Pusat Pengajian Sains Kesihatan - Tesis

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A 4-week internal training load monitoring and fatigue responses of malaysian under-18 rugby players during competitive season
(2018-08)
Azis, Muhamad Fakhrul Hakim
Monitoring internal training loads using session ratings of perceived exertion (RPE) has been used extensively to manage fatigue and to optimise sports performance in athletes but none was reported in Malaysian athletes. Accurate monitoring of internal training loads could assist coaches in the adjustment of training, mode, intensity and duration during the competitive season. This study was to quantify the internal training loads (training load, monotony and strain) and fatigue and to identify the correlation of internal loads on fatigue responses of Malaysian under-18 rugby players for 4-weeks during competitive season. Thirty eight male participants of the study, aged from 16-18 years old, were recruited among the students from the Kolej Vokasional Pengkalan Chepa (N=38). The research variables of this study were collected in four weeks prior to their competition. After 90 minutes of every training session, they were asked to rate their training session using the RPE scale. Then, the Multidimensional Fatigue Symptom Inventory (MFSI)-Short form were administered once per week at the end of their training session for 4 weeks. The participants were trained five days per week as per coach’s training programme, hence the total number of days of data collection were 20 days. The types of training consisted of cardiovascular, strength, power and tactical. All data was entered into Microsoft Excel 2013. Statistical analyses was performed using IBM SPSS version 24.0. All data are presented as mean �} standard deviation (SD) in descriptive statistics. The statistical analysis used in this study was repeated measure ANOVA. The statistical significance was set 0.05. Pearson correlation at p was used to analyse the relationship between internal training load variables and MFSI. Results showed that the training load in week 4 (2594.00 �} 2.30) was significantly higher compared to week 1 (2388.55 �} 343.87), week 2 (2284.34 �} 411.41) and week 3 (2218.42 �} 521.63). Monotony in week 4 was higher (1.70 �} 3.13) compared to week 3 (1.43 �} 0.44). The mean of monotony in week 2 was higher (1.60 �} 0.35) than week 1 (1.49 �} 0.09). Strain increased in week 2 was higher (3728.44 �} 1228.51) compared to week 1 (3605.57 �} 653.51). In week 3, the mean strain decreased (3354.59 �} 1810.58) and increased in week 4 (4145.66 �} 306.38). In training load, monotony, strain and the total score of fatigue (TSF) correlation, the result showed that training load increased with moderate correlations to TSF (r=0.342; r=0.402; r=0.469). In monotony (r=354; r=0.371; i=0.421) and strain (r=0.343; r=0.383; r=0.446), there were also moderate correlation to TSF. The results obtained in this study will help the coaches and trainers to develop an effective training programme in order to maximise their athlete’s performance, reduce fatigue and subsequently prevent injuries.
A monitoring of archery performance predictors among state-level archers
(2023-09)
Sien, Lau Jiun
Archery is a sport that required a certain level of techniques, physical conditions, tactics, and psychology to perform. It is important to understand the most crucial criteria in archery to build excellent archers. Thus, this study aimed to determine the predictors of archery performance among state-level recurve archers. Eighteen state-level recurve archers were recruited from Terengganu State Sports Council and Malaysia Pahang Sports School and 13 participants (mean age = 16.23 ± 1.74) had completed the whole study protocol. Muscle activation level, draw force line, mood states, and physical fitness level of the archers were monitored predictors of archery performance in this research. The mood states of the participants were evaluated with Brunel Mood Scale Questionnaire before the scoring session. During the scoring session, the muscle activation of left deltoid muscles, left triceps muscles, right trapezius muscles, and right triceps muscles were measured with electromyography. Meanwhile, the draw force line during the anchoring and releasing was recorded with a video camera and was analysed with Kinovea motion analysis software. The archery shooting performance was based on a total score of 36 arrows shot at a distance of 70 meters. After the scoring session, the physical fitness level of the participants was measured with fitness tests including push-ups, sit-ups, handgrip test, stork stand test, back and leg test, sit and reach test, and multistage fitness test. All the parameters were measured five times, with each measurement taken at a twomonths interval. The results of the Multiple Linear Regression (MLR) revealed muscle activation level and physical fitness level can be used as a guideline in predicting the archery shooting performance. Among the muscles tested in this study, the left deltoid is the only muscle that is associated with the archery shooting performance in the fifth measurement session. Furthermore, physical fitness level also able to predict the shooting performance significantly in the first measurement session, third measurement session and forth measurement session. The physical fitness components that were associated with the archery shooting performance included left and right handgrip strength, back and leg strength, flexibility, balance, upper muscle endurance, core muscle endurance, and cardiovascular endurance. However, the mood states and the draw force line of participants are not associated with the archery performance. It is concluded that the physical fitness level and muscle activation level of the archers can predict the archery shooting performance among state-level archers.
A preliminary study of colorimetric nanoparticle evaluation of adulterated Simulated urine for amphetamine-type stimulants (ATS) abuse testing
(2023-09)
Majeed, Masar Ibrahem
Drug abuse is a serious and widespread problem, and urine testing is considered one of the most used methods to detect drug abuse, but as evidenced by the history of people who have been referred to forensic laboratories, the use of cleaning powders, bases and their components, birth control pills, or aspirin pills to change Drug analysis results, because it is believed that these substances will affect the urine screening test, the purpose of this study is to determine the effect of these substances on common colorimetric laboratory tests (UDSTs) and to use colorimetric detection of unmodified gold nanoparticles to detect false negative results. In this study, a drug screening test strip (commonly performed on urine samples using immunoassays) will be screened using urine positive for amphetaminetype stimulants (ATS) and verifying the authenticity of the sample and the presence of ATS in the sample after addition of counterfeits using thin layer chromatography method. A method was used to screen false negative results with less effort and time than the thin layer chromatography (TLC) method using nanoparticle techniques of unmodified gold, the effect of eleven common types of adulteration was studied. Acetic acid, citric acid, hydroxide, hypochlorite based bleach, Pyridinium chorochromatic PCC, potassium dichromate, sodium chloride, ammonia and nitrate compounds, eye drops and detergents are the compounds discussed. In four tests, were tested on urine positive for ATS by adding adulterants at a 2:1 ratio, urine Dipstick testing and drug presence testing gave negative results for the adulteration cases, and a third colorimetric test was performed in the urine using TLC method, Marquis reagent, iodoplatins, and Dragendoff reagent. A silica plate was sprayed with a reagent for the virtual determination of amphetamine, methamphetamine, and 3,4- methylenedioxy-N-methamphetamine (MDMA) at a temperature higher than 20 °C as a result, false negative medications can be detected in the urine sample. But this method requires time, effort and materials, the fourth test is to use a nanoparticle detector formulated to detect the presence of amphetamine-type stimulants, by changing the colour from red to blue at a temperature of 24 degrees Celsius, the nanoparticle detector was able to detect the presence of amphetamine-type stimulants in low concentrations in urine samples, when compared the use of the TLC colorimetric detection method with the nanoparticle colorimetric detection method, we conclude that the latter is superior because it gives results in less time and requires less effort.
A study on geriatric patients attending emergency department Hospital Universiti Sains Malaysia.
(2017)
Sjahid, Afifah Sjamun
This study aimed to determine the proportion of geriatric patients attending Emergency Department in Hospital Universiti Sains Malaysia (USM) within January 2015 to March 2015, the mean duration of hospital stay and the outcome of the illness in geriatric patients admitted to Hospital USM. This study also aimed to identify the associated factors of mortality in geriatrics patients admitted to Hospital USM. This study was a retrospective cohort study from January 2015 till March 2015 at Emergency Department Hospital USM. All patients aged 60 years and above attended Emergency Department of Hospital USM from January 2015 until March 2015 were included. Systematic random sampling was used. A total of 209 patients had been included in this study. Descriptive statistics were expressed as cross-tables for categorical variables and as mean ± standard deviation for numerical variables. Independent categorical variables were compared using Chi-Square test or Fisher’s exact test. Paired group comparisons were performed using Independent t-test or Mann Whitney test for numerical variables. Total patients included in this study were 209 patients. The mean (standard deviation, SD) age was 68.4 (6.95) years old, with age range from 60 till 106 years old. Fifty-eight percent were male and 95.7% were Malay. Seventy-eight percent were triaged as an emergency; with 19.6% were red zone cases, while 51.2% were yellow zone cases. Three most common presenting symptoms were respiratory symptoms (24.9%), cardiovascular symptoms (19.65%) and gastrointestinal symptoms (12.9%). Out of209 patients studied, 95 patients (45.5%) were admitted. Mean duration of hospital stay was 8 days (mean 7.57, SD 12.97). Out of 95 patients admitted, only 15 patients (15.8%) died in the ward. Factors associated with mortality in hospitalized geriatric patients were gender (p = 0.009), patient’s method of arrival (p = 0.001), conscious level on arrival (p < 0.001), patient’s condition when transferring to the ward; either ventilated (p = 0.014) and on inotropic agent (p < 0.001) or not, patient’s first pulse rate taken at triage (p < 0.001) and first blood investigations taken in emergency department; white blood cell (p = 0.007), hemoglobin (p = 0.019), serum lactate (p < 0.001) and serum urea (p = 0.036). Majority of the geriatric patients triaged as emergency cases indicated that they mostly came with ill-conditioned that need to be attended immediately. By knowing the common presenting symptoms and associated factors of mortality in admitted geriatric patients will alert medical personnel in the emergency department to treat this group of patients more thoroughly and judiciously.
A study on the profile of ketum preparation using colour test and GCMS
(2022-09)
Rosli, Wan Nur Qasrina Wan
Mitragyna speciosa, or known as ketum in Malaysia, is always misused as herbal drug of abuse. Typically, ketum is sold as their raw leaves, drinks or campsules in the street as well as incense online and also available at markets in more rural areas in Southeast Asia as traditional medicine, especially in Malaysia and Thailand. Ketum is very popular among men workers in Malaysia and Thailand. Many decades ago, ketum leaves have been used by natives due to its opium-like effect and cocaine-like stimulant ability to increase energy and combat fatigue. Mitragynine, an alkaloid from ketum leaves is responsible for these mentioned effects and this makes ketum drinks to become the emerging drug of abuse. However, it is unknown at all whether or not other ingredients were added in the ketum drinks available in the market.This present study was done to determine active compounds in the ketum drinks mixtures and to study the recent trend of ketum “cocktails”. In this study, all ketum drinks were obtained in the form of drinks. Presumptive colour test on ketum samples was successfully conducted using Van Urk reagent and 70 samples gave pink colour change, 4 samples gave dark pink colour change and one showed negative screening results. The preparation of ketum drink standard was successfully done by boiling 10 ketum leaves in a beaker on a hotplate. Besides, the extraction process of mitragynine from all 75 samples were successfully performed using liquid-liquid extraction method. Afterwards, the chloroform extracts were subjected to gas chromatographymass spectrometry (GC-MS) analysis. The resulting chromatograms and possible fragmentation pathways detected by GC-MS were discussed extensively. Out of 75 samples, only one sample did not exhibit mitragynine peak and majority showed simple chromatograms with only several peaks present in the chromatogram which include caffeine (RT=5.137) and mitragynine (RT=18.839). Sample 49 showed the most complex chromatograms with the presence of a MDMA peak. The trend of ketum drink mixtures in Malaysia was also studied. The findings showed that most of the ketum preparation were merely ketum drinks, without addition of any adulterants. A few samples were, however, in the form of cocktails, and these can cause serious health effects. It is therefore important that the monitoring of the streect drugs are conducted, perhaps via a more frequent drung profiling study to obtain information which could be useful for forensic intelligence as decision making for the respective authorities.
Acute oral toxicity evaluation of baicalein active compound extracted from oroxylum indicum in sprague-dawley rats
(2022-09)
Yan, Yeap Mei
Oroxylum indicum is a unique plant which can be found throughout Southeast Asia and has gained increasing attention in the field of oncology. Baicalein is the most abundantly found and dominant active compound of the O. indicum plant in general. It has been reported to exert anti-metastatic, anti-bacterial, anti-obesity, anti-diabetic, anti-inflammatory, neuroprotective, and cardioprotective, as well as wound healing potentials. However, there is a gap in scientific knowledge on the toxicological profile of baicalein active compound extracted from O. indicum. This study aims to evaluate the acute toxicity effect of baicalein extracted from O. indicum leaves by conducting acute oral toxicity testing on Sprague-Dawley rats. The Soxhlet binary extraction process using finely crushed O. indicum leaf material yielded 3.94 g (16%) of crude extract powder. Next, fractionation of the crude extract powder using 100% methanol concentration generated fraction 5 (F5) with enriched baicalein compound. TLC analysis detected the presence of baicalein in F5 under short-waved (254 nm) and longwaved (365 nm) UV light. The initial sighting study revealed that F5 did not cause any mortality among the rat models throughout the experimental period, at fixed doses of 5 mg/kg, 50 mg/kg, 300 mg/kg, and 2000 mg/kg set by Organisation for Economic Cooperation and Development (OECD) guidelines. Thus, the sub-lethal dose of baicalein was more than 2000 mg/kg. The results of the acute toxicity study revealed that body weight of all animals did not show any increment or reduction of more than 20% of their initial body weight after 14 days. Although, statistically significant differences (p < 0.05) were seen in the relative weight of the brain, lung, and reproductive organs among male and female treated groups. Nevertheless, the haematological and biochemical indices for treated groups of both sexes were all within normal range according to Clinical and Laboratory Standards Institute (CLSI) and American Society for Veterinary Clinical Pathology (ASVCP) guidelines, similar to the non-treated groups. Moreover, the animals showed no clinical signs of toxicity and changes in behaviours related to the treatment. Histopathological examination also revealed normal cellular architecture with absence of treatment related toxicity on all vital internal organs of the treated group. Therefore, the results of this study demonstrate that baicalein extracted from O. indicum produced no adverse toxic effects on Sprague-Dawley rat behaviour and organ tissue morphology at highest dosage of 2000 mg/kg.
An integrated Raman spectroscopy and self-organizing feature map chemometrics analysis for the discrimination of gel inks
(2022-07)
Asri, Muhammad Naeim Mohamad
One of the techniques often used by forensic document examiner in the analysis of questioned documents is Raman spectroscopy. This technique has proven effective in rapidly and accurately characterising ink with the advantage of not causing permanent damage to the analysed document. Gel ink pen was first introduced to the market around 1990s by the Sakura Colour Product Corporation, Japan as an alternative daily writing instrument other than ballpoint-pen. Being marketed in varieties of attractive colours and also environmentally friendly, gel ink pen has become very popular among consumers therefore it appearances in cases involving document fraud is anticipated. Unfortunately, studies involving gel ink pen in the perspective of questioned document are limited compared to ball-point pen. In forensic investigation, it was reported that 80% handwritten documents were written using ballpoint pens. Therefore, due to the lack of objectivity in interpreting gel inks, this study proposed using novel chemometric techniques for discriminating gel-pen inks in forensic investigation. This study show the comprehensive conceptual work flow with conventional chemometrics techniques of Principal Component Analysis (PCA), Hierarchical Cluster Analysis (HCA) and novel Self-Organising Feature Maps (SOFM) in tandem with Raman spectroscopy to discriminate gel inks of three different colours i.e. blue, red and black before and after undergoing ageing process for nearly three years. Preliminary dissolution studies performed by dissolving gel inks in a varieties of organic solvents show that gel inks of pigment based colourants do not normally dissolve in organic solvents while Thin Layer Chromatography (TLC) is only successful to dye-based colourant gel inks. Queries made to the acquired blue, red and black gel inks Raman spectra against a database containing Raman spectra of 200 pigments, suggested that CI Pigment Blue 15: 1 and 15: 3, could be the main pigment in blue gel inks conversely Red DPP BO (23180 – CI Pigment Red) and XSL Poppy Red (26308 – CI Pigment 112) could be the main pigment in red gel inks however main pigments in black gel inks remain unidentified. In most cases, Hierarchical Cluster Analyses (HCA) have recorded lesser number of clusterings compared to Principal Component Analyses (PCA). In general, both conventional chemometrics techniques are unable to discriminate the gel inks according to their brands however this is not the case for the novel SOFM. All SOFM maps are in line with the classification made by the visual Raman comparison of inks. The misclassified sample (HCA and PCA) was successfully resolved using the SOFM model signifying its capability for both discrimination and classification purposes. Cross validations employing the k-validation strategy have recorded 100% correct classification rates for all the SOFM models, thus signifies the robustness and potential of SOFM for discrimination of gel inks. As for the aged gel inks, SOFM has also successfully sourced the aged inks to their fresh counterparts. This study reported the first use of SOFM for discrimination and classification of gel inks. The findings of this study did not only communicate the comprehensive work flow for gel ink analysis but most importantly signify the potential of SOFM to be employed in tandem with Raman spectroscopy as an alternative pattern recognition technique to the conventional chemometrics techniques that can be highly useful in document fraud investigation involving gel inks.
Analysis of the association between SLCO1B1 genetic polymorphism (rs4149056) and lipid profile among statin users of HUSM, Kelantan
(2022-09)
Yusri, Nur Farah Izzati
Statin is a medication that was proven to treat hyperlipidaemia effectively. Despite its well-known efficacy in statin users, the cases of its effectiveness have been reported. Single nucleotide polymorphism of rs4149056 in SLCO1B1 gene has been reported to alter the efficacy of statin. Until now there is no genetic association study among Malaysian population has been reported pertaining the influence of SNP on the efficacy of statin. Thus, the aim of this study is to investigate the association between SLCO1B1 rs4149056, patient’s demographic profiles and other clinical features among statin’s users from HUSM, Kelantan. Information regarding the demographic and clinical features of statin’s users obtained through examination of patient’s medical record. The extracted DNAs for this study were obtained from previous researcher. The genotyping of selected DNA sample of statin’s users was performed by using ARMS-PCR technique followed by gel electrophoresis. The results indicated that, there were no different in demographic profiles and clinical features between group 1 (those who achieved LDL-c level <2.60 mmol/L) and group 2 (those who achieved LDL-c level >2.60 mmol/L) except for concomitant drugs. The minor allele frequency (MAF) of the SNP value obtained was 0.23. However, there is no variables (age, race, gender, type of statin, concomitant drugs, supplement, genotype, physical activity, diet and smoking status) that are statistically significant associated with the achievement of LDL-c goal of <2.60 mmol/L. In conclusion, the SLCO1B1 rs41419056 polymorphism had no effect on lipid level changes in 72 hyperlipidaemic statin users.
Anti cancer effect of paddy husk extracts in human salivary gland epidermoid cancer cells in vitro model
(2024-02)
Al-Azazi, Entesar Ahmed Abdullah
Global agriculture produces millions of tons of waste yearly. Paddy husk is an inedible agriculture waste obtained during the process of rice milling. Studies reported that it has chemopreventive potential due to the presence of related phytochemicals. The aim of this study is to elucidate the presence of anti-cancer related phytochemicals from paddy husk extract and evaluate its inhibitory and anti-proliferative effects against human submaxillary salivary gland epidermoid carcinoma cells (HTB-41). Two types of solvent for paddy husk extract have been used; water and aqueous methanol. The phytochemical constituents of paddy husk extracts were identified using GC-MS. The inhibitory activity and cytotoxicity analysis was calculated using Trypan Blue Exclusion Assay (TBEA). Apoptosis and cell cycle analysis were evaluated by flow cytometer, and cell morphology post treatment was analysed ultrastructurally, while Western blot was performed for proteomic analysis. Our results showed presence of vitamin E and other phytochemicals in paddy husk extracts. Both water and aqueous methanol extracts demonstrated inhibitory activity on HTB- 41 cells where IC50 dose of water extract (400 μg/ml) managed to reduce cell viability to 53.0 % and IC50 dose of aqueous methanol extract (200 μg/ml) managed to reduce cell viability to 51.12 % without exhibiting any significant cytotoxic effects. Apoptosis analysis revealed that water and aqueous methanol extracts induce apoptosis effect on HTB-41 as supported with microscopic findings of cell shrinkage, membrane blebbing and apoptotic bodies, meanwhile, Hoechst 33342 staining showed nuclear shrinkage and fragmentation. Flow cytometry analysis demonstrated that paddy husk extracts promote a significant amount of apoptotic cellular population from 76.00% (untreated) to 47.86% (paddy husk water extract) and 43.13% (paddy husk aqueous methanol) and arresting the cells at S-phase from 19.90% (control) to 36.90 % (paddy husk aqueous methanol extract) and 27.86 % (paddy husk water extract). Western blot analysis reveals that apoptosis was induced through caspase 3-mediated intrinsic pathway. Pro-apoptotic and tumour suppressor proteins; Bax, p27kip1 expressed higher (P <0.05), while anti-apoptotic protein, Bcl-2 downregulated after treatment (P <0.01). This leads to increase of caspase 9 expression which in turn activate caspase 3 and 7 leading to cell apoptosis. In conclusion, the presence of phytochemicals in paddy husk especially in aqueous methanol extract successfully showed better inhibitory and anti-proliferative effects on the human submaxillary salivary gland epidermoid carcinoma cells (HTB-41), while it acted in a tumour-selective manner by not inducing any significant changes on human gingival fibroblast cell (HGF-1).
Antibacterial activity and mechanisms of action of the semi-purified fractions from melaleuca cajuputi leaves against selected bacterial strains
(2024-06)
Musa, Isah
The increasing incidence of bacterial infections and the rapid spread of antimicrobial resistance underscores the need to find novel alternative medications from natural sources, especially medicinal plants. Thus, this study aimed to investigate the antibacterial activities of Melaleuca cajuputi leaf extract and unveil the possible antibacterial mechanisms of the most potent semi-purified fractions against selected bacterial strains. The mineral content in M. cajuputi leaf was analyzed using inductively coupled plasma-mass-spectrometry (ICP-MS). Methanolic, ethanolic, and aqueous extracts were obtained by cold maceration. Subsequently, the most potent crude extract was fractionated to obtain semi-purified fractions by bioassay-guided fractionation technique. The antibacterial activity of the crude extracts and semi-purified Melaleuca fractions (MFs) was evaluated using a broth microdilution assay. Ultraviolet-visible (UV-Vis), Fourier transform infrared (FTIR) spectroscopies, and gas chromatography-mass spectrometry (GC-MS) were employed to identify the chemical compositions of the most potent extract and semi-purified MFs. Mechanisms of action of the most potent MFs were investigated using time-kill assay, cell morphology examination, and in-silico molecular docking studies. The toxicity profile was evaluated using the brine shrimp lethality test (BSLT). Macronutrients such as potassium (7182.042 mg/kg), sodium (3895.795 mg/kg), calcium (3730.259 mg/kg), and trace elements including iron (89.394 mg/kg), manganese (57.070 mg/kg), and zinc (51.626 mg/kg) were detected in M. cajuputi leaf extract. The antibacterial assays demonstrated that MF2c and MF2d were the most potent, with minimum inhibitory concentration (MIC) values ranging from 0.13 mg/mL to 0.25 mg/mL and 0.063 mg/mL to 0.25 mg/mL, respectively. The bioactive compounds identified in MF2c were β-eudesmol (71.96%), α-eudesmol (18.83%), and γ-eudesmol (9.21%). Meanwhile, 2-isopropyl-10-methylphenanthrene (83.09%), 10-methylanthracene-9-carboxaldehyde (10.95%), trimethyl gallic acid (2.60%), methyl-lathodoratin (2.10%), and methoxyamine (0.28%) were identified in MF2d. Time-kill assay revealed that MF2c and MF2d exhibited concentration-dependent bactericidal effects against the tested bacterial strains. The scanning electron micrographs of the treated bacteria showed apparent cell membrane damage characterized by abnormal cell elongation, shrinkage, and organic debris on the cell surfaces. Furthermore, the in-silico molecular docking analysis revealed that 2-isopropyl-10-methylphenanthrene had the highest binding propensity against DNA-dependent RNA polymerase, D-alanyl transferase, DNA gyrase, and dihydropteroate synthase, with docking energy scores of -8.4, -6.9, -6.5, and -6.1 kcal/mol respectively. Based on the toxicity results, M. cajuputi methanolic extract (LC50 781 μg/mL showed mild toxicity, whereas MF2c (LC50 6621 μg/mL) and MF2d (LC50 1165 μg/mL) were non-toxic. In conclusion, the semi-purified MFs showed remarkable antibacterial effects and were non-toxic. The findings hold promise for developing alternative therapeutic strategies to combat bacterial infection
Antibiotic resistance during covid-19 pandemic and perspective of healthcare providers towards antibiotic resistance: a mixed-method study
(2024-02)
Sulayyim, Hadi Jaber Al
During the Novel coronavirus disease 2019 (COVID-19), there was an overuse of antibiotics in hospitals. The improper use of antibiotics during COVID-19 has increased the antibiotic resistance (AR), which was reported by multiple studies. The main objective of this study was to study the AR during COVID-19 and perspective of healthcare providers towards AR. This study employed a mixed method design throughout two phases. Phase Ⅰ study (ⅰ): A retrospective cross-sectional study was employed to identify patients who had positive AR bacteria before, during and after COVID-19 as well as the bacterial isolates; Phase Ⅰ study (ⅱ): A cross sectional design was employed to assess the knowledge, attitude, and practice (KAP) of healthcare worker (HCWs) in Najran, Kingdom of Saudi Arabia (KSA); Phase Ⅱ study: A qualitative multi-centre study was carried out in the KSA to explore the experience of health commissioners toward AR during COVID-19. Results of Phase Ⅰ study (ⅰ) showed the prevalence of Pan Drug Resistance (PDR) during COVID-19 pandemic (85.7%) was higher as compared to the time before (0%) and after (14.3%), p= 0.001. S. aureus showed a negligible resistance after pandemic, while the resistance Gramnegative bacteria decreased during and after pandemic compared to the time before. Results of Phase Ⅰ study (ⅱ) revealed poor knowledge, negative attitude and poor practice of HCWs. The significantly associated factors with good knowledge were nationality, cadre, qualification, and working place. Positive attitude was significantly associated with cadre, qualification, and working place. Good practice was significantly associated with gender, cadre, qualification, and working place. In Phase Ⅱ, seven themes emerged from data. Therefore, despite the AR increased globally during COVID-19 pandemic, it dropped gradually in Najran region, KSA. Knowledge, attitude and practice of HCWs in Najran, KSA regarding AR during pandemic need improvement, whereas healthcare commissioners showed scientific and up to date knowledge about the AR. Antibiotics’ prescription should be strictly implemented, relying on the antimicrobial stewardship programs (ASP) and guidelines from the world health organization (WHO) or ministry of health (MOH). Implementation of effective educational and training programs are urgently needed. Findings of this study could be used to inform policy and practice for governmental HCWs and public to reduce the impact of pandemics on the AR.
Antimicrobial activity and prebiotic effects of senna alata leaf extracts
(2022-09)
Zakaria, Nik Hasanah
Senna alata or Cassia alata is a medicinal plant found mostly in the tropics and subtropics. The leaves of the plant have been employed in the treatment of skin infection and digestion-related problems. The purpose of this study was to assess the antimicrobial activity of S. alata leaf extracts against several intestinal pathogens and their prebiotic effects against a few probiotic strains, as well as to screen the phytoconstituents in S. alata leaf extracts. MIC and MBC assays of aqueous and ethanolic leaf extract in a concentration ranging from 0.39 mg/mL to 200 mg/mL were performed on the intestinal pathogens in a sterile 96-well microtiter plate. The prebiotic effects of aqueous and ethanolic leaf extracts in concentrations from 1.25 mg/mL to 10.00 mg/mL were evaluated based on the growth rate of the probiotic within 24 hours. The phytoconstituents of aqueous and ethanolic leaf extracts were screened by standard qualitative methods. Both leaf extracts showed a bactericidal effect against S. aureus, while only aqueous leaf extract showed a bacteriostatic effect against S. Typhi. Probiotics of L. helveticus and B. longum showed a positive mean growth rate after being treated with both leaf extracts for 24 hours. However, the growth rate of both bacteria decreases as the concentration of both leaf extracts increases. Both leaf extracts showed the presence of tannins, saponins, alkaloids, carbohydrates, and flavonoids. In conclusion, both S. alata leaf extracts showed significant antimicrobial activity against S. aureus and S. Typhi at the tested extract concentrations. Besides, both S. alata leaf extracts are weak prebiotics because they only stimulate a minimal growth of probiotics.
Antimicrobial susceptibility and molecular profiles of acinetobacter baumannii in Makkah hospitals, and the potential use of bacteriophage as a treatment option
(2022-12)
Raees, Fahad
Acinetobacter baumannii is an opportunistic Gram-negative pathogen that frequently causes infections especially in intensive care settings worldwide including Saudi Arabia. This organism is known to acquire resistant to almost all clinically available antimicrobial agents. To understand the magnitude of A. baumannii acquisition in local settings, 895 isolates were collected from King Abdullah Medical City Makkah, Al Noor Hospital and Al Zahir Hospital of Makkah from 2013-2019. Vitek2® system was used for identification of the organism and antimicrobial susceptibility test. Thirty MDR A. baumannii isolates from King Abdullah Medical City Makkah and seven from Al Noor Hospital were selected for whole genome sequencing. To study the role of bacteriophage, sewage water from King Abdullah Medical City Makkah and Al Noor Hospital were screened for clinical isolates A. baumannii lytic phenomenon. A few bacteriophage candidates were found, but the subsequent lytic tests were negative. This phenomenon was studied by reviewing the bacteriophage genomes integrated in the bacterial nucleic acids. In this study, 70-80% of A. baumannii isolated from Makkah hospitals were found to be resistant to commonly used antibiotics in intensive care units. There are increasing trends of resistance to agents that been reserved to treat carbapenem-resistant A. baumannii i.e. tigecycline and colistin. The sequence type (ST)-195 was the predominant sequence type, contributed to 48.6% of A. baumannii isolations in Makkah hospitals. There were three novel sequence types that associated with 18.9% of infections that need further characterization. Among the β-lactamase resistant mutations, this study found blaADC-25 and blaOXA-66 were the most common with 86.5% and 83.8% respectively, followed by blaOXA-23 and blaTEM-1D, both at 37.8%. This study also found 75.7% and 73.0% of the tested MDR A. baumannii isolated from Makkah hospitals acquired mph(E) and msr(E) macrolides resistant genes respectively. The aminoglycosides resistance was encoded mainly by aminoglycoside phosphor-transferase gene, aph(3′′)-Ib at 83.8% and aminoglycoside O-phosphotransferase aph(6)-Id at 70.3%. Besides, these MDR isolates were also acquired of sulphonamide resistant genes of sul1 (32.4%) and sul2 (18.9%). Part of the core of this project was to find the potential bacteriophage that has capability to infect and lyse A. baumannii cells. After extensive searching for bacteriophage from sewage water of two tertiary care hospitals in Makkah, several bacteriophage candidates were shortlisted, however these bacteriophages failed to perform lytic phenomenon consistently. Almost one-fourth of MDR A. baumannii were found to acquire intact bacteriophage genomes, indicated prophages condition. The whole genome sequence of two MDR A. baumannii isolates (AB417 and AB552) were studied before and after bacteriophage treatment indicated additional intact bacteriophage genomes were added in isolate AB552. Three genomes of non-Acinetobacter bacteriophages was found to be integrated in these MDR Acinetobacter series. In conclusion, this study found the resistant rate of A. baumannii were more than 80% in Makkah hospitals which may lead to treatment failure in clinical practice. Searching for a non-pharmacological approach by means of using bacteriophage therapy showed inconsistent outcomes. With few treatment options available, robust infection control strategies and antibiotic stewardship programs are critical for preventing the spread of these resistant strains. Further research is very critical to find alternative agents to treat MDR A. baumannii.
Assessing the level of lead, cadmium and arsenic among farmers in KADA agricultural area, Kelantan
(2016-06)
Kasri, Hazmira Mohd
Heavy metals, particularly cadmium, lead, and arsenic, constitute a significant potential threat to human health. This study was conducted to determine the concentration of lead, cadmium and arsenic in nail samples from farmers at Kemubu Agricultural Development Authority (KADA), Kelantan, Malaysia. Control group of this study was selected from participants working in different environment which are USM Health Campus’s staffs. A total of 35 farmers and 35 USM Health Campus’s staffs participated in this study. The fingernails samples were extracted by using acid digestion and then analysed by Atomic Absorption spectrometry (AAS). Checklist was given to participants to get demographic, health status, and their agricultural activities data. In this study, the concentration of heavy metals was within the normal range and varies according to demographic factors. The result showed that the concentration of all heavy metals were significant different in exposed group as compared to control group (p < 0.05). There were also significant correlations between age with concentration of lead, arsenic (r = 0.317 and r = 0.326, resp., p < 0.01) respectively and cadmium (r = 0.257, p < 0.05). Findings suggested that agricultural activities could contribute to the accumulation of heavy metals in farmers. Hence, the control of human exposure to these metals was important in order to prevent adverse health effects. In conclusion, lead, cadmium and arsenic concentration among farmers were lower compared to the allowable limit and they should conduct good agricultural practice to maintain in normal range.
Assessment of nutrient intake and levels of nutrition knowledge, attitude, and practice among gymnasium users in Jordan
(2023-03)
Moh’d, Al-Quran Mohammad Abdel-Hakim
Proper nutrition is important for physical performance of an individuals. However, lack of knowledge might lead to negative attitude and poor dietary practice. The purpose of this study is to assess nutrient intake and the levels of nutrition knowledge, attitude, and practice (KAP) among gymnasium users in Jordan. In this study, a total of 138 male gymnasium users (18 – 35 years) were recruited from several gymnasiums in Jordan. Their height and weight were measured, and body mass index (BMI) was calculated. The KAP-Sports nutrition questionnaires which contains 3 sections was administered. In addition, participants were asked to record their dietary intake in a given food diary for three days (two weekdays and one day on the weekend). Data were analysed using Nutritionist Pro Software and SPSS vs. 25.0 (Descriptive and Pearson correlation analysis). As a result, majority of the participants had moderate knowledge on sports nutrition (77.6%), neutral attitude (84.7%) and fair dietary practice (67.4%). The mean score for knowledge, attitude and practice was 18.07±2.56, 58.75±6.24 and 29.72±3.55 respectively. The correlation analysis revealed that there was a positive significant correlation between knowledge and attitude (p=0.048, r=0.18) as well as practice (p=0.018, r=0.20). The mean of daily total energy intake was 2085.7 ± 468.1 Kcals while the percentage out of total energy for CHO, protein and fat was 42%, 19%, and 39% respectively. The total energy and CHO intake were lower than the recommended value. Protein intake was within the RDA while fat intake was higher. The mean of daily Vitamin B6, Vitamin C, Vitamin E, calcium, magnesium, and zinc intake was 0.7 ± 0.3 mg, 98.0 ± 34.7 mg, 9.0 ± 1.8 mg, 823.5 ± 277.8 mg, 279.3 ± 64.3 mg, and 8.6 ± 1.1 mg respectively. Compared to the DRI value, participants’ micronutrients intake was lower except for Vitamin C and calcium. In conclusion, gymnasium users in Jordan did not have adequate knowledge that can affect positive attitude as well as good dietary practice. Sports nutrition education is recommended to ensure adequate and correct knowledge are disseminated to the athletes.
Assessment of nutritional status, nutrient intake, physical activity and quality of life among overweight & obese female government staffs in Kota Bharu, Kelantan.
(2017)
Ayoub, Aqila
Assessment of nutritional status, nutrient intake, physical activity and quality of life were carried out among 160 overweight and obese women government staffs in Kota Bharu, Kelantan. Data was collected using a questionnaire which included socio-demographic characteristics, the International Physical Activity Questionnaire (IPAQ), 24-hour dietary recall and Impact Weight Quality of Life (IWQOL) questionnaire. Body mass index, waist circumference, weight and height were measured using standardized methods. Almost half of the respondents (36.9 %) were within age of 30-39 years. Majority of the respondents were Malay (99.4%) and followed by Chinese (0.6%). Mean weight, height and BMI of the respondents were 72.3 ± 9.12 kg, 1.55 ± 0.06 cm, and 30.0 ± 3.33 kg/m2 respectively. Based on WHO classification, 60.0% of respondent were overweight and 40% of respondents are obese respectively. The waist circumference of respondents for normal and obese individuals are 1.9% and 98.1% respectively. The mean total physical activity score was high in obese group (17171.63 ± 13353.24) than overweight group (14238.23 ± 9963.04). Furthermore, the mean total calorie intake of respondents for overweight (1631.13 ± 458.18 kcal) was higher than obese (1513.03 ± 475.68 kcal). Significant linear relationship was found between protein intake in sexual life of quality of life (b=0.13, 95% CI= 0.001, 0.258, p < 0.048), age in public distress of quality of life (b= -0.386, 95% CI= -0.006, -0.106, p < 0.007) and individual income in public distress of quality of life (b= -0.002, 95% CI= -0.003, 0.000, p < 0.024). This indicate that age, individual income and protein intake can be used a predictor for quality of life. However, there is no association was identified between physical activity and BMI with quality of life.
Assessment of phagocytosis and cytokine secretions by monocytes in the presence of plasmodium falciparum
(2021-09)
Xuan, Keh Min
Malaria remains one of the most common human infections worldwide. In endemic areas, malaria is a leading cause of morbidity and mortality and it causes significant socioeconomic burdens to the affected people. Monocytes are part of the immune system to control parasite burden and to protect host against malaria infection. Monocytes play their protective roles against malaria via phagocytosis, cytokine production and antigen presentation. Though monocytes are crucial for clearance of malaria infection, they also have been shown to cause adverse clinical outcomes. The objective of this study was to determine the morphology of P. falciparum, to assess phagocytic capability of infected red blood cells by human monocytes and further measure the cytokine secretions of monocytes following phagocytosis by using ELISA. In this study, monocytes were isolated from whole blood collected from healthy individuals while Plasmodium falciparum (3D7) was cultured under optimal conditions. Phagocytotic activity and cytokine production by the monocytes following malaria infection were assessed in vitro by co-culturing the monocytes and P. falciparum-infected red blood cells for 1 and 2 hours. The present study demonstrated that the monocytes phagocytosed the P. falciparum-infected red blood cells and the phagocytosis index increased with longer incubation time, from 8.2% at 1 hour incubation time to 10.4% (p<0.05) at 2 hours incubation time. Following phagocytosis, the monocytes produced TNF-α, initiating innate immune response to help in the clearance of parasite. The data have shown that monocytes cultured alone expressed the highest level of TNF-α during 0 and 1 hour of incubation, while co-culture of monocytes with P. falciparum-infected red blood cells produced the highest level of TNF-α after 2 hours of incubation. Comparing the trend among monocyte control, parasite control and co-culture, all showed an increase in the level of TNF-α produced in the first hour, but the concentration decreased significantly in the second hour. As a conclusion, these findings suggest that monocytes play an important role in malaria infection by phagocytosing the parasites and producing TNF-α for the removal of parasites, thereby initiating an immune response for malaria eradication.
Caspase-dependent apoptotic mechanism of gallic acid and its derivatives isolated from quercus infectoria ethyl acetate extract against cervical cancer cells lines (hela)
(2023-09)
Ismail, Illyana
Cervical cancer is one of the most common cancers in women worldwide. In 2020, cervical cancer ranked the fourth most diagnosed cancer among Malaysian women. The induction of apoptosis is one of the essential mechanisms to prevent the process of carcinogenesis. The previous study indicated that natural products were able to induce apoptosis and showed promising advantages in cancer treatment. The Quercus infectoria galls (QI) have been reported to have antimicrobial, antioxidant, anticancer and wound healing activities. However, the antiproliferative activity and the underlying molecular mechanisms against human cancer cells have been poorly elucidated. Hence, the present study was undertaken to examine the cell death mechanisms of gallic acid and its derivatives isolated from Quercus infectoria ethyl acetate extract (EAQI) against cervical cancer cells (HeLa). Gallic acid (GA) and its derivative, methyl gallate (MG), were isolated by using a bioassay-guided isolation technique. The antiproliferative effect that characterised by inhibitory concentration at 50 % cell populations (IC50) of EAQI, GA and MG were determined by using the MTT [3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide] assay at various concentration ranging from 0.39 to 100 μg/ml at 72 hours of treatment in HeLa cell lines and the control serving non-cancerous Vero cell lines. Cisplatin was used as a positive control, while untreated HeLa and Vero cells served as the negative control. Changes in cell morphology were measured by acridine orange/propidium iodide (AO/PI) staining for 24, 48 and 72 h. Viable, apoptotic and necrotic cells were identified using a fluorescence microscope. Determination of phosphatidylserine (PS) externalisation was performed using annexin-V Fluorescein isothiocyanate (FITC) / propidium iodide (PI) dual staining assay. The cells were treated for 3, 6 and 12 h and analysed by flow cytometry. Cellular deoxyribonucleic acid (DNA) content was measured in HeLa cells using flow cytometry at 24, 48 and 72 h for cell cycle distribution. Apoptosis pathways were elucidated based on pro and anti-apoptotic protein expressions (p53, Bax and Bcl-2) at 3 hours of treatment and caspases activity (caspase-8 and -9) were analysed by flow cytometry technique at 6 hours of treatment. The results showed that EAQI, MG and GA exhibited the antiproliferative effect on HeLa cells with IC50 values of 11.50 ± 0.5 μg/ml, 11.00 ± 0.58 μg/ml and 10.00 ± 0.67 μg/ml, respectively. In the cell morphology analysis, cells treated with IC50 value of EAQI, MG and GA displayed an increased apoptotic cell population compared to untreated cells (p<0.05) at 72 hours of treatment. The induction of apoptosis was confirmed by the externalisation of phosphatidylserine on early apoptotic cells, which showed the treated cell population shifted from viable to apoptotic quadrant. Based on the cell cycle distribution, the accumulation of cells at the subG0 phase in treated cells indicated the discontinuity of deoxyribonucleic acid DNA fragmentation and led to apoptosis. Furthermore, the results showed that p53 and Bax (pro-apoptotic proteins) were expressed in the treated cells, whereas Bcl-2 (anti-apoptotic protein) was not expressed at 3 hours of treatment. The caspase analysis also revealed that EAQI, MG and GA had induced apoptosis by activating caspase-8 and -9 at 6 hours of treatment. In conclusion, these findings suggested that EAQI, MG and GA significantly induced apoptotic mechanisms via the regulation of intrinsic and extrinsic pathways, which should provide new insight into therapeutic activity and anticancer agents of QI.
Characterization and mechanical properties of kenaf cellulose nanocrystal reinforced nanohybrid dental composite from agricultural biowaste
(2023-07)
Sheng, Su Bing
The innovation of nanocellulose as reinforcement filler in composites has attracted interest in various fields for development of new biomaterials. This study aims to characterize cellulose nanocrystals (CNC) extracted from kenaf as reinforcement filler in rice husk silica nanohybrid dental composite. The kenaf fiber reinforced composite was evaluated in terms of flexural and compressive strength. Features of fractured flexural samples were also investigated. Kenaf CNC was isolated from a series of chemical processes, then treated with γ-methacryloxypropyltrimethoxysilane (γ- MPS). Properties of CNC was characterized using transmission electron microscope (TEM), Fourier transform infrared spectroscopy (FTIR) and thermogravimetric analysis (TGA). Experimental composite was fabricated with different fiber loading of 1wt%, 2wt%, 3wt%, 4wt%, 6wt% silane-treated kenaf CNC, which are K0, K1, K2, K3, K4, K6 respectively. Commercial composite of Filtek Z350XT(3M ESPE, USA), Neofil (Kerr Corporation, USA), and Ever-X Posterior (GC Corporation, Tokyo, Japan) were used as comparison. Seven composite specimens were prepared for each group (n=7) using stainless steel molds with dimensions 25mm x 2mm x 2mm bars and 6mm x 4mm cylinders for evaluation of flexural and compressive strength respectively. After light curing using a light cure unit (Elipar Deep Cure L, 3M, USA) for 40 seconds, specimens were tested using an Instron Universal Testing Machine (Shimadzu, Japan). SEM was used to examine fractured flexural samples. Average diameter of kenaf CNC under TEM was 6.31nm. FTIR results suggested adsorption of γ-MPS on kenaf CNC. TGA results did not show significant improvement in thermal properties. For flexural and compressive strength tests, one-way ANOVA showed statistically significant difference (P<0.05) between all groups. The incorporation of kenaf CNC (1wt%) into rice husk silica nanohybrid dental composite has shown slight improvement in mechanical properties. SEM analysis showed fibers as crack stoppers despite suboptimum interfacial adhesion. The results indicate that 1 wt% of kenaf CNC is optimum for reinforcement of rice husk silica nanohybrid dental composite. Excessive fiber content can result in decline in mechanical properties due to poor dispersion of fibers within composite. Kenaf CNC is a viable reinforcement co-filler at low concentrations and may be further studied to fully elicit its profound properties.
Chemical profiling of erimin-5 pills using GC-MS for active ingredient detection and TLC for dye detection
(2022-09)
Latiff, Mohamad Firdaus Abdul
The abuse of the drug is a never-ending concern for law enforcement authorities all around the world. In Malaysia, Erimin-5 tablets are still being widely abused as can be seen based on the cases reported frequently in the news. These drugs are known to contain nimetazepam or other substituted benzodiazepines. A benzodiazepine is a psychoactive substance that is made up of a benzene ring and a diazepine ring fused together that gives sedative and tranquillizing effects. Many benzodiazepines listed in Schedule IV of the International Convention on Psychotropic Substances 1971 have been classified as controlled substances with a low to moderate potential for misuse and addiction in most countries. It is unknown what types of benzodiazepines are currently used in the formulation of Erimin-5 tablets simply because the clandestine drug chemist can substitute the active ingredients based on their availability as well as use the ingredients which are not controlled by the Dangerous Drug Act. In this study, 50 samples were examined using GC-MS for qualitative study for the presence of active ingredients in Erimin-5 samples. The 50 samples were found to have used different active ingredients where the most common one is etizolam, followed by flualprazolam, nimetazepam, clozapine, 7-aminonimetazepam and alprazolam. For further dye characterisation, 15 samples with sufficient bulk samples were selected for dye profiling using TLC. The dye profiles indicate that most of the samples were of yellow colour, which appeared to be almost similar to the original tablet. Depending on the chemist in the clandestine drug laboratory, different combinations of dyes can be used in producing the tablets. The dyes identified in the examined tablets were tartrazine, sunset yellow and ponceau 4R. In conclusion, forensic profiling was successfully carried out, at least for sample-to-sample comparison. The trend of the most popular benzodiazepines currently used as active compounds is also successfully identified, and certainly, such profiling work shall be conducted from time to time to provide forensic intelligence as well as information for decision-makers.

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