Proceeding of

1st  International Community Health Conference

(ICHC 2017)

7th-9th October 2017

On

Holistic Medicine For Quality of Life: Benefiting from Developing Knowledge

 

Organized by

Faculty of Medicine, Universiti Sultan Zainal Abidin,

Kuala Terengganu, Terengganu, Malyaisa

 

ORAL ABSTRACTS ICHC 2017

 

Prevention of Pressure Ulcer Among Acute Hospitalized Elderly Using Pharmacologic (Cavilon Cream) Vs. Non-Pharmacologic Alone: A Quasi Experimental Study

 

Mazlinda Musa1*, Pathamawathi Subramaniam2, Shahrul Bahyah Kamaruzzaman3

1Faculty of Medicine, University Malaya Sabah,

2Nursing Science Department, Faculty of Medicine, University Malaya, Kuala Lumpur.

3Department of Medicine Faculty of Medicine University  Malaya, Kuala Lumpur

*Corresponding Author E-mail: mazlinda@ums.edu.my

 

ABSTRACT:

Pressure Ulcer (PU) is a common health problem particularly among the physically limited or bedridden and the group most vulnerable to suffer this condition is the frail elderly. The Objective was to determine the efficacy of using the Cavilon cream plus the PU prevention intervention in reducing the progress of PU development among Geriatric inpatient in both groups. Using the Quasi experimental study design, where the participants were divided into two groups. The test group received the Durable barrier cream (Cavilon cream) plus the pressure ulcer prevention intervention as per protocols which linked to Braden risk score (AHCPR 1992 pressure ulcer protocol prevention) whilst the control group received the pressure ulcer prevention intervention as per protocols linked to Braden risk score only. Independent t-test were conducted, the mean different between test and control group was 4.02 and the standard deviation different between test and control group 0.5. The p value for the equality mean is 0.00, which is less than 0.05, 95% CI (2.72 – 5.31), which did not include 0, therefore there is a significant different in the change score between test and control group. The change in test group is much higher compare to control group. This study shows that the use of Cavilon cream does improve PU prevention among hospitalize elderly. 

 

 

KEYWORDS: Pressure ulcer, elderly, Cavilon cream, Quasi experimental

 

 

 

 

Barriers to Cataract Surgery at Primary Healthcare Level in the Eastern Zone of Peninsular Malaysia: An Interpretative Phenomenological Analysis

 

M. Z. Nurulain1,2, A. Shahir 3, H. Asma1, , A. Mutalib1*

1Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu,

2Department of Ophthalmology, Hospital Kuala Krai, 18000 Kuala Krai, Kelantan, Malaysia.

3Faculty of Health Sciences, Universiti Teknologi Mara, 42300 Puncak Alam, Selangor, Malaysia

*Corresponding Author E-mail: abdulmutalib@unisza.edu.my

 

ABSTRACT:

The Malaysian Rapid Assessment of Avoidable Blindness Survey in 2014 revealed cataract as the leading cause of blindness and estimated more than six hundred thousand cataract surgery backlog for the whole country. Understanding the barriers to undertake early cataract surgery at primary care level may increase cataract detection and the surgical rate to reduce the prevalence of cataract blindness. Thus the objective of this qualitative study is to explore the barriers to cataract surgery at primary healthcare level from the perspective of patients who are already blind due to cataract. This study involves eleven participants from the state of Kelantan, Terengganu and Pahang. All interviews were carried out in their own home setting. Utilising interpretative phenomenological analysis approach in health psychology, semi-structured interview was tape recorded, transcribed verbatim and analysed using N-Vivo software version 8.0.  This study identified two main themes regarding the barriers to cataract surgery at primary care level namely refusal to disclose vision problem and patient-provider related issues. These are the barriers that seem to have prevented them from revealing their visual problems, delay cataract detection and thus the decision for earlier cataract surgery. The subthemes include their belated needs for better sight, delayed awareness and decision to disclose their visual problem to family members or primary healthcare providers. However, appropriate approach and advice from healthcare providers may be able to motivate patients undergo earlier cataract surgery to improve their vision. Thus, further improvement in health education, promotion, vision screening and eyecare delivery system can increase the awareness of the community and also healthcare provider about cataract and improve the strategies towards earlier and more extensive cataract surgery uptake.

 

KEYWORDS: Cataract surgery, barriers, qualitative

 

 

 

 

Evaluation of a Web-Based Tobacco Cessation Counseling Program

Among Third Year Medical Students of Private Medical Universities In

Northern Malaysia

 

K. K. Nyo1*, Z. Ahmad2, R. Jaafar3, N. N. Naing4

1Department of Community Medicine, Faculty of Medicine, MAHSA University, Malaysia

2School of Dental Sciences, Universiti Sains Malaysia, Department of Medical Education, School of

Medical Sciences, UniversitI Sains Malaysia,

3Department of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia,

4Institute for Community (Health) Development (i-CODE), Universiti Sultan Zainal Abidin, Kuala

Nerus, Terengganu, Malaysia.

*Corresponding Author E-mail: kkhine@mahsa.edu.my

 

ABSTRACT:

People should avoid unhealthy behaviours such as smoking. Muslims are forbidden from smoking because it’s harmful to health. This provision can be used in tobacco control programs for Muslims. A cross-sectional study was conducted among medical students on their knowledge and perception of religion in tobacco control. A web-based Tobacco Cessation Program (WTCC) was developed, including a module on “religion in tobacco control” and implemented to medical students. The effectiveness of the module in improving knowledge and perceptions of tobacco control among Malay medical students was studied using a validated self-administered questionnaire. The results were analysed by Generalised Estimating Equation modeling (GEE). Of the 176 Malay students, 96 (54.5%) were males and 80 (45.5%) were females. There was significant improvement in knowledge scores of the role of religion in tobacco cessation of the intervention group between before and after the intervention (p <0.001). There was also significant improvement in positive religious beliefs and perceptions scores in the role of religion between the intervention group and control group (p <0.001). The module on “religion in tobacco control” increased knowledge and improved religious beliefs and perceptions towards tobacco control among the medical students. Also, the module played a significant role in inspiring Malay medical students towards tobacco control in Malaysia.

 

KEYWORDS: Tobacco cessation, web-based, medical students.

 

 

 

 

 

Prevalence of Stress and Associated Stressors among Medical Students:

A Comparative Study between a Private and Public Medical School in

Malaysia

 

 

Retneswari Masilamani1*, Myat Moe Thwe Aung2, Vidya Bhagat2, Aini Abu Bakar1, Chun Shi Hao1, Lim Chee Yao1, Ng Jia Hui1

1 UCSI University, Terengganu Campus. Malaysia.

2University Sultan Zainal Abidin, Malaysia

*Corresponding Author E-mail: retnes@gmail.com

 

ABSTRACT:

Stress among medical students has been well documented as a significant problem. The objective of this study is to compare the stress levels and its associated stressors between public and private university medical students. A cross-sectional study design was carried out using universal sampling in both University Sultan Zainal Abidin (UniSZA) (245) and UCSI University (315) medical students year 1-5, from 2015 till 2016. Data was collected using a self-administered questionnaire including sociodemography, Medical Student Stress Questionnaire and General Health Questionnaire. Data entry and analysis were done using SPSS version 20.0 software. The studies reported a mean age of 23.02 years (SD 1.78) and 21.8 years (SD 1.50) at UCSI University and UniSZA respectively. UCSI University had majority Chinese medical students (52.1%) while UniZSA had majority (66.5) Malay medical students. The stress prevalence was 57.% and 33% among UCSI University and UniZSA medical students respectively. UCSI University had a higher mean stress score of 4.66 (SD 3.4) compared to UniZSA 2.91 (SD 2.98), which was statistically different (p<0.001). Both universities reported Academic and Group Activity related stressors as of high severity. Multiple logistic regression models showed that academic related stressors (ARS), social related stressors (SRS) and group activity related stressors (GARS) were significant predictors of stress levels among UCSI University medical students while Academic (ARS) and interpersonal and intrapersonal related stressors (IRS) were significant predictors of stress among UniSZA medical students. Private university students reported higher stress prevalence compared to the government university but both university students documented similar (academic and group related) stressors as of high severity. Academic related stressors were reported by both universities to be significantly associated with stress. Review of the academic curriculum to reduce stress, and support groups and workshops to inculcate good inter and intrapersonal skills cum teamwork skills are highly recommended.

 

KEYWORDS:  Stress, medical students, private, public

 

 

Teachers Perception towards Reporting Child Abuse and Neglect: A Content Analysis of Interview Narratives

 

Segaran Ramodran

University Malaysia Sabah

*Corresponding Author E-mail: segaran@ums.edu.my

 

ABSTRACT:

In Malaysia, child abuse and neglect (CAN) remains as an on-going public concern with increasing number of cases reported year to year. Whilst the increase in reported cases may be an optimistic indicator of heightened public awareness towards CAN, experts are sceptical that beneath this illusive iceberg, lies a large number of unreported CAN cases. In Malaysia, the Child Act 2001 does not mandate teachers to report CAN and as such, reporting is voluntary. Currently, there is a paucity of voluntary reporting by teachers, accounting for merely 2 -3 % of the total reported CAN cases yearly. Critics argue that teachers are in a key position to encounter and report suspected CAN but seemingly are myopic to the issue. There is limited evidence on what shapes their decision-making in reporting CAN. This study aimedto explore teacher’s perception of barriers and enablers in reporting incidents of suspected CAN. The study entails a qualitative design and using a structured questionnaire to cue and elicit teacher`s views via interview. Individual interviews between 30 and 45 minutes in duration were conducted with a purposive sample of 16 teachers who had managed suspected abuse or neglect students. Views narrated were audio recorded, transcribed and analyzed using Graneheim and Lundman’s method. Five major themes identified were; i) knowledge deficit, ii) fear of repercussion of reporting, iii) cultural challenges, iv) legal challenges, and v) organization challenges. The paper discusses pragmatic evidence-based preventive strategies to improve teacher-led reporting of CAN. This paper explored teacher’s perception in reporting CAN and elicited a number of barriers in reporting. There is a need to address this gap to improve reporting CAN by teachers.

 

KEYWORD: Child abuse and neglect, teacher, perception

 

 

Level of Burden Among the Caregivers of Mentally Ill Patients Receiving

Treatment at Psychiatric Clinic in Kuala Lumpur

 

Halim Ismail

Faculty of Medicine Universiti Kebangsaan Malaysia Jalan Yaakob Latiff Bandar Tun Razak 56000

Cheras Kuala Lumpur

*Corresponding Author E-mail: halimismail@ppukm.ukm.edu.my

 

ABSTRACT:

Consistent rise in mentally ill patient among Malaysian population are a worrying trend facing the nation nowadays which does not only become a burden to our national health care system but affecting the caregivers as well. The objectives of this research were to determine the level of burden and factors contributing to it among the caregivers of mentally ill patients. This was a cross sectional study conducted among caregiver who accompanied the mentally ill patients and they were required to filled up validated questionnaires consist of socio-demographic information, Zarit Burden Interview questionnaire and their knowledge in taking care of mentally ill patients. Overall 140 respondents participated in this research. The prevalence of high level of burden experienced by the caregivers were 33.6% (47 respondents). The factors which have significant statistical association with high level of burden were male caregivers (42.5%; p = 0.010), low education level of caregivers (42.4%; p = 0.036), taking care of schizophrenia patients (53.1%; p = 0.008) and caregivers who were distant relatives (80.0%; p = 0.001). This research had highlighted the importance of burden faced by the caregivers of mentally ill patients. Medical professionals taking care of mental illness patient must also provide support to caregivers to ensure their mental health were being taking care of.

 

KEYWORDS: Caregivers, burden, mentally ill

 

 

Tetanus Immunization Coverage in Pregnant Women: Findings from National Health and Morbidity Survey 2016

 

Lim KK 1*, Chan YY 1, Noor Ani A1, Nur Azna M1, Hashimah I1, Rohani J2

1Institute for Public Health, Ministry of Health, Malaysia,

2Ministry of Health, Kuala Lumpur, Malaysia.

*Corresponding Author E-mail: limkk@moh.gov.my

 

ABSTRACT:

Neonatal Tetanus is a severe disease with high fatality rate and the vaccination of pregnant women can protect the young infants before they are age-eligible for Diphtheria, Tetanus, and acellular Pertussis (DTaP) vaccination. Despite the existing healthcare initiates, neonatal tetanus has not been fully eliminated in Malaysia. The aim of this study was to determine the tetanus toxoid (TT) vaccination coverage status and its associated factors among mothers who had a live birth within the last two years in Malaysia. Data on immunization were extracted from the National Health and Morbidity Survey (NHMS) 2016. This cross-sectional study utilized stratified random sampling with proportional allocation covering all 16 states in Malaysia.  A validated questionnaire was used to obtain data on history of TT vaccination and socio-demographic characteristics among the mothers. Univariate and multivariate logistic regression analyses were conducted to determine the socio-demographic factors associated with TT vaccination. A total of 10,253 mothers were interviewed and 93.2% (n= 9768, 95%CI 89.9%95.4%) claimed they had been vaccinated against TT. Multivariate regression analysis revealed  that  mother’s age, ethnicity, occupation, household  income, strata and  delivery facility were significantly associated with TT vaccination status. However, no significant association was found between mother’s educational level and TT vaccination status. The TT vaccination coverage of pregnant women was high (93.2%) in  Malaysia. However, about 7% remained unprotected against TT. To achieve the 100% target of TT vaccination coverage, studies into reasons for non-vaccination from these vulnerable mothers are warranted.

 

KEYWORDS: Tetanus immunization, vaccination, pregnancy

 

 

 

 

In Vitro Fermentation of Acacia Senegal by Fecal Microbiota from Healthy and Lean Adults to Stimulate the Growth of Probiotic

 

Hammad Ahallil 1*, Aminah Abdullah 1,3, Mohamad Yusof Maskat 1, Shahrul R. Sarbini 2

1School of Chemical Science and Food Technology, Faculty of Science and Technology, University

Kebangsaan Malaysia, 43600 Bangi Selangor, Malaysia.

2Department of Crop Science, Faculty of Agricultural and Food Sciences, Universiti Putra Malaysia

Bintulu Campus, Jalan Nyabau, 97008 Bintulu, Sarawak, Malaysia,

3Natural Medicine Research Centre, Level 7, Blok I, Bangunan MKN Embassy Techzone, Jalan

Teknokrat 2, 63000 Cyberjaya, Selangor

*Corresponding Author E-mail: ahlilhammad@gmail.com

 

ABSTRACT:

Gum Arabic believed to have many health benefits including prevention of gastrointestinal diseases. Prebiotic resist digestion in the upper gastrointestinal tract and allow for stimulation of bacteria in the distal intestine and colon. The potential prebiotic properties of Acacia Senegal was studied using mixed cultures of human fecal bacteria from four healthy and lean individuals. These results were compared with inulin as positive prebiotic control. Fermentation studies were carried out using anaerobic, pH-controlled faecal batch cultures, and the changes in the faecal microbial population were monitored at 0, 6, 12, 24 and 36h by fluorescent in situ hybridization (FISH). Quantitative FISH revealed that Bifidobacterium spp. Bacteroidacea spp. And Lactobacillus spp. were selectively increased (P<0.05) after fermentation of Acacia Senegal and inulin by fecal microbiota derived from lean donors. Acacia Senegal showed a significant increase in Bacteroidacea spp. populations followed by bifidobacterial spp. and Lactobacillus spp. respectively. Whereas Clostridium spp. showed slight increase in fermentation of Acacia Senegal from log10 (7.467) at 0h to log 1 10 (7.612) at 36h comparing to inulin with no significant different among both samples. The fermentation of Acacia Senegal may help improve health through stimulation of bacteria growth wish led to production of (SCFA).  This study provides proof for the prebiotic effectiveness of Acacia Senegal, and shows that it might have a prolonged bifidogenic effect, thus could prevent certain type of diseases.

 

KEYWORDS: Prebiotic; Acacia Senegal; Colonic fermentation; probiotic 

 

 

 

 

 

 

 

 

Development of Novel Tool for the Quantification of Obesity Related/ Induced Non Genetics Associated Factors in Malaysia

 

 

Saif UK1, Norizan AG1, Emilia A2, Yasrul IAB2, Nordin S2, A. Zubaidi AL2, Atif AB2*,

Zahri MK3,  Al-Hatamleh MAI1

1Faculty of Social Sciences, Universiti Sultan Zainal Abidin,

2Faculty of Medicine, Universiti Sultan Zainal  Abidin,

3Faculty of Health Sciences, Universiti Sultan Zainal Abidin

*Corresponding Author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

Obesity is highly heterogeneous issue that is linked with associated factors, affecting social and economic development of the country. We have developed a tool for the quantification and curating of associated factors of obesity in Malaysia, as no proper valid tool is available till date to assess those factors associated with obesity with specification to multi- rationale, multi-ethnic and multi sub-ethnic population in Malaysia. Pubmed, Research Gate, BMC and Google Scholar were used as search engines for previous studies. Specific keywords were used, such as obesity in Malaysia, associated factors with obesity, socio-economic factors obesity tools, and obesity surveys. A total of 2000 studies were selected, and associated factors of obesity in Asian and Asean countries across the world were listed for the face validation among experts in Malaysia. The tool was constructed as per objective measures for the use among Malay obese attributes and for the comparison with normal healthy individuals. The tool was constructed with a total of 99 items subdivided into a total of 19 domains (sections) inclusive of 176 variables. The face validity was performed and questionnaire was distributed for its validity. The results of validity for translated version in future will help us to make this vital tool available in Malay language too for future use. Increasing ratio of obesity in Terengganu (>20%) is scientifically evidenced in Malaysia and to the best of our knowledge, there is still no proper tool available to measure the associated factors for interventional associated factors towards prevention and treatment of obesity. It is one of best tool, precisely addressing the variable for specific issues as per cited articles. Obesity experts evaluated this tool through face validation and have been followed through.

 

KEYWORDS: Obesity, tool for quantification

 

 

Efficacy of Functional Rehabilitation on Dynamic Balance in Athletes with Lateral Ligament Ankle Injury

 

Deivendran Kalirathinam1*, Hairul Anuar Hashim2, Taran Singh Pall Singh3,

Mohamed Saat Ismail4

1,4Universiti Sultan Zainal Abidin, Faculty of Health Sciences. Kuala Terengganu, Malaysia.

2Universiti Sains Malaysia, School of Health Sciences, Exercise and Sport Science Program. Kubang Kerian, Kelantan, Malaysia.

3Universiti Sains Malaysia, Department of Orthopedics. Kubang Kerian, Kelantan, Malaysia.

4Universiti Sains Malaysia, School of Health Sciences, Kubang Kerian, Kelantan, Malaysia.

*Corresponding Author E-mail: deivendran@unisza.edu.my

 

ABSTRACT:

The aim of the present study was to construct an integrated rehabilitation exercise program to improve dynamic balance in cases of grade II lateral ligament ankle injury. Fifty-Two (30 female and 22 male) athletes who required functional strength exercises due to grade II lateral ligament ankle injury and they were randomly assigned to four groups. The Group A received conventional physiotherapy training, Group B received  BOSU exercise training, Group C received Neuromuscular training, Group D receive combination of group B + C (BOSU Exercise training and Neuromuscular training) for 12 weeks. A 12-week rehabilitation training program was constructed with the aim of improving dynamic balance of the lower limb. Dynamic balance was evaluated using the Y Balance Test were measured before and after the 12-week program. Following 12 weeks of rehabilitation program, there were statistically significant improvements in the ratios of dynamic balance in subjects received combination of BOSU exercise training and neuromuscular training. The rehabilitation exercise program for grade II lateral ligament ankle injury helped to restore normal joint range of motion, muscle strength and endurance, and functional ability.

 

KEYWORDS: Functional rehabilitation, lateral ligament ankle injury, endurance.

 

 

Unconditional Probability of Dying Between Age of 30 to 70 Years Old Due to Major Non-Communicable Diseases in Malaysia, 2013

 

Azahadi O*, Shubash SG, MFuad MAnuar, Chandrika J, Fazila HA, Nazirah A, Tan LA

Institute for Public Health, Ministry of Health, Malaysia

                *Corresponding Author E-mail: drazahadi@moh.gov.my

 

ABSTRACT:

Non communicable diseases (NCDs) deaths are projected to increase from 30 million in 2012 to 52 million by 2030. Four majors NCDs (cancer, cardiovascular, diabetes and chronic obstructive respiratory disease) are responsible for 82% of NCD deaths. This study was conducted to determine the Unconditional Probability of Dying (UPoD) between age 30 to 70 due to major NCDs in Malaysia for 2013. We applied the life table method which allows calculation of the risk of death in the absence of other causes of death, to examine the UPoD between ages 30 and 70 from four major NCDs. The population data for 2013 were obtained from Department of Statistic Malaysia. The cause of deaths for 2013 were based on the “determination of cause of deaths” study conducted by Institute for Public Health, Ministry of Health, Malaysia. The UPoD for age 30 to 70 in Malaysia was 19.1%. The probability was higher in males compared to females (23.1 % vs 14.7%). The major contributor of UPoD was cardiovascular diseases (11.1%), followed by cancer (5.7%), diabetes mellitus (2.3%) and chronic obstructive respiratory disease (1.1%). The similar pattern were seen in both males and females. A large percentage of NCDs deaths are preventable through the reduction of their major risk factors: raised blood pressure, tobacco used, physical inactivity, and unhealthy diet (especially hypercholesterolemia and obesity). Understanding the role of these risk factors is important for developing clear and effective strategies to reduce the burden of premature mortality due to major NCDs.

 

KEYWORDS: NCD, premature mortality, global NCD target.

 

Associated Factors Affecting the Quality of Life of Opioid Addicts in Kuala Nerus, Terengganu

 

Nurulhuda MH*, Norwati D, Aniza AA, MAR Husbani

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu

*Corresponding Author E-mail: nurulhudamh@unisza.edu.my

 

ABSTRACT:

Opioid dependence results in social and health problems such as unemployment, crimes, family disruption, and transmission of diseases. It also affects the quality of life of those involved. This study aims to determine the associated factors affecting the quality of life (QOL) of opioid addicts in Kuala Nerus, Terengganu. This cross-sectional study was done from June until July 2016. All opioid addicts receiving therapy in primary care therapy centers in Kuala Nerus district, Terengganu, Malaysia who fulfilled the inclusion and exclusion criteria were included. The World Health Organization Quality of Life brief version(WHOQOL-BREF) questionnaire measuring the physical health, psychological health, social and environment domains were routinely used to assess the addicts during first enrolment to the therapy. The respondent WHOQOL-BREF scoring and other related data obtained by interviewer guided questionnaire were collected. Sociodemographic factors and addiction factors such as duration of heroin addiction, severity of addiction and comorbidities were analyzed using multiple linear regression in SPSS version 22 software with WHOQOL-BREF score as the dependent variable. All respondents were males of Malay race. Mean age was 36.2 years old. Only 57 (47.2%) out of 122 respondents had WHOQOL-BREF score recorded in their case records. The mean(SD) QOL score was 80.9 (13.74). The significant factors affecting QOL was the duration of heroin addiction (p=0.013) and average daily heroine (p =0.44), where addicts who had a duration of heroin addiction more than 5 years and average daily spending of more than RM100 for heroin had a significantly worse quality of life compared to those addicts with duration of 5 years or less and spent less than RM100. Further efforts should be taken to recruit opioid addicts into early therapy before they had a prolonged duration and more severe heroin addiction in order to help them have a better quality of life.

 

KEYWORDS: Quality of life, opioid addicts

 

 

Effect of Non-Hydrogen Peroxide on Antibacterial Activities of Meliponini and Apis Honeys against Staphylococcus Aureus

 

Mohd Hilmi Abu Bakar*, Fatima Ibrahim Jibril, Lavaniya Manivannan

School of Biomedicine,Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Nerus, Terengganu, Malaysia.

*Corresponding Author E-mail: mhilmiab@unisza.edu.my

 

ABSTRACT:

Honey is one of the greatest natural sources, enables to eliminate decay from infectious microorganisms due to effect of non-hydrogen peroxide. The study aims to explore the effect of non-hydrogen peroxide derived from Meliponini and Apis honeys against Staphylococcus aureus. Meliponini honey from stingless bee and Apis honey from non-stingless bee were used in the analysis of agar well diffusion assay that contained Staphylococcus aureus grown cultures. An amplex red hydrogen peroxide kit was used to identify the presence of hydrogen peroxide in the honey. Meanwhile, non-hydrogen peroxide activity was identified after catalase treatment. Hydrogen peroxide was absent in all Meliponini honeys however, it was present in Apis honey. Antibacterial activity of Meliponini honey is solely affected by non-hydrogen peroxide. Meanwhile, diverse effect between hydrogen peroxide and non-hydrogen peroxide on antibacterial activity in Apis honey.

 

KEYWORDS: Meliponini honey, Apis honey, stingless bee

 

 

Effects of Gelam Honey and Fluorouracil (5-FU) Against Human Colorectal Cancer HT-29 Cells

 

Syed Ahmad Tajudin Tuan Johari, Fatimah Hashim, Wan Iryani Wan Ismail, Abdul Manaf Ali

 

 

Syed Ahmad Tajudin Tuan Johari1,2*, Fatimah Hashim1, Wan Iryani Wan Ismail1, Abdul Manaf Ali2,3

1School of Fundamental Science, Universiti Malaysia Terengganu, 21030 Kuala Terengganu, Terengganu Darul Iman.

2Faculty of Bioresources and Food Industry, Universiti Sultan Zainal Abidin, 22200 Besut, Terengganu Darul Iman.

3Universiti Islam Malaysia, Block I, MKN Embassy Techzone Building, Jalan Teknokrat 2, 63000  Cyberjaya, Selangor Darul Ehsan

*Corresponding Author E-mail: syedtajudin85@gmail.com

 

 

ABSTRACT:

Gelam or Melaleuca Honey (GH) is the honey of Apis mellifera from the forest of Melalueca spp in Malaysia widely being studied, but combinatorial effects with drugs is still lacking. Thus, this study was carried out to determine combinatorial effects of Gelam honey and 5-FU on human colorectal cancer HT-29 cells. In this study, MTT assay was done to determine the cytotoxic dose. Cells membrane changes was observed in AO/PI assay. Early event of apoptosis detection were done by annexin-v FITC and mitochondria membrane potential. TUNEL assay was performed to examine the fragmented DNA.The results for MTT assay showed that the IC50 for gelam honey and 5-FU alone were 36.2 mg/ml and 15.5 µg/ml. Meanwhile, the IC50 of combination treatment was 13.2 mg/ml for gelam honey, respectively. The combination index was < 1 suggesting the synergism.Early event of apoptosis was occurred in all treatment groups but with different percentage. Combinatorial treatment in apoptosis detection assay showed the highest percentage among other treatment groups. In conclusion, combinatorial treatment of gelam honey and 5-FU may be an effective’s chemotherapy strategy in fighting colon cancer cells.

 

KEYWORDS: Gelam honey, HT-29, synergistic, apoptosis

 

 

Blood Culture Contamination in Emergency Department of a Tertiary Teaching Hospital in North-Eastern Malaysia: Association With Working Shift, Triage And Stroke

 

Mohd Nizam Zahary1*, Azizul Fadzli Jusoh2, Nik Ahmad Shaiffudin Nik Him2, Rosliza Yahaya2, Keng Sheng Chew3, Hashairi Mohd Fauzi4, Hassan Siti Asma5

1Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300 Kuala Terengganu, Terengganu, Malaysia.

2Faculty of Medicine, Universiti Sultan Zainal Abidin, Medical Campus, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Terengganu, Malaysia.

3Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, 94300 Kota Samarahan, Sarawak, Malaysia.

4Emergency Medicine Department, Universiti Sains Malaysia, Health Campus 15200 Kubang Kerian, Kelantan, Malaysia.

5Microbiology Department, Universiti Sains Malaysia, Health Campus 15200 Kubang Kerian, Kelantan, Malaysia.

*Corresponding Author E-mail: nizamzahary@unisza.edu.my

 

ABSTRACT:

Blood culture is a crucial investigation with major implication in the management of severe infection especially on the best-appropriate selection of anti-microbial therapy. Blood culture contamination can lead to adverse consequences such as inappropriate use of antibiotics, increased antibiotic resistance and prolonged hospital stay. The present study aimed to determine the prevalence of blood culture contamination and to investigate the factors associated with blood culture contamination such as patients, healthcare providers and environmental at Emergency Department, Hospital Universiti Sains Malaysia. A prospective cross-sectional study was conducted on sepsis, severe sepsis and septic shock patients from 1st September 2012 to 31st August 2013. One hundred and thirty six (136) consented patients who fulfilled criteria according to International Sepsis Guidelines and required intravenous antibiotics were enrolled into the study. Blood culture was processed according to the recommendations of the Clinical and Laboratory Standard Institute.Positive blood cultures were 44 (32.4%) with 27 of them were contaminated. The prevalence of blood culture contamination in the study population was 19.9%. Night shift work (OR, 4.73; CI, 1.35-16.57; p=0.015), semi-critical zone in triage (OR, 3.78; CI, 1.47-9.73; p=0.006) and patients who have stroke (OR, 5.49; CI, 1.36-22.19; p=0.017) were found to be significantly associated with the risk for blood culture contamination. Cultures taken during night shift work, semi critical zone in triage and patients who have stroke are associated with the risk for blood culture contamination. These findings should be regarded as a time for change and provide an impetus towards improving patient care.

KEYWORD: Blood culture, working shift, triage, stroke.

Effectiveness of Modified Basic Life Support Module on Knowledge, Attitude, and Performance of Cardiopulmonary Resuscitation Among University Students

 

Azizul Fadzli Jusoh1*, Rosliza Yahaya1, Wan Pauzi Wan Ibrahim1, Mohd Shahril Othman2,

Nik Ahmad Shaiffudin Nik Him1

1Faculty of Medicine, Medical Campus, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu,

Terenganu, Malaysia,

2Faculty of Islamic Contemporary, Gong Badak Campus, Universiti Sultan Zainal Abidin, 21300

Kuala Nerus, Terenganu, Malaysia

*Corresponding Author E-mail: azizulfadzli@unisza.edu.my

 

ABSTRACT:

Cardiopulmonary resuscitation (CPR) is the primary method used in the treatment of sudden cardiac arrest (SCA). It is a crucial skill that healthcare and lay rescuer should acquire to improve the outcome of out- hospitals cardiac arrest (OHCA). Several modules were used to teach CPR in healthcare and lay rescuer, but no module was developed that can utilize in both populations. Thus, this study aims to investigate the effectiveness of modified CPR training to knowledge (K), attitude (A), and performance (P) between medical and non-medical university students. This study was a single experimental study involving 125 students, 57 students for medical group and 68 students for non-medical groups. A modified BLS module based on AHA 2015 delivered to both groups in the same study setting. Pre and post KA scores were assessed using ResQ questionnaire. The performance evaluated by resuscitation feedback machine. The KA score analyzed using repeated measure ANOVA (RmANOVA), and practice examined using Pearson Chi- Square. The study showed 56.6% of the participants able to perform high-quality chest compression. Despite significant differences of socio-demographic background, there was no significant difference on effective chest compressions between two groups (p= 0.294). There were also significant improvements in KA scores in both groups after intervention (p<0.001). The knowledge of CPR can be delivered to everyone as aspired by our stakeholder to have one qualified CPR provider in a family. This modified BLS module is applicable in both healthcare and lay- rescuer CPR training. All rescuer will speak the same language, and it will reduce the discrepancy in CPR quality. Ultimately, improving the prognosis of OHCA.

 

KEYWORD: CPR, basic life support, knowledge, attitude, performance, university students

 

Surface Electromyographic Analysis of the Common Strengthening Exercises for the Vastus Medialis and Vastus Lateralis Muscles.

 

Nordin Simbak1, Naresh Bhaskar Raj2, Mohd Khairuudin Mohd Safee2, Nor Azizah Hussin2*

¹Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Malaysia

²Faculty of Health Science,Universiti Sultan Zainal Abidin, 21300 Kuala Terengganu, Malaysia

*Corresponding Author E-mail: norazizahhussin@gmail.com

 

ABSTRACT:

This study was done to identify strengthening exercises that elicit the greatest level of EMG activity in the vastus medialis and vastus lateralis muscles. Strengthening exercises are important to improve muscle power. The vastus medialis and vastus lateralis muscles are important for knee function. Reduced muscle power of vastus medialis and vastus lateralis muscles causes instability of knee and abnormal knee biomechanics. Little information exists on the EMG activity of vastus medialis and vastus lateralis muscles during common strengthening exercises. This study, therefore, was designed to compare electromyographic data obtained from the vastus medialis and vastus lateralis muscles during static quadriceps exercise, inner range quadriceps exercise and straight leg raise exercise. Fifty healthy subjects, aged 20-21 years (35 females and 15 male) were recruited. Surface electrodes recorded EMG activity of the vastus medialis and vastus lateralis muscles during static quadriceps exercise, inner range quadriceps and straight leg raise. The normalized electromyographic muscle data were analysed using Repeated Measure ANOVA (p ≤ 0.05). The inner range quadriceps exercise was found to produce the greatest EMG activity in the vastus lateralis muscle. For the vastus medialis muscle, the greatest EMG activity was observed during inner range quadriceps exercise rather than static quadriceps exercise and straight leg raise exercise. This study identified that inner range quadriceps exercises maximally activated the vastus medialis and vastus lateralis muscles. This information may be helpful for clinicians in developing and prescribing exercise programs for patients with musculoskeletal disorders.

 

KEYWORDS: Vastus medialis, vastus lateralis, strength, electromyography

 

 

 

 

 

 

Tualang Honey Supplementation as Cognitive Enhancer in Patients with Schizophrenia

 

Rosliza Yahaya1*, Mohd Nizam Zahary2, Azizul Fadzli Wan Jusoh1,

Nik Ahmad Shaiffudin Nik Him1, Zahiruddin Othman3, Rahima Dahlan1, Hatta Sidi4

1Faculty of Medicine, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu,

2Faculty of Health Sciences, Universiti Sultan Zainal Abidin, 20400 Kuala Terengganu, Terengganu,

3Department of Psychiatry, School of Medical Sciences, Hospital Universiti Sains Malaysia, 16150

Kubang Kerian, Kelantan, Malaysia.

4Department of Psychiatry, Faculty of Medicine, Hospital Universiti Kebangsaan Malaysia, 56000

Cheras, Kuala Lumpur, Malaysia.

*Corresponding Author E-mail: roslizayahaya@unisza.edu.my

 

ABSTRACT:

Cognitive impairment in schizophrenia, including deficits in working memory, verbal learning and memory, predate the onset of frank psychosis and are stable throughout the the illness in most patients. Recently, tualang honey (TH) has been shown to improve immediate memory in postmenopausal women and rats. The present study aimed to investigate the effect of TH supplementation, on verbal learning and memory (VLM) in schizophrenia patients. A total of 80 schizophrenia patients in outpatient Psychiatric Clinic, Hospital Universiti Sains Malaysia, Kelantan were recruited between August to December 2014 and randomly assigned into two groups: TH (20 mg/d) and untreated control. Their VLM performances were assessed using the Malay version of the Auditory Verbal Learning Test (MVAVLT) before (week 0) and after (week 8) of intervention. Repeated measures analysis of covariance control for age, education and duration of illness was done using PASW version 20.0. A total of 28 subjects completed the study (TH group = 17, control group = 11). There were no significant differences in socio-demographic characteristics between the subjects in TH and control group except for the number of admission. The mean total learning and delayed recall within each group based on time were important for control with mean difference -4.18 (-7.63, -0.74), p=0.024 and -0.91 (-1.29,0.53), p < 0.01, respectively when controlled for covariate age, education and duration of illness. However, there were no significant differences in total learning and delayed recall scores between TH and control groups based on time even when controlled for covariate. Patient with schizophrenia who received TH supplementation for 8 weeks did not show significant improvement in the total learning (immediate memory/STM) and delayed recall (LTM) compared to control group.

 

KEYWORDS:  Honey, Cognitive, Schizophrenia, Memory, AVLT.

 

 

 

 

 

 

 

Knowledge, Attitude and Practice of Medical Students Towards Complementary and Alternate Medicine

 

Fauzia Imtiaz*, Sarmad Pirzada, Arham younus, Rafay Amir

Department of Biochemistry, Dow medical College, Dow University of Health Sciences

*Corresponding Author E-mail: f.imtiaz@duhs.edu.pk

 

 

ABSTRACT:

Complementary and alternative medicine (CAM) is the term for medical products and practices that are not part of standard medical care. It is an alternative form of healing patients used widely in Asian countries like China, Japan, India and Pakistan1. The usage of CAM has increased considerably in the past 10 years by general people2. Present study was conducted to see the knowledge, attitude and practice of medical students towards the other types of therapy used for cure of diseases. This was a cross sectional questionnaire based study, conducted at medical college both in a public and private sector of Karachi. The duration of study was from Jan to March 2017. The sample size was calculated as 379 by open epi online software. The questionnaire comprises of questions related to knowledge, attitude and practices. Among 379 participants 32.9% were male and 67.1% were females they belong to MBBS (67.7%) and BDS (33.3 %). The mean age was 21.06 ± 1.79. The response rate was calculated as 92%. 69% of students used allopathic treatment in their everyday problem followed by home remedy. 68% have the sound knowledge of CAM. Considering the barriers between the use of CAM and allopathic medicine 39.5 % agree that they have a factor of believe in ineffectiveness of CAM while rest says fear and profitability and others. The younger generation opt allopathic mode of treatment both in their everyday and emergency. It could be due to lack of knowledge or some barriers in the use of CAM.

 

KEYWORDS: Complementary medicine, attitude, practice, medical students.

 

 

Islamic-Oriented Supportive Psychotherapy for Muslim Women with Borderline Personality Disorder in Crisis: A Case Report

 

Rozanizam Zakaria*, Nora Mat Zin

                 Department of Psychiatry, Kuliyyah of Medicine, International Islamic University Malaysia

*Corresponding Author E-mail: nizamzakaria@iium.edu.my

 

ABSTRACT:

Borderline personality disorder is a complex mental illness characterised by a pervasive pattern of instability in affect regulation, impulse control and interpersonal relationship. Their presentations can be complicated by significant spiritual issues such as their enduring struggle to deal with inner-self emptiness and fragile connection with religion; dilemma over their suicidal wishes; and their impulsivity which at times involve sinful behaviour. Recent studies have revealed that the severity of this disorder has an inverse relationship with one’s spirituality level. The current mainstream psychotherapy approaches for this disorder lack the integration of spiritual input to address the issues faced by the Muslim patients. In this paper, we highlight the utilisation of Islamic-oriented supportive psychotherapy as part of an integrated treatment for two cases of Muslim women with borderline personality disorder while in crisis. Both cases involved highly educated Muslim women who presented to psychiatry services with presentation of recurrent thoughts of self-harm, depressed mood and impulsivity. The three-month outpatient-based therapy sessions incorporated Islamic input into the existing model of supportive psychotherapy which emphasizes on the mobilization of strengths to enhance self-esteem and utilize adaptive defences and positive coping skills. Collaborative empiricism using the Quranic verses and hadith; spiritual reflection and Islamic values are among approaches applied using in this model. The integration of Islamic-input into the holistic management of the patients has successfully helped the patients to achieve certain degree of stability in their lives. The positive outcome can be seen by the short duration for crisis resolution, successful prevention of re-admission to the ward, reduction in self-harm behaviour and improved interpersonal and occupational function. The Islamic-oriented supportive psychotherapy for Muslim borderline personality disorder patients can be a potential area for further development. The model will provide an alternative treatment for the Muslim population. 

 

KEYWORDS: Personality disorder, Islamic-oriented supportive therapy, muslim women.

 

 

Antioxidants and Antibacterial Activities of Extract from Thyme and Mint Leaves

 

Eqbal Dauqan1*, Aminah Abdullah1,2, Nursheila Mustafa Muin1

1School of Chemical Sciences and Food Technology, Faculty of Science and Technology, University

Kebangsaan Malaysia, Malaysia

2Universiti Islam Malaysia, Blok I, Bangunan MKN Embassy Techzone, Jalan Teknokrat 2, 63000

Cyberjaya, Selangor Darul Ehsan

*Corresponding Author E-mail: edouqan@gmail.com

 

ABSTRACT:

Thyme (Thymus vulgaris L.) and mint (Mentha spicata L.) are the mint family (Lamiaceae) herbs that usually applied in culinary and medicinal uses due to the health benefits contributed by various natural antioxidants. Thus, this study was aimed to evaluate the antioxidant and antibacterial activities in these two herbs. The total phenolic content (TPC) of aqueous extracts of Thymus vulgaris L. and Mentha spicata L. herbs were determined spectrophotometrically according to the Folin Ciocalteau method and the results were expressed as gallic acid equivalents (GAE). The extracts also were screened for their antioxidant activities by two methods namely Free Radical Scavenging Activity (DPPH) and Ferric Reducing Antioxidant Power (FRAP) where the activity expressed as per percent inhibition of oxidation (%) and μmol Trolox Equivalent/g (μmol TE/g) respectively. For antibacterial test, the powdered dried leaves were extracted using absolute methanol.  The disc diffusion method was used to screen the antimicrobial activity as reported by Duraipandiyan. All of the three antioxidant test assays showed that Thymus vulgaris L. significantly (p<0.05) had higher antioxidant activities compared to Mentha spicata L. The extract of Thymus vulgaris L. contained 0.350mg GAE/g total phenolic compounds and 52.8% inhibition of oxidation activity for DPPH assay which were significantly higher than those in extract from Mentha spicata L. (TPC: 0.219mg GAE/g and DPPH: 27.5%). For the antioxidant activity of FRAP assay, Thymus vulgaris L. also showed the higher significant (p<0.05) result compared to Mentha spicata L. with 339.2μmol TE/g and 121.1 μmol TE/g respectively. The highest inhibitory effect for Thyme was observed against Staphylococcus aureus (zone of inhibition: 12 mm) while the weakest activity was demonstrated against Listeria monocytogene and Salmonella typhi (zone of inhibition: 7 and 7 mm) respectively. It can be concluded that the Thymus vulgaris L. can be regarded as promising candidates for natural plant sources of antioxidants with high value and the most antibacterial activity against all the isolates tested of Staphylococcus aureus, Bacillus cereus, Escherichia coli, Listeria monocytogene and Salmonella typhi.

 

KEYWORDS: Thymus vulgaris L, Mentha spicata L, natural antioxidant, phenolic compounds, antibacterial.

 

 

 

 

 

Auditory Elicitation of Event Related Desynchronization Reveals the Neuronal Mechanism during Listening to Sura Fatiha Recitation

 

Samhani Ismail1,2*, Mohamed Faruque Reza1

1Department of Neurosciences, Universiti Sains Malaysia,

2Faculty of Medicine, Universiti Sultan  Zainal Abidin, Malaysia

*Corresponding Author E-mail: samhanismail@gmail.com

 

ABSTRACT:

Auditory stimulus produces brainwave potential variation with time in the midbrain that can be measured on the scalp through electroencephalography (EEG). This standing frequency can be intensified, reinforced and prolonged by the interaction with other waves producing brainwave entrainment. This interactional rhythm and wave correspondingly applied in cognitive rehabilitation procedures in music therapy. However, such neural synchronization with the rhythmic and melodic intonation of the Holy Quran recitation is still unclear. Emphasizing on alpha brainwave ranges at the frequency of 8 to 13Hz, we aim to learn the neural oscillations evoked by the rhythmic sound of Sura Fatiha recitation. This auditory stimulation was done on 28 normal healthy subjects in treated quiet room with dimmed light. Electrical current was measured by using the 128-electrode sensor net of EEG (Electrical Geodesics, Inc). The data was pre-processed and analyzed by Fast Fourier Transform (FFT) to yield spectrum in power (amplitude squared, µV2) in alpha frequency band by using BESA Research 6.0 software, Germany. Event Related Desynchronization (ERD) analysis was subsequently performed.Result shows that listening to Sura Fatiha elicits event related desynchronization (ERD) which pronounced as increased cortical excitability reflecting the attentive behaviour. There is general supposition that listening to Sura Fatiha recitation modulates the neuronal amplitudes referred as alpha event-related desynchronization.

 

KEYWORDS: Alpha event-related desynchronization, quranic recitation listening, brain wave entrainment.

 

 

A Case Report on Breastfeeding an Adoptive Child: The Challenges and Success Factors in Attaining Mahram Status

 

 

Zaharah Sulaiman1*, Tengku Alina Tengku Ismail2, Noraini Mohamad3

1Women’s Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia,

2Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia,

3School of Dental Sciences, Universiti Sains Malaysia

*Corresponding Author E-mail: zaharah@usm.my

 

ABSTRACT:

Induced lactation is a process of producing breast milk in nonpuerperal women. This case report illustrates the challenges and success factors of a woman who underwent induced lactation process in attaining mahram status. This is a case of a woman who presented to Lactation Clinic, Hospital Universiti Sains Malaysia in 2015 for induce lactation but defaulted after the initial phase. Only after a year, she represented and managed to abide the treatment plan religiously until she reached the mahram status. The 37 years old lab technician with primary infertility came for the first consultation when her adopted baby was three months old. After a thorough history taking and examination, she was identified as a suitable candidate for inducing lactation. She agreed to start on oral contraceptive pills for breast preparation. However, upon completing the initial phase, she did not manage to proceed to the stimulation phase mainly due to lack of motivation and support. A year later, she presented with the intention to restart the process. She was advised on how to overcome the challenges at work so that she was able to adhere to the treatment plan. After consistently following the stimulation schedules and taking Domperidone tablets as prescribed, with the support from family members and colleagues at work, she was able to produce drops of milk. She managed to complete five feedings and attained mahram status when her adopted child was 18 months old. Induce lactation opens up an opportunity for nonpuerperal women to experience motherhood, bonding with her adopted child and creating emotional ties between the adoptive families. Women who are eligible for induce lactation, need family support, conducive working environment and the ability to comply with the treatment plan in making the journey to attain mahram status a success.

 

KEYWORDS: Breast-feeding, mahram status, induce lactation

 

 

Teaching Methods Preference by Medical Students in a Malaysian Public University

 

Norhasiza Mat Jusoh*, Norwati Daud, Myat Moe ThweAung, Harafinova Harman Shah,

Aniza Abdul Aziz

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia

*Corresponding Author E-mail: hasizamj@unisza.edu.my

ABSTRACT:

Bachelor of Medicine and Bachelor of Surgery (MBBS) programme in Universiti Sultan Zainal Abidin (UniSZA) started in 2009. Its curriculum uses many different types of teaching method during clinical years. There is a strong association between teaching methods and apprehension of knowledge by students.  The curriculum is currently at a review process. An online survey was conducted to evaluate graduating medical students’ satisfaction on various teaching methods during clinical years of the existing curriculum. An anonymous online feedback on the MBBS curriculum UniSZA was done on 56 final year students who have just graduated.  A scale of one to five was used to determine their satisfaction on teaching methods in clinical year. Scale one represents ‘very dissatisfied’ while scale five is meant for ‘very satisfied’. Microsoft Excel Programme was used for descriptive analysis. All 56 students gave their feedbacks.  71.4% of them were female students. Students’ satisfaction on the teaching methods is presented as mean (SD) score. All 56 students gave their feedbacks.  71.4% of them were female students. Students’ satisfaction on the teaching methods is presented as mean (SD) score. All teaching methods were scored above 4.0. The results showed that the scores in descending order were;  bed side teaching 4.59 (0.50), lecture 4.50 (0.51), case discussion 4.46 (0.57), ward round 4.46 (0.66), practical session 4.45 (0.63), clinical skill lab 4.45 (0.63), film viewing 4.43 (0.57), projected material quiz 4.41 (0.60), clinical problem solving 4.34 (0.67), seminar 4.30 (0.71), ward work 4.29 (0.68), tutorial 4.27 (0.62),  clinical case correlation 4.23 (0.79), on-call 4.05 (0.84).Students’ satisfaction on the number of students for each teaching session was 4.4 (0.54).The level of satisfaction of graduating medical students on the existing teaching methods is reasonably high. Most students are preferred teacher-centred learning teaching methods as evidence by high satisfaction scores on bed side teaching followed by lecture. The low satisfaction scores are majority student-centred learning teaching methods.  This feedback will help the faculty in revising and improving their teaching methods of the future curriculum.

 

KEYWORDS: Medical curriculum, undergraduate medical students, curriculum review, teaching method

 

 

How Does Performance of Clinical Bedside Examination Correlate with Objective Structured Clinical Examination (OSCE) Performance in Final Professional Examination?

 

MAR Husbani*, Norwati Daud, Myat Moe Thwe Aung, Harmy Mohd Yusoff

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu

*Corresponding Author E-mail: husbanimar@unisza.edu.my

 

ABSTRACT:

There are many methods in assessing clinical competence. OSCE, clinical long case and clinical short case are among the widely used method in medical programmes in Malaysia. To determine the correlation of clinical bedside performance with the overall OSCE performance, communication skills OSCE and psychomotor skills OSCE. Fifty-seven undergraduate medical students sat for the Professional II (final) examination for the session of 2016/2017 in Faculty of Medicine, University Sultan Zainal Abidin, Terengganu, Malaysia. The clinical components exam was 12 interactive OSCE stations, one long case and three short cases. OSCE comprised of seven communication skills stations and five psychomotor skills stations. Their results were analysed using SPSS Version 22. Pearson’s correlation test was applied to determine the correlation between bedside performance and the three variables. The correlation coefficient (r) values for OSCE performance, communication skills performance and psychomotor skills performance are 0.488 (p<0.001), 0.369 (p=0.005) and 0.458 (p<0.001) respectively. There was statistically significant, fair to good positive correlation between overall, communication skills, and psychomotor skills OSCE and clinical bedside marks.  Psychomotor skills performance showed better correlation than communication skills. Steps may need to be taken to improve the correlation especially in communication skills stations. 

 

KEYWORDS: OSCE, bedside teaching, psychomotor skills, communication skills, medical education.

 

 

Fat-O: A Natural, Halal, Cost Effective and Holistic Novel Anti-Obesity Drink

 

Atif AB1*,Hassan A R2, Saba R3, Khaid M4, Ahmad ZAL1, Zilfalil BA5, Nordin S1

1Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia

2School of Pharmacy, Universiti Sains Malaysia, Malaysia

3Department of Microbiology and Molecular Genetics, University of the Punjab, Pakistan

4Department of Pathology, Josef-Schneider Str 2, 97080, Wuzburg Germany

5Department of Pediatrics, School of Medical Sciences, Universiti Sains Malaysia

*Corresponding Author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

FAT-O (No Fats) is a novel drink, which is made of tulong honey, vinegar and water in a very specific ratio which has been tested and optimized though many preclinical and toxigenic experiments in vivo and in vitro. This drink can be used in diet restricted or non-diet restricted subjects targeting holistic approach against obesity at lipogenic to infllamatory levels. Total of 11 groups (n = 6) of rats were used as per standard protocols of maintanance inclusive of Group 2 to group 6 (No Dietary restriction with High Fat Diet) and group 7 to Group 11 (Obese with Dietary Restrictions). The effect of group tested with Fat-O in comparison with other groups were assessed through its effect on food intake and growth performance, weight of vital organs, total leukocyte counts, lipid profile and glucose quantification, plasma cardiac biomarkers, plasma inflammatory biomarkers, plasma derived cytokines, visceral adipose tissue derived cytokines, cognitive function and Brain Derived Neurotrophic Factor  expression, CRE derived expression of downstream genes, anti-bacterial and anti-fungal effects, anti edema and analgesic effects using standardised protocols and methods. Significant effect of FAT-O on all the parameters related with obesity were prooven that the ratio of tulong honey, vinegar and water used for this vital drink has significant effects on controlling all types of obesity in dietary restricted or non-dietary restricted subjects. FAT-O is a novel holistic drink with a specific ratio of ingredients tested for treatment and prevention of obesity. To the best of our knowledge, we believe that this halal based product is a cost effective, environmental friendly, safe, easy to use and with a pleasant to taste product to be tried for normal, over weight and obese attributes for a healthy body and mind beside the hidden blessings narrated in ahadith and quranic verses.

 

KEYWORDS:  Anti-obesity drink, Fat-O, cardio-protective, anti-lipid.

 

 

Predictors of Academic Achievement Among Malaysian Adolescents: Social Support Network and Educational Encouragement

 

Aqeel Khan*, Ahmad Mustaqim Bin Yusoff, Mahani Mokhtar

Faculty of Education, Universiti Teknologi Malaysia (UTM), Johor, Malaysia

*Corresponding Author E-mail: draqeelkhan@gmail.com

 

ABSTRACT:

Emerging research in academic achievement has shown linkages with many psychological factors. Present researcher feels academic achievement have relevance in other domains of life, especially for students such as social support network and educational encouragement. The objectives of the study were to examine the relationship of academic achievement and social support network, and educational encouragement; and to examine the role of demographic characteristics, social support network and educational encouragement as predictors of academic achievement. Data were collected from 350 University students, 120 males and 220 females (age 20-25 years) residing in Johor Bahru city of Malaysia. Descriptive, correlations and regression analysis were performed. Gender, socio economic, marital status and religious belief of the students significantly influencing on academic achievement. Significant positive relationships were found between academic achievement with social support network and educational encouragement from parents, siblings and friends. Regression model revealed that social support network, and educational encouragement significantly predicted academic achievement. Social support network and educational encouragement from parents, siblings and teachers were found to be imperative in developing academic achievement of contemporary adolescent, as well counter in developing skill to face challenges of life. Encouraged people do not feel fear about the mistakes; they are open to their experiences, and free of success and failure. They realize all learning involves mistakes and they view mistakes as opportunities for development.

 

KEYWORDS:

Social support network, academic achievement, educational encouragement

 

 

Cross-Professional Team Composition, Behaviour and Barriers: A Comparison of Medical and Nursing Perspectives

 

Wan Siti Auni, W. S.1, Pereira, D.J.1*, Lim P.Y.2, Sakinah, H.3

¹School of Health Sciences, University Sains Malaysia.

²Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra

Malaysia.

³Faculty of Health Sciences, Universiti Sultan Zainal Abidin

*Corresponding Author E-mail: dpereira@usm.my

 

ABSTRACT:

Cross-professional teams that require collaboration from different healthcare professionals are a necessary component of patient care. Medical and nursing professionals are often dominant members in cross-professional settings. To promote improvements in local healthcare teamwork, this study aimed to compare medical and nursing perspectives on their respective teams. Eight medical specialists and 15 inpatient ward nurse managers were recruited from a tertiary teaching hospital in the Malaysian state of Kelantan. Between January and June 2016, all participants were interviewed with regards to team composition, team behaviour and teamwork barriers. All interviews were recorded, transcribed and subject to thematic analysis. Cross-professional composition identified by ward nurse managers and medical specialists was found to be similar. Both professional groups showed awareness that wards are served by doctors, nurses, dieticians, physiotherapists and occupational therapists. Cross-professional team behaviour cited by specialists and nurse managers were in sharing patient care objectives, communication and joint ward rounds. Specialists identified themselves as team leaders who diagnose patients and plan treatment. Both participant groups agreed that nurses and allied health professionals implement treatment plans. Specialists mentioned that doctors refer patients through direct communication with allied health professionals. In contrast nurses stated that they played an intermediary communication role between doctors and allied health professionals. A teamwork barrier mentioned by both groups is understaffing. Nurse absence during joint ward rounds and a lack of team evaluation are barriers cited by specialists. Nurse managers highlighted that doctors’ position in service hierarchy is sometimes a teamwork barrier. Specialists and nurse ward managers recognize cross-professional diversity and behaviour within their teams. The findings suggest that cross-professional pathways of communication may require harmonization and mutual recognition from both doctors and nurses. Both professional groups could strive to collaborate in overcoming mutual and professional specific barriers for cross-professional teamwork. 

 

KEYWORDS:  Cross-professional teams, Healthcare professionals.

 

The Prevalence of Lactose Intolerance and Its Relation With Bone Health Status in Malay and Chinese Children In Selangor

 

Ika Aida Aprilini M, Norlida MD, Nurul Azrianti AA

Food Science Program, School of Chemical Science and Food Technology, Faculty of Science and

Technology, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor.

*Corresponding Author E-mail: norlida.daud@ukm.edu.my

 

ABSTRACT:

The prevalence of lactose intolerance (LI) in Malaysian adults has been reported previously. In contrast, data on the prevalence of LI among Malaysian children is scarce. This study determined the prevalence of LI and its relation with bone health status (BHS) among children in Selangor. A total of 400 school children (Malay=200, Chinese=200) aged 9 to 11 years old were participated in this study. On the study day, basal breath hydrogen and blood glucose samples were obtained after an overnight fasted. Then, the subjects were asked to drink 25g of lactose solution before postprandial breath hydrogen, blood glucose (BG) and gastrointestinal symptoms (GIS) were measured every 30 minutes for 2.5 hours.Subjects with high breath hydrogen concentrations (>20ppm), an increase of BG (<1.1mmol/L) and occurrence of GIS (≥2 score) above baseline measurement following lactose ingestion were determined as LI. Individuals with similar conditions except the occurrence of GIS were known as lactose malabsorption (LM). The calcaneal broadband ultrasound attenuation (BUA) measurement was used to measure BHS. A total of116 subjects were LI, 231 subjects were LM and 53 subjects were lactose tolerance.There was a significant difference (p=0.006) between these groups. However, no significant difference (p>0.05) between BUA of LI (71.2±11.5 dB/MHz), LM (72.6±11.5 dB/MHz) and lactose tolerance (73.2±10.6 dB/MHz) subjects although BUA of LI was lower compared to other groups. The results also showed that Chinese had a significantly higher (p=0.02) LI percentage (62.1%) and lower (p<0.001) BUA scores (69.8±10.53dB/MHz) compared to Malays (37.9% and 75.0±11.5 dB/MHz respectively). This study demonstrated that LI already began at a young age and Chinese are more prone to LI and low BHS than Malays. Practical strategies for increasing dairy product consumption in children are crucial in order to prevent osteoporosis in later life.

 

KEYWORDS: Lactose intolerance,dairy product, bone health, osteoporosis.

 

Calorie Adequacy for Optimal Cognitive Recovery Among Traumatic Brain Injury Patient

 

Mohd Ibrahim Abdullah1*, Noor Aini Mohd Yusoff1, Sharifah Wajihah Wafa Syed Saadun Tarek Wafa1, Aryati Ahmad1, Nujaimin Udin2, Kartini Abdul Karim3, Ahmad Zubaidi Abdul Latif4

1Faculty of Health Science, Universiti Sultan Zainal Abidin (UniSZA), Malaysia.

2Neurosurgery unit of Department of Surgery, Hospital Sultanah Nur Zahirah, Malaysia.

3Dietetic and Food Service Department, Hospital Sultanah Nur Zahirah, Malaysia.

4Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Malaysia.

*Corresponding Author E-mail: ibrahim_dietetik@yahoo.com.my

 

ABSTRACT:

Cognitive recovery become a major concern to traumatic brain injury (TBI) patients and their caregivers because patients need to resume their normal life after hospital discharge. Recent discovery shows that calorie restriction is good for cognitive recovery, associated with low mortality rate and better clinical outcome. However adequate calorie needed for optimal cognitive recovery is not determined yet. This pilot study involved nine respondents recruited from Hospital Sultanah Nur Zahirah, Kuala Terengganu. The respondents underwent a series of nutritional assessment, neuropsychology test, and electroencephalography (EEG) for 3-5 days according to days of full calorie intake (CI) achieved based on their requirement. The demography, nutritional and neuropsychology data were analysed using SPSS with CI% set as independent variable and time to finish (FT) trail-making and total score (TS) of Montreal Cognitive Test set as dependent variable. EEG data was analysed using FFT and later power ratio was calculated by comparing slow to fast EEG band during first and subsequent visit. Preliminary result using scatter/dot graph showed relation of CI% to FT and TS at early part but plateau at certain range of CI% at later part. Pearson correlation test showed significant negative correlation between CI% to FT (r = -0.615; p = 0.000) and positive correlation to TS (r = 0.838; p = 0.000). Result also indicated that cognitive improved at low CI% and the mean different of power ratio for EEG of follow-up and first visit was significant (p = 0.03). In this pilot study, it appears that cognitive function shows improvement with calorie restriction.

 

KEYWORDS: Calorie adequacy; calorie restriction; cognitive recovery; traumatic brain injury.

 

A Study to Compare the Effectiveness of Bimanual Movement Training vs Modified Constraint Induced Movement Therapy On Upper Limb Motor Activities in Chronic Stroke Patients

 

Albin Jerome*

School of Physiotherapy, Faculty of Allied Health Professions, AIMST University, Bedong 08100,

Kedah, Malaysia

*Corresponding Author E-mail: albinjerome@gmail.com

 

ABSTRACT:

World Health Organization (WHO) defines Stroke as “rapidly developing clinical signs of focal/at times global disturbance of cerebral function, lasting more than 24 hours or leading to death with no apparent cause other than that of vascular Bimanual Movement Training and Modified Constraint Induced Movement Therapy are emerging as effective approaches which can be intervened for rehabilitation of upper limb. This study aims to compare the effectiveness of Bimanual Movement Training and Modified Constraint Induced Movement Therapy on upper limb motor activities. A comparative study was on 30 Patients aged 30-60 years diagnosed as with MCA infarct having a score ≥ 63 on the Modified Mini-Mental State Examination, a score score ≥ 2 on the Modified Ashworth Scale and with Voluntary Control Grade III with duration of 6-12 months was randomly selected for the study. Patients having congenital upper limb deformity, history of upper limb fractures, having visual and auditory deficits and unable to stand were excluded from the study. The samples were divided into Group A and B with 15 patients each. Group A Individuals were treated with Bimanual Movement Training and Group B with Modified Constraint Induced Movement Therapy. Scores were taken on the first day with the Amount of Use scale and Quality of Movement scale for the affected upper limb for both the groups as pre intervention scores. Post intervention measure was taken at the end of 3rd week for both the groups as post intervention scores. The mean difference of Amount Of Use of Bimanual Movement Training (Group A = 1.615) was less than the Modified Constraint Induced Movement Therapy (Group B = 2.308) and also the mean difference of Quality Of Movement of Bimanual Movement Training (Group A = 1.385) was less than the Modified Constraint Induced Movement Therapy (Group B = 2.385). This study concludes that Modified Constraint Induced Movement Therapy is therapeutically more effective than Bimanual Movement Training in treating Chronic Stroke patients for upper limb motor activities.

 

KEYWORDS: Stroke, bimanual activity, modified constraint induced therapy.

 

 

 

Factors Associated with Risk of Smartphone Addiction among Undergraduate University Students in Kelantan

 

Nurfarhan Rahim*, Norzila Zakaria, Maruzairi Husain

Department of Psychiatry, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kota Bharu,

Kelantan

*Corresponding Author E-mail: mc_hans@hotmail.com

 

ABSTRACT:

Excessive smartphone use could lead to addiction. Smartphone addiction becomes a recent concern because of its potential to adversely impact on many aspects of life. The aim of this study is to assess the level of risk for smartphone addiction and to identify the predictors on the smartphone addictive behaviour among undergraduate university students in Kelantan. This is a cross-sectional study conducted among 140 students of School of Health Science USM. Students recruited from five study programs that were randomly selected through multistage cluster sampling method. Socio-demographic and smartphone usage characteristic proforma, Smartphone Addiction Scale Malay Version (SAS-M) to measure the level of risk for developing smartphone addiction and Depression Anxiety Stress Scale 21 – Malay Version (DASS 21) to measure depression, anxiety and stress level; were self-administered by the students. The mean score of SAS was 111.07 ± 25.11. Majority of the students used smartphone for more than 4 hours daily (78.6 %). Daily usage smartphone time (13.63, 95% CI: 4.18, 23.08, p = 0.005) and stress level (1.57, 95% CI: 0.51, 2.62, p = 0.004) were found to have significant positive relationship, while Audiology program (-12.98, 95% CI: -24.43, -1.54, p = 0.027) and family income less than RM1000 (-12.52, 95% CI: -21.54, -3.50, p = 0.007) have significant negative relationship with SAS-M score. Stress and daily smartphone usage time are significant predictors for risk of smartphone addiction. This knowledge could help in early detection for smartphone addiction among undergraduate university students, subsequently to plan for early intervention in order to prevent further negative implications of smartphone addiction.

 

KEYWORDS: Smartphone addiction, predictors, stress, students, university

 

 

 

Weekday and weekend variation in the distribution of daily stepping in 9-11 years old obese school children

 

Wafa SW1,2*, NN Aziz1, H Halib1, M Rahim3

1School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Malaysia

2 Institute for Community Development and Quality of Life, Universiti Sultan Zainal Abidin (UniSZA), Malaysia

3School of Rehabilitation Sciences, Universiti Sultan Zainal Abidin (UniSZA), Malaysia

*Corresponding Author E-mail: sharifahwajihah@unisza.edu.my

 

ABSTRACT:

A major health threat for children in the 21st century is physical inactivity in conjunction with the elevated prevalence of obesity.In Malaysia, low physical activity among children is a major concern.

The objective of the study was to analyze the day to day variation of step count in a sample of obese children using the activPALTM monitor. This was a cross sectional study conducted in Kuala Terengganu, Terengganu. The sample compromised 41 boys and 24 girls between the ages of 9-11 years. Number of steps was objectively measured using an activPALTM accelerometer over a period of 4-7 days and had their height and weight measured. Mean step count from this sample of obese children was 8861 ± 3157steps. Steps per day were significantly higher for boys compared to girls (p=0.034). Obese children took significantly more steps at weekdays than on weekends (p=0.001).  Steps/hour were significantly higher in weekday compared to weekend between 0600 to 0700 (p<0.001), 0700 to 0800 (p<0.001), 0800 to 0900 am (p<0.001), 0900 to 1000 (p=0.032), 1000 to 1100 (p=0.046), 1100 to 1200 (p<0.001), 1300 to 1400 (p=0.002), 1400 to 1500 (p<0.001), 1800 to 1900 (p=0.026) and 2000 to 2100 (p=0.019). Detailed daily patterns of physical activity are required to fully understand the differences across days that help future interventions to target those falling short particularly during weekend.

 

KEYWORDS: Physical activity, obesity, school children, activPAL, step count

 

Effect of Isokinetic Training on Quadriceps Muscle Strength in Osteoarthritis of Knee

 

Naresh Bhaskar Raj1*, Soumendra Saha2, Amran Shokri3, Srilekha Saha2,Hairul Anwar Hashim4, Choo Morley Liza5

1Senior Lecturer, University of Sultan Zainal Abidin

2Department of Sport Science, RKM Vivekananda University, Belur, Kolkata, W. Bengal, India

3Professor, Dept. of Orthopedics, School of Medical Science, Universiti Sains Malaysia

4Associate Professor, Exercise and Sports Science Program, School of Health Science, Universiti Sains Malaysia

5Physiotherapist, Hospital Universiti Sains Malaysia

*Corresponding Author E-mail: bnaresh@unisza.edu.my

 

ABSTRACT:

Knee Osteoarthritis is twice as common as hand or hip osteoarthritis with an incidence of 240 out of 100,000 population/ year affecting about 15% of the human population globally. The aim of the present study was to investigate the role of Isokinetic Training and EMG biofeedback training in improving strength of quadriceps femoris in participants with Osteoarthritis of knee. Fifty four participants in the age range of 50-63 years with knee Osteoarthritis of Grade II and III (Kellgren-Lawrence criteria) severity were recruited from the Department of Orthopedics, Hospital Universiti Sains Malaysia. The strength of quadriceps femoris was assessed at baseline employing the isokinetic device BIODEX 4 System Pro. The participants were randomly categorized into three groups (Gr.) Viz. Gr. A (conventional physiotherapy), Gr. B (isokinetic training) , Gr. C (EMG Biofeedback)  and thus each group consisted of 18 participants. All the interventions were imparted for 25 - 30 minutes per session; 2 sessions per week for 10 weeks (20 sessions). Mid term evaluation was done at the 5th week, post intervetnion assessment at the end of 10 the week of intervention and follow up at 14th and 18th week. Quadriceps muscle strength improved in all the intervention groups. Two-way repeated measure of ANOVA revealed that, the average peak torque of quadriceps femoris at 180 degree/ second was significantly higher (p<0.05) in participants of the isokinetic training group compared with that of the participants of the conventional physiotherapy and EMG Biofeedback group. Isokinetic Training was effective in enhancing the muscle-strength in participants suffering from Osteoarthritis of knee.

 

KEYWORDS: Osteoarthritis, Quadriceps Femoris, Isokinetic Training, EMG Biofeedback.

 

 

Characteristics of Stroke Survivors in Rehabilitation Health Organization,

Kuala Nerus, Terengganu: A Retrospective Study

 

Chin YY*, Sakinah H, Aryati A

School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Gong

Badak Campus, 21300 Kuala Nerus, Terengganu, Malaysia

*Corresponding Author E-mail: chinyiying92@gmail.com

 

ABSTRACT:

Stroke is the second leading cause of death after ischaemic heart disease worldwide and the third in Malaysia. The incidence and prevalence of stroke have increased dramatically in the past 5 years in Terengganu. Stroke event is life-changing to stroke survivors in terms of functional impairment, emotional, and communication skills. This study aims to describe various aspects of stroke such as diagnosis, previous history of stroke and multiple chronic conditions. In this community-based retrospective study, a total of one hundred and fifteen case records of stroke patients who previously attended Rehabilitation Health Organization, Kuala Nerus, Terengganu, starting from October 2013 until May 2017, were reviewed in this study. The socio-demographic and clinical information were assessed using medical folders. Descriptive statistics was performed using IBM SPSS version 21. Stroke patients consisted of 54 (47%) men and 61 (53%) women; with the median age of 61.0 ± 17.0 years (age range 26-83 years). Ischaemic stroke accounted for 80.0% in the cohort with slightly higher female proportion (55.7%), followed by haemorrhagic stroke (20.0%). Nevertheless, there was no significant association between gender and types of stroke (p> 0.05). A hundred patients (87.0%) had their first-ever stroke while 13.0% experienced the recurrent stroke. Patients with multiple chronic conditions were diagnosed to have diabetes mellitus and hypertension (31.3%), followed by hypertension (23.5%), and diabetes mellitus, hypertension and hyperlipidaemia (13.9%). These findings are essential for a reference in proper stroke management especially secondary prevention of stroke to reduce the burden of stroke as well as lower the stroke recurrence rate among stroke survivors.

 

KEYWORDS: Stroke survivors, rehabilitation

 

 

Assessing the fruitfulness of defense analysis in brief focal psychodynamic

therapy in the intervention of marital therapy

 

Vidya Bhagat1, Shivalingappa B. Javali2

1University Sultan Zainal Abidin, Faculty of Medicine, Kuala Terengganu 20400, Terengganu,

2International Medical programme, Nehru Nagar, Belgaum, Karnataka, India

*Corresponding Author E-mail: vidyabhagat@unisza.edu.my

 

ABSTRACT:

The psychoanalytical approach in the couple patients becomes significant when the psychological parameters causing sufferings are unconscious. The technique, analysis of defense mechanisms is proven useful in understanding the unconscious roots of marital disturbances in gaining insight into problems. Thus the study objective focuses on analysis and interpretation of defenses. This is a case study research design used for analyzing defense mechanisms used by patients in situational aspects of their life discussed in the clinical interview to find unconscious roots disturbing their marriage. Universal sampling was used for sample selection from Nitte psychiatry center, private patients and couples attended camps from 2007 to 2014. The intervention provided was brief focal psychotherapy, defense analysis and its interpretation was used as a tool for gaining insight into problems faced by the subjects in their marriage. There was high prevalence among patient couples who had unconscious roots in their past causing disturbances in their marriage. Of the 100 sample couples only 40 patient couple indicative for defense analysis and other 60 were excluded. Defense used by patient couple was interpreted to gain insight into problem behaviors thus improved interpersonal relationships among the marital couple. End of the intervention they were rated on 3 points scale measuring satisfaction levels that evaluate therapeutic success. More than 50% of sample population found to be highly satisfied and none of them spelt dissatisfaction. The collected data were presented with frequency and parentages and statistically analyzed by using Chisquare with Yates's correction test for association. The statistical software used is SPSS 20.00 version. The statistical significance was set at 5% level of significance (p<0.05).The present study has proven the hypothetical view that deeply rooted unconscious causes of marital disturbances among the patient couple shown its interventional success and fruitfulness of defense analysis.

 

KEYWORD: Psychodynamic therapy, marital disturbances, defence analysis.

 

 

 

 

 

Need for Focus on Personality Dimension Impacting Academics of Medical Students

 

Charan Kishor Shetty*, Vidya Bhagat

Faculty of Medicine, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, 20400 Kuala

*Corresponding Author E-mail: charanshetty@unisza.edu.my

 

ABSTRACT:

Personality dimensions are known to be associated with achievements in individual lives. The present study focuses on one of such dimension neuroticism those impacting academics of medical students. This dimension is one of the big five factors of Eysenckian personality model.The Eysenckian personality model was developed to assess a specific theoretical model and is still commonly used in educational settings and research. This research study is a useful in developing awareness among the medical students and they can be educated to prevent the effect of neuroticism by using mental health exercises. The sample group consisted of 60 years one medical Students of University Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Malaysia. They were selected by convenient sampling technique. The Eysenckian personality inventory was used to find out the extent of neuroticism among the sample group. These neuroticism scores were matched with academic scores to find the association between the two variables. Carl Pearson’s correlation coefficient method was carried out to find the significance of their association. There was high prevalence in extent of neuroticism among medical students.  Of the 64 subjects 60 were chosen and 4 were excluded because of invalid answer found in the inventory. High score on Eysenckian personality inventory showed higher extent of neuroticism among the sample population. The tabulated neuroticism score and academic scores were statistically analyzed to find their association. The results revealed that there was significant correlation between neuroticism and academic scores (r= -0.824, p=<0.001). The study result was compatible with the hypothetical assumption. There was a significant correlation between academic scores and neuroticism among study sample group. Neuroticism is a one of the personality dimension that has a negative impact on academics of medical students. The hypnotized assumption has been proven in the current study.   Implication of this studies accentuates that developing awareness of personality dimensions in the initial stages of medical studies may foster their academic performance.

 

KEYWORDS: Personality; neuroticism, academics, performance.

 

 

 

 

Serum Adiponectin and Resistin Levels in Correlation with Metabolic

Syndrome and Its Risk Factors Among Temiar Subtribe in Kuala Betis

 

 

Nur Sakinah Harun1, Mohd Nizam Zahary1, Mohd Adzim Khalili Rohin1,

Nur Haslinda Ridzwan1, Mimie Noratiqah Jumli1, Rosliza Yahaya2, Aniza Abd Aziz2,

Nik Ahmad Shaiffudin Nik Him2, Azizul Fadzli Wan Jusoh2

*Corresponding Author E-mail: mhnursakinah@gmail.com

 

ABSTRACT:

Metabolic syndrome (MetS) is characterized as a cluster of metabolic disorder including increase blood pressure (BP), elevated blood glucose level, high cholesterol level, and visceral fat obesity. MetS has a five-fold risk to develop type 2 diabetes mellitus (T2DM) and two-fold inclining risk for cardiovascular diseases (CVD).  Polypeptide hormones such as adiponectin and resistin play a significant role in glucose and lipids metabolism, liver and pancreas function. These hormones have been tagged as potential MetS markers. This study aimed to determine the relationship between serum adiponectin and resistin levels with MetS risk factors among Temiar subtribe in Kuala Betis.The cross sectional study involving 123 subjects from Temiar subtribe in Kuala Betis, Gua Musang, Kelantan. Different parameters of MetS including serum adiponectin and resistin levels were measured according to standard protocols as given for modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) (2005) guideline. Serum adiponectin were significantly lower in subjects with MetS (7.98 ± 5.65 ng/ml) compared to subjects without MetS (15.93 ± 7.17 ng/ml). Meanwhile, serum resistin were significantly higher in MetS (11.22 ± 6.34 ng/ml) compared to non-MetS (7.06 ± 5.64 ng/ml) subjects. Adiponectin concentration were significantly correlated with BMI (P<0.001), waist circumference (WC) (P<0.001), systolic (P=0.045) and diastolic (P<0.001) blood pressure (BP), fasting blood glucose (FBG) (P=0.002), triglyceride (TG) (P<0.001), high density lipoprotein (HDL) (P<0.001) and total cholesterol (P=0.004). However, only BMI (P<0.001), WC (P=0.009), FG (P<0.01), HDL (P<0.001), and TC (P=0.017) were significantly associated with resistin concentration. Serum adiponectin was decreased in subjects with MetS, whereas serum resistin was increased with MetS. All MetS risk factors were significantly associated with serum adiponectin, while systolic and diastolic BP, and TG were found to be insignificantly associated with serum resistin among Temiar subtribe in Kuala Betis.

 

KEYWORDS: Metabolic syndrome, serum adiponenctic, resistin, Temiar subtribe.

 

 

 

The Role of Maternal Serum and Breast Milk Adipokines in Determining

Infant Adiposity Development

 

Marhazlina Mohamad1*, Loy See Ling2, Hamid Jan Jan Mohamed3, Yu Wang4, Bosheng Huang4

1School of Nutrition and Dietetics, Faculty of Health Sciences, Universiti Sultan Zainal Abidin

2KK Research Centre, KK Women’s and Children’s Hospital Singapore, Singapore

3Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia

4Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of

Hong Kong

*Corresponding Author E-mail: marhazlina@unisza.edu.my

 

ABSTRACT:

Obesity has been a great concern in Malaysia since there is an alarming increase in its prevalence. Besides storing fat, adipose tissue is also an endocrine organ that secretes a large number of adipokines. Pregnancy, a state with metabolic changes, has been recognized as a critical period for the development of infant adiposity as a result of imbalanced adipokines production. Hence, the Universiti Sains Malaysia Pregnancy Cohort Study was established to investigate the role of maternal serum and breast milk adipokines (adiponectin and leptin) in determining the first year infant adiposity development. This study was conducted from April 2010 until December 2012. A total of 155 healthy pregnant mothers aged 19 to 40 years were recruited at first and second trimester of pregnancy in Kelantan, Malaysia. Data collection was consisted of maternal sociodemography, anthropometry and clinical biochemistry analysis; and infant’s anthropometry and feeding patterns. Fasting serum samples were taken during pregnancy for adiponectin and leptin levels analyses. Breast milk samples were collected at birth and 2 months postpartum. Data collection was performed at second and third trimester of pregnancy, continued with follow-up visits at birth, 2 months, 6 months and 12 months postpartum. Multiple linear regression (MLR) analyses were performed to examine the associations of maternal serum and breast milk adiponectin and leptin on infant adiposity development. MLR models showed that in the first year of age, as maternal serum and breast milk adiponectin increased, infant weight, BMI-for-age Z-scores, abdominal circumference and triceps skinfold significantly decreased (p<0.05). Maternal serum and/or breast milk adiponectin were associated with the first year infant adiposity development. The favourable results of breast milk adiponectin indicated the potential role of breastfeeding practice in the prevention of obesity since infanthood.

 

KEYWORDS:  Pregnancy, maternal serum adipokines, breast milk adipokines, infant adiposity.

 

 

 

The Prevalence of Unusual Intramolecular Thioester Cross-Link On The

Surface Proteins of Enterococci

 

Nabilah Huda Abdul Halim, Su-Yin Kan*

Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Terengganu, Malaysia

*Corresponding Author E-mail: suyinkan@unisza.edu.my

 

ABSTRACT:

The emergence of nosocomial infections caused by multi-drug resistant enterococci is becoming a cause for concern. According to the 2015 National Surveillance of Antibiotic Resistance (NSAR) report by the Ministry of Health Malaysia, Enterococcus faecium was found to be resistant to a variety of antibiotics especially to vancomycin which recorded an increased resistant rate. Recent studies showed that many clinically significant Grampositive human pathogens possess a unique covalent intramolecular thioester bond on at least one of their surface dhesion proteins which may serve as potential therapeutic targets, an alternative to antibiotics. Sequence search based on the protein query of thioester-containing domain (TED) of Streptococcus pyogenes were performed using the Basic Local Alignment Search Tool (BLAST) against non-redundant protein sequences (nr) and UniProt Knowledgebase (UniProtKB) databases. The protein BLAST followed by multiple sequence alignment revealed that a total of 54 strains of E. faecium and 75 strains of E. faecalis were predicted to contain a thioester bond on their surface protein, whereby the critical cysteine and glutamine residues were found to be perfectly conserved. These predicted TEDs showed low sequence homology (about 35 % similarity) to known streptococcal TED and many of which functions are unknown. However, the high prevalence of TEDs across enterococcal strains is astonishing. Therefore, the biochemical function of thioester bond in these proteins contributing to enterococcal pathogenicity needs to be further assessed experimentally, which may serve as a new drug target or diagnostic tool for enterococcal infections.

 

KEYWORDS: Intramolecular, thioester, enterococcal.

 

 

Antibiotic Resistance, Plasmid Profiling and Random Amplified

Polymorphic DNA (RAPD) Fingerprinting Among Cockles (Anadara Ganosa)and Clams (Mercenaria Mercenaria) of Vibrio Vulnificus

 

Mohammed M. K. A.1, Sahilah, A. M.2*, Aminah, A.3, Azuhairi A. A. A4

1Biotechnology Centre, Ministry of Environment, Doha, Qatar,

2School of Chemical Sciences and Food Technology, Faculty Science and Technology, Universiti

Kebangsaan Malaysia (UKM), 43600 UKM Bangi, Malaysia,

3Natural Medicine Research Centre, Universiti Islam Malaysia, 63000 Cyberjaya

4Department of Community Health, Faculty of Medicine and Health Sciences Universiti Putra

Malaysia, 43400 UPM Serdang, Selangor, Malaysia

*Corresponding Author E-mail: sahilah@ukm.edu.my

 

ABSTRACT:

Vibrio vulnificus is a gram-negative bacterium and can be isolated from water, sediments, fish and shellfishes. A total of 60 V. vulnificus isolates, 37 cockle isolates were from Malaysia and 23 clam isolates were from Qatar. All those V. vulnificus isolates were characterized by antibiotic resistance, plasmid profiling and random amplified polymorphic DNA (RAPD) fingerprinting. The antibiotic resistance test was performed for 12 antibiotics by the disc diffusion method and 18 resistance patterns were observed namely A1 to A18. The isolates were highly resistant to penicillin (93.3%), ampicillin (68.3%), clindamycin and cephalothin (66.7%) and vancomycin (63.3%), bacitracin (56.6%), erythromycin (51.7%) novobiocin 48.3%), kanamycin (5.0%) and streptomycin (1.6%). None of the isolates were resistant toward cefoperazone and tetracycline. Plasmids were detected in 65 % of the isolates with 16 different patterns having one to four plasmids and ranging in the size from 1.5 to 35.8 kb. The results of RAPD-PCR were analyzed using gel Compare II software. RAPD fingerprinting using primer OPC 15 revealed 6 clusters and 3 single isolates at a similarity level 80%.

Combination of antibiogram, plasmid profiling and RAPD printing indicated that 60 genome types showed a high degree of genetic diversity among V. vulnificus isolates isolated from different regions. Thus, this should attract attention of public health authority to monitor the cockles and clams in preventing food-borne infection by this bacterium.

 

KEYWORDS: Antibiotic resistance, plasmid profiling, random amplified polymorphic DNA (RAPD), vibrio vulnificus, cockles, clams.

 

Upregulation of Kappa Opioid Receptor System and Its Association with

Relapse to Morphine/Methamphetamine (Poly-Drug) Addiction

 

Nur Syafinaz Wasli1*, Irna Elina Ridzwan1, Marwan Saad Azzubaidi2, Abdul Razak Kasmuri1, Qamar Uddin Ahmed1, Long Chiau Ming3, Nornisah Mohamed4

1Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang,

2Fakulti Perubatan, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu,

3Fakulti Farmasi, Universiti Teknologi MARA, Puncak Alam, Selangor,

4Pusat Pengajian Sains Farmasi, UniversitI Sains Malaysia, Pulau Pinang.

*Corresponding Author E-mail: nursyafinaz1992@gmail.com

ABSTRACT:

The kappa opioid receptor (KOR) system has been linked to many types of drug addiction. An upregulation of the KOR leads to negative reinforcement effects which might contribute to drug relapse. Previously, our study has shown that a treatment combination of 0.3 mg/kg buprenorphine and 1.0 mg/kg naltrexone (a partial nociception opioid peptide [NOP] agonist and mu/kappa antagonists) has successfully attenuated relapse in morphine/methamphetamine (poly-drug)- dependent mice using a conditioned place preference (CPP) model. Therefore, this recent research work aimed to further investigate the involvement of the KOR system in poly-drug relapse at the brain level. The CPP test procedure was repeated where the mice were conditioned with poly-drug (7.5 mg/kg morphine and 1.0 mg/kg methamphetamine). Following CPP test, the investigation was extended at the brain level by using an immunohistochemistry (IHC) technique. Rabbit monoclonal (EPR 18881) was used as it will bind specifically at the KOR. The level of the KOR is determined at two different stages of addiction; the post-conditioning (dependence) phase and reinstatement (relapse) phase. Four brain regions that have high expression of the KOR and involved in addiction circuits have been selected to be investigated. A significant increment of the KOR expression was seen in striatum during reinstatement compared to post-conditioning (33.39 ± 5.60 % and 16.73 ± 5.27 % respectively, p andlt; 0.05, n = 12). While a significant reduction of the KOR expression during reinstatement compared to post-conditioning observed in the prefrontal cortex (35.07 ± 3.51 % and 44.09 ± 1.78 % respectively, p andlt; 0.01, n = 12), no significant changes were detected in hippocampus and amygdala. Surprisingly, the KOR was not affected in amygdala which regulates emotion. The KOR upregulation seen in the striatum suggests that this brain region might be triggered in order to oppose the stimulus-related reaction caused by this poly-drug.

 

KEYWORDS: Kappa opioid receptor, addiction

 

 

Development and Characterization of Lipid Nano-carrier to Deliver Bioactive on Lymphatic System

 

Vishal Jain*

University Institute of Pharmacy, Pt. Ravishankar Shukla University, Raipur, Chhattisgarh, India.

492010

*Corresponding Author E-mail: vishaljain123@gmail.com

 

ABSTRACT:

The aim of the present research work was to develop and characterize bioactive loaded solid lipid nanoparticles (SLN) by a modified hot homogenization process followed by ultrasonication technique to deliver bioactive on lymphatic system which could be used in the treatment of lymphatic disease. The optimization of SLN Box-Behnken experimental design was used. Optimization was done on the basis of responses such as mean particle size (PS), entrapment efficiency (EE) and zeta potential (ZP). Further optimized SLN was evaluated by transmission electron microscopy (TEM), differential scanning calorimetry (DSC), in-vitro release study and stability study. The optimized SLN having 87.77 ± 1.48% EE, 252.31 ± 10.21 nm PS, 0.431 ± 0.210 polydispersity index (PDI) and -37.27 ± (-1.75) mV zeta potential. Optimized SLN TEM image showed their spherical or ellipsoidal shape with rough surface and also indicates their nano size range. DSC result indicates that bioactive present in SLN either an amorphous dispersion or soluble in the lipid matrix. After 24 hrs release study 67.27 ± 2.81% of bioactive release from SLN indicates their sustained action. Three months accelerated stability study result confirms their stability because no significant change recognize during study.

 

KEYWORDS: Lipid, nano-carrier, lymphatic system

 

 

Optimization of Stingless Bee Propolis Extractions and Comparison of Chemical Composition and Biological Activity

 

 

Nur Basyirah Md Zin, Azierah Azemin, Muhammad Muslim Mohd Rodi,

Khamsah Suryati Mohd*

School of Agriculture and Biotechnology, Faculty of Bioresources and Food Industry, Universiti

Sultan Zainal Abidin, Besut Campus, 22200 Besut, Terengganu, Malaysia

*Corresponding Author E-mail: khamsahsuryati@unisza.edu.my

 

 

ABSTRACT:

Propolis has been used as therapeutic agent since ancient time and considered as high value materials. In order to obtain maximum yield of extract production with excellent biological activity, extraction techniques need to be optimized. This study aimed to optimize extraction protocol and screen total phenolic, total flavonoid and antioxidant activity. Propolis was collected from Apiary of UniSZA, Besut Campus and extracted with 70% and 95% of ethanol using different extraction methods which were: maceration, sonication and soxhlet. The total phenolic and flavonoid contents were determined using spectrophotometric method. Antioxidant activity was evaluated by DPPH assay. Effectiveness of extraction methods were compared based on extraction yield, total metabolite (total phenolic and flavonoid) and antioxidant activity. Propolis extraction by 4 hours soxhlet using 95% ethanol produced the highest yield at 49.29%. However, extraction by sonication at 10 minutes of 70% ethanolic extract showed the highest total phenolic content of 16.98 ± 0.10 mg gallic acid equivalents/g extract propolis (GAE/g). While 70% ethanolic extract from 30 minutes of sonication method displayed the highest total flavonoid content as compared to that of 95% ethanol with value of 107.27±4.10 mg quercetin equivalents/g extract (QE/g). The lowest total flavonoid content was 95% ethanolic extract by soxhlet extraction at 2 hours (18.65 ± 0.47 QE/g). The propolis extract of 95% ethanol from sonication (30 minutes) showed a good antioxidant activity with IC 50 value of 11± 0.55 mg Trolox equivalents/g extract. In the present study, propolis extracted by 30 minutes sonication period showed the most efficient to obtain extract with good phenolic content, flavonoid content and antioxidant activity than those two other methods. Finding from this study also showed that specification of extraction method is important to yield high quality extract.

 

KEYWORDS: Stingless bee, propolis

 

 

Estrogen Receptors in Merkel Cell Carcinoma: Its Possible Roles in Pathogenesis

 

Abdullah Azmahani1,2*, Yasuhiro Nakamura1, Hirotaka Ishida1,3, Keely M. McNamara1,

Taku Fujimura4, Takahiro Haga4, Akira Hashimoto4, Setsuya Aiba4, Hironobu Sasano1

1Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

2Faculty of Health Sciences, University Sultan Zainal Abidin, Kuala Terengganu, Terengganu

3Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of

Medicine, Sendai, Japan

4Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.

*Corresponding Author E-mail: azmahani@unisza.edu.my

 

ABSTRACT:

Sex steroids have been postulated to influence skin development and functions as well as its pathogenesis. Merkel cell carcinoma (MCC) occurs in both genders however, the specific differences in pathogenesis amongst genders have yet to be conclusively defined. The detailed status of sex steroid receptors (androgen receptor (AR), progesterone receptor (PR) A and PRB, and estrogen receptor (ER) a, ERß) are also unknown in Merkel cell carcinoma (MCC) patients. We first immunolocalized sex steroid receptors and compared the results with immunolocalization of relevant transcription factors including SOX2, forkhead box protein A1 (FOXA1) and Bcl-2 and Ki-67 in 14 cases of MCCs. AR, PRA, PRB, ERa, ERß, Bcl-2, SOX2 and FOXA1 immunoreactivity was evaluated by employing the modified H-score method and Ki-67 were quantified using labeling index (LI%). ERß immunoreactivity was markedly present in all the cases of MCC examined with relatively weak immunoreactivity of ERa, AR and PRA. The status of ERß immunoreactivity was also significantly correlated with Ki67 LI and Bcl-2 score. These results demonstrated that ERß could be associated with regulation of both cell proliferation and apoptosis in MCCs.

 

KEYWORDS: Estrogen receptor, merkel cell carcinoma.

 

 

 

Probiotic as Bacteriotherapy Candidate Against Gram-negative

Periodontopathogen

 

Norzawani Jaffar1*, Toshinari Maeda2, Kouhei Mizuno3

1Faculty of Health Sciences, Gong Badak Campus, Universiti Sultan Zainal Abidin (UniSZA), Kuala

Terengganu, Terengganu Darul Iman, Malaysia.

2Department of Biological Functions Engineering, Graduate School of Life Science and Systems

Engineering, Kyushu Institute of Technology, Wakamatsu-ku, Kitakyushu, Japan.

3Department of Materials Science and Chemical Engineering, Kitakyushu National College of

Technology, Kitakyushu, Japan

*Corresponding Author E-mail: zawanijaffar@unisza.edu.my

 

ABSTRACT:

Lactobacillus spp. appearance in the oral cavity was suggested as a relevant target in order to coordinate a microbial balance and to counteract pathogenic bacteria, meanwhile prevent the onset of periodontal disease. This study aims to evaluate potential of probiotic bacteria as bacteriotherapy against the Gram negative periodontal pathogens, Aggregatibacter actinomycetemcomitan and Porphyromonas gingivalis. Eleven species of probiotic bacteria were screened for inhibition activity against A. actinomycetemcomitans and P. gingivalis using an overlay agar method. Probiotic bacteria with inhibition activity were subjected to indirect co-culture assay. Then, the bactericidal activity against A. actinomycetemcomitans was evaluated for morphological changes using Scanning Electron Microscope (SEM). In addition to this, biofilm deformation of A. actinomycetemcomitans was also evaluated by co-culturing the probiotic bacteria with A. actinomycetemcomitans and the biofilm formation was compared with A. actinomycetemcomitans without probiotic bacteria (monoculture). Our finding showed out of eleven probiotic strains subjected for indirect co-culture, three strains showed bactericidal effect against A. actinomycetemcomitans. They were Lactobacillus plantarum NBRC 15891, Lactobacillus johnsonii NBRC 13952 and Leuconostoc fructosum NBRC 3516 with growth reduction value 4.18, 4.77 and 3.6 log CFU/ml respectively. Whereas the bactericidal effect against P. gingivalis was showed by two strains; L. plantarum NBRC 15891 and L. johnsonii NBRC 13952. The growth reduction values were 9.5 and 9.1 log CFU/ml respectively. Morphological observation of A.actinomycetemcomitans and P. gingivalis cells treated with indirect co-culture L. plantarum NBRC 15891 and L. johnsonii NBRC 13952 showed collapsed and smaller in size compared to control. The biofilm deformation of A. actinomycetemcomitans showed up to 3-fold reduction in the co-culture with probiotic strains compared to mono-culture. In conclusion, this probiotic strains owns great potential as a candidate for bacteriotherapy in controlling A.actinomycetemcomitans growth in-vitro.

 

KEYWORDS:  Probiotic, periodontopathogen, bacteriotherapy.

POSTER ABSCTRACT ICHC 2017

 

Trend of Parents’ Acceptance for Human Papilloma Virus Vaccination in Malaysia

 

Aizuniza A*, Noorhaire N, Faridah AB, Don Ismail M, Shahriel MS, Abd Shukor S, Kaharnisah MN, Marhaida M, Saidatul Norbaya B

School Health Sector, Family Health Development Division, Ministry of Health Malaysia

*Corresponding Author E-mail: draizuniza@moh.gov.my

 

ABSTRACT:

Malaysia has initiated school based human papilloma virusHPV vaccination for 13 years old school girls in 2010. The success of the program is monitored by completion HPV immunisation coverage among target population. Other factor can contribute the success of HPV vaccination program depends also on the parents’ willingness to have their girls vaccinated. This paper aims to describe the trend of parental acceptance in contributing to success of school based vaccination. Data from national HPV vaccination database from 2010 to 2016 were analysed to determine the trend of parental consent over time. Parent acceptance is defined as parents allowing their daughters to be immunised. It is measured by number of parents providing written consent for their daughters to be vaccinated. From 2010 until 2016, 1,634962 13 years old school girls were enrolled into this programme. In general, the acceptance percentage was above 95%. However, few states showed slight reduction in parental acceptance. Although overall HPV vaccination acceptance is satisfactory, there is a need to continuously monitor the HPV vaccine acceptance among parents.

 

KEYWORDS:  Acceptance, Human Papilloma Virus  vaccine, Malaysia

 

Nurses’ Perception, Satisfaction And Attitude Towards Computerised System In A Tertiary Hospital

 

Norfazilah Ahmad, Mohd Rohaizat Hassan*, Nur Syazana Binti Mohammad Nizar

Department of Community Health, Faculty of Medicine, UKM Medical Centre, Kuala Lumpur

*Corresponding Author E-mail: rohaizat@ppukm.ukm.edu.my

 

ABSTRACT:

Application of computerised hospital system will improve cost efficiency, quality of care, delivery and patient safety. Therefore, users’ perception, satisfaction and attitude especially among nurses need to be accepting and positive to ensure the optimum utilisation of the computerised system. Aim of this study is to determine the nurses’ perception, level of satisfaction and attitude level towards the use of computerised system and its influencing factors among the nurses in a tertiary hospital. A cross sectional study was conducted among 210 nurses whom were conveniently sampled from various wards in UKM Medical Centre (UKMMC) from April to June 2015. A self-administered and validated questionnaire from previous studies was used to determine their perception (perceived usefulness (PU) and perceived ease of use (EOU), satisfaction and attitude towards the system. The demographic factors including age, gender, race, level of education, work experience and attendance to computer class were analysed for associations.Mean score of perceived usefulness was 13.71 (±3.61) (max=40), perceived ease of use 5.69(±1.76) (max=15), satisfaction 13.96 (±3.89) (max=40) and attitude 9.51 (±2.81) (max=25). The lower scores reflect positivity of the domains. There were significant associations between attending computer class and perceived usefulness   (p=0.043). There were also associations between level of education (p=0.040) and attending computer class (p=0.007) with satisfaction. No significant association observed for perceived ease of use and attitude.In conclusion, level of perception, satisfaction and attitude towards computerised system among nurses are good. Further exposure to computer training may help in promoting the system utilisation.

 

KEYWORDS: Perception, satisfaction, attitude, computerised system, nurses tertiary hospital.

Emergency Department(ED) Overload: Are We Waiting for it to Explode?

 

Amir Rassip*, Eliza Mohamed, Minson Majimbun, Nursyahda Zakaria, Hafidza Baharum, Nor Izzah Ahmad Shauki.

Institute for Health Management, Ministry of Health, Kuala Lumpur.

*Corresponding Author E-mail: nur.amir@moh.gov.my

 

ABSTRACT:

The emergency department (ED) has long been recognized as one of the hospitals’ primary gateways. The yearly increasing trend of patient load contribute to the overcrowded ED and has been a main concern within the Ministry of Health as well as among the ED healthcare providers throughout the country. This scenario may result in hospitals being unable to cope with patient loads and end up finally boarding their inpatients in ED. Access block is defined as the situation where patients are unable to gain access to appropriate wards within a reasonable amount of time, no greater than 8 hours. Primary data from ED of selected hospitals in Peninsular and East Malaysia were collected with exclusion of direct admission maternal and paediatrics cases from other health facilities. Based on the sampled hospitals, 47.6%-62.6% of the total admission through ED suffer accessed block. Non-state hospitals had higher prevalence of access block (46.4%) where their patients faced excessive delay in access to appropriate inpatient beds, as compared to 38.1% patients in state hospitals. Congested wards is the main contributing factors (90%) and followed by unavailable beds due to discharged patients’ delayed departure (8%). General Medicine department recorded the highest incidence of access block (82.8%) followed by General Surgery (10.3%) and Orthopaedic department (6.6%). Non-state hospitals recorded higher magnitudes of access block due to relatively smaller hospital, hence smaller wards, fewer staff and constantly overburdened. The common factor leading to access block is ward congestions due to hospitals suffering from high bed occupancy rate (BOR) resulted from high patient volume. This vicious cycle will inevitably result in the inability of ED to cope with the patient loads. Thus, the problem might escalate and access block will be a common situation in many ED in major Malaysia public hospitals.

 

KEYWORDS: Access Block, Emergency Department, Adult Inpatients.

 

 

Factors Affecting the Effectiveness of Breast Self-Examination among Women in Health Centre, Sabah

 

Patricia Sator*, Thilagah A/P Vellautham

Faculty of Medicine and Health Sciences, Department of Nursing, Universiti Malaysia Sabah

*Corresponding author E-mail: patricia.sator@ums.edu.my

 

ABSTRACT:

Breast cancer is the number one killer for women worldwide. In aiming the best health care for women, health facility provides services of women and health wellness including the education on how to detect early sign of breast cancer by performing regular breast self-examination (BSE). However, the statistic in this health center showed occurrence of breast lump and breast cancer. Descriptive quantitative survey by using structured questionnaire which was developed based on observation, secondary data and supported by previous studies. The questions have been modified using “Likert Scale”. A pilot study was conducted to 5 respondents, excluded the study sample to test the validity and reliability. The objective of this study is to identify the factors that affecting the effectiveness of breast self-examination. The sample was selected using purposive sampling, comprised of 50 reproductive age women, 20 to 50 years old. This study was conducted under part time basis and took one year to complete. The ethical consideration done by getting permission from the District Health Officer and informed consent from the respondents. The result was analysed through SPSS version 17. The factors affecting the effectiveness of BSE are: i) insufficient knowledge about BSE, 48% agree; ii) forgotten to perform BSE which supposed to be done monthly, 26% not sure and 34% agree; iii) no time or too busy to perform BSE, 14% not sure and 42% agree; iv) embarrassed to do BSE with trained staff for first time, 26% not sure and 74% agree; v) fear to undesirable result, 76% agree. Based on the result, effective health approaches need to take to ensure the information and awareness of BSE accessible to the clients. For a home take message, “the power to detect breast cancer is in your hands”.

 

KEYWORDS: Breast self-examination, effectiveness, awareness, Sabah

 

 

The Psychological Problems of Client with History of Juvenile Delinquency: A Case Study in Juvenile School, Kota Kinabalu, Sabah

 

 

Norkiah Arsat*

Faculty of Medicine and Health Sciences , Universiti Malaysia Sabah

*Corresponding author E-mail: norkiah.arsat@ums.edu.my

 

ABSTRACT:
The effects and consequences of past juvenile delinquency behaviour affect the present lives of client. The purpose was to identify factors contributes to the client’s psychological problems and to carry out interventions on the issues related to the problems. The main problems are angry and resentful feeling towards his father, difficult to control anger, anxieties about health problems that may be develop in the present as a result of drug overdose in suicidal attempts and delinquency behaviour in the past, experiencing finger’s tremor and muscle spasm and tattoo removal problem, stress stems from past experiences and dormitory environments that disturb his present life, and have suicidal thoughts. The method is a single case study design and evaluative category of case study. Inventory of Youth Psychological Profile, Inventory of Suicide Orientation 30 and Index of Clinical Stress (Neill Abell, 1991) used to verify the client's problems. To improve client’s relationship with his father, to control anger, to reduce anxiety and stress level, and eliminate suicidal thoughts. Adler's theory, eclectic technique, medical and surgical intervention used in treatment plan in 12 counselling sessions for 3 months.  Suicidal thought problem is expected to be solved when other problems could be solved. After therapy, client’s relationship with his father improved, ability in controlling anger slightly, anxiety with health problems was reduced. The stress level decreased from 2.4 to 2.2 score. Inventory of Suicide Orientation-30 decreased to 25 score and no critical item identified from 6.3 score with 5 critical items before therapy. Adlerian theory to handle clients overall, eclectic techniques and other intervention has been used in the therapy. The process of counselling is education oriented and aims to guide clients in order to live a normal life. An overall client problem has been reduced. 

 

KEYWORDS: Juvenile delinquency, psychological problems, counselling, suicide

 

 

Health Profile of Osteoarthritis Malay Patients in Rehabilitation Health Organization, Kuala Nerus, Terengganu

 

Nur Aimi Asyrani Zamri*, Sakinah Harith, Noor Aini Mohd Yusoff

School of Nutrition and Dietetics, Faculty of Health Sciences Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300 Kuala Nerus, Terengganu, Malaysia.

* Corresponding Author E-mail: nuraimiasyranizamri@gmail.com

 

ABSTRACT:
Osteoarthritis (OA) is the most prevalence of the chronic rheumatic disease which estimated to be the fourth cause of pain and disability in most countries worldwide. According to World Health Organization (WHO) worldwide estimates there are 9.6% of men and 18.0% of women aged over 60 years have symptomatic osteoarthritis. Approximately 80% of people with osteoarthritis will have limitations in movement and 25% cannot perform their major daily activities of life. Literature search showed that studies on health profile is lacking in Malaysia on OA patients. A retrospective study of osteoarthritis Malay patients was carried out in October 2013 to May 2017. Data collection of gender, age, occupation, type of osteoarthritis and underlying disease were taken from patient's medical folder. The data were analyzed by using  IBM SPSS version 21.One hundred and  nineteen subjects participated in this study. OA patients more frequently observed in female (74.8%) with median age 64 ± 9.89 years, aged 21 to 83 years. Most subjects were in the 60 to 69 years age category with 37.8%, followed by 50 to 59 years with 31.1%. The subjects (48.7%) were housewife. Common type of OA were bilateral knee OA (62.2%), right knee OA (14.3%) and left knee OA (14.3%). The underlying diseases were no known medical illness (37.0%), hypertension (25.2%), hypertension and diabetes mellitus (16.0%) and others.The findings in this study showed that further  study is needed to assess and link OA with associated factors such as anthropometry, diet, exercise, education and cognitive.

 

KEYWORDS: Osteoarthritis, health profile, Malay, Terengganu

 

Urban - Rural Disparities in Postnatal Home Visit Performance: Findings from the National Health and Morbidity Survey (NHMS) 2016

 

Nur Azna Mahmud*, Noor Ani Ahmad, S Maria Awaluddin, Maisarah Omar,

Noraida Mohamad Kasim, Muslimah Yusof, Norzawati Yeop, Faizah Paiwai, Norazizah Ibrahim Wong

Institutes for Public Health, Jalan Bangsar 50590, Kuala Lumpur

*Corresponding author E-mail: norkiah.arsat@ums.edu.my

 

ABSTRACT:

World Health Organization (WHO) recommends postnatal home visit within 24 hours of birth for the mother and new-born. Based on Model of Good Care for Postnatal by Ministry of Health, Malaysia, nine postnatal visits are required in a normal pregnancy and delivery after 24 hours of birth to day 20 of puerperium. The objective of this study is to examine the urban-rural disparities in postnatal home visit performance in Malaysia. National Health and Morbidity Survey (NHMS) is a cross-sectional survey with a two-stage stratified sampling design to collect health information on a nationally representative sample of mothers and their children in Malaysia. Data was obtained via face-to-face interviews based on validated questionnaires using tablets as data collection tools. Descriptive analysis were performed to analyse disparities between urban and rural in postnatal home visit performance in Malaysia using SPSS 20. The prevalence of mothers who notified their birth (n=1074) was 92.0% (95% CI: 86.90, 95.63), of which 60.1% (95% CI: 50.64, 68.94) and 31.9% (95% CI: 22.65, 42.78) were mothers from urban and rural areas respectively. Among notified births, 92.3% (95% CI: 89.11, 94.64) received at least one postnatal home visit per week. In comparison to rural areas, women from urban areas showed significantly higher prevalence of receiving postnatal home visits in the first, second and third/fourth weeks; 63.4% vs 33.5%, 61.2% vs 32.0% and 56.8% vs 31.6% respectively. As indicated in other study, geography and terrain were the main barriers to postnatal home visits besides refusal of mothers to receive postnatal visits by healthcare workers in rural areas. Therefore, cooperation between government, health workers and community is vital in improving the logistic, accessibility and awareness of mothers in rural areas on the importance of postnatal home visits.

 

KEYWORDS: Postnatal home visits, rural-urban, barriers

 

 

Medical Student’s Evaluation of a Web-based Tobacco Cessation Counselling Program (WTCC e-Learning Package)

 

K. K. Nyo1*, Z. Ahmad2, R. Jaafar3, N. N. Naing3

1Department of Community Medicine, Faculty of Medicine, MAHSA University, Malaysia

School of Dental Sciences, Universiti Sains Malaysia, Malaysia

2Department of Medical Education, School of Medical Sciences, UniversitI Sains Malaysia, Malaysia

3Department of Biostatistics and Research Methodology, School of Medical Sciences, Universiti Sains Malaysia, Malaysia

*Corresponding author E-mail : kkhine@mahsa.edu.my

ABSTRACT:

Web-based Tobacco Cessation Counselling (WTCC) e- Learning Package was developed, implemented and evaluated among third year medical students of a private medical university in Northern Malaysia. This e-Learning Package comprised of nine interactive web-based modules, two hands on practical sessions and one directed self-learning (DSL) module. At the end of e-Learning program, students required to complete and submit two final assignments. A cross-sectional study was carried out among 75 third year medical students of a private medical university in Northern Malaysia. All students have successfully completed the e-learning package. A validated self-administered questionnaire, which contains self-rated values of Moodle LMS activities, acceptability and 28 items of overall evaluation on WTCC e-Learning package, was distributed among the students.  This study was conducted 6 months after the WTCC e-Learning intervention. The objective of the study was to collect and analyse medical student’s feedback on WTCC e-Learning package.In this study, 22 respondents (29%) were males and 54 respondents (71%) were females.Majority were Malay 66 (87%), followed by Chinese 6(8%) and Indian 4(6%). Most of the students mentioned Moodle activities of e-learning package such as quizzes, discussion forum, WTCC chat, final assignments, student feeback, journals and other online resources were valuable. About over 30% agreed that quizzes (42%), journals, resources and feedback were very valuable.  About 50% of respondents expressed WTCC Moodle activities were acceptable in terms of personally relevant, valuable, usefulness and interesting..  About 40% of respondents rated the WTCC e-Learning Programme was good, and about 30% rated very good. Regarding students feedback scores on overall e-learning package, a large majority (92.1%) rated good, the mean score is 91.37± 14.54 (maximum is 126). About 44(57.9%) of students wanted continuous training in tobacco cessation. It was indicated that the teaching learning methods of hospital bed-side training with real smokers of tobacco related diseases, tobacco history taking session and OSCE for tobacco cessation counselling should be included in subsequent clinical years.WTCC e-Learning package was well accepted and appreciated by the third year medical students of a private medical university of Northern Malaysia. Hence, it is highly recommended for the integration of tobacco cessation education and formal training of tobacco cessation counselling in undergraduate medical school curricula of public and private medical universities of Malaysia.

 

KEYWORDS:  Medical students, evaluation, web-based, tobacco cessation counselling, WTCC

 

 

Comparing Coping Strategies Practiced and its association with stress among medical students from a Private and Public Medical University

 

Retneswari Masilamani1*, Myat Moe Thwe Aung2, Vidya Bhagat2, Aini Abu Bakar1,

Chun Shi Hao1, Lim Chee Yao1, Ng Jia Hui1

1UCSI University, Terengganu Campus. Malaysia

2University Sultan Zainal Abidin, Malaysia

*Corresponding author E-mail:retnes@gmail.com

 

ABSTRACT:

Medical education has been reported to be stressful resulting in physical and mental health problems affecting academic achievement. It has been reported that coping plays a significant role in adaptation to stressful life events. No studies have been published comparing the type of coping strategies practice between a private and public Medical University in Malaysia. The objective of this study is to compare the coping strategies practiced and its association with stress between medical students from a private and public university. This was a cross-sectional study using universal sampling on 315 UCSI University medical students (UCSIMS) (66.5% Chinese students) and 245 University Sultan Zainal Abidin medical students (UniSZAMS) (52.1% Malaya students), year 1-5, from 2015 till 2016, who reported both higher stress prevalence (57% versus 33%) and higher mean stress scores (4.66 (SD 3.4) versus 2.91 (SD 2.98) respectively in the first part of the study. Data was collected using a self-administered Brief COPE inventory added to the General Health Questionnaire and sociodemography.Data entry and analysis were done using SPSS version 20.0 software.The top five coping strategies practiced by UCSIMS were ranked as active coping (60%), acceptance (58.6%), religion (55.2%), planning (53.7%) and positive reframing (53.3%) while UniSZAMS ranked them as religion (70.2%), acceptance (65.7%), positive reframing (59.6%), planning (56.7%) and denial (55.1%). The lowest ranked coping strategies by both universities students were similar namely; substance use and behavioural disengagement. Both university medical students reported similar coping strategies significantly associated with stress, namely denial (p<0.05), behavioural disengagement (p<0.05), venting (p<0.05) and self-blame (p<0.05). Though private university medical students reported higher stress levels than the public university medical students, both reported practicing similar top 4 coping strategies in dealing with stress. Creating student or peer-support groups to enhance adoption of appropriate coping skills should be encouraged in medical institutions, including establishment of Medical Student Well-being Workshops.

 

KEYWORDS: Medical students, stress, coping strategies, private university, public university.

 

Health Risk Associated With Nitrate Exposure In Groundwater From Mukim Tualang Salak In Bachok, Kelantan

 

Muhamad Nur Fakhri MR, Shaharuddin MS*

Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences

Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia

*Corresponding author E-mail: shaha@upnm.edu.my

 

ABSTRACT:

Agriculture activities in Malaysia have increased from time to time in the form of production to cater for the ever increasing population of the country. Modern agriculture has been practiced by farmers to increase their productivity. Nitrogen fertilizer is mostly used by farmers in rural areas, where it is known to have essential components for making protein in plants. High nitrate levels in potable water can cause methemoglobinemia or blue baby syndrome, a condition found especially in infants under six months and in the long-term, could be potentially carcinogenic to humans. According to the National Standard for Drinking Water Quality (NDWQS) Malaysia, nitrate levels in water used for human consumption must not exceed 10 mg/L NO3N. To determine nitrate levels in groundwater and to perform health risk assessment from nitrate exposure among residents in Mukim Tualang Salak, a subdistrict in Bachok, Kelantan. This study was conducted among residents from two villages, namely Tualang Salak village and Kuchelong village in Mukim Tualang Salak. Fifty (50) respondents were chosen based on the inclusive and exclusive criteria and they were initially interviewed in order to obtain demographic data and groundwater usage information. Groundwater samples were taken from each of the respondent’s house who used groundwater exclusively for drinking and cooking. The samples were then analyzed using a HACH brand DR 1900 direct reading spectrophotometer. Risk assessment of the exposure to nitrate was also calculated. Nitrate levels ranged from 0.4 to 6.5 mg/L, with a mean of 1.834 + SD 1.335 mg/L. All readings obtained did not exceed the national standard and there was no significant risk of nitrate contamination in ground water (where HI<1). Residents from the two villages studied were exposed to low levels of nitrate in groundwater and in the case for nitrate, it was safe to be used for drinking and cooking.

 

KEYWORDS: Agriculture, nitrite exposure, health risk assessment

 

 

Perceptions of Religion in Tobacco Control Among Malay Medical Students

 

K. K. Nyo1*, Z. Ahmad2, R. Jaafar3, N. N. Naing3

1Department of Community Medicine, Faculty of Medicine, MAHSA University, Malaysia

2Faculty of Medicine and Health Sciences, UCSI University, Terengganu

3Department of Medical Education, School of Medical Sciences, Universiti Sains Malaysia

4Biostatistics Unit, School of Medical Sciences, Universiti Sains Malaysia.

*Corresponding author E-mail: zulkifli1954@gmail.com

 

 

 

ABSTRACT:

People should avoid unhealthy behaviours such as smoking. Muslims are forbidden from smoking because it’s harmful to health. This provision can be used in tobacco control programs for Muslims. A cross-sectional study was conducted among medical students on their knowledge and perception of religion in tobacco control. A web-based Tobacco Cessation Program (WTCC) was developed, including a module on “religion in tobacco control” and implemented to medical students. The effectiveness of the module in improving knowledge and perceptions of tobacco control among Malay medical students was studied using a validated self-administered questionnaire. The results were analysed by Generalised Estimating Equation modelling (GEE). Of the 176 Malay students, 96 (54.5%) were males and 80 (45.5%) were females.There was significant improvement in knowledge scores of the role of religion in tobacco cessation of the intervention group between before and after the intervention (p <0.001). There was also significant improvement in positive religious beliefs and perceptions scores in the role of religion between the intervention group and control group (p <0.001). The module on “religion in tobacco control” increased knowledge and improved religious beliefs and perceptions towards tobacco control among the medical students. Also, the module played a significant role in inspiring Malay medical students towards tobacco control in Malaysia.

 

KEYWORDS: Smoking, Muslims,web-based tobacco control program

 

 

Serum Biochemistry, Liver and Lung Histology of Sprague Dawdley Rats Exposure to Formaldehyde.

 

Santhra Segaran a/l Balan*, Sairah Abdul Karim

Family of Health and Life Science, Management and Science University, Shah Alam, Selangor

*Corresponding author E-mail: santhra@msu.edu.my

 

ABSTRACT:

The objective of this study was to determine the effect of formaldehyde on serum biochemistry and histopathological changes of liver and lung. In this research 34 Sprague-Dawley rates, age 7-8 weeks were divided into three groups. In one group ten rats served as controls and another two group rats were exposed to the formaldehyde (FA).  Blood samples were collected and liver enzymes such as ALT, AST, LDH, ALP and total protein were analysed using commercial kit from Human Gesellschaft.  The result revealed serum ALP and LDH activities of FA exposed groups showed different in concentration level, but did not show significant differences compared to control group. Total protein concentration in rats from exposed groups also showed decrease patterns against the time but no significant differences among the FA exposed groups. However, serum ALT and AST show significant increase (p<0.05) in FA exposed groups compare to control group. This was confirmed by liver tissues histopatological evidence. Histopathlogical grading of liver sections of FA exposed rats showed a significant higher score for necrosis, which more than 50% of hepatocytes are necrotic and this gives scores 2 of the necrosis grading. For histopathology of lung section of formaldehyde exposed rats showed increased in cellularite of alveolar walls. Besides, congestion and haemorrhages were observed in lung tissue. The formaldehyde exposure can damage the liver and also the lung and it depend on the duration of exposure to FA. These findings may have implications for minimized and prevented and can ensure that workers are in the best possible health to ensure job satisfaction.

 

KEYWORDS: Formaldehyde, alanine aminotransferase (ALT), alanine aminotransferase (AST), Lactate    dehydrogenase (LDH), alkaline phosphatase (ALP)

 

Association Between Nutritional Status and Its Associated Factors for Breastfeeding Pattern Among Lactating Mothers in Klang Valley

 

Hemanandini Salamuthu, Neni Widiasmoro Selamat*

Faculty of Health and LifeSciences, ManagementandScience University

*Correspondingauthor Email: neni_widiasmoro@msu.edu.my

ABSTRACT:

Adequate nutrition for the mothers during lactation and proper breastfeeding practices are crucial for good health and reducing childhood morbidity and mortality. While many mothers understand the importance of breastfeeding, more are still lacking in knowledge on the benefits of breastfeeding and weaning. Therefore, this study intended to determine the relationship between nutritional status and its associated factor on breast feeding pattern among lactating mothers in Klang Valley. A cross-sectional study was conducted among lactating mothers utilizing questionnaires consisting of socio-demography (9 items), nutritional status (2 items), and breast-feeding pattern (3 items). SPSS version 23 and Nutritional Pro software were employed for data analysis. One-way ANOVA was used to determine the mean difference in nutritional status among lactating mothers and chi square test was used to determine the association between race and breastfeeding pattern with p<0.05 set as value of significance. Findings showed that mean energy intake for an exclusive breastfeeding mother (4916.38 ± 154.09 Kcal) was higher than standard RNI by Malaysia. A total of 54.2% exclusive breastfeeding mothers were categorized under normal delivery. In conclusion, there was an association between nutritional status and breastfeeding pattern of lactating mothers. Intake of some essential nutrients was higher than recommendation by standard RNI. Therefore, nutrition education and dietary diversity practices should be given during antenatal and lactation period to educate them to improve better health and nutrition outcome.

 

KEYWORDS: Lactating mothers, breastfeeding pattern, maternal nutrient intake, nutritional status, associated factors.

 

The Crucial Roles of Nociceptin Opioid Peptide (NOP) Receptor in Attenuating Relapse to Morphine/Methamphetamine (Poly-drug) Addiction in Mice

 

Irna Elina Ridzwan*, Nor Akhi Hijriyati Abdul Rahman, Nur Syafinaz Wasli

Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang

*Corresponding author E-mail: elina@iium.edu.my

 

ABSTRACT:

A combination of buprenorphine/naltrexone treatment had been proven to successfully attenuate relapse (reinstatement) to morphine/methamphetamine (poly-drug) addiction in mice using a conditioned place preference (CPP) model. This treatment combination exhibits a mixed opioid receptor pharmacological activities (mu/kappa antagonist and partial NOP agonist). Thus, this recent study aimed to investigate the independent role of the NOP receptor in attenuating relapse to this poly-drug addiction. The male Swiss albino mice were made dependent on 7.5 mg/kg morphine/1.0 mg/kg methamphetamine (poly-drug). The mice were injected with 6.0 mg/kg  SB 612111 (a selective NOP antagonist) during reinstatement phase, 30 minutes before the administration of 0.3 mg/kg buprenorphine/1.0 mg/kg naltrexone combination. The priming doses of poly-drug (2.5 mg/kg morphine/1.0 mg/kg methamphetamine) were given 10 minutes later. The percentage of time spent at the drug-paired compartment was compared with the control group (did not receive SB 612111 treatment).The results revealed that relapse to poly-drug addiction happened in the group of mice that received SB 612111 prior to buprenorphine/naltrexone (53.81 ± 11.23 %, n = 6). This result was significantly different compared to its own baseline (before the mice were made dependent on poly-drug  [-5.37 ± 6.42 %, n = 9, p< 0.05]). In contrast, relapse was significantly attenuated (reduced) in the group of mice that did not receive SB 612111 prior to buprenorphine/naltrexone (19.14 ± 16.89 %, n = 5). The percentage of time spent at the drug-paired compartment was found to be not significantly different compared to its own baseline(-16.14 ± 4.81 %, n = 13). The result suggests that an agonist activity at the NOP receptor is crucial in attenuating relapse to morphine/methamphetamine (poly-drug) addiction. Hence, further investigation needs to be done to evaluate the involvement of this receptor at the brain level.

 

KEYWORDS: Conditioned place preference, methamphetamine, morphine, nociceptin, relapse

 

 

Community Based Intervention Program to Promote Vegetable Intake Among Adults with Overweight Problem: Findings from Project F.E.A.T

 

Wirdah Mohamed, Arif Azlan, Ruzita Abd Talib*

Nutritional Science Programme, School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A. Aziz, 50300Kuala Lumpur.

*Corresponding author E-mail: rzt@ukm.edu.my

 

ABSTRACT:

This study assessed the effect of group vegetables gardening program in promoting vegetables intake among adults with obesity problem in semi-urban area. The study was one of the activities in Arus Perdana Research Grant for obesity intervention program, The Fit, Eat, Active and Training (F.E.A.T) program. 31 overweight and obese subjects aged between 25 to 59 years old involved in the intervention group. After a baseline data collection, the subjects received a series of activities of The F.E.A.T program for 12 weeks. In one of the activities, the subjects received a nutrition counselling session with nutritionist on daily vegetables intake based on individual requirement. One session with the agriculture officers was also conducted with the subjects to encourage and educate them on vegetable gardening. The subjects were divided into a few groups and planted their own vegetables at the local community hall compound during the intervention period. At 13-week follow-up, the subjects had increased their vegetables consumption from 0.8 daily serving at baseline data to 1.7 daily serving (p<0.05). Significant reductions in body weight (-3.6%, p = 0.0001) and BMI (-3.8%, p = 0.0001), percent of body fat (-4.3%, p = 0.0001) and waist circumference (-9.9%, p = 0.0001) were also observed at 13-week follow-up as compared to baseline data. Thus, thegroup vegetables gardening activity in The F.E.A.T program was a successful model for promoting vegetables intake in the semi-urban community.

 

KEYWORDS: Vegetables consumption, gardening, obesity intervention

 

 

Hearing Loss Among Manufacturing Factory Workers in Sarawak

 

Azizul Idris, Halim Ismail*

Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur

*Corresponding author Email: halimismail@ppukm.ukm.edu.my

 

ABSTRACT:

Manufacturing factory workers in Malaysia are exposed to multiple type of hazards at their workplace. One of the hazards is noise which is a type of physical hazard that could lead to hearing loss. This condition is called Noise Induced Hearing Loss (NIHL) and the incidence of it is on the rise among working factory workers. The objectives of this research were to measure the prevalence of NIHL and identify the factors contributing to it. A cross sectional study were conducted among manufacturing factory workers located in Sarawak where were required to filled up validated questionnaires under a guide of trained interviewer and their baseline and most recent audiometric results were provided by the manufacturing factory. A total of 173 manufacturing factory workers participated in this research. The prevalence of NIHL were 49.7%. The factors which were found to have significant association with NIHL age (p < 0.05, 95% CI), male workers (OR = 7.60; CI = 3.34 –18.38), duration of employment (p <0.05), poor knowledge of noise level (OR = 4.11; CI = 1.10 – 15.28), working at Polishing Department (OR = 4.23; CI = 2.13 – 8.43) and smoking (OR = 39.6; CI = 16.5 – 94.8). The high number of NIHL among manufacturing factory workers had showed that this problem is still persist despite application of Hearing Conservation Program (HCP) at workplace. Continuous hearing protection promotion and education must be done at the workplace on a regular basis to ensure compliance with HCP.

 

KEYWORDS: Noise, hearing loss, manufacturing industry, factory workers, smoking

 

 

Exposure ot Second-Hand Smoke Among Secondary School-Going Adolescents: Findingsfrom The Malaysian Youth Health Risk Behaviour (Myhrb) Study

 

Sayan P1*, Faizah P1, Hazrin H1, Noor Aliza L1, Teh CH2, Lim HL3, Chong KH3, Kee CC2,

Tee EO4, Sumarni MG2, Lim KH2

1Institite for Public Health, Jalan Bangsar, 50590, Kuala Lumpur,

2Institute for Medical Research, Jalan Pahang, 50588, Kuala Lumpur,

3Melaka Manipal Medical Colledge, Jalan Padang Jambu, Bukit Baru, 75150 Melaka,

4Allied Health College Sungai Buloh, 47000, Jalan Hospital, Sungai Buloh, Selangor.

*Corresponding author E-mail: sayan@moh.gov.my

 

ABSTRACT:

Exposure to second-hand smoke (SHS) is one of the main causes of morbidity and it had been proven to be associated with an increased likelihood of smoking initiation among adolescents. Nonetheless, evidence on SHS exposure among Malaysian adolescents is scarce and this warranted a detailed investigation in order to address the existing knowledge gaps. Therefore, this write-up aims to demonstrate the magnitude and factor/s associated with SHS exposure among school-going adolescents in selected secondary schools in Peninsular Malaysia.  Data was derived from the Malaysian Youth Health Risk Behaviour (MyHRB) study conducted in 2013. A total of 2599 adolescents were recruited into the study using a two-stage proportionate-to-size sampling method. Data were obtained from self-administered questionnaires. Descriptive analysis and multivariable logistic regression were performed to determine risk factors/predictors associated with SHS.More than half of the respondents were exposed to SHS during last one week (56.4%) and SHS exposure was significantly higher among respondents who smoked (94.0% vs 49.9%, p<0.001). Multivariable analysis revealed that the likelihood of exposure to SHS was higher among those who smoked (aOR 12.90, 95% CI: 8.01-20.4), have at least one parent/guardian who smoked (aOR 5.49, 95% CI: 4.41-6.94) and adolescents of Malay descent (aOR 2.10, 95% CI: 1.68-2.63).Our findings suggested that effectiveness of anti-smoking measures implemented in the recent years to protect adolescents from the health risks of passive smoking were less obvious. Therefore, educational and awareness programmes which emphasize on the negative health impact of SHS exposure on Malaysian adolescents, particularly among the smoking adults should be intensified and prevent them from initiating smoking.

 

KEYWORDS: Second-hand smoke, adolescents, health risks

 

 

Multimedia Education Effects on Knowledge and Attitude of Primigravida Mothers in Breastfeeding

 

Nazirah J1*, Zaharah S2, Noraini M3, Tengku Alina TI4, and Soon LK5

1Lactation Secretariat, Hospital Universiti Sains Malaysia,

2Women’s Health Development Unit, School of Medical Sciences, Universiti Sains Malaysia,

3School of Dental Sciences, Universiti Sains Malaysia,

4Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia,

5School of Health Sciences, Universiti Sains Malaysia

*Corresponding author E-mail: nazirahj@usm.my

 

ABSTRACT:

Multimedia as a delivery of instructional content and teaching tool is the in trend to construct knowledge. However, limited studies have investigated the effects of using multimedia education approaches on primigravida mother’s knowledge and attitude towards breastfeeding. The aim of this study was to develop and evaluate the effects of a multimedia education on breastfeeding knowledge and attitude of primigravida mothers.A quasi-experimental study was carried out among 33 primigravida mothers in antenatal clinic Hospital USM (December 2012 to February 2013) using convenient sampling. They were divided into two groups: Experimental (n=18) and Control (n=15). Control group mothers received usual breastfeeding education while experimental group received breastfeeding education via flip chart with guide book and power point slides. For practical session, breast model were used. Their knowledge and attitude were measured at baseline (during 3rd trimester) and re-measured at 2 weeks post-intervention, using validated questionnaire. Student’s t-test and paired t-test were used to analyse the data and P values less than 0.05 were considered significant. Knowledge towards breastfeeding of the intervention group was higher than the control group after the intervention (p=0.001). There was a significant difference in knowledge score pre and post intervention. The results showed that there was no significant difference between pre and post attitude score in both groups. Correlation between breastfeeding knowledge and attitude in the intervention group was poor (r=0.11). This study confirmed that a multimedia breastfeeding education is effective and can be used to improve knowledge regarding breastfeeding. These results match those observed in earlier studies that found the knowledge score on breastfeeding had increased after two weeks education compared to the control group. The implications for future practice are this multimedia breastfeeding education has the potential to revolutionize breastfeeding education in community and hospital by nurses or communities midwives.

 

KEYWORDS: Multimedia, education kit, knowledge, attitude, primigravida mothers

 

Healing Verses (As-Syifa Verses): A Proposed Novel Therapy Approach to Reduce Stress in Drug Addiction

 

Zulfa Izza Mohamed  Hashim1 , Samhani Ismail1,4 , Rohayah Husain1 , Nasir Mohamad1 ,

Khairi Che Mat1 , Syed Hadzrullathfi Syed Omar2,3 ,Mohd Shahril Othman 2

1Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Terengganu Darul Iman, Malaysia

2Faculty of Contemporary Islamic Studies, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Terengganu Darul Iman, Malaysia

3Research Institute for Islamic Products andamp; Civilization (INSPIRE), Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Terengganu Darul Iman, Malaysia

4Department of Neurosciences, Universiti Sains Malaysia, Malaysia

*Corresponding author E-mail: zulfa_izza@yahoo.com

 

ABSTRACT:

Stress increases internalized and psychosocial vulnerability in development of illicit drug abuse. A considerable number of researches show stress initiates and escalates drug abusive behavior as coping strategies to deal with stressors and to self-medicate. National Institute on Drug Abuse has stated that drug addicts is part of mental illness for brain changes it made and disturbance in normal hierarchy of needs and desire. Although many strategies had been launched, the extent of worldwide illicit drug users accounts at 185 million people. Stress relates to increased muscle tension with heighten its electrical conductivity impacting in vasoconstriction and decreased blood flow that leads to heart rate problem. Their brain also exhibited altered patterns of connectivity which reduced of self- control over impulses thus making self-reward a compulsory need. Looking at the relaxation effect served by the Holy Quran, As-Syifa Verses is thoughtful to have a novel therapeutic significance of self-reward to ease the emotional disturbance associates with chronic stress. We aimed to conduct a study to learn the contribution of As-Syifa Verses in alleviating stress those leads to drug abusive behavior. A systematic documentation was done through qualitative content analysis regarding drug addiction and its relationship to stress, current treatment modalities and the therapeutic value of As-Syifa Verses from various Islamic traditions rationaled by scientific evidences. An abundant trustworthiness qualitative data found harmonically advocate that As-Syifa Verses have power of control on stress. It is proposed that As-Syifa Verses could be implemented as an intervention in controlling stress among drug addicts.

 

KEYWORDS: As-Syifa Verses, stress, drug addiction

 

Factors Associated with Daily Smoking Among Malaysian Adolescents –Findings from Tobacco and E-Cigarette Survey Among Malaysian Adolescents (TECMA)

 

Wan Shakira R.H.*, Ling M. Y, Hamizatul A, Hasimah I., Liana A. M., Halizah M. R.,

Tania R. L, Thamil A. S, Aiman A.G, Fadhli M. Y.

Institute of Public Health, Bangsar, Kuala Lumpur

*Corresponding author E-mail: wshakira@moh.gov.my

 

ABSTRACT:

Daily smoking among adolescents is a public health problem. Understanding factors associated for daily smoking may help public health policy makers and practitioners in improving strategies to prevent or delay adolescent cigarette smoking. To identify the prevalence and associated factors of current daily smoking among Malaysian adolescents. This study analysed data from the Tobacco and E- Cigarette Survey among Malaysian Adolescent (TECMA) conducted in 2016 targeted school-going adolescents aged 10-19 years old. A cross-sectional population design and two stage stratified cluster sampling was applied. A total of 14832 students from 136 schools were selected in this survey. A complex sampling and Multiple Logistic Regression analysis were applied. The overall prevalence of daily smoking among adolescents was 1.60% (95%CI: 1.2, 2.1), with the highest prevalence in males (3.2%) and secondary school students (2.4%). 13.9% of students who currently smoke took cigarette every day. The multivariable model showed that adolescents aged above 12 years was 24.4 times more likely to smoke daily compared to those aged below 12 years old (AOR 24.4, 95% CI: 5.9, 99.7). Male adolescents also had 23.3 times higher odds of being daily smokers compared to females (AOR 23.3, 95% CI: 5.7, 95.0). Students who were given more amount of pocket money (RM 2-5) were 2.6 times higher odds of taking cigarette every day (AOR 2.65, 95% CI: 1.17, 6.00). Adolescents who claim that the premise refused to sell tobacco to underage were 43% less likely of being daily smokers (AOR 0.57, 95% CI: 0.40, 0.82). Male, secondary school students, those who had more pocket money and not prevented from underage tobacco purchases were at greater risk of becoming daily smokers.  It recommended strengthening the laws against cigarette sales to underage person. Also, parents/guardians should monitor their child’s spending.

 

KEYWORDS: Adolescents, daily smoking, Malaysia

 

 

Translation of Teamwork Survey Questionnaire (TSQ) for Malaysian Public Healthcare Services: Process and Findings

 

Wan Siti Auni, W. S.1, Pereira, D.J.1*, Lim P.Y.2 ,Sakinah, H.3

1School of Health Sciences, University Sains Malaysia

2Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia

3Faculty of Health Sciences, Universiti Sultan Zainal Abidin

*Corresponding author E-mail: ghiong88@yahoo.com

 

ABSTRACT:

Teamwork is a prerequisite for effective healthcare services. However, there is a lack of teamwork assessment tools tailored for developing country services. To provide a tool for teamwork assessment in Malaysian public healthcare services, this study aimed to translate the original English version teamwork survey questionnaire into the Malay language.The teamwork survey questionnaire was previously used for Australian rehabilitation services. The 35 item questionnaire covers teamwork domains representing demographics, integration, efficiency and relationships. The translation process involved: contextual adaptation; two forward translations; reconciliation of the two forward translation Malay versions; back translation into English; reconciliation of back translated tool with original and Malay versions; and face validation with ten respondents. A main reference for researchers was an official Malay language resource website.Contextual adaptation resulted in the questionnaire’s statements being generalized for various healthcare services. Two forward translation versions enabled comparison of phrasing and choice of words. Some phrasing showed variation requiring reference to the original English tool to confirm intended meaning of statements. Few Malay statements deviated in meaning from the original English tool due to inappropriate word for word translation. The majority of items in the back translated English version showed similarity of meaning with the original English tool. Differences in the two English versions highlighted mistranslations overlooked during forward translation. Face validation highlighted three demographic questions that could potentially confuse respondents due to a common key word. Researchers decided to provide verbal clarification for the problematic questions before tool administration.Preserving the original tool’s purpose while mitigating local language nuances relied upon: translators’ competence; availability of a reliable language resource; and feedback from target respondents. In adopting this approach for other tools and contexts, additional translator involvement could be required if researchers are not proficient in either a questionnaire’s foreign language or the intended local language.

 

KEYWORDS: Survey questionnaire, translation, teamwork, healthcare

 

Evidence-based Findings Towards Developing a Smoke-free Generation Policy in Malaysia

 

Tee Guat Hiong1*, Norayana Hassan2, Nizam Baharom2, Izzuna Mudla Mohamed Ghazali3, Tahir Aris3

1Institutefor Public Health, Ministry of Health Malaysia

2Disease Control Division,Ministry of Health Malaysia

3Health Technology Assessment Section, Ministry of Health Malaysia

*Corresponding author E-mail: helentee.gh@moh.gov.my

 

ABSTRACT:

Smoking is an important public health problem in Malaysia. The Global Adult Tobacco Survey (GATS) Malaysia conducted in 2011 among adults aged 15 years and above reported the prevalence of current tobacco used at 23.1%.  Global Youth Tobacco Surveys (GYTS) 2003 and 2009 found the prevalence of smoking among adolescents aged 13-15 years were 22.2% and 18.2% respectively.  The objective of this study was to illustrate the translation of research findings into policy making towards creating a smoke-free generation in Malaysia.  Data on tobacco use from various national surveys from 2003 to 2011 were identified and analysed to form the basis for national tobacco control targets.  WHO Framework Convention on Tobacco Control (FCTC) principles was used to formulate strategies for creating a smoke-free generation in Malaysia.  Findings from GYTS 2003 and 2009, NHMS 2006 and GATS 2011 were used to formulate the National Strategic Plan (NSP) for Tobacco Control 2015-2020 and the Malaysian Tobacco Control Road Map for 2011-2025.  The three main objectives of NSP are to maintain the prevalence of smoking among women to less than 5%; to reduce smoking prevalence to 15% by 2025 and to reduce smoking prevalence to less than 5% by the year 2045.  One of the strategies outlined in NSP is to expand further gazetted smokefree public places including Rest and Relax areas in 2014, leisure and recreational parks in 2017 as well as Smokefree City programmes in Melaka, Johor, Penang, Kelantan and Terengganu.  Findings from local research in tobacco use are essential in formulating strategies towards developing a smoke-free generation policy in Malaysia.

 

KEYWORDS: Smoke-free generation, smoking, evidence-based, policy, Malaysia

 

Assessing the Malaysians’ Perception and Practice in Elimination of Mosquito Breeding Sites - Findings from the National Health and Morbidity Survey (NHMS) 2015

 

Faizah Paiwai*, Norzawati Yoep, Mohd Hatta Abdul Mutalip, Noor Aliza Lodz, Sayan Pan, Mohd Hazrin Hasim, Tee Guat Hiong

Institute of Public Health, Bangsar, Kuala Lumpur

*Corresponding author E-mail: faizahpaiwai@gmail.com

ABSTRACT:

Ministry of Health Malaysia has carried out numerous awareness campaigns to prevent dengue fever including recommending every household to perform “search and destroy” mosquito breeding sites in their houses for at least once a week. The aim of this study was to identify practices and perception in elimination of mosquito breeding sites among Malaysians. This study was part of the population-based NHMS 2015. Respondents aged 18 years and above were asked about the frequency of elimination of mosquito breeding sites, participation in gotong-royong, active biting time of Aedes mosquitoes, larvicide used, their perception on dengue fever and cleanliness responsibilities outside their houses. Descriptive and analytical analyses were conducted using SPSS version 21. Among 12,548 eligible respondents, 37.2% (n=4,603) never inspected/ inspected their houses for mosquito breeding sites less than once a week. It was noted higher among those aged 18 to 30 years old (33.1%, 95% CI:31.4, 34.8), Malays (61.0%, 95% CI:57.7, 64.2) and those who lived in urban areas (57.7%, 95% CI:55.1, 60.3). Among these respondents, 17.1% (95% CI:15.6, 18.8) used larvicide and 55.4% (95% CI:52.0, 58.4) had joined gotong-royong activities in their neighbourhoods. Regarding to  perception, majority of the respondents (84.9%, 95% CI:83.0, 86.6) agreed that they and their families were responsible towards cleanliness outside their houses. Majority (95.4%, 95% CI:94.5, 96.1) knew that dengue fever is dangerous and fatal. However, only 38.3% (95% CI:36.0, 40.6) had knowledge about active biting time of Aedes mosquitoes. Despite the high level of awareness about the danger of dengue fever, many Malaysians did not carry out practices to eliminate the source of mosquito breeding sites. Local prevention and control activities, involving community members and supported by health education are essential in elimination of mosquitoes breeding sites. This will offer potential to reduce the prevalence of dengue fever.

 

KEYWORDS: KAP, Dengue breeding elimination, Dengue Prevention

 

Effectiveness of the Non-Surgical Periodontal Therapy on Glycemic Control of Type 2 Diabetic Patients with Periodontitis in Public Primary Care Clinics, Kuantan, Pahang

 

Mohd Aznan Md Aris1*, Tin Myo Han2, Razida Ismail3, Munirah Yaacob4,Iskandar Firzada Osman5, Sorayah Sidek6 ,Mahendran Thuraiappah7,Fa'iza Abdullah1, Padmini Hari8, Than Tun Sein9, Roslan Bin Saub10

1Department of Family Medicineand Non-Communicable Disease Research Unit, Kulliyyah of Medicine, International Islamic University Malaysia,

2Medical Statistics Unit, Kulliyyah of Dentistry, International Islamic University Malaysia,

3Periodontal SpecialistClinics, Klinik Kesihatan Paya Besar, Kuantan

4Periodontal Specialist, Kulliyyah of Dentistry, IIUM, Kuantan, Malaysia

5Klinik Kesihatan , Jaya Gading, Kuantan, Jalan Bukit Sekilau 25000, Bandar Kuantan

6Periodontal Specialist Clinic, Klinik Kesihatan Presinct 18, Putrajaya

7Primary Care Department, Faculty of Medicine, MAHSA University, KL

8Senior Lecturer, Department of Periodontology, MAHSA University, KL

9Anthropology Department, Yangon University, Myanmar

10Department of Community Oral Health and Clinical Prevention, Faculty of Dentistry, University Malaya

*Corresponding author E-mail: aznan@iium.edu.my

 

ABSTRACT:

Bilateral relationship between DM and periodontal disease (PD) and effectiveness of periodontal therapy (PT) on glycemic control of DM patients with periodontitis (DM-P) has been well reported in dental literature. However, there are still conflicting results on the effectiveness of PT on target glycaemic control achievement of DM-P patients. Aim of this study was to evaluate effectiveness of completion of non-surgical periodontal therapy (NSPT) on target glycaemic control achievement in HbA1C of type-2DM patients with periodontitis (T2DM-P). A clinical control trial (CCT) was conducted in Kuantan, Pahang in 2016. Periodontitis status was screened among DM from three selected public primary care clinics (PPCCs) and 35 T2DM-P who agreed to undergo NSPT were referred to two periodontal specialist clinics. After 6 month of PT, 17 of T2DM-P who completed NSPT were defined as cases and 19 of them who did not complete NSPT were defined as positive controls. Negative controls were selected from 33 T2DM-P who did not receive any PT. The HbA1C assessments pre and post-6 months of NSPT were collected. A cross analysis between completion status of NSPT and HbA1C achievement of ≤ 6.5% was analyzed. Out of 238 T2DM patients who were screened PD co-morbidity, 52% (123/238) had periodontitis co-morbidity and 47% (112/238) had gingivitis. Only three DM patients (1%) had healthy periodontium. After 6 months, only 17 of T2DM-P who completed NSPT were defined as cases and 19 of them as positive controls. Negative controls were selected from 33 T2DM-P who did not receive any PT. The cases with target HbA1C≤ 6.5% after completion of NSPT was significantly higher (47.1%) than both positive controls (15.8%) and negative controls (15.2%). Thus, the study had shown that the completion of non- surgical periodontal therapy will help the T2DM-P to achieve the target glycaemic control.

 

KEYWORDS: Type-2 diabetic patients with periodontitis,periodontal treatment, primary care clinic,HbA1C%, glycemic control

 

 

Glycemic Control And Lipid Profile of Diabetic Defaulters in Kuantan, Malaysia

 

Fa'iza Abdullah1, Tin Myo Han2, Mohd Aznan Md Aris1, Iskandar Firzada Osman3

1Family Medicine Department, Kulliyyah of Medicine, IIUM

2Medical Statistics Unit, Kulliyyah of Dentistry, IIUM

3Family Medicine Specialist, Klinik Kesihatan Jaya Gading, Kuantan, Pahang

*Corresponding author E-mail: drfaiza1968@gmail.com

 

ABSTRACT:

Most successful management of chronic disease patients depends on their follow-up. Type-2-diabetes mellitus (T2DM) patients who default their follow-up will receive minimal medical supervision. This will give an impact to the glycemic and lipid control achievement which finally will increase risk of complications. To compare both glycemic and lipid profile control status in between T2DM defaulters and regular attendees at diabetes clinics.  A prospective one-yearstudy was conducted among T2DM from primary care clinics and DM-specialist clinic (hospital) in Kuantan. The research was conducted from July-2014 to Jun-2015.  There were two follow-up appointments; at 6-month and 12-month within study period.  Defaulter is defined as missing at least one occasion. Regular attendees were included as control group. Patients with missing records, known deceased cases and who are transferred out to other clinics were excluded. Investigation results of glycemic and lipid profile were collected at baseline (0-month) and after 1-year (12-month).  Of 405 diabetic patients, 18% (73/405) were defaulters. Lower percentage of defaulters came for blood investigations when compared to regular attendees (19%-26% vs 78%-88%) p<0.05. Target-achieved levelin diabetic defaulters was lower than regular attendees in all blood parameters of fasting/random blood glucose (1.4% vs 23.4%); HbA1c (0% vs 11.4%); triglyceride (8.2% vs 48.5%); LDL-C (8.2% vs 35.0%) and HDL-C (5.5% vs 26.5%) with p<0.05. The study shows the defaulter rate is high among T2DM. They significantly contribute lower target-level achievement than regular attendees.

 

KEYWORDS: Diabetic-defaulters, primary care clinics, DM-specialists’ clinic

 

 

Pregnancy Induced Hypertension In Malaysia : Prevalence And Associated Risk Factors

 

Noor Aliza L, S. Maria A, Faizah P, Norzawati Y, Sayan P, Mohd Hatta AM, Mohd Hazrin H, Tee Guat Hiong

Institute of Public Health, Bangsar, Kuala Lumpur

*Corresponding author E-mail: aliza_lodz@yahoo.com

 

 

ABSTRACT:

Gestational hypertension, also referred to as pregnancy induced hypertension (PIH) is a condition characterized by high blood pressure during pregnancy. The hypertensive syndromes of pregnancy are the leading cause of maternal and fetal morbidity and mortality in the developed world. The aim of this study was to determine the prevalence of PIH and the associated risk factors.The study was part of the National Health and Morbidity Survey in 2016 (NHMS 2016) in Malaysia. It was a cross-sectional population based survey focused on Maternal and Child Health. The target population was mothers aged 15-49 years with last childbirth <2 years prior to interview and their children were below five years old.  A total of 11,845 respondents were selected but only 7,865 respondents were able to provide antenatal booklet as a proof of diagnosis. A face to face interview was held with all the respondents. Multivariate analysis was used to analysed the data using SPSS.Of these 7,865 respondents, 390 [5% (95% CI : 4.3 – 5.8)] of them developed pregnancy induced hypertension (PIH). The following risk factors were significantly increase the risk of hypertension during pregnancy : diabetes mellitus (gestational and pre-existing) whose blood sugar was more than 5.6mmol/L with odd ratio of 2.19 (95% CI: 1.6 – 3.0)  compared to non-diabetes mothers and body mass index (BMI) with overweight BMI (>25kg/m2) with the odd ratio of 2.02 (95% CI: 1.5 - 2.7) while the most significant risk was obese (>30kg/m2) mothers with odd ratio of 4.85 (95% CI: 3.6 – 6.4) compared to normal BMI mothers.From this study, we can conclude that mothers who were overweight and obese with GDM or pre-existing diabetes mellitus has higher possibilities of getting PIH. Campaigns and awareness regarding PIH should be done for this reproductive age women even before the pregnancy in order to lessen the mortality and morbidity of the disease.

 

KEYWORDS:  Pregnancy, hypertension, risk factors, Malaysia

 

Hypertension and Related Risk Factors in Type 2 Diabetes Mellitus Population in Malaysia- Findings from National Health and Morbidity Survey 2015

 

Hasimah Ismail*, Tahir Aris,Mohd Azahadi Omar, Rashidah Ambak, Muhammad Fadhli Mohd Yusoff, Tee Guat Hiong, Wan Shakira Rodzlan Hasani, Lim Kuang Kuay

Institute for Public Health, Jalan Bangsar 50590, Kuala Lumpur

*Corresponding author E-mail: hasimah.i@moh.gov.my

 

ABSTRACT:

The prevalence of hypertension and diabetes continue to rise globaly. The combination of hypertension and type 2 Diabetes Mellitus (T2DM) is particularly lethal and can significantly raise the risk of having a heart attack or stroke. Aggressive management of hypertension in the presence or absence of T2DM is associated with more health benefits and less risk of cardiovascular morbidity. To examine the national prevalence of hypertension and related risk factors in T2DM population in Malaysia. A sub-analysis of data from National Health Morbidity Survey (NHMS) 2015  was conducted among 4229 respondents with T2DM. The data were obtained from respondents aged 18 years and above via face-to-face interviews. T2DM was defined as one who self reported of having diabetes or who had fasting capillary blood glucose of ≥6.1 mmol/L (or non-fasting blood glucose of >11.1 mmol/L). Hypertension was defined as one who has systolic and diastolic blood pressure of ≥140 and 90 respectively. Logistic regression analyses were conducted to identify factors related with hypertension among T2DM respondents. The prevalence of hypertension among respondents with T2DM was 57.9% (n=2625). The highest prevalence of hypertension were among females (58.7%), ≥60 years old (80.1 %), Chinese (61.1%), those with primary education (69.6%), widow/widower/divorce (75.4%), not working (67.7%), rural residents (60.6%), non-smokers (60.1%), non-drinkers (58.1%), those who were obese (66.0%) and with abnormal cholesterol level (63.5%). Logistic regression analyses revealed that age group, working status, obesity and cholesterol were associated with hypertension among respondents with T2DM. Our findings showed that more than half of respondents with T2DM had co-morbidity of hypertension.  Age, working status, obesity and cholesterol were associated with hypertension among this population. Early detection of hypertension and other related cardiovascular risk factors should be an integral part of T2DM management to prevent development of hypertension among T2DM population in Malaysia.

KEYWORDS: Hypertension, Type 2 Diabetes Mellitus, risks factors, Malaysia

Antibacterial properties of Etlingera elatior flower extracts against acne-inducing bacteria (Propionibacterium acnes and Staphylococcus aureus).

 

Nurul Saidah Din1*, Abu Bakar Mohd Hilmi2, Rabiatul Adawiyah Umar2, Nurul ‘Adani Sanusi1, Salwani Ismail1*

1Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA)
2School of Biomedicine, Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Terengganu, Malaysia.

*Corresponding Author E-mail: salwani@unisza.edu.my

 

 

ABSTRACT:

Herbal and botanically derived remedies are increasingly popular for the treatment of acne due to the increasing cases of microbial resistance and side effects of available current treatment. The flower of Etlingera elatior locally known as bunga kantan was reported to have antibacterial properties. However, there are still no extensive studies reported on the antibacterial properties of Etlingera elatior flower extracts against acne-inducing bacteria. This study aimed to investigate the antibacterial effects of Etlingera elatior flower extracts against Staphylococcus aureus and Propionibacterium acnes. Etlingera elatior flower was extracted with three different polarity solvents namely n-hexane (non-polar), dichloromethane (semi polar) and ethanol (polar). The antibacterial effect was tested by disk diffusion anddilution method for the determination of the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Total phenolic acids and flavonoids contents were estimated using Folin-Ciocalteu and colorimetric assay respectively. Among all the extracts, dichloromethane flower extract of Etlingera elatior has demonstrated the maximum zone of inhibition with the diameter of 7.71 ± 0.07 mm for Staphylococcus aureus and 11.39 ± 0.45 mm for Propionibacterium acnes at the concentration of 100 mg/mL. The MIC value for dichloromethane flower extract against Staphylococcus aureus and Propionibacterium acnes were 6.25 mg/mL and 1.56 mg/mL while the MBC value were 25 mg/mL and 6.25 mg/mL respectively. The total phenolic acids and flavonoids contents of the different flower crude extracts were in the range of 7.68 ± 3.86 to 96.69 ± 11.45 (mg GAE/g) and 4.279 ± 5.84 to 64.315 ± 6.86 (mg QE/g) respectively. All three Etlingera elatior flower extracts exhibited antibacterial properties against Staphylococcus aureus and Propionibacterium acnes.Thus, the flower extracts of Etlingera elatior could possibly be used as substitute therapeuticagents againstacne inducing Staphylococcus aureus and Propionibacterium acnes.

 

KEYWORDS: Antibacterial properties, Etlingera elatior, acne-inducing bacteria

 

 

Perception on Electronic Cigarette and Vape (ECV) Use and School Environment Influence among Current Smokers: Findings from the Tobacco and E-Cigarette Survey among Malaysian Adolescents (TECMA)

 

Hamizatul Akmal A.H*, Wan Shakira R.H., Tania R. L, Ling M. Y., Hasimah I., Halizah M. R., Liana A. M., Thamil A. S, Aiman A.G, Fadhli M. Y.

Institute of Public Health, Bangsar, Kuala Lumpur

*Corresponding author E-mail: hamizatulakmal@gmail.com

 

ABSTRACT:

Electronic cigarettes and vape (ECV) use has increased rapidly around the world. However, published data on the Malaysian population is limited especially its use among adolescents. This study aimedto investigate the association of the adolescent’s perception on ECV use and school environment influence among current smokers.Data from the Tobacco and E- Cigarette Survey among Malaysian Adolescents (TECMA) 2016, a cross-sectional study using two-stage stratified cluster sampling design was analysed. A total of 14,832 school going adolescents aged 10-19 years old were selected in this study. A validated self-administered questionnaire was used. Complex sampling and multivariate analysis were applied to identify the association of the individual perception on the ECV use and school environment influence among current smokers. A total of 13162 (response rate 88.7%) respondents participated in this study. The prevalence of the ECV users among adolescents who currently smoke cigarette was 51.7% (95% CI: 46.3, 57.0) overall, 51.9% (95% CI: 46.3, 57.3) among males, 58.9% (95% CI: 46.3, 57.3) among Sabah Bumiputera and adolescents with mean age of 14.7 (±1.88) years old. Logistic regression analysis showed that ECV use among current smokers was associated with age and several individual perceptions (e.g. that they will use ECV if offered by their best friend, felt that ECV use is less harmful than cigarette smoking and thought that they might enjoy using ECV). Age and several individual perceptions (e.g. that they will use ECV if offered by their best friend, felt that ECV use is equally harmful as cigarette smoking and thought that they might enjoy using ECV) were noted as significantly associated with the ECV use among smokers. These findings could assist policy makers in forming specific interventions targeting adolescents so as to increase awareness on the detrimental health effects of ECV use. 

KEYWORDS: Adolescents, perception, electronic cigarette, vape, cigarette

 

Outcomes In Pregnant Patients Undergoing Dialysis-A Tertiary Center Experience

 

Harafinova Harman Shah1*, Zawawi Nordin1, Zaiha Harun2 , Anisah Jalaluddin1,Che Azzah2

1Faculty of Medicine, Universiti Sultan Zainal Abidin ,Terengganu

2Nephrology Unit,Hospital Sultanah Nurzahirah,Terengganu

*Corresponding Author E-mail: harafinovahshah@unisza.edu.my

 

ABSTRACT:

Pregnancy on dialysis is rare but not impossible .There were associated adverse maternal and fetal outcomes.In these 16 case series we reviewed  the fetal and maternal outcomes in pregnant women on hemodialysis. All pregnant patients on dialysis at 6  Hemodialysis Centres across Terengganu from January  2004 to March 2017 were included. 16 pregnancies identified. We review the maternal’s survival, blood pressure, haemoglobin and calcium’s level , fetal’s survival and fetal birth weight.Descriptive analysis was used using Microsoft Excel. There were 16 pregnancies from 13 women. Among 13 patients , 3 (23%) were diagnosed as chronic glomerulonephritis, 3( 23%) were diabetic nephropathy and three had lupus nephritis, hypertensive nephrosclerosis, obstructive uropathy respectively. The other 4(30%) aetiology were unknown. Outcomes of the 16 pregnancies, 2(12%) patients developed uncontrolled hypertension, 1(6.25%) patient had gestational hypertension,1 patient had antepartum haemorrhage and 1 patient had postpartum pulmonary oedema. 8(50%) pregnancies needed increased dose of erythropoietin and calcium supplements. Regarding foetal outcome, 75% (12 out of 16 pregnancies) resulted in live birth, 2 ( 12.5%) had spontaneous abortion, one intrauterine death and one early neonatal death due to Edward syndrome.All the live birth babies were born prematurely. 58% of them born with very low birth weight (less than 1.5 kg) and 41.7% were less than 2.5 kg (low birth weight). 15(93.7%) of the babies delivered by Caesarean sections and 1(6.25%) by vagina delivery. Our review demonstrated a good maternal outcome with minimal complication. A good fetal survival rate were achieved despite majority of them delivered prematurely. This data will help physicians discussing pregnancies with dialysis female patients.

 

KEYWORDS: Pregnant, dialysis, outcome, fetal survival rate

 

Influence of Drying Methods on Chemical Composition and Antioxidant Activity of Selected Malaysian Wild Edible Vegetable

 

Zalilawati Mat Rashid1*, Natasha Aziz1, Nashriyah Mat2

1School Food Industry, Faculty of Bioresources and Food Industry, Universiti Sultan Zainal Abidin, Besut Campus, 22200 Besut, Terengganu, Malaysia

2School of Agriculture Science and Biotechnology, Faculty of Bioresources and Food Industry, Universiti Sultan Zainal Abidin, Besut Campus, 22200 Besut, Terengganu, Malaysia

*Corresponding author E-mail: zalilawati@unisza.edu.my

ABSTRACT:

In this study, some selected and rarely studied Malaysian wild edible vegetables or commonly known as ‘ulam’ young leaves were investigated for chemicals composition and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging activity. The plants were Erechtites valerianifolia, Erechtites hieraciifolia, Manihot esculenta, Phyllanthusacidus, Piper sarmentosum, Ziziphus mauritiana, Gnetum gnemon, Oroxylum indicum, Acrosticum aureum and Terminalia catappa. Leaves samples were grind under liquid nitrogen, dried using either freeze-drying (FD) or oven-drying (OD) drying methods, following maceration in ethanol, sonication (20 minutes) and centrifugation (10 minutes). Crude extracts were obtained after drying the supernatants under nitrogen gas. Chemicals content analysis of the extracts included total neutral sugars (TSC) via phenol-sulfuric acid assay, total phenolics (TPC) via Follin-Ciocalteau assay, total flavonoids (TFC) via aluminium chloride assay and total proteins (TP) by Bradford assay. DPPH scavenging activity was found to be consistent with TPC results in which ethanolic freeze dried (EFD) samples of T. catappa exhibited the strongest antioxidant potential (IC50=14.3 mg/mL) and the highest TPC (65.6±0.98 mg GAE/g extracts) compared to ethanolic oven dried (EOD). All EFD displayed moderate and strong DPPH scavenging activity with percentages inhibition ranging from 72.3 to 90.4% and IC50values 14.3 to 125 mg/mL, while EOD extracts activities were weaker with percentages inhibition ranging from 62 to 84.2% and IC50 values 15 to 290 mg/mL. Meanwhile, among EOD samples, O. indicum showed the strongest scavenging action (IC50 = 15 mg/mL) and greater TPC (53.4±1.32 mg GAE/ g extracts). All ethanolic extracts following FD methods displaying higher chemicals content and stronger antioxidant potential compared to OD methods could indicates that different drying methods of leaves did affect chemical composition isolation and antioxidant activity of plant extracts.

 

KEYWORDS: Freeze drying, oven drying, chemicals composition analysis, DPPH scavenging activity, total phenolics content, total flavonoids content.

 

Correlation Between Continuous Assessment Performance and End Of Posting Performance: The Importance of Appropriate Rubric in Continuous Assessment

 

Norwati Daud, Nurulhuda Mat Hassan*, Harmy Mohd Yusoff

Family Medicine Unit, Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu

*Corresponding author E-mail: nurulhudamh@unisza.edu.my

 

ABSTRACT:

Assessment method is important in determining clinical performance. Assessment relies strongly on how good the marking scheme is. For the session of 2016/2017, family medicine unit in the Faculty of Medicine, Universiti Sultan Zainal Abidin had taken some steps to improve its assessment marking scheme as well as the method of assessment for family medicine rotation. Assessment rubrics for subjective marking were refined and a more objective assessment was used for the continuous assessment. The objective is to determine the correlation between end of posting performance and continuous assessment performance before and after an improved marking scheme for continous assessment. Medical students’ examination results for family medicine rotation for the session of 2015/2016 (pre intervention) and session 2016/2017 (post intervention) were analyzed for correlation of end of posting performance with continuous assessment, and mean difference between end of posting results and continuous assessment. Correlation was analyzed using Pearson correlation test and mean difference was analyzed using t-test. For the session of 2015/2016, the correlation coefficient (r) value for continuous assessment was 0.147 (p<0.001), while for 2016/2017 it was 0.484 (p<0.001). The mean difference of marks between end of posting and continuous assessment was 12.54 for 2015/2016 and 5.68 for 2016/2017. Both differences were statistically significant (p<0.001).Improvement in continuous assessment marking scheme and a more objective continuous assessment have increased the correlation between continuous assessment performance and end of posting performance. The correlation was poor for 2015/2016 and improved to high fair for 2016/2017. Improved marking scheme has also reduced the difference in mean marks between continuous assessment and end of posting marks.  Thus it is worth to revise the marking scheme of especially subjective assessment to reflect the true performance of medical students.

 

KEYWORDS: Family medicine, assessment method, marking scheme, correlation

A Case Series of the Outcome of Traumatic Rhabdomyolysis in Emergency Department Hospital Universiti Sains Malaysia

 

Mohd Najib bin Abdul Ghani, Siti Khadijah binti Abdul Hamid, Hafizul Asrar bin Abdul Razak,  Saiful Azlan bin Mohamed, Tuan Hairulnizam bin Tuan Kamauzaman,

Mohd Hashairi bin Fauzi, Mohd Boniami bin Yazid.

Department of  Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150 Kelantan, Malaysia

*Corresponding author E-mail: jeeb_84@yahoo.com

 

ABSTRACT:

Rhabdomyolysis is not uncommon but the prevalence in the Emergency Department (ED) setting still remains unknown. Trauma is one of the many causes of rhabdomyolysis in the ED and it should be recognized early to prevent untoward complications such as acute renal failure (ARF) and mortality. However, early recognition is challenging especially in the ED setting.  Adding to the growing body of knowledge, we present the outcome of traumatic rhabdomyolysis in ED Universiti Sains Malaysia. We retrospectively extracted patients’ data in this case series once the diagnosis of traumatic rhabdomyolysis was made in ED. Creatinine kinase (CK) was thesurrogate diagnostic marker. The outcome of interest were progression into ARF, need for dialysis and mortality during the in-hospital admission. We highlighted three patients who sustained major poly-trauma with initial readings of CK of more than 10000 U/L that were highly suggestive of rhabdomyolysis. They were subsequently treated with aggressive fluid therapy and forced alkaline diuresis as per Advanced Trauma Life Support protocol to manage rhabdomyolysis. None of our patients progressed into ARF, required dialysis and died throughout their admission period. Trauma is one of the presentation to the ED. Early identification of rhabdomyolysis by raised CK level is important especially in poly-trauma patients. Aggressive fluid therapy and forced alkaline diuresis are the treatment strategies that can be initiated in ED with favourable outcome.

 

KEYWORDS: Traumatic rhabdomyolysis, Creatinine kinase, forced alkaline diuresis

 

Suggestive Evidence of Predisposing Haplotype of Leptin Gene in Obesity among Malays in Terengganu, Malaysia Population

 

Amiratul Athirah Shamsuddin1, Aryati Ahmad1, Wan Rohani Wan Taib2*

1Faculty of Health Science, Block Hafsah, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300, Kuala Nerus, Terengganu, Malaysia

2Institute for Community [Health] Development, Universiti Sultan Zainal Abidin, Gong Badak Campus, 21300 Kuala Nerus, Terengganu, Malaysia

*Corresponding author E-mail: wanrohani@unisza.edu.my

 

ABSTRACT:

The prevalence of obesity and overweight has become the critical global threat which leads to metabolic risks and mortality. Leptin is a hormone that regulates the food intake as well as food expenditure that is encoded by Leptin gene.  Besides, Leptin gene had been proved to play a pivotal role in obesity pathogenesis. This study was sought to determine the single and haplotype association of the Leptin gene polymorphisms (G2548A, H1328080 and A19G) with obesity among Malay in Terengganu, Malaysia. This cross-sectional study comprised of 249 participants (148 overweight/ obese and 101 normal BMI as control).  The PCR-RFLP technique was performed to distinguish the genotypes for the three polymorphisms of Leptin gene. The allele and genotype frequencies were assessed for single and haplotype analyses. Single association analysis for G2548A, H1328080 and A19G polymorphisms of Leptin yielded no statistically significant association with obesity with the p-value of 0.74, 0.56 and 0.38 respectively. However, haplotype association analysis might suggest that haplotype AAG deliberated susceptibility with P=0.002, OR=8.897 (1.59–9.78) to obesity predisposition. This data on single and haplotype might disclose the preliminary exposure and pave the way for the obesity development with an evidence of revealed susceptibility to obesity.

 

KEYWORDS:  Leptin, haplotypes, obesity, gene polymorphism

 

Students Feedback on the Undergraduate MBBS Curriculum Faculty of Medicine, Universiti Sultan Zainal Abidin, Terengganu, Malaysia.

 

Norwati Daud , Norhasiza Mat Jusoh*, Aniza Abdul Aziz, Siti Yusrina Nadihah Jamaludin, Nordin Simbak

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu

*Corresponding author E-mail: hasizamj@unisza.edu.my

 

ABSTRACT:

Universiti Sultan Zainal Abidin (UniSZA), Terengganu started its Bachelor of Medicine and Bachelor of Surgery (MBBS) programme in 2009. By September 2017, four batches of MBBS programme students have graduated. Currently, the Faculty of Medicine is in the process of revising its MBBS curriculum. The objective of the survey was to evaluate the medical students’ satisfaction on the existing MBBS curriculum. An anonymous online feedback on the MBBS curriculum UniSZA was done on 56 final year students from the fourth batches who had just graduated.  A scale of 1 to 5 was used to determine their satisfaction in the specified area. Scale 1 is for ‘very dissatisfied’ and scale 5 is for ‘very satisfied’. Descriptive analysis was used Microsoft Excel Programme. All 56 students responded to the feedback and 71.4% were female students. The mean (SD) score fortheir satisfaction on the overall curriculum, overall content for basic sciences, overall content for clinical subjects, adequacy of clinical content for future practice, competency of clinical skills for future practice and overall quality of the MBBS programme was 4.2(0.60),  4.2(0.65),  4.3(0.49),  4.4(0.56) ,  4.3(0.58)  and 4.3(0.53) respectively.  About 71.4% of students responded that the MBBS curriculum should be revised. About 71.4% of students would definitely recommend UniSZA MBBS programme to others. The level of satisfaction of graduating medical students of UniSZA MBBS curriculum is reasonably high and they highly recommend this programme to others. However, there is a need for the curriculum to be revised. This feedback will help the faculty in revising and improving their future curriculum.

 

KEYWORDS: Medical curriculum, medical school, curriculum review, undergraduate medical students

 

Prevalence of Vitamin D Deficiency in Pakistani Population

 

Khan MU1, Norhasiza Mat Jusoh2, Rao Sanaullah Khan3, Atif Amin Baig2*, Ilyas MN2,

Ghafoor A4, Tahir M4

1AL-RAZI Health Care Centre, Lahore, Pakistan.

2Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia.

3Institute for Community Health Development, Universiti Sultan Zainal Abidin, Malaysia.

4Centre for Applied Molecular Biology,University of the Punjab, Lahore, Pakistan.

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

Vitamin D deficiency (VDD) has arisen as a global issue and having manifold damaging effects on human health it needs urgent attention. Vitamin D is characteristically involved in bone and mineral regulation, but its deficiency can cause many extra-skeletal problems as well such as infections, heart diseases and even cancer. Due to its high incidence all over the world VDD is now documented as a pandemic. Situation is even more worrying in Pakistan. The present study was aimed to determine the status of vitamin D levels in general population of Lahore with sufficiently large sample size.  Blood samples of 5000 healthy individuals were taken after taking their consent. After extracting serum, 25(OH)D assay was performed by Electrochemiluminescence  Immuno Assay (ECLIA). Results revealed that 42% of the subjects had deficient levels of vitamin D and 29% of the participants showed insufficient levels.In current study 49% of male participants and 37 % females showed deficient levels of vitamin D. No significant association was found between vitamin D deficiency and gender or age group. Vitamin D deficiency is prevalent in Pakistan in all age groups. There is a need to take immediate measures to tackle this growing public health problem. As we are blessed to have good sunny days all-round the year, by adopting simple measures and life style changes we can win the battle against vitamin D and get rid of the risks associated with vitamin D deficiency.

 

KEYWORDS: Vitamin D deficiency, prevalence, Pakistan population

 

 

Antioxidant Potentials of Contemporary Health Tonics Popular Among the Malay Communities in Malaysia Consumed for Wellness

 

Mohd Nazri Zayapor1,2*, Aminah Abdullah2,3, Wan Aida Wan Mustapha2

1Center of Promotion and Business Development, MARDI Johor Baharu, Lot 6313, Jalan Taruka off Jalan Datin Halimah, 81200 Johor Baharu, Johor.

2Food Science Program, School of Chemical Sciences and Food Technology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, 43600 Bangi, Selangor.

3Natural Medicine Research Centre, Level 7, Blok I, Bangunan MKN Embassy Techzone, Jalan Teknokrat 2, 63000 Cyberjaya, Selangor

*Corresponding author E-mail: nazri_mardi@ymail.com

 

ABSTRACT:

Nowadays, contemporary health tonics are prolifically driven the consumer believes that their consumption can improve the health status as they claim high in antioxidants. But none of the claims are supported by the laboratory test, therefore, a dire demand to clarify the potential antioxidant status of those products is in need. Therefore, the in vitro testing of antioxidant activities is conducted on the selected health tonics to compare with a commercial green tea and to distinguish the tonic with the high antioxidant and low sugar content. A total of 8 popular health tonics and a selected green tea were analyzed for their Total Phenolic content (TPC), the DPPH strengths of inhibition capacities, IC50, the FRAP reducing capacities and Oxygen Radical Absorbance Capacity (ORAC). The total sugars and the L value were determined as well and the data obtained were analyzed by Principal Component Analysis (PCA). Three of 8 health tonics (JNA, JMG, and JSK) has approximately 3 to 4-fold higher in TPC, 1.1-fold higher in ORAC, and 2.5-fold higher in FRAP reducing capacities than the tested green tea. The TPC, ORAC, and FRAP mean values for the latter are (p<0.05) 483.32 GAE mg/mL, 6288.30 TE μM/mL, and 11.23 TE mM/mL, respectively. JNA significantly possessed the lowest IC50 value (46.86 μL/mL, p<0.05) among the tonics but slightly 1.5-fold weaker than the green tea. From the PCA, tonics with lower L values (<40) and formulated with more than 13 polyherbal ingredients explained 93.33 %, a higher trend in antioxidant activities. Consumer shall select a tonic with multi antioxidant-rich ingredients, deeper color and low in sugar for a healthier choice. Even though the tonics showed promising therapeutic values through high antioxidant activities, the efficacies and safety of those tonics shall be verified by reliable clinical trials.

 

KEYWORDS: Herbs and Spices, Natural Medicine, Aging, Health and Wellness

 

 

Perceptions and Experiences of Preconception Care Services among Mothers with High Risk Pregnancy in Kinta District, Perak: a Qualitative Study

 

Nazirah Jusoh

Kinta Health Clinic, Kinta, Perak, Malaysia

*Corresponding author E-mail: iraaudadi@gmail.com

 

ABSTRACT:

Preconception care (PCC) is a promising new approach to improve the health of future children through primary intervention and to ensure appropriate action and avoid risks in early pregnancy.  This has recently been implanted in Malaysia. To explore the perceptions and experiences of preconception care services among mothers with high risk pregnancy in Kinta District, Perak. A qualitative study was used to explore research objectives in various categories of participants. It was conducted from April till October 2016 in health clinics in Kinta District, Perak. Participants of focus group discussion (FGD) and in-depth interview (IDI) were chosen through convenience sampling among mothers with high risk pregnancy who had attended PCC clinic in Kinta District. The interviews were audio-recorded and transcribed verbatim. The transcribed data were analysed using thematic analysis. There were three major themes emerged from the interviews (1 FGD, 13 IDIs) which were: mother’s perceived PCC is for family planning, PCC is indicated for mothers with high risk pregnancy and PCC is a preparatory service for the next pregnancy. In terms of experience of the clinic, mothers experienced a long waiting time, a lack of privacy and confidentiality and a few mothers preferred to be seen by female doctors. Strategies should focus on health education and promotion about preconception care knowledge and services. It should be considered that the content of preconception care be extended to include pregnancy planning and management.

 

KEYWORDS: Preconception care, qualitative, high risk pregnancy, Kinta

 

Relationship Between Continous Assessment And  Final Professional Examination Performance Of Medical Students In Universiti Sultan Zainal Abidin, Terengganu, Malaysia

 

Norwati Daud, Husbani Mohd Amin Rebuan*, Myat Moe Thwe Aung, Harmy Mohd Yusoff

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu

* Corresponding author E-mail: husbanimar@unisza.edu.my

 

ABSTRACT:

Continuous assessment used as a part of summative assessment for the final professional examination is commonly practiced in medical programmes in Malaysia. The Malaysian Medical Council allows up to 40% of the final marks taken from continuous assessment. In Universiti Sultan Zainal Abidin (UniSZA), continuous assessment contributes to 30% of the final professional examination results. Continuous assessment reflects the overall students’ performance during clinical years (year 3, 4 and 5). To determine the relationship of the continuous assessment with the final professional examination performance (70% contribution) and the clinical component of final professional examination. Fifty-seven undergraduate medical students sat for the Professional II (final) examination for the session of 2016/2017 in Faculty of Medicine, University Sultan Zainal Abidin, Terengganu, Malaysia. The continuous assessment mark was the average of their end of posting examinations marks. In the final professional examinations, the theory component consisted of multiple choice questions and problem based questions. The clinical component consisted of 12 interactive OSCE stations, one long case and three short cases. Their results were analysed using SPSS programme version 22. Pearson correlation test was applied to determine the correlation between continuous assessment marks and the two variables. The correlation coefficient (r) value for the final professional performance is 0.796 (p<0.001) while for the clinical component performance is 0.662 (p<0.001).There was statistically significant, excellent positive correlation between continuous assessment marks and the final professional performance.  While for the clinical component performance, the correlation was good. Clinical posting marks may be used as a continuous assessment and part of summative assessment to test medical student’s clinical competence.

 

KEYWORDS: Clinical competence, communication skills, psychomotor skills, OSCE, clinical bedside examination.

 

 

Breast Cancer Screening Knowledge and Practices among Nursing Students in Kuala Terengganu.

 

MAR Husbani*, Hamidah Othman, Nurulhuda Mat Hassan, Myat Moe

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu.

* Corresponding author E-mail: husbanimar@unisza.edu.my

ABSTRACT:

In Malaysia, females suffering from breast cancer often present late when their cancer has progressed to advanced stages. Lack of knowledge among population is one of the the factor that act as a barrier to prevent the patient to come early. Nursing staffs are one of the front-liner person in medical services and thus they are the referring person for the public to seek the information. To assess the awareness and practice of the breast cancer screening among nursing students.This is a cross sectional study involving 89 nursing students from School of Nursing Science, Medical Faculty, University Sultan Zainal Abidin (UniSZA) done from 1st of March till 15th of March 2016. A self-administered questionnaire was given intended to provoke their sociodemographic information and knowledge of the breast cancer screening and their practices towards breast cancer screening. Data analysis was carried out using SPSS Version 21.Eighty-nine participants fully responded. Overall the students’ knowledge regarding symptoms of breast cancer was good with majority knowing the common symptoms and screening methods of breast cancer with 87 (97.8%), 83 (93.3%) and 85 (95.5%) respondents know about breast self-examination, clinical breast examination and mammogram respectively. Students’ had variable knowledge on risk factor (family history, 49.4%, contralateral cancer, 55.1%, increasing age, 83.1%) for having breast cancer.  Only 41 students (46.1%) carried out the breast self-examination procedure and 5 participants (5.6%) had clinical breast examination.The overall students had good knowledge about the common symptoms of breast cancer and its screening programmes however lack of practice among them. More programme must be done to increase the awareness of the breast cancer screening programme among nursing students thus they will be able to transfer the knowledge to the public effectively. 

 

KEYWORDS: Breast cancer screening, breast self-examination, clinical breast examination

 

 

Fat-Mass and Obesity-Associated (FTO) Gene Polymorphism (rs9939609): Genotypic, Allelic Frequency in Malay Obese Attributes

 

Ilyas MN, Atif AB*, Yasrul AB, Al-Hatamleh MAI, Ahmad Zubaidi AL, Nordin S

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

The fat-mass and obesity-associated (FTO) is reported to be the common gene associated with obesity. FTO is involved with its role in nucleic acid demethylation and energy balance towards feeding behaviours. FTO polymorphism (T>A) has been reported to be associated with high BMI, weight and waist circumference in different population globally. The rs9939609 T>A, polymorphism is widely studied SNP in association with obesity and associated inflammatory disorders because of its non-inflammatory nature. The objective is to elucidate the contribution of genotypic and allelic frequencies of FTO rs9939609 (A/T) polymorphism towards rising prevalence and its association with obesity among Malay obese attributes. This cross-sectional study includes a total of 217 Malay volunteers; 94 healthy obese (BMI ≥30kg/m2) and 123 normal healthy non-obese (18.5 ≤BMI ≤24.99 kg/m2), that were recruited following the inclusion and exclusion criteria. Genomic DNA was extracted from the whole blood, and genotyping analysis was performed by means of RFLP-PCR. The FTO genotypic and allelic frequencies among the subjects were calculated and compared by Chi-Square test. Statistical significant was accepted at p < 0.05. The analysis of FTO T>A gene polymorphism in all subjects found frequencies of 87.23%, 7.45% and 5.31% for the TT, AT and AA genotypes, respectively. The allele frequency was 94.69% for the T allele and 12.77% for the A allele. The risk allele ‘A’ is found least associated with obesity among Malay obese. This study concludes that the genotypic and allelic distribution of FTO gene polymorphism (T>A) was much lower than other reported in ASEAN populations. The other studies on Malaysian population also found similar results in two regions of Malaysia. Therefore, it is concluded that FTO (T>A) polymorphism is not/least associated with obesity but further investigations are required on other ethnicities to validate our findings in Malaysia.

 

KEYWORDS: Fat-mass Obesity-associated gene, genotypic and allelic frequencies, polymorphism, obesity, Malay.

 

Determination of Vital Anthropometric Indices and Their Association With Obesity Related Cardiovascular Risk Factors Among Malay Obese Attributes Towards Rising Malaysian Obesity

 

Ilyas MN, *Atif AB, Yasrul IAB,Al-Hatamleh MAI, Ahmad Zubaidi AL, Nordin S

Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

Obesity is the rising health risk in Malaysia and associated with many chronic diseases. There are various classical anthropometric measurements used for obesity but the critical Cardiovascular(CVD) risk related anthropometric indices are always neglected. The associated CVD risk factors include lipid profile in our study. Few studies had been conducted to find best anthropometric indices predictor for CVD risks among “ASEAN” populations. The objective is to determine the association of vital anthropometric indices with cardiovascular risk factors among Malay obese attributes. This cross-sectional study was conducted at Terengganu with a total of 92 obese subjects beside non obese as control. Anthropometric indices (W/H, W/Ht, BMI, AVI, and CI) and lipid profiles were determined beside arithmetic means and differences between the obese and non-obese group were compared and correlated. The results showed mean of W/H, W/Ht, BMI, AVI and CI for Malay obese attributes was 13%, 31%, 49%, 73%, and 8% respectively higher than the mean of these parameters in non-obese. The results reflected that the W/H (r=0.44 for TG, r=0.43 for TG/HDL, r=0.42 for TC/HDL, r=0.42) and W/Ht (r=0.45 for fat%, r=0.43 for TG) have fair correlation with CVD risk factors. While AVI (r=0.31 for TG/HDL) and Conicity index (r=0.34 for TG/HDL, r=0.32 for TG) are quiet significant with association to CVD risk factors. BMI remains non-significant in predicting CVD risk factors. It is concluded that W/H ratio and AVI are good predictors for CVD risks in Malay obese attributes. While the measure for central obesity (W/Ht ratio and conicity index) tends to show fair correlation with CVD risk factors. BMI remains the non-significant predictor among all indices to predict CVD risk.  To the best of our knowledge it’s the first report in Malaysia that determines the association of critical anthropometric indices with obesity related CVD risk factors.

 

KEYWORDS: Obesity, anthropometric indices, cardiovascular (CVD), risk, predictors, Malaysian

 

Comparative analysis of the Anthropometric Indices between Malay Obese Attributes and Normal Healthy Individuals

 

Ilyas MN1, *Atif AB1, Saif UK2, Emilia A1, Al-Hatamleh MAI1, Zahri MK3, Norizan Abd Ghani2, Zilfalil BA4, Khawar SJ5, Nordin S1, A. Zubaidi AL1,  Malaysian node of HVP6

1Faculty of Medicine, University Sultan Zainal Abidin

2Faculty of Applied Social Sciences, Universiti Sultan Zainal Abidin

3Faculty of Health Sciences, Universiti Sultan Zainal Abidin

4Department of Pediatrics, Universiti Sains Malaysia

5DOW University of Health Sciences, Pakistan

6Team Members for Malaysian Node of HVP

*Corresponding author E-mail: atifamin@unisza.edu.my

ABSTRACT:

Recently, globosity has become an alarming problem for health. The comparative anthropometric measurements between obese and normal healthy individuals are of great importance for the the underlying pathology associated with obesity. The objective was to compare means of anthropometric measurements between normal and obese healthy Malays. A cross sectional study was conducted, comprising of a total of 400 samples recruited through volunteer random sampling. A total of 95 subjects [male = 44 (46.3%) and females = 51 (53.7%); Age: 19 – 60 years], were included for the analysis for being the obese individuals as per inclusion criterion beside a total of 123 normal healthy subjects [male = 32 (26.0%) and females = 91 (74.0%); Age: 19 – 60 years]. Classical anthropometric measurements (waist circumference, hip circumference, body mass index (BMI), waist to hip ratio (WHR) and body fat percentage (Fat %) were determined beside determination of a novel ASindex [hip – waist (cm)]. The mean values of BMI, ASindex [hip – waist (cm)], waist to hip ratio (WHR) and body fat% were determined and compared to see the difference between obese and normal healthy individuals.The comparative analysis was performed and the results were represented as mean. The mean of the BMI, WHR, Fat% and ASindex, in Malay obese attributes were calculated to be 32.83, 0.88, 33.5 and 13.21 respectively. Similarly, the mean of the BMI, WHR, Fat% and ASindex, in normal healthy individuals were calculated to be 22.1, 0.78, 24.2 and 20.1 respectively. The difference of mean of BMI, WHR, Fat% and ASindex was calculated to be 10.73, 0.1, 9.3 and 6.89 respectively.To the best of our knowledge, this is the first report in Malaysia; comparing mean values of BMI, WHR, Fat% and ASindex are clearly indicating the difference of mean in obese and normal healthy individuals in Malay attributes.

 

KEYWORDS: Malay obese, obesity, anthropometric measurements, comparative analysis, Malaysia

 

Frequencies of Gynocoid, Android and Barrel shape in Malay Obese Attributes

 

Atif Amin Baig1*, Saif Ullah Khan2, Muhmmad Ilyas Nadeem1, Norizan Abdul Ghani2,

Zilfalil BA3, Khawar Saeed Jamali4, Nordin Bin Simbak1, Ahmad Zubaidi A. Latif1

1Faculty of Medicine, University Sultan Zainal Abidin

2Faculty of Applied Social Sciences, Universiti Sultan Zainal Abidin

3Department of Paediatrics, Universiti Sains Malaysia

DOW University of Health Sciences, Pakistan

4Team Members for Malaysian Node of HVP

*Corresponding Author Email: atifamin@unisza.edu.my

 

ABSTRACT:

The prevalence of obesity has been increasing globally, with high prevalence in Malaysia. Malay obtained sedentary lifestyle besides western diet due to rapid socioeconomic growth for the last few decades. Obesity has risen to be alarming (currently 14.1%) in Terengganu, which is associated with many metabolically associated diseases including cardiovascular, metabolic dysfunctions and arterial hypertension.A total of 95 obese subjects (44.2% men, n=42, 55.8% women, n=53; Age: 19 - 60) were recruited through volunteer random sampling to be involved in a cross-sectional study. Classical anthropometric measurements (waist circumference, hip circumference, body mass index (BMI), waist to hip ratio (WHR) and body fat% were determined beside determination of a novel ASindex [hip – waist (cm)]. The Asindex was used for the determination of gynocoid, android and barrel shaped obesity in Malay obese attributes. As per methodology, the frequencies represented as percentage (fractions), are determined to be 62.1% (1:1.79) for gynocoid obesity, 6.3% (1:15.8) for android obesity and 31.5% (3:1) for barrel shape.To the best of our knowledge, this is the first report in Malaysia, reflecting the calculations derived through Asindex clearly indicating that the prevalence of gynocoid obesity is greater 89.9% of android obesity in Malay obese attributes.

 

KEYWORDS: Frequencies obesity, obesity Malaysia, Terengganu obesity Ratio, classification obesity, body shape

 

ASindex: A Novel Screening tool to characterize the Gynocoid, Android

and Barrel shaped Obesity

 

Atif Amin Baig1, Saif Ullah Khan2, Muhammad Ilyas Nadeem1, Zilfalil BA3,

Nordin Bin Simbak1, Ahmad Zubaidi A. Latif1, Malaysian node of HVP4

1Faculty of Medicine, Universiti Sultan Zainal Abidin

2Faculty of Applied Social Sciences

3Department of Paediatrics, Universiti Sains Malaysia

4Team Members for Malsyain Node of HVP

*Corresponding Author Email:atifamin@unisza.edu.my

ABSTRACT:

Till date, to the best of our knowledge the genocide, android and barrel shaped obesity are characterized by the pear shaped, apple shaped and barrel shape body appearance respectively.  There was a need to develop a screening strategy based on the anthropometric measurements and the available/ reported anthropometric indices are unable to define these different types of obesity. Here we explain a screening method for this purpose by using the novel three indices, namely ASindex [Hip circumference (Hc) minus Waist circumference Wc)]. The screening criterion involves the following steps: 1:The weight (kg) and height (meters) of the subject will be measured to calculate the BMI. 2:The hip circumference (Hc) and waist circumference (Wc), will be measured in obese subjects and the ASindex will be calculate for the difference will be calculated by the formula; Hc – Wc (cm). 3:The mean and +SD, for the ASindex for the given sampleswill becalculated. 4:The subjects with the negative value for ASindex and the subject withthe ASindex value between -1 SD and -2 SD of the mean ASindex will be the android obese.5:The subjects with the positive values equal to or more than the mean value for ASindex will be considered to be genocide obese for that specific observational frame.6:Subjects with the ASindex values lesser than mean and between the mean ASindex and -1SD will be the barrel shaped obese. The criterion can be subjected to obese attributes beside its application on normal healthy individuals for the prediction of the genocide, android and barrel shaped obesity. The method was tested on a total of 50 type I, obese subjects (as per sample size calculations).  The results showed the specificity and sensitivity of the screening method to be acceptable (more than 0.5) via XLSTAT data analyser. To the best of our knowledge, this is the first study proposing the method to differentiate the genocide, android and barrel shaped obesity as per statistical avoided rigors.

 

KEYWORDS: Waist to hip ratio tool, anthropometric indices, criteria obesity, novel measurements

 

ORAL: Development of Novel Tool for the Quantification of Obesity related/ Induced Non-genetics Associated Factors in Malaysia

 

Saif Ullah Khan1, Norizan Abdul Ghani1, Emilia Apidi2, Yasrul  Izad Bin Abu Bakar2, Mohammad Khairi Zhari3, Mohammadahmed Issa Al-Hatamleh1, Nordin Bin Simbak2,

Ahmad Zubaidi A. Latif2, Atif Amin Baig2

1Faculty of Social Sciences, Universiti Sultan Zainal Abidin,

2Faculty of Medicine, Universiti Sultan Zainal Abidin,

3Faculty of Health Sciences, Universiti Sultan Zainal Abidin

*Corresponding Author Email:atifamin@unisza.edu.my

 

ABSTRACT:

Obesity is highly heterogeneous issue that is linked with associated factors, affecting social and economical development of the country. We have developed a tool for the quantification and curating of associated factors of obesity in Malaysia, as no proper valid tool is available till date to assess those factors associated with obesity with specification to multi- rationale, multi-ethnic and multi sub-ethnic population in Malaysia. PubMed, Research Gate, BMC and Google Scholar were used as search engines for previous studies. Specific keywords were used, such as obesity in Malaysia, associated factors with obesity, socio-economic factors obesity tools, and obesity surveys. A total of 2000 studies were selected, and associated factors of obesity in Asian and Asean countries across the world were listed for the face validation among experts in Malaysia. The tool was constructed as per objective measures for the use among Malay obese attributes and for the comparison with normal healthy individuals.  The tool was constructed with a total of 99 items subdivided into a total of 19 domains (sections) inclusive of 176 variables. The face validity was performed and questionnaire was distributed for its validity. The results of validity for translated version in future will help us to make this vital tool available in Malay language too for future use. Increasing ratio of obesity in Terengganu (>20%) is scientifically evidenced in Malaysia and to the best of our knowledge, there is still no proper tool available to measure the associated factors for interventional associated factors towards prevention and treatment of obesity. It is one of best tool, precisely addressing the variable for specific issues as per cited articles. Obesity experts evaluated this tool through face validation and have been followed through. This questionnaire is available in both Malay and English languages (English one is validated). We will modify and update this questionnaire with time to time so it will help people accordingly to bring this tool in future at national level to prevent from real time associated factors of obesity in Malaysia.

 

KEYWORDS: Obesity tool, instruments, associated factors, obesity, social factors

 

Malaysian Obesity DNA Bank; Towards Developing Anti

Obese Nation Wide Strategy

 

Atif AB, Emilia A, Aliya S, Ramla F, Ahmad Zubaidi A Latif, Nordin S

Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

The pathophysiology of obesity being multifaceted disorder involves intricate choreography of environmental, behavioural and genetic factors. The genetics factors may influence metabolism or diet intake thus leading to increased adiposity. In order to understand the interaction and role of different candidate genes reported to be involved in obesity, there is a need to get the complete pattern for a better understanding of the genetics factors associated with obesity. To develop the Malaysian obesity DNA bank for future studies on obesity towards developing anti-obesity nation-wide strategy. Malay subjects have been recruited from Terengganu after the approval of ethical approvals from respective agencies and departments. The samples have been recruited in three stages; pre-screening via official letters and phone connections on the basis of promotion of health knowledge. It has been followed by screening phase via BMI calculations as per WHO criterion. The Last phase has been enrolment of subjects to be involved in obesity research. Till date we have recruited a total of 450 samples as per inclusion and exclusion criterion beside, the control samples from normal healthy individuals who are not tested for genotypically normality but are phenotypically normal. The data is well curated and recorded with the index number of sample and subject indexing to access samples, when required. Samples are stored well as per regulation of DNA storage. We have developed successfully the first Malaysian obesity DNA bank at faculty of medicine, Universiti Sultan Zainal Abidin for obesity related. The future undertakings will be focusing to provide a free service for the genetic pattern of their obesity status.

 

KEYWORDS:  Obesity in Malaysia, Obesity DNA-Bank, Obesity and Genetics, BMI and Obesity, Anti-Obesity.

 

X-Infect: Halal, Non Toxigenic, Anti-bacterial, Anti-Fungal and Multipurpose Cleaning Detergent; towards Development of Multipurpose Skin Ointment

 

Atif A.B1, Yasrul IAL1, Zahri MK2, Adzim MKR2, Ahmad Zubaidi A. Latiff1, Nordin S1

1Faculty of Medicine, Universiti Sultan Zainal Abidin (UNISZA)

2Faculty of Health Sciences, Universiti Sultan Zainal Abidin (UniSZA)

*Corresponding author E-mail: atifamin@unisza.edu.my

ABSTRACT:

Assessment method is important in determining clinical performance. Assessment relies strongly on how good the marking scheme is. For the session of 2016/2017, family medicine unit in the Faculty of Medicine, Universiti Sultan Zainal Abidin had taken some steps to improve its assessment marking scheme as well as the method of assessment for family medicine rotation. Assessment rubrics for subjective marking were refined and a more objective assessment was used for the continuous assessment. The objective is to determine the correlation between end of posting performance and continuous assessment performance before and after an improved marking scheme for continous assessment. Medical students’ examination results for family medicine rotation for the session of 2015/2016 (pre intervention) and session 2016/2017 (post intervention) were analyzed for correlation of end of posting performance with continuous assessment, and mean difference between end of posting results and continuous assessment. Correlation was analyzed using Pearson correlation test and mean difference was analyzed using t-test. For the session of 2015/2016, the correlation coefficient (r) value for continuous assessment was 0.147 (p<0.001), while for 2016/2017 it was 0.484 (p<0.001). The mean difference of marks between end of posting and continuous assessment was 12.54 for 2015/2016 and 5.68 for 2016/2017. Both differences were statistically significant (p<0.001).Improvement in continuous assessment marking scheme and a more objective continuous assessment have increased the correlation between continuous assessment performance and end of posting performance. The correlation was poor for 2015/2016 and improved to high fair for 2016/2017. Improved marking scheme has also reduced the difference in mean marks between continuous assessment and end of posting marks.  Thus it is worth to revise the marking scheme of especially subjective assessment to reflect the true performance of medical students.

 

KEYWORDS: X-infect, non-toxic detergent, antifungal detergent, antifungal cleaning agent, cleaning agent.

 

 

Angiotensin-1 Converting Enzyme I/D Gene Polymorphism: Its Prevalence and Association with Obesity among Malaysian Malay Subjects

 

Yasrul IAB1, Atif AB1* , Emilia A1, Rohayu I.M.R2, Zahri M.K2, Zilfalil BA3, Nordin S1,

A Zubaidi AL1

1Faculty of Medicine, Universiti Sultan Zainal Abidin

2Faculty of Health Sciences, Universiti Sultan Zainal Abidin

3Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia

4Team Members of Malaysian node of Human Variome Project

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

Angiotensin converting enzyme (ACE) has been identified as one of the candidate gene associated with obesity. ACE is central for the effective modulation of renin-angiotensin system (RAS). Ever since ACE gene has been reported to be polymorphic, numerous studies have been conducted to identify the distribution of I/D allele and its association with various diseases including obesity. This study sought to determine the genotypic and allelic distribution of ACE I/D gene polymorphism and its association with obesity in Malay subjects. This cross-sectional study including 217 Malay volunteers; 94 obese (BMI ≥30kg/m2) and 123 non-obese (18.5 ≤BMI ≤24.99 kg/m2) that were recruited following the inclusion and exclusion criteria of this study. Genomic DNA was extracted from the whole blood, and genotyping analysis was performed by means of allele-specific PCR. The ACE genotypic and allelic frequencies among the subjects were calculated and compared by Chi-Square test. Statistical significant was accepted at p < 0.05. Analysis of ACE I/D gene polymorphism in all subjects found frequencies of 51.6, 39.2 and 9.2% for the II, ID and DD genotypes, respectively. The allele frequency was 71.2% for the I allele and 28.8% for the D allele. Stratification of subjects according to obesity status showed no significant changes in the genotypic and allelic distribution of ACE gene in both groups, as the distribution of II, ID and DD genotypes in obese subjects was 47.9, 42.6 and 9.5%, respectively, while the I and D allele frequency was 69.1% and 30.9%, respectively. In non-obese subjects, the distribution of II was 54.5%, followed by ID (36.6%) and DD (8.9%). The allele frequency was 73.0% for the I allele and 27.0% for the D allele. The genotype and allelic distribution were similar in both groups and in accordance with Hardy-Weinberg equilibrium. This study demonstrates that the genotypic and allelic distribution of ACE gene was still lower than that reported in Western populations. Although it is not associated with obesity, further larger studies are required to validate our findings.

 

KEYWORDS: Angiotensin converting enzyme (ACE), renin-angiotensin system, polymorphism, obesity, Malaysia

 

 

 

 

Prevalence of Helicobacter pylori infection in Pakistani population

 

Khan MU1, Yasrul IAB3, Ahmed S , Munir R,  Ghafoor A2 , Tahir M2, Atif AB3*

1Centre for Applied Molecular Biology,University of the Punjab, Lahore, Pakistan

2AL-RAZI Health Care Centre, Lahore, Pakistan

3Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia.

*Corresponding author E-mail:atifamin@unisza.edu.my

 

ABSTRACT:

Helicobacter pylori (H Pylori) is the microorganism causes persistent bacterial infection worldwide. It is related to peptic ulcers, gastric ulcers; mucosa associated lymphoid tissue lymphoma and gastric cancers. H. pylori has higher prevalence in developing countries of world. This study was conducted to determine the prevalence of H. pylori infection in general population of Lahore, Pakistan. A cross sectional study was conducted at AL-Razi Health Care Centre, Lahore from January 2015 to January 2017. The serum samples of individuals were estimated for anti H. pylori IgG antibodies by enzyme linked immunosorbent assay (ELISA). Total 1502 individuals with age range from 5 to 86 years were included in this study. Out of these 734 (49%) were males and 768 (51%) were females. The results showed that 853 (57%) out of 1502 subjects were seropositive for H. pylori. The prevalence of H. pylori infection was highest (63%) in middle age (41-60 years) group while lowest (33%) in teens and pre teens (<20 years) group. In young age (20-40) and old age (>60 years) groups, the prevalence of H. pylori was 55% and 60% respectively. It can be concluded that the frequency of H. pylori infection increases with age in Pakistani population. Others factors associated with H. pylori infection are needed to be investigated in future.                              

 

KEYWORDS:  Prevalence, H. Pylori, infection, Pakistan, developing countries

 

Molecular Characterization of CYP1B1 in Primary Congenital Glaucoma in Pakistan

 

Khan MU1, Yasrul IAB3,  Kaul H2 , Rehman R2 , Mahmood S2, Atif AB3*

1Centre for Applied Molecular Biology/University of the Punjab, Lahore, Pakistan

2University Of Health Sciences, Lahore, Pakistan

3Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

Primary congenital glaucoma (PCG) is the foremost cause of blindness in children. In PCG the optic nerve damage and permanent loss of vision occurs because of developmental defects of trabecular meshwork of the eye. The mode of inheritance of PCG is mostly autosomal recessive, so, its incidence is higher in residents where consanguinity is common. CYP1B1 is a major contributing gene for PCG. The present study aimed to investigate the mutational spectrum of the CYP1B1 in Pakistani patients affected with PCG. This study comprised of 35 unrelated individuals clinically diagnosed with PCG by standard ophthalmological examinations. Genomic DNA was extracted from blood samples of these patients and screened for mutations in CYP1B1 by amplifying itsall coding regions with specifically designed primers. PCR products were purified and Sanger sequencing was done by using BigDye terminators and capillary electrophoresis. Sequencing analysis revealed one mutation, c.1169 G>A in exon 3 of CYP1B1 gene. This missense mutation replaces Arginine with Histidine at codon 390. This homozygous mutation was observed in (7 patients) 20% of the PCG patients enrolled in the study. In addition two missense sequence variants c.1294G>C (2 patients), c.1358A>G (4 patients) and a synonymous variant c.1347T>C (18 patients) were also seen in the present study. The results of the current study reflect that CYP1B1 mutation is one of the cause of primary congenital glaucoma in Pakistani patients.

 

KEYWORDS: Primary congenital glaucoma,CYP1B1, mutation, Pakistan, polymorphism

 

Moelcular Characterization of the Promoter Region of the Nuclear Factor Kappa-B Subunit 1 (NFKB1) Gene; Towards its Involvement in Susceptibility to Obesity in Malay Obese Attributes

 

Mohammad Ahmed Issa Al-Hatamleh1, Tengku Mohammad Ariff2, Omar Mahmoud Al-Shajrawi1, Muhmmad Nadeem Ilyas1, Ahmad Zubaidi A. Latif1, Nordin Bin Simbak1, Atif Amin Baig1*

1Faculty of Medicine, Universiti Sultan Zainal Abidin,

2Institute for Community Development and Quality of Life, University Sultan Zainal Abidin.

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

The nuclear factor kappa-B subunit 1 (NFKB1) gene at 4q24 encodes a 105 kD protein which can undergo cotranslational processing by the 26S proteasome to produce a 50 kD protein. The 105 kD protein is a Rel protein-specific transcription inhibitor and the 50 kD protein is a DNA binding subunit of the NFKB protein complex. The NFKB protein is a pleiotropic transcription factor present in most of the cell types and is the endpoint of a series of signal transduction proceedings that are initiated by a vast array of stimuli related to many biological processes such as immunity, differentiation, cell growth, apoptosis, inflammation and tumorigenesis. It has been postulated to be the integrated molecule between obesity and hypoxia.This study aimed to perform molecular characterization of the human NFKB1 promoter region.The sequence of the promoter region of the human NFKB1 (Accession no. AY515254) was obtained from Gene bank. The open reading frames (ORFs), restrictions/methylation sites against a total of 560 recognition sequences, a total of three TATA boxes (TATA, tata, Goldberg Hogness Sequences) were identified using clustal X feature of VectorNTI. Transcriptional factors binding sites (TFBS) were identified using online tool. Promoter prediction was determined by doing manually matching of TFBS with TATA box from outward in. These manual findings were compared with online promoter prediction results. A total of 4 ORFs were identified, A total of two vital restrictions sites; AvaI (-177bp) and BamHI (-201 bp) were found. Four TATA boxes [TATA (TATAA): at -219 bp (100.0% similar) on complementary strand, tata (TTGACA): at -281 bp  (83.3% similar) on complementary strand and -271 bp  (83.3% similar) on complementary strand, and Goldberg–Hogness (TATAAAA): at -221 (100.0% similar) on complementary strand] were identified. Thirty five TFBS were found online, five TFBS (GR-beta, TFIID, TBP, MEF-2A, and HNF-3alpha) matches exactly with TATA box (TATAA), position -219 bp. In the online promoter prediction, prediction transcription start site (TSS) was not found. Till date this is the first study characterizing the molecular motifs and crucial elements within the reported promoter region of NFKB1 though successfully characterized in this study, there is a serious need to study the involvement of these motif in the transcriptional regulation of NFKB1 in future studies as per the role of these transcriptional factors in cell proliferation and motility in obesity and hypoxia.

 

KEYWORDS: Bioinformatics, NFKB1, promoter region, obesity, Malay obese.

 

 

 

 

Molecular Characterization of the Promoter Region of the Vascular Endothelial Growth Factor (VEGF) Gene; Towards its Involvement in Susceptibility to Obesity in Malay Obese Attributes

 

Mohammad Ahmed Issa Al-Hatamleh1, Tengku Mohammad Ariff2, Muhmmad Nadeem Ilyas1, Nordin Bin Simbak1, Ahmad Zubaidi A. Latif1, Atif Amin Baig1*

1Faculty of Medicine, Universiti Sultan Zainal Abidin,

2Institute for Community Development and Quality of Life, University Sultan Zainal Abidin.

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

The vascular endothelial growth factor (VEGF) gene at 6p12 encodes the VEGF protein which is a potent angiogenic factor and was first described as an essential growth factor for vascular endothelial cells. This protein was originally described as an endothelial cell-specific mitogen. VEGF plays a role in normal physiological functions such as haematopoiesis, bone formation, and wound healing. The activities of VEGF are unlimited to the vascular system; VEGF is produced by many cell types including platelets, macrophages, renal mesangial cells, keratinocytes, and tumour cells. It has been postulated to be the VEGF polymorphisms play a role in the integrated molecule between obesity and hypertension. This study aimed to perform molecular characterization of the human VEGF promoter region. The sequence of the promoter region of the human VEGF (Accession no. AF095785) was obtained from Gene bank. The open reading frames (ORFs), restrictions/methylation sites against a total of 560 recognition sequences, a total of three TATA boxes (TATA, tata, Goldberg Hogness Sequences) were identified using clustal X feature of VectorNTI. Transcriptional factors binding sites (TFBS) were identified using online tool. Promoter prediction was determined by doing manually matching of TFBS with TATA box from outward in. These manual findings were compared with online promoter prediction results.A total of 34 ORFs were identified, with a total of 20 on direct strand and 15 complementary strand. A total of 14vital restrictions sites were found against 560 recognition sequence in our database. Thirty eight TATA boxes inclusive of, 22 TATA (TATAA), 12 tata (TTGACA) and 4 Goldberg–Hogness (TATAAAA) sequences were identified. A total of 79 TFBS were identified using online tools. In the online promoter prediction program, prediction of transcription start site (TSS) was determined to be at -1562 bp and -562 bp. To the best of our knowledge this is the first study characterizing the molecular motifs and crucial elements within the reported promoter region of VEGF though successfully characterized in this study, there is a serious need to study the involvement of these motif in the transcriptional regulation of VEGF in future studies as per the role of these transcriptional factors in susceptibility to obesity and hypertension.

 

KEYWORDS: Bioinformatics,VEGF, promoter region, obesity, Malay obese.

 

Molecular Characterization of the Promoter Region of the Brain Derived Neurotrophic Factor (BDNF) Gene; Towards its Involvement in Academic Stress Induced Oxidative Stress and Blood Indices Alteration in Medical Students

 

Mohammad Ahmed Issa Al-Hatamleh1, Tengku Mohammad Ariff2, Gotam Kumar1,

Muhmmad Nadeem Ilyas1, Nordin Bin Simbak1, Ahmad Zubaidi A. Latif1, Atif Amin Baig1*

1Faculty of Medicine, Universiti Sultan Zainal Abidin,

2Institute for Community Development and Quality of Life, University Sultan Zainal Abidin.

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

The brain derived neurotrophic factor (BDNF) gene at 11p14.1 encodes the BDNF protein which is found in the brain and spinal cord. This protein is a member of the neurotrophic family of neurotrophic factors, and one of the most important proteins, promoting the survival of neurons via regulation of the growth and maintenance of neurons. The BDNF protein plays a significant role in neurogenesis, memory and learning, mood changes, and found in regions of the brain that control drinking, eating, and body weight. It has been postulated to be involved in academic stress in medical students and alteration of blood indices as per level of oxidative stress as per academic stress. This study aimed to perform molecular characterization of the human BDNF promoter region.The sequence of the promoter region of the human BDNF(Accession no.KX964617) was obtained from Gene bank. The open reading frames (ORFs), restrictions/methylation sites against a total of 560 recognition sequences, a total of three TATA boxes (TATA, tata, Goldberg Hogness Sequences) were identified using clustal X feature of VectorNTI. Transcriptional factors binding sites (TFBS) were identified using online tool. Promoter prediction was determined by doing manually matching of TFBS with TATA box from outward in. These manual findings were compared with online promoter prediction results. A total of 11 ORFs were identified, with a total of 7 on direct strand (Table 1). A total of two vital restrictions sites; ApaLI (-479bp) and PstI (-220 bp) were found (Figure 1). Six TATA boxes [1 TATA (TATAA): at -605 bp (100.0% similar) on complementary strand, 1 tata (TTGACA): at -79 bp  (100.0% similar), and 4 Goldberg–Hogness (TATAAAA): at -650 bp (85.7% similarities) on complementary, -621 bp (85.7% similarities), -530 bp (85.7% similarities), and -514 bp (85.7% similarities) on complementary] were identified (Figure 2). Sixty three TFBS were found online, four TFBS (TFIID, GR-beta, HOXD9, and HOXD10) matches exactly with Goldberg–Hogness TATA box at position -530 bp. In the online promoter prediction, prediction transcription start site (TSS) was at 300 bp.This is the first study characterizing the molecular motifs and crucial elements within the reported promoter region of BDNF though successfully characterized in this study, there is a serious need to study the involvement of these motif in the transcriptional regulation of BDNF in future studies as per the role of these transcriptional factors in academic stress in medical students and oxidative stress beside involvement in blood haemostasis.

 

KEYWORDS: Bioinformatics,BDNF, promoter region, stress, oxidative stress, medical students, blood indices.

 

Frequency of Antinuclear antibodies in normal healthy population in Pakistan

 

Khan MU1, Hasan B3, Zahri MK4, Salman A3, Ghafoor A2 , Tahir M2, Atif AB3

1Centre for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan

2AL-RAZI Health Care Centre, Lahore, Pakistan.

3Faculty of Medicine, Universiti Sultan Zainal Abidin, Malaysia,

4Faculty of Health Sciences, Universiti Sultan Zainal Abidin.

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

The autoimmune disorders and auto antibodies are rapidly becoming a major cause of concern in the medical field. Antinuclear antibody plays a significant role in autoimmunity and it is targeted against different nuclear antigens. Although its elevated levels are found in autoimmune disorders but it is also synthesized in healthy individuals. The study objective is to determine the frequency of antinuclear antibodies in healthy individuals in Pakistan. Blood samples of 587 (503 females and 84 males) individuals were taken through convenience sampling technique. Serum was separated by centrifugation and then ANA titer was determined by Enzyme Linked Immunosorbent Assay (ELISA). SPSS version 20.0 (IBM-SPSS, Inc, Armonk, New York) was used for statistical calculations. ANA autoantibodies were found only in 6 individuals, out of which 5 were females and 1 was male.No significant association of antinuclear antibodies was observed between males and females. Evaluation of the incidence of ANA in general population is important to ensure its reliability as a biomarker of disease. Current study found very low occurrence of ANA in general population which indicates its exclusive association with the diseases especially autoimmune diseases. The one percent positive cases can be further followed up for being at risk of developing disease.

 

KEYWORDS: Antinuclear antibodies in Pakistan, healthy individual, serum, frequency, Pakistan

 

 

Prevalence of Obesity in Malay Population in Malaysia Based on the

BMI Status; A study in Terengganu

 

Hassan B1, Atif AB1, Saif UK2, Norizan AG2, Ahmad Zubaidi A Latif1, Nordin S1

1Faculty of Medicine, Universiti Sultan Zainal Abidin

2Faculty of Applied Social Sciences, Universiti Sultan Zainal Abidin

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

A normal health status is highly depends on body weight. Many health problems may occur or imposed risk for extremely obese individuals. BMI status may be useful to overcome the associated comorbidities. This study determined the prevalence of obesity and its types among adults, aged 19 – 60 years, in the Terengganu during 2015. A cross sectional study was conducted for a period of six months. A total of 340 subjects were recruited through volunteer sampling. The BMI was determined by the standard method. Well-appropriate antropometric calculations (BMI, waist circumference, hip circumference, fat percentage) were computed to assess the indices of obesity and its types. WHO classification for determining an obese subject was followed. BMI was determined for all the subjects and it was found that out of 340 subjects, a total of 95 subjects (27.9%) were found to be obese as per WHO criterion for BMI, a total of 122 subjects were  overweight (35.8%) and normal BMI individuals were 123 (36.1%). To the best of our knowledge, this is the first report with a high subject size, reporting the prevalence of obesity in Malaysia (Terengganu) to be 27.6% with a prevalence of overweight to be 35.8%. There is a serious need to address this alarming prevalence of obesity by studying the genetics, non-genetics associated factors and diet related CVD risks for obese and overweight subjects in Terengganu and Malaysia.

 

KEYWORDS: Prevalence of obesity, obesity in Malaysia, BMI, Malay population, Terengganu

 

Research Institution via Z to A Based Graphs

 

Atif Amin Baig1, Hassan Basri1, Khairi Che Mat1, Saif Ullah Khan2, Muhammad Ilyas Nadeem1,  Mohd Khairi Zahri3, Muhammad Ali Mirza4, Nordin Bin Simbak1

1Faculty of Medicine, Universiti Sultan Zainal Abidin,

2Faculty of Applied Social Sciences, Universiti Sultan Zainal Abidin,

3Faculty of Health Sciences, Universiti Sultan Zainal Abidin,

4Lets Graph, iSocialYou,  Dallas, USA

*Corresponding author E-mail: atifamin@unisza.edu.my

 

ABSTRACT:

Research institution is a complex and highly advance process including the higher order thinking, targeting the teaching, learning, training, research and development and productivity of the academicians, researchers, management teams and coordinating staff at all levels of institutional policies to the level of postgraduate integrity. The entire process is not well understood mainly because of poor life/work balance of the staff to be involved in learning and enhancing the tips and skills involved as per global standards. Z to A type of approach is well considered for a better productivity for a baseline knowledge beside least resources and time in this era of blue ocean strategy to be aligned with competitors and collaborators. Here, we explain a new method based on educating the staff and postgraduates via graphical presentations using fractions, percentages and rates beside basic mathematical interventions for summarizing the basic concepts to be motivational and productive. A total of 300 individuals in three countries were tested via online tool for the specificity, sensitivity and comparison of our electronic graphs via social media as compare to traditional methods. Results showed that the 91% of the subjects were highly satisfied with the level of knowledge, awareness and use of that knowledge without any contact hour based teachings. To the best of our knowledge, this is the first time we have been using this tool based on Z to A type of research institution and laboratory education, under blue ocean based strategic planning.

KEYWORDS: Research institution, e-learning in Malaysia, metacognition and teaching, blue ocean strategy, teaching through graphs.

 

Comparison between Clinical Severity of Transfusion Dependent Beta Thalassemia and Haemoglobin E Beta Thalassemia

 

Nurul Fatihah Azman1*, Rosline Hassan2, Wan-Zaidah Abdullah2, Sarifah Hanafi1,

Diana rashid1, Ariffin Nasir1, Maryam Mohd Zulkifli 3, Muhammad Farid Johan2,

Rosnah Bahar2, B. A. Zilfalil1

1Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia

2Department of Hematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia

3Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia.

*Corresponding author E-mail: roslin@usm.my

ABSTRACT:

Transfusion dependent thalassemia patients are defined as patients who require lifelong regular blood transfusion. In Malaysia, the most common types of thalassemia are beta thalassemia and Haemoglobin E Beta Thalassemia (HbE/beta thalassemia) with estimated carrier rate 4.5% for beta thalassemia and 3-40% for HbE. Hence, aim of this study was to identify the clinical disease presentation of transfusion dependent beta thalassemia syndrome in Malaysia. About 388 transfusion dependent thalassemia patients were recruited in this study. The parameters retrieved from patients’ folder were clinical diagnosis, haemoglobin level (g/dl), growth chart assessment, age of disease presentation (years), age receiving blood transfusion (years) and spleen size (cm). The scoring system was classified using Pearson Chi-square test. P-value <0.05 were considered statistically significant. Out of 388 patients, 234 (61.1%) and 151 (38.9%) patients were classified as beta thalassemia and HbE beta thalassemia respectively. 27% of them have spleen size less than 3 cm.  About 46% and 49% patients presented at age less than 2 years old and have stunted growth respectively. Only spleen size and height were significantly different between transfusion dependent beta thalassemia and HbE beta thalassemia (p-value<0.05). Transfusion dependent beta thalassemia syndrome heterogeneous in their clinical manifestation. The disease is more severe in beta thalassemia as compared to HbE beta thalassemia. The underline mechanisms of the difference need to be elucidated.

 

KEYWORDS: Beta thalassemia, HbE Beta thalassemia, Scoring, Transfusion dependent.     

 

Stunted Growth of Transfusion Dependent β Thalassemia Patients and the Association with Taq1 SNP of VDR gene and Vitamin D Levels

 

Diana Rashid1, Wan-Zaidah Abdulah2, Rosline Hassan2, Muhammad Farid Johan2, Rosnah Bahar2, Fatihah Azman1, Sarifah Hanafi1, Suhaimi Hussain1, B.A. Zilfalil3*, Ariffin Nasir1

1Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia

2Department of Hematology, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia

3Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kelantan, Malaysia

*Corresponding author E-mail: zilfalil@gmail.com

 

ABSTRACT:

Vitamin D receptor (VDR) gene has been suggested as one of the candidate genes to control bone mass. TaqI Single Nucleotide Polymorphisms (SNPs) of VDR gene has been reported responsible for stunted growth phenotype. This study was conducted to determine the association of the Taq1 SNP in the VDR gene and the serum Vitamin D level with growth development among transfusion dependent β thalassemia patients. Transfusion dependent β thalassemia patients were categorized into 2 groups; stunted and non-stunted growth groups based on height percentile on growth chart assessment. Subsequently, 25-hydroxy-Vitamin D was measured and TaqI polymorphism was detected using Restriction Fragment Length Polymorphism- Polymerase Chain Reaction (RFLP-PCR). The association of vitamin D levels and the genotypes of Taq1 VDR gene were determine against growth chart using statistical analysis by SPSS version 22.Out of 33 samples analysed, genotype distribution of TT and Tt were 24.2%(8) and 36.4%(12) in stunted growth group and 36.4%(12) and 3%(1) in non-stunted group respectively. Significantly, higher frequencies of heterozygous TaqI was observed in the stunted growth of thalassemia patients. No significant association between growth development and vitamin D levels.A significant association might be due to functional SNPs in the vitamin D receptor (VDR) gene and could be responsible for up to 60.6 % of stunted growth cases in this β thalassemia cohort. Despite not statistically significant, low vitamin D is more prevalent in stunted group which may be attributed to defective 25 hydroxylation of Vitamin D in the liver from iron overload and subsequent liver dysfunction.

 

KEYWORDS: Growth development, stunted growth thalassemia, TaqI, VDR gene, vitamin D level