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Background: Developing countries still struggle with late detection and mortality from pertussis. A review of clinical case definitions is necessary for early disease detection. This paper aimed to study possible clinical characteristics for earlier pertussis detection in a sporadic setting. Methods: We conducted a retrospective review of medical and laboratory records in a general paediatric ward of a district hospital in a developing country. Inclusion criteria were all children hospitalised with nasopharyngeal swab taken for Bordetella pertussis. We compared sensitivity and specificity of World Health Organization diagnostic criteria with other clinical characteristics. Polymerase chain reaction Bordetella pertussis was the gold standard used. Results: Out of 207 eligible admissions, the study retrieved 128 complete records. Approximately half of the children were less than 3 months old. The World Health Organization diagnostic criteria had a low sensitivity (15%), but high specificity (92%). In comparison, combinations that included paroxysmal cough, ill contact and facial congestion had higher sensitivity. Increasing cough duration improved specificity while compromising sensitivity. Conclusion: Several clinical characteristics such as paroxysmal cough, facial congestion and a history of ill contact have potential for early clinical detection. Conventional emphasis on cough duration may hamper early detection. [ABSTRACT FROM AUTHOR]

The present study aims to identify the essential technical and tactical performance indicators that could differentiate winning and losing performance in the Asian elite beach soccer competition. A set of 20 technical and tactical performance indicators namely; shot back-third, shot mid-third, shot front-third, pass back-third, pass mid-third, pass front-third, shot in box, shot outbox, chances created, interception, turnover, goals scored 1st period, goals scored 2nd period, goals scored 3rd period, goals scored extra time, tackling, fouls committed, complete save, incomplete save and passing error were observed during the beach soccer Asian Football Confederation tournament 2017 held in Malaysia. A total of 23 matches from 12 teams were notated using StatWatch application in real-time. Discriminant analysis (DA) of standard, backward as well stepwise modes were used to develop a model for the winning (WT) and losing team (LT) whilst Mann-Whitney U test was utilized to ascertain the differences between the WT and LT with respect to the performance indicators evaluated. The standard backward, forward and stepwise discriminates the WT and the LT with an excellent accuracy of 95.65%, 91.30% and 89.13%, respectively. The standard DA model discriminated the teams from seven performance indicators whilst both the backward and forward stepwise identified two performance indicators. The Mann-Whitney U test analysis indicated that the WT is statistically significant from the LT based on the performance indicators determined from the standard mode model of the DA. It was demonstrated that seven performance indicators namely; shot front-third, pass front-third, chances created, goals scores at the 1st period, goals scored at the 2nd period, goals scored at 3rd period were directly linked to a successful performance whilst the incomplete save by the keeper attribute towards the poor performance of the team. The present finding could serve useful to the coaches as well as performance analysts as a measure of profiling successful performance and enables team improvement with respect to the associated performance indicators. [ABSTRACT FROM AUTHOR]

Preterm birth incidence has risen globally and remains a major cause of neonatal mortality despite improved survival. Demand and cost of initial hospitalization has also increased. This study assessed the cost of preterm birth during initial hospitalization from care provider perspective in neonatal intensive care units (NICU) of two hospitals in the state of Kedah, Malaysia. It utilized universal sampling and prospectively followed up preterm infants till discharge. Care provider cost was assessed using mixed method of top down approach and activity based costing. A total of 112 preterm infants were recruited from intensive care (93 infants) and minimal care (19 infants) units. Majority were from the moderate (23%) and late (36%) preterm groups followed by very preterm (32%) and extreme preterm (9%). Median cost per infant increased with level of care and degree of prematurity. Cost was dominated by overhead (fixed) costs for general (hospital), intermediate (clinical support services) and final (NICU) cost centers where it constituted at least three quarters of admission cost per infant while the remainder was consumables (variable) cost. Breakdown of overhead cost showed NICU specific overhead contributing at least two thirds of admission cost per infant. Personnel salary made up three quarters of NICU specific overhead. Laboratory investigation was the cost driver for consumables. Gender, birth weight and length of stay were significant factors and cost prediction was developed with these variables. This study demonstrated the inverse relation between resource utilization, cost and prematurity and identified personnel salary as the cost driver. Cost estimates and prediction provide in-depth understanding of provider cost and are applicable for further economic evaluations. Since gender is non-modifiable and reducing LOS alone is not effective, birth weight as a cost predictive factor in this study can be addressed through measures to prevent or delay preterm birth. [ABSTRACT FROM AUTHOR]

Background: Despite perennial sunshine, vitamin D deficiency is prevalent among Malaysians especially pregnant women. This study determines the vitamin D status and its associated factors among third trimester pregnant women attending government health clinics in Selangor and Kuala Lumpur, Malaysia. Methods: Information on socio-demographic characteristics, obstetrical history, and sun exposure were obtained through face-to-face interviews. Vitamin D intake was assessed using a semi-quantitative food frequency questionnaire (FFQ). Serum 25-hydroxyvitamin D concentration was measured and classified as deficient (< 30 nmol/L), insufficient (30–50 nmol/L), and sufficient (≥ 50 nmol/L). Results: Of the 535 pregnant women recruited, 42.6% were vitamin D deficient. They consumed an average of 8.7 ± 6.7 μg of vitamin D daily. A total of 80.4% of the vitamin D were obtained from the food sources, while 19.6% were from dietary supplements. Fish and fish products showed the highest contribution to vitamin D intake (35.8%). The multivariable generalized linear mixed models, with clinic as a random effect, indicates that higher intake of vitamin D is associated with lower odds of vitamin D deficiency among pregnant women (OR = 0.96; 95% CI = 0.93–0.99). The odds of having vitamin D deficiency was reduced by 87% in non-Malays (OR = 0.14; 95% CI = 0.05–0.41) compared to Malays. No associations were found between age, educational level, monthly household income, work status, gravidity, parity, pre-pregnancy body mass index, total hours of sun exposure, total percentage of body surface area, and sun exposure index per day with vitamin D deficiency. Conclusion: Vitamin D deficiency is prevalent among Malaysian pregnant women. Considering the possible adverse obstetric and fetal outcomes of vitamin D deficiency during pregnancy, future nutrition education should emphasise on vitamin D-fortified foods consumption among pregnant women by taking into consideration ethnic differences. [ABSTRACT FROM AUTHOR]

Nipah virus (NiV) is a highly pathogenic re-emerging virus that causes outbreaks in South East Asia. Currently, no approved and licensed vaccine or antivirals exist. Here, we investigated the efficacy of ChAdOx1 NiVB, a simian adenovirus-based vaccine encoding NiV glycoprotein (G) Bangladesh, in Syrian hamsters. Prime-only as well as prime-boost vaccination resulted in uniform protection against a lethal challenge with NiV Bangladesh: all animals survived challenge and we were unable to find infectious virus either in oral swabs, lung or brain tissue. Furthermore, no pathological lung damage was observed. A single-dose of ChAdOx1 NiVB also prevented disease and lethality from heterologous challenge with NiV Malaysia. While we were unable to detect infectious virus in swabs or tissue of animals challenged with the heterologous strain, a very limited amount of viral RNA could be found in lung tissue by in situ hybridization. A single dose of ChAdOx1 NiVB also provided partial protection against Hendra virus and passive transfer of antibodies elicited by ChAdOx1 NiVB vaccination partially protected Syrian hamsters against NiV Bangladesh. From these data, we conclude that ChAdOx1 NiVB is a suitable candidate for further NiV vaccine pre-clinical development. [ABSTRACT FROM AUTHOR]

Background: The intentional use of illicit drugs for sexual purposes (also known as 'chemsex') is well known within the MSM communities in Malaysia although research in this population is scarce primarily because both drug use and homosexuality are illegal and stigmatised in Malaysia.Methods: From April to December 2014, interviews were conducted with twenty men (age range 21-43) living in Greater Kuala Lumpur who had sexual intercourse with other men in the past 6 months and who used illicit drugs at least monthly in the past 3 months. Fourteen men were recruited via gay social networking smartphone applications or websites while six were referred by the participants. Data were analsed using thematic analytic approach.Findings: The average duration of illicit drug use was 6.4 years (range 1-21) and all participants were using methamphetamine ("ice" or crystal meth) with frequency of use ranged from daily to once a month. Participants came from diverse ethnic, economic, and occupational backgrounds. Most participants used an inhalation apparatus ("bong") to consume methamphetamine and injection was rare in the sample. The primary motivation of methamphetamine use was to increase sexual capacity, heighten sexual pleasure and enhance sexual exploration and adventurism. Socializing with friends ("chilling"), and increased energy for work were secondary motivations. Participants emphasized the need to control the use of methamphetamine and some have established rules to control the amount and duration of use and a minority of men have maintained condom use during anal sex while under the influence of methamphetamine. Participants who professed to be in control of their drug use characterized themselves as functional users regardless of the health and social consequences from continuing use. Overall, participants perceived themselves differently from the traditional opioid users and reported limited access to sexual health and substance use treatment services.Conclusion: There is a need to increase access to HIV prevention services such as PrEP and PEP, professional support, and substance abuse treatment for drug-using MSM. A more open and friendly environment towards drug-using MSM may help them access and engage with the health services. [ABSTRACT FROM AUTHOR]

Five species of toads (Bufonidae) ( n = 22) from Peninsular Malaysia were examined for helminths: Duttaphrynus melanostictus, Ingerophrynus parvus, Leptophryne borbonica, Phrynoidis asper, and Rentapia hosii. The helminth community contained 10 species of Nematoda, consisting of mature individuals of Abbreviata bufonis, Aplectana macintoshii, Cosmocerca ornata, Falcaustra pahangi, Meteterakis singaporensis, Oswaldocruzia filiformis, Oswaldocruzia hoepplii, Seuratascaris numidica, and larvae assigned to Ascarididae and Physalopteridae. Nematoda reported in this study are mainly Old World in distribution. Bufonid species from Peninsular Malaysia are infected by generalist nematodes that also infect other anurans. Seven new host records are reported. [ABSTRACT FROM AUTHOR]

Various prevalence studies on Leptospira in animals and humans, as well as environmental samples, had been conducted worldwide, including Malaysia. However, limited studies have been documented on the presence of pathogenic, intermediate, and saprophytic Leptospira in selected animals and environments. This study was therefore conducted to detect Leptospira spp. in rats, soil, and water from urban areas of Sarawak using the polymerase chain reaction (PCR) method. A total of 107 rats, 292 soil samples, and 324 water samples were collected from April 2014 to February 2015. Pathogenic Leptospira was present in 5.6% (6/107) of rats, 11.6% (34/292) of soil samples, and 1.9% (6/324) of water samples. Intermediate Leptospira was present in 2.7% (8/292) of soil samples and 1.9% (6/324) of water samples. Saprophytic Leptospira was present in 10.3% (11/107) of rats, 1.4% (4/292) of soil samples, and 0.3% (1/324) of water samples. From this study, 76 Leptospira spp. were isolated. Based on DNA sequencing, the dominant Leptospira spp. circulating in urban areas of Sarawak are pathogenic Leptospira noguchii, intermediate Leptospira wolffii serovar Khorat, and saprophytic Leptospira meyeri, respectively. Overall, this study provided important surveillance data on the prevalence of Leptospira spp. from rats and the environment, with dominant local serovars in urban areas of Sarawak. [ABSTRACT FROM AUTHOR]

This cross-sectional study was designed to determine factors contributing to glyceamic control in order to provide better understanding of diabetes management among Type 2 Diabetes patients. A pre-tested structured questionnaire was used to obtain information on socio-demographic and medical history. As a proxy measure for glycaemic control, glycosylated haemoglobin (HbA1c) was obtained as secondary data from the medical reports. Perceived self-care barrier on diabetes management, diet knowledge and skills, and diet quality were assessed using pretested instruments. With a response rate of 80.3%, 155 subjects were recruited for the study. Mean HbA1c level of the subjects was 9.02 ± 2.25% with more than 70% not able to achieve acceptable level in accordance to WHO recommendation. Diet quality of the subjects was unsatisfactory especially for vegetables, fruits, fish and legumes as well as from the milk and dairy products group. Higher body mass index (BMI), poorer medication compliance, lower diet knowledge and skill scores and lower intake of milk and dairy products contributed significantly on poor glycaemic control. In conclusion, while perceived self-care barriers and diet quality failed to predict HbA1c, good knowledge and skill ability, together with appropriate BMI and adequate intake of dairy products should be emphasized to optimize glycaemic control among type 2 diabetes patients. [ABSTRACT FROM AUTHOR]

Among the unsorted materials of the Natural History Museum Vienna, a new species of the E. striata group from West Malaysia was detected and is described under the name Echinopla lateropilosa sp.n. From Carlo Emery's collection in the Museo Civico di Storia Naturale Giacomo Doria, Genova, the holotype of Echinopla rugosa André, 1892 is redescribed and a paralectotype of Echinopla senilis Mayr, 1862 was rediscovered. In addition, Echinopla cherapunjiensis Bharti & Gul, 2012 is recorded from Myanmar for the first time, and a new record of Echinopla tritschleri Forel, 1901 is published from Perak in West Malaysia. The species-group system by Xu & Zhou (2015) is updated to include recently described species and a key to the species of the E. serrata group occurring west of Weber's Line is proposed. [ABSTRACT FROM AUTHOR]

Transfusion-transmissible infections including HIV-1 continue to pose major risks for unsafe blood transfusions due to both window phase infections and divergent viruses that may not be detected by donor screening assays. Given the recent emergence of several HIV-1 circulating recombinant forms (CRFs) in high-risk populations in the Southeast Asia region, we investigated the genetic diversity of HIV-1 among the blood donors in Kuala Lumpur, Malaysia. A total of 211 HIV-positive plasma samples detected among 730,188 donations to the National Blood Centre between 2013 and 2014 were provided (90.5% male, median age: 27.0 years old). Recent or long-term infection status at the time of donation was determined using a limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA). HIV-1 gag-pol genes were amplified and sequenced from residual plasma for 149 cases followed by genotype determination using phylogenetic and recombination analyses. Transmitted antiretroviral resistance mutations were not observed among the blood donors, among which 22.7% were classified as recent or incident infections. Major circulating HIV-1 genotypes determined by neighbour-joining phylogenetic inference included CRF01_AE at 40.9% (61/149), CRF33_01B at 21.5% (32/149), and subtype B at 10.1% (15/149). Newly-described CRFs including CRF54_01B circulated at 4.0%, CRF74_01B at 2.0%, and CRF53_01B and CRF48_01B at 0.7% each. Interestingly, unique HIV-1 genotypes including African subtype G (8.7%), CRF45_cpx (1.3%), CRF02_AG (0.7%) and CRF07_BC (0.7%) from China were detected for the first time in the country. A cluster of subtype G sequences formed a distinct founder sub-lineage within the African strains. In addition, 8.7% (13/149) of HIV-infected donors had unique recombinant forms (URFs) including CRF01_AE/B' (4.7%), B'/C (2.7%) and B'/G (1.3%) recombinants. Detailed analysis identified similar recombinant structures with shared parental strains among the B'/C and B'/G URFs, some of which were sequenced from recently infected individuals, indicating the possible emergence and on-going spread of foreign clades of CRF candidates among the local population. The findings demonstrate extensive molecular complexity of HIV-1 among the infected blood donors in Malaysia, driven in part by the increased spread of recently described CRFs and multiple introductions of previously unreported genotypes from highly prevalent countries. [ABSTRACT FROM AUTHOR]

Despite the rise in recreational use of ketamine in Malaysia, there have been no studies of users or of the health-related consequences they face. This study was initiated to examine ketamine use and its health consequences. A structured questionnaire was used to elicit information. A final sample of 127 males was divided into persons who used only ketamine and those who were poly-drug users. Each group was further divided into long-period and short-period users. Urine toxicology screening for ketamine and other illicit drugs commonly used in Malaysia was also done. Our findings corroborate those of earlier studies that link ketamine use to urological problems such as frequent urination, dysuria, incontinence, painful bladder, nocturia, and urinary urgency. A new finding in this study is the significant association between ketamine use and erectile dysfunction, such that higher odds of reporting erectile dysfunction were linked to long-period users. Our findings strengthen the case for early intervention, as ketamine users are drawn from young and unmarried male participants. The association of ketamine use with erectile dysfunction, if substantiated, will help physicians in their diagnosis of erectile dysfunction, particularly among youths. [ABSTRACT FROM AUTHOR]

Enterovirus A71 (EV-A71) is an important emerging pathogen causing large epidemics of hand, foot and mouth disease (HFMD) in children. In Malaysia, since the first EV-A71 epidemic in 1997, recurrent cyclical epidemics have occurred every 2–3 years for reasons that remain unclear. We hypothesize that this cyclical pattern is due to changes in population immunity in children (measured as seroprevalence). Neutralizing antibody titers against EV-A71 were measured in 2,141 residual serum samples collected from children ≤12 years old between 1995 and 2012 to determine the seroprevalence of EV-A71. Reported national HFMD incidence was highest in children <2 years, and decreased with age; in support of this, EV-A71 seroprevalence was significantly associated with age, indicating greater susceptibility in younger children. EV-A71 epidemics are also characterized by peaks of increased genetic diversity, often with genotype changes. Cross-sectional time series analysis was used to model the association between EV-A71 epidemic periods and EV-A71 seroprevalence adjusting for age and climatic variables (temperature, rainfall, rain days and ultraviolet radiance). A 10% increase in absolute monthly EV-A71 seroprevalence was associated with a 45% higher odds of an epidemic (adjusted odds ratio, aOR1.45; 95% CI 1.24–1.69; P<0.001). Every 10% decrease in seroprevalence between preceding and current months was associated with a 16% higher odds of an epidemic (aOR = 1.16; CI 1.01–1.34 P<0.034). In summary, the 2–3 year cyclical pattern of EV-A71 epidemics in Malaysia is mainly due to the fall of population immunity accompanying the accumulation of susceptible children between epidemics. This study will impact the future planning, timing and target populations for vaccine programs. [ABSTRACT FROM AUTHOR]

Age 18 years is considered as the age of majority by most countries. To ascertain the age of interest, both third molar development (TMD) and eruption (TME) staging scores are beneficial without needing multiple imaging modalities. This study aimed to assess the chronological course of TMD and TME in a Malay sub-adult population and evaluate predictions when specific stage(s) of TMD and TME have been attained that are pertinent to the age group of interest (<18 years or ≥18 years). A sample of 714 digital panoramic images for subjects stratified by age between 14.1 and 23.9 years was retrospectively collected. The techniques described by Gleiser and Hunt (modified by Kohler) and Olze were employed to stage TMD and TME, respectively. A binary logistic regression was performed to predict the 18-year threshold with staging score as predictors. Stages 4–6 (TMD) and A–B (TME) for males and stages 4 (TMD) and A (TME) for females were found to discriminate the <18-year group. For both genders, stages 9–10 (TMD) and D (TME) can be used as reference stages to estimate whether a subject is likely to be ≥18 years, with 94.74–100% and 85.88–96.38% correct predictions, respectively. Stages 4 (TMD) and A (TME) can also be used to identify juveniles (<18 years) with a high degree of correct predictions, 100%. The juvenility of an individual is easily anticipated by using the specific staging scores of both third molar variables (TMD and TME) without complex calculations. [ABSTRACT FROM AUTHOR]

Inorganic nutrient contents of mucus released by Acropora corals and its utilization by heterotrophic bacteria at several different hour intervals in the coral mucus were investigated at a coral reef in Malaysia. The dissolved inorganic phosphate ( DIP) concentration was 135-fold higher than in the ambient seawater, probably due to inorganic P release from the coral gut cavity. We experimentally confirmed that heterotrophic bacteria rapidly (within 8 h) consumed ca. 80% of the initial concentration of DIP derived from coral mucus. High DIP concentration in coral mucus may enhance heterotrophic bacterial production and associated carbon flow in the microbial loop of reef ecosystems. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the effects of age and gender on wideband energy absorbance in adults with normal middle ear function. Method: Forty young adults (14 men, 26 women, aged 20-38 years), 31 middle-aged adults (16 men, 15 women, aged 42-64 years), and 30 older adults (20 men, 10 women, aged 65-82 years) were assessed. Energy absorbance (EA) data were collected at 30 frequencies using a prototype commercial instrument developed by Interacoustics. Results: Results showed that the young adult group had significantly lower EA (between 400 and 560 Hz) than the middle-aged group. However, the middle-aged group showed significantly lower EA (between 2240 and 5040 Hz) than the young adult group. In addition, the older adult group had significantly lower EAthan the young adult group (between 2520 and 5040 Hz). No significant difference in EA was found at any frequency between middle-aged and older adults. Across age groups, gender differences were found with men having significantly higher EA values than women at lower frequencies, whereas women had significantly higher EA at higher frequencies. Conclusions: This study provides evidence of the influence of gender and age on EA in adults with normal outer and middle ear function. These findings support the importance of establishing age- and gender-specific EA norms for the adult population. [ABSTRACT FROM AUTHOR]

Keratinases are proteolytic enzymes predominantly active when keratin substrates are available that attack disulfide bridges in the keratin to convert them from complex to simplified forms. Keratinases are essential in preparation of animal nutrients, protein supplements, leather manufacture, textile processing, detergent formulation, feather meal processing for feed and fertilizer, the pharmaceutical and biomedical industries, and waste management. Accordingly, it is necessary to develop a method for continuous production of keratinase from reliable sources that can be easily managed. Microbial keratinase is less expensive than conventionally produced keratinase and can be obtained from fungi, bacteria, and actinomycetes. In this overview, the expansion of information about microbial keratinases and important considerations in keratinase production are discussed. [ABSTRACT FROM AUTHOR]

A total of 22 species of freshwater fish representing 10 families were collected from peat swamp area of Kuala Langat and Sungai Dusun in Selangor. Five families, comprised of 16 species were found in Kuala Langat and 15 species belonging to 10 families in Sungai Dusun peat swamp areas. Osphronemidae was the dominant group of fishes at both areas. Higher species diversity was recorded at Sungai Dusun (H' = 1.75) than Kuala Langat (H' = 1.42) peat swamp. Independent t-test based on H' values mean [t(18) = 2.764; p < 0.05] showed there are statistically difference in diversity index between areas. Species diversity was unaffected by monsoon season as precipitation occurred all year around. Dissolved oxygen is the only physical parameter measured that shows positive correlation with species diversity of fish at both areas. [ABSTRACT FROM AUTHOR]

In this study, the radiobiological analysis of natural alpha emitters in extracted human teeth and animal bones from Malaysia was estimated. The microdistributions of alpha particles in tooth and bone samples were measured using CR-39 alpha-particle track detectors. The lowest and highest alpha emission rates in teeth in the Kedah and Perak states were 0.0080 ± 0.0005 mBq cm−2 and 0.061 ± 0.008 mBq cm−2, whereas those of bones in the Perlis and Kedah states were 0.0140 ± 0.0001 mBq cm−2 and 0.7700 ± 0.0282 mBq cm−2, respectively. The average alpha emission rate in male teeth was 0.0209 ± 0.0008 mBq cm−2, whereas that of female teeth was 0.0199 ± 0.0010 mBq cm−2. The alpha emission rate in teeth is higher in smokers (0.0228 ± 0.0008 mBq cm−2) than in non-smokers (0.0179 ± 0.0008 mBq cm−2). Such difference was found statistically significant (p < 0.01). [ABSTRACT FROM AUTHOR]

This study was carried out to develop a set of indicators for measuring and reporting the state of family well-being in Malaysia, and subsequently, to produce an Index of Family Well-Being. To build the set of indicators, domains of family well-being and relevant indicators were identified from past studies. Focus group discussions with families, professional groups and NGOs helped to refine the indicators prior to the main study. Using a stratified random sampling design, 2,808 households were identified (a parent and a child aged at least 13 years), making a total sample of 5,616 respondents. Results indicated ten key indicators that can predict family well-being-resiliency, safety, savings, healthy lifestyle, time with family, work-family balance, importance of religion, number of bedrooms at home, debt and child care-supporting the notion of family well-being being multi-dimensional and interconnected. On the basis of the results, a model of family well-being was hypothesized. This model was used to guide the development of the Index of Family Well-being. Confirmatory factor analysis (CFA) was carried out to determine the fit of the model to data. Five domains of family well-being were identified-family relationships, economic situation, health and safety, community relationship and religion/spirituality. The Index of Family Well-Being was calculated using the equal weighting strategy to each of these five domains. This index showed that the current family well-being of Malaysians is relatively high at 7.95 (SD = 1.38) on a 0-10 Likert response format. The findings suggest that family well-being is multifaceted, made up not only of the immediate family relationships and health and safety of its members, but include having adequate income to meet the demands of a minimum standard of living. Currently, the Index that is developed is only in the form of a numerical value reflecting the state of family well-being, but in future, it can be used to track changes in the family from time to time. [ABSTRACT FROM AUTHOR]

The tropical edible red seaweed (Eucheuma cottoniiL.) is rich in nutrients and polyphenolic compounds that may suppress cancer through its antioxidant and antiproliferative properties. The study reports on rat mammary tumor suppression and tissue antioxidant status modulation byE. cottoniiethanol extract (ECE). The effect of orally administered ECE (100 mg/kg body-weight) was compared with that of tamoxifen (10 mg/kg body-weight). Rat was induced to develop mammary tumor with subcutaneous injection of LA-7 cells (6 × 106cells/rat). The ECE was more effective than tamoxifen in suppressing tumor growth (27%), improving tissues (plasma, liver, and kidney) malondialdehyde concentrations, superoxide dismutase activity and erythrocyte glutathione concentrations (P< 0.05). Unlike tamoxifen, the ECE displayed little toxicity to the liver and kidneys. The ECE exhibited strong anticancer effect with enzyme modulating properties, suggesting its potential as a suppressing agent for mammary gland tumor. [ABSTRACT FROM AUTHOR]

The current study was designed to evaluate the in vitro cytotoxicity effect of a phenylbutenoid dimer, cis-3-(3',4' -dimethoxyphenyl)-4-[(E)-3'",4'"-dimethoxystyryl]cyclohex-l-ene (ZC-B11) isolated from the rhizome of Zingiber cassumunar on various cancer cell line, and normal human blood mononuclear cells, and to further investigate the involvement of apoptosis-related proteins that leads, to the probable pathway in which apoptosis is triggered. Cytotoxicity test using MTT assay showed selective inhibition of ZC-B11 towards T-acute lymphoblastic leukemia cells, CEMss, with an IC50 value of 7.11 ± 0.240 μg/mL, which did not reveal cytotoxic effects towards normal human blood mononuclear cells (IC50 > 50μg/mL). Morphology assessments demonstrated distinctive morphological changes corresponding to a typical apoptosis. ZC-B11 also arrested cell cycle progression at S phase and causes DNA fragmentation in CEMss cells. Decline of mitochondrial membrane potential was also determined qualitatively. In the apoptosis-related protein determination, ZC-B11 was found to significantly upregulate Bax, caspase 3/7, caspase 9, cytochrome c, and SMAC and downregulate Bcl-2, HSP70, and XIAP, but did not affect caspase 8, p53, and BID. These results demonstrated for the first time the apoptogenic property of ZC-B11 on CEMss cell line, leading to the programmed cell death via intrinsic mitochondrial pathway of apoptosis induction. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress is associated with the pathogenesis of cardiovascular diseases. The process of deep-fat frying in dietary cooking oil plays a role in the generation of free radicals. In this study, palm olein heated to 180 °C was tested for its effect on the activity of blood pressure-regulating enzymes and lipid peroxidation. Methods: Forty-two adult male Sprague-Dawley rats were equally assigned into 6 groups. The first group was fed with normal rat chow as the control group, and the subsequent groups were fed with rat chow fortified with 15% weight/weight of the following: fresh palm olein, palm olein heated once, palm olein heated twice, palm olein heated 5 times, or palm olein heated 10 times. The duration of feeding was 6 months. Fatty acid analyses of oil were performed using gas chromatography. Peroxide values were determined using standard titration. Plasma was collected for biochemical analyses. Results: Repeatedly heated palm olein increased the levels of peroxide, angiotensin-converting enzyme, and lipid peroxidation as well as reduced the level of heme oxygenase. Fresh palm olein and palm olein heated once had lesser effects on lipid peroxidation and a better effect on the activity of blood pressure-regulating enzymes than repeatedly heated palm olein. Conclusion: Repeatedly heated palm olein may negatively affect the activity of blood pressure-regulating enzymes and increase lipid peroxidation. [ABSTRACT FROM AUTHOR]

For the coherent understanding of heat acclimatization in tropical natives, we compared ethnic differences between tropical and temperate natives during resting, passive and active heating conditions. Experimental protocols included: (1) a resting condition (an air temperature of 28°C with 50% RH), (2) a passive heating condition (28°C with 50% RH; leg immersion in a hot tub at a water temperature of 42°C), and (3) an active heating condition (32°C with 70% RH; a bicycle exercise). Morphologically and physically matched tropical natives (ten Malaysian males, MY) and temperate natives (ten Japanese males, JP) participated in all three trials. The results saw that: tropical natives had a higher resting rectal temperature and lower hand and foot temperatures at rest, smaller rise of rectal temperature and greater temperature rise in bodily extremities, and a lower sensation of thirst during passive and active heating than the matched temperate natives. It is suggested that tropical natives' homeostasis during heating is effectively controlled with the improved stability in internal body temperature and the increased capability of vascular circulation in extremities, with a lower thirst sensation. The enhanced stability of internal body temperature and the extended thermoregulatory capability of vascular circulation in the extremities of tropical natives can be interpreted as an interactive change to accomplish a thermal dynamic equilibrium in hot environments. These heat adaptive traits were explained by Wilder's law of initial value and Werner's process and controller adaptation model. [ABSTRACT FROM AUTHOR]

This study was conducted under laboratory conditions to evaluate germinated barley seeds brought from Libya (semi-temperate) to Malaysia (Tropical area). Rate of germination, malt yield and proximate analysis for several quality parameters were measured. The results showed that germinated barley has high malt yield (72%) with good quality. The dry matter content of the malted samples ranged from 94- 95%. There is a significant difference in protein (at p > 0.05) between the malted and non-malted barley. The highest value of protein in the malted barley is 12.85%; while in the non-malted barley, it is the lowest (4.12%). There is a significant difference between the lipid and ash (at p > 0.05); the lipid and ash contents of the malted barley samples were 1.94% and 2.53% of the dry matter, respectively. For the dry matter, there was no significant difference in fiber percentage and Nitrogen Free Extract (NFE) percentage. The malt in the germinated barley was found to be acceptable and of good quality with a slight difference when compared with the malt produced under non-tropical environment. Hence, this method could be used as an alternative in the production of malt in non-barley producing cultivates. [ABSTRACT FROM AUTHOR]

Background: Chronic venous disorders are conditions of increasing prevalence in the developing world, and venous ulceration is the terminal sequel. Currently there are only limited data on all aspects of this from Southeast Asia. The aim of the present study was to assess differences in the demography and outcome between varicose vein surgery (VVS) and the relatively new endovenous laser therapy (EVT) in patients from Penang, Malaysia. Methods: A retrospective study was performed. Patients who presented to the outpatient clinic of the surgical department with saphenofemoral junction and/or saphenopopliteal junction incompetence associated with reflux of the great saphenous vein or small saphenous vein, respectively, underwent either surgery (1999–2004) or laser therapy (2004–2006). A single surgeon at a single institution performed all procedures. Results: A total of 350 limbs were treated from 292 patients. Demographics, symptoms, outcomes and complications that arose in both groups were compared. There were significant improvements in pains, swelling, cramps and heaviness postoperatively ( P < 0.001) in both groups. Deep venous thrombosis was present as a complication in the VVS group at 3.0%, but was absent altogether in the EVT group. Conclusions: Although both are highly effective procedures, laser therapy has become popular as an elective procedure with its minimally invasive nature, cosmesis, rapid recovery and other advantages. Surgery remains an important and very cost-effective procedure, especially in a developing society such as Penang. [ABSTRACT FROM AUTHOR]

Physico-chemical and sensory characteristics of frankfurters prepared with three types of palm fats (PF60: 40, PF70: 30 and PF80: 20) and palm olein (POo) at 20 and 25% of fat levels were studied. Incorporation of different fats at 20 and 25% did not affect the cooking yields of the frankfurters. Frankfurters incorporated with 25% POo showed the highest value of water-holding capacity (WHC) among eight formulations. The frankfurters containing POo showed the least cooking loss compared to those with palm fats. The incorporation of different type and level of fats resulted in significant changes in the colour (lightness, redness, yellowness) of frankfurters. Texture profiles of both raw and cooked frankfurters were found to be altered by the blending of different type and level of fats. In raw frankfurters, hardness for frankfurters mixed with palm fats were significantly higher than the one with POo but greater values for cohesiveness was observed in raw frankfurters blended with POo. Lowest chewiness was demonstrated by frankfurters mixed with 20% POo. Grilling increased the hardness values of all frankfurters. Contrary to the raw counterparts, cooked frankfurter with POo was the hardest among all formulations. Cohesiveness and chewiness was also found to be significantly higher for cooked frankfurters mixed with POo. Raw frankfurters with fat content of 25% showed greater value in hardness than those of 20%. However, there were no significant differences (P > 0.05) observed for all the texture profile attributes in cooked frankfurters due to fat levels. In sensory evaluation, frankfurters prepared with POo were found to be most acceptable by consumer panels as they scored the highest for hardness rating, chicken flavour, oiliness and overall acceptance attributes. [ABSTRACT FROM AUTHOR]

Although endemic goitre is no longer a major public health problem in Malaysia, iodine deficiency still remains a significant problem in a few remote settlements. The aim of this study was to determine the effectiveness of iodized oil intervention in the prevention of endemic goitre among the indigenous people in Malaysia. A pretest and post-test controlled trial was conducted among primary schoolchildren and pregnant mothers in Lasah, Sungai Siput and Perak. Legap Post and Yum Post were selected as the intervention areas, while Perwor Post and Poi Post were taken as controls. The variables studied included thyroid hormone concentrations, thyroid volume, urinary iodine excretions and mental performance. A baseline and two follow-up visits were conducted in both intervention and control areas. Intervention subjects were given iodized oil in the form of capsules which were taken orally (Laboratoire Guerbet, Paris, France). There was a significant increase in serum thyroxine hormone (T4) concentrations (P < 0.0001) and a significant decrease in thyroid stimulating hormone (TSH) concentrations (P < 0.05) in the schoolchildren following the intervention, however, pregnant mothers did not show any significant changes in T4 and TSH concentrations. Thyroid size was significantly reduced in both groups (P < 0.05). Urinary iodine excretions showed a significant increase in both groups following the intervention (P < 0.01). However, mental performance in schoolchildren was not affected. In conclusion, iodized oil (oral) is effective in reducing thyroid size, as well as improving the supply of iodine among schoolchildren and pregnant mothers in endemic goitre areas; however, its long-term effects need to be monitored closely. This method can be considered as an alternative while awaiting national coverage for the salt iodization program. [ABSTRACT FROM AUTHOR]

Thalassemia is a hereditary blood disorder that results from genetic defects causing deficient synthesis of hemoglobin polypeptide chains. Although thalassemia mostly affects developing countries, there is limited knowledge of its accurate frequency and distribution in these regions. Knowing the prevalence of thalassemia and the frequency of responsible mutations is therefore an important step in the prevention and control program as well as treatment strategies. This study was performed to determine the prevalence and to study the spectrum of gene deletions that are responsible in a-thalassemia in Kelantan, located in northeastern Malaysia. A total 400 first-time blood donors from multiple areas of donation centre were chosen randomly. The presence of three types of a-thalassemia gene deletion in southeast Asian population which were -SEAdeletion, -a3.7 rightward deletion, and -a4.2 leftward deletion was detected by using multiplex PCR method. 37 (9.25%) of blood donors were confirmed to have a- thalassemia deletion types. 34 (8%) were heterozygous for a3.7 deletion, 1 (0.25%) was heterozygous for a4.2 deletion, and 2 (0.5%) were heterozygous for SEA type deletion. Alpha-thalassemia-2 with 3.7 deletion was the most common determinant detected in Kelantan Malay compared to other ethnic groups. It has been noted that alpha-thalassemia-2 with 3.7 deletion is the most common type of a-thalassemia throughout the world. [ABSTRACT FROM AUTHOR]

Objective: Although the relationship between snack food eating and dental caries has been investigated in the United States and European groups, no data exist for Asian snack foods and diets. Our objective was to investigate snack food eating and dental caries in a Malaysian dental student group. Methodology: Frequency of eating was assessed on a basis of 2 weekday and 2 weekend day diaries for non-fasting students and one weekday and one weekend day during Ramadan, and a similar set outside Ramadan for fasting students. The sucrose and carbohydrate composition of between meal snacks and drinks was identified. The total number of decayed, missing, and filled teeth was recorded by two dental examiners. Results: The modal number of total food intakes was 2 or 3 per day on both weekdays and weekends. The number of between-meal snacks and drinks varied between 0 and 5. They were either high sucrose/low carbohydrate or high sucrose/high carbohydrate. DMFS scores were very low in all subjects but increased with between- meal snack intakes, particularly in the high sucrose/low carbohydrate category. Conclusions: Malaysian students had relatively low frequencies of food intakes but there was still an association between frequency of between-meal snacks and caries rates, as in Western countries. [ABSTRACT FROM AUTHOR]

The article reports that students at Melaka Manipal Medical College have undergone their first 2.5 year of a medical training program in Malaysia. Students are taught anatomy, physiology, and biochemistry. The anatomy classes include both small-group cadaveric dissection sessions and large-group lecture classes of 1 hour each. In an effort to break the monotomy and to engage the students in active learning, a midlecture student seminar is conducted. The midlecture student seminar consists of two parts, a short presentation by students, followed by postpresentation discussions.

Introduction: Coronary artery disease is the most important cause of morbidity and mortality in the industrialized world. It is also true in Malaysian population as heart disease is the number one cause of death. Each year over 1 million people around the world die from coronary atherosclerosis. Is there any difference in terms of demographic picture between patient who are over weight and non overweight? Can obesity be considered as an independent risk factor for patients to develop atherosclerosis? Various published articles examining obesity and CABG surgery contain conflicting results about the role of body mass index (BMI) as a risk factor for in-hospital mortality. Methodology: This study was conducted on 141 patients who underwent isolated CABG in Cardiothoracic Unit, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan from November 2001 to October 2004. The demographic picture of patients who had underwent CABG in HUSM were assessed by dividing patients into Group 1 which is non overweight (BMI = or < 25 kg/m²) and Group 2 which is overweight (BMI > 25 kg/m²) group. Results: In Group 1; there were 80 patients; 70(87.5%) were Malays, 9(11.4%) were Chinese and 1(1.3%) was Indian; 64 patients were male and 16 were female, the mean age was 58.6+ 8.2. In Group 2; there were 61 patients; 50(82.0%) were Malays, 10(16.4%) were Chinese and 1(1.25%) was Siamese; 53 patients were male and 8 were female, the mean age was 55.6+ 8.7. Risk factors (NYHA Class, preoperative cardiac ejection fraction, presence of diabetes mellitus, hypertension and hyperlipidamaemia alone or in combination) were similar in both groups. Conclusion: There are no significant differences in terms of demographic data between there two groups of patients who underwent CABG in HUSM. [ABSTRACT FROM AUTHOR]

Introduction: Oral cancer is a preventable disease that can be linked to behaviors such as tobacco use, heavy use of alcohol, and betel quid chewing habit. These cancers can be prevented through lifestyle choices that reduce one's risk for the disease. Many of these patients also suffered from comorbidities such as hypertension and diabetes, which lead to more disease burden. Objectives: The aim of this study was to explore the co-morbidity and habits as well as their effect on survival among oral cancer patients in Hospital University Sains Malaysia (HUSM). Methodology: A retrospective record review was conducted from August 2006 till December 2006 in HUSM. All patient's records diagnosed as oral cancer from 1986 to 2005 were reviewed. The required information was retrieved from patient's records and the data was transferred to a proforma. Data on follow-up period was obtained to determine patient's status and their survival time. All data extraction procedure was done by the main researcher. Results: There were 133 oral cancer patients in HUSM from 1986 to 2005. Majority of the patients had no co-morbidity (61.6%). Hypertension (17.3%) was the main co-morbidity suffered by the patients, followed by cardiovascular disease (12.1%) and respiratory problems (9.8%). Most of the patients were smokers (60.5%), very few were with betel quid chewing habit (22.5%) and minority with alcohol drinking 4.5%). Overall 5-year survival was 16.1%. There were no significant different on survival of oral cancer patients with regard to co-morbidity (HR=0.81, 95%CI= 0.55, 1.19, p = 0.284) or habits (HR=1.09, 95%CI= 0.73, 1.65, p = 0.669). Conclusions: Most of oral cancer patients didn't suffered from co-morbidity. Smoking were the most frequent habit among this patients. Co-morbidity and habit didn't effect the survival of oral cancer patients in HUSM. [ABSTRACT FROM AUTHOR]

Summaryobjective To evaluate the usefulness of antifilarial IgG4 antibody assay in detecting B. malayi infection in a filaria endemic area in Malaysia. methods A sandwich ELISA using B. malayi soluble antigen was employed to detect antifilarial IgG4 antibodies in serum samples of 330 individuals who comprised 88 healthy individuals from nonendemic areas, 15 B. malayi microfilaraemic cases, 22 individuals with soil-transmitted helminthiases, 9 elephantiasis cases and 196 residents from a B. malayi-endemic area. An O.D. value of > 0.420 at serum dilution of 1:400 was used as the cut-off point. This cut-off point was obtained by taking the mean optical density (0.252 + 4 S.E.) of 36 negative sera which had O.D. values greater than 0.1 at serum dilution of 1: 400. results All 15 microfilaraemic persons were positive for antifilarial IgG4 antibody. Non-endemic normals, soil-transmitted helminth infected persons and chronic elephantiasis cases were negative for antifilarial IgG4 antibody. Of the 196 individuals from the filaria endemic area, 37 (18.8%) demonstrated presence of antifilarial IgG4 antibodies; and only eight individuals (4.1%) were positive for microfilariae. All eight microfilaraemic individuals were also positive for antifilarial IgG4 antibodies. conclusion Antifilarial IgG4-ELISA could detect 4.6 times more positive cases than the microfilaria detection method. With appropriate cut-off values that eliminate cross-reactivities, this serological tool is very useful for Brugia malayi prevalence surveys and diagnosis. [ABSTRACT FROM AUTHOR]