Introduction: Hanging is one of the most common methods of suicide in Malaysia, and to date, there is a rise in the number of deaths by hanging among adults. The purpose of this study was to determine the pattern of hanging in Malaysia from the year 2000 till 2009. Methods: The sample comprised 108 cases received at the Universiti Kebangsaan Malaysia Medical Centre, and five parameters, namely, age, sex, racial affiliation, marital status, and medical history were studied. Results: Of the 108 cases, 56% was reported to be Chinese. Suicide by hanging was more predominant in males (81%), and a high number of cases were seen in age groups of 21 to 30, 31 to 40 and 41 to 50 years. Of the cases studied, half of them were married, and previous history of physical and mental illness and alcohol intoxication were reported. Conclusions: In brief, this data would help the higher authorities in detecting the causes of suicide by hanging, as well as detecting the high risk groups with suicidal tendencies. In this way, suicide can be prevented and thus, the rate of suicide by hanging could be reduced in Malaysian.
Introduction: Diabetes mellitus possesses severe adverse effects on the urinary bladder. Urinary bladder dysfunction is a common health problem affecting diabetic patients causing recurrent infections and urinary incontinence. Objective: To evaluate the histopathological changes in the tissue of urinary bladder in Streptozotocin (STZ) diabetic rats and the protective role of insulin. Methods: Thirty rats were classified into three groups: a control group which received no treatment (Group A), STZ diabetic group (Group B) and Insulin diabetic group (Group C). Animals were sacrificed after six weeks and urinary bladders were harvested and processed for light and electron microscopy. Results: Several histopathological changes were observed in the urinary bladder of the diabetic group including an increase in the thickness of the urothelium, epithelial cells with dark nuclei and large lenticular vesicles, and wide intercellular spaces with numerous collagen fibers. Treatment with insulin reduced the pathological changes induced by STZ. Conclusion: Diabetes mellitus caused significant pathological changes in the urinary bladder of experimental rats. For instance, treating diabetic animals with insulin prevented the development of damaging effects of diabetes on the urinary bladder.
Comorbid adult attention-deficit hyperactivity disorder (ADHD) and stimulant dependence is widely recognized, but efficacy of pharmacotherapy in this patient population is not well established. We aimed to review whether pharmacotherapy is efficacious in reducing ADHD symptoms and stimulant use in comorbid adult ADHD and stimulant use disorder. English articles until June 2017 were systematically searched in electronic databases (MEDLINE and PsycINFO), an online clinical trials register (ClinicalTrial.gov), and through hand-search of article references. Randomized, double-blind, placebo-controlled trials that studied efficacy of pharmacotherapy in adults with comorbid ADHD and stimulant dependence were included. Two reviewers assessed studies for inclusion and extracted data; disagreements were resolved by consensus. Study outcomes included were changes in ADHD symptom severity, substance abstinence, treatment retention rates and safety. From the 1394 records identified, five trials (n=358) were included. Four studies involved methylphenidate; in another study extended-release mixed amphetamine were used. The comorbid stimulant was cocaine in three studies, and amphetamines in the rest. All were short-term studies involving predominantly young male adults conducted in outpatient settings. There is early promising but mixed evidence for therapeutic efficacy in improving ADHD symptoms. Stimulant medications did not worsen stimulant dependence or adverse effects of stimulant medications. Side effects were mild and tolerable. High attrition rates and small sample size limited the generalizability of findings. Current limited evidence suggests that stimulant treatment for comorbid adult ADHD and stimulant dependence is feasible. Welldesigned trials with adequate power are needed for more robust evidence on ADHD and stimulant use outcomes.
Introduction: Entomological surveillance is crucial to determine the abundance of dengue vector and to evaluate breeding areas of Aedes aegypti and Aedes albopictus. The objective of this study is to determine the distribution and breeding preference for both Ae. aegypti and Ae. albopictus in dengue endemic areas. Materials and Methods: Ovitraps surveillance was conducted in two dengue endemic areas; AU2, Keramat and Seksyen 7, Shah Alam, Selangor. A minimum number of 100 ovitraps were deployed for 5 days in the study sites. Samples collected were brought back to the lab and all larvae recovered were identified to species level. Results: The ovitap index (OI) in both localities exceeded the transmission threshold of 10% with the OI recorded ranged from 42.3-79.8% in AU2, Keramat and 16.7-42.9% in Seksyen 7, Shah Alam. Ae. albopictus was the dominant species in AU2 Keramat with the highest ratio Ae. aegypti to Ae. albopictus recorded was 1.00:22.79. Nonetheless, in Seksyen 7, Shah Alam the difference in Ae. aegypti to Ae. albopictus ratio is not really prominent with 1.00:3.61 for ovitraps deployed outdoor and 3.40:1.00 for ovitraps set indoor. It was determined that single infestation of either Ae. aegypti or Ae. albopictus is more frequent for ovitraps deployed indoor and/or outdoor, respectively. It was also determined that mixed infestations were found in this study indicating that both species can oviposit in the same container. Conclusion: This study indicates that OI is still above transmission threshold in both study sites. While Ae. aegypti and Ae. albopictus remain as a dominant indoor and outdoor breeder, respectively, mixed breeding of Aedes species in a same container was also observed.
Venom is a mixture of biologically active toxins that affect normal physiological functions. With the advance in technology, the complexity and functions of venom and its toxins are slowly being revealed. It has become important source for therapeutic, diagnostic and cosmetic agents. However, there is concern among the Muslim community pertaining to halal and safety issues on the venom and venom-derived product usage. There are few studies that discuss the Islamic views in the usage of venom and venom-based product in medicine and cosmetic applications. There is a need for Muslim scientists and scholars to seriously identify the potential ethical and safety issues in the usage of venom and venom-derived products in view of the widespread application in medicine and cosmetic, which subsequently forming the basis for relevant and reliable shariah ruling. This is an attempt to review the relevant articles based on the following keywords: venom and Islamic ruling, venom-based product, venom and medicine, venom and cosmetic, antivenom, venom toxin, snake poison and venom diagnostics. It will also attempt to clarify and elaborate the implication of the “halal” status for venom-based product. Finaly the current available shariah rulings on the usage of venom and venom-based product both in medical and cosmetic area and the related principle of fiqh involved will be analyzed. The findings from this review, particularly the current available ruling will allow various parties to be well informed on the current ruling and related issues on the usage of this products.
In contrast to classic Turner syndrome, Turner patients with ring X chromosome are associated with distinct dysmorphism and are likely to be mentally impaired. Four Turner patients with ring X chromosome were examined for phenotypic features of Turner syndrome and additional dysmorphism. Both patients 1 and 2 are twins with normal intelligence whereas patients 3 and 4 have mental impairment. With the exception of patient 4, the other three patients only have few Turner characteristics. None of the patients have the distinctive dysmorphism previously reported in Turner syndrome with ring X chromosome. Both twins developed spontaneous puberty. Patients 3 and 4 however had no spontaneous puberty. We postulate that this variation may be related to the ring size, the proportion of 45,X and ring X chromosome in cell lines of various body tissues as well as the ability of these rings to be inactivated as a result of lyonisation.
Medicinal plants become very important in our days for their therapeutic benefits to humankind. It sustains human health, and it is commonly known as herbal medicines since ancient times. Annona muricata is a heart-shaped fruit that is consumed raw or as the fruit juice in the tropical area. A. muricata is used in traditional and alternative medicine to treat different ailments such as diabetes, hypertension, respiratory and skin illness, inflammation and cancer. A. muricata contains essential anticancer agents named acetogenins that play the significant role in various cancer types. Acetogenins are strong nicotinamide adenine dinucleotide oxidase inhibitors of the cancer cell's mitochondrial membrane but showed neurotoxic effects in rats. Therefore, acetogenins need to be further investigated to determine the exact mechanisms of action, long-term safety, optimal dosage, and potential side effects. Given the extensive studies on A. muricata, this review focuses on the phytochemistry, medicinal uses, biological activities and the mechanisms of action for the fruit extracts and acetogenins, to stimulate further studies on the fruit pulp used for human consumption.
Introduction: The Five-Factor Nonverbal Personality Questionnaire (FF-NPQ) is a non-verbal personality inventory consisting of illustrations of different social situations, designed to measure five broad factors underlying the Big-Five model of personality. This study aimed to prove the validity of the FF-NPQ in Malaysia. Methods: The FF-NPQ instruction and the answer option were translated to the Malay language, which is the main language spoken in Malaysia. A total of 153 university students aged 18–30 years from Universiti Sains Malaysia were involved in this study. Confirmatory factor analysis (CFA), composite reliability and intraclass correlation (ICC) were applied to show evidence of validity by internal structure. Results: CFA indicated that only 26 out of 60 items remained in the final model while maintaining the five personality factors. Each factor had a good composite reliability value of 0.68–0.77. The ICC values from the test-retest analysis ranged from 0.65 to 0.75. Conclusion: Overall, the shortened Malay Version of the FF -NPQ (five-factor, 26 items) exhibited acceptable evidence of validity in Malaysia.
Introduction: Cervical cancer is the third leading cause of cancer death among females in less developed countries. Drugs used in the treatment of cervical cancer were reported to exert a cytotoxic effect on the normal cells. This study aimed to determine the effectiveness of Quercus infectoria (QI) vaginal cream towards cervical cancer cell, HeLa and its toxicity effect on the female rat model. Methods: MTT assays were utilized to determine the median concentration (IC50) for cell cytotoxicity of QIA and QI vaginal cream against cervical cancer cells, HeLa. Expression of HPV E6 and E7 protein in HeLa cells treated with QI vaginal cream for 24 hours were conducted by Western blot analysis. In separate experiments, the toxicity of QI vaginal cream on a lower reproductive tract of the female rat model has been assessed by histopathological examination after application for three weeks. The antioxidant activity of QIA extract and QI vaginal cream were assessed by DPPH radical scavenging assay. Results: A moderate cytotoxicity activity exerted by QIA extract and QI vaginal cream against HeLa cell with IC50 values of 13.90 ± 2.27, and 20.80 ± 1.94 respectively. Furthermore, QI vaginal cream suppressed the expression of HPV E6 and E7. Daily application of QI vaginal did not exert any inflammation to the vaginal mucosa and cervix. QIA extract and QI vaginal cream demonstrated high DPPH radical scavenging activity. Conclusion: Formulated QI vaginal cream has cytotoxic effect on HeLa cells without causing an adverse effect on the lower reproductive tract in female rat model.
Introduction: Good control of glycaemia negates potential maternal and fetal complications. A diet suitable for women with gestational diabetes mellitus (GDM) is a first line approach. However, little is said about suitable exercise in pregnancy that will potentially help control glycaemia. This pilot study seeks to understand the perceived barriers to exercise in women with GDM.
Materials and Methods: This crosssectional study recruited patients with GDM on diet control at the antenatal clinic of Hospital Sultanah Aminah Johor Bahru, Malaysia between October 2017 and January 2018. Those who fulfilled the recruitment criteria were approached and 89 women consented to participate. Data was obtained from antenatal records and a self-administered questionnaire.
Results: The mean age of the participants was 33.3 years. More than 80% were Para 1 and above. 69.6% were either overweight or obese at booking of pregnancy. 80.9% were aware that exercise was necessary for women with GDM. Only 6.7% say that healthcare professionals were their source of information on exercise in pregnancy. 77.3% of the women with low physical activity had full time jobs. Housewives (64.5%) had the highest level of physical activity. Tiredness (43.8%), childcare duties (38.2%) and lack of time (27.0%) were the most common perceived barriers to exercise. Nulliparity was significantly associated with tiredness.
Conclusion: Main barriers to exercise are tiredness and childcare duties. Health care professionals did little in educating women with GDM on suitable exercise.
Introduction: Marital satisfaction is vital to the wellbeing and functioning of the individual and family. Marital dissatisfaction can lead to detrimental effects on mental, physical and family health. The study aimed to determine the proportion of marital dissatisfaction in outpatient setting and its association with sexual functioning and psychiatric morbidity in Kuala Lumpur, Malaysia.
Materials & Methods: A cross-sectional study was conducted in selected primary care using purposive sampling. Data collection was done using socio-demographic questionnaire and several validated Malay version of self-administered questionnaires. Marital satisfaction was measured by the Malay version of Golombok-Rust Inventory of Marital State (Mal-GRIMS).
Results: The prevalence of marriage dissatisfaction in sample population was about 37.3% with almost equal prevalence in both, 36.5% (male) and 37.8% (female). Using a regression analysis, the significant factors that affect marital dissatisfaction were respondent's age group between 31- 40 years old (Adjusted Odds Ratio, AOR. =11.4, 95% Confidence Interval, CI. =1.2-110.9), spouse's salary of RM1000-RM2000 (lower income category) (AOR=7.3, 95% CI= 1.9-28.1), anxiety case (AOR= 4.8, 95% CI=1.1- 21.5), depression case (AOR= 4.8, 95% CI=1.0-22.8), female sexual dysfunction in term of arousal function (AOR= 0.01, 95% CI=0.0-0.7), satisfaction dysfunction (AOR= 9.4, 95% CI= 1.5-58) and pain function (AOR=43.7, 95% CI=1.28 - 1489.2).
Conclusion: Marital dissatisfaction can be influenced by financial factor, sexual dysfunction and presence of psychiatric morbidity. Hence, in management of marital discord, thorough screening of these factors should be prioritized in clinical setting.
Background: With increasing number of dengue cases in Malaysia, it’s of utmost importance that immediate
action be taken to limit the epidemic. Since dengue control is a behavioral problem, the knowledge,
attitude and practice in population needs to be studied in order to control the disease. Hence, the aim of
this study is to assess knowledge, attitude and practice regarding dengue and its associated factors among
adult residents of Felda Sungai Panching Timur (SPT), Kuantan, Pahang, 2014.
Method: A cross sectional
study was carried out involving 265 adult respondents. A face to face interview questionnaire which was
divided into 2 parts (Part A: Sociodemoghraphic; Part B: Knowledge, Attitude and Practice) was used. Data
was analyzed using descriptive statistics, simple and multiple logistic regression.
Results: 53.2% of the
respondents had good knowledge about dengue and it was found that the main source of information from
mass media (76.6%). However, only 43.4% were found to have good attitude towards dengue. Multiple
Logistic Regression analysis showed there was no association between sociodemographic characteristics with
the level of knowledge and attitude towards dengue. There was also no association found between
knowledge of dengue and the attitude of the respondents towards dengue. Descriptive analysis on the
practice of dengue showed majority of the respondents who had possible breeding site for Aedes mosquitos
(water container, drains/gutter roof/flower pots/tires) in their compound practiced good habit in
preventing the Aedes mosquitoes from breed.
Conclusion: Although knowledge and practice towards dengue
is good, their attitude require improvement.
The increasing awareness amongst the society on medico-legal issues as well as the growth of consumerist
attitude towards the provision of medical services has caused the medical profession to be subjected to
vociferous criticism if they do not meet rising expectations of the society. Substandard services have not
been well tolerated and paternalistic approaches in medical treatment are considered to be outmoded and
inappropriate. Any dissatisfaction on the part of the patient towards medical services provided nowadays
may easily trigger claims in the court of law. This changing trend has also fundamentally changed the
behaviour of the courts towards the medical profession. Judicial and legislative interventions in medical
practice have created more and more rights for the patients and consequently, corresponding legal duties
for the medical profession to uphold. In the present healthcare setting, the medical profession will not be
able to provide infallible services without knowledge of the legal standards which they have to adhere.
Thus, educating future medical professionals with the fundamentals of law and ethics would ensure greater
accountability, knowledge and personal commitment in providing medical services to the society as the
ideals of professionalism not only require them to have the necessary expertise, dedication, respect,
compassion, empathy, honesty, altruism, responsibility, integrity, self-improvement and accountability but
also adherence to the demands of law and highest ethical standards.
Introduction: Malocclusion is one of the most common dental problems observed. Limited data is currently
available regarding the demographics of malocclusion observed locally.
Materials And Methods: This is a
retrospective study where 770 patients were recruited from May 2009 till December 2014. 560 orthodontic
study models that met the inclusion criteria were examined and the malocclusions were classified according
to the British Standard Institute (BSI) incisor classification. Demographic pattern and their relationship were
analysed by structural equation modelling using SPSS (version 23.0).
Results: From 560 study models
analysed, 72% were female. The age of the patients ranges from 7-12 years old (17.1%), 13-17 years old
(55.9%) and >18 years old (27.0%). Majority of the patients were Malay followed by Chinese (5.7%), Indian
(1.8%) and other races (1.8%) Treatments received were fixed appliances (FA) (60.0%), removable appliances
(RA) (12.5%), functional appliances (FnA) (1.1%), combination of RA and FA (16.1%), combination of FnA and
FA (2.1%) and consultation (8.2%). Types of malocclusions observed were Class I (25.7%), Class II/1(32.7%),
Class II/2 (7.5%) and Class III (34.1%). There was significant association (p
Introduction: Dyslipidaemia is one of the risk factors contributing to the pathogenesis of cardiovascular
diseases (CVDs). This study was conducted to investigate the effect of wet cupping on lipid profile.
Methods: This randomized controlled trial was conducted in 2012 at the School of Medical Sciences,
Universiti Sains Malaysia, Malaysia. Sixty-two healthy volunteers ranging from 30 to 60 years old were
randomized into control and intervention groups. Subjects in the intervention group were assigned to two
sessions of wet cupping at the beginning of the study and at the third month; individuals in the control group
did not undergo any cupping procedure. Venous blood sample was collected for serum lipid profile: Total
Cholesterol (TC), High Density Lipoprotein Cholesterol (HDL-C), Low Density Lipoprotein Cholesterol (LDL-C),
and triglycerides; measured at baseline, first, third and fourth month.
Results: Subjects in the cupping
group had significant improvements from baseline to third and fourth month for TC (MD=-0.56, P=0.004),
HDL-C (MD=-0.22, P
The upper airway is a crucial structure. It becomes a grave problem should it be narrowed. Several methods
of treatment were rendered for patients with laryngotracheal stenosis. We share our experience with the
combination total intravenous anaesthesia and apneic pause technique with or without steroid injection.
Four cases of laryngotracheal stenosis were observed in Hospital Ampang: two adult and two paediatric
cases. Age, gender, causative factor, stenosis segment length, grade or severity were observed before and
after dilatation, number of dilatation were observed and compared. The outcome measures are
decannulation and avoidance of tracheostomy. All cases had improvement of symptoms. Half or 50% of the
patient required repeated balloon dilatations. The paediatric cases successfully avoided tracheostomy while
the adult cases successfully decannulated with no complication from the procedure. Balloon dilatation by
total intravenous anaesthesia coupled with apneic method is a safe and effective method of treatment for
the narrowed airway.
Introduction: A survey in 2011 reported that the prevalence of diabetes in Malaysia is 20.8% (2.8 million people) and 88% have uncontrolled diabetes. Diabetic foot ulcer (DFU) is one of the common diabetes complications in Malaysia that leads to other devastated situation including infection, amputation and death. In Pahang, 95% of the patients have uncontrolled diabetes and 50% of them suffered from DFU. Self-wound management is an important element in reducing the risk of further complications of DFU. However, little is known on the patients' understanding of diabetes and their practice of self wound management. This study aimed to understand the knowledge, attitude and practice of self-wound management among patients with diabetic ulcer in Pahang.
Materials and method: A quantitative, cross-sectional study was conducted in a tertiary hospital in Pahang involving 100 participants. Participants were recruited using purposive sampling from April 2017 until May 2017. Participants' knowledge, attitude and practice of self-wound management were measured using self-administered questionnaires. Additionally, the data on socio-demographic was gathered. The data was computed into SPSS and analyzed using descriptive and inferential statistics.
Results: Out of 100 participants, 95% of them had good knowledge on diabetes and DFU, 84% had a positive attitude towards self-wound management and 56% perceived good practices of self-wound management. However, a chi-square test between knowledge on diabetes and DFU and practice of self-wound management found no significant interaction (p > 0.05). Meanwhile, there was a significant interaction between attitude and practice of self-wound management (p < 0.05).
Conclusion: Good knowledge on diabetes and DFU do not determine the patients’ practice of self-wound management. However, positive attitude towards self-wound management would contribute to the practice and willingness of the patients to selfmanage their foot ulcer wound at home.
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.
Over accumulation of polyamines is one of the causes of cancer because
polyamines could promote the cancer cells growth. Due to the lack of specificity and
increased reports of side effects in the current cancer treatment, one of the strategies
to overcome the challenges is by utilizing polyamines as vectors of known cytotoxic
compounds to target the cancer cells. Therefore, this study was aimed to investigate
the cytotoxicity effect of Spermidine Sulphur Analogues Type 1 and Type 2 (SSA-1 and
SSA-2) against human lung adenocarcinoma cells (A549), human colorectal
adenocarcinoma cells (HCT-8) and human breast adenocarcinoma cell (MCF-7). (Copied from article).
Streptococcus pneumoniae (S. pneumoniae) is a gram-positive diplococci belonging to the genus Streptococcus and it is a well-studied pathogenic bacterium. Pneumococcal diseases such as otitis media, pneumonia, sepsis and meningitis caused by pathogenic strains of S. pneumoniae still brought significant mortality and morbidity worldwide. The pathogenicity of S. pneumoniae is exerted by various virulence factors and one of it is the enzyme hyaluronate lyase. Hyaluronate lyase plays a major role in
the invasive capability of S. pneumoniae. Its mechanism of action and crystallographic
structure have been determinedbut its regulatory mechanism is still poorly understood.
Drawing connections between the nutritional behaviour and invasive property of S.
pneumoniae, CodY regulator is hypothesized as a potential hyaluronate lyase regulator.
This work was aimed to construct CodY deficient mutant of S. pneumoniae to form
foundational work for the study of CodY regulatory effect on hyaluronate lyase.