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  1. Sabri AM, Ramli MA, Abdul Rahman NN, Hamdan MN
    Asian Bioeth Rev, 2023 Jan;15(1):69-80.
    PMID: 36618954 DOI: 10.1007/s41649-022-00210-9
    The outburst of the fourth Industrial Revolution had a significant impact on many aspects of life. The discovery of new technologies in medicine has resulted in innovations: organ transplants. The introduction of three-dimensional (3D) organ printing technology promises improvements to the field. Organs such as the liver, kidneys, heart and others are printed to meet the needs of the actual organs. However, the production of prototype organs to replace the original organs is associated with the issue of changing the creation of Allah. Accordingly, this study will analyse the issue of changing the creation of God in three-dimensional (3D) organ printing technology according to the perspective of Islamic law. Several appropriate methodologies in Islamic law (usul fiqh) are used such as legal reasoning through maqasid shariah perspective and analogical reasoning. The result shows that three-dimensional (3D) organ printing technology falls under the permissible category of changing the creation of Allah because it can save human lives. The production of organs through 3D printing involving changes included in the category of necessity (daruri) and need (hajiy) is permissible, but the category of desirable (tahsini) requires further specifications.
  2. Ramasamy K, Khamalrudin N, Teo DSHM, Hashim ND
    Cureus, 2024 Jul;16(7):e64763.
    PMID: 39156370 DOI: 10.7759/cureus.64763
    Preauricular sinuses are congenital anomalies arising from the incomplete fusion of hillocks of His of the first and second branchial arches. Surgery is warranted when there is recurrent infection or abscess formation. However, the presence of scarring and skin thinning could result in large tissue defects after complete excision. In such cases, meticulous preoperative planning with regard to the reconstruction technique is imperative. We describe the clinical presentation, surgical technique, and postoperative outcomes of such a case in a young toddler, with a focus on the rationale behind the chosen management strategy. By sharing our experience, we aim to contribute to the existing literature on the management of complicated preauricular sinuses and provide insights that may guide clinicians facing similar challenges.
  3. Abdulwahid Mohammad Noor K, Mohd Norsuddin N, Che Isa IN, Abdul Karim MK
    Radiography (Lond), 2024 Jul;30(4):1041-1052.
    PMID: 38723445 DOI: 10.1016/j.radi.2024.04.019
    INTRODUCTION: Breast imaging plays a crucial role in the early detection and management of breast cancer, with visual quality, modality innovation and diagnostic performance being key factors in achieving accurate diagnoses and optimal patient outcomes. This paper presents a comprehensive bibliometric analysis of the literature on the three above elements focusing on breast imaging, aiming to uncover publication trends, identify influential works and authors, and highlight future research directions.

    METHODS: We employed a methodical bibliometric approach, making use of Scopus and Web of Science (WoS) databases for gathering literatures. We planned our search strategy, concentrating on terms linked to "breast imaging," "image quality," and "diagnostic accuracy" to ensure a systematic examination of the subject. The enhanced search functions in these databases enabled us to narrow down and improve our findings, choosing only the articles, conference papers, and book sections that are most relevant. After conducting a thorough screening process to remove duplicates and evaluate significance, we utilized ScientoPy and VOSviewer software for an in-depth bibliometric analysis. This helped to explore trends in publications, patterns of citations, and thematic groups, giving us a better understanding of how the field has changed and where it currently stands. Our approach prioritized assessing methodological quality and bias in the studies we included, guaranteeing the reliability of our findings.

    RESULTS: We reviewed 2984 relevant publications, revealing a consistent annual growth rate of 2.8% in breast imaging research, with the United States and Europe leading in contributions. The study found that advancements in radiological technologies and international collaboration are driving forces behind the field's expansion. Key subject areas such as 'Radiology, Nuclear Medicine, and Medical Imaging' dominated, underscoring their impact on diagnostic quality. Notable authors and institutions have been identified for their influential research, characterized by high citation metrics and significant scholarly impact.

    CONCLUSION: The study shows a continuous increase in research on breast imaging, considered by new technologies and teamwork defining the present time. The assessment highlights a key move towards utilizing digital imaging methods and computational analysis, affecting the improvement of future diagnostic procedures and patients' results. The study highlights the importance of continued international collaborations to tackle the new barriers in breast imaging and make the most of technological progress.

    IMPLICATIONS FOR PRACTICE: This study shows a focus on using interdisciplinary methods and cutting-edge technology in breast imaging to help healthcare professionals improve their performance and accuracy in diagnosis. Recognizing vital research and emerging trends should guide clinical guidelines, radiology training, and patient care plans to encourage the use of effective techniques and stimulate innovation in diagnostic approaches.

  4. Mohd Shukri MF, Norhayati MN, Badrin S, Abdul Kadir A
    PeerJ, 2022;10:e13992.
    PMID: 36132218 DOI: 10.7717/peerj.13992
    BACKGROUND: Polycystic ovary syndrome (PCOS) is a disorder in reproductive age women and is characterized by hyperandrogenic anovulation and oligo-amenorrhea, which leads to infertility. Anovulation in PCOS is associated with low follicle-stimulating hormone levels and the arrest of antral follicle development in the final stages of maturation. L-carnitine (LC) plays a role in fatty acid metabolism, which is found to be lacking in PCOS patients. This systematic review and meta-analysis aimed to determine the effectiveness of LC supplementation for patients with PCOS.

    METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Psychological Information Database (PsycINFO), and the World Health Organization International Clinical Trials Registry Platform for all randomized control trials, comparing LC alone or in combination with other standard treatments for the treatment of PCOS from inception till June 2021. We independently screened titles and abstracts to identify available trials, and complete texts of the trials were checked for eligibility. Data on the methods, interventions, outcomes, and risk of bias from the included trials were independently extracted by the authors. The estimation of risk ratios and mean differences with a 95 percent confidence interval (CI) was performed using a random-effects model.

    RESULTS: Nine studies with 995 participants were included in this review. Five comparison groups were involved. In one comparison group, LC reduced the fasting plasma glucose (FPG) (mean differences (MD) -5.10, 95% CI [-6.25 to -3.95]; P = 0.00001), serum low-density lipoprotein (LDL) (MD -25.00, 95% CI [-27.93 to -22.07]; P = 0.00001), serum total cholesterol (MD -21.00, 95% CI [-24.14 to -17.86]; P = 0.00001), and serum triglyceride (TG) (MD -9.00, 95% CI [-11.46 to -6.54]; P = 0.00001) with moderate certainty of evidence. Another comparison group demonstrated that LC lowers the LDL (MD -12.00, 95% CI [-15.80 to -8.20]; P = 0.00001), serum total cholesterol (MD -24.00, 95% CI [-27.61 to -20.39]; P = 0.00001), and serum TG (MD -19.00, 95% CI [-22.79 to -15.21]; P = 0.00001) with moderate certainty of evidence.

    CONCLUSION: There was low to moderate certainty of evidence that LC improves Body Mass Index (BMI) and serum LDL, TG, and total cholesterol levels in women with PCOS.

  5. Lee JX, Tan YJ, Ismail NAS
    Int J Mol Sci, 2024 Nov 15;25(22).
    PMID: 39596340 DOI: 10.3390/ijms252212275
    NPHS1 and NPHS2 are kidney gene components that encode for nephrin and podocin, respectively. They play a role in the progression of congenital (CNS) and steroid-resistant (SRNS) nephrotic syndrome. Hence, this study aimed to determine the prevalence and renal outcomes of NPHS mutations among pediatric patients with CNS and SRNS. We also aimed to identify potential predictors of NPHS mutations in this patient cohort. Overall, this study included 33 studies involving 2123 patients screened for NPHS1, whereas 2889 patients from 40 studies were screened for NPHS2 mutations. The patients' mean age was 4.9 ± 1 years (ranging from birth to 18 years), and 56% of patients were male (n = 1281). Using the random-effects model, the pooled proportion of NPHS1 mutations among pediatric patients with CNS and SRNS was 0.15 (95% CI 0.09; 0.24, p < 0.001, I2 = 92.0%). The pooled proportion of NPHS2 mutations was slightly lower, at 0.11 (95% CI 0.08; 0.14, p < 0.001, I2 = 73.8%). Among the 18 studies that reported ESRF, the pooled proportion was 0.47 (95% CI 0.34; 0.61, p < 0.001, I2 = 75.4%). Our study showed that the NPHS1 (β = 1.16, p = 0.35) and NPHS2 (β = 5.49, p = 0.08) mutations did not predict ESRF in CNS and SRNS pediatric patients. Nevertheless, patients from the European continent who had the NPHS2 mutation had a significantly higher risk of developing ESRF (p < 0.05, β = 1.3, OR = 7.97, 95% CI 0.30; 2.30) compared to those who had the NPHS1 mutation. We recommend NPHS mutation screening for earlier diagnosis and to avoid unnecessary steroid treatments. More data are needed to better understand the impact of NPHS mutations among pediatric patients with CNS and SRNS.
  6. Robson NZ, Razack AH, Dublin N
    Asia Pac J Public Health, 2010 Jul;22(3):271-8.
    PMID: 20460294 DOI: 10.1177/1010539509357446
    Recent advances in the fields of organ donation and organ transplant have introduced new hope for the treatment of serious diseases. However, this promise has been accompanied by several issues. The most common issue raised is ethical implications, but in a multicultural society like Malaysia, additional concerns arise pertaining to social and religious issues. These concerns needs to be addressed as attitudes toward and acceptability of organ donation varies according to social, culture, and religion. The diverse cultural, religious, and traditional concepts pertaining to organ donation may hamper its acceptability and cause a lack of willingness to donate organs. The purpose of this article is to briefly explore the ethical issues involved in organ transplant and the various religious opinions on organ donation. It is hoped that this knowledge and understanding may benefit both health care providers and patients in a multicultural society like Malaysia.
  7. Ching KWC, Mokhtar NF, Tye GJ
    Comput Biol Med, 2025 Jan;184:109396.
    PMID: 39549529 DOI: 10.1016/j.compbiomed.2024.109396
    Metastatic breast cancer (MBC) is an advanced-stage breast cancer associated with more than 90 % of cancer-related deaths. Immunosuppressive properties of tolerogenic dendritic cells (tolDCs) in tumour immune microenvironment (TIME) may be a risk factor for the rapid progression to MBC. However, the exact connections between the two are unknown. The aim of the current study is to uncover gene signatures and key pathways associated with MBC and tolDCs via an integrated bioinformatics approach. Gene expression profiles of MBC and tolDCs were retrieved from Gene Expression Omnibus (GEO) to identify common differentially expressed genes (DEGs). From DGE analysis, 529 upregulated common DEGs and 367 downregulated common DEGs had been identified. In enrichment analysis, common DEGs enriched in GO terms of defense response to virus and KEGG pathway of transcriptional misregulation in cancer were reported to be significantly associated with MBC and tolDCs. From the constructed PPI networks, 23 hub genes were identified, although only 5 genes were significant; 3 upregulated (ISG15, OAS2 and RSAD2) and 2 downregulated (eEF2 and PPARG) as they were found to be significantly correlated and had the same expression trend as predicted in validation analysis of overall survival (OS) analysis, expression levels, immune infiltration analysis and immunohistochemistry (IHC) analysis. These 5 hub genes can now be exploited in developing novel therapeutic interventions and as diagnostic biomarkers for enhancing the clinical outcomes of MBC patients.
  8. Jusoh Z, Tohid H, Omar K, Muhammad NA, Ahmad S
    Malays J Med Sci, 2018 Feb;25(1):84-95.
    PMID: 29599638 MyJurnal DOI: 10.21315/mjms2018.25.1.10
    Background: The quality of life (QoL) describes the multidimensional self-perceived well-being of a person, which is an important diabetes outcome. This study aimed to measure the QoL scores among patients with type 2 diabetes mellitus (T2DM), as well as their clinical and sociodemographic predictors.

    Methods: This cross-sectional study involved 180 randomly sampled patients at a primary care clinic on the East Coast of Peninsular Malaysia. A self-administered questionnaire containing the Audit of Diabetes Dependent Quality of Life-18 (ADDQoL-18) was used.

    Results: Most of the respondents (96.7%) were Malay, with a median (interquartile range, IQR) age of 54.0 (14.0) years old. The majority of them were females (60.0%), married (81.1%) and from low-income families (63.3%), who attained a secondary education or lower (75.6%). Only 49.4% of them were employed. The mean (standard deviation, SD) ADDQoL-18 average weighted impact score was -4.58 (2.21) and all 18 domains were negatively affected, particularly the living condition, family life and working life. The multiple linear regression analysis showed that the age (adjusted B = 0.05,P= 0.004) and insulin use (adjusted B = -0.84,P= 0.011) were QoL predictors.

    Conclusion: T2DM negatively impacts the patient's QoL in all aspects of their life. The QoL improvement with age suggests that the older patients had accepted and adapted to their illness. The need to improve the QoL among insulin users was also highlighted.
    Study site: Klinik Kesihatan, Malaysia
  9. Abdullah AC, Adnan JS, Rahman NA, Palur R
    Malays J Med Sci, 2017 Mar;24(1):104-112.
    PMID: 28381933 DOI: 10.21315/mjms2017.24.1.11
    INTRODUCTION: Computed tomography (CT) is the preferred diagnostic toolkit for head and brain imaging of head injury. A recent development is the invention of a portable CT scanner that can be beneficial from a clinical point of view.

    AIM: To compare the quality of CT brain images produced by a fixed CT scanner and a portable CT scanner (CereTom).

    METHODS: This work was a single-centre retrospective study of CT brain images from 112 neurosurgical patients. Hounsfield units (HUs) of the images from CereTom were measured for air, water and bone. Three assessors independently evaluated the images from the fixed CT scanner and CereTom. Streak artefacts, visualisation of lesions and grey-white matter differentiation were evaluated at three different levels (centrum semiovale, basal ganglia and middle cerebellar peduncles). Each evaluation was scored 1 (poor), 2 (average) or 3 (good) and summed up to form an ordinal reading of 3 to 9.

    RESULTS: HUs for air, water and bone from CereTom were within the recommended value by the American College of Radiology (ACR). Streak artefact evaluation scores for the fixed CT scanner was 8.54 versus 7.46 (Z = -5.67) for CereTom at the centrum semiovale, 8.38 (SD = 1.12) versus 7.32 (SD = 1.63) at the basal ganglia and 8.21 (SD = 1.30) versus 6.97 (SD = 2.77) at the middle cerebellar peduncles. Grey-white matter differentiation showed scores of 8.27 (SD = 1.04) versus 7.21 (SD = 1.41) at the centrum semiovale, 8.26 (SD = 1.07) versus 7.00 (SD = 1.47) at the basal ganglia and 8.38 (SD = 1.11) versus 6.74 (SD = 1.55) at the middle cerebellar peduncles. Visualisation of lesions showed scores of 8.86 versus 8.21 (Z = -4.24) at the centrum semiovale, 8.93 versus 8.18 (Z = -5.32) at the basal ganglia and 8.79 versus 8.06 (Z = -4.93) at the middle cerebellar peduncles. All results were significant with P-value < 0.01.

    CONCLUSIONS: Results of the study showed a significant difference in image quality produced by the fixed CT scanner and CereTom, with the latter being more inferior than the former. However, HUs of the images produced by CereTom do fulfil the recommendation of the ACR.

  10. Kassim MSA, Manaf MRA, Nor NSM, Ambak R
    Malays J Med Sci, 2017 Dec;24(6):83-91.
    PMID: 29379390 DOI: 10.21315/mjms2017.24.6.10
    Background: The obesity rate in Malaysia is the highest in Asia. Half its population is obese or overweight. The present study aims to determine the effects of lifestyle intervention on weight loss and blood pressure among Malaysian overweight and obese housewives in Klang Valley.

    Methods: A quasi-experimental study with 328 obese and overweight low socio- economic status housewives aged 18-59 years old who met the screening criteria participated in the study. They were recruited into an intervention group (N = 169) or control group (N = 159). The intervention group received a lifestyle intervention consisting of a diet, physical activity and self-monitoring behavior package. The control group (delayed intervention group) received a women's health seminar package. Both groups were followed up for six months. Weight, body mass index (BMI), and blood pressure were evaluated both pre- and post-intervention.

    Results: A total of 124 participants from the intervention group and 93 participants from the control group completed the study. Mean weight loss was 1.13 ± 2.70 kg (P < 0.05) in the intervention group and 0.97 ± 2.60 kg (P < 0.05) in the control group. Systolic blood pressure (SBP) reductions in the intervention group were 5.84 ± 18.10 mmHg (P < 0.05). The control group showed reduction in SBP 6.04 ± 14.52 mmHg (P < 0.05). Both group had non-significant DBP reduction. Multivariate analysis via General Linear Model Repeated Measures observed no significant differences in terms of parameter changes with time in both groups for all parameters.

    Conclusions: The results indicate that the lifestyle interventions in this study resulted in modest weight loss and thus decreased BMI and blood pressure (SBP) within six months of intervention.

  11. Nor Azura I, Azlina I, Rosnani Z, Norhayati MN
    Malays J Med Sci, 2020 May;27(3):84-92.
    PMID: 32684809 DOI: 10.21315/mjms2020.27.3.9
    Background: Because of their frequent, regular contact with antenatal mothers, healthcare providers play an important role in promoting the health benefits of antenatal exercise. This study aimed to determine the effectiveness of an antenatal-exercise counseling module on knowledge and self-efficacy of staff nurses.

    Methods: A quasi-experimental design was conducted. The intervention and control groups consisted of 66 nurses randomly selected from the Tumpat and Pasir Mas districts, respectively, in Kelantan. The intervention group received an antenatal-exercise counseling module, and the control group performed counseling based on self-reading. Knowledge and self-efficacy were assessed at the baseline and at week 4. Analysis of variance and repeated measure analysis of covariance were performed using SPSS.

    Results: There was a significant difference in the knowledge scores [estimated marginal mean (95% confidence interval, CI): 33.9 (33.29, 34.53) versus 27.4 (26.52, 28.29); P < 0.001)] and the self-efficacy scores [estimated marginal mean (95% CI): 31.3 (30.55, 32.03) versus 27.4 (26.03, 28.74); P = 0.005)] between intervention and control groups at week 4 after adjusting for duration of practice and formal training.

    Conclusion: The antenatal-exercise counseling module is recommended for use in routine counseling in health centers to promote healthy lifestyles among pregnant women.

  12. Hassan R, Siregar JA, A Rahman Mohd NA
    Malays J Med Sci, 2014 Mar;21(2):54-62.
    PMID: 24876808 MyJurnal
    Telemedicine in neurosurgery or teleneurosurgery has been widely used for transmission of clinical data and images throughout the country since its implementation in 2006. The impact is a reduction of patient number that need to be reviewed in the level III hospitals and an increment in the number of patients that are kept in level II hospitals for observation by the primary team. This translates to reduction of unnecessary transfer of patients and subsequently cost benefits for patients and medical providers. The main aim is to determine the amount of reduction in unnecessary transfer by the implementation of teleneurosurgery in the management of referrals to neurosurgical department in Hospital Sultanah Amninah Johor Bahru (HSAJB). Other factors associated with transfer decision are also evaluated.
  13. Jane Ling MY, Ahmad N, Mohd Radi MF, Aizuddin AN
    PLoS One, 2025;20(1):e0311834.
    PMID: 39775213 DOI: 10.1371/journal.pone.0311834
    BACKGROUND: The burden of type 2 diabetes is increasing globally. Risk perception of type 2 diabetes plays an important role in motivating adoption of healthy lifestyle and preventive health interventions. To address the increasing burden of type 2 diabetes in Malaysia, a better understanding on its risk perception is needed as a guide for preventive interventions. This study was aimed at developing and validating a Malay-language questionnaire to assess the risk perception of type 2 diabetes (RPDM) among Malaysians.

    METHODS: The questionnaire (RPDM) was developed based on the Health Belief Model and previous literature. A 59-item question pool was initially developed, reviewed by experts for content validity and pretested on five respondents. Different samples were used for pilot study (n = 100) and subsequent validation study (n = 158). Exploratory factor analysis (EFA) and Confirmatory factor analysis (CFA) were used to evaluate construct validity and construct reliability of the questionnaire.

    RESULTS: The EFA yielded five-factors model, including 48 items with good factor loadings of > 0.40. CFA was carried out using item parceling. The final model shows acceptable model fit and had sufficient convergent and discriminant validity. The value of construct reliability ranged between 0.76 and 0.90.

    CONCLUSION: This newly developed and validated Malay-language RPDM questionnaire is valid and reliable for measuring the five constructs (perceived self-efficacy, perceived severity, perceived benefit, perceived susceptibility and perceived barrier) of risk perception of type 2 diabetes among Malaysians. This Malay-language questionnaire may contribute to a better understanding of risk perception of type 2 diabetes among Malaysians, as well as enhancement of diabetes prevention communication between healthcare providers and their clients.

  14. Mohd Nor MA, Abdul Rahman NA, Adnan JS
    Malays J Med Sci, 2013 Jan;20(1):95-6.
    PMID: 23613662
  15. Idris MA, Shee PY, Syed-Yahya SNN
    Ind Health, 2023 Jul 29;61(4):237-239.
    PMID: 37518184 DOI: 10.2486/indhealth.61_400
  16. Mohd Nor NS, Anuar Zaini A, Jalaludin MY
    J Child Health Care, 2024 Dec;28(4):804-814.
    PMID: 37029637 DOI: 10.1177/13674935231168911
    The study aimed to evaluate diabetes self-care among diabetic children and adolescents and compare with glycaemic control. Summary of Diabetes Self-Care Activities (SDSCA) questionnaire was distributed to patients aged 10-18 years with types 1 and 2 diabetes mellitus (DM) at paediatric diabetes clinics in Malaysia. Haemoglobin A1c levels were measured after questionnaire completion. A total of 106 patients completed the questionnaire with a mean age of 13.91 (± SD 2.48) years. Mean haemoglobin A1c and SDSCA score were 9.78 (± SD 2.43)% and 19.09 (± SD 5.81), respectively. Type 1 DM patients had significantly higher haemoglobin A1c (10.11 95% CI [9.62, 10.59] vs 8.38 95% CI [7.13, 9.62]). Total score was higher in type 1 DM although not statistically significant (19.32 95% CI [18.21, 20.43] vs 18.08 95% CI [14.28, 21.87]). Blood glucose testing score was significantly higher in type 1 DM (5.24 95% CI [4.82, 5.66] vs 3.50 95% CI [2.23, 4.77]). There was statistically significant negative correlation between score in diet subcategory and haemoglobin A1c. In conclusion, self-care activities among diabetic children and adolescents are still suboptimal. Self-care activities on blood glucose testing are significantly better in type 1 DM. Diet section correlated well with glycaemic control necessitating further research.
  17. Abel AG, Shamarina S, Hisham MNMN, Hafiz ARA
    Afr J Infect Dis, 2025;19(1):45-56.
    PMID: 39618539 DOI: 10.21010/Ajidv19i1.6
    BACKGROUND: Hepatitis B (HB), caused by the hepatitis B virus (HBV), remains a critical public health challenge in Nigeria. Globally, the HBV infects approximately 296 million people, significantly contributing to morbidity and mortality, with liver cirrhosis and liver cancer ranking as the 11th and 24th leading causes of death, respectively. This study aimed to determine the prevalence of HBV infection and the associated risk factors within the Lafia Metropolis, Nasarawa State, Nigeria.

    MATERIALS AND METHODS: A cross-sectional study was conducted from September to November 2023, utilizing a validated questionnaire to assess 461 randomly selected participants from four communities (Azuba, Bukan Sidi, Danka Sarki, and Doka), representing diverse sociodemographic profiles and varying degrees of exposure to risk factors associated with HBV infection. Data were analyzed using chi-square (χ2) tests with IBM SPSS statistical software version 28.0 at a significance level of p < 0.05.

    RESULTS: The findings showed that the overall prevalence of HBV infection was 7.8%. A significant association was observed between the prevalence of HBV infection and monthly income (p < 0.01). However, no associations were found with age, gender, educational level, marital status, occupation, or religion. Regarding risk factors, a significant association was found between HBV infection and awareness of one's HBV status (p < 0.03).

    CONCLUSION: These findings highlight the need for targeted public health interventions and policies aimed at reducing HBV transmission among high-risk sociodemographic groups in Lafia Metropolis. This approach could potentially reduce the burden of HBV and improve health outcomes in affected communities.

  18. Omar IS, Abd Jamil AH, Mat Adenan NA, Chung I
    PLoS One, 2022;17(7):e0270830.
    PMID: 35816477 DOI: 10.1371/journal.pone.0270830
    Obese women have a higher risk of developing endometrial cancer (EC) than lean women. Besides affecting EC progression, obesity also affects sensitivity of patients to treatment including medroxprogesterone acetate (MPA). Obese women have a lower response to MPA with an increased risk for tumor recurrence. While MPA inhibits the growth of normal fibroblasts, human endometrial cancer-associated fibroblasts (CAFs) were reported to be less responsive to MPA. However, it is still unknown how CAFs from obese women respond to progesterone. CAFs from the EC tissues of obese (CO) and non-obese (CN) women were established as primary cell models. MPA increased cell proliferation and downregulated stromal differentiation genes, including BMP2 in CO than in CN. Induction of IRS2 (a BMP2 regulator) mRNA expression by MPA led to activation of glucose metabolism in CO, with evidence of greater mRNA levels of GLUT6, GAPDH, PKM2, LDHA, and increased in GAPDH enzymatic activity. Concomitantly, MPA increased the mRNA expression of a fatty acid transporter, CD36 and lipid droplet formation in CO. MPA-mediated increase in glucose metabolism genes in CO was reversed with a progesterone receptor inhibitor, mifepristone (RU486), leading to a decreased proliferation. Our data suggests that PR signaling is aberrantly activated by MPA in CAFs isolated from endometrial tissues of obese women, leading to activation of IRS2 and glucose metabolism, which may lead to lower response and sensitivity to progesterone in obese women.
  19. Ismail NA, Kamaruddin NA, Azhar Shah S, Sukor N
    Clin Endocrinol (Oxf), 2020 06;92(6):509-517.
    PMID: 32073675 DOI: 10.1111/cen.14177
    INTRODUCTION: Primary aldosteronism (PA) contributed to the cardiovascular disease and metabolic alterations independent of the blood pressure level. Evidence exists that aldosterone excess also affects calcium and mineral homeostasis. PA subjects have been shown to have greater prevalence of vitamin D deficiency. However, the impact of vitamin D treatment in this population has never been assessed.

    OBJECTIVE: This study aimed to evaluate the effect of vitamin D treatment on clinical and biochemical outcomes of PA patients.

    METHODS: Two hundred forty hypertensive subjects were screened, 31 had positive ARR, and 17 patients with newly confirmed PA following positive confirmatory test that has not been subjected for definitive treatment were enrolled. Clinical parameter (blood pressure) and biochemical parameters (renal profile, plasma aldosterone concentration, plasma renin activity, serum calcium, vitamin D, intact parathyroid hormone, 24-hour urinary calcium) were measured at baseline and 3 months of treatment with Bio-D3 capsule. Primary outcomes were the changes in the blood pressure and biochemical parameters.

    RESULTS: About 70% of our PA subjects have low vitamin D levels at baseline. Three months following treatment, there were significant: (a) improvement in 25(OH)D levels; (b) reduction in systolic blood pressure and plasma aldosterone concentration; and (c) improvement in the eGFR. The vitamin D deficient subgroup has the greatest magnitude of the systolic blood pressure reduction following treatment.

    CONCLUSIONS: This study demonstrated significant proportion of PA patients has vitamin D insufficiency. Vitamin D treatment improves these interrelated parameters possibly suggesting interplay between vitamin D, aldosterone, renal function and the blood pressure.

  20. Syasyila K, Gin LL, Jamaludin ANSJ
    J Cogn Psychother, 2024 Nov 11;38(4):353-359.
    PMID: 39528297 DOI: 10.1891/JCP-2023-0031
    This clinical case assessed the efficacy of cognitive behavioral therapy (CBT) in treating major depressive disorder in a 26-year-old female, Sara, attributing her depression to pregnancy, financial constraints, parental duties, and emotional stress. Sara had eight sessions of CBT, during which her symptoms were measured using the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory-Second Edition (BDI-II). Sara's depressive symptoms dramatically decreased after the intervention, moving her HAM-D and BDI-II scores from moderate to mild depression and from clinically depressed to mild, respectively. The assessment showed improved interest, concentration, energy levels, and a more positive self-perception. Integrating Malaysian cultural elements into CBT, emphasizing family support, community engagement, and spirituality positively impacted Sara. This study emphasizes the value of culturally appropriate CBT for depression as it can help with symptom management, challenging negative thoughts, and bolstering self-esteem. This method identifies and addresses cultural impacts on mental health, recommending the incorporation of cultural aspects in therapy, enhancing relapse prevention and quality of life for Malaysians experiencing depression.
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