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  1. Nadarajan VS, Ooi CH, Sthaneshwar P, Thompson MW
    Int J Lab Hematol, 2010 Feb;32(1 Pt 2):82-7.
    PMID: 19170774 DOI: 10.1111/j.1751-553X.2008.01132.x
    Altitude training is sometimes employed by elite endurance athletes to improve their sea level performance. This improvement results from the increased red cell mass consequent upon the boost in erythropoietin (EPO) level that occurs as a response to the relatively hypoxic environment at high altitudes. We measured serum EPO levels together with various red cell and reticulocyte parameters including immature reticulocyte fraction (IRF) in eight national track-endurance cyclists, resident at sea-level, prior to and upon return from an altitude of approximately 1905 m. Reticulocytes and soluble transferrin receptor (sTfR) were significantly increased with reduction in ferritin levels immediately on return from high altitude indicating increased erythropoietic activity. IRF in particular showed a significant peak immediately on return but decline to sub-baseline levels by day 9, and recovery to baseline by day 16. Our results indicate that IRF is a sensitive marker of erythropoietic status in athletes undergoing altitude training and subsequent loss of EPO stimuli on return to sea level.
    Matched MeSH terms: Erythropoiesis*
  2. Teh SH, Fong MY, Mohamed Z
    Genet Mol Biol, 2011 Jul;34(3):464-70.
    PMID: 21931521 DOI: 10.1590/S1415-47572011005000022
    The Pichia pastoris expression system was used to produce recombinant human erythropoietin, a protein synthesized by the adult kidney and responsible for the regulation of red blood cell production. The entire recombinant human erythropoietin (rhEPO) gene was constructed using the Splicing by Overlap Extension by PCR (SOE-PCR) technique, cloned and expressed through the secretory pathway of the Pichia expression system. Recombinant erythropoietin was successfully expressed in P. pastoris. The estimated molecular mass of the expressed protein ranged from 32 kDa to 75 kDa, with the variation in size being attributed to the presence of rhEPO glycosylation analogs. A crude functional analysis of the soluble proteins showed that all of the forms were active in vivo.
    Matched MeSH terms: Erythropoiesis
  3. Krishnamoorthy A, Hadi FA, Naidu A, Sathar J
    Med J Malaysia, 2017 02;72(1):53-54.
    PMID: 28255141
    Anaemia is a common condition in Malaysia, and is mostly due to iron deficiency. In many cases, allogeneic blood transfusion (ABT) is administered unnecessarily to treat anaemia. Patient blood management (PBM) is a concept whereby a patient becomes his or her "own blood bank", instead of receiving ABT. The concept encompasses three pillars namely optimising erythropoiesis, minimising blood loss and harnessing human physiological reserve. We present a safe and fruitful outcome of managing severe anaemia without utilising any ABT, made possible with the PBM approach including administration of intravenous iron.
    Matched MeSH terms: Erythropoiesis
  4. Tan PY, Loganathan R, Teng KT, Mohd Johari SN, Lee SC, Selvaduray KR, et al.
    Eur J Nutr, 2024 Apr;63(3):905-918.
    PMID: 38240773 DOI: 10.1007/s00394-023-03314-6
    PURPOSE: Vitamin A deficiency (VAD) remains a significant contributor to childhood morbidity and mortality in developing countries; therefore, the implementation of sustainable and cost-effective approaches to control VAD is of utmost pertinence. This study aims to investigate the efficacy of red palm olein (RPO)-enriched biscuit supplementation in improving vitamin A, haematological, iron, and inflammatory status among vitamin A-deficient schoolchildren.

    METHODS: We conducted a double-blinded, randomised controlled trial involving 651 rural primary schoolchildren (8-12 years) with VAD in Malaysia. The schoolchildren were randomised to receive either RPO-enriched biscuits (experimental group, n = 334) or palm olein-enriched biscuits (control group, n = 317) for 6-month duration.

    RESULTS: Significant improvements in retinol and retinol-binding protein 4 levels were observed in both groups after supplementation (P 

    Matched MeSH terms: Erythropoiesis
  5. Lim, L. N., Yu, K. S., Chua, S. M., George, E., Lai, M. I., Wong, L., et al.
    MyJurnal
    Introduction: Filipino β°-deletion is predominant among the β-thalassaemia patients in the indigenous population of Sabah, Malaysia particularly among the Kadazandusun. Individuals who co-inherit with α- and β-thalassaemia will demonstrate milder clinical symptoms with modified complete blood count (CBC) and Hb subtype parameters. HBS1L-MYB variants act as one of the key regulator of haematopoiesis and erythropoiesis and display strong association
    with variation of HbF levels. Therefore, this study aims to evaluate the association between genetic variants in HBS1L-MYB with Hb subtypes level among Filipino β°-deletion carriers co-inherited with -α3.7 deletion. Methods: Filipino β°-deletion and -α3.7 deletion were identified using gap-polymerase chain reaction (PCR). A total of 34 subjects found with coinheritance of Filipino β°-deletion and -α3.7 deletion were subjected for HBS1L-MYB intergenic polymorphisms (HMIP) analysis. Hb subtypes level were quantified using BioRad Variant II Hb analyser. Genotyping of HBS1L-MYB variants rs9399137 and rs11759553 was done using own designed tetra primer ARMS-PCR. Results: The minor allele frequencies (MAF) of the two HMIP is found more than 0.05 (rs11759553, MAF=0.18 and rs9399137, MAF=0.15), indicating the significance of these variants among the study subjects. Significant difference was found between HbF level and HBS1L-MYB variant rs11759553 with p-value less than 0.05 (p=0.001). Subjects with homozygous genotype for rs11759553 (T/T) was found with higher HbF, followed by heterozygous (A/T) and wild type (A/A). rs11759553 and rs9399137 was found did not influence the level of HbA and HbA2. HMIP of rs11759553 and rs9399137 are found significant among Filipino β°-deletion carriers co-inherited with -α3.7deletion with its high minor allelic frequency and high HbF level. Strong association with HbF level was demonstrated when
    coinheritance of rs11759553. Conclusion: This study demonstrates that there are significant associations between certain genetic variants in HBS1L-MYB with Hb subtypes level among Filipino β°-deletion carriers co-inherited with -α3.7 deletion.
    Matched MeSH terms: Erythropoiesis
  6. Bavanandan S, Ahmad G, Teo AH, Chen L, Liu FX
    Value Health Reg Issues, 2016 May;9:8-14.
    PMID: 27881266 DOI: 10.1016/j.vhri.2015.06.003
    OBJECTIVES: To investigate the 5-year health care budget impact of variable distribution of adult patients treated with peritoneal dialysis (PD) and in-center hemodialysis (ICHD) on government funding in Malaysia.

    METHODS: An Excel-based budget impact model was constructed to assess dialysis-associated costs when changing dialysis modalities between PD and ICHD. The model incorporates the current modality distribution and accounts for Malaysian government dialysis payments and erythropoiesis-stimulating agent costs. Epidemiological data including dialysis prevalence, incidence, mortality, and transplant rates from the Malaysian renal registry reports were used to estimate the dialysis patient population for the next 5 years. The baseline scenario assumed a stable distribution of PD (8%) and ICHD (92%) over 5 years. Alternative scenarios included the prevalence of PD increasing by 2.5%, 5.0%, and 7.5% or decreasing 1% yearly over 5 years. All four scenarios were accompanied with commensurate changes in ICHD.

    RESULTS: Under the current best available cost information, an increase in the prevalent PD population from 8% in 2014 to 18%, 28%, or 38% in 2018 is predicted to result in 5-year cumulative savings of Ringgit Malaysia (RM) 7.98 million, RM15.96 million, and RM23.93 million, respectively, for the Malaysian government. If the prevalent PD population were to decrease from 8% in 2014 to 4.0% by 2018, the total expenditure for dialysis treatments would increase by RM3.19 million over the next 5 years.

    CONCLUSIONS: Under the current cost information associated with PD and HD paid by the Malaysian government, increasing the proportion of patients on PD could potentially reduce dialysis-associated costs in Malaysia.

    Matched MeSH terms: Erythropoiesis
  7. Al-Hatamleh MAI, Baig AA, Simbak NB, Nadeem MI, Khan SU, Ariff TM
    Pak J Biol Sci, 2017;20(10):478-488.
    PMID: 30187724 DOI: 10.3923/pjbs.2017.478.488
    Medical students in Malaysia and globally were considered among the most exposure groups in the community to stress due to several sources. The most significant and severe sources of stress in medical students is an academic sources, includes a lot of exams/tests, lack of time and facilities for entertainment, stay in a hostel, high parental expectations and vastness of syllabus, in addition to emotional problems and others personal sources. Stress is a very important issue that leads to a worsening of health problems. Stress develops in the body and leads to oxidative stress which in turn leads to a disorder in the whole body. Oxidative stress may lead to abnormal haematological indices elevated white blood cells (WBCs) count. Oxidative stress can lead to massive destruction of red blood cells (RBCs). The brain and the gastrointestinal system (GI) are intimately connected as one system. The brain has a direct impact on the GI tract. A stressful brain can send signals to the gut, just as a troubled intestine can send signals to the brain. Therefore, stress can be the cause of block the breakdown and assimilation of food for energy and nutriment. This malabsorption can then lead to a reciprocal negative effect to the stress and can be another cause of anaemia through malabsorption minerals and vitamins that are to erythropoiesis. So, stress can be one of the leading causes of anaemia among medical students. Stress is a chronic epidemic in the most medical students and can directly affect how well body works. This review article discovers the effect of stress in medical students that can be effect on their studies and further create researcher's interest to generate database that help to reduce stress response and bring about the empowerment of balanced life among Malaysian medical students besides the increasing level of health and academic performance.
    Matched MeSH terms: Erythropoiesis
  8. Sumera A, Radhakrishnan A, Baba AA, George E
    Blood Cells Mol. Dis., 2015 Apr;54(4):348-52.
    PMID: 25648458 DOI: 10.1016/j.bcmd.2015.01.008
    Thalassemia is known as a diverse single gene disorder, which is prevalent worldwide. The molecular chaperones are set of proteins that help in two important processes while protein synthesis and degradation include folding or unfolding and assembly or disassembly, thereby helping in cell homeostasis. This review recaps current knowledge regarding the role of molecular chaperones in thalassemia, with a focus on beta thalassemia.
    Matched MeSH terms: Erythropoiesis/genetics
  9. Jamian, E., Sanip, Z., Ramli, M., Mohd Daud, K., Mohamad, S., Hassan, R.
    MyJurnal
    Iron deficiency anaemia (IDA) frequently occurs in haemodialysis
    (HD) patients undergoing recombinant human erythropoietin (rHuEPO)
    therapy and is commonly associated with rHuEPO hypo-responsiveness.
    However, the conventional iron indices are inadequate to exhibit the status or
    utilisation of iron during erythropoiesis. The aim of this study was to elucidate
    the accuracy and usefulness of the reticulocyte haemoglobin (RET-He) test
    for diagnosing IDA in HD patients undergoing rHuEPO therapy. Methods: In
    this cross-sectional study, fifty-five blood samples of HD patients on rHuEPO
    therapy were collected and analysed for haematological and biochemical
    parameters. A receiver operating characteristics curve was also plotted for
    sensitivity and specificity analysis. IDA detection rates by RET-He, soluble
    transferrin receptor (sTfR) and serum ferritin were 63.64%, 3.64% and 0%,
    respectively. RET-He level was significantly correlated with sTfR level, mean
    cell volume, mean cell haemoglobin level and the transferrin receptor-ferritin
    index. The sensitivity and specificity of RET-He in detecting IDA were 78.3%
    and 92.0%, respectively, with an area under the curve of 0.864. IDA was more
    frequently detected by RET-He than by ferritin or sTfR in HD patients
    undergoing rHuEPO therapy. The RET-He level also showed higher sensitivity
    and specificity for the iron status in these patients. Therefore, RET-He is a
    useful biomarker for the detection of IDA in HD patients undergoing rHuEPO
    therapy.
    Matched MeSH terms: Erythropoiesis
  10. Thambiah, S., George, E., Nor Aini, U., Sathar, J., Zarida, H., Mokhtar, A.B.
    MyJurnal
    Management of Beta (β)-thalassaemia intermedia in contrast to β-thalassaemia major patients has no clear guidelines as to indicators of adequate transfusion. Regular blood transfusion suppresses bone marrow erythropoietic activity. Serum soluble transferrin receptor (sTfR) concentration is a marker for erythropoietic activity, with increased sTfR being associated with functional iron deficiency and increased erythropoietic activity. This study aimed to determine the use of sTfR as an indicator of adequate transfusion in adult β-thalassaemia intermedia patients. A cross-sectional study was conducted at Hospital Ampang, Malaysia, for six months. Patient group included six β-thalassaemia intermedia and 34 HbE-β-thalassaemia transfused patients. None of the patients were on regular monthly blood transfusions as in β-thalassaemia major. The control group comprised of 16 healthy subjects with normal haematological parameters. Haemoglobin (Hb) analysis, sTfR and ferritin assays were performed. Hb and HbA percentages (%) were found to be significantly lower in patients compared to the controls, while HbE%, HbF%, sTfR and ferritin were significantly higher in patients. An inverse relationship was found in the controls between HbF% with Hb (r = -0.515, p < 0.05) and HbA% (r = -0.534, p < 0.05). In patients, sTfR showed an inverse relationship with HbA% (r = -0.618, p = 0.000) and a positive correlation with HbE% (r = 0.418, p = 0.007) and HbF% (r = 0.469, p = 0.002). Multivariate analysis showed that HbA% (r = 2.875, p = 0.048), HbE% (r = 2.872, p = 0.020) and HbF% (r = 2.436, p = 0.013) best predicted sTfR independently in patients. Thus, sTfR is a useful marker for erythropoiesis. The elevated sTfR in these patients indicate that the transfusion regimen used was inadequate to suppress ineffective erythropoiesis. Hb levels may not be the best target for monitoring transfusion treatment in β-thalassaemia intermedia patients, but the use of sTfR is helpful in individualising transfusion regimens.
    Matched MeSH terms: Erythropoiesis
  11. Lee TY, Muniandy L, Teh LK, Abdullah M, George E, Sathar J, et al.
    Turk J Haematol, 2016 Mar 05;33(1):15-20.
    PMID: 26377036 DOI: 10.4274/tjh.2014.0197
    The diverse clinical phenotype of hemoglobin E (HbE)/β-thalassemia has not only confounded clinicians in matters of patient management but has also led scientists to investigate the complex mechanisms involved in maintaining the delicate red cell environment where, even with apparent similarities of α- and β-globin genotypes, the phenotype tells a different story. The BTB and CNC homology 1 (BACH1) protein is known to regulate α- and β-globin gene transcriptions during the terminal differentiation of erythroid cells. With the mutations involved in HbE/β-thalassemia disorder, we studied the role of BACH1 in compensating for the globin chain imbalance, albeit for fine-tuning purposes.
    Matched MeSH terms: Erythropoiesis/genetics
  12. Toman HA, Hassan R, Hassan R, Nasir A
    PMID: 22299450
    This comparative cross-sectional study was conducted in the pediatric daycare unit, Hospital Universiti Sains Malaysia to determine the prevalence of craniofacial deformities (CFD) and the association between these deformities and different clinical presentations among thalassemia patients. Patients were classified as either craniofacial deformity positive (CFD+) or craniofacial deformity negative (CFD-) by two examiners based on the presence or absence of deformity of the cheeks, frontal and/or maxillary bones. Fifteen clinical parameters were compared between the groups. Nineteen out of 43 patients (44.2%; confidence interval, 30.2-58.2%) had craniofacial deformities (CFD+). Both groups were comparable among the clinical parameters studied. Patients in the CFD+ group did not start their blood transfusions significantly earlier than the CFD- group (p = 0.50) and had a nonsignificantly lower mean pretransfusion hemoglobin level than the CFD- group (p = 0.71). Patients receiving regular monthly blood transfusions had a nonsignificantly smaller percentage of CFD than those transfused less often (p = 0.495). CFD+ patients had a splenectomy at a nonsignificantly younger age than CFD- patients (p = 0.36). HbE/beta thalassemia patients were not significantly less likely to develop CFD than other varieties (p = 0.50) and males had a nonsignificantly higher percentage of CFD than females (p = 0.29). This study shows CFD in thalassemia patients are still prevalent but no significant associated factors were found; however, a nonsignificantly higher prevalence of CFD was observed in patients with signs of severe disease and less efficient treatment.
    Matched MeSH terms: Erythropoiesis
  13. Hibbard BM, Hibbard ED
    J Obstet Gynaecol Br Commonw, 1972 Jul;79(7):584-91.
    PMID: 5043421
    Matched MeSH terms: Erythropoiesis
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