Introduction: Bladder cancer is associated with high risk of tumour recurrence and therapeutic resistance. Cancer stem cells (CSC) within a particular tumour are postulated to drive tumorigenesis and influence tumour behaviour. Recent studies have shown that Newcastle disease virus (NDV) is able to selectively kill and exert a strong oncolytic effect against various cancer types. However little is known about the oncolytic effect of NDV against CSC. In this study, the oncolytic effect of NDV against putative bladder CSC was examined. Methods: Putative bladder CSC was selectively grown in the form of 3D-spheroids from six different bladder cancer cell lines. The spheroid cells were characterised for their stemness properties to ensure that these cells truly represent CSC. This was conducted via the analysis of CSC associated genes and cell surface markers expression. Subsequently, the oncolytic effect of the wild-type NDV-AF2240 strain against the bladder cancer spheroids was investigated. Results: All the spheroids expressed significantly high levels of CSC-associated genes. Flow-cytometry analysis revealed that the expression pattern of the CSC-associated surface markers was different in the spheroid cells; suggesting heterogeneity in the expression signatures of these cells. The infection of spheroids with NDV showed that the NDV was able to target bladder cancer spheroids but there was a spectrum of response across the different spheroids. Intriguingly, NDV was able to persistently infect bladder cancer spheroids that were not sensitive towards NDV infection as the presence of NDV viral genes were detected in the spheroid cells. The NDV persistently infected bladder cancer spheroids were resistant to superinfection and developed an antiviral state by expressing low levels of interferon-beta (IFN-b). NDV persistency of infection affects the process of epithelial to mesenchymal transition (EMT) of cancer cells as the spheroid forming ability of an established NDV persistently infected bladder cancer cell line, EJ28-PI was shown to be impaired. The EJ28-PI cells expressed significantly high levels of the EN2 gene. Knockdown of the EN2 expression reduced the viability of EJ28-PI cells; suggesting a role for EN2 in mediating NDV persistency of infection in cancer cells. Conclusion: Bladder CSC gene expression signatures influence the efficacy of NDV-mediated oncolysis. Our current work is focused on identifying genes and signalling pathways that influence NDV-mediated oncolysis us-ing whole-transcriptomic sequencing. The findings of this study can potentially be used to enhance the efficacy of NDV-mediated oncolysis and accelerate the translation of NDV as an oncotherapeutic agent in the clinic.
Introduction: Systemic lupus erythematosus (SLE) has a broad spectrum of clinical presentations. The diagnosis of SLE remains a challenge and largely depends on the presence of several serum autoantibodies including anti-nuclear antibody (ANA), anti-double-stranded DNA antibody (anti-dsDNA) and anti-Smith antibody (anti-Sm). ANA, a highly sensitive but not specific marker is used for SLE screening Anti-dsDNA and anti-Sm are SLE-specific biomarkers but has lower sensitivity of 80% and 30% for SLE, respectively. However, it is noted that there are SLE patients who are persistently negative for SLE-specific autoantibodies. Anti-dsDNA and anti-Sm were reported to be negative in up to 51.2% and 62.4% of SLE, respectively. This limitation can lead to misdiagnosis and halter proper treatment to SLE patients. Previous studies have suggested that cell membrane DNA (cmDNA) can act as a specific target for the autoantibodies in SLE patients. Autoantibodies towards cmDNA (anti-cmDNA) were reported to have promis-ing value as a reliable biomarker for SLE. In this study, we would like to determine the usefulness of anti-cmDNA in diagnosing SLE as compared to the standard SLE-specific autoantibodies. Methods: Serum samples from 83 SLE patients, 86 other connective tissue diseases and 61 healthy subjects were included in this study. The other connec-tive tissue diseases include samples from 10 Sjogren’s syndrome, 56 rheumatoid arthritis, 12 scleroderma and eight mixed connected tissues disease (MCTD) patients. All samples were analysed by indirect immunofluorescence (IIF) technique using Raji cells as substrate to detect the presence of anti-cmDNA. Anti-cmDNA was reported as positive if there was presence of a fluorescent ring, either continuous or punctate. Sera from SLE patients were also tested for anti-dsDNA and anti-Sm antibodies by using enzyme-immunoassays. Results: Anti-cmDNA positivity was highest in SLE (55.4%) than in other connective tissue diseases (9.3%) and healthy subjects (0%). Anti-cmDNA was 100% spe-cific at differentiating SLE from healthy subjects and 90.7% specific at differentiating SLE from other connective tissue diseases. There was no difference in the sensitivity (55.4%) of anti-cmDNA at differentiating SLE from both groups. Anti-cmDNA were present in 46 SLE samples negative for standard SLE-specific autoantibodies. It was detected in 11 (42.3%) of anti-dsDNA, 23 (63.9%) of anti-Sm and 8 (12.9%) of both anti-Sm and anti-dsDNA negative samples. Conclusion: The high specificity of anti-cmDNA detection using IIF method makes it an excellent diagnostic tool for SLE. Anti-cmDNA is potentially a very useful biomarker for SLE with negative anti-dsDNA or/and anti-Sm antibodies.
Introduction:Alternative treatment for cancer from herbal medicine has gained interest due to its benefits on im-mune modulation, improving the survival and quality of life. Mitragyna speciosa (M. speciosa) or Kratom is an indig-enous plant that can be found in Thailand and northern part of Peninsular Malaysia has becomes popular in recent years due to its ability to exhibit the opioid-like effects of analgesia. Mitragynine is the main alkaloid in M. speciosa which is found to reduce gastrointestinal motility and has been used by local communities as traditional treatment for diarrhoea and many other diseases. However, there is lack of scientific evidence to show that M. speciosa has anti-oxidative and anti-cancer properties especially in colorectal cancer. Therefore, our study aims to evaluate the anti-oxidative properties of M. Speciosa methanolic extract (MSME) and its effects on colorectal cancer cell line, SW480. Methods: The anti-oxidant content and scavenging activity of MSME were determined by total phenolic content (TPC) assay and total flavonoid content (TFC) assay as well as 2,2’-azino-bis (3-ethylbenzothiazoline-6-sul-phonic acid) (ABTS) assay and 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay respectively. Cytotoxicity and cytokine inhibitory effects of MSME on SW480 cells were determined by (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxy-phenyl)-2-(4-sulfophenyl)-2H-tetrazolium) (MTS) and cytokine beads array (CBA), respectively. Results: The TPC of MSME (0.1mg/ml = 85.85 ± 8.25 mg GAE/g extract; 1mg/ml = 167.43 ± 13.50 mg GAE/g extract; 10mg/ml = 408.94 ±7.17 mg GAE/g extract) was lower than pterostilbene, the positive control drug (76.37 ± 2.75; 230.52 ± 10.92; 835.44 ± 6.84 mg GAE/g extract). Conversely, the TFC of MSME (0.1mg/ml = 32.17 ± 27.92 mg QE/g extract; 1mg/ml = 347.72 ± 15.97 mg QE /g extract; 10mg/ml = 739.81 ± 5.56 mg QE /g extract) was slightly higher than pteros-tilbene (ND; 212.73 ± 17.92; 700.50 ± 3.47 mg QE/g extract). In DPPH assay, MSME showed comparatively similar antioxidant scavenging activity (IC50=4.34μg/ml) with pterostilbene (IC50=4.393μg/ml). However, MSME showed lower anti-oxidant scavenging activity (IC50=4.26μg/ml) than pterostilbene (IC50=1.556μg/ml) as measured by ABTS assay. In cytotoxicity assay, IC50 of MSME on SW480 cells was determined to be at 1.486 mg/ml. Overexpression of cytokines such as IL-6, IL-8 (CXCR8) and IL-10 could potentially promote tumour cell proliferation, growth and metastasis. Increased production of these cytokines through LPS stimulation in SW480 was slightly reduced by treat-ment with MSME. Conclusion: MSME could have a potential bioactive compound that possesses anti-oxidative and anti-cancer properties that would be beneficial as an alternative treatment of colorectal cancer.
Introduction:Candida albicans is an opportunistic fungus that is associated with oral carcinogenesis. In addition, biofilm formation has been one of the important virulence factors of the yeast. Streptococcus salivarius K12 is an oral probiotic while Musa acuminata is a well-known prebiotic. The objective of this study is to investigate the effect of S. salivarius K12 and M. acuminata skin aqueous extract (synbiotic) on C. albicans with the hypothesis that S. salivariusK12 and M. acuminata inhibit C. albicans biofilm formation. Methods: To develop mono-species biofilm, C. albicans(ATCC MYA-4901 and cancer isolates, ALC2 and ALC3 strains) and S. salivarius K12 were standardised to 105 cells and 106 cells, respectively and grown in 96-well plate in nutrient broth (NB) or RPMI at 37 °C for 72 h. Polymicro-bial biofilms were developed by inoculating both microorganisms in the same well with similar cell number as in mono-species. To determine the effect of synbiotic, similar protocol was repeated by mixing with 800 mg mL-1 of M. acuminata skin extract and incubated at 37 °C for 72 h. The medium was replenished at every 24 h, aseptically. Finally, the biofilms were assessed using crystal violet assay and the optical density was measured at OD620nm. Results:C. albicans strain MYA-4901 and ALC3, when grown in polymicrobial with S. salivarius K12 in NB that is predominated by yeast-form C. albicans, exhibited decreased biofilms by 71.40±11.7% and 49.40±3.9%, respec-tively when compared to the expected biofilms. Meanwhile in RPMI, which C. albicans strain ATCC MYA-4901, ALC2 and ALC3 were predominated by hyphal-form showed decreased biofilms by 72.0±26.7%, 53.4±14.4% and 65.7±6.7%, respectively when compared to the expected biofilms. Conclusion:S. salivarius K12 and M. acuminata skin extract synbiotic inhibit biofilm formation of C. albicans yeast and hyphal forms thus supported the hypothesis of the present study.
Introduction: Silver nanoparticles has been proven to be an effective agent for antimicrobial efficacy against bacte-ria, viruses and other eukaryotic microorganisms. Green synthesis is one of the methods that has been developed to synthesize silver nanoparticles in environmentally-friendly conditions. It uses plant extracts as reducing and capping agents. Besides act as reducing and capping agents, bioactives such as phenolic compounds may bind to silver nanoparticles and enhance its medicinal properties. Strobilanthes crispus is a Malaysian native plant. Previous stud-ies had shown that S. crispus contains polyphenols, catechins, alkaloids, caffeine, tannins and vitamins. Therefore, the aim of this study is to determine antibacterial activities of silver nanoparticles-Strobilanthes crispus (AgNP-SC) against clinically important pathogens such as Escherichia coli, Pseudomonas aeruginosa and Streptococcus mutans. Methods: The disc diffusion assay (DDA) was performed to investigate the inhibition zone of AgNps-Sc towards E. coli, P. aeruginosa and S. mutans. Minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC) was used to determine bactericidal/bacteriostatic profile of AgNP- SC against E. coli, P. aeruginosa and S. mu-tans. Results: AgNP-SC (40mg/mL) shows the greatest inhibition properties (12.67±0.6mm) against S. mutans when compared to Strobilanthes crispus leaves extract (6.0±0.001mm) and blank silver nanoparticles (6.0±0.001mm). MIC values for AgNP-SC against S. mutans and E. coli were at 0.625 mg/mL and 1.25 mg/mL, respectively. Whereas the MIC value of AgNP- SC against P. aeruginosa was at 2.5 mg/mL. MBC values of AgNP-SC against E. coli, P. aerugino-sa and S. mutans were at 1.25, 2.5 mg/mL respectively. Results are concentration-dependent, with higher concentra-tion demonstrating better inhibition property. Conclusion: It can be concluded that AgNP-SC possesses bactericidal properties against S. mutans, E. coli and P. aeruginosa.
Introduction:Candida spp. are most common opportunistic pathogenic yeast that inhabit human oral cavity, epider-mis, gastrointestinal tract, and vagina leading to candidiasis. The transition of this yeast from commensal to potent pathogen is facilitated by numbers of virulence factors including biofilm formation. While most reports on candidi-asis are associated with formation Candida albicans biofilms, however, non-albicans Candida species prevalence is of growing concern. Recently, the use of probiotics as antifungal and antibiofilm has gained an increasing attention. As such, we aim to evaluate the inhibitory effect of monomicrobial and polymicrobial of Streptococcus salivariuson six strains of NAC namely Candida dubliniensis, Candida glabrata, Candida krusei, Candida lusitanaei, Candida parapsilosis and Candida tropicalis. Methods: Antifungal activity of S. salivarius on NAC species was performed using well diffusion method on Mueller Hinton Agar (MHA) and the diameter of inhibition zone were assessed. For formation of monomicrobial biofilm, standardized cell suspensions of NAC species (1 x 105 cells/ml) and probiotic Streptococcus salivarius (1 x 106 cells/ml) were grown in RPMI or nutrient broth media at 37°C for 72 h. Meanwhile to study polymicrobial biofilm of both NAC and S. salivarius, similar protocol was employed by inoculating both microorganisms with a similar cell density as in monomicrobial. Finally, biofilm formation was assessed through quantification of total biomass by crystal violet (CV) assay and the absorbance of adherent biofilm was measured in triplicate at 620nm. Results: Antifungal susceptibility testing of S. salivarius on all six NAC species discerned no zone of inhibition. Furthermore, our results showed variability of monomicrobial and polymicrobial biofilm biomass between NAC species and growth medium. All six polymicrobial NB-grown and RPMI-grown exhibited decreased of the biofilm formation. C. parapsilosis co-cultured with S. salivarius in NB medium had shown lowest biofilm bio-mass by 75.51+_1.34% while in RPMI medium, C. lusitanaei demonstrated with most reduced biofilm biomass by 67.03+_5.19. Conclusion: Our study elucidated the antagonistic relationship between Streptococcus salivarius and non-albicans Candida by supressing the growth of polymicrobial biofilm and pseudohyphae/hyphae of NAC species.
Introduction:PTGS2 and DEFB1 single nucleotide polymorphisms (SNP) have been validated to be associated with chronic periodontitis (CP) in European, Japanese and Chinese populations. Polymorphisms of these genes play a role in the pathogenesis of CP. Thus far, no study has been done on the Malay ethnic group. Hence, this study assessed the allele and genotype frequencies of PTGS2 and DEFB1 variants in subjects with chronic periodontitis and healthy individuals in Malaysian Malays. Methods: Malay CP subjects and periodontally-healthy controls were obtained from Malaysian Periodontal Database and Biobanking system (MPDBS) for this case-control study. Diagnosis for cas-es was based on case definition by Eke et al (2012). DNA samples were genotyped for 4 candidate SNPs, rs689466, rs5275, rs20417 (PTGS2) and rs1047031 (DEFB1). Genotyping was carried out using Taqman genotyping method. The association between SNPs and study groups were assessed using logistic regression analysis. Results: DNA sam-ples from 140 individuals, 76 CP cases and 64 healthy controls were genotyped. Logistic regression results demon-strated that rs689466 for PTGS2 gene was associated with CP susceptibility in the Malay study group (p=0.03; OR: 1.80; 95% CI=1.05-3.07). The dominant and additive model test showed significant association with rs689466 (C/T) (pdominant-adjusted=0.02; OR: 2.22; 95% CI=1.11-4.43;padditive-adjusted=0.03; OR:1.85; 95% CI=1.07-3.19) after controlling for age and smoking. However, no significant association with CP was observed with other SNPs. Conclusion: The results suggest that rs689466 of PTGS2 gene may contribute to CP susceptibility in Malaysian Malay population in our preliminary study.
Introduction: While sharing a common causal link, both rheumatoid arthritis (RA) and periodontitis (PD) manifest similar inflammatory responses. With the progression of severity, both diseases result in bone loss. Hence, Ca and Zn, as structural components of the bones, are expected to be altered in saliva and serum in PD and RA respectively. Zinc and calcium concentrations have been studied previously in patients with PD or RA, with PD patients exhibiting increased salivary Ca and decreased Zn concentrations in serum, while RA patients have been reported to express low plasma concentrations of both Zn and Ca. The aim of this study is to evaluate the saliva and serum levels of Ca and Zn in PD patients with or without RA. Methods: Serum and saliva samples were collected from 82 patients from the Faculty of Dentistry, University of Malaya and the University Malaya Medical Centre rheumatoid clinic. Patients were grouped according to their periodontal health and RA status (healthy n=21; PD n=21; RA n=21; RAPD n=19). Results: Zinc concentration in serum was significantly higher (p
Introduction:Spilanthes acmella, also known as “subang nenek’, has been used traditionally in Malaysia to treat toothache. A previous study has shown Spilanthes acmella leaves extracts (SALE) inhibit Streptococcus mutans growth. Streptococcus mutans is commonly found in the human oral cavity and is the main contributor to tooth de-cay. There is no study on the antibacterial effects of Spilanthes acmella flower extracts (SAFE) against Streptococcus mutans reported to date. Therefore, the objective of this study is to investigate antibacterial properties of SAFE against S. mutans. Methods:S. mutans was subcultured in Muller Hinton (MH) broth and agar. Sequential extractions of S. acmella flowers were conducted using four different solvents with increasing polarity, [n- hexane, dichloromethane (DCM), acetone, methanol (MeoH)] and tested with different concentrations against S. mutans via the disc diffusion assay, minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC). Sodium fluoride (NaF) was used as a positive control while DMSO was used as a negative control. Results: The disc diffusion assay shows SAFE inhibited Streptococcus mutans growth. SAFE-DCM shows the greatest inhibition properties (12.33±2.30 mm) followed by SAFE-n-hexane (11.33±0.57 mm). Meanwhile, SAFE-Meoh and SAFE-acetone show no inhibition zone (6.00±0.001 mm). MIC value for SAFE-DCM and SAFE-n-hexane is 12.5 mg/mL respectively. Whereas, MBC value SAFE-DCM and SAFE-n-hexane is 50.0 mg/mL respectively. Conclusion: It can be concluded SAFE-DCM and SAFE-n-hexane possesses bactericidal properties against Streptococcus mutans.
Introduction: Protein and gene expressions are intensively profiled for potential biomarkers in diagnosis or prognosis of diseases. The correlation between corresponding protein and mRNA of a gene is important to establish whether transcript levels of a given gene can be used as proxies for the corresponding protein levels. mRNA profiling is more commonly utilised as this method is cheaper and the technology more advanced. Acute myeloid leukaemia (AML) is a heterogeneous group of malignant precursors of the myeloid lineage that leads to death if not treated. Cytokines and death receptors are commonly evaluated in this disease in search of potential biomarkers; however, the mRNA/protein correlations of these biomarkers are still unclear. Methods: Semi-quantitative expression of mRNA expression and protein levels of IL-1β, IL-18Rα, IL-6, TNF-α and DR5 were measured by conventional polymerase reaction (PCR) and flow cytometry in 11 cases of AML at diagnosis. Correlation in the intensity of the PCR amplicon and corre-sponding mean fluorescence intensity of protein was determined by Spearman’s rank correlation test. Results: None of the cytokines/death receptor was significantly correlated except IL-6 (Rs= -0.6287, p=0.038). Unexpectedly, this was also a significant negative correlation. Conclusion: For the majority of selected biomarkers in AML, whether secreted or surface-expressed, mRNA and protein expressions were not significantly correlated. The strong negative correlation for IL-6 is worth further investigation.
Introduction: Biologic patients are at increased risk of tuberculosis (TB) infection, especially in TB prevalent areas like Sabah. We present three cases of rheumatology patients who developed tuberculosis infection while on bi-ologics. Case description: Case1: 47 year old lady with active rheumatoid arthritis despite being on four disease modifying antirheumatic drugs (DMARDS) was given subcutaneous Etanercept after prescreening with mantoux test and interferon gamma release assay (IGRA). Due to poor response, she was switched to Tofacitinib with a repeat pre-screening done except IGRA. Three months after biologics, she developed pulmonary tuberculosis and Tofacitinib was stopped. Case2: 50 year old male with seropositive rheumatoid arthritis and seroconverted hepatitis B. He was worked up for biologic treatment after failing multiple DMARDS; mantoux was 10mm, IGRA not done. He was start-ed on subcutaneous Etanercept for disabling arthritis while being treated for latent TB but developed TB Lymphadeni-tis on his third month of biologic therapy which was withheld thereafter. Case3:48 year old teacher with seropositive rheumatoid arthritis and old pulmonary TB, had intolerance to methotrexate, was initiated on three DMARDS but symptoms remained uncontrolled. Prescreening with IGRA was negative and Adalimumab commenced. Following two years of biologic, she developed reactivation of TB. Rituximab was commenced a year after for persistent active arthritis but withheld due to dermatitis. Conclusion: All patients had mantoux test done routinely but not IGRA due to its cost and limited availability. A follow up study to analyze the effectiveness of IGRA versus Mantoux in detecting latent TB in such patients would be beneficial.
Introduction:Increasing number and the complexity of dengue cases pose a great challenge. The dengue outbreak preparedness and contingency plan is a series of collective intervention or polices put into place via collective agreement between administrative, Medical, Emergency Department and Intensive Care Unit (ICU). The aim of this paper is to evaluate the impact implementation of a dengue contingency plan on the clinical outcome of dengue cases. Methods: Implementation of the dengue outbreak preparedness and contingency plan was commenced in 2017. A pre-intervention (2017) and post-intervention (2018) retrospective review of mortality cases and referral to ICU were undertaken. The interventions included mandatory fast review by Emergency Physician, Medical Physi-cian and Anaesthesist in Emergency Department for ill patients (Dengue Care Pathway), cohorting dengue patient to one ward with mandatory monitoring and review system, clinical management adhering to the Clinical Practice Guideline of Management of Dengue Infection in Adults (2015), referring ill patients to ICU, deployment of nurses and experienced doctors to the dengue ward based on ratio of staff to patients, increasing number of doctors on-call at the dengue ward and a dengue bed manager system led by the Matron and Sisters. The plan was activated by mutual agreement between the Head of Medical Department and the Hospital Director. Results: There was a marked increment of admission of dengue cases into intensive care unit by 59% either directly from emergency department or the dengue wards in 2018 compared to 2017. The mortality rates reduced significantly from 5.4 deaths for every 1000 admission in 2017 to 3.3 in 2018. This is a reduction 2.1 death for every 1000 dengue admission. Conclusion:The implementation of the dengue outbreak preparedness and contingency plan aided the team to provide best care and practice in dengue management especially in the severely ill.
Introduction: Varicella pneumonitis is a rare but lethal complication of varicella zoster infection. Case description:We report a case of a 42 year old gentleman who presented with fever, rash, cough and worsening shortness of breath after exposure to his daughter who just recovered from varicella zoster infection. He is an active smoker with no comorbidities. He presented on day 4 of illness with generalised vesicular eruption and respiratory examination revealed reduced vesicular breath sounds bilaterally. He was intubated in view of worsening respiratory distress and was transferred to ICU. Chest X-ray and ABG was suggestive of acute respiratory distress syndrome(ARDS). He was treated with IV Acyclovir and broad spectrum antibiotics in view of subsequent hospital acquired infection. He was discharged well after 3 weeks of hospitalisation. Discussion: Varicella zoster infection is caused by Human alpha-herpesvirus 3, one of eight herpes viruses known to infect humans. Diagnosis of varicella pneumonitis with ARDS was made on the basis of rash, respiratory symptoms and contact with a child who just recovered from varicella zoster infection and rapid worsening of radiological changes. The risk factor of developing severe pneumonitis can be attributed to active smoking. Conclusion: High degree of suspicion and timely diagnosis is crucial for a favourable outcome in a patient with this rare complication.
Introduction: The National Immunization Program in Malaysia began in the 1950s and was integrated into the Ma-ternal and Child Health Program. Administrative data showed that coverage for all vaccinations was more than 95% except for measles vaccination. Despite the high coverage, there were clusters of outbreaks of vaccine preventable diseases. One of the reasons is the increasing phenomena of vaccines refusals following the rapid spread of negative perception and concerns through social media. Nurses as front liners play an important role to communicate on vac-cine safety and adverse events (AEFI). A survey was conducted to identify the level of knowledge among nurses who deal with immunisation programme. Methods: Nurses from all states attending a National seminar on immunisation communication in Putrajaya were asked to answer a Digital online questionnaire. They were asked to answer 12 questions on knowledge of vaccines, immunization schedule and cold chain management. Results: A total of 74% (429) of the seminar participants responded to the questionnaire, of which 85% were from the government sector and 15% from private. Findings showed that although about 75% of the nurses had formal training on immunisation, 50% had lack of knowledge about vaccination schedule for defaulters and 63.2% (268) had knowledge gaps related to questions on vaccines and handling of vaccines. Conclusion: In view of the knowledge gap from this survey, there is a need for ongoing training for the nurses and evaluation by supervisors on the knowledge and practices among nurses.
Introduction: Restricted and repetitive behaviours (RRBs) is one of autism spectrum disorders (ASD) core criteria. Exhibitions of RRBs produce profound implications on the functional aspect of these children and family. Evidence found that RRBs is related to the reward system dysfunction in the basal ganglia of these children. RRBs induces intrinsically rewarding effects on children with ASD. Listening to music was found to influence the reward system on the typical population and also discover to be promising as complementary strategies for ASD. A study found that high functioning adolescents with ASD cognitively stimulated through listening to happy music. Planning inter-vention for RRBs by looking towards the mechanism of reward system function remained unexplored. The primary objectives of this study is to examine the effect of happy music on RRBs symptoms. Methods: This study will use a randomised control trial research design with pre-test and post-test assessments in 20 children with ASD. Two parallel randomly assigned group will undergo twelve weeks of intervention sessions. The experimental group will listen to happy music and engage in free play sessions. For the control group, they will engage in free play session only without the music. Parents will complete the Repetitive Behaviour Scale-Revised, which consists of 6 subscales on RRBs to measure the outcome of the study. Results: The study will compare the RRBs between two groups. Con-clusion: Outcome of this study may set forth further investigation on the management of RRB using non-aversive contemporary approach.
Introduction: Zika virus is mainly transmitted to human through bite of an infected Aedes species mosquito. It was reported that the transmission also occurs by blood transfusion, sexual intercourse and from mother to foetus. The World Health Organization (WHO) had declared Zika infection outbreak as Public Health Emergency of Internation-al Concern (PHEIC) in February 2016. Since December 2016, total of eight Zika cases had been reported to Ministry of Health, Malaysia (MOH). Since there is no available vaccine and specific treatment for the Zika virus infection, the preventive practices against Zika virus infection is the only defense and method to curb the infection. The ob-jective of this study is to determine predictors of preventive practices towards Zika virus infection among patients attending health clinics in Seremban. Methods: A cross-sectional study was done in selected public health clinics in Seremban, involving 874 respondents recruited by simple random sampling method. Primary data was collected using self-administered questionnaires in English and Bahasa Malaysia. Descriptive and analytical statistics were performed using SPSS version 22.0. Results: Majority of the respondents were female (57.2%), below 40 years old (62.5%), Malay (83.1%), Muslim (83.8%), married (86.2%) and had secondary school education (51.8%), working (64.9%) with monthly household income of
Introduction: Antenatal period is the best time to promote physical activity among women. However, this oppor-tunity is usually missed due to various factors such perceived harm to the baby, tiredness, difficulty to perform the activities, pelvic and back pain, lack of information, as well as low social support. This study determined the associ-ation of social support with the level of physical activity among pregnant women in the district of Seremban, Negeri Sembilan. Methods: A total of 936 antenatal women met the eligibility criteria and were enrolled in a cross-sectional study using proportionate stratified random sampling. Data on social support from the spouse, family and friend were obtained using a 5-point Likert scale while physical activity was assessed using a short version of the Interna-tional Physical Activity Questionnaire (IPAQ). Statistical analysis was conducted using chi-square test to evaluate the association between the study variables. Results: A total of 880 respondents completed the questionnaire. Out of that, 64.2% were physically inactive. Significant associations were found between social support from the spouse (p < 0.001), family (p = 0.001) and friends (p = 0.004) with the level of physical activity among the respondents. Conclusion: Social support plays a pivotal role in motivating antenatal women to perform physical activity. Thus, health intervention on physical activity among these women should involve the spouse, family members and friends to ensure the success of the program.
Local profiles on the use of weight loss products are scarce. The study aims to address this together with concerns on the users’ misperception of the safety of these products, and the absence of high-quality evidence to support such use. Methods: This was a cross-sectional study conducted in overweight and obese patients attending a public primary care clinic in Penang. Selected patients were given a set of self-administered questionnaire that assessed types of weight loss products used, factors that influenced the usage and the users’ perception of their own body weight and the diet products they are taking. Results: From 332 participants of this study, 18.7% were users. Mean age of users were 44.6 (SD 11.9) years. The majority (66.1%) only used dietary supplements, 11.3% used weight loss medications and the rest (22.6%) used both products. Reasons for its use were for health, a faster result to lose weight and failing dieting and exercise regimes. The average amount spent on this was RM100 per month. Commonest source of weight loss products were friends. Majority (80.6%) did not discuss the use of the products with doctors. Factors associated with the use of weight loss products were being female (AOR=5.59), had tertiary level education (AOR=2.27), being employed (AOR=3.42), self-perceived of overweight (AOR=3.61) and perception that weight loss products as safe (AOR 2.48). Conclusion: Users of weight loss products are among highly educated working females who perceived themselves as being overweight and assume the products are safe.
Lactobacilli are well-documented probiotics that exert health benefits on their host. They exhibit characteristics that make them potential alternative treatments to address the antimicrobial resistance conundrum and diseases. Their mechanism of action varies with strain and species. Five lactobacilli strains previously isolated from the anogenital region were subjected to several assessments highlighted in the FAO/WHO document, ‘Guidelines for the Evaluation of Probiotics in Food’ to determine its suitability as potential probiotics. Methods: The five lactobacilli strains were subcultured onto Man de Rogosa agar (MRS). Their ability to auto- and co-aggregate was determined spectrophotometrically. Simultaneously, the cell surface hydrophobic properties of these strains towards xylene and toluene were evaluated using the microbial adhesion to hydrocarbon (MATH) test. The lactobacilli strains were also tested for their ability to withstand acid, bile and spermicide to determine their level of tolerance. Results: Lact. reuteri 29A, L. delbrueckii 45E and L. reuteri 29B exhibited the highest degree of auto- and co-aggregation properties. These lactobacilli strains also demonstrated high cell surface hydrophobicity, with the exception of L. delbrueckii 45E. Further tests to evaluate the isolated lactobacilli tolerance identified L. reuteri 29B as the most tolerant strain towards low pH (pH 2.5 for 4 h), high bile concentration (0.5% for 4 h) and high spermicides concentration (up to 10%). Conclusion: Out of the five lactobacilli strains which possessed high antimicrobial activities, L. reuteri 29B portrayed the best probiotic qualities with good auto- and co-aggregation abilities and high tolerance against acid, bile and spermicide.
Blood supply shortage is a worldwide problem including Malaysia. According to statistical data from 2011 to 2015, Terengganu which is one of the states in Malaysia has the lowest blood donation rate. The objective of this study was to determine the knowledge and attitude score towards blood donation and their associated factors among nondonors of Kuala Terengganu. Methods: This was a cross-sectional study using a self-administered questionnaire involving systematically random sampling of 320 nondonors attending Hospital Sultanah Nur Zahirah. Data were analysed using Multiple Logistic Regression and Pearson correlation. Results: The mean knowledge and attitude scores were 5.19 (1.87) and 70.79 (8.19), respectively. Sixty-four percent (64.69%) and 92.81% of the participants have good knowledge and attitude, respectively. Gender, education level, and occupation have a significant association with knowledge, while education level and occupation were found to be significantly associated with attitude. No significant association found between the knowledge and attitude level. Most reported barriers to blood donation were a refusal to give blood to other religion and race. The main source to acquire information pertaining to blood donation was mainly from social media. Conclusion: Refusal of giving blood to other religion and race is recognised as the main issue that hinders participants to donate their blood. Thus, proper education and aggressive promotion regarding blood donation are needed especially among the nondonor in this region of Malaysia.