Search

Background: Metformin has been added in the Malaysian clinical practice guideline (CPG) as one of the first-line options in the management of gestational diabetes mellitus (GDM); however, the uptake on this practice among healthcare professionals is unknown. Objective: The objective of the study is to determine the awareness, attitude, and practice and their predictors on the use of metformin for GDM among healthcare professionals in Malaysia. Materials and Methods: This was a multicenter, cross-sectional study in three tertiary hospitals in Malaysia. Medical doctors and pharmacists working in several departments were invited to participate in a survey using self-administered questionnaires. Results: From 350 questionnaires distributed, 225 were completed by medical doctors (43.1%), pharmacists (40.4%), and specialists (7.5%). Less than 30% of them were aware on the option of using metformin as one of the first-line agents in GDM. Education level, department, and profession were found to be associated with the awareness level (P = 0.016, P = 0.004, and P = 0.001, respectively). 70.2% of the respondents showed a positive attitude toward metformin use in GDM. Only 64 (28.4%) of the respondents have prescribed/dispensed metformin for GDM before, although more than half will consider doing so in the future. Having postgraduate qualifications increased the likelihood of having a good awareness (odds ratio [OR]: 2.44, 95% confidence interval [CI] 1.23–4.85) and to consider prescribing/dispensing metformin for GDM patients (OR: 2.27, 95% CI 1.08–4.78). Conclusion: Despite a positive attitude toward metformin use in GDM among healthcare professionals in Malaysia, their awareness level on this practice was low as they currently prefer the use of insulin over metformin.

Mardina V, Harmawan T, Fitriani, Sufriadi E, Febriani, Yusof F. 2020. Euthynnus affinis viscera-an alternative source for protease and lipase enzymes: Characteristic and potential application as destainer agent. Biodiversitas 21: 5858-5864. This study described the characterization of protease and lipase, extracted from the viscera of Euthynnus affinis and their applications as stains removal. Enzyme increased a few folds (3.99 folds for protease and 2.45 folds for lipase) after the submission to partial purification processes by ammonium sulfate precipitation and dialysis. Molecular mass assessment by SDS-PAGE showed that the enzyme solution contains three protein bands, estimated at 70, 42, and 24 kDa for protease and 32 kDa for lipase. Zymography confirmed the presence of protease and lipase in the sample. The protease and lipase exhibited optimum activities at pH 7.0 and pH 8.0 respectively, active at temperatures from 35 to 75oC with optimal activities at 65oC for both. The enzymes were stable at alkaline pH after 90 minutes (mins) of incubation and were also stable up to 65oC, showing the remaining activities of more than 70%. Samples containing protease and lipase as de-staining agents were tested by their ability to remove blood and palm oil stains, with results proving they were effective. Overall, the study showed that crude fish visceral extract contains protease and lipase and is useful in removing household stains, and could substitute for commercial detergents.

In this article, we have studied the process of silver nanoparticles (AgNPs) aggregation and to stop aggregation 0.3% Polyvinylpyrrolidone (PVP) was used. Aggregation study carried out via UV-vis spectroscopy and it is reported that the absorption spectrum of spherical silver nanoparticles were found a maximum peak at 420 nm wavelength. Furthermore, Transmission Electron Microscopy (TEM) were used to characterized the size and shape of AgNPs, where the average particle size is around 10 to 25 nm in diameter and the AgNPs shape is spherical. Next, Dynamic Light Scattering (DLS) were used, owing to observed size distribution and self-correlation of AgNPs.

Objective The activity of enzymes participating in the systems of antioxidant protection was assayed in the peel and pulp of sunflower. The essential roles of proteases in food stimulate research to find other sources of the enzyme especially from non-conventional sources. In the present work, we study several biochemical parameters in the pulp and peel of sunflower. Methods Pulp and peel of sunflower was extracted, antioxidant enzymes and non-enzymatic antioxidant were measured. Alkaline protease was measured and purified from pulp in sunflower. Results High carbohydrate concentration, beta-carotene, catalase and ascorbate peroxidase activities, free radical scavenging capacity and free flavonoid content were observed in the peel of sunflower. Whereas, MDA and ceruloplasmin activities were high in the pulp of sunflower. Conclusions The present study concluded that peel in sunflower are strong radical scavengers and can be considered as good sources of natural antioxidants for medicinal and commercial uses. Further analysis showed that protease activity was a significantly high in the pulp compared to the peel.

Dietary polyphenols exist in two forms; extractable polyphenols (EPP) or compounds solubilised by aqueous/organic solvents, and non-extractable polyphenols (NEPP) or compounds remain in the corresponding residues after the extraction. At present, most researchers focus on EEP fractions, while NEPP is neglected. Thus, this study aimed to release NEPP from the remaining powder residue of Barhi date palm kernels (BDPK) with acid hydrolysis. The related extraction conditions were determined and optimised using response surface methodology (RSM) for maximisation of NEPP with highest cytotoxic and antioxidant activities. The face-centred central composite design (FCCCD) was used to establish treatments based on three independent variables, namely; extraction temperature, time, and solvent/sample ratio. Under the optimal conditions, the experimental values for DPPH radical-scavenging capacity of NEPP (IC50=57.52µg/mL), and cytotoxicity of NEPP against A549 and HT29 cells were IC50=17.4 µg/mL and 31.4µg/mL, respectively. The experimental values were in agreement with those predicted by RSM models, confirming the suitability of the model employed and the success of RSM for optimisation of the extraction conditions for NEPP from BDPK. These results indicate that NEPP from industrial date fruit waste could be a promising candidate as natural antioxidants with significant antiproliferation effect against A549 and HT29 cancer cells in-vitro.

Background The genetic features indicate a crucial role in nephrolithiasis. The present study was aimed to investigate the role of Glutathione-S-transferase Mu (GSTM1), Glutathione-S- transferase Theta (GSTT1) and endothelial nitric oxide synthase (eNOs) gene polymorphism in nephrolithiasis. Methods We involved a case-control study in which 480 individuals were divided into 240 healthy control and 240 patients with nephrolithiasis. For each patient and control, we measured biochemical criteria, levels of glutathione S-transferase, eNOs, GSTM1, GSTT1genes and eNOS genes polymorphism by PCR-RFLP. Results GSTM1 and GSTT1 null genotypes are not a risk features for nephrolithiasis. The eNOS frequency GG, GT, and TT genotypes by using Ban II enzyme as restriction enzyme were found to be (48.33, 36.67, and 15.00) %. The eNOS frequency TT, GT, and GG genotypes by using the Ban II enzyme as restriction enzyme were found to be 15.84, 25.83, and 58.33%, respectively. The result showed an increase in serum eNOs levels were in the patient's group comparing to control. Conclusions This work is the first in the literature to study the relation between eNOs genes polymorphisms and nephrolithiasis. The results conclude that TT genotypes in the eNOs genes are associated with an increase the oxidative stress in patients.

Fungi are not classified as plants or animals. They resemble plants in many ways but do not produce chlorophyll or make their own food photosynthetically like plants. Fungi are useful for the production of beer, bread, medicine, etc. More complex than viruses or bacteria; fungi can be destructive human pathogens responsible for various diseases in humans. Most people have a strong natural immunity against fungal infection. However, fungi can cause diseases when this immunity breaks down. In the last few years, fungal infection has increased strikingly and has been accompanied by a rise in the number of deaths of cancer patients, transplant recipients, and acquired immunodeficiency syndrome (AIDS) patients owing to fungal infections. The growth rate of fungi is very slow and quite difficult to identify. A series of molecules with antifungal activity against different strains of fungi have been found in insects, which can be of great importance to tackle human diseases. Insects secrete such compounds, which can be peptides, as a part of their immune defense reactions. Active antifungal peptides developed by insects to rapidly eliminate infectious pathogens are considered a component of the defense munitions. This review focuses on naturally occurring antifungal peptides from insects and their challenges to be used as armaments against human diseases.

In this study, the kinetic of a thermo-stable extracellular protease produced by Bacillus licheniformis (ATCC 12759) cultured in skim latex serum fortified media was investigated. The enzyme was stable up to 65 o C after incubation for 60 min at pH 8. The Lineweaver-Burk exhibited v max (maximum rate) of 37.037 U/mg min -1 and K M (Michaelis-Menten constant) of 8.519 mg/mL. The activation energy (E a ) of casein hydrolysis and temperature quotient (Q 10 ) were found to be 4.098 kJ/mol and 1.038 - 1.034, respectively, at a temperature ranging from 35 o C to 65 o C. The results of the residual activity test allowed estimating activation energy for irreversible inactivation of the protease (denaturation) which was approximately E a(d) = 62.097 kJ/mol. The thermodynamic parameters for the enzyme irreversible denaturation were as follow enthalpy (59.286 ≤Δ H * d ≥ 59.535 kJ/mol), Gibbs free energy (97.375 ≤ Δ G * d ≥ 93.774kJ/mol), and entropy (-122.797 ≤ Δ S * d ≥ -101.992 kJ/mol). These thermodynamic parameters inferred that the thermo-stable proteases could be potentially important for industrial application, for example, in the detergent industries. Abstrak : Pada penelitian ini, kinetika protease ekstraseluler termo-stabil yang diproduksi oleh Bacillus licheniformis (ATCC 12759), yang dikultur dalam media yang diperkaya serum lateks skim diselidiki. Enzim stabil hingga 65 o C setelah diinkubasi selama 60 menit pada pH 8. Lineweaver-Burk menunjukkan v max (laju maksimum) adalah 37.037 U/mg min -1 dan K M (konstanta Michaelis-Menten) 8.519 mg/mL. Energi aktivasi (E a ) dari hidrolisis kasein dan suhu quotient (Q 10 ) ditemukan masing-masing sebesar 4.098 kJ/mol dan 1.038 - 1.034, pada suhu yang berkisar dari 35 o C hingga 65 o C. Hasil uji aktivitas residu memungkinkan estimasi energi aktivasi untuk inaktivasi ireversibel dari protease (denaturasi) yang kira-kira Ea (d) = 62.097 kJ/mol. Parameter termodinamika untuk denaturasi enzim ireversibel adalah sebagai berikut entalpi (59.286 ≤ΔH * d≥ 59.535 kJ / mol), energi bebas Gibbs (97.375 ≤ ΔG * d≥ 93.774kJ / mol) dan entropi (-122.797 ≤ ΔS * d≥ -101.992 kJ / mol). Parameter termodinamika pada penelitian ini menyimpulkan bahwa protease termo-stabil dapat berpotensi penting untuk aplikasi industri seperti dalam industri deterjen.

This study focused on the production of a novel multi-CLEA comprising the enzyme activities of lipase and protease from fish viscera. A multi-CLEA is a single biocatalyst that can catalyze separate unrelated reactions, but these reactions can be conducted in one application. Tests pertaining to the effect of various additives on the multi-CLEA’s activity were performed. Response Surface Methodology’s Face Centered Central Composite Design (FCCCD) was employed to optimize the preparation parameters of the multi-CLEA in an aqueous medium. It was found that 55% (w/v) of ammonium sulfate, 65 mM of glutaraldehyde, and 0.113 mM of bovine serum albumin were the optimum levels of additives to prepare the multi-CLEA with the protease and lipase recovery activity of 43.82% and 99.91%, respectively. Multi-CLEAs were found to retain an average of more than 34% of the initial activity after five consecutive batches for both enzymes. Finally, the multi-CLEA was utilized to catalyze two reactions: improved washing process and biodiesel production. The stain removal percentage of a commercial detergent was improved by 67.78% after adding multi-CLEA. In addition, the multi-CLEA catalyzed biodiesel production from vegetable oil with a percentage conversion of 51.7%. Such results demonstrated that the multi-CLEA is a promising catalyst for biotechnological applications.

A tremendous amount of research has investigated carcinoma and looked into treatments to lower cancer mortality. Nevertheless, oral cancer is still a considerable health issue worldwide and mortality and incidence rates are rising. Oral cancer is ranked as the sixth most common carcinoma and is a prime health dilemma globally. Thus, it is increasingly important to have tools that allow for discrimination between oral dysplasia and squamous-cell carcinoma. Although conventional methods such as medical imaging can be helpful in prediction and diagnosis of oral cancer, these methods continue to have limitations. More recently, machine learning has been used as a complementary approach in biomedical research and it now plays a leading role in the emerging domains of computational biology and bioinformatics. Specifically, DNA chip gene expression technology is currently helping researchers to distinguish oral dysplasia and squamous-cell carcinoma thru analysis of gene expression in tissue samples. Nonetheless, one of the prime challenges in the computational process of microarray data is the curse of dimensionality due to the crushing number of features. Therefore, we applied a random projection (RP) feature construction technique to tackle the problem of high-dimensional gene expression data and to increase the efficiency of our proposed model. In addition, we combined a RP technique with a support vector machine (SVM) that employs a sequential minimal optimization training algorithm (SMO) in order to efficiently differentiate squamous-cell carcinoma and oral dysplasia. The highest classification accuracy recorded by our proposed model was 95.6332%. We show in this study that using a SMO machine-learning classifier with a RP dimensionality reduction tool can be effective for classifying oral cancer.

Over the past two decades, lung cancer has been a dominant malignant form of cancer. Around 80% of major lung cancers are non-small cell lung carcinoma (NSCLC). NSCLC is the major reason for death from a malignant disease worldwide. As a result, there is urgent interest in the improvement of innovative diagnostic noninvasive technologies that may enhance early diagnosis of the disease. One of the most promising techniques for early detection of cancerous cells depends on machine learning based on molecular cancer classification using gene expression profiling data. Current technological breakthroughs in gene expression profiling, specifically with DNA and oligonucleotide microarrays, permit the concomitant analysis of the expression of thousands of genes and also enables surveillance of disease prediction and progression of patient survival at the molecular level. For this reason, we attempted to come up with a machine-learning-based strategy called composite hypercubes on iterated random projections (CHIRP) in order to settle the problem of detection of early NSCLC from DNA biochip gene expression data. Furthermore, we utilized an unsupervised dimensionality reduction approach, named t-distributed stochastic neighbor embedding (T-SNE), to reduce computational complexity and to increase the efficiency of the developed system. The average accuracy obtained by the proposed system in terms of detection and diagnosis of early non-small cell lung cancer was 97.21871%. The empirical results prove that the combination of dimensionality reduction models with machine-learning algorithms can be effectively used for early detection of specific NSCLC tumor type.

Cervical carcinoma remains a prime cause of cancer-related deaths in woman globally. Research into the prediction of the survivability for cervical cancer has been a challenge for researchers. Survival rates increase with earlier detection of cancer of the cervix. Cancer research and associated domains have made significant strides over recent years. For example, cancer prognosis using machine learning techniques is now a promising area of research. Data mining and machine learning have found considerable application thru the use of microarray expression profiling inspection. Specifically, DNA chip gene expression technology is a promising tool that can identify cancerous cells in early phases of the disease by examining the gene expression of analyzed instances. Furthermore, microarray technology enables researchers to assay the expression of thousands of genes in parallel. In this paper, we present a Gaussian process regression model in order improve the prediction of survivability of patients with early cervical cancer. Additionally, stochastic proximity embedding (SPE) was applied to reducing the number of attributes by selecting the most informative genes of the input dataset. Consequently, the computational complexity was reduced and the performance of the proposed model was increased. Our results indicate that gene expression profiles combined with carefully chosen learning algorithms can predict patient survival for certain diseases.

Introduction and aims: It is necessary to ascertain current prescribing of antibiotics for upper respiratory tract infections (URTIs) to address potential overuse. A retrospective analysis was conducted of all prescriptions for URTIs among ten public primary healthcare centres in Kedah, Malaysia from 1st January to 31st March 2014. Results: A total of 123,524 prescriptions were screened and analysed. Of these, 7129 prescriptions were for URTI, with 31.8% (n=2269) containing antibiotics. Macrolides were the most commonly prescribed antibiotic constituting 61% (n=1403) of total antibiotics prescribed. There was a statistically significant association between different prescribers and diagnoses (p=0•001) and a weak positive trend suggesting family medicine specialists are more competent in antibiotic prescribing, followed by medical officers and assistant medical officers (τ=0•122).. Conclusions: Prescribing practices of some prescribers were inconsistent with current guidelines encouraging resistance development. National antimicrobial stewardship programmes and further educational initiatives are ongoing in Malaysia to improve antibiotic use

Background: Acute leukaemia is characterized by fast growth of abnormal clones of haemopoietic precursor cells inside bone marrow leading to undue accumulation in the bone marrow. Acute lymphoblastic leukemia (ALL) is the most common form of childhood cancer. Materials and Methods: The study concerned 50 children diagnosed with ALL (mean age, 8.55±2.54) compared to 40 healthy controls (mean age, 8.00±1.85). The Hb, serum copper , ceruloplasmin oxidase, advanced oxidation protein products (AOPPs), total antioxidant activity (TAA) and protein were measured in all groups.One proteinous component was isolated by gel filtration chromatography from the precipitate produced by polyethylene glycol. Results: Significantly higher levels of AOPP, copper and decrease in total antioxidant activity were noted in the cases. Statistical analysis also showed a significant increase (p

Objective To verify possible relations between 5ʹ-nucleotidase, xanthine oxidase to E3 small ubiquitin-like modifier-protein ligase non structural maintenance of chromosomes elements 2 in sera patients with kidney stones and to evaluate the possibility of a new biomarker for the evaluation of kidney damage. Methods A sixty patients with known kidney stones who appeared the government health clinics in Kuantan–Pahang and fifty apparently healthy were taken as control group. The 5ʹ-nucleotidase, xanthine oxidase and other biochemical parameters were measured by colorimetric tests. The serum NSMCE2 were measured by enzyme linked immunosorbent assay. Results The mean serum xanthine oxidase [(39.98 ± 19.70) IU/L] and ecto-5ʹ-nucleotidase activity (40.03 ± 9.53 IU/L) were significantly higher than the controls' levels of (18.04 ± 6.26) and (16.06 ± 4.61) IU/L respectively. There were 85.00% and 83.33%, of patients with kidney stones who had abnormal ecto-5ʹ-nucleotidase activity and uric acid respectively while xanthine oxidase activity was less sensitive 58.33%. Conclusions The present study suggests that the increase in serum of xanthine oxidase,ecto-5ʹ-nucleotidase activities E3 small ubiquitin-like modifier-protein ligase NSE2 concentration can be used as biomarkers for diagnosis of kidney damage in patients with kidney stone, also in developments of change DNA damage and inflammation disorders in these patients.

Background: ALL is an irredeemable disease due to the resistance to treatment. There are several influences which are involved in such resistance to chemotherapy, including oxidative stress as a result of the generation of reactive oxygen species (ROS) and presence of hypodiploid cells. Cluster of differentiation 26 (CD26), also known as dipeptidyl peptidase-4, is a 110 kDa, multifunctional, membrane-bound glycoprotein. Aim and objectives: The aim of this study was to evaluate the clinical significance of serum CD26 in patients with acute lymphoblastic leukaemia patients in the post remission induction phase, as well as the relationship between CD26 activity and the oxidative stress status. Materials and Methods: CD26, total antioxidant status (TAS), total oxidant status (TOS), and oxidative stress index (OSI), in addition to activity of related enzymes myeloperoxidase, glutathiones- transferase and xanthine oxidase, were analysed in sixty children with acute lymphoblastic leukaemia in the post remission induction phase. Results: The study showed significant elevation in CD26, TOS and OSI levels in patients with acute lymphoblastic leukaemia in the post remission induction phase in comparison to healthy control samples. In contrast, myeloperoxidase, glutathione-s-transferase and xanthine oxidase activities were decreased significantly. A significant correlation between CD26 concentration and some oxidative stress parameters was evident in ALL patients. Conclusions: Serum levels of CD26 appear to be useful as a new biomarker of oxidative stress in children with acute lymphoblastic leukaemia in the post remission induction phase, and levels of antioxidants must be regularly estimated during the treatment of children with ALL.

Knowledge, perceptions and prescribing behaviour are key to antibiotic prescribing. The aim of this paper is to systematically review this.An extensive literature search from 1990 to 2014.Nineteen articles were included; eight in ambulatory care, seven in hospital settings and four in both, across all countries. Physicians still have inadequate knowledge and misconceptions about antibiotic prescribing. Moreover, some physicians, although aware that antibiotics are of limited benefit in some conditions, still prescribed them. Several factors influenced prescribing, including patients' expectations, severity and duration of infections, uncertainty over diagnosis, potentially losing patients and influence of pharmaceutical companies. Pocket-sized guidelines seen as an important source of information for physicians.Inadequate knowledge of prescribing is prevalent among physicians. However, many physicians were interested in improving their antibiotic prescribing. Multifaceted interventions targeting all key stakeholders, including patients, are needed to improve future antibiotic prescribing.

Antibiotics are widely prescribed especially for upper respiratory tract infections (URTIs). Their irrational use can increase costs and resistance.Assess knowledge, attitude and prescribing of antibiotics for URTIs in Selangor, Malaysia, using a cross-sectional survey among general practitioners (GPs) working in private clinics in 2011.One hundred and thirty-nine physicians completed the questionnaire (response rate = 34.8%). 49.6% (n = 69) agreed antibiotics are helpful in treating URTIs, with most GPs agreeing antibiotics may reduce URTI duration and complications. The majority of GPs reported they felt patients expected antibiotics, with 36.7% (n = 51) agreeing patients would change doctors if they did not prescribe antibiotics and 21.6% (n = 30) agreeing when requested they prescribe antibiotics even if they believe them to be unnecessary. When assessed against six criteria, most GPs had a moderate level of knowledge of prescribing for URTIs. However, antibiotic prescriptions could be appreciably reduced.Further programs are needed to educate GPs and patients about antibiotics building on current initiatives.

Background It is assumed that genetic factors play crucial role in nephrolithiasis. The present study was conducted to explore the role of Human Transcription Factor-7 like-2 (TCF7L2) β-defensin (DEFB1) and CD14 gene polymorphism in development and progression of nephrolithiasis. Methods The genotypes of TCF7L2, DEFB1 and CD14 polymorphism were determined in 240 nephrolithiasis patients and 240 healthy controls by restriction digestion method of PCR. The levels of serum TCF7L2, DEFB1, CD14, uric acid and other biochemical parameters were measured both in nephrolithiasis patients and healthy control. Results The patients and control groups showed 30% and 50% 1654 AA DEFB1 genotype respectively. The Allele frequency in case of patient's group was 63.67% while in control group it was 36.33%. The mean serum DEFB1 levels of the patients and control groups attained were 115.66 and 239.43 pg/mL respectively. The allele frequency of TCF7L2 in patients and controls were 44.17% and 70.0% for C-allele, 55.83% and 30.00% for T-allele respectively. The mean of serum TCF7L2 levels were significantly decreased in patients compared to control group. Conclusions The present findings are first of its class that validates a considerable connection of DEFB1 and TCF7L2 gene polymorphisms with nephrolithiasis and could probably act as indicators to estimate the risk associated to nephrolithiasis.

Background The pharmacy internship program is designed to provide comprehensive training for interns to perform various roles in pharmacy practice. In Malaysia, the current internship program has been in place since 2004 in public health facilities, but has never been extensively evaluated. Aim To assess the level of job satisfaction and perception of Provisionally Registered Pharmacists (PRP) towards the internship training provided. Methods A cross-sectional nationwide survey was conducted amongst all PRPs undergoing training between December 2015 and February 2016 to assess their level of job satisfaction and perception towards the training requirements stipulated by the Pharmacy Board of Malaysia. Results A total of 733 PRPs participated in the survey and the response rate was 95.8%. On the basis of the response received, 92.5% (n = 678) felt that the one year training period was ‘just nice’, 30.5% (n = 223) felt that the logbooks were ‘too complicated’, and 33.2% (n = 241) said the targets set by the Pharmacy Board of Malaysia were ‘too high’. On a scale of 1 to 5, respondents rated 3.32 (SD 0.54) for mean score of job satisfaction. Significant factors influencing mean score of job satisfaction were: perceived fairness at the work place; perceived self-competence after one year of training; preceptors' competence; and pharmacy as a chosen career pathway. Conclusion Intern pharmacists were fairly satisfied with the internship training in government facilities in the Ministry of Health, Malaysia. A review of the internship logbooks and the practicality of targets set by the Pharmacy Board warrant further improvement.

Background The intron 5 insertion/deletion polymorphism of Alpha-2-macroglobulin receptor-associated protein gene (Alpha-2-MRAP) has been implicated in numerous diseases. The current study was designed to analyze the association of intron 5 insertion/deletion polymorphism of Alpha-2-MRAP with nephrolithiasis patients. Methods PCR was conducted on genomic DNA of patients and control to look for Alpha-2-MRAP insertion/deletion polymorphism. Besides that, serum level of Alpha-2-MRAP, oxidative stress marker myeloperoxidase, Malondialdehyde (MDA), Advanced oxidation protein products (AOPP), and uric acid were determined. Results The D and I allele frequencies were 57.50% and 42.50% in patients, 77.50% and 22.50% in control, individually. The result showed that II genotype was associated with nephrolithiasis patients group. A significant decrease was observed in serum Alpha-2-MRAP,myeloperoxidase and TAS,while TOS,OSI,MDA,AOPP and uric acid were substantially increased in II and ID when compared to DD genotype in patients with nephrolithiasis. Conclusion Our results demonstrate for the first time that patients with II genotype had an increased risk of stones. Also, the results demonstrate that I allele of the 5 insertion/deletion polymorphism in the Alpha-2-MRAP gene is related with an increase of oxidative stress in nephrolithiasis patients and may possibly impose a risk for cardiovascular diseases in patients with II genotype of Alpha-2-MRAP.

After numerous breakthroughs in medicine, microbiology, and pathology in the past century, lung cancer still remains as a leading cause of cancer-related death even in the developed countries. Lung cancer accounts roughly for 30% of all cancer-related deaths in the world. Diagnosis and treatments are still based on traditional histopathology. It is of paramount importance to predict the survivability of patients in early stages of lung cancer so that specific treatments can be sought. Nonetheless, histopathology has been shown by previous studies to be inadequate in predicting lung cancer development and clinical outcome. The microarray technology allows researchers to examine the expression of thousands of genes simultaneously. This paper describes a state-of-the-art machine learning based approach called averaged one-dependence estimators with subsumption resolution to tackle the problem of predicting whether a patient in early stages of lung cancer will survive by mining DNA microarray gene expression data. To lower the computational complexity, we employ an entropy-based gene selection approach to select relevant genes that are directly responsible for lung cancer survivability prognosis. The proposed system has achieved an average accuracy of 92.31% in predicting lung cancer survivability over 2 independent datasets. The experimental results provide confirmation that gene expression mining can be used to predict survivability of patients in early stages of lung cancer.

Objective To prove probable relations between serum E3 SUMO-protein ligase NSE2 (NSMCE2) concentration, peroxynitrite related to oxidative stress in nephrolithiasis patients. Methods A total of 60 patients with nephrolithiasis and 50 healthy volunteers were involved in this study. Colorimetric method was used to detect blood urea, creatinine, uric acid, protein, albumin, total antioxidant status, total oxidant status, peroxynitrite, nitric oxide and oxidative stress index. Glutathione, NSMCE2 and superoxide dismutase were measured by ELISA. Results A significant increase in level of peroxynitrite, total oxidant status, NSMCE2 and oxidative stress index in patients was observed, while total antioxidant status and glutathione were significantly decreased. Conclusions The study concluded that serum NSMCE2 significantly correlated with peroxynitrite and oxidative stress in patients with nephrolithiasis.

Cancer is a major leading cause of death and responsible for around 13% of all deaths world-wide. Cancer incidence rate is growing at an alarming rate in Malaysia and the world as we know it. It is estimated that statistically one out of every four Malaysians will develop cancer by the age of 75. Conventional methods of diagnosing cancer rely solely on skilled physicians, with the help of medical imaging, to detect certain symptoms which usually appear in the late stage of cancer. Furthermore, biopsy examinations are highly invasive since tissue samples are required to be extracted from patients. There exist minimally invasive cancer biomarkers in forms of proteins from serum. Nevertheless, existing protein-based diagnosis techniques require labor-intensive analysis compounded by low diagnosis sensitivity. There have indeed been a number of studies to identify novel miRNA-based cancer biomarkers. However, the existing diagnosis techniques using miRNA suffer from low diagnosis accuracy, sensitivity, and specificity. The low diagnosis accuracy and sensitivity of the existing techniques stems from the fact that there is extremely low miRNA count in body fluids. There is also an inevitable problem of cross contamination between cells and exosomes in sample preparation steps. This paper proposes to circumvent these problems in data analysis stage with a machine learning technique called Random Forest. The proposed system achieved 93.48 % accuracy for gastric cancer and 100 % accuracy for ovarian cancer. The results are promising and encouraging. Despite much noise contaminated the sample preparation process and low miRNA count in body fluids, the proposed system able to identify miRNA markers responsible for classification of cancer.

Commercially available bromelain is prepared by performing a tedious and costly purification method that yields bromelain at different degrees of purity. In the current study, a gene encoding stem bromelain from Ananas comosus was amplified using polymerase chain reaction. This bromelain gene was initially cloned into the pENTR/TEV/D-TOPO vector before being sub-cloned into the pDEST17 expression vector. DNA sequencing of the amplified products exhibited a high level of homology to the corresponding gene from the NCBI public database. Protein expression was conducted in the BL21-AI Escherichia coli strain. The recombinant bromelain was then purified in a single step using immobilized metal affinity chromatography, specifically a Ni-NTA spin column. The purified recombinant bromelain was detected by Western blotting. In addition, the purified enzyme exhibited hydrolytic activity towards gelatin and a synthetic substrate, LNPE. The purified recombinant bromelain exhibited optimum activity at pH 4.6 and 45 °C.

We aimed to demonstrate the suitability of the Anatomical Therapeutic Chemical Classification (ATC) to describe duplicate drugs and duplicate drug classes in prescription data and describe the pattern of duplicates from public and private primary care clinics of Kuala Lumpur, Malaysia. We analyzed prescription data year 2005 from all 14 public clinics in Kuala Lumpur with 12,157 prescriptions, and a sample of 188 private clinics with 25,612 prescriptions. As ATC Level 5 code represents the molecule and Level 4 represents the pharmacological subgroup, we used repetitions of codes in the same prescription to describe duplicate drugs or duplicate drug classes and compared them between the public and private clinics. At Level 4 ATC, prescriptions with duplicates drug classes were 1.46% of all prescriptions in private and 0.04% in public clinics. At Level 5 ATC, prescriptions with duplicate drugs were 1.81% for private and 0.95% for public clinics. In private clinics at Level 5, 73.3% of prescriptions with duplicates involved systemic combination drugs; at Level 4, 40.3% involved systemic combination drugs. In the public sector at Level 5, 95.7% of prescriptions with duplicates involved topical products. Repetitions of the same ATC codes were mostly useful to describe duplicate medications; however, we recommend avoid using ATC codes for tropical products for this purpose due to ambiguity. Combination products were often involved in duplicate prescribing; redesign of these products might improve prescribing quality. Duplicates occurred more often in private clinics than public clinics in Malaysia

Euthynnusaffinis is one of tuna species that distributed throughout the world. Their visceral accounts for approximate less than 20% of body weight and its value are still underutilized. This study screened four the potential individual visceral organ to produce protease and lipase enzyme viz. spleen, stomach, pancreas, and liver. Among the individual visceral organ, liver exhibited the highest source for protease activity (57.786 U/ml), while pancreas revealed as the best source for lipase activity (69.425 U/ml). Therefore, the finding of alternative sources for protease and lipase in this study might converted visceral waste by product to generate protease and lipase enzyme that may be applied in biotechnological process.

Cancer is a complicated disease for which finding a cure presents challenges. In recent decades, new ways to treat cancer are being sought; one being nanomedicine, which manipulates nanoparticles to target a cancer and release drugs directly to the cancer cells. A number of cancer treatments based on nanomedicine are under way and mostly are in preclinical trials owing to challenges in administration, safety, and effectiveness. One alternative method for drug delivery is the use of photovoltaic nanoparticles, which has the potential to deliver drugs via light activation. The concepts are based on standard photovoltaic cell that holds opposite charges on its surfaces and releases drugs when charge intensity or polarity changes upon photo-stimulation such as from a laser source or sunlight. This review will cover some recent progress in cancer treatment using nanoparticles, including photovoltaic nanoparticles.

As the living cytoplasm of laticiferous cells, Hevea brasiliensis latex is a rich blend of organic substances that include a mélange of proteins. A small number of these proteins have given rise to the problem of latex allergy. The salient characteristics of H. brasiliensis latex allergens that are recognized by the International Union of Immunological Societies (IUIS) are reviewed. These are the proteins associated with the rubber particles, the cytosolic C-serum proteins and the B-serum proteins that originate mainly from the lutoids. Procedures for the isolation and purification of latex allergens are discussed, from latex collection in the field to various preparative approaches adopted in the laboratory. As interest in recombinant latex allergens increases, there is a need to validate recombinant proteins to ascertain equivalence with their native counterparts when used in immunological studies, diagnostics, and immunotherapy.

Background: Nephrolithiasis is one of the causes which lead to chronic kidney disease (CKD). Matrix metalloproteinases (MMPs) are endopeptidases degrading extracellular matrix which correlate with the pathogenesis of atherosclerosis. The current study was designed to analyze the association of (R279Q, C1562T) polymorphism of MMP-9 with nephrolithiasis patients. Methods: Genotyping of MMP-9/R279Q and of MMP-9/C1562T polymorphism were carried out by PCR-based restriction digestion method. Serum level of MMP-9, oxidative stress marker, MDA, and uric acid were measured in patients and control. Results: Allele frequencies of the MMP-9/C1562T polymorphism for C and T allele were 71.25% and 28.75% in patients, 87.08% and 12.92% in control respectively. The homozygote TT was more frequent in the nephrolithiasis patients group, while T allele frequency was significantly higher in the nephrolithiasis patients group than in the control group. The patients with CT and TT genotype showed a significant increase in serum MMP-9, Total Oxidant Status (TOS), Oxidative Stress Index (OSI), Malondialdehyde (MDA), and uric acid when compared to CC genotype in patients with nephrolithiasis. The R279Q polymorphism site with regard to the relationship with nephrolithiasis was not significant. Conclusion: The result indicates that patients with TT genotype had an increased risk of stones. Also, the results demonstrate that TT allele of the C1562T polymorphism in the MMP-9gene is related with an increase of oxidative stress in nephrolithiasis patients and may possibly impose a risk for cardiovascular diseases in patients with TT genotype of MMP-9.

Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium- priced medicines. This will grow necessitating the development of new models to optimize their use. The objective is to review case histories among health authorities to improve the utilization and expenditure on new medicines. Subsequently, use these to develop exemplar models and outline their implications. A number of issues and challenges were identified from the case histories. These included the low number of new medicines seen as innovative alongside increasing requested prices for their reimbursement, especially for oncology, orphan diseases, diabetes and HCV. Proposed models center on the three pillars of pre-, peri- and post-launch including critical drug evaluation, as well as multi- criteria models for valuing medicines for orphan diseases alongside potentially capping pharmaceutical expenditure. In conclusion, the proposed models involving all key stakeholder groups are critical for the sustainability of healthcare systems or enhancing universal access. The models should help stimulate debate as well as restore trust between key stakeholder groups.

Azuana Ramli,1,3 Syed Mohamed Aljunid,1,2 Saperi Sulong,2 Faridah Aryani Md Yusof31United Nations University International Institute for Global Health (UNU-IIGH), Kuala Lumpur, Malaysia; 2International Centre for Casemix and Clinical Coding (ITCC), Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia; 3Pharmaceutical Services Division, Ministry of Health, Petaling Jaya, MalaysiaPurpose: HMG-CoA reductase inhibitors (statins) are extensively used in treating hypercholesterolemia. The statins available in Malaysia include atorvastatin, lovastatin, pravastatin, rosuvastatin, simvastatin, and fluvastatin. Over the years, they have accumulated in the National Drug Formulary; hence, the need for review. Effective selection of the best drugs to remain in the formulary can become complex due to the multiple drug attributes involved, and is made worse by the limited time and resources available. The multiattribute scoring tool (MAST) systematizes the evaluation of the drug attributes to facilitate the drug selection process. In this study, a MAST framework was developed to rank the statins based on their utilities or benefits.Methods: Published literature on multicriteria decision analysis (MCDA) were studied and five sessions of expert group discussions were conducted to build the MAST framework and to review the evidence. The attributes identified and selected for analysis were efficacy (clinical efficacy, clinical endpoints), safety (drug interactions, serious side effects and documentation), drug applicability (drug strength/formulation, indications, dose frequency, side effects, food–drug interactions, and dose adjustments), and cost. The average weights assigned by the members for efficacy, safety, drug applicability and cost were 32.6%, 26.2%, 24.1%, and 17.1%, respectively. The utility values of the attributes were scored based on the published evidence or/and agreements during the group discussions. The attribute scores were added up to provide the total utility score.Results: Using the MAST, the six statins under review were successfully scored and ranked. Atorvastatin scored the highest total utility score (TUS) of 84.48, followed by simvastatin (83.11). Atorvastatin and simvastatin scored consistently high, even before drug costs were included. The low scores on the side effects for atorvastatin were compensated for by the higher scores on the clinical endpoints resulting in a higher TUS for atorvastatin. Fluvastatin recorded the lowest TUS.Conclusion: The multiattribute scoring tool was successfully applied to organize decision variables in reviewing statins for the formulary. Based on the TUS, atorvastatin is recommended to remain in the formulary and be considered as first-line in the treatment of hypercholesterolemia.Keywords: multicriteria decision analysis, utility score, drug attributes, drug selection

Methods In this study, proteomics methods have been used to study the effects of different currents and voltages used to stun chickens. Protein profiles of chicken hearts were constructed to detect differences in protein expression and modification. The different voltages studied were 10 V, 40 V and 70 V, while the currents examined were 0.25 A, 0.5 A, and 0.75 A. The profiles obtained from these stunning conditions were compared to the non-stunned (0 A, 0 V) sample. Results Proteomics analyses using 2D Platinum ImageMaster 6.0 and Matrix-assisted laser desorption/ionization with time-of-flight mass spectrometry (MALDI-TOF) identified troponin I and alpha cardiac muscle actin 1 in the electrically stimulated heart samples. The overexpression of the proteins was further confirmed at the transcriptional level by Real Time PCR. Conclusion The results from MALDI-TOF and Real Time PCR agreed; therefore, this method for identifying biomarkers of electrically stimulated chicken hearts provides a novel approach for differentiation the hearts of increased electrically stimulated chickens from those of non-stunned chickens.

Cross-linked enzyme aggregate (CLEA) is considered as an effective technique in the production of immobilized biocatalysts for its industrially attractive advantages. Simplicity, stability, low cost, time saving and reusability are proved to be some of CLEA’s main advantages. In this study, an active, stable and recyclable CLEA-protease from the viscera of channel catfish Ictalurus punctatus has been prepared. Optimization of the preparation parameters is carried out with the help of Response Surface Methodology. This methodology helped in studying the interaction between the most contributing factors such as cross-linker, precipitant and the additive concentrations. The optimum specific activity for CLEA-protease of 4.512 U/mg protein has shown a high stability against the denaturation forces such as temperature and pH as compared to free protease. It is further found from the study that the highest activity was achieved at the pH of 6.8 and at the temperature of 45 °C. After six cycles, CLEA-protease maintained 28 % of its original activity. Additionally, Michaelis–Menten models were used to determine the kinetic parameters i.e. K m and V max that helped in showing a significant difference after immobilization as compared to free protease. This work found that this novel CLEA-protease can be used as a very active biocatalyst in industrial applications.

Background Drug expenditures continue to rise due to increasing disease burden and emergence of new drugs. World Health Organization (WHO) recommended that Drug and Therapeutic Committee (DTC) be set up in healthcare institutions to manage drug formularies and policies promoting rational drug selection and use. Operations of DTCs in MOH facilities are yet to be documented. This study was set to gain insights on DTCs particularly in exerting these roles.