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  1. Fulltext Computed Tomography (CT) Imaging of Injuries from Blunt Abdominal Trauma: A Pictorial Essay
    Hassan R, Abd Aziz A
    Malays J Med Sci, 2010 Apr;17(2):29-39.
    PMID: 22135535 MyJurnal
    Blunt abdominal trauma can cause multiple internal injuries. However, these injuries are often difficult to accurately evaluate, particularly in the presence of more obvious external injuries. Computed tomography (CT) imaging is currently used to assess clinically stable patients with blunt abdominal trauma. CT can provide a rapid and accurate appraisal of the abdominal viscera, retroperitoneum and abdominal wall, as well as a limited assessment of the lower thoracic region and bony pelvis. This paper presents examples of various injuries in trauma patients depicted in abdominal CT images. We hope these images provide a resource for radiologists, surgeons and medical officers, as well as a learning tool for medical students.
  2. Fulltext Computed tomography (CT) of bowel and mesenteric injury in blunt abdominal trauma: a pictorial essay
    Hassan R, Abd Aziz A, Mohamed SKC
    Med J Malaysia, 2012 Aug;67(4):445-51; quiz 452.
    PMID: 23082464 MyJurnal
    Computed tomography (CT) is currently the diagnostic modality of choice in the evaluation of clinically stable patients with blunt abdominal trauma, including the assessment of blunt bowel and mesenteric injuries. CT signs of bowel and/or mesenteric injuries are bowel wall defect, free air, oral contrast material extravasation, extravasation of contrast material from mesenteric vessels, mesenteric vascular beading, abrupt termination of mesenteric vessels, focal bowel wall thickening, mesenteric fat stranding, mesenteric haematoma and intraperitoneal or retroperitoneal fluid. This pictorial essay illustrates CT features of bowel and/or mesenteric injuries in patients with blunt abdominal trauma. Pitfalls in interpretation of images are emphasized in proven cases.
  3. Lung abscess rather than pneumatocele following kerosene ingestion
    Abd Aziz A, Abdullah AF, Mahmud A
    Br J Hosp Med (Lond), 2007 Nov;68(11):616-7.
    PMID: 18087856 DOI: 10.12968/hmed.2007.68.11.27686
  4. Fulltext Calcification of the Alar Ligament Mimics Fracture of the Craniovertebral Junction (CVJ): An Incidental Finding from Computerised Tomography of the Cervical Spine Following Trauma
    Che Mohamed SK, Abd Aziz A
    Malays J Med Sci, 2009 Oct;16(4):69-72.
    PMID: 22135515 MyJurnal
    When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury.
  5. Enhanced magnetic separation and photocatalytic activity of nitrogen doped titania photocatalyst supported on strontium ferrite
    Abd Aziz A, Yong KS, Ibrahim S, Pichiah S
    J Hazard Mater, 2012 Jan 15;199-200:143-50.
    PMID: 22100220 DOI: 10.1016/j.jhazmat.2011.10.069
    An enhanced ferromagnetic property, visible light active TiO(2) photocatalyst was successfully synthesized by supporting strontium ferrite (SrFe(12)O(19)) onto TiO(2) doped with nitrogen (N) and compared with N-doped TiO(2). The synthesized catalysts were further characterized with X-ray diffraction (XRD), transmission electron microscope (TEM), energy dispersive X-ray spectroscopy (EDS), BET surface area analysis, vibrating sample magnetometer (VSM), X-ray photon spectroscopy (XPS) and visible light spectroscopy analysis for their respective properties. The XRD and EDS revealed the structural and inorganic composition of N-TiO(2) supported on SrFe(12)O(19). The supported N-TiO(2) exhibited a strong ferromagnetic property with tremendous stability against magnetic property losses. It also resulted in reduced band gap (2.8 eV) and better visible light absorption between 400 and 800 nm compared to N-doped TiO(2). The photocatalytic activity was investigated with a recalcitrant phenolic compound namely 2,4-dichlorophenol (2,4-DCP) as a model pollutant under direct bright and diffuse sunlight exposure. A complete degradation of 2,4-DCP was achieved with an initial concentration of 50mg/L for both photocatalysts in 180 min and 270 min respectively under bright sunlight. Similarly the diffuse sunlight study resulted in complete degradation for supported N-TiO(2) and >85% degradation N-TiO(2), respectively. Finally the supported photocatalyst was separated under permanent magnetic field with a mass recovery ≈ 98% for further reuse.
  6. Fulltext Augmenting ECG Data with Multiple Filters for a Better Emotion Recognition System
    Hasnul MA, Ab Aziz NA, Abd Aziz A
    Arab J Sci Eng, 2023 Jan 11.
    PMID: 36685996 DOI: 10.1007/s13369-022-07585-9
    A physiological-based emotion recognition system (ERS) with a unimodal approach such as an electrocardiogram (ECG) is not as popular compared to a multimodal approach. However, a single modality has the advantage of lower development and computational cost. Therefore, this study focuses on a unimodal ECG-based ERS. The ECG-based ERS has the potential to become the next mass-adopted consumer application due to the wide availability of wearable and mobile ECG devices in the market. Currently, ECG-inclusive affective datasets are limited, and many of the existing datasets have small sample sizes. Hence, ECG-based ERS studies are stunted by the lack of quality data. A novel multi-filtering augmentation technique is proposed here to increase the sample size of the ECG data. This technique augments the ECG signals by cleaning the data in different ways. Three small ECG datasets labelled according to emotion state are used in this study. The benefit of the proposed augmentation techniques is measured using the classification accuracy of five machine learning algorithms; k-nearest neighbours (KNN), support vector machine, decision tree, random forest and multilayer perceptron. The results show that with the proposed technique, there is a significant improvement in performance for all the datasets and classifiers. KNN classifier improved the most with the augmented data and the reported classification accuracies of over 90%.
  7. Fulltext Two cases of congenital vallecular cyst: a reminder of the potentially fatal cause of upper airway obstruction in infants
    Abd Aziz A, Abdullah AF, Ahmad RA
    Malays J Med Sci, 2010 Jul;17(3):68-73.
    PMID: 22135553 MyJurnal
    Vallecular cyst, a benign yet rare laryngeal lesion, may cause stridor and even life-threatening upper airway obstruction in infants. It can cause apnoea and poor feeding habits, thus reducing the chance of survival. Although laryngomalacia remains the most common cause of stridor in this age group, awareness and a high level of suspicion for this condition can help lead to early management and intervention. Direct laryngoscopy is accepted as the gold standard for diagnostic purposes, and marsupialisation of the cyst is the preferred treatment. We describe 2 cases of vallecular cysts in infants admitted to our hospital where timely diagnoses led to appropriate treatment.
  8. Fulltext Computed tomography of blunt spleen injury: a pictorial review
    Hassan R, Abd Aziz A, Md Ralib AR, Saat A
    Malays J Med Sci, 2011 Jan;18(1):60-7.
    PMID: 22135575 MyJurnal
    The spleen is one of the organs most frequently injured in blunt abdominal trauma. Computed tomography (CT) scanning can accurately detect splenic injury and is currently the imaging modality of choice in assessing clinically stable patients with blunt abdominal trauma. The CT features of spleen injury include lacerations, subcapsular or parenchymal haematomas, active haemorrhage, and vascular injuries. We present a pictorial review of the spectrum of CT findings for blunt splenic injuries. This article will be a useful reference for radiologists and surgeons as CT scan is widely used for the assessment of splenic injuries and contributes to the current trend towards nonsurgical management of this injury.
  9. Fulltext Psychometric properties of the 'Skala Kepuasan Interaksi Perubatan-11' to measure patient satisfaction with physician-patient interaction in Malaysia
    Abd Aziz A, Izyan Farhana Nordin N, Mohd Noor N, Bachok N, Nor Ismalina Isa S
    Fam Pract, 2014 Apr;31(2):236-44.
    PMID: 24317538 DOI: 10.1093/fampra/cmt062
    Background. Patient satisfaction influences the outcomes of the patient-physician encounter.
    Objective. The objective of this study was to validate the Malay version patient satisfaction
    (MISS-21) questionnaire using a confirmatory validity approach.
    Methods. A cross-sectional study was conducted involving 252 patients attending primary health
    clinic, Hospital Universiti Sains Malaysia. Construct validity (convergent and discriminant) using
    confirmatory factor analysis and internal consistency were performed after the translation, content
    validity and face validity processes. Criterion validity was assessed using Pearson correlations
    with the scale of shared decision making 9-item questionnaire (SDMQ-9). The data was
    analysed using Analysis of Moment Structure version 19.
    Results. A total of 252 (100%) outpatients responded to this study. The final model that consists
    of three domains with 11 items had a good fit; (χ2
    (df) = 65.805 (32), P 
  10. Fulltext Correlation Study Between Clinical Special Tests for Myelopathy and Static MRI Parameters in Patients of Malaysian Population Treated for Cervical Dysfunction
    Zakaria Mohamad Z, Sharifudin MA, Din H, Abd Aziz A, Karupiah RK
    Cureus, 2021 Oct;13(10):e18826.
    PMID: 34804683 DOI: 10.7759/cureus.18826
    INTRODUCTION: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction. Magnetic resonance imaging (MRI) remains the imaging modality of choice, but its findings are not completely specific for clinically significant CSM. This cross-sectional study aims to determine the pathoanatomy of CSM in patients and analyze the correlations between clinical key symptoms, myelopathic signs, and MRI findings.

    METHODS: Patients with CSM aged 30 to 80 years old with no previous cervical spine disease or injuries were recruited. Clinical parameters include myelopathic hand signs and other clinical-specific tests. The MRI findings were analyzed for level of compression, underlying degenerative pathology, and parameters for cord compression.

    RESULTS: Thirty patients were recruited. The most common myelopathic signs observed were positive Hoffmann's sign and the presence of reverse brachioradialis reflex. All patients had either degenerative or prolapse disc changes on MRI. There was a positive correlation between the clinical key features with MRI parameters for canal and cord diameter. The transverse cord diameter, cord compression ratio, and approximate cord area were the only independent variables related to almost all the positive clinical specific tests. All three have a moderate to strong correlation with the clinical findings.

    CONCLUSION: The MRI parameters such as canal and cord size of the cervical spine are an objective reflection of compression on the spinal cord. Correlations observed indicate cord compression that plays a major role in the pathophysiology of CSM. These measurements are sensitive indicators of canal stenosis and play a significant role in predicting the severity and outcome of CSM.

  11. Amalgamation of N-graphene quantum dots with nanocubic like TiO2: an insight study of sunlight sensitive photocatalysis
    Lim PF, Leong KH, Sim LC, Abd Aziz A, Saravanan P
    Environ Sci Pollut Res Int, 2019 Feb;26(4):3455-3464.
    PMID: 30515688 DOI: 10.1007/s11356-018-3821-1
    In this work, a sunlight-sensitive photocatalyst of nanocubic-like titanium dioxide (TiO2) and N-doped graphene quantum dots (N-GQDs) is developed through a simple hydrothermal and physical mixing method. The successful amalgamation composite photocatalyst characteristics were comprehensively scrutinized through various physical and chemical analyses. A complete removal of bisphenol A (BPA) is attained by a synthesized composite after 30 min of sunlight irradiation as compared to pure TiO2. This clearly proved the unique contribution of N-GQDs that enhanced the ability of light harvesting especially under visible light and near-infrared region. This superior characteristic enables it to maximize the absorbance in the entire solar spectrum. However, the increase of N-GQDs weight percentage has created massive oxygen vacancies that suppress the generation of active radicals. This resulted in a longer duration for a complete removal of BPA as compared to lower weight percentage of N-GQDs. Hence, this finding can offer a new insight in developing effective sunlight-sensitive photocatalysts for various complex organic pollutants degradation.
  12. Fulltext Exercise and pre-habilitation with high whey-protein-based meal replacement therapy promote weight loss and preserve muscle mass before bariatric surgery
    Ho C, Samwil SNM, Kahairudin Z, Jamhuri N, Abd Aziz A
    Asian J Surg, 2023 Sep;46(9):3716-3721.
    PMID: 36931924 DOI: 10.1016/j.asjsur.2023.03.026
    BACKGROUND: Bariatric surgery is considered as an effective therapy for those with morbid obesity. Preoperative weight loss with a very low-calorie diet is commonly used to ease the bariatric surgery. Pre-habilitation increases functional and physiological capacity. The study demonstrated the changes of body composition and functional status following short term pre-habilitation before bariatric surgery.

    METHOD: This prospective study targeted those admitted for bariatric surgery. Participants underwent the biweekly pre-habilitation program included an individualized high whey-based protein very low-calorie (VLCHP) enteral regime (600-900 kcal/day) and moderate intensive exercise before bariatric surgery. Body composition and waist circumference were assessed after fortnight. Participants were segregated into morbid obese (MOG) (BMI <49 kg/m2) and super morbid obese group (SMOG) (BMI ≥50 kg/m2) for analysis.

    RESULT: Majority of participants were female (71%) with median age 36.0 years old (MOG) and 34.3 years old (SMOG) respectively. SMOG achieved significant greater loss in weight (-7.4 kg vs -4.0 kg), fat percentage (-4.4% vs -1.7%) and fat mass (-9.9 kg vs -3.8 kg); but MOG had a significant increment in muscle mass (3.2 kg vs 2.8 kg) as compared to SOG (p 

  13. A Rare Case of Monostotic Spinal Fibrous Dysplasia Mimicking Solitary Metastatic Lesion of Thyroid Carcinoma
    Sharifudin MA, Zakaria Z, Awang MS, Mohamed Amin MA, Abd Aziz A
    Malays J Med Sci, 2016 Jan;23(1):82-6.
    PMID: 27540330 MyJurnal
    Monostotic fibrous dysplasia of the vertebra is a rare entity. A case of a 53-year-old lady who presented with an 8 months history of pain in the thoracic spine region with paraparesis is discussed. She had a history of papillary thyroid carcinoma and had undergone total thyroidectomy one year prior to her current problem. Magnetic resonance imaging revealed isolated osteolytic lesion over the posterior element of the T12 vertebra with narrowing of the spinal canal causing compression of the cord. The diagnosis of fibrous dysplasia was made histologically. Fibrous dysplasia rarely occurs in axial bones compared with peripheral bones. This case illustrates that osteolytic lesion of the vertebrae should be evaluated with detailed radiological and histopathological examination before an empirical diagnosis of spinal metastasis is made in an adult with a background history of primary malignancy well-known to spread to the bone.
  14. Fulltext Tualang honey supplementation as cognitive enhancer in patients with schizophrenia
    Yahaya R, Zahary MN, Othman Z, Ismail R, Nik Him NAS, Abd Aziz A, et al.
    Heliyon, 2020 May;6(5):e03948.
    PMID: 32426546 DOI: 10.1016/j.heliyon.2020.e03948
    Introduction: Schizophrenia is a chronic mental illness with clusters of symptoms, including cognitive impairment. This study aimed to explore the effect of Tualang Honey (TH) on cognitive domains, especially as it pertained to the verbal memory of schizophrenia patients.

    Method: This was a cross-sectional study involved 80 individuals, diagnosed with schizophrenia. The Malay Version Auditory Verbal Learning Test (MVAVLT) was used. Data were analysed using SPSS 20.0 software. Intention to treat analysis was applied.

    Result: A comparison of the total learning score at eight weeks between the two groups based on time effect and time-treatment interaction favoured TH group.

    Conclusion: This study concludes that by supplementing schizophrenia patients with 8-week of TH did improve total learning performance across domains in the immediate memory among patients with schizophrenia.

  15. Fulltext Potential of Stimuli-Responsive In Situ Gel System for Sustained Ocular Drug Delivery: Recent Progress and Contemporary Research
    Pandey M, Choudhury H, Binti Abd Aziz A, Bhattamisra SK, Gorain B, Su JST, et al.
    Polymers (Basel), 2021 Apr 20;13(8).
    PMID: 33923900 DOI: 10.3390/polym13081340
    Eyesight is one of the most well-deserved blessings, amid all the five senses in the human body. It captures the raw signals from the outside world to create detailed visual images, granting the ability to witness and gain knowledge about the world. Eyes are exposed directly to the external environment; they are susceptible to the vicissitudes of diseases. The World Health Organization has predicted that the number of individuals affected by eye diseases will rise enormously in the next decades. However, the physical barriers of the eyes and the problems associated with conventional ocular formulations are significant challenges in ophthalmic drug development. This has generated the demand for a sustained ocular drug delivery system, which serves to deliver effective drug concentration at a reduced frequency for consistent therapeutic effect and better patient treatment adherence. Recent advancement in pharmaceutical dosage design has demonstrated that a stimuli-responsive in situ gel system exhibits the favorable characteristics for providing sustained ocular drug delivery and enhanced ocular bioavailability. Stimuli-responsive in situ gels undergo a phase transition (solution-gelation) in response to the ocular environmental temperature, pH, and ions. These stimuli transform the formulation into a gel at the cul de sac to overcome the shortcomings of conventional eye drops, such as rapid nasolacrimal drainage and short contact time with the ocular surface This review highlights the recent successful research outcomes of stimuli-responsive in situ gelling systems in treating in vivo models with glaucoma and various ocular infections. Additionally, it also presents the mechanism, recent development, and safety considerations of stimuli-sensitive in situ gel as the potential sustained ocular delivery system for treating common eye disorders.
  16. Fulltext Diagnostic Yield of CT Pulmonary Angiogram in the Diagnosis of Pulmonary Embolism and Its Predictive Factors
    Low CL, Kow RY, Abd Aziz A, Mohd Yusof M, Lim BC, Kamarudin NA, et al.
    Cureus, 2023 Jun;15(6):e40484.
    PMID: 37461753 DOI: 10.7759/cureus.40484
    Introduction Computed tomography pulmonary angiography (CTPA) is the reference investigation of choice to diagnose pulmonary embolism (PE). Nevertheless, the use of CTPA should be weighed against its risks, such as radiation and contrast-induced nephropathy. We aim to assess the yield of CTPA in diagnosing PE at a tertiary centre in Malaysia. We also identify predictive factors associated with the yield of CTPA in this cohort. Methods This was a cross-sectional study involving all patients who had had CTPA done at Hospital Tengku Ampuan Afzan, Kuantan, Malaysia, from January 1, 2021, to November 30, 2021. All patients' records were retrieved and reviewed. CTPA images were retrieved from the Radiology Information System (RIS) and Picture Archiving and Communication System (PACS). They were double-reviewed by the authors, with the initial reports redacted from reporting radiologists to prevent reporting bias. The predictive factors were determined using simple logistic regression and multiple logistic regression. Results A total of 351 CTPAs were reviewed, of which 93 were found to be positive for PE, giving rise to an overall CTPA yield of 26.5%. Upon simple logistic regression, factors such as gender, discipline, history of trauma, presence of COVID-19 infection, and pneumonia were found to be associated with positive CTPA. Upon multiple logistic regression, male patients were found to have a higher chance of positive CTPA results. On the other hand, patients with COVID-19 infection and pneumonia have a lower chance of positive results in CTPA. Conclusion The yield of CTPA in diagnosing PE at our institution was acceptable at 26.5%. Upon multiple logistic regression, patients with COVID-19 infection and pneumonia were more likely to have a negative CTPA result, highlighting the need for clinicians to be more prudent in requesting CTPAs in these patients.
  17. Impact of harvesting seasons on physicochemical properties and volatile compound profiles of Malaysian stingless bee honey analysed using chemometrics and support vector machine
    Sharin SN, Abdullah Sani MS, Kassim NK, Yuswan MH, Abd Aziz A, Jaafar MA, et al.
    Food Chem, 2024 Jan 19;444:138429.
    PMID: 38330597 DOI: 10.1016/j.foodchem.2024.138429
    Stingless bee honey's nutritional value is gaining attention, but the impact of harvesting seasons, specifically the rainy (September 2018) and dry (February 2019) seasons in Malaysia on the honey's physicochemical properties and volatile compounds remains insufficiently explored. This research revealed marginal differences in the physicochemical properties between seasons. However, through individual bee species and cumulative data analysis, honey samples were effectively differentiated based on harvesting seasons. A set of seventeen volatile compounds were identified as potential chemical markers for distinguishing H. bakeri, G. thoracica, and T. binghami honey between rainy and dry seasons. For cumulative data, four significant markers were proposed. These discrimination methods and chemical markers can serve as valuable references in distinguishing stingless bee honey, whether its entomological origin is specified or not between rainy and dry seasons.
  18. Fulltext Comparing Efficacy and Safety of Empirical vs. Guided Therapy for Non-cardiac Chest Pain: A Pragmatic Randomized Trial
    Abdul Kadir NP, Ma ZF, Abdul Hafidz MI, Annamalai C, Jayaraman T, Hamid N, et al.
    Front Med (Lausanne), 2021;8:605647.
    PMID: 33659261 DOI: 10.3389/fmed.2021.605647
    Background: Non-cardiac chest pain is common with two-thirds due to gastroesophageal reflux disease (GERD). Objective: To evaluate the effectiveness and safety of guided vs. empirical therapy in non-cardiac chest pain. Methods: Adults with normal angiogram or stress test were randomized into either a guided or empirical group. In the guided group, after the ambulatory pH-impedance test, if GERD then dexlansoprazole 30 mg/day for 8 weeks, but if functional or hypersensitive chest pain, then theophylline SR 250 mg/day for 4 weeks. In the empirical group, dexlansoprazole 60 mg/day was given for 2 weeks. The primary outcome was global chest pain visual analog score (VAS) and secondary outcomes were Quality of Life in Reflux and Dyspepsia (QOLRAD), GERD questionnaire (GERDQ), and pH parameters, all determined at baseline, 2nd and 8th weeks. Results: Of 200 screened patients, 132 were excluded, and of 68 randomized per-protocol, 33 were in the guided group and 35 in the empirical group. For between-group analysis, mean global pain scores were better with guided vs. empirical group at 8th week (P = 0.005) but not GERDQ or QOLRAD or any of pH measures (all P > 0.05). For within-group analysis, mean QOLRAD improved earliest at 8th week vs. baseline (P = 0.006) in the guided group and 2nd week vs. baseline (P = 0.011) in the empirical group but no differences were seen in other secondary outcomes (P > 0.05). No serious adverse events were reported. Conclusions: Guided approach may be preferred over short-term empirical therapy in symptom response, however QOLRAD, acid-related symptoms, or pH measures are not significantly different (trial registration ID no. NCT03319121).
  19. Fulltext Medical Experts' Agreement on Risk Assessment Based on All Possible Combinations of the COVID-19 Predictors-A Novel Approach for Public Health Screening and Surveillance
    Ibrahim MS, Naing NN, Abd Aziz A, Makhtar M, Mohamed Yusoff H, Esa NK, et al.
    Int J Environ Res Public Health, 2022 Dec 10;19(24).
    PMID: 36554487 DOI: 10.3390/ijerph192416601
    During the initial phase of the coronavirus disease 2019 (COVID-19) pandemic, there was a critical need to create a valid and reliable screening and surveillance for university staff and students. Consequently, 11 medical experts participated in this cross-sectional study to judge three risk categories of either low, medium, or high, for all 1536 possible combinations of 11 key COVID-19 predictors. The independent experts' judgement on each combination was recorded via a novel dashboard-based rating method which presented combinations of these predictors in a dynamic display within Microsoft Excel. The validated instrument also incorporated an innovative algorithm-derived deduction for efficient rating tasks. The results of the study revealed an ordinal-weighted agreement coefficient of 0.81 (0.79 to 0.82, p-value < 0.001) that reached a substantial class of inferential benchmarking. Meanwhile, on average, the novel algorithm eliminated 76.0% of rating tasks by deducing risk categories based on experts' ratings for prior combinations. As a result, this study reported a valid, complete, practical, and efficient method for COVID-19 health screening via a reliable combinatorial-based experts' judgement. The new method to risk assessment may also prove applicable for wider fields of practice whenever a high-stakes decision-making relies on experts' agreement on combinations of important criteria.
  20. Fulltext The upper respiratory tract microbiome of indigenous Orang Asli in north-eastern Peninsular Malaysia
    Cleary DW, Morris DE, Anderson RA, Jones J, Alattraqchi AG, A Rahman NI, et al.
    NPJ Biofilms Microbiomes, 2021 01 05;7(1):1.
    PMID: 33402693 DOI: 10.1038/s41522-020-00173-5
    Much microbiome research has focused on populations that are predominantly of European descent, and from narrow demographics that do not capture the socio-economic and lifestyle differences which impact human health. Here we examined the airway microbiomes of the Orang Asli, the indigenous peoples of Malaysia. A total of 130 participants were recruited from two sites in the north-eastern state of Terengganu in Peninsular Malaysia. Using 16S rRNA sequencing, the nasal microbiome was significantly more diverse in those aged 5-17 years compared to 50+ years (p = 0.023) and clustered by age (PERMANOVA analysis of the Bray-Curtis distance, p = 0.001). Hierarchical clustering of Bray-Curtis dissimilarity scores revealed six microbiome clusters. The largest cluster (n = 28; 35.4%) had a marked abundance of Corynebacterium. In the oral microbiomes Streptococcus, Neisseria and Haemophilus were dominant. Using conventional microbiology, high levels of Staphylococcus aureus carriage were observed, particularly in the 18-65 age group (n = 17/36; 47.2% 95% CI: 30.9-63.5). The highest carriage of pneumococci was in the <5 and 5 to 17 year olds, with 57.1% (4/7) and 49.2% (30/61), respectively. Sixteen pneumococcal serotypes were identified, the most common being the nonvaccine-type 23A (14.6%) and the vaccine-type 6B (9.8%). The prevalence of pneumococcal serotypes covered by pneumococcal conjugate vaccines support introduction into a Malaysian national immunisation schedule. In addition, the dominance of Corynebacterium in the airway microbiomes is intriguing given their role as a potentially protective commensal with respect to acute infection and respiratory health.
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