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Fulltext Exploring the Neuroinflammatory Pathway in Epilepsy and Cognitive Impairment: Role of HMGB1 and Translational Challenges

Ngadimon IW, Seth EA, Shaikh MF

Front Biosci (Landmark Ed), 2024 Jun 24;29(6):229.
PMID: 38940048 DOI: 10.31083/j.fbl2906229

Neuroinflammation has emerged as a shared molecular mechanism in epilepsy and cognitive impairment, offering new insights into the complex interplay between immune responses and brain function. Evidence reveals involvement of High mobility group box 1 (HMGB1) in blood-brain barrier disruption and correlations with epilepsy severity and drug resistance. While anti-inflammatory treatments show promise, translating these discoveries faces challenges in elucidating mechanisms and developing reliable biomarkers. However, strategically targeting neuroinflammation and HMGB1-mediated inflammation holds therapeutic potential. This review synthesises knowledge on HMGB1 and related biomarkers in epilepsy and cognitive impairment to shape future research and treatments targeting these intricate inflammatory processes.

Matched MeSH terms: Translational Medical Research/methods
Fulltext Future Directions for Dementia Risk Reduction and Prevention Research: An International Research Network on Dementia Prevention Consensus

Anstey KJ, Peters R, Zheng L, Barnes DE, Brayne C, Brodaty H, et al.

J Alzheimers Dis, 2020;78(1):3-12.
PMID: 32925063 DOI: 10.3233/JAD-200674

In the past decade a large body of evidence has accumulated on risk factors for dementia, primarily from Europe and North America. Drawing on recent integrative reviews and a consensus workshop, the International Research Network on Dementia Prevention developed a consensus statement on priorities for future research. Significant gaps in geographical location, representativeness, diversity, duration, mechanisms, and research on combinations of risk factors were identified. Future research to inform dementia risk reduction should fill gaps in the evidence base, take a life-course, multi-domain approach, and inform population health approaches that improve the brain-health of whole communities.

Matched MeSH terms: Biomedical Research*
An Insight Into the Experiences of Malaysian Patients With Advanced Cancer and Their Preferences in End-of-Life Care: A Qualitative Study

Chung I, Khoo SY, Low LL

Am J Hosp Palliat Care, 2025 Jan;42(1):5-13.
PMID: 38394223 DOI: 10.1177/10499091241233599

BACKGROUND: Preferences of patients with advanced cancer are well studied in Western countries but less so in Asian communities where end-of-life discussions can be seen as taboo. This may lead to patients receiving care that is incongruent with their wishes as their disease progress. It is important for healthcare providers to have a better understanding of patients' experiences and preferences especially in a multicultural country like Malaysia with its diverse beliefs and values to facilitate better planning for future medical care.
OBJECTIVES: To explore the experiences and preferences of Malaysian patients with advanced cancer.
DESIGN: Qualitative study of semi-structured interviews with thematic analysis.
SETTING/SUBJECTS: Purposive sampling of 19 patients with Stage 4 cancer recruited from inpatient and outpatient settings in National Cancer Institute Malaysia.
RESULTS: Three major themes emerged in the exploration of patients' experiences and care preferences in facing advanced cancer namely: 1) Dealing with poor prognosis 2) Spirituality as a source of strength and 3) Enablers of advance care planning.
CONCLUSION: This study highlighted the preference for healthcare providers to be culturally sensitive during end-of-life care discussion and the need for improved spiritual care for Malaysian patients with advanced cancer. Further studies exploring the role of spiritual and cultural factors in advance care planning among Malaysians would be helpful in guiding these efforts.

Matched MeSH terms: Qualitative Research*
Fulltext Practices and Barriers in Implementing the Low FODMAP Diet for Irritable Bowel Syndrome Among Malaysian Dietitians: A Qualitative Study

Ke TJ, Sameeha MJ, Siah KTH, Jeffri PBQB, Idrus NAB, Krishnasamy S

Nutrients, 2024 Oct 23;16(21).
PMID: 39519430 DOI: 10.3390/nu16213596

The low fermentable oligo-, di-, mono-saccharides and polyols (FODMAP) diet (LFD) is a second-line dietary intervention for irritable bowel syndrome (IBS) patients, involving FODMAP restriction, reintroduction, and personalization, and it needs to be delivered by dietitians. However, the application of this diet among Malaysian IBS patients is not well understood. This study aimed to explore the practices and barriers in delivering the LFD among Malaysia dietitians. Semi-structured qualitative interviews were conducted online with practicing dietitians until the data reached saturation. All the interview sessions were audio recorded and transcribed verbatim. Thematic analysis was used to analyze the data. Eleven dietitians were interviewed, with 36.4% (n = 4) having more than 10 years of experience. The following four themes regarding their practices emerged: 1. dietary advice on FODMAP restriction; 2. duration of FODMAP restriction phase; 3. references used to get information about FODMAPs, and 4. strategies on reintroduction. Meanwhile, the following seven barriers were identified: 1. lack of culturally relevant educational materials; 2. limited knowledge about the LFD; 3. inadequate formal training among dietitians; 4. lack of integration in multi-disciplinary care; 5. low health literacy of patients; 6. low compliance rate among patients, and 7. restrictions for certain populations. LFD implementation in Malaysia is not standardized as only experienced dietitians can provide dietary evidence-based advice. Lack of training and culturally specific resources are some of the main barriers that were identified to be limiting the implementation of the diet. Therefore, there is a need for training programs and resource development to support Malaysian dietitians in managing IBS patients.

Matched MeSH terms: Qualitative Research*
Parents of children with cancer require health literacy support to meet their information needs

Tan CE, Lau SCD, Abdul Latiff Z, Lee CC, Teh KH, Mohd Sidik S

Health Info Libr J, 2024 Sep;41(3):267-282.
PMID: 37332240 DOI: 10.1111/hir.12491

BACKGROUND: Timely and relevant information helps parents to cope when a child is diagnosed with cancer. However, obtaining and understanding information is not a straightforward process for parents.
OBJECTIVES: This article aims to explain paediatric cancer parents' information behaviour related to the care of their child.
METHODS: Qualitative in-depth interviews were conducted with fourteen Malaysian paediatric cancer parents and eight healthcare professionals who worked with paediatric cancer patients. Reflexivity and inductive approaches were used to interpret the data to identify meaningful themes and subthemes.
RESULTS: Three themes about how paediatric cancer parents interact with information emerged: Acquiring information, internalising information, and using information. Information may be actively sought or passively acquired. Cognitive and affective aspects influence how information is internalised into meaningful knowledge. Knowledge then leads to further action including further information gathering.
CONCLUSION: Paediatric cancer parents need health literacy support to meet their information needs. They require guidance in identifying and appraising suitable information resources. Development of suitable supporting materials is needed to facilitate parents' ability to comprehend information related to their child's cancer. Understanding parents' information behaviour could assist healthcare professionals in providing information support in the context of paediatric cancer.

Matched MeSH terms: Qualitative Research*
The readiness of the Asian research ethics committees in responding to the COVID-19 pandemic: A multi-country survey

Karbwang J, Torres CE, Navarro AM, Wongwai P, Jimenez EB, Shetty Y, et al.

F1000Res, 2024;13:19.
PMID: 39165349 DOI: 10.12688/f1000research.143138.1

BACKGROUND: COVID-19 is a highly challenging infectious disease. Research ethics committees (RECs) have challenges reviewing research on this new pandemic disease under a tight timeline and public pressure. This study aimed to assess RECs' responses and review during the outbreak in seven Asian countries where the Strategic Initiative for Developing Capacity in Ethical Review (SIDCER) networks are active.
METHODS: The online survey was conducted in seven Asian countries from April to August 2021. Two sets of online questionnaires were developed, one set for the chairs/secretaries and another set for the REC members.The REC profiles obtained from the REC members are descriptive in nature. Data from the chairs/secretaries were compared between the RECs with external quality assessment (SIDCER-Recognized RECs, SR-RECs) and non-external quality assessment (Non-SIDCER-Recognized RECs, NSR-RECs) and analyzed using a Chi-squared test.
RESULTS: A total of 688 REC members and 197 REC chairs/secretaries participated in the survey. Most RECs have standard operating procedures (SOPs), and have experience in reviewing all types of protocols, but 18.1% had no experience reviewing COVID-19 protocols. Most REC members need specific training on reviewing COVID-19 protocols (93%). In response to the outbreak, RECs used online reviews, increased meeting frequency and single/central REC. All SR-RECs had a member composition as required by the World Health Organisation ethics guidelines, while some NSR-RECs lacked non-affiliated and/or layperson members. SR-RECs reviewed more COVID-related product development protocols and indicated challenges in reviewing risk/benefit and vulnerability (0.010), informed consent form (0.002), and privacy and confidentiality (P = 0.020) than NSR-RECs.
CONCLUSIONS: Surveyed RECs had a general knowledge of REC operation and played a significant role in reviewing COVID-19-related product development protocols. Having active networks of RECs across regions to share updated information and resources could be one of the strategies to promote readiness for future public health emergencies.

Matched MeSH terms: Ethics Committees, Research*
Tuberculosis treatment interruption: a qualitative exploration of barriers, challenges, coping strategies and facilitators in Malaysia

Oh AL, Makmor-Bakry M, Islahudin F, Ting CY, Chan SK, Tie ST

Health Promot Int, 2024 Dec 01;39(6).
PMID: 39584467 DOI: 10.1093/heapro/daae176

Tuberculosis (TB) treatment interruption undermines the effectiveness of TB medications and jeopardizes treatment outcomes. This study aimed to explore barriers, challenges, coping strategies and facilitators of TB treatment interruption to understand the treatment pathway in achieving successful outcomes. In-depth interviews were conducted at public health clinics in Sarawak, Malaysia, utilizing a phenomenological approach. Thirty patients who experienced TB treatment interruption with eventual successful treatment were purposively selected based on various reasons for treatment interruption to obtain diverse viewpoints. The audio-recorded transcriptions underwent thematic and content analysis. Five major themes emerged under barriers and challenges: socioeconomic, patient, therapy, healthcare and condition-related factors. Notably, financial burdens led individuals to prioritize work over health. Adverse drug reactions resulted in inappropriate self-medication and healthcare dissatisfaction. Medication error with suboptimal dosing was another facet leading to treatment forfeiture. Lack of knowledge about treatment duration and medication adherence, along with negative personal factors such as laziness, dishonesty and forgetfulness were reported. Participants employed coping strategies to confront barriers and challenges, including acceptance and commitment to disease and treatment, self-adaptation in mental, physical and social aspects, and self-management of minor adverse events. Fear of disease worsening, previous experiences, social and financial supports, along with intrinsic motivators, were essential facilitators that prevented interruptions. Interconnectivity across the explored dimensions contextualized the understanding of TB treatment interruption and offered valuable information for designing patient-centered intervention strategies. Improving patient education coupled with tailored interventions addressing psychosocial and economic barriers is crucial for ensuring TB treatment completion.

Matched MeSH terms: Qualitative Research*
Fulltext Overview of research at the Institute for Medical Research, Kuala Lumpur, on its ninetieth anniversary

Jegathesan M

Southeast Asian J Trop Med Public Health, 1992 Sep;23(3):361-8.
PMID: 1488687
Matched MeSH terms: Research/history
Symposium on nutrition and cognition: towards research and application for different life stages

Benton D, Winichagoon P, Ng TP, Tee ES, Isabelle M

Asia Pac J Clin Nutr, 2012;21(1):104-24.
PMID: 22374567

A SYMPOSIUM ON NUTRITION AND COGNITION: Towards research and application for different life stages was held on October 2010 in Malaysia. The influence of diet and nutrition on the cognitive development of the child and on cognitive decline in later life was reviewed. Central to the study of such topics is the assessment of cognitive functioning. Cognitive functioning falls into six main areas: executive functioning, memory, attention, perception, psychomotor and language skills, although each domain can be further subdivided. As it is in the nature of human functioning that the performance on any cognitive test can reflect aspects of many of these domains, ideally a battery of tests should be used to establish the basis of any difference in performance. In intervention studies, frequently there has been a failure to demonstrate a beneficial influence of changes in diet. A possible reason is that studies have failed to acknowledge the time scale and critical ages over which diet has an impact. Diet may have a slow and progressive influence making it difficult for short-term studies to show an improvement. In addition, as many factors influence human behaviour, dietary interventions should only be one part of a coordinated approach; the effect of diet will depend on the social and psychological context in which an individual lives. Placing diet into a broader social and psychological context greatly increases the chance of generating significant findings. This report highlights and reviews presentations and discussions at the symposium.

Matched MeSH terms: Biomedical Research*
Fulltext A review of schizophrenia research in Malaysia

Chee KY, Salina AA

Med J Malaysia, 2014 Aug;69 Suppl A:46-54.
PMID: 25417951 MyJurnal

Research in schizophrenia has advanced tremendously. One hundred and seventy five articles related to Schizophrenia were found from a search through a database dedicated to indexing all original data relevant to medicine published in Malaysia between the years 2000-2013. This project aims to examine published research articles, in local and international journals in order to provide a glimpse of the research interest in Malaysia with regards to schizophrenia. Single case study, case series report, reviews and registry reports were not included in this review. Medication trial, unless it concerned a wider scope of psychopharmacology was also excluded from this review. A total of 105 articles were included in this review. Despite numerous genetics studies conducted and published, a definitive conclusion on the aetiology or mechanism underlying schizophrenia remains elusive. The National Mental Health - Schizophrenia Registry (NMHR) proved to be an important platform for many studies and publications. Studies stemmed from NMHR have provided significant insight into the baseline characteristic of patients with schizophrenia, pathway to care, and outcomes of the illness. International and regional collaborations have also encouraged important work involving stigma and discrimination in schizophrenia. Ministry of Health's hospitals (MOH) are the main research sites in the country with regards to schizophrenia research. Numbers of schizophrenia research are still low in relation to the number of universities and hospitals in the country. Some of the weaknesses include duplication of studies, over-emphasising clinical trials and ignoring basic clinical research, and the lack of publications in international and regional journals.

Matched MeSH terms: Research
Fulltext A review of dengue research in Malaysia

Cheah WK, Ng KS, Marzilawati AR, Lum LC

Med J Malaysia, 2014 Aug;69 Suppl A:59-67.
PMID: 25417953 MyJurnal

Dengue infection is a major cause of morbidity and mortality in Malaysia. To date, much research on dengue infection conducted in Malaysia have been published. One hundred and sixty six articles related to dengue in Malaysia were found from a search through a database dedicated to indexing all original data relevant to medicine published between the years 2000-2013. Ninety articles with clinical relevance and future research implications were selected and reviewed. These papers showed evidence of an exponential increase in the disease epidemic and a varying pattern of prevalent dengue serotypes at different times. The early febrile phase of dengue infection consist of an undifferentiated fever. Clinical suspicion and ability to identify patients at risk of severe dengue infection is important. Treatment of dengue infection involves judicious use of volume expander and supportive care. Potential future research areas are discussed to narrow our current knowledge gaps on dengue infection.

Matched MeSH terms: Research
Fulltext Developing a primary care research agenda through collaborative efforts - a proposed "6E" model

Tan NC, Ng CJ, Rosemary M, Wahid K, Goh LG

Asia Pac Fam Med, 2014;13(1):17.
PMID: 25606021 DOI: 10.1186/s12930-014-0017-9

Primary care research is at a crossroad in South Pacific. A steering committee comprising a member of WONCA Asia Pacific Regional (APR) council and the President of Fiji College of General Practitioners garnered sponsorship from Fiji Ministry of Health, WONCA APR and pharmaceutical agencies to organize the event in October 2013. This paper describes the processes needed to set up a national primary research agenda through the collaborative efforts of local stakeholders and external facilitators using a test case in South Pacific.

Matched MeSH terms: Research
Fulltext Draft Genome Sequence of Erwinia mallotivora BT-MARDI, Causative Agent of Papaya Dieback Disease

Redzuan RA, Abu Bakar N, Rozano L, Badrun R, Mat Amin N, Mohd Raih MF

Genome Announc, 2014;2(3).
PMID: 24812220 DOI: 10.1128/genomeA.00375-14

Erwinia mallotivora was isolated from papaya trees infected with dieback disease, which were planted at the Malaysian Agricultural Research and Development Institute (MARDI), Malaysia. Here, we report a draft genome sequence of E. mallotivora BT-MARDI, which offers an important source of information for understanding pathogen and host interaction during papaya dieback development.

Matched MeSH terms: Research
Cure at IAS 2013

Berry J

Posit Aware, 2013 Sep-Oct;25(6):22-3.
PMID: 24847583
Matched MeSH terms: Biomedical Research
Fulltext "Personal mission statement": An analysis of medical students' and general practitioners' reflections on personal beliefs, values and goals in life

Chew BH, Lee PY, Ismail IZ

Malays Fam Physician, 2014;9(2):26-33.
PMID: 25893068

BACKGROUND: Personal mission in life can determine the motivation, happiness, career advancement and fulfilment in life of the medical students (MSs) along with improvement in professional/clinical performance of the family physicians. This study explored the personal beliefs, values and goals in the lives of MSs and general practitioners (GPs).
METHODS: Fourth-year MSs at the Universiti Putra Malaysia and GPs who participated in a 2-hour session on 'Ethics in Family Medicine' in 2012 were invited. All the participants submitted the post-session written reflections about their personal missions in life. The written reflections were analysed using thematic analysis.
RESULTS: A total of 87 MSs and 31 GPs submitted their written reflections. The authors identified 17 categories from the reflections contained by four themes-good vs. smart doctor, professional improvement vs. self-improvement, self-fulfilment and expressed motivation. The most common categories were "to be a good doctor" (97/330) and "professional improvement" (65/330). Many MSs had expressed motivation and wanted to be a smart doctor as compared to the GPs, whereas a larger number of GPs wished to have a fulfilled life and be a good doctor through professional improvement.
CONCLUSION: The difference between the two student groups might indicate different levels of maturity and life experiences. Medical teachers should engage students more effectively in orientating them towards the essential values needed in medical practice.
KEYWORDS: Concept formation; education; goals; medical; medical students general; practitioners; professional; values of life

Matched MeSH terms: Qualitative Research
Fulltext Assessing HIV and AIDS treatment safety and health-related quality of life among cohort of Malaysian patients: a discussion on methodological approach

Syed IA, Syed Sulaiman SA, Hassali MA, Lee CK

Health Expect, 2015 Oct;18(5):1363-70.
PMID: 24010818 DOI: 10.1111/hex.12116

BACKGROUND: Health-related quality of life (HRQoL) is increasingly recognized as an important outcome and as a complement to traditional biological end points of diseases such as mortality. Unless there is a complete cure available for HIV/AIDS, development and implementation of a reliable and valid cross cultural quality of life measure is necessary to assess not only the physical and medical needs of HIV/AIDS people, but their psychological, social, environmental, and spiritual areas of life.
METHODS: A qualitative exploration of HIV/AIDS patients' understanding, perceptions and expectations will be carried out with the help of semi structured interview guide by in depth interviews, while quantitative assessment of patient reported adverse drug reactions and their impact on health related quality of life will be carried out by using data collection tool comprising patient demographics, SF-12, Naranjo scale, and a clinical data sheet.
RESULTS/OUTCOMES: The findings may serve as baseline QOL data of people living with HIV/AIDS in Malaysia and also a source data to aid construction of management plan to improve HIV/AIDS patients' QOL. It will also provide basic information about HIV/AIDS patients' perceptions, expectations and believes towards HIV/AIDS and its treatment which may help in designing strategies to enhance patients' awareness which in turn can help in addressing issues related to compliance and adherence.
KEYWORDS: HIV/AIDS; adverse drug reactions; patients' perspective; quality of life

Matched MeSH terms: Qualitative Research
Fulltext The Kuala Lumpur Declaration on Promotion of Scholarly Writing Skills and Standards in the Asia Pacific Region

Lim KG

Med J Malaysia, 2012 Aug;67(4):357-8.
PMID: 23082440
Matched MeSH terms: Biomedical Research
Fulltext Investigator-initiated clinical trials in Malaysia and the role of the Clinical Research Centre of the Ministry of Health

Sivanandam AF, Hon YK, Yuen S, Muninathan P, Goh PP, Lim TO

Med J Malaysia, 2010 Jun;65 Suppl A:138-42.
PMID: 21488475

The objective of this review is to better understand the concept of investigator-initiated trials and its benefits. While investigator-initiated trials can be an invaluable tool, there are several challenges in its initiation and management. However, it is for these reasons that Clinical Research Centre (CRC) had developed the Investigator Initiated Trial (IIT) Programme where financial support and technical assistance are provided to local investigators embarking on their own clinical trials. In the course of preparing the review, we found that the inclination of investigator-initiated trials has yet to be well established in Ministry of Health, Malaysia. Given the potential and impact of such trials, clinicians should be aware of their ability as well as the availability of a supportive network in mobilising their concerted research efforts. Greater research collaboration among investigators could foster more innovative, insightful and constructive research.

Matched MeSH terms: Research Design
Fulltext Social sciences research in neglected tropical diseases 1: the ongoing neglect in the neglected tropical diseases

Allotey P, Reidpath DD, Pokhrel S

Health Res Policy Syst, 2010 Oct 21;8:32.
PMID: 20961461 DOI: 10.1186/1478-4505-8-32

Centuries of scientific advances and developments in biomedical sciences have brought us a long way to understanding and managing disease processes, by reducing them to simplified cause-effect models. For most of the infectious diseases known today, we have the methods and technology to identify the causative agent, understand the mechanism by which pathology is induced and develop the treatment (drugs, vaccines, medical or surgical procedures) to cure, manage or control.Disease, however, occurs within a context of lives fraught with complexity. For any given infectious disease, who gets it, when, why, the duration, the severity, the outcome, the sequelae, are bound by a complex interplay of factors related as much to the individual as it is to the physical, social, cultural, political and economic environments. Furthermore each of these factors is in a dynamic state of change, evolving over time as they interact with each other. Simple solutions to infectious diseases are therefore rarely sustainable solutions. Sustainability would require the development of interdisciplinary sciences that allow us to acknowledge, understand and address these complexities as they occur, rather than rely solely on a form of science based on reducing the management of disease to simple paradigms.In this review we examine the current global health responses to the 'neglected' tropical diseases, which have been prioritised on the basis of an acknowledgment of the complexity of the poverty-disease cycle. However research and interventions for neglected tropical diseases, largely neglect the social and ecological contextual, factors that make these diseases persist in the target populations, continuing instead to focus on the simple biomedical interventions. We highlight the gaps in the approaches and explore the potential of enhanced interdisciplinary work in the development of long term solutions to disease control.

Matched MeSH terms: Research
Determination of fast neutron flux distribution in irradiation sites of the Malaysian Nuclear Agency research reactor

Yavar AR, Sarmani SB, Wood AK, Fadzil SM, Radir MH, Khoo KS

Appl Radiat Isot, 2011 May;69(5):762-7.
PMID: 21295987 DOI: 10.1016/j.apradiso.2011.01.005

Determination of thermal to fast neutron flux ratio (f(fast)) and fast neutron flux (ϕ(fast)) is required for fast neutron reactions, fast neutron activation analysis, and for correcting interference reactions. The f(fast) and subsequently ϕ(fast) were determined using the absolute method. The f(fast) ranged from 48 to 155, and the ϕ(fast) was found in the range 1.03×10(10)-4.89×10(10) n cm(-2) s(-1). These values indicate an acceptable conformity and applicable for installation of the fast neutron facility at the MNA research reactor.

Matched MeSH terms: Research

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