan purata paling tinggi di dalam tanih diikuti oleh Mn dan Cu. Tumbuhan Nepenthes sp boleh dijadikan sebagai pengumpul biologi untuk logam Fe kerana nilai BACnya adalah tinggi.
Kandungan logam berat dalam tumbuhan penyedap rasa terpilih dan dalam tanih ultrabes di felda Rokan barat, Negeri sembilan, Malaysia

Sahibin Abd Rahim, Wan Mohd Razi Idris, Zulfahmi Ali Rahman, Tukimat Lihan, Ramilan Omar, Liew KY

Sains Malaysiana, 2012;41:11-21.

Kajian ini dijalankan di kawasan tanih ultrabes di Felda Rokan Barat (FRB), Negeri Sembilan. Sebanyak dua puluh sampel cili, kunyit, pandan dan serai serta substratnya telah diambil secara rawak untuk penentuan kandungan logam berat Fe, Cd, Co, Cu, Mn, Ni, Pb, Cr dan Zn. Kandungan logam berat dalam tumbuhan diekstrak secara penghadaman basah, manakala kandungan logam berat resistan dan tersedia dalam tanih diekstrak dengan kaedah pengekstrakan berjujukan. Kandungan logam berat jumlah diperoleh dengan menjumlahkan kandungan logam berat rintang dan tersedia. Kandungan logam berat di dalam larutan ekstrak tanih dan tumbuhan ditentukan dengan menggunakan Spektrofotometer Penyerapan Atom Nyalaan (FAAS). Hasil kajian menunjukkan logam Fe adalah dominan di dalam tanih di kawasan kajian manakala kepekatan logam Cd paling rendah dengan nilai < 10 mg/kg. Sela kepekatan logam-logam berat dalam tanih ialah Fe (2618.4 hingga 4248 mg/kg), Mn (240.9 hingga 741.9 mg/kg), Zn (81.9 hingga 324.8 mg/kg), Cr (46.8 hingga 438.7 mg/kg), Cu (15.7 hingga 81.7 mg/kg), Pb (14.9 hingga 116.8 mg/kg), Ni (10.1 hingga 545.6 mg/kg), Cd (5.6 hingga 10.6 mg/kg) dan Co (0.8 hingga 126.1 mg/kg). Nilai kepekatan Fe tersedia mencatatkan nilai tertinggi bagi semua substrat tumbuhan, diikuti oleh Mn, Zn, Pb, Ni, Cr, Cu, Co dan Cd. Berdasarkan peratusan tersedia Mn, Pb dan Zn merupakan logam berat yang paling banyak tersedia diambil oleh tumbuhan dengan nilai 8 hingga 10%. Kepekatan Fe, Mn, Ni dan Zn menunjukkan purata kepekatan yang tinggi pada bahagian tumbuhan yang dikaji berbanding dengan logam lain. Nilai koefisien penyerapan biologi (BAC) bagi cili, kunyit, pandan dan serai masing-masing dalam julat 0.02-0.36, 0.03-0.41, 0.03-0.63 dan 0.03-1.15. Boleh disimpulkan bahawa penyerapan logam berat oleh tumbuhan adalah normal walaupun kepekatan logam berat dalam tanih ultrabes adalah tinggi.
Fulltext A comparison technique of alpha and gamma spectrometry to measure 210Pb activity in marine sediment core

Zal Uyun Wan Mahmood, Yii, Mei-Wo, Che Abd. Rahim Mohamed, Norfaizal Mohamed @ Mohamad, Abdul Kadir Ishak

Jurnal Sains Nuklear Malaysia, 2013;25(2):61-67.
MyJurnal

The most commonly used techniques of alpha and gamma spectrometry were performed to measure
210Pb activity in marine sediment core as a comparison. Alpha analytical technique measured the
activity of 210Pb from it’s in-grow grand-daughter 210Po after a chemical separation, assuming
radioactive equilibrium between the two radionuclides. Meanwhile, gamma analysis technique
allows direct measurement, non-destructive and no preliminary chemical separation. Through the
comparison, it is found that both alpha and gamma analysis techniques were slightly difference.
Overall, the results from alpha analytical technique were basically higher than those from the
gamma analytical techniques. Some logical argument had been discussed to explain this situation.
In routine analysis, the analytical technique used should be chosen carefully based on advantages
and disadvantages of the each technique and analysis requirements. Therefore, it is recommended to
determine exactly the needs and purpose of analysis and to know the sample history before decide
the appropriate analytical technique
Fulltext Puspati triga reactor (RTP) radiation monitoring program

Ligam, Alfred Sanggau, Zarina Masood, Mohd Fairus Abdul Farid, Ahmad Nabil Abd Rahim, Nurhayati Ramli, Mohammad Suhaimi Kassim

Jurnal Sains Nuklear Malaysia, 2013;25(2):68-74.
MyJurnal

Radiation Monitoring System aims to limit the exposure dose to personnel to the lowest level
referring to the concept of ALARA (As Low As Reasonably Achievable). Atomic Energy Licensing
(Basic Safety Radiation Protection) Regulations 2010 is useful to control employee and public
radiation protection program and guideline. This paper discussed the methodology and
implementation of the radiation protection program at PUSPATI TRIGA Reactor (RTP) which is
implemented in Nuklear Malaysia, Complex Bangi.
Women participation in Malaysia informal sector, challenges, and policy implication: overview on literature perspective

Ab. Razak Othman, Zuroni Md. Jusoh, Husniyah Abd. Rahim@Abdul Wahab, Wan Arnidawati Wan Abdullah, Laily Paim

Jurnal Pengguna Malaysia - Malaysian Journal of Consumer, 2020;35(1):1-25.
MyJurnal

The informal sector is a major part of the Malaysian economy, and there is still insufficient information about the informal economic activities in Malaysia. In the term, 'informal economy' became current as a label for economic activities which take place outside the framework of corporate public and private sector establishments. According to International Labor Organization (ILO), the common characteristics of the informal enterprise includes the ease of entry, reliance on an indigenous resource, family ownership, small scale operations, labour-intensive and adaptive technology, skills acquired outside of the formal sector, unregulated and competitive markets. The objective of this paper is to identify the participation of informal sector among women in Malaysia. How much females participate in the informal sector and why they participate. This paper also discusses the challenges and opportunities of women participating in the informal sector in Malaysia to explain why females participate in the informal sector and the policy implications of their participation. The study found that the major challenges of women involved in informal activities which are financial difficulties, social security protection, low income, and low productivity activities with no rules/regulation. Despite all these challenges, these women are very positive about their employment and business. While informality offers greater labour flexibility, it can also exacerbate economic inefficiency and labour vulnerability. There are separate policy options for formalising workers and firms. To maximise the positive and minimise the negative, indiscriminate formalisation is ill-advised. The importance of local context in policy design is also highlighted.
Antiulcer activity of methanol-chloroform extract of Channa striatus fillet

Azemi AK, Abd Rahim MH, Mamat SS, Mat Jais AM, Zakaria ZA

Pak J Pharm Sci, 2018 Jan;31(1):143-151.
PMID: 29348096

Channa striatus (Haruan) is Malaysian freshwater fish that is traditionally used to treat ailments related to wound and also ulcers. The aimed of the present study was to determine the mechanisms of anti-ulcer activity of chloroform: methanol extract of C. striatus fillet (CMCS) in rats. The antiulcer profile of CMCS, given orally in the doses of 50, 250 and 500mg/kg, was assessed using the ethanol- and indomethacin-induced gastric ulcer models. The mechanisms of antiulcer of CMCS were determined as follows; i) the antisecretory activity of CMCS was measured using the pyloric ligation rat model, and; ii) the role of nitric oxide (NO) and sulfhydryl compounds in the modulation of CMCS antiulcer activity were determined by pre-treating the rats with L-NAME or NEM, respectively, followed by the pre-treatment of rats with CMCS before subjecting the animals to the ethanol-induced gastric ulcer model. From the results obtained, CMCS exerted significant (P<0.05) antiulcer activity in both models of gastric ulcer wherein the macroscopic and microscopic analysis of the stomach supported the antiulcer claim. With regard to its antisecretory effect, CMCS did not change the volume and pH, but reduce the total acidity only at the lower doses of the gastric juice. Moreover, CMCS demonstrated antiulcer activity was reversed by NEM, but not affected by L-NAME. In conclusion, CMCS shows antiulcer activity that is modulated via its cytoprotective, but not antisecretory effect, and in the presence of sulfhysryl compounds, but not NO.
Overexpression of acetyl-CoA carboxylase in Aspergillus terreus to increase lovastatin production

Hasan H, Abd Rahim MH, Campbell L, Carter D, Abbas A, Montoya A

N Biotechnol, 2018 Sep 25;44:64-71.
PMID: 29727712 DOI: 10.1016/j.nbt.2018.04.008

The present work describes the application of homologous recombination techniques in a wild-type Aspergillus terreus (ATCC 20542) strain to increase the flow of precursors towards the lovastatin biosynthesis pathway. A new strain was generated to overexpress acetyl-CoA carboxylase (ACCase) by replacing the native ACCase promoter with a strong constitutive PadhA promoter from Aspergillus nidulans. Glycerol and a mixture of lactose and glycerol were used independently as the carbon feedstock to determine the degree of response by the A. terreus strains towards the production of acetyl-CoA, and malonyl-CoA. The new strain increased the levels of malonyl-CoA and acetyl-CoA by 240% and 14%, respectively, compared to the wild-type strain. As a result, lovastatin production was increased by 40% and (+)-geodin was decreased by 31% using the new strain. This study shows for the first time that the metabolism of Aspergillus terreus can be manipulated to attain higher levels of precursors and valuable secondary metabolites.
Fulltext Optimal sizing and energy scheduling of isolated microgrid considering the battery lifetime degradation

Sufyan M, Abd Rahim N, Tan C, Muhammad MA, Sheikh Raihan SR

PLoS One, 2019;14(2):e0211642.
PMID: 30763331 DOI: 10.1371/journal.pone.0211642

The incessantly growing demand for electricity in today's world claims an efficient and reliable system of energy supply. Distributed energy resources such as diesel generators, wind energy and solar energy can be combined within a microgrid to provide energy to the consumers in a sustainable manner. In order to ensure more reliable and economical energy supply, battery storage system is integrated within the microgrid. In this article, operating cost of isolated microgrid is reduced by economic scheduling considering the optimal size of the battery. However, deep discharge shortens the lifetime of battery operation. Therefore, the real time battery operation cost is modeled considering the depth of discharge at each time interval. Moreover, the proposed economic scheduling with battery sizing is optimized using firefly algorithm (FA). The efficacy of FA is compared with other metaheuristic techniques in terms of performance measurement indices, which are cost of electricity and loss of power supply probability. The results show that the proposed technique reduces the cost of microgrid and attain optimal size of the battery.
Improved lovastatin production by inhibiting (+)-geodin biosynthesis in Aspergillus terreus

Hasan H, Abd Rahim MH, Campbell L, Carter D, Abbas A, Montoya A

N Biotechnol, 2019 Sep 25;52:19-24.
PMID: 30995533 DOI: 10.1016/j.nbt.2019.04.003

Lovastatin is widely prescribed to reduce elevated levels of cholesterol and prevent heart-related diseases. Cultivation of Aspergillus terreus (ATCC 20542) with carbohydrates or low-value feedstocks such as glycerol produces lovastatin as a secondary metabolite and (+)-geodin as a by-product. An A. terreus mutant strain was developed (gedCΔ) with a disrupted (+)-geodin biosynthesis pathway. The gedCΔ mutant was created by inserting the antibiotic marker hygromycin B (hyg) within the gedC gene that encodes emodin anthrone polyketide synthase (PKS), a primary gene responsible for initiating (+)-geodin biosynthesis. The effects of emodin anthrone PKS gene disruption on (+)-geodin and lovastatin biosynthesis and the production of the precursors acetyl-CoA and malonyl-CoA were investigated with cultures based on glycerol alone and in combination with lactose. The gedCΔ strain showed improved lovastatin production, particularly when cultivated on the glycerol-lactose mixture, increasing lovastatin production by 80% (113 mg/L) while simultaneously inhibiting (+)-geodin biosynthesis compared to the wild-type strain. This study thus shows that suppression of the (+)-geodin pathway increases lovastatin yield and demonstrates a practical approach of manipulating carbon flux by modulating enzyme activity.
Fulltext Diagnostic Accuracy of FOBT and Colorectal Cancer Genetic Testing: A Systematic Review & Meta-Analysis

Ramdzan AR, Abd Rahim MA, Mohamad Zaki A, Zaidun Z, Mohammed Nawi A

Ann Glob Health, 2019 05 15;85(1).
PMID: 31099505 DOI: 10.5334/aogh.2466

INTRODUCTION: Colorectal cancer (CRC) is the second leading cause of cancer related death in the world after lung cancer. Early detection of CRC leads to improvement in cancer survival rate. In recent years, efforts have been made to discover a non-invasive screening marker of higher sensitivity and specificity. Fecal occult blood testing (FOBT) and genetic testing become alternative modalities to screen CRC in the population other than colonoscopy. The aim of this systematic review and meta-analysis is to determine the diagnostic accuracy, sensitivity and specificity of FOBT and genetic testing as screening tools in colorectal cancer.
METHODS: A literature search of PubMed, ScienceDirect, and Scopus was carried out. The search strategy was restricted to human subjects and studies are published in English. Data on sensitivity and specificity were extracted and pooled. Heterogeneity was assumed at significance level of p < 0.10 and was tested by chi squared. Degree of heterogeneity was quantified using the I2 statistic, and values of less than 25% is considered as homogenous. All analyses were performed using the software Meta-Disc.
RESULTS: A total of eleven studies were suitable for data synthesis and analysis. Five studies were analyzed for the accuracy of genetic testing, the pooled estimate for sensitivity and specificity were 71% (95% CI: 66, 75%) and 95% (95% CI: 93, 97%) respectively. Another group of studies which had been evaluated for the accuracy of FOBT, the pooled sensitivity was 31% (95% CI: 25, 38%) while the pooled specificity was 87% (95% CI: 86, 89%).
CONCLUSIONS: FOBTs is recommended to use as population-based screening tools for colorectal cancer while genetic testing should be focusing on patients with moderate and high risk individuals.
13C-Urea Breath Test Accuracy for Helicobacter pylori Infection in the Asian Population: A Meta-Analysis

Abd Rahim MA, Johani FH, Shah SA, Hassan MR, Abdul Manaf MR

Ann Glob Health, 2019 Jul 24;85(1).
PMID: 31348624

BACKGROUND: Helicobacter pylori (H. pylori) infection is known to be associated with peptic ulcer and gastric cancer. Detection of H. pylori infection is a significant part of peptic ulcer and gastric cancer prevention and management. 13C-urea breath test (UBT) provides a good option for the pathogen detection due to its accuracy and safety.
OBJECTIVE: This review aims to evaluate the 13C-UBT diagnostic accuracy studies conducted among Asian population and validate its use for the Asian population.
METHODS: Original articles were systematically searched in PubMed, Scopus, and Google Scholar using the PICOS strategy by applying relevant keywords. Only studies published in English and conducted in Asia were included. Our search returned 276 articles. After assessment, 11 articles which answered our research question and met the criteria set for systematic review and meta-analysis were accepted. A total of 15 study protocols were extracted from the 11 accepted articles.
FINDINGS: Majority of the studies were conducted in Hong Kong (six), followed by Taiwan (five), Japan (two), and one each in Singapore and Israel. All studies had used histology as part of its gold standard of reference. All but one study was performed on adult populations. The summary estimate for sensitivity was 97% (95% CI: 96, 98%), and specificity was 96% (95% CI: 95, 97%), with significant heterogeneity between studies. Adjusting for the dose (50 mg) and breath sample collection time (20 minutes) had improved both accuracy estimates and significantly reduced heterogeneity.
CONCLUSION: This review supports the test-and-treat strategy for H. pylori infection management. Prevalence and cost-effectiveness studies are mandatory for health authorities to adopt this strategy into national policy.
From Evidence to Policy: Economic Evaluations of Healthcare in Malaysia: A Systematic Review

Ku Abd Rahim KN, Kamaruzaman HF, Dahlui M, Wan Puteh SE

Value Health Reg Issues, 2020 May;21:91-99.
PMID: 31698173 DOI: 10.1016/j.vhri.2019.09.002

OBJECTIVE: To identify and describe the various economic evaluation studies in Malaysia and to determine the range of incremental cost-effectiveness ratios (ICERs) as reported in these studies.
METHODS: A comprehensive search of the scientific electronic databases was conducted (Medline, EBM Reviews, Embase, and hand search) to identify all published economic evaluation studies related to Malaysian healthcare. Two researchers assessed the quality of selected studies using the Critical Appraisal Skills Programme (CASP) checklist and Quality of Health Economic Studies instrument. The assessment was also reviewed by expert members of the Technical Advisory Committee of Health Technology Economic Evaluations (TACHTEE).
RESULTS: A total of 64 full-text articles were assessed for eligibility and included in this systematic review. Thirty studies were partial economic evaluations; the full economic evaluations included 17 cost-effectiveness analyses and 17 cost-utility analyses. From all the reported ICERs, the majority (68%) were categorized as highly cost-effective (ICER of less than 1 gross domestic product (GDP) per capita per quality-adjusted life-years or disability-adjusted life-years gained).
CONCLUSION: This review identifies information gaps and loopholes in health economics research in Malaysia. Additionally, this study provides the information that the majority of published interventions in Malaysia fell within the cost-effectiveness threshold of 1 GDP per capita per quality-adjusted life-years or disability-adjusted life-years gained.
Fulltext Effective refolding of a cysteine rich glycoside hydrolase family 19 recombinant chitinase from Streptomyces griseus by reverse dilution and affinity chromatography

Oyeleye AO, Mohd Yusoff SF, Abd Rahim IN, Leow ATC, Saidi NB, Normi YM

PLoS One, 2020;15(10):e0241074.
PMID: 33091044 DOI: 10.1371/journal.pone.0241074

Conventional refolding methods are associated with low yields due to misfolding and high aggregation rates or very dilute proteins. In this study, we describe the optimization of the conventional methods of reverse dilution and affinity chromatography for obtaining high yields of a cysteine rich recombinant glycoside hydrolase family 19 chitinase from Streptomyces griseus HUT6037 (SgChiC). SgChiC is a potential biocontrol agent and a reference enzyme in the study and development of chitinases for various applications. The overexpression of SgChiC was previously achieved by periplasmic localization from where it was extracted by osmotic shock and then purified by hydroxyapatite column chromatography. In the present study, the successful refolding and recovery of recombinant SgChiC (r-SgChiC) from inclusion bodies (IB) by reverse dilution and column chromatography methods is respectively described. Approximately 8 mg of r-SgChiC was obtained from each method with specific activities of 28 and 52 U/mg respectively. These yields are comparable to that obtained from a 1 L culture volume of the same protein isolated from the periplasmic space of E. coli BL21 (DE3) as described in previous studies. The higher yields obtained are attributed to the successful suppression of aggregation by a stepwise reduction of denaturant from high, to intermediate, and finally to low concentrations. These methods are straight forward, requiring the use of fewer refolding agents compared with previously described refolding methods. They can be applied to the refolding of other cysteine rich proteins expressed as inclusion bodies to obtain high yields of actively folded proteins. This is the first report on the recovery of actively folded SgChiC from inclusion bodies.
Fulltext Effect of Plant Growth Regulators on Coloured Callus Formation and Accumulation of Azadirachtin, an Essential Biopesticide in Azadirachta indica

Ashokhan S, Othman R, Abd Rahim MH, Karsani SA, Yaacob JS

Plants (Basel), 2020 Mar 11;9(3).
PMID: 32168737 DOI: 10.3390/plants9030352

For centuries, Azadirachta indica or neem has been utilized as a primary source of medicine due to its antimicrobial, larvacidal, antimalarial and antifungal properties. Recently, its potential as an effective biopesticide has garnered attention, especially towards efficient and continuous production of its bioactive compounds. The present study investigated the effect of the plant growth regulators (PGRs) thiadiazuron (TDZ) and 2,4-dichlorophenoxyacetic acid (2,4-D) on the induction of colored callus formation and subsequent accumulation of azadirachtin (AZA) in A. indica. An efficient protocol was established for micropropagation and colored callus production of this species, followed by quantification of AZA (a mixture of azadirachtin A and B) and its safety assessment. For induction of the callus, leaf and petiole explants obtained from a young growing neem plant were excised and cultured on Murashige and Skoog (MS) medium supplemented with TDZ (0.2-0.6 mg L-1) and 2,4-D (0.2-0.6 mg L-1), either applied singly or in combination. Callus was successfully induced from both explant types at different rates, where media with 0.6 mg L-1 of TDZ resulted in the highest fresh weight (3.38 ± 0.08 g). In general, media with a single hormone (particularly TDZ) was more effective in producing a high mass of callus compared to combined PGRs. A culture duration of six weeks resulted in the production of green, brown and cream colored callus. The highest callus weight and accumulation of AZA was recorded in green callus (214.53 ± 33.63 mg g-1 dry weight (DW)) induced using TDZ. On the other hand, small amounts of AZA were detected in both brown and cream callus. Further experimentation indicated that the green callus with the highest AZA was found to be non-toxic (LC50 at 4606 µg mL-1) to the zebrafish animal model. These results suggested that the addition of different PGRs during in vitro culture could prominently affect callus and secondary metabolite production and can further be manipulated as a sustainable method for the production of a natural and environmentally friendly pesticide.
Fulltext A Biomechanical and Ease of Learning Comparison Study of Arthroscopic Sliding Knots

Teo SH, Ng WM, Abd Rahim MR, Al-Fayyadh MZM, Ali MRM

Indian J Orthop, 2020 Apr;54(2):168-173.
PMID: 32257034 DOI: 10.1007/s43465-019-00024-2

Introduction: This study aims to compare the biomechanical properties and ease of learning and tying of our novel knot (UM Knot) with other commonly used arthroscopic sliding knots.
Materials and methods: The Duncan, HU, SMC, Pretzel, Nicky's and square knots were selected for comparisons with UM knot. All knots were prepared with size 2 HiFi® suture by a single experienced surgeon and tested with cyclic loading and load to failure tests. The ease of learning was assessed objectively by recording the time to learn the first correct knot and the total number of knots completed in 5 min by surgeons and trainees.
Results: The UM knot average failure load is significantly superior to the HU knot (p

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