Introduction: Moringa oleifera Lam. is a miracle tree that has been widely utilised in folklore medicine due to its immense amount of phenolic constituents that could treat various ailments. Different techniques have been imple- mented to extract the phenolic but the parameters may not be optimised to further enhance the amount of phenolic extracted. Thus, the work aimed to enhance phenolic content and antioxidant activity of M. oleifera through RSM methodology, which is rapid and convenience. Methods: At first, antioxidant activity of different parts of M. oleifera (leaves, stem, pod and seed) were investigated. The plant part with the highest antioxidant activity was selected for the optimisation of extraction condition using RSM. In RSM, temperature (XA), extraction time (XB) and solid-liquid ratio (XC) were employed to study the effects on yield, total phenolics, flavonoids and antioxidant activity. Then, the optimum extraction condition obtained via RSM was utilised in LC-MS and HPLC analysis to determine the poten- tial bioactive constituents. Results: The leaves of M. oleifera displayed the highest antioxidant activity as compared to other plant parts. The optimum extraction condition obtained for the leaves extract was: temperature (XA): 82°C, extraction time (XB): 48 min and solid-liquid ratio (XC): 1:30 g/mL (w/v). Meanwhile, LC-MS revealed the presence of gallic acid, chlorogenic acid, quercetin, kaempferol and 3-O-glucoside kaempferol. HPLC analysis detected six compounds; gallic acid, epicatechin gallate, chlorogenic acid, myricetin, quercetin and kaempferol. Conclusion: The optimisation are promising to improve yield and antioxidant activity in M. oleifera as compared to non-conven- tional extractions.
Introduction: Aedes albopictus is known for its aggressiveness towards human and recently expanded to more coun- tries outside the native regions. Thus, the demographic parameters of Aedes albopictus are important to determine the characteristics of this species mosquitoes in terms of the reproduction rates and dispersal distance. Materials and Methods: This study, was performed using a Shah Alam strain of Aedes albopictus originally collected in twenty district areas of the central zone of Shah Alam. This research applies field work-study with a cross-sectional design to investigate the demographic parameters of Aedes albopictus. The demographic evaluation of Aedes albopictus was conducted under the control environment in insectarium. Results: Investigation on the demographic parameters of Aedes albopictus clearly showed that there is a significance different observed in the total number of mosquito eggs produced in both high and low incidence rate IR areas (p=0.03). In contrast, other parameters showed insignificant value between high and low IR areas. Conclusion: The key to control the mosquito vectors population is by tracking the vector’s life cycle including its survival. Therefore, the outcome of this study may provide as a baseline to esti- mate the dengue outbreak in the current episystem.
Introduction: Vibrio cholerae is a motile, Gram-negative curved rod belonging to the Vibrionaceae family. It is the causative agent of cholera. The acute diarrheal disease cholera causes about 120 000 casualties annually and has a significant effect on the health of young kids between the ages of 1 and 5. The main cause of death is due to resistance to antibiotics. As a result, new drug targets need to be identified immediately. The study’s goal is to identify Vibrio Cholerae’s putative drug target through an integrated approach to genomics and proteomics. Methods: Through this study, 2241 core protein sequence of Vibrio Cholerae were retrieved from the Panx tool. The sequence decreased to 173 druggable sequences by undergoing different phases of the process such as determining the non-homolo- gous sequence against human proteome by using the BlastP tool, identifying the essential genes by using the DEG database, and determining the sequence of virulent proteins by using Virulent prediction tool. Results: 11 potential drug targets were identified through molecular weight, and sub-cellular localization analysis. Conclusion: Through pan-genome analysis, we can able to find potential drug targets. This study also helps to identify the potential drug targets against Vibrio cholerae and to increase the efforts of drug and vaccine developments.
Introduction: Glucose-6-phosphate dehydrogenase (G6PD) deficiency causes red blood cell destruction due to oxi- dative stress. G6PD is essential for NADPH conversion; which is critical for glutathione reductase to prevent damage to cellular structures. In Malaysia, blood donors are not routinely screened for G6PD deficiency. We hypothesise that G6PD-deficient red blood cells are more likely to haemolyse during storage due to increased oxidative molecules. The objectives of this study were to determine the prevalence of G6PD deficiency among blood donors, describe their characteristics and to evaluate the effects of storage on G6PD-deficient donated blood. Methods: This study was conducted at selected mobile donation centres in Terengganu. Consented blood donors were screened for G6PD sta- tus using fluorescent spot tests (FST). G6PD enzyme activities were measured for donors who were G6PD deficient. Effects of storage on haemolysis from G6PD-deficient donors were compared with non G6PD-deficient group. Sixty ml of blood was collected from blood unit to transfer pouch for estimation of haemoglobin (Hb), plasma Hb, per- centage of haemolysis and plasma potassium. Serial sampling with a 7-day interval was done from Day 1 to Day 35. Statistical analysis was considered significant if p 0.05. Results: A total of 440 blood donors were screened and 12 male donors were found to be G6PD deficient by FST. Enzymatic activities were measured in 11 donors as one donor sample failed to be sent to the centre due to logistic problem. Their enzymatic activities ranged from 1.66-2.93 U/g Hb whereby 6 have severe deficiency and the other 5 were categorised as partial deficiency. Donors were asymp- tomatic for haemolytic episode. Serial sampling showed there was no significant difference of haemolytic parameters in blood units of G6PD-deficient donors as compared to control (p>0.05). Conclusion: Prevalence of G6PD blood donors in Terengganu mobile centres was 2.7%. G6PD enzyme activities did not correlate with clinical symptoms. Haemolytic parameters were not affected in blood units which were G6PD-deficient.
Introduction: Accelerants and fabrics are commonly used to spread fire attributable to their highly flammable prop- erties. Hence, having the ability to discriminate the different types of accelerants on various types of fabrics after fire and/or arson using the non-destructive Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spec- troscopy coupled with chemometric techniques appears forensically relevant. Methods: Six types of fabrics viz. cotton, wool, silk, rayon, satin, and polyester, were burnt completely with RON95 and RON97 gasoline as well as diesel. Subsequently, the samples were analyzed by ATR-FTIR spectroscopy followed by Principal Component Analysis (PCA) and Linear Discriminant Analysis (LDA) for discriminating the different types of accelerants on such burned fabrics. Results: RON95 showed the fastest rate of burning on all fabric types. Results also revealed that while wool had the slowest burning rate for all the three different accelerants, polyester, cotton, and satin demon- strated the highest rate of burning in RON95, RON97, and diesel, respectively. FTIR spectra revealed the presence of alkane, alcohol, alkene, alkyne, aromatic, and amine compounds for all fabrics. The two dimensional PCA (PC1 versus PC2) demonstrated 71% of variance and it was improved by cross-validation through the three dimensional LDA technique with correct classification of 77.8%. Conclusion: ATR-FTIR spectroscopy coupled with chemometric techniques had enabled identification of the functional groups, as well as statistically supported discrimination of the different accelerants, a matter of relevance in forensic fire and arson investigations.
Introduction: There are numerous studies on the therapeutic properties of Artocarpus heterophyllus. However, stud- ies on the aqueous extraction of A. heterophyllus leaves are limited. This present study was conducted to optimize the extraction conditions of A. heterophyllus leaves to yield the highest phenolic, flavonoids and antioxidant contents. Methods: Response surface methodology (RSM) was employed to obtain a higher phenolic extraction parameter(s) of A. heterophyllus leaves using Central Composite Design (CCD). The antioxidant activity was then determined via ABTS (2,29-azinobis (3 ethylbenzothiazoline-6-sulfonic acid)) and DPPH (2,2-Diphenyl-1-picrylhydrazyl) assay and analysis of the individual phenolics was performed by high performance liquid chromatography (HPLC). Results: The optimum extraction conditions with higher phenolics content and antioxidant activity was achieved at 81°C, 100 min and 40 mL/g sample with a good desirability value of 0.87. Under these optimized parameters, total phenolics and flavonoids were 174.48 ± 4.05 mg GAE/g sample and 21.44 ± 0.05 mg RE/g sample, respectively. Meanwhile, antioxidant activity via ABTS and DPPH assays were 90.88% ± 0.09 and 87.22% ± 0.62, respectively. Finally, under optimal extraction conditions revealed 4 compounds identified as chlorogenic acid, quercetin, rutin and kaempferol. Conclusion: The optimisation are promising to improve phenolic yield and antioxidant activity in A. heterophyllus leaves. It also proved that A. heterophyllus leaves can be used as an alternative natural antioxidant especially in medicinal applications since all identified compound possess significant biological activities for human health.
Introduction: Lean healthcare outcome is usually measured with multiple key performance metrics but there is a lack of tools that enabled efficiency assessment. This research aimed to assess the efficiency among lean public emergen- cy departments (ED) through Slack-Based Measure Data Envelopment Analysis (SBM-DEA) and evaluate the impact of lean on the efficiency in public emergency departments. Methods: A retrospective observational study design using data on the number of support staff, number of doctors, number of discharge, arrival to consultant and length of stay. Efficiency scores of 20 Malaysian public EDs were computed using SBM-DEA modelling and compared be- tween before and after lean implementation. Results: A total of 13 out of 20 public EDs exhibited improvement in ar- rival to consultant and length of stay upon lean implementation. However, only 9 out of the 13 public EDs have had an improvement in efficiency score. Conclusion: Lean healthcare demonstrated a positive impact on the efficiency level of some public EDs. The SBM-DEA model offers the benchmarking capability and slack elimination information that may complement the lean continuous improvement philosophy.
Introduction: Age-related macular degeneration (ARMD) is an ocular degenerative disorder that associated with impairment of central vision. Oxidative stress plays an important role in the pathogenesis of ARMD. The aim of this study was to determine the level of antioxidant enzymes (catalase and glutathione peroxidase) in tears among Malay ARMD patients. Methods: A cross sectional study was conducted between September 2015 and November 2017 among Malay ARMD patients. Schirmer paper was used to collect the tear samples. The level of catalase and glu- tathione peroxidase level in tears was evaluated using commercially available oxidative stress marker kits. Results: A total of 136 Malay ARMD patients were recruited into the study with 68 controls. Mean tear catalase and gluta- thione peroxidase levels were significantly lower in ARMD patients (1348.97 SD 109.11 µM and 453.87 SD 41.96 U/L respectively) as compared to the control group (1453.38 SD 38.87 µM and 502.28 SD 34.29 U/L respectively) (P
Introduction: FertiQoL questionnaire was developed and validated in 2011. It has been widely used and translated
into many languages to measure QoL among infertile individuals. The use of translated psychometric tools is often
subjected to cross-cultural variations. The objective of this study is to assess the psychometric properties of the
Malaysian FertiQoL. Methods: A study was conducted among attendees of a public infertility clinic. Demographic
details were collected and respondents answered the Malaysian FertiQoL. The questionnaire consists of 34 items.
Factor analysis and internal consistency were analysed using SPSS v24. Results: Data from 175 respondents were
analysed. Mean age is 32.1 ±3.8 SD with 56.6% female and 43.4% male. KMO index were 0.826 and significant
Bartlett’s test for sphericity. For Treatment domain, factor loadings for items T2 and T5 were < 0.32 but for all other
items were acceptable between 0.32 – 0.80 with no cross loadings and Cronbach alpha for environment (0.717)
and tolerability (0.660). For Core items, Q4, Q6 and Q14 loaded onto different domains and Q19 had poor factor
loading. All other items were acceptable. Cronbach alpha for specific domains were emotional (0.788) mind-body
(0.829), relational (0.639) and social (0.666). Cronbach alpha for emotional, relational, social improved to 0.857,
0.643 and 0.732 if Q4, Q6 and Q14 were omitted respectively. Conclusion: The study identified six items that affected the psychometric validity of the questionnaire and maybe explained by language or cross-cultural reasons.
However, the Malaysian FertiQoL can still be useful to measure QoL in those with infertility.
Introduction: The World Health Organization recommends evaluation of maternal satisfaction to improve quality of health care during childbirth. Dissatisfaction may lead to undesired outcomes such as unassisted homebirth and delay in seeking treatment. Determining the maternal satisfaction level and its associated factors may help to improve health care services and prevent negative implications to both mothers and infants. This study aimed to determine the maternal satisfaction towards intrapartum care of designated healthcare facilities and its associated factors among postnatal women. Methods: This was a cross-sectional study of postnatal women attended Klinik Kesihatan Salak from December 2017 to February 2018. Systematic random sampling with the ratio of 1:3 was applied to the eligible respondents. A self-administered questionnaire that include respondent’s socio-demographic characteristics and a validated 14-items Maternal Satisfaction with Hospital-based Intrapartum Care Scale was used. Data was analyzed using SPSS 23. Results: 274 respondents were recruited in this study. Overall, only 21.2% of respondents were sat- isfied with the intrapartum care given. The level of satisfaction was highest in interpersonal care domain (36.1%), followed by physical birth environment (34.3%) and the least satisfied was information and decision making domain (27.7%). Binary logistic regression showed that maternal satisfaction was significantly associated with place of birth (AOR (95% CI): 0.046 (0.183, 0.984)) and labour complications (AOR (95% CI): 3.387 (1.345, 8.528)). Conclusion: The overall maternal satisfaction towards intrapartum care was low and the information and decision-making do- main appeared to be the least satisfied. Maternal satisfaction was associated with place of birth and labour compli- cations. Therefore, health care providers should emphasize and improve the quality of services especially for this domain and to consider factor that contribute to dissatisfaction towards the intrapartum care.
Introduction: Short-term fasting may influence intraocular pressure (IOP) due to alteration of fluid (total body water;
TBW, and water intake) and fat (total body fat; TBF). This study aimed: i) to compare IOP values within and between,
fasting and non-fasting periods; and ii) to assess the association between IOP and, TBW and TBF. Methods: Thirty
healthy participants aged 21.8±1.1 years were assessed on two different periods (fasting vs. non-fasting). During each
period, the IOP, TBW and TBF values were assessed for four times (morning, afternoon, evening, late-evening). The
IOP was measured using AccuPen® tonopen, while TBW and TBF were assessed by using a Tanita body composition
analyser. Results: During fasting, the IOP value in the afternoon (14.53±2.33 mmHg) was significantly higher than in
the evening (12.43±2.73 mmHg, p=0.009) and late-evening (12.60±2.44 mmHg, p=0.003). No significant difference
in IOP was observed during non-fasting period. The mean of IOP in the evening was significantly lower during fasting
compared to non-fasting (12.43±2.73 mmHg vs 13.75±2.53 mmHg, p=0.044). The IOP and TBW were negatively
correlated (r=-0.268; p=0.011) during non-fasting and showed no association during fasting period. There was no
significant correlation between IOP and TBF during both fasting and non-fasting periods. Conclusion: IOP reduction
during short-term fasting, together with the no association with TBF and TBW suggested that IOP is an independent
factor that reduces during fasting in healthy population.
Introduction: Pesticides may influence the physicochemical properties of soil and the water quality parameters, which is vital in maintaining soil fertility and producing high quality crops. Objective: This study aims to determine the relationship between the concentration of pesticides, the physicochemical properties of the paddy soil samples and the water quality parameters of paddy water samples. Methods: A total of 72 soil and 72 water samples were collected in Tanjung Karang, Malaysia. The paddy soil and water were extracted using Quick, Easy, Cheap, Efficient, Rugged and Safe (QuEChERS) and solid phase extraction (SPE) techniques respectively. The concentrations of pesti- cides were analysed in ultra-high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS). The relationship of the concentration of target pesticides and the paddy soil and water physicochemical properties were studied using Spearman correlation. Results: In paddy soil, the concentration of propiconazole shows moderate positive correlation with manganese (Mn) (r = 0.587) (p 0.01). Meanwhile buprofezin-total organic carbon (TOC) (r = -0.55) (p 0.01), imidacloprid-cation exchange capacity (CEC) (r = -0.519) (p 0.01), pymetrozine-sodium (Na) (r = -0.588) (p 0.01), and trifloxystrobin-calcium (Ca) (r = 0.566) (p 0.01) showed moderate negative correlation. Whereas in water, trifloxystrobin showed significant positive correlation with turbidity (r = 0.718) (p 0.01) and te- buconazole showed negative correlation to dissolved oxygen (DO) (r = 0.634) (p 0.01). Conclusion: The presence of pesticides in paddy field may influence the soil and water quality, thus regular monitoring of pesticides usage and nutrient management in soil is deemed important.
Introduction: Chronic musculoskeletal pain is a common disabling condition among older adults with the major- ity, remain undertreated. This study aimed to determine the uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults and the associated factors. Methods: A stratified sampling proportionate to size with individual clinics as the strata were used to recruit 276 respondents from six public health clinics in Petaling district, one of the most aged districts in the state of Selangor, Malaysia. Based on the proportion calculat- ed, eligible older adults were selected by systematic random sampling from the registration list. Data was collected using a pre-tested and validated questionnaire through a face-to-face interview with respondents. The questionnaire comprised of seven sections, namely, socio-demographic, comorbidity, depression, pain severity, treatment options, attitude towards chronic pain and chronic musculoskeletal pain. Inferential analysis was conducted using Chi- Square (X2) and Fisher’s Exact Tests. The P value of < 0.05 regarded as statistically significant. Results: A total of 242 (87.7%) of the respondents had chronic musculoskeletal pain, in which 235 (85.1%) were treated with non-pharma- cological treatments. The commonly used non-pharmacological treatments were exercise (67.8%), biological-based therapies (40.9%) and massage (33.7%). The uptake of non-pharmacological treatment for chronic musculoskeletal pain among older adults was significantly associated with the presence of diabetes. Conclusion: The findings re- vealed the remarkably high uptake of non-pharmacological treatment among older adults who experienced chronic musculoskeletal pain which was significantly associated with diabetes and the presence of other diseases like high blood pressure, osteoarthritis, back pain and rheumatic arthritis.
Introduction: Hypercholesterolemia has been proven as a main pathogenic trigger for pathogenesis of atherosclerosis. Atherosclerosis characterised by chronic inflammatory process and increased expression of inflammatory markers. In this study; Trihoney (a combination of three types of natural honey namely: Trigona, mellifera, and Dorsata)
was investigated for its anti-inflammatory effect in hypercholesterolemic atherosclerotic rabbits. Methods: Thirty
male New Zealand white rabbits (NZW) were grouped into: normal diet (C), normal diet with 0.6g/kg/day of Trihoney (C+H), 1% cholesterol diet (HCD), 1% cholesterol diet with 0.6g/kg/day of Trihoney (HCD+H), and 1%
cholesterol diet with 2mg/kg/day of atorvastatin (HCD+At.). After 12 weeks of starting the experiment, animals were
sacrificed and serum analysed for homocysteine and pro-atherogenic inflammatory markers such as: interleukin-1β
(IL-1β), interleukin-6 (IL-6), and tumour necrosis factor-α (TNF-α). Fasting serum glucose was analysed to assess glycaemic status. Results: Trihoney treated group showed significantly lower (p
Introduction: Previous studies reported that a two-week double-dose clopidogrel treatment following percutaneous coronary intervention has no difference in safety compared to standard therapy. This study aimed to determine the all-cause readmission rate and survival after a year of percutaneous coronary intervention (PCI) in patients who were treated with two-week double-dose clopidogrel regimen. Methods: This was a retrospective study on patients who underwent PCI in a state general hospital in Malaysia in 2014. Patients’ one month and one-year survival status were retrieved using the hospital electronic patient management system. Patients who received a two-week course of 150mg clopidogrel and subsequently a one-year course of standard double antiplatelet therapy were included. Results: A total of 381 out of 563 patients who underwent PCI were included in the analysis, while those who were switched to ticagrelor and transferred to other hospitals post-PCI excluded. Patients had a mean age of 56.9 (SD 10.7), with majority male (331, 86.9%) and Malay (144, 37.8%). The PCI was mainly indicated for ST-elevated myocardial infarction (188, 49.3%), non-STEMI (114, 29.9%) and unstable angina (36, 9.4%). A total of 107 (28.1%) patients were readmitted within the one year post-PCI period. Readmissions were mainly due to ACS (55.5%) and bleeding events (2.4%). The 30-day and 1-year all-cause mortality was 33 cases and 43 cases, respectively. Conclu- sion: The low readmission and bleeding related readmission suggested that the two-week double-dose clopidogrel regimen was safe for the post PCI patients. Future randomised trial to establish the efficacy of this dosing regimen is therefore warranted.
Introduction: Usage of smartphones have increased rapidly because of its importance in our daily life. This led to an increase in incidence of ocular problems among smartphone users. This research was conducted to determine the effect of smartphone usage on accommodation status. Methods: A cross-sectional study was conducted among young adults aged 19 to 30 years old in Management and Science University, Shah Alam. All subjects were asked to use smartphone for 20 minutes. The symptoms and accommodation status were evaluated before and after the smartphone usage. Results: Total subjects showed the mean age of 23.60 ± 2.77 years, 50% (n = 20) were males and 50% (n = 20) were females. The mean smartphone usage per day was 8.60 ± 2.80) hours. After 20 minutes of smartphone usage, subjects complained of tired eyes (92.50%), dry eyes (90.00%), blurred vision (87.50%), and headache (82.50%). Paired t-test showed significant reduction in amplitude of accommodation, monocularly from 9.9 ± 1.9 D to 8.76 ± 2.50 D (p = 0.00), and binocularly from 12.01 ± 1.95 D to 10.96 ± 2.16 D (p = 0.00); monoc- ular accommodative facility from 13.93 ± 3.13 cpm to 11.10 ± 4.32 cpm (p = 0.00) and binocular accommodative facility from 12.70 ± 3.57 cpm to 9.70 ± 4.21 cpm (p = 0.00); positive relative accommodation from -2.72 ± 0.87 D to -2.13 ± 1.28 D (p = 0.00) and increase in lag of accommodation from 0.4 ± 0.26 D to 0.93 ± 0.48 D (p = 0.00). Conclusion: This study shows that there were significance changes on accommodation status after 20 minutes of smartphone usage which can lead to weakness of accommodation.
Interpretation of thyroid function test (TFT) is often straightforward but in certain scenarios, discordance between the clinical impression and the laboratory results exists. A 50-year-old woman with a ten years history of hypothyroidism on levothyroxine presented with a recent notable change in TFT [elevated free thyroxine (FT4) and thyroid-stimulat- ing hormone (TSH)], in an otherwise clinically euthyroid and previously stable TFT, leading to levothyroxine being withheld. This case report highlights the possibility of assay interference as a cause of discordant TFT. It also draws the importance of close collaboration between clinicians and the laboratory to avoid unnecessary investigations and inappropriate management of such a case.
Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition which is important for clinicians to recognize as it has a high mortality rate and can result in significant neurological morbidities. It presents as acute encephalopathy with radiological findings of symmetrical brain lesions in bilateral thalami, putamen, brain stem teg- mentum, internal capsule, periventricular white matter and cerebellar medulla. Intravenous methylprednisolone is the mainstay of treatment. Immunoglobulin therapy and therapeutic hypothermia may be used as adjunctive therapy in cases with severe clinical and neuroradiological presentation. We present a case of severe ANEC and discuss the clinical manifestations, neuroimaging and management options.
This review provides an overview of the evidence which concerns the parental stress of children with type 1 diabe- tes mellitus. Articles for this review were collected using the Science Direct, CINAHL, PsycINFO, Medline, Scopus, EBSCO, Springer, Ovid, PubMed, Google Scholar, and Cochrane Library. In total, 38 articles were relevant to this review. The findings of the reviewed studies provide an exciting opportunity to advance our knowledge for a differ- ent aspect of parental stress which is related to the disease and predictor’s factor contributes to parental stress. This review sheds new light on developing the educational programs to reduce the level of parental stress and to help them to cope positively with this disease.
Using pulmonary tuberculosis (pTB) as an example of a vaccine-preventable disease (VPD), we aimed to gather evidence on the economic impact of treating a case or managing an outbreak of a VPD. A scoping review was con- ducted. Online databases (MEDLINE and Google Scholar) were used to collate published studies from the year 2015 to 2019 on the management cost of one case or an outbreak of pTB. Keywords used were cost, treatment, outbreak, pulmonary tuberculosis, tuberculosis, economic, economic evaluation. A total of 29 studies were analysed. The costs of pTB treatment for individual patient were higher in high-income countries compared to middle-income and low-income countries. A case of pTB can result in household catastrophic health expenditure; while an outbreak can overwhelm the health system’s capacity, and disrupts the economy of a country. Therefore, accessibility of vaccines especially in low-income countries must be ensured. Also, vaccine-hesitant individuals must reconsider their stance on vaccination.