Introduction:Alcohol is a major factor that can affect many aspects of life. The prevalence of current drinker in Malaysia aged 13 years old and above was 7.7% as reported by NHMS 2015. Sabah was ranked the third in highest consumption of alcohol in Malaysia, at 18.4% after Kuala Lumpur 20.3% and Sarawak 19.7%. The aim of the study is to investigate prevalence of different types of drinkers and identify demographic characteristic of drinkers in Kota Kinabalu (KK). This study also aims to investigate the effectiveness of screening and brief intervention in reduction of alcohol consumption and risky drinking in KK. Methods: A cross-sectional study was done where the data were col-lected from seven different areas in KK, selected by stratified and simple randomized sampling. Alcohol Use Disorder Identification Test (AUDIT) questionnaire translated and validated in Malay version by Unit Terjemahan Universiti Malaya was used. AUDIT score was calculated and brief intervention was given accordingly and scoring was then repeated after three months. The intervention applied was based on Guideline on Risk Assessment and Primary In-tervention in Alcohol Harm, published by Ministry of Health Malaysia in 2010. Results: The age range of population studied is from 13 to 85 years old with 243 males and 230 females. Out of the 473 participants, 13.1% adolescent, 37.6% young adulthood, 36.4% middle adulthood and 12.9% in late adulthood. We observed that the male mean weight was 68.27±12.72kg versus 58.86±12.45kg mean weight in female. The prevalence of drinkers – 3.6% depen-dent drinkers, 22.2% high risk drinkers, 36.2% low risk drinker while the remaining 38.1% are abstainers. Majority of consumers were practicing low-risk drinking pattern which highlighted the need for prevention and harm minimiza-tion programme. Paired sample t-test shows that the decrease in AUDIT three months after intervention is statistically significant. Conclusion: This study conducted in KK suggests that screening coupled with brief intervention can help reduce alcohol misuse and risky drinking and should be practiced in all primary healthcare facilities.
Bisphenol A (BPA) is a controversial plastics ingredient used mainly in the production of polycarbonate plastics (PC) and epoxy resins that widely used nowadays in food and drink packaging. Even though BPA is not involved in polyethylene terephthalate (PET) manufacturing, recent study had reported the present of BPA in PET water bottle. This study was conducted to investigate effects storage conditions on release of BPA from PC and PET bottled water as well as to assess health risks associated with consumption. Methods: Solid phase extraction (SPE) was used to extract the samples, followed by analysis using ultra high performance liquid chromatography with fluorescence detector (UHPLC-FLD). The possibility of developing chronic non-carcinogenic health risk among consumers of bottled water was evaluated using hazard quotient (HQ). Results: Results showed that BPA migrated from PC and PET water bottles at concentrations ranging from 9.13 to 257.67 ng/L and 11.53 ng/L to 269.87 ng/L respectively. Concentrations of BPA were higher in PET bottled water compared to PC bottled water across all storage conditions. Higher storage temperature and longer storage duration increased BPA concentrations in PC and PET bottled water. Concentrations of BPA in bottled water which were kept in a car and were exposed to sunlight were higher than control samples which were stored indoor at room temperature. Conclusion: No significant chronic non-carcinogenic health risks were calculated for daily ingestion of BPA-contaminated bottled water; calculated HQ was less than one.
Introduction: Night eating syndrome (NES) has been progressively drawing attention and becoming a global con- cern due to its clinical implications. However, the study related to NES was found to be scarce in Malaysia. As such, this study aimed to determine the risk factors of NES among Malaysian public university students. Methods: This cross-sectional study involved 270 participants (mean age: 20.9±1.4 years), who were selected randomly from three different course disciplines at a public university in Selangor, Malaysia. The data were collected using a self-admin- istered questionnaire on socio-demographic background, NES, depression, anxiety, stress, sleep quality, and disor- dered eating. Weight, height, and waist circumference of the participants were measured. Results: Results showed that 12.2% of the participants were engaged in NES. Binary logistic regression identified four significant risk factors of NES namely, being a male (AOR = 3.050, 95% CI = 1.129 – 8.238), persuading in a technical-stream course (AOR= 6.010, 95% CI = 2.057 – 17.555), being a stressful student (AOR = 3.580, 95% CI = 1.149 – 11.151), and having poor sleep quality (AOR = 4.664, 95% CI = 1.431 – 15.209). Conclusion: Early screening process should be con- ducted from time to time in which university students with potentially NES are able to receive necessary behavioural and cognitive therapy in order to recover.
Introduction: Acalypha indica is commonly referred to as “pokok kucing galak”. It is an herbaceous species that grow along the earth’s equator line, including the wet, temperate and tropical regions. Domestic cats experience the effect of this plant by reacting very favorably to the root. The first compilation of the ethnopharmacology and phytochemistry of the Acalypha plants was published. This genus is the fourth largest genus of the Euphorbiaceae family, with about 500 species. However, the review only represents about one third of the species from the Acalypha genus. Methods: Hence, this study is performed to obtain updates on the biochemistry of this plant, via literature search. Results: From the articles, almost every part of the plant, including the leaves, stems and roots, are used as traditional remedies. Local people consume the plant for therapeutic purposes such as anthelminthic, anti-ulcer, anti-bacteria, anti-microbial and wound healing. In homeopathy practice, it is used for asthma and bronchitis. Nevertheless,
there is still a potential risk of using A. indica. It was reported that this traditional medicine could induce Intravascular haemolysis in patients with a glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Clinical evaluations of Acalypha extract could be utilized to justify the ethnomedicinal claims and for the safety of its therapeutic applications. Meanwhile, there is an increase in the phytochemical and chromatographic experiments of A. indica that could introduce the extract’s role in pharmaceutical, nutraceutical, zoology and veterinary fields. It contains secondary metabolites, including dihydroactinidiolide; a terpenoid, alkaloids, flavonoids and steroids, for example, brassicasterol. Conclusion: The finding of this review concludes that Acalypha is a natural source, worth to be further investigated. It is hoped that new biologically active constituents could be discovered, since only few Acalypha species were comprehensively studied.
Coffee is a well-known beverage being processed from coffee beans of either Arabica and/or Robusta. Observational and experimental research on coffee shows positive health impact. Coffee often relates with dyspeptic condition (i.e. Gastric release) and manifest Gastro-esophageal Reflux (GERD) and peptic ulcer (PU) diseases. Despite much con- tradictive results, epidemiological studies were inclined towards debunking the possible relationship between coffee and gastrointestinal diseases. Putative compounds were experimentally found to be chlorogenic acid (CQA), caffeine (CAFF), βN-alkanoyl-5-hydroxytryptamide (C5HT), N-methylpyridinium (NMP), chlorogenic acid lactones (CQL) and hydroxybenzenes in coffee that leads to gastric release. The type 2 bitter taste receptors (TAS2Rs), were physiologi- cally involve in the gastric acid secretion. These contrarily results need much considerations involving genetic, types of coffee used and the compounds in coffee that might interact causing gastrointestinal problem.
Haemophilia A is an inherited bleeding disorder, commonly involve soft tissues and joints. Gastrointestinal tract
bleeding, are not uncommon but seldom highlighted. A 23-year-old male with underlying severe haemophilia A was
presented with a generalised abdominal pain for 2 days, abdominal distension, diarrhoea and vomiting. He did not
have any trauma to the abdomen. Abdominal examination revealed generalized tenderness with sign of guarding
on palpation. Laboratory investigations revealed isolated, prolonged activated partial thromboplastin time (APTT)
with normal total white blood cell count and haemoglobin level. In view of acute abdomen, which was not resolved
by conservative treatment, an emergency laparotomy was done with FVIII concentrate and recombinant factor VII
(rFVII) coverage. Intraoperative findings noted patchy gangrenous spots of about 30 cm in length in the small bowel.
Histopathology examination revealed an evidence of haemorrhage within the submucosal and intramuscularis layer
from the resected specimen. This case highlighted the possibility of gastrointestinal bleeding without prior trauma,
which can be presented as acute abdomen in severe haemophilia patient.
Introduction: Leptospirosis is a re-emerging zoonotic disease caused by Leptospira bacteria. The clinical manifes-tations of leptospirosis include mild-fever to a severe or even fatal. Increased levels of inflammatory cytokines pro-duced in response to the Leptospira infection by the host immune system were hypothesized as among the causes of severity in leptospirosis. Besides the classical presentation with the triad of febrile, jaundice, and renal failure, patients with leptospirosis also can pose with predominant sign and symptoms of pulmonary involvement. This study aimed to compare the levels of TNF-α, IL-1b, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IL-17A, IL-18, and IL-22 In the plasma of samples of leptospirosis patients with and without pneumonia. Methods: Circulating cytokine levels in plasma were measured in seventeen patients hospitalized and diagnosed with leptospirosis in Malaysia (January 2016 – December 2017) and nineteen healthy individuals as controls. Patients were categorized into leptospirosis without pneumonia (n=12) and with pneumonia (n=5). Cytokine was measured using SimplePlexTM assays (San Jose, CA, USA). Measurement was performed in triplicate and statistical analysis was conducted using Graphpad® Prism v6 (San Diego, CA, USA). Results: Elevation of plasma TNF-α, IL-6, IL-8, IL-10, IL-18, and IL-22 levels were observed among leptospirosis patients with pneumonia compared to without, although no statistical differences were observed between these two groups. Conclusion: There are no significant differences observed between the levels of plasma TNF-α, IL-6, IL-8, IL-10, IL-18, and IL-22 in patients with pneumonia compared to without.
Maternal depression has been linked to the development of adolescents’ emotional and behavioural problems. The main objective of this study was to determine the association between maternal depressive disorders and externalizing and internalizing problems among their adolescent children. This was a cross-sectional, comparison study of 35 mothers with depression and their adolescents, matched with 35 healthy mothers and their adolescents as controls. The mothers completed Quick Inventory Depressive Symptomatology (QIDS) for assessment of current depression. The emotional and behavioural problems in the adolescents were assessed independently by the mothers and their adolescents off-springs using Child Behavioral Checklist (CBCL) and Youth Self-Report (YSR), respectively. SPSS version 12.0 was used for statistical analysis. The findings showed that adolescents who have mothers with depressive disorders had significantly higher scores of externalizing (mean difference = 4.686 + 10.887, p = 0.016) and total emotional and behavioural problems (mean difference = 10.171 + 23.007, p = 0.013) than controls. The cases also scored higher than the controls in the following CBCL syndrome scales: aggressive behaviour (mean difference = 3.200 + 6.773, p = 0.008), social problem (mean difference = 1.286 + 2.865, p = 0.012), and attention problem (mean difference = 1.543 + 4.435, p = 0.047). Mothers with depressive disorders reported that their adolescents have greater emotional and behavioural problems than the controls. The findings suggested a need for preventive strategies to curb problematic behaviour focusing on this vulnerable group.
Attention Deficit Hyperactivity Disorder(ADHD) and Tourrete Syndrome(TS) commonly
co-occur, imposing a special challenge in the management. Case report: This is a case of a nine year old boy with ADHD and TS, who had been on methylphenidate, risperidone, fluvoxamine and atomoxetine, alone and in combination. Tics worsened with methylphenidate but improved after its withdrawal, and the addition of risperidone and fluvoxamine. Later, atomoxetine was added which worsened the tics, even when it was removed. Significant improvement in the tics were only obvious when fluvoxamine was taken off. Discussion: The possible roles of dopamine and serotonin neurotransmission, and metabolism of cytochrome P450 D26 in the pathophysiology were discussed. Conclusion: The use of multiple medications need cautious consideration and monitoring in a child patient to avoid unwanted complications and risks.
Toxoplasmosis, caused by an intracellular protozoan parasite, Toxoplasma gondii, is widespread throughout the world. The disease is of major medical and veterinary importance, being a cause of congenital disease and abortion in humans and in domestic animals.[1] In addition, it has gained importance recently due to toxoplasma encephalitis in AIDS patients.[2] T. gondii was discovered 100 years ago. Its identification was rapidly followed by the recognition that it was a human pathogen. During the past 100 years, the spectrum of diseases caused by this ubiquitous pathogen has expanded to include both congenital and acute infections as well as the recognition of diseases caused by this pathogen in the immune-compromised host. Recent data on behavioural changes in animals due to chronic toxoplasmosis is leading to research on the effect of this pathogen on the behaviour of humans.[3] Experimental studies on T. gondii have resulted in it becoming a model organism for studies on host pathogen interactions. Integration of clinical and experimental data on T. gondii should continue to lead to important insights into improvements in diagnosis for clinical management and vaccine development for control of toxoplasmosis.
Malaria remains one of the most important infectious diseases worldwide considering that 40% of the world’s population live in health risk areas and millions of febrile episodes due to malaria infection occur annually in children under the age of five in Africa alone and almost 3 million patients, primarily children, die each year. Among the various measures envisaged, to contain the disease, the concept of a vaccine to protect humans against malaria appears particularly attractive. The development of an effective malaria vaccine represents one of the most important approaches to provide cost-effective intervention, in addition to currently available malaria control strategies. Here, we review malaria as a public health problem and the status and promise in malaria vaccine development.
Introduction: Oral squamous cell carcinoma (OSCC) is a major health problem worldwide. The overall survival rate remains at 50% despite numerous studies and various treatment modalities in OSCC. The presence of lymph node metastasis in OSCC is well established as an independent prognostic factor. This present study aims to investigate the association of four tumour antigens; FJX-1, GNα12, IFITM3 and MAGED4B with the sociodemographic and clinicopathological parameters of OSCC. The potential use of these markers as a prognostic indicator of patient sur-vival and lymph node metastasis in OSCC was explored. Methods: 35 cases of OSCC with available formalin-fixed paraffin-embedded (FFPE) specimens involving the tongue, buccal mucosa, gingiva, alveolus and floor of mouth were evaluated by immunohistochemistry for FJX-1, GNA12, IFITM3 and MAGED4B expression. Assessment of the expression of these tumour antigens was based on the cellular sub-site, intensity and percentage of staining in the OSCC samples. Results: The expression of all four tumour markers were expressed in all samples (n=35) but none statistically associated with any clinicopathological or socio-demographic parameters. Survival analysis using Kaplan-Meier test showed high expression of GNA12, IFITM3 and MAGED4B individually with poor prognosis in OSCC patients. A combination of markers, GNA12 and MAGED4B demonstrated a significant association with pa-tient survival in OSCC (p=0.014). Multivariate analysis after adjustment for selected socio-demographic factors (age, gender, risk habits and sub-sites of the oral cavity) revealed that high expression of both MAGED4B and GNA12 remained as an independent prognostic factor for poor prognosis in OSCC (HRR =5.231, 95% CI 1.601,17.084; p=0.006). Conclusion: We concluded that high combined expression of both marker (Gα12 and mAGED4B) might be used as an independent prognostic indicator in OSCC.
Glutathione s-transferases (GSTs) are the vital enzymes involved in Phase II metabolism to detoxify a wide range of carcinogenic metabolites in the body. GST class mu-1 (GSTM1) and GST class theta-1 (GSTT1) are the genes encoding for the GST isoenzymes. Nevertheless, both genes were frequently reported absent (null) in most of the populations at different frequencies. Null polymorphism will affect the production of GSTs and impair the ability to eliminate carcinogenic compounds which had been shown to expose null individuals to high risk of several cancers such as gastric and lung cancer. Thus, this review will briefly summarize on the GSTM1 and GSTT1 polymorphisms, frequencies of null variants in populations worldwide, including Malaysian, and their relevancy to the underlying basis of toxicological response to xenobiotics. Additionally, the genotyping assays used in GST studies will also be discussed.
Introduction: Benzimidazole analogues are bicyclic compounds that had been synthesized comprising the fusion of benzene and imidazole. It gains interest in research as it poses numerous therapeutic potential such as anti-ulcer, anti-malarial, anti-helminthic, anti-fungal, anti-inflammatory, and anti-cancer. Hence, this work aims to screen novel benzimidazole analogues using MTT assay for potential anti-proliferation activities on gastric cancer, which is the second cause of cancer-related death. Methods: MTT assay was conducted following standard protocol on HGT-1 gastric cancer cells. Cells were seeded and allowed to attach overnight before being introduced with various con-centration of benzimidazole analogues up to 72 hours and the optical density of the MTT was recorded using 560 nm wavelength. Two-Way ANOVA was used to analyse all data, followed by post-hoc Tukey test and the structure analysis relationship was analysed using MTT result. Results: From five analogues, only compound 4 showed an-ti-proliferation activity with IC50 8.212 ± 0.813 μM at 72 hours. Compound 4 had hydroxyl group at ortho- and para- position and remarkably, compound 2 which contained the hydroxyl group at ortho- and meta- position together with compound 5 which contained the combination of meta- and para- induced proliferation on gastric cancer. Conclusion: Different position of hydroxyl group on the benzene ring gives different activities on gastric cancer and from the experiment, only compound 4 had the anti-proliferative activity.
Introduction: Early environmental factors play a major role in shaping the health of an individual. Dietary prefer- ence and habits shaped by parental feeding practice during childhood are likely to persist into adulthood which further determines body weights status. This study aimed to determine the retrospective child feeding practices asso- ciated with obesity risk in young adults. Methods: This was a retrospective cross-sectional study with 176 university students in Kuala Lumpur. Data of maternal age, gestational age and feeding practices were collected retrospectively using Child Feeding Questionnaire (CFQ). Subject’s current socio-demographic data was collected and anthropo- metric measurements were taken using standard protocol. Results: Around 22% of the subjects were overweight/ obese. No significant association was found between child feeding practices with maternal age. A significant asso- ciation (p
Introduction: Obesity is one of the major health problems in Malaysia. It can lead to other metabolic diseases including diabetes and cardiovascular diseases. Unfortunately, effective treatment to overcome the health problem is yet to be discovered. One of the alternative solutions is by introducing a healthy diet through functional foods. Honey is well-known as one of the functional foods. However, the effectiveness in controlling obesity and then reducing the excess weight gain is still unclear. Several types of local honey were selected to observe their effects on obese-induced rats. Methods: Acacia, Gelam and Pineapple honey were harvested directly from apiaries and forest in Malaysia. Then, the quality of the honey was measured and standardized through physicochemical and antioxidant analyses. Male Sprague Dawley rats were induced to obese by consuming a high-fat diet. Then, the rats were fed with the honey for acute (one single honey consumption for 14 days) and subacute study (honey consumption daily for 16 weeks). Rats fed with orlistat (commercial drug for obesity) and fake honey were used as controls. Physical observation and biochemical analysis were conducted. Results: In the acute study, Gelam and Pineapple honey were significantly reduced the rat’s body weight, glucose, cholesterol and triglycerides level. More profound effects were observed in the subacute study, where all the honey samples were significantly reduced excess weight gain, glucose and the lipid profiles. Meanwhile, orlistat was also demonstrated a reduction in the excess weight gain but with toxicity side effects to the hepatic and renal function. In contrast, fake honey showed significantly increased body weight gain, glucose and the lipid profile in the rats. Conclusion: Based on the results, Malaysian honey samples have the potential to be a part of the daily diet in controlling obesity and reducing excess gain. However, more studies are required to confirm the findings.
Introduction: Many studies have investigated the knowledge and attitude towards breastfeeding among fathers and mothers, however studies looking at working adults’ knowledge and attitude towards breastfeeding is limited. Work- ing adults with good knowledge and favourable attitude toward the practice of breastfeeding may increase the breast- feeding initiative among working mothers. Therefore, the objective of this study was to investigate the knowledge and attitude toward breastfeeding among staff from the Faculty of Medicine and Health Sciences of a public univer- sity and its associated factors. Methods: A cross sectional study was conducted among faculty staff members. The respondents were selected by simple random sampling and a self-administered questionnaire was used to investigate the knowledge and attitude towards breastfeeding among them. Multiple linear regression was used to determine the factors associated with knowledge and attitude respectively. Results: A total of 117 respondents were recruited to take part in this study. Of these, 83(70.9%) had good knowledge while 61(52.6%) respondents had favourable attitude toward breastfeeding. There was significant positive fair correlation between knowledge and attitude score (r=0.396,p
Introduction: The number of children diagnosed with Autism Spectrum Disorder (ASD) keeps increasing every year. ASD is a neurodevelopmental disability that affects social communication and social interaction. They also demon-strate restricted, repetitive pattern of behaviour, interest or activities (RRB) that shows at an early developmental age. Due to this characteristic, ASD children are facing difficulties in social skills aspect such as eye contact, expression, and making friends. Studying and reciting the Quran are often used in Malaysia to ameliorate the symptoms, but there is no specific study in Malaysia that demonstrates the impact of these renditions on ASD’s children’s social skills. The objective of this study was to investigate the effect selected Qur’anic verses recitation on the social skills of the children with Autism Spectrum Disorder (ASD). Methods: This study will use the quasi-experimental research design. This study will be held at IDEAS Autism Centre, Rawang. The purposive sampling technique will be used and 14 ASD Muslim children aged 4-6 years old will be chosen. The ASD children will be divided into an experimental and control group. The experimental group will be listening to selected Qur’anic verses before the intervention. The Social Responsiveness Scale- Second Edition (SRS-2) will be used to assess the response. The scale consists of a 65-item questionnaire, with a 4-point Likert-scale. Results: The expected result for this study is the ASD children in the experimental group will have lower Total-scores of SRS-2 compared to control group. Conclusion: Listening to Qur’anic recitation provides a cost-effective complementary therapy to improve social skills among Muslim ASD children. Information from this study also can be used as a stepping stone in developing the teaching module to ASD children.
Trigeminal neuralgia is a debilitating disease that can lead to depression and even suicide. Trigeminal neuralgia is usually treated using carbamazepine; however, many patients are refractory to such medical treatment. Thus, other treatment modalities are required, such as physical treatment and dry needling. The objective of this case report is to describe the management of trigeminal neuralgia in a 35 years old Malay housewife, who had left side atypical trigeminal neuralgia involving V2 region in the last four years, which was refractory to medical treatment. The appli- cation of Malay massage, combined with dry needling executed along the distribution of trigeminal nerve showed an improvement of pain on the Visual Analog Scale (VAS) from 7–8/10 to 0-1/10 after 11 sessions. Therefore, Malay massage combined with dry needling can be used as a non-pharmaceutical approach to managing trigeminal neu- ralgia.
Sarcomas usually frequented in the head and neck region of young adults. Trachea is a rare site, and due to scarce clinical data, its clinical outcome is unclear. We reported a case of 60-year old patient presented with progressive worsening shortness of breath, cough, and progressive worsening dysphagia. Computer tomography scan revealed extensive 2 lobulated soft tissue lesions within and surrounding the trachea at the T4 level. Rigid bronchoscopy with mass cryo-debulking was performed and ultimately synovial sarcoma was diagnosed. Shortness of breath was com- pletely relieved post-procedure.