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Fulltext Coatings in Decellularized Vascular Scaffolds for the Establishment of a Functional Endothelium: A Scoping Review of Vascular Graft Refinement

Heng JW, Yazid MD, Abdul Rahman MR, Sulaiman N

Front Cardiovasc Med, 2021;8:677588.
PMID: 34395554 DOI: 10.3389/fcvm.2021.677588

Developments in tissue engineering techniques have allowed for the creation of biocompatible, non-immunogenic alternative vascular grafts through the decellularization of existing tissues. With an ever-growing number of patients requiring life-saving vascular bypass grafting surgeries, the production of functional small diameter decellularized vascular scaffolds has never been more important. However, current implementations of small diameter decellularized vascular grafts face numerous clinical challenges attributed to premature graft failure as a consequence of common failure mechanisms such as acute thrombogenesis and intimal hyperplasia resulting from insufficient endothelial coverage on the graft lumen. This review summarizes some of the surface modifying coating agents currently used to improve the re-endothelialization efficiency and endothelial cell persistence in decellularized vascular scaffolds that could be applied in producing a better patency small diameter vascular graft. A comprehensive search yielding 192 publications was conducted in the PubMed, Scopus, Web of Science, and Ovid electronic databases. Careful screening and removal of unrelated publications and duplicate entries resulted in a total of 16 publications, which were discussed in this review. Selected publications demonstrate that the utilization of surface coating agents can induce endothelial cell adhesion, migration, and proliferation therefore leads to increased re-endothelialization efficiency. Unfortunately, the large variance in methodologies complicates comparison of coating effects between studies. Thus far, coating decellularized tissue gave encouraging results. These developments in re-endothelialization could be incorporated in the fabrication of functional, off-the-shelf alternative small diameter vascular scaffolds.
Fulltext Factors Influencing the Prevalence of Mental Health Problems among Malay Elderly Residing in a Rural Community: A Cross-Sectional Study

Abdul Manaf MR, Mustafa M, Abdul Rahman MR, Yusof KH, Abd Aziz NA

PLoS One, 2016;11(6):e0156937.
PMID: 27280529 DOI: 10.1371/journal.pone.0156937

BACKGROUND AND PURPOSE: Mental health problems are common in old age, but frequently remain undetected and untreated. Mental health problems in the elderly are the result of a complex interaction of social, psychological and biological factors. The aim of this study is to determine the prevalence of mental health problems (depression, anxiety, and emotional stress) and their associated factors among the Malay elderly in a rural community of Perak, Malaysia.
METHODS: It was a cross-sectional study. The Malay elderly aged 60 years and above were selected through convenient sampling to give a total of 230 respondents. The Depression, Anxiety, and Stress Scale (DASS-21) was used to assess the symptoms of depression, anxiety, and stress. Bivariate analyses were performed using chi-square tests and multiple logistic regression analyses were conducted to determine the association between the factors and each of the mental health statuses assessed.
RESULTS: The results showed that the prevalence of depression, anxiety, and stress among the elderly respondents was 27.8%, 22.6%, and 8.7%, respectively. The significant factors for depression were single elderly (Adjusted OR = 3.27, 95%CI 1.66, 6.44), living with family (Adjusted OR = 4.98, 95%CI 2.05, 12.10), and poor general health status (Adjusted OR = 2.28, 95%CI 1.20, 4.36). Living with family was the only significant factor for anxiety (Adjusted OR = 2.68, 95%CI 1.09, 6.57). There was no significant factor for stress.
CONCLUSIONS: Depression and anxiety among the Malay elderly in the rural community were very worrying. More equity in health should be created or strengthened in order to intensify the opportunity to identify, diagnose, and treat those with mental health problems. Living arrangement in the rural community was an important factor that had influenced depression and anxiety. Therefore, further research is recommended for more comprehensive information, as a result of which appropriate intervention can be made.
Chest tube entrapment: a simple solution for technical error

Haron H, Baharudin MN, Ismail I, Zainuddin K, Abdul Rahman MR

Ann Thorac Surg, 2014 Jun;97(6):2166-7.
PMID: 24882295 DOI: 10.1016/j.athoracsur.2013.07.129

Unrecognized chest tube entrapment by surgical closure is a technical error. We present a rare case of chest tube entrapment that was successfully treated with a simple and safe solution in an elderly man after coronary artery bypass grafting (CABG). We visualized the suture using a small endoscope through the chest tube and incised it with the help of thoracoscopic scissors. The tube was then removed without the need for surgical exploration.
Pedunculated parietal pleural lesion: a rare presentation of bronchogenic cyst

Abdul Rahman MR, Yaman MN, Dimon MZ, Zabir AF, Min JO, Hamid HA

Ann Thorac Surg, 2011 Aug;92(2):714-5.
PMID: 21801925 DOI: 10.1016/j.athoracsur.2011.02.028

We present a 35-year-old man with a preoperative diagnosis of a right lower lobe cystic mass. Misled by a radiological suggestion of an intraparenchymal lesion, he had a thoracotomy and right lower lobectomy. An intraoperative finding of a pedunculated cyst arising from the parietal pleural with subsequent histopathology confirmation of a benign bronchogenic cyst, however, would have made a less invasive surgical excision more appropriate.
Bismuth paste injection for empyema thoracis: a 100-year-old method revisited

Reda Mahmoud TA, Ismail NI, Muda AS, Abdul Rahman MR

Ann Thorac Surg, 2010 Aug;90(2):654-5.
PMID: 20667375 DOI: 10.1016/j.athoracsur.2010.02.031

Bismuth paste injection into the pleural cavity used to be a treatment for chronic empyema thoracis. This method, however, was long forgotten and scarcely practiced due to advanced surgical techniques and antibiotic therapy. We report a 50-year-old man with chronic empyema thoracis who was successfully treated with bismuth paste injection after a failed surgical decortication and a long-term chest drainage. This case highlights a trial of a 100-year-old method of bismuth paste injection which proved effective after standard measures had failed.
Chest tube injury to left ventricle: complication or negligence?

Haron H, Rashid NA, Dimon MZ, Azmi MH, Sumin JO, Zabir AF, et al.

Ann Thorac Surg, 2010 Jul;90(1):308-9.
PMID: 20609810 DOI: 10.1016/j.athoracsur.2010.01.075

An injury to the left ventricle after a chest tube insertion is a rare but lethal phenomenon that is likely to occur if precautions are not seriously addressed. We present a 15-year-old girl who was diagnosed a left empyema thoracis. An attempt to place a chest drain in this young girl was almost fatal. A left ventricular repair together with thoracotomy and decortication were successful. This case emphasizes the rarity of this lethal complication and the importance of the correct technique for chest tube insertion.
Pocket-sized Heimlich valve (Pneumostat) after bullae resection: a 5-year review

Abdul Rahman MR, Min Joanna OS, Fikri AM, Adeeb SM, Zamrin DM

Ann Thorac Surg, 2009 Sep;88(3):979-81.
PMID: 19699932 DOI: 10.1016/j.athoracsur.2009.03.065

This study was conducted to evaluate the practicability, effectiveness, and potential complications of a newly improvised pocket-sized Heimlich valve named the Pneumostat (Atrium Medical Corp, Hudson, NH).
Renal outcome following on- and off-pump coronary artery bypass graft surgery

Ooi JS, Abdul Rahman MR, Shah SA, Dimon MZ

Asian Cardiovasc Thorac Ann, 2008 Dec;16(6):468-72.
PMID: 18984756

A prospective study was carried out to compare the outcomes of patients with preexisting non-dialysis-dependent renal dysfunction who underwent coronary artery bypass grafting with or without cardiopulmonary bypass. Elective off-pump coronary artery bypass was performed in 29 patients with renal dysfunction. Their results were compared with those of a similar group of 35 patients who underwent the conventional on-pump coronary artery grafting. There was a significant deterioration in creatinine clearance in the on-pump group on days 1, 2, and 4 after surgery, while creatinine clearance in the off-pump group remained close to the baseline level. Both groups had improved to the preoperative creatinine clearance values on follow-up at 4 weeks. It was concluded that off-pump surgery provided better renal protection than the conventional on-pump technique in patients with preexisting non-dialysis-dependent renal dysfunction.
Fulltext The Effects of Pro-Inflammatory and Anti-Inflammatory Agents for the Suppression of Intimal Hyperplasia: An Evidence-Based Review

Che Man R, Sulaiman N, Ishak MF, Bt Hj Idrus R, Abdul Rahman MR, Yazid MD

Int J Environ Res Public Health, 2020 10 26;17(21).
PMID: 33114632 DOI: 10.3390/ijerph17217825

Anti-atherogenic therapy is crucial in halting the progression of inflammation-induced intimal hyperplasia. The aim of this concise review was to methodically assess the recent findings of the different approaches, mainly on the recruitment of chemokines and/or cytokine and its effects in combating the intimal hyperplasia caused by various risk factors. Pubmed and Scopus databases were searched, followed by article selection based on pre-set inclusion and exclusion criteria. The combination of keywords used were monocyte chemoattractant protein-1 OR MCP-1 OR TNF-alpha OR TNF-α AND hyperplasia OR intimal hyperplasia OR neointimal hyperplasia AND in vitro. These keywords combination was incorporated in the study and had successfully identified 77 articles, with 22 articles were acquired from Pubmed, whereas 55 articles were obtained from Scopus. However, after title screening, only twelve articles meet the requirements of defined inclusion criteria. We classified the data into 4 different approaches, i.e., utilisation of natural product, genetic manipulation and protein inhibition, targeted drugs in clinical setting, and chemokine and cytokines induction. Most of the articles are working on genetic manipulation targeted on specific pathway to inhibit the pro-inflammatory factors expression. We also found that the utilisation of chemokine- and cytokine-related treatments are emerging throughout the years. However, there is no study utilising the combination of approaches that might give a better outcome in combating intimal hyperplasia. Hopefully, this concise review will provide an insight regarding the usage of different novel approaches in halting the progression of intimal hyperplasia, which serves as a key factor for the development of atherosclerosis in cardiovascular disease.
Fulltext Molecular Action of Hydroxytyrosol in Attenuation of Intimal Hyperplasia: A Scoping Review

Vijakumaran U, Yazid MD, Hj Idrus RB, Abdul Rahman MR, Sulaiman N

Front Pharmacol, 2021;12:663266.
PMID: 34093194 DOI: 10.3389/fphar.2021.663266

Objective: Hydroxytyrosol (HT), a polyphenol of olive plant is well known for its antioxidant, anti-inflammatory and anti-atherogenic properties. The aim of this systematic search is to highlight the scientific evidence evaluating molecular efficiency of HT in halting the progression of intimal hyperplasia (IH), which is a clinical condition arises from endothelial inflammation. Methods: A systematic search was performed through PubMed, Web of Science and Scopus, based on pre-set keywords which are Hydroxytyrosol OR 3,4-dihydroxyphenylethanol, AND Intimal hyperplasia OR Neointimal hyperplasia OR Endothelial OR Smooth muscles. Eighteen in vitro and three in vitro and in vivo studies were selected based on a pre-set inclusion and exclusion criteria. Results: Based on evidence gathered, HT was found to upregulate PI3K/AKT/mTOR pathways and supresses inflammatory factors and mediators such as IL-1β, IL-6, E-selectin, P-selectin, VCAM-1, and ICAM-1 in endothelial vascularization and functioning. Two studies revealed HT disrupted vascular smooth muscle cells (SMC) cell cycle by dephosphorylating ERK1/2 and AKT pathways. Therefore, HT was proven to promote endothelization and inhibit vascular SMCs migration thus hampering IH development. However, none of these studies described the effect of HT collectively in both vascular endothelial cells (EC) and SMCs in IH ex vivo model. Conclusions: Evidence from this concise review provides an insight on HT regulation of molecular pathways in reendothelization and inhibition of VSMCs migration. Henceforth, we propose effect of HT on IH prevention could be further elucidated through in vivo and ex vivo model.
Fulltext Selection of an appropriate left-sided double-lumen tube size for one-lung ventilation among Asians

Ideris SS, Che Hassan MR, Abdul Rahman MR, Ooi JS

Ann Card Anaesth, 2017 Jan-Mar;20(1):28-32.
PMID: 28074791 DOI: 10.4103/0971-9784.197824

CONTEXT: Selecting an appropriate size double-lumen tube (DLT) for one-lung ventilation has always been a challenge as most choose it based on experience or using the existing guidelines based on gender and height.

AIMS: The aim of this study was to determine if the appropriate choice of this tube could be based on the patients' height, weight, tracheal diameter (TD), or the left main stem bronchus diameter (LMBD) and also to determine the relationship between height and depth of insertion among Asians.

SUBJECTS AND METHODS: This was a retrospective review of 179 patients who were intubated with a left-sided DLT and also had a posterior-anterior view of a digital chest radiograph for tracheal and left main bronchus diameter measurements. Additional data collected included patients' demographics and DLT size used.

RESULTS: There were 123 (68.7%) males and 56 (31.3%) females with an overall mean age of 33.3 ± 16.3 years. Majority of the males (48.8%) used a size 39 Fr while females (46.4%) used a 35 Fr. There were weak correlations between DLT size with height (male: R2 = 0.222; female: R2 = 0.193), DLT size with weight (male: R2 = 0.109; female: R2 = 0.211), DLT size with TD (male: R2 = 0.027); female: R2 = 0.016), and DLT size with LMBD (male: R2 = 0.222; female: R2 = 0.193). There was a good correlation between depth of DLT inserted with patient's height for both genders.

CONCLUSION: The appropriate size of the left-sided DLT could not be predicted based on patients' height, weight, tracheal or left main bronchus diameter alone in Asians; however, the depth of insertion of the tube was dependent on the height in both genders.
Fulltext Synchronous Primary Parosteal Osteosarcoma and Primary Mediastinal Germ Cell Tumour with Atypical Mycobacterial Infection - A Rare Phenomenon: A Case Report

Lim CH, Mohamed-Haflah NH, Abdullah-Sani MH, Loh CK, Abdul-Rahman MR

Malays Orthop J, 2023 Mar;17(1):188-192.
PMID: 37064628 DOI: 10.5704/MOJ.2303.023

Mediastinal germ cell tumours are a rare group of extragonadal germ cell tumours with less than 5% prevalence of all germ cell tumours. Primary mediastinal germ cell tumours themselves account for 16-36% of the extragonadal germ cell tumours. Along the spectrum of osteosarcoma, parosteal osteosarcoma is a well-differentiated surface osteosarcoma with a prevalence of 4% of all osteosarcoma. As such synchronous primary parosteal osteosarcoma and primary mediastinal germ cell tumour are exceedingly rare. This leads to complexity in determining the most appropriate chemotherapy for two different types of tumours and its potential side effects of reduced immunity leading to potential secondary infection. Here we report a case of a 16-year-old boy who presented with synchronous primary osteosarcoma and primary mediastinal germ cell tumour, complicated with atypical mycobacterial infection post-operatively. Additionally, we discuss our choice of chemotherapy and the management of the atypical mycobacterial infection.
Generation of a novel ex-vivo model to study re-endothelialization

Azman SS, Yazid MD, Abdul Ghani NA, Raja Sabudin RZA, Abdul Rahman MR, Sulaiman N

Artif Cells Nanomed Biotechnol, 2023 Dec;51(1):408-416.
PMID: 37584645 DOI: 10.1080/21691401.2023.2245456

Endothelial dysfunction initiates the pathogenesis of a myriad of cardiovascular diseases, yet the precise underlying mechanisms remain unclear. Current model utilises mechanical denudation of arteries resulting in an arterial-injury model with onset of intimal hyperplasia (IH). Our study shows that 5 min enzymatic denudation of human umbilical artery (hUA) lumen at 37 °C efficiently denudes hUA while maintaining vessel integrity without significantly increase intima-media thickness after 7 days in culture. This ex-vivo model will be a valuable tool in understanding the mechanism of re-endothelialization prior to smooth muscle cells (SMC) activation thus placating IH at an early stage.
Fulltext Successful Treatment of Sternal Osteomyelitis and Mediastinitis Caused by Rhizopus Following Cardiac Surgery

Tiew TC, Md Ali NA, Ismail MI, Abdul Rahman MR, Ding CH, Tzar MN

Cureus, 2024 Jun;16(6):e62312.
PMID: 39006712 DOI: 10.7759/cureus.62312

Sternal osteomyelitis and mediastinitis are rare yet severe complications post-cardiac surgery, often associated with significant morbidity and mortality. Fungal etiologies, particularly those caused by Rhizopus spp., are infrequent but can lead to aggressive infections. Here, we present the case of a 68-year-old male who developed sternal osteomyelitis and mediastinitis caused by Rhizopus spp. two weeks following coronary artery bypass grafting surgery. Debridement and pectoralis flap reconstruction were performed following clinical identification and confirmation with microbiological examinations and a CT scan. Prompt recognition, aggressive surgical intervention, and targeted antifungal therapy were crucial for successful management. This case underscores the importance of considering fungal pathogens, such as Rhizopus, in the differential diagnosis of post-cardiac surgery infections, as well as aggressive treatment to improve outcomes for affected patients.
Comminuted sternal fracture -- a sternotomy wire fixation: report of 2 cases

Abdul-Rahman MR, Seong NK, Hee TG, Aljada ME, Reda TA, Sumin JO, et al.

Heart Surg Forum, 2009 Jun;12(3):E184-6.
PMID: 19546075 DOI: 10.1532/HSF98.20091016

Various techniques of sternal stabilization via either metal plates or wires have been described. We describe an alternative technique of simple median sternotomy followed by reduction and wire fixation of the sternal fracture. The 2 patients described in this report had traumatic comminuted and displaced sternal fractures. Even though wire repair was deemed to be tedious and achieved poor approximation of the bone, we performed median sternotomy and achieved simple wire fixation with an excellent result.
Location and Patterns of Persistent Pain Following Cardiac Surgery

Katijjahbe MA, Royse C, Granger C, Denehy L, Md Ali NA, Abdul Rahman MR, et al.

Heart Lung Circ, 2021 Aug;30(8):1232-1243.
PMID: 33608196 DOI: 10.1016/j.hlc.2020.12.009

OBJECTIVES: To investigate the specific clinical features of pain following cardiac surgery and evaluate the information derived from different pain measurement tools used to quantify and describe pain in this population.
METHODS: A prospective observational study was undertaken at two tertiary care hospitals in Australia. Seventy-two (72) adults (mean age, 63±11 years) were included following cardiac surgery via a median sternotomy. Participants completed the Patient Identified Cardiac Pain using numeric and visual prompts (PICP), the McGill Pain Questionnaire-Short Form version 2 (MPQ-2) and the Medical Outcome Study 36-item version 2 (SF-36v2) Bodily Pain domain (BP), which were administered prior to hospital discharge, 4 weeks and 3 months postoperatively.
RESULTS: Participants experienced a high incidence of mild (n=45, 63%) to moderate (n=22, 31%) pain prior to discharge, which reduced at 4 weeks postoperatively: mild (n=28, 41%) and moderate (n=5, 7%) pain; at 3 months participants reported mild (n=14, 20%) and moderate (n=2, 3%) pain. The most frequent location of pain was the anterior chest wall, consistent with the location of the surgical incision and graft harvest. Most participants equated "pressure/weight" to "aching" or a "heaviness" in the chest region (based on descriptor of pain in the PICP) and the pain topography was persistent at 4 weeks and 3 months postoperatively. Each pain measurement tool provided different information on pain location, severity and description, with significant change (p<0.005) over time.
CONCLUSION: Mild-to-moderate pain was frequent after sternotomy, improved over time and was mostly located over the incision and mammary (internal thoracic) artery harvest site. Persistent pain at 3 months remained a significant problem in the community within this surgical population.
Fulltext Impact of ZnO nanoparticles as additive on performance and emission characteristics of a diesel engine fueled with waste plastic oil

Suhel A, Abdul Rahim N, Abdul Rahman MR, Bin Ahmad KA, Khan U, Teoh YH, et al.

Heliyon, 2023 Apr;9(4):e14782.
PMID: 37064486 DOI: 10.1016/j.heliyon.2023.e14782

Neat waste plastic oil (WPO) application as a fuel in engines reduces BTE and increases deleterious emissions of CO, UHC, NOx, and smoke due to the presence of insufficient oxygen and unbreakable hydrocarbon chains in WPO. Present investigation was performed to evaluate the impact of ZnO nanoparticles on the performance and emission characteristics of a diesel engine operated with the waste plastic oil (WPO20) blend. The objective of doping ZnO nanoparticles with WPO20 was to enhance the oxidation reaction and heat transfer rate between fuel droplets during combustion, which aids in completing the combustion. The sol-gel technique was adopted to successfully synthesize the ZnO nanoparticles using zinc acetate (Zn(CH3CO2)2.2H2O) and sodium hydroxide (NaOH) precursors. The structure and morphology of resulted particles were studied by XRD and FESEM tests. Both results indicate the stable formation of ZnO, and exhibit the crystallinity nature, spherical surface, and size consistency. The synthesized ZnO nanoparticles were infused in WPO20 blend in the amounts of 50, 100, and 150 ppm with the aid of the ultrasonication technique. Engine test was conducted with diesel fuel, WPO20 blend, and nano-infused fuels at a constant speed of 1500 rpm under various loads. The disparities in performance and emission characteristics were examined and compared with pure diesel fuel. The findings demonstrated that adding nanoparticles to WPO20 significantly lowers the smoke, CO, UHC, and NOx emissions and simultaneously improves the BTE and decreases the BSFC of the diesel engine. Optimum results were obtained for 100 ppm concentration of ZnO nanoparticles. Reduction of smoke by 11.86%, CO by 5.7%, UHC by 28%, and NOx by 14.93%, along with the enhancement of BTE by 2.47%, were noticed at maximum load with 100 ppm particles. Based on the test results, it is concluded that ZnO nanoparticles can be used as a suitable additive in WPO blends to improve the overall engine characteristics. Further scope of the present work is to study the effect of organic nanoparticles with WPO on engine behaviour, the detailed combustion of nanoparticles infused WPO, and the nanoparticles doped WPO on engine wear and corrosion.
Fulltext Neurodevelopmental effects of childhood malnutrition: A neuroimaging perspective

Galler JR, Bringas-Vega ML, Tang Q, Rabinowitz AG, Musa KI, Chai WJ, et al.

Neuroimage, 2021 05 01;231:117828.
PMID: 33549754 DOI: 10.1016/j.neuroimage.2021.117828

Approximately one in five children worldwide suffers from childhood malnutrition and its complications, including increased susceptibility to inflammation and infectious diseases. Due to improved early interventions, most of these children now survive early malnutrition, even in low-resource settings (LRS). However, many continue to exhibit neurodevelopmental deficits, including low IQ, poor school performance, and behavioral problems over their lifetimes. Most studies have relied on neuropsychological tests, school performance, and mental health and behavioral measures. Few studies, in contrast, have assessed brain structure and function, and to date, these have mainly relied on low-cost techniques, including electroencephalography (EEG) and evoked potentials (ERP). The use of more advanced methods of neuroimaging, including magnetic resonance imaging (MRI) and functional near-infrared spectroscopy (fNIRS), has been limited by cost factors and lack of availability of these technologies in developing countries, where malnutrition is nearly ubiquitous. This report summarizes the current state of knowledge and evidence gaps regarding childhood malnutrition and the study of its impact on neurodevelopment. It may help to inform the development of new strategies to improve the identification, classification, and treatment of neurodevelopmental disabilities in underserved populations at the highest risk for childhood malnutrition.
Exploring the Potential of Saphenous Vein Grafts Ex Vivo: A Model for Intimal Hyperplasia and Re-Endothelialization

Haron NA, Ishak MF, Yazid MD, Vijakumaran U, Ibrahim R, Raja Sabudin RZA, et al.

J Clin Med, 2024 Aug 14;13(16).
PMID: 39200916 DOI: 10.3390/jcm13164774

Coronary artery bypass grafting (CABG) utilizing saphenous vein grafts (SVGs) stands as a fundamental approach to surgically treating coronary artery disease. However, the long-term success of CABG is often compromised by the development of intimal hyperplasia (IH) and subsequent graft failure. Understanding the mechanisms underlying this pathophysiology is crucial for improving graft patency and patient outcomes. Objectives: This study aims to explore the potential of an ex vivo model utilizing SVG to investigate IH and re-endothelialization. Methods: A thorough histological examination of 15 surplus SVG procured from CABG procedures at Hospital Canselor Tuanku Muhriz, Malaysia, was conducted to establish their baseline characteristics. Results: SVGs exhibited a mean diameter of 2.65 ± 0.93 mm with pre-existing IH averaging 0.42 ± 0.13 mm in thickness, alongside an observable lack of luminal endothelial cell lining. Analysis of extracellular matrix components, including collagen, elastin, and glycosaminoglycans, at baseline and after 7 days of ex vivo culture revealed no significant changes in collagen but demonstrated increased percentages of elastin and glycosaminoglycans. Despite unsuccessful attempts at re-endothelialization with blood outgrowth endothelial cells, the established ex vivo SVG IH model underscores the multifaceted nature of graft functionality and patency, characterized by IH presence, endothelial impairment, and extracellular matrix alterations post-CABG. Conclusions: The optimized ex vivo IH model provides a valuable platform for delving into the underlying mechanisms of IH formation and re-endothelialization of SVG. Further refinements are warranted, yet this model holds promise for future research aimed at enhancing graft durability and outcomes for CAD patients undergoing CABG.
Knowledge, attitude and practice levels regarding malaria among the Semai sub-ethnic indigenous Orang Asli communities in Pahang, Peninsular Malaysia: a stepping stone towards the prevention of human malaria re-establishment

Samsudin L, Mohd Jaafar MF, Kamarulzaman MKA, Mohd Nor NN, Ahmad Shafei S, Mohamad Shukor NA, et al.

Malar J, 2024 Sep 05;23(1):269.
PMID: 39238007 DOI: 10.1186/s12936-024-05095-7

BACKGROUND: In Malaysia, despite a decline in cases, malaria remains a major public health concern, especially among the vulnerable indigenous people (i.e. Orang Asli) in remote areas. Effective preventive and control measures require an evidence-based understanding of their knowledge, attitudes, and practices (KAP) regarding malaria. This study aimed to evaluate the KAP regarding malaria in an indigenous settlement in Peninsular Malaysia.
METHODS: A household-based cross-sectional study was conducted in March 2024 in six Semai sub-ethnic indigenous villages in Pos Lenjang, Kuala Lipis, Pahang. A structured questionnaire was administered to randomly selected individuals (≥ 12 years old) to collect data on sociodemographic characteristics and KAP. Data were analysed using descriptive statistics and predictors of KAP were determined using logistic regression. A p-value less than 0.05 was considered statistically significant.
RESULTS: A total of 267 individuals from 160 households were interviewed. Nearly half had good knowledge (49.4%) and positive attitudes (54.3%) towards malaria, with high practice scores for prevention and control (83.1%). Multivariate logistic regression analysis showed higher odds of good knowledge in those aged 40-59 years (adjusted odd ratio [aOR] = 6.90, p = 0.034), with primary (aOR = 2.67, p = 0.015) or secondary education (aOR = 2.75, p = 0.019), and with previous malaria history (aOR = 5.14, p

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