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Fulltext A scoping review on the relationship between mental wellbeing and medical professionalism

Sattar K, Yusoff MSB, Arifin WN, Mohd Yasin MA, Mat Nor MZ

Med Educ Online, 2023 Dec;28(1):2165892.
PMID: 36621960 DOI: 10.1080/10872981.2023.2165892

BACKGROUND: Mental wellbeing issues among medical students are common, and their relationship to medical professionalism is debated. Few studies have attempted to link such issues with undergraduate medical education. This review aimed to advance the knowledge on this matter by exploring the relationship between mental wellbeing and medical professionalism in undergraduate medical education.
METHODS: We collected the literature about mental wellbeing and medical professionalism (published from 1 January 1986 to 31 March 2021) from the Web of Science, PubMed, Scopus and ScienceDirect databases using the search terms 'mental wellbeing' and 'medical professionalism'.We included all peer-reviewed articles in which mental wellbeing and medical professionalism in the undergraduate medical education context were the central topics regardless of the age range, nationality, race and gender of the participants.
RESULTS: From the 13,076 Iinitially found articles, 16 were included. These 16 articles were from nine countries in four different continents, which all together helped us find answer to our research question using extracted points relating to the main study themes (mental wellbeing and medical professionalism). Under theme 1 (mental wellbeing), six subthemes emerged: burnout, stress, depression, disappointment, depersonalisation and conscientiousness. Theme 2 (medical professionalism), on the other hand, had five subthemes: empathy, academic performance, compassion, unprofessional behaviour and professionalism. A significant inverse association was found between empathy and burnout. Academic performance was also related to burnout. At the same time, empathy was found to have a varied association with stress. Moreover, compassion was found to alleviate burnout and nurture professional gratification.
CONCLUSION: The medical professionalism attributes were found to deteriorate as the mental wellbeing issues grow. This can harm medical students' overall health, current learning abilities and future attitudes towards their patients. Explicit primary research is thus required to examine and intervene in the cause-effect relationship between medical professionalism and mental wellbeing.
Fulltext Prevalence of the metabolic syndrome and its influencing factors among adolescent girls in Mashhad, Iran

Mirhosseini NZ, Yusoff NA, Shahar S, Parizadeh SM, Mobarhen MG, Shakery MT

Asia Pac J Clin Nutr, 2009;18(1):131-6.
PMID: 19329406

Introduction: This study sought to determine the prevalence of the metabolic syndrome, one of the major public-health challenges worldwide, and its influencing factors among 15 to 17 years old adolescent girls in Mashhad, Iran.
Methods: A total of 622 high school adolescents participated in a cross-sectional study. A self-administered questionnaire was used to assess socio-demographic characteristics and dietary habits. Anthropometric assessments, blood pressure measurement and biochemical assessment were done.
Results: Applying BMI Z-score for age and gender (WHO 2007), 14.6 % and 3.4 % of subjects were classified as overweight and obese, respectively. Enlarged WC (> 80 cm) was seen in 9.5% of subjects. The prevalence of combined hypertension was 6.1% which was increased by the severity of obesity. A total of 24.5% of subjects had hypertriglyceridemia and 57% of them had low level of HDL-cholesterol. Hyperglycemia was present in 16.7% of subjects. Based on the NCEP ATP III (2001) criteria, the prevalence of the metabolic syndrome was 6.5% and increased to 45.1% in obese subjects. Increasing BMI or WC, led to significant increment in the number of metabolic syndrome features (p < 0.001). High socioeconomic status of family, medical history of parents and dietary habits especially high consumption of carbohydrates were influencing factors in the prevalence of the metabolic syndrome.
Conclusion: Approximately 6.5% of all and 45% of obese subjects met the criteria for the metabolic syndrome. Dietary habits especially carbohydrate consumption, socioeconomic status of family and medical history of parents can be influential factors in the prevalence of the metabolic syndrome.
Fulltext Understanding the Functional Components of Technology-Enhanced Learning Environment in Medical Education: A Scoping Review

Naeem NI, Yusoff MSB, Hadie SNH, Ismail IM, Iqbal H

Med Sci Educ, 2023 Apr;33(2):595-609.
PMID: 37251205 DOI: 10.1007/s40670-023-01747-6

Increasing use of technology in medical education has caused concerns to medical teachers pertaining to the quality of digital learning environments. Thus, this review aimed to unearth the functional components of effective technology-enhanced learning environment in the undergraduate medical education context. The revised Arksey and O'Malley protocol was utilized that include identification of research question and relevant studies, selection of studies, data charting and collection, and collating, summarizing, and reporting results after consultation. We discovered nine components with 25 subcomponents of 74 functional elements found to be present in effective online learning environments. The nine components include cognitive enhancement, content curation, digital capability, technological usability, pedagogical practices, learner characteristics, learning facilitator, social representations, and institutional support. There is an interplay between these components, influencing each other in online learning platforms. A technology-enhanced learning in medical education (TELEMEd) model is proposed which can be used as a framework for evaluating online learning environment in medical education.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-023-01747-6.
Fulltext Effective Learning Behavior in Problem-Based Learning: a Scoping Review

Ghani ASA, Rahim AFA, Yusoff MSB, Hadie SNH

Med Sci Educ, 2021 Jun;31(3):1199-1211.
PMID: 33903829 DOI: 10.1007/s40670-021-01292-0

Problem-based learning (PBL) emphasizes learning behavior that leads to critical thinking, problem-solving, communication, and collaborative skills in preparing students for a professional medical career. However, learning behavior that develops these skills has not been systematically described. This review aimed to unearth the elements of effective learning behavior in a PBL context, using the protocol by Arksey and O'Malley. The protocol identified the research question, selected relevant studies, charted and collected data, and collated, summarized, and reported results. We discovered three categories of elements-intrinsic empowerment, entrustment, and functional skills-proven effective in the achievement of learning outcomes in PBL.
A Scoping Review of Effective Teaching Strategies in Surface Anatomy

Abu Bakar YI, Hassan A, Yusoff MSB, Kasim F, Abdul Manan Sulong H, Hadie SNH

Anat Sci Educ, 2022 Jan;15(1):166-177.
PMID: 33650315 DOI: 10.1002/ase.2067

To become skilled physicians, medical students must master surface anatomy. However, the study of surface anatomy is less emphasized in medical and allied health science curricula, and the time devoted to direct engagement with the human body is limited. This scoping review was designed to answer one research question: "What are the elements and strategies that are effective in teaching surface anatomy?" The review was performed using a five-stage scoping review framework, including research question identification, relevant study identification, study selection, data charting, and result collating and reporting. Three databases were searched using two search terms combined with a Boolean operator: "teaching" and "surface anatomy." The initial pool of 3,294 sources was assessed for duplication, and study eligibility was evaluated using inclusion and exclusion criteria. Data were abstracted from 26 original articles by one researcher and verified by two other researchers. A thematic analysis was performed, and several elements of effective teaching strategies for surface anatomy were identified, namely contextualized teaching, embracing experiential learning, and learning facilitation. This review revealed that a multimodal approach was most commonly used in surface anatomy instruction. Hence, future research should explore the effectiveness of multimodal teaching strategies that adopt the three aforementioned primary elements of effective teaching in an authentic learning environment. It is pertinent to clarify the effectiveness of these teaching strategies by evaluating their impact on student learning, organizational changes, and benefits to other stakeholders.
Fulltext Scoping Review of frequently highlighted attributes of Medical Professionalism in an Undergraduate Medical Education Context

Sattar K, Yusoff MSB, Arifin WN, Yasin MAM, Nor MZM

Pak J Med Sci, 2021;37(4):1221-1229.
PMID: 34290812 DOI: 10.12669/pjms.37.4.4004

BACKGROUND AND OBJECTIVES: Medical Professionalism (MP) establishes the trust between society and doctors. We aimed at finding frequently highlighted qualities of MP in the literature.
METHODS: We searched PubMed and Scopus for attributes of MP, using terms, "Professionalism," "Medical Students," and "Undergraduate Medical Education". We included English language, original research articles with MP attributes from the perspective of undergraduate medical education, any nationality, race, gender, and age range, as the central topic of the article. Papers published from January 1st 1986 to 29th February 2020 were included.
RESULTS: From 1349 identified articles, finally, 18 were included, authored in 10 countries, collectively contributing to answering the scoping review question. Two themes were identified: (1) Nurturing of MP, 11 (61.11%) out of 18 included articles, highlighted "respect" as the most dominant attribute as it appeared in 6 (54.55%) out of 11 reviews, "communication" 5 (45.45 %) studies and "honesty" and "integrity" 4 (36.36%). (2) Assessment of MP, 7 (38.89%) studies, and majority, 4 (57.14 %) assessed MP using American Board of Internal Medicine's elements of MP, viz, "altruism, accountability, excellence, duty, honor and integrity, respect for others."
CONCLUSIONS: Themes exemplified MP's most discoursed issues. The attributes are frequently used worldwide. MP deliberates as a commitment toward the individual patient, society, and necessitates transforming from its present generic form to more explicit details.
FeCl3 and GdCl3 solutions as superfast relaxation modifiers for agarose gel: a quantitative analysis

Hamzaini NN, Ghazali SA, Yusoff AN, Mohd Zaki F, Wan Sulaiman WNA, Dwihapsari Y

MAGMA, 2025 Feb;38(1):141-160.
PMID: 39666219 DOI: 10.1007/s10334-024-01216-0

OBJECT: This study aimed to evaluate the relaxivity and uniformity of agarose gel phantoms added with relaxation modifiers. It is hypothesized that the modifiers could manipulate the T1 and T2 relaxations as well as the signal uniformity.
MATERIALS AND METHODS: Twenty agarose gel phantoms with different GdCl₃ and FeCl₃ volume fractions were prepared. The phantoms were scanned using a 3-T scanner implementing a turbo spin echo sequence to acquire T1 and T2 images. The SNR of the images were computed using Image-J software from 1, 3, and 25 regions-of-interest (ROIs) and were inverted as T1 and T2 curves.
RESULTS: With the increase in relaxation modifier content, T1 SNR increased at a faster rate at very short TR and reached saturation at TR well below 400 ms. Agarose gel phantoms containing GdCl3 showed a higher saturation value as compared to phantoms containing FeCl3. For T2 SNR, differences between plots are observed at low TE. As TE gets larger, the SNR between plots is incomparable. The SNR for both groups was uniform among 1, 3, and 25 ROIs.
DISCUSSIONS: It can be concluded that GdCl₃ and FeCl₃ solutions can be used as effective relaxation modifiers to reduce T1 but not T2 relaxation times.
Lactobacillus plantarum DR7 alleviates stress and anxiety in adults: a randomised, double-blind, placebo-controlled study

Chong HX, Yusoff NAA, Hor YY, Lew LC, Jaafar MH, Choi SB, et al.

Benef Microbes, 2019 Apr 19;10(4):355-373.
PMID: 30882244 DOI: 10.3920/BM2018.0135

Probiotics have been reported to exert beneficial effects along the gut-brain axis. This randomised, double-blind and placebo-controlled human study aimed to evaluate such properties of Lactobacillus plantarum DR7 and its accompanying mechanisms in stressed adults. One hundred and eleven (n=111; DR7 n=56, placebo n=55) stressed adults were recruited based on moderate stress levels using the PSS-10 questionnaire. The consumption of DR7 (1×109 cfu/day) for 12 weeks reduced symptoms of stress (P=0.024), anxiety (P=0.001), and total psychological scores (P=0.022) as early as 8 weeks among stressed adults compared to the placebo group as assessed by the DASS-42 questionnaire. Plasma cortisol level was reduced among DR7 subjects as compared to the placebo, accompanied by reduced plasma pro-inflammatory cytokines, such as interferon-γ and transforming growth factor-α and increased plasma anti-inflammatory cytokines, such as interleukin 10 (P<0.05). DR7 better improved cognitive and memory functions in normal adults (>30 years old), such as basic attention, emotional cognition, and associate learning (P<0.05), as compared to the placebo and young adults (<30 years old). The administration of DR7 enhanced the serotonin pathway, as observed by lowered expressions of plasma dopamine β-hydroxylase (DBH), tyrosine hydroxylase (TH), indoleamine 2,3-dioxygenase and tryptophan 2,3-dioxygenase accompanied by increased expressions of tryptophan hydroxylase-2 and 5-hydroxytryptamine receptor-6, while stabilising the dopamine pathway as observed via stabilised expressions of TH and DBH over 12 weeks as compared to the placebo (P<0.05). Our results indicated that DR7 fulfil the requirement of a probiotic strain as per recommendation of FAO/WHO and could be applicable as a natural strategy to improve psychological functions, cognitive health and memory in stressed adults.
Fulltext Sociodemographic factors associated with multiple cardiovascular risk factors among Malaysian adults

Ghazali SM, Seman Z, Cheong KC, Hock LK, Manickam M, Kuay LK, et al.

BMC Public Health, 2015;15:68.
PMID: 25636327 DOI: 10.1186/s12889-015-1432-z

BACKGROUND: To determine the prevalence and sociodemographic correlates of multiple risk factors for cardiovascular disease (CVD) among Malaysian adults.
METHODS: We analysed data on 1044 men and 1528 women, aged 24-64 years, participants in the Non Communicable Disease Surveillance 2005/2006, a nationally representative, population-based, cross-sectional study. Prevalence of obesity, high blood pressure, dyslipidaemia, hyperglycemia, physical inactivity, smoking, risky drinking, low vegetable and fruit intake were determined and multivariable logistic regression was used to identify sociodemographic factors associated with having ≥3 of these cardiovascular disease risk factors.
RESULTS: The response rate was 84.6% (2572/3040). Overall, 68.4% (95% CI: 63.2, 73.1) had at least three risk factors. Among men, older age and Indian ethnicity were independently associated with having ≥3 CVD risk factors; while among women, older age, low education, and housewives were more likely to have ≥3 CVD risk factors.
CONCLUSION: The prevalence of cardiovascular risk factors clustering among Malaysian adults is high, raising concerns that cardiovascular disease incidence will rise steeply in the near future if no immediate preventive measures are taken. The current national health education and promotion programmes pertaining to modifiable risk factors can be further improved by taking into account the sociodemographic variation in CVD risk factors clustering.
Study name: Malaysia Non-Communicable Disease Surveillance-1 (MyNCDS-1) survey.
Fulltext CD4+CD25hiCD127low regulatory T cells are increased in oral squamous cell carcinoma patients

Lim KP, Chun NA, Ismail SM, Abraham MT, Yusoff MN, Zain RB, et al.

PLoS One, 2014;9(8):e103975.
PMID: 25153698 DOI: 10.1371/journal.pone.0103975

Regulatory T cells (Tregs), a subset of CD4+ T cells plays a pivotal role in regulating the immune system. An increase in Treg numbers enables cancer progression by dampening the immune system and allowing tumor cells to evade immune detection and destruction. An increase in Treg numbers and expression of inhibitory cytokines including TGF-β and IL-10 are mechanisms by which Tregs exert their immune suppressive function. However, the presence of Tregs and inhibitory cytokines in oral cancer patients is still unclear. In this study, the presence of circulating Tregs in 39 oral cancer patients and 24 healthy donors was examined by studying the presence of the CD4+CD25hiCD127low cell population in their peripheral blood mononuclear cells using flow cytometry. Serum levels of TGF-β and IL-10 were measured by ELISA. T cell subsets of OSCC patients were found to differ significantly from healthy donors where a decrease in CD8+ cytotoxic T cells and an increase in Tregs (CD4+CD25hiCD127low) were observed. Further, the ratio of CD8+ T cells/Tregs was also decreased in patients compared to healthy donors. The presence of Tregs was accompanied by a decrease in IL-10 but not TGF-β secretion in OSCC patients when compared to donors; in addition, the analysis also revealed that an increased presence of Tregs was accompanied by better patient survival. Amongst OSCC patients, smokers had significantly higher levels of TGF-β. It is apparent that the immune system is compromised in OSCC patients and the characterization of the Treg subpopulation could form a basis for improving our understanding of the perturbations in the immune system that occur during OSCC tumorigenesis.
Quantitation of methadone and metabolite in patients under maintenance treatment

Diong SH, Mohd Yusoff NS, Sim MS, Raja Aziddin RE, Chik Z, Rajan P, et al.

J Anal Toxicol, 2014 Nov-Dec;38(9):660-6.
PMID: 25106416 DOI: 10.1093/jat/bku096

Gas chromatography-mass spectrometry quantitative method was developed to monitor concentrations of methadone and its metabolite 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP) in plasma and urine of patients. The developed method was simple, accurate and reproducible to quantify methadone and EDDP in plasma and urine samples in the concentration range of 15-1,000 and 50-2,000 ng/mL, respectively. The proposed analytical method was applied to plasma and urine samples obtained from 96 patients undergoing methadone maintenance treatment (MMT) with daily methadone doses of 2-120 mg/day. Urinary methadone excretion was observed to be significantly affected by pH, in which the ratio of methadone to EDDP was two times higher in acidic urine (P = 0.029). The findings of this study further enhance the guidelines for monitoring of methadone treatment among outpatients. Methadone-to-EDDP ratio in urine was found to be consistent at 24 and 4 h, hence suggesting the possibility that outpatients may be monitored with single urine sample in order to check for compliance. This study which provides data on peak concentrations of methadone and EDDP as well as the ratio of both compounds has added to the body of knowledge regarding pharmacokinetic properties of methadone among heroin-dependent patients under MMT.
Study site: University Malaya Medical Centre (UMMC), HKL, University Malaya Centre for Addiction Sciences (UMCAS) and Rehabilitation Centre of Al-Rahman Mosque, Kuala Lumpur, Malaysia
Caffeic acid phenethyl ester (CAPE): scavenger of peroxynitrite in vitro and in sepsis models

Kassim M, Mansor M, Kamalden TA, Shariffuddin II, Hasan MS, Ong G, et al.

Shock, 2014 Aug;42(2):154-60.
PMID: 24667629 DOI: 10.1097/SHK.0000000000000179

Excessive free radical production by immune cells has been linked to cell death and tissue injury during sepsis. Peroxynitrite is a short-lived oxidant and a potent inducer of cell death that has been identified in several pathological conditions. Caffeic acid phenethyl ester (CAPE) is an active component of honeybee products and exhibits antioxidant, anti-inflammatory, and immunomodulatory activities. The present study examined the ability of CAPE to scavenge peroxynitrite in RAW 264.7 murine macrophages stimulated with lipopolysaccharide/interferon-γ that was used as an in vitro model. Conversion of 123-dihydrorhodamine to its oxidation product 123-rhodamine was used to measure peroxynitrite production. Two mouse models of sepsis (endotoxemia and cecal ligation and puncture) were used as in vivo models. The level of serum 3-nitrotyrosine was used as an in vivo marker of peroxynitrite. The results demonstrated that CAPE significantly improved the viability of lipopolysaccharide/interferon-γ-treated RAW 264.7 cells and significantly inhibited nitric oxide production, with effects similar to those observed with an inhibitor of inducible nitric oxide synthase (1400W). In addition, CAPE exclusively inhibited the synthesis of peroxynitrite from the artificial substrate SIN-1 and directly prevented the peroxynitrite-mediated conversion of dihydrorhodamine-123 to its fluorescent oxidation product rhodamine-123. In both sepsis models, CAPE inhibited cellular peroxynitrite synthesis, as evidenced by the absence of serum 3-nitrotyrosine, an in vivo marker of peroxynitrite. Thus, CAPE attenuates the inflammatory responses that lead to cell damage and, potentially, cell death through suppression of the production of cytotoxic molecules such as nitric oxide and peroxynitrite. These observations provide evidence of the therapeutic potential of CAPE treatment for a wide range of inflammatory disorders.
Fulltext Rising from the dead!

Low DW, Looi I, Manocha AB, Ang HA, Nagalingam M, Ayop NA, et al.

Med J Malaysia, 2012 Oct;67(5):538-9.
PMID: 23770879 MyJurnal

A report of a patient with Lazarus phenomenon (the return of spontaneous circulation after cardiopulmonary resuscitation) following cardiac arrest (myocardium ischemia) is presented. A 65 year patient was found unconscious at home. He taken to the emergency department On arrival he was unconscious, his pupils fixed and dilated bilaterally. Resuscitation proceeded for 55 minutes. He was then pronounced dead. Forty minutes later spontaneous breathing was noted and his blood pressure was 110/48 and heart rate 90bpm. He survived a further 13 days in the coronary care unit. The implications for management of cardiac arrest in the emergency and medical department are discussed.
Fulltext A population-based study measuring the prevalence of chronic kidney disease among adults in West Malaysia

Hooi LS, Ong LM, Ahmad G, Bavanandan S, Ahmad NA, Naidu BM, et al.

Kidney Int, 2013 Nov;84(5):1034-40.
PMID: 23760287 DOI: 10.1038/ki.2013.220

In this population-based study, we determine the prevalence of chronic kidney disease in West Malaysia in order to have accurate information for health-care planning. A sample of 876 individuals, representative of 15,147 respondents from the National Health and Morbidity Survey 2011, of the noninstitutionalized adult population (over 18 years old) in West Malaysia was studied. We measured the estimated glomerular filtration rate (eGFR) (CKD-EPI equation); albuminuria and stages of chronic kidney disease were derived from calibrated serum creatinine, age, gender and early morning urine albumin creatinine ratio. The prevalence of chronic kidney disease in this group was 9.07%. An estimated 4.16% had stage 1 chronic kidney disease (eGFR >90 ml/min per 1.73 m(2) and persistent albuminuria), 2.05% had stage 2 (eGFR 60-89 ml/min per 1.73 m(2) and persistent albuminuria), 2.26% had stage 3 (eGFR 30-59 ml/min per 1.73 m(2)), 0.24% had stage 4 (eGFR 15-29 ml/min per 1.73 m(2)), and 0.36% had stage 5 chronic kidney disease (eGFR <15 ml/min per 1.73 m(2)). Only 4% of respondents with chronic kidney disease were aware of their diagnosis. Risk factors included increased age, diabetes, and hypertension. Thus, chronic kidney disease in West Malaysia is common and, therefore, warrants early detection and treatment in order to potentially improve outcome.
Study name: National Health and Morbidity Survey (NHMS-2011)
Non-practice of breast self examination and marital status are associated with delayed presentation with breast cancer

Ghazali SM, Othman Z, Cheong KC, Hock LK, Wan Mahiyuddin WR, Kamaluddin MA, et al.

Asian Pac J Cancer Prev, 2013;14(2):1141-5.
PMID: 23621202

Delay in seeking treatment for breast cancer is a barrier to the early diagnosis and management of the disease, resulting in a poorer prognosis. We here estimated the prevalence of delayed presentation for breast cancer and identified possible influential sociodemographic factors in a cross-sectional study of 250 patients diagnosed with primary breast cancer at the Radiotherapy and Oncology Clinic in Kuala Lumpur Hospital. Data were collected by face-to-face interview using a structured questionnaire and from medical records. We examined associations between delayed presentation (presenting to a physician more than 3 months after self-discovery of a symptom) and sociodemographic characteristics, practice of breast self examination (BSE), history of benign breast disease, family history of breast cancer and type of symptom, symptom disclosure and advice from others to seek treatment using multiple logistic regression. Time from self-discovery of symptom to presentation ranged from tghe same day to 5 years. Prevalence of delayed presentation was 33.1% (95%CI: 27.4, 39.3). A significantly higher proportion of delayers presented with late stages (stage III/IV) (58.3% vs. 26.9%, p<0.001). Divorced or widowed women (OR: 2.23, 95% CI: 1.11, 4.47) had a higher risk of delayed presentation than married women and women who never performed breast self examination were more likely to delay presentation compared to those who regularly performed BSE (OR: 2.74, 95% CI: 1.33, 5.64). Our findings indicate that delayed presentation for breast cancer symptoms among Malaysian women is high and that marital status and breast self examination play major roles in treatment-seeking for breast cancer symptoms.
Pilot study of the sensitivity and specificity of the DNA integrity assay for stool-based detection of colorectal cancer in Malaysian patients

Yehya AH, Yusoff NM, Khalid IA, Mahsin H, Razali RA, Azlina F, et al.

Asian Pac J Cancer Prev, 2012;13(5):1869-72.
PMID: 22901138

BACKGROUND: To assess the diagnostic potential of tumor-associated high molecular weight DNA in stool samples of 32 colorectal cancer (CRC) patients compared to 32 healthy Malaysian volunteers by means of polymerase chain reaction (PCR).
METHODS: Stool DNA was isolated and tumor-associated high molecular weight DNA (1.476 kb fragment including exons 6-9 of the p53 gene) was amplified using PCR and visualized on ethidium bromide-stained agarose gels.
RESULTS: Out of 32 CRC patients, 18 were positive for the presence of high molecular weight DNA as compared to none of the healthy individuals, resulting in an overall sensitivity of 56.3% with 100% specificity. Out of 32 patients, 23 had tumor on the left side and 9 on the right side, 16 and 2 being respectively positive. This showed that high molecular weight DNA was significantly (p=0.022) more detectable in patients with left side tumor (69.6% vs 22.2%). Out of 32 patients, 22 had tumors larger than 1.0 cm, 18 of these (81.8%) being positive for long DNA as compared to not a single patient with tumor size smaller than 1.0 cm (p<0.001).
CONCLUSION: We detected CRC-related high molecular weight p53 DNA in stool samples of CRC patients with an overall sensitivity of 56.3% with 100% specificity, with a strong tumor size dependence.
Detection and phylogenetic profiling of nodavirus associated with white tail disease in Malaysian Macrobrachium rosenbergii de Man

Saedi TA, Moeini H, Tan WS, Yusoff K, Daud HM, Chu KB, et al.

Mol Biol Rep, 2012 May;39(5):5785-90.
PMID: 22223294 DOI: 10.1007/s11033-011-1389-7

White tail disease (WTD) is a serious viral disease in the hatcheries and nursery ponds of Macrobrachium rosenbergii in many parts of the world. A new disease similar to WTD was observed in larvae and post larvae of M. rosenbergii cultured in Malaysia. In the present study, RT-PCR assay was used to detect the causative agents of WTD, M. rosenbergii nodavirus (MrNV) and extra small virus (XSV) using specific primers for MrNV RNA2 and XSV. The results showed the presence of MrNV in the samples with or without signs of WTD. However, XSV was only detected in some of the MrNV-positive samples. Phylogenetic analysis showed that the RNA2 of our Malaysian isolates were significantly different from the other isolates. Histopathological studies revealed myofiber degeneration of the tail muscles and liquefactive myopathy in the infected prawns. This was the first report on the occurrence of MrNV in the Malaysian freshwater prawn.
Obstructive sleep apnea among express bus drivers in Malaysia: important indicators for screening

Yusoff MF, Baki MM, Mohamed N, Mohamed AS, Yunus MR, Ami M, et al.

Traffic Inj Prev, 2010 Dec;11(6):594-9.
PMID: 21128189 DOI: 10.1080/15389588.2010.505255

Obstructive sleep apnea (OSA) has been identified as one of the significant risk factors for motor vehicle crashes (MVCs). In the interest of public safety, this study was conducted to determine the prevalence of OSA and its associated factors among express bus drivers in Malaysia. Identifying factors or conditions related with OSA is very important because they can be used as indicators to subject a person to a confirmatory diagnosis using polysomnography testing.
Blunted endogenous GABA-mediated inhibition in the hypothalamic paraventricular nucleus of rats with streptozotocin-induced diabetes

Hassan Z, Sattar MZ, Suhaimi FW, Yusoff NH, Abdulla MH, Yusof AP, et al.

Acta Neurol Belg, 2013 Sep;113(3):319-25.
PMID: 23242937 DOI: 10.1007/s13760-012-0165-3

The hypothalamic paraventricular nucleus (PVN) is involved in the regulation of sympathetic outflow and particularly affects the heart. This study sets out to determine the role of GABA of the paraventricular nucleus (PVN) in cardiovascular regulation in streptozotocin-induced diabetic rats. Pharmacological stimulation of glutamatergic receptors with DL-Homocysteic acid (200 mM in 100 nL) in the PVN region showed a significant depression in both mean arterial pressure (MAP) and heart rate (HR) of diabetic rats (Diabetic vs. non-diabetic: MAP 15.0 ± 1.5 vs. 35.8 ± 2.8 mmHg; HR 3.0 ± 2.0 vs. 30.0 ± 6.0 bpm, P < 0.05). Microinjection of bicuculline methiodide (1 mM in 100 nL), a GABAA receptor antagonist, produced an increase in baseline MAP and HR in both non-diabetic and diabetic rats. In the diabetic rats, bicuculline injection into the PVN reduced the pressor and HR responses (Diabetic vs. non-diabetic: MAP 6.2 ± 0.8 vs. 25.1 ± 2.2 mmHg; HR 1.8 ± 1.1 vs. 25.4 ± 6.2 bpm, P < 0.05). A microinjection of muscimol (2 mM in 100 nL), which is a GABAA receptor agonist, in the PVN elicited decreases in MAP and HR in both groups. The diabetic group showed a significantly blunted reduction in HR, but not MAP (Diabetic vs. non-diabetic: MAP -15.7 ± 4.0 vs. -25.0 ± 3.8 mmHg; HR -5.2 ± 2.1 vs. -39.1 ± 7.9 bpm). The blunted vasopressor and tachycardic responses to bicuculline microinjection in the diabetic rats are likely to result from decreased GABAergic inputs, attenuated release of endogenous GABA or alterations in GABAA receptors within the PVN.
Identification of naphthalene metabolism by white rot fungus Pleurotus eryngii

Hadibarata T, Teh ZC, Rubiyatno, Zubir MM, Khudhair AB, Yusoff AR, et al.

Bioprocess Biosyst Eng, 2013 Oct;36(10):1455-61.
PMID: 23334282 DOI: 10.1007/s00449-013-0884-8

The use of biomaterials or microorganisms in PAHs degradation had presented an eye-catching performance. Pleurotus eryngii is a white rot fungus, which is easily isolated from the decayed woods in the tropical rain forest, used to determine the capability to utilize naphthalene, a two-ring polycyclic aromatic hydrocarbon as source of carbon and energy. In the meantime, biotransformation of naphthalene to intermediates and other by-products during degradation was investigated in this study. Pleurotus eryngii had been incubated in liquid medium formulated with naphthalene for 14 days. The presence of metabolites of naphthalene suggests that Pleurotus eryngii begin the ring cleavage by dioxygenation on C1 and C4 position to give 1,4-naphthaquinone. 1,4-Naphthaquinone was further degraded to benzoic acid, where the proposed terepthalic acid is absent in the cultured extract. Further degradation of benzoic acid by Pleurotus eryngii shows the existence of catechol as a result of the combination of decarboxylation and hydroxylation process. Unfortunately, phthalic acid was not detected in this study. Several enzymes, including manganese peroxidase, lignin peroxidase, laccase, 1,2-dioxygenase and 2,3-dioxygenase are enzymes responsible for naphthalene degradation. Reduction of naphthalene and the presence of metabolites in liquid medium showed the ability of Pleurotus eryngii to utilize naphthalene as carbon source instead of a limited glucose amount.

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