Introduction: Ascariasis is a parasitic infection, which commonly affects immunocompromised patients. Most pa-tients remained asymptomatic during the early larval migration stage and respond well with conventional anti-hel-minthic drugs. Previous literature had reported symptomatic Ascaris infection mimicking bacterial pneumonia and the typical eosinophilia found in Loeffler syndrome was absent in patients on corticosteroids. Thus, a high index of suspicion for ascariasis is needed for immunosuppressed patients presented with infection. We present here a case of severe ascariasis infection in a systemic lupus erythematosus patient. Case description: A 16-year-old boy presented with fever, generalized maculopapular rash associated with neutropenia and thrombocytopenia. He was treated initially as Dengue Fever initially. However his symptoms did not resolve at even day 14 of admission. On further assessment, we were convinced he has SLE based upon presence of malar rash, oral ulcers, urinary protein-uria, persistent leucopenia, thrombocytopenia with low complements and ANA positive. He was promptly started on IV hydrocortisone. He showed a good progress in the first few days. On day 5 of admission, he coughed out a round worm which later identified as Ascarisis lumbricoides. He was started on Albendazole. Unfortunately he developed hemoptysis and respiratory compromisation where he required intubation. Post intubation he went into cardiac arrest, which required CPR. Following that event, his condition further deteriorated with multi organ failure. He succumbed to his illness three days later. Conclusion: Immunocompromised patients are prone to opportunistic infections including parasitic infections. we present here a case of ascariasis in an SLE patient who unfortunately succumbed to the illness. Due to the variable clinical symptoms that mimic other infections, screening for parasitic infections needs to be considered especially if the patients do not respond to antibiotics and routine treatments.
Introduction: Cholera epidemics can produce devastating public health outcomes. Cholera distribution is influenced by temperature, precipitation, elevation, distance to the coastline and oceanic environmental factors such as sea surface temperature, sea surface height and ocean chlorophyll concentration. The purpose of this study is to describe the spatial epidemiology of cholera in the four districts of Sabah. Methods: This is a retrospective review of 4 years (2011 to 2014) data from the districts of Kota Kinabalu, Penampang, Putatan and Papar, Sabah. All reported cases of cholera from those areas are included. Coordinates for locations of the cases are based on home addresses. SPSS v20, ArcGIS v10 and CrimeStat IV were used for data analysis and mapping. Results: Cholera showed several clustering of cases, such as in 2011 and 2014 in Kota Kinabalu. In the year 2011 and 2013, Penampang and Papar districts had the nearest neighbour index of less than 1, but p value was not significant, meaning the pattern did not appear to be significant. Nearest neighbour hierarchical clustering analysis further revealed cholera had 7 clusters, of those 6 were first order and 1 was a second order cluster. Conclusion: Cholera shows disease clustering which could mean it is due to its common point source or localised human to human transmission. Using GIS as a tool may help in surveillance and control of cholera infections.
Introduction:HPV vaccination is considered to be the primary form of cervical cancer prevention. However, the practice of HPV vaccination in Malaysia was not satisfied based on low vaccination rate among Malaysian. The health personal play a major roles in this scenario hence; this study was conducted to determine the knowledge and awareness on human papillomavirus vaccination and its relationship with socio –demographic among final year nursing and medical students in University Kebangsaan Malaysia Medical Center. Methods: A cross-sectional design was conducted in the faculty of medicine, University Kebangsaan Malaysia Medical Center. Two hundred and thirty four students were recruited using universal sampling equivalent to 86% respondent rate. Data was collected using self-administered structured questionnaires contains three sections. Pearson Chi-square analyses were used to de-termine the relationship between various socio-demographic factors and outcome variables namely knowledge and awareness on HPV vaccination. Results: Findings indicates that most of the respondents (85.9%) had a high level knowledge and (100%) awareness on HPV vaccination. Among the socio-demographic factors, respondents’ race (p=0.006) and marital status (p=0.0006) were associated with knowledge while, there were significant relationship between awareness and gender (p=0.0001). Conclusion: It can be concluded, that final year nursing and medical students had high knowledge and awareness on HPV vaccination. Race and marital status affected the knowledge while gender and family history of cervical cancer are significant predictors for awareness on HPV vaccination.
Introduction: Presentation of Dermatomyositis with Interstitial Lung Disease (ILD) is not uncommon. Case descrip-tion: A 50 years old lady with dyspnoea of 1 month. On examination patient had heliotrope rash around face with gottron papules and fine crepitations bibasally over lung auscultation with proximal weakness of the limbs. High Resolution Computer Tomography of Chest(HRCT of Chest) revealed ground glass appearance with fibrotic changes in both lungs. Blood test serum ANA 1:160, Anti MDA5 strong positive, Anti Ro 52 positive with Serum dsDNA nega-tive. Skin Biopsy-compatible with cutaneous manifestation of dermatomyositis. EMG revealed there is electrophysio-logical cause of myopathy. Lung function test was unable to perform due to severe pain. Investigate for the possibility of underlying malignancy were taken with Serum Tumour Markers, Nasoscopy, ultrasound of pelvis, OGDS and colonoscopy. Did not reveal lesions suspicious of malignancy. Patient treated by using tablet prednisolone 50mg once daily with tapering done and tablet azathioprine 100mg once daily. Planned for IV Methylprednisolone if wors-ening of disease. Patient passed away due to rapidly worsening ILD. Conclusion: Amyotrophic Dermatomyositis with interstitial lung disease(ILD) diagnosis can be confidently diagnosed with clinical correlation and Serum AntiMDA5.
Introduction: The Faculty of Medicine & health sciences, UMS has implemented a co-curricular programme which is aimed to be improving rural health and reducing inequalities of health in Sabah. Groups of medical students are formed and distributed in various areas of rural remote areas in Sabah. Based on the observation and interview find-ings, each student group conducted health promotion activities with the limited resources. Various health problems were explored in different areas and different ethnic groups of Sabah and students conducted their health promotion activities .There are some questions “Are they effective, how it works in implementation?” Poor implementation can lead to errors in outcome of the programmes. In this paper we focus on process evaluation for measuring the degree to which Health promotion programmes were implemented as designed by using determinant framework (active implementation framework) and process evaluation tools in yearly health promotion programmes from 2009-2018.Methods: The study measures the implementation of programmes with active implementation framework (Explo-ration, Installation, Initial implementation, Full implementation) and process evaluation tools such as validation of implementation integrity using specification of intervention areas, making guidelines and manual for intervention protocol, competency of students and supervisors and fidelity monitoring. We used 7 components of process eval-uation particularly in context( Environmental influences), reach (Target participation), dose delivered (Lectures), dose received (learned by students with assessment methods), fidelity (Adherence to intervention delivery protocol), implementation (rating of execution and receipt of intervention) and recruitment (participant engagement). Results:It was found that fidelity, implementation strategies and some lessons learned after outreach programmes are impor-tantly influence in implementing the programmes. Conclusion: The study shows process evaluation strategies is ideal tool for conducting the rural outreach health promotion programme to reduce the errors and obstacles in implement-ing the programmes to maintain the better quality of the projects.
Introduction: Aerobic power reflects the physical fitness of the individual. Evidences support differences in phys-iological responses to exercise. There is less data on VO2 max among common ethnic population of Sabah. Ob-jective of this study was to investigate VO2 max among Kadazan, Dusun, Brunei Melayu, Bugis, Murut and others of Sabah in male and female young adult population. Methods: A total of 385 participants were randomly selected. Monark 894 E leg bicycle ergo meter was used to measure aerobic power VO2 max. Based on the heart rate male and female respectively 450 & 300 kilogram-force meter/minute was chosen. Based on Astrand rhyming nomogram (age correction factor included-VO2 Max multiplied by 1.05) calculations Vo2Max was calculated in l/min. The age correction done VO2 Max (l/min) was multiplied by 1000 and later divided by the body weight to derive the actual VO2Max in ml/kg/min. The recovery heart rate after 1 minute was taken and the difference were calculated for the further analysis. Data was tabulated and analysed by one way ANOVA test - Hocherberg’s GT2. Results: There was no significant difference in VO2 max between the common ethnic young adult population both in males and fe-males. Conclusion: There is no significant difference in VO2 max among the common ethnic adult but have a similar aerobic capacity in the study group.
Introduction: The impact of irrational use of drug is reduction in the quality of drug therapy leading to increased morbidity and mortality. The main objective was to obtain baseline information regarding the prescribing pattern for non-steroidal anti-inflammatory drugs (NSAIDs) by physicians in the outpatient departments (OPDs) of two selected polyclinics in Kota Kinabalu, Sabah. Methods: Four hundred (200 from each polyclinic) prescriptions containing NSAIDs were collected, photocopied and later analyzed. Two hundred selected patients (100 from each polyclinic) attending the OPDs were interviewed using a questionnaire. Results: Educated and higher income group of patients mostly attended in private polyclinic (PPC) whereas comparatively less educated and lower income group of patients generally attended government UMS polyclinic (UPC). Analgesics with no or minimal anti-inflammatory effects were the most commonly prescribed NSAIDs in the OPD of UPC. On the contrary, analgesics with potent anti-inflam-matory effects were the most commonly prescribed NSAIDs in PPC. Due to the nature of potent drugs, socioeco-nomically advantaged patients attending PPC is more likely to develop adverse effects. Therefore, the prescribers in PPC had to prescribe additional drugs to counter the adverse effects of NSAIDs, hence increasing the cost of drugs prescribed compared to UPC. The patients taking NSAIDs before coming to hospital were influenced by pharmacists, friends and doctor’s advice given previously. Conclusions: The overall prescribing pattern of NSAIDs among two polyclinics is satisfactory, although there may be scopes for improvement. Educational intervention can be designed for rational prescribing to improve the quality of health care.
Introduction: Most of the recent publications on malaria in Malaysia were conducted in Sabah focusing on the emer-gence of Plasmodium knowlesi. This analysis aims to look into the incidence, mortality, and case fatality rate (CFR) of malaria caused by all Plasmodium species in the whole of Malaysia and to compare the different malaria char-acteristics and trends between Peninsular Malaysia (PM) and Sabah & Sarawak. Methods: This is a secondary data review of all malaria confirmed cases notified to the Ministry of Health, Malaysia from January 2013 to December 2017. Results: From 2013 to 2017, a total of 16,500 malaria cases were notified in Malaysia. The cases were mainly contributed from Sabah (7,150; 43.3%) and Sarawak (5,684; 34.4%). Plasmodium knowlesi was the commonest species in Sabah and Sarawak (9,902; 77.1%), while there were more Plasmodium vivax cases (1,548; 42.2%) in PM. The overall average incidence rates (IR), mortality rate (MR) and CFR for malaria in Malaysia were 0.106/1,000, 0.030/100,000 and 0.27%, respectively. Sarawak reported the highest average IR of 0.420/1,000 followed by Sabah (0.383/1,000). Other states in PM reported below the national average IR with
Introduction: Regular physical activity and VO2 max are correlated directly. Physical anthropometry physical ac-tivity, lung function and cardiac parameters such as systolic, diastolic blood pressure and resting heart rate are the important baseline parameters in relation to the a healthy life. In this study, a comprehensive determination of these parameters were planned among the common ethnicities of Sabah. This study in turn aims at making the sedentary people to make physically active and implicate a possible relationship between cardio-respiratory parameters with the physical activity levels. Methods: A total of 385 young adult Sabah, Malaysia college students with n=148 males and n= 237 females were randomly selected from the different colleges in Kota Kinabalu. Ethical clearance was received from Faculty of Medicine & Health Sciences UMS, and the participants were briefed on the procedures with their voluntary consent. IPAQ-Score/Met-Min/Week, BMI, resting heart rate, blood pressure, lung function parameters – forced vital capacity, peak expiratory flow rate etc were estimated by standard techniques. Data was analyzed, a regression analysis and ANOVA was performed to assess the relationship between independent and dependent variables. Results: Physical activity level has a significant correlation with the dependent variables of this study. VO2max is significantly and inversely related to body weight, BMI, blood pressure and pulse rate, whereas physical activity level is directly correlated. A weak positive correlation for VO2 max with lung function parameters.Conclusion: Physical activity, VO2 max and cardio-respiratory parameters; interdependently correlated and regular activity contributed to the rate of oxygen consumption.
Introduction: Tuberculosis negatively impacts the patients’ quality of life (QoL). Information on QoL among tuber-culosis patients may highlight gaps in the current management of the disease by identifying target groups with lower QoL. This study aimed to identify the sociodemographic factors associated with QoL among patients followed up in an urban tertiary hospital. Methods: A cross sectional study was conducted among adults with drug-sensitive pulmonary tuberculosis, selected using simple random sampling method, in the Institute of Respiratory Medicine, Kuala Lumpur. The WHOQOL BREF was utilised to evaluate the physical, psychological, social relationships and environment domains of QoL. Descriptive analysis and univariate analyses to test association between independent sociodemographic factors and QoL domain mean scores were done. Results: A total of 237 patients participated with a response rate of 96.34%. The factor associated with the physical domain was sex (t = 2.06, p = 0.04), whilst age (F = 3.77, p = 0.02), sex (t = 4.04, p < 0.001), marital status (F = 3.09, p = 0.04) and education level (F = 4.92, p = 0.008) were associated with the social relationships domain. Age (F = 3.55, p = 0.03), sex (t = 2.12, p = 0.03), edu-cation level (F = 7.97, p < 0.001) and monthly household income (F = 3.57, p = 0.03) were factors associated with the environment domain. No sociodemographic factors were associated with the psychological domain in this study. Conclusion: Patients who were younger, female, married, had tertiary education or monthly household income of more than RM6000 were associated with higher QoL. Targeted interventions among the sociodemographic groups with lower QoL could complement current clinical management to improve tuberculosis patients’ QoL.
Introduction: HIV-related stigma refers to prejudice, negative attitudes and abuse directed at people living with HIV (PLHIV) and interferes with both prevention and treatment efforts. This study was designed to examine drivers of HIV-related stigma among healthcare workers in health clinics in Hulu Langat, Selangor. Methods: This is a sin-gle-blinded, cluster randomised controlled trial (parallel groups). A total of 158 participants from the intervention group and 158 participants from the control group were randomised via balloting process at the cluster (clinic) level. A comprehensive self-administered questionnaire based on the stigma index tool was used. Data were analysed using IBM SPSS version 25 involving descriptive and bivariate analyses. The baseline results were analysed using the chi-square test and Mann-Whitney U test. Results: The response rate for the intervention group was 83.5% and 81.6% for the control group (82.3% combined response rate). Majority of the respondent’s age between 30 – 39 years old, female, nurses, have experience working with PLHIV and worked for 0 – 9 years in the healthcare setting. Comparison of total infection concern score (p = 0.001) and total willingness to treat key populations (KPs) score (p = 0.025) between intervention and control group at baseline were significant. However, comparison of total opinion/perception about PLHIV score, total knowledge about HIV score, total intention to stigmatise score and total health facility policies and guidelines score between intervention and control group at baseline showed no significant dif-ference. Conclusion: The significant difference between groups on certain scores above might be due to different job category between the two groups thus influence how willing they are in treating PLHIV. These findings may assist stigma reduction intervention programmes targeting healthcare providers in Hulu Langat, Selangor and ensure quality care for PLHIV.
Introduction: Childhood obesity is increasing in prevalence in Malaysia. Excess in dietary intake and inadequate physical activity contribute to the development of obesity among children. The objective of this study was to de-termine the association between eating behaviour and excess weight among primary school children in an urban community in Malaysia. Methods: This is a baseline data of a randomized control field trial of a family-based inter-vention to reduce adiposity in overweight and obese children. It involved five primary government schools in Bandar Baru Bangi, Selangor. The inclusion criteria include parent-child dyad; children aged 7 to 10 years with body mass index (BMI) z-score of +1 standard deviation or more. Parents completed the validated self-administered Children Eating Behaviour Questionnaire (CEBQ). This questionnaire assessed children’s eating behaviour that includes food responsiveness, enjoyment of food, emotional overeating, desire to drink, slowness in eating, satiety responsiveness, emotional undereating and food fussiness. The children’s weight and height were measured and the BMI z-score was calculated. The association between CEBQ subscales and obesity was assessed using multiple linear regression, adjusted for sex and family income. Results: One hundred and thirty-four parent-child dyads had participated in this study. The food responsiveness was found to be significant with excess weight (β = 0.094, 95% CI: 0.02-0.17, p= 0.014). Conclusion: The food responsiveness subscale was associated with excess weight. This eating behaviour need to be taken into consideration in the development and implementation of health campaign targeted at the re-duction of childhood obesity.
Introduction: Vaccine hesitancy is “to delay in acceptance or refusal of vaccination despite availability of vacci-nation services. Vaccine hesitancy is complex and context specific, varying across time, place and vaccines...”. National vaccination data showed presence of hesitancy and the potential for others to develop hesitancy. An over-view of vaccine hesitancy is needed to organise our understanding and to focus our efforts in health promotion. The objectives of this review were to (1) describe the scope of vaccine hesitancy involving target population, theoretical developments and practical implications and (2) to identify potential research avenues for health promotion in Ma-laysia. Methods: Scoping review methodology was used. Search strategy utilised keywords for publications from the year 2000 onwards with a focus on local parental vaccine hesitancy. Literature review focused on global theoretical development and analysis were done on local empirical findings. Results: Theoretical developments have led to the Vaccine Hesitancy Determinant Matrix (VHDM) describing factors within three themes: “vaccine/vaccination-specif-ic issues”, “individual or group influence” and “contextual influence”. Parents can be classified into ‘unquestioning acceptor’, ‘cautious acceptor’, ‘hesitant’, ‘late or selective vaccinator’ and the ‘refuser’ of all vaccines. Globally, various mode of interventions has been explored. However, there was a disproportionate focus on knowledge, at-titude and practice research among local parents. There were only two local interventional studies that have been published. Conclusion: There is a dearth of interventional studies locally. Each of the parental groups outlined needs a tailored approach to combat vaccine hesitancy. Global interventional research showed a multitude of approaches towards educational intervention that local researchers should capitalise on developing strategies, techniques and modules for the local population.
Introduction: Autism spectrum disorder (ASD) is a public health concern globally, characterized by impairments in cognitive process, social functioning, communication skills, behaviours and interests. These problems require mul-tidisciplinary approach through an early intervention programme (EIP) which is remarkably expensive. To date, the knowledge of EIP costs for ASD children in Malaysia remains unknown. The objective of this study was to determine the annual average EIP costs for ASD children from the societal perspective (total average costs, education costs, treatment costs, and living costs), and its contributing factors. Methods: A cross-sectional cost analysis study using simple random sampling according to proportion was conducted among 280 parents of ASD children receiving EIP services in Klang Valley. The data was collected using interview-based questionnaire and proforma. The Ac-tivity-based Costing Technique and Microsoft Excel 2016 were used to estimate the total annual average EIP costs, education costs, treatment costs, and living costs per ASD child. The association between the total annual average EIP costs and its contributing factors were carried out using Statistical Package for Social Sciences version 25. Results: The total annual average EIP costs, education costs, treatment costs, and living costs per ASD child were estimated at RM15,158; RM3,896; RM1,948; and RM4,409 respectively. There was a significant association (p
ntroduction: Nasopharyngeal carcinoma (NPC) is a prevalent cancer among human population in Southern China, Hong Kong and Southeast Asia. In Malaysia, NPC is the fourth most common cancer in both sexes, predominantly in the Chinese. Epstein-Barr virus (EBV) infection is known to be highly associated with NPC. Fibroblast growth factor receptor-4 (FGFR4) is part of the family of tyrosine kinase receptors that regulate cell survival, differentiation and pro-liferation. The binding of FGFR4 ligands such as fibroblasts growth factors (FGFs) has been shown to activate various oncogenic signalling pathway including MAPK, Ras and PI3K-Akt pathways. In the past, FGFR4 has been shown to promote tumorigenesis and tumour progression in various cancers such as liver, colon, breast and pancreatic and gastric cancers. However, its role in NPC establishment and pathogenesis is under-explored. This study aimed to evaluate the FGFR4 expression in NPC using various cell lines and its potential as a therapeutic target for NPC treat-ment by gene silencing. Methods: The basal FGFR4 level of NPC (EBV-positive: C666-1 and EBV-negative: HONE1 and HK1) and nasopharyngeal epithelial (NPE) normal (NP69 and NP460) cell lines was determined by western blot analysis and RT-qPCR. FGFR4 level at different time points (0, 24, 48, and 72 hours) in HONE1 and C666-1 cell lines were determined by western blot analysis. Luminescence-based assay was performed to determine the cell prolifer-ation of NPC cells in correlation with the FGFR4 expression. NPC cells were then treated with the optimised FGFR4 siRNA or FGFR inhibitor, BLU-9931 and the silencing/ inhibition of FGFR4 expression was confirmed by western blot analysis. The effect of FGFR4 inhibition on the cell proliferation and aggressiveness of NPC cells was then investigat-ed through wound healing assay and invasion marker analysis. Results: Out of the five tested cell lines, HONE1 and C666-1 highly expressed FGFR4, NP69 showed very low expression while HK1 and NP460 did not express FGFR4. In the time-point study, the FGFR4 level of HONE1 and C666-1 peaked at 24-48 hours which is the exponential phase of cells. Following that, the FGFR4 level decreased corresponding to the decreased cell growth rate due to the nutrient deprivation. siRNA experiments showed that 6.25nM of four siRNAs (5, 6, 9 and 10) could effectively target and silence the FGFR4 expression of HONE1, but not in C666-1 even up to 250nM was tested. When BLU-9931 was used, only modest inhibition was observed in both cells at 3uM. Compared to the untreated control, FGFR4-inhibited HONE1 exhibited decreased cell proliferation rate. Cell migration and invasion capabilities of HONE1 were also significantly reduced following the FGFR4 silencing, suggesting the potential of utilising FGFR4 as the therapeutic target. Conclusion: FGFR4 is highly expressed in C666-1 (EBV-positive) and HONE1 (initially EBV-positive, but lost EBV genome in subsequent in vitro passage) NPC cells, but not in EBV-negative HK1 NPC cell and normal NPE cells. FGFR4 gene silencing effectively inhibited the cell proliferation, migration and invasive potentials of NPC cell line. These findings highlight the therapeutic value of targeting FGFR4 for NPC treatment. Further investigations are war-ranted to reveal the molecular mechanism and the possible role of EBV in regulating FGFR4 pathway.
Introduction: Benzimidazole analogues are bicyclic compounds that had been synthesized comprising the fusion of benzene and imidazole. It gains interest in research as it poses numerous therapeutic potential such as anti-ulcer, anti-malarial, anti-helminthic, anti-fungal, anti-inflammatory, and anti-cancer. Hence, this work aims to screen novel benzimidazole analogues using MTT assay for potential anti-proliferation activities on gastric cancer, which is the second cause of cancer-related death. Methods: MTT assay was conducted following standard protocol on HGT-1 gastric cancer cells. Cells were seeded and allowed to attach overnight before being introduced with various con-centration of benzimidazole analogues up to 72 hours and the optical density of the MTT was recorded using 560 nm wavelength. Two-Way ANOVA was used to analyse all data, followed by post-hoc Tukey test and the structure analysis relationship was analysed using MTT result. Results: From five analogues, only compound 4 showed an-ti-proliferation activity with IC50 8.212 ± 0.813 μM at 72 hours. Compound 4 had hydroxyl group at ortho- and para- position and remarkably, compound 2 which contained the hydroxyl group at ortho- and meta- position together with compound 5 which contained the combination of meta- and para- induced proliferation on gastric cancer. Conclusion: Different position of hydroxyl group on the benzene ring gives different activities on gastric cancer and from the experiment, only compound 4 had the anti-proliferative activity.
Introduction: Oral squamous cell carcinoma (OSCC) is a major health problem worldwide. The overall survival rate remains at 50% despite numerous studies and various treatment modalities in OSCC. The presence of lymph node metastasis in OSCC is well established as an independent prognostic factor. This present study aims to investigate the association of four tumour antigens; FJX-1, GNα12, IFITM3 and MAGED4B with the sociodemographic and clinicopathological parameters of OSCC. The potential use of these markers as a prognostic indicator of patient sur-vival and lymph node metastasis in OSCC was explored. Methods: 35 cases of OSCC with available formalin-fixed paraffin-embedded (FFPE) specimens involving the tongue, buccal mucosa, gingiva, alveolus and floor of mouth were evaluated by immunohistochemistry for FJX-1, GNA12, IFITM3 and MAGED4B expression. Assessment of the expression of these tumour antigens was based on the cellular sub-site, intensity and percentage of staining in the OSCC samples. Results: The expression of all four tumour markers were expressed in all samples (n=35) but none statistically associated with any clinicopathological or socio-demographic parameters. Survival analysis using Kaplan-Meier test showed high expression of GNA12, IFITM3 and MAGED4B individually with poor prognosis in OSCC patients. A combination of markers, GNA12 and MAGED4B demonstrated a significant association with pa-tient survival in OSCC (p=0.014). Multivariate analysis after adjustment for selected socio-demographic factors (age, gender, risk habits and sub-sites of the oral cavity) revealed that high expression of both MAGED4B and GNA12 remained as an independent prognostic factor for poor prognosis in OSCC (HRR =5.231, 95% CI 1.601,17.084; p=0.006). Conclusion: We concluded that high combined expression of both marker (Gα12 and mAGED4B) might be used as an independent prognostic indicator in OSCC.
Introduction: Leptospirosis is a re-emerging zoonotic disease caused by Leptospira bacteria. The clinical manifes-tations of leptospirosis include mild-fever to a severe or even fatal. Increased levels of inflammatory cytokines pro-duced in response to the Leptospira infection by the host immune system were hypothesized as among the causes of severity in leptospirosis. Besides the classical presentation with the triad of febrile, jaundice, and renal failure, patients with leptospirosis also can pose with predominant sign and symptoms of pulmonary involvement. This study aimed to compare the levels of TNF-α, IL-1b, IL-4, IL-6, IL-8, IL-10, IL-12, IL-13, IL-17A, IL-18, and IL-22 In the plasma of samples of leptospirosis patients with and without pneumonia. Methods: Circulating cytokine levels in plasma were measured in seventeen patients hospitalized and diagnosed with leptospirosis in Malaysia (January 2016 – December 2017) and nineteen healthy individuals as controls. Patients were categorized into leptospirosis without pneumonia (n=12) and with pneumonia (n=5). Cytokine was measured using SimplePlexTM assays (San Jose, CA, USA). Measurement was performed in triplicate and statistical analysis was conducted using Graphpad® Prism v6 (San Diego, CA, USA). Results: Elevation of plasma TNF-α, IL-6, IL-8, IL-10, IL-18, and IL-22 levels were observed among leptospirosis patients with pneumonia compared to without, although no statistical differences were observed between these two groups. Conclusion: There are no significant differences observed between the levels of plasma TNF-α, IL-6, IL-8, IL-10, IL-18, and IL-22 in patients with pneumonia compared to without.
Introduction: This is a proto-type product which is based on Frankincense essential oil and hydrosol. Methods: Three oleo gum resin species, namely; Boswellia carterii (BC), Boswellia frereana (BF), and Commiphora myrrha (CM) of Burceraceae family were extracted for their essential oil by hydro-distillation. They were screened for their poten-tial of anti-cariogenic activity by in-vitro experimental study of two main bacterial species (Streptococcus mutans and Lactobacillus spp), which are considered the main cause of dental and mouth diseases. Results: Methanol and acetone extracts of the three plants inhibited the growth of the bacteria. However, BF-methanol extract shows the greatest inhibition followed by BC and CM respectively. Hence, the obtained result encourages proceeding further thorough investigation to benefit the positive outcomes of these plant extracts in terms of introducing new potential antimicrobial formulations, such as mouth wash which can be used for mouth cleansing and protection from the diseases such as mouth ulcers, gingivitis, sinusitis, glandular fever and brucellosis as well as dental caries. This result can be converted to Boswellia Mouthwash Essential Oil (BosMEO) and Boswellia Mouthwash Hydrosol (BosMoHy) based products. This new plant extract product can be exploited for further research for its potential used as moth infection natural treatments such as mouth ulcers, gingivitis, sinusitis, glandular fever, brucellosis as well as respi-ratory problem. It is free of synthetic chemicals, organic, natural, plant based, and halal with no major health side effects. Conclusion: Plant-based product which is free from synthetic chemicals and with minimal side effects will satisfy its quality efficiency.
Introduction: Currently, organoid technology provides a useful tool for modelling human organ development and pathologies in vitro. Salivary gland (SG) organoids developed from mice SG cells display self-organizing properties closely mimic the native organ. Thus, this study would like to investigate the potential of this organoid system to de-velop a human salivary gland in vitro. Methods: Organoids were developed from biopsy samples of normal human sublingual gland tissue. Cells were isolated and cultured in Matrigel at an Air Liquid Interface (ALI) for up to 14 days in an enriched media supplementing with Wnt-3A, R-spondin1, EGF, and FGF2. Specific differentiation factors like TGFβ, BMP, and LIMK inhibitors were added to enriched media for further differentiation studies. Haematoxylin and eosin-stained sections of the cultures were used to visualise growth. RT-PCR, immunohistochemistry and immunoflu-orescence were used to determine the differential expression of cell-specific markers. Results: Human SG organoids developed when the cells were grown in Matrigel at ALI in a defined culture system. The addition of TGFβ inhibitor and all the inhibitors (TGFβ, BMP and LIMK) to the culture media affected SG organoids development by displaying distinct characteristics that closely resemble native glands and expressed specific cell-type markers; BPIFA2, AQP5, CK5 and E-cadherin. The inhibition of BMP signalling demonstrated SG organoids growth more into ductal-like struc-tures and expressed ductal cell marker, CK7. While LIM kinase inhibition signalling showed significantly higher of amylase activity assay. Conclusion: This study certainly offers valuable insight into determining the optimal culture conditions for developing human SG organoids.