The Clitoria ternatea (Fabaceae) root, seed, and leaf are commonly used in Ayurvedic medicine in Malaysia and Indonesia. The methanol leaf extracts of C. ternatea was tested for toxicity by means of brine shrimp lethality test and acute oral toxicity assay. In the brine shrimp lethality test, the leaf extract were non-toxic or showed weak lethality (LC50 > 1 mg/ml) at the 6 h, 12 h and 24 h incubation period. Nevertheless, at the 48 h incubation time, the leaf extract exhibited moderate toxicity activity with LC50 values of 0.49 mg/ml. In the acute toxicity study using mice, the median lethal dose (LD50) of the extract was found greater than 2000 mg/kg, and we found no pathological changes by means of macroscopic examination of tissues of mice treated with the extract. We conclude that the C. ternatea leaf extract is not toxic in mice and brine shrimp.
A 42-year-old gentleman presented with left eye pain after accidental contact with Euphorbia lactea sap while gar- dening. At presentation, left eye best-corrected visual acuity (BCVA) was 20/30. Ocular examination revealed left eye conjunctiva congestion and cornea abrasion. Eye symptoms and BCVA deteriorated over 12 hours. Cornea showed diffuse stromal oedema with presence of anterior uveitis. A diagnosis of toxic keratouveitis was made. He was treat- ed with intensive topical steroids, cycloplegics, lubricants, prophylactic antibiotics and oral non-steroidal anti-in- flammatory analgesic. Patient achieved complete resolution two weeks later. We aim to raise awareness among the ophthalmologists to detect and manage these injuries.
Introduction: Archidendron bubalinum is an underutilised plant with numerous antioxidant properties and has a great potential to inhibit enzymes linked with diabetes and obesity. Food irradiation is an advanced technology to prolong the lifespan of plant, prevent physical spoilage and eradicate food borne disease. Present study was aimed to determine the total antioxidant activity, enzymatic inhibition against alpha-amylase, alpha-glucosidase and pancre- atic lipase and the toxicity levels of non-irradiated and irradiated (3, 6, 9 & 12 kGy) hot aqueous extract of A. bubal- inum. Methods: The antioxidant ability of the extract was determined by total phenolic content (TPC), total flavanoid content (TFC), Diphenyl-1-Picrylhydrazyl (DPPH), β-carotene assay and ferric reducing antioxidant potential (FRAP) assay. The inhibitory activities were evaluated using α-amylase, α-glucosidase, and pancreatic lipase inhibition as- say. The toxicity levels of A. bubalinum extract were determined using Brine shrimp and Zebra-fish assays. Results: Results showed that irradiated A. bubalinum at 12 kGy demonstrated the highest TFC (448.99 ± 5.02 mg GAE/g), FRAP (2.55 ± 0.40 mmol Fe2+/g) and β-carotene bleaching activity (79.49%). Whereas, non-irradiated A. bubalinum samples expressed the highest TPC (2517.07 ± 15.81 mg GAE/g) and exhibited the lowest IC50 values of α-amylase (31.99 ± 3.15 μg/ml), α-glucosidase (23.40 ± 0.69μg/ml) and pancreatic lipase (32.81 ± 7.96 μg/ml) activity. The toxicity assays also showed no significant different between irradiated and non-irradiated samples. Conclusion: The study suggests that gamma irradiation has the prospective future to increase antioxidant properties and maintaining the enzyme inhibitory activities to preserve the sample of A. bubalinum for commercial purposes.
Although the transformation towards adopting an Outcome-based Education (OBE) is gathering momentum globally, several medical schools are finding it hard to implement the change. Based and built on authors’ experience and cues from the literature, the tips – relating to the process of identification, description and dissemination of learning outcomes (LOs); usage of LOs to ascertain the curricular contents, the teaching/learning and assessment methods; implementing, monitoring and reviewing the curriculum – are the actions that the institutions of higher learning need to perform to transform the existing curriculum or to develop an altogether a new curriculum according to OBE approach. The development of the faculty through dialogues, discussions and training sessions should be an initial and essential step in this process. It is hoped that these tips will alley some of the fears and facilitate the adoption of OBE curriculum in new as well as in existing established institutions.
Introduction: Hepatocellular carcinoma is one of the most common cancers that affected human in more than half of the world population. Although there is yet any alternatives treatment found for this disease, the antitumor property of thymoquinone has been well studied in most of cancer cell lines. Nonetheless, poor bioavailability of TQ limits its efficiency. The encapsulation form of TQ, TQ-NLC is suggested to enhance its bioavailability as well as cytotoxicity towards cancer cells via increasing resistance time and targeting drug to specified location in the body. Therefore, it is a great advantage to look at the effects of TQ-NLC towards HepG2. This study is design to look at the anti-pro- liferative effect of TQ-NLC on HepG2 and the changes in the cells morphology. Methods: Both cells were bought from ATCC and cultured in supplemented DMEM. Cell viability was determined via MTT assay. Pro-apoptotic effect of TQ-NLC was further confirmed with Annexin V staining. Morphology hallmarks of apoptosis of treated cells were also analysed using inverted microscope. Images were captured at 24, 48 and 72 hours. Results: TQ-NLC was very potent towards HepG2 compared to 3T3 with the relative IC50 of 25 µM. TQ-NLC was also more potent compared to the non-encapsulated form, TQ. Further analysis confirmed that TQ-NLC capable to increase the percentage of apoptotic cells in time-dependent manner. Qualitatively, all treated cells displayed the apoptosis morphology with increasing concentration and longer time-point. Conclusion: TQ-NLC showed greater cytotoxic effects towards HepG2 which was further confirmed with the morphological analysis.
Thrombosis is one of the causes of morbidity and mortality in women of reproductive age group. Thrombosis at unusual sites may pose diagnostic and management dilemma for health care personnel. Teamwork and good communication provide the best modalities for maximum benefits to patients. Here with, we presented a case series of thrombosis at unusual sites seen and managed in our clinic.
A 35 year-old Malay lady presented with left hemiparesis while she was on oestrogen based combined contraception pills (C-OCP). Imaging studies showed extensive venous thrombosis with bilateral acute cortical infarct. Thrombophilia screening of antiphospholipid syndrome were negative. She was put on anticoagulant and stopped 2 years after the incident.
A 40 year-old Malay lady presented with abdominal discomfort, lethargy and massive splenomegaly. Bone marrow and trephine examination revealed primary myelofibrosis with positive JAK2617F. Imaging study showed chronic portal vein thrombosis with portal vein hypertension, complicated by gastro-oesophageal varices. She was put on hydroxyurea and later started on ruxolitinib with banding done over her gastro-oesophageal varices.
A 26 year-old Malay lady presented with serositis, mouth ulcer and anaemia symptoms. Laboratory studies were positive for systemic lupus erythematosus and negative for antiphospholipid study. Imaging study showed long segment thrombosis of right internal jugular vein with surrounding subcutaneous oedema. She is currently stable on anticoagulants and steroid. Teamwork and holistic approach is practiced in the investigation and management to provide maximum benefits for patients.
Introduction: Detecting breast cancer at earlier stage is crucial to increase the survival rate. Mammography as the golden screening tool has shown to be less effective for younger women due to denser breast tissue. Infrared Ther- mography has been touted as an adjunct modality to mammography. Further investigation of thermal distribution in breast cancer patient is important prior to its clinical interpretation. Therefore, thermal profiling using 3D compu- tational simulation was carried out to understand the effect of changes in size and location of tumour embedded in breast to the surface temperature distribution at different breast densities. Methods: Extremely dense (ED) and pre- dominantly fatty dense (PF) breast models were developed and simulated using finite element analysis (FEA). Pennes’ bioheat equation was adapted to show the heat transfer mechanism by providing appropriate thermophysical prop- erties in each tissue layer. 20 case studies with various tumour size embedded at two asymmetrical positions in the breast models were analysed. Quantitative and qualitative analyses were performed by recording the temperature values along the arc of breast, calculating of temperature difference at the peaks and comparing multiple thermal images. Results: Bigger size of tumour demands a larger increase in breast surface temperatures. As tumour is located far from the centre of the breast or near to the edge, there was a greater shift of temperature peak. Conclusion: Size and location of tumour in various levels of breast density should be considered as a notable factor to thermal profile on breast when using thermography for early breast cancer detection.
Introduction: Spray dry is a single step of drying method to transform the fluid materials to dry particles. Common practice for producing the solid form is by using the freeze dry technique. However, the existing freeze dry process was associated with longer drying process, high maintenance and costly. Alternatively, researchers used spray drying during extraction process, yet, an elevated drying temperature applied may incur some effects on the quality and quantity of the extract. Therefore, the present study was aimed to investigate the thermal effect of spray drying process on the quality of spray dried Ficus deltoidea (F.deltoidea). Methods: The thermal effects of spray drying were identified at three different inlet air temperatures (160 oC, 191 oC and 220 oC) which are minimum, optimum and maximum of inlet air temperature, respectively. The Box-Behnken Design through response surface methodology was utilized to identify the optimum operating conditions at these temperatures. The quality of F. deltoidea in terms of yield, moisture content, marker compound (vitexin), total saponins, total protein and total polysaccharides were studied. Results: From the study, total saponins and polysaccharides exhibited better retentions during the spray drying process. Meanwhile, vitexin and total protein was found decreasing by 30% and 50% respectively, during the spray drying process. Conclusion: High operating of air inlet temperatures in spray drying process contribute to higher process yield, produce non-sticky particles with lower moisture contents compared to drying process at 160 oC.
Local profiles on the use of weight loss products are scarce. The study aims to address this together with concerns on the users’ misperception of the safety of these products, and the absence of high-quality evidence to support such use. Methods: This was a cross-sectional study conducted in overweight and obese patients attending a public primary care clinic in Penang. Selected patients were given a set of self-administered questionnaire that assessed types of weight loss products used, factors that influenced the usage and the users’ perception of their own body weight and the diet products they are taking. Results: From 332 participants of this study, 18.7% were users. Mean age of users were 44.6 (SD 11.9) years. The majority (66.1%) only used dietary supplements, 11.3% used weight loss medications and the rest (22.6%) used both products. Reasons for its use were for health, a faster result to lose weight and failing dieting and exercise regimes. The average amount spent on this was RM100 per month. Commonest source of weight loss products were friends. Majority (80.6%) did not discuss the use of the products with doctors. Factors associated with the use of weight loss products were being female (AOR=5.59), had tertiary level education (AOR=2.27), being employed (AOR=3.42), self-perceived of overweight (AOR=3.61) and perception that weight loss products as safe (AOR 2.48). Conclusion: Users of weight loss products are among highly educated working females who perceived themselves as being overweight and assume the products are safe.
Introduction: Simulation is widely practiced as learning strategies in many disciplines including nursing. It is con- sidered an updated technological approach towards providing safe and sound patients care. Thus, this study was conducted to assess the level of knowledge among nursing students using a simulated mannequin for cardiovascular assessment. Methods: This is a cross-sectional study design focusing Year 4 nursing students at Kulliyyah of Nurs- ing, International Islamic University Malaysia (IIUM). A simulation mannequin was used for students performing a cardiovascular assessment. Level of knowledge was tested using an adapted questionnaire. The study was approved by the Kulliyyah of Nursing Postgraduate Research Committee (Ref: IIUM/313/DDAA/20/4/10) and IIUM Research Ethics Committee (Ref: IREC 2018-024). Results: A total of 57 nursing students involved in this study revealing good cardiovascular assessment knowledge. Majority of them reported that simulation exercise is one of the good learning strategies to enhance their capabilities and increase their confidence level. Conclusions: The results from this study could indicate that using technological simulation approach could provide a similar effect in performing cardiovas- cular assessment among nursing student IIUM. Future larger scale is needed including for any other disciplines in nursing to facilitate students’ preparation towards the real clinical setting.
Introduction: Oral cancer is the sixth most common malignancy in the world. It is a major concern in Southeast Asia primarily due to betel quid chewing, smoking, and alcohol consumption. In Malaysia, oral cancer related cases accounts for 1.55% of the cause of deaths. Despite recent advances in cancer diagnoses and therapies, the survival rate of oral cancer patients only reached 50% in the last few decades. Tissue engineering (TE) principles may pro-vide new technology platforms to study mechanisms of angiogenesis and tumour cell growth as well as potentially tumour cell spreading in cancer research. The use of biomaterial, appropriate cell source and proper signalling mol-ecules are vital components of TE. Collagen biomaterial are widely used scaffold or membrane in oral application. Nevertheless, no review has been performed on the its usage for the study of oral cancer. This study aimed to sys-tematically review the use of collagen scaffold in oral cancer application. Methods: Research articles were searched using Scopus, Pubmed and Web of Science (WOS) databases. The keywords were limited to “collagen membrane OR collagen scaffold” AND “oral cancer”. Results: Initial search yielded 61 papers (Scopus:37, Pubmed: 12, WOS: 12). Further scrutinization of the papers based on the inclusion criteria resulted total of 3 papers. Two of the papers used collagen membrane for regeneration of oral mucosal defect and increment of alveolar ridge height post-surgery. The remaining paper utilize collagen biomaterial as scaffold for the culture of adenoid cystic carcinoma (ACC) cells. All papers reported significant role of collagen biomaterial in terms of tissue formation, healing scaffold and cellular proliferation. Conclusion: Collagen utilization as biomaterial offers potential use for regeneration of oral related structures as well providing useful model for therapeutics anti-cancer research.
Introduction: Rooted form the ancient times, having a white and a delicate skin has been a dream of all women as it is perceived as a perfect beauty. Due to this high desideratum, the global beauty industry had taken an advantage to this target group promising an instant white skin for as early as three days. Global industry analysts (GIA) pre- dicted that this year 2020 the global market for skin lighteners will reach $23 billion. Despite the effectiveness of using skin-lightening, some had reported of having adverse effect including dermatological as well as neurological. Methods: This is a quantitative study using descriptive analysis approach to all nursing students in Sabah. The type of sampling is using snowball sampling methods. A questionnaire was developed and distributed to all nursing colleges in Sabah. Results: A total of 161 nursing students responded. Based on this study, most of students start are using cos- metic product in the age of15years old. Using an open-ended question, the top three cosmetic products containing skin-lightening ingredients use by students are Safi(27.9%), Garnier (25.5%)and Simple(16.1.%). Majority experience acne (47.5%) and skin irritation (18.8%)after using cosmetic products containing skin-lightening ingredients while 36.6% did not experience any skin problem. It is about80% concern about safety when choosing skin care contain skin-lightening ingredients,76.9% will make an effort to read leaflet provided prior to purchasing, 69.4% aware about the list of dangerous ingredients in choosing skin care contain skin-lightening ingredients, 78.1% aware about its side effect. Conclusion: The outcome of this preliminary study lead to the conclusion that nursing students in Sa- bah are aware that using a cosmetic product contain skin-lightening ingredient is harmful for them.
Introduction: Parents of a disabled child might require extra basic needs which most of the time are unmet due to several factors. Thus, understanding the unmet needs could help the respective institution to provide and prioritise the needs required. Methods: A cross-sectional study was conducted between September to December 2013 to de- termine the proportion of unmet needs among parents of children with disabilities at support institutions in Kelantan, Malaysia. Biological parents of disabled children aged between 2 to 18 years old were included in the study. A 35- item validated Malay version of the Family Needs Survey was used in this study. A scoring of 4-point Likert scale was used; the prevalence of unmet needs was determined based on the proportion of those who scored “3” from each domain. Results: A total of 226 parents were involved in the present study. The mean age of parents and children were 44.6 (8.99) and 10.2 (4.85) years old respectively. The most common type of disabilities was learning disability (n=151, 66.8%). The unmet need for information has the highest prevalence (97.8%), followed by the unmet need for social support (93.8%). Conclusion: Parents with disabled children require information to guide them in managing their children. Findings from this study may better enable policymakers to devote resources in assisting parents, and service providers in designing appropriate interventions in fulfilling the unmet needs of these parents.
Penetrating injury to the abdominal viscera is not uncommon unless when it is caused by marine life. We present a 39-year-old fisherman from a tropical country who had sustained a penetrating injury from a stab wound to the abdomen due to needlefish impalement. He sustained a small perforation of the sigmoid colon during exploratory laparotomy and primary repair was done. Although this incident is rare, there are cases involving seawater activities either for leisure, sport or diving for fishing. We highlight this rare incident and discuss the management plan.
Introduction: Prostate cancer is one of the most common causes of cancer deaths among men worldwide. In Ma- laysia however, it is the fifth leading cause of cancer among men. The increases of prostate cancer among men in Malaysia due to its close association with lack of awareness, poor knowledge and attitude. Therefore, this study is to obtain information on the prostate in terms of the level of awareness, perception, and the practice of prevention of prostate cancer among Malaysians, particularly residents of PPR Lembah Subang 1. Methods: A cross-sectional survey was collected among 200 respondents aged 18 years and above in PPR Lembah Subang 1 consisting of 37 questions comprised of socio-demographic data, source of information, risk factors, knowledge on prostate cancers, attitude on prostate cancer and practice of prevention. Likert scale scoring system used in this research. Results: Men in PPR Lembah Subang 1, show a significant association between knowledge on prostate cancer with age group, level of education, and family history showing (p value:
Introduction: Refractive error is the most common cause of visual impairment among the school children. The visual acuity screening has long been administered through the school health service in Malaysia. The objective of this study was to examine the status of refractive error in the school health screening from year 1990 to 2017. Methods: Every year an average of 1.2 million students were screened for refractive errors through school health service. Stu-dents with visual acuity reading of 6/9 or worst based on 6-meter Snellen chart ware referred for confirmation of refractive error. Secondary data on school visual acuity screening from the Health Informatics for the period of 1990 to 2017 were used to describe the changing pattern of refractive errors. Results: It was observed that the prevalent of suspected refractive errors amongst the Standard 1 student increased from 7 per 1,000 students examined in 1990 to 44.4 per 1,000 students in the 2000 and further increased to 74 per 1,000 students before slow decline to 55 per 1,000 students from year 2015 to 2017. A higher level of detection was observed for students in standard 6 and form 3 between the period of 1990 to 2009 (78/1,000 and 65/1,000 respectively) and further decline thereafter to lowest level in 2017 (33/1,000 to 21.5/1,000 respectively). Conclusion: The Standard 1 students in the 21st century have higher rate of suspected refractive errors compared to their counterpart that lived in the 20th century. Community awareness program need to be introduce for early detection of visual acuity problem.
Introduction: Measuring the competence of nurses in spiritual care and their ability to provide spiritual care is im- portant and check the validity and reliability of the instrument is recommended in the literature. Thus, the aim of this study was to validate the translation of the spiritual care competence (SCC) scale to the Malay language version. Methods: Data were collected from staff nurses at the hospital Universiti Sains Malaysia. A total of 270 nurses par- ticipated in the study (female: 92.6%, male: 7.4%), with the mean age of 35 years (SD = 8.4). Spiritual care compe- tence was assessed with the 27-item SCC-M. Standard forward–backward translation was performed to translate the English version of the SCC into the Malay version (SCC-M). All the participants completed the SCC-M. Results: The initial measurement models tested (6-factor models) did not result in a good fit to the data. Subsequent investigation of the confirmatory factor analysis (CFA) results recommended some modifications, including adding correlations between the item residuals within the same latent variable. These modifications resulted in acceptable fit indices for the 6-factor model (RMSEA = .050, CFI = .900, TLI = .885, SRMR = .065). The final measurement models comprised all 27 SCC-M items, which had significant factor loadings of more than .40. The composite reliability was .696-.853 for 6-factors model. These results suggest that the subscales in 6-factor SCC-M model are unique, the factors do not overlap much, and each factor explains different variance than the other factors. Conclusions: The translated version of the SCC-M was valid and reliable for assessing the level of spiritual care competence among hospital nurses in Malaysia.
Introduction: Negative automatic thoughts refer to subconscious thinking patterns in response to irrational and self-defeating stimuli. Individuals who are depressed tend to have biased negative automatic thoughts. Therefore, there is a need to refine our understanding of what contributes to the development of adolescent depressive symp- toms. The current study examined the mediating role of negative automatic thoughts in the link between maternal attachment and depressive symptoms among late adolescents in Pakistan. Methods: This cross-sectional study fo- cused on 936 (males=423, females=513) students aged 17 to 19 years old, who were selected through multistage cluster sampling technique. Respondents answered self-report questionnaires which assessed maternal attachment, depressive symptoms, and negative automatic thoughts. Structural equation modelling was utilised to analyse the relationships among the research variables. Results: The findings indicated that 39.3% had negative automatic thoughts; whereas, 5.6% experienced severe depressive symptoms. Correlational analysis showed that maternal attachment had a negative association with depressive symptoms and negative automatic thoughts. In contrast, de- pressive symptoms were positively related to negative automatic thoughts. Structural analysis revealed that negative automatic thoughts partially mediated the association of maternal attachment with depressive symptoms among late adolescents. Findings specifically demonstrated that those with insecure maternal attachment tend to have negative automatic thoughts, which subsequently lead to depressive symptoms. Conclusion: In conclusion, findings highlight the importance of secure attachment to the mother and positive automatic thoughts in combating depressive symp- toms; thus ensuring a healthy psychological development for adolescents.
As urban centres pursue localisation of the Sustainable Development Goals (SDGs), rapidly growing cities in low-and middle-income countries (LMICs), many of which are located in the Asia-Pacific region, are experiencing competing demands for limited resources. The protection and enhancement of Urban Green Spaces (UGS) is a practical, low- cost opportunity to produce multiple benefits across the SDGs, ranging from improving the health and wellbeing of city dwellers and reducing inequalities to protecting local flora and fauna and attracting economic investments for future generations. In developing a city-wide strategy for UGS that aligns with the New Urban Agenda, it is important to consider the coordination of efforts from multiple sectors through participatory decision-making mechanisms that engage the civil society and address the needs of the most vulnerable population groups regarding mobility (such as children, elderly, women and people with disabilities) to ensure no one is left behind.
Introduction: The Hedgehog (Hh) pathway serves as a major regulator in organ development, stem cell maintenance, cell proliferation, and cell differentiation. This pathway is highly regulated and aberrant activation will promote tumorigenesis. Hh pathway notably Sonic Hedgehog pathway was reported to be upregulated and promote tumorigenesis in various human malignancies including colorectal, gastric, lung, prostate, and breast. This review was aimed to discuss the current understanding of Hh pathway activation in different types of human cancers and discuss the development of the therapeutic applications targeting Hh pathway. Methods: A systematic review was conducted using the electronic research database PubMed Central (PMC) from 2014-2019. The search was limited to studies that are relevant to both Hh signalling pathway and human cancers. A total of 50 articles were selected and their references cited were searched and reviewed. Results: The results regarding the role of Hh signalling in pancreatic cancer and colorectal cancer are controversial with some reporting tumor promoting activities whereas others tumor suppressive activity. Besides, results from other studies suggesting that Hh signalling pathway plays an oncogenic role by inducing tumor cells proliferation, promoting metastasis and maintaining cancer stem cells in human cancers such as lung, stomach, and breast. To date, Glasdegib (PF-04449913) is the only Hh targeting small molecule inhibitor being studied at FDA Phase 3 clinical trial. Identification of the right tumors and minimization of the side effects remain as the main obstacles in the development of Hh signalling inhibitors. Conclusion: In conclusion, advancement in our understanding of Hh pathway has provided us opportunity to develop novel therapeutic strategies to fight human cancers with activated Hh pathway but more studies need to be conducted to solve the controversial regarding the role of Hh pathway in certain cancers.