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  1. Halim, H., Noranizan, M., Sobhi, B., Sew, C.C., Karim, R., Osman, A.
    MyJurnal
    Red pitaya juice (RPJ) was subjected to UV-C irradiation and the potential of UV as a pasteurization tool for reducing microbial load in pitaya juice was evaluated. Effectiveness of the hurdle concept, i.e. addition of citric acid (CA) and dimethyl dicarbonate (DMDC) was also studied. Total plate counts (TPC) and yeast and mould counts (YMC) achieved 2.43 log₁₀ and 2.7 log₁₀ reductions respectively after exposure to UV irradiation. Addition of the CA (0.5 - 2.0%) and dimethyl dicarbonate (DMDC) (5 - 20 µL/100mL) to pitaya juice reduced the microbial loads, with 1.5% CA and 15 µL/100mL DMDC being the most effective concentrations. Addition of CA and DMDC into RPJ prior to UV treatment achieved significantly higher microbial reduction compared to UV alone, which were 4.12 log ₁₀ and 4.14 log₁₀ reductions for TPC and for YMC, respectively.
  2. Abd Halim H, Abdul-Razak S, Md Yasin M, Isa MR
    Hum Vaccin Immunother, 2020 05 03;16(5):1040-1049.
    PMID: 31567057 DOI: 10.1080/21645515.2019.1674112
    Vaccine hesitant parents are linked with re-emergence of vaccine preventable diseases, but evidence is scarce locally. The Parent Attitudes about Childhood Vaccines (PACV) questionnaire was validated and used in the USA to identify vaccine hesitant parents. This study aimed to adapt and translate the 15-item PACV questionnaire from English into the Malay language, and to examine its validity and reliability. The sample population was parents of children aged 0-24 months, recruited at an urban government health clinic between November 2016-June 2017. During content validation, two items from the "Behavior" subdomain were identified as items with formative scale and excluded from exploratory factor analysis (EFA) but retained as part of demography. A total of 151 parents completed the questionnaire with response rate of 93.3%. Test-retest reliability was tested in 25 respondents four weeks later and the intra-class correlation was between 0.53 and 1.00. EFA of the 13 items showed possibility of two to four factor domains, but three domains were most conceptually equivalent. Two of the domains were similar to the original and one factor was identified de novo. One item was deleted due to poor factor loading of < 0.3. Therefore, the validated final PACV-Malay consisted of 12 items framed within three-factor domains. The PACV-Malay was reliable with total Cronbach alpha of 0.77. In conclusion, the PACV-Malay is a valid and reliable tool which can be used to identify vaccine hesitant parents in Malaysia. Confirmatory factor analysis and predictive validity are recommended for future studies.
  3. Ashraf K, Halim H, Lim SM, Ramasamy K, Sultan S
    Saudi J Biol Sci, 2020 Jan;27(1):417-432.
    PMID: 31889866 DOI: 10.1016/j.sjbs.2019.11.003
    Background: Medicinal plants are important source of drugs with pharmacological activities. Therefore, there is always rising demands to discover more therapeutic agents from various species. Orthosiphon stamineus, Gynura procumbens and Ficus deltoidea are high valued medicinal plants of Malaysia contain rich source of phenolic and flavonoid compounds. The aims of the present study were to evaluate anti-oxidant, antimicrobial and anti-proliferative effects on A549, HeGP2 and MCF7 cell lines of four different extracts of Orthosiphon stamineus, Gynura procumbens and Ficus deltoidea.

    Methodology: The leaves of all selected plants were extracted with methanol, chloroform, ethyl acetate and butanol separately with simple cold maceration. Antioxidant activity of all crude extracts were quantitatively measured against DPPH and Ferric Reducing Assay. Antimicrobial evaluation was done by Microdilution and MTT assay and antipoliferative activity of all extracts of selected plant were evaluated against A549, HePG2 and MCF7 cell lines.

    Results: Results showed that methanol extract exhibited highest percentage free radical scavenging activity of almost all extracts of selected plants. Antimicrobials results showed chloroform and methanol extracts of O. stamineus extract were the two most active extracts against resistant MRSA but not S. aureus. Only methanol extract of G. procumbens showed antimicrobial activity against the tested pathogens. Chloroform and methanol extracts of F. deltoidea elicited antimicrobial activity against S. aureus but not MRSA. Antiproliferative activity against three tested cell lines results showed that ethyl acetate extract of O. stamineus showed good effect whereas methanol extract of F. deltoidea and G. procumbens exhibited good antiproliferative activity.

    Conclusions: The results of the present investigation demonstrated significant variations in the antioxidant, antimicrobial and antiproliferative effects of different solvent extracts. These data could be helpful in isolation of pure potent compounds with good biological activities from the extracts of plants.

  4. Wang L, Ang LH, Gao F, Abdul Halim H
    Humanit Soc Sci Commun, 2023;10(1):104.
    PMID: 36938578 DOI: 10.1057/s41599-023-01603-3
    The corporate profile translations of multinational corporations (MNCs) in emerging economies such as China possess rich information for narrative analysis. Nevertheless, how the parts of a corporate profile translation form a whole narrative remains undertheorized. This study, therefore, examines the relationality of parts in the corporate profile translations of China's MNCs by integrating William Labov's narrative structure with Margaret Somers' narrative identity theory. Specifically, we conduct a theoretical thematic analysis of how constituents form a whole narrative in relevant corporate profiles, of the shifts in the relationality of parts from the Chinese source texts (STs) to the English target texts (TTs) of these profiles, and of the influences of these shifts on the constitution of corporate identities in the target texts. Our results show that in the corporate profiles of Chinese MNCs, episodes are not randomly selected and related to each other but follow predominant patterns. However, we find no unified patterns in the shifts in the relationality of parts via the corporate profile translation of China's MNCs. We thus reveal how corporations' identities are constituted in diverse ways that reflect their fluid and unique features. Accordingly, our findings have implications for translation studies and corporate communications.
  5. Gan GG, Leong YC, Bee PC, Chin EF, Abdul Halim H, Nadarajan VS, et al.
    Cytokine, 2016 Feb;78:55-61.
    PMID: 26638029 DOI: 10.1016/j.cyto.2015.11.022
    Non-HLA gene polymorphisms have been shown to be associated with the risk of graft-versus-host disease (GVHD) and outcome of allogeneic haematopoietic stem cell transplantation (AHSCT). This study aims to investigate the role of IL6, TNFα, IL10, IL2 and IL12 gene polymorphisms in the outcome of AHSCT in a South East Asian population. A total of 67 patients and 59 donors who underwent HLA-identical matched sibling AHSCT were available for analysis. There was no significant association between the different cytokine genotypes of patients with the incidence and severity of acute GVHD. Patients with IL2 166∗T allele and patients who received donor stem cells who had IL2 166∗G allele appeared to have reduced incidence of cGVHD. Patients who received donor stem cells with IL12 1188∗C allele are found to be associated with better disease free survival. These results suggest a possible role of IL2 and IL12 gene polymorphisms in the outcome of AHSCT in a South East Asian population.
  6. Gan GG, Subramaniam R, Bee PC, Chin EF, Abdul-Halim H, Tai MC
    Asian Pac J Cancer Prev, 2014;15(4):1703-6.
    PMID: 24641394
    BACKGROUND: The current standard treatment for patients with newly diagnosed diffuse large B cell lymphoma (DLBCL) is rituximab combined with cyclophosphamide, doxorubicin, vincristine and prednisolone (CHOP). A significant number of patients were not treated with recommended dose of rituximab due to limited financial resources in Malaysia. This study evaluates the efficacy of R-CHOP like chemotherapy in Malaysian patients with DLBCL.

    MATERIALS AND METHODS: The study comprised a retrospective analysis of patients with DLBCL treated at a single centre. The outcome was compared with patients who were treated with R-CHOP like and CHOP like chemotherapy. Patients who were treated with lower dose of rituximab was subanalysed for outcome.

    RESULTS: A total of 86 patients who had CHOP-like chemotherapy were included. Only 39 (45%) patients had rituximab and only 12 (29%) patients had the recommended dose. The overall response (OR) and complete response (CR) rates were 88% and 81% respectively. There was no significant difference in OR and CR in patients who had rituximab and those without rituxmab. Those with International Prognostic Index (IPI) score of ≤ 2 had significant higher CR rate, progression free survival (PFS) and overall survival (p<0.001).

    CONCLUSIONS: The lack of significant improvement in CR and DFS in our patients may be due to an inadequate dose of rituximab.

  7. Karunakaran R, Halim HA, Ng KP, Hanifah YA, Chin E, Jaafar FL, et al.
    Eur Rev Med Pharmacol Sci, 2011 Nov;15(11):1343-6.
    PMID: 22195371
    Tsukamurella spp. are a rare but important cause of intravascular catheter-related bacteremia in immunocompromised patients. The organism is an aerobic, Gram-positive, weakly acid-fast bacillus that is difficult to differentiate using standard laboratory methods from other aerobic actinomycetales such as Nocardia spp., Rhododoccus spp., Gordonia spp., and the rapid growing Mycobacterium spp. We report a case of Tsukamurella tyrosinosolvens catheter-related bacteremia in a 51-year-old haematology patient who responded to treatment with imipenem and subsequent line removal. 16srRNA sequencing allowed for the prompt identification of this organism.
  8. Letchmi S, Das S, Halim H, Zakariah FA, Hassan H, Mat S, et al.
    Nurs Health Sci, 2011 Mar;13(1):60-4.
    PMID: 21392194 DOI: 10.1111/j.1442-2018.2011.00579.x
    The fatigue that is observed in patients who are undergoing dialysis is usually associated with an impaired quality of life. The present cross-sectional study was conducted from January to April 2009 in three hemodialysis units in Kuala Lumpur, Malaysia. In this study, the Multidimensional Fatigue Inventory and Depression Anxiety and Stress Score 21 were used to determine the level of fatigue, depression, anxiety, and stress of patients who were undergoing dialysis. The data were obtained from a calculated sample of 116 and a total of 103 respondents participated in the study. A total of 56 (54.4%) and 47 (45.6%) respondents experienced a high level and a low level of fatigue, respectively. There was a significant relationship between the duration of treatment and the level of fatigue. The respondents who had been receiving treatment for > 2 years experienced more fatigue, compared to the respondents who had been undergoing hemodialysis for > 2 years. There was a significant difference in relation to the age of the participants regarding the level of fatigue. No significant relationship between the sex of the participants, anemia, depression, anxiety, stress, and the level of fatigue was observed. Special attention needs to be paid to both the younger and older adults who are receiving treatment. In addition, proper planning is needed for the patients regarding their daily activities in order to reduce fatigue. Nurses who work in hemodialysis units are recommended to provide exercise classes or group therapy in order to boost the energy levels among patients who are undergoing dialysis. Health professionals should provide appropriate treatment for patients who are experiencing fatigue in order to prevent any other complications that could arise.
  9. Mak WY, Nagarajah JR, Abdul Halim H, Ramadas A, Mohd Pauzi Z, Pee LT, et al.
    PMID: 32566235 DOI: 10.1186/s40545-020-00238-y
    Background: In Malaysia, for more than a decade, dipeptidyl peptidase-4 inhibitors (DPP-4i) are among the oral antidiabetic medications used as monotherapy or in combination to manage type II diabetes mellitus (T2DM). These medications are known for the efficacy in glycated haemoglobin (HbA1c) reduction and weight neutral effect with minimal hypoglycaemia occurrence. This study aimed to identify the outcomes of DPP-4i use in one of the largest tertiary public hospital in Southeast Asia.

    Methods: This is a retrospective cross sectional study conducted in 2016, where stratified sampling method was used. Patients with T2DM treated with available DPP-4i; namely Linagliptin, Saxagliptin, Sitagliptin and Vildagliptin, for at least 3 months were identified from the pharmacy record. Medical records from Physician Clinic in Hospital Kuala Lumpur (HKL) were reviewed. Data on demographic, anthropometric, antidiabetic treatment modalities, laboratory and documented outcomes were collected. Outcomes endpoints which include changes in HbA1c, fasting blood glucose (FBG), and body weight were recorded and analysed. Adverse drug reactions (ADR) documented were also reported.

    Results and discussion: A total of one hundred and five patients were recruited. The patients were 49.5% men (n = 52), with a mean age of 57 years, mean HbA1c of 8.5% (69 mmol/mol) and mean BMI of 29.5 kg/m2. At least 50% of the patients had T2DM for more than 10 years and more than two third of these patients had both T2DM and hypertension. Thirty nine patients were on Vildagliptin, 32 on Sitagliptin, 26 on Saxagliptin and the remaining on Linagliptin. The most commonly prescribed DPP-4i were Vildagliptin and Sitagliptin. Majority of the patients (90.4%) were prescribed with Metformin, with 62.8% of patients on fixed-dose combination, and the remaining on add-on Metformin therapy. Use of DPP-4i as an adjunct was associated with a mean reduction of 0.9% (9 mmol/mol) in HbA1c (p 

  10. Mohd Hussain RH, Abdul Ghani MK, Khan NA, Siddiqui R, Aazmi S, Halim H, et al.
    Pathogens, 2022 Dec 05;11(12).
    PMID: 36558808 DOI: 10.3390/pathogens11121474
    Amoebic keratitis and encephalitis are mainly caused by free-living amoebae of the genus Acanthamoeba, which consists of both pathogenic and nonpathogenic species. The global distribution, amphizoic properties and the severity of the disease caused by Acanthamoeba species have inspired the scientific community to put more effort into the isolation of Acanthamoeba, besides exploring the direct and indirect parameters that could signify a pathogenic potential. Therefore, this study was performed to characterize the pathogenic potential of Acanthamoeba isolated from contact lens paraphernalia and water sources in Malaysia. Various methodologies were utilized to analyze the thermotolerance and osmotolerance, the secretion level of proteases and the cytopathic effect of trophozoites on the cell monolayer. In addition, the in vitro cytopathogenicity of these isolates was assessed using the LDH-release assay. A total of 14 Acanthamoeba isolates were classified as thermo- and osmotolerant and had presence of serine proteases with a molecular weight of 45-230 kDa. Four T4 genotypes isolated from contact lens paraphernalia recorded the presence of serine-type proteases of 107 kDa and 133 kDa. In contrast, all T3 genotypes isolated from environmental samples showed the presence of a 56 kDa proteolytic enzyme. Remarkably, eight T4 and a single T3 genotype isolates demonstrated a high adhesion percentage of greater than 90%. Moreover, the use of the HeLa cell monolayer showed that four T4 isolates and one T3 isolate achieved a cytopathic effect in the range of 44.9-59.4%, indicating an intermediate-to-high cytotoxicity level. Apart from that, the LDH-release assay revealed that three T4 isolates (CL5, CL54 and CL149) and one T3 isolate (SKA5-SK35) measured an exceptional toxicity level of higher than 40% compared to other isolates. In short, the presence of Acanthamoeba T3 and T4 genotypes with significant pathogenic potential in this study reiterates the essential need to reassess the functionality of other genotypes that were previously classified as nonpathogenic isolates in past research.
  11. Mohammad Khuzaini A, Mohd Baharudin JA, Md Fauzi A, Zulkeflee HA, Abdul Halim H, Mazli SK, et al.
    J Neonatal Perinatal Med, 2024;17(2):269-273.
    PMID: 38728206 DOI: 10.3233/NPM-230146
    BACKGROUND: Tumor lysis syndrome (TLS) is an oncological emergency associated with hematological malignancies or highly proliferative solid tumors, commonly after chemotherapy. It is rarely associated with transient abnormal myelopoiesis.

    OBSERVATION: We report a rare case of a neonate with transient abnormal myelopoiesis and tumor lysis syndrome, complicated with concomitant heart failure due to an underlying atrioventricular septal defect. Hyperhydration was contraindicated due to heart failure. The patient was managed conservatively with full recovery.

    CONCLUSION: Tumor lysis syndrome should be suspected in neonates with transient abnormal myelopoiesis with electrolyte abnormalities. Treatment options should be considered carefully for their risks and benefits.

  12. Abdul Halim R, Mohd Hussain RH, Aazmi S, Halim H, Ahmed Khan N, Siddiqui R, et al.
    J Water Health, 2023 Sep;21(9):1342-1356.
    PMID: 37756200 DOI: 10.2166/wh.2023.186
    The present study aims to identify the Acanthamoeba genotypes and their pathogenic potential in three recreational lakes in Malaysia. Thirty water samples were collected by purposive sampling between June and July 2022. Physical parameters of water quality were measured in situ while chemical and microbiological analyses were performed in the laboratory. The samples were vacuum filtered through nitrate filter, cultured onto non-nutrient agar and observed microscopically for amoebic growth. DNAs from positive samples were extracted and made to react with polymerase chain reaction using specific primers. Physiological tolerance tests were performed for all Acanthamoeba-positive samples. The presence of Acanthamoeba was found in 26 of 30 water samples by PCR. The highest rate in lake waters contaminated with amoeba was in Biru Lake (100%), followed by Titiwangsa Lake (80%) and Shah Alam Lake (80%). ORP, water temperature, pH and DO were found to be significantly correlated with the presence of Acanthamoeba. The most common genotype was T4. Temperature- and osmo-tolerance tests showed that 8 (30.8%) of the genotypes T4, T9 and T11 were highly pathogenic. The presence of genotype T4 in habitats related to human activities supports the relevance of this amoeba as a potential public health concern.
  13. Haji Noor Mohamed NM, S M N Mydin RB, Che Halim H, Musa MY
    Indian J Otolaryngol Head Neck Surg, 2023 Dec;75(4):4151-4157.
    PMID: 37974670 DOI: 10.1007/s12070-023-03905-z
    BACKGROUND: Nasopharyngeal cancer (NPC) is a type of malignancy that is highly prevalent in Asian countries. Therefore, an understanding between NPC epidemiological trend, the clinico-pathological and aetiological profiles are needed. This systematic review focuses on asian countries demographic and clinico-pathological presentation reported in 9982 NPC cases diagnosed from the year 2010 to 2021.

    METHODOLOGY: Data were extracted from databases, such as PubMed, Springer Link, Science Direct, Google Scholar and general search engines, by using pre-determined keywords (e.g. clinico-pathological data, age, sex, tumour stage, nasopharyngeal cancer, nasopharyngeal carcinoma, naso-pharynx and cancer in Asia).

    RESULTS AND CONCLUSION: Findings from our systematic review shows that from 2010 to 2021, males in age range below 50 years old are at a higher risk of developing NPC in Asia. NPC is mostly diagnosed at advanced stage in Asia, which is likely due to the deep-seated location of the cancer. Type III NPC and EBV proteins (EBNA1 and LMP2A) are frequently associated with reported EBV-positive NPC cases in Asian countries. Meanwhile, NPC type I, II, and III are associated with EBV-negative NPC cases in Asia. Human leucocyte antigen (HLA) alleles (A2, B27, and B46) are frequently present in reported EBV-negative NPC cases in Asia. In Asia, males below 50 years old are more prone to NPC and often diagnosed at late stage. EBV-positive and EBV-negative NPC in Asia have unique histological profiles. Systemic approach of this study may help to provide better knowledge on reported NPC cases especially on the risk factors and clinical presentation focusing in Asian countries.

  14. Gan GG, Ng DLC, Leong YC, Bee PC, Chin EFM, Abdul Halim H, et al.
    Med J Malaysia, 2019 Jun;74(3):191-197.
    PMID: 31256172
    BACKGROUND: It is not uncommon that anxiety and depression occur in patients with cancers, and past researches have shown that the quality of life of patients is negatively affected. This study aims to determine the prevalence of anxiety and depression of patients with haematological cancers in Malaysia and to investigate the possible association of these psychological symptoms with their quality of life.

    METHODS: This is a cross-sectional study where patients with haematological cancers attending two major hospitals were recruited. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression scale (HADS). Quality of life (QoL) of these patients was measured using the European Organisation for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ C30). An overall summary QoL score in combination with financial difficulty score and global health score were used for analysis.

    RESULTS: A total of 319 patients were recruited. Thirty-three percent of patients had anxiety symptoms, 23.5% had depression symptoms. In summary the overall score of QoL is significantly lower in patients with higher scores for depression and anxiety, (p<0.05). Patients who exhibit anxiety symptoms were more frequently female, still undergoing treatment whereas patients who had higher depression scores were older and had acute leukemias or myeloproliferative neoplasms. Patients who have depression are significantly associated with a higher financial difficulty score, p<0.05.

    CONCLUSION: The poor quality of life in patients who have anxiety and depression should raise awareness amongst the health professions treating them so that additional support can be provided.

  15. Naz T, Nazir Y, Nosheen S, Ullah S, Halim H, Fazili ABA, et al.
    Biomed Res Int, 2020;2020:8890269.
    PMID: 33457420 DOI: 10.1155/2020/8890269
    Carotenoids produced by microbial sources are of industrial and medicinal importance due to their antioxidant and anticancer properties. In the current study, optimization of β-carotene production in M. circinelloides strain 277.49 was achieved using response surface methodology (RSM). Cerulenin and ketoconazole were used to inhibit fatty acids and the sterol biosynthesis pathway, respectively, in order to enhance β-carotene production by diverting metabolic pool towards the mevalonate pathway. All three variables used in screening experiments were found to be significant for the production of β-carotene. The synergistic effect of the C/N ratio, cerulenin, and ketoconazole was further evaluated and optimized for superior β-carotene production using central composite design of RSM. Our results found that the synergistic combination of C/N ratios, cerulenin, and ketoconazole at different concentrations affected the β-carotene productions significantly. The optimal production medium (std. order 11) composed of C/N 25, 10 μg/mL cerulenin, and 150 mg/L ketoconazole, producing maximum β-carotene of 4.26 mg/L (0.43 mg/g) which was 157% greater in comparison to unoptimized medium (1.68 mg/L, 0.17 mg/g). So, it was concluded that metabolic flux had been successfully redirected towards the mevalonate pathway for enhanced β-carotene production in CBS 277.49.
  16. Raza A, Matloob S, Abdul Rahim NF, Abdul Halim H, Khattak A, Ahmed NH, et al.
    Front Psychol, 2020;11:572450.
    PMID: 33240162 DOI: 10.3389/fpsyg.2020.572450
    The coronavirus disease 2019 (COVID-19) pandemic, first reported in late December 2019, is regarded as the most significant public health emergency of the century. According to the World Health Organization (WHO), the current outbreak of COVID-19 has affected millions of people and killed hundreds of thousands in more than 200 countries, including Pakistan. Health-care professionals (HCPs) cannot minimize human interactions or isolate themselves from patients due to their jobs and moral duties. Hence, the outbreak needed HCPs to work in adverse and challenging conditions with possible mental health problems. In light of the stated background, this study aims to explore and understand the factors that impede HCPs to effectively treat COVID-19 patients in Karachi, Pakistan. Based on qualitative methods, a phenomenological approach was considered to record the true experiences of HCPs. Twelve doctors and nurses were recruited from five COVID-19 designated hospitals in Karachi, Sindh Province, using purposive and snowball sampling. Semi-structured in-depth telephone interviews were conducted from April 6 to 14, 2020, and analyzed through thematic analysis. The findings suggest that there were two types of constraints, institutional and personal, which were impeding HCPs to treat COVID-19 patients effectively. Institutional constraints include the poor condition of isolation wards, inadequate availability of personal protective equipment (PPE), excessive and uneven workload, and absence of emotional and psychological support in hospitals. Besides, personal constraints include nervousness due to the novel virus, a constant fear of becoming infected, fear of taking virus to family, extreme isolation and loneliness, and feeling of powerlessness. The study found that HCPs in Pakistan have been dealing with a high risk of infection, causing mental health problems such as stress, anxiety, and depressive symptoms. These mental health problems not only affect attention, understanding, and decision-making capacity of HCPs, which could hinder the fight against COVID-19, but they could also have a continuous effect on their overall well-being on a long-term basis. Therefore, the present study outlines important clinical and policy strategies that are needed to support HCPs as the pandemic continues.
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