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Effect of vitamin E on periodontitis: Evidence and proposed mechanisms of action

Shadisvaaran S, Chin KY, Shahida MS, Ima-Nirwana S, Leong XF

J Oral Biosci, 2021 06;63(2):97-103.
PMID: 33864905 DOI: 10.1016/j.job.2021.04.001

BACKGROUND: Periodontitis is a noncommunicable inflammatory disease of the soft tissue and bone surrounding the teeth in the jaw, which affects susceptible individuals with poor oral hygiene. A growing interest has been seen in the use of dietary supplements and natural products for the treatment and prevention of periodontitis. Vitamin E consists of two major groups, namely tocopherols and tocotrienols, which are botanical lipophilic compounds with excellent anti-inflammatory and antioxidant properties.
HIGHLIGHT: This review aimed to summarize the preclinical and clinical findings on the effects of vitamin E on periodontitis. The current literature suggests that vitamin E could improve the periodontal status by correcting redox status imbalance, reducing inflammatory responses, and promoting wound healing, thus highlighting the potential of vitamin E in the management of periodontitis.
CONCLUSION: Direct evidence for the use of vitamin E supplementation or treatment of periodontitis in humans is still limited. More well-designed and controlled studies are required to ascertain its effectiveness.
Islamic moral judgement on abortion and its nursing applications: expository analysis

Mohamad Ismail MF, Abdullahi Hashi A, Bin Nurumal MS, Bin Md Isa ML

Enferm Clin, 2018 Feb;28 Suppl 1:212-216.
PMID: 29650189 DOI: 10.1016/S1130-8621(18)30070-6

Health workers, like nurses are tasked to save the lives of their patients, however, there are instances in which health workers have to deal with difficult cases in taking a life, such as abortion. Scholars in the field of healthcare assert that abortion is morally justified if it is sought for health reasons. Nevertheless, there are a number of cases in which abortion is sought on other grounds other than health, such as the individual choice to do so. Can a nurse refuse to provide their professional service towards these people? This paper uses analytical and comparative methods to address ethical issues in abortion from the Islamic and conventional perspectives. Nursing implication: Since the nurses instruct and assist people in forming a decision as they engage in nursing care, utilising a comprehensive view of abortion based on Islamic sources would provide a foundation in Muslim perspectives as they interact with Muslim patients. The subject area to investigate the degree of knowledge among nurses regarding the Islamic moral judgement on this event is extremely recommended for future management.
Impact of increased digital use and internet gaming on nursing students' empathy: A cross-sectional study

Lee WL, Rambiar PNIMS, Rosli NQB, Nurumal MS, Abdullah SSS, Danaee M

Nurse Educ Today, 2022 Dec;119:105563.
PMID: 36150294 DOI: 10.1016/j.nedt.2022.105563

BACKGROUND: The COVID-19 restrictions and quarantines had led to increased dependence and usage of digital devices for various human activities and internet gaming to the extent of risking vulnerable individuals to develop addiction towards it. Little is known on such risks among populations of nursing students and its impact on their empathy skills or trait.
OBJECTIVE: Determining the impact of digital use and internet gaming on empathy of nursing students undergoing remote learning during closure of learning institutions nationwide.
DESIGN: Cross-sectional online survey was conducted from October to December 2020.
SETTINGS: Two established public institutions located in Malaysia.
PARTICIPANTS: A total of 345 nursing students pursuing diploma and bachelor nursing programs.
METHODS: Toronto Empathy Questionnaire (TEQ), Digital Addiction Scale (DAS) and Internet Gaming Disorder Scale-Short form (IGDS9-SF) were self-administered via Google Form™. Following principal component analysis of TEQ using IBM-SPSS™ (V-27), path analyses was performed using SmartPLS™ (V-3).
RESULTS: Despite the increased time spent on digital devices (∆ 2.8 h/day) and internet gaming (∆ 1 h/week) before and during the pandemic, the proportion of high digital users (1.4 %) and gamers (20.9 %) were low; and sizable ≈75 % had higher-than-normal empathy. Digital-related emotions and overuse of them were associated with lower empathy (β = -0.111, -0.192; p values < 0.05) and higher callousness (β = 0.181, 0.131; p values < 0.05); internet gaming addiction predicted callousness (β = 0.265, p
Fulltext Behavioral interventions to improve self-management in Iranian adults with type 2 diabetes: a systematic review and meta-analysis

Azami G, Soh KL, Sazlina SG, Salmiah MS, Aazami S

J Diabetes Metab Disord, 2018 Dec;17(2):365-380.
PMID: 30918872 DOI: 10.1007/s40200-018-0376-0

PURPOSE: The aim of this study was to systematically-review published experimental studies to determine the effectiveness of behavioral interventions on self-management in Iranian adults with type 2 diabetes.
METHOD: Pub Med, Web of Science, Science Direct, Ovid Medline, EBSCO, ProQuest, Google Scholar, and the Scientific Information Database (SID) were searched for English and Persian language studies published between 2009 and 2017. The primary outcome of this review was to assess the effects of behavioral interventions on glycosylated hemoglobin. Changes in the blood pressure, Lipid profiles, BMI, Self-efficacy, knowledge, attitude, practice, Self-care behaviors, social support, anxiety, and depression were the secondary outcomes.
RESULTS: Comprehensive search procedures resulted in twenty-three experimental studies with 2208 participants. Eleven studies were included in the Meta-analysis. Compared with the control group, behavioral interventions significantly lower glycosylated hemoglobin -0.61% (95% CI -0.80, -0.41). To explore the effects of the study intervention (regarding what aspects of the intervention are most effective), we then conducted a stratified analysis for HbA1c. Larger effects were found in interventions with a longer duration and higher intensity, delivered in the group format, interventions offered to individuals with higher baseline HbA1c, and interventions delivered by a multidisciplinary team. Moreover, behavioral interventions were effective in improving blood glucose, lipid profiles, knowledge, attitude, practice, self-efficacy, quality of life, and self-care.
CONCLUSION: In line with other behavioral studies, our study shows that behavioral interventions improve self-management in Iranian adults with type 2 diabetes.
An evaluation of digital intervention for perinatal depression and anxiety: A systematic review

Arifin SRM, Kamaruddin A, Muhammad NA, Nurumal MS, Mohadis HM, Hussain NHN, et al.

AIMS Public Health, 2024;11(2):499-525.
PMID: 39027400 DOI: 10.3934/publichealth.2024025

Digital intervention has been shown to be helpful in improving perinatal mental health. However, the design characteristics of such interventions have not been systematically reviewed. Considering that a lack of support-especially from a partner-is one of the major contributing factors to perinatal depression and anxiety, it is crucial to determine whether digital interventions have included partner participation. In this review, we systematically examined the design characteristics of digital interventions related to perinatal depression and anxiety and aimed to determine whether partner participation was incorporated as part of the interventions. Based on the PRISMA 2020 guidelines, five databases (PubMed, EBSCO, Cochrane, ProQuest, and Scopus) were searched. Narrative results of design characteristics were developed to provide a framework for the design and evaluation of the studies. A total of 12 intervention studies from China, Sweden, Australia, New Zealand, Singapore, Norway, and the United Kingdom were included. Across all studies, internet cognitive behavioral therapy and mindfulness therapy were overwhelmingly utilized as the major intervention approaches. While all studies reported reduced depressive symptoms after the intervention, only four studies reported subsequent decreased levels of both depressive and anxiety symptoms. Only one study included partner support in the intervention. Cognitive behavioral therapy and mindfulness therapy, two of the most common intervention approaches, were found to be effective in alleviating perinatal depression and anxiety. Partner participation should be prioritized in designing digital interventions to ensure comprehensive and easily accessible social support for persons in need.
Fulltext A subcritical water extract of soil grown Zingiber officinale Roscoe: Comparative analysis of antioxidant and anti-inflammatory effects and evaluation of bioactive metabolites

Razak AM, Zakaria SNA, Abdul Sani NF, Ab Rani N, Hakimi NH, Mohd Said M, et al.

Front Pharmacol, 2023;14:1006265.
PMID: 36843947 DOI: 10.3389/fphar.2023.1006265

Introduction: Ginger (Zingiber officinale Roscoe) can scavenge free radicals, which cause oxidative damage and inflamm-ageing. This study aimed to evaluate the antioxidant and anti-inflammatory effects of soil ginger's sub-critical water extracts (SWE) on different ages of Sprague Dawley (SD) rats. The antioxidant properties and yield of SWE of soil- and soilless-grown ginger (soil ginger and soilless ginger will be used throughout the passage) were compared and evaluated. Methods: Three (young), nine (adult), and twenty-one (old) months old SD rats were subjected to oral gavage treatments with either distilled water or the SWE of soil ginger at a concentration of 200 mg/kg body weight (BW) for three months. Results: Soil ginger was found to yield 46% more extract than soilless ginger. While [6]-shogaol was more prevalent in soilless ginger, and [6]-gingerol concentration was higher in soil ginger (p < 0.05). Interestingly, soil ginger exhibited higher antioxidant activities than soilless ginger by using 2,2-diphenyl-1-(2,4,6-trinitrophenyl) hydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) assay. With ginger treatment, a reduced levels of tumour necrosis factor-α (TNF-α) and C-reactive protein (CRP) but not interleukin-6 (IL-6) were observed in young rats. In all ages of SD rats, ginger treatment boosted catalase activity while lowering malondialdehyde (MDA). Reduction of urine 15-isoprostane F2t in young rats, creatine kinase-MM (CK-MM) in adult and old rats and lipid peroxidation (LPO) in young and adult rats were also observed. Discussion: The findings confirmed that the SWE of both soil and soilless grown ginger possessed antioxidant activities. Soil ginger produced a higher yield of extracts with a more prominent antioxidant activity. The SWE of soil ginger treatment on the different ages of SD rats ameliorates oxidative stress and inflammation responses. This could serve as the basis for developing a nutraceutical that can be used as a therapeutic intervention for ageing-related diseases.
Fulltext Polymer-Based MEMS Electromagnetic Actuator for Biomedical Application: A Review

Yunas J, Mulyanti B, Hamidah I, Mohd Said M, Pawinanto RE, Wan Ali WAF, et al.

Polymers (Basel), 2020 May 22;12(5).
PMID: 32455993 DOI: 10.3390/polym12051184

In this study, we present a comprehensive review of polymer-based microelectromechanical systems (MEMS) electromagnetic (EM) actuators and their implementation in the biomedical engineering field. The purpose of this review is to provide a comprehensive summary on the latest development of electromagnetically driven microactuators for biomedical application that is focused on the movable structure development made of polymers. The discussion does not only focus on the polymeric material part itself, but also covers the basic mechanism of the mechanical actuation, the state of the art of the membrane development and its application. In this review, a clear description about the scheme used to drive the micro-actuators, the concept of mechanical deformation of the movable magnetic membrane and its interaction with actuator system are described in detail. Some comparisons are made to scrutinize the advantages and disadvantages of electromagnetic MEMS actuator performance. The previous studies and explanations on the technology used to fabricate the polymer-based membrane component of the electromagnetically driven microactuators system are presented. The study on the materials and the synthesis method implemented during the fabrication process for the development of the actuators are also briefly described in this review. Furthermore, potential applications of polymer-based MEMS EM actuators in the biomedical field are also described. It is concluded that much progress has been made in the material development of the actuator. The technology trend has moved from the use of bulk magnetic material to using magnetic polymer composites. The future benefits of these compact flexible material employments will offer a wide range of potential implementation of polymer composites in wearable and portable biomedical device applications.
Subclinical memory dysfunction in Malaysian systemic lupus erythematosus patients: Association with clinical characteristics and disease activity – A pilot study

Mohd Said MS, Bin Shudim SS, Mohamad K, Shaharir SS, Kong NCT, Ali RA

Egyptian Rheumatologist, 2016;38:189-194.
DOI: 10.1016/j.ejr.2015.12.001

Aim of the work This work aimed to determine the frequency of subclinical memory dysfunction in a group of Malaysian systemic lupus erythematosus (SLE) patients and to study its relation to clinical characteristics, laboratory investigations and disease activity. Patients and methods Fifteen SLE patients attending the Universiti Kebangsaan Malaysia Medical Centre (UKMMC) and not known to have neuropsychiatric lupus were recruited. These patients were assessed using the Wechsler Memory Scale. Disease activity was assessed using the SLE disease activity index 2000 (SLEDAI-2K). Results The median age of the patients was 28 years (25–37 years) and they were 14 females and one male. Their median disease duration was 9.3 years (4.8–10 years). Their median SLEDAI-2K was 4 (0–6). Memory dysfunction was identified in 7/15 (46.7%) SLE patients and was significantly associated with lower serum thyroxine levels (median 12.27; 11.8–13.3 μg/dl) (p = 0.027) compared to those without memory impairment (15.48; 14.39–16.56 μg/dl). Auditory memory impairment was associated with the education level as the auditory memory index was significantly lower in patients with secondary education (n = 7, median 88; 86.5–91.5) compared to those who received tertiary education (n = 8, median 103; 97.5–119.5) (p = 0.025) while visual memory was influenced by disease duration (p = 0.016). There was no association between overall memory dysfunction and disease duration, number of relapses, clinical manifestations and SLEDAI-2K scores. Conclusion There is a high frequency of subclinical memory dysfunction among SLE patients. A remarkable association is present with lower thyroxine. Auditory memory impairment is related to the level of education and visual memory to disease duration. © 2015 The Authors
Fulltext The knowledge, ability, and skills of primary health care providers in SEANERN countries: a multi-national cross-sectional study

Du S, Cao Y, Zhou T, Setiawan A, Thandar M, Koy V, et al.

BMC Health Serv Res, 2019 Aug 27;19(1):602.
PMID: 31455377 DOI: 10.1186/s12913-019-4402-9

BACKGROUND: Primary health care (PHC) is usually the initial point of contact for individuals seeking to access health care and providers of PHC play a crucial role in the healthcare model. However, few studies have assessed the knowledge, ability, and skills (capacity) of PHC providers in delivering care. This study aimed to identify the capacity of PHC providers in countries of the Southeast and East Asian Nursing Education and Research Network (SEANERN).
METHODS: A multi-national cross-sectional survey was performed among SEANERN countries. A 1-5 Likert scale was used to measure eight components of knowledge, ability, and skill of PHC providers. Descriptive statistics were employed, and radar charts were used to depict the levels of the three dimensions (knowledge, skill and ability) and eight components.
RESULTS: Totally, 606 valid questionnaires from PHC providers were returned from seven countries of SEANERN (China, Myanmar, Indonesia, Thailand, Vietnam, Cambodia, and Malaysia), with a responsive rate of 97.6% (606/621). For the three dimensions the ranges of total mean scores were distributed as follows: knowledge dimension: 2.78~3.11; skill dimension: 2.66~3.16; ability dimension: 2.67~3.06. Furthermore, radar charts revealed that the transition of PHC provider's knowledge into skill and from skill into ability decreased gradually. Their competencies in four areas, including safe water and sanitation, nutritional promotion, endemic diseases prevention, and essential provision of drugs, were especially low.
CONCLUSIONS: The general capacity perceived by PHC providers themselves seems relatively low and imbalanced. To address the problem, SEANERN, through the collaboration of the members, can facilitate the appropriate education and training of PHC providers by developing feasible, practical and culturally appropriate training plans.
Knowledge and Attitudes of Maintaining Bone Health among Post-Menopausal Women in Malaysia

Mohd Hatta NNKN, Nurumal MS, Isa MLM, Daud A, Ibrahim M, Sharifudin MA, et al.

Cent Asian J Glob Health, 2019;8(1):348.
PMID: 32002313 DOI: 10.5195/cajgh.2019.348

Introduction: Public awareness of osteoporosis is low among women in the developing countries. Health education was shown to be effective in improving knowledge and awareness on maintaining bone health. This study aims to identify the level of knowledge and attitudes among post-menopausal women in Malaysia on achieving bone health throughout the menopausal transition period.
Methods: A total of 116 post-menopausal female patients of orthopedic menopause clinic were recruited using a purposive sampling approach. Data on osteoporosis awareness and knowledge were collected using validated structured questionnaires Osteoporosis Prevention and Awareness Tool and Osteoporosis Attitude Knowledge Test. The chi-square test was used to determine the association between post-menopausal women's socio-demographic characteristics and their knowledge and attitude towards maintaining bone health.
Results: Participants' age ranged between 49 and 82 years (61.84, SD=7.87). The knowledge of osteoporosis varied significantly by age (p=0.014) and education (p=0.001) among the studied population. No significant diffrences were found for participants' attitude towards bone health.
Conclusion: This study showed that the age and education levels have significantly different knowledge of bone health.
Fulltext Malaysia Health System Review

Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al.

ISBN: 978-92-9061-584-2

Citation: Jaafar S, Mohd Noh K, Abdul Muttalib K, Othman NH, Healy J, Maskon K, et al. Malaysia Health System Review. Geneva: World Health Organization; 2013

Malaysia is a federation of 13 states and 2 territories in a parliamentary democracy, with the Prime Minister the head of government and a constitutional monarch elected by the Sultans. Malaysia is a multicultural society and a secular state with Sunni Islam as the official religion. Classified by the World Bank as an upper middle-income country, its society and economy were transformed by rapid economic growth in the latter half of the 20th century. Malaysia’s population (now numbering over 28 million with 70% living in urban areas) has benefited from a well developed health care system, good access to clean water and sanitation, and strong social and economic programmes. Life expectancy at birth is 73 years. Noncommunicable diseases now account for most mortality and morbidity but communicable diseases remain a concern. Section 2 describes the organization and governance of the health system. Health care services consist of tax-funded and governmentrun primary health care centres and hospitals, and fast-growing private services mainly located in physician clinics and hospitals in urban areas. Public sector health services are administered by the Ministry of Health through its central, state and district offices. The Ministry of Health regulates the private sector, pharmaceutical industry and food safety and plans and regulates its own health care services. Legislation governing health care professionals requires them to register with statutory professional bodies. Section 3 reports on health care financing. Malaysia’s public health system is financed mainly through general revenue and taxation collected by the federal government, while the private sector is funded principally through out-of-pocket payments from patients and some private health insurance. Spending on health reached 4.6% of GDP in 2009 with the majority from public spending, reaching 56% of total health expenditure (THE) in 2009. The main sources of THE in 2008 were the Ministry of Health (42%), followed by household out-of-pocket expenditure at nearly 34%. The Ministry of Health funds public facilities through line item budgets and patients pay private physicians and private hospitals on a fee-for-service basis. Physical and human resources are described in Section 4. The number of public primary care facilities (currently 802 centres and over 2000 small community clinics) and dental clinics were expanded steadily in earlier decades, particularly to reach people in under-served rural areas. Secondary care is offered in smaller public hospitals and more complex tertiary care, in regional and national hospitals (including university teaching hospitals run by the Ministry of Higher Education). Growth has slowed in recent years, however, and public services in urban areas have not kept pace with rapid urbanization, while the population ratio of hospital beds has declined slightly. Private clinics and hospitals in urban areas have grown rapidly over the last decade. The supply of health professionals remains seriously below the required number, although the government has increased the number of training places. Section 5 looks at provision of services. National health policies stress public health and health promotion, that is, ‘a wellness’ as well as a ‘disease’ perspective. The Ministry of Health has developed an extensive network of public primary care centres and also dental services especially for children, but these services are under strain and have staff shortages, so patients often encounter long waits. Primary care exerts only a limited gatekeeper function since people can bypass a referral from a general practitioner and for a small additional fee (if in the public sector) can go directly to specialists and hospitals. Government services increasingly serve the poor and private services the better-off people who live in urban areas. Hospital policy currently has three main thrusts: strengthening specialty care in large public hospitals; increasing the number of day surgery centres; and expanding top-end private hospital care to cater to the medical tourism market (with 35 participating hospitals in 2010). Malaysia has a large pharmaceutical manufacturing sector that exports to other countries and also supplies 30% of domestic demand. The principal health care reforms are discussed in Section 6. The government has stepped up its surveillance and early response to infectious disease outbreaks as a result of recent pandemics such as SARS and avian flu, which had a major impact on the country’s economy. The Ministry of Health has maintained its extensive vaccination programmes, has consolidated its primary health care clinics and upgraded its hospitals, and is slowly introducing information communication technology into its public facilities. The government has increased training places to counter shortages of health professionals, has strengthened food and drug safety regulation, is considering price xv regulation of pharmaceuticals, and is positioning the country as a medical tourism destination. Section 7 provides an assessment of the health system. Malaysia has a strong population health tradition and well-established and extensive health care services. Although total health expenditure at 4.6% of GDP in 2008 is in the range for middle-income countries, the government is concerned about future sustainable financing. Successive administrators have prioritized the provision of cost-effective, preventative and mainly free primary health care in public clinics. The rapid growth of private health care means that private spending has risen faster than public spending, including out-of-pocket payments by the public, with the government share (from general revenue) just above half (56%) of health expenditure in 2009. In conclusion, Malaysia has achieved impressive health gains for its population with a low-cost health care system funded through general revenue that provides universal and comprehensive services. Like many other countries in the region, Malaysia has struggled to produce an adequate supply of health professionals, and to integrate and regulate its rapidly growing private health sector. Public services have not kept pace with population growth in urban areas and those with higher purchasing power use private rather than public doctors and hospitals, which leaves the public sector with more poorer and sicker patients. The Malaysian Government recently revived the debate over options for a national social health insurance scheme. The financing challenge is to agree on a scheme for fair and sustainable funding and its respective contributions from general revenue and private payments. The regulatory challenge for the Malaysian Government is to strengthen its governance of both public and private health services in order to ensure high quality and safe services and fair charges. The structural challenge is to determine the balance between public and private sector delivery and to engage in a more productive partnership between public and private sectors. The administrative challenge is to consider whether the community would be better served by more decentralized and responsive services. As Malaysia seeks to attain high income country status, and as demographic and epidemiological transitions continue and new technology expands the possibilities for intervention, the demand for xvi health care by the population will continue to rise. The government will need to address growing concerns about equity, efficiency and budgetary constraints and balance conflicting policy principles. Pressures are building up for health system reform in Malaysia looking towards the year 2020 and beyond.
A review of the treatment technologies for hexavalent chromium contaminated water

Ramli NN, Kurniawan SB, Ighalo JO, Mohd Said NS, Marsidi N, Buhari J, et al.

Biometals, 2023 May 20.
PMID: 37209220 DOI: 10.1007/s10534-023-00512-x

The toxicity of hexavalent chromium (Cr(VI)) present in the environment has exceeded the current limits or standards and thus may lead to biotic and abiotic catastrophes. Accordingly, several treatments, including chemical, biological, and physical approaches, are being used to reduce Cr(VI) waste in the surrounding environment. This study compares the Cr(VI) treatment approaches from several areas of science and their competence in Cr(VI) removal. As an effective combination of physical and chemical approaches, the coagulation-flocculation technique removes more than 98% of Cr(VI) in less than 30 min. Most membrane filtering approaches can remove up to 90% of Cr(VI). Biological approaches that involve the use of plants, fungi, and bacteria also successfully eliminate Cr(VI) but are difficult to scale up. Each of these approaches has its benefits and drawbacks, and their applicability is determined by the research aims. These approaches are also sustainable and environmentally benign, thus limiting their effects on the ecosystem.
Fulltext Microbial Diversity in Decaying Oil Palm Empty Fruit Bunches (OPEFB) and Isolation of Lignin-degrading Bacteria from a Tropical Environment

Tahir AA, Mohd Barnoh NF, Yusof N, Mohd Said NN, Utsumi M, Yen AM, et al.

Microbes Environ, 2019 Jun 27;34(2):161-168.
PMID: 31019143 DOI: 10.1264/jsme2.ME18117

Oil palm empty fruit bunches (OPEFB) are the most abundant, inexpensive, and environmentally friendly lignocellulosic biomass in Malaysia. Investigations on the microbial diversity of decaying OPEFB may reveal microbes with complex enzymes that have the potential to enhance the conversion of lignocellulose into second-generation biofuels as well as the production of other value-added products. In the present study, fungal and bacterial diversities in decaying OPEFB were identified using Illumina MiSeq sequencing of the V3 region of the 16S rRNA gene and V4 region of the 18S rRNA gene. Fungal diversity in decaying OPEFB was dominated by the phylum Ascomycota (14.43%), while most of the bacterial sequences retrieved belonged to Proteobacteria (76.71%). Three bacterial strains isolated from decaying OPEFB, designated as S18, S20, and S36, appeared to grow with extracted OPEFB-lignin and Kraft lignin (KL) as the sole carbon source. 16S rRNA gene sequencing identified the 3 isolates as Paenibacillus sp.. The molecular weight distribution of KL before and after degradation showed significant depolymerization when treated with bacterial strains S18, S20, and S36. The presence of low-molecular-weight lignin-related compounds, such as vanillin and 2-methoxyphenol derivatives, which were detected by a GC-MS analysis, confirmed the KL-degrading activities of isolated Paenibacillus strains.
Fulltext From darkness, a light shall spring: Zero-fluoroscopic ablation of supraventricular tachycardia in a pregnant lady

Mohd Said MR, Gian Singh SS, Lee KT, Khor LM, Chea CY, Silveraju AR, et al.

J Arrhythm, 2021 Feb;37(1):251-253.
PMID: 33664912 DOI: 10.1002/joa3.12485

Our case illustrated zero-fluoroscopic approach on AVNRT ablation in a pregnant lady.
Fulltext Achieving cervical cancer elimination: The simulated impacts of HPV vaccination and transitioning from liquid-based cytology to HPV-based screening test

Balqis-Ali NZ, Anis-Syakira J, Fun WH, Mohd Said Z, Abdul Samad S, Zainal Abidin N, et al.

PLoS One, 2024;19(7):e0307880.
PMID: 39052665 DOI: 10.1371/journal.pone.0307880

The Ministry of Health Malaysia aims to fully replace liquid-based cytology (LBC) with Human Papillomavirus (HPV) tests and increase the screening coverage from a baseline of 25% to 40% by 2023, followed by a 10% yearly increment until 70% coverage. This transition requires proper planning, including the number of tests needed and budget allocation. This study aims to simulate different transition strategies involving the shift from LBC to HPV testing with expanded screening coverage to predict their impact on cervical cancer elimination in Malaysia. A system dynamics model was developed to simulate the transition from LBC to HPV testing and HPV vaccination coverage in Malaysia. The dynamic model utilised local epidemiological data, published research, and expert opinion when data was unavailable. The simulation showed that a combination of high HPV vaccination coverage and transitioning fully to five-yearly HPV testing by 2030, coupled with a 70% screening uptake by 2040, would accelerate cancer elimination in Malaysia by 18 years with an estimated screening cost of MYR1.81 billion equivalent to USD 411 millions compared to the baseline of using LBC as the primary screening method (MYR1.39 billion, USD 315 millions). Sustained, it would lead to averting 6,000 new cancer cases by 2070. Alternatively, conducting HPV screenings twice before age 50 would advance cervical cancer elimination by 14 years and prevent approximately 1000 new cases by 2070, with an estimated cost of MYR1.13 billion equivalent to USD 257 millions. A delay in achieving the full transition prolonged the elimination more than a delay in increasing the screening coverage. In all scenarios, yearly vaccination of 90% of girls age 13 is crucial to achieving elimination. In the Malaysian context, where HPV vaccination coverage has reached considerable levels, the evidence advocates for a full transition from LBC to HPV testing, ideally by 2030. While expanding screening coverage remains a critical factor in this endeavour, the findings unequivocally endorse prioritising the transition process. Trial registration: Trial registration number: NMRR ID-22-00187-DJU.
Fulltext Investigation of the key determinants of Asian nurses' quality of life

Makabe S, Kowitlawakul Y, Nurumal MS, Takagai J, Wichaikhum OA, Wangmo N, et al.

Ind Health, 2018 Jun 01;56(3):212-219.
PMID: 29491251 DOI: 10.2486/indhealth.2017-0066

The study aimed to compare nurses' quality of life and investigate key determinants among Asian countries with different economic status. A cross-sectional survey was conducted across five Asian countries (Japan, Singapore, Malaysia, Thailand, and Bhutan). Quality of life (WHOQOL-BREF), job stress (National Institute of Occupational Safety and Health questionnaire), and demographic data were assessed. Stepwise multivariate linear regression analysis was performed to identify the key determinants of quality of life. Participants were 3,829 nurses (response rate: 82%) with a mean age of 33 ± 10 yr and majority were women (92%). Regarding quality of life, Bhutan yielded the highest scores, followed by Malaysia, Thailand, Singapore, and Japan, and these results were statistically significant. The key determinants that were significantly related to quality of life were "stress coping ability," "life satisfaction," "Japan," "social support," "job stress," and "Singapore" (adjusted R2=0.46). In conclusion, nurses' quality of life differs across Asian countries and is not linked to the country's economic development. To maintain a good quality of life for nurses, an international exchange program like international nursing conferences for work environment and staff coping strategies is recommended to broaden institution' minds and share experiences and exchange views to be able to realize their own problems and discover global solutions to them.
The rate of blood culture contamination and common organisms isolated in Malaysian public hospitals

Mokhtar NA, Ting SY, Zainol Abidin NZ, Abdul Hameed A, Mohamed Z, Mustapa NI, et al.

Malays J Pathol, 2024 Aug;46(2):307-314.
PMID: 39207008

INTRODUCTION: Blood culture contamination remains a dilemma issue in the diagnosis of bloodstream infection. However, to date, there is no national data on blood culture contamination and the common organism isolated in Malaysia. This is a pioneer multi-centre study involving public hospitals with medical microbiologists in Malaysia to determine the blood culture contamination rate and the common organism isolated.
MATERIALS AND METHODS: This retrospective cross-sectional study involved record review of all blood culture results over 9 months period from 1st January 2018 until 30th September 2018 in 27 government hospitals in Malaysia. For each positive culture result, the type of isolated organism was classified to represent true bacteraemia or contamination.
RESULTS: We analysed 448,109 blood culture records from the participating hospitals. The blood culture positivity rate was 12.5% (57395 of 448109) and 25.0% (14367 of 57395) of the positive blood culture represents contamination. The national blood culture contamination rate in Malaysia was 3.2%. The contamination rate in the adult population was significantly higher than the paediatric population (3.6% vs. 2.6%; p<0.001). The blood contamination rate by institution ranged from 1.5% to 6.8%. The most frequently isolated microorganisms in the contaminated cultures were coagulase-negative staphylococci (71.0%).
CONCLUSION: Blood culture contamination is a major issue that warrants priority in recognition, and interventions should be implemented to reduce the blood contamination rate in Malaysia.
Fulltext Nursing students' and faculty members' experiences of online education during COVID-19 across Southeast Asia: A Photovoice study

Kunaviktikul W, Ang E, Baridwan NS, Bernal AB, Dones LBP, Flores JL, et al.

Nurse Educ Today, 2022 Apr;111:105307.
PMID: 35217457 DOI: 10.1016/j.nedt.2022.105307

BACKGROUND: The COVID-19 pandemic has caused extraordinary disruptions to education systems globally, forcing a rapid switch from conventional to online education. Although some qualitative studies have been carried out exploring the online education experiences of nursing students and faculty members during the COVID-19 pandemic, to our knowledge, no study has used the Photovoice approach.
OBJECTIVES: To explore the experiences of nursing students and faculty members as related to online education during the COVID-19 pandemic.
DESIGN: A descriptive qualitative design using Photovoice was adopted.
SETTING: The study took place across five countries and one city in Southeast Asia (Indonesia, Malaysia, the Philippines, Thailand, Vietnam, and Hong Kong).
PARTICIPANTS: Fifty-two nursing students and twenty-eight nursing faculty members who participated in online education during the COVID-19 pandemic.
METHODS: Each participant submitted one photo substantiated with written reflections. Data were analysed using thematic analysis. Ethical approval was obtained from institution-specific ethics boards.
RESULTS: Three themes and eleven sub-themes emerged from the data. The three main themes were: 1) Psychological roadblocks to online education; 2) Developing resilience despite adversities; and 3) Online education: What worked and what did not.
CONCLUSION: Through Photovoice, the reflections revealed that nursing students and faculty members were generally overwhelmed with the online education experience. At the same time, participants were satisfied with the flexibility and convenience, opportunities for professional and personal development and safety afforded by online education. However, concerns over academic integrity, practical skills and clinical competencies, engagement and participation, the duality of technology and social isolation out-shadowed the advantages. It is worthwhile to explore the concerns raised to enhance online education across the nursing curriculum.
Fulltext Salutogenesis and COVID-19 pandemic impacting nursing education across SEANERN affiliated universities: A multi-national study

Shorey S, Ang E, Baridwan NS, Bonito SR, Dones LBP, Flores JLA, et al.

Nurse Educ Today, 2022 Mar;110:105277.
PMID: 35101809 DOI: 10.1016/j.nedt.2022.105277

BACKGROUND: The COVID-19 pandemic has disrupted the lives of many. Particularly, nursing students experience greater stress as their normal curriculum is interrupted and some of them face the risk of being infected as frontline workers. Nursing faculty members may face similar struggles, in addition to developing teaching materials for online learning. Thus, it is important to examine the faculty members' and students' views on their ability to adapt during the pandemic to obtain a holistic view of how learning and training has been affected.
DESIGN: The descriptive cross-sectional quantitative design was used.
SETTINGS: Data were collected from Southeast and East Asian Nursing Education and Research Network (SEANERN) affiliated nursing institutions from January 2021 to August 2021.
PARTICIPANTS: A total of 1897 nursing students and 395 faculty members from SEANERN-affiliated nursing institutions in Cambodia, Hong Kong, Indonesia, Japan, Laos, Malaysia, Philippines, Singapore, Thailand and Vietnam were recruited for this study.
METHODS: Quantitative surveys were used to explore the satisfaction levels in education modalities, confidence levels, psychosocial well-being, sense of coherence and stress levels of nursing students and faculty members during the COVID-19 pandemic.
RESULTS: Participants were mostly satisfied with the new education modalities, although most students felt that their education was compromised. Both groups showed positive levels of psychosocial well-being, despite scoring low to medium on the sense of coherence scale and experiencing great stress. The participants' sense of coherence was positively correlated with their psychosocial well-being and negatively correlated with stress levels.
CONCLUSIONS: While the COVID-19 pandemic had negatively impacted the lives of nursing students and faculty members, most of them had a healthy level of psychosocial well-being. Having a strong sense of coherence was associated with better psychosocial health and lower stress levels. As such, it may be helpful to develop interventions aimed at improving the sense of coherence of nursing students and staff to help them manage stressors better.
Barriers to implementing a national health screening program for men in Malaysia: An online survey of healthcare providers

Ng CJ, Teo CH, Ang KM, Kok YL, Ashraf K, Leong HL, et al.

Malays Fam Physician, 2020;15(1):6-14.
PMID: 32284799

Introduction: This study aimed to determine the views and practices of healthcare providers and barriers they encountered when implementing the national health screening program for men in a public primary care setting in Malaysia.
Methods: An online survey was conducted among healthcare providers across public health clinics in Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants' socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool.
Results: A total of 231 healthcare providers from 129 health clinics participated in this survey. Among them, 37.44% perceived the implementation of the screening program as a "top-down decision." Although 37.44% found the screening tool for adult men "useful," some felt that it was "time consuming" to fill out (38.2%) and "lengthy" (28.3%). In addition, 'adult men refuse to answer' (24.1%) was cited as the most common patient-related barrier.
Conclusions: This study provided useful insights into the challenges encountered by the public healthcare providers when implementing a national screening program for men. The screening tool for adult men should be revised to make it more user-friendly. Further studies should explore the reasons why men were reluctant to participate in health screenings, thus enhancing the implementation of screening programs in primary care.

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