Kaedah Diagnostik Semasa dan Penggunaan Ujian Titik Penjagaan Pantas (POC) Bagi Mendiagnos Hiperkolesterolemia Famili (FH) (Current Diagnostic Techniques and the Use of Rapid Point-of-Care (POC) Testing to Diagnose Familial Hypercholesterolemia (FH)) / Jurnal Sains Kesihatan Malaysia

@#Familial hypercholesterolemia (FH) is an autosomal dominant inherited genetic disease characterized by increased concentrations of low-density lipoprotein (LDL-C) cholesterol in the blood. The risk of premature coronary heart disease in FH patients may increase without early treatment. Advancement in molecular biology techniques has enable early detection and diagnosis of FH. These techniques are cost-effective and have a shorter turnaround time. The current diagnostic tools available for FH diagnosis involving algorithm-based scoring criteria and various molecular diagnosis methods including next-generation sequencing (NGS), Sanger sequencing, Multiplex ligation-dependent probe amplification (MLPA) and DNA hybridisation assay are discussed in this review. However, molecular genetic testing is not widely available due to time-consuming procedures, high cost and requires trained personnel. Thus, this 36 review highlights the use of point of care (POC) testing as an approach to diagnose FH, particularly in countries lacking infrastructure and expertise in this field. Lateral flow testing (LFA) has gained attention as a POC diagnostic tool due to its simplicity, low cost and involved simple procedure and settings. The advantages of LFA made this technique a potential tool in addressing challenges in diagnosing FH, particularly for early diagnosis of family members.

Cytotoxic Activity of Ethanolic Extract Aquilaria malaccensis Leaves Against MCF-7 Cells

@#Introduction: Aquilaria malaccensis, also known as “Pokok Karas” in Malaysia, is widely used in Southeast Asian countries for the treatment of joint pain, diarrhoea and inflammatory diseases, and has shown beneficial effects as an anticancer agent. The aim of this study was to investigate the effect of ethanol leaf extracts of A. malaccensis on MCF-7 cells. Methods: MTT-based cytotoxic and antiproliferative assay was used to determine the outcome of ethanolic extract toward MCF-7 cells. The mode of cell death was determined by the AO/PI double staining assay and the depolarisation of the mitochondria membrane potential. Results: IC50 value of the extract against MCF-7 cells treated for 72 hours was 4.1 ± 2.08 µg/mL, while the IC50 value for doxorubicin was 2.92 ± 0.12 µg/mL. The extract showed a lower cytotoxic effect against the NIH/3T3 cells and inhibited the growth of MCF-7 cells in a dose dependent manner. AO/PI double stain showed that the ethanolic extract of A. malaccensis leaves induced MCF-7 cells into apoptotic cell death. The present study showed that the ethanolic extract of A. malaccensis induced apoptosis through mitochondrial pathway as indicated by its ability to take up JC-1. Conclusion: The study found that ethanolic extract obtained from A. malaccensis leaves is cytotoxic on MCF-7 cells, resulting to apoptotic cell death of the cells.

Food Safety Knowledge, Beliefs and Behaviour among Health Sciences-related Field Undergraduate Students at a Local University (Pengetahuan, Kepercayaan dan Tingkah Laku Keselamatan Makanan dalam Kalangan Pelajar Bidang Berkaitan Sains Kesihatan di Sebuah Universiti Tempatan) / Jurnal Sains Kesihatan Malaysia

@#Foodborne disease is among the primary illness that causes morbidity and mortality in the world. Several studies show that most students do not have adequate food safety knowledge to protect themselves against foodborne diseases. This study aimed to determine the food safety knowledge, behaviour, and beliefs among undergraduate students at a local university in Malaysia. This cross-sectional study involves 121 respondents from three health science-related faculties at the studied institution. The questionnaire was distributed via an online platform. This study used multiple-choiceformat questions for Food Safety Knowledge and a Likert type scale for Food Safety Behaviour and Belief question statements. Most of the respondents were female (78%). About 16% of the respondents have experience working / volunteering in food services, and half of them are involved in food handling during their services. This study recorded a moderate score in all sections (knowledge, behaviour, beliefs) with a total percentage score of 60.3%, 60.3%, and 66.1%, respectively. A strong but not significant correlation between food safety knowledge and beliefs (r = 0.69 p > 0.05) and between food safety knowledge and behaviour (r = 0.83 p > 0.05) were observed. This study is useful as a basis to develop a targeted food safety education program among undergraduate students. Students with high knowledge of food safety will increase food safety beliefs and behaviour, thus preventing them from getting any foodborne illness.

Mycoplasma pneumoniae - The Culprit for Juvenile Dermatomyositis in A 9-Year-Old Girl: A Case Report

@#Mycoplasma pneumoniae is frequently known as an “atypical bacterium” that can cause wide-ranging extrapulmonary manifestations. Here, we outline a case of a child, aged 9-year-old, who presented with profound proximal muscle weaknesses and a vague rash, associated with markedly elevated serum creatinine kinase (CK). Muscle biopsy suggested Juvenile Dermatomyositis (JDM) following an upper respiratory illness of M. pneumoniae origin. The child responded exceptionally well to a combined therapy of immunoglobulin, intravenous glucocorticoid and methotrexate.

Is depression a concern among medical students: a cross sectional study in different academic years of a private medical college in Bangladesh

Background: Depression is not uncommon among medical students all over the world. Few studies have been conducted so far in Bangladesh to depict its actual prevalence and severity. So, the aim of this study was to assess the severity of depression and the level of difficulty faced by medical students in different academic years.Methods: This cross-sectional study was conducted in North East medical college of Bangladesh from January 2018 to June 2018 involving 443 students from 1st year to 5th year. Students were instructed to fill up the patient health questionnaire (PHQ-9) which incorporates diagnostic and statistical manual of mental disorders (DSM-IV) depression diagnostic criteria categorized as no, mild, moderate, moderately severe, and severe depression and also evaluates their level of function.Results: The prevalence of depression was quite high (79.68%). 196 (44.24%) and 157 (35.44%) students had mild and major depression respectively, while 90 (20.32%) showed no depression. Students with major depression were scored as moderate depression 24.38%, moderately severe depression 8.35%, and severe depression 2.71%. Moderate depression was significantly higher in year 1 and year 2 students in comparison to year 3, 4 and 5. Students from year 1 to year 5 with mild, moderate, moderately severe and severe depression experienced varying degree of difficulty in their daily activities. Almost all the students in all years with severe depression found themselves very difficult or extremely difficult to cope.Conclusions: High prevalence of depression among medical students is really alarming and underlying factors need to be addressed.

A review on biological activities of Gelam honey

Honey has been extensively researched on their chemical and biological properties. It’s revealed the ability and capability of honey in treating or preventing many diseases. As people concerned, a safer approach using natural based product is critically needed and honey as one of the potential agent to be consider. Therefore, the information on its biological activities has to be clarify to make society understand the benefit of honey especially Gelam honey.

Development and validation of TaqMan real-time PCR for the detection of Burkholderia pseudomallei isolates from Malaysia

@#Rapid detection of Burkholderia pseudomallei, the etiologic agent of melioidosis, allows for timely initiation of appropriate treatment and better clinical outcomes. In the current gold standard, the culture method is time consuming and suffers from low sensitivity. Meanwhile, previously reported molecular assays are fast and sensitive, but their performance on isolates from Malaysia, an endemic region of melioidosis is under reported. This study designed oligonucleotides targeting orf2 of Type III secretion system (TTSS) genes cluster for the detection of Malaysian B. pseudomallei isolates and evaluated the assay on 95 local B. pseudomallei strains, 58 other microorganisms and 71 clinical specimens from patients. The developed assay exclusively detected all tested B. pseudomallei isolates with a detection limit of 20 fg per reaction (equivalent to ~2.5 copies). Subsequent testing on clinical samples showed that the assay detected all confirmed specimens with the growth of B. pseudomallei (n = 10/10). None of the negative specimens had a detectable signal of our TTSS-orf2 assay (n = 0/61). In conclusion, the present study provides crucial preliminary data for a subsequent study and should be considered as a potential alternative to current time-consuming culture method for the detection of B. pseudomallei.

Progression of fibroadenoma to malignant phyllodes tumour in a 14-year female

Phyllodes tumours are uncommon breast tumours which account for less than 1% of all breast neoplasms. High-grade malignant phyllodes tumour is a very rare but aggressive breast malignancy and forms approximately 15-30% of all phyllodes tumours. The transformation of a benign fibroadenoma into a malignant phyllodes tumour in a teenaged female is even rarer. We report here an interesting case of malignant phyllodes tumour in a 14-year female patient who was operated twice previously with the diagnosis of complex fibroadenoma in the same breast. There was a large tumour involving whole of the breast and infiltrating the skin. The patient was operated and total mastectomy was done. Diagnosis was confirmed after histopathological examination and immunohistochemistry of the resected specimen. Patient received adjuvant radiotherapy and there was no recurrence on 6-month follow-up. Owing to the rare occurrence of malignant phyllodes tumour in this age group along with previous operations for complex fibroadenoma, this case is being reported here

Analgesic, anti-inflammatory and diuretic activities of Cicer arietinum L.

Analgesic, anti-inflammatory and diuretic activities of the methanol extract of two varieties of Cicer arietinum viz black or Desi and white or Kabuli were tested in the doses of 200 and 400 mg/kg. For analgesic effect of the extracts, acetic acid induced writhing, tail immersion and hot plate tests were employed in mice. The anti-inflammatory activity was carried out by carrageenan induced inflammation in rats, whereas the diuretic action was determined using metabolic cages for rats. Animals were divided into six groups [n=7]: [1] Control [2] Standard [3] MECAB 200 [4] MECAB 400 [5] MECAW 200 [6] MECAW 400. All extracts and standard drugs were administered orally. Acute oral toxicity of the extracts was also checked in mice up to 2000mg/kg dose, which showed a favorable safety. Significant analgesic and anti-inflammatory effects were observed. The results of diuretic activity were significant at 12th and 24 th hrs. Therefore, it is concluded that the methanol extracts of the seeds of Cicer arietinum have analgesic, anti-inflammatory and diuretic potential

Comparing the efficacy of Morphine alone with Morphine and mgso4 in pain management after coronary artery bypass surgery

Objective: To compare the effectiveness of Morphine alone and Morphine with MgSo4 in pain management after CABG surgery

Methods: This randomized control trial was conducted in the department of anesthesia and critical care Choudhary Pervaiz Ellahi Institute of Cardiology, Multan from November 2016 to June 2017. All collected data was entered and analyzed by using computer software SPSS version 23.1. Quantitative data like age, VAS score was analyzed and presented as mean and standard deviation. Similarly qualitative data like gender and ASA status was calculated and presented as frequency and percentages. Independent sample T-test was applied for significance of VAS score. P value ?0.05 was considered as significant

Results: A total number of 150 patients of both genders were included in this study. The main outcome variables of our study were VAS score. It was observed that, in group [M], the mean VAS score after 4, 12 and 24 hours of operation was 5.24+/-1.61, 5.8+/-2.27 and 5.44+/-2.27 respectively. And in group [MM], the mean VAS score after 4, 12 and 24 hours of operation was 4.36+/-2.58, 3.48+/-2.10 and 4.12+/-1.05 respectively. It was noted that both groups had statically significant difference of VAS score, as group [M] had higher VAS score than group [MM]

Conclusion: Morphine with Mgso4 has better efficacy as compared to morphine alone when used as analgesic agent after CABG surgery

Design Automotive Driver Seat Ergonomically For Malaysian Anthropometry Measurement

Aesthetic value of the automotive car seat has been one of the selling points of each car besidesproviding functions such as being safe, supportive as well provides comfort to the occupants. Othercriteria considered besides the aesthetic element are cushion foam and self-adjustment factor.Ergonomics is not a new issue because most of the existing seat design today have already practiced it.Existing car seat manufacturers have considered anthropometry data. The average upon 95th percentile ofhuman measurement had been deliberated. However, issues such as time spent driving and seat designissue have arisen upon the search of comfort and rising of musculoskeletal disease such as back pain. As asolution, this study would propose an automotive car seat design of ergonomic evolution, which wouldcreate comfort by manipulating the seat cushion foams. The proposed seat cushion foam would be use toreplace the existing polymers with beanbag foam. This is inspire by the nature of beanbag, fitting up andproviding comfort to the occupants of various body sizes and shapes. Malaysian anthropometrymeasurements are required for design of car seat, which later compared with the existing seats ofcommercial vehicle. The literature review showed the pressure mapping technique of respondent seatingon the existing car seat. The most sensitive compartments where discomfort are experienced studied andplaced with sachets filed with beanbag beads. This experiment conducted many times over a fewrespondents by using the pressure mat to find out, if there are any changes in terms of comfort. Thisdesign of new car seat with a manipulation cushion foam replaced with beanbag foam could be a niche toeliminate discomfort to all range body sizes and shapes.

Zika virus infection and its emerging trends in Southeast Asia

Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. Previously, this rare virus was limited to sporadic cases in Africa and Asia until its emergence in Brazil, South America in 2015, where it rapidly spread throughout the world. Recently, a high number of cases were reported in Singapore and other Southeast Asia countries. A combination of factors explains the current Zika virus outbreak although it is highly likely that the changes in the climate and high frequency of travelling contribute to the spread of Aedes vector carrying the Zika virus mainly to the tropical climate countries such as the Southeast Asia. The Zika virus is known to cause mild clinical symptoms similar to those of dengue and chikungunya and transmitted by different species of Aedes mosquitoes. However, neurological complications such as Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a serious concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Therefore, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.

Prevalence and antibiotic trials against Salmonella enterica isolated from diarrheic lambs and kids

Salmonella enterica [S. enteric] is the major zoonotic threat for small ruminants and humans responsible for huge economic losses and high mortality in Pakistan. Lambs and kids of Lahore district were examined to determine the prevalence, hematology and chemotherapy of S. enterica. A total of 200 diarrheic samples [n=100 lambs; n=100 kids] were collected and examined; 59 [29.50%] were found positive for S. enterica. Lambs had lightly greater prevalence [31%] than kids [29%]. The frequency analysis [OR=1.16 [reciprocal =0.87]] showed non-significant difference in both the lambs and kids. The significant decrease [P5R0.001] in hemoglobin, pack cell volume and total erythrocyte count was observed in infected lambs and kids. Results of in-vitro antibiotic susceptibility test revealed that S. enteric isolated from both lambs and kids were susceptible to levofloxacin, ciprofloxacin, ofloxacin, gentamicin, azithromycin, tobramycin, amoxicillin, ampicillin and nalidixic acid. Where as the results of in vivo antibiotic trials showed that isolates from both lambs and the kids with diarrhea were susceptible to levofloxacin and ciprofloxacin

Zika virus infection and its emerging trends in Southeast Asia

Zika virus is a mosquito-borne flavivirus that represents a public health emergency at the ongoing epidemic. Previously, this rare virus was limited to sporadic cases in Africa and Asia until its emergence in Brazil, South America in 2015, where it rapidly spread throughout the world. Recently, a high number of cases were reported in Singapore and other Southeast Asia countries. A combination of factors explains the current Zika virus outbreak although it is highly likely that the changes in the climate and high frequency of travelling contribute to the spread of Aedes vector carrying the Zika virus mainly to the tropical climate countries such as the Southeast Asia. The Zika virus is known to cause mild clinical symptoms similar to those of dengue and chikungunya and transmitted by different species of Aedes mosquitoes. However, neurological complications such as Guillain-Barré syndrome in adults, and congenital anomalies, including microcephaly in babies born to infected mothers, raised a serious concern. Currently, there is no specific antiviral treatment or vaccine available for Zika virus infection. Therefore, international public health response is primarily focused on preventing infection, particularly in pregnant women, and on providing up-to-date recommendations to reduce the risk of non-vector transmission of Zika virus.

Role of diagnostic laparoscopy in recurrent vague abdominal pain

To determine the role of laparoscopy in the management of recurrent vague abdominal pain. Descriptive case series. Surgical Unit 1, Civil Hospital Karachi, from January 2005 to June 2007. All patients who presented with vague recurrent abdominal pain and underwent laparoscopic surgery to make a definitive diagnosis were included in the study. A total of 60 patients were managed. There were 36 [60%] females and 24 [40%] males. The mean age was 26 year [range 18-58 year]. The common mode of admission was out patient department [73.3%]. Fourteen [23.3%] patients presented with vague abdominal pain in lower Abdomen, followed by 12 [20%] with right lower abdominal pain and 12 [20%] with central pain radiating to right lower abdomen. Diagnosis was established in 56 [93.3%] patients. In 4 [6.6%] patients no pathology was found. The most common diagnosis was inflamed appendix in 18 [30%] patients followed by abdominal tuberculosis in 16 [26.6%] patients. Most [36.6%] of the patients stayed in hospital for 24 hours. There was no readmission and no major postoperative complications. Diagnostic laparoscopy in vague abdominal pain provided a higher diagnostic accuracy and improved treatment. It may be considered as first line operative investigation for undiagnosed vague abdominal pain

clinicoetiological study of Stevens-Johnson syndrome and toxic epidermal necrolysis

To present the pattern of morbidity associated complications, and causative factors in individual cases of Stevens-Johnson syndrome [SJS]/toxic epidermal necrolysis [TEN]. Patients and methods This case series descriptive study, using a convenience sampling technique, was carried out in the In-patients department of Dermatology Unit I, Mayo Hospital, King Edward Medical University, Lahore from January 2007 to September 2008. Thirty clinically diagnosed patients, suffering from SJS/TEN, fulfilling the inclusion criteria were included in the study. Patients' demographic data, symptoms, signs and any relevant investigations were recorded and scored. Using an appropriately designed pro forma, symptoms/ and signs were categorized into thirteen variables. The severity of each variable was scored froml-3 [total score range 13 to 39]. An association of these variables with patient outcome, in terms of either discharge from hospital or death, was calculated. Pain and gastrointestinal involvement were seen in all 30 [100%] patients. Mortality was found to be 13.3% and was significantly associated with infection, total morbidity score, area of epidermal involvement and respiratory system involvement. Similarly development of wound infection, area of epidermal involvement, fever and total score significantly affected the duration of hospital stay. While the causative drug/s remained unknown in 26.7% cases the most common identifiable drug was trimethoprim-sulphamethoxazole, causing disease in 13.3%. Conclusions Mortality in cases of SJS/TEN showed significant association with wound infection, area of skin involvement, total morbidity score and respiratory system involvement

Training of non-physician practitioners to identify and refer diabetic patients

To improve the practices of non-physician practitioners on early diagnosis and referral of patients with diabetes mellitus. Study will be conducted in a peri-urban village community in Lahore, Pakistan, during 2007 - 2008. Quasi - experimental study, one group before and after design was used to document the effect of training of non-physician practitioners on improving their diabetic patient identification practices and referral to the hospital for diagnostic and treatment facilities. Fasting blood glucose test was used to identify hyperglycaemics out of those referred by the NPPs. Patient referral was increased by 48.44% after training. Identification of hyperglycaemic patients on the basis of signs and symptoms was 47% before and 48% after training and the difference between two proportions was not significant. increased number of referral showed motivation of NPPs towards the task however more prolonged and structured training program is required to utilize their services in community as part of our health care delivery system

Effectiveness and safety of vaginal misoprostol for induction of labour in unfavourable cervix in 3[rd] Trimester

The use of prostaglandin preparations with or without oxytocin infusion, is widely recognized and accepted as a standard method of induction of labour. It has been shown to reduce induction time and the risk of failed induction. The objective of this quasiexperimental observational study was to determine the effectiveness and safety of Misoprostol administered vaginally for induction of labour to achieve vaginal delivery. This study was conducted from October 2004 to October 2007. The study was conducted at Shaheena Jamil Teaching Hospital, Frontier Medical College, Abbottabad and Women and Children Hospital Abbottabad. A total of 6299 obstetric patients were received for delivery and 946 patients had to undergo induction of labour. Primary outcome measures were to address clinical effectiveness [delivery within 24-hours] and safety [uterine hyper-stimulation, Caesarean Section and serious Maternal Morbidity]. Secondary outcome measures included neonatal outcome. Out of 946 cases, successful vaginal deliveries were achieved in 843 [89.1%] cases. Time interval between induction and delivery was 4-24 hours. Oxytocin was required in 107 [12%] patients. Caesarean Section had to be done in 103 [10.8%] cases. The indications for Caesarean Section were foetal distress in 42 [40%], occipito-posterior position in 8 [7.7%], abruptioplacentae 2 [1.9%], cord around the neck 9 [7%], uterine hyperstimulation 6 [5.8%] and failure to progress in 20 [19%] cases. Admission to NICU was 28 [3.3%] and Neonatal deaths were 5 [0.5%]. Postpartum Haemorrhage [PPH] was observed in 22 [2.3%] patients. There was no case of rupture uterus. Vaginal Misoprostol appears to be safe and effective for cervical ripening in third Trimester. It helps vaginal delivery within 24 hours, does not increase incidence of Caesarean Section and has no adverse effect on foetal outcome. It could also be used in circumstances where extensive monitoring techniques are not available though close observation and vigilance is mandatory