IIUM Medical Journal Malaysia (IMJM)
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Stress Monitoring Device and its Future Direction
Get PDFStress and mental health have become a global concern as a result of the COVID-19 pandemic. This review highlights the technologies applied to stress monitoring with up-to -date literature on psychological and behavioural evaluation for stress detection. The working principle and potential of these stress identifiers, particularly physiological signals are explored. Researchers have been directing their interest in producing reliable and wearable devices to detect and prevent stress and panic attacks. The breakthrough of biochemical-near-infrared stress monitoring devices will facilitate medical practitioners in the early detection of stress and panic attacks. The review seeks to explore the types of methods used to detect stress as well as the pros and cons of the available technology while providing a new solution for future implications of stress monitoring detection devices
Urban-Rural Discrepancy of Low Income Women’s Health Outcomes.
No full textIntroduction: Malaysia's rapid economic growth and rising living costs significantly affect the lower-income population, which is defined as individuals earning less than MYR3,855.00 (USD892.26) per month (B40). The study aimed to ascertain the quality of life (QOL), the needs of B40 women living in urban and rural areas, and their health status. Materials and Methods: On the year 2020, a cross-sectional study was conducted. A total of 300 respondents from the rural and urban poor were questioned about their needs, health status, and QOL using semi-guided instruments such as the EuroQol 5 Dimension (EQ5D) and Visual Analogue Score (VAS). Bivariate and multivariate analyses were performed to identify factors influencing QOL and health status. Results: A total of 88% of respondents were Malays, 9.3% were Indian, and 2.7% were Chinese. The respondents' mean age was 45 years old. Most of the respondents were stay-at-home mothers (39.7%), employed (39.0%), and had completed secondary school education (61.0%). The average monthly household income was MYR1654.00 (SD845.3). Approximately 58.7% of respondents received subsistence assistance. A total of 47.7% of the respondents suffered chronic medical illness (hypertension, diabetes, hyperlipidemia, renal problems, asthma, heart disease and cancer). The respondents obtained services from government-funded clinics or hospitals (86.0%) and private clinics or hospitals (14.0%). Most women sought treatment as inpatients at government hospitals (89.3%), while 10.7% sought care in private hospitals. A total of 94.0% paid for their own treatment, while 6.0% had their employers reimburse them. The respondents did not suggest any insurance benefits, particularly pertinent to the current government. Conclusion: The lack of chronic medical illnesses was one of the most crucial characteristics associated with high QOL and good health status
Effects of Stromal Vascular Fraction and Platelet-Rich Plasma Treatment on Capillary Histopathology During Anal Trauma Healing in Rats: An in Vivo Study
Get PDFINTRODUCTION: Anal traumas, such as blunt and penetrating injuries to the perineum, can disrupt the anal sphincter and cause considerable morbidity. Non-invasive anal trauma therapies have been widely developed, including growth factors administered as platelet-rich plasma (PRP) and stromal vascular fraction (SVFs) containing adipose[1]derived stem cells (ASCs) and limited growth factor. This study aimed to assess PRP and SVF effects on capillary histopathology in the anal trauma Wistar rat model. MATERIALS AND METHODS: This experimental study used a rat model. Rats were divided into three groups: Group A (n=12) was treated with PRP and SVFs; Group B (n=12) was treated with normal saline (placebo); Group C (n=4) was sacrificed on day 0 to obtain baseline capillary counts. Groups A and B were further divided into three subgroups, sacrificed on days 1, 7, and 14 post-treatment. RESULTS: Capillary counts significantly showed higher density between Groups A and B (p=0.037, analysis of variance). On day 7, there was a significant difference between Groups A and B (p=0.001). CONCLUSION: Mean capillary density significantly improved in anal trauma treated with a combination of PRP and SVFs compared to control. Our findings support the use of PRP and SVFs to aid recovery of patients with anal trauma
A Review on the Role of Vascular Endothelial Growth Factor Receptors in Human Papillomavirus-related Oral Squamous Cell Carcinoma
Get PDFOral squamous cell carcinoma (OSCC) is a neoplasm at the epithelial lining of the oral cavity that is prevalent worldwide. Smoking tobacco and consumption of alcohol are the main risk factors for OSCC. However, human papillomavirus (HPV) could also be an aetiological factor for OSCC. Transmission through urogenital contact increases the risk of developing OSCC, especially in developed countries. HPV-related cancer displays different pathogenesis and clinical outcomes. HPV through its oncogene E6 and E7 play a critical role in carcinogenesis by disrupting the DNA repair mechanism and cell cycle. Increased expression of VEGF ligand in HPV-related cancer has been reported in numerous studies. In OSCC, VEGFRs, i.e., VEGFR-1, VEGFR-2, and VEGFR-3, are overexpressed, with a higher expression on VEGFR-2. In HPV-infected OSCC, HPV is associated with VEGF expression. However, VEGFRs show no such association. This review highlights the possible role of angiogenesis in the progression of HPV-related OSCC. Also, it discusses how VEGF/VEGFR regulated the angiogenic activity caused by the HPV infection. Data on VEGF/VEGFR associated with HPV status is limited, and their role in OSCC progression remains unclear. Elucidating the mechanism of angiogenesis in HPV-associated OSCC may help develop strategies for OSCC-targeted therapy
Urinary Apolipoprotein A1 and its Potential as a Biomarker for Coronary Artery Disease in Young Adults
Get PDFINTRODUCTION: Very few studies have focused on exploring the utilisation of urinary protein biomarkers to improve the risk stratification of coronary artery disease (CAD) in young adults. Apolipoprotein A1 (ApoA1) as a primary constituent protein of High-density Lipoprotein (HDL) known to modulate cholesterol metabolism exhibits promising properties to be used as a protein biomarker, specifically for CAD in young adults. Thus, this study is aimed to evaluate the potential of urinary ApoA1 as a urinary biomarker of CAD in young patients with acute myocardial infarction (AMI). MATERIALS AND METHOD: This case-control study recruited 40 newly diagnosed AMI patients and 40 healthy control subjects aged 18–45. Urine samples were collected from all subjects. Once centrifuged, the supernatant was collected and stored at -80 °C until further analysis. The urinary concentration of ApoA1 was quantified using the ApoA1 Enzyme-linked Immunosorbent Assay (ELISA) kit according to the manufacturer's protocol. All subjects' risk factors were determined and documented, such as smoking status, Body Mass Index (BMI), blood pressure, plasma total cholesterol, and glucose levels. RESULTS: The mean age of AMI patients was higher than the controls; 37.11 ± 5.2 and 31.6 ± 8.1 years respectively. The mean urinary concentration of ApoA1 of AMI patients was significantly higher than the controls (12.442 ± 3.571 vs. 10.067 ± 5.606 ng/mL (p<0.05). Following an adjustment to other conventional CAD risk factors, there was an insignificant association between urinary excretion of ApoA1 and AMI in young adults (Odd Ratio (OR)=3.123, 95% CI: 0.756–1.015, p>0.05). CONCLUSION: A significant elevation of urinary excretion of ApoA1 in AMI young adults demonstrated its potential use as a urinary protein biomarker for CAD in young adults
Clinical Characteristics and Outcomes of Klebsiella Pneumonia Bacteraemia in Adult
Get PDFINTRODUCTION: Klebsiella pneumonia (K. pneumonia) bacteremia is one of the leading causes of hospital morbidity and mortality. Our study aimed to evaluate the clinical characteristics, risk factors and outcomes of K. pneumonia bacteremia in a Malaysian public hospital. MATERIALS AND METHODS: A retrospective cross-sectional study of adults with K. pneumonia bacteremia was conducted in a hospital in Johor, Malaysia. Demographics, medical comorbidities, source of infections and the mortality rate was reviewed and analyzed. RESULTS: A total of 185 cases of K. pneumonia bacteremia were included for analysis. The mean age for this study was 54.9 (SD 15.4), with 56.8% males and 46.5% in-hospital mortality. Extended-spectrum Beta Lactamase (ESBL) producing and Carbapenem-resistant K. pneumonia contributed to 37.3% and 1.1 % of K. pneumonia bacteremia, respectively. Among those who contracted K. pneumonia bacteremia, two most frequent sources were primary bloodstream infections (n=75, 40.5%), pneumonia (n=44, 23.8%) and urinary tract infections (n=28, 15.1%). There was statistically significant associations found between diabetes mellitus (AOR 1.46, 95% CI 1.02-2.08), cancer (AOR 2.02, 95% CI 1.33-3.05) and alcohol use disorder (AOR 7.73,95% CI 1.38-43.21 ) with K. pneumonia bacteremia. In-hospital mortality was higher in older patients by 1.03 odds (p=0.003). CONCLUSION: Diabetes mellitus, cancer, and alcohol use disorder were independent risk factors associated with K. pneumonia bacteremia. Patients with advanced age had a higher mortality rate
The Association of Sugar and Sugar Substitutes to Breast, Lung, and Oral Cancer Cell Lines: A Scoping Review
Get PDFCancer which synonymously known as neoplasia is a genetic disorder of cell growth that is triggered by acquired or less commonly inherited mutations affecting a single cell and its clonal progeny. The aims of this scoping review was to investigate the role of sugar and sugar substitutes in breast, lung, and oral cancers with a hypothesis that sugar promoted carcinogenesis. Three databases (EBSCO, PubMed, and Scopus) were searched from January 2010 to December 2021 to identify the preclinical studies eligible for this scoping review. The review was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses for Scoping Reviews (PRISMA-ScR) guidelines. A total of 361 articles were reviewed and the qualitative synthesis used 12 of these articles. Based on the qualitative synthesis, four studies reported dietary sugar (glucose- and/or sucrose) induced cancer progression, one study revealed sugar substitute (aspartame) induced cancer proliferation, seven studies reported that sugar substitutes inhibit cancer proliferation, and one study reported that sucrose promotes cancer while xylitol inhibits cancer. In addition., it was reported that D-allose and cisplatin have a synergistic effect in treating cancer. In conclusion, simple sugar intake is associated with an increased risk of carcinogenesis. In contrast, sugar substitutes inhibit cancer cell line progression, subsequently acting as a potential cancer therapy, thus supporting the study's hypothesis
The Effect of the Topical Application of Eurycoma Longifolia Jack (TA) Root Extract Hydrogel on Vascular Endothelial Growth Factor (VEGF) Expression during Wound Healing in vivo Excisional Wound Model
Get PDFINTRODUCTION: Medicinal plants are known for their positive impacts on wound healing by stimulating angiogenesis in the skin. Eurycoma longifolia Jack locally known as Tongkat Ali (TA), is a medicinal plant characterised by anti-inflammatory and antioxidant effects. MATERIALS AND METHODS: Excisional wound (15mm × 15mm) in diameter and (2mm) depth was created at the back of 20 male Sprague Dawley rats by incising the marked skin with sterilized surgical scalpel blade then excised the skin by surgical scissors and toothed forceps. The wounded rats were divided into 4 groups, each group contained 5 rats (n=5). Experimental groups were formed as follows: untreated (-ve) control, Hydrocyn® aqua gel (+ve) control, vehicle hydrogel, and TA hydrogel. All the treatments were applied twice daily for 5 days starting on the first day (wounding day). On Day 5 post-wounding, the granulation tissue was harvested from all groups and evaluated by immunohistochemistry assay for Vascular endothelial growth factor (VEGF) expression. RESULTS: VEGF expression in granulation tissue of rat’s skin treated with TA hydrogel and vehicle hydrogel increased significantly compared to that in the untreated (-ve) control group with p-values of 0.040 and 0.029, respectively. Although there was no significant difference in VEGF expression in granulation tissue of rat’s skin treated with the TA group, Hydrocyn® aqua gel (+ve) control, and vehicle hydrogel groups, our study group showed higher expression of VEGF. CONCLUSION: Our study showed that the topical application of TA hydrogel increased the VEGF expression in granulation tissue of rat’s skin, which is an essential growth factor for wound healing. Thus, there is great potential for TA hydrogel to be an effective wound-healing agent for managing cutaneous wounds.
A Systematic Review of Maternal Dietary Intake and its Association with Childhood Stunting
Get PDFThe first 1,000 days of a child’s life is a critical period of development in preventing childhood stunting. Despite various intervention programs, the global prevalence remains high. Maternal nutrition during pregnancy and exclusive breastfeeding plays an important role in infant development; thus, a systematic review of the relationship between maternal dietary intake and childhood stunting was conducted. The Web of Science, Scopus, PubMed, and Google Scholar electronic databases were used. Articles related to maternal nutrition and supplement intake with children's anthropometry data were included. Eleven studies met the inclusion criteria and seven were included after quality assessment. The studies were reviewed thematically as the statistical analysis was not possible due to data heterogeneity. The Appraisal Tool for Cross-Sectional Studies (AXIS) and Critical Appraisal Skills Program tools were used to assess the quality of the included studies. The findings demonstrated that pregnant women need to eat a diverse diet with the inclusion of at least five food groups to fulfill the nutritional requirement. Daily protein intake between 0.8 and 1.1g/kg body weight is recommended for positive birth weight and height outcomes. Supplementation of vitamin A, vitamin C, iron, zinc, vitamin D, and calcium, was also shown to improve pregnancy outcomes. However, future studies should consider confounding factors such as hygiene level and clean water availability to determine the transparent effect of nutrition on childhood stunting. More longitudinal studies are required to ascertain the relationship between maternal dietary intake and childhood stunting, especially in Malaysia