Displaying all 13 publications

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  1. Abu NA, Lim CB, Nor NSM
    Clin Pediatr Endocrinol, 2021;30(2):93-97.
    PMID: 33867669 DOI: 10.1297/cpe.30.93
    Mauriac syndrome is a rare and underdiagnosed complication of type 1 diabetes mellitus (T1DM). It is characterized by growth retardation, delayed puberty, Cushingoid features, hepatomegaly, and increased transaminase levels. The term glycogenic hepatopathy has been used to describe patients with poorly controlled T1DM and glycogen overload in the hepatocytes but without all the features of Mauriac syndrome. Although rare, glycogenic hepatopathy is reported to be the main cause of hepatomegaly in young patients with T1DM. We report two cases of glycogenic hepatopathy in children with poorly controlled T1DM. Both children had hepatomegaly, elevated liver enzyme levels, and elevated lactate levels. A liver biopsy confirmed the diagnosis of glycogenic hepatopathy in both patients. In conclusion, hepatomegaly with elevated liver enzymes, negative infective and metabolic screenings and persistently elevated plasma lactate levels should raise the suspicion of glycogenic hepatopathy in poorly controlled T1DM. Early diagnosis and improvement in glycemic control are the mainstays of treatment, which can prevent long-term complications.
  2. Zulkifli S, Rahman AA, Kadir SHSA, Nor NSM
    Eur J Pediatr, 2021 Oct;180(10):3111-3127.
    PMID: 33893858 DOI: 10.1007/s00431-021-04085-0
    For the past two decades, growing research has been pointing to multiple repercussions of bisphenol A (BPA) exposure to human health. BPA is a synthetic oestrogen which primarily targets the endocrine system; however, the compound also disturbs other systemic organ functions, in which the magnitude of impacts in those other systems is as comparable to those in the endocrine system. To date, the discoveries on the association between BPA and health outcomes mainly came from animal and in vitro studies, with limited human studies which emphasised on children's health. In this comprehensive review, we summarised studies on human, in vivo and in vitro models to understand the consequences of pre-, post- and perinatal BPA exposure on the perinatal, children and adult health, encompassing cardiovascular, neurodevelopmental, endocrine and reproductive effects.Conclusion: Evidence from in vitro and animal studies may provide further support and better understanding on the correlation between environmental BPA exposure and its detrimental effects in humans and child development, despite the difficulties to draw direct causal relations of BPA effects on the pathophysiology of the diseases/syndromes in children, due to differences in body system complexity between children and adults, as well as between animal and in vitro models and humans. What is known: • Very limited reviews are available on how BPA adversely affects children's health. • Previous papers mainly covered two systems in children. What is new: • Comprehensive review on the detrimental effects of BPA on children health outcomes, including expectations on adult health outcomes following perinatal BPA exposure, as well as covering a small part of BPA alternatives. • Essentially, BPA exposure during pregnancy has huge impacts on the foetus in which it may cause changes in foetal epigenetic programming, resulting in disease onsets during childhood as well as adulthood.
  3. Latt TN, Rahman SI, Nor NSM
    J ASEAN Fed Endocr Soc, 2018;33(1):45-48.
    PMID: 34400852 DOI: 10.15605/jafes.033.01.07
    Transient pseudohypoaldosteronism is strongly linked to urinary tract infections complicating structural urinary tract anomalies. A 3-month-old baby girl with hyponatremia, hyperkalemia and metabolic acidosis associated with urinary tract infection and structural urinary tract anomalies was diagnosed with transient pseudohypoaldosteronism following elevated serum aldosterone and normal 17-hydroxyprogesterone level. Electrolytes normalized with corrections and antibiotic therapy. Clinicians should have a high index of suspicion for transient pseudohypoaldosteronism in an infant presenting with hyponatremia, hyperkalemia and urinary tract infection with or without associated urinary tract anomalies.
  4. Kassim MSA, Manaf MRA, Nor NSM, Ambak R
    Malays J Med Sci, 2017 Dec;24(6):83-91.
    PMID: 29379390 DOI: 10.21315/mjms2017.24.6.10
    Background: The obesity rate in Malaysia is the highest in Asia. Half its population is obese or overweight. The present study aims to determine the effects of lifestyle intervention on weight loss and blood pressure among Malaysian overweight and obese housewives in Klang Valley.

    Methods: A quasi-experimental study with 328 obese and overweight low socio- economic status housewives aged 18-59 years old who met the screening criteria participated in the study. They were recruited into an intervention group (N = 169) or control group (N = 159). The intervention group received a lifestyle intervention consisting of a diet, physical activity and self-monitoring behavior package. The control group (delayed intervention group) received a women's health seminar package. Both groups were followed up for six months. Weight, body mass index (BMI), and blood pressure were evaluated both pre- and post-intervention.

    Results: A total of 124 participants from the intervention group and 93 participants from the control group completed the study. Mean weight loss was 1.13 ± 2.70 kg (P < 0.05) in the intervention group and 0.97 ± 2.60 kg (P < 0.05) in the control group. Systolic blood pressure (SBP) reductions in the intervention group were 5.84 ± 18.10 mmHg (P < 0.05). The control group showed reduction in SBP 6.04 ± 14.52 mmHg (P < 0.05). Both group had non-significant DBP reduction. Multivariate analysis via General Linear Model Repeated Measures observed no significant differences in terms of parameter changes with time in both groups for all parameters.

    Conclusions: The results indicate that the lifestyle interventions in this study resulted in modest weight loss and thus decreased BMI and blood pressure (SBP) within six months of intervention.

  5. Hanim A, Mohamed IN, Mohamed RMP, Das S, Nor NSM, Harun RA, et al.
    Mini Rev Med Chem, 2020;20(17):1696-1708.
    PMID: 32579497 DOI: 10.2174/1389557520666200624122325
    Alcohol use disorder (AUD) is characterized by compulsive binge alcohol intake, leading to various health and social harms. Protein Kinase C epsilon (PKCε), a specific family of PKC isoenzyme, regulates binge alcohol intake, and potentiates alcohol-related cues. Alcohol via upstream kinases like the mammalian target to rapamycin complex 1 (mTORC1) or 2 (mTORC2), may affect the activities of PKCε or vice versa in AUD. mTORC2 phosphorylates PKCε at hydrophobic and turn motif, and was recently reported to be associated with alcohol-seeking behavior, suggesting the potential role of mTORC2-PKCε interactions in the pathophysiology of AUD. mTORC1 regulates translation of synaptic proteins involved in alcohol-induced plasticity. Hence, in this article, we aimed to review the molecular composition of mTORC1 and mTORC2, drugs targeting PKCε, mTORC1, and mTORC2 in AUD, upstream regulation of mTORC1 and mTORC2 in AUD and downstream cellular mechanisms of mTORCs in the pathogenesis of AUD.
  6. Baqer AA, Nor NSM, Alagely HS, Musa M, Adnan NA
    Pol Merkur Lekarski, 2023;51(1):35-41.
    PMID: 36960898 DOI: 10.36740/Merkur202301105
    OBJECTIVE: Aim: Klebsiella pneumonia has emerged as an increasingly important cause of community-acquired nosocomial infections and many of these strains are highly virulent and exhibit a strong propensity to spread. Infections cause by K. pneumonia produces carbapen¬emase (KPC) enzyme and can be difficult to treat since only a few antibiotics are effective against them. Bacteriophage targeting this strain can be an alternative treatment. Characterisation of bacteriophage is utmost important in assisting the application of bacteriophage in phage therapy.

    PATIENTS AND METHODS: Materials and methods: In the present study, the lytic bacteriophage, k3w7, isolated by the host Klebsiella pneumoniae kP2 was characterised using transmission electron microscope (TEM), plaque assay, and restriction digestive enzyme to investigate mor¬phology, host spectrum, bacteriophage life cycle and stability accordingly.

    RESULTS: Results and conclusions: As shown by TEM, k3w7 was observed to have the characteristic of icosahedral heads 100 nm and contractile sheaths 120 nm suggesting it belongs to the family of myoviridae.The Investigation has done on the phage growth cycle showed a short latent period of 20 min and a burst size of approximately 220 plaque forming units per infected cell. Stability test showed the phage was stable over a wide range of pH and temperatures. According to restriction analysis, k3w7 had 50 -kb double-stranded DNA genome as well as the heterogeneous nature of genetic material. These findings suggest that K3W7 has a potential use in therapy against infections caused by K. pneumonia produces carbapenemase.

  7. Liyana AZ, Appannah G, Sham SYZ, Fazliana M, Nor NSM, Ambak R, et al.
    BMC Womens Health, 2018 07 19;18(Suppl 1):126.
    PMID: 30066628 DOI: 10.1186/s12905-018-0593-1
    BACKGROUND: The effectiveness of lifestyle intervention for weight loss on cardiometabolic risk factors among overweight and obese individuals in the community setting remains inconclusive. This study aimed to evaluate the effect of a 6-month weight loss lifestyle intervention on cardiometabolic risk factors among overweight and obese women and the sustainability of the changes in those markers at 12-month follow-up, comparing an intervention group with a control group.

    METHODS: A total of 243 participants from MyBFF@home were included in this study. Fasting blood samples at baseline, 6- and 12-month were assessed for fasting plasma glucose (FPG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides. The effect of the intervention on cardiometabolic risk markers were investigated within and between study groups using t-test and general linear model (GLM) repeated measure ANOVA.

    RESULTS: Results from repeated measures ANOVA showed intervention effect only in TC where significant reduction was found in the intervention group (- 0.26 mmol/L [95% CI: - 0.47 to - 0.06], p 

  8. Omar A, Husain MN, Jamil AT, Nor NSM, Ambak R, Fazliana M, et al.
    BMC Womens Health, 2018 07 19;18(Suppl 1):103.
    PMID: 30066645 DOI: 10.1186/s12905-018-0598-9
    BACKGROUND: Regular physical activity has always been strongly recommended for good cardiovascular health. This study aimed to determine the effect of physical activity on fasting blood glucose and lipid profile among low income housewives in Klang Valley.

    METHODS: Data of 328 eligible housewives who participated in the MyBFF@Home study was used. Intervention group of 169 subjects were provided with an intervention package which includes physical activity (brisk walking, dumbbell exercise, physical activity diary, group exercise) and 159 subjects in control group received various health seminars. Physical activity level was assessed using short-International Physical Activity Questionnaire. The physical activity level was then re-categorized into 4 categories (active intervention, inactive intervention, active control and inactive control). Physical activity, blood glucose and lipid profile were measured at baseline, 3rd month and 6th month of the study. General Linear Model was used to determine the effect of physical activity on glucose and lipid profile.

    RESULTS: At the 6th month, there were 99 subjects in the intervention and 79 control group who had complete data for physical activity. There was no difference on the effect of physical activity on the glucose level and lipid profile except for the Triglycerides level. Both intervention and control groups showed reduction of physical activity level over time.

    CONCLUSION: The effect of physical activity on blood glucose and lipid profile could not be demonstrated possibly due to physical activity in both intervention and control groups showed decreasing trend over time.

  9. Abidin ZZ, Halim RA, Noor E, Nor NSM, Nazari NSM, Zaini AA, et al.
    J Int Soc Prev Community Dent, 2023;13(5):416-425.
    PMID: 38124724 DOI: 10.4103/jispcd.JISPCD_123_23
    AIM: The bidirectional relationship between type 1 diabetes mellitus (T1DM) and inflammatory periodontal disease (PD) is globally recognized. However, oral health components are often given lower priority, and studies related to knowledge and the bidirectional association are limited. This study assesses the knowledge and perceptions of PD and its associated risk factors among T1DM patients and/or their parents.

    MATERIALS AND METHODS: Patients under 18 with T1DM at Universiti Teknologi MARA and Universiti Malaya were invited to participate. Structured interviews were conducted to assess participants' knowledge and perceptions of T1DM, and statistical analysis was performed to examine their associations using Pearson's chi-squared test and Fisher's exact test.

    RESULTS: A total of 113 T1DM patients, with a mean age of 11.4 ± 4, completed the interviews. Poor knowledge was observed among parents and T1DM patients (P-value = 0.007) and those who exercised regularly (P-value = 0.047). A significant association with good perception was found among individuals with uncontrolled HbA1c levels (P-value = 0.0018) and those experiencing bleeding symptoms (P-value = 0.021).

    CONCLUSIONS: The study highlights the importance of increasing awareness, a key factor in improving oral health knowledge. Interestingly, despite poor control of clinical parameters, the population displayed good perception, suggesting a potential lack of understanding regarding disease control.

  10. Saw LH, Leo BF, Nor NSM, Yip CW, Ibrahim N, Hamid HHA, et al.
    Environ Sci Pollut Res Int, 2021 Oct;28(38):53478-53492.
    PMID: 34036501 DOI: 10.1007/s11356-021-14519-9
    The COVID-19 pandemic has plunged the world into uncharted territory, leaving people feeling helpless in the face of an invisible threat of unknown duration that could adversely impact the national economic growths. According to the World Health Organization (WHO), the SARS-CoV-2 spreads primarily through droplets of saliva or discharge from the mouth or nose when an infected person coughs or sneezes. However, the transmission of the SARS-CoV-2 through aerosols remains unclear. In this study, computational fluid dynamic (CFD) is used to complement the investigation of the SARS-CoV-2 transmission through aerosol. The Lagrangian particle tracking method was used to analyze the dispersion of the exhaled particles from a SARS-CoV-2-positive patient under different exhale activities and different flow rates of chilled (cooling) air supply. Air sampling of the SARS-CoV-2 patient ward was conducted for 48-h measurement intervals to collect the indoor air sample for particulate with diameter less than 2.5 μm. Then, the reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was conducted to analyze the collected air sample. The simulation demonstrated that the aerosol transmission of the SARS-CoV-2 virus in an enclosed room (such as a hospital ward) is highly possible.
  11. Othman F, Ambak R, Omar MA, Shahar S, Nor NSM, Ahmad MH, et al.
    J Health Popul Nutr, 2021 05 31;40(Suppl 1):10.
    PMID: 34059149 DOI: 10.1186/s41043-021-00232-3
    BACKGROUND: Monitoring sodium intake through 24-h urine collection sample is recommended, but the implementation of this method can be difficult. The objective of this study was to develop and validate an equation using spot urine concentration to predict 24-h sodium excretion in the Malaysian population.

    METHODS: This was a Malaysian Community Salt Study (MyCoSS) sub-study, which was conducted from October 2017 to March 2018. Out of 798 participants in the MyCoSS study who completed 24-h urine collection, 768 of them have collected one-time spot urine the following morning. They were randomly assigned into two groups to form separate spot urine equations. The final spot urine equation was derived from the entire data set after confirming the stability of the equation by double cross-validation in both study groups. Newly derived spot urine equation was developed using the coefficients from the multiple linear regression test. A Bland-Altman plot was used to measure the mean bias and limits of agreement between estimated and measured 24-h urine sodium. The estimation of sodium intake using the new equation was compared with other established equations, namely Tanaka and INTERSALT.

    RESULTS: The new equation showed the least mean bias between measured and predicted sodium, - 0.35 (- 72.26, 71.56) mg/day compared to Tanaka, 629.83 (532.19, 727.47) mg/day and INTERSALT, and 360.82 (284.34, 437.29) mg/day. Predicted sodium measured from the new equation showed greater correlation with measured sodium (r = 0.50) compared to Tanaka (r =0.24) and INTERSALT (r = 0.44), P < 0.05.

    CONCLUSION: Our newly developed equation from spot urine can predict least mean bias of sodium intake among the Malaysian population when 24-h urine sodium collection is not feasible.

  12. Sallehuddin SM, Ambak R, Othman F, Aziz NSA, Palaniveloo L, Nor NSM, et al.
    J Health Popul Nutr, 2021 05 31;40(Suppl 1):9.
    PMID: 34059153 DOI: 10.1186/s41043-021-00234-1
    BACKGROUND: Sodium intake is associated with anthropometric measurement including weight, waist circumference (WC), and body mass index (BMI). Higher intake of sodium is usually linked to higher risk of obesity among adults globally, especially in developing countries. This study aims to explore the probable relationship between sodium intake by 24-h urine excretion assessment and anthropometric measurement of adults in Malaysia.

    METHODS: A cross-sectional study was conducted from October 2017 to March 2018 using a multi-stage stratified sampling method among Malaysian adults aged 18 years old and above. Sodium intake was determined by 24-h urinary sodium excretion, estimated from the respondents' 24-h urinary sample. Height was obtained based on standard protocol. Weight and WC were measured twice using validated anthropometric equipment and BMI was calculated according to World Health Organization (WHO) 1998 classification. Descriptive analysis was done to describe socio-demographic characteristics. A simple linear regression and multiple linear regression tests were done to assess the relationship of 24-h urinary excretion and anthropometric measurement. All statistical analysis was done using SPSS version 22.0.

    RESULTS: Of 1047 interviewed respondents, 798 respondents had done the 24-h urine collection (76.0% response rate). Majority was between 40 and 59 years old (43.5%) and married (77.7%). Simple linear regression showed a significant positive linear association between 24-h urinary excretion and household income, WC, and obese group. In the multivariate analysis, it was indicated that, an increase of 1 unit of BMI will significantly increase the sodium intake by 129.20 mg/dl and an increase of 1 cm of WC will significantly increase the sodium intake by 376.45 mg/dl.

    CONCLUSION: Our study showed a positive significant relationship between sodium intake estimated by 24-h urinary sodium excretion and BMI of Malaysian adults. More research is suggested on how sodium control can potentially contribute to obesity prevention.

  13. Nor NSM, Yip CW, Ibrahim N, Jaafar MH, Rashid ZZ, Mustafa N, et al.
    Sci Rep, 2021 01 28;11(1):2508.
    PMID: 33510270 DOI: 10.1038/s41598-021-81935-9
    The rapid spread of the SARS-CoV-2 in the COVID-19 pandemic had raised questions on the route of transmission of this disease. Initial understanding was that transmission originated from respiratory droplets from an infected host to a susceptible host. However, indirect contact transmission of viable virus by fomites and through aerosols has also been suggested. Herein, we report the involvement of fine indoor air particulates with a diameter of ≤ 2.5 µm (PM2.5) as the virus's transport agent. PM2.5 was collected over four weeks during 48-h measurement intervals in four separate hospital wards containing different infected clusters in a teaching hospital in Kuala Lumpur, Malaysia. Our results indicated the highest SARS-CoV-2 RNA on PM2.5 in the ward with number of occupants. We suggest a link between the virus-laden PM2.5 and the ward's design. Patients' symptoms and numbers influence the number of airborne SARS-CoV-2 RNA with PM2.5 in an enclosed environment.
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