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Fulltext Growth velocity in transfusion dependent prepubertal thalassemia patients: results from a thalassemia center in Malaysia

Hamidah A, Arini MI, Zarina AL, Zulkifli SZ, Jamal R

Southeast Asian J Trop Med Public Health, 2008 Sep;39(5):900-5.
PMID: 19058587

Growth impairment is commonly seen in children with thalassemia despite regular blood transfusions and desferrioxamine treatments. We investigated the growth velocity of 26 prepubertal patients with beta-thalassemia or HbE-beta thalassemia who were transfusion dependent aged between 2 and 13 years. The prevalence of impaired growth velocity (ie, growth velocity less than the third percentile) amongst the transfusion dependent prepubertal thalassemics was 57.7% compared to 19.2% in the control group. The mean height velocity of the thalassemics was 11.1% less than controls but this difference was not statistically significant (4.23cm/year vs 4.76cm/year, p = 0.08). The mean serum ferritin level of the thalassemics with a height < 3rd percentile was higher compared to those with a height > 3rd percentile (4,567.0 vs 2,271.0, p = 0.01). Our study showed that there was a high prevalence of impaired growth velocity amongst our transfusion dependent prepubertal thalassemics. This highlights the problem of inadequate chelation therapy, and compliance with chelation therapy amongst our patients. This study emphasizes the importance of monitoring growth parameters and optimal iron chelation therapy in these patients.
Diagnostic Evaluation of Technetium-99 metastable TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography in the Differential Diagnosis of Parkinsonism in Hospital Kuala Lumpur: A preliminary experience

Kamarulzaman K, Abd Razak N, Mawardi AS, Amir Hassan SZ

Med J Malaysia, 2024 Nov;79(6):690-702.
PMID: 39614786

INTRODUCTION: Parkinsonian syndrome encompasses a group of movement disorders characterized by symptoms such as tremor, rigidity, bradykinesia, and postural instability. While Idiopathic Parkinson's disease is the most common cause, several other etiologies can also result in parkinsonism. Identifying the specific type of Parkinsonian syndrome is essential due to its varying therapeutic and prognostic implications. This study aims to evaluate the role of Technetium-99 metastable TRODAT-1 Single Photon Emission Computed Tomography-Computed Tomography (Tc-99m TRODAT-1 SPECT-CT) in patients with parkinsonism.
MATERIALS AND METHODS: The clinical data and scintigraphy findings of patients referred to the Department of Nuclear Medicine, Hospital Kuala Lumpur for Tc-99m TRODAT-1 SPECT-CT from July 2022 to July 2023 were retrospectively reviewed. Follow-up with primary team was conducted to determine the clinical implications and subsequent therapeutic management of the patients.
RESULTS: Tc-99m TRODAT-1 SPECT-CT was performed on sixteen patients (10 females and 6 males) with a mean age of 55.2 years (range 26 to 75 years). Five patients exhibited normal scintigraphy findings, while eleven patients showed abnormal Tc-99m TRODAT-1 SPECT-CT results. The scintigraphy findings led to changes in therapeutic management for 81.3% of the patients. Additionally, 19% of the patients were referred for further evaluation with Fluorine-18 fluorodeoxyglucose PET to assist in diagnosing atypical Parkinsonian disease.
CONCLUSIONS: Tc-99m TRODAT-1 SPECT-CT is a readily available tool for assessing presynaptic dopamine transporters in patients with parkinsonism. This study demonstrated that Tc-99m TRODAT-1 SPECT-CT significantly impacts the diagnostic and therapeutic outcomes for patients with parkinsonism.
Fulltext Anticipated difficulties in house-officership for graduating medical students of the school of medical sciences, universiti sains malaysia kubang kerian, kelantan, malaysia

Rahim AF, Hitam WH, Alwi MN, Ghazali G, Rahim SZ

Malays J Med Sci, 2000 Jul;7(2):9-12.
PMID: 22977384

To aid future curriculum revision and planning, a batch of newly graduated medical students were surveyed using a questionnaire containing items representing possible areas of concern during house-officership. Students rated items representing communication issues as areas of concern. They did not agree that areas concerning responsibilities as a doctor, continuing medical education, theoretical and practical skills and potentially stressful working conditions were problem areas. Communication skills should remain among the priority areas for undergraduate training. Students should also be given more information about the house-officership period prior to graduation. Further study is needed to confirm perceived strengths of the USM curriculum suggested by the study, which are skills in finding resources for further learning and skills in leadership. A task-analysis of the house-officership period is also needed.
Fulltext Ime course detachment of biofilms in pipes by hydrochlorination

Shanzay, A., Siddra, T. A., Warda, F., Sheeza, A., Maryam, A., Aina, S. Z., et al.

Asian Journal of Medicine and Biomedicine, 2018;1(1):28-31.
MyJurnal

Bacterial biofilms are a complex community of microbes in which the cells are embedded in a polysaccharide matrix.
This slime is a mean of protection in hostile environments. Biofilms in hospital settings are perilous as they not only
make treatment difficult, cause blockage of pipes but are also cause of serious nosocomial infections thus making their
dispersal an even more important phenomenon. Any foaming method is not applicable at all places for the cleaning of
biofilms hence biofilm dispersal by household sweep containing hydrochloric acid was checked using the microliter
plate assay as dispersal strategy. Bacteria from hospital waste disposal pipes were isolated, its ability to form biofilm
was noted under different time intervals and then finally biofilm degradation was done using different concentrations
of household sweep. It was noted that household sweep can be successfully employed at many places especially waste
disposal pipes and acid resistant tubes. Our results indicated that 20% sweep (HCl conc. 1%) if used for only one
minute can reduce the biofilms to 50%. Similarly increasing contact time can reduce the biofilms further.
Fulltext Knowledge and awareness regarding osteoporosis among multi ethnic people attending the orthopaedic clinic at Universiti Kebangsaan Malaysia Medical Centre

Zaris SNABSM, Ahmad MSB, Mohamed SZB, Shuid ANB, Mohamed INB, Mokhtar SAB

Malaysian Journal of Public Health Medicine, 2016;16(3):166-175.

Malaysia is a multi-ethnic country with an osteoporosis prevalence of 24.1% in 2005. Only few study reported on osteoporosis awareness. Aim of this study was to investigate the awareness and knowledge regarding osteoporosis among persons attending orthopaedic clinic at Universiti Kebangsaan Malaysia (UKM) Medical Centre, Kuala Lumpur. A total of 368 participants (male and female) aged 20 years old or older, was assessed using the Osteoporosis Questionnaire (OPQ). The mean total OPQ score was 1.7 (SD ± 3.08; range -5 to 9; maximum possible score 20). Subjects with family history of osteoporosis and high education level were found to have significantly higher OPQ scores (p<0.05). However, there was no significant difference (p>0.05) with respect to different age groups, gender, ethnicities, and menopausal status. The main source of osteoporosis knowledge was magazine/newspaper (45.9%). An overall low score indicates that new strategies to increase awareness of osteoporosis among the public is urgently required.
Fulltext Impact of juice extraction method on the physicochemical, functional, and sensory properties of Sabah snake grass (Clinacanthus nutans) juice mix

Noranizan, M., Pean, L. F., Li, J. W., Aadil, R. M., Ahmad, T., Rosli, S. Z., et al.

International Food Research Journal, 2020;27(5):835-845.
MyJurnal

The present work investigated the impact of several juice extraction methods (blender,
centrifugal juicer, and slow juicer) and thermal pasteurisation (72°C, 15 s) on the different
properties [physicochemical, polyphenol oxidase (PPO) activity, and functional] of
Clinacanthus nutans juice mix during storage (28 d, 4°C). Regardless of juicing technique, all
juices had similar colour and antioxidants [tested using 2,2-diphenyl-1-picrylhydrazyl
(DPPH) and ferric reducing antioxidant power (FRAP) methods]. The juices also had similar
PPO activity and sensory acceptance in terms of colour, aroma, flavour, mouthfeel, and
overall acceptability. The blender yielded juice with higher pH, soluble solids, and relative
viscosity than other methods. The slow juicer was the best at retaining ascorbic acid (39.33 ±
3.06 mg/100 mL), while the blender was best at retaining phenolic compounds (11.82 ± 0.12
mg gallic acid equivalents/100 mL) and chlorophyll (6.95 ± 0.31 μg/mL). Pasteurisation
negatively affected the colour, functional properties, and sensory characteristics (colour,
aroma, flavour, and mouthfeel) of the juice.
Fulltext Optimisation of stabiliser combinations in instant ice cream mix powder formulation via mixture design methodology

Abdul Razak, S. Z., Abd. Rahman, N. A., Baharuddin, A. S., Mohd Amin, N. A., Mat Johari, A., Mohammad Parid, D.

International Food Research Journal, 2019;26(6):1689-1698.
MyJurnal

The present work aimed at obtaining the optimum combination of stabilisers used in an
instant ice cream formulation. Instant ice cream mixes were formulated using milk protein,
fat, sucrose, stabilisers, emulsifiers and water. A basic formulation for ice cream mix was
prepared according to the process flow of instant ice cream. Three different stabilisers
mixtures, which were carboxymethyl cellulose (CMC), carrageenan, and sodium alginate
used in 14 formulations were studied using mixture design methodology. Physical analyses on
meltdown rate, hardness, melted ice cream viscosity, and overrun were performed. The results
were compared with those of commercial instant ice cream to determine the acceptability and
quality of the final products. From the optimisation study, the recommended combination of
stabilisers was found to be 0.151% CMC and 0.149% sodium alginate. The optimised sample
had a higher viscosity of 0.17 Pa.s than the commercial one (0.16 Pa.s), which corresponded to
higher hardness thus indicating slower melting rate, which is a good texture for ice cream. The
overrun of the optimised sample was 108.33%, which is considered high. The high amount of
air, viscosity, and hardness resulted in a low melting rate of 0.22 g/min, which is desirable for
ice cream consumption. Based on sensory evaluation, the optimised instant ice cream was the
most preferred by panellists as compared to commercial sample.
Fulltext Validation of self-reported smoker and second hand smoke exposure by urinary cotinine within The Malaysian Cohort Project

Abdullah N, Al-Junid SH, Looi ML, Chin SF, Mohd Haniff EA, Syed Zakaria SZ, et al.

Journal of Biomedicine and Translational Research, 2019;5(1):15-22.

Background: Validation of self-reported questionnaire is very crucial in ensuring the quality and reliability of data collection.
Objective: The aim of this study were i) to validate the questionnaire on tobacco smoke intake and second hand smoke exposure among The Malaysian Cohort (TMC) subjects through the determination of urinary cotinine levels, ii) to determine the optimal cut-off point of urine cotinine that discriminates smokers from non-smokers and iii) to estimate misclassification rate between self-reported smoking and urinary cotinine level.
Methods: Urine samples from a total of 775 The Malaysian Cohort subjects (104 smokers, 102 former smokers and 569 non-smokers) were obtained and urinary cotinine levels were determined by high-performance liquid chromatography (HPLC). Differences between groups were compared using Kruskal Wallis and Mann-Whitney tests. The Receiver Operating Characteristic (ROC) curved was performed to define the optimal urinary cotinine cut-off point.
Results: Urinary cotinine concentration significantly (p<0.001) correlated with smoking status (r=0.46), the average number of cigarettes smoked per day (r=0.53), duration of smoking (r=0.33) and number of cigarettes packed per year (r=0.47). Smokers and second hand smokers have significantly higher median cotinine levels (978.40 and 21.31 respectively) compared to non-smokers (15.52) and non-exposed (13.60) subjects. Cotinine level at cut-off value of 1.51 ng/mg creatinine is able to distinguish smokers and non-smokers with a sensitivity of 84.62% and specificity of 81.97%.
Conclusion: The Malaysian Cohort self-reported smoking questionnaire is a reliable tool in assessing the use of tobacco and second hand smoke exposure among the subjects.
Study name: The Malaysian Cohort (TMC) project
Fulltext Immunogenicity and Safety of the AS04-adjuvanted Human Papillomavirus-16/18 Cervical Cancer Vaccine in Malaysian Women Aged 18-35 years: A Randomized Controlled Trial

Lim BK, Ng KY, Omar J, Omar SZ, Gunapalaiah B, Teoh YL, et al.

Med J Malaysia, 2014 Feb;69(1):2-8.
PMID: 24814620

INTRODUCTION: Cervical cancer is the third most common cancer in women worldwide. The HPV-16/18 AS04- adjuvanted vaccine (Cervarix©) has previously been shown to be highly immunogenic with a clinically acceptable safety profile. This phase IIIb, double-blind, randomized (1:1) and placebo controlled trial (NCT00345878) was designed to evaluate the vaccine immunogenicity against HPV-16 and HPV-18 as well as its safety and reactogenicity in Malaysian women.

METHODS: Healthy women aged 18-35 years received intramuscularly three doses of either the vaccine (HPV group) or aluminium hydroxide (ALU group) at 0, 1, and 6 months. Antibody titers were measured by an enzyme-linked immunosorbent assay (ELISA).

RESULTS: A total of 271 eligible subjects were enrolled and 266 subjects completed the study. Initially seronegative subjects in the HPV group showed 100% seroconversion one month post-dose-3 for anti HPV-16 and anti-HPV-18 antibodies with geometric mean titers of 11107.5 (95% CI: 9727.3-12683.4) EL.U/mL and 4273.5 (95% CI: 3771.8-4841.9) EL.U/mL, respectively. Over 96% of subjects in both groups received all three vaccine doses. Solicited local (pain) and general symptoms (myalgia, fatigue, arthralgia and headache) were commonly reported in both HPV and ALU groups. Eight serious adverse events were reported throughout the study (five in the HPV group; three in the ALU group), all considered by investigators to be unrelated to vaccination.

CONCLUSION: The HPV-16/18 AS04-adjuvanted vaccine was immunogenic and generally well tolerated in Malaysian women aged 18-35 years.
Molecular study and genotype/phenotype correlation of β Thalassemia in Malaysia

Sivalingam M, Looi ML, Zakaria SZ, Hamidah NH, Alias H, Latiff ZA, et al.

Int J Lab Hematol, 2012 Aug;34(4):377-82.
PMID: 22335963 DOI: 10.1111/j.1751-553X.2012.01405.x

INTRODUCTION: To study the ß-gene mutations spectrum, the genotype/phenotype correlation, the modulatory effect of co-inherited factors such as α-gene mutations and of Xmn1 polymorphism in a large cohort of Malaysian patients.
METHODS: A total of 264 cases clinically diagnosed as Thalassemia major (TM) (111), Thalassemia intermedia (21), HbE-β Thalassemia (131), and 1 HbE homozygous were studied. The detection of α and ß gene mutations and characterization of Xmn1 polymorphism were performed by multiplex PCR, amplification refractory mutation system (ARMS), DNA sequencing, and restriction fragment length polymorphism (RFLP)-PCR.
RESULTS: A total of 19 ß Thalassemia mutations were characterized. CD26 and CD41/42 were the most common found in the Malay and Chinese population, respectively. The sensitivity of the clinical diagnosis for β TM, thalassemia intermedia, and HbE/β thalassemia was 94.0%, 15.2%, and 89.2%, respectively. Patients with Xmn1 heterozygosity [+/-] required less frequent transfusion compared with those without the polymorphism. Co-inheritance of α-thalassemia alleviates the severity of HbE-β thalassemia in our cohort.
CONCLUSION: Molecular analysis should be used for a better diagnosis and management of β thalassemia.
Fulltext Spectrum of infections in splenectomised thalassaemia patients

Zarina AL, Norazlin KN, Hamidah A, Aziz DA, Zulkifli SZ, Jamal R

Med J Malaysia, 2010 Dec;65(4):283-5.
PMID: 21901946

Splenectomised thalassaemia patients are at risk of developing sepsis. As the infection may be life-threatening, treatment should be sought and given promptly. A retrospective study was performed amongst our thalassaemia major patients who were splenectomised. The vaccination status of each patient and the types of infections seen were reviewed to obtain a local perspective. In our cohort of 49 splenectomised patients, 25 patients required hospitalization for the treatment of infection. There were a total of 40 febrile episodes within this hospitalised group of which 27.5% were microbiologically documented infection with bacteraemia. The predominant causative organisms were gram negative rods and three patients succumbed to overwhelming septicaemic shock as a result of delayed presentation. Sixty percent of the febrile episodes were clinically documented infection and comprised mainly upper respiratory tract infections. Based on the spectrum of infections seen, there is a need to improve the patients' awareness level so that early treatment is sought. There is also a need to re-address the approach towards vaccination in this immunocompromised group of patients by administering a booster pneumococcal and influenza vaccination in an attempt to reduce morbidity.
Assessment of P-gp and MRP1 activities using MultiDrugQuant Assay Kit: a preliminary study of correlation between protein expressions and its functional activities in newly diagnosed acute leukaemia patients

Fazlina N, Maha A, Zarina AL, Hamidah A, Zulkifli SZ, Cheong SK, et al.

Malays J Pathol, 2008 Dec;30(2):87-93.
PMID: 19291917

Multidrug resistance (MDR) is believed to be responsible for poor response of patients towards chemotherapy particularly patients with acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). The best-characterized resistance mechanism is the one mediated by permeability-glycoprotein (P-gp) encoded by MDR1 gene, which is responsible for drug efflux. We studied P-gp and multidrug resistance-associated protein 1 (MRP1) expression and functional activities in 43 newly diagnosed acute leukemia cases (19 paediatric ALL cases and 24 adult AML cases). The expression and functional activities were examined using flow cytometry and MultiDrugQuant assay kit (involving calcein AM uptake and efflux). P-gp and MRP1 expression and its functional activities were observed in 68.4% of paediatric ALL. In adult AML cases, all cases expressed MRP1 and its functional activities but only 58.3% were positive for P-gp and its functional activities. We were able to show a significant correlation between the expression of the multidrug resistant protein (P-gp and MRP1) and their functional activity in adult AML and paediatric ALL samples.
Fulltext Clinical utility of 64-row multislice CT angiography in the detection of cerebral aneurysms in acute subarachnoid haemorrhage

Chang LK, Liew NS, Soh HL, Tan SZ, Wong SH

Med J Malaysia, 2008 Jun;63(2):131-6.
PMID: 18942299 MyJurnal

CT angiography (CTA) is a fast examination performed with a time-optimised contrast injection to enhance the cerebral arteries. Being a new imaging modality in our hospital, evaluation of the effectiveness of 64-row multislice CTA in detecting intracranial aneurysms in ruptured subarachnoid haemorrhage (SAH) cases is necessary. We conducted a descriptive prospective study by recruiting 30 consecutively operated SAH cases from May 2005 until November 2006. CTA findings were studied by radiologist and neurosurgeon and these were compared with operative findings. The sensitivity and specificity of CTA were 94.4% and 97.2% respectively. Approximately half of the patients were scanned within four hours and operated within 24 hours. In conclusion, CTA proves to be highly sensitive and specific in the diagnosis of intracranial aneurysms in our study.
KEY WORDS: Subarachnoid haemorrhage, Intracranial aneurysm, Computed tomography (CT), CT angiography (CTA), Sarawak
Expression of multidrug resistance (MDR) proteins and in vitro drug resistance in acute leukemias

Fazlina N, Maha A, Jamal R, Zarina AL, Cheong SK, Hamidah H, et al.

Hematology, 2007 Feb;12(1):33-7.
PMID: 17364990

The expression of the multidrug resistance (MDR) proteins may influence the outcome of treatment in patients with acute leukemia. The aim of this study was to determine the IC50 of cytotoxic drugs (cytosine arabinoside, ara-C and daunorubicin, dnr) using the in vitro 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)2H-tetrazolium, inner salt (MTS) assay method. A total of 82 newly diagnosed acute leukemia cases (43 adult myeloid leukaemia, AML cases and 39 acute lymphoblastic leukaemia, ALL cases) and 16 relapsed cases (8 AML cases and 8 ALL cases) were studied. The MTS assay was performed using two cytotoxic drugs, dnr and ara-C. Cells were incubated with different concentrations of drugs for 4 days and the IC50 was extrapolated from the viability curve. In newly diagnosed cases, we found that childhood ALL samples showed higher IC50 values of dnr (0.040 +/- 2.320) compared to adult AML samples (0.021 +/- 0.158). In contrast, newly diagnosed adult AML samples showed higher IC50 values of ara-C (0.157 +/- 0.529) compared to childhood ALL samples (0.100 +/- 2.350). In relapsed cases, two samples of childhood ALL showed IC50 values of dnr (0.910 +/- 1.760) and ara-C (1.310 +/- 2.390), which was higher compared to childhood AML samples (0.129 +/- 0.214 and 0.210 +/- 0.003, respectively). However, there was no correlation between IC50 values of these drugs tested with clinical outcome. In conclusion, we found that MTS assay is an easy, rapid and non laborious method to study in vitro drug resistance in acute leukaemia cases.
Micro-bending based optical band-pass filter and its application in S-band Thulium-doped fiber amplifier

Emami SD, Rashid HA, Zarifi A, Zarei A, Soltanian MR, Yasin SZ, et al.

Opt Express, 2012 Dec 31;20(28):29784-97.
PMID: 23388806 DOI: 10.1364/OE.20.029784

A new approach for filtering an optical band-pass in optical amplifier is proposed using a macro bending. The proposed filter leverages the bending loss of higher order modes at shorter wavelengths. At longer wavelengths, the filter increases fiber's bending loss as the fundamental mode 'tail' is leak out from the cladding. The combination of wavelength dependent loss at longer and shorter wavelength gives rise to the optical band-pass filter characteristic inside the fiber. The simulated spectral response of the filter is found to be in good agreement with the experimental results. Subsequently, the proposed optical band-pass filter is applied in Thulium-doped fiber amplifiers (TDFA) system for gain and noise figure enhancements. The filter functions to suppress both the amplified spontaneous emission (ASE) at 800 nm and 1800 nm wavelength regions and thus improves both gain and noise figure performances in S-band region. By bending of the gain medium, gain and noise figure of the TDFA are improved by about 2 dB and 0.5 dB respectively, within a wavelength region from 1440 and 1500 nm when the 1050 nm pump power is fixed at 250 mW.
Fulltext Pulmonary disease empirically treated as tuberculosis-a retrospective study of 107 cases

Loh LC, Abdul Samah SZ, Zainudin A, Wong GLS, Gan WH, Yusuf WS, et al.

Med J Malaysia, 2005 Mar;60(1):62-70.
PMID: 16250282

Pulmonary disease is sometimes treated empirically as tuberculosis (TB) in the absence of microbial confirmation if the clinical suspicion of active TB is high. In a country of relatively high TB and low HIV burden, we retrospectively studied 107 patients (69.2% male; mean age (SD): 45 (17) years) who received empirical anti-TB treatment for intrapulmonary opacities or pleural effusions suspected of active TB in our hospitals between 1998 and 2002. The diagnosis of definite or probable 'smear-negative' pulmonary TB was made based on treatment outcome at two months with rifampicin, isoniazid, pyrazinamide and ethambutol (or streptomycin). At this end-point, 81 patients (84.4%) had both clinical and radiological improvement (definite cases), 12 (12.5%) had clinical improvement alone and 3 (3.1%) had radiological improvement alone (probable cases). Confirmation of acid-fast bacilli was subsequently obtained in 12 patients (all definite cases) from culture of initial pulmonary specimens. Eleven patients (10.5%) were diagnosed as 'non-TB' based on absence of both clinical and radiological improvement or discovery of another cause for the pulmonary condition at or before this two-month study end-point. In the 'non-TB' group, 2 had carcinoma, 2 had HIV-related pulmonary diseases, 1 had bronchiectasis, while in 6 causes were indeterminate. Six (6.3%) and 3 (27.3%) patients reported adverse effects from anti-TB drugs from the 'TB' and 'non-TB' groups respectively. Our findings suggest that empirical anti-TB treatment is an acceptable practice if clinical suspicion is high in patients coming in our region.
Parental awareness and attitude towards environmental tobacco smoke exposure in children with respiratory illnesses

Hasniah AL, Tan YP, Nur Buhairah MA, Chan TW, Muhammad Nabil TI, Syed Zulkifli SZ

Public Health, 2016 08;137:182-4.
PMID: 26976490 DOI: 10.1016/j.puhe.2015.10.028
Utilizing hybrid functional fuzzy wavelet neural networks with a teaching learning-based optimization algorithm for medical disease diagnosis

Majeed Alneamy JS, A Hameed Alnaish Z, Mohd Hashim SZ, Hamed Alnaish RA

Comput Biol Med, 2019 09;112:103348.
PMID: 31356992 DOI: 10.1016/j.compbiomed.2019.103348

Accurate medical disease diagnosis is considered to be an important classification problem. The main goal of the classification process is to determine the class to which a certain pattern belongs. In this article, a new classification technique based on a combination of The Teaching Learning-Based Optimization (TLBO) algorithm and Fuzzy Wavelet Neural Network (FWNN) with Functional Link Neural Network (FLNN) is proposed. In addition, the TLBO algorithm is utilized for training the new hybrid Functional Fuzzy Wavelet Neural Network (FFWNN) and optimizing the learning parameters, which are weights, dilation and translation. To evaluate the performance of the proposed method, five standard medical datasets were used: Breast Cancer, Heart Disease, Hepatitis, Pima-Indian diabetes and Appendicitis. The efficiency of the proposed method is evaluated using 5-fold cross-validation and 10-fold cross-validation in terms of mean square error (MSE), classification accuracy, running time, sensitivity, specificity and kappa. The experimental results show that the efficiency of the proposed method for the medical classification problems is 98.309%, 91.1%, 91.39%, 88.67% and 93.51% for the Breast Cancer, Heart Disease, Hepatitis, Pima-Indian diabetes and Appendicitis datasets, respectively, in terms of accuracy after 30 runs for each dataset with low computational complexity. In addition, it has been observed that the proposed method has efficient performance compared with the performance of other methods found in the related previous studies.
Cow- and herd-level factors associated with lameness in dairy farms in Peninsular Malaysia

Sadiq MB, Ramanoon SZ, Shaik Mossadeq WM, Mansor R, Syed-Hussain SS

Prev Vet Med, 2020 Nov;184:105163.
PMID: 33038612 DOI: 10.1016/j.prevetmed.2020.105163

Lameness is a major welfare issue in dairy cows. This study was aimed at investigating the cow- and herd -level factors associated with lameness in dairy farms from four states in Peninsular Malaysia. The study population was 1001 lactating cows from 28 dairy farms located in Selangor (n = 9), Perak (n = 8), Negeri Sembilan (n = 6) and Johor (n = 5). Lameness was assessed by locomotion scoring. Individual cow characteristics such as breeds, parity, body condition score (BCS), hock condition, leg hygiene, presence of claw lesion and claw overgrowth were recorded. Data on herd characteristics, management practices and housing design were collected by on-farm inspection and farmers' interview. Mixed-eﬀ ;ects logistic regressions were used to model the data and to assess the factors associated with lameness. Cow-level lameness prevalence was 34.2 % (95 % CI 22.2-50.0 %), with all the farms having at least one case of lameness. Claw lesions were recorded in 470 cows (46.9 %; CI 33.3-63.3 %) of which 296 (62.9 %) of them were lame. Of these, 78.9 % of the lesions were present on the rear feet and 25.5% of the cows had more than one foot affected. The proportion of cows having non-infectious and infectious claw lesions were 81.9 % and 18.1 %, and the predominant claw lesions were sole ulcers (24.9 %), white line disease (19.6 %), sole haemorrhage (10.2%), swelling of coronet (9.6 %), toe ulcers (8.4 %), and digital dermatitis (5.6%). Cows at third or more parities had higher odds of lameness (OR = 2.2; 95 % CI 1.2-4.1) compared to primiparous cows. Low BCS (< 2.5) increased the odds of lameness (OR = 4.8; 95 % CI 2.9-7.9) relative to cows with moderate BCS, and cows with hair loss around the hock (OR = 1.4; 95 % CI 1.1-1.9) relative to those with normal hock condition. Greater odds of being lame was observed in cows having claw lesion (OR = 15.2; 95 % CI 10.4-19.2) and those with overgrown claw (OR = 3.3; 95 % CI 2.4-4.5). There was increased odds of lameness in farms with high stocking density (OR = 1.8; 95 % CI 1.1-3.1), concrete floored walkways (OR = 1.9; 95 % CI 1.0-3.6), dirty floors (OR = 2.3; 95 % CI 1.9-3.7), and practicing preventive claw trimming (OR = 2.3; 95 % CI 1.9-4.6). Based on the high lameness prevalence, these findings could assist dairy farmers to make informed decisions on areas to implement on-farm changes to reduce lameness in the studied herds.
Fulltext Anti-malarial and anti-inflammatory effects of Gleichenia truncata mediated through inhibition of GSK3β

Suhaini S, Liew SZ, Norhaniza J, Lee PC, Jualang G, Embi N, et al.

Trop Biomed, 2015 Sep;32(3):419-33.
PMID: 26695202 MyJurnal

Gleichenia truncata is a highland fern from the Gleicheniaceae family known for its traditional use among indigenous communities in Asia to treat fever. The scientific basis of its effect has yet to be documented. A yeast-based kinase assay conducted in our laboratory revealed that crude methanolic extract (CME) of G. truncata exhibited glycogen synthase kinase-3 (GSK3)-inhibitory activity. GSK3β is now recognized to have a pivotal role in the regulation of inflammatory response during bacterial infections. We have also previously shown that lithium chloride (LiCl), a GSK3 inhibitor suppressed development of Plasmodium berghei in a murine model of malarial infection. The present study is aimed at evaluating G. truncata for its anti-malarial and anti-inflammatory effects using in vivo malarial and melioidosis infection models respectively. In a four-day suppressive test, intraperitoneal injections of up to 250 mg/kg body weight (bw) G. truncata CME into P.berghei-infected mice suppressed parasitaemia development by >60%. Intraperitoneal administration of 150 mg/kg bw G. truncata CME into Burkholderia pseudomallei-infected mice improved survivability by 44%. G. truncata CME lowered levels of pro-inflammatory cytokines (TNF-α, IFN-γ) in serum and organs of B. pseudomallei-infected mice. In both infections, increased phosphorylations (Ser9) of GSK3β were detected in organ samples of animals administered with G. truncata CME compared to controls. Taken together, results from this study strongly suggest that the anti-malarial and anti-inflammatory effects elicited by G. truncata in part were mediated through inhibition of GSK3β. The findings provide scientific basis for the ethnomedicinal use of this fern to treat inflammation-associated symptoms.

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