Introduction: Breast cancer is ranked first among other cancers in women. Ineffectiveness of current treatments and adverse effects such as multiple organ failure and nephrotoxicity are the common problems faced in cancer therapy. Therefore, alternatives to treat breast cancer metastasis with fewer toxic effects are actively sought-after. Dillenia suffruticosa (DS) commonly known as ‘Simpoh air’ has been a traditional remedy for cancer growth. Therefore, this study investigated the metastasis inhibiting properties of DS root dichloromethane extract (DCMDS) in tumour bearing female BALB/c mice and sub-acute multiple dose oral toxicity upon treatment with this extract. Methods: Forty-eight tumour bearing mice were given either oral treatment of DCMDS (50, 100 and 200 mg/kg) or doxorubicin (2 mg/kg) for 28 days and the degree of metastasis was analysed in each group. Thirty other female BALB/c mice were treated with DCMDS (50, 100 and 200 mg/kg) and the general behaviours, biochemical, haematological and histo- pathological changes were observed. Data were analysed with One-way ANOVA and Dunnet’s test where p
Introduction: Patients with Nasopharyngeal carcinoma (NPC) usually diagnosed at advanced cancer stage and re- current case. Rac1 have become an emerging therapeutic target for metastasis cancer. This gene is critically involved in cell polarization and reactive oxygen species-mediated cell killing. This study aims to investigate the Rac1 activ- ities in NPC/HK1 cell line using siRNA approach and evaluate the calcium deposition profile. Methods: The NPC/ HK1cells were transfected with Rac1-siRNA (siRac1) at concentrations of 50nM, 100nM and 200nM for 24 hours and stained with alizarin red s for calcium mineralization profile. Levels of Rac1 gene expression were measured via qRT-PCR followed by the time dependent assessment for 24, 48 and 72 hours. Results: Findings revealed that siRac1 concentrations of 200nM (p-value
Cancer metastasis is a multistep process, which results in cancer cells disseminating to other organs. The crucial metastasis step involves cancer invasion which occurs via actin-protrusion by invasive malignant cells, termed as invadopodia. In solid tumours, invadopodia formation increases as a result of hypoxia which is found to be resis- tant against chemotherapy and radiotherapy. Phytochemicals have been potentially identified as a prime source of effective conventional drugs for metastasis treatments, which target cancer cell invasion, particularly molecular components of the invadopodia formation. The Hypoxia-Inducible Factor-1α (HIF-1α) is an essential target in terms of treatment for hypoxic tumour, as well as helping to identify the mode of action for the drugs, particularly phy- tochemical compounds. The aim of this review is to highlight the current development with regards to the ability of phytochemicals in targeting cancer metastasis, as well as phytochemical compounds which are able to inhibit HIF-1α and invadopodia formation. The use of phytochemicals for targeting hypoxic cancer cells may open new prospects for reducing cancer metastasis.
Bacteria and their metabolites are shown to be a potential therapeutic agent for cancer treatment. Much attention has been directed to Lactic acid bacteria (LAB) which exhibits several killing mechanisms via invasion and coloni- zation of solid tumors. Discovery of the characteristics of postbiotic metabolites that exert the same probiotic effects has attracted immense attention towards anti-cancer effect. It is known that LAB improves health and composition of microbiota in the gut. Supplementation of LAB is proven to enhance the host immunity and modulation of the immune system to fight diseases including cancers. Lactobacillus plantarum I-UL4 is the LAB species isolated from Malaysian fermented food, Tapai Ubi which capable of producing bioactive metabolic products. In this review, the properties of UL4-PPM will be discussed including anti-microbial, anti-cancer and immunomodulatory effects. Overall, it would be beneficial to discover the potential effects of UL4-PPM to possibly serve as an alternative treat- ment for cancer.
Glutathione s-transferases (GSTs) are the vital enzymes involved in Phase II metabolism to detoxify a wide range of carcinogenic metabolites in the body. GST class mu-1 (GSTM1) and GST class theta-1 (GSTT1) are the genes encoding for the GST isoenzymes. Nevertheless, both genes were frequently reported absent (null) in most of the populations at different frequencies. Null polymorphism will affect the production of GSTs and impair the ability to eliminate carcinogenic compounds which had been shown to expose null individuals to high risk of several cancers such as gastric and lung cancer. Thus, this review will briefly summarize on the GSTM1 and GSTT1 polymorphisms, frequencies of null variants in populations worldwide, including Malaysian, and their relevancy to the underlying basis of toxicological response to xenobiotics. Additionally, the genotyping assays used in GST studies will also be discussed.
C-C motif Chemokine Ligand 3 Like 1 (CCL3L1) is characterized as a gene with copy number variable (CNV) and clustered at the segmental duplication on chromosome 17q12. CCL3L1 is responsible for the production of mac- rophage inflammatory protein (MIP) 1α that plays an important function in the immune system and host defense. Various copies range of CCL3L1 have been reported and associated with the diseases in different populations. Thus, this review aimed to summarise the distribution of CCL3L1 copy number from different populations according to the geographical region and highlighted the lacking of data from Malaysian population, which is one of the multi-ethnic countries due to the impacts of CCL3L1 copies on various diseases. Besides, we also outlined the methodologies available for the copy number typing. In overall, this review could provide significant information on the role of CCL3L1 copies in disease association and as well as providing evidence on the population diversity.
Introduction: Accumulation of heavy metals through seafood consumption constitutes a significant potential threat to human health. Biomonitoring of whole blood heavy metals level gave an insight into the internal body burden to the exposure of heavy metals. The aims of this study were to assess the blood heavy metals (arsenic and lead) level among the coastal community of Melaka and to determine their association with sociodemographic background and potential sources of heavy metals accumulation. Methods: Respondents were recruited through purposive sampling technique based on inclusion and exclusion criteria. The questionnaires were distributed to obtain sociodemograph- ic information, the frequency of seafood intake and smoking habit. Blood samples were obtained on a voluntary basis. A total of 63 respondents completed all the information required. The heavy metals concentration in blood was determined by inductively coupled plasma- mass spectrometry (ICP-MS). Results: The blood arsenic (BAs) con- centration of respondents was 0.076 (0.059 – 0.107) µg/L and the blood lead (BPb) concentration of respondents was 1.204 (0.670 – 2.094) µg/L respectively. A significant association was observed between seafood-based product frequency intake and BPb concentration (p < 0.05). Other seafood frequency intake and background factors were not significantly associated with the BAs and BPb concentration of respondents. Conclusion: The findings showed that arsenic and lead levels in the blood of respondents along the coastal area of Melaka did not exceed the blood heavy metals reference levels and there was also lack of associations between blood heavy metals concentration and the potential factors of heavy metals accumulation studied.
Introduction: Not only does flood affects the household community, but it also has an impact on business entities, particularly small and medium enterprises (SMEs) located in flood-prone areas. In order to assist SMEs to prepare for a flood disaster effectively, the set-up of a disaster preparedness plan is essential. The purpose of this study is to devel- op a validated instrument for identifying the different levels of disaster preparedness among SMEs in their readiness to face a flood disaster. Methods: In this preliminary study, 26 items of flood disaster preparedness activities (FDPA) reviewed from works of literature were adopted and adapted to be randomly administered to 30 respondents (SME business owners) located in the Temerloh province, Malaysia, which is identified as a flood-prone area. A Rasch analysis technique was used to identify the psychometric properties of the instrument. Results: Using the Rasch mea- surement analysis technique, the instrument used was able to categorise the SMEs into two level of preparedness: low and moderate. About 25 items were found to possess good psychometric features in determining the flood pre- paredness level of SMEs despite the lack of items on measuring high-level preparedness activities. Conclusion: The results of this preliminary study have served to highlight the strength of the instrument and gaps identified for further improvement in the near future.
Introduction: Children spend most of the time indoors and make them easily exposed to indoor air contaminants. Exposure to poor indoor air quality has led to various health problem especially, respiratory-related illness. This study is intended to determine the relationship between indoor air pollutants exposure and the airway inflammation among children aged 5 to 6 years old in selected preschools from mid-2015 until mid-2016. Methods: Four hours of indoor air quality assessment had been conducted at six preschools in Puchong district (urban area) and six preschools in Hulu Langat district (suburban area) of Selangor. The respiratory inflammation among 120 healthy preschool chil- dren had been assessed using non-invasive biomarker of Fractional Exhale Nitric Oxide (FeNO). Meanwhile, respi- ratory symptoms and information on possible residential air pollutant exposures were obtained from a standardized questionnaire. Results: The indoor air quality measurement demonstrated significant high concentration air pollut- ants (PM0.1, PM2.5, PM10, VOCs) at the preschools in the urban as compared to preschools in the suburban area(p < 0.05). Besides, PM2.5 was found to be significantly associated with respiratory inflammation (FeNO value) measured (p
Vector surveillance in high-rise buildings is important to predict and monitor the presence of vectors regarding their abundance and distribution. In this study, the infestation profile of Aedes aegypti and Aedes albopictus species in different environmental settings were investigated. Methods: Four high-rise apartments in four different localities were selected for ovitrap surveillance. Fifty ovitraps were placed in semi indoor and outdoor settings. Results: A total of 507 (42.8%) from ovitraps showed the presence of the Aedes species larvae. Out of these, 170 (33.5%) of the positive ovitraps were those placed in semi indoor and 337 (66.5%) in outdoor. Of the total 16,613 Aedes larvae found, 4,130 (24.9%) were from semi indoor, and 12,483 (75.1%) from outdoor. In terms of distribution, Ae. albopictus was predominantly found in outdoor environments (POI=87.5%; MLT=36.45 larvae). Ae. aegypti was also found in outdoor environments (POI=14.89%; MLT=8.26 larvae). There was a significant difference in POI for both Ae. aegypti and Ae. albopictus in the two different environments but no significant difference was observed in MLT, indicating that the density of the Aedes species in both environments was well distributed. Conclusion: In this study, the patterns of Aedes habitat in high-rise apartments were observed. This study has shown an invasion and adaptation of Aedes mosquitoes into the ecosystems of high-rise buildings. It can be concluded that housing designs and the condition of the surrounding environment affects the infestation profile and the distribution of Aedes mosquitoes.
Introduction: Breast cancer is the commonest cancer in Malaysia, predominantly among women under age of 60 and they often presented late. Borneo is home to multi-racial indigenous with heterogeneous background and breast cancer profile can be absolutely unique. This study aims to examine the demographic characteristics and stage at presentation in Sandakan women with newly diagnosed breast cancer. Methods: This is a cross-sectional, retrospec-tive study involving those women who were newly diagnosed with breast cancer from January 2016 to December 2018 in Duchess of Kent Hospital, Sandakan identified via hospital cancer registry and patient records. Only breast cancer with epithelial origin was included. Age, ethnicity and stages at presentation of breast cancer were analysed. Logistic regression was used to study their relationships. Results: 110 women were newly diagnosed as breast cancer. Mean age was 53.5 (SD 12.7), the youngest at 30 and the eldest at 97. Majority (64.6%) were local indigenous wom-en, constituted by 25.4% Sungai, 14.1% Kadazan-Dusun, 12.7% Bugis and the minorities. Chinese women are the main local non-indigenous (32.7%) followed by 2.7% Malay. 52.1% presented at late stages (stage III/IV). Subgroup analysis of T-staging revealed 41.7% had advanced symptoms (T3/T4). Indigenous group was more likely to present at younger ages (OR 12.0; 95%CI 1.5-93.8) and with advanced symptoms (OR 3.1; 95%CI 1.2-8.0). Conclusion: Awareness on breast cancer remains inadequate particularly among indigenous women. Difficult healthcare accessi-bility and incline towards traditional medicine could attribute to late presentation. Outreach awareness programmes are warranted in addition to mobile screening services.
Introduction: Primary health care providers face a wide range of stressors and are at high risk of developing occu-pational burnout, which may cause ineffectiveness and reduce the productivity of the health care system. Methods: A cross-sectional study was conducted among the primary health care provider working in health facilities under Tuaran Area Health Office. A total of 199 of 604 providers randomly selected as respondents for this study. Self-ad-ministered questionnaire and the Maslach Burnout Inventory are used for data collection. Descriptive statistics were used to determine the prevalence and Chi-square test was used to determine the association of risk factors. Results: Prevalence of occupational burnout is 10.1% with high level of overall burnout (n = 20), 60.8% are having low to moderate level of overall burnout (n = 121) and 29.1% has no burnout (n = 58). A significant relationship was observed between burnout, high workload, out-of-scope workload and distance between home and workplace (p≤0.01). However, no significant relationship was observed between burnout and age, gender, marital status, finan-cial status, education level, experience and income. Conclusion: This study shows that distribution of workload as well as the job scope may affect burnout. Further study can be conducted to identify home-workplace distance re-lation to burnout. With the identification of these factors, a counter measures and intervention can be implemented.
Introduction: Responder’s action during mass environmental chemical incident involves collaboration of multiple agency. They clean the exposure site, control public safety and safe lives. The health of the responder is also as valuable as the public and always been neglected. Hence, this study is to highlights the method used and challenges during the incidents. Methods: A modified Occupational Health Surveillance Programme designed by Baker and Matte (Thirteen Steps in designing and implementing an Occupational Health Surveillance Programme) was imple-mented. These method full fill the criteria of impossible further reduce exposure to known hazards and uncertain health effect of the offending chemicals. Two core workplace namely the source of chemical contamination locale and victims’ evacuation centre were identified. The exposed responder is identified and categorised according to their expected exposure. Offending chemicals identified were known hazardous to health. An electronic survey form was developed and the surveillance were conducted during the event and post-exposures of one, third and sixth months. Laboratory tests were performed as a grab sample randomly and strategically to represent responder exposure. Results: During the event, 1338 responders were surveyed and twenty percent had symptoms of cough, headache, sore throat, nausea and skin irritation. After one-month post-exposure, three percent of responder noted to have continue symptoms. Laboratory tests were performed randomly due to the sheer numbers of responders in action. Only sixty-one samples were collected and sixteen percent had positive metabolites for urine cyanide. Re-sponders with abnormal laboratory result (FBC/LFT/RP/Urine) were interviewed and a repeat sample were performed. Conclusion: The health surveillance of the responder in mass environmental chemical incident is a great challenge when the exposure level is unsure and involve more than one chemicals. Likewise, reliability and validity adopting statistical test for health surveillance instruments is unattainable due to urgency. However, a proper method of occu-pational surveillance need to be devised and implemented to ensure the protection of worker’s health is guaranteed.
Introduction: Healthcare workers (HCWs) are exposed to occupational blood and body fluid exposure (OBBE) that potentially cause blood-borne infection such as HIV, Hepatitis B and Hepatitis C, with risk of transmission 0.3%, 6 to 30% and 0-10% respectively. They are exposed to these infections through percutaneous injury, splash exposure of blood and body fluids to mucous membrane and non-intact skin. Aim of this study was to determine prevalence and risk factors associated with occupational exposure of blood and body fluid in a tertiary government hospital in Sabah. Methods: A cross sectional study was conducted involving 10 places, was chosen by stratified random sampling and involved various job categories (specialist, medical officer, house officer, nurse, hospital assistant and Sedafiat worker). Self-administered questionnaire used as study tool. The data was analysed by using SPSS version 22.0. Association of risk factors and OBBE incidence were determined by Chi-square test and simple logistic regression. Results: A total of 334 respondents involved in this study. Prevalence of OBBE was 25.2% with 95% CI of 20.6% to 30.2% and highest (41.3%) among HCWs working in medical ward. Nurses were less likely to have occupational exposure to blood and body fluids (Crude OR=0.33, 95% CI: 0.20, 0.57). Needle recapping (Crude OR=3.77, 95% CI: 1.99, 7.10) and never attend training in infection prevention (Crude OR=3.19, 95% CI: 1.69, 6.05) were associ-ated with higher odds of OBBE. There was 76.3% of respondents adhere to universal precaution. HCWs who did not work in shift (Crude OR=3.04, 95% CI: 1.49, 6.21) and non-nurses (Crude OR=2.04, 95% CI: 1.06, 3.92) profession had better adherence to universal precaution. Conclusion: Prevalence of OBBE was 25.2%. Modifiable risk factors for OBBE were identified including needle recapping and training on infection prevention. Shift work is associated with adherence to universal precaution. Adequate training, increasing knowledge and awareness may help to reduce OBBE burden.
Introduction: Low socio-economic status (SES) has been associated with poorer access and worse outcome in kid-ney transplantation (KT) for high-income countries. In contrast, relatively little is known about the KT access and outcome between the socio-economic gradient in Malaysia, which is a low- and middle-income country. The aim is to determine the association of SES with access and outcome of kidney transplantation in Malaysia. Methods: We examined the Malaysian National Renal Registry for kidney transplant candidates listed between 2002 to 2011. Cox’s regression was used to assess associations of SES with transplant access and outcome (survival). Results: 1234 patients were transplanted in 2002-2011 after excluding pediatric patients and multiple transplantations. The mean age of patients was 42.3 ± 12.3 years, 789 (63.9%) were male and 797 (65.0%) were of Chinese ethnicity. After multivariate adjustment, the highest income group were 20% less likely to access KT compared the lowest income group (adjusted HR=0.80, CI: [0.62, 1.04] producing trend for P-Value = 0.001. While patient with highest education were 50% more likely to survive compared to patient with lowest education (adjusted HR=0.50, CI: [0.34, 0.73] producing trend for P-Value < 0.001. Conclusion: Even in a healthcare system that is almost achieving universal health coverage, disparities exist in both extremes of the socio-economic gradient for the access and outcomes for KT in Malaysia. Reducing the SES disparities in KT will require policy initiatives addressing the components of SES (income, education, and employment) as well as the pathways by which this affect the health of KT patient.
Introduction: Smartphone addiction is a hotly debated public health issue and it affects every generation especially the youth and younger generation nowadays (Generation Z / i-Generation) and contributes to the poor mental health status like stress, anxiety and depression. This study is carried out to determine the prevalence of smartphone addic-tion and its association with stress, anxiety and depression among the undergraduate students in Unitversity Malaysia Sabah. Methods: A cross-sectional study was conducted among the undergraduate students in Universiti Malaysia Sabah. A total number of 456 undergraduate students in Universiti Malaysia Sabah with at least a smartphone device were enrolled in the study by stratified random sampling. A self-administered questionnaire, Smartphone Addiction Scale Malay Version (SAS-M) and The Depression, Anxiety and Stress Scale – 21 Items (DASS-21) Malay Version were used for data collection. The prevalence of smartphone addiction, stress, anxiety and depression among un-dergraduate students of Universiti Malaysia Sabah were determined. Simple linear regression was used to determine the effect of smartphone addiction to stress, anxiety and depression. Results: Prevalence of smartphone addiction among undergraduate students in Universiti Malaysia Sabah is 61.2% (95% CI : 56.5%, 65.7%). The prevalence of stress, anxiety and depression among undergraduate students in Universiti Malaysia Sabah are 34.9%, 58.6% and 42.5% respectively. The univariate analysis shows that smartphone addiction is significantly associated with stress (Regression Coeeficient = 0.774, 95% CI 0.54, 1.01 ; P-value
Introduction: Coronary heart disease (CHD) has become the number one cause of death worldwide. Past studies have established the efficiency of prebiotics, probiotics, and their combination on lowering blood lipids. However, the mechanism(s) on the reduction of cholesterol involved is not fully understood due to limited in-vivo studies. Therefore, the reported hypocholesterolaemic potential of probiotics and prebiotics supplementations warrants fur-ther research. This study examined the effectiveness of the intervention products on improving lipid profiles, (to-tal cholesterol (TC), HDL-C, LDL-C, TG). Methods: A randomized, single blind intervention involving 8 weeks of treatment followed by 4 weeks of washout period was carried out on 29 volunteers with TC 5.2-6.0 mmol/L who were screened from 517 volunteers. Exclusion criteria included chronic diseases, immune-compromised diseases, consumption of cholesterol-lowering drugs, and pregnancy if female. Informed consent was obtained before com-mencement of the study. Participants were randomly assigned to receive 2g/d Lactobacillus Acidophilus NCFM pro-biotic powder, 10g/d inulin, 10g/d dietary fibre, control intervention of 20mg/d statin, or control intervention of diet counseling. Results: No significant (p>0.05) changes were observed in the fasting blood glucose, physical activities and total nutrient intake of all the groups. Inulin reduced LDL-C by 12.13%. Probiotic reduced TC by 6.98%. Dietary fibre reduced TC by 8.6%, and LDL-C by 16.08%. Conclusion: Although the results showed no significant changes, it may be clinically significant as the intervention products improve the lipid profiles. It was concluded that the im-provement in the lipid profiles may be attributable to the intervention products.
Introduction: Tuberculosis (TB), commonly caused by Mycobacterium tuberculosis (Mtb), is one of the ten leading causes of death worldwide. The gold standard, microbiological culture for detection and differentiation of mycobac-teria are time-consuming and laborious. The use of fast, easy and sensitive nucleic acid amplification tests (NAATs) for diagnosis of TB remains challenging because there is a high degree of homology within Mtb complex (MTBC) members and absence of target genes in the genome of some strains. This study aimed to identify new candidate genetic marker and to design specific primers to detect Mtb using in silico methods. Methods: Using Basic Local Alignment Search Tool (BLAST) program, Mtb H37Rv chromosome reference genome sequence was mapped with other MTBC members and a single nucleotide polymorphism (SNP) at Rv1970 was found to be specific only for Mtb strains. Mismatch amplification mutation assay (MAMA) combine with polymerase chain reaction (PCR) was used as an alternative method to detect the point mutation. MAMA primers targeting the SNP were designed using Primer-BLAST and the PCR assay was optimized via Taguchi method. Results: The assay amplified a 112 bp gene fragment and was able to detect all Mtb strains, but not the other MTBC members and non-tuberculous Mycobacte-ria. The detection limit of the assay was 60 pg/μl. Conclusion: Bioinformatics has provided predictive identification of many new target markers. The designed primers were found to be highly specific at single-gene target resolution for detection of Mtb.
Introduction: Japanese encephalitis (JE) is a vector-borne zoonotic disease caused by the Japanese encephalitis virus (JEV). Paddy fields are high risk area for JEV transmission due the presence of Culex tritaeniorhynchus as vector and wild boar as an amplifier host. Methods: We presented case reports for three patients infected with JEV residing in paddy field area from 2015 to 2018 in Kerian, Perak; illustrating the symptoms and epidemiology trend of the dis-ease. Results: All three cases live next to paddy field and were exposed during peak biting hours. They presented with fever and altered consciousness. IV Acylovir was started as one of the treatments and all had lumbar puncture for CSF testing. Two cases (adult) were confirmed JE after they had passed away. Two cases occurred during fasting month where food wastes were abundance. The source of infection was probably from wild boars that came out at night to hunt for food. Presence of C. tritaeniorhynchus was demonstrated as the main vector in these areas. Conclusion: JE has no cure and human vaccination is the main prevention method. At the moment, vector control, environmental management, chemical control and personal protection are the main mitigation strategies for this area. Further study on JEV and wild board in Kerian will be most beneficial.
Introduction: Tuberculosis (TB) is the ninth leading cause of mortality in the world while it is the most prevalent infection which is ranked abolve HIV/AIDS. In Malaysia, tuberculosis is still a public health problem. Sabah State on Malaysian Borneo had 20-30% of total TB cases of the country. In Sabah, case notification rate of almost 200 per 100,000 population was still present in the last 10 years. Hotspots are defined as TB notification rate more than 100/100.000 in a district or TB notification rate more than 100/100,000 in the squatters’ area. In this study, cycle threshold (ct) values in GeneXpertMTB/RIF (Xpert) were tried to be correlated with growth in Mycobacterim growth indicator tubes (MGIT) by measurement of time to detection (TTD). Methods: Sputum samples from six hotspots of Kota Kinabalu were studied by Xpert as well as MGIT culture after processing of sputum samples. The correlation between Mean ct value of Xpert and TTD in MGIT was analysed by using IBM SPSS Statistic 25 and the statistical test used was Pearson Correlation test. Results: The results of Xpert indicated 35 of 204 sputum samples were pos-itive whereas only one sample was rifampicin resistant. The mean ct values were very low, low and medium in all the hotspots with sputum from one hotspot showed medium ct values predominantly. The sputum from remaining hotspots showed mainly very low and low ct values. MGIT results showed no growth in five samples with two very low, two low and one medium mean ct values. Conclusion: The finding indicated that there were correlations be-tween mean ct values of Xpert and TTD in MGIT with a few exceptions.