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  1. Njinaka I, Uhumwangho OM, Edema OT, Dawodu OA, Omoti AE
    Malays J Med Sci, 2011 Jul;18(3):43-8.
    PMID: 22135600
    BACKGROUND: Workers in the sawmilling industry are at risk of various ocular hazards as a direct result of the sawmilling processes. The aim of this study was to determine the pattern of conjunctival disorders between technical and administrative sawmill workers in Benin, Nigeria.

    METHODS: A cross-sectional study was performed on sawmill workers in Benin, Nigeria, between January and May 2009, with the aid of pre-tested questionnaires. Ocular examination was performed on all subjects. Data obtained were recorded and analysed using SPSS version 13.

    RESULTS: A total of 553 sawmill workers were studied, among whom 449 (81.2%) and 104 (18.8%) were technical and administrative workers, respectively. There were 496 (89.7%) males and 57 (10.3%) females. The age range was 15-80 years, with a mean of 38.9 years (SD 12.8). Pingueculum was found in 127 (23%) workers, among whom 122 (27.2%) were technical workers and 5 (4.8%) were administrative workers. Pterygium was present in 65 (11.8%) workers, among whom 64 (14.3%) were technical workers and 1 (1%) was an administrative worker. Seven (1.6%) technical workers used protective eyewear; 2 (0.4%) wore this protective eyewear regularly.

    CONCLUSION: Technical sawmill workers are at risk of developing conjunctival disorders, which result from chronic ocular irritation. This can be prevented by the provision of protective eye devices in the workplace.

  2. Oguntibeju OO
    Malays J Med Sci, 2006 Jan;13(1):68-73.
    PMID: 22589594
    The aim of this study was to assess the prevalence of intestinal parasites among HIV-positive/AIDS patients. A control group comprising 30 apparently healthy HIV-negative individuals was included. Of the 60 samples collected from the patients and examined, 34 (56.7%) presented with diarrhoea, while 26 (43.3%) had no reported cases of diarrhoea at the time of study. Seventeen (50%) of the parasites detected in the 34 patients (those with history of diarrhoea) were diarrhoea-related causative agents. However, 17 (50%) of the parasites detected were not diarrhoea-related causative agents. In relation to diarrhoea, Cryptosporidium parvum had the highest prevalence (10%), followed by Giardia intestinalis (8.3%), Entamoeba histolytica (6.7%), Isospora belli (3.3%) and Blastocystis hominis (3.3%) in that order. This study showed a significant prevalence (P<0.05) of intestinal parasites in HIV-positive/AIDS patient. Also, the prevalence of intestinal parasites was higher (P<0.05) in HIV-positive/AIDS patients than in HIV-negative subjects. Although the study is limited in scope, however, it does reflect the importance of evaluating the prevalence of intestinal parasites in HIV-positive/AIDS patients especially at the local level where antiretroviral therapy is not available. The results of this study thus provide vital information for health professionals who are managing these patients. This could lead to improvement in patients' management and care.
  3. Jain AK, Jain S, Rana AC
    Malays J Med Sci, 2007 Jan;14(1):10-7.
    PMID: 22593646
    The clinical application of new antineoplastic drugs has been limited because of low therapeutic index and lack of efficacy in humans. Thus, improvement in efficacy of old and new anticancer drugs has been attempted by manipulating their pharmacokinetic properties. Four inter-related factors, which determine the pharmacokinetic behavior of a drug include absorption, distribution, metabolism and excretion. The drug-metabolizing enzymes have been classified in two major groups: phase I and phase II enzymes. Phase I enzymes comprise the oxidases, dehydrogenases, deaminases, hydrolases. Phase II enzymes include primarily UDP-glucuronosyltransferases (UGTs), glutathionetransferases (GSTs), sulfotransferases (SULTs), N-acetyl transferases (NATs), methyltransferases and aminoacid transferases that conjugate products of phase I reactions and parent compounds with appropriate functional groups to generate more water soluble compounds which are more readily eliminated. The importance of these enzymes in the metabolism of specific drugs varies according to the chemical nature of the drug, Drug metabolism is modulated by factors that change among species and even among individuals in a population. Such factors can be environmental or genetic in origin, and influence how a drug is metabolized and to what extent. An awareness of these variables is invaluable when the safety and efficacy of new anticancer drugs are evaluated (1).
  4. Abd Karim NB, Ismail NM, Naing L, Ismail AR
    Malays J Med Sci, 2008 Oct;15(4):35-40.
    PMID: 22589636
    Tooth wear is the non-carious loss of tooth tissue, which results from three processes namely attrition, erosion and abrasion. These can occur in isolation or simultaneously. Very mild tooth wear is a physiological effect of aging. This study aims to estimate the prevalence of tooth wear among 16-year old Malay school children and determine a feasible sample size for further study. Fifty-five subjects were examined clinically, followed by the completion of self-administered questionnaires. Questionnaires consisted of socio-demographic and associated variables for tooth wear obtained from the literature. The Smith and Knight tooth wear index was used to chart tooth wear. Other oral findings were recorded using the WHO criteria. A software programme was used to determine pathological tooth wear. About equal ratio of male to female were involved. It was found that 18.2% of subjects have no tooth wear, 63.6% had very mild tooth wear, 10.9% mild tooth wear, 5.5% moderate tooth wear and 1.8 % severe tooth wear. In conclusion 18.2% of subjects were deemed to have pathological tooth wear (mild, moderate & severe). Exploration with all associated variables gave a sample size ranging from 560 - 1715. The final sample size for further study greatly depends on available time and resources.
  5. Singh G, Thulkar S, Seith A, Parshad R, Kumar P
    Malays J Med Sci, 2008 Jan;15(1):37-41.
    PMID: 22589613
    Tumor size is an important independent indicator in patients with carcinoma of the breast. Repeated size measurements during primary systemic therapy produce detailed information about response that could be used to select the most effective treatment regimen and to estimate the patient's prognosis. Measurement of tumor burden with ultrasonography and computed tomography is being used with increasing frequency to assess the effectiveness of cytotoxic anticancer drugs. Standardization of assessment and results reporting are important steps that aim at increasing the amount of usable therapeutic information at the physician's disposal. The purpose of our study is to calculate the tumor volume by mammography after demagnification and compare the tumor volume measured from this method with ultrasonography volumes.
  6. Mahmud WM, Awang A, Mohamed MN
    Malays J Med Sci, 2003 Jul;10(2):71-5.
    PMID: 23386800
    AIM: To reevaluate the psychometric characteristics of the Malay version of the Edinburgh Postnatal Depression Scale among a sample of postpartum Malay women attending the Bakar Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia.

    MATERIALS AND METHODS: 64 women between 4 to 12 weeks postpartum were recruited for there validation study. They were given questionnaires on socio-demography, the 21-item Malay version of the Beck Depression Inventory II (BDI-II) and the 10-item Malay version of the Edinburgh Postnatal Depression Scale (EPDS). All the participants were later interviewed using the Hamilton Depression Rating Scale (HDRS-17) and the Composite International Diagnostic Interview (CIDI). All diagnoses were made based on the Tenth Edition of the International Classification of Diseases (ICD-10)

    RESULTS: 9 women (14.1%) were diagnosed to have significant depression (7 mild depressive episodes and 2 moderate depressive episodes according to ICD-10). EPDS was found to have good internal consistency (Cronbach alpha =0.86) and split half reliability (Spearman split half coefficient = 0.83). The instrument also showed satisfactory discriminant and concurrent validity as evidenced by the statistically significant difference in EPDS scores between the depressed group and their non-depressed counterparts (Mann Whitney U test: 2 tailed p value < 0.01) and good correlations between the instrument and both the Malay version of BDI-II and the HRDS-17 (Spearman rank correlation coefficients of 0.78 and 0.88 respectively). At the 11/12 cut-off score the sensitivity of the EPDS is 100%, with a specificity of 98.18%, positive predictive value of 90%, negative predictive value of 100 % and misclassification rate of 1.56%.

    CONCLUSION: This study confirmed the reliability and validity of the Malay version of the Edinburgh Postnatal Depression Scale in identifying postpartum depression among recently delivered Malay women attending the Bata Bata Health Center in Alor Setar, Kedah, North West of Peninsular Malaysia.

  7. Zin NNINM, Mohamad MN, Roslan K, Abdul Wafi S, Abdul Moin NI, Alias A, et al.
    Malays J Med Sci, 2020 Jul;27(4):36-50.
    PMID: 32863744 MyJurnal DOI: 10.21315/mjms2020.27.4.4
    BACKGROUND: The spread of Plasmodium falciparum resistance in common antimalarial drugs, including artemisinin-based combination therapies, has necessitated the discovery of new drugs with novel mechanisms of action. In the present study, the in vitro antimalarial and toxicological activities of acetone, methanol, ethanol and aqueous extracts of Quercus infectoria (Q. infectoria) galls were investigated.

    METHODS: The extracts were assessed for the antimalarial potential using a malarial SYBR Green I fluorescence-based (MSF) assay, while the toxicity was screened by using brine shrimp lethality test (BSLT), haemolytic assay, and cytotoxicity assay against normal embryo fibroblast cell line (NIH/3T3) and normal kidney epithelial cell line (Vero).

    RESULTS: The acetone extract showed the highest antimalarial activity (50% inhibitory concentration, IC50 = 5.85 ± 1.64 μg/mL), followed by the methanol extract (IC50 = 10.31 ± 1.90 μg/mL). Meanwhile, the ethanol and aqueous extracts displayed low antimalarial activity with IC50 values of 20.00 ± 1.57 and 30.95 μg/mL ± 1.27 μg/mL, respectively. The significant antimalarial activity was demonstrated in all extracts and artemisinin (P < 0.05). All extracts were non-toxic to brine shrimps (50% lethality concentration, LC50 > 1000 ppm). Furthermore, no occurrence of haemolysis (< 5%) was observed in normal erythrocytes when treated with all extracts compared to Triton X-100 that caused 100% haemolysis (P < 0.05). The acetone and methanol extracts were non-toxic to the normal cell lines and statistically significant to artemisinin (P < 0.05).

    CONCLUSION: Taken together with satisfactory selectivity index (SI) values, the acetone and methanol extracts of Q. infectoria galls could serve as an alternative, promising and safe antimalarial agents.

  8. Fitriawan AS, Kartika AI, Chasanah SN, Aryandono T, Haryana SM
    Malays J Med Sci, 2020 Dec;27(6):27-38.
    PMID: 33447132 DOI: 10.21315/mjms2020.27.6.4
    BACKGROUND: Epithelial ovarian cancer (EOC) is a lethal disease due to late diagnosis and lack of effective screening methods. MicroRNA (miR/miRNA) plays an important role in ovarian carcinogenesis and may serve as a non-invasive biomarker for EOC. This study aimed to assess miR-141 expression in the blood plasma of patients with EOC and healthy subjects and determine its association with the clinical stage of EOC.

    METHODS: This cross-sectional study used blood plasma from 30 newly diagnosed untreated patients with EOC and 25 healthy subjects. The mean age was 47.73 (SD = 10.29) years for EOC and 44.48 (SD = 16.14) years for healthy subject. The total RNA was isolated from blood plasma and reversed transcribed to obtain cDNA. The expression of miR-141 was measured by real-time quantitative polymerase chain reaction (qRT-PCR), and calculated using 2-ΔΔCt methods. The data were analysed using Mann-Whitney test.

    RESULTS: The expression of miR-141 was upregulated 8.41 fold in the blood plasma of EOC patients compared to healthy controls (P < 0.001). Expression of miR-141 in the advanced stage was upregulated 4.2 fold compared to the early stage (P < 0.001).

    CONCLUSION: The miR-141 was upregulated in the blood plasma of EOC and associated with an advanced stage of disease, suggesting it has potential as a biomarker for EOC detection.

  9. Md Nizar ND, Hassan SK, Mohamad Zaini RH, Hassan MH, Wan Hassan WMN, Mazlan MZ
    Malays J Med Sci, 2020 Dec;27(6):68-78.
    PMID: 33447135 DOI: 10.21315/mjms2020.27.6.7
    BACKGROUND: Hypotension is a common complication following spinal anaesthesia. The administration of intravenous fluids prior to spinal anaesthesia, known as pre-loading, has been used to offset the hypotension effect; however, the ideal fluid for pre-loading is still a matter of debate. The objective of this study was to compare the effects of Gelaspan 4% and Volulyte 6% as pre-loading fluids.

    METHODS: A total of 93 patients with American Society of Anaesthesiologists (ASA) physical status I or II having lower limb orthopaedic surgery under spinal anaesthesia were randomised into two groups that received either Volulyte (n = 47) or Gelaspan (n = 46). Before the spinal anaesthesia, these patients were pre-loaded with 500 mL of the fluid of their respective group. Blood samples were taken before pre-loading and again after spinal anaesthesia and sent for venous blood gas and electrolyte level measurement. Baseline and intraoperative records of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and the requirement of ephedrine to treat hypotension were also recorded.

    RESULTS: Both fluids could not prevent significant reductions in SBP (P = 0.011), DBP (P = 0.002) and MAP (P = 0.001). There was also significant reduction in HR over time (P < 0.001). There was no significant difference in terms of ephedrine usage between both groups. Neither Volulyte 6% nor Gelaspan 4% caused significant changes in acid-base status.

    CONCLUSION: The use of 500 mL of either Gelaspan 4% or Volulyte 6% as pre-loading fluids did not significantly prevent the incidence of post-spinal anaesthesia hypotension following orthopaedic lower limb surgery; however, both were useful in the maintenance normal acid-base balance.

  10. Tan CH, Abd Rashid R, Guan NC
    Malays J Med Sci, 2020 Jul;27(4):51-63.
    PMID: 32863745 MyJurnal DOI: 10.21315/mjms2020.27.4.5
    BACKGROUND: Amphetamine-type stimulant (ATS) use brings severe adverse effects to the mental well-being of an individual and it is an essential contributor to the global disease burden. Meanwhile, religiosity and religious coping might improve one's conduct, physical and mental well-being. Hence, this study aims to determine the prevalence of anxiety and depression in ATS user and their association with religiosity and religious coping.

    METHODS: It is a cross-sectional study conducted at the Department of Psychological Medicine, Universiti Malaya Medical Centre, Malaysia. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression among ATS users. Religiosity and religious coping were measured with Duke University Religious Index and Brief RCOPE.

    RESULTS: This study involved 215 ATS users. Almost half of the ATS users had either anxiety (n = 96; 44.6%) or depression (n = 108; 50.2%), which were associated with polysubstance use or having an existing psychiatric disorder. Subjects with higher religiosity and positive religious coping were less anxious or depressed. However, negative religious coping was significantly associated with anxiety and depression in ATS users.

    CONCLUSION: Anxiety and depression are prevalent in ATS users. Integrating religiosity and religious coping into the ATS users' treatment plan helps to improve their mental well-being.

  11. Abbas MA, Oriquat GA, Abbas MM, Al-Najjar BO, Kandil YI
    Malays J Med Sci, 2020 Dec;27(6):39-52.
    PMID: 33447133 DOI: 10.21315/mjms2020.27.6.5
    BACKGROUND: Dyslipidaemias are common in patients with diabetes mellitus. A high prevalence of type 2 diabetes in hyperlipidaemic patients also exists. The aim of this study was to find a treatment that lowers both blood glucose and lipid levels simultaneously.

    METHODS: The hypolipidaemic effect of (R)-(-)-carvone was investigated in a tyloxapol-induced hyperlipidaemia mice model. Furthermore, its effect on insulin secretion and proliferation of 1.1E7 human pancreatic β-cells was studied. In addition, using molecular docking, the binding affinity of (R)-(-)-carvone against 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase was estimated.

    RESULTS: (R)-(-)-carvone (100 mg/kg) decreased plasma triglyceride, total cholesterol, low-density lipoprotein cholesterol (LDL-C) levels and atherogenic index by 90.6%, 49.3%, 56.6% and 70.3%, respectively, but it had no effect on high-density lipoprotein cholesterol (HDL-C). Furthermore, it increased hepatic triglyceride level and catalase activity by 79.6% and 59.6%, respectively. In-vitro, 500 μM (R)-(-)-carvone increased insulin secretion by 454.4% and proliferation of 1.1E7 cells with no cytotoxic effects up to a concentration of 100 μM. Molecular docking simulation demonstrated a good binding affinity with -5.03 Kcal/mol of (R)-(-)-carvone to HMG-CoA reductase.

    CONCLUSION: The hypolipidaemic effect of (R)-(-)-carvone is comparable to that of fenofibrate. (R)-(-)-carvone has the advantage over fenofibrate of not producing hypoglycaemia in animals. Furthermore, (R)-(-)-carvone increased proliferation and insulin secretion of human pancreatic β-cells.

  12. Musa KI, Abdullah JM
    Malays J Med Sci, 2020 Dec;27(6):1-6.
    PMID: 33447129 DOI: 10.21315/mjms2020.27.6.1
    The recent spike of transmissibility of COVID-19 was evident by a large number of COVID-19 cases and apparent quick spread of SARS-CoV-2 in the state of Sabah, Selangor and Negeri Sembilan in Malaysia. The question remains as to what are the main contributory factors for the impending COVID-19 second wave in Malaysia and why the current surveillance system fails to show signs of the impending second - or the third - COVID-19 wave. In public health surveillance, data are the ultimate indicator, and in the era of big data and the Industrial Revolution 4.0, data has become a valuable commodity. The COVID-19 data keeper must fulfil some criteria to ensure COVID-19 data are useful. Researchers are obligated to share their COVID-19 data responsibly. The surveillance for COVID-19 is paramount, and the guidelines such as the one published by the World Health Organization 'Public health surveillance for COVID-19: interim guidance' must be referred to. Data must be taken seriously and shared to enable scientists, clinicians, epidemiologists and public health experts fight COVID-19.
  13. Ganeson M, Amirthalingam SD, Kim KS
    Malays J Med Sci, 2020 Dec;27(6):183-186.
    PMID: 33447143 DOI: 10.21315/mjms2020.27.6.15
    The Malaysian government's ongoing movement control order (MCO) to prevent coronavirus disease 2019 (COVID-19) spread, has disrupted the teaching and learning (T&L) activities of higher education institutions in the country. This paper seeks to outline the steps taken by the Department of Family Medicine of the International Medical University (IMU), Malaysia, to adapt its online teaching and learning activities. The five tips are: i) understand how to use online T&L platforms; ii) teachers should create multiple communication channels; iii) ensure attendance is captured; iv) enhance the online T&L experience and v) conduct online formative assessments.
  14. Abdul Khaiyom JH
    Malays J Med Sci, 2020 Jul;27(4):147-153.
    PMID: 32863754 MyJurnal DOI: 10.21315/mjms2020.27.4.14
    COVID-19 and the Movement Control Order (MCO) may trigger a 'next wave' of mental health problems. However, the relationship is not linear. Human psychology also has an impact on the outbreak. Thus, proper strategies to manage human psychology, especially mental health, is very important to break the vicious cycle. This article aims to discuss ways to manage mental health using cognitive-behavioural approaches, mindfulness and spirituality. Specific cognitive-behavioural and mindfulness strategies are listed and suggestions to return to the foundation of human existence are discussed. By practising the cognitive-behavioural, mindfulness, and spirituality strategies described, we may enhance our acceptance, optimism and commitment to prepare for a 'new or renewed normal'.
  15. Zolkefli Y
    Malays J Med Sci, 2020 Dec;27(6):144-147.
    PMID: 33447141 DOI: 10.21315/mjms2020.27.6.13
    We recognise that people lie to health professionals for several reasons. However, these incidents endanger the well-being of the professionals and bring us to the question of whether people have an exclusive moral duty to always profess the truth about their health and other facts, particularly in a pandemic crisis. This review argues that an honest patient is a key to undertaking their roles as health professionals and delivering the best services possible to meet the needs of the patient. Greater awareness and comprehension of the potential ramifications of dishonesty, not only helps establish the moral obligation, to tell the truth, particularly in a pandemic situation, but also translates into a better relationship with health professionals. It also enforces an ethical solidarity on every single of us to show tangible moral response to ensure that those most vulnerable to risks from the pandemic illness such as health professionals are protected as far as possible.
  16. Larki M, Sharifi F, Manouchehri E, Latifnejad Roudsari R
    Malays J Med Sci, 2021 Dec;28(6):8-19.
    PMID: 35002486 DOI: 10.21315/mjms2021.28.6.2
    The pandemic and its consequences have been shown to have a negative impact on the availability and accessibility of the basic services, including sexual and reproductive health (SRH) needs. The aim of this study was to investigate the responses to the essential SRH needs for women during the COVID-19 pandemic. This narrative review was conducted based on the Scale for Assessing Narrative Review Articles (SANRA), in order to present key activities for responding to the important SRH needs of women in the current COVID-19 pandemic. The literature search was performed through English databases of Cochrane Library, PubMed, Scopus and ScienceDirect, as well as Persian databases including Magiran and Scientific Information Database (SID). In addition, the World Health Organization (WHO), the Joint United Nations Programme on HIV and AIDS (UNAIDS) and the reports of Center for Disease Control and Prevention (CDC) were searched. The search was carried out from December 2019 up to 10 January 2021. Essential reproductive healthcare services for women during the COVID-19 pandemic were divided into six categories including access to contraception, safe abortion and post-abortion care, sexual health and sexually transmitted disease (STD) prevention, cervical cancer screening and prevention, maternity services and also addressing violence against women and girls. These essential needs should be considered as a priority by governments as well as public and private stakeholders. It seems that the implementation of the shifted strategies, active participation of public and private stakeholders, consideration of human rights and ethical issues, ensuring access to vulnerable populations, regular contact with individuals and the increased cooperation of individuals for responding to the SRH needs during the COVID-19 outbreak, are necessary.
  17. Kho GS, Kandasamy R, Bujang MA, Swammy M, Mustapha M, Abdullah JM
    Malays J Med Sci, 2021 Dec;28(6):42-54.
    PMID: 35002489 DOI: 10.21315/mjms2021.28.6.5
    BACKGROUND: Nitric oxide (NO) is involved in a multitude of physiological processes in the central nervous system (CNS). Given the ubiquitous nature of NO and its involvement in various vital processes, nitric oxide metabolite (NOx) has been investigated as a biomarker in CNS diseases. This study aims to investigate the ratio of NOx levels and serum in cerebrospinal fluid (CSF) in patients with spontaneous subarachnoid haemorrhage (SAH). The associations among these markers with clinical outcomes were also studied.

    METHODS: A prospective cohort study was conducted over a 2-year period (May 2013-May 2015) to investigate the levels of NOx in the CSF and serum of patients with radiologically confirmed aneurysmal SAH. NOx samples and all relevant data were collected from the patients on admission and serially over 5 days. On admission, NOx levels were compared between the groups of patients, who were divided as per the World Federation Neurosurgeons Score (WFNS) grading scale, Fisher scale, occurrence of vasospasm on transcranial doppler (TCD), and Glasgow outcome scale (GOS) upon discharge and at 6 months follow-up. The ratios of CSF-to-serum were calculated and correlated with SAH severity and the outcome parameters listed above.

    RESULTS: The patients (N = 40) had a mean (SD) age of 58.2 (11.8) years old. The majority (65%) had a higher severity of SAH (WFNS score 3-5). On evaluation of the CT scan findings, 74% had outcomes equivalent to 4 on the Fisher scale. Vasospasm was detected via TCD in nearly half (45%) of the cohort during the study period; 80% were noted to have a poor outcome (GOS 1-3) at discharge; this persisted at 6 months follow-up. Comparison of NOx levels in the CSF/serum ratio was based on the incidence of vasospasm and severity of outcome (GOS) for day-1 and day-4. Statistically significant results were evident for patients with better outcomes, high severity grading, and the presence of vasospasm (P-values: 0.031, 0.034 and 0.043, respectively).

    CONCLUSION: Elevated NOx levels in CSF and serum and reductions in the ratio of NOx in CSF/serum were found to be associated with severity, occurrence of vasospasm and clinical outcome in aneurysmal SAH patients. This indicates the possible role of NOx as a biomarker to assess severity and prognosis in patients with SAH.

  18. Zeynali Bujani M, Behnampour M, Rahimi N, Safari T, Khazaei Feizabad A, Hossein Sarbazi A, et al.
    Malays J Med Sci, 2021 Dec;28(6):20-31.
    PMID: 35002487 DOI: 10.21315/mjms2021.28.6.3
    Coronavirus disease 2019 (COVID-19) pandemic is rapidly developing worldwide with a high mortality rate. In this meta-analysis study, the effect of influenza vaccination on the prevention of COVID-19 and its consequences in patients were investigated. The systematic search for this study was performed from November 2019 to 25 November 2020, in the databases of Medline, PubMed, Scopus, Web of Science, Embase, Ebsco, Cochrane and medRxiv. Search terms used included COVID-19, coronavirus, SARS-CoV-2, covid, influenza, flu, grippe and vaccine. The present study examined the association between influenza vaccination and COVID-19 including COVID-19 infection, mortality, hospitalisation and intensive care unit (ICU) admission. Finally, the pooled estimates for different outcomes were calculated by the software for statistics and data science (STATA) version 15 and I2 was used to determine the heterogeneity. By analysing the data of articles, the pooled estimates of these data indicated that influenza vaccination could lower probability of COVID-19 infection up to 24% (OR = 0.77; 95% CI: 0.65, 0.91), of death up to 32% (OR = 0.68; 95% CI: 0.42, 1.11), of the hospitalisation up to 25% (OR = 0.75; 95% CI: 0.46; 1.23) and of admission to ICU up to 29% (OR = 0.71; 95% CI: 0.40, 1.27). Influenza vaccination can help decrease the COVID-19 infection and reduce hospitalisation and the need for ICU and mortality rates.
  19. Choudhari OK, Rani A, Kampani G, Kaur C, Sengupta A
    Malays J Med Sci, 2021 Dec;28(6):32-41.
    PMID: 35002488 DOI: 10.21315/mjms2021.28.6.4
    Background: Genetic and environmental factors, along with hypertension, diabetes mellitus and smoking cause accelerated atherosclerosis and, eventually, stroke. Matrix metalloproteinase-9 (MMP-9) are inflammatory mediators of the endoproteinase family, and their polymorphism and methylation are associated with the development of atherosclerosis and stroke. This study explores this association in the Indian population.

    Objective: To study the association of MMP gene polymorphism and methylation with the risk of stroke.

    Methods: A case-control study was conducted on 100 admitted patients (both genders) diagnosed with ischaemic stroke. Another 100 healthy subjects, not suffering from any chronic illness or stroke, were taken as controls. All participants were genotyped for rs3918242 (MMP-9) by polymerase chain reaction (PCR) and restriction fragment length polymorphism. Methylation of the MMP-9 gene-promoter region was assessed by methylation-specific PCR.

    Results: The case (mean age = 61.3 ± 7.36 years old) and control (mean age = 60.68 ± 7.1 years old) groups were age-matched. Among cases, 61 patients were smokers, 55 were diabetic and 53 were hypertensive. A significant risk of ischaemic stroke was associated with the CT genotype (adjusted odds ratio [aOR] = 7.09; P < 0.001), TT genotype (aOR = 19.75; P < 0.001) and T allele (aOR = 10.71; P < 0.001). MMP-9 methylation decreased the risk of stroke (aOR = 0.23; P < 0.001).

    Conclusion: MMP-9 gene-1562C/T polymorphism (SNP rs3918242) (single-nucleotide polymorphism [SNP] rs3918242) is a potential marker to predict ischaemic stroke and constitutes a significant proportion of the general population. Its polymorphism predisposes to ischaemic stroke, while its methylation is protective.

  20. Sukiman H, Mohamad AM, Raduan MFN, Yasim MNAM, Lazim MIM
    Malays J Med Sci, 2021 Oct;28(5):130-136.
    PMID: 35115895 DOI: 10.21315/mjms2021.28.5.13
    Background: Appendicitis is common and delayed presentation results in complicated appendicitis with increased morbidity. This study investigates the effect of the Movement Control Order (MCO) during the COVID-19 pandemic on the presentation and severity of appendicitis.

    Methods: A cross-sectional study including 193 patients diagnosed with appendicitis was conducted at four hospitals in Pahang, Malaysia. Those who presented between 1 February 2020 and 17 March 2020 were included in the pre-MCO group and those between 18 March 2020 and 30 April 2020 in the MCO group. The definitions of simple and complicated appendicitis were based on the Sunshine Appendicitis Grading Score. The primary outcome was the incidence of complicated appendicitis, and the secondary outcomes were length of stay, a composite of surgical morbidities and a composite of organ failure.

    Results: A total of 105 patients in the pre-MCO group and 88 in the MCO group were analysed. The incidence of complicated appendicitis was 33% and it was higher in the MCO than in the pre-MCO group (44% versus 23%, P = 0.002). The MCO period was independently associated with complicated appendicitis in the logistic regression (P = 0.001). It was also associated with prolonged length of stay (3.5 days versus 2.4 days, P < 0.001) and higher overall surgical morbidity (19% versus 5%, P = 0.002).

    Conclusion: The MCO imposed during the COVID-19 pandemic was associated with a higher incidence of complicated appendicitis and surgical morbidity.

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