Oral inoculation of Enterococcus faecalis, DNA quantification and histopathological evaluation of gingival, heart and kidney tissue samples in rats.

Background and Objectives: Enterococcus faecalis is known as common pathogen for endodontic infections and cause secondary and refractory pulp periapical periodontitis. The bacteria can opportunistically colonize periodontal pockets and presents a possibility of infection developing in other organs. This research will investigate the dissemination of E. faecalis from the gingival tissue to the heart and kidney. Materials and Methods: Three groups were formed, consisting of twelve male Sprague Dawley rats: a control group designated as 0-day, and experimental groups labeled as 7-days and 14-days. Periodontitis induced by concurrent infection with sterile wire 0.2 mm insertion and E. faecalis inoculation is performed into the gingival sulcus located between the maxillary right 1st and 2nd molar teeth area. After euthanasia, tissue samples around the maxillary gingiva, maxillary jaw samples, kidney and heart tissues were obtained for quantitative Real-Time PCR assay and histopathological analysis. Results: Results showed at 7-days, there was an upregulation of E. faecalis gene expression in the gingiva, heart, and kidney samples as well as infiltration of the inflammatory cells at 7-days post induction, which consequently decreased at 14-days. Conclusion: Thus, the study suggests dissemination of E. faecalis from gingival tissue to the heart, kidney which could be probable link between periodontal disease, heart, and kidney disease.

Effects of clitorienolactones from Clitoria ternatea root on calcium channel mediating hippocampal long-term potentiation in rats induced chronic cerebral hypoperfusion.

Chronic cerebral hypoperfusion (CCH) is a common mechanism of acute brain injury due to impairment of blood flow to the brain. Moreover, a prolonged lack of oxygen supply may result in cerebral infarction or global ischemia, which subsequently causes long-term memory impairment. Research on using Clitoria ternatea root extract for treating long-term memory has been studied extensively. However, the bioactive compound contributing to its neuroprotective effects remains uncertain. In the present study, we investigate the effects of clitorienolactone A (CLA) and B (CLB) from the roots of Clitoria ternatea extract on hippocampal neuroplasticity in rats induced by CCH. CLA and CLB were obtained using column chromatography. The rat model of CCH was induced using two-vessel occlusion surgery (2VO). The 2VO rats were given 10 mg/kg of CLA and CLB orally, followed by hippocampal neuroplasticity recording using in vivo electrophysiological. Rats received CLA and CLB (10 mg/kg) significantly reversed the impairment of long-term potentiation following 2VO surgery. Furthermore, we investigate the effect of CLA and CLB on the calcium channel using the calcium imaging technique. During hypoxia, CLA and CLB sustain the increase in intracellular calcium levels. We next predict the binding interactions of CLA and CLB against NMDA receptors containing GluN2A and GluN2B subunits using in silico molecular docking. Our result found that both CLA and CLB exhibited lower binding affinity against GluN2A and GluN2B subunits. Our findings demonstrated that bioactive compounds from Clitoria ternatea improved long-term memory deficits in the chronic cerebral hypoperfusion rat model via calcium uptake. Hence, CLA and CLB could be potential therapeutic tools for treating cognitive dysfunction.

The level of knowledge and acceptance towards the COVID-19 vaccine among the community in Johor Bahru, Johor.

INTRODUCTION: Several necessary initiatives have been made to create a readily available vaccine against the Coronavirus Disease 2019 (COVID-19) worldwide pandemic. However, the vaccination program's success is dependent on the population's willingness as well as their knowledge of vaccination. Hence, the present study aimed to assess the level of knowledge and acceptance towards the COVID-19 vaccine among the community in Johor Bahru, Johor. MATERIALS AND METHODS: A cross-sectional study was conducted using an online survey between February and May 2022, with 423 respondents. The questionnaire consisted of socio-demographic, assessment of knowledge level and acceptance level towards COVID-19 vaccine. The descriptive analysis and non-parametric tests were employed to investigate the study outline objectives. RESULTS: Of all 423 participants, 293 (69.3%) of the participants had a high level of knowledge about the COVID- 19 vaccine (median knowledge score 6; IQR = 3), and 239 (56.5%) were reported to have a low level of vaccine acceptance (median acceptance scores 4; IQR=2). The knowledge level towards the COVID-19 vaccine was significantly associated with the vaccine acceptance level (p<0.001). CONCLUSION: The community's level of knowledge towards COVID-19 vaccine was high; however, the vaccine acceptance was low.

Prevalence and associated factors of moderate to severe erectile dysfunction among adult men in Malaysia.

Erectile dysfunction (ED) is a pervasive problem among men, often shrouded in silence and stigma. This manuscript analysed the National Health and Morbidity Survey 2019 data to identify the prevalence of moderate to severe ED among men aged 18 and above in Malaysia and describe its associated factors. Self-administered questionnaire on ED utilised a locally validated International Index of Erectile Function. Variables on sociodemographics, risky lifestyles and comorbidities were obtained via an interviewer-administered questionnaire. The prevalence was determined using complex sampling analysis, and logistic regression was used to determine the associated factors of ED. A sample of 2403 men aged ≥ 18 participated, with a moderate to severe ED prevalence was 31.6% (95% CI 28.8, 34.6). The mean (± SD) of the total score of IIEF-5 for overall respondents was 18.16 (± 4.13). Multiple logistic regression analysis revealed a significant association between moderate to severe ED among men aged 60 years and above, single or divorcee, men without formal, primary, and secondary education, non-government employees, unemployed, and retiree, as well as physically inactive men. Focused public health interventions are necessary to improve education in sexual health, increase health promotion programs, and promote healthy ageing across the population.

Organotin (IV) Dithiocarbamate Compounds as Anticancer Agents: A Review of Syntheses and Cytotoxicity Studies.

Organotin (IV) dithiocarbamate has recently received attention as a therapeutic agent among organotin (IV) compounds. The individual properties of the organotin (IV) and dithiocarbamate moieties in the hybrid complex form a synergy of action that stimulates increased biological activity. Organotin (IV) components have been shown to play a crucial role in cytotoxicity. The biological effects of organotin compounds are believed to be influenced by the number of Sn-C bonds and the number and nature of alkyl or aryl substituents within the organotin structure. Ligands target and react with molecules while preventing unwanted changes in the biomolecules. Organotin (IV) dithiocarbamate compounds have also been shown to have a broad range of cellular, biochemical, and molecular effects, with their toxicity largely determined by their structure. Continuing the investigation of the cytotoxicity of organotin (IV) dithiocarbamates, this mini-review delves into the appropriate method for synthesis and discusses the elemental and spectroscopic analyses and potential cytotoxic effects of these compounds from articles published since 2010.

Bio-enhanced fraction from Clitoria ternatea root extract ameliorates cognitive functions and in vivo hippocampal neuroplasticity in chronic cerebral hypoperfusion rat model.

Research employing a bio-enhanced fraction of Clitoria ternatea (CT) to treat cognitive decline in the animal model has not yet been found. This study aimed to determine the neuroprotective effect of CT root bioactive fraction (CTRF) in chronic cerebral hypoperfusion (CCH) rat model. CTRF and its major compound, clitorienolactones A (CLA), were obtained using column chromatography. A validated HPLC-UV method was employed for the standardization of CTRF. CCH rats were given orally either vehicle or fraction (10, 20 and 40 mg/kg). Behavioural and hippocampal neuroplasticity studies were conducted following 4 weeks post-surgery. The brain hippocampus was extracted for proteins and neurotransmitters analyses. HPLC analysis showed that CTRF contained 25% (w/w) of CLA. All tested doses of CTRF and CLA (10 mg/kg) significantly restored cognitive deficits and reversed the inhibition of neuroplasticity by CCH. However, only CTRF (40 mg/kg) and CLA (10 mg/kg) significantly reversed the elevation of amyloid-beta plaque. Subsequently, treatment with CTRF (40 mg/kg) and CLA (10 mg/kg) alleviated the downregulation of molecular synaptic signalling proteins levels caused by CCH. The neurotransmitters level was restored following treatment of CTRF and CLA. Our finding suggested that CTRF improves memory and neuroplasticity in CCH rats which was mainly contributed by CLA.

Therapeutic Potential of Hibiscus sabdariffa Linn. in Attenuating Cardiovascular Risk Factors.

Cardiovascular diseases (CVDs) represent a broad spectrum of diseases afflicting the heart and blood vessels and remain a major cause of death and disability worldwide. CVD progression is strongly associated with risk factors, including hypertension, hyperglycemia, dyslipidemia, oxidative stress, inflammation, fibrosis, and apoptosis. These risk factors lead to oxidative damage that results in various cardiovascular complications including endothelial dysfunctions, alterations in vascular integrity, the formation of atherosclerosis, as well as incorrigible cardiac remodeling. The use of conventional pharmacological therapy is one of the current preventive measures to control the development of CVDs. However, as undesirable side effects from drug use have become a recent issue, alternative treatment from natural products is being sought in medicinal plants and is gaining interest. Roselle (Hibiscus sabdariffa Linn.) has been reported to contain various bioactive compounds that exert anti-hyperlipidemia, anti-hyperglycemia, anti-hypertension, antioxidative, anti-inflammation, and anti-fibrosis effects. These properties of roselle, especially from its calyx, have relevance to its therapeutic and cardiovascular protection effects in humans. This review summarizes the findings of recent preclinical and clinical studies on roselle as a prophylactic and therapeutic agent in attenuating cardiovascular risk factors and associated mechanisms.

Recent Advances in Nanocellulose Aerogels for Efficient Heavy Metal and Dye Removal.

Water pollution is a significant environmental issue that has emerged because of industrial and economic growth. Human activities such as industrial, agricultural, and technological practices have increased the levels of pollutants in the environment, causing harm to both the environment and public health. Dyes and heavy metals are major contributors to water pollution. Organic dyes are a major concern because of their stability in water and their potential to absorb sunlight, increasing the temperature and disrupting the ecological balance. The presence of heavy metals in the production of textile dyes adds to the toxicity of the wastewater. Heavy metals are a global issue that can harm both human health and the environment and are mainly caused by urbanization and industrialization. To address this issue, researchers have focused on developing effective water treatment procedures, including adsorption, precipitation, and filtration. Among these methods, adsorption is a simple, efficient, and cheap method for removing organic dyes from water. Aerogels have shown potential as a promising adsorbent material because of their low density, high porosity, high surface area, low thermal and electrical conductivity, and ability to respond to external stimuli. Biomaterials such as cellulose, starch, chitosan, chitin, carrageenan, and graphene have been extensively studied for the production of sustainable aerogels for water treatment. Cellulose, which is abundant in nature, has received significant attention in recent years. This review highlights the potential of cellulose-based aerogels as a sustainable and efficient material for removing dyes and heavy metals from water during the treatment process.

A Review on the Role of Earthworms in Plastics Degradation: Issues and Challenges.

Recently, the contribution of earthworms to plastic degradation and their capability to swallow smaller plastic fragments, known as microplastics, has been emphasized. The worm physically changes the size of microplastics and enhances microbial activities to increase the possibility of degradation. However, no research has shown that earthworms can chemically degrade microplastics to an element form, CO2 or H2O. In this review, previous research has been thoroughly explored to analyse the role that earthworms could play in plastic degradation in the soil. Earthworms can significantly affect the physical characteristics of plastics. However, earthworms' abilities to chemically degrade or change the chemical structure of plastics and microplastics have not been observed. Additionally, earthworms exhibit selective feeding behaviour, avoiding areas containing a high plastics concentration and rejecting plastics. Consequently, earthworms' abilities to adapt to the microplastics in soil in the environment can cause a problem. Based on this review, the challenges faced in earthworm application for plastic degradation are mostly expected to be associated with the toxicity and complexity of the plastic material and environmental factors, such as the moisture content of the soil and its temperature, microbial population, and feeding method.

The Role of PKC-MAPK Signalling Pathways in the Development of Hyperglycemia-Induced Cardiovascular Complications.

Cardiovascular disease is the most common cause of death among diabetic patients worldwide. Hence, cardiovascular wellbeing in diabetic patients requires utmost importance in disease management. Recent studies have demonstrated that protein kinase C activation plays a vital role in the development of cardiovascular complications via its activation of mitogen-activated protein kinase (MAPK) cascades, also known as PKC-MAPK pathways. In fact, persistent hyperglycaemia in diabetic conditions contribute to preserved PKC activation mediated by excessive production of diacylglycerol (DAG) and oxidative stress. PKC-MAPK pathways are involved in several cellular responses, including enhancing oxidative stress and activating signalling pathways that lead to uncontrolled cardiac and vascular remodelling and their subsequent dysfunction. In this review, we discuss the recent discovery on the role of PKC-MAPK pathways, the mechanisms involved in the development and progression of diabetic cardiovascular complications, and their potential as therapeutic targets for cardiovascular management in diabetic patients.

Prediction of Oil Palm Yield Using Machine Learning in the Perspective of Fluctuating Weather and Soil Moisture Conditions: Evaluation of a Generic Workflow.

Current development in precision agriculture has underscored the role of machine learning in crop yield prediction. Machine learning algorithms are capable of learning linear and nonlinear patterns in complex agro-meteorological data. However, the application of machine learning methods for predictive analysis is lacking in the oil palm industry. This work evaluated a supervised machine learning approach to develop an explainable and reusable oil palm yield prediction workflow. The input data included 12 weather and three soil moisture parameters along with 420 months of actual yield records of the study site. Multisource data and conventional machine learning techniques were coupled with an automated model selection process. The performance of two top regression models, namely Extra Tree and AdaBoost was evaluated using six statistical evaluation metrics. The prediction was followed by data preprocessing and feature selection. Selected regression models were compared with Random Forest, Gradient Boosting, Decision Tree, and other non-tree algorithms to prove the R2 driven performance superiority of tree-based ensemble models. In addition, the learning process of the models was examined using model-based feature importance, learning curve, validation curve, residual analysis, and prediction error. Results indicated that rainfall frequency, root-zone soil moisture, and temperature could make a significant impact on oil palm yield. Most influential features that contributed to the prediction process are rainfall, cloud amount, number of rain days, wind speed, and root zone soil wetness. It is concluded that the means of machine learning have great potential for the application to predict oil palm yield using weather and soil moisture data.

The Role of Polyphenol in Modulating Associated Genes in Diabetes-Induced Vascular Disorders.

Diabetes-induced vascular disorder is considered one of the deadly risk factors among diabetic patients that are caused by persistent hyperglycemia that eventually leads to cardiovascular diseases. Elevated reactive oxygen species (ROS) due to high blood glucose levels activate signaling pathways such as AGE/RAGE, PKC, polyol, and hexosamine pathways. The activated signaling pathway triggers oxidative stress, inflammation, and apoptosis which later lead to vascular dysfunction induced by diabetes. Polyphenol is a bioactive compound that can be found abundantly in plants such as vegetables, fruits, whole grains, and nuts. This compound exerts therapeutic effects in alleviating diabetes-induced vascular disorder, mainly due to its potential as an anti-oxidative, anti-inflammatory, and anti-apoptotic agent. In this review, we sought to summarize the recent discovery of polyphenol treatments in modulating associated genes involved in the progression of diabetes-induced vascular disorder.

Influence of Particle Size and Zeta Potential in Treating Highly Coloured Old Landfill Leachate by Tin Tetrachloride and Rubber Seed.

Old leachate normally has a low organic compound content, poor biodegradability and is hard to biologically treat. The efficacy of tetravalent metal salts as a coagulant and the application of a natural coagulant as a flocculant in landfill leachate treatment is still inconclusive. Hence, this study aimed to evaluate the potential application of tin tetrachloride (SnCl4) as the main coagulant and the rubber seed (Hevea brasiliensis) (RS) as the natural coagulant aid as the sole treatment in eradicating highly coloured and turbid stabilised landfill leachate present at one of the old local landfills in Malaysia. The standard jar test conducted revealed that SnCl4 was able to eliminate 99% and 97.3% of suspended solids (SS) and colour, respectively, at pH8, with 10,000 mg/L dosages, an average particle size of 2419 d·nm, and a zeta potential (ZP) of -0.4 mV. However, RS was found to be ineffective as the main coagulant and could only remove 46.7% of SS and 76.5% of colour at pH3 with 6000 mg/L dosages, and also exhibited smaller particles (933 d·nm) with ZP values of -6.3 mV. When used as a coagulant aid, the polymer bridging mechanism in RS helped in reducing the SnCl4 concentration from 10,000 mg/L to 8000 mg/L by maintaining the same performances. The presence of 1000 mg/L RS as a coagulant aid was able to remove 100% of SS and 97.6% of colour. The study concluded that RS has the potential to be used together with SnCl4 in treating concentrated leachate with SS and colour.

A community-based study on lower urinary tract symptoms in Malaysian males aged 40 years and above.

Lower urinary tract symptoms (LUTS) commonly affecting ageing men and is thought to be linked with other comorbidities and unhealthy lifestyles. This study was performed to report the prevalence of LUTS and its association with quality of life (QOL) in urination and other related factors. The study was part of the National Health and Morbidity Survey (NHMS) 2019, a cross-sectional community-based survey in Malaysia. Validated self-administered bilingual International Prostate Symptom Score (IPSS) was used to assess the LUTS. Other comorbidities and unhealthy lifestyles were recorded using face-to-face interview and in-situ measurements such as anthropometry assessment and blood measurement. There were a total of 2251 respondents. 16.3% of the respondents had clinically significant LUTS (IPSS ≥ 8). LUTS was found to be significantly associated with QOL, age and inactive physical activities. Nocturia was the most prevalent and bothersome symptom. LUTS is a common condition and adversely affect QOL. Ageing and physically inactive males are associated with the development of LUTS. It is recommended to increase public awareness of the condition and availability of treatment options for LUTS. Any upcoming survey should have a more in-depth investigation such as clinical profiling of subjects.

Assessing knowledge, acts of discrimination, stigmatizing attitudes and its associated factors towards people living with HIV (PLHIV) among Family Medicine trainees in Malaysia.

Introduction: Human immunodeficiency virus (HlV)-related stigmatisation and discrimination adversely affect health outcomes in terms of timely diagnosis, treatment and care. Despite global efforts, they remain common among healthcare workers worldwide. In Malaysia, family medicine specialists are entrusted with the care of HIV patients at the primary care level. This study aimed to assess HIV-related knowledge, acts of discrimination, stigmatising attitudes and their associated factors among family medicine trainees in Malaysia. Methodology: This cross-sectional study was conducted among 397 family medicine trainees in Malaysia using a validated, self-administered questionnaire that assessed the participants' sociodemographic information, HIV/AIDS knowledge, stigmatising attitudes (attitudes of blame, attitudes towards imposed measures, comfort in dealing with HIV patients) and acts of discrimination. Results: The most common stigmatisation was "attitudes of blame" (mean [SD] score: 3.0 (0.74); range score:1-5), and the most frequent discriminatory act was breaching patient confidentiality (54.9%). Around 82.1% had good knowledge of HIV/AIDS. Married participants and participants who had 7 years or less in service were more stigmatising in "attitudes of imposed measures" towards people living with HIV (p=0.006). Conclusion: Family medicine trainees exhibited stigmatisation and discrimination towards HIV patients despite having good HIV knowledge. Hence, appropriate and concerted health education should be given to all family medicine trainees to eliminate stigmatisation and discrimination.

Combination Therapy of Navitoclax with Chemotherapeutic Agents in Solid Tumors and Blood Cancer: A Review of Current Evidence.

Combination therapy emerges as a fundamental scheme in cancer. Many targeted therapeutic agents are developed to be used with chemotherapy or radiation therapy to enhance drug efficacy and reduce toxicity effects. ABT-263, known as navitoclax, mimics the BH3-only proteins of the BCL-2 family and has a high affinity towards pro-survival BCL-2 family proteins (i.e., BCL-XL, BCL-2, BCL-W) to induce cell apoptosis effectively. A single navitoclax action potently ameliorates several tumor progressions, including blood and bone marrow cancer, as well as small cell lung carcinoma. Not only that, but navitoclax alone also therapeutically affects fibrotic disease. Nevertheless, outcomes from the clinical trial of a single navitoclax agent in patients with advanced and relapsed small cell lung cancer demonstrated a limited anti-cancer activity. This brings accumulating evidence of navitoclax to be used concomitantly with other chemotherapeutic agents in several solid and non-solid tumors that are therapeutically benefiting from navitoclax treatment in preclinical studies. Initially, we justify the anti-cancer role of navitoclax in combination therapy. Then, we evaluate the current evidence of navitoclax in combination with the chemotherapeutic agents comprehensively to indicate the primary regulator of this combination strategy in order to produce a therapeutic effect.

Perception of nurses on the practice environment: experience from Malaysia.

INTRODUCTION: Positive professional practice environments are crucial to safeguard a healthy and safe working conditions for health workforce, including nurses; so as to ensure provision of quality healthcare and safety of patient. METHODS: This was a cross-sectional study to assess nurses' perceptions towards nursing practice environment and factors associated with their perceptions. A validated Practice Environment Scale of the Nursing Work Index (PESNWI) questionnaire was administered to nurses working in two Ministry of Health hospitals. The questionnaire comprises of five subscales: Participation, Foundation, Managers Support, Workforce Adequacy and Physician/Nurse Relations. Mean scores of >2.50 were considered as favourable, and ≤2.50 were considered as unfavourable. Simple linear and multiple linear regression analysis were employed to identify factors associated with their perceptions. Analysis was carried out using STATA version 14.0. RESULTS: A total of 366 respondents took part in the study, with a response rate of 98.4%. Majority were working shift (89.6%) and working extended hours (62.3%). In general, the nursing practice environments were rated as favourable. Overall mean score was 2.90±0.03 and four out of five subscales' mean scores were >2.50. Foundation for quality nursing care was perceived as the most favourable subscale, while workforce adequacy was perceived as the least favourable. There were statistically significant association between working extended hours, doing double shift and working during day off with perceived unfavourable workforce adequacy. CONCLUSION: Nursing practice environment was perceived as favourable in the studied hospitals. Policy makers, service providers, and hospital managers could explore further on human resource planning and management of nursing personnel to tackle the issue of nurse staffing in the country.

Perception of nurses on the practice environment: Experience from Malaysia

@#Introduction: Positive professional practice environments are crucial to safeguard a healthy and safe working conditions for health workforce, including nurses; so as to ensure provision of quality healthcare and safety of patient. Methods: This was a cross-sectional study to assess nurses’ perceptions towards nursing practice environment and factors associated with their perceptions. A validated Practice Environment Scale of the Nursing Work Index (PESNWI) questionnaire was administered to nurses working in two Ministry of Health hospitals. The questionnaire comprises of five subscales: Participation, Foundation, Managers Support, Workforce Adequacy and Physician/Nurse Relations. Mean scores of >2.50 were considered as favourable, and ≤2.50 were considered as unfavourable. Simple linear and multiple linear regression analysis were employed to identify factors associated with their perceptions. Analysis was carried out using STATA version 14.0. Results: A total of 366 respondents took part in the study, with a response rate of 98.4%. Majority were working shift (89.6%) and working extended hours (62.3%). In general, the nursing practice environments were rated as favourable. Overall mean score was 2.90±0.03 and four out of five subscales’ mean scores were >2.50. Foundation for quality nursing care was perceived as the most favourable subscale, while workforce adequacy was perceived as the least favourable. There were statistically significant association between working extended hours, doing double shift and working during day off with perceived unfavourable workforce adequacy. Conclusion: Nursing practice environment was perceived as favourable in the studied hospitals. Policy makers, service providers, and hospital managers could explore further on human resource planning and management of nursing personnel to tackle the issue of nurse staffing in the country.

Clinical Review: Navitoclax as a Pro-Apoptotic and Anti-Fibrotic Agent.

B-cell lymphoma 2 (BCL-2) family proteins primarily work as a programmed cell death regulator, whereby multiple interactions between them determine cell survival. This explains the two major classes of BCL-2 proteins which are anti-apoptotic and pro-apoptotic proteins. The anti-apoptotic proteins are attractive targets for BCL-2 family inhibitors, which result in the augmentation of the intrinsic apoptotic pathway. BCL-2 family inhibitors have been studied extensively for novel targeted therapies in various cancer types, fibrotic diseases, aging-related as well as autoimmune diseases. Navitoclax is one of them and it has been discovered to have a high affinity toward BCL-2 anti-apoptotic proteins, including BCL-2, BCL-W and B-cell lymphoma-extra-large. Navitoclax has been demonstrated as a single agent or in combination with other drugs to successfully ameliorate tumor progression and fibrosis development. To date, navitoclax has entered phase I and phase II clinical studies. Navitoclax alone potently treats small cell lung cancer and acute lymphocytic leukemia, whilst in combination therapy for solid tumors, it enhances the therapeutic effect of other chemotherapeutic agents. A low platelet count has always associated with single navitoclax treatments, though this effect is tolerable. Moreover, the efficacy of navitoclax is determined by the expression of several BCL-2 family members. Here, we elucidate the complex mechanisms of navitoclax as a pro-apoptotic agent, and review the early and current clinical studies of navitoclax alone as well as with other drugs. Additionally, some suggestions on the development of navitoclax clinical studies are presented in the future prospects section.

Association of sociodemographic factors and self-perception of health status on oral health-related quality of life among the older persons in Malaysia.

AIM: This study aimed to evaluate the oral health-related quality of life (OHRQoL) among older persons in Malaysia and its associations with sociodemographic and self-perception towards general health as well as oral health. METHODS: A cross-sectional survey among community dwelling older persons utilizing stratified cluster sampling was conducted in 2018. Well-trained interviewers conducted a face-to-face interview with older persons aged ≥60 years to collect information on participants' sociodemographic characteristics, self-perception on general as well as oral health using the Geriatric Oral Health Assessment Index (GOHAI). Multivariate analysis of the data collected was performed using SPSS version 23. RESULTS: Overall, the GOHAI mean ± SD score for older persons in Malaysia was 51.83 ± 7.98, which was an average of fair mean (P < 0.001). Those with poor self-rated oral health (48.34 ± 8.96) or poor self-rated general health (47.13 ± 8.93) had poor mean OHRQoL (P < 0.001). Logistic regression analysis shows older persons who stay with spouse/partner (adjusted odds ratio [aOR]: 1.96 [1.66, 2.31]), no formal education (aOR: 1.84 [1.29, 2.61]) and self-perceived unhealthy oral health (aOR: 3.83 [3.19, 4.59]) were significantly associated with higher odds of having poor OHRQoL. CONCLUSIONS: The estimated OHRQoL of older persons in Malaysia is rated as fair, with minimum association contributed by the sociodemographic factors, but with a significant influence by self-rated oral and general health. Self-perception of health can be used as a good indicator to estimate the OHRQoL. Geriatr Gerontol Int 2020; 20: 57-62.