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Fulltext Infectious Bronchitis Virus (Gammacoronavirus) in Poultry Farming: Vaccination, Immune Response and Measures for Mitigation

Bhuiyan MSA, Amin Z, Rodrigues KF, Saallah S, Shaarani SM, Sarker S, et al.

Vet Sci, 2021 Nov 12;8(11).
PMID: 34822646 DOI: 10.3390/vetsci8110273

Infectious bronchitis virus (IBV) poses significant financial and biosecurity challenges to the commercial poultry farming industry. IBV is the causative agent of multi-systemic infection in the respiratory, reproductive and renal systems, which is similar to the symptoms of various viral and bacterial diseases reported in chickens. The avian immune system manifests the ability to respond to subsequent exposure with an antigen by stimulating mucosal, humoral and cell-mediated immunity. However, the immune response against IBV presents a dilemma due to the similarities between the different serotypes that infect poultry. Currently, the live attenuated and killed vaccines are applied for the control of IBV infection; however, the continual emergence of IB variants with rapidly evolving genetic variants increases the risk of outbreaks in intensive poultry farms. This review aims to focus on IBV challenge-infection, route and delivery of vaccines and vaccine-induced immune responses to IBV. Various commercial vaccines currently have been developed against IBV protection for accurate evaluation depending on the local situation. This review also highlights and updates the limitations in controlling IBV infection in poultry with issues pertaining to antiviral therapy and good biosecurity practices, which may aid in establishing good biorisk management protocols for its control and which will, in turn, result in a reduction in economic losses attributed to IBV infection.
Antibacterial effect of red laser-activated silver nanoparticles synthesized with grape seed extract against Staphylococcus aureus and Escherichia coli

Yaqubi AK, Astuti SD, Zaidan AH, Syahrom A, Nurdin DZI

Lasers Med Sci, 2024 Jan 26;39(1):47.
PMID: 38277009 DOI: 10.1007/s10103-024-03991-7

Living organisms, particularly humans, frequently encounter microorganisms such as bacteria, fungi, and viruses in their surroundings. Silver nanoparticles are widely used in biomedical devices because of their antibacterial and antiviral properties. The study evaluates the efficacy of red laser and silver nanoparticles from grape seed extract (AgNPs-GSE) in reducing Gram-negative Escherichia coli and Gram-positive Staphylococcus aureus bacteria, which cause infections. The sample comprised three groups: a control group without laser irradiation (T0), Escherichia coli samples (A1 and A2) irradiated with a 405-nm diode laser at different times and concentrations of silver nanoparticles, and Staphylococcus aureus samples (A3 and A4) illuminated with a 405-nm diode laser at different times and concentrations. Bacteria in groups A2 and A4 were treated with a photosensitizer (PS) made from grape seed extracts, incubated for 10 min, and then irradiated for 90, 120, 150, and 180 s. The samples were cultured on TSA media, set at 37 °C, counted using a Quebec colony counter, and analyzed using ANOVA and Tukey tests with a significance level of p
Fulltext Photobiomodulation effect of infra-red laser on the level of gonad maturity in the Simese Catfish (Pangasianodon hypophthalmus)

Astuti SD, Febriastri AR, Mukti AT, Yaqubi AK, Susilo Y, Syahrom A

Heliyon, 2023 Dec;9(12):e23253.
PMID: 38149202 DOI: 10.1016/j.heliyon.2023.e23253

The purpose of this study is to determine how photo biomodulation therapy utilizing infrared diode laser irradiation (975.2 nm) affects the gonadal maturity level (GML) of male Siamese catfish (Pan-gasianodon hypothalamus). The interest in applying laser therapy in medicine and dentistry has remarkably increased in the last decade. Different types of lasers are available, and their usage is well-defined by different parameters, such as wavelength, energy density, power output, duration of radiation, power density and radiation mode. Infrared diode laser irradiation is used at the reproductive point (governor's vessel), situated 2/3 of the way between the anus and the pectoral fin. This study examined the metrics GML, gonads somatic index, and hepatosomatic index. The treatments were Control+ (ovaprim), Control- (without the treatment), P1 (0.2 J/cm2), P2 (0.4 J/cm2), P3 (0.6 J/cm2), and P4 (0.8 J/cm2). Therapy with infrared diode laser irradiation can modify gonad maturity (GML), gonadosomal index, and hepatosomatic index in male Siamese catfish. The photobiomodulation effect of an infrared laser stimulated the gonadal maturation of Siamese catfish. This is based on the values of wavelength (nm), power (mW), beam area (cm2), time (s), radiation mode (rad) and energy dose (J/cm2) in Control- (no treatment), control+ (ovaprim), P1, P2, P3, and P4. The increase in the observed parameter values is due to the vitellogenesis process. The fish gonads at the GML IV had the highest GML at P2 (dose 0.4 J/cm2), with a GSI value of 1.02% and an HSI value of 1.46%. According to the study's findings, photo biomodulation therapy with infrared diode laser exposure at a dose of 0.4 J/cm2 is the best way to increase the gonad maturity of male Siamese catfish.
Fulltext Factor Influences for Diagnosis and Vaccination of Avian Infectious Bronchitis Virus (Gammacoronavirus) in Chickens

Bhuiyan MSA, Amin Z, Bakar AMSA, Saallah S, Yusuf NHM, Shaarani SM, et al.

Vet Sci, 2021 Mar 16;8(3).
PMID: 33809420 DOI: 10.3390/vetsci8030047

Infectious bronchitis virus (IBV) is a major economic problem in commercial chicken farms with acute multiple-system infection, especially in respiratory and urogenital systems. A live-attenuated and killed vaccine is currently immunized to control IBV infection; however, repeated outbreaks occur in both unvaccinated and vaccinated birds due to the choice of inadequate vaccine candidates and continuous emergence of novel infectious bronchitis (IB) variants and failure of vaccination. However, similar clinical signs were shown in different respiratory diseases that are essential to improving the diagnostic assay to detect IBV infections. Various risk factors involved in the failure of IB vaccination, such as various routes of application of vaccination, the interval between vaccinations, and challenge with various possible immunosuppression of birds are reviewed. The review article also highlights and updates factors affecting the diagnosis of IBV disease in the poultry industry with differential diagnosis to find the nature of infections compared with non-IBV diseases. Therefore, it is essential to monitor the common reasons for failed IBV vaccinations with preventive action, and proper diagnostic facilities for identifying the infective stage, leading to earlier control and reduced economic losses from IBV disease.
Fulltext Bilateral carotid body tumours: a case report from surgeon's perspective

Chandra Sakaran KR, Tiew T, Kamil K, Habeebullah Khan HA, Idris MA, Safri LS

J Surg Case Rep, 2024 Mar;2024(3):rjae011.
PMID: 38487394 DOI: 10.1093/jscr/rjae011

Carotid body tumour (CBT) is the most common paraganglioma of the head and neck and may compromise neurovascular structures such as carotid vessels, and cranial nerves. Intracranial extension from the mass is possible if left untreated. The main treatment for CBT is surgical resection albeit extremely challenging due to tumour hypervascularity and its relationship to the carotid artery. A bilateral CBT, however, is a rare occurrence. Herein, we present a case of a man who presented to us with bilateral painless and palpable neck mass. He underwent staged bilateral CBT excision and it was complicated with left hypoglossal nerve palsy, which recovered over time.
Fulltext A Rare Incidence of Splenic Artery Aneurysm and Hypersplenism

M Azmi N, Safri LS, Abdul Rahman N, Dualim DM, Chandrakanthan S

Cureus, 2024 Feb;16(2):e54280.
PMID: 38371434 DOI: 10.7759/cureus.54280

A 31-year-old woman with Child's B liver cirrhosis with portal hypertension and splenomegaly presented with a one-month history of abdominal pain. A physical examination confirmed splenomegaly. A blood investigation revealed a low white blood cell (WBC) and platelet count. Computed tomography (CT) revealed a splenic artery aneurysm at the distal splenic artery measuring 3.4 x 3.4 x 4.3 cm (AP x W x CC) with thrombus and splenic infarction. A successful angiographic embolisation was performed without immediate complications. The abdominal pain symptoms resolved, leading to the patient's discharge from the ward on the third day post-embolisation. Follow-up at the surgical outpatient clinic indicated the patient remained asymptomatic, and repeated blood counts showed improvement in both WBC and platelet counts. Furthermore, follow-up CT scans demonstrated a reduction in spleen size, indicating positive outcomes and a favourable response to the intervention.
Fulltext Delayed Presentation of Metastatic Renal Cell Carcinoma as an Arteriovenous Malformation Mimicking Vascular Tumour of the Forearm

Caunter G, Faeez Md Noh MS, Safri LS, Kumar K, Md Idris MA, Harunarashid H, et al.

EJVES Short Rep, 2019;44:19-22.
PMID: 31453386 DOI: 10.1016/j.ejvssr.2019.06.003

INTRODUCTION: The development of metastatic renal cell carcinoma (RCC) many years after a nephrectomy is not common but has been reported. A metastasis appearing as a hypervascular tumour, mimicking an arteriovenous malformation (AVM), is a highly unusual phenomenon, with a biopsy required for diagnostic confirmation. Surgery is an option for a solitary metastatic lesion amenable to complete excision, with proven survival benefits. However, widespread metastatic disease carries a very poor prognosis, and is best treated with systemic agents such as anti-angiogenic drugs or tyrosine kinase inhibitors.
REPORT: A 58 year old man developed an AVM mimicking a vascular tumour within his left brachioradialis muscle 10 years after a nephrectomy for RCC. Ultrasound and magnetic resonance imaging did not reveal any suspicious features of the vascular lesion.The lesion was successfully removed surgically, and was later proven histopathologically to be metastatic RCC. Further imaging showed widespread metastatic disease, and the patient survived only 15 months after receiving tyrosine kinase inhibitor therapy.
DISCUSSION: This case report aims to highlight a few important points: RCC metastases may be hypervascular, mimicking an AVM. A long disease free interval does not necessarily exclude recurrence or metastasis, as in this case, therefore long term surveillance is recommended. A high index of suspicion must be maintained to avoid delay in treatment, and biopsy of any suspicious lesion for histological examination is mandatory, albeit after many years of cancer remission. Whole body imaging with computed tomography or positron emission tomography computed tomography may detect clinically occult recurrence or metastases, and is important to guide further treatment.
Fulltext A Retrospective Review of Global Commercial Seaweed Production-Current Challenges, Biosecurity and Mitigation Measures and Prospects

Sugumaran R, Padam BS, Yong WTL, Saallah S, Ahmed K, Yusof NA

Int J Environ Res Public Health, 2022 Jun 09;19(12).
PMID: 35742332 DOI: 10.3390/ijerph19127087

Commercial seaweed cultivation has undergone drastic changes to keep up with the increasing demand in terms of the quantity and quality of the algal biomass needed to meet the requirements of constant innovation in industrial applications. Diseases caused by both biotic and abiotic factors have been identified as contributing to the economic loss of precious biomass. Biosecurity risk will eventually affect seaweed production as a whole and could cripple the seaweed industry. The current review sheds light on the biosecurity measures that address issues in the seaweed industry pushing towards increasing the quantity and quality of algal biomass, research on algal diseases, and tackling existing challenges as well as discussions on future directions of seaweed research. The review is presented to provide a clear understanding of the latest biosecurity developments from several segments in the seaweed research, especially from upstream cultivation encompassing the farming stages from seeding, harvesting, drying, and packing, which may lead to better management of this precious natural resource, conserving ecological balance while thriving on the economic momentum that seaweed can potentially provide in the future. Recommended breeding strategies and seedling stock selection are discussed that aim to address the importance of sustainable seaweed farming and facilitate informed decision-making. Sustainable seaweed cultivation also holds the key to reducing our carbon footprint, thereby fighting the existential crisis of climate change plaguing our generation.
Fulltext Unexpected complication of arteriovenous fistula of the left common carotid to internal jugular vein following central venous catheterization

Henry TCL, Huei TJ, Yuzaidi M, Safri LS, Krishna K, Rizal IA, et al.

Chin J Traumatol, 2020 Feb;23(1):29-31.
PMID: 31744657 DOI: 10.1016/j.cjtee.2019.10.001

Incidence of inadvertent arterial puncture secondary to central venous catheter insertion is not common with an arterial puncture rate of <1%. This is due to the advancements and wide availability of ultrasound to guide its insertion. Formation of arteriovenous fistula after arterial puncture is an unexpected complication. Till date, only five cases (including this case) of acquired arteriovenous fistula formation has been described due to inadvertent common carotid puncture. The present case is a 26-year-old man sustained traumatic brain injuries, chest injuries and multiple bony fractures. During resuscitative phase, attempts at left central venous catheter via left internal jugular vein under ultrasound guidance resulted in inadvertent puncture into the left common carotid artery. Surgical neck exploration revealed that the catheter had punctured through the left internal jugular vein into the common carotid artery with formation of arteriovenous fistula. The catheter was removed successfully and common carotid artery was repaired. Postoperatively, the patient recovered and clinic visits revealed no neurological deficits. From our literature review, the safest method for removal is via endovascular and open surgical removal. The pull/push technique (direct removal with compression) is not recommended due to the high risk for stroke, bleeding and hematoma formation.
Fulltext Comparative Study of The Yield and Physicochemical Properties of Collagen from Sea Cucumber (Holothuria scabra), Obtained through Dialysis and the Ultrafiltration Membrane

Saallah S, Roslan J, Julius FS, Saallah S, Mohamad Razali UH, Pindi W, et al.

Molecules, 2021 Apr 28;26(9).
PMID: 33924820 DOI: 10.3390/molecules26092564

Collagen was extracted from the body wall of sea cucumber (Holothuria scabra) using the pepsin-solubilized collagen method followed by isolation using dialysis and the ultrafiltration membrane. The yield and physicochemical properties of the collagen obtained from both isolation methods, denoted as D-PSC and UF-PSC, were compared. The ultrafiltration method affords a higher yield of collagen (11.39%) than that of the dialysis (5.15%). The isolated collagens have almost the same amino acid composition, while their functional groups, referred to as amide A, B, I, II, and III bands, were in accordance with commercial collagen, as verified by Fourier Transform Infrared (FT-IR) spectroscopy. The UV-Vis absorption peaks at 240 nm and 220 nm, respectively, indicated that the collagens produced are type-I collagen. The D-PSC showed interconnecting sheet-like fibrils, while the UF-PSC exhibited a flaky structure with flat-sheets arranged very close to each other. The higher yield and comparable physicochemical properties of the collagen obtained by ultrafiltration as compared with dialysis indicate that the membrane process has high potential to be used in large-scale collagen production for food and pharmaceutical applications.
Fulltext Reduced occludin and claudin-7 expression is associated with urban locations and exposure to second-hand smoke in allergic rhinitis patients

Nur Husna SM, Siti Sarah CO, Tan HT, Md Shukri N, Mohd Ashari NS, Wong KK

Sci Rep, 2021 01 13;11(1):1245.
PMID: 33441633 DOI: 10.1038/s41598-020-79208-y

The breakdown of nasal epithelial barrier occurs in allergic rhinitis (AR) patients. Impairment of cell junction molecules including tight junctions (TJs) and desmosomes plays causative roles in the pathogenesis of AR. In this study, we investigated the transcript expression levels of TJs including occludin (OCLN), claudin-3 and -7 (CLDN3 and CLDN7), desmoglein 3 (DSG3) and thymic stromal lymphopoietin (TSLP) in AR patients (n = 30) and non-allergic controls (n = 30). Nasal epithelial cells of non-allergic controls and AR patients were collected to examine their mRNA expression levels, and to correlate with clinico-demographical and environmental parameters. We demonstrated that the expression of OCLN (p = 0.009), CLDN3 (p = 0.032) or CLDN7 (p = 0.004) transcript was significantly lower in AR patients compared with non-allergic controls. No significant difference was observed in the expression of DSG3 (p = 0.750) or TSLP (p = 0.991) transcript in AR patients compared with non-allergic controls. A significant association between urban locations and lower OCLN expression (p = 0.010), or exposure to second-hand smoke with lower CLDN7 expression (p = 0.042) was found in AR patients. Interestingly, none of the TJs expression was significantly associated with having pets, frequency of changing bedsheet and housekeeping. These results suggest that defective nasal epithelial barrier in AR patients is attributable to reduced expression of OCLN and CLDN7 associated with urban locations and exposure to second-hand smoke, supporting recent findings that air pollution represents one of the causes of AR.
An in-vivo study of photobiomodulation using 403 nm and 649 nm diode lasers for molar tooth extraction wound healing in wistar rats

Astuti SD, Sulistyo A, Setiawatie EM, Khasanah M, Purnobasuki H, Arifianto D, et al.

Odontology, 2021 Sep 07.
PMID: 34491461 DOI: 10.1007/s10266-021-00653-w

PURPOSE: This study aims to examine the effects of red 649 nm 4 J/cm2 and blue 403 nm 8 J/cm2 diode laser treatment for post-extraction wounded healing in rats through histopathological and immunohistochemical analysis.
METHODS: Samples of 54 Wistar rats were divided into six groups: C- control group without treatment; C + wounded group without treatment; TB wound group with Povidone-iodine treatment; TD wounded group with doxycycline treatment; TLB wounded group with 403 nm diode laser treatment; and TLR wounded group with 649 nm diode laser treatment. Mandibular samples were observed for the number of lymphocytes and fibroblasts cells, new blood vessels formation, Interleukin 1β, and Collagen 1α expression level.
RESULTS: Based on the histopathological test results, red laser diode treatment significantly increased the number of lymphocyte, fibroblast cells and the formation of new blood vessels. Meanwhile, immunohistochemical tests showed an increase in the expression of the Colagen-1α protein which plays a role in the formation of collagen for new tissues formation after damage, as well as a decrease in Interleukin-1β expression level. Blue laser is also able to show a positive effect on wound healing even though its penetration level into the tissue is lower compared to red laser.
CONCLUSION: The red diode laser 649 nm has been shown to accelerate the process of proliferation in wound healing post molar extraction based on histopathological and immunohistochemical test results.
Fulltext A case of metastatic adenocarcinoma from an unknown primary involving the aortic bifurcation

Safri LS, Md Noh MSF, Hariz Ramli AR, Md Pauzi SH, Md Idris MA, Harunarashid H

J Vasc Surg Cases Innov Tech, 2018 Jun;4(2):160-162.
PMID: 29942910 DOI: 10.1016/j.jvscit.2018.03.004

Aortic malignant neoplasms are rare; these may be primary or secondary (metastatic). Increasing use of cross-sectional imaging has allowed better detection and diagnosis of these conditions. We encountered a young woman presenting with acute abdomen who was found on cross-sectional imaging to have a malignant tumor involving the aortic bifurcation. An en bloc excision of the tumor was performed, with distal aorta reconstruction using an aortoiliac Dacron graft; this was complicated with infection and graft occlusion, necessitating total removal and extra-anatomic bypass. A pathologic diagnosis of metastatic adenocarcinoma involving the aortic bifurcation, with an unknown primary, was made.
Fulltext Seroprevalence and molecular characterisation of infectious bronchitis virus (IBV) in broiler farms in Sabah, Malaysia

Bhuiyan MSA, Sarker S, Amin Z, Rodrigues KF, Bakar AMSA, Saallah S, et al.

Vet Med Sci, 2023 Dec 27.
PMID: 38151844 DOI: 10.1002/vms3.1153

BACKGROUND: Infectious bronchitis virus (IBV) is classified as a highly contagious viral agent that causes acute respiratory, reproductive and renal system pathology in affected poultry farms. Molecular and serological investigations are crucial for the accurate diagnosis and management of IBV.
OBJECTIVES: The purpose of this study was to determine the seroprevalence of IBV and to characterise the circulating IBV in poultry farms in Sabah Province, Malaysia.
METHODS: To determine IBV antibodies, a total of 138 blood samples and 50 organ samples were collected from 10 commercial broiler flocks in 3 different farms by using the enzyme-linked immunosorbent assay (ELISA) (IDEXX Kit) and reverse transcription-polymerase chain reaction (RT-PCR) followed by sequencing.
RESULTS: A total of 94.2% (130/138) of the samples were seropositive for IBV in the vaccinated flock, and 38% (52/138) of the birds was the IBV titre for infection. The selected seropositive samples for IBV were confirmed by RT-PCR, with 22% (11/50) being IBV positive amplified and sequenced by targeted highly conserved partial nucleocapsid (N) genes. Subsequently, phylogenetic analysis constructed using amplified sequences again exposed the presence of Connecticut, Massachusetts, and Chinese QX variants circulating in poultry farms in Sabah, Malaysia.
CONCLUSIONS: The unexpectedly increasing mean titres in serology indicated that post infection of IBV and highly prevalent IBV in selected farms in this study. The sequencing and phylogenetic analysis revealed the presence of multiple IBV variants circulating in Malaysian chicken farms in Sabah, which further monitoring of genetic variation are needed to better understand the genetic diversity.
Fluorescent microscopy evaluation of diode laser effect on the penetration depth of turmeric (Curcuma longa) extract cream on skin tissues of Wistar rats

Astuti SD, Mawaddah A, Kusumawati I, Mahmud AF, Nasution AMT, Purwanto B, et al.

Lasers Med Sci, 2024 Feb 23;39(1):79.
PMID: 38393433 DOI: 10.1007/s10103-024-04020-3

The study investigates the effect of diode laser exposure on curcumin's skin penetration, using turmeric extraction as a light-sensitive chemical and various laser light sources. It uses an in vivo skin analysis method on Wistar strain mice. The lasers are utilized at wavelengths of 403 nm, 523 nm, 661 nm, and 979 nm. The energy densities of the lasers are 20.566 J/cm2, 20.572 J/cm2, 21.162 J/cm2, and 21.298 J/cm2, which are comparable to one another. The experimental animals were divided into three groups: base cream (BC), turmeric extract cream (TEC), and the combination laser (L), BC, and TEC treatment group. Combination light source (LS) with cream (C) was performed with 8 combinations namely 523 nm ((L1 + BC) and (L1 + TEC)), 661 nm ((L2 + BC) and (L2 + TEC)), 403 nm ((L3 + BC) and (L3 + TEC)), and 979 nm ((L4 + BC) and (L4 + TEC)). The study involved applying four laser types to cream-covered and turmeric extract-coated rat skin, with samples scored for analysis. The study found that both base cream and curcumin cream had consistent pH values of 7-8, within the skin's range, and curcumin extract cream had lower viscosity. The results of the statistical analysis of Kruskal-Wallis showed a significant value (p 0.05), while the treatment using BC and TEC showed a significant difference (p
A profile of TNFR2+ regulatory T cells and CD103+ dendritic cells in the peripheral blood of patients with asthma

Azid NA, Ahmad S, Boer JC, Al-Hatamleh MAI, Mohammad N, Mohd Ashari NS, et al.

Hum Immunol, 2020 08 06;81(10-11):634-643.
PMID: 32771274 DOI: 10.1016/j.humimm.2020.07.006

The interaction of tolerogenic CD103+ dendritic cells (DCs) with regulatory T (Tregs) cells modulates immune responses by inducing immune tolerance. Hence, we determined the proportion of these cells in the peripheral blood mononuclear cells (PBMC) of asthmatic patients. We observed lower trends of CD11b-CD103+ DCs and CD86 within CD11b-CD103+ DCs, while increased levels of Foxp3 expressing CD25+/-TNFR2+ cells in asthmatics. There was a positive correlation in the expression of Foxp3 within CD3+CD4+CD25+TNFR2+ Tregs and CD11b-CD103+ as well as the expression of CD86 within HLA-DR+CD11c+CD11b-CD103+ DCs. In conclusion, we suggest that the increased levels of Tregs in blood could continuously suppress the T helper 2 (Th2) cells activation in the circulation which is also supported by the increase of anti-inflammatory cytokines IL-10 and TNF. Overall, functional immunoregulation of the regulatory cells, particularly Tregs, exhibit immune suppression and induce immune tolerance linked with the immune activation by the antigen presenting cells (APC).
Underutilization of epilepsy surgery in ASEAN countries

Thuy Le MA, Fong SL, Lim KS, Gunadharma S, Sejahtera DP, Visudtibhan A, et al.

Seizure, 2019 Jul;69:51-56.
PMID: 30974407 DOI: 10.1016/j.seizure.2019.04.002

PURPOSE: This survey was performed to determine the availability of epilepsy surgery, and understand the limiting factors to epilepsy surgery in ASEAN countries with total of 640 million population.
METHOD: A cross-sectional survey was completed by national representatives in all ASEAN countries (Brunei, Cambodia, East Timor, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam).
RESULTS: Overall facilities for initial epilepsy pre-surgical evaluation are available in most countries, but further non-invasive and invasive investigations are limited. Three countries (Brunei, Cambodia, and East Timor) have no epilepsy center, and 2 countries (Laos, Myanmar) have level 2 centers doing tumor surgery only. Level-3 epilepsy centers are available in 6 countries (Indonesia, Malaysia, Philippine, Singapore, Thailand, Vietnam); only 5 countries (Indonesia, Malaysia, Philippine, Singapore, Thailand) has at least one level-4 epilepsy care facility. Indonesia with 261 million population only has one level 3 and another level 4 center. The costs of presurgical evaluation and brain surgery vary within and among the countries. The main barriers towards epilepsy surgery in ASEAN include lack of expertise, funding and facilities.
CONCLUSIONS: Epilepsy surgery is underutilized in ASEAN with low number of level 3 centers, and limited availability of advanced presurgical evaluation. Lack of expertise, facilities and funding may be the key factors contributing to the underutilization.
Fulltext Presentation of Breast Cancer and Impact of Patient Navigation on Timeliness of Diagnosis and Treatment and on Adherence to Treatment Recommendations in a Multicenter Network in Malaysia

Jaganathan M, Ang BH, Ali A, Sharif SZ, Mohamad M, Mohd Khairy A, et al.

JCO Glob Oncol, 2024 Mar;10:e2300297.
PMID: 38484197 DOI: 10.1200/GO.23.00297

PURPOSE: Breast cancer deaths disproportionately affect women living in low- and middle-income countries (LMICs). Patient navigation has emerged as a cost-effective and impactful approach to enable women with symptoms or suspicious mammogram findings to access timely diagnosis and patients with breast cancer to access timely and appropriate multimodality treatment. However, few studies have systematically evaluated the impact of patient navigation on timeliness of diagnosis and treatment in LMICs.
METHODS: We established a nurse- and community-navigator-led navigation program in breast clinics of four public hospitals located in Peninsular and East Malaysia and evaluated the impact of navigation on timeliness of diagnosis and treatment.
RESULTS: Patients with breast cancer treated at public hospitals reported facing barriers to accessing care, including having a poor recognition of breast cancer symptoms and low awareness of screening methods, and facing financial and logistics challenges. Compared with patients diagnosed in the previous year, patients receiving navigation experienced timely ultrasound (84.0% v 65.0%; P < .001), biopsy (84.0% v 78.0%; P = .012), communication of news (63.0% v 40.0%; P < .001), surgery (46% v 36%; P = .008), and neoadjuvant therapy (59% v 42%, P = .030). Treatment adherence improved significantly (98.0% v 87.0%, P < .001), and this was consistent across the network of four breast clinics.
CONCLUSION: Patient navigation improves access to timely diagnosis and treatment for women presenting at secondary and tertiary hospitals in Malaysia.
Trust in government moderates the association between fear of COVID-19 as well as empathic concern and preventive behaviour

Karakulak A, Tepe B, Dimitrova R, Abdelrahman M, Akaliyski P, Alaseel R, et al.

Commun Psychol, 2023 Dec 15;1(1):43.
PMID: 39242865 DOI: 10.1038/s44271-023-00046-5

With the COVID-19 pandemic, behavioural scientists aimed to illuminate reasons why people comply with (or not) large-scale cooperative activities. Here we investigated the motives that underlie support for COVID-19 preventive behaviours in a sample of 12,758 individuals from 34 countries. We hypothesized that the associations of empathic prosocial concern and fear of disease with support towards preventive COVID-19 behaviours would be moderated by trust in the government. Results suggest that the association between fear of disease and support for COVID-19 preventive behaviours was strongest when trust in the government was weak (both at individual- and country-level). Conversely, the association with empathic prosocial concern was strongest when trust in the government was high, but this moderation was only found at individual-level scores of governmental trust. We discuss how motivations may be shaped by socio-cultural context, and outline how findings may contribute to a better understanding of collective action during global crises.

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