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.
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.
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.
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.
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.
Comparative phenomics and genomics of carbapenem-resistant escherichia coli from human and broiler chicken
(2023-07)
Woldegiorgis, Erkihun Aklilu
The emergence of carbapenem-resistant Enterobacterales (CRE) has been alarming, and its control has been considered one of the priorities set by the World Health Organization (WHO). In Malaysia, recent reports show that the prevalence of CRE in general and tertiary hospitals has been alarmingly rising. However, little is known about the occurrence of CRE in animals, particularly food-producing animals such as broiler chickens in Malaysia. Moreover, there is no study on the comparative study of CRE from humans and food animals in Malaysia. Therefore, this study was conducted with the general objective of elucidating the comparative genomics of carbapenem-resistant Escherichia coli (CREC) from humans and broiler chickens. The study was conducted on clinical isolates archives of presumptive CREC isolates (n=32) from Hospital Universiti Sains Malaysia (HUSM), Kubang Kerian, and 384 cloacal swab samples of broiler chickens collected from East Coast Malaysia (Kelantan, Terengganu, and Pahang). Routine bacteriology followed by phenotypic and molecular characterization and determination of molecular epidemiology using multilocus sequence typing (MLST) were conducted. High-throughput Illumina HiSeqTM whole genome sequencing (WGS) of ten selected CREC isolates was done to determine the comparative genomics of the CREC isolates. The assembled genomes were annotated using RASTtk, BAKTA, and eggNOG-Mapper tools, and quantitative and qualitative measurements for ad-hoc downstream analyses were generated using M1CR0B1AL1Z3R server (Microbializer). Analyses of the WGS were done using ResFinder 4.1, VirulenceFinder 2.0, SerotypeFinder 2.0 tool, FimTyper version 1.0 CHTyper 1.0, cgMLST 1.2, pMLST (2.0), CSI Phylogeny, MobileElementFinder, Alien Hunter 1.7, ISFinder and IslandCompare (v1.0). Additional comprehensive genome analyses were done using different genomic analysis pipelines. The results showed an overall CREC detection rate of 7.29% (28/384) which is 10.94% (28) of the 256 E. coli isolated from cloacal swabs of broiler chickens based on phenotypic detection methods. Out of all the CREC, 40% (24/60) of the CREC isolates from human and broiler chickens harbor more than one carbapenemase gene, including the combinations blaNDM+blaOXA-48, blaNDM+blaOXA-48+blaIMP, and blaOXA-48+blaIMP. The molecular typing using MLST showed the detection of ST69, ST131, ST155, ST405, and ST410, which have been recognized as high-risk pandemic lineages. The comparative genomic analyses showed close similarities between CREC isolates from human and broiler chickens, which were evident from almost all the genomic profiles, including phylogeny, genomic islands, SNP analysis, plasmid, serotyping, and cgMLST and other genomic and proteome profiles. The comparative genomic analysis results showing similarities among CREC isolates from humans and apparently healthy chickens are important epidemiological data on CREC in human and broiler chickens in Malaysia. The findings from this study can help in better understanding the local CREC epidemiology and shed light on the possible CRE transmission dynamics in the local context. These findings, in turn, can help in devising of evidence-based control and prevention strategies that can contribute to the national antimicrobial resistance control programs to safe guard the public health.
Comparative spatial analysis of enteric fever and leptospirosis in Kelantan, Malaysia using e-notifikasi surveillance database, 2016 – 2022
(2023-09)
Hatta, Hazlienor Mohd
Background: Enteric fever and leptospirosis are increasingly important bacterial causes of acute undifferentiated febrile illness associated with severe complications and higher fatality. The burden of these diseases is high in Northern Malaysia, particularly Kelantan State. Accurate diagnosis is challenging without laboratory confirmation, and despite various public health strategies implemented, enteric fever and leptospirosis remain endemic in Kelantan. Objective: To provide information on the distribution, magnitude, geographical patterns, and risk areas of enteric fever and leptospirosis in Kelantan, and to explore the spatial relationship between the two diseases. Methodology: Laboratory-confirmed enteric fever and leptospirosis cases registered in Kelantan between the years 2016 and 2022 were extracted from the national e-Notifikasi passive surveillance online database. Descriptive and spatial analyses were carried out including incidence and disease mapping, univariate and multitype point pattern analysis, spatial autocorrelation as well as spatial risk variation using spatstat, spdep, sparr, spatialEco and ggplot2 R packages inside RStudio IDE. Result: A total of 212 confirmed cases of enteric fever and 1106 cases of leptospirosis were examined in this study. The average annual incidence for the period of 2016-2022 was 0.016 per 1000 population (95% CI: 0.011, 0.022) for enteric fever and 0.084 per 1000 population (95% CI: 0.071, 0.097). Enteric fever cases were found to be significantly younger than leptospirosis cases, but there was no significant gender difference observed. The study identified seven cases of co-infection, primarily occurring in areas where both diseases were endemic. Both diseases did not show any spatial correlation with population density. Substantial geographical variation of enteric fever and leptospirosis was observed across the state. Enteric fever cases were significantly clustered, and hotspots were predominantly concentrated in the northern part of Kelantan. Leptospirosis cases were as intense as enteric fever in the northern region but exhibited higher spatial intensity in the southern part of Kelantan with higher spatial risk for leptospirosis compared to enteric fever. Leptospirosis was positively spatially autocorrelated with high-high clusters mostly observed in southern and southeastern regions. Spatial dependence between enteric fever and leptospirosis cases within two to ten kilometres distance was also demonstrated. Despite gradual declines in the number of cases for both diseases from 2016 to 2021, there were notable surges observed during the post-COVID-19 pandemic era. Conclusion: Understanding local dynamics is crucial as infectious disease transmission is influenced by various factors, leading to geographical variations in infection risk. Spatial analysis revealed distribution patterns, clustering, and hotspot locations for both diseases, indicating common environmental and socio-economic risk factors for both diseases. Diagnostic algorithms, targeted interventions and early warning systems can be implemented based on these findings to improve disease control and prevention strategies.
Comparison of marpe and alt-ramec protocol in correcting skeletal transverse discrepancy in young adults: a randomized controlled clinical trial
(2024-05)
Allam, Amira Hussein Ahmed Mohamed
The skeletal deficiency could be expressed in the maxilla sagittally, vertically, and transversally. The most effective treatment for transverse maxillary deficiency in growing children and adolescents is still rapid maxillary expansion (RME). In adults, mini-screw-assisted rapid palatal expansion (MARPE) proved to be the efficient method for overcoming all dentoalveolar drawbacks. In treating adult patients with anteroposterior deficient maxilla (skeletal class III), the clinician had to decide between an invasive surgical approach to resolve the skeletal imbalance or a camouflage therapy to mask the class III malocclusion. However, in younger patients, alternate rapid maxillary expansion and constriction (ALT-RAMEC) is the treatment of choice. In this study, the 7-week ALT-RAMEC protocol was modified and combined with MARPE to evaluate its efficiency and advantages over conventional MARPE in young adult ages. Twenty-nine patients with transverse maxillary deficiency (mean age of 21.3) were randomly assigned to two groups. The conventional group received MARPE with its conventional rate of expansion, while the ALT-RAMEC group was treated with a combination of MARPE with ALT-RAMEC modified protocol. The efficiency of expansion, circummaxillary sutural displacement, dentoskeletal, respiratory, and clinical periodontal effects were all assessed. Analysis of the change before and after intervention was examined using paired t-tests while analysis of the parameters comparing the two groups was examined using an independent t-test. For variables that were not normally distributed, the p-value was obtained from Bootstrap for pairwise comparison (BCA). The analysis of covariance (ANCOVA) was used when the baseline data was significantly different between groups. The results showed 100% efficiency of both techniques to produce expansion in both groups. Mid-palatal, frontonasal, and intermaxillary sutures displaced and increased significantly (p ≤ 0.001) in width after treatment with both protocols, while the zygomaticomaxillary sutures compressed and showed a significant decrease in width with conventional MARPE, though, expanded and increased significantly in width with the ALT-RAMEC group (p < 0.001). The dentoskeletal effects revealed that conventional MARPE produced a buccal molar tipping while ALT-RAMEC showed a more bodily movement of the anchor molars. There were no additional effects of ALT-RAMEC on airway volume than MARPE did. Both protocols significantly increased the nasal cavity and oropharynx volumes and significantly decreased the nasopharynx and maxillary sinus volumes (p < 0.001) with a non-significant difference between groups (p > 0.05). The periodontium conditions were not correlated to the activation protocols in the current study, but the longer treatment time in the ALT-RAMEC group proved to have a more negative impact on the surrounding gingiva than conventional MARPE did. The modified ALT-RAMEC technique is a promising protocol sufficient to expand the maxilla transversely without tipping the anchored teeth in young adult patients.
Comparison of the three forensic DNA Sampling and extraction techniques on various mock crime scene samples for reliable and rapid DNA analysis.
(2022-09)
Yee, Glenna Tan Jie
The capability to generate reliable DNA profiles rapidly via short tandem repeat (STR) analysis to identify the suspect could greatly assist in crime investigations. This study evaluated the performance of a compilation of sample collection and extraction techniques consisting of the Maxwell RSC 48 FSC DNA IQ Casework Kit, Casework Direct System, and the COPAN MicroFLOQ® Direct Swab. A total of 48 reactions consisting of 16 mock casework samples for each technique ranging from bloodstain, saliva stained and touch DNA samples that were commonly encountered in crime scene were used in this study. The samples extracted using the Maxwell RSC 48 FSC DNA IQ Casework Kit were quantified using the NanoDrop™ 2000 Spectrophotometer. Subsequently, the collected samples for the three techniques were amplified using the GlobalFiler™ Express PCR Amplification Kit. The amplified products were then loaded for capillary electrophoresis via the ABI 3500xL Genetic Analyzer before analyzed using the GeneMapper ID-X v1.4 software. Results demonstrated that the three techniques generated relatively high percentage of autosomal STR allele call in total (100%, 100% and 96% respectively). Particularly, the COPAN MicroFLOQ™ with 96% was possible to analyze wide range of DNA samples where seven out of 16 samples were typed successfully. Meanwhile, the same number of sample types (n=6) with 100% autosomal STR allele call percentage and full consistent profiles were generated via the extraction using the two extraction kits. Notably, the average peak height across the samples using the former extraction kit was the highest which attributed to the automated extraction and purification employed that corresponded to the high DNA concentration yielded. This were followed by Casework Direct System and COPAN MicroFLOQ . In terms of turnaround time and cost associated, the MicroFLOQ® Direct Swab outperformed the other two techniques followed by the Casework Direct System extraction which took one hour for complete extraction. Meanwhile, the Maxwell FSC DNA IQ Casework Kit which took a longer time and higher cost for the entire extraction (1 hour 30 minutes and average RM 76.15 per reaction respectively). Not to mention, the use of the kit coupled with the automated Maxwell RSC 48 instrument ( RM 450, 000 per instrument) were on the more expensive end as compared to the other two techniques. Overall, the three different techniques had their respective merits and pitfalls but the COPAN MicroFLOQ® Direct Swab had an edge over the other two methods in terms of time, cost-effectiveness and ease to use. It also offered numerous advantages due to its direct PCR amplification properties, relatively high detection ability and quality DNA profiles produced. This resulted in the COPAN MicroFLOQ® Direct Swab capable to generate DNA profiles reliably in a short time thus potentially become a novel preferable collection technique employed by law enforcement officers.
Complete mitochondrial genome of tragulus kancil and tragulus napu in peninsular Malays
(2023-09)
Suleiman, Asia Abdillahi
The tropical country of Malaysia has a unique ecosystem, located in the southeast Asian region and sharing a border with Thailand,Singapore,Burnei and Indonesia. Malaysian conservation authorities have identified the need to conserve their natural resources and environment including floral and faunal. These include Tragulidae which is a small family group with 3 genera and 2 species. Two of Tragulidae species are T.kancil and T.napu that native to Peninsular Malaysia are facing a crucial threat of extinction including habitat degradation, forest fragmentation, illegal hunting, and trading. These threats are leading to decline in their population size. The present study involved full mitochondrial DNA (mtDNA) genomic sequence using next generation sequencer platform of T.kancil and T.napu from Peninsular Malaysia for the first time. A total of 17 individuals of Tragulus spp. were used to collect tissue specimens. There were 10 T.kancil individuals and triplet samples of a T.napu which were collected from Perlis and Perak. Additional six of those 17 were T.kancil samples sent to wildlife forensic laboratory from Selangor, Phang,Kedah,Perak and Sarawak as a part of routine operations. In phylogenetic tree, T.kancil are different from their lesser Tragulus relative (T.javanicus). Unlike T.napu where a clear distiniction can be observed between a T.napu samples from Malaysia (Perlis) versus a T.napu from Thailand, no full mtDNA reference sequence of T.kancil from other country is currently available for geographical comparison. Overall, the whole mtDNA genomic data collected from T.kancil and T.napu support the current classification of Tragulus and distinication between Tragulus and Rusa species.
Confirmatory factor analysis of the Malaysia medication adherence assessment tool (MYMAAT) among patients with chronic medications
(2024-03)
Tian, Ong Gaik
The MyMAAT was developed using Exploratory Factor Analysis and the current study intends to confirm the measurement model, dimensionality and ensure the factor structure by Confirmatory Factor Analysis (CFA). A cross-sectional study was conducted using a self-report questionnaire at six health facilities in the Federal Territories Kuala Lumpur and Putrajaya Health Department between May to November 2023. Participants with age≥18 years old, prescribed with one or more chronic medications for at least six months and understand English or Malay language were selected using quota sampling. There were two constructs in the MyMAAT, namely the Specific Medication-Taking Behaviour (Factor 1) with eight items and the Social-Cognitive Theory of Self-Efficacy and Social Support (Factor 2) with four items. There were 470 participants which comprised of Malay (62.7%), Chinese (24.0%) dan Indian (12.2%). Most participants had five drugs or less (81.3%). The final model for the Malay version of the MyMAAT retained the two constructs and 12 items with good fit: CFI=0.978, TLI=0.973, RMSEA=0.036(90%CI 0.001,0.067) and with good composite reliability CR=0.790 for Factor 1 and CR=0.787 for Factor 2. The factor loadings ranged from 0.413 to 0.832 with p-value<0.001 The AVE for Factor 1 was 0.664 and for Factor 2 was 0.491. There was a strong correlation (ρ=0.507, p < 0.001) between the Malay version of the MyMAAT with the Malay version of the MMAS-8 by adherence category from the data of 191 participants. The final measurement model of the English version did not achieve the minimum level of good fit to the data: CFI=0.933, TLI=0.917, RMSEA=0.073(90%CI 0.052,0.094) but had good composite reliability CR=0.802 for Factor 1 and CR=0.852 for Factor 2. The factor loadings ranged from 0.347 to 0.845. The AVE was 0.630 for Factor 1 and 0.392 for Factor 2. Fifty-two participants completed the test-retest after five to ten days from the first administration. The Malay version had moderate to excellent reliability based on ICC=0.932(95%CI:0.661,0.986) for Factor 1 whereas Factor 2 had poor to excellent reliability based on ICC=0.956(95%CI:0.325,0.997) by using the Two-Way Mixed Model and Consistency type. The English version had moderate to excellent reliability based on ICC=0.911(95%CI:0.554,0.982) for Factor 1 whereas Factor 2 had poor to excellent reliability based on ICC=0.941(95%CI:0.092,0.996). It can be concluded that the Malay version of the MyMAAT is valid and reliable in measuring medication adherence among participants with chronic medication(s), but the English version needs to be improved and then re-tested
Detection of single nucleotide polymorphisms in acquired anemia patients with high hemoglobin f
(2024-03)
Mohammad, Siti Nur Nabeela A’ifah
Anemia is a common clinical condition that can be either acquired or inherited. Normally, adults display fetal hemoglobin (HbF) levels of <1%, but variability in genomic regions can cause higher HbF levels (>1%). Unlike inherited anemia, clinical and genetic data on HbF levels associated with acquired causes of anemia among the Malaysian population are still scarce. Therefore, this study aims to determine the association between HbF level and single nucleotide polymorphisms (SNPs) in acquired anemia patients. A total of 106 out of 223 anaemic patients were detected to have high HbF levels using high performance liquid chromatography (HPLC). From 106 patients with high HbF, 79 (74.5%) samples were found to have high HbA2 (=/>3.2%) and were tested with multiplex amplification refractory mutations-system polymerase chain reactions (ARMS-PCR) for β-globin gene mutation while the remaining 27 anemic patients with high HbF has lower HbA2 (<3.2%) were tested using multiplex gap-PCR for four β-globin gene cluster deletion (Siriraj J Gγ(Aγδβ)othalassemia, Thai (δβ)°-thalassaemia, HPFH-6, and Hb Lepore). β-globin gene mutations were detected in 50 patients using multiplex ARMS-PCR, 37 heterozygous Cd26, 6 heterozygous IVS 1-5, 3 heterozygous Cd 41/42, 1 heterozygous IVS 1-1, 2 compound heterozygous Cd26 with Cd8/9, and 1 compound heterozygous Cd26 with Cd41/42. However, no β-globin gene cluster deletion detected in all 27 patients. Besides, there was no significant difference between the HbF levels of acquired and inherited anemic patients. 36 genomic DNA of samples with high HbF and no mutation and deletion together with 5 DNA samples with normal HbF level were chosen for analysis using the Infinium Asian Screening SNPs microarray platform. Two SNPs, rs73170684 and rs2893863 in GSTK1 and CDK1 gene were observed as the most significant variants that achieved GWA significant threshold (p<10-8). However, other SNPs from common major loci associated with high HbF, such as those in HBS1LMYB and BCL11A genes, were not significant. Thus, these findings can be used as a new genetic predictor and guideline for future studies in high HbF levels among acquired anemic patients for better treatment.

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