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Fulltext Foot reflexology therapy for non-specific low back pain condition : a protocol for a randomized controlled trial

Nor Dalila Marican, Rozita Hod, Nadiah Wan-Arfah, Azmi Hassan

Int J Public Health Res, 2018;8(1):933-938.
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Introduction Non-specific low back pain is one of the most common physical ailments
affecting millions of people worldwide. This condition constitutes a
significant public health problem and was listed as a prevalent health
complaint in most societies. Even though there are many anecdotal claims
for reflexology in the treatment of various conditions such as a migraine,
arthritis and multiple sclerosis, but very little clinical evidence exists for
reflexology on the management of low back pain per se. This study aims to
evaluate the effects of foot reflexology therapy as an adjunctive treatment to
the Malaysian low back pain standard care in relieving pain and promoting
health-related quality of life among people with non-specific low back pain.
Methods This is a parallel randomized controlled trial with pre and post-treatment
study design. The study setting for the intervention located at Penawar
Reflexology Center, Kuala Terengganu, Malaysia. A total of 100
participants with non-specific low back pain will be allocated to one of two
groups, using a randomization computer program of Research Randomizer.
The control group will receive low back pain standard care, while the
intervention group will receive standard care plus eight sessions of foot
reflexology therapy. The pain intensity and health-related quality of life
scores will be measured using Visual Analogue Scale and Euro-quality of
life scale respectively in both groups. The study was approved by the
Human Research Ethics Committee of University Sultan Zainal Abidin
(UHREC/2016/2/011). The study protocol was registered at
ClinicalTrials.gov, with the ID number of NCT02887430.
Measurements Outcome measures will be undertaken at pre-intervention (week 1), postintervention
(week 6) and follow-up (week 10).
Conclusions This will be the first trial to compare the foot reflexology therapy with
control group among people who medically diagnosed with non-specific low
back pain in Malaysia. The result of this study will contribute to better
management of this population, especially for Malaysia healthcare setting.

Study site: Penawar Reflexology Center, Kuala Terengganu, Malaysia
Fulltext Association of angiogenic cells in the tumour microenvironment and the circulating matured endothelial cells in astrocytic glioma

Das, Priscilla, Naing, Nyi Nyi, Nadiah Wan-Arfah, Noorjan, KON, Yee, Cheng Kueh, Rasalingam, Kantha

International Medical Journal Malaysia, 2018;17(2):3-10.
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Introduction: Astrocytic gliomas are the most common and lethal intracranial brain tumours and rely on angiogenesis for the tumour development. Endothelial progenitor cells (EPCs) contribute to the angiogenesis of glioma tumour. Objectives: The study aimed to investigate the matured circulating endothelial cells population in the peripheral blood mononuclear cells (PBMCs) and its associations with tissue resident angiogenic cells in astrocytic glioma patients. Methods: A total of 22 astrocytic glioma patients were recruited from Hospital Universiti Sains Malaysia. Tumour were sliced and stained with CD133+ and VEGFA+ for angiogenic cells (n=22). The circulating (CD133-/VEGFR2+) matured endothelial cells in PBMCs (n=22) were quantified using FACS. The paired t-test and Pearson correlation test were used for the data analysis. Results: The angiogenic cells in brain tumour tissue were significantly higher compared to adjacent normal brain tissue (median 1.07±0.96% vs. median 0.69±0.68%; Wilcoxon signed rank test Z=-3.100; p=0.002). Positive correlation was found between the angiogenic cells of brain tumour tissue and adjacent normal brain tissue (Spearman’s rho correlation test, r=0.56; p=0.007). Significant positive correlation was found between matured endothelial cells in peripheral circulating systems and angiogenic cells in tumour of astrocytic glioma patients (Pearson correlation test, r=0.60, p=0.003).Conclusion:The findings of the study give support to the possible roles of EPCs in astrocytic glioma patients. Thus targeting tissue resident angiogenic cells and matured circulating endothelial cells by antiangiogenic treatment might be useful to prevent the tumour growth.
Fulltext Increased endothelial progenitor cells with age and grade of malignancy in Astrocytic Glioma patients

Das, Priscilla, Naing, Nyi Nyi, Nadiah Wan-Arfah, Noorjan, K.O.N., Kueh, Yee Cheng, Rasalingam, Kantha

Pertanika Journal of Science & Technology, 2018;26(2):641-652.
MyJurnal

Astrocytic gliomas are the most common primary brain tumours that originated from human glial cells. The tumours rely upon endothelial progenitor cells (EPCs) for neoangiogenesis. This study aimed to investigate the association between tissue resident EPCs in a brain tumour and normal adjacent tissue in relation to age and grade of astrocytic glioma. Astrocytic glioma patients (n=22), grade I to grade IV were consented from Hospital Universiti Sains Malaysia. Brain tumour tissue and normal adjacent brain tissue samples were obtained from each patient during surgery. The EPCs were stained with CD133+ and VEGFR-2+ markers. The tissue residents EPCs for each sample were determined using the immunofluorescence microscopy method. The age of the patients increased by disease severity in the following order (Grade I: 21.33±20.79 years) < (Grade II: 46.50±0.707 years) < (Grade III: 47.38±11.95 years) < (Grade IV: 48.44 ±10.66 years). The EPCs in brain tumour correlated significantly with the age of the patients with positive correlation (Spearman’s rho correlation test, r=0.52; p=0.013). The tissue resident EPCs in the brain tumour (median=0.40, IqR=0.59) were significantly higher compared with the adjacent normal brain (median=0.067, IqR=0.29) (Wilcoxon Signed-Rank Test, Z stat=-3.587, p
Fulltext The socio-demographic and clinical factors associated with quality of life among patients with brain pathology in a tertiary referral hospital in Malaysia

Das, Priscilla, Naing, NyiNyi, Nadiah Wan-Arfah, Naing Noor Jan, K.O., Yee, Cheng Kueh, Rasalingam, Kantha

JUMMEC, 2019;22(1):50-57.
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Background: This paper investigates the quality of life of brain pathology patients in relation to their sociodemographic
profiles and clinical factors.

Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100
patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The
European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered
questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning,
Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea,
Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study.

Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean
score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in
quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged
below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared
to patients who were more than 40 years old. Male patients faced more financial difficulties compared with
female patients. Patients who were married had increased insomnia compared to the single patients. Employed
patients had better physical functioning and less financial difficulties compared with patients who were
unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower
than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher.
Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had
better physical functioning. Meningioma patients had more symptoms of insomnia compared with other
patients. All the findings were with p value less than 0.05.

Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and
clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.
Pattern and Proportion of Unintentional Injuries Mortality among Children: A Surveillance Data Analysis from the National Trauma Database

Siti Farhanah Hasnan, Nadiah Wan Arfah, Nyi, Nyi Naing, Sabariah Faizah Jamaluddin, Nik Hisamuddin Nik Abdul Rahman

Pertanika Journal of Science & Technology, 2019;27(3):1371-1379.
MyJurnal

Unintentional injuries cause huge economic and social burden for the country. To further prevent unintentional injury by different age groups, it is crucial to identify the recent pattern of paediatric mortality. For a start, this study included a retrospective record review of 334 paediatric trauma patients (0-18 years) who were hospitalized due to unintentional injuries. The patient’s medical records from the period 2007 to 2010 were obtained from the National Trauma Database (NTrD). The patients were categorized into
Fulltext Quality of life among patients with brain pathology in a Malaysian hospital

Das, Priscilla, Naing, Nyi Nyi, Nadiah Wan Arfah, KO, Naing Noor Jan, Yee, Cheng Kueh, Rasalingam, Kantha

Pertanika Journal of Science & Technology, 2019;27(2):921-931.
MyJurnal

The objective of this study was to determine the prevalence of symptoms and problems in Malaysian brain pathology patients. A total of 100 respondents in Kuala Lumpur Hospital were included in this cross-sectional study. The study utilized European Organization for Research and Treatment of Cancer Quality Of Life questionnaire (EORTC QLQ-C30). Patient with a “symptom/problem” having the minimum response of “a little”. A response of “quite a bit” was defined as having a “severe symptom/problem”. The two most prevalent “symptoms/problems” among the neurological disorder patients were fatigue (65%; severe: 28%) and reduced cognitive functioning (64%; severe: 25%). The mean number of “symptoms/problems” ranged from 4.63 (meningioma) to 6.80 (cerebellar edema) while the mean number of “severe symptoms/problems” ranged from 1.39 (astrocytic glioma) to 2.8 (cerebellar edema). Therefore special attention should be given to these patients in order to improve the overall quality of life of the patients.
Fulltext Impacts of Microprocessor-Controlled Versus Non-microprocessor-Controlled Prosthetic Knee Joints Among Transfemoral Amputees on Functional Outcomes: A Comparative Study

Alzeer AM, Bhaskar Raj N, Shahine EM, Nadiah WA

Cureus, 2022 Apr;14(4):e24331.
PMID: 35607529 DOI: 10.7759/cureus.24331

INTRODUCTION: Selecting a prosthetic knee mechanism is an important part of transfemoral (TF) amputee rehabilitation. Prosthetic knee joint selection depends on the users' gait and their energy consumption. This study compares the feedback of transfemoral prosthesis users based on the prosthetic knee design self-reporting responses using the Prosthetic Evaluation Questionnaire (PEQ) outcome measure.
OBJECTIVE: This study aims to assess the impact of using a microprocessor-controlled prosthetic knee (MCPK) compared with a non-microprocessor-controlled prosthetic knee (NMCPK); feedback on the amputee usage can improve the clinical decision for proper prosthetic knee joint selection.
METHODS: This is a cross-sectional study with a total of 76 adult unilateral transfemoral amputees classified into two groups. The participants in the first group (38) used the MCPK (Genium, Otto Bock, Minneapolis, MN, USA), and the participants in the second group (38) used the NMCPK (hydraulic and total knee joints). Enrolment was based on a sequence of appointments where all participants answered the PEQ, with different subscale questions including utility (UT), sounds (SO), appearance (AP), residual limb health (RL), frustration (FR), perceived response (PR), social burden (SB), ambulation (AM), and quality of life (QoL). PEQ was filled out during the follow-up appointments at the prosthetic clinic through a visual analog scale (VAS). All data entered into a database were analyzed.
RESULT: The MCPK participants have significantly improved utility, appearance, ambulation, and total PEQ score, the same results as the male participants. Middle-adulthood (25-40 years) MCPK participants have a significant p-value in the score of utility, frustration, ambulation, and total PEQ score compared to early-adulthood (18-24 years) and late-adulthood (41-60 years) participants. Also, there was a significant improvement in the p-value in ambulation scores in participants using MCPK with amputations caused by diseases compared to amputations caused by trauma and congenital cause.
CONCLUSION: Transfemoral amputee prosthesis utility, natural gait, and ambulation improved when using MCPK compared to when using NMCPK during prosthetic rehabilitation.
Fulltext Evidence of new intragenic HBB haplotypes model for the prediction of beta-thalassemia in the Malaysian population

Aziz NA, Taib WW, Kharolazaman NK, Ismail I, Al-Jamal HAN, Jamil NWWA, et al.

Sci Rep, 2021 Aug 18;11(1):16772.
PMID: 34408192 DOI: 10.1038/s41598-021-96018-y

This study sought to determine the potential role of HBB haplotypes to predict beta-thalassemia in the Malaysian population. A total of 543 archived samples were selected for this study. Five tagging SNPs in the beta-globin gene (HBB; NG_000007.3) were analyzed for SNP-based and haplotype association using SHEsis online software. Single-SNP-based association analysis showed three SNPs have a statistically significant association with beta-thalassemia. When Bonferroni correction was applied, four SNPs were found statistically significant with beta-thalassemia; IVS2-74T>G (padj = 0.047), IVS2-16G>C (padj = 0.017), IVS2-666C>T (padj = 0.017) and 3'UTR + 314G>A (padj = 0.002). However, 3'UTR + 233G>C did not yield a significant association with padj value = 0.076. Further investigation using combined five SNPs for haplotype association analysis revealed three susceptible haplotypes with significant p values of which, haplotypes 1-2-2-1-1 (p = 6.49 × 10-7, OR = 10.371 [3.345-32.148]), 1-2-1-1-1 (p = 0.009, OR = 1.423 [1.095-1.850] and 1-1-1-1-1 (p = 1.39 × 10-4, OR = 10.221 [2.345-44.555]). Three haplotypes showed protective effect with significant p value of which, 2-2-1-1-1 (p = 0.006, OR = 0.668 [0.500-0.893]), 1-1-2-2-1 (p = 0.013, OR = 0.357 [0.153-0.830]) and 1-1-2-1-1 (p = 0.033, OR = 0.745 [0.567-0.977]). This study has identified the potential use of intragenic polymorphic markers in the HBB gene, which were significantly associated with beta-thalassemia. Combining these five SNPs defined a new haplotype model for beta-thalassemia and further evaluation for predicting severity in beta-thalassemia.