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Introduction: Obesity is a lifestyle disease that is becoming prevalent nowadays and is associated with a surplus in energy balance related to lipid metabolism, inflammation and hypoxic condition, resulting in maladaptive adipose tissue expansion. This study used the publicly available gene dataset to identify a small subset of important genes for diagnostics or as potential targets for therapeutics. Methods: Chemometric analyses by principal component analysis (PCA), random forest (RF), and genetic algorithm (GA) were used to identify 50 genes that differentiate adipose samples from high-fat diet- and normal diet-fed mice. The first 30 important genes were studied for classifying the samples using six different classification techniques. Gene ontology (GO), pathway analysis, and protein-protein interaction studies on the 50 selected genes were subsequently done to identify important functional genes. Finally, gene regulatory effects by microRNA were assessed to confirm the genes’ potential as targets for new therapeutic drugs. Results: The genes identified by RF are best for differentiating the samples, followed by PCA, with the least predictability shown by genes chosen by GA. However, PCA identified more genes with functional importance, such as the hub genes ATP5a1 and Apoa1. ATP5a1 is the main hub gene, whereas Apoa1 is involved in cholesterol metabolism. Vapa and Npc2 are crosstalk genes that link both of these main genes and could be targeted for therapeutic drug design. Conclusion: The combination of different chemometric techniques and functional analysis of genes could be used to select for a small number of genes which could serve as more suitable diagnostic or therapeutic targets.

Background: A new approach involving immune-cell-mediated cancer therapy has been adopted extensively for the sake of lung cancer treatments by utilizing natural killer (NK) cells. NK cell activity can be enhanced with certain agents, and among them are flavonoids. Thus, this study was conducted to investigate the immunomodulatory roles of apigenin, luteolin and quercetin on NK cell activity against lung cancer cells and on the secretions of perforin and granulysin profile. Methods: The NK-92 cells were grown in complete α-Minimum Essential Medium (MEM). NCI-H460 lung cancer cells were cultured in Roswell Park Memorial Institute 1640 media. NK cell activity against lung cancer cells were done using MTT(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. The secretions of perforin and granulysin profiles were then analysed using enzyme-linked immunosorbent assay. Results: Apigenin, luteolin and quercetin significantly increased the NK-cell-mediated cytotoxic activity against lung cancer cells at concentrations 12.5 µg/ml and 25µg/ml ( P < 0.001). The secretion levels of perforin and granulysin from NK cells were also significantly enhanced with apigenin and luteolin treatment but not with quercetin. Conclusions: All three flavonoid compounds possessed some significant immunomodulatory actions on NK cell cytotoxic activity and granule secretion profiles towards lung cancer therapy.

This is the first study evaluating the frequencies of nucleophosmin (NPM1) gene mutation according to the hyperleukocytosis (HL) grading score. The current two cut off values of this score in acute myeloid leukaemia (AML) patients are [1] those with 50–100 × 109/L and [2] those with ≥ 100 × 109/L total WBC count. The score represents the current clinically based definition of HL in patients with AML. A total of 90 patients with AML were included. AML patients were stratified into three groups: [1] those with a WBC count below 50 × 109/L (n = 33), [2] those with a WBC count 50–100 × 109/L (n = 29) and [3] those with a WBC above 100 × 109/L (n = 28). Complete blood cell count, immunophenotyping and PCR of the exon 12 of NPM1 gene followed by sequencing analysis were done. NPM1 mutations were detected in 20/90 (22.2%) of patients with AML involving exon 12 of NPM1 gene and showed significant correlations with some hematologic characteristics. Contrary to expectation, no statistically significant difference was found in the WBC counts according to the NPM1 gene the mutation status among the studied groups. Also, there were no significant differences in the WHO classification categories according to the HL grading score. The difference in the frequency of NPM1 mutation in Asian compared to Western patients might be attributed to biology and aetiology variation of the disease in different population. The current two cut off values defining the HL are molecularly unreliable in spite of being clinically defined.

Treatment of Behcet disease (BD) is still considered challenging since no single agent has yet proved to reverse the underlying oxidative stress-induced inflammatory process. Zinc sulfate treatment has been shown to have an effective therapeutic outcome, however adequate exploration of the exact mechanism for its therapeutic benefit is still lacking. This study was carried out to assess and relate the oxidative stress parameters with the clinical manifestation index before and after oral zinc sulfate treatment. Twenty-five Behcet disease (BD) patients were recruited in the study besides an equal number of healthy individuals representing the control group. Patients were treated with 300mg/day oral zinc sulfate in three divided doses for one month. Blood samples were collected from the control group, patient group (before starting treatment),and treatment group (after zinc sulfate treatment) to measure serum oxidative stress parameters as well as antioxidant parameters. A dermatologist who was blind to the treatment calculated the clinical manifestation index (CMI) score and the oral ulcer parameters for each individual in the patient and treatment groups. Serum MDA, copper levels were found significantly higher in the patient group than in the control group. However, both parameters were considerably lower in the treatment group than in the patient group. Serum glutathione (GSH), zinc levels and RBC catalase activity were significantly lower in the patient group than in the control group, but they were substantially higher in the treatment group as compared to the patient group. The CMI score and oral ulcer parameters decreased significantly in the treatment group (after zinc sulfate treatment) compared to the patients’ group. The CMI demonstrated a significant positive correlation (P

Infections caused by Streptococcus (S.) pneumoniae have become one of the leading causes of mortality and morbidity worldwide. Through colonization, it causes local or systemic infection among the human population belonging to all age groups. Its spreads from the nasopharynx become the source of local infections such as sinusitis or acute otitis media. In the case of aspiration S. pneumonia directly spreads in the lungs and leads to pneumonia acquired from the community. More than 96 serotypes have been reported so far, so determining all serotypes’ susceptibility and resistance is a cumbersome process that needs hefty effort, time, and resources. Thus, it becomes evident and necessitates that there should be some appropriate approach or technique to effectively and timely identify strains of bacteria, especially widespread ones like S. pneumoniae. Instead of identifying all these reported strains, identifying only two pherotypes can effectively serve the purpose of accurate identification and treatment. As a result of effective identification, the susceptibility and resistance of prevalent strains of S. pneumoniae can be easily done promptly with a minimum level of complex technology or complex protocols. It will pave the way for effective treatment of S. pneumoniae strains with rapid and higher recovery rates and minimal mortality rates. This chapter aims to evaluate antibiotics susceptibility and resistance to S. pneumoniae pherotypes called CSP-1 and CSP-2. Different methods of pherotypes determination have also been objectively evaluated.

PURPOSE: To predict potential inhibitors of alpha-enolase to reduce plasminogen binding of Streptococcus pneumoniae (S. pneumoniae) that may lead as an orally active drug. S. pneumoniae remains dominant in causing invasive diseases. Fibrinolytic pathway is a critical factor of S. pneumoniae to invade and progression of disease in the host body. Besides the low mass on the cell surface, alpha-enolase possesses significant plasminogen binding among all exposed proteins. METHODS: In-silico based drug designing approach was implemented for evaluating potential inhibitors against alpha-enolase based on their binding affinities, energy score and pharmacokinetics. Lipinski’s rule of five (LRo5) and Egan’s (Brain Or IntestinaL EstimateD) BOILED-Egg methods were executed to predict the best ligand for biological systems. RESULTS: Molecular docking analysis revealed, Sodium (1,5-dihydroxy-2-oxopyrrolidin-3-yl)-hydroxy-dioxidophosphanium (SF-2312) as a promising inhibitor that fabricates finest attractive charges and conventional hydrogen bonds with S. pneumoniae alpha-enolase. Moreover, the pharmacokinetics of SF-2312 predict it as a therapeutic inhibitor for clinical trials. Like SF-2312, phosphono-acetohydroxamate (PhAH) also constructed adequate interactions at the active site of alpha-enolase, but it predicted less favourable than SF-2312 based on binding affinity. CONCLUSION: Briefly, SF-2312 and PhAH ligands could inhibit the role of alpha-enolase to restrain plasminogen binding, invasion and progression of S. pneumoniae. As per our investigation and analysis, SF-2312 is the most potent naturally existing inhibitor of S. pneumoniae alpha-enolase in current time. GRAPHICAL ABSTRACT: [Image: see text]

The majority of deaths due to Streptococcus pneumoniae infections are in developing countries. Although polysaccharide-based pneumococcal vaccines are available, newer types of vaccines are needed to increase vaccine affordability, particularly in developing countries, and to provide broader protection across all pneumococcal serotypes. To attenuate pneumococcal virulence with the aim of engineering candidate live attenuated vaccines (LAVs), we constructed knockouts in S. pneumoniae D39 of one of the capsular biosynthetic genes, cpsE that encodes glycosyltransferase, and the endonuclease gene, endA, that had been implicated in the uptake of DNA from the environment as well as bacterial escape from neutrophil-mediated killing. The cpsE gene knockout significantly lowered peak bacterial density, BALB/c mice nasopharyngeal (NP) colonisation but increased biofilm formation when compared to the wild-type D39 strain as well as the endA gene knockout mutant. All constructed mutant strains were able to induce significantly high serum and mucosal antibody response in BALB/c mice. However, the cpsE-endA double mutant strain, designated SPEC, was able to protect mice from high dose mucosal challenge of the D39 wild-type. Furthermore, SPEC showed 23-fold attenuation of virulence compared to the wild-type. Thus, the cpsE-endA double-mutant strain could be a promising candidate for further development of a LAV for S. pneumoniae.

Medical students in Malaysia and globally were considered among the most exposure groups in the community to stress due to several sources. The most significant and severe sources of stress in medical students is an academic sources, includes a lot of exams/tests, lack of time and facilities for entertainment, stay in a hostel, high parental expectations and vastness of syllabus, in addition to emotional problems and others personal sources. Stress is a very important issue that leads to a worsening of health problems. Stress develops in the body and leads to oxidative stress which in turn leads to a disorder in the whole body. Oxidative stress may lead to abnormal haematological indices elevated white blood cells (WBCs) count. Oxidative stress can lead to massive destruction of red blood cells (RBCs). The brain and the gastrointestinal system (GI) are intimately connected as one system. The brain has a direct impact on the GI tract. A stressful brain can send signals to the gut, just as a troubled intestine can send signals to the brain. Therefore, stress can be the cause of block the breakdown and assimilation of food for energy and nutriment. This malabsorption can then lead to a reciprocal negative effect to the stress and can be another cause of anaemia through malabsorption minerals and vitamins that are to erythropoiesis. So, stress can be one of the leading causes of anaemia among medical students. Stress is a chronic epidemic in the most medical students and can directly affect how well body works. This review article discovers the effect of stress in medical students that can be effect on their studies and further create researcher's interest to generate database that help to reduce stress response and bring about the empowerment of balanced life among Malaysian medical students besides the increasing level of health and academic performance.

Low back pain (LBP) is a common and elusive disorder. It cannot be comfortably diagnosed through clinical procedures, and little is understood about its etiology. From a public health perspective, it would be important to know if lifestyle factors, such as body weight, play an important role in its genesis. However, a look at the literature reveals some misperceptions. There are several hypotheses relating to a link between obesity and LBP. Increased mechanical demands resulting from obesity have been suspected of causing LBP through excessive wear and tear, and it has been suggested that metabolic factors associated with obesity may be detrimental. Thus, some consider it possible, but not particularly strong contributing factor of LBP, whereas others do not think that it is a risk factor of LBP. It has also been postulated that obesity may be a marker or an organizer for some other factors that are considered the causes of LBP. This study aims to measure the relationship between body weight and low back pain (LBP).

Background: Lower back, neck and shoulder pain, which affects the lumbar spine, are the most commonly reported Musculoskeletal Disorders (MSDs). Approximately 80 percent of the general population is affected by these disorders at a certain point during their lifetime, with some estimates being as high as 84 percent. The most commonly used approach for the treatment of MSDs is exercise therapy. Stretching provides several benefits for people at work, and may help improve morale and team cohesiveness. Another benefit of stretching is that participants may increase their range of motion compared to their counterparts who do not participate in stretching programs. Objective: The aim of this study is to synthesize the recent literature on workplace stretching exercise programs and their effects on reducing work-related MSDs in different occupational groups. Method: Specific keywords were identified and used in a systematic search to guide the discovery of relevant studies and data. Electronic databases including PubMed, ScienceDirect, and Google Scholar, were searched for the following combination of keywords: workplace, stretching, exercises, injury, work, prevention, safety, occupation, and ergonomics. Studies that do not focus on the benefits of stretching exercise were excluded simply because the present study examines prevention of work-related musculoskeletal disorders through stretching exercises. Results: Whilst majority of the literature examined in this study may not completely explain that stretching at the office will prevent work-related musculoskeletal accidental injuries, some studies have shown that performing stretching exercises can lead to reducing discomfort/pain and raising range of motion (ROM). Conclusion: Majority of the literature reviewed in this study might not fully explain that stretching at work prevents work-related musculoskeletal injuries. Some studies have shown that performing stretching exercises can contribute to reducing discomfort/pain and increasing range of motion (ROM). Particularly, construction workers who participated in stretching exercise programs reported significant positive effects including reduction in pains/disability, increase in muscle flexibility and endurance. These exercises are recommended to be performed during breaks throughout, depending on the type of occupation. All the exercises suggested could be performed at the workstation, and only require a few seconds to perform.

Background Cervical cancer is an important public health concern worldwide, and in both developed and developing countries. In Malaysia, cervical cancer is the second most common cancer in women after breast cancer and colorectal cancer. The relation between cervical cancer and oncogenic human papillomavirus (HPV) infection has been well-established and it has been reported that almost all cervical cancers are correlated to oncogenic HPV DNA. Worldwide around 70 per cent of cervical cancer cases are caused by HPV type 16 and HPV type 18 and responsible for 90 per cent of penile and anal cancer in men. However, HPV type 6 and 11 cause over 90 per cent of genital warts in both men and women. Aims The objective was to assess the knowledge and attitude level among health givers and to compare among the groups. Methods This was a cross-sectional multi-centre study. Simple random sampling was adopted to collect the data. A questionnaire has been developed and it was pretested. Medical doctors and nurses of Malaysian health service were the study population. The data was evaluated with the necessary statistical tests as applicable. P-values

Introduction : Pneumonia is a potentially life-threatening illness that poses global health teething troubles particularly among elderly population and performing Hajj. Empirical antibiotic treatment has been recommended for all suspected community-acquired pneumonia (CAP) patients as initial treatment on admission. Aim of the research : To describe the antibiotic therapy of CAP and determine the associated factors related to the treatment options among Malaysian Hajj pilgrims. Material and methods: This was a cross-sectional study involving 91 patients who were admitted to Tabung Haji Hospital, Makkah in 2012, with the clinical diagnosis of pneumonia during Hajj season. The antibiotic treatment for the patients as well as demographic factors and co-morbidity, which potentially influence the treatment options, were studied. Results : The mean age of the hajj pilgrims was 71.4 ±8.7 years. The most frequently prescribed antibiotic was levofloxacin (44.0%), followed by azithromycin (40.7%), cefuroxime (23.1%), ampicillin + sulbactam (16.5%), and amoxicillin + clavulanate (15.4%). The age of patients was significantly associated with levofloxacin, azithromycin, and meropenem (p = 0.032, 0.028, and 0.026, respectively). Patients with diabetes were statistically significantly highly prescribed with cefuroxime (p = 0.036). Conclusions : Levofloxacin and azithromycin were classified as the most common antibiotic treatment given to Malaysian Hajj pilgrim with CAP and their choice was associated with older age of patients. Otherwise, cefuroxime was the prescription of choice in diabetics.

Background : Hajj is the largest annual gatherings in the Islamic world. Hajj pilgrims encounter a great deal of heavy physical and mental stress. Chest infection, especially pneumonia is a potentially life-threatening illness which poses global health problems, particularly among elderly performing hajj. The objective of this study was to identify the sociodemographic, clinical and laboratory characteristics of patients clinically suspected of having pneumonia during Hajj season. Methods: A cross-sectional study was conducted on Malaysian hajj pilgrims who were admitted to Tabung Haji (medical center) in Makkah with clinical diagnosis of pneumonia. The relevant patient’s data were recorded from the hospital information system. Results: A total number of 157 Hajj pilgrims clinically diagnosed as pneumonia were recruited during the 2012/2013 Hajj season. Pneumonia affected male more than females (55.4% and 44.6%), with a mean age of 69.4(10.0) years. Coughing (96.2%) was recorded as the commonest symptoms followed by fever (84.7%) and breathlessness (47.1%). Most of the pilgrims were noted to have hypertension (60.5%) while 28.0% of them had diabetes, chronic obstructive pulmonary disease (25.5%) and asthma (12.7%). The laboratory finding showed mean white blood cell count was 16.9 (13.0) x10 9 L, and the neutrophils differential count was 81.1% (15.5). The most frequently prescribed antibiotic is levofloxacin (54.8%), followed by azithromycin (39.2%) and cefuroxime (23.6%). The mean length of hospital stay was 4.17(± 3.13) days, and most of the patients (97.5%) were discharged after getting treatment. Conclusion: The current study found that elderly males were the main sufferers of bronchopneumonia after Wuquf with an average length of stay 4.17 ± 3.13. Moreover, levofloxacin was found to be most effective antibiotic. Key words: Hajj, Pneumonia, Pilgrims, Clinical manifestation, Laboratory findings.

The elderly population rising rapidly in Malaysia and contributes to the increasing number of cognitive problems including mild cognitive impairment (MCI). However, due to limited information regarding this problem which may progress towards severe neurologic degeneration, this problem rarely diagnosed and left untreated. Hence, the use of electroencephalography (EEG) biomarker is seen to be important with the spectral power, coherence and synchronization between the both halves of brain explain the pathophysiology underlined. This method is becoming popular for its capabilities in quantifying changes in brain electrical activity and provide early signs of brain impairment. This paper reviews the incidence of mild cognitive impairment in elderly as an early cognitive deterioration signal. It continues with the role of quantitative EEG analysis in providing the physiological meaning of their brain. This paper also provides the information about neurochemical changes which associated with MCI. In addition, this paper proposes an idea of study towards examining physiology, neurochemicals, diet and lifestyles to promote healthy lifestyle in elderly.International Journal of Human and Health Sciences Vol. 04 No. 04 October’20 Page : 267-270

Artocarpus heterophyllus Lam. (Moraceae) has been traditionally used in treating various diseases such as diabetes, diarrhea, malarial fever, inflammation, wound healing and other diseases. Since various bioactive compounds have been found in this plant, this review focuses on the phytochemical and pharmacological properties of a potent bioactive compound artocarpin. Despite its various functions, a mechanistic review on this compound has not been reviewed specifically. Here, pharmacological studies in vitro and in vivo on artocarpin are discussed thoroughly stressing on anticancer, antimicrobial, anti-tyrosinase, antioxidant and antiinflammatory aspects of artocarpin. This review would be beneficial for future study to show the competency of natural products for their therapeutic characteristics.

The breathing technique helps in anxiety management based on psycho-physiological correlates of slow breathing. The psycho-physiological changes due to the brain-body interaction are observed in normal individuals and anxiety patients. Patients trained and practicing diaphragmatic breathing technique and people who practice breath control by meditation have demonstrated slowing down of breath frequency. There are limited studies regarding mechanisms involving breath control and its psychophysiological effects. This review study is aimed at exploring psychophysiological mechanisms underlying slow breathing techniques followed in the east and west and their effects on healthy subjects. This literature review completed using electronic databases such as PubMed, Medline, and Scopus databases using keywords such as breathing techniques, psychophysiology of breath control, meditation and breath control, relaxation and breathing technique, cardiorespiratory fitness and relaxing the nervous system. The current study analyzed 62 articles from the year 1970 to 2019. The main effects of slow breathing techniques have proven psychophysiological correlation paving to psychological/behavioral outputs that had increased comfort, relaxation, pleasantness, vigor and alertness, and reduced symptoms of arousal, anxiety, depression, anger, and confusion.

Increased criminality over the globe has led researchers to focus on the various happenings of criminal behavior. The scientific rationale for reduced control of inhibiting antisocial impulses and aggressive behavior, that goes with a variant of the relevant gene such as MAO-A is underactive prefrontal cortex area of the brain. The current study explores past reviews regarding gene expression in criminal behavior. The purpose of this study is to develop an awareness of gene expression in criminal behavior. A literature review conducted using electronic databases for this study, reviewing 30 articles from the year 1970 to 2018. The articles reviewed focused on genetic variation in human aggression, MAOA genotype, and aggression, MAOA promoter activity, a gene (MAOA) predicting behavioral aggression. The study concludes that although MAOA is a promoter of various activity variations, in MAOA can lead to hazardous criminal behaviour. The depth of understanding in this area would bring insights into professionals to rehabilitate criminals on a humanitarian base. The current study suggests there are limited studies in this area, especially in developing countries, thus the government and non-governmental agencies should encourage more researches in this area, which would bring more insight into this area.

Problem-based learning (PBL) extensively practiced learning approaches in medicine and various higher education settings. Success or failure of PBL depends on student's perception and attitude as well as the facilitators. Understanding student's perception and attitude toward PBL and also the facilitator would work as feedback to upgrade PBL. The purpose of this is study was to determine the students of clinical years and pre-houseman perceptions and attitudes towards the PBL and its facilitators. A questionnaire-based cross-sectional study conducted in a private institution in Malaysia; the questionnaire was prepared using Google docs and distributed to pre-housemen and clinical year students. The results showed 86.2% of participant's positive perception that voiced as the Problem Based Learning encourages them for learning cognitive and soft skills. More than half of the students have consented; that students with dominant leadership benefit more with PBL, and others remain disadvantages in PBL is one of the drawbacks. The majority of the students expressed a positive attitude towards the facilitators; that the guidance and encouragement extended during the PBL session. They also expressed their opinion that the facilitator should debrief at the end of the PBL session. The study concludes that PBL is an appropriate tool to nurture students and enrich them with their soft skills and making better use of cognitive ability. Furthermore, the study conceptualizes that besides some drawbacks in PBL facilitation, it is one of the best methods pave up to the achievements of university objectives. This study results would be beneficial in the facilitation of future PBL sessions not only in Lincoln University College but also in other global universities.

Background The Dundee Ready Education Environment Measure (DREEM) was planned and designed to quantify the educational environment precisely for medical schools and health-related professional schools. DREEM is now considered a valid and reliable tool, which is globally accepted for measuring the medical educational environment. The educational environment encountered by students has an impact on satisfaction with the course of study, perceived sense of well-being, aspirations, and academic achievement. In addition to being measurable, the educational environment can also be changed, thus enhancing the quality of medical education and the environment, and the medical education process. The objective of this study was to assess the educational environment of the Universiti Sultan Zainal Abidin (UniSZA) undergraduate medical program from the students’ perspective. The study expected to explore UniSZA medical students’ overall perceptions, perceptions of learning, teachers, atmosphere, academic self-perception, and social self-perception using the DREEM questionnaire. Methods A cross-sectional survey was conducted to study the perceptions of the students toward the educational environment of UniSZA as a new medical school, using the DREEM questionnaire. All medical students of UniSZA from Years I–V enrolled in the Bachelor of Medicine and Bachelor of Surgery programs were the target population (n=270). Therefore, the universal sampling technique was used. The data were analyzed using the SPSS 20 software. This study obtained ethical clearance from the Faculty of Medicine and Health Sciences, UniSZA. Results A total of 195 out of 270 students responded. Respondents included 31% males and 69% females. The overall DREEM scores were significantly higher (P, Video abstract

The primary aim of patient care is to provide the best medication that can produce the best treatment with minimal or no harm. This is only possible when the entire health care workers play their card well through correct prescription, dispensing, drug administration and adequate patient monitoring. However, the outcome is not always favorable because of the limited time undergone by the drug during premarketing studies as well as the bias by the pharmaceutical-industries to get approval from regulatory-agencies. As a result of this many safety data and information are lacking. Therefore, in order to preserve patient confidence and integrity of pharmaceutical products, post-marketing surveillance has become necessary. The methods commonly in used in post-marketing surveillance include spontaneous reporting, data mining and active reporting which have meaningfully contributed to patient safety. Despite the improvement made, spontaneous reporting have some disadvantages such as underreporting, poor quality of reports, and cannot be used to determine risk rate. Pharmaceutical companies as owners of the drug have noteworthy role to play in adverse drug reactions monitoring and can adopt similar techniques used by the regulatory-agencies and academic research. Unfortunately, this has led to reporting bias. This has suggested the need for more awareness and educational intervention for health care professionals at all levels. The curriculum of training medical and health related students should be incorporated with PV programme. This appraisal has described how to identify adverse drug reactions and methods used in reporting, current developments in pharmacovigilance and role of pharmaceutical-industries in drug safety studies. Key Words: Pharmacovigilance, Spontaneous-Reporting, Patient-safety, Pharmaceutical-industries.

Background: Adverse drug reactions (ADRs) have been making headlines because of life threatening issues. ADRs are always underreported and still the major public health problem. Spontaneous reporting system has remained the most significant method for safeguarding patients’ lives. Objectives: Is to examine and analyse the various pharmacovigilance studies conducted among health care professionals, medical and pharmacy students and to make recommendations for future research. Study Selection: 14 studies covered from 2000 to 2014 were selected. Data Sources: Four electronic data-bases including Science-Direct, Springer-Link, PubMed and MEDLINE were used to obtain 30 relevant publications using HotBot and Google Scholar as search engines. Data Extraction: Studies conducted on doctors, pharmacist, community pharmacist, nurses, medical and pharmacy students were selected covering research from seven countries. Data Synthesis: Knowledge, attitude and practice (KAP) regarding pharmacovigilance of health care professionals, medical and pharmacy students were poor. Longitudinal study involving educational intervention and training through workshops and seminars were found to be effective in improving knowledge and attitude of nurses. Conclusion: There is urgent need to improve knowledge, awareness and practice of health workers, medical and pharmacy students about pharmacovigilance. It is imperative for WHO and national pharmacovigilance centres to take proactive measures to curve the menace of ADRs in order to safeguard the patients’ lives. The curriculum of all health and health related schools should be restructured with respect to pharmacovigilance without any delay and hesitation.

Artocarpus heterophyllus has been used as traditional medicine. This plant is one of the sources of flavonoid. Flavonoid compounds possessed a wide range of biological properties including anticancer. This study was performed to investigate the cytotoxic effect of flavonoids from A. heterophyllus on H460 and MCF-7 cell lines. The interaction of flavonoids and cisplatin against tested cancer cells was also evaluated. MTT assay was used to determine the cytotoxic effect of flavonoid. Isobologram analysis was selected to evaluate the synergistic effect between flavonoid and cisplatin, their interaction was then confirmed using AO/PI staining method. Amongst of flavonoid compounds, artocarpin exhibited strong cytotoxic effect on both MCF-7 and H460 cell lines with IC50 values of 12.53 μg/mL (28.73 μM) and 9.77 μg/mL (22.40 μM), respectively. This compound enhanced anticancer activity of cisplatin against H460 and MCF-7. The combination produced a synergistic effect on H460 and MCF-7 cell lines with a combination index (CI) values of 0.2 and 0.18, respectively. The AO/ PI stained demonstrated that the combination of artocarpin and cisplatin caused morphological changes that indicated apoptosis. Moreover, artocarpanone also significantly increased cytotoxic effect of cisplatin compared to its single concentration with CI below than 1. This result suggested the potency of flavonoid named artocarpin to enhance the anticancer activity of cisplatin on H460 and MCF-7 cell lines.

Adolescence characterized the highest rate of neurodevelopment; their levels of cognitive, social and emotional capacities relatively at the peak. Transiting from childhood to adulthood intensively preparing for the responsibilities of adulthood is challenging for adolescents. It is a period of stress and storms the pressures of modern day life can affect a child's mental and emotional wellbeing. Thus, there is a need for parental awareness regarding various biological and psychological factors involved in their adaption process. The current review study aims to explore different aspects of an adaption process and need for parental awareness. This literature review was completed using electronic databases. The current study had analyzed 70 articles from the years 1933 to 2018. Reviewed articles had explored an adolescent behavior from different a perspective and also learned the need for parental awareness to stand beside adolescents to promote their identity formation process. The study concludes in its place of stigmatizing adolescents are weird conceptualize the wonderful part of them. Further, the study suggests that governmental and non-governmental organizations conduct should conduct awareness programs for the parents and teachers, and educators to promote adolescent health and wellbeing. The current review study had analyzed that weirdness and wonderfulness in adolescents’ behavior. Further study concludes parents and teachers should be aware of these lifespan developmental facts that adolescents’ undergo. Developing awareness among parents and educators can change their perspective towards adolescence. Parents and teachers need to conceptualize wonderful qualities in adolescents like neuronal plasticity, ability to flex, quick learning and adaptability may help to mend adolescents to grow as a healthy adult.

Introduction: Personality is an integration of individuals’ characteristics, benefits them to be successful in their career path. In the field of education, the educators, researchers, and psychologists are on the constant explosion of the tightfisted set of variables that predicts patterns of students’ behaviors, and their association with academic achievement. Objectives: to assess the big five personality traits among medical students, and to find out the relationship between ‘Big Five’ personality traits and academic achievement of undergraduate medical students. Method: A cross-sectional study conducted on122 medical students of year one and two Universiti Sultan from Zainal Abidin, Malaysia. The researchers used a convenient sampling method in the selection of the study sample. Students’ personality traits were assessed using the USM personality inventory USMaP-I scale. Academic scores collected from the academic office. Collected data entered into excel sheet, IBM SPSS version 22 used for the statistical analysis. All the Big Five Personality traits of students positively predicted students overall grade. Of all personality traits, openness, and neuroticism positively related to student’s academic achievement, predicted their overall grade .The student's traits, agreeableness, and conscientiousness showed an association but not with significance. Another dimension extraversion was positively related (r =.150) but not statistically significant. Conclusion: The study results evidence the Big Five Personality Traits has an association with the Academic Performance of Medical Students. Conceptualizing this fact could be useful for the teachers, mentors, and counselors to guide their students. Additionally, students can help themselves in their academic progress and strengthen their career paths.

Personality dimension negative emotionality is known to be associated with academic achievement. The present study focuses on the influence of negative emotionality (neuroticism) on the medical students’ academic achievements. The main objective of this study was to ascertain the negative emotionality scores among the first year Malaysian medical students studying in Malaysia and India, further to find out the association between negative emotionality and their academic achievements. The current study sample includes 60 first year Malaysian medical students from Universiti Sultan Zainal Abidin, Malaysia, and USM-KLE IMP, Belgaum, India. They were selected by convenient sampling technique. The Medico-Psychological questionnaire was used to find out the negative emotionality scores among the students and these scores were compared with academic scores. The data were analyzed using SPSS- 20. Thus, the study result goes with the prediction that there is a significant correlation between academic achievement and negative emotionality. We concluded that negative emotionality has a negative impact on medical student’s academic achievement regardless of the fact whether they study in their own country or overseas., Video abstract

Stress is a constraining force that causes bodily or mental tension and may be a factor in disease causation. The study showed that medical students have more proneness to higher stress than students study in non-medical fields. The objective of this study is to discover the stress as evident among Malaysian medical students and general positive effects of mentation programmes in stress management. The current study was worked with the review of literature of the past study reports regarding stress in Malaysian medical students and general positive effect of mentation in stress management. The study had used electronic databases for rummaging and reviewing literature articles published on stress and other psychological determinants among medical students and mindfulness in the management of stress. Stress, mindfulness and related terminologies are used in searching related articles. In the current study, data were extracted through reviewing various related research articles focussing more on the prevalence and stress management in medical students. Stress among medical students found to be more than 50% needs close attention and monitoring. The academically related stressors were found to be high with the existence of other stressors with financial and relationship problem. Mentors help and religious sources were used as coping strategy. Medical education is found to be highly stressful. Developing awareness effects of managing stress through mindfulness and mentation among students and teachers and facilitate students to cope with academic and other stress that can negatively affect students' mental health. Prospective studies are encouraged using matured mentation programmes in medical schools.

SMN (Survival of Motor Neuron) has two isotypes; SMN1 and SMN2 encoding for FL-SMN protein (functional SMN) and ?7SMN protein (non functional). The lack of SMN1 produce spinal muscular atrophy (SMA) and the increasing gene dosage of SMN2 have been shown to decrease the severity of the SMA. The core promoter region of the SMN genes is still not identified but previous literature have shown these genes to be regulated by a 4.6 kb region up stream of the transcription start site (TSS). There was a need of computational analysis of this region as the presence of important features can help to develop a strategy for gene therapy against spinal muscular atrophy (SMA). In this analysis, the open reading frames, Pribnow box sequences, restriction sites and the transcriptional factor binding sites were identified. Important restriction sites were determined with in 15 open reading frames. Total of 15 ORFs and 24 nested ORFs were determined with 7 and 11 ORFs on the complementary strand. These ORFs contained 15 TATA box sequences reflecting the diverse function integrity of SMN promoter region. The whole data was used for the prediction of the promoter region of the SMN. Up to the best of our knowledge this is the first reported study in the literature reflecting the computational analysis of the ~4.6 kb expected promoter region of the SMN genes towards analyzing the core promoter region of the SMN genes in the future studies.

Alzheimer disease (AD) is considered among the most important neurodegenerative disorder in elderly individuals. AD patients have higher oxidative stress as compared to normal people with a higher susceptibility to health problems. Oxidative stress results into several disorders including AD. Oxidative stress in AD patients may lead to abnormal red blood cells (RBCs) indices and elevated white blood cells (WBCs) count. Oxidative stress in AD patients can lead to massive destruction of red blood cells (RBCs). The brain and the gastrointestinal system are intimately connected, as one system. The brain has a direct impact on the GI tract. A stressful brain can send signals to the gut, just as a troubled intestine can send signals to the brain. Therefore, oxidative stress in AD patients can be reason for hindering the breakdown and assimilation of food for energy and nourishment. This malabsorption can then lead to a reciprocal negative effect on oxidative stress and also can be another cause of anaemia due to malabsorption of minerals and vitamins that are important to erythropoiesis. Therefore this review article is designed to unearth the effect of oxidative stress in AD patients and incite leading researchers to generate database that will help in understand the relationship between oxidative stress and haematological parameters especially in AD patients.

Emotional development has close association in promoting emotional competency. Indeed, its implication erupts in early developmental stages through regulating, learning expressive emotional behaviour and building up relation in interpersonal domain. The purpose of the article is to promote awareness of emotional development and to endorse emotional competence. This article bases on developmental perspective of emotion and its linkage with emotional regulation trough the developmental stages and emerging competencies that upholds emotional wellbeing. In nutshell views of this article indicates that promoting emotional competency and may help in endorsing the abilities that helps to cope effectively in particular circumstances, promoting characteristics associated with positive developmental outcomes, self-efficacy, prosocial behaviour and supportive relationships in social life; it further serves as a protective factor in waning of risk factors in life.

Medical students who are suffering a stressful life have high chance to internet addiction disorder (IAD), as they spend most of their time inappropriately on the internet. Medical students are assumed to be among the most exposed group in any community towards stress. Deferent factors effect on level of stress, variant of BDNF gene may thus play a key role in genetic predispositions to stress. This review article hypothesised that there is a correlation between IAD, level of stress, and BDNF gene (Met66Val) polymorphism; medical students with high levels of stress and IAD may carry BDNF met-allele. This review article aimed to create researcher's interest further to generate a future database that helps in the academics and education about disadvantages and distress of IAD, besides emphasising the empowerment of balanced life among medical students in Malaysia besides the increasing level of health and academic performance.

The muscles of the thigh are important in the functioning of the lower extremity. The main muscles of the lower limb that is effectively involved in the biomechanics of the lower limb are the quadriceps femoris and hamstring. Many researchers have investigated the activity of these muscles during various daily activities and exercises. The main focus of this review is to highlight the anatomy of these muscles, the methodology of measuring the activity of these muscles and researches that have measured the activity of these muscles in different strengthening exercises that were commonly used in rehabilitation of people with orthopedic crises. The main articles that were included in the review were those in which the exercises such as static quadriceps, inner range quadriceps, straight leg raise, active knee extension and semi squat were performed and the activity of quadriceps femoris and hamstrings were measured. Electromyography (EMG) analysis provides information on the relative amount of muscular activity during the exercise. The main muscles that were reviewed were those of the vastus medialis oblique, vastus lateralis, rectus femoris and biceps femoris. This review has highlighted the importance of the exercises that were frequently advised for patients with orthopedic problems and the activity of the muscles during the exercises. There are evidences that the strength of the thigh muscles influence the quality of life an individual. The level of activity of the muscles is evident from this review and it could give a clear idea on the exercises that could be performed in order to strengthen an individual muscle.

The purpose of this study is to determine the effect of combining anodal cortical and back muscle stimulations in chronic low back pain (CLBP). Forty eight patients divided into four groups participated in the study. The control group received infrared therapy (IRT) and a session soft tissue massage (STM), while those in the other groups received combined dorsolateral prefrontal cortex (DLPFC) and Back muscle stimulation plus IRT and STM, combine primary motor cortex (PMC) and Back muscle stimulations plus IRT and STM and Williams flexion exercise plus IRT and STM respectively. The primary outcome (disability level) was assessed using modified Oswestry low back pain disability questionnaire while bothersome questionnaire (secondary outcome) was used to assess the level of bothersome of the participants. Statistical analysis revealed that participants that received DLPFC/Back muscle stimulation plus IRT and STM (p=0. 046, z=-2.02) have much improvement in disability compare to those that received PMC /Back muscle stimulations plus IRT and STM. In addition, the control intervention (IRT and STM) proves to be more effective (P=0.025, Z=-2.24) compare to other groups. It is concluded that IRT and a session of STM is more effective in the reduction of disability and improvement of the functions in CLBP than the combine stimulations, but the result cannot be generalized because of the small sample size and type of design used in this clinical trial.

Autism spectrum disorder (ASD) may affect all spheres of a child's life. Indeed, parents and siblings also live with emotional instabilities in the family. The experience of parents with ASD child can be distressing since they need to make more adjustments to the demanding need to cope with their life situations. Perhaps, their life is drastically exaggerated with their complexities of life. Particularly, their social life is radically affected. The presence of pervasive and severe deficits in children with ASD isolates these parents from their social life; demanding adjustments to their social environment of parents in their life situations shove them into distress and unstable emotions. Finally, they culminate being shattered in their interpersonal relationship, their family and social life. Indeed, these aspects of distress mask social intelligence of these parents, thus narrow down their focus more on the treatment rather than holistic management of their child. Thus, the management of ASD with these parents of the deficit children to reach their fullest abilities remains doubtful. Therefore, the objectives of this study are as follows: (a) to examine the impact of emotionality on social intelligence of parents blessed with autistic child, (b) to develop awareness regarding social intelligence and its significance among these parents, (c) to propose a new model stabilising emotionality of these parents through developing social adaption skills and (d) to suggest a new model as a guide in the current intervention regimens to ensure the emotional well-being and better social adoption. This study is made based on the keenly examined past evidence with the correlation of emotionality and its impact on social intelligence of the parents with ASD children. The results reveal that the social intelligence is perceived as lowered evidenced by poor social adjustment reflected in social isolation observed in the parents of children with ASD. A new model proposed for stabilising and developing awareness of social intelligence among the parents of ASD children. Integrating this model with the existing treatment paradigm has been suggested to attain the better result. The conclusion is drawn in this study by analysing the fact that considerable improvement in the diagnosed child may not amend the parent and family distress and drastically affect social intelligence. Indeed, the intervention can be more promising with the healthy personality of parents, where their multiple aspects of intelligence are not affected. The new proposed model of intervention can pave the way for further research in this regard.

Various forms of exercises are imparted for patients with lower extremity problems. These exercises are helpful in strengthening the muscles of the lower limb mainly those of quadriceps and hamstring. This study was intended to investigate the activity of vastusmedialis oblique and vastuslateralis during selected exercises of Static Quadriceps Exercise (SQE), Inner Range Quadriceps exercise (IRQ), Straight Leg Raise (SLR), Active Knee Extension exercise (AKE) and semisquat. About 50 healthy individuals (15 Males and 35 Females) in the age group of 18–24 years (Male= 21.2 ± 1.21, Female= 20.3 ± 0.8) were recruited for the study based on the inclusion criteria. Surface electromyographic electrodes were affixed to Vastusmedialis Oblique (VMO) and vastuslateralis (VL) muscle. Each subject was advised to perform all the five exercises, and the muscle activity during each exercise was recorded using Myotrac Infiniti, and the data were analysed with the aid of Biograph Infiniti software. Descriptive and inferential statistics were performed using SPSS version 22.0. The findings of the research indicated that inner range quadriceps exercise was significantly better in facilitating VMO and VL with no significant difference between the two during various exercise. It was also observed that the VMO/VL ratio was similar in all the exercise indicating equal activation of both muscles.

Research has illustrated that the risk of lower back pain (LBP) among women population is signi?cantly higher owing to the hormonal and reproductive factors such as irregular or prolonged menstrual cycle and hysterectomy. The trunk and hip muscles are regarded as the most affected muscles in LBP patients and as such precise training of these muscles could be of value to the patients. Diverse exercises programmes exist, yet, the appropriate training that could be suitable in stimulating certain groups of muscles for a specified gender remains a challenge. As a result, this study aims to determine the efficacy of a strength training programme (STTP) in improving and stimulating the trunk and hips muscles of female’s subjects. 25 healthy females with normal BMI and ages range from 19 to 24 years performed five sets of strength exercises three times a week for five weeks. Electromyography (EMG) data were collected from 5 muscles of rectus abdominis, external oblique, multifidus, gluteus maximus and gluteus medius. The readings from the EMG were compared after the five weeks interventions (pre and post). An independent t-test was administered to the data collected to study the effectiveness of the STTP between pre and post on the trained muscles. A statistically significant difference of muscle activations between the pre and post on all the assessed muscles were obtained p < 0.05. The finding suggests that STTP intervention is effective in stimulating the females’ pelvic muscles activations. STTP could be a viable means for prevention and rehabilitation of LBP.

Background: Majority of students tend to have their own preferred pastime physical exercise in dealing stress and to benefit them in their academic piece. Aim: The present cross sectional survey is aimed to probe the positive networking between physical exercise and academic performances amongst future medical professionals in Universiti Sultan Zainal Abidin (UniSZA). Review of literature: The reviews of previous researches validate that there may be some short-term improvements of stress related positive mental activity such as memory enrichment but the long-term improvement of academic achievement as a result of more vigorous physical activity is not well corroborated. The relationship between physical activity in student and academic outcomes requires further exposition. Justification: Since previous research did not clearly state the positive relationship between exercise carried out by students and academic excellence in a longer time span, therefore our research aims to find out apt exercise(s) that students prefer in improving their mental state and in turn academic enrichment among both preclinical and clinical phase MBBS students in UniSZA through survey done by questionnaires. Expected outcome: The outcome of this research will hopefully benefit not only the medical students of UniSZA but also others by encouraging a healthy lifestyle and also reduce the incidence of chronic health diseases. Methodology: The respondents are the future medical professionals (year I to V) of UniSZA residing in MAIDAM with 100 in number which includes both genders and different races. Results and Interpretation: The following yardsticks were scrutinized through the questionnaire and were tabulated as per the detail furnished. i.e. choice of exercise, period of practice, duration of exercise per session, past and current CGPA results, and their level of stress. Conclusion: From this cross sectional study among future UniSZA meducationists, it could be postulated that the choice of physical exercise may have an impact on stress-free academic performance.

Background: Emotional stability is defined as a person's capacity to stay calm when faced with stress. An emotionally unstable person is more explosive, which confers that provoking of such persons puts them at enhanced risk of harmful behaviors. Whether the persons avoid emotions and the extent to which a person experiences anxiety in situations is determined by emotional stability. Emotional stability is associated with persons life, coping and adapting to various life situations. Moreover, it is intricately related to the individual’s occupational life, which has been focused in this study. Aims and Objective: To ascertain the subject’s social adjustment, maladjustment, and their association with emotional stability. Materials and Methods: Participants for this study were 100 working men selected from health, education, and banking sectors in and around Mangalore city, Karnataka, India. They were selected by a random sampling technique. Personal visits were made to the respective institutional heads of each of of these sectors; 35, 35, and 30 samples were selected from each of these sectors, respectively. They were randomly selected from each of these sectors. Eysenck Personality Inventory was administered to evaluate the emotional stability, and interview schedule was used to assess their social adjustment. Pearson’s X2-test was carried out. Result: The result reveals that there was a significant (r = -0.873, p < 0.001) relation between the emotional stability of these subjects with regard to their social adjustment at their workplace. Conclusion: The implication of this study is to develop insight among the employers and employees with regard to their emotionality affecting the social adjustment, which may pervade into the compatible work environment important for work productivity.

Method: To explore the pattern of preferred learning styles of 82 students, we administered the VARK questionnaire to the participants. To assess self-esteem, Rosenberg self-esteem questionnaire was used and the academic performance was based on the overall results of the formative assessments. Results: Among the respondents, 84% preferred multimodal style of learning. Out of that, dual, trimodal and quadrimodal styles were preferred by 8.5%, 2.4% and 73.2% respectively. The remaining 16% of the students preferred single mode. Female students had more diverse learning style preferences with several VARK combinations. A large proportion of our students were in the average group in terms of self- confidence and academic performance. Conclusion: Most students in this study preferred multimodal inputs in their learning process. Our study did not reveal any major gender differences in preferred learning styles. The results of selfesteem, learning style preference and academic performance did not have any bearing on each other.

Although antibiotic has been frequently used for the treatment of infection, it has led to the emergence of resistant problem. Plant-derived compounds are alternative source for discovering novel therapeutics. Flavonoid is widely distributed and present in plant kingdom. This compound possessed several pharmacological properties including antibacterial. This review aims to present some information about the potency of flavonoids as antibacterial compound including their mechanism of antibacterial action as well as the relationship between their activity and flavonoid structure. The synergistic effect of flavonoids when used in combination with antibiotics against resistant bacterial is also described. Published literatures were collected from data bases such as PubMed, Google Scholar, Science Direct and Scopus. Scientific papers were selected based on information of antibacterial activity of flavonoid compounds. The information may provide an insight on the potency of flavonoid compounds to overcome resistant problem.