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Roles traditional healers play in cancer treatment in Malaysia: implications for health promotion and education

Merriam S, Muhamad M

Asian Pac J Cancer Prev, 2013;14(6):3593-601.
PMID: 23886151

BACKGROUND: For a number of reasons from cultural compatibility, to accessibility, to cost, traditional healers are a major source of health care in developing countries. In Malaysia, 'en estimated that upwards of 80% of the population consult traditional healers even if simultaneously seeking treatment from the Western medical system. Partially as a result of the widespread practice of visiting traditional healers, cancer diagnosis and treatment in Malaysia is often delayed or interrupted resulting in late presentation, advanced stage diagnosis, and a higher mortality rate than in Western countries. However, there is very little research on the role of traditional healers in cancer treatment in Malaysia.
MATERIALS AND METHODS: This qualitative study was designed to identify the roles traditional healers play in cancer diagnosis and treatment, with an eye to alleviating the cancer burden through educational responses with four publics in mind-policy makers, Western medical personnel, traditional healers, and the general public. In-depth interviews were conducted with 14 Malay traditional healers, 13 cancer survivors who had seen both traditional healers and Western doctors, and 12 cancer medical specialists.
RESULTS: Analysis of the data from these 39 participants revealed four roles traditional healers play in cancer treatment-medicinal healer, emotional comforter, spiritual guide, and palliative caregiver.
CONCLUSIONS: Three roles (emotional, spiritual, palliative) can be seen as complementary to the allopathic system. Emotional and spiritual roles may augment the effectiveness of biomedical treatment. Cancer awareness and education programs need to position traditional healers as complementary, rather than an alternative to Western medical treatment; Validating the roles Traditional Healers can play in cancer treatment in MY through health promotion and education will contribute to alleviating the nation's cancer burden.
Fulltext Older women breast cancer survivors: decision making, sources of information and wellness activities in Malaysia

Mohamed NA, Muhamad M

Asian Pac J Cancer Prev, 2013;14(3):2043-8.
PMID: 23679316

The purpose of this study ??s to profile older breast cancer survivors in Malaysia. In a survey study, ? custom made questionnaire was administered to 69 breast cancer patients and survivors between 60 and 84 years of age in Peninsular Malaysia. The main ethnic group recorded was Chinese, followed by Malay and Indian. The majority of women were married (87%) and had children (84.1%). Just over half (53.6%) had primary and secondary education, whereas 24.7% had higher education. Fifty five percent of the study participants made their own decision on treatment, 60.8% exercised at least 3 times in a week, and 56.6% sought information from specialists. Our study suggests that older breast cancer survivors are aware of the importance of exercise in their daily lives and make attempts to be cancer free (e.g. doing exercise, recreational activity and have good relationships with friends and family).
Fulltext Pulmonary Tuberculosis in HIV Infection : The Relationship of the Radiographic Appearance to CD4 T-Lymphocytes Count

San KE, Muhamad M

Malays J Med Sci, 2001 Jan;8(1):34-40.
PMID: 22973154

Pulmonary tuberculosis (TB) in the AIDS population has a variable chest radiographic presentation. The association between the chest radiographic presentation of pulmonary TB and CD4 T-lymphocyte count in the HIV-infected patient was investigated in order to provide an empirical approach for early diagnosis, treatment, and isolation of these patients. A retrospective analysis of chest radiographs, CD4 T-lymphocyte counts, and clinical history of 80 patients from Hospital Kota Bharu, was performed. All patients were HIV-seropositive and had culture and /or cytology-proven pulmonary tuberculosis. Radiographs were evaluated for the presence of atypical or typical patterns of pulmonary TB. Thirteen (16.2%) patients had typical postprimary pattern, where opacities were distributed at the upper zones, with or without cavitation. Sixty-seven (83.8%) patients had atypical patterns, consisting of normal chest radiograph, middle and/or lower zones parenchymal opacities, mediastinal lymphadenopathy, pleural effusion and miliary TB. Of these, 18 (22.5%) patients demonstrated normal chest radiographs, 36 (45%) patients showed parenchymal opacities at the middle and/or lower zones of the lungs, 30 (37.5%) had mediastinal lymphadenopathy, 18 (22.5%) revealed pleural effusion and 6 (7.5%) presented with miliary TB. Sixty-two (77.5%) patients had CD4 T-lymphocytes count less than 200 cells/ul. Of these patients, only 1 (1.6%) had typical pattern. Eighteen (22.5%) patients had CD4 T-lymphocyte count more than 200 cells/ul, where 12 (66.7%) of them showed typical pattern. Patients with CD4 T-lymphocytes count of less than 200 cells/ul, were more likely to produce normal chest radiographs, middle and /or lower zones parenchymal opacities and mediastinal lymphadenopathy. The mean CD4 T-lymphocytes count were also found significantly lower. AIDS patients with pulmonary TB can present with both typical and atypical chest radiograph patterns. An AIDS patient who had CD4 T-lymphocytes count less than 200 cells/ul were more likely to present with atypical radiographic appearance of pulmonary TB. They required appropriate treatment and isolation until the diagnosis of pulmonary TB was confirmed.
Fulltext Family support in cancer survivorship

Muhamad M, Afshari M, Kazilan F

Asian Pac J Cancer Prev, 2011;12(6):1389-97.
PMID: 22126470

This paper raises issues about the role of family members in providing support for breast cancer survivors. Data were collected from 400 breast cancer survivors in Peninsular Malaysia through a custom-designed questionnaire fielded at hospitals and support group meetings. The data were analyzed using descriptive statistics. The analyses show that all family members could be supportive, especially in decision making and help with emotional issues. The spouse was the main support provider among the family members (others were children, parents, siblings and more distant relatives). The results also indicated that a significant percentage practiced collaborative decision-making. Breast cancer survivors needed their family members' support for information on survivorship strategies such as managing emotions, health, life style and dietary practice. The family members' supportive role may be linked to the Malaysian strong family relationship culture. For family members to contribute more adequately to cancer survivorship, it is suggested that appropriate educational intervention also be provided to them.
Fulltext Why breast cancer patients seek traditional healers

Muhamad M, Merriam S, Suhami N

Int J Breast Cancer, 2012;2012:689168.
PMID: 22295249 DOI: 10.1155/2012/689168

Traditional healing is a common practice in low and middle income countries such as Malaysia. Eighty percent of Malaysians consult traditional healers or "bomoh" at some time in their life for health-related issues. The purpose of our study was to explore why breast cancer patients visit traditional healers. This is a qualitative study utilizing in-depth interviews with 11 cancer survivors who sought both traditional and Western medicine. The findings revealed the following reasons for which patients seek traditional healers: (1) recommendation from family and friends, (2) sanction from family, (3) perceived benefit and compatibility, (4) healer credibility, and (5) reservation with Western medicine and system delay. These factors work together and are strongly influenced by the Malaysian cultural context. The issue with the Western health system is common in a developing country with limited health facilities.
Communication competencies of oncology nurses in Malaysia

Maskor NA, Krauss SE, Muhamad M, Nik Mahmood NH

Asian Pac J Cancer Prev, 2013;14(1):153-8.
PMID: 23534716

This paper reports on part of a large study to identify competencies of oncology nurses in Malaysia. It focuses on oncology nurses' communications-related competency. As an important cancer care team member, oncology nurses need to communicate effectively with cancer patients. Literature shows that poor communication can make patients feel anxious, uncertain and generally not satisfied with their nurses' care. This paper deliberates on the importance of effective communication by oncology nurses in the context of a public hospital. Four focus group discussions were used in this study with 17 oncology/cancer care nurses from Malaysian public hospitals. The main inclusion criterion was that the nurses had to have undergone a post-basic course in oncology, or have work experience as a cancer care nurse. The findings indicated that nurses do communicate with their patients, patients' families and doctors to provide information about the disease, cancer treatment, disease recurrence and side effects. Nurses should have good communication skills in order to build relationships as well as to provide quality services to their patients. The paper concludes by recommending how oncology nursing competencies can be improved.
Malignant paraganglioma of frontoethmoidal region

Sharma HS, Madhavan M, Othman NH, Muhamad M, Abdullah JM

Auris Nasus Larynx, 1999 Oct;26(4):487-93.
PMID: 10530746

Nonchromaffin paragangliomas are unusual tumours arising from widely distributed paraganglionic tissues probably of neural crest origin. In the head and neck region they are usually seen as carotid body or jugulotympanic tumours. Other rarely reported sites in the head and neck region are the orbit, nose and larynx. This report deals with a case of sinonasal paraganglioma which was initially treated with surgery and radiotherapy. Twenty two years later the tumour recurred and showed a rapid growth due to malignant transformation which we believe is late effect of radiotherapy. The clinical features, histopathology and role of radiotherapy in sinonasal paragangliomas together with a review of the medical literature have been discussed.
Teratocarcinosarcoma of the nasal cavity and ethmoid

Sharma HS, Abdullah JM, Othman NH, Muhamad M

J Laryngol Otol, 1998 Jul;112(7):682-6.
PMID: 9775307

Sinonasal teratocarcinosarcoma is very unusual malignant neoplasm histologically consisting of an epithelial element and one or more mesenchymal components. This is a report of teratocarcinosarcoma, in a 74-year-old male, involving the right nasal cavity and ethmoids with intracranial extension. The tumour was totally resected via the craniofacial approach and the patient was given post-operative chemotherapy. Extensive tumour necrosis, rapid growth and local destruction are the prominent features of this tumour. The clinical presentation, pathological features and clinical course of this rare malignancy are discussed with a review of the literature.
Estrogenic phytochemical from Labisia pumila (Myrsinaceae) with selectivity towards estrogen receptor alpha and beta subtypes

Muhamad M, Choo CY, Hasuda T, Hitotsuyanagi Y

Fitoterapia, 2019 Sep;137:104256.
PMID: 31295513 DOI: 10.1016/j.fitote.2019.104256

Labisia pumila var. alata (Myrsinaceae) or "Kacip fatimah" is a famous Malay traditional herb used for the maintenance of women's health. The extracts of L.pumila displayed estrogenic activity in rats. Nonetheless, the estrogenic bioactives were not identified. The aim of the study is to identify estrogenic compounds contributing to the established estrogenic activity. Bioactivity-guided-isolation method guided the isolation of pure bioactives. The hexane extract was subjected to a series of silica gel flash and open column chromatography with increasing amount of ethyl acetate in hexane or methanol in chloroform. Each fraction or pure compounds were evaluated on it's estrogen receptor (ER) binding activity with the fluorescence polarization competitive ERα and ERβ binding assay kit. Cytotoxic assay using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay method was used to establish the cytotoxic activity of the compounds. Four alkyl resorcinols and a dimeric 1,4-benzoquinone, namely belamcandol B (1), 5-pentadec-10'-(Z)-enyl resorcinol (2), 1,3-dihydroxy-5-pentadecylbenzene (3), 5-(heptadec-12'-(Z)-enyl) resorcinol (4) and demethylbelamcandaquinone B (5) were identified with selective binding affinities towards either ERα or ERβ exhibiting selectivity ratio from 0.15-11.9. Alkyl resorcinols (2)-(4) exhibited cytotoxic activity towards HL60 cells with IC50 values from 19.5-22.0 μM. Structural differences between compounds influence the binding affinities to ER subtypes. Further study is needed to establish the agonist or antagonist effect of these compounds on various tissues and to identify if these compounds exert cytotoxic activity through the ERs. When consuming L.pumila as a complementary medicine, careful consideration regarding it's estrogenic compound content should be given due consideration.
Fulltext The Roles of Low-Density Lipoprotein Receptor-Related Proteins 5, 6, and 8 in Cancer: A Review

Roslan Z, Muhamad M, Selvaratnam L, Ab-Rahim S

J Oncol, 2019;2019:4536302.
PMID: 31031810 DOI: 10.1155/2019/4536302

Low-density lipoprotein receptor (LDLR) has been an object of research since the 1970s because of its role in various cell functions. The LDLR family members include LRP5, LRP6, and LRP8. Even though LRP5, 6, and 8 are in the same family, intriguingly, these three proteins have various roles in physiological events, as well as in regulating different mechanisms in various kinds of cancers. LRP5, LRP6, and LRP8 have been shown to play important roles in a broad panel of cancers. LRP5 is highly expressed in many tissues and is involved in the modulation of glucose-induced insulin secretion, bone development, and cholesterol metabolism, as well as cancer progression. Recently, LRP5 has also been shown to play a role in chondroblastic subtype of osteosarcoma (OS) and prostate cancer and also in noncancer case such as osteoporosis. LRP6, which has been previously discovered to share the same structures as LRP5, has also been associated with many cancer progressions such as human triple negative breast cancer (TNBC), primary chronic lymphocytic leukemia (CLL), nonsmall cell lung cancer (NSCL), lung squamous cell carcinoma (LSCC), and hepatocellular carcinoma (HCC). In addition to its role in cancer progression, LRP8 (apolipoprotein E receptor 2 [APOER2]) has also been demonstrated to regulate canonical Wnt/β-catenin signaling pathway whereby this pathway plays a role in cell migration and development. Therefore, this review aimed to elucidate the role of LRP 5, 6, and 8 in regulating the cancer progression.
Dataset from Code-switching between English and Malay Languages in Malaysian Premier Polytechnics ESL Classrooms

Mohamed Mokhtar M, Muhamad M, Bahari AA, Mohd Khaja FN

Data Brief, 2022 Dec;45:108709.
PMID: 36426022 DOI: 10.1016/j.dib.2022.108709

The data was collected using a mixed method study of convergent parallel design, conducted using classroom observations, interviews and questionnaires to triangulate the data obtained from the three Premier Polytechnics in Malaysia, which involved nine lecturers and 183 students. The data is useful in focussing on the structure that normally occurs whenever code-switching happens and to test on how effective it is in the learning of English. Further research could also be based on these data as to identify the potential functions of code-switching and its contribution towards the language policy in Malaysia as reference to other countries too. It will provide an understanding of patterns and reasons for code-switching and subsequently offer insights into the use of code-switching as an effective language teaching and learning strategy.
Antiviral actions of flavanoid-derived compounds on dengue virus type-2

Muhamad M, Kee LY, Rahman NA, Yusof R

Int J Biol Sci, 2010 May 23;6(3):294-302.
PMID: 20567498

Dengue viruses, mosquito-borne members of the Flaviviridae family, are the causative agents of dengue fever and its associated complications, dengue haemorrhagic fever and dengue shock syndrome. To date, more than 2.5 billion people in over 100 countries are at risk of infection, and approximately 20 million infections were reported annually. There is currently no treatment or vaccine available for dengue infection. This study employed a whole-cell organism model or in vitro methods to study the inhibitory property of the flavanoid-derived compounds against DENV2 activity. Results showed that at concentration not exceeding the maximum non-toxic dose (MNTD), these compounds completely prevented DENV2 infection in HepG2 cells as indicated by the absence of cytophatic effects. The in vitro antiviral activity assessed in HepG2 cells employing virus inhibition assay showed high inhibitory activity in a dose dependent manner. At concentration below MNTD, compounds exhibited inhibitory activity against DENV2 with a range of potency strengths of 72% to 100%. The plaque forming unit per ml (pfu/ml) was reduced prominently with a maximum reduction of 98% when the infected HepG2 cells were treated with the highest non-toxic dose of compounds. The highly potent activity of the compounds against DENV2 infection strongly suggests their potential as a lead antiviral agent for dengue.
Pulmonary Embolism in an Asymptomatic COVID-19 Patient Detected on Ventilation/Perfusion SPECT/CT

Mahaletchumy T, Muhamad M, Mohammad Kazmin NE, Kori N, Periyasamy P

Clin Nucl Med, 2021 Jul 01;46(7):e360-e362.
PMID: 33443945 DOI: 10.1097/RLU.0000000000003513

Severe COVID-19 infection is associated with significant coagulopathy. We would like share a case of an asymptomatic 26-year-old man who tested positive for COVID-19 and had elevated d-dimer levels. Because of inconclusive CTPA findings, V/Q (ventilation/perfusion) SPECT/CT was performed, which confirmed the presence of pulmonary embolism. This case highlights the fact that pulmonary embolism should not be overlooked in a COVID-19 patient who has raised d-dimer levels, even in the absence of symptoms. It also highlights the importance of performing a V/Q study when CTPA results are inconclusive or when there are contraindications for iodinated contrast media.
Fulltext Relationship between Personal Values, Work Experience and Nursing Competencies among Cancer Care Nurses in Malaysia

Maskor NA, Muhamad M, Eric Krauss S, Nik Mahmood NH

Asian Pac J Cancer Prev, 2021 Jan 01;22(1):287-294.
PMID: 33507710 DOI: 10.31557/APJCP.2021.22.1.287

Oncology nurses are an essential component of cancer care teams. Nurses play a vital role in ensuring that cancer patients comply with their cancer treatment. In the cancer care nursing context, competency is not merely being skilled, but also implies the characteristic of being able to perform effectively. In addition to the need for competence, nursing is a discipline rich in values including human dignity, caring, humanity, and respect for personal privacy. Research from a variety of disciplines indicates that values often influence human behaviour in professional and work settings. It is often believed, therefore, that nurse' values and work experience influence and contribute to their work performance. Few studies have attempted to examine these relationships, particularly in the context of cancer care nursing. The purpose of this study was to determine the relationship between personal values, work experience and competency among cancer care nurses in Malaysia. Quantitative surveys were used to collect the data. A total of 845 cancer care nurses from 38 public hospitals in Peninsular Malaysia participated in the study. Descriptive statistics and Pearson Product-Moment Correlations were used to analyse the data. The findings revealed positive and significant relationships between personal values and competency (r = 0.59, p < 0.01) and work experience and competency (r = 0.11, p < 0.047). The findings support the assertion that Malaysian nurses' values and work experience are related to performance-related competency.
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Fulltext Simple room-temperature preparation of high-yield large-area graphene oxide

Huang NM, Lim HN, Chia CH, Yarmo MA, Muhamad MR

Int J Nanomedicine, 2011;6:3443-8.
PMID: 22267928 DOI: 10.2147/IJN.S26812

Graphene has attracted much attention from researchers due to its interesting mechanical, electrochemical, and electronic properties. It has many potential applications such as polymer filler, sensor, energy conversion, and energy storage devices. Graphene-based nanocomposites are under an intense spotlight amongst researchers. A large amount of graphene is required for preparation of such samples. Lately, graphene-based materials have been the target for fundamental life science investigations. Despite graphene being a much sought-after raw material, the drawbacks in the preparation of graphene are that it is a challenge amongst researchers to produce this material in a scalable quantity and that there is a concern about its safety. Thus, a simple and efficient method for the preparation of graphene oxide (GO) is greatly desired to address these problems. In this work, one-pot chemical oxidation of graphite was carried out at room temperature for the preparation of large-area GO with ~100% conversion. This high-conversion preparation of large-area GO was achieved using a simplified Hummer's method from large graphite flakes (an average flake size of 500 μm). It was found that a high degree of oxidation of graphite could be realized by stirring graphite in a mixture of acids and potassium permanganate, resulting in GO with large lateral dimension and area, which could reach up to 120 μm and ~8000 μm(2), respectively. The simplified Hummer's method provides a facile approach for the preparation of large-area GO.
Fulltext Antioxidant Effects, Antiproliferative Effects, and Molecular Docking of Clinacanthus nutans Leaf Extracts

Ismail NZ, Md Toha Z, Muhamad M, Nik Mohamed Kamal NNS, Mohamad Zain NN, Arsad H

Molecules, 2020 Apr 29;25(9).
PMID: 32365508 DOI: 10.3390/molecules25092067

Clinacanthus nutans is a well-known herb that has been used as an alternative and therapeutic medicine, however more selective C. nutans extracts are needed. In this study, leaves were extracted with 80% methanol and further fractionated with n-hexane, dichloromethane, chloroform, n-butanol, and aqueous residue. Subsequently, the total phenolic content (TPC), total flavonoid content (TFC), antioxidant scavenging activity, and antiproliferative effects on breast cancer (Michigan Cancer Foundation-7 [MCF7]) and normal breast (Michigan Cancer Foundation-10A [MCF 10A]) cells of the extracts were measured. Additionally, molecular docking simulation of the major compounds from C. nutans extracts was conducted. The aqueous residue had the highest TPC and TFC, whereas the crude extract had the highest scavenging activity. Among the extracts, dichloromethane extract (CN-Dcm) was selected as it had the highest selectivity index (SI) (1.48). Then, the chosen extract (CN-Dcm) was proceed for further analysis. The compounds from CN-Dcm were identified using gas chromatography-mass spectrometry (GC-MS). The major compounds from CN-Dcm were further investigated through molecular docking studies. Palmitic acid and linolenyl alcohol were the compounds found in the CN-Dcm extract that exhibited the highest binding affinities with p53-binding protein Mdm-2. These results highlight the potential of C. nutans as a source of anticancer activities.
Fulltext Role of ErbB1 in the Underlying Mechanism of Lapatinib-Induced Diarrhoea: A Review

Raja Sharin RNFS, Khan J, Ibahim MJ, Muhamad M, Bowen J, Wan Mohamad Zain WNI

Biomed Res Int, 2022;2022:4165808.
PMID: 35800225 DOI: 10.1155/2022/4165808

Lapatinib, an orally administered small-molecule tyrosine kinase inhibitor (SM-TKI), is an effective treatment for ErbB2-positive breast cancer. However, its efficacy as one of the targeted cancer therapies has been hampered by several adverse effects, especially gastrointestinal toxicity, commonly manifested as diarrhoea. Although it can be generally tolerated, diarrhoea is reported as the most common and most impactful on a patient's quality of life and associated with treatment interruption. Severe diarrhoea can result in malabsorption, leading to dehydration, fatigue, and even death. ErbB1 is an epidermal growth factor profoundly expressed in normal gut epithelium while lapatinib is a dual ErbB1/ErbB2 tyrosine kinase inhibitor. Thus, ErbB1 inhibition by lapatinib may affect gut homeostasis leading to diarrhoea. Nevertheless, the underlying mechanisms remain unclear. This review article provides evidence of the possible mechanisms of lapatinib-induced diarrhoea that may be related to/or modulated by ErbB1. Insight regarding the involvement of ErbB1 in the pathophysiological changes such as inflammation and intestinal permeability as the underlying cause of diarrhoea is covered in this article.
The incidence of post-operative deep vein thrombosis in general surgical patients of hospital universiti sains malaysia

Tun M, Shuaib IL, Muhamad M, Mat Sain AH, Ressang AS

Malays J Med Sci, 2004 Jan;11(1):75-80.
PMID: 22977363

The incidence of deep vein thrombosis is believed to be rare in Asians. During recent years, a few reports have appeared with high incidence in orthopaedic patients comparable to Western studies. This study was carried out to find out the incidence of post-operative deep vein thrombosis (DVT) after major surgical procedures in general surgical patients in an Asian population. In a prospective study of 45 consecutive Asian patients after major general surgery, colour-flow duplex scan of the legs as an initial screening was done twice within two weeks. Mean age of the patients was 54 years 5 months and 87% of patients were included in the moderate and high risk group for deep vein thrombosis. Ascending venography was used to confirm deep vein thrombosis on patients with equivocal or positive results from colour flow duplex scan. One patient showed positive evidence of post-operative deep vein thrombosis on colour flow duplex scan which was further confirmed by ascending venography; giving an incidence of 2.2%. The incidence of post-operative deep vein thrombosis in general surgical patients is lower than the Western studies.
Fulltext A Bottom-Up Synthesis Approach to Silver Nanoparticles Induces Anti-Proliferative and Apoptotic Activities Against MCF-7, MCF-7/TAMR-1 and MCF-10A Human Breast Cell Lines

Zulkifli NI, Muhamad M, Mohamad Zain NN, Tan WN, Yahaya N, Bustami Y, et al.

Molecules, 2020 Sep 22;25(18).
PMID: 32971740 DOI: 10.3390/molecules25184332

A bottom-up approach for synthesizing silver nanoparticles (AgNPs-GA) phytomediated by Garcinia atroviridis leaf extract is described. Under optimized conditions, the AgNPs-GA were synthesized at a concentration of 0.1 M silver salt and 10% (w/v) leaf extract, 1:4 mixing ratio of reactants, pH 3, temperature 32 °C and 72 h reaction time. The AgNPs-GA were characterized by various analytical techniques and their size was determined to be 5-30 nm. FTIR spectroscopy indicates the role of phenolic functional groups in the reduction of silver ions into AgNPs-GA and in supporting their subsequent stability. The UV-Visible spectrum showed an absorption peak at 450 nm which reflects the surface plasmon resonance (SPR) of AgNPs-GA and further supports the stability of these biosynthesized nanoparticles. SEM, TEM and XRD diffractogram analyses indicate that AgNPs-GA were spherical and face-centered-cubic in shape. This study also describes the efficacy of biosynthesized AgNPs-GA as anti-proliferative agent against human breast cancer cell lines, MCF-7 and MCF-7/TAMR-1. Our findings indicate that AgNPs-GA possess significant anti-proliferative effects against both the MCF-7 and MCF-7/TAMR-1 cell lines, with inhibitory concentration at 50% (IC50 values) of 2.0 and 34.0 µg/mL, respectively, after 72 h of treatment. An induction of apoptosis was evidenced by flow cytometry using Annexin V-FITC and propidium iodide staining. Therefore, AgNPs-GA exhibited its anti-proliferative activity via apoptosis on MCF-7 and MCF-7/TAMR-1 breast cancer cells in vitro. Taken together, the leaf extract from Garcinia atroviridis was found to be highly capable of producing AgNPs-GA with favourable physicochemical and biological properties.
Validation of Malay brief screening instrument for ascertainment of epilepsy

Fong SL, Lim KS, Tan L, Aris T, Khalid RA, Ali RA, et al.

Epilepsy Behav, 2019 08;97:206-211.
PMID: 31252280 DOI: 10.1016/j.yebeh.2019.05.033

INTRODUCTION: Prevalence studies of epilepsy in Asia revealed a prevalence ranging from 1.5 to 14.0 per 1000 among Asian populations. However, the prevalence of epilepsy in Malaysia is not available for comparison with other countries. This study aimed to translate and validate a Malay brief screening instruments for ascertainment of epilepsy.
METHOD: We translated into Malay a brief screening instrument for ascertainment of epilepsy designed and validated by Ottman et al., using the three-stage cross-cultural adaptation process developed by the International Quality of Life Assessment (IQOLA) project. We then administered the translated questionnaire via online survey to 162 cases (patients with epilepsy under follow-up care at the neurology clinic in University of Malaya Medical Centre, Kuala Lumpur) and 146 controls with no known history of epilepsy for validation.
RESULTS: Applying the most liberal definition for a positive screen, we obtained a sensitivity of 96.3% (95% confidence interval [CI]: 91.8-98.5%), with a specificity of 66.4% (95% CI: 58.1-73.0%) and positive predictive value (PPV) of 2.0%. The most stringent definition for a positive screen (only epilepsy) resulted in a sensitivity of 97.4% (95% CI: 62.0-72.6%), specificity of 98.6% (95% CI: 94.6-99.7%), and PPV of 26.6%. Narrowing the definition of a positive screen decreased sensitivity but improved PPVs. When compared to the original English questionnaire, the sensitivities were similar for all four definitions of a positive screen.
CONCLUSION: This is the first validated epilepsy screening questionnaire in the Malay language and represents a useful tool for the ascertainment of epilepsy in population-based studies.

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