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Fulltext Avoiding common errors in key feature problems

Kwa SK, Sheikh Mohd Amin MM, Ng AC

Malays Fam Physician, 2007;2(1):18-21.
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Questions on Key Features Problems (KFP) are an important component of the theory paper for Part 1 of the membership examination of the Academy of Family Physicians of Malaysia (MAFP) and the Fellowship for the Royal Australian College of General Practitioners (FRACGP).This paper will attempt to provide information on the format and marking scheme of KFP. Expected answers for some KFP cases will be discussed and common errors made by candidates highlighted with suggestions on how to avoid them.
Electron flow of biological H2 production by sludge under simple thermal treatment: Kinetic study

Amin MM, Taheri E, Bina B, van Ginkel SW, Ghasemian M, Puad NIM, et al.

J Environ Manage, 2019 Nov 15;250:109461.
PMID: 31499462 DOI: 10.1016/j.jenvman.2019.109461

Mixed culture sludge has been widely used as a microbial consortium for biohydrogen production. Simple thermal treatment of sludge is usually required in order to eliminate any H2-consuming bacteria that would reduce H2 production. In this study, thermal treatment of sludge was carried out at various temperatures. Electron flow model was then applied in order to assess community structure in the sludge upon thermal treatment for biohydrogen production. Results show that the dominant electron sink was acetate (150-217 e- meq/mol glucose). The electron equivalent (e- eq) balances were within 0.8-18% for all experiments. Treatment at 100 °C attained the highest H2 yield of 3.44 mol H2/mol glucose from the stoichiometric reaction. As the treatment temperature increased from 80 to 100 °C, the computed acetyl-CoA and reduced form of ferredoxin (Fdred) concentrations increased from 13.01 to 17.34 e- eq (1.63-2.17 mol) and 1.34 to 4.18 e- eq (0.67-2.09 mol), respectively. The NADH2 balance error varied from 3 to 10% and the term e-(Fd↔NADH2) (m) in the NADH2 balance was NADH2 consumption (m = -1). The H2 production was mainly via the Fd:hydrogenase system and this is supported with a good NADH2 balance. Using the modified Gompertz model, the highest maximum H2 production potential was 1194 mL whereas the maximum rate of H2 production was 357 mL/h recorded at 100 °C of treatment.
Fulltext The relationship between bacterial sources and genotype to the antimicrobial resistance pattern of Burkholderia pseudomallei

Sadiq MA, Hassan L, Aziz SA, Zakaria Z, Musa HI, Amin MM

Vet World, 2018 Nov;11(10):1404-1408.
PMID: 30532493 DOI: 10.14202/vetworld.2018.1404-1408

Background: Melioidosis is a fatal emerging infectious disease of both man and animal caused by bacteria Burkholderia pseudomallei. Variations were suggested to have existed among the different B. pseudomallei clinical strains/genotypes which may implicate bacterial susceptibility and resistance toward antibiotics.
Aim: This study was designed to determine whether the phenotypic antibiotic resistance pattern of B. pseudomallei is associated with the source of isolates and the genotype.
Materials and Methods: A collection of 111 B. pseudomallei isolates from veterinary cases of melioidosis and the environments (soil and water) were obtained from stock cultures of previous studies and were phylogenetically characterized by multilocus sequence typing (ST). The susceptibility to five antibiotics, namely meropenem (MEM), imipenem, ceftazidime (CAZ), cotrimoxazole (SXT), and co-amoxiclav (AMC), recommended in both acute and eradication phases of melioidosis treatment were tested using minimum inhibitory concentration antibiotics susceptibility test.
Results: Majority of isolates were susceptible to all antibiotics tested while few resistant strains to MEM, SXT, CAZ, and AMC were observed. Statistically significant association was found between resistance to MEM and the veterinary clinical isolates (p<0.05). The likelihood of resistance to MEM was significantly higher among the novel ST 1130 isolates found in veterinary cases as compared to others.
Conclusion: The resistance to MEM and SXT appeared to be higher among veterinary isolates, and the novel ST 1130 was more likely to be resistant to MEM as compared to others.
Phylogenetic Diversity of Burkholderia pseudomallei isolated from veterinary cases and the environments in Peninsular Malaysia

Sadiq MA, Hassan L, Aziz SA, Zakaria Z, Musa HI, Amin MM, et al.

Vet Anim Sci, 2018 Dec;6:21-28.
PMID: 32734049 DOI: 10.1016/j.vas.2018.07.004

This study was designed to determine the genotype and the phylogeny of Burkholderia pseudomallei isolated from veterinary cases and from the animal environments in Peninsular Malaysia. The Malaysian B. pseudomallei population were then compared to those found elsewhere. A total of 113 isolates from veterinary cases (35) and the environment (56 from soil and 22 from water) were characterized using multilocus sequence typing (MLST). Two novel alleles, allele 97 and 69 of the gene locus ace and lepA respectively were recovered. Isolates were resolved into 12 distinct sequence types (STs) out of which five were novel, namely ST1130, ST1131, ST1338, ST1339 and ST1367. The isolates from veterinary cases co-clustered with those from the environment. B. pseudomallei isolates in this study were highly clonal and have descended from a common ancestor clonal complex (CC) 48 found in Southeast Asia. This study shows that veterinary case isolates are often caused by similar STs, with similar populations found in the direct animal environment and those previously reported to cause human infections in Malaysia and elsewhere. Isolates of B. pseudomallei from human infections have been given more attention, with a comparatively lower focus on isolates from animals and the farm environment. This study highlighted the genotype and phylogeny of B. pseudomallei isolated from animals and the environment and their relations to the isolates from human cases reported in Malaysia and elsewhere. Most STs reported in this study, from veterinary cases and animal environment are similar to those previously reported as causing human infections in Malaysia and elsewhere. Therefore, even though direct zoonosis is uncommon, monitoring melioidosis occurrences in animals can provide insights on the bacterial strains infecting humans.
Intestinal spirochaetes (Brachyspira spp.) colonizing flocks of layer and breeder chickens in Malaysia

Amin MM, Phillips ND, La T, Robertson ID, Hampson DJ

Avian Pathol, 2014;43(6):501-5.
PMID: 25246135 DOI: 10.1080/03079457.2014.966056

Avian intestinal spirochaetosis causes problems including delayed onset of lay and wet litter in adult chickens, and results from colonization of the caecae/rectum with pathogenic intestinal spirochaetes (genus Brachyspira). Because avian intestinal spirochaetosis has not previously been studied in South East Asia, this investigation was undertaken in Malaysia. Faecal samples were collected from 25 farms and a questionnaire was administered. Brachyspira species were detected by polymerase chain reaction in 198 of 500 (39%) faecal samples from 20 (80%) farms, including 16 (94%) layer and four (50%) breeder farms. Pathogenic Brachyspira pilosicoli was identified in five (29%) layer and two (25%) breeder farms whilst pathogenic Brachyspira intermedia was detected in nine (53%) layer and one (12.5%) of the breeder farms. Twelve (80%) layer farms had egg production problems and 11 (92%) were positive for Brachyspira: three (25%) for B. pilosicoli and six (50%) for B. intermedia. Of three breeder farms with egg production problems, one was colonized with B. pilosicoli. Three of ten layer farms with wet litter were positive for B. pilosicoli and six for B. intermedia. Of four breeder farms with wet litter, one was colonized with B. pilosicoli and one with B. intermedia. No significant associations were found between colonization and reduced egg production or wet litter, perhaps because so many flocks were colonized. A significant association (P = 0.041) occurred between a high prevalence of colonization and faecal staining of eggs. There were significant positive associations between open-sided housing (P = 0.006), and flocks aged >40 weeks (P < 0.001) and colonization by pathogenic species.
Assessment of vaccination with gamma radiationattenuated infective Toxocara canis eggs on murine toxocariasis

Hafez EN, Awadallah FM, Ibrahim SA, Amin MM, El-Nawasera NZ

Trop Biomed, 2020 Mar 01;37(1):89-102.
PMID: 33612721

Toxocara canis is a major parasite that infects many animals with high risk of human infections. This study aims at assessing the immunization with gamma radiationattenuated infective stage on rats challenged with non-irradiated dose. Level of vaccine protection was evaluated in liver and lung regarding parasitological, histopathological, biochemical and molecular parameters. Fifty rats were enrolled in three groups: group A (10 rats) as normal control; group B (20 rats) subdivided into subgroup B1 (infected control) and subgroup B2 infected then challenged after 14 days with the same dose of infection (challenged infected control); and group C (20 rats) subdivided into subgroup C1 vaccinated with a dose of 800 gray (Gy) gamma-radiated infective eggs (vaccine control) and subgroup C2 vaccinated then challenged on 14th day with same number of infective eggs (vaccinated-challenged). Tissues were stained with Haematoxylin and Eosin (H and E) for histopathological studies. Biochemical studies through detection of nitric oxide (NO) and Caspase-3 were conducted. Extent of DNA damage by Comet assay was assessed. Vaccinated-challenged subgroup revealed a marked reduction in larvae in tissues with mild associated histological changes. In addition there was accompanied reduction of NO, Casepase-3 level and DNA damage compared to the control infected group. It could be concluded that vaccination of rats with a dose of 800Gy gamma radiation-attenuated infective stage improves immune response to challenge infection and drastically reduces the morbidity currently seen.
Fulltext Water Extract Have Superior Cytotoxic Effect Than Ethanolic Extract of Clinacanthus Nutans Leaves in Breast Cancer Stem Cells

Syarifah S, Rambe AS, Putra A, Ichwan M, Pane YS, Muhar AM, et al.

Acta Inform Med, 2023;32(1):4-10.
PMID: 38585603 DOI: 10.5455/aim.2024.32.4-10

BACKGROUND: The rapid development of medical technology in managing breast cancer patients still cannot solve the problem of recurrence and resistance. One of the causes of recurrence and molecular resistance is the presence of breast cancer stem cells (BCSCs). Clinacanthus nutans (C.nutans) is a plant found in Medan, North Sumatra, Indonesia. This plant is believed to have anticancer activity in community.
OBJECTIVE: Our study aimed to assess phytochemical of C.nutans leaves, isolate breast cancer stem cells and determine the cytotoxic effects of the ethanolic extract and water extract of C.nutans leaves on breast cancer stem cells at 24, 48, and 72 h of observation.
METHODS: We underwent the cytotoxic test by using MTT assay and isolated breast cancer stem cells by using MACS and validated them by mammosphere test.
RESULTS: We found alkaloids, flavonoids, glycosides and tannins in simplicia and all extracts. BCSCs was valid with the diameter of the mammosphere BCSCs was > 60 μm. The IC50 values of 100%, 60%, 40%, 20% EE, and WE of C.nutans leaves were 227.30; 46.05; 31.12; 98.54, and 16.16 μg/ml respectively in the first 24 hours. In administering WE of C.nutans leaves, BCSCs viability was decreased at 24,48 and 72 hours of observation, namely 69.29±26%; 75.82 ± 21.02% and 38.94±9.34 % (p < 0.0001).
CONCLUSION: The WE of C.nutans leaves had more substantial cytotoxic potential against BCSCs than the EE. The capability of WE C.nutans leaves to suppress BCSC's viability was time-dependent. The anticancer activity were believed originate from alkaloid and flavonoid group.
Fulltext Prevalence and Associated Factors of Psychological Distress and Burnout among Medical Students: Findings from Two Campuses

Arif NMNA, Roslan NS, Ismail SB, Nayak RD, Jamian MR, Mohamad Ali Roshidi AS, et al.

Int J Environ Res Public Health, 2021 08 10;18(16).
PMID: 34444193 DOI: 10.3390/ijerph18168446

Medical training is intensive and predisposes students to psychological distress and burnout. Unaddressed burnout in medical training may persist in the internship phase and impact the quality of patient care. While some associations have been established, the link between some individual factors and training characteristics with distress and burnout in medical training remained unclear. In this study, we aim to examine the prevalence of psychological distress and burnout, and its association with gender, training phase, funding status, cumulative grade points average (CGPA), and coping strategies among medical students. The study applied a multicenter cross-sectional study design and convenience sampling on medical students from two medical schools from Malaysia and India. We used a self-reporting instrument that includes demographic details, the 12-item General Health Questionnaire (GHQ), the Copenhagen Burnout Inventory (CBI), and the Brief Coping Orientation to Problems Experienced (Brief COPE). A total of 748 medical students participated in the study. The prevalence of psychological distress, personal-related, work-related, and patient-related burnout were 33.0%, 56.1%, 35.0%, and 26.2%, respectively. Being male, clinical year, self-funded, and having a CGPA of more than 3.50 predicted psychological distress and burnout with mixed results. Maladaptive coping mechanisms consistently predicted the risk of psychological distress and burnout by more than two times. The findings indicate that primary and secondary mental health interventions have a role in medical training. A systematic intervention should incorporate coping skills training alongside institutional-targeted intervention.