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Fulltext Comparison of the Modified Barthel Index (MBI) Score Trends Among Workers With Stroke Receiving Robotic and Conventional Rehabilitation Therapy

Kamdi MKA, Shafei MN, Musa KI, Hanafi MH, Suliman MA

Cureus, 2023 Jan;15(1):e34207.
PMID: 36843743 DOI: 10.7759/cureus.34207

INTRODUCTION: Stroke is one of the top causes of adult-acquired disabilities and the fifth most prominent cause of death worldwide. Working-age populations contribute about 40% of the stroke cases which occur annually in Malaysia. The modified Barthel Index (MBI) score has been used for self-care assessment to determine if stroke patients can meet their fundamental needs. The study was designed to compare the trend of MBI scores of workers who had a stroke and underwent robotic rehabilitation therapy to those who had conventional therapy.
METHODOLOGY: A cohort study was conducted among workers who had a stroke in northeastern Malaysia. They were assigned either to undergo robotic or conventional rehabilitation therapy. The robotic therapy is performed three times per day for four weeks. Meanwhile, conventional therapy involved walking exercises five days per week for two weeks. Data were collected for both therapies on the admission, at week 2 and week 4. The MBI, modified Rankin Scale (mRS) and Hospital Anxiety and Depression Scale (HADS) trends were examined one month after the therapies. The R (version 4.2.1) (R Core Team, Vienna, Austria) and RStudio (R Studio PBC, Boston, USA) were applied to perform the descriptive analyses on the respective platforms. Repeated measures of analysis of variance were performed to evaluate the outcomes trend and the effectiveness of the two therapies was also compared.
RESULTS: A total of 54 stroke patients participated in this study of which 30 (55.6%) of them received robotic therapy. The age of the subjects ranged from 24 to 59 years and the majority (74.1%) were male. Stroke outcomes were evaluated using mRS, HADS, and MBI scores. Except for their age, the individuals' characteristics did not significantly differ between those undergoing conventional therapy and those receiving robotic therapy. After four weeks, it was found that the good mRS had increased, whereas the poor mRS had decreased. Comparing the therapy groups, the MBI scores improved significantly with time, although there were no significant differences between the therapy groups. However, the interaction term between the treatment group (p=0.031) and improvements over time was significant (p=0.001), indicating that robotic was more effective than conventional therapy in improving the MBI scores. For HADS score, there was a significant difference between the therapy groups (p=0.001), with those receiving robotic therapy having higher HADS score.
CONCLUSION: Functional recovery occurs in acute stroke patients when the mean Barthel Index score rises from the baseline (on admission) to week 2 (during therapy) and subsequently on discharge (week 4). Based on these findings, it appears that there was not one therapy superior to the other; nevertheless, robotic therapy may be better tolerated and more effective in certain individuals.
Fulltext The Combined Use of Interleukin-6 with Serum Albumin for Mortality Prediction in Critically Ill Elderly Patients: The Interleukin-6-to-albumin Ratio

Lim KY, Shukeri WFWM, Hassan WMNW, Mat-Nor MB, Hanafi MH

Indian J Crit Care Med, 2022 Oct;26(10):1126-1130.
PMID: 36876199 DOI: 10.5005/jp-journals-10071-24324

BACKGROUND: The association between interleukin-6 (IL-6) and serum albumin (ALB) with mortality in critically ill elderly patients, either as stand-alone biomarkers or in combination, has been scarcely reported. We, therefore, aimed to investigate the prognostic value of the IL-6-to-albumin ratio in this special population.
PATIENTS AND METHODS: This was a cross-sectional study conducted in the mixed intensive care unit (ICU) of two university-affiliated hospitals in Malaysia. Consecutive elderly patients (aged above or equal to 60 years) admitted to the ICU, who underwent simultaneous measurement of plasma IL-6 and serum ALB, were recruited. The prognostic value of the IL-6-to-albumin ratio was assessed by analysis of the receiver-operating characteristic (ROC) curve.
RESULTS: A total of 112 critically ill elderly patients were recruited. The outcome of all-cause ICU mortality was 22.3%. The calculated IL-6-to-albumin ratio was significantly higher in the non-survivors compared to the survivors {14.1 [interquartile range (IQR), 6.5-26.7] vs 2.5 [(IQR, 0.6-9.2) pg/mL, p <0.001]}. The area under the curve (AUC) of IL-6-to-albumin ratio for discrimination of ICU mortality was 0.766 [95% confidence interval (CI), 0.667-0.865, p <0.001] which was slightly higher than that of IL-6 and albumin alone. The ideal cut-off value of the IL-6-to-albumin ratio was above 5.7 with a sensitivity of 80.0% and specificity of 64.4%. After adjusting for severity of illness, the IL-6-to-albumin ratio remained as an independent predictor of ICU mortality with an adjusted odd ratio of 0.975 (95% CI, 0.952-0.999, p = 0.039).
CONCLUSION: The IL-6-to-albumin ratio offers a slight improvement in mortality prediction than either of its constituent individual biomarkers and as such, it may be a potential tool to aid in the prognostication of critically ill elderly patients although this requires further validation in a larger prospective study.
HOW TO CITE THIS ARTICLE: Lim KY, Shukeri WFWM, Hassan WMNW, Mat-Nor MB, Hanafi MH. The Combined Use of Interleukin-6 with Serum Albumin for Mortality Prediction in Critically Ill Elderly Patients: The Interleukin-6-to-albumin Ratio. Indian J Crit Care Med 2022;26(10):1126-1130.
Prevalence and Distribution of Major β-Thalassemia Mutations and HbE/β-Thalassemia Variant in Nepalese Ethnic Groups

Lama R, Yusof W, Shrestha TR, Hanafi S, Bhattarai M, Hassan R, et al.

Hematol Oncol Stem Cell Ther, 2022 Mar 01;15(1):279-284.
PMID: 33592169 DOI: 10.1016/j.hemonc.2021.01.004

BACKGROUND: Beta-thalassemia is a genetic disorder that is inherited in an autosomal recessive pattern. This genetic disease leads to a defective beta-globin hemoglobin chain causing partial or complete beta-globin chain synthesis loss. Beta-thalassemia major patients need a continuous blood transfusion and iron chelation to maintain the normal homeostasis of red blood cells (RBCs) and other systems in the body. Patients also require treatment procedures that are costly and tedious, resulting in a serious health burden for developing nations such as Nepal.
METHODS: A total of 61 individuals clinically diagnosed to have thalassemia were genotyped with multiplex amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Twenty-one major mutations were investigated using allele-specific primers grouped into six different panels.
RESULTS: The most common mutations found (23%) were IVS 1-5 (G-C) and Cd 26 (G-A) (HbE), followed by 619 deletion, Cd 8/9 (+G), Cd 16 (-C), Cd 41/42 (-TTCT), IVS 1-1 (G-T), Cd 19 (A-G), and Cd 17 (A-T) at 20%, 12%, 8%, 6%, 4%, 3%, and 1%, respectively.
CONCLUSION: The results of this study revealed that Nepal's mutational profile is comparable to that of its neighboring countries, such as India and Myanmar. This study also showed that thalassemia could be detected across 17 Nepal's ethnic groups, especially those whose ancestors originated from India and Central Asia.
Fulltext Comparative stability analysis of Indonesian banks: Markov Switching-Dynamic Regression for Islamic and conventional sectors

Mawardi I, Al Mustofa MU, Widiastuti T, Fanani S, Bakri MH, Hanafi Z, et al.

PLoS One, 2024;19(4):e0301398.
PMID: 38635825 DOI: 10.1371/journal.pone.0301398

The banking industry necessitates implementing an early warning system to effectively identify the factors that impact bank managers and enable them to make informed decisions, thereby mitigating systemic risk. Identifying factors that influence banks in times of stability and crisis is crucial, as it ultimately contributes to developing an improved early warning system. This study undertakes a comparative analysis of the stability of Indonesian Islamic and conventional banking across distinct economic regimes-crisis and stability. We analyze monthly banking data from December 2007 to November 2022 using the Markov Switching Dynamic Regression technique. The study focuses on conducting a comparative analysis between Islamic banks, represented by Islamic Commercial Bank (ICB) and Islamic Rural Bank (IRB), and conventional banks, represented by the Conventional Commercial Bank (CCB) and Conventional Rural Bank (CRB). The findings reveal that both Islamic and conventional banks exhibit a higher probability of being in a stable regime than a crisis regime. Notably, Islamic banks demonstrate a greater propensity to remain in a stable regime than their conventional counterparts. However, in a crisis regime, the likelihood of recovery for Sharia-compliant institutions is lower than for conventional banks. Furthermore, our analysis indicates that larger banks exhibit higher stability than their smaller counterparts regarding assets and size. This study pioneers a comprehensive comparison of the Z-score, employed as a proxy for stability, between two distinct classifications of Indonesian banks: Sharia (ICB and IRB) and conventional (CCB and CRB). The result is expected to improve our awareness of the elements that affect the stability of Islamic and conventional banking in Indonesia, leading to a deeper comprehension of their dynamics.
Improvements of mid-thigh circumferences following robotic rehabilitation in hemiparetic stroke patients

Mat Nawi NF, Simok AA, Hanafi MH, Mohd Ismail ZI

Physiother Res Int, 2024 Apr;29(2):e2091.
PMID: 38642068 DOI: 10.1002/pri.2091

INTRODUCTION: Stroke has emerged as the leading cause of disability globally. The provision of long-term rehabilitation to stroke survivors poses a health care burden to many countries. Robotic devices have created a major turning point in stroke rehabilitation program. Currently, the anthropometric evidence to support the benefit of robotic rehabilitation (RR) among stroke patients is scarce. Therefore, the aim of this study was to evaluate the impact of RR on the mid-thigh circumferences of the paretic limbs in stroke patients.
METHODS: Twenty stroke patients from conventional rehabilitation (CR) (n = 10) and RR (n = 10) groups were recruited through a purposive sampling method. Patients in the CR group received a two-hour session of a five-day-a-week home-based CR program for 4 weeks. Patients in the RR group received a five-day-a-week of an hour combined physiotherapy and occupational therapy session and a one-hour robotic therapy session using the HAL® Cyberdyne lower-limb, for 4 weeks. The mid-thigh circumferences of both limbs were measured on day 1 (baseline), week 2 and week 4 of rehabilitation program.
RESULTS: The results revealed no statistically significant difference in the mid-thigh circumferences between the paretic (F1.05,9.44 = 1.96, p = 0.20), and the normal (F1.05,9.44 = 1.96, p = 0.20) sides in the CR group (n = 10). For the comparison between the paretic and normal sides in the RR group (n = 10), the paretic mid-thigh circumferences revealed significant time effect results (F2,18 = 11.91, p = 0.001), which were due to changes between baseline and week 2, and baseline and week 4 measurements. Interestingly, the normal mid-thigh circumferences also revealed a significant time effect (F2,18 = 6.56, p = 0.007), which is due to changes between baseline and week 4. One-way analysis of variance was employed to compare the mean average between groups due to the difference in the baseline measurements of the mid-thigh circumferences between the paretic side of the CR and the RR groups. With this adjustment, the average means mid-thigh circumferences after 4 weeks of therapy were shown to be significantly different between the CR and RR groups (F1,18 = 12.49, p = 0.02).
CONCLUSION: Significant increments in the mid-thigh circumferences following RR were seen in the paretic limbs of stroke patients. Hence, this study may provide some insights into further potential research related to the benefits of RR in stroke patients.
Fulltext Anti-D Alloimmunization Following Rhesus-Incompatible Platelet Transfusion in a Myelodysplastic Syndrome Patient

Hanafi R, Zulkeflee RH, Hassan MN, Saidin NIS, Adzahar S, Hassan R

Cureus, 2024 Mar;16(3):e57165.
PMID: 38681415 DOI: 10.7759/cureus.57165

Patients with myelodysplastic syndrome (MDS) often need platelet transfusions to address thrombocytopenia. The risk of alloimmunization, particularly in Rhesus (Rh) incompatibility between donors and recipients during platelet transfusions, is heightened, especially with whole blood-derived pooled platelets as opposed to apheresis platelets. Although the occurrence of alloimmunization from platelet transfusions is minimal, there is an ongoing debate about whether Rh immune globulin (RhIg) should be administered to Rhesus D (RhD)-negative recipients of RhD-positive platelet units. We present a unique case of anti-D alloimmunization in a 56-year-old patient with underlying MDS following multiple platelet transfusions but never received packed cell transfusion or anti-D immunoglobulin. Some studies advocate for RhIg administration in specific scenarios and for certain patient populations. This case underscores the importance of considering Rhesus compatibility or administering anti-D immunoglobulin in cases where frequent platelet transfusions are required.
Fulltext Factors associated with vascular and neurological complications of hand-arm vibration syndrome among tire shop workers in Kelantan, Malaysia

Qamruddin AA, Nik Husain NR, Sidek MY, Hanafi MH, Mohd Ripin Z

J Occup Health, 2021 Jan;63(1):e12220.
PMID: 33942440 DOI: 10.1002/1348-9585.12220

OBJECTIVE: Prolonged exposure to hand-arm vibration (HAV) at the workplace is associated with hand-arm vascular syndrome (HAVS). This study aimed to determine the prevalence and the factors associated with the vascular and neurological complications of HAVS among tire shop workers in Kelantan, Malaysia.
METHODS: A cross-sectional study involving 200 tire shop workers from two districts in Kelantan was conducted. Data were collected at the field using Malay Translated HAVS questionnaire, and hand-arm vibration was measured. Multiple logistic regression analysis was used to determine the associated factors.
RESULTS: The prevalence of vascular and neurological complications of HAVS among the tire shop workers was 12.5% (95% CI: 10.16, 14.84) and 37.0% (95% CI: 30.31, 43.69), respectively. From multiple logistic regression analysis, only A(8) of HAV exposure was significantly associated with the development of vascular complications and A(8) of HAV exposure, age. and body mass index were significantly associated with the development of neurological complications of HAVS.
CONCLUSION: This study has identified that HAVS is a significant problem among workers exposed to HAV in a warm environment. A(8) of HAV exposure is significantly associated with the development of both vascular and neurological complications. Therefore, there is a need for better control of vibration exposure in Malaysia.
Fulltext Isolation and expression analysis of novel silicon absorption gene from roots of mangrove (Rhizophora apiculata) via suppression subtractive hybridization

Sahebi M, Hanafi MM, Abdullah SN, Rafii MY, Azizi P, Nejat N, et al.

Biomed Res Int, 2014;2014:971985.
PMID: 24516858 DOI: 10.1155/2014/971985

Silicon (Si) is the second most abundant element in soil after oxygen. It is not an essential element for plant growth and formation but plays an important role in increasing plant tolerance towards different kinds of abiotic and biotic stresses. The molecular mechanism of Si absorption and accumulation may differ between plants, such as monocotyledons and dicotyledons. Silicon absorption and accumulation in mangrove plants are affected indirectly by some proteins rich in serine and proline amino acids. The expression level of the genes responsible for Si absorption varies in different parts of plants. In this study, Si is mainly observed in the epidermal roots' cell walls of mangrove plants compared to other parts. The present work was carried out to discover further information on Si stress responsive genes in Rhizophora apiculata, using the suppression subtractive hybridization technique. To construct the cDNA library, two-month-old seedlings were exposed to 0.5, 1, and 1.5 mM SiO2 for 15 hrs and for 1 to 6 days resulting in a total of 360 high quality ESTs gained. Further examination by RT-PCR and real-time qRT-PCR showed the expression of a candidate gene of serine-rich protein.
Fulltext Pap Smear Images Classification Using Machine Learning: A Literature Matrix

Alias NA, Mustafa WA, Jamlos MA, Alquran H, Hanafi HF, Ismail S, et al.

Diagnostics (Basel), 2022 Nov 22;12(12).
PMID: 36552907 DOI: 10.3390/diagnostics12122900

Cervical cancer is regularly diagnosed in women all over the world. This cancer is the seventh most frequent cancer globally and the fourth most prevalent cancer among women. Automated and higher accuracy of cervical cancer classification methods are needed for the early diagnosis of cancer. In addition, this study has proved that routine Pap smears could enhance clinical outcomes by facilitating the early diagnosis of cervical cancer. Liquid-based cytology (LBC)/Pap smears for advanced cervical screening is a highly effective precancerous cell detection technology based on cell image analysis, where cells are classed as normal or abnormal. Computer-aided systems in medical imaging have benefited greatly from extraordinary developments in artificial intelligence (AI) technology. However, resource and computational cost constraints prevent the widespread use of AI-based automation-assisted cervical cancer screening systems. Hence, this paper reviewed the related studies that have been done by previous researchers related to the automation of cervical cancer classification based on machine learning. The objective of this study is to systematically review and analyses the current research on the classification of the cervical using machine learning. The literature that has been reviewed is indexed by Scopus and Web of Science. As a result, for the published paper access until October 2022, this study assessed past approaches for cervical cell classification based on machine learning applications.
Fulltext Factors Associated with Attitudes towards Rejecting Intimate Partner Violence among Young Adults in Malaysia

Hanafi WSWM, Ismail TAT, Ghazali AK, Sulaiman Z, Daud A

Int J Environ Res Public Health, 2022 May 08;19(9).
PMID: 35565113 DOI: 10.3390/ijerph19095718

Intimate partner violence (IPV) is a serious public health issue, which is health threatening across all age groups, including young adults, and makes them and vulnerable. The rejection of IPV and willingness to disclose IPV as part of the solution are important as they correlate to this concealed violent behavior. This study aimed to investigate determinants of attitudes towards rejecting IPV among young adults. A cross-sectional study was carried out on 405 young adults attending premarital courses who were selected using purposive sampling. A validated questionnaire (MYPAIPVQ) was used as the study instrument. Logistic regression analyses were performed to test for associations between sociodemographic characteristics and relationship status with attitudes towards IPV. Attitudes towards rejecting IPV included not accepting IPV and have the willing to disclose it. About half of the premarital young adults (50.4%) had attitudes towards rejecting IPV. In the regression analysis, age (AdjOR 1.12), female (AdjOR 2.49), self-employed (AdjOR 0.20), and drama as sources of information (AdjOR 3.66) were significantly associated with attitudes towards rejecting IPV. The findings have potentially important implications for interventions aimed at preventing violence among the young adult population as they are vulnerable to being involved in IPV in the future.
Fulltext Evaluation of the Time Course on the Effectiveness of WHO Standard Pyrethroid and Carbamate Impregnated Test Papers against Anopheles stephensi, the Main Malaria Vector in Iran

Dehghan A, Moosa-Kazemi SH, Sedaghat MM, Vatandoost H, Hanafi-Bojd AA

J Arthropod Borne Dis, 2023 Mar;17(1):72-82.
PMID: 37609566 DOI: 10.18502/jad.v17i1.13203

BACKGROUND: Anopheles stephensi is a major vector of malaria in some parts of the world. A standard method for determining resistance in adult mosquito populations is the bioassay test recommended by the world health organization (WHO). The papers used in this method have an expiry date. This study aimed to determine the effectiveness of outdated susceptibility test papers for use in insecticide resistance monitoring programs.
METHODS: Beech and Bandar Abbas strains of An. stephensi were reared in the insectary. Permethrin 0.75%, Deltamethrin 0.05%, and Bendiocarb 0.1% impregnated test papers prepared by Universiti Sains Malaysia were used. Probit analysis was used to analyze the results and prepare time-mortality regression lines of LT50 and LT90.
RESULTS: There was a difference in the mortality of both tested strains of An. stephensi was exposed to all tested insecticides. Both expired and not expired Permethrin and Deltamethrin papers induced 100% mortality at the diagnostic time (60min), but their insecticidal properties were reduced gradually in serial times. The highest efficacy of test papers was in the first trimester after the expiry date and decreased over time.
CONCLUSION: At the diagnostic time of 60 minutes, the mortality rate of both dated and expired papers was 100% in the pyrethroid insecticides, even three years after expiry dates, if stored in the package provided by the producer, in a refrigerator. This value was reduced to less than 100% in the expired papers of Bendiocarb comparing the dated papers that induced 100% mortality.
Fulltext Histopathology imagery dataset of Ph-negative myeloproliferative neoplasm

Mohamad Yusof UK, Mashohor S, Hanafi M, Md Noor S, Zainal N

Data Brief, 2023 Oct;50:109484.
PMID: 37636134 DOI: 10.1016/j.dib.2023.109484

Tumorous cancer has been a widely known and well-studied medical phenomenon; however, rare diseases like Myeloproliferative Neoplasm (MPN) have received less attention, leading to delayed diagnosis. Despite the availability of advanced technology in diagnostic tools that can boost the procedure, the morphological assessment of bone marrow trephine (BMT) images remains critical to confirm and differentiate MPN subtypes. This paper reports a histopathological imagery dataset that was created to focus on the most common MPN from the Philadelphia Chromosome (Ph)-negative type, namely Essential Thrombocythemia (ET), Polycythemia Vera (PV), and Primary Myelofibrosis (MF). The dataset consisted of 300 BMT images that can be used to enable computer vision applications, such as image segmentation, disease classification, and object recognition, in assisting the classification of the MPN disease. Ethical approval was obtained from the Ministry of Health, Malaysia and the bone marrow trephine images were captured using a digital microscope from the Olympus model (BX41 Dual head microscope) with x10, x20, and x40 lens types. The development of comprehensive tools deployed from this dataset can assist medical practitioners in diagnosing diseases, thus overcoming the current challenges.
Fulltext New robustaflavone from Garcinia latissima Miq. leave and Its antibacterial activity

Ambarwati NSS, Elya B, Malik A, Omar H, Hanafi M, Ahmad I

J Adv Pharm Technol Res, 2022;13(1):50-55.
PMID: 35223441 DOI: 10.4103/japtr.japtr_132_21

Isolation and determination of antibacterial compounds from plants are essential to obtain a new antibacterial as a substitute for conventional resistant antibiotics. This study aims to isolate and identify a new robustaflavone as antibacterial activity from Garcinia latissima Miq. leave. In this study, the isolation process was carried out using column chromatography followed by preparative thin layer chromatography (TLC) based on the TLC profile. The fraction D was tested for anti-bacterial Bacillus subtilis using the TLC bioautography method. The isolates obtained were then identified using 1H-NMR, 13C-NMR, distortionless enhancement by polarization transfer, heteronuclear single quantum coherence, and heteronuclear multiple bond coherence. The Activity assay of the isolate was performed using the microdilution method. A pure compound obtained the result of the separation process with eluent n-hexane: Ethyl acetate (3:2) with Rf 0.6. This spot follows the spot in the contact bioautographic result of fraction D, the spot with Rf 0.6 gives an inhibition zone. After identifying and purifying the isolate were known as Robustaflavone, this compound has activity against B. subtilis with a (minimum inhibitory concentration) value of 2500 ppm. Robustaflavone successfully isolated and identified from G. latissima leave and its antibacterial activity.
Fulltext Valorization of rare earth processing byproducts for agriculture usage

Hanafi MM, Azizi P, Akinbola ST, Ismail R, Sahibin AR, Wan Mohd Razi I, et al.

Sci Rep, 2021 Jul 27;11(1):15234.
PMID: 34315931 DOI: 10.1038/s41598-021-93704-9

Sandy texture soil, a major problem for agriculture requires structure and capacity improvements. However, utilization of soil conditioner may arrest this problem. This research was carried out to investigate the accumulated levels of metal ions and radionuclides in water, soil and plants following phosphogypsum organic (PG organic) added to a sandy soil for 23-month in 3 cropping seasons. The condition in the field was simulated in the laboratory using an open leaching column for 30-day under constant but different pH of leachant. More ions were released at pH 5.6. The metal ions measured in the surface and borehole water, and soils were below the target values for respective standard raw drinking water. The metal ions did not accumulate in soil, plant and grain, and water as indicated by biological accumulation coefficients, contamination factors, I-geo index and pollution load index in a sandy soil that received the PG organic. Naturally occurring radionuclide concentrations, such as 226Ra, 228Ra, and 40K, in soil and plant tissue were found to be lower than the average value reported by several earlier studies. Under field condition the pH of water (i.e., rainfall) was greater than pH 5.6, thus renders PG organic became less soluble. There was no leaching of natural occurring radionuclides to the groundwater. Therefore, the application of PG organic to the studied soil had no impact on the soil, plants, and water and suitable as a soil conditioner in sandy texture soils.
Molecular markers: a potential resource for ginger genetic diversity studies

Ismail NA, Rafii MY, Mahmud TM, Hanafi MM, Miah G

Mol Biol Rep, 2016 Dec;43(12):1347-1358.
PMID: 27585572

Ginger is an economically important and valuable plant around the world. Ginger is used as a food, spice, condiment, medicine and ornament. There is available information on biochemical aspects of ginger, but few studies have been reported on its molecular aspects. The main objective of this review is to accumulate the available molecular marker information and its application in diverse ginger studies. This review article was prepared by combing material from published articles and our own research. Molecular markers allow the identification and characterization of plant genotypes through direct access to hereditary material. In crop species, molecular markers are applied in different aspects and are useful in breeding programs. In ginger, molecular markers are commonly used to identify genetic variation and classify the relatedness among varieties, accessions, and species. Consequently, it provides important input in determining resourceful management strategies for ginger improvement programs. Alternatively, a molecular marker could function as a harmonizing tool for documenting species. This review highlights the application of molecular markers (isozyme, RAPD, AFLP, SSR, ISSR and others such as RFLP, SCAR, NBS and SNP) in genetic diversity studies of ginger species. Some insights on the advantages of the markers are discussed. The detection of genetic variation among promising cultivars of ginger has significance for ginger improvement programs. This update of recent literature will help researchers and students select the appropriate molecular markers for ginger-related research.
Traumatic Orbital Emphysema Following Blunt Trauma and Nose Blowing

Ng QX, Lim XC, Chong JC, Hanafi H, Lim LT

Cureus, 2023 Nov;15(11):e48584.
PMID: 38084184 DOI: 10.7759/cureus.48584

Orbital emphysema commonly resolves with no morbidity. However, sight-threatening complications, such as central retinal artery occlusion and ischemic optic neuropathy, may occur, which can result in poor visual outcomes. Plain skull X-ray, which is widely available, is a useful tool in identifying orbital emphysema. We report a case of a 29-year-old gentleman with underlying allergic rhinitis who presented with a painless, progressively increasing periorbital swelling of the right eye, which was aggravated by nose blowing. He had a history of blunt trauma one day prior to the presentation. Visual acuity was unaffected and optic nerve function tests were unremarkable. There was right upper lid swelling with crepitations, right hypoglobus with restricted upward gaze movement, and right conjunctival injection. Intraocular pressure was within normal limits. The posterior segment examination was unremarkable. A plain skull radiograph revealed a "black eyebrow sign" over the right orbit with no obvious orbital wall fracture. Computed tomography of the orbit showed focal indentation over the right lamina papyracea with superior orbito-palpebral emphysema. Systemic antibiotics, steroid nasal spray, and oral antihistamines were initiated with the prohibition of nose blowing. On post-trauma day five, he made an uneventful recovery. High clinical suspicion and thorough clinical examination with the aid of a plain skull radiograph can diagnose orbital emphysema in order for prompt referral to be undertaken to prevent morbidity. Clinicians should consider orbital emphysema as a differential diagnosis for periorbital swelling, especially if there was a preceding trauma.
Fulltext Investigation of alpha-glucosidase inhibition activity of Artabotrys sumatranus leaf extract using metabolomics, machine learning and molecular docking analysis

Rosa D, Elya B, Hanafi M, Khatib A, Budiarto E, Nur S, et al.

PLoS One, 2025;20(1):e0313592.
PMID: 39752479 DOI: 10.1371/journal.pone.0313592

One way to treat diabetes mellitus type II is by using α-glucosidase inhibitor, that will slow down the postprandial glucose intake. Metabolomics analysis of Artabotrys sumatranus leaf extract was used in this research to predict the active compounds as α-glucosidase inhibitors from this extract. Both multivariate statistical analysis and machine learning approaches were used to improve the confidence of the predictions. After performance comparisons with other machine learning methods, random forest was chosen to make predictive model for the activity of the extract samples. Feature importance analysis (using random feature permutation and Shapley score calculation) was used to identify the predicted active compound as the important features that influenced the activity prediction of the extract samples. The combined analysis of multivariate statistical analysis and machine learning predicted 9 active compounds, where 6 of them were identified as mangiferin, neomangiferin, norisocorydine, apigenin-7-O-galactopyranoside, lirioferine, and 15,16-dihydrotanshinone I. The activities of norisocorydine, apigenin-7-O-galactopyranoside, and lirioferine as α-glucosidase inhibitors have not yet reported before. Molecular docking simulation, both to 3A4A (α-glucosidase enzyme from Saccharomyces cerevisiae, usually used in bioassay test) and 3TOP (a part of α-glucosidase enzyme in human gut) showed strong to very strong binding of the identified predicted active compounds to both receptors, with exception of neomangiferin which only showed strong binding to 3TOP receptor. Isolation based on bioassay guided fractionation further verified the metabolomics prediction by succeeding to isolate mangiferin from the extract, which showed strong α-glucosidase activity when subjected to bioassay test. The correlation analysis also showed a possibility of 3 groups in the predicted active compounds, which might be related to the biosynthesis pathway (need further research for verification). Another result from correlation analysis was that in general the α-glucosidase inhibition activity in the extract had strong correlation to antioxidant activity, which was also reflected in the predicted active compounds. Only one predicted compound had very low positive correlation to antioxidant activity.
Fulltext Awareness and Knowledge of Oral Cancer among Siamese Ethnic Group in Tumpat, Kelantan

Kassim NK, Adnan MM, Wern CW, Ru LZ, Hanafi MH, Yusoff A

Malays J Med Sci, 2017 Aug;24(4):47-54.
PMID: 28951689 MyJurnal DOI: 10.21315/mjms2017.24.4.6

INTRODUCTION: Oral cancer is a life-threatening disease. Lack of public awareness is a potent barrier for the early detection of oral cancer, especially for high-risk populations.
OBJECTIVE: This study aimed to determine the awareness and knowledge of the signs, symptoms and risk factors of oral cancer among a Siamese ethnic group in Tumpat, Kelantan.
METHODS: A cross-sectional study was conducted, using a guided questionnaire on sociodemography, habits, awareness and knowledge of the signs, symptoms and risk factors of oral cancer. Individuals under 18 years old and who had been diagnosed with oral cancer were excluded from this study.
RESULTS: A total of 195 respondents participated, 61.5% were female and the mean age was 46 (1.64). About 41% of the respondents had received secondary education and 35.4% were illiterate. Most respondents were self-employed (21.5%), followed by farmers (19.5%) and housewives (20%). The majority of them had a monthly income that fell below the poverty level of RM 830 (76.9%). Among the respondents, 22.6% had the habit of smoking, 25.6% consumed alcohol, 8.2% were betel quid chewers and 2.6% chewed tobacco. Out of 195 respondents, only 6.7% were aware of oral cancer. About 16.9% of the respondents correctly answered all of the questions regarding the signs and symptoms of oral cancer and only 4.1% knew the risk factors of oral cancer.
CONCLUSION: The awareness and knowledge of oral cancer in this targeted population were unsatisfactory. Future effective health promotion programs and education should be emphasised.
Fulltext Provision of Prosthetic Services Following Lower Limb Amputation in Malaysia

Arifin N, Hasbollah HR, Hanafi MH, Ibrahim AH, Rahman WAWA, Aziz RC

Malays J Med Sci, 2017 Oct;24(5):106-111.
PMID: 29386978 MyJurnal DOI: 10.21315/mjms2017.24.5.12

The incidence of lower limb amputation is high across the globe and continues to be a major threat to morbidity and mortality. Consequently, the provision of high quality and effective prosthetics services have been known as an essential component for a successful rehabilitation outcome. In Malaysia, amputation prevalence has been increasing in which several main components of service delivering aspects (such as service intervention, prosthetic personnel) should be anticipated to accommodate for the increasing demand. This article highlights the hurdles experienced in providing prosthetic services in Malaysia from multiple aspects such as financial burden to acquire the prosthesis and lack of expertise to produce quality prosthesis. This paramount issues consequently justify for the urgency to carry out national level survey on the current statistics of lower limb amputation and to ascertain the available workforce to provide a quality prosthetics services. Only with accurate and current information from the national survey, strategies and policies aimed at enhancing the outcome from prosthetics services can be achieved.
Fulltext Periodontal Health of Pre-Dialysis Chronic Kidney Disease Patients in a Northeast Peninsular Malaysia Tertiary Hospital

Ibrahim HA, Kassim NK, Jamsari FZ, Zainuddin SLA, Hanafi MH, Adnan AS

Malays J Med Sci, 2020 Feb;27(1):106-114.
PMID: 32158350 MyJurnal DOI: 10.21315/mjms2020.27.1.11

Introduction: Chronic kidney disease (CKD) is associated with periodontal disease due to its hyperinflammatory state. Limited studies have explored the prevalence of periodontal disease among CKD patients in Malaysia.
Objective: To assess the periodontal status of pre-dialysis CKD patients in Hospital Universiti Sains Malaysia.
Methods: A total of 46 pre-dialysis CKD patients who attended the nephrology clinic at Hospital Universiti Sains Malaysia were enrolled in this study. Periodontal examination was performed using the periodontal probing depth (PPD), clinical attachment loss (CAL) and plaque index.
Results: The majority of the CKD patients were Malay (95.7%) and 80.4% were males. The mean age of the patients was 58.5 years. Using PPD measurement, 37 (74.0%) of the patients had mild periodontitis, 9 (20.0%) had moderate periodontitis and 3 (6.0%) had no periodontitis. Based on CAL measurement, 12 (26%) patients had mild periodontitis, 29 (63.0%) had moderate periodontitis and 5 (11%) had severe periodontitis. The mean (standard deviation [SD]) value of mild and moderate-to-severe periodontitis by PPD measurement were 4.26 (0.26) and 5.24 (0.36), respectively. The mean of mild and moderate-to-severe periodontitis by CAL measurement were 2.66 (0.62) and 4.98 (0.73), respectively. There was no correlation between the periodontal parameters and estimated glomerular filtration rate (PPD: r = -0.160, P = 0.914; CAL: r = -0.135, P = 0.372; plaque index: r = 0.005, P = 0.974).
Conclusion: This study revealed a greater prevalence and severity of chronic periodontitis among CKD patients. Thus, the periodontal health of CKD patients' needs to be screened and monitored.

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