Displaying publications 81 - 100 of 115 in total

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  1. Wong LP, Wu Q, Hao Y, Chen X, Chen Z, Alias H, et al.
    Int Health, 2021 May 04.
    PMID: 33945613 DOI: 10.1093/inthealth/ihab023
    BACKGROUND: We aimed to investigate the association between institution trust and public responses to the coronavirus disease 2019 (COVID-19) outbreak.

    METHODS: An Internet-based, cross-sectional survey was administered on 29 January 2020. A total of 4393 adults ≥18 y of age and residing or working in the province of Hubei, central China were included in the study.

    RESULTS: The majority of the participants expressed a great degree of trust in the information and preventive instructions provided by the central government compared with the local government. Being under quarantine (adjusted odds ratio [OR] 2.35 [95% confidence interval {CI} 1.80 to 3.08]) and having a high institutional trust score (OR 2.23 [95% CI 1.96 to 2.53]) were both strong and significant determinants of higher preventive practices scores. The majority of study participants (n=3640 [85.7%]) reported that they would seek hospital treatment if they suspected themselves to have been infected with COVID-19. Few of the participants from Wuhan (n=475 [16.6%]) and those participants who were under quarantine (n=550 [13.8%]) expressed an unwillingness to seek hospital treatment.

    CONCLUSIONS: Institutional trust is an important factor influencing adequate preventive behaviour and seeking formal medical care during an outbreak.

  2. Lin Y, Su Z, Chen F, Zhao Q, Zimet GD, Alias H, et al.
    Hum Vaccin Immunother, 2021 01 02;17(1):304-315.
    PMID: 32401617 DOI: 10.1080/21645515.2020.1756152
    Little is known regarding Chinese mothers' intention to vaccinate their daughters against human papillomavirus (HPV) since the HPV vaccine was approved for use in China in 2016. The aim was to explore maternal HPV vaccination acceptance, preference for 2-, 4- or 9-valent HPV vaccine and acceptance of domestically manufactured HPV vaccines. Study participants were mothers of primary school children in Southeastern region of Fujian. An online cross-sectional survey was undertaken between June and August 2019. Among the total of 3,586 completed responses (response rate 28.5%), the intention to vaccinate daughter against HPV was high (83.3%). Higher maternal education and perceived benefit and barriers were associated with greater intention to vaccinate. Among mothers who did not intend to vaccinate their daughters, the three most common reasons were daughter being too young to receive HPV vaccination (40.6%), fear of side effects (31.9%) and vaccine price is too high (16.0%). The largest proportion (41.4%) preferred their daughter to be vaccinated with the 9-valent HPV vaccine (9vHPV). Greater preference for 9vHPVwas strongly associated with higher maternal education level and annual household income. The majority of mothers expressed a preference for imported HPV vaccine (56.3%). Our result indicates that lower intentions to vaccinate daughters against HPV among less educated and lower-income mothers may lead to significant social inequalities in HPV vaccine uptake in the country.
  3. Lee JL, Mohd Saffian S, Makmor-Bakry M, Islahudin F, Alias H, Noh LM, et al.
    Br J Clin Pharmacol, 2021 07;87(7):2956-2966.
    PMID: 33377197 DOI: 10.1111/bcp.14712
    AIMS: There is considerable interpatient variability in the pharmacokinetics (PK) of intravenous immunoglobulin G (IVIG), causing difficulty in optimizing individual dosage regimen. This study aims to estimate the population PK parameters of IVIG and to investigate the impact of genetic polymorphism of the FcRn gene and clinical variability on the PK of IVIG in patients with predominantly antibody deficiencies.

    METHODS: Patients were recruited from four hospitals. Clinical data were recorded and blood samples were taken for PK and genetic studies. Population PK parameters were estimated by nonlinear mixed-effects modelling in Monolix®. Models were evaluated using the difference in objective function value, goodness-of-fit plots, visual predictive check and bootstrap analysis. Monte Carlo simulation was conducted to evaluate different dosing regimens for IVIG.

    RESULTS: A total of 30 blood samples were analysed from 10 patients. The immunoglobulin G concentration data were best described by a one-compartment model with linear elimination. The final model included both volume of distribution (Vd) and clearance (CL) based on patient's individual weight. Goodness-of-fit plots indicated that the model fit the data adequately, with minor model mis-specification. Genetic polymorphism of the FcRn gene and the presence of bronchiectasis did not affect the PK of IVIG. Simulation showed that 3-4-weekly dosing intervals were sufficient to maintain IgG levels of 5 g L-1 , with more frequent intervals needed to achieve higher trough levels.

    CONCLUSIONS: Body weight significantly affects the PK parameters of IVIG. Genetic and other clinical factors investigated did not affect the disposition of IVIG.

  4. Amini S, Alias H, Aizat-Juhari MA, Mat-Isa MN, Adam JH, Goh HH, et al.
    Genom Data, 2017 Dec;14:5-6.
    PMID: 28761813 DOI: 10.1016/j.gdata.2017.07.008
    Rafflesia cantleyi, known as one of the world's largest flowers, is a specialised holoparasite due to dramatic morphological modifications. It possesses highly reduced vegetative structure and only appears as a flower for sexual reproduction. Moreover, it has an unusual life cycle in that its floral bud development takes up to nine months. In order to fully understand the highly modified floral organ structure and long life cycle of R. cantleyi, we used Illumina sequencing technology (HiSeq) for sequence generation followed by de novo assembly of sequence reads. We obtained the RNA-seq data from three different stages of floral bud, representing the early, mid and advanced developmental stages. These data are available via BioProject accession number PRJNA378435. More than 10.3 Gb raw sequence data were generated, corresponding to 102,203,042 raw reads. Following removal of low-quality reads and trimming of adapter sequences, a total of 91,638,836 reads were obtained. De novo assembly of these sequences using Trinity resulted in 89,690 unique transcripts with an N50 of 1653 bp. The obtained transcriptomic data will be useful for further study to understand the molecular interactions that result in R. cantleyi floral development.
  5. Wong LP, Edib Z, Alias H, Mohamad Shakir SM, Raja Muhammad Yusoff RNA, Sam IC, et al.
    J Obstet Gynaecol, 2017 Oct;37(7):937-943.
    PMID: 28641049 DOI: 10.1080/01443615.2017.1317239
    Assessing physicians' experiences in HPV vaccine recommendation and delivery to adolescent boys is essential to providing an understanding of the issues of vaccine acceptance and an insight for policymakers to enhance HPV vaccinations among adolescent boys. Between January and April 2014 a mail survey was conducted using physicians in Malaysia known to provide either one or both HPV vaccine (Gardasil and Cervarix) immunisation services. A total of 357 completed questionnaires were received (response rate 22.5%). Of these, 335 physicians see adolescent boys aged 11 to 18 years old in their practice. Only 26.3% (n = 88) recommended the HPV vaccine to these boys. A total of 46.6% (n = 41) have successfully given the HPV vaccine to adolescent boys. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to the boys (37.2%) and a lack of awareness of the availability of the vaccine for boys (32.8%) were the most commonly cited reasons for non-recommendation. Impact statement Recommending the HPV vaccine for adolescent boys remains a challenge for physicians. Our study provides evidence of challenges and barriers faced by Malaysian physicians who recommend the HPV vaccines (Gardasil and Cervarix) in their practices. In this study, physicians reported HPV vaccine uptake by adolescent boys was very poor. A lack of proper guidelines from the health authorities regarding the recommendation of HPV vaccine to boys and a lack of awareness of the availability of the vaccine for boys were the most commonly cited reasons for non-recommendation. Physicians viewed that support and encouragement from the health authorities are needed to promote the recommendation of the HPV vaccine to adolescent boys. Physicians were also of the opinion that the lay public should be educated about the availability of the HPV vaccine for boys, and its benefits, safety and efficacy, and the high susceptibility of boys to getting HPV infections. The findings provide insights that could be helpful to policymakers or high-level decision-makers of the potential strategies to enhance HPV uptake among adolescent boys.
  6. Mohamed M, Lau DSC, Loh CK, Syed Zakaria SZ, Alias H, A Jamal AR, et al.
    MyJurnal
    Introduction: Parents of children with chronic illness such as thalassaemia, experience parental anxiety as a result of multiple stressors; these parents will consequently undergo the process of coping and adjustment in order to overcome the situation. Identifying families who may require psychosocial intervention is an important step towards providing holistic management for these children.

    Methodology: A cross-sectional study was conducted to determine the level of parenting stress amongst parents of children with thalassaemia. Risk factors associated with high parenting stress score were identified. Research instruments used were the Parenting Stress Index/Short Form and Coping Inventory for Stressful Situations.

    Results: A total of 54 subjects were recruited. High total parenting stress score (TPSS, defined at 75th centile) for this cohort was 99.5 whereas the mean TPSS was 86.18. Overall, 24% of these parents have high TPSS. Chinese ethnicity, number of children, monthly income, task-oriented and emotion-oriented coping mechanisms were significantly associated with a high TPSS. Logistic regression analysis revealed that low task-oriented but high emotion-oriented scores were risk factors with the greatest predictive power.

    Conclusion: Early recognition of parenting stress is important to identify at risk parents so that interventions such as counseling and social support may be given.
  7. Alias H, Yong WL, Muttlib FAA, Koo HW, Loh CK, Lau SCD, et al.
    J Med Case Rep, 2018 Sep 17;12(1):276.
    PMID: 30223886 DOI: 10.1186/s13256-018-1806-9
    BACKGROUND: Acquired thrombotic thrombocytopenia purpura is very rarely encountered in children. It is often misdiagnosed initially when the condition is not inherited.

    CASE PRESENTATION: We describe a 3-year-old Malay boy who presented with simple febrile seizure and had no neurological deficit, however, he was found to have microangiopathic hemolytic anemia, thrombocytopenia, and elevated serum lactate dehydrogenase. An ADAMTS13 assay results showed zero activities (0%), and markedly high level of ADAMTS13 inhibitor (93.15 U/mL) confirming the diagnosis of secondary thrombotic thrombocytopenia purpura. He received fresh frozen plasma infusions for 3 days and subsequently his platelet levels normalized. Serial ADAMTS13 assay results showed improvement. He was also given a short course of prednisolone after which the ADAMTS13 activity normalized (> 114%) at the end of prednisolone course.

    CONCLUSIONS: At presentation, acquired thrombotic thrombocytopenia purpura in a very young child is commonly misdiagnosed as other conditions like idiopathic thrombocytopenic purpura, Evans syndrome, atypical hemolytic-uremic syndrome, or malignancy. ADAMTS13 assay should be performed early when thrombotic thrombocytopenia purpura is suspected as this condition is associated with dire consequences.

  8. Lin Y, Lin Z, He F, Chen H, Lin X, Zimet GD, et al.
    Vaccine, 2020 03 23;38(14):3021-3030.
    PMID: 32127227 DOI: 10.1016/j.vaccine.2020.02.042
    OBJECTIVE: This study aims to investigate acceptance and willingness to pay for HPV vaccination among adult women in China.

    METHODS: An online survey was sent to mothers aged 27-45 years of primary school pupils in the Fujian province, China. Participants completed questions about HPV related knowledge and health beliefs, intention to take the HPV vaccine and the willingness to pay for bivalent vaccine (2vHPV), quadrivalent vaccine (4vHPV), and 9-valent HPV vaccine (9vHPV).

    RESULTS: Of a total of 2339 complete responses, 58.3% reported intent to obtain HPV vaccine. Mothers who were younger in age, residing in urban, working in managerial or professional occupations, who knew someone with cervical cancer and who were able to make independent decisions about the HPV vaccine (vs. joint decision with spouse) were more likely to express intent to have HPV vaccination. Perceived barriers, cues to action and self-efficacy were three of the constructs in the health belief model that significantly influenced HPV vaccination intent. A higher proportion of participants expressed willingness to pay for 2vHPV (81.2%) and 4vHPV (75.9%), as compared to 9vHPV (67.7%).

    CONCLUSION: Adults women expressed moderate intention to receive the HPV vaccine. Intervention to address barriers to uptake of the HPV vaccine among adult women in China is warranted.

  9. Wong LP, Alias H, Danaee M, Ziaee M, Abedi F, Ziaee A, et al.
    Transbound Emerg Dis, 2020 Nov;67(6):2892-2900.
    PMID: 32512635 DOI: 10.1111/tbed.13662
    Iran is the country in Western Asia most impacted by the COVID-19 outbreak. A survey was conducted among the general public in Iran aimed at investigating psychobehavioural issues related to the COVID-19 outbreak, namely (a) barriers to preventive measures against SARS-CoV-2 infection; (b) negative emotions towards SARS-CoV-2 infection; and (c) anxiety levels among the general public in Iran. A cross-sectional, web-based survey using an online questionnaire was carried out between 16 March and 1 April 2020. The six-item version of the State-Trait Anxiety Inventory (STAI-6) was used to assess anxiety levels. A total of 1,789 complete responses were received. Nearly 60% reported having difficulty in wearing a face mask to protect against SARS-CoV-2 infection. The mean and standard deviation (SD) for the total prevention barrier score was 35.8 (SD ± 7.1; range 18-68) out of a possible score of 72. Male respondents [odds ratio (OR) = 1.25; 95% confidence interval (CI) 1.03-1.51] and respondents who perceived their health status as poor/fair (OR = 1.49; 95% CI 1.31-1.82) were predictors of high prevention barriers. Negative emotions such as fear (74.6%) followed by depression (43.4%) and stigma (23.0%) associated with SARS-CoV-2 infection were reported. Respondents who perceived their health as poor/fair (OR = 2.19; 95% CI 1.57-3.04) reported a higher likelihood of having higher negative emotions. Findings on anxiety level revealed 68.0% (95% CI 65.8-70.1) reported moderate to severe anxiety. Respondents who perceived their health as poor/fair (OR = 3.46; 95% CI 12.22-5.40) and who were females (OR = 1.91; 95% CI 1.55-2.36) were predictors of moderate to severe anxiety. In conclusion, psychobehavioural interventions are needed to facilitate management and control of the COVID-19 outbreak.
  10. Wong LP, Alias H, Danaee M, Lee HY, Tan KM, Tok PSK, et al.
    Front Public Health, 2021;9:787672.
    PMID: 35004587 DOI: 10.3389/fpubh.2021.787672
    Background: The confinement measures during COVID-19 had a massive effect on physical and psychological health in public. This study assessed the impact of containment and coping behaviour among the Malaysia public during the COVID-19 pandemic. Questions assessing the impact of containment and coping behaviours were developed and psychometrically tested. Methods: Exploratory factor analysis (EFA) was conducted with the items using principal component analysis extraction and Varimax rotation. Partial least squares structural equation modelling was used to determine the relationship between coping and impact. Results: The 13-item of impact and 10-item coping instruments were developed with three dimensions identified through EFA. Both scales demonstrated excellent composite reliability and good convergent validity. The survey findings revealed that the impact on individual psychological aspects was prominent, followed by well-being and lifestyle. Mindfulness and physical coping strategies were most commonly reported. Coping through seeking help from health professionals and hotlines had a positive direct effect on well-being and lifestyle (b = 0.231, p < 0.001), psychological (B = 0.132, p < 0.001), and employment-related (0.194, p < 0.001) impacts. Coping through mindfulness practise had a negative effect on well-being and lifestyle-related impact (B = -0.180, p < 0.001) and employment-related impact (B = -0.096, p = 0.008). Conclusions: Despite some limitation, the scales for measuring impact and coping behaviours have the potential to be used as a measurement tool in future studies. Findings highlight the enormous impact of the pandemic on psychological well-being and lifestyles. Health authorities should support individual coping as it was found to be an important resilience-related factor to mitigate the impacts of containment during the pandemic.
  11. Cai G, Lin Y, Lu Y, He F, Morita K, Yamamoto T, et al.
    J Psychiatr Res, 2021 Apr;136:296-305.
    PMID: 33631655 DOI: 10.1016/j.jpsychires.2021.02.008
    BACKGROUND: This study explored the behavioural responses and anxiety symptoms of the general adult population in Japan during the ongoing coronavirus disease 2019 (COVID-19) outbreak.

    METHODS: A web-based cross-sectional survey was conducted between 12th and May 13, 2020. Quota sampling was used to attain equal gender and age distributions representative of the Japanese population.

    RESULTS: A total of 4127 complete responses were analysed. Higher educational level (B = 0.045, p = 0.002) and household income (B = 0.04, p = 0.009) were associated with a higher increase in preventive measures when comparing before and after the state of emergency was declared. The highest reported social anxiety was a feeling of fear (65.6%), followed by embarrassment (43.8%), keeping infection a secret (41.3%), avoidance (41.3%), and stigma (25.5%). A total of 86.1% of the respondents reported moderate to severe anxiety. The partial least square-based structural equation modelling (PLS-SEM) revealed that being female has the greatest effect (B = 0.246, p 

  12. Al-Jaber HA, Arsad A, Bandyopadhyay S, Jaafar MZ, Tahir M, Nuhma MJ, et al.
    Molecules, 2023 Sep 18;28(18).
    PMID: 37764461 DOI: 10.3390/molecules28186685
    Alkaline-surfactant-polymer (ASP) flooding, a recognized method for oil recovery, encounters limited use due to its expense. In addition, ASP's best composition and injection sequence still remains uncertain today. This study explores conventional ASP flooding using PT SPR Langgak's special surfactants, simulating Langgak oilfield conditions in Sumatra, Indonesia. By comparing the outcomes of this flooding technique with that of starch-assisted ASP performed in another study, the benefits of adding starch nanoparticles to flooding are evident. Nano-starch ASP increased oil recovery by 18.37%, 10.76%, and 10.37% for the three configurations investigated in this study. Water flooding preceded ASP flooding, and flooding operations were carried out at 60 °C. This study employed sodium hydroxide (NaOH), sodium carbonate (Na2CO3), and specialized surfactants from PT SPR. The adopted polymer is solely hydrolyzed polyacrylamide (HPAM) at 2000 ppm. Starch nanoparticles underwent comprehensive characterization and focused more on charge stability. Purple yam nanoparticles (PYNPs) exhibited remarkable stability at -36.33 mV, unlike cassava starch nanoparticles (CSNPs') at -10.68 mV and HPAM's at -27.13 mV. Surface properties affect interactions with fluids and rocks. Crystallinity, a crucial characterization, was assessed using Origin software 2019b. CSNPs showed 24.15% crystallinity, surpassing PYNPs' 20.68%. Higher crystallinity benefits CSNPs' thermal stability. The amorphous behavior found in PYNPs makes them less suitable if applied in harsh reservoirs. This research correlated with prior findings, reinforcing starch nanoparticles' role in enhancing oil recovery. In summary, this study highlighted conventional ASP flooding using HPAM as the sole polymer and compared it with three formations that used two starch nanoparticles included with HPAM, assessing their impact on charge stability, crystallinity, and recovery rate to emphasize their importance in the oil recovery industry. Starch nanoparticles' benefits and limitations guided further investigation in this study.
  13. Zhang Y, Ren H, Li B, Udin SM, Maarof H, Zhou W, et al.
    Int J Biol Macromol, 2023 Jul 01;242(Pt 2):124829.
    PMID: 37210053 DOI: 10.1016/j.ijbiomac.2023.124829
    Deep eutectic solvents (DESs) composed by amino acids (L-arginine, L-proline, L-alanine) as the hydrogen bond acceptors (HBAs) and carboxylic acids (formic acid, acetic acid, lactic acid, levulinic acid) as hydrogen bond donors (HBDs) were prepared and used for the dissolution of dealkaline lignin (DAL). The mechanism of lignin dissolution in DESs was explored at molecular level by combining the analysis of Kamlet-Taft (K-T) solvatochromic parameters, FTIR spectrum and density functional theory (DFT) calculations of DESs. Firstly, it was found that the formation of new hydrogen bonds between lignin and DESs mainly drove the dissolution of lignin, which were accompanied by the erosion of hydrogen bond networks in both lignin and DESs. The nature of hydrogen bond network within DESs was fundamentally determined by the type and number of functional groups in both HBA and HBD, which affected its ability to form hydrogen bond with lignin. One hydroxyl group and carboxyl group in HBDs provided active protons, which facilitated proton-catalyzed cleavage of β-O-4, thus enhancing the dissolution of DESs. The superfluous functional group resulted in more extensive and stronger hydrogen bond network in the DESs, thus decreasing the lignin dissolving ability. Moreover, it was found that lignin solubility had a closed positive correlation with the subtraction value of α and β (net hydrogen donating ability) of DESs. Among all the investigated DESs, L-alanine/formic acid (1:3) with the strong hydrogen-bond donating ability (acidity), weak hydrogen-bond accepting ability (basicity) and small steric-hindrance effect showed the best lignin dissolving ability (23.99 wt%, 60 °C). On top of that, the value of α and β of L-proline/carboxylic acids DESs showed some positive correlation with the global electrostatic potential (ESP) maxima and minima of the corresponding DESs respectively, indicating the analysis of ESP quantitative distributions of DESs could be an effective tool for DESs screening and design for lignin dissolution as well as other applications.
  14. Chong ASS, Ahmad M, Mohd Harizan NB, Alias H, Iqbal Hussain R, Lateh A, et al.
    Asian Pac J Cancer Prev, 2023 Jun 01;24(6):1923-1929.
    PMID: 37378920 DOI: 10.31557/APJCP.2023.24.6.1923
    OBJECTIVE: The caregivers of children diagnosed with acute lymphoblastic leukaemia (ALL) are believed to experience post-traumatic stress symptoms (PTSS), depression and anxiety. This present study endeavoured to explore the prevalence and predictors of PTSS, depression, and anxiety among the caregivers of children with ALL.

    METHODS: Purposive sampling was used to select the 73 caregivers of children with ALL who participated in this cross-sectional study. The Post-traumatic Stress Disorder Checklist for DSM-5 (PCL-5), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were used to measure psychological distress.

    RESULT: There was a low prevalence (11%) of post-traumatic stress disorder (PTSD) among the participants. Although all the criteria for PTSD were not met, a few post-traumatic symptoms remained, suggesting that PTSS was likely present. Most of the participants reported minimal symptoms of depression (79.5%) and anxiety (65.8%). Anxiety, depression, and ethnicity predicted the PTSS scores (R2 = .77, p =.000). Subsequently, depression predicted the PTSS scores (R2 = 0.42, p =0.000). Participants of 'Other' or 'Indigenous' ethnicity had lower PTSS scores and higher anxiety scores (R2 = 0.75, p =0.000) than participants of Malay ethnicity.

    CONCLUSION: The caregivers of children with ALL experience post-traumatic stress symptoms (PTSS), depression, and anxiety. These variables co-exist and may have different trajectories in different ethnic groups. Therefore, healthcare providers should take ethnicity and psychological distress into consideration when providing paediatric oncology treatment and care.

  15. Chow KS, Mat-Isa MN, Bahari A, Ghazali AK, Alias H, Mohd-Zainuddin Z, et al.
    J Exp Bot, 2012 Mar;63(5):1863-71.
    PMID: 22162870 DOI: 10.1093/jxb/err363
    The cytosolic mevalonate (MVA) pathway in Hevea brasiliensis latex is the conventionally accepted pathway which provides isopentenyl diphosphate (IPP) for cis-polyisoprene (rubber) biosynthesis. However, the plastidic 2-C-methyl-D-erythritol 4-phosphate (MEP) pathway may be an alternative source of IPP since its more recent discovery in plants. Quantitative RT-PCR (qRT-PCR) expression profiles of genes from both pathways in latex showed that subcellular compartmentalization of IPP for cis-polyisoprene synthesis is related to the degree of plastidic carotenoid synthesis. From this, the occurrence of two schemes of IPP partitioning and utilization within one species is proposed whereby the supply of IPP for cis-polyisoprene from the MEP pathway is related to carotenoid production in latex. Subsequently, a set of latex unique gene transcripts was sequenced and assembled and they were then mapped to IPP-requiring pathways. Up to eight such pathways, including cis-polyisoprene biosynthesis, were identified. Our findings on pre- and post-IPP metabolic routes form an important aspect of a pathway knowledge-driven approach to enhancing cis-polyisoprene biosynthesis in transgenic rubber trees.
  16. Alauddin H, Mohamad Nasir S, Ahadon M, Raja Sabudin RZ, Ithnin A, Hussin NH, et al.
    Malays J Pathol, 2015 Dec;37(3):287-92.
    PMID: 26712677
    Haemoglobin (Hb) Lepore is a variant Hb consisting of two α-globin and two δβ-globin chains. In a heterozygote, it is associated with clinical findings of thalassaemia minor, but interactions with other haemoglobinopathies can lead to various clinical phenotypes and pose diagnostic challenges. We reported a pair of siblings from a Malay family, who presented with pallor and hepatosplenomegaly at the ages of 21 months and 14 months old. The red cell indices and peripheral blood smears of both patients showed features of thalassaemia intermedia. Other laboratory investigations of the patients showed conflicting results. However, laboratory investigation results of the parents had led to a presumptive diagnosis of compound heterozygote Hb Lepore/β-thalassaemia and co-inheritance α+-thalassaemia (-α3.7). Hb Lepore has rarely been detected in Southeast Asian countries, particularly in Malaysia. These two cases highlight the importance of family studies for accurate diagnosis, hence appropriate clinical management and genetic counseling.
  17. Alauddin H, Kamarudin K, Loong TY, Azma RZ, Ithnin A, Jalil N, et al.
    Hemoglobin, 2018 Jul;42(4):247-251.
    PMID: 30623696 DOI: 10.1080/03630269.2018.1528985
    Nondeletional α-globin mutations are known to cause more serious clinical effects than deletional ones. A rare IVS-I-1 (G>A) (HBA2: c.95+1G>A) donor splice site mutation interferes with normal splicing of pre mRNA and results in activation of a cryptic splice site as well as a frameshift mutation. Hb Adana [HBA2: c.179G>A (or HBA1)] is a highly unstable variant hemoglobin (Hb) resulting from a mutation at codon 59 on the HBA2 or HBA1 gene, recognized to cause severe α-thalassemia (α-thal) syndromes. We report a unique case of compound heterozygosity for these two mutations in a 9-year-old boy who presented with a Hb level of 5.3 g/dL and hepatomegaly at the age of 15 months. He required regular blood transfusions in view of a Hb level of <7.0 g/dL and failure to thrive. He had thalassemic red cell indices and peripheral blood film. The Hb electrophoresis only showed a raised Hb F level (3.3%) and a pre run peak but the Hb H inclusion test was negative. His father had thalassemic red cell indices but a normal Hb level. His mother had almost normal Hb levels and red cell indices. Hb Adana involving the HBA2 gene was detected by mutiplex amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) in the proband and his father. DNA sequencing of the HBA2 gene confirmed the IVS-I-1 mutation in the proband and his mother. This case highlighted the unique interaction of the IVS-I-1 mutation with Hb Adana in a young Malay boy presenting with transfusion-dependent α-thal.
  18. Wong LP, Alias H, Choy SH, Goh XT, Lee SC, Lim YAL, et al.
    Zoonoses Public Health, 2020 05;67(3):263-270.
    PMID: 31927794 DOI: 10.1111/zph.12681
    Malaysia is a non-endemic country for hepatitis E virus (HEV) infection. However, seroprevalence as high as 50% among samples of aboriginal people were reported over two decades ago. A total of 207 samples collected from seven aboriginal villages in rural settlements across two states in Malaysia were analysed for anti-HEV IgG and IgM by an enzyme-linked immunoassay. Following the detection of anti-HEV seroprevalence, we organized health outreach to inform and educate the community. Qualitative interviews were conducted with individuals tested positive for anti-HEV antibodies. Data derived from interviews and observations were used to investigate possible lifestyle behaviours associated with HEV infection. Anti-HEV IgG was detected in six samples (5.9%) from the village of Dusun Kubur. Qualitative inquiry and observation study revealed poor dietary and household hygiene, contaminated food and water, contact with animal faeces, unsanitary and domestic waste disposal, and wildlife reservoirs could be the contributing factors for transmission and acquisition of HEV infection. Investigation during health outreach is important to provide insights for future empirical research and implementation for improvement of lifestyle behaviours among the aborigines. Managing the risk of HEV infection in the aborigines may reduce the risk of HEV transmission to the local communities.
  19. Lau SC, Azim E, Abdul Latiff Z, Syed Zakaria SZ, Wong SW, Wu LL, et al.
    Med J Malaysia, 2018 12;73(6):382-387.
    PMID: 30647208
    INTRODUCTION: A smooth transition of healthcare for young people with chronic illnesses from paediatric to adult healthcare services is important to ensure optimal outcome. At the moment, there are no standard guidelines to assess a patient's readiness to transfer care.

    METHODS: A cross-sectional study using a self-administered questionnaire, adapted from UNC (University of North Carolina) TRxANSITION self-assessment tool was conducted to evaluate patients' transition care readiness in paediatric haematology and paediatric diabetes clinic.

    RESULTS: A total of 80 patients (37 thalassaemia and 43 diabetes) with the mean age of 21.2 (SD±4.3) years, were recruited during the 3-month study period. Majority of the patients have basic knowledge regarding their medications, and were able to comply with their follow-up. The mean total score obtained by the respondents on this questionnaire was 15.3 (SD±3.59). Self-management skills and knowledge on disease were the two poorly scored section; with mean score of 3.78 (SD±1.38) and 4.28 (SD±1.20) respectively. Overall, only 21 (26.2%) respondents obtained high score (score above 75th percentile). Seventy-five percent of the respondents admitted that they were not ready for transfer to an adult healthcare service yet at the time of the study.

    CONCLUSION: We suggest that patients with high score should be prepared for transition to adult facility whereas those with a low score need to be identified to ensure provision of continuous education.
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