Review on the In Vitro Cytotoxicity Assessment in Accordance to the International Organization for Standardization (ISO)

@#Cytotoxicity is a predominant biological evaluation applied to search for a suitable and non-toxic bioactive compound and to determine the biocompatibility of medical devices-related human body. The broad usage of cytotoxicity tests leads to a robust establishment of cytotoxicity assays with high sensitivity and prompt results. In vitro assays are always prioritized over in vivo due to the reproducible data, reduce numbers of animal used and easily accessible material. Compounds concentration that execute 50% of cell population is determined by calculating the IC50. According to ISO10993, cytotoxicity tests must be performed to determine the biocompatibility of medical devices that has contact with human body. This is crucial to ensure the safety of research and its clinical use. Under the recommendation of ISO10995-Part 5, three categories of tests have been documented; extract elution, direct contact and indirect contact test. Each category plays significant role depending on the nature of experiment and sample used.

Evaluation of beak and feather disease virus, avian polyomavirus and avian papillomavirus of captives psittacine birds in Seri Kembangan, Selangor, Malaysia

Aims@#Psittacine birds such as parrots, macaws, cockatoos, lovebirds and parakeets, are widely reared as household pets or at aviary due to their attractive features. However, the status of virus-causing diseases of psittacine species in Malaysia is fairly under-documented. Therefore, this study was aimed to detect the presence of three common avian viruses that infect psittacine birds, i.e. beak and feather disease virus (BFDV), avian polyomavirus and avian papillomavirus. @*Methodology and results@#Faecal samples from twelve asymptomatic captive psittacine birds of different species were collected from an undisclosed animal garden in Serdang, Selangor, Malaysia. Briefly, the sample was homogenised and resuspended with SM buffer with the ratio 1:1 (weight of sample/g: volume of SM buffer/mL) before centrifugation at 1,000 × g for 20 min. The supernatant was collected and filtered before subjected to genomic DNA extraction using a commercialised kit. Polymerase chain reaction (PCR) technique was used to screen the V1, VP1 and L1 genes of beak and feather disease virus (BFDV), avian polyomavirus and avian papillomavirus, respectively. Findings revealed that the samples were negative for BFDV and avian polyomavirus. However, positive results of 1.5 kbp PCR amplicon were detected for avian papillomavirus in four out of the 12 samples (33.33%), which was from the white-crested cockatoo, African grey parrot, yellow-collared macaw and Senegal parrot. Sequence analysis of the L1 gene from the Senegal parrot Poicephalus senegalus revealed 93% identity to a reference Psittacus erithacus timneh avian papillomavirus.@*Conclusion, significance and impact of study@#This study added to the limited prevalence data of three important avian viruses which infect captive psittacines in Seri Kembangan, Selangor, Malaysia. Avian papillomavirus, but not BFDV and avian polyomavirus, was detected in the collected captive psittacine birds. Therefore, a routine screening can be performed to monitor the health status of birds despite their asymptomatic manifestation, in order to prevent possible virus transmission.

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.

Boarding School: A Simple Approach To Reduce Soil Transmitted Helminth Infections In Orang Asli Children Of Sungai Siput, Perak, 2017

@#Soil transmitted helminth (STH) infection is a major public health concern among the indigenous children of Malaysia. Precarious living conditions at home including unavailability of water, drinking of contaminated water, poor sanitation and livestock presence, are known risk factors for the infection. In order to provide better living conditions, these children are enrolled in boarding schools. This study was conducted to determine whether boarding schools is a solution in reducing soil transmitted helminth infection among Orang Asli children in Sg Siput, Perak, Malaysia. An analytical cross-sectional study was conducted among 204 schoolchildren aged 7-17 years from three boarding schools in Sungai Siput, Perak from January to March 2017. Stool samples were collected and examined using direct smear and Kato-Katz technique. Information on sociodemographic and environmental conditions were collected using a modified Demographic Health Survey (DHS) questionnaire. Data analysis was done using IBM SPSS Statistics Processor 20.0.Out of a total of 204 children, only 48% (n= 97) were infected with at least one type of STH species which showed a reduced prevalence as compared to previous studies conducted among home dwelling schoolchildren with overall prevalence of 78-97%. Majority of the children had monoparasitism (31%; n=63) with moderate intensity by T trichuira (n=51, 25%). Univariate analysis shows that unavailability of water at home has a statistically significant association with STH infection among boarding school children (OR=0.73; 95% CI= 0.56-0.95 p=0.021). Multivariate analysis proves children who had unavailability of water at home has 2.1 times more likelihood of getting an STH infection (OR= 2.08; 95%CI= 1.07-4.07; p= 0.032).This study demonstrates a reduced STH prevalence among Orang Asli boarding school children as better living condition there limits the spread of STH infection among them.

A review of smell and taste dysfunction in COVID-19 patients

@#and taste loss were early subclinical symptoms of COVID-19patients. The objective of this review was to identify theincidence of smell and taste dysfunction in COVID-19,determine the onset of their symptoms and the risk factorsof anosmia, hyposmia, ageusia or dysgeusia for COVID-19infection.Methods: We searched the PubMed and Google Scholar on15th May 2020, with search terms including SARS-COV-2,coronavirus, COVID-19, hyposmia, anosmia, ageusia anddysgeusia. The articles included were cross sectionalstudies, observational studies and retrospective orprospective audits, letters to editor and shortcommunications that included a study of a cohort ofpatients. Case reports, case-series and interventionalstudies were excluded. Discussion: A total of 16 studies were selected. Incidence ofsmell and taste dysfunction was higher in Europe (34 to86%), North America (19 to 71%) and the Middle East (36 to98%) when compared to the Asian cohorts (11 to 15%) inCOVID-19 positive patients. Incidence of smell and tastedysfunction in COVID-19 negative patients was low incomparison (12 to 27%). Total incidence of smell and tastedysfunction from COVID-19 positive and negative patientsfrom seven studies was 20% and 10% respectively.Symptoms may appear just before, concomitantly, orimmediately after the onset of the usual symptoms. Occurspredominantly in females. When occurring immediately afterthe onset of the usual symptoms, the median time of onsetwas 3.3 to 4.4 days. Symptoms persist for a period of sevento 14 days. Patients with smell and taste dysfunction werereported to have a six to ten-fold odds of having COVID-19.Conclusion: Smell and taste dysfunction has a highincidence in Europe, North America, and the Middle East.The incidence was lower in the Asia region. It is a strong riskfactor for COVID-19. It may be the only symptom and shouldbe added to the list of symptoms when screening for COVID-19.KEYW

Management of Atopic Eczema in primary care

@#Introduction: Atopic eczema (AE) is a common infammatory skin dermatosis that is increasing in prevalence. However, it can present in various clinical presentations, which leads to challenges in the diagnosis and treatment of the condition, especially in a primary care setting. Te Clinical Practice Guidelines on the Management of Atopic Eczema was developed by a multidisciplinary development group and approved by the Ministry of Health Malaysia in 2018. It covers the aspects of diagnosis, severity assessment, treatment, and referral.

Detection and distribution of putative pathogenicity-associated genes among serologically important Leptospira strains and post-flood environmental isolates in Malaysia

@#Aims: Leptospirosis is an infectious disease that is endemic to many tropical regions. Large epidemics usually happen after heavy rainfall and flooding. This potentially fatal zoonosis is caused by pathogenic bacteria belonging to the genus Leptospira. Leptospirosis can be diagnosed using specific biomarkers such as target genes and virulence indicators that are well preserved across various Leptospira spp., including those that are prevalent in clinical samples and in the environment. To date, several pathogenicity-determinant genes, including lipL32 and lipL41, have been described and used for diagnosing leptospirosis. However, prevalence of these genes in leptospiral strains is unclear. Methodology and results: In the present study, we assessed the distribution of eight pathogenicity-determinant genes in reference Leptospira strains and environmental isolates in Malaysia, by polymerase chain reaction (PCR). We found that only lipL32 and ligB were consistently expressed in all pathogenic Leptospira strains compared with the other tested genes. Moreover, our results suggested that the use of lipL41, lipL21, ompL1, lfb1, ligA, and ligC as biomarkers could incorrectly misdetect pathogenic Leptospira strains present in the environment. Conclusion: Thus, our results suggest that the pathogenicity-determinant genes lipL32 and ligB can be used as biomarkers for detection pathogenic Leptospira

A Systematic Review on the Intervention Using Exercise Gaming to reduce Childhood Obesity

@#The worsening trend of childhood obesity is a global public health issue. Digital technology evolution is a contributing factor towards physical inactivity and obesity among children. In order to overcome this growing problem, exercise games have been introduced in early eighties to ameliorate this obesogenic environment. Exercise games utilize innovative technologies that provide an interactive environment, requiring gestures and body movements to simulate on-screen gameplay. The objective of this review is to assess the effectiveness of exercise gaming intervention in managing childhood obesity. A systematic review was performed. Six articles examining exercise video games impact on weight management among children published between January 2013 and December 2017 in the English language were selected from a total of 54 articles identified through five major search engines. Majority of the researchwas conducted in developed countries particularly in the United States whereby some developing countries had started with small-scale researches in this area. The result indicated that there was a significant increase in physical activity level, reduction of BMI, reduced adipose tissue composition and a positive psychological impact after the intervention of exercise games. However, the impact of exercise games on physiological and metabolic parameters were inconclusive and requires further study. In conclusion, exercise games are the effective way to combat childhood obesity, along with other modules of lifestyle.

Management of diabetes in pregnancy in primary care

@#Diabetes in pregnancy is associated with risks to the woman and her developing fetus. Management of the condition at the primary care level includes pre-conception care, screening, diagnosis, as well as antenatal and postpartum care. A multidisciplinary approach is essential in ensuring its holistic management.

Hyperlipidemia and hyper glycaemia in breast cancer Patients is related to disease stage

Objective: The study was designed to determine the hyperlipidemia in breast cancer of patients at disease presentation, without any treatment and to correlate these variations with disease stage

Methods: This cross sectional study was conducted at Liaquat National teaching hospital in Karachi from 2006 to 2011, Age and family history of 208 breast cancer patients with infiltrating Ductal Carcinoma were compared with 176 matched control subjects. Married females were selected, with children and short breast feeding period. Cancer stage I-III was considered for the study and patients were grouped on the basis of Tumor grade, Tumor size, lymph node metastasis and disease free survival. Disease staging was based on tumor size and lymph node metastasis. Biochemical estimations included variations in random blood glucose level and lipid profile

Results: Lipid profile and random blood glucose level were found significantly high [p<0.05] compared to control subjects. Hyperlipidemia was significantly high in breast cancer patients with lymph node metastasis. On increase in tumor grade I to II, increase in total cholesterol [4%], LDL-cholesterol 23% and 11% increase in triglycerides was observed. On Tumor size increase from

Conclusion: Study suggests that variation in lipid profile and blood random glucose level is associated with disease stage. No independent correlation of hyperlipidemia and hyperglycemia was developed with disease free survival

Management of asthma in adults in primary care

@#Asthma is a chronic inflammatory disease of the airway which is often misdiagnosed and undertreated. Early diagnosis and vigilant asthma control are crucial to preventing permanent airway damage, improving quality of life and reducing healthcare burdens. The key approaches to asthma management should include patient empowerment through health education and selfmanagement and, an effective patient-healthcare provider partnership.

Attachment, Proliferation, and Morphological Properties of Human Dermal Fibroblasts

Introduction: Collagen type I is widely used as a biomaterial for tissue-engineered substitutes. This study aimed to fabricate different three-dimensional (3D) scaffolds using ovine tendon collagen type I (OTC-I), and compare the attachment, proliferation and morphological features of human dermal fibroblasts (HDF) on the scaffolds. Methods: This study was conducted between the years 2014 to 2016 at the Tissue Engineering Centre, UKM Medical Centre. OTC-I was extracted from ovine tendon, and fabricated into 3D scaffolds in the form of sponge, hydrogel and film. A polystyrene surface coated with OTC-I was used as the 2D culture condition. Genipin was used to crosslink the OTC-I. A noncoated polystyrene surface was used as a control. The mechanical strength of OTC-I scaffolds was evaluated. Attachment, proliferation and morphological features of HDF were assessed and compared between conditions. Results: The mechanical strength of OTC-I sponge was significantly higher than that of the other scaffolds. OTC-I scaffolds and the coated surface significantly enhanced HDF attachment and proliferation compared to the control, but no differences were observed between the scaffolds and coated surface. In contrast, the morphological features of HDF including spreading, filopodia, lamellipodia and actin cytoskeletal formation differed between conditions. Conclusion: OTC-I can be moulded into various scaffolds that are biocompatible and thus could be suitable as scaffolds for developing tissue substitutes for clinical applications and in vitro tissue models. However, further study is required to determine the effect of morphological properties on the functional and molecular properties of HDF.

Electrospun Collagen Nanofibers and Their Applications in Skin Tissue Engineering

Electrospinning is a simple and versatile technique to fabricate continuous fibers with diameter ranging from micrometers to a few nanometers. To date, the number of polymers that have been electrospun has exceeded 200. In recent years, electrospinning has become one of the most popular scaffold fabrication techniques to prepare nanofiber mesh for tissue engineering applications. Collagen, the most abundant extracellular matrix protein in the human body, has been electrospun to fabricate biomimetic scaffolds that imitate the architecture of native human tissues. As collagen nanofibers are mechanically weak in nature, it is commonly cross-linked or blended with synthetic polymers to improve the mechanical strength without compromising the biological activity. Electrospun collagen nanofiber mesh has high surface area to volume ratio, tunable diameter and porosity, and excellent biological activity to regulate cell function and tissue formation. Due to these advantages, collagen nanofibers have been tested for the regeneration of a myriad of tissues and organs. In this review, we gave an overview of electrospinning, encompassing the history, the instrument settings, the spinning process and the parameters that affect fiber formation, with emphasis given to collagen nanofibers' fabrication and application, especially the use of collagen nanofibers in skin tissue engineering.

Management of malodour fungating wound with nanocrystalline silver coated dressing

Chronic exudative malodorous fungating wound of four years at the right arm due to diffuse large B cell lymphoma managed with silver dressings. In two months of application with nanocrystalline silver coated dressings, there was significant improvement in wound.

Cytotoxic, Anti-Inflammatory and Adipogenic Effects of Inophyllum D, Calanone, Isocordato-oblongic acid, and Morelloflavone on Cell Lines

This paper reports in vitro cytotoxic, anti-inflammatory and adipocyte diffentiation with adipogenic effects of coumarins inophyllum D (1) and calanone (2), and a chromanone carboxylic acid namely isocordato-oblongic acid (3) isolated from Calophyllum symingtonianum as well as a biflavonoid morelloflavon e (4) isolated from Garcinia prainiana on MCF-7 breast adenocarcinoma RAW 264.7 macrophages and 3T3-L1 preadipocytes cells, respectively. The cytotoxicity study on MCF-7 cell was conducted by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Meanwhile, the study of anti-inflammatory effects in RAW 264.7 macrophages and adipogenic effects on 3T3-L1 pre-adipocytes were conducted through nitrite determination assay and induction of adipocyte differentiation, respectively. In the cytotoxicity study, inophyllum D (1) was the only compounds that exhibited significant cytotoxic effect against MCF-7 cell with IC₅₀ of 84 µg/mL. Further, all by inhibiting the compounds have shown anti-inflammatory effects in lipopolysaccharide (LPS)-induced RAW 264.7 macrophages of nitrite concentration with production. In addition, the compounds also exhibited adipogenic effects on 3T3-L1 pre-adipocytes by stimulating lipid formation. Thus, this study may provide significant input in discovery of the potential effects cytotoxic, anti-inflammatory and adipogenic agents.

Recent Updates in Neuroprotective and Neuroregenerative Potential of Centella asiatica

Centella asiatica, locally well known in Malaysia as pegaga, is a traditional herb that has been used widely in Ayurvedic medicine, traditional Chinese medicine, and in the traditional medicine of other Southeast Asian countries including Malaysia. Although consumption of the plant is indicated for various illnesses, its potential neuroprotective properties have been well studied and documented. In addition to past studies, recent studies also discovered and/or reconfirmed that C. asiatica acts as an antioxidant, reducing the effect of oxidative stress in vitro and in vivo. At the in vitro level, C. asiatica promotes dendrite arborisation and elongation, and also protects the neurons from apoptosis. In vivo studies have shown that the whole extract and also individual compounds of C. asiatica have a protective effect against various neurological diseases. Most of the in vivo studies on neuroprotective effects have focused on Alzheimer’s disease, Parkinson’s disease, learning and memory enhancement, neurotoxicity and other mental illnesses such as depression and anxiety, and epilepsy. Recent studies have embarked on finding the molecular mechanism of neuroprotection by C. asiatica extract. However, the capability of C. asiatica in enhancing neuroregeneration has not been studied much and is limited to the regeneration of crushed sciatic nerves and protection from neuronal injury in hypoxia conditions. More studies are still needed to identify the compounds and the mechanism of action of C. asiatica that are particularly involved in neuroprotection and neuroregeneration. Furthermore, the extraction method, biochemical profile and dosage information of the C. asiatica extract need to be standardised to enhance the economic value of this traditional herb and to accelerate the entry of C. asiatica extracts into modern medicine.

Expression of mesenchymal stem cell phenotype in human nasal respiratory epithelial cells / Expresión del fenotipo de células troncales mesenquimales en células epiteliales nasales humanas

The respiratory epithelium is the first line of contact with the external hazards. Thus it can be damaged and need to be replaced to avoid healing by fibrosis. Tracheal tissue engineering is an alternative promising treatment modality. Mesenchymal stem cell markers are surface proteins, which are responsible for some of these cells unique properties. The objective of this study was to detect the mesenchymal stem cell phenotype among the human nasal respiratory epithelial cells via two immunophenotyping techniques. Respiratory epithelial cells were cultured using co-culture technique, fibroblasts was removed at confluence leaving respiratory epithelial cells, which were passage further to passage 4. Cells were evaluated for mesenchymal stem cell markers that were CD73, CD90, CD105 and the hematopoietic stem cell marker CD45 at passage 1 (P1) and passage 4 (P4) using Flow cytometry and Immunocytochemistry techniques. Respiratory epithelial cells expressed the mesenchymal stem cell markers at P1 and maintain the expression these markers until P4. Using both techniques, to compare the values of mesenchymal stem cell markers expression at P1 to P4 there was no significant difference. This study indicates that respiratory epithelial cells derived from nasal turbinate retain some of mesenchymal stem cells properties even after serial passages. Both methods of Immunophenotyping are comparable.

El epitelio respiratorio es la primera línea de contacto con los peligros externos. Por lo tanto, puede ser dañado y necesita ser reemplazado para evitar uan cicatrización por fibrosis. La ingeniería de tejidos traqueales es una modalidad de tratamiento alternativo prometedora. Los marcadores de células troncales mesenquimales son proteínas de superficie, que son responsables de algunas propiedades únicas de estas células. El objetivo fue detectar el fenotipo de células troncales mesenquimales entre las células epiteliales respiratorias nasales humanas a través de dos técnicas de inmunofenotipaje. Fueron cultivadas las células epiteliales respiratorias utilizando la técnica de co-cultivo; los fibroblastos se eliminaron en la confluencia dejando solo células epiteliales respiratorias, resultantes de los 4 pasajes. Las células fueron evaluadas para encontrar marcadores de células troncales mesenquimales mediante CD73, CD90, CD105 y el marcador de células troncales hematopoyéticas CD45 en el paso 1 (P1) y el paso 4 (P4), usando citometría de flujo y técnicas de inmunocitoquímica. Las células epiteliales respiratorias expresaron los marcadores de células troncales mesenquimales en P1 y mantuvieron la expresión de estos marcadores hasta P4. No hubo diferencias significativas en el uso de ambas técnicas al comparar los valores de los marcadores de células troncales mesenquimales expresadas desde P1 a P4. Este estudio indica que las células epiteliales respiratorias derivadas de la concha nasal retienen algunas de las propiedades de células troncales mesenquimales, incluso después de pases seriados. Ambos métodos de inmunofenotipificación son comparables.

Technology Advancement Enabling the Link of Gut Microbiota with Obesity and Metabolic Disorder / Jurnal Sains Kesihatan Malaysia

Obesity is a growing epidemic due to an accelerated phase of industrialization and urbanization with the overfed people now outnumbered the underfed. It is the major public health problem with a lot of research interest as it is associated with many complicated chronic disorders such as type-2 diabetes, cardiovascular diseases (CVD) and cancers. A global estimation of 2.8 million deaths per year is due to obesity and there are tremendous on-going efforts to identify hosts and environmental factors that infl uence the cause and pathogenesis of obesity. Concerted efforts from different research groups had successfully shown that obese subjects have altered composition of gut microbiota and transplantation of this microbiota infl uences body weight in the germ-free recipient mice. The advancement of technology had made possible the study of gut microbiota which was unculturable for better understanding of their impact to human health. Rapid deep sequencing of DNA at reasonable cost through various options of platforms followed by data analysis using robust bioinformatic tools are an important way of analysing the gut microbiome. Here we review the role of gut microbiota which modulates host’s metabolic functions and gene expression, facilitating the extraction and storage of energy from the ingested dietary substances and leading to body-weight gain. We will discuss on the different techniques used, focusing on the high-defi nition technologies for the determination of the composition, function and ecology of gut microbiota. This allows the appropriate selection of platform which becomes the key for success of subsequent research.

Analysis of Onion Benefi ts Toward Health from the Perspective of Islamic Medical Scholar and Scientifi c Reasearch / Jurnal Sains Kesihatan Malaysia

Scientifi cally known as Allium Cepa L., onion is a plant which contains various benefi ts and has been used as food and medicine over the years by many nations and races. This research is conducted to identify the benefi ts of onion for human body from the perspectives of Islamic medical scholars and scientifi c research. The literature data for this study has been collected from four Islamic medical books and 14 articles of a variety of related journals. The cumulative data has been analysed by using Nvivo10.0 to identify emerging suitable categories and subsequently generate the fi ndings. The fi ndings of this study discovered that there are at least 17 benefi ts of onion. This includes six which are based on the perspectives of Islamic scholars which are to treat epiphora, to treat ear problems, to medicate infections from dog bites, to neutralize poisons, to stimulate sexual desire and to treat water-borne diseases. Another 11 benefi ts identifi ed in the scientifi c researches include its potential as an antiplatelet agent, anti-fat formation agent, antioxidant agent, antithrombotic agent, anticarcinogen agent, antidepressant agent, antiinfl ammatory agent, antiasthmatic agent, and antibiotic agent, as well as it helps decrease hyperglicemia levels and reduce the risk of atherosclerosis. Thus, this study suggest that onion should be highlighted as one of organic treatment/remedy as well as an alternative to conventional treatment.