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Fulltext Aggressive variant large granular lymphocytic leukaemia: a case report

Sabariah, M. N., Zainina, S., Faridah, I., Leong, C. F.

Malaysian Journal of Medicine and Health Sciences, 2011;7(1):57-60.
MyJurnal

Clonal disorders of LGL may either be CD3+ CD56- or CD3- CD56+ phenotype and these have been designated as T-cell leukaemia (T-LGL) or natural killer cell (NK)-LGL leukaemia respectively. Clonality is usually demonstrated by clonal rearrangement of T-cell receptor gene rearrangement or identified by flowcytometry analysis. Most patients with T-LGL will have an indolent course. In this report we described an aggressiveness of disease in a patient with clonal CD3+ LGL leukaemia whose cells also co-expressed CD56 diagnosed by flowcytometry. The patient responded well to interrupt ALL standard risk protocol however succumbed to her disease while waiting for upfront stem cell transplant. This case highlights on both the classical laboratory findings of rare entity of disease as well as a review of the literature pertaining particularly on its management.
Fulltext Antigen expression pattern of acute promyelocytic leukaemia cases in Malaysia

Ambayya A, Zainina S, Salmiah MS, Sabariah MN

Med J Malaysia, 2014 Apr;69(2):64-9.
PMID: 25241814 MyJurnal

INTRODUCTION: Acute Promyelocytic Leukaemia (APL) is associated with devastating coagulopathy and life threatening condition which requires immediate medical attention. It is crucial to establish an expedited diagnosis as early therapeutic intervention has led to optimal patient management. In this study, we assessed the type and frequency of antigen expressions in APL and correlated these findings with genetic studies.

METHODS: Multiparametric immunophenotyping was performed on 30 samples and findings were correlated with karyotypes, FISH for t(15;17) translocation and RT-PCR for PML-RARΑ for detection of breakpoint cluster regions (bcr1,bcr2 and bcr3).

RESULTS: On SSC/CD45, APL cells displayed high to moderate SSC, with the expression of CD33 (100%), CD13 (96.8%), cMPO (71%) but lacked CD34 (3.2%) and HLA-DR (9.7%). Aberrant expression of CD4 was seen in 12.9% and CD56 in 6.5% of the cases. A significant association between cumulative aberrant antigen expression and bcr1 were observed bcr1 (X2(2) =6.833,p.05) and (X2(2)=4.599,p>.05) respectively.

CONCLUSIONS: Flow cytometry is a rapid and effective tool in detecting APL. It is interesting to note that there is significant association between cumulative aberrant antigen expression and genotype analysis. Further validation is required to corroborate this relationship.
Fulltext Childhood idiopathic myelofibrosis: a case report and review of literature

Noor-Fadzilah Z, Leong CF, Sabariah MN, Cheong SK

Malays J Pathol, 2009 Dec;31(2):129-32.
PMID: 20514856 MyJurnal

Idiopathic myelofibrosis occurs predominantly in older adults. It is very rarely seen in children. We describe a 3-year-old girl with Down's syndrome who presented with recurrent chest infections associated with anaemia and easy bruising. There was mild hepatosplenomegaly. Full blood picture revealed pancytopaenia with leucoerythroblastosis with absence of circulating blast cells. Repeated attempts at bone marrow aspiration and trephine biopsy were unsuccessful. A trephine biopsy from the tibia showed depressed myelopoiesis and erythropoiesis, megakaryocytes with atypical morphology and increased bone marrow reticulin fibres, findings compatible with idiopathic myelofibrosis. She was treated symptomatically as she was clinically stable. Review of the English literature online yielded 46 reported cases of childhood idiopathic myelofibrosis with variable outcome from spontaneous remission to an indolent course with shortened survival. 6 cases evolved to another malignancy. 5 cases were associated with Down's syndrome.
Is input on Complementary and Alternative Medicine (CAM) necessary in our medical curriculum? A perspective from a survey on medical practitioners

Nabilla AS, Safura J, Karina R, Noran H, Norizan M, Sabariah M, et al.

Med J Malaysia, 2002 Dec;57 Suppl E:37-43.
PMID: 12733192

A cross-sectional study was carried out through a postal survey of a random sample of registered medical practitioners in Malaysia to explore the pursuit and practice of CAM among them. A response rate of 42% was acquired. 27.1% of the medical practitioners are currently using CAM on themselves or their own families and 22.2% actually have referred patients to CAM practitioners. Analysis showed that only 14.9% of the medical practitioners who responded were exposed to CAM during their undergraduate days. Out of 28 respondents graduated from USM, 15 (53.6%) were exposed while out of the 80 graduates of UM, only 6 (7.5%) were exposed and out of 58 respondents graduates of UKM, only 5 (8.6%) were exposed to CAM during their undergraduate teaching. These differences are statistically different (p < 0.001). Analysis also showed that more (72.6%) medical practitioners are for having training in CAM during the medical undergraduate studies. Only 9.1% of the respondents have attended any training in CAM post graduation and 36.8% would like further training on CAM postgraduate and would pay for it. The findings illustrate the need for training in CAM in medical undergraduate education especially in this new age where alternative therapy is in demand by the consumers.
Fulltext MTHFR C677T polymorphism, homocysteine and B-vitamins status in a sample of Chinese and Malay subjects in Universiti Putra Malaysia

Choo SC, Loh SP, Khor GL, Sabariah MN, Rozita R

Malays J Nutr, 2011 Aug;17(2):249-58.
PMID: 22303578 MyJurnal

Methylenetetrahydrofolate reductase (MTHFR) C677T is involved in folate and homocysteine metabolism. Disruption in the activity of this enzyme will alter their levels in the body.
Fulltext Andrographolide effect on both Plasmodium falciparum infected and non infected RBCs membranes

Zaid OI, Abd Majid R, Sabariah MN, Hasidah MS, Al-Zihiry K, Yam MF, et al.

Asian Pac J Trop Med, 2015 Jul;8(7):507-12.
PMID: 26276279 DOI: 10.1016/j.apjtm.2015.06.007

OBJECTIVE: To explore whether its antiplasmodium effect of andrographolide is attributed to its plausible effect on the plasma membrane of both Plasmodium falciparum infected and non-infected RBCs.
METHODS: Anti-plasmodium effect of andrographolide against Plasmodium falciparum strains was screened using the conventional malaria drug sensitivity assay. The drug was incubated with uninfected RBCs to monitor its effect on their morphology, integrity and osmotic fragility. It was incubated with the plasmodium infected RBCs to monitor its effect on the parasite induced permeation pathways. Its effect on the potential of merozoites to invade new RBCs was tested using merozoite invasion assay.
RESULTS: It showed that at andrographolide was innocuous to RBCs at concentrations approach its therapeutic level against plasmodia. Nevertheless, this inertness was dwindled at higher concentrations.
CONCLUSIONS: In spite of its success to inhibit plasmodium induced permeation pathway and the potential of merozoites to invade new RBCs, its anti-plasmodium effect can't be attributed to these functions as they were attained at concentrations higher than what is required to eradicate the parasite. Consequently, other mechanisms may be associated with its claimed actions.
Berberis vulgaris fruit crude extract as a novel anti-leukaemic agent

Saedi TA, Ghafourian S, Jafarlou M, Sabariah MN, Ismail P, Eusni RM, et al.

J Biol Regul Homeost Agents, 2015 Apr-Jun;29(2):395-9.
PMID: 26122228

Tumor protein p53 encoded by the TP53 gene in humans is known as a cancer biomarker in patients diagnosed with cancer, and it plays an essential role in apoptosis, genomic stability, and inhibition of angiogenesis. Cancer therapies with common chemotherapy methods are effective, as known, but have some side effects. Berberis vulgaris is traditionally administrated as a cancer drug. The current research aims to evaluate p53 as a biomarker in WEHI-3 cell line and to demonstrate the Berberis vulgaris fruit crude extract (BVFCE) as a new anticancer drug. For this purpose, we evaluated the effect of BVFCE in different concentrations against WEHI-3cell line in vitro and determined the quantitative level of p53 gene in the treated WEHI-3 cells. The results demonstrated that even at only 1 mg/ml concentration of Berberis vulgaris crude extract, there was a low level of p53 biomarker expression on WEHI-3 cells in comparison with doxorubicin. Therefore, the current study suggests BVFCE as a reliable anti-leukaemic drug and candidate for anticancer therapy. However, further investigation need be carried out to confirm its efficiency in vivo.
Fulltext Anti-plasmodial and Chloroquine Resistance Suppressive Effects of Embelin

Zaid OI, Majid RA, Hasidah MS, Sabariah MN, Al-Zihiry K, Rahi S, et al.

Pharmacogn Mag, 2017 Jan;13(Suppl 1):S48-S55.
PMID: 28479726 DOI: 10.4103/0973-1296.203982

BACKGROUND: Emergence of chloroquine (CQ) resistance among different strains of Plasmodium falciparum is the worst catastrophe that has ever perplexed the dedicated efforts to eradicate malaria. This urged the scientists to search for new alternatives or sensitizers to augment its antiplasmodium effect.
MATERIALS AND METHOD: In this experiment, the potential of embelin, isolated from Embelia ribes, to inhibit the growth and sensitize CQ action was screened using SYBRE-green-I based drug sensitivity and isobologram assays, respectively. Its effect on red blood cells stability was screened to assess its safety. To explore its molecular mechanism, its effect on plasmodial Hemozoin and the in vitro β-hematin formation was screened as well. Furthermore, its anti-oxidant activity was measured using the conventional in vitro tests and its molecular characters were obtained using Molispiration program.
RESULTS: The results showed that its anti-plasmodial effect was weaker than CQ but synergism was obtained when they were combined at ratios lower than 5:5 CQ/embelin. Furthermore, β-hematin formation was inhibited by embelin without showing any synergism after mixing with CQ.
CONCLUSION: Overall, embelin is not ideal to be suggested as a conventional antiplasmodium but it has a potential to ameliorate CQ resistance. Furthermore, its action is not related to its impact on hemozoin formation. Further, investigations are recommended to illustrate its detailed mechanism of action. Abbreviation used: CQ-DV-PBS-HEPES: Chloroquine-Digestive vacuole-Phosphate-buffer-saline-4-(2-hydroxyethyl-1-piperazin-ethan-sulphoni-acid), EDTA: Ethylen-diamin-tetra-acetic-acid, g.m.wt: Gram molecular weight, cMCM: Complete-malaria-culture-medium, Hct: Hematocrite, PRBCs: Parasitized-redblood-cells, nRBCs: Normal-red-blood-cells, RT: Room temperature, IC: Inhibitory concentration, FIC: Fractional inhibitory concentration, iCM: Incomplete-culturemedium, BSA: Bovin serum albumin, MTT: 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide, DPPH: 2,2-diphenyl-1- picrylhydrazy, BHT: Butylatedhydroxyl-toleuen, PSA: Polar surface area, ClogP: Log partition coefficient (octanol/water), GPCR: G-protein-coupled-receptors, DMSO: Dimethylsulphoxide, NaOH: Sodium hydroxide.
Integrating CCL2 and TNF-α into the Framingham Risk Score for cardiovascular risk prediction: a cross-sectional study in a Malaysian cohort

Nurul Izzati A, Fatin Syazwani AM, Kahar F, Amrina MA, Izzudin MP, Sazlina SG, et al.

Med J Malaysia, 2025 Mar;80(2):133-140.
PMID: 40145153

INTRODUCTION: Cardiovascular diseases (CVDs) are the leading cause of death worldwide, significantly contributing to increased healthcare costs and deteriorated health. In Malaysia, CVDs account for 20.79% of deaths in government hospitals. Key risk factors include high blood sugar levels, elevated blood pressure, and increased cholesterol levels. Atherosclerosis frequently serves as the underlying condition for coronary heart disease (CHD), with CCL2 and TNF-α playing a crucial role in recruiting immune cells to inflammation sites. Early diagnosis of CVDs risk is important for preventing severe complications. This crosssectional study aims to investigate the relationship between biomarker CCL2 and TNF-α expression levels and Framingham Risk Score (FRS) categories in a Malaysian cohort.
MATERIALS AND METHODS: A total of 333 patients from the Family Medicine Specialist Clinic at Hospital Sultan Abdul Aziz Shah were recruited between March 2022 and February 2023. Blood samples were taken after a 12-hour fasting period, and levels of fasting blood sugar (FBS), triglycerides (TG), total cholesterol (TC), HDL cholesterol, and LDL cholesterol were measured. 150 plasma samples were randomly selected for cytokine analysis of CCL2 and TNF-α using the Human Magnetic Luminex Assay. Patients' cardiovascular risk was assessed using the FRS calculator. The Kruskal-Wallis test was used to analyze the relationship between cytokine levels and FRS categories, followed by a post hoc test with Bonferroni correction. A logistic regression model was implemented to assess the independent effects of these variables.
RESULTS: The results demonstrated a significant association between the level of chemokines CCL2 and proinflammatory TNF-α, and FRS categories (low-risk, moderate-risk, and high-risk). CCL2 levels were notably higher in the high-risk group, as were TNF-α levels, with both biomarkers showing increasing trends with higher risk categories, (p<0.001, effect size=0.32) and (p<0.001, effect size-0.29), respectively. Multiple logistic regression analysis showed that dyslipidaemia, FBS, and TNF-α remained significant after adjusting for other variables. Specifically, dyslipidaemia had lower odds of being in the high-risk group (AOR: 0.04), while FBS (AOR: 3.19) and TNF-α (AOR: 1.18).
CONCLUSION: This study highlights the potential of CCL2 and TNF-α as biomarkers for CVDs risk assessment. Integrating these biomarkers into CVDs risk prediction models may enhance the precision of identifying individuals at elevated risk. However, the study's cross-sectional design and small sample size for cytokine analysis constrain the findings. Future research should explore the long-term predictive value of these cytokines in larger, longitudinal cohorts and explore more advanced techniques for improving CHD risk prediction models.