IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm <p>IIUM Medical Journal Malaysia (IMJM) formerly known as the International Medical Journal Malaysia (IMJM) is the official journal of the Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia. It serves primarily as a forum for education and intellectual discourse for health professionals namely in clinical medicine but covers diverse issues relating to medical ethics, professionalism as well as medical developments and research in basic medical sciences. It also serves the unique purpose of highlighting issues and research pertaining to the Muslim world. Contributions to the IMJM reflect its international and multidisciplinary readership and include current thinking across a range of specialties, ethnicities and societies.</p> en-US <p>All material submitted for publication is assumed to be submitted exclusively to the IIUM Medical Journal Malaysia (IMJM) unless the contrary is stated. Manuscript decisions are based on a double-blinded peer review process. The Editor retains the right to determine the style and if necessary, edit and shorten any material accepted for publication.</p> <p>IMJM retain copyright to all the articles published in the journal. All final ‘proof’ submissions must be accompanied by a completed&nbsp;Copyright Assignment Form, duly&nbsp;signed by all authors. The author(s) or copyright owner(s) irrevocably grant(s) to any third party, in advance and in perpetuity, the right to use, reproduce or disseminate the research article in its entirety or in part, in any format or medium, provided that no substantive errors are introduced in the process, proper attribution of authorship and correct citation details are given, and that the bibliographic details are not changed. If the article is reproduced or disseminated in part, this must be clearly and unequivocally indicated.</p> imjm@iium.edu.my (Prof. Dr. Nasser Muhammad Amjad, nasser@iium.edu.my) noyu@iium.edu.my (Nurul Afifah Min Hussain, noyu@iium.edu.my) Sat, 01 Oct 2022 19:07:58 +0800 OJS http://blogs.law.harvard.edu/tech/rss 60 Vaginal Injury Due to Inflicted Self-Medication: A Rising Concern https://journals.iium.edu.my/kom/index.php/imjm/article/view/1845 <p>Improper self-treatment of vaginal discharge may result in various complications to the patient. We reported a case of a 24-year-old single and nulliparous lady with an oak gall stick lodged in her vagina during an attempt to treat her own vaginal discharge. During an examination under anaesthesia (EUA), her hymen was noted to be torn and a foreign body was identified and removed out from her vaginal. Her upper vaginal swab cultures negative for any pathogen. We concluded that this was a case of intravaginal foreign body complicated with vaginal injury secondary to a self-medication for vaginal discharge by using a herbal stick. Hence, the public should be educated to seek proper medical treatment rather than performing self-treatment.</p> Hezlin Md Zin, Hazwani Hanum Hashim , Samsul Draman Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/1845 Sat, 01 Oct 2022 00:00:00 +0800 Clinico-Radiological Features of Ileocaecal Duplication Cyst in Children https://journals.iium.edu.my/kom/index.php/imjm/article/view/1899 <p>Enteric duplication cyst (EDC) is a rare malformation of the alimentary tract which can potentially cause intestinal obstruction in children. It can cause obstruction directly either by narrowing the bowel lumen, or indirectly by causing an intussusception. We are reporting three cases of ileocaecal EDC in children who presented with symptoms of distal bowel obstruction; one case of ileal EDC with intussusception and two cases of chronic obstruction by an EDC at caecum and terminal ileum. Ultrasound showed a typical cystic lesion with gut signature sign in two of them. Resection was performed in all cases; primary repair was performed in the intussusception case and diversion stoma with delayed closure was performed in the other two cases with chronic obstruction.</p> <p> </p> Norhafiza Ab. Rahman, Mohd Yusran Othman, Mohd Yusof Abdullah, Che Zubaidah Che Daud Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/1899 Sat, 01 Oct 2022 00:00:00 +0800 Elevated CA 125 in A Male Patient with Lung Carcinoma: A Laboratory Perspective https://journals.iium.edu.my/kom/index.php/imjm/article/view/1971 <p>CA 125 is a tumour marker that is widely used for the management of patients with ovarian malignancy. However, elevated CA 125 has been reported in various non-ovarian cancer patients, including males. This report describes a case of an elevated CA 125 level in a 49-year-old male patient who presented with chronic cough associated with constitutional symptoms. The patient was diagnosed with lung carcinoma based on radiological investigations and tissue histopathological examination. According to recent studies, CA 125 has a potential role as a marker for lung malignancies. However, questions arise about the effectiveness of its measurement for such patients due to its poor specificity and improper utilization of the test. This report focuses on the clinical role of CA 125, the appropriateness of the test request for this patient, the significance of the result, and its implications for the patient and laboratory management.</p> Julia Omar, Tuan Salwani Tuan Ismail, Nur Karyatee Kassim, Aniza Mohammed Jelani Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/1971 Sat, 01 Oct 2022 00:00:00 +0800 Dilemma in the Treatment of Paediatric Vagal Paraganglioma https://journals.iium.edu.my/kom/index.php/imjm/article/view/1847 <p>Vagal paraganglioma is a rare tumour of the head and neck region, particularly in the paediatric age groups. A 13-year-old girl presented at the Department of Otorhinolaryngology, Head &amp; Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre Malaysia with painless left neck swelling, associated with multiple cranial nerve palsies for 14 months. The neck swelling was diagnosed as a carotid body tumour initially, but it was deemed inoperable, and the child received radiotherapy instead. The treatment response was suboptimal. Upon re-evaluating the radiological images, a revised diagnosis of vagal paraganglioma was made. Her family refused surgical intervention, and the child was treated conservatively. Over the last four years, serial imaging has demonstrated a decrease in tumour size. Although vagal paraganglioma in paediatric may require surgical excision, there is still a role in the wait-and-see approach. Frequent follow-up with radiological surveillance can save patients from surgical morbidity.</p> Khairil Afif Mahmud, Thean Yean Kew, Bee See Goh Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/1847 Sat, 01 Oct 2022 00:00:00 +0800 Parkinson’s Plus Syndrome Treatment: Are We There Yet? https://journals.iium.edu.my/kom/index.php/imjm/article/view/2251 <p>-</p> Wael Mohamed Copyright (c) 2022 https://journals.iium.edu.my/kom/index.php/imjm/article/view/2251 Sat, 01 Oct 2022 00:00:00 +0800 Mechanism of Chlorpyrifos Induced Chronic Nephrotoxicity https://journals.iium.edu.my/kom/index.php/imjm/article/view/2023 <p><strong>INTRODUCTION:</strong> Chlorpyrifos is one of the most commonly used organophosphates in agriculture. Report on animal models of chronically exposed chlorpyrifos showed significant histo-structural renal damage. Moreover, evidence of high incidence of diabetes mellitus were observed among agricultural workers exposed to organophosphates. Available evidence linking derangement of glucose metabolism pathway with renal damage in this chronically exposed chlorpyrifos is lacking. The aim of this study was to determine the involvement of advanced glycation end-products formation in the development of nephrotoxicity in animals with chronic subcutaneous exposure to chlorpyrifos.<strong> MATERIALS AND METHODS:</strong> Eighteen rats were divided into three groups, with six rats in each group. Group 1 served as a control group, while Groups 2 and 3 received subcutaneous 3% dimethyl sulfoxide and 97% volume per volume soy oil as a vehicle or chlorpyrifos, respectively, alternate day for 180 days. Blood samples were taken for biochemical analysis. Kidney tissues were examined for immunohistochemistry and gene expression of pathways related to oxidative stress and advanced glycation end-products. <strong>RESULTS:</strong> Serum fasting glucose, creatinine, advanced glycation end-products and malondialdehyde levels were significantly increased (p&lt;0.05), whereas paraoxonase-1 level was decreased in chlorpyrifos-treated rats compared with the control groups (p&lt;0.05). The proximal tubular cells and the glomeruli of chlorpyrifos-exposed kidney showed strong malondialdehyde and advanced glycation end-products expression respectively. Gene expression of catalase and glutathione reductase were downregulated in the chlorpyrifos-treated rats. <strong>CONCLUSION:</strong> Glucose derangement and oxidative stress are the possible mechanisms of organophosphate-induced kidney damage.</p> Sanda Aung, Norlelawati Talib A. , Nor Zamzila Abdullah, Zamzuria Mat Zainone Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2023 Sat, 01 Oct 2022 00:00:00 +0800 Effects of Time Delay in Processing Common Clinical Biochemical Parameters in an Accredited Laboratory https://journals.iium.edu.my/kom/index.php/imjm/article/view/2070 <p><strong>INTRODUCTION</strong>: Analyte stability time is challenging to employ in clinical settings. The diversity of processing time may affect the accuracy of results. This study evaluates the maximum time delay permissible before sample centrifugation and analysis. <strong>MATERIALS AND METHODS:</strong> We evaluated 15 serum electrolytes in 40 samples centrifuged and analysed using an automated analyser. The time was divided into 1, 2, 6, and 24 hours. <strong>RESULTS:</strong> Most analytes studied remained stable for up to 24 hours before centrifugation. However, delayed processing affected the value of potassium, magnesium, LDH, and calcium after 2 hours up to a maximum of 6 hours at room temperature for total protein, phosphate, and sodium. <strong>CONCLUSIONS:</strong> Most analytes were unaffected by a delay in centrifugation at room temperatures, but several critical analytes were severely affected.</p> Julia Omar, Wan Norlina Wan Azman, Tan Say Koon, Nor Aziantie Abdul Wahab, Samantha Xin-Yuin, Law Xi Ling, Chew Hsiao Junn, Azlan Husin, Hans Van Rostenberghe, Mohamed Rusli Abdullah Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2070 Sat, 01 Oct 2022 00:00:00 +0800 Post-COVID-19 Symptoms, an Online Survey in Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2100 <p><strong>INTRODUCTION</strong>: Prolonged COVID-19 symptoms is one of the major challenges in the management of the disease. As the number of COVID-19 cases increased drastically, the number of those with prolonged symptoms are also accumulating, either diagnosed or undiagnosed. This study aimed to identify the long-term clinical symptoms of COVID-19 and the associated risk factors among Malaysian populations. <strong>MATERIALS AND METHODS:</strong> A cross-sectional survey using Google Form link for distribution of a self-administered questionnaire was shared and disseminated via online platforms such as Facebook, WhatsApp, and Telegram. The inclusion criteria included those with a history of positive COVID-19 from 1st March 2020 until one month prior to the survey, and age above 18 years old. <strong>RESULTS:</strong> A total of 215 Malaysians participated, with 74% female respondents and a mean age of 36.4 years. Twenty-seven (12.6%) were asymptomatic when diagnosed with COVID-19. More than half (56%) still had symptoms at one-month of diagnosis, while 39% and 18% still had symptoms at the second and third months respectively. The most reported symptoms were lethargy (45.1%), difficult concentrating (22.3%) and cough (21.9%). Female, chronic lung disease and hypertension are significantly associated with prolonged symptoms at one month of COVID-19 infection. <strong>CONCLUSIONS:</strong> Lethargy, difficulty to concentrate and cough were the most common symptoms reported months after COVID-19 diagnosis. Apart from treating acute conditions, physicians should also be able to recognize and manage those symptoms. The findings of this study will help policymakers better grasp the social and economic consequences of long-term post-COVID-19 symptoms.</p> <p> </p> <p> </p> Hana Maizuliana Solehan, Nurul Azmawati Mohamed, Mohd Dzulkhairi Mohd Rani, Muslimah Ithnin Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2100 Sat, 01 Oct 2022 00:00:00 +0800 Exploring Problem-Based Learning (PBL) and Case-Based Learning (CBL) in Stimulating Cognitive Skills among Medical Students: Analysis of Verbal Interaction https://journals.iium.edu.my/kom/index.php/imjm/article/view/2066 <p><strong>INTRODUCTION:</strong> Problem based learning (PBL) has many benefits; however, research on PBL indicates that students are not quite good at integrating knowledge in basic sciences and clinical aspects. Case-based learning (CBL) might be an alternative method to enhance the integration of this knowledge. No research explored the way these two methods stimulate cognitive skills. This study aimed to explore the differences between PBL and CBL in stimulating cognitive skill by analyzing verbal interaction. <strong>MATERIALS AND METHODS:</strong> This descriptive research was performed at the Faculty of Medicine, Universitas Islam Indonesia (FM UII). Twenty-one undergraduate students contributed voluntarily to this study. The students were then split up randomly into a PBL Group (n=10) and a CBL group (n=11). Each group performed twice discussion meetings facilitated by an experienced tutor. The discussion processes were video recorded and analyzed using a coding scheme categorizing the verbal interaction into five types: cumulative reasoning, exploratory questioning, procedural interaction, handling conflict about knowledge, off-task/ irrelevant interactions. <strong>RESULTS:</strong> Students in both PBL and CBL groups spent most of their time-sharing cumulative reasoning and then asking exploratory question. Students in the PBL group were more frequently asking exploratory questions. Students in both groups rarely handled conflict about knowledge since it was a high order thinking skill. Students in the CBL group were more frequent than the PBL group in performing procedural interaction.<strong> CONCLUSIONS:</strong> Students performed various cognitive skills in both PBL and CBL. Each method has its own strengths in stimulating reasoning skills of students.</p> Umatul Khoiriyah, Diani Puspa Wijaya Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2066 Sat, 01 Oct 2022 00:00:00 +0800 Minocycline Ameliorated LPS-Induced Learning and Memory Impairment by Inhibiting Microglia and Astrocytes Activation in the Hippocampus https://journals.iium.edu.my/kom/index.php/imjm/article/view/2042 <p><strong>INTRODUCTION:</strong> Many studies support the notion that neuroinflammation involving glial cells may be the fundamental pathogenic event that lead to brain damage and degeneration in Alzheimer’s disease (AD). The effects of minocycline on glial cells activation in the lipopolysaccharide (LPS) rat model is studied here. <strong>MATERIALS AND METHODS:</strong> Fifty adult male Sprague Dawley rats were split into five groups: control, LPS, LPS-treated with minocycline 25 mg/kg, LPS-treated with minocycline 50 mg/kg, and LPS treated with memantine 10 mg/kg. For two weeks, rats were treated with minocycline and memantine intraperitoneally daily, while were injected with LPS intraperitoneally once on day 5. Morris water maze (MWM) test was performed to evaluate the learning and working memory behaviour. Immunohistochemistry and Western blot were performed to measure ionized calcium-binding adaptor molecule 1 (Iba-1) and glial fibrillary acidic protein (GFAP) expressions in the hippocampal tissue. <strong>RESULTS:</strong> LPS injection caused significant learning and working memory deficits (p&lt;0.05) as well as increased expressions of Iba-1 and GFAP (p&lt;0.05), indicating microglia and astrocytes activation, respectively. Minocycline treatment significantly improved learning and working memory performance (p&lt;0.05) and reduced microglia/astrocytes activation (p&lt;0.05) in a dose-dependent manner, similar to the effect of memantine. <strong>CONCLUSIONS:</strong> Our results suggest that minocycline modulates LPS-induced microglia and astrocytes activation as well as improves learning and working memory comparable to memantine. Thus, minocycline may have preventive-therapeutic effect in diseases involving neuroinflammation such as AD.</p> Idris Long, Entesar Yaseen Abdo Qaid, Zuraidah Abdullah, Rahimah Zakaria Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2042 Sat, 01 Oct 2022 00:00:00 +0800 The Obstetric Outcomes of Obese Primigravida with Spontaneous Onset of Labour at Term https://journals.iium.edu.my/kom/index.php/imjm/article/view/2104 <p><strong>INTRODUCTION:</strong> Obesity has reached pandemic level with higher prevalence among women. Obese pregnant women have higher risk of comorbidities, maternal and fetal complications. This study aimed to determine the prevalence of vaginal delivery and pregnancy outcomes of obese primigravida presented with spontaneous labour at term. <strong>MATERIALS AND METHODS:</strong> This prospective cohort study was conducted in a tertiary hospital in Perak involving 250 obese primigravida (BMI ≥27.5kg/m<sup>2</sup>) and 250 non-obese primigravida. Data collected from August 2020 till January 2021 and analyzed using descriptive statistics, independent T-test and Mann-Whitney U test by SPSS version 23.0. <strong>RESULTS:</strong> Our study found that there were no significant differences in the proportion of vaginal delivery and caesarean delivery between obese and non-obese primigravida [72.0% vs. 78% (vaginal delivery) and 28% vs. 22% (caesarean delivery)] with spontaneous onset of labour at term. No difference in complications of labour such as PPH and OASIS (p=0.187), with high successful delivery without complications. Obese women presented with cervical dilatation of 4cm had longer delivery interval [5.82(2.97) vs. 4.75(2.71), p=0.013] but shorter delivery interval at 6cm [2.41(1.58) vs. 3.61(1.78), p=0.026] compared to non-obese. They also had higher caesarean rate indicated for abnormal labour progress [28(71.8) vs. 11(28.2), p=0.019] and higher comorbidities [149(72.3) vs. 57(27.7), p=&lt;0.001]. There was no difference in the fetal outcome (p=0.311). <strong>CONCLUSION:</strong> After careful selection, obese women with spontaneous labour at term are safe for vaginal delivery as they have similar risk of labour augmentation, duration of active labour, caesarean delivery, PPH and OASIS despite higher comorbidities.</p> Sharifah Nurul Inas Syed Mohd Ridzuan, Hamizah Ismail, Karimah Hanim Abd Aziz, Nurkhairulnisa Abu Ishak , Aruku Naidu Apparau, Jumaida Abu Bakar Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2104 Sat, 01 Oct 2022 00:00:00 +0800 Challenging the Journalistic Ideal of Objectivity in Reporting Vaccination https://journals.iium.edu.my/kom/index.php/imjm/article/view/2012 <p><strong>INTRODUCTION:</strong> The resurgence of vaccine-preventable diseases such as polio, diphtheria, measles, mumps, among others demonstrate the anti-vaccine movement's growing popularity and efficacy in spreading its views. To overcome the vaccine fallacies that are now prevalent, effective news media coverage on vaccination that emphasises the urgency and necessity of vaccination to the public is required. To determine whether such emphasis is made in the mainstream media, this study analysed vaccine coverage in two English newspapers in Malaysia, The Star and the New Straits Times (NST). <strong>MATERIALS AND METHODS:</strong> Framing analysis was performed on a total of 308 vaccine-related news items gathered over 14 months, from January 2019 to March 2020. <strong>RESULTS: </strong>Both publications used almost similar patterns in reporting vaccine-related issues. They relied heavily on official or government institutions as sources of information with high emphasis given on creating awareness and providing information about vaccines. In broad, vaccination is primarily covered as news to be reported, rather than a problem to be highlighted and further explored in-depth. <strong>CONCLUSION: </strong>Considering contemporary health realities, newspapers must play a persuasive and consistent role in publicising the necessity of immunisation.</p> <p> </p> Wan Norshira Wan Mohd Ghazali, Shafizan Mohamed, Mohd Helmi Yusoh Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2012 Sat, 01 Oct 2022 00:00:00 +0800 Nutritional Status of Under-Five Children and the Relationship with Household Food Wastage and Food Security in Samarahan, Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2052 <p><strong>Introduction: </strong>Malnutrition is prevalent among children in developing countries. The cause of malnutrition, although complex, can be attributed to demographic factors, household food wastage, and food insecurity. This study aims to determine the under-five nutritional status of children and its association with household food wastage and food security in the Samarahan division in Sarawak, Malaysia. <strong>Materials and Methods: </strong>This is a cross-sectional study involving 304 children from rural areas of Asajaya and Samarahan District using a random sampling technique. An interviewer-administered questionnaire was used to collect data from the parents. The nutritional status of the children was assessed by anthropometry. IBM SPSS Version 27.0 and WHO Anthro version 3.2.2 were used for data analysis. A p-value &lt; 0.05 was considered statistically significant. <strong>Results: </strong>Analysis revealed that 9.5% of the children were moderately wasted, followed by 5.9% who were severely wasted; 20.4% were moderately stunted and 8.9% were severely stunted. Hierarchical regression analysis indicated that male gender (AOR = 1.931, 95% CI: 1.139, 3.274; p&lt;0.05), low birth weight (AOR =2.645, 95% CI: 1.245, 5.618, p&lt;0.05), poor appetite (AOR = 2.547; 95% CI: 1.298, 4.995, p&lt;0.05), and preventive attitude (AOR = 0.460, 95% CI: 0.227, 0.929, p &lt; 0.05) of household food wastage appeared to be significant predictors of nutritional status. However, household food insecurity had a negative correlation but did not significantly impact the nutritional status. <strong>Conclusion</strong><strong>: </strong>Under-five malnutrition was prevalent in the study area and still a public health concern. Although the study did not find any significant association between household food wastage and food security towards the nutritional status of children, addressing the nutritional problem warranted an appropriate Public Health approach for the specific group, especially the modifiable risk factors such as birth weights, appetite, and attitude.</p> <p> </p> Mohd Faiz Gahamat, Md Mizanur Rahman, Muhammad Siddiq Daud Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2052 Sat, 01 Oct 2022 00:00:00 +0800 Oxidative Stress Induces Endothelial Dysfunction and Endothelial Cell Damage in Rapid Eye Movement (REM) Sleep Deprivation Animal Model https://journals.iium.edu.my/kom/index.php/imjm/article/view/2071 <p><strong>INTRODUCTION</strong><strong>: </strong>Rapid eye movement (REM) sleep deprivation causes oxidative stress, leading to endothelial dysfunction, a predictor of cardiovascular disease. It is still unclear what causes endothelial dysfunction in patients with sleep disorder. This study evaluates the effects of REM sleep deprivation on the endothelium in the rat model of REM sleep deprivation. <strong>MATERIALS AND METHODS: </strong>Sprague-Dawley male rats (N=28) were divided into four groups (n=7); (1) free-moving control (FMC), (2) REM sleep deprivation (REMsd), (3) tank control (TC), and (4) sleep recovery (SR). The inverted flowerpot technique was utilised to develop REM sleep deprivation. Bodyweight gain (BWg), food consumption (Fc), and systolic blood pressure (SBP) were evaluated. The descending thoracic aorta was isolated to assess oxidative stress markers, in vitro functional study, and histomorphological examination. <strong>RESULTS: </strong>REM sleep deprivation showed a decrease in BWg significantly despite a significant increase in Fc, increased SBP, increased oxidative stress markers, caused endothelial dysfunction and endothelial cell damage. In REM sleep-deprived rats, there was a significant reduction in antioxidant markers, including total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, catalase (CAT), and glutathione (GSH), while the levels of malondialdehyde (MDA) were significantly increased. The REM sleep-deprived rats displayed altered vascular function, including impaired vasorelaxation and hypercontractility. Histomorphology of the endothelium in REM sleep-deprived rats revealed features of endothelial damage. <strong>CONCLUSION: </strong>REM sleep deprivation is suggested to be linked to endothelial dysfunction due to endothelial damage. These changes are proposed to result from increased oxidative stress. Sleep recovery reduced the harmful effects following REM sleep deprivation.</p> <p> </p> <p> </p> Liza Noordin, Afifah Nawi, Anani Aila Mat Zin, Wan Amir Nizam Wan Ahmad Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2071 Sat, 01 Oct 2022 00:00:00 +0800 Detection of FMS-Like Tyrosine Kinase 3 (FLT3) and Nucleophosmin 1 (NPM1) Mutations from Marrow Tissues in Patients with Acute Myeloid Leukaemia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2095 <p><strong>INTRODUCTION</strong><strong>: </strong>Acute myeloid leukaemia is a haematological malignancy with diverse cytogenetic abnormalities and molecular mutations. Amongst the important mutations are FMS-related tyrosine kinase 3 (FLT3) and nucleophosmin 1 (NPM1) gene mutations. These mutations have been shown to be of prognostic significance. A cross-sectional study to examine the frequency of these mutations and their association with the haematological and cytogenetic characteristics of the cases was carried out in Kuantan, Pahang, Malaysia. <strong>MATERIALS AND METHODS</strong><strong>: </strong>A total of 43 cases were included in the study. Polymerase chain reaction-based assays were employed for mutation detection from the retrieved trephine biopsy tissue blocks. Mutation positivity was subsequently validated by Sanger DNA sequencing. <strong>RESULTS</strong><strong>: </strong>Six of the 43 cases (14.0%) of the acute myeloid leukaemia were positive for FLT3-type internal tandem duplications (FLT3-ITD) and a similar proportion (6/43, 14.0%) were positive for NPM1 mutations. FLT3 mutations at codon D835 (FLT3-D835) mutation was identified in three of the cases (7.0%) while concurrent mutations of NPM1 and FLT3-ITD were seen in two of the mutation-positive cases (4.7%). The total white cell count was found to be significantly higher in patients with FLT3 mutations (p=0.001). Other haematological parameters and the cytogenetic results did not reveal any significant association with the mutational status. <strong>CONCLUSION</strong><strong>: </strong>The frequency of FLT3-ITD, FLT3-D835, and NPM1 mutations among AML patients were 14%, 7%, and 14% respectively. Follow-up studies to include the clinical parameters and the treatment outcomes are advocated.</p> Asmah Hanim Hamdan, Mohammad Naeem Mansoor, Naznin Muhammad, Norlelawati A. Taliba , Rusmawati Ismail, Ismail Ibrahim, Karimah Hanim Abd Aziz Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2095 Sat, 01 Oct 2022 00:00:00 +0800 Tualang Honey Supplementation Alleviates Obesity and Dyslipidaemia in High Cholesterol Diet Induced Non-Alcoholic Steatohepatitis Animal Model https://journals.iium.edu.my/kom/index.php/imjm/article/view/2107 <p><strong>INTRODUCTION</strong><strong>: </strong>Dyslipidaemia and obesity are two main features of non-alcoholic steatohepatitis (NASH). This study aimed to investigate the effects of Tualang honey (TH) supplementation on bodyweight, liver weight, and lipid profiles in high cholesterol diet (HCD) induced NASH animal model. <strong>MATERIALS AND METHODS</strong><strong>: </strong>Sixteen Sprague-Dawley rats were given 12% HCD for 16 weeks to induce NASH. These animals were divided into 4 groups; Group 1 (continued HCD), Group 2 (changed to normal diet), Group 3 (normal diet and TH 1.2g/kg) and Group 4 (normal diet and TH 3.0g/kg) for the following 4 weeks. Bodyweight was measured daily. At the end of the study, blood was collected via retro-orbital bleeding and the rats were sacrificed to harvest their liver. <strong>RESULTS</strong><strong>: </strong>The group 4 rats had significantly lower mean final bodyweight than rats in group 1, 2 and 3 (478.0±24.4 vs. 641.5±25.1, 593.8 ±29.3, 552.0±72.9 g, p&lt;0.05). Animals in group 4 were also found to have a significantly lower mean liver weight compared to groups 1 and 2 (12.9±0.9 vs 20.1±2.2, 15.7±1.2 g, p&lt;0.05). In comparison to controls, the mean concentration of total cholesterol was significantly lower in all the other groups and the lowest mean concentration of triglycerides was recorded in group 4 with significant difference when compared to the controls (0.9±0.4 vs 3.6±0.4 mmol/L, p&lt;0.05). <strong>CONCLUSION</strong><strong>: </strong>The change from HCD to a normal diet coupled with TH supplementation has been shown to reduce bodyweight, liver weight, total cholesterol and triglyceride levels in the 12% HCD NASH induced animal models.</p> <p> </p> <p> </p> Mohd Afzal Alias, Roslina Abdul Rahim, Siti Aesah @ Naznin Muhamad, Nor Zamzila Abdullah, Norlelawati A Talib, Khairunisa Ahmad Affandi Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2107 Sat, 01 Oct 2022 00:00:00 +0800 MicroRNAs Expression Profile in Young Patients with Acute Myocardial Infarction https://journals.iium.edu.my/kom/index.php/imjm/article/view/2108 <p><strong>Introduction: </strong>Acute myocardial infarction (AMI) is a severe coronary heart disease. Targeted miRNAs studies implicated two main pathways in the regulation of AMI namely pro-apoptosis (miR-29b and miR-194-5p on PTEN) and pro-necroptosis (miR-325 &amp; miR-105 on RIPK3 ) pathways. This study aims to profile the miRNAs in Healthy Controls, Young AMI, and Mature AMI patients with matching criteria. <strong>MATERIALS AND </strong><strong>Methods: </strong>Total RNA was extracted from plasma and the miRNA expression profiling using small RNA was done on the BGISEQ500 SE5 sequencing platform with BGI sequencing libraries. The sequence data were analysed using Gene Ontology (GO) to determine the function of the differently expressed genes, while Kyoto Encyclopaedia of Genes and Genomes (KEGG) enrichment analyses were applied to identify the biological pathways in Young AMI against Mature AMI. <strong>Results:</strong> Of 1497 differentially expressed miRNAs, 1090 miRNAs were upregulated, and 407 miRNAs were downregulated in Young AMI against Mature AMI. The top 10 upregulated miRNAs were miR-552, miR-4446-3p, miR-432-5p, miR-548j-5p, miR-219, miR-982, miR-181a-2-3p, miR-654-5p, miR-58 and miR-548k; while the top 10 downregulated were miR-16-5p, miR-1064, miR-431-5p, miR-790 miR-1177, miR-201, miR-105, miR-518, miR-419 and miR-1103. There were 9 novel miRNAs discovered in this study; miR-58, miR-982, miR-548k, miR-1064, miR-790, miR-1177, miR-201, miR-419, and miR-1103. The target genes of differentially expressed miRNAs that were mapped to the signal transduction pathway in KEGG indicated that 346 classes were enriched. <strong>Conclusion: </strong>Our miRNA profiling revealed differentially expressed miRNAs including 9 novel miRNAs in Young and Mature AMI that require further evaluations for their roles in AMI. </p> <p> </p> Nurul Ashikin Muhammad Musa, Nor Zamzila Abdullah, Norlelawati A. Talib, Azarisman Shah Mohd Shah, Aszrin Abdullah, Aida Nur Sharini Mohd Shah Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2108 Sat, 01 Oct 2022 00:00:00 +0800 Knowledge in Dealing with the COVID-19 Based on the Guidance of Al-Quran and Al-Sunnah: A Cross-Sectional Survey among the Pharmacy and Health Sciences Diploma Students in Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2138 <p><strong>INTRODUCTION: </strong>Medicine and communicable disease control are embedded in many Islamic teachings as conveyed by the Prophet Muhammad (PBUH) through the Al-Quran, Al-sunnah, and Al-hadith more than 1400 years ago. Therefore, when the COVID-19 outbreak hits Malaysia, with the majority of the population being Muslims, the society should be equipped with knowledge in dealing with this pandemic. This study investigates the knowledge towards dealing with COVID-19 based on the guidance of Al-Quran and Al-Sunnah of Prophet Muhammad (PBUH) among undergraduate students in Malaysia. <strong>MATERIALS AND METHODS: </strong>A cross-sectional study using self-constructed questionnaires was performed. The questionnaires were pre-validated and distributed to pharmacy and health sciences students via an online survey platform. One of the selection criteria was that the respondent must be a Muslim. <strong>RESULTS: </strong>The students scored a median of 26 (IQR 4) in the knowledge test. Students’ percentage knowledge levels were divided into three categories: poor (n = 42, 15%); moderate (n = 207, 73%) and good (n = 33, 12%). The lowest scored knowledge item was observed on the Islamic terminology, Maqasid Shariah (4.3%), and differences between hadith and sunnah (20.9%). No significant differences in knowledge scores were observed in the pre-determined independent variables such as age, year of study, accommodation, and previous religious school admission. <strong>CONCLUSION: </strong>The study findings suggest that the students have a good understanding of scientific aspects of COVID-19 but lack knowledge in handling the pandemic as recommended by Al-Quran and Al-Sunnah.</p> Roz Azinur Che Lamin, Yuet Yen Wong, Emie Sylviana Mohd Zahid, Muhammad Che Saad Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2138 Sat, 01 Oct 2022 00:00:00 +0800 Brain Wave Changes during Cognitive Task Performance in Uncomplicated Diabetic Adults: An Exploratory Study https://journals.iium.edu.my/kom/index.php/imjm/article/view/2147 <p><strong>Introduction: </strong>Diabetes mellitus (DM) is a chronic disease associated with cognitive decline and dementia in the elderly population. This exploratory study analysed the brain wave changes during cognitive task performance in working adults with and without type 2 diabetes mellitus (T2DM). <strong>MATERIALS AND Methods: </strong>The Mini-Mental State Examination was used to screen subject’s cognitive function and quantitative electroencephalography was used to analyse subject’s brain waves at rest and whilst performing the serial seven test. <strong>Results: </strong>When performing the serial seven test, the diabetic group showed a higher absolute power of theta waves in the left frontal (Fp1, 16.22 ± 3.81 vs 3.75 ± 1.69; p = 0.022) and temporal regions (T3, 24.27 ± 3.69 vs 7.92 ± 2.17; p = 0.045), but lower absolute power of beta waves in both the frontal regions (Fp1, 27.35 ± 3.67 vs 41.14 ± 5.67; p = 0.029; Fp2, 23.01 ± 3.31 vs 39.05 ± 2.64; p = 0.041) and left temporal region (T3, 37.93 ± 4.64 vs 50.94 ± 3.56; p = 0.046) when compared to those of the control group. The diabetic group took longer to complete the task (127.9 ± 8.3 s vs 95.6 ± 5.9 s; p = 0.032) than the control group, despite no statistically significant difference in correct response rates. Diabetes duration was positively correlated with the theta/alpha ratio in the left frontal (Fp1, r = 0.525; p = 0.041) and temporal (T3, r = 0.618; p = 0.037) regions. <strong>Conclusions: </strong>T2DM may affect cognitive function in patients before clinical manifestation.</p> <p> </p> Sze Kiat Sim, Madzlifah Ahadon, Sohail Mushtaq Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2147 Sat, 01 Oct 2022 00:00:00 +0800 Stigma and Depression among Tuberculosis Patients in Kedah, Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2055 <p><strong>INTRODUCTION: </strong>Tuberculosis (TB) related stigma is one of the significant barriers in the global TB control programme and it may lead to depression. This study aims to assess the level of stigma among TB patients and its associated factors, as well as to ascertain the correlation between stigma and depression in Kedah, Malaysia. <strong>MATERIALS AND METHODS: </strong>This was a cross-sectional study using the proportionate sampling method. TB patients were recruited from respiratory clinics in three government hospitals in Kedah. Case report form, Malay version of TB stigma scale (TSS) and Beck Depression Inventory (BDI-Malay) were used for data collection. Data were then analyzed using the linear regression and correlation analysis. <strong>RESULTS: </strong>A total of 200 respondents were enrolled and the mean score of TB stigma from patient’s perspective was 13.3 (6.87). Younger patient, currently married, higher education, unemployment, and HIV co-infection were significantly associated with the stigma experienced. 27.5% (n=55) of the TB patients were found to be depressed, with the majority categorized into mild severity (20%, n=40), followed by moderate (5.5%, n = 11) and severe depression (2%; n = 4). There was a moderate, positive correlation between stigma and depression which was statistically significant (r = 0.345, p&lt;0.001). <strong>CONCLUSION: </strong>Although the stigma score among TB patients was not as high as has been postulated, there was a moderate, positive correlation between stigma and depression. Thus, the intervention to reduce the stigma among TB patients may be helpful as it may reduce the depression level.</p> Rosnani Zakaria, Nur Syafiqa Amri, Noraini Mohamad Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2055 Sat, 01 Oct 2022 00:00:00 +0800 A Review on Complete Freund’s Adjuvant-Induced Arthritic Rat Model: Factors Leading to its Success https://journals.iium.edu.my/kom/index.php/imjm/article/view/2026 <p>Arthritis-induced adjuvant (AIA) is an established animal model reflecting several clinical manifestations of human arthritis. It provides more understanding of pathogenesis and pathways involved in arthritic development and for testing various treatment modalities. Complete Freund’s adjuvant (CFA) is one of the most known algogenic agents used to develop AIA rodent model. Its wide application increases understanding of CFA effects locally and systemically following adjuvant-containing mycobacterium exposure in-vivo. This study aims to review possible factors involved in producing a successful CFA-induced arthritic rat model. We conducted a review of previous studies to determine critical factors to be emphasized. Since arthritis can be classified as gout, osteoarthritis, and rheumatoid arthritis, among others, factors that should be assessed include different dosage and volume, injection site, remission, arthritic and animal gender, and strain selections to successfully develop an arthritic rat model.</p> Che Aishah Nazariah Ismail, Ain' Sabreena Mohd Noh, Dai Chuan Tan, Nurul Ajilah Mohamed Khir, Nazlahshaniza Shafin Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2026 Sat, 01 Oct 2022 00:00:00 +0800 In Vitro Study on Collagen Application in Wound Healing: A Systematic Review https://journals.iium.edu.my/kom/index.php/imjm/article/view/2088 <p>Collagen is key component of extracellular matrix for human and animals. It can be extracted and applied for various field especially in tissue engineering as main component for wound healing. Collagen especially type I collagen is used in skin regeneration process due to its high compatibility with donor site and low antigenicity besides of having suitable properties for wound healing like high cell proliferation and adhesion. However, the usage of collagen alone would not give maximum wound healing since collagen degrades faster, has poor structure for a scaffold and attracts bacteria due to high moisture content. Therefore, to produce a good collagen scaffold, it must be incorporated with functional biomaterials to enhance the characteristic of the collagen and fabricated for a better scaffold structure. The objective of this systematic review is to summarize the relevant literature for in vitro study on collagen application in wound healing by focusing on the source of collagen, biomaterials and fabrication methods used in making collagen scaffold. Three databases were searched; PubMed, Scopus and Science Direct. Keywords used were: collagen, recombinant collagen, collagen scaffold, application and wound healing. A total of 1105 were articles screened but only 50 articles were suitable and were further reviewed. Collagen in wound healing study has versatility in terms of the source of collagen used, the biomaterials combined with the collagen to make an enhanced scaffold, and the fabrication methods to create a desirable structure of collagen scaffold.</p> Azura Amid, Faqihah Salleh, Noor Faizul Hadry Nordin Copyright (c) 2022 IIUM Medical Journal Malaysia https://journals.iium.edu.my/kom/index.php/imjm/article/view/2088 Sat, 01 Oct 2022 00:00:00 +0800 Medical Education through Sejahtera Academic Framework https://journals.iium.edu.my/kom/index.php/imjm/article/view/2250 Prof. Dr. Jamaluddin Ab. Rahman Copyright (c) 2022 https://journals.iium.edu.my/kom/index.php/imjm/article/view/2250 Sat, 01 Oct 2022 00:00:00 +0800