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  1. Rahim NS, McTaggart E, Cohen MC
    Pediatr Dev Pathol, 2023;26(2):115-123.
    PMID: 36755423 DOI: 10.1177/10935266221146045
    OBJECTIVES: To establish the incidence of "diabetes-related death" (DRD) in children with known and unknown Diabetes Mellitus (DM) dying unexpectedly, and describe post-mortem (PM) biochemistry findings.

    PATIENTS AND METHODS: PM reports from the previous 16-year period were reviewed. Cases of DRD were extracted. All available demographic, clinical, and autopsy data including laboratory analyses was retrieved.

    RESULTS: 9/1376 (0.7%) DRD cases were identified. This was attributed to Diabetic Ketoacidosis in 7 and to Death in Bed Syndrome in 2. 4/9 cases were known diabetic and on insulin; whilst in 5/9 cases the diagnosis of DM was at PM. The mean age was 11.6 years (range 2.5-15). At PM, 4 cases were undernourished. The histology demonstrated pancreatic changes in keeping with DM in 3/9 and unremarkable pancreatic findings in 6/9. 3 cases also had autoimmune thyroiditis (1 also had myocarditis and Armanni-Ebstein nephropathy). Toxicological and biochemical analysis showed raised: β-hydroxybutyrate in 6, ketone bodies in 5 cases and raised HbA1c in 3c.

    CONCLUSION: Type 1 DM is an infrequent but yet potentially preventable cause of death in children. Our findings highlight the value of routine biochemical and toxicological analysis in all PM examinations of infants and children dying suddenly and unexpectedly.

  2. Mohd Fuad SK, Adznan N, Hayati AR, Virasamy V, Rahim NS
    Malays J Pathol, 2020 Dec;42(3):439-444.
    PMID: 33361726
    INTRODUCTION: Chronic histiocytic intervillositis (CHI) is a rare placental lesion strongly associated with recurrent miscarriages and fetal losses. It requires histopathological diagnosis and can only be made after delivery of the products of conception (POC). We describe a case of CHI in a 41-yearold lady with a 16-year history of thirteen recurrent consecutive first trimester miscarriages.

    CASE REPORT: The patient is a 41-year-old lady who suffered first trimester miscarriages in all her thirteen pregnancies. The relevant clinical investigations revealed neither significant nor helpful findings in determining the cause of recurrent miscarriages. Histological findings in each except one of the submitted conceptual tissue showed similar features of histiocytic aggregates primarily within the intervillous spaces, a characteristic description of CHI. One of the samples showed degenerative changes.

    DISCUSSION: Practicing pathologists are not familiar with the histological features of CHI and this may be a potential pitfall in routine examination of POCs. Recognising this entity allows for accurate diagnosis and hence better management. The aetiology remains unclear, although an immunopathological basis are being explored.

  3. Khairani O, Mohamed NA, Ismail Z, Shalinawati R, Chamhuri NH, Rahim NS
    Medicine & Health, 2018;13(1):97-105.
    MyJurnal
    Choosing a course to pursue is an important decision for students to make. A suitable career should correspond to the students’ personalitiy for future work satisfaction and success. The objectives of this study were to determine the students’ reasons for choosing medicine, their personality traits and aptitude (suitability). This was a cross-sectional study involving all third-year medical students at Universiti Sains Islam Malaysia. A self-administered questionnaire was used, which included questions on demographic data, Sidek Career Interest Inventory and reasons for choosing medicine. The inventory was used to measure the students’ personality traits and career suitability. A total of 80 students participated in the study. Majority of them were females (n=56, 70.0%). The findings showed that 45.7% (n=44) of the repondents chose medicine because of ‘passion and interest’, while 24.7% (n=20) and 19.8% (n=16) because of ‘parental influence’ and ‘to help the society’, respectively. For medicine, two personality traits are essential which are investigative and social personality traits. Approximately, 47.5% (n=38) of the respondents had high scores in investigative personality trait. However, only 13.8% (n=11) of them had high scores in social personality trait. Only 12.5% (n=10) of the students had high scores when combining both of the traits. Majority of the students chose medicine for altruistic reasons. However, only a few of them had suitable aptitude for this course namely investigative and social skill. Therefore, the students and the teachers need to be aware of these issues and cultivate the required skills in the students for better career outcome.
  4. Rahim NS, Lim SM, Mani V, Hazalin NAMN, Majeed ABA, Ramasamy K
    J Diet Suppl, 2020 Oct 14.
    PMID: 33962540 DOI: 10.1080/19390211.2020.1830223
    Neuroinflammation is associated with neuronal cell death and could lead to chronic neurodegeneration. This study investigated the neuroprotective potential of virgin coconut oil (VCO) against lipopolysaccharide (LPS)-induced cytotoxicity of neuroblastoma SK-N-SH cells. The findings were validated using Wistar rats, which were fed with 1-10 g/kg VCO for 31 days, exposed to LPS (0.25 mg/kg) and subjected to the Morris Water Maze Test. Brain homogenate was subjected to biochemical analyses and gene expression studies. α-Tocopherol (α-T; 150 mg/kg) served as the positive control. VCO (100 µg/mL) significantly (p 
  5. Rahim NS, Lim SM, Mani V, Abdul Majeed AB, Ramasamy K
    Pharm Biol, 2017 Dec;55(1):825-832.
    PMID: 28118770 DOI: 10.1080/13880209.2017.1280688
    CONTEXT: Virgin coconut oil (VCO) has been reported to possess antioxidative, anti-inflammatory and anti-stress properties.

    OBJECTIVE: Capitalizing on these therapeutic effects, this study investigated for the first time the potential of VCO on memory improvement in vivo.

    MATERIALS AND METHODS: Thirty male Wistar rats (7-8 weeks old) were randomly assigned to five groups (n = six per group). Treatment groups were administered with 1, 5 and 10 g/kg VCO for 31 days by oral gavages. The cognitive function of treated-rats were assessed using the Morris Water Maze Test. Brains were removed, homogenized and subjected to biochemical analyses of acetylcholine (ACh) and acetylcholinesterase (AChE), antioxidants [superoxide dismutase (SOD), catalase (CAT), glutathione (GSH), glutathione peroxidase (GPx) and glutathione reductase (GRx)], lipid peroxidase [malondialdehyde (MDA)] as well as nitric oxide (NO). α-Tocopherol (αT; 150 mg/kg) was also included for comparison purposes.

    RESULTS: VCO-fed Wistar rats exhibited significant (p  33%) and NO (≥ 34%). Overall, memory improvement by VCO was comparable to αT.

    DISCUSSION AND CONCLUSION: VCO has the potential to be used as a memory enhancer, the effect of which was mediated, at least in part, through enhanced cholinergic activity, increased antioxidants level and reduced oxidative stress.

  6. Selamat R, Mohamud WN, Zainuddin AA, Rahim NS, Ghaffar SA, Aris T
    Asia Pac J Clin Nutr, 2010;19(4):578-85.
    PMID: 21147721
    A nationwide cross-sectional school-based survey was undertaken among children aged 8-10 years old to determine the current iodine deficiency status in the country. Determination of urinary iodine (UI) and palpation of the thyroid gland were carried out among 18,012 and 18,078 children respectively while iodine test of the salt samples was done using Rapid Test Kits and the iodometric method. The results showed that based on WHO/ ICCIDD/UNICEF criteria, the national median UI was 109 μg/L [25th, 75th percentile (67, 166)] showing borderline adequacy. The overall national prevalence of iodine deficiency disorders (IDD) with UI<100 μg/L was 48.2% (95% CI: 46.0, 50.4), higher among children residing in rural areas than in urban areas. The highest prevalence of UI<100 μg/L was noted among the aborigines [(81.4% (95% CI: 75.1, 86.4)]. The national total goitre rate (grade 1 and grade 2 goitre) was 2.1%. Of 17,888 salt samples brought by the school children, 28.2% (95% CI: 26.4, 30.2) were found to have iodine content. However, the overall proportion of the households in Malaysia using adequately iodised salt as recommended by Malaysian Food Act 1983 of 20-30 ppm was only 6.8% (95% CI: 5.1, 9.0). In conclusion, although a goitre endemic was not present in Malaysia, almost half of the states in Peninsular Malaysia still have large proportion of UI level <100 μg/L and warrant immediate action. The findings of this survey suggest that there is a need for review on the current approach of the national IDD prevention and control programme.
  7. Sucedaram Y, Johns EJ, Husain R, Abdul Sattar M, H Abdulla M, Nelli G, et al.
    J Inflamm Res, 2021;14:689-710.
    PMID: 33716510 DOI: 10.2147/JIR.S299083
    Purpose: We hypothesized that low estrogen levels aggravate obesity-related complications. Diet-induced obesity can cause distinct pathologies, including impaired glucose tolerance, inflammation, and organ injury that leads to fatty liver and chronic kidney diseases. To test this hypothesis, ovariectomized (OVX) rats were fed a high-fat style diet (HFSD), and we examined structural changes and inflammatory response in the kidney and liver.

    Methods: Sprague-Dawley female rats were ovariectomized or sham-operated and divided into four groups: sham-operated rats fed a normal diet (ND); ovariectomized rats fed a normal diet (OVX-ND); sham-operated rats fed a HFSD; ovariectomized rats fed a high-fat style diet (OVX-HFSD). Mean blood pressure and fasting blood glucose were measured on weeks 0 and 10. The rats were sacrificed 10 weeks after initiation of ND or HFSD, the kidney and liver were harvested for histological, immunohistochemical and immunofluorescence studies.

    Results: HFSD-fed rats presented a significantly greater adiposity index compared to their ND counterparts. Liver index, fasting blood glucose and mean blood pressure was increased in OVX-HFSD rats compared to HFSD rats at study terminal. Histological and morphometric studies showed focal interstitial mononuclear cell infiltration in the kidney of HFSD rats with mesangial expansion being greater in the OVX-HFSD rats. Both HFSD fed groups showed increased expressions of renal inflammatory markers, namely TNF-alpha, IL-6 and MCP-1, and infiltrating M1 macrophages with some influence of ovarian hormonal status. HFSD-feeding also caused hepatocellular steatosis which was aggravated in ovariectomized rats fed the same diet. Furthermore, hepatocellular ballooning was observed only in the OVX-HFSD rats. Similarly, HFSD-fed rats showed increased expressions of the inflammatory markers and M1 macrophage infiltration in the liver; however, only IL-6 expression was magnified in the OVX-HFSD.

    Conclusion: Our data suggest that some of the structural changes and inflammatory response in the kidney and liver of rats fed a HFSD are exacerbated by ovariectomy.

  8. Lim XY, Lau MS, Zolkifli NA, Sastu Zakaria UR, Mohd Rahim NS, Lai NM, et al.
    PLoS One, 2024;19(4):e0297839.
    PMID: 38603736 DOI: 10.1371/journal.pone.0297839
    Herbal medicine is popularly used among patients who suffer from allergic rhinitis. This systematic review and meta-analysis was conducted to evaluate the efficacy and safety of single medicinal plants in the management of allergic rhinitis. We searched MEDLINE, CENTRAL, and Web of Science for randomised controlled trials which evaluated the use of single medicinal plant for allergic rhinitis among adults and children. Twenty-nine randomised controlled trials (n = 1879) were eligible while 27 (n = 1769) contributed data for meta-analyses. Most studies (studies = 20) compared medicinal plants against placebo and Petasites hybridus was most frequently investigated (studies = 5). Very-low-to-low-certainty evidence suggests that compared to placebo, single medicinal plants may improve overall total nasal symptoms (SMD -0.31, 95% CI -0.59 to -0.02; participants = 249; studies = 5; I2 = 21%) especially nasal congestion and sneezing; and rhinoconjunctivitis quality of life (RQLQ) scores (MD -0.46, 95% CI -0.84 to -0.07; participants = 148; studies = 3; I2 = 0%). Moderate-certainty evidence show no clear differences between single medicinal plants and antihistamine in overall symptoms (Total nasal symptoms: SMD -0.14, 95% CI -0.46 to 0.18; participants = 149; studies = 2; I2 = 0%). As adjunctive therapy, moderate-certainty evidence shows that medicinal plants improved SNOT-22 scores when given as intranasal treatment (MD -7.47, 95% CI -10.75 to -4.18; participants = 124; studies = 2; I2 = 21%). Risk of bias domains were low or not clearly reported in most studies while heterogeneity was substantial in most pooled outcomes. Route of administration and age were identified to be plausible source of heterogeneity for certain outcomes. Medicinal plants appear to be well tolerated up to 8 weeks of use. Clear beneficial evidence of medicinal plants for allergic rhinitis is still lacking. There is a need for improved reporting of herbal trials to allow for critical assessment of the effects of each individual medicinal plant preparation in well-designed future clinical studies.
  9. Mohamad MA, Ahmad Asnawi AW, Suhiman MS, Sathar J, Hayati AR, Abdul Rahim NS, et al.
    Malays J Pathol, 2023 Dec;45(3):425-440.
    PMID: 38155384
    The onset of obstetric antiphospholipid syndrome (APS) occurs when antiphospholipid antibodies act upon the placenta. During pregnancy, APS exhibits traits such as vascular thrombosis, inflammation, and hindered trophoblast implantation. The involvement of microRNA expression has been proposed as a genetic factor contributing to the syndrome's development. MicroRNAs play a role in regulating gene expression in various cellular processes, including the formation of placental tissue. Therefore, additional research is needed to explore the control of placental miRNA in APS. In this study, we aimed to profile miRNA expressions from placenta tissue of patients with APS. Differentially expressed miRNAs were determined for its targeted genes and pathways. Agilent microarray platform was used to measure placental microRNA expressions between normal placental tissue and those obtained from patients with APS. Differentially expressed miRNAs were detected using GeneSpring GX software 14.2 and sequences were mapped using TargetScan software to generate the predicted target genes. Pathway analysis for the genes was then performed on PANTHER and REACTOME software. Selected miRNAs and their associated genes of interest were validated using qPCR. Microarray findings revealed, 9 downregulated and 21 upregulated miRNAs expressed in placenta of patients with APS. Quantitative expressions of 3 selected miRNAs were in agreement with the microarray findings, however only miR-525-5p expression was statistically significant. Pathway analysis revealed that the targeted genes of differentially expressed miRNAs were involved in several hypothesised signalling pathways such as the vascular endothelial (VE) growth factor (VEGF) and inflammatory pathways. VE-cadherin, ras homolog member A (RHOA) and tyrosine kinase receptor (KIT) showed significant downregulation while Retinoblastoma gene (RET), Dual specificity protein phosphatase 10 (DUSP10) and B-lymphocyte kinase (BLK) genes were significantly upregulated. These preliminary findings suggest the involvement of miRNAs and identified novel associated genes involvement in the mechanism of obstetric APS, particularly through the alteration of vascular-associated regulators and the inflammatory signalling cascade.
  10. Wu YS, Osman AI, Hosny M, Elgarahy AM, Eltaweil AS, Rooney DW, et al.
    ACS Omega, 2024 Feb 06;9(5):5100-5126.
    PMID: 38343989 DOI: 10.1021/acsomega.3c07047
    Mercury is a type of hazardous and toxic pollutant that can result in detrimental effects on the environment and human health. This review is aimed at discussing the state-of-the-art progress on the recent developments on the toxicity of mercury and its chemical compounds. More than 210 recent works of literature are covered in this review. It first delineates the types (covering elemental mercury, inorganic mercury compounds, organic mercury compounds), structures, and sources of mercury. It then discusses the pharmacokinetic profile of mercury, molecular mechanisms of mercury toxicity, and clinical manifestation of acute and chronic mercury toxicity to public health. It also elucidates the mercury toxicity to the environment and human health in detail, covering ecotoxicity, neurotoxicity diseases, neurological diseases, genotoxicity and gene regulation, immunogenicity, pregnancy and reproductive system damage, cancer promotion, cardiotoxicity, pulmonary diseases, and renal disease. In order to mitigate the adverse effects of mercury, strategies to overcome mercury toxicity are recommended. Finally, some future perspectives are provided in order to advance this field of research in the future.
  11. Gan TS, Ghazali NI, Voo SYM, Low DE, Tang JJ, Kiing JW, et al.
    Int J Rheum Dis, 2023 Feb;26(2):327-336.
    PMID: 36382593 DOI: 10.1111/1756-185X.14492
    OBJECTIVE: To describe the clinical characteristics, management and quality of life of psoriasis patients with and without coexistent lupus erythematosus (LE).

    METHODS: This retrospective cross-sectional study uses data from the Malaysian Psoriasis Registry (MPR) from January 2007 to December 2018.

    RESULTS: Of 21 735 psoriasis patients, 34 (0.16%) had coexistent LE. The male to female ratio among psoriasis patients with coexistent LE was 1:5.8 versus 1.3:1 in patients with psoriasis but without LE. Nearly 70% presented with LE preceding psoriasis. Psoriasis patients with LE had an earlier age of psoriasis onset (27.56 ± 11.51 versus 33.31 ± 16.94 years, P = 0.006), a higher rate of psoriatic arthropathy (26.5% versus 13.0%, P = 0.02), and a significantly greater impairment of quality of life (Dermatology Quality of Life Index >10; 57.6% versus 40.3%, P = 0.04) compared with psoriasis patients without LE. The majority (87.5%) had systemic LE. The incidences of lupus nephritis (72.7% versus 40%) and hematological abnormalities (50% versus 20%) were higher among patients with LE preceding psoriasis compared with those with psoriasis preceding LE. Antinuclear antibody and double-stranded DNA were positive in 59.4% and 28.1% of psoriasis patients with LE, respectively. Hydroxychloroquine triggered the onset of psoriasis in 7 (24.1%) patients. Patients with LE were more likely to receive systemic treatment for psoriasis compared with those without LE (30.3% versus 14.2%, P = 0.008).

    CONCLUSIONS: Psoriasis patients with coexistent LE were uncommon, displayed a female preponderance, were more likely to have joint involvement, and had greater quality of life impairment than those without LE. LE preceded psoriasis in most of these patients, and systemic LE was the most common subtype.

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