Endophytic Bacillus amyloliquefaciens surfactin possesses anti-inflammatory potential through acetylcholinesterase and lipoxygenase inhibitory activities

Aims@#This study was aimed to investigate the anti-inflammatory and anti-rheumatoid effects of the Bacillus amyloliquefaciens derived surfactin.@*Methodology and results@#Crude and biosurfactant extracts were analyzed using thin-layer chromatography to determine the presence of biosurfactant. Both extracts were evaluated for their inhibitory effects against the acetylcholinesterase and 5-lipoxygenase enzymes. Human synovial cells were induced with TNF-α and IL-1β. The percentages of the cell viability for both normal and induced cells were determined with an MTT assay. Results showed that surfactin was detected in the biosurfactant extract and demonstrated higher inhibitory effects compared to the crude extract against both inhibitory enzymes acetylcholinesterse (IC50=30.60 μg/mL) and lipoxygenase (IC50=110.10 μg/mL). Both crudes showed no cytotoxic effects at the highest concentration used (50 μg/mL) against normal human synovial cells but showed active reactions against the induced cells. The anti-proliferative effects of biosurfactant and crude extracts were in dose-dependent manner.@*Conclusion, significance and impact of study@#Notably, surfactin obtained from B. amyloliquefaciens has shown an inhibitory effect against pro-inflammatory enzymes and cell viability of the induced rheumatoid arthritis cell line. These results highlighted the therapeutic potential of surfactin application as an anti-inflammatory agent for arthritis treatment. Further study is needed to elucidate the mechanisms underlying the anti-inflammatory effect of surfactin.

Malaysian clinical practice guidelines for management of diabetic foot: A synopsis for the primary care physician

@#Diabetic foot requires careful attention and coordinated management by a dedicated team. Screening, prevention, adequate assessment, and appropriate referral are crucial to prevent complications. Multimodal treatment and rehabilitation are recommended to ensure a better quality of life and reduction of amputation rate in people with diabetic foot.

Food Insecurity Situation In Malaysia: Findings From Malaysian Adult Nutrition Survey (MANS) 2014

@#Food insecurity affects food intake, and it could prevent an individual from consuming enough nutritious food to support and maintain health. The aim of this paper is to determine the prevalence and factors influencing food insecurity among Malaysian households. In 2014, the Malaysian Adult Nutrition Survey (MANS) was carried out, and one of the components measured was food insecurity. Six out of sixteen questions from the food security core-module questionnaire were adopted and answered by 2962 adults. The results showed that about 25.0% adult experienced food quantity insufficiency, 25.5% had food variety insufficiency, 21.9% practised reduced size of the meal, and 15.2% skipped main meal due to lack of money to spend on. For the parents, 23.7% only rely on cheap food to feed children, and 20.8% could not afford to purchase various foods to feed their children. Location, strata, race, level of education, working status and household income shows significant difference while none of the nutritional status components found to be difference in all six parameters of food insecurity measured. Logistic regression with adjusted odds ratios discovered race, education level and household income were related to risk to all six parameters of food insecurity. In conclusion, food insecurity can be a serious problem in Malaysia. An effective and comprehensive effort by the government in terms of policy solution is required to increase education level and ensure an adequate income for every household. Therefore, future research should focus on some of those promising policy solutions and at the same time, study the other possible underlying factors that may lead to food insecurity.

Anticancer effect of Psidium guajava (Guava) leaf extracts against colorectal cancer through inhibition of angiogenesis

Objective: To evaluate the anti-angiogenic and anticancer activities of Psidium guajava leaf extracts against angiogenesis-dependent colorectal cancer. Methods: Three extracts were produced using distilled water, ethanol, and n-hexane as solvents. The extracts were physically characterised through gas chromatography-mass spectrometry, ultraviolet-visible spectroscopy, and Fourier transform infrared spectroscopy. Their antioxidant activity was evaluated using the 2,2-diphenyl-1-picrylhydrazyl, total phenolic content, and total flavonoid content assays. To assess their anti-angiogenic activity, cell viability and rat aortic ring assays were conducted, while cell migration, tube formation, colony formation, and VEGF ELISA assays were conducted to elucidate their effects on different aspects of angiogenesis. Molecular docking was used to assess the anti- angiogenic potential of some possible compounds in the extracts. Tumour spheroid assay was used to assess the extracts' potential as a treatment for colorectal cancer. Results: The ethanol extract showed the best antioxidant activity. The distilled water and ethanol extracts exhibited more inhibitory activity against EA.hy926 cell viability and aortic ring microvessel growth. In addition, the ethanol extract performed significantly better than the distilled water extract against cell migration and colony formation, and VEGF expression of the cells was suppressed by the ethanol extract. Both the distilled water and ethanol extracts showed significant inhibitory effect on EA.hy926 tube formation and tumour spheroids consisting of EA.hy926 and HCT116 cells. The ethanol extract contained β-caryophyllene and β-elemene by phytochemical analysis and subsequent docking studies, which may contribute to its anti-angiogenic activity. Conclusions: The ethanol extract of Psidium guajava has potential in the treatment of colorectal cancer through the inhibition of angiogenesis.

Assessment of patients with thoracic trauma in emergency department

Objective: Thoracic trauma is a common cause of significant morbidity and mortality. The present study presents a series of thoracic trauma and evaluation of epidemiologic features, distribution of pathologies, diagnosis, additional systemic injuries, management and outcome

Materials and Methods: Between May 2016 and April 2017, all patients with thorax trauma admitted to the emergency service of King Abdulaziz hospital were retrospectively reviewed with respect to age, gender, etiological factors, distribution of pathologies, additional systemic injuries, diagnosis, treatment modalities, referral and outcome

Results: A total of 228 patients with thorax trauma were encompassed in the study. Of all the patients, [140] , 61.4% were male and 88 [38.6%] were female. The majority of the patients presented with blunt thoracic trauma [218 of 228 [95.6%]], whereas 10 [4.4%] presented with penetrating injuries. Etiological factors included falls in 158 [69.3%] patients, motor vehicle accidents in 52 [22.8%], animal related accidents in 8 [3.5%] and penetrating injuries in 10 [4.4%]. Among penetrating injuries, 6 [2.6%] were stabbing injuries and 4 [1.8%] were firearm injuries. The patients aged between 16 and 85 [mean 52.2 +/- 16.9] years. The vast majority [69.3%] of the patients aged between 31 and 70 years. Blunt thoracic traumas were observed most frequently in patients aged 51-70 years [36.8%], while penetrating traumas were observed most frequently in those aged 31-50 [32,5%] years

Conclusion: Even though majority of the patients with thorax trauma received treatment as outpatients; thoracic traumas can be a life threatening condition, and should be recognized and treated immediately. Mortality differs based on etiological factors, additional systemic pathologies, capabilities of the hospital especially diagnostic and treatment facilities in emergency services. We believe that a multidisciplinary method to the patients with severe thorax trauma, and the opportunities of emergency bedside thoracotomy in emergency services will significantly decrease the morbidity and mortality

Hyperuricemia: a predictor of in hospital complications in acute coronary syndrome patients

Background:Various studies done in the past few decades have shown association of hyperuricemia with the increase in cardiovascular [CV] mortality

Objective: To determine the association of hyperuricemia and in hospital complications in acute coronary syndrome patients

Methodology: This cohort study was conducted on 154 patients in department of Cardiology Sheikh Zayed Medical College/Hospital, Rahim Yar Khan from 1st January to 30th June 2017. Hyperuricemia was defined as serum uric acid level >/= 7.2 mg/dl in males and serum uric level >/= 6 mg/dl in females.The data collection was started after getting informed consent of the patients admitted through accident and emergency department. Consecutive patients of acute coronary syndrome were selected and those with hyperuricemia were labeled as exposed [Group I] and those with normouricemia were considered as non-exposed [Group II]. The two groups were followed for 7 days and outcome i.e inhospital complications in terms of conduction defect and heart failure were noted as per operational definition. The data were collected on a proforma like age and sex. Effect modifiers like age, sex, family history of ACS, history of T2DM, history of hypertension, smoking and BMI were stratified to see the impact of these on outcomes. Chi square test were applied to determine the association of hyperuricemia with in hospital complications like conduction defect and heart failure. P value . 5% was taken as significant

Results: Among the total study subjects [n=154], 100[65%] were male and 54[35%] were female. The mean age and BMI of Group I [ACS with hyperuricemia] and Group II [ACS without hyperuricemia] were 65+/- 2 years vs. 62+/-11 years and BMI 27+/- 3.2 vs 25+/- 2.8 respectively. Out of 154 patients, 28 [18.1%] have conduction defect and only 40[26%] patients suffered heart failure. From these 28 patients with conduction defects, 19 [24.6%] were with ACS and hyperuricemia and 09[11.6%] were with ACS without hyperuricemia. From these 40 patients with heart failure,33 [42.8%]were with ACS and hyperuricemia and 07 [9%] were with ACS without hyperuricemia

Conclusion: This study showed that in-hospital complications were significantly higher in patients with ACS with hyperuricemia as compared to patients with ACS without hyperuricemia

Role of Percutaneous Radiofrequency Rhizotomy for atypical facial pain syndrome

Background: Atypical facial Pain is a debilitating condition characterized by stabbing, burning and dysesthetic sensation. With a variety of underlying causes neurosurgeons has struggled to find its effective treatments. Surgical options available for the treatment of atypical fascial pain are radiofrequency Rhizotomy, glycerol Rhizotomy and balloon compression. Radiofrequency Rhizotomy is currently use in Pakistan. Studies have shown that it is less costly with minimal complication rate as compared with the other surgical interventions. But up till now, no study has been conducted in Pakistan to assess its efficacy

Objective: The objective of this study was to determine the effectiveness of RFR for atypical facial pain syndrome in terms of complete pain relief

Study Design: It is a descriptive case series. Period of study: One year from 01-12-2016 to 30-11-2017

Place of Study: Department of Neurosurgery Lahore General Hospital [LGH] Lahore

Methods: The objective of this study was to determine the effectiveness of RFR for Atypical Facial Pain syndrome in terms of complete pain relief. It is a descriptive case Series. Research was conducted at Department of Neurosurgery, Lahore General Hospital Lahore. Duration of study was 1 year. This study involved 38 patients of both genders aged between 35 to 75 years diagnosed case of Atypical fascial pain syndrome for more than 12 months. All the patients were assessed per operatively according to functional pain score

Results: The mean age of the patients was 49.47+/-11.92 years and there were 15 [39.5 percent] male and 23 [60.5 percent] female patients in the study group. Most of the patients were aged between 30-40 years [28.9 percent]. The duration of pain ranged from 7 months to 15 months with a mean of 10.74+/-2.34 months. The functional pain score before the treatment ranged from 2 to 5 with a mean of 3.84+/-1.00 while the function pain score after treatment ranged from 0-3 with a mean of 1.50+/-.73. The frequency of patients with pain relief was 47.4 percent

Conclusion: Pain relief was observed in 18 [47.4 percent] patients, 6 weeks after treatment. The frequency of pain relief was insignificantly lower with increasing duration and severity of pain at admission

Effect of an Education Programme on Cardiovascular Health Index among Patients with Myocardial Infarction: A Preliminary Study

Introduction: Health education is an essential part of controlling the risk of myocardial infarction (MI). This study evaluates the effects of one-on-one education programmes on the cardiovascular health index among patients with MI.Methods: A quasi-experimental study was conducted in Kuala Lumpur Hospital, Malaysia. Data were collected from November 2014 to January 2015 with a total of 58 respondents who met the inclusion criteria. The respondents received a 20-min one-on-one education programme regarding coronary heart disease, treatment and prevention, and healthy lifestyle. A questionnaire comprising demographic data was administered and the cardiovascular health index was measured before and after four weeks of the education programme. Data were analysed with descriptive and inferential statistics.Results: There were statistically significant decreases in the score of anxiety, stress, depression, body mass index, and smoking status (P < 0.001) between pre-test and post-test.Conclusion: The findings suggest that the one-on-one education programme could improve the cardiovascular health index of patients with MI. Furthermore, nurses need to develop and implement a standard education structure programme for patients with MI to improve health outcomes.

Magnetic iron oxide nanoparticles as T[2] MR imaging contrast agent for detection of breast cancer [MCF-7] cell

Background: Advances of nanotechnology have led to the development of nanomaterials with both potential diagnostic and therapeutic applications. Among them, Super Paramagnetic Iron Oxide Nanoparticles [SPIONs] have received particular attention. Modified EDC coupling fraction was used to fabricate the SPION-C595 as an MR imaging contrast agent for breast cancer detection in early stages

Methods: Nanoprobe characterization was confirmed using Fourier Transform Infrared Spectroscopy [FT-IR], Scanning Electron Microscopy with Energy Dispersive X-Ray Spectroscopy [SEM-EDAX], and Photon Correlation Spectroscopy [PCS]. Protein and iron concentration of nanoprobe was examined by standard method. MTT assay was performed to evaluate the cytotoxicity of the nanoprobe in breast cancer cell line [MCF-7]. T[2]-weighted MR imaging was performed to evaluate the signal enhancement on T[2] relaxation time of nanoprobe using spin-echo pulse sequence

Results: As results showed, SPIONs-C595 provided active targeting of breast cancer cell [MCF-7] at a final concentration of 600 micro gFe/ml. The final concentration of protein was calculated to be at 0.78 micro gprotein/ml. The hydrodynamic size of the nanoprobe was 87.4+/-0.7 nm. The MR imaging results showed a good reduction of T[2] relaxation rates for the highest dose of SPIONs-C595

Discussion: Based on the results, SPIONs-C595 nanoprobe has a potential in T[2]- weighted MR imaging contrast agent for breast cancer cell [MCF-7] detection

In vitro study of SPIONs-C595 as molecular imaging probe for specific breast cancer [MCF-7] cells detection

Background: Magnetic resonance imaging [MRI] plays an essential role in molecular imaging by delivering the contrast agent into targeted cancer cells. The aim of this study was to evaluate the C595 monoclonal antibody conjugated super paramagnetic iron oxide nanoparticles [SPIONs-C595] for the detection of breast cancer cell [MCF-7]

Methods: The conjugation of monoclonal antibody and nanoparticles was confirmed using X-ray diffraction, transmission electron microscopy, and photon correlation spectroscopy. The selectivity of the nanoprobe for breast cancer cells [MCF-7] was obtained by Prussian blue, atomic emission spectroscopy, and MRI relaxometry

Results: The in vitro MRI showed that T2 relaxation time will be reduced 76% when using T2-weighed magnetic resonance images compared to the control group [untreated cells] at the dose of 200 micro g Fe/ml, as the optimum dose. In addition, the results showed the high uptake of nanoprobe into MCF-7 cancer cells

Conclusion: The SPIONs-C595 nanoprobe has potential for the detection of specific breast cancer

Mesua ferrea stem bark extract induces apoptosis and inhibits metastasis in human colorectal carcinoma HCT 116 cells, through modulation of multiple cell signalling pathways / 中国天然药物

Considering the great potential of natural products as anticancer agents, the present study was designed to explore the molecular mechanisms responsible for anticancer activities of Mesua ferrea stem bark extract against human colorectal carcinoma. Based on MTT assay results, bioactive sub-fraction (SF-3) was selected for further studies using HCT 116 cells. Repeated column chromatography resulted in isolation of less active α-amyrin from SF-3, which was identified and characterized by GC-MS and HPLC methods. α-amyrin and betulinic acid contents of SF-3 were measured by HPLC methods. Fluorescent assays revealed characteristic apoptotic features, including cell shrinkage, nuclear condensation, and marked decrease in mitochondrial membrane potential in SF-3 treated cells. In addition, increased levels of caspases-9 and -3/7 levels were also observed in SF-3 treated cells. SF-3 showed promising antimetastatic properties in multiple in vitro assays. Multi-pathway analysis revealed significant down-regulation of WNT, HIF-1α, and EGFR with simultaneous up-regulation of p53, Myc/Max, and TGF-β signalling pathways in SF-3 treated cells. In addition, promising growth inhibitory effects were observed in SF-3 treated HCT 116 tumour spheroids, which give a hint about in vivo antitumor efficacy of SF-3 phytoconstituents. In conclusion, these results demonstrated that anticancer effects of SF-3 towards colon cancer are through modulation of multiple molecular pathways.

Prevalence and Predictors of Intestinal Worm Infections Among Semai Aboriginal Tribe School Children in Tapah, Malaysia

Introduction: Worm infection is one of the major global public health problems especially among rural communities. Objectives: to determine the prevalence of intestinal worm infection and factors associated among Semai Aboriginal children aged between 6 to 13 years in Tapah, Malaysia. Methods: A cross-sectional study design was used in this study. The estimated sample size was 508. Data was collected using a validated pretested questionnaire. Faecal samples were also examined. Data was analysed using SPSS version 22. Results: The response rate was 80.9%. The overall mean age of the 411 respondents was 10.1 years(95% CI = 9.89, 10.22). Majority (71.5%) were poor. Prevalence of intestinal worm infections was 60.8% and 57.2% had multiple infections. The multiple logistic regression analysis showed that those with poor hygiene practices were 2.18 times the odds of worm infection when compared with children with good hygiene practices (95% CI = 1.4, 3.4). Similarly, poor attitudes towards prevention of worm infection increased the odds of having worm infection by 1.62 times among Orang Asli children. Children living without toilets had 2.45 times higher odds as compared with those who had proper toilets. Absence of river near by these areas where there is no safe water supply also increases the risk of worm infection among children by 1.84 times among Orang Asli children. Conclusions: the prevalence of worm infection is still very high among rural Aboriginal community. Current control measures should be reassessed to enable introduction of effective measures to reduce the worm infection among Orang Asli children.

The Impact of Life Style and Nutritional Components in Primary Prevention of Colorectal Cancer.

Colorectal cancer (CRC) is one of the most aggressive malignant solid tumors which remain a rampant killer across the world. Toxic drugs have failed to reduce the morbidity and mortality rate of CRC patients. In addition, adoption of cancer-causing behaviors has increased the globule burden of CRC. Inappropriate lifestyle such as, smoking, obesity, physical inactivity, alcohol consumption and poor dietary components, all of which have been reported to aggravate the CRC incidence worldwide. In this regard, there is a growing awareness and increasing interest in cancer prevention approaches focusing on environmental and behavioral interventions, where specific carcinogenic factors implicated in cancer initiation, promotion, and progression may be triggered. In this communication, we report the role of lifestyle patterns and nutritional components in the modulation of CRC, and discuss the possible biological mechanism which involves in CRC pathogenesis. The findings indicate that smoking and alcohol consumption release a wide range of carcinogenic compounds such as, polynuclear aromatic hydrocarbons and acetaldehyde which can cause DNA damage and alter the function of tumor suppressor genes. Moreover, the link between obesity and CRC has been detected in several studies, whereby obesity induces insulin resistance and hyperglycemia, resulted in NF-κB and IGF-1 activation. In contrast, an inverse association between physical activity and cancer incidence has been constantly observed; the risk of CRC has been reduced 10-60% in the regular physical activity. With respect to nutritional components, compelling evidence indicates that avoidance of high intake of processed red meat, highly refined grains, starches, sugar and salt, and replacing them with poultry, fish, unrefined grains, legumes, vegetables, and fruits are strongly associated with lower risks of CRC.

Anti-encystment and amoebicidal activity of Lonicera japonica Thunb. and its major constituent chlorogenic acid in vitro

Objective To examine the acanthamoebicidal effects of ethyl acetate, aqueous and butanol fractions of dried flower buds of Lonicera japonica (L. japonica) Thunb. (Flos Lonicerae) in vitro. Methods Acanthamoeba triangularis isolates were obtained from environmental water samples and identified by PCR. They were exposed to ethyl acetate, water and butanol fractions of L. japonica Thunb. at concentrations ranging from 0.5 mg/mL to 1.5 mg/mL. The extracts were evaluated for growth inhibition at 24, 48 and 72 h, respectively. Chlorogenic acid at a concentration of 1 mg/mL was examined for inhibition of encystment. Results Ethyl acetate fraction at a concentration of 1.5 mg/mL evoked a significant reduction of trophozoite viability by 48.9% after 24 h, 49.2% after 48 h and 33.7% after 72 h chlorogenic acid, the major active constituent of L. japonica Thunb. at the concentration of 1 mg/mL reduced the cysts/trophozoite ratio by 100% after 24 h, 84.0% after 48 h and 72.3% after 72 h. This phenolic compound at concentration of 1 mg/mL concurrent with 0.6% hydrogen peroxide inhibited hydrogen peroxide-induced encystment by 92.8% at 72 h. Conclusions Results obtained from this study show that ethyl acetate fraction at 1.5 mg/mL is the most potent fraction of L. japonica Thunb. and its major constituent chlorogenic acid showed the remarkable inhibition of encystment at a concentration of 1 mg/mL.

Anti-encystment and amoebicidal activity of Lonicera japonica Thunb. and its major constituent chlorogenic acid in vitro

OBJECTIVE@#To examine the acanthamoebicidal effects of ethyl acetate, aqueous and butanol fractions of dried flower buds of Lonicera japonica (L. japonica) Thunb. (Flos Lonicerae) in vitro.@*METHODS@#Acanthamoeba triangularis isolates were obtained from environmental water samples and identified by PCR. They were exposed to ethyl acetate, water and butanol fractions of L. japonica Thunb. at concentrations ranging from 0.5 mg/mL to 1.5 mg/mL. The extracts were evaluated for growth inhibition at 24, 48 and 72 h, respectively. Chlorogenic acid at a concentration of 1 mg/mL was examined for inhibition of encystment.@*RESULTS@#Ethyl acetate fraction at a concentration of 1.5 mg/mL evoked a significant reduction of trophozoite viability by 48.9% after 24 h, 49.2% after 48 h and 33.7% after 72 h chlorogenic acid, the major active constituent of L. japonica Thunb. at the concentration of 1 mg/mL reduced the cysts/trophozoite ratio by 100% after 24 h, 84.0% after 48 h and 72.3% after 72 h. This phenolic compound at concentration of 1 mg/mL concurrent with 0.6% hydrogen peroxide inhibited hydrogen peroxide-induced encystment by 92.8% at 72 h.@*CONCLUSIONS@#Results obtained from this study show that ethyl acetate fraction at 1.5 mg/mL is the most potent fraction of L. japonica Thunb. and its major constituent chlorogenic acid showed the remarkable inhibition of encystment at a concentration of 1 mg/mL.

Extracorporeal shockwave lithotripsy; which parameter determines the outcome: calculus radiodensity or calculus size

To evaluate the effect of urinary calculi attenuation values from non enhanced computed tomography [stone radiodensity] and stone size in determining the outcome of treatment by ESWL. Descriptive case series study. Department of Diagnostic Radiology, Lahore General Hospital Lahore, in collaboration with the Department of Urology, Lahore General Hospital Lahore. Study was carried out over a period of six months from January 2012 to July 2012. Seventy patients with solitary renal calculus of 05 mm - 20 mm size were evaluated for calculus attenuation values in Hounsfield Units on non enhanced computed tomography. Patients were being grouped according to calculus attenuation values as: 1] less than 500 HU [soft] 2] 500-1000 HU [medium] 3] more than 1000 HU [Hard]. Patients were also distributed in three groups according to stone size as: 1] 5-10 mm 2] 11-15 mm 3] 16-20 mm. Patients were being subsequently treated with ESWL. During each ESWL session 3000 shockwaves were given. Stone clearance was documented by USG within three month after start of treatment. Out of 70 patients stones were cleared in 84.3% [n=59] patients. According to the stone density, the rate of stone clearance was 100% [n=19] in group 1, 88.9% [n=27] in group 2 and 66.7% [n=24] in group 3. Regarding the stone size, stones were cleared in 88.9% [n=9] in group 1, 77.4% [n=31] and 90% [n=30] in group 3. The best outcome was in patients with stone diameter of 16-20 mm and a density of < 500 HU. The worst outcome was in patients with stone diameter of 11-15 mm and a density of >1000 HU. The attenuation value of stone has a greater impact on ESWL outcome than the stone size. Further these attenuation values of urinary tract stones before ESWL helps in determining the treatment outcome and in planning alternative treatment in patients with likelihood of poor outcome from ESWL

Common school fears in a sample of primary stage students a comparative study between males and females

Objectives: Detection of common school fears among the students aged [6-9] year olds, detection as well the differences due to age stage and due to gender [Males//Females]

Sample: The study sample consisted of primary school children in the first three rows and their numbers were 268 pupils of males and females between the ages of [6-9] years of private schools and experimental schools

Instruments: The parents social and educational level application [FayzaYousefAbd-El Megeed's preparation], Common School Fears criterion [Researcher]

Results: There are significant differences between average marks of all students in degree of school common fear according to the stage of age [6-9] years in private schools and experimental and at the level of significance 0.01, There are statistically significant differences between the average degrees of all students in the degree of common school fear between males and females in private schools and experimental school and at the level of significance is less than 0.01, There are statistically significant differences between the average degrees of all students in degree of school common fear for different social and educational level for parents [medium-high] in private schools and experimental at the level of significance 0.05, No statistically significant differences between the average degrees of all students in degree of school common fear among private and experimental schools at the students

comparative study between the Montessori curriculum and the developed curriculum of the Egyptian Ministry ofEducation in the capabilities of creative thinking for kindergarten children

Problem: The research studies the comparison in the Capabilities of Creative Thinking of kindergarteners between Montessori's curriculum and the Developed Curriculum of the Egyptian Ministry of Education. The Research's Question was there significant differences in the average total scores in the Capabilities of Creative Thinking between kindergarteners who use the Montessori curriculum and kindergarteners who use the Curriculum of the Egyptian Ministry of Education?

Aim:The research aims to measure the creative capabilities of kindergarteners by using both the Montessori curriculum and the Curriculum of the Egyptian Ministry of Education and to make a comparison between the Montessori curriculum and the Curriculum of the Egyptian Ministry of Education in the Capabilities of Creative Thinking

Methodology: The researcher depended on the Comparative Approach by using two groups, a group of kindergarteners under Montessori's, and another that uses the Curriculum of the Egyptian Ministry of Education

Community: The researcher relayed on 60 children divided into two groups of 30 students each. One group in Montessori's classrooms; and the other in the curriculum of the Egyptian Ministry of Education classrooms

Tools: Goodenough-Harris Draw-a-Person test, to measure the intelligence level, and The Creative Thinking Test by E. Paul Torrance

Statistical Methods: Will be used the value of T-test to find the difference of the averages between the two groups

Results: There are significant statistical differences in the Capabilities of Creative Thinking between kindergarteners in Montessori's curriculum and the Developed Curriculum of the Egyptian Ministry of Education

The 11-item Medication Adherence Reasons Scale: reliability and factorial validity among patients with hypertension in Malaysian primary healthcare settings

<p><b>INTRODUCTION</b>The aim of this study was to assess the reliability and validity of a modified Malaysian version of the Medication Adherence Reasons Scale (MAR-Scale).</p><p><b>METHODS</b>In this cross-sectional study, the 15-item MAR-Scale was administered to 665 patients with hypertension who attended one of the four government primary healthcare clinics in the Hulu Langat and Klang districts of Selangor, Malaysia, between early December 2012 and end-March 2013. The construct validity was examined in two phases. Phase I consisted of translation of the MAR-Scale from English to Malay, a content validity check by an expert panel, a face validity check via a small preliminary test among patients with hypertension, and exploratory factor analysis (EFA). Phase II involved internal consistency reliability calculations and confirmatory factor analysis (CFA).</p><p><b>RESULTS</b>EFA verified five existing factors that were previously identified (i.e. issues with medication management, multiple medications, belief in medication, medication availability, and the patient's forgetfulness and convenience), while CFA extracted four factors (medication availability issues were not extracted). The final modified MAR-Scale model, which had 11 items and a four-factor structure, provided good evidence of convergent and discriminant validities. Cronbach's alpha coefficient was > 0.7, indicating good internal consistency of the items in the construct. The results suggest that the modified MAR-Scale has good internal consistencies and construct validity.</p><p><b>CONCLUSION</b>The validated modified MAR-Scale (Malaysian version) was found to be suitable for use among patients with hypertension receiving treatment in primary healthcare settings. However, the comprehensive measurement of other factors that can also lead to non-adherence requires further exploration.</p>