list of publications and abstracts year...

1

LIST OF PUBLICATIONS AND ABSTRACTS YEAR 2016

No Publication Page no. 1 Agarwal R, Agarwal P. Targeting ECM remodeling in disease: Could

resveratrol be a potential candidate? Experimental Biology and Medicine, 2016; 0: 1–10. (ISI IF: 2.542; SCI IF: 2.376; HI: 122; Tier: Q1).

25

2 Ahmadi K, Hasan SS. Implementing professionalism by deprofessionalized strategies: A moral quandary. Currents in Pharmacy Teaching and Learning, 2016; 9(1): 9-11. Doi: http://dx.doi.org/10.1016/j.cptl.2016.08.032. (SCI IF: 0.478; HI: 7; Tier: Q1).

26

3 Amarra MSV, Khor GL, Chan P. Intake of added sugar in Malaysia: A review. Asia Pacific Journal of Clinical Nutrition, 2016; 25(2): 227-240.

(SCI IF: 1.371; HI: 51; Tier: Q2).

27

4 Arfuzir NNN, Lambuk L, Jafri AJA, Agarwal R, Iezhitsa I, Sidek S, Agarwal P, Bakar NS, Kutty MK, Md Yusof AP, Krasilnikova A, Spasov A, Ozerov A, Mohd Ismail N. Protective effect of magnesium acetyltaurate against endothelin-induced retinal and optic nerve injury. Neuroscience, 2016; 325: 153-164. (ISI IF: 3.231; SCI IF: 3.297; HI:

179; Tier: Q1).

28

5 Assenheimer D, Knox K, Nadarajah VD, Zimitat C. Medical students' epistemological beliefs: Implications for curriculum. Education for Health, 2016; 29(2): 107-112. (SCI IF: 0.366; HI: 22; Tier: Q3).

29

6 Aung HH, Barua A, Sivakumar A, Khin MM. Application of anatomical knowledge by final year dental students of integrated curriculum: A pilot study. Journal of Medical Science and Clinical Research, 2016; 4(11):

13827-33. [IMU Internal Grant – IMU 309_2014]. (ISI IF: 5.244).

30

7 Azadeh K, Farid M, Niusha S, Mahidzal D. Dynamic modeling of PEM fuel cell of power electric bicucle system. International Journal of Hydrogen Energy, 2016; 24(22), 9585–9594. (ISI IF: 3.205; SCI IF:

3.311; HI: 146; Tier: Q1).

31

8 Aznal SS, Nalliah S, Chng TW. Revisiting cerebral palsy: Pathogenesis and management. Journal of South Asian Federation Obstetrics and Gynecology (SAFOG), 2016; 8(1): 57-65. (SCI IF: 0.0; HI: 3; Tier: Q3).

32

9 Babar MG. Professionalism 2.0. IeJSME, 2016; 10(1): 1-2. (MyCite IF:

0.038).

33

10 Bahrani R, Chan YM, Khor GL, Hejar AR, Wong TW, Esmailzadeh A. Metabolic syndrome and socio-economic status in adolescents of Shiraz Southern-Iran. Southeast Asian Journal of Tropical Medicine and Public Health, 2016; 47: 92. (SCI IF: 0.617; HI: 38; Tier: Q3).

*

11 Balakrishnan J, Appalasamy JR, Verma RK. A study on awareness of skin infection among adults in Petaling district, Malaysia. International Journal of Pharmacy and Pharmaceutical Sciences, 2016; 8(2): 136-

139. (ISI IF: 0.49; SCI IF: 0.486; HI: 24; Tier: Q2).

*

* Abstract not available

http://dx.doi.org/10.1016/j.cptl.2016.08.032

2

No Publication Page no.

12 Banavar SR, Chippagiri P, Pandurangappa R, Annavajjula S, Rajasheraiah P. Image montaging for creating a virtual pathology slide: An innovative and economical tool to obtain a whole slide image. Analytical Cellular Pathology, 2016; 2016: 1-7. (ISI IF: 0.459; SCI IF:

0.692; HI: 12; Tier: Q3).

35

13

Banavar SR, Saileela A. Association of lip prints and palatal rugae with birth month. International Journal of Current Advanced Research, 2016; 5(5): 912-914. (ISI IF: 4.915).

36

14 Banavar SR, Saileela A. Comparison of cyanoacrylates and Dpx for mounting a histological section. International Journal of Recent Scientific Research, 2016; 7(5): 10971-10975. (ISI IF: 5.971).

37

15 Banneheke H, Fernandopulle R, Gunasekara U, Barua A, Fernando N, Wickremasinghe R. Can trichomonas immunochromatographic test

increase the validity and reliability of WHO syndromic algorithm for vaginal discharge as a screening tool for trichomoniasis? Annals of Tropical Medicine and Public Health, 2016; 9(1): 43. (SCI IF: 0.185; HI:

5; Tier: Q3).

38

16 Banumathy R, Lee KW, Goh PL, Saw MM, Ng HF, Sivalingam N. The effectiveness of pelvic floor muscle exercise in treatment of genuine stress incontinence in women: A systematic review. Indian Journal of Physiotherapy and Occupational Therapy, 2016; 10(1): 54-60. (IF: NA).

*

17 Barling PM, Shyam S, Selvathevan MD, Misra S. Anomalous association of salivary amylase secretion with the postprandial glycaemic response to starch. BMC Nutrition, 2016; 2(1): 50. DOI:

10.1186/s40795-016-0088-0. [IMU Internal Grant: BMS I02\2014 (07)]. (IF: NA).

39

18 Beshir SA, Chee KH, Lo YL. Factors associated with abrupt discontinuation of dabigatran therapy in patients with atrial fibrillation in a teaching hospital in Kuala Lumpur, Malaysia. International Journal of Clinical Pharmacy, 2016; 38: 1182-1190. DOI 10.1007/s11096-016-

0350-1. (ISI IF: 1.339; SCI IF: 1.424; HI: 43; Tier: Q1).

40

19 Beth MRM, Wong SM, Foo SF. Health literacy and self-care management among patients with diabetes mellitus in a selected private hospital, Malaysia. Journal of Nursing Science and Practice,

2016; 6(2): 38–44. [IMU internal grant- BNurS project]. (IF: NA).

*

20 Bhatia S, Kohli S. CBCT usage: An alert to dentistry. Imaging Science

in Dentistry, 2016; 46(2): 145–146. (SCI IF: 0.989; HI: 8; Tier: Q2).

41

21 Birnin-Yauri AU, Ibrahim NA, Zainuddin N, Abdan K, Then YY, Chieng BW. Influence of kenaf core fiber incorporation on the mechanical performance and dimensional stability of oil palm fiber reinforced poly(lactic acid) hybrid biocomposites. BioResources, 2016; 11(2):


42


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22 Birnin-Yauri AU, Ibrahim NA, Zainuddin N, Abdan K, Then YY, Chieng BW. Enhancement of the mechanical properties and dimensional stability of oil palm empty fruit bunch-kenaf core and oil palm mesocarp-kenaf core hybrid fiber-reinforced poly(lactic acid) biocomposites by borax decahydrate modification of fibers. BioResources, 2016; 11(2): 4865. (ISI IF: 1.334; SCI IF: 1.329; HI: 36; Tier: Q2).

43

23 Chan CW, Lai JW, Ooi IH, Er HM, Chye SM, Tan KW, Ng SW, Mohd JM, Ng CH. Structural characterization, ROS-inductive and proteasome inhibitory properties of ternary and binary copper(II) complexes of N2-and N2O2-ligands. Inorganica Chimica Acta, 2016; 450: 202 [eSc 02-02-09-SF0036]. (ISI IF: 1.918; SCI IF: 1.826; HI: 84; Tier: Q2).

44

24 Chang SK, Alasalvar C, Bolling BW, Shahidi F. Nuts and their co-products: The impact of processing (roasting) on phenolics, bioavailability, and health benefits – A comprehensive review. Journal of Functional Foods, 2016; 26: 88-122. (ISI IF: 3.973; SCI IF: 4.168; HI:

35; Tier: Q1).

45

25 Chaubal TV, Bapat RA, Patil PG, Shetty A. Allergic contact dermatitis due to latex gloves in dental undergraduate student. Contact Dermatitis, 2016: 75(4): 256–257. (ISI IF: 5.692; SCI IF: 3.594; HI: 77; Tier: Q2).

*

26 Chellappan DK, Candasamy M. Cellulitis – Current management approach through complementary and alternative medicine. Advances in Pharmacoepidemiology and Drug Safety, 2016; 5: 211.

doi:10.4172/2167-1052.1000211. (ISI IF: 0.94).

46

27 Chia YC, Beh HC, Ng CJ, Teng CL, Hanafi NS, Choo WY, Ching SM. Ethnic differences in the prevalence of knee pain amongst adults of a community in a cross-sectional study. BMJ Open, 2016; 6: e011925.

Doi: 10.1136/bmjopen-2016-011925. (ISI IF: 2.562; SCI IF: 2.588; HI: 35; Tier: Q1).

48

28 Chieng BW, Ibrahim NA, Then YY, Loo YY. Mechanical, thermal, and morphology properties of poly(lactic acid) plasticized with poly(ethylene glycol) and epoxidized palm oil hybrid plasticizer. Polymer Engineering and Science, 2016; 56(10): 1169-1174. DOI: 10.1002/pen.24350. (ISI IF: 1.719; SCI IF: 1.557; HI: 86; Tier: Q2).

49

29 Chin YT, Lim YAL, Chong CW, Teh CSJ, Yap IKS, Lee SC, Tee MZ, Siow VWY, Chua KH. Prevalence and risk factors of intestinal parasitism among two indigenous sub-ethnic groups in Peninsular Malaysia. Infectious Diseases of Poverty, 2016; 5: 1-15. (ISI IF: 2.13;

SCI IF: 2.075; HI: 12; Tier: Q1).

50

30 Ching S, Ramachandran V, Gew LT, Lim SM, Sulaiman WA, Foo YL, Zakaria ZA, Samsudin NH, Lau PC, Veettil SK, Hoo F. Complementary alternative medicine use among patients with dengue fever in the hospital setting: A cross-sectional study in Malaysia. BMC Complementary and Alternative Medicine, 2016; 16(1): 37. (SCI IF:

2.208; HI: 53; Tier: Q1).

52


4


31 Chong HP, Kasi R, Ng KY, Koh RY, Ng CH, Chye SM. para-Phenylenediamine containing hair dye: An overview of mutagenicity, carcinogenicity and toxicity. Journal of Environmental and Analytical Toxicology, 2016; 6: 403. doi: 10.4172/2161-0525.1000403. (ISI IF:

2.72).

53

32 Chong MX, Khoo CD, Goh KH, Rahman F, Shoji Y. Effect of age on bite

force. Journal of Oral Science, 2016; 58(3): 361-363. (SCI IF: 0.908; HI:

35; Tier: Q2).

54

33 Chu WL, Phang SM. Marine algae as a potential source for anti-obesity agents. Marine Drugs, 2016; 14(12): 222. (ISI IF: 3.345; SCI

IF: 3.373; HI: 56; Tier: Q2).

55

34 Chung FFL, Mai CW, Ng PY, Leong CO. Roles of cytochrome P450 2W1 (CYP2W1) in colorectal cancers. Current Cancer Drug Targets,

2016; 16(1): 71-8. DOI: 10.2174/1568009616888151112095948. (ISI IF: 3.707; SCI IF: 3.752; HI: 73; Tier: Q1).

56

35 Chung PY. Plant-derived compounds as potential source of novel anti-biofilm agents against Pseudomonas aeruginosa. Current Drug Targets, 2016; 17. (ISI IF: 3.029; SCI IF: 3.14; HI: 77; Tier: Q1).

57

36 Chung PY. The emerging problems of Klebsiella pneumoniae infections: Carbapenem resistance and biofilm formation. FEMS Microbiology Letters, 2016; 363, fnw219. (ISI IF: 1.858; SCI IF: 2.817;

HI: 118; Tier: Q2).

58

37 Dujaili JA, Syed Sulaiman SA, Awaisu A, Hassali MA, Blebil AQ, Bredle JM. Comparability of interviewer-administration versus self-administration of the Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB) health-related quality of life questionnaire in pulmonary tuberculosis patients. Pulmonary Therapy, 2016; 2(1): 127-137. (IF: NA).

59

38 Ebrall PS. Commentary: Is EBM damaging the social conscience of chiropractic? Chiropractic Journal of Australia, 2016; 44(3): 204-213. (SCI IF: 0.222; HI: 3; Tier: Q4).

60

39 Edavanputhillath R, Joseph L, Kademane K, Rao SN. Anticonvulsant activity of Nigella sativa, Aegle marmelos and Benincasa hispida in Pentylenetetrazole induced seizure in Swiss albino mice. Asian Journal of Medical Sciences, 2015; 7(3):97-102. (E-ISSN 2091-0576; P-ISSN

2467-9100). (IF: NA).

61

40 Edib Z, Kumarasamy V, Abdullah N, Rizal AM, Al-Dubai SA. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia. Health and Quality of Life Outcomes, 2016; 14(1): 1. (ISI IF: 2.212; SCI IF: 2.433; HI: 75; Tier:

Q1).

62


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41 Erna L, Ling APK, Koh RY, Wong YP, Mohd Lila MA, Hussein S. Plant-based vaccines: Production and challenges. Journal of Botany, 2016:

Article ID: 4928637. doi:10.1155/2016/4928637. [ERGS- [ERGS/1/2012/SKK10/IMU/03/4]. (IF: NA).

63

42 Fong BY, Lin Ma, Khor GL, van der Does Y, Rowan A, McJarrow P, Mac Gibbon AKH. Ganglioside composition in beef, chicken, pork, and fish determined using liquid chromatography − High-resolution mass spectrometry. Journal of Agricultural and Food Chemistry, 2016; DOI:

10.1021/acs.jafc.6b02200. [External Grant from Fonterra, IMU R 139/2014]. (ISI IF: 2.857; SCI IF: 2.923; HI: 216; Tier: Q1).

64

43 Fu JY, Tan DMY, Er HM, Chen YS, Nesaretnam K. Tumour-targeted niosome as novel carrier for intravenous administration of tocotrienol. Asian Journal of Pharmaceutical Sciences, 2016; 11(1): 79-80. DOI: http://dx.doi.org/doi: 10.1016/j.ajps.2015.10.062. (SCI IF: 1.89; HI: 11; Tier: Q2).

65

44 George P, Balasingam V, Thurairajasingam S, Ramasamy P, Yusof HM, Yasin MAM, Bahkt ZU. Methadone complications among opioid dependent patients in Malaysia: A case series. Drug and Alcohol Review, 2016; DOI: 10.1111/dar.12456. (ISI IF: 2.405; SCI IF: 2.447;

HI: 54; Tier: Q1).

66

45 Ghazi HF, Al-abed AAA, Hasan TN, Zaleha MI, Qader MAA, Abdul-Majeed S. Nutrition and breast cancer risk: Review of recent studies. Malaysian Journal of Public Health Medicine, 2016; 16 (1): 75-80. (SCI

IF: 0.216; HI: 3; Tier: Q4).

67

46 Hamid Jan b Jan Mohamed, Loy SL, Mohd Nasir Mohd Taib, Norimah A Karim, Tan SY, Appukutty M, Nurliyana Abdul Razak, Thielecke F, Hopkins S, Ong MK, Ning C, Tee ES. Characteristics associated with the consumption of malted drinks among Malaysian primary school children: Findings from the MyBreakfast Study. BMC Public Health,

2015; 15: 1322. (ISI IF: 2.209; SCI IF: 2.381; HI: 81; Tier: Q1).

68

47 Harvinder GS, Chee WSS, Karupaiah T, Sahathevan S, Chinna K, Ahmad G, Bavanandan S, Goh BL. Dialysis malnutrition and malnutrition inflammation scores: Screening tools for prediction of dialysis – related protein-energy wasting in Malaysia. Asia Pacific Journal of Clinical Nutrition, 2016; 25(1): 26-33. (SCI IF: 1.371; HI: 51;

Tier: Q2).

70

48 Hasan SS, Thiruchelvam K, Syed Imran Ahmed, Clavarino AM, Mamun AA, Kairuz T. Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes. Asian Journal of Psychiatry, 2016; 23: 56–63. (SCI IF: 1.353; HI: 13; Tier: Q2).

71


6


49 Ho SE, Ting JAJ, Lee LC, Wong PF. Information needs in relation to physical activity among angina patients before percutaneous coronary intervention (PCI) at a private hospital in Penang, Malaysia. Journal of Krishna Institute of Medicine Sciences University (JKIMSU), 2016; 5(4):

18-23. ISSN 2231-4261. (IF: NA).

72

50 Iezhitsa I, Agarwal R, Saad SD, Zakaria FK, Agarwal P, Krasilnikova A, Rahman TH, Rozali KN, Spasov A, Ozerov A, Alyautdin R, Ismail NM. Mechanism of the anticataract effect of liposomal MgT in galactose-fed rats. Molecular Vision, 2016; 22: 734-47. (ISI IF: 2.11; SCI IF: 2.106; HI:

70; Tier: Q1).

73

51 Ingle PV, Patil SD, Sharma SA, Patil PH, Surana SJ. A prospective study on adverse drug reactions from pegylated interferon alfa-2a and alfa-2b in combination with ribavirin in hepatitis B and C. Journal of Pharmaceutical Research and Clinical Practice, 2016; 6(1): 1-6. (ISI IF:

3.8).

74

52 Ingle PV, Samsudin SZ, Chan PQ, Ng MK, Heng LX, Yap SC, Chai AS, Wong AS. Development and novel therapeutics in hepatocellular carcinoma: A review. Therapeutics and Clinical Risk Management, 2016; 12: 445-455. (ISI IF: 1.903; SCI IF: 2.286; HI: 31; Tier: Q1).

75

53 Jafri AJA, Arfuzir NNN, Lambuk L, Iezhitsa I, Agarwal R, Agarwal P, Razali N, Krasilnikova A, Kharitonova M, Demidov V, Serebryansky E, Skalny A, Spasov A, Yusof APM, Ismail NM. Protective effect of magnesium acetyltaurate against NMDA-induced retinal damage involves restoration of minerals and trace elements homeostasis. Journal of Trace Elements in Medicine and Biology, 2016; 39: 147-

154. doi: 10.1016/j.jtemb.2016.09.005. (ISI IF: 2.55; SCI IF: 2.196; HI: 49; Tier: Q3).

76

54 Janvier A, Lantos J, Aschner J, Barrington K, Batton B, Batton D, Berg SF, Carter B, Campbell D, Cohn F, Lyerly AD, Ellsbury D, Fanaroff A, Fanaroff J, Fanaroff K, Gravel S, Haward M, Kutzsche S, Marlow N, Montello M, Maitre N, Morris JT, Paulsen OG, Prentice T, Spitzer AR. Stronger and more vulnerable: A balanced view of the impacts of the NICU experience on parents. Pediatrics, 2016; doi: 10.1542/peds.2016-0655. (ISI IF: 3.890; SCI IF: 5.179; HI: 263; Tier: Q1).

78

55 Jayaraman J, Roberts GJ. Demirjian's method is unsuitable for dental

age estimation. Forensic Science, Medicine, and Pathology, 2016;

12(4): 532-533. DOI: 10.1007/s12024-016-9811-z. (ISI IF: 1.896; SCI

IF: 1.209; HI: 20; Tier: Q2).

79

56 Jayaraman J, Wong HM, King NM, Roberts GJ. Development of a

Reference Data Set (RDS) for dental age estimation (DAE) and testing

of this with a separate Validation Set (VS) in a southern Chinese

population. Journal of Forensic and Legal Medicine, 2016; 43: 26-33.

(ISI IF: 0.870; SCI IF: 1.003; HI: 31; Tier: Q1).

81


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57 Kadam A, Patil SK, Patil S, Tumkur A. Pharmaceutical waste management - An Overview. Indian Journal of Pharmacy Practice,

2016; 9(1): 2-8. (IF: NA).

82

58 Kademane K, Karikalan B. Micronucleus – Applications in non-communicable diseases. International Journal of Innovative and Applied Research, 2016; 4(4): 32-7. (ISI IF: 2.845).

83

59 Kannan MM. Knowledge, attitude, and practice of people toward epilepsy in a South Indian village. Journal of Neurosciences in Rural Practice, 2016; 7(3): 339–340. (SCI IF: 0.761; HI: 10; Tier: Q3).

84

60 Kasi R, Ng KY, Koh RY, Gnanajothy P, and Chye SM. para-Phenylenediamine induces apoptosis through activation of reactive oxygen species-mediated mitochondrial pathway, and inhibition of the NF-κB, mTOR, and Wnt pathways in human urothelial cells. Environmental Toxicology, 2016; 32(1): 265-277. DOI:

10.1002/tox.22233. (ISI IF: 2.868; SCI IF: 2.191; HI: 54; Tier: Q2).

85

61 Khajotia RR, Sree Raman K. Managing severe COPD: Addressing the challenges with latest trends and treatment options (Part I: Pharmacological Management). Journal of Clinical Respiratory Diseases and Care, 2016; 2(3): 118. doi:10.4172/2472-1247.1000118.

(IF: NA).

86

62 Khajotia RR. A middle-aged man with right-sided chest pain, hemoptysis and weight loss. Journal of Clinical Respiratory Diseases and Care, 2016; 2(2): i002. doi:10.4172/2472- 1247.1000i002. (IF: NA).

87

63 Khanum R, Qureshi MJ, Mohandas K. Antibiofilm potential of meropenem-loaded poly(ɛ-caprolactone) nanoparticles against Klebsiella pneumoniae. International Journal of Pharmaceutical and Clinical Research, 2016; 8(9): 1343-1350. [IMU Internal Grant for MSc

candidature - IMU 241/2011]. (ISI IF: 1.668; SCI IF: 0.165; HI: 4; Tier: Q4).

88

64 Kheirandish A, Motlagh F, Shafiabady N, Dahari M. Dynamic modelling of PEM fuel cell of power electric bicycle system. International Journal of Hydrogen Energy, 2016; 41(22): 9227-9718. (ISI IF: 3.205; SCI IF:

3.311; HI: 146; Tier: Q1).

89

65 Kheirandish A, Shafiabady N, Dahari M, Isa D. Modelling of commercial proton exchange membrane fuel cell using support vector machine. International Journal of Hydrogen Energy, 2016; 41(26): 11351–11358.


90

66 Kho MT, Chong CW, Lim ESH, Ismail NH, Draper LO, Yam WK, Lim PKC, Mak JW, Yap IKS. Systems biology analyses of the dynamic host response to Toxoplasma gondii infection in a murine model. Parasitology Open, 2016; 2: e9. [IMUR093/2012]. (IF: NA).

91


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67 Khoo EJ. Systemic lupus erythematosus (SLE): Not just a rash. Archives of Disease in Childhood, 2016; DOI:

http://dx.doi.org/10.1136/archdischild-2016-311438. (ISI IF: 3.231; SCI IF: 2.645; HI: 118; Tier: Q1).

92

68 Khor GL, Shyam S, Misra S, Fong B, Chong MHZ, Sulaiman N, et al. Correlation between dietary intake and serum ganglioside concentrations: A cross-sectional study among Malaysian toddlers. BMC Nutrition, 2016; 2: 74. DOI: 10.1186/s40795-016-0113-3. [IMU

external Grant: Project ID No. IMU R 139/2014]. (IF: NA).

93

69 Khor GL, Tan SY, Tan KL, Chan PS, Amarra MSV. Compliance with WHO IYCF indicators and dietary intake adequacy in a sample of Malaysian subjects aged 6-23 months. Nutrients, 2016; 8: 778. (ISI IF:

3.759; SCI IF: 3.952; HI: 38; Tier: Q1).

94

70 Kingston R, Kannan MM. Framework for action to implement interprofessional education and collaborative practice in pharmacy and allied health sciences programs in India. Indian Journal of Pharmaceutical Education and Research, 2016; 50(2): 238-245. (ISI IF:

0.219; SCI IF: 0.226; HI: 13; Tier: Q3).

95

71 Kingston R, Mari Kannan M, Sarah ZBS, Choo Lin T, Tan AYP, Wong ASY. Ebola: Emergency preparedness and perceived response of Malaysian healthcare providers: Perceptions of preparedness. American Journal of Infection Control, 2016; 44: 1720-1722. DOI:

http://dx.doi.org/10.1016/j.ajic.2016.05.019. (ISI IF: 1.995; SCI IF: 2.046; HI: 81; Tier: Q1).

96

72 Koh KC, Pak JW. Immune reconstitution inflammatory syndrome in a HIV-infected patient with disseminated tuberculosis. Malaysian Family Physician, 2016; 11(1): 31-34. (SCI IF: 0.13; HI: 7; Tier: Q3).

97

73 Kohli S, Bhatia S. The need for dental digital photography education.

Australian Dental Journal, 2016; 61(1): 125. (ISI IF: 1.272; SCI IF:

1.417; HI: 46; Tier: Q2).

98

74 Krishanappa SKK, Prashanti E, Sumanth KN, Naresh S, Moe S, Aggarwal H, Mathew RJ. Interventions for treating oro-antral communications and fistula due to dental procedures. Cochrane Database of Systematic Reviews, 2016; Issue 5, Art No.: CD011784.

DOI: 10.1002/14651858. CD011784.pub2. (ISI IF: 6.103; SCI IF: 4.662; HI: 133; Tier: Q1).

99

75 Krishnappa P, Eu JL, Ibtisam BM, Mahadevan DT, Meenakshi A, Kandasami P. A histomorphological and immunohistochemical study of gastrointestinal stromal tumors in Hospital Tuanku Ja’afar Seremban, Malaysia. Asia Pacific Journal of Cancer Prevention, 2016; 17(6): 2795-


101


http://dx.doi.org/10.1136/archdischild-2016-311438

http://dx.doi.org/10.1016/j.ajic.2016.05.019

9


76 Kugan V, Mahadevan DT, Kandasami P. Comparison of features and outcomes of perforated peptic ulcer between Malaysians and foreigners. Medical Journal of Malaysia, 2016; 71(1): 12-6. (SCI IF:

0.528; HI: 24; Tier: Q3).

102

77 Kumanan T, Guruparan M, Mohideen MR. Non-adherence of antihypertensive therapy: A serious public health issue in Sri Lanka. Journal of the Ceylon College of Physicians, 2016; 47: 50-51. (IF: NA).

103

78 Kutzsche S, Kutzsche H. Arvo Henrik Yllpo. Tidskr Nor Barnelegeforen [J Nor Pediatric Association], 2016; 36(3): 118-121. [REGULAR ARTICLE]. (IF: NA).

*

79 Kutzsche S, Kutzsche H. Benjamin McLane Spock (1903-1998) - den kontroversielle rebellen. Tidskr Nor Barnelegeforen (Journal of the Norwegian Pediatric Association), 2016; Paidos, 34(1): 26-28. [Text in

Norwegian]. (IF: NA).

*

80 Kutzsche S, Kutzsche H. Kåre Håvard Torp - Nord Norges første barnelege. Paidos Tidskr Nor Barnelegeforen (Journal of Norwegian Pediatric Association), 2016; 35(2): 72-73 [Text in Norwegian]. (IF: NA).

*

81 Kutzsche S, Kutzsche H. Ola Knutrud (1919-1996) - Barnekirurgiens banebryter. Tidskr Nor Barnelegeforen Paidos [J Nor Paediatr Association], 2016; 34(4): 198-200. [Text in Norwegian] (IF: NA).

*

82 Kutzsche S, Kutzsche H. Ola Knutrud (1919-1996) - Barnekirurgiens banebryter. Kirurgen [J Nor Surgical Society], 2016; (4): 204-205. [Text in Norwegian] (IF: NA).

*

83 Kutzsche S, Kutzsche H. Yllpo AH. Tidskr Nor Barnelegeforen [J Nor Pediatric Association], 2016; 36(3): 118-121. [REGULAR ARTICLE] [Text in Norwegian]. (IF: NA).

*

84 Kutzsche S. Girl in glass – Dispatches from the end of life. Tidskr Nor Barnelegeforen [J Nor Pediatric Association], 2016; 36(3): 124. [BOOK

REVIEW]. (IF: NA).

*

85 Kwa SK, Zainab AM, Tan KN. Delay and misdiagnosis in adult myasthenia gravis: A case report. IeJSME, 2016; 10(3): 37-39. (MyCite

IF: 0.038).

104

86

Kweh TJ, Tham RY, Gu JY, Ahsan MS, Jacob PS, Khoo SP. Effect of local and systemic inflammation on gingival mesenchymal stem cells. Journal of Periodontology and Implant Dentistry, 2016; 8(1). (IF: NA).

*

87 Lai JW, Chan CW, Ng CH, Ooi IH, Tan KW, Maah MJ, Ng SW. Hydrated and anhydrous forms of copper (II) complex of 3-methylpicolinic acid, and spectroscopic studies of their ROS-inducing and proteasome inhibition. Journal of Molecular Structure, 2016; 1106: 234-41. (ISI IF:

1.78; SCI IF: 1.716; HI: 75; Tier: Q3).

105


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88 Lakshman AR, Kanneppady SK, Castelino RL. Evaginated odontome with dens invaginatus in maxillary lateral incisor – A rare presentation. Saudi Journal of Medicine, 2016; 1(1): 16-20. (IF: NA).

106

89 Lam KY, Ling APK, Koh RY, Wong YP, Say YH. A review on medicinal properties of orientin. Advances in Pharmacological Sciences, 2016;

Volume: 2016, Article ID: 4104595. DOI: dx.doi.org/10.1155/2016/4104595. [FRGS/1/2013/SKK07/IMU/03/3] (IF: NA).

107

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181 Singh S, Rajendran R, Kuroda K, Isogai E, Krstic-Demonacos M, Demonacos C. Oxidative stress and breast cancer biomarkers: The case of the cytochrome P450 2E1. Journal of Cancer Metastasis and Treatment, 2016; Volume 2016; 2: 269. (IF: NA).

196

182 Sivanandy P, Shim HS, Ong YC, Rajasekar D, Gan SW, Hii HC, Ng CE, Khoo XW, Yeap WL. Current trends in the management of Ebola virus disease - An updated systematic review. Asian Pacific Journal of Tropical Disease, 2016; 6(8): 589-595. (SCI IF: 0.982; HI: 17; Tier: Q3).

197

183 Solayar GN, Rauf A. Case of the month: Acetabular tuberculosis in a 12 year old. A report focusing on diagnosis and current management. SICOT Global Network for Electronic Learning – SIGNEL. SICOT e-Newsletter, 2016; Issue No. 81. (IF: NA).

*

184 Solayar GN. Choice of autograft for primary ACL reconstruction: Hamstrings are the better option. (Scientific Debate). International Society for Orthopaedics & Traumatology, SICOT e-Newsletter, 2016;

79. (IF: NA).

*

185 Sumathy A, Palanisamy S, Arathi KN, Aswathi UP, Hamna Fathima K. Docking analysis of potent inhibitors of topoisomerase IV as potential antimicrobial agents. Asian Journal of Pharmaceutical and Health Sciences, 2016; 6(2): 1467-1471. (IF: NA).

198

186 Sumathy A, Palanisamy S, Arathi KN, Karthik D, Srinivasan M. Microwave assisted synthesis and evaluation of some thiazole analogues as antitubercular agent. Asian Pacific Journal of Pharmacy and Phytochemistry, 2016; 1(01): 2-10. (IF: NA).

199


20


187 Sumera A, Inn LC, Barua A. An update on new vaccines for tuberculosis. Journal of Asian Scientific Research, 2016; 6(3): 41. (IF:

NA).

200

188 Supramaniam Y, Chong CW, Silvaraj S, Tan IK-P. Effect of short term variation in temperature and water content on the bacterial community in a tropical soil. Applied Soil Ecology, 2016; 10: 279-289. [IMUR121-

2013]. (ISI IF: 2.67; SCI IF: 2.716; HI: 83; Tier: Q1).

201

189 Suresh A, Mathan R, Nagendrababu V, Deivanayagam K, Yarramreddy

S, Kalaiselvam R. Evaluation of the antibacterial efficacy of Azadirachta

indica, Commiphora myrrha, Glycyrrhiza glabra against Enterococcus

faecalis using real time PCR. Open Dentistry Journal, 2016; 11(10):

160-5. doi: 10.2174/1874210601610010160. (SCI IF: 0.952; HI: 9; Tier:

Q3).

202

190 Syed IA, Sulaiman SA, Hassali MA, Syed SH, Shan LH, Lee CK. Factors associated with poor CD4 and viral load outcomes in patients with HIV/AIDS. Journal of Medical Virology, 2016; 88(5): 790-797. (ISI

IF: 1.998; SCI IF: 2.022; HI: 98; Tier: Q2).

203

191 Tan BH, Ong CE. The use of natural remedies to treat osteoarthritis. TANG [HUMANITAS MEDICINE], 2016; 6(1): e1. DOI:

http://dx.doi.org/10.5667/tang.2015.0023. (IF: NA).

204

192 Tan SY, Wong MM, Tiew ALW, Choo YW, Lim SH, Ooi IH, Modamio P, Fernández C, Mariño EL, Segarra I. Sunitinib DDI with paracetamol, diclofenac, mefenamic acid and ibuprofen shows sex-divergent effects on the tissue uptake and distribution pattern of sunitinib in mice. Cancer Chemotherapy and Pharmacology, 2016; 1-10. Doi: 10.1007/s00280-

016-3120-9. [IMU Internal grant BPharm Sem 7– IMU_2010] (ISI IF: 2.824; SCI IF: 2.965; HI: 86; Tier: Q1).

205

193 Tan WZ, Krishnappa P. Gene polymorphism in cervical cancer. International Journal of Current Medical and Pharmaceutical Research Sciences, 2015; 1(11): 189-192. ISSN: 2395-6429. (ISI IF: 0.543).

206

194 Tan YJ, Lee CS, Er HM, Lim WH, Wong SF. In-vitro evaluation of griseofulvin loaded lipid nanoparticles for topical delivery. Journal of Drug Delivery Science and Technology, 2016; 31: 1-10. (ISI IF: 0.620;

SCI IF: 0.749; HI: 31; Tier: Q2).

207

195 Tan ZZ, Hossain MZ, Ahsan MS, Chew YC, Win SS, Khoo SP. Microvessel density in different grades of squamous cell carcinoma and its relationship with keratin pearl. Sains Malaysiana, 2016; 45(2): 201–205. (ISI IF: 0.35; SCI IF: 0.474; HI: 15; Tier: Q2).

208

196 Tang WB, Sikarwar AS. Diagnostics: Conventional versus modern methods. Journal of Advances in Medical and Pharmaceutical Sciences, 2016; 8(4): 1-7. (IF: NA).

209


http://dx.doi.org/10.5667/tang.2015.0023

21


197 Tang WM, Abdul Rahman Idris. Leaving intention and exit destinations among the Malaysian private hospital nurses. IeJSME, 2016; 10(1): 24-

35. (MyCite IF: 0.038).

210

198 Teng CL, Lim WY, Chua CZ, et al. Does a single cup of caffeinated drink significantly increase blood pressure in young adults? A randomised controlled trial. Australian Family Physician, 2016; 45(1):


211

199 Thiruchelvam K, Hasan SS, Wong PS, Kairuz T. Residential aged care medication review to improve the quality of medication use: A systematic review. Journal of the American Medical Directors Association (JAMDA), 2016; DOI:

http://dx.doi.org/10.1016/j.jamda.2016.10.004. [IMU Internal Grant- IMU349/2016]. (ISI IF: 6.616; SCI IF: 6.623; HI: 55; Tier: Q1).

212

200 Thuraisingham C, Sinniah D. Stiff hands and feet, facial deformities. Journal of Family Practice, 2016; 65(2): 121-124. (SCI IF: 0.473; HI: 81; Tier: Q3).

213

201 Tiong JJL, Loo J, Mai CW. Global antimicrobial stewardship: A closer look at the formidable implementation challenges. Frontiers in Microbiology, 2016; 7: 1860. Accepted for publication. doi:

10.3389/fmicb.2016.01860. (ISI IF: 4.165; SCI IF: 4.093; HI: 41; Tier: Q1).

214

202 Tiong JJL, Mai CW, Gan PW, Mak VSL, Johnson J. Separation of prescribing and dispensing in Malaysia: The history, necessities and challenges. International Journal of Pharmacy Practice, 2016; 24(4):

302-5. (SCI IF: 1.009; HI: 28; Tier: Q1).

215

203 Tiong KH, Tan BS, Choo HL, Chung FFL, Hii LW, Tan SH, Khor NTW, Wong SF, See SJ, Tan YF, Rozita R, Cheong SK, Leong CO. Fibroblast growth factor receptor 4 (FGFR4) and fibroblast growth factor 19 (FGF19) autocrine enhance breast cancer cells survival. Oncotarget, 2016; 7(36): 57633-57650. doi: 10.18632/oncotarget.9328. (ISI IF: 6.359; SCI IF: 4.886; HI: 46; Tier: Q1).

216

204 Tumkur A, Yee CTW, Yee ELC, Sheng FS, Ern TS. Usage of angiotensin converting enzyme receptor blockers in diabetic hypertensive patients. Manipal Journal of Pharmaceutical Sciences,

2016; 2(1): 3-10. (IF: NA).

217

205 Tye KY, Gan SY, Lim ESH, Tan SE, Chen CA, Phang SM. Comparison of visual observation and emission intensity of resazurin for antimicrobial properties of hexane, dichloromethane, methanol and water extracts from a brown alga, Turbinaria ornata. Cogent Biology,

2016; 2: 1225877. [BP1–01/11(14)2014]. (IF: NA).

218


http://dx.doi.org/10.1016/j.jamda.2016.10.004

22


206 Vasiwala R, Burud I. Malignant melanoma of the ear canal presenting as wart. IeJSME, 2016; 10(1): 47-48. (MyCite IF: 0.038).

219

207 Veeraveedu PT, Sanada S, Minamino T. Ablation of IL-33 gene exacerbate myocardial remodelling in mice with heart failure induced by mechanical stress. Circulation Journal, 2016; 80(Suppl I): I-951. (SCI

IF: 3.503; HI: 75; Tier: Q1).

*

208 Veeraveedu PT, Sari FR, et al. Vesnarinone attenuates myocardial inflammation and fibrosis in acute experimental autoimmune myocarditis. The Journal of Biomedical Research, 2016; 30(Suppl 1): 17. (IF: NA).

220

209 Veettil SK, Lim KG, Chaiyakunapruk N, Ching SM, Muhammad Radzi AH. Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country. Asian Journal of Surgery, 2016; DOI:

http://dx.doi.org/10.1016/j.asjsur.2016.07.005 (ISI IF: 0.912; SCI IF: 0.809; HI: 24; Tier: Q2).

221

210 Veettil SK, Saokaew S, Lim KG, Ching SM, Phisalprapa P, Chaiyakunapruk N. Comparative effectiveness of chemopreventive interventions for colorectal cancer: Protocol for a systematic review and network meta-analysis of randomised controlled trials. Journal of Gastrointestinal Oncology, 2016; 7(4): 595–602. (IF: NA).

222

211 Venkateshbabu N, Anand S, Abarajithan M, Sheriff SO, Jacob PS,

Sonia N. Natural therapeutic options in endodontics – A review. Open

Dentistry Journal, 2016; 11(10): 214-26. doi:

10.2174/1874210601610010214. (SCI IF: 0.952; HI: 9; Tier: Q3).

224

212 Venkateswaran SP, Nathan LE, Mutalik VS, Shamsuddin NH. Argyrophilic nuclear organizer region and p73 expression in head and neck squamous cell carcinomas: Teammates or adversaries? Journal of Oral and Maxillofacial Pathology, 2016; 20: 427-35. [IMU Internal

Grant – BMS I 1/2014(5)]. (SCI IF: 0.752; HI: 10; Tier: Q3).

225

213 Wickramatilake CM, Mohideen MR, Pathirana C. High-sensitivity C-reactive protein in Sri Lankan males with coronary artery disease. Bangladesh Journal of Medical Science, 2016; 15(1): 44-50. (SCI IF: 0.096; HI: 4; Tier: Q3).

226

214 Wong CH, Shah ZUBS, Teng CL, Lin TQ, Zainab AM, Chan CW. A systematic review of anxiety prevalence in adults within primary care and community settings in Malaysia. Asian Journal of Psychiatry, 2016;

24: 110-117. (SCI IF: 1.353; HI: 13; Tier: Q2).

227

215 Wong CH, Tan TR, Heng HY, Ramesh T, Ting PW, Lee WS, Teng CL, Sivalingam N, Tan KK. Parental preferences with regards to disclosure following adverse events occurring in relation to medication use or diagnosis in the care of their children - Perspectives from Malaysia. Medical Journal of Malaysia, 2016; 71(4): 186-92. [IMU Internal Grant].

(SCI IF: 0.528; HI: 24; Tier: Q3).

228


http://dx.doi.org/10.1016/j.asjsur.2016.07.005

23


216 Wong YC, Mohan M, Pau A. Dental students' compliance with antibiotic prescribing guidelines for dental infections in children. Journal of Indian Society of Pedodontics and Preventive Dentistry, 2016; 34(4): 348-53.


229

217 Wong YP, Jeya Seela AR, Ling APK, Koh RY. Anti-inflammatory effect of Strobilanthes crispus methanolic extract on Lipopolysaccharide-stimulated RAW 264.7 macrophages. Journal of Medical and Biological Sciences, 2016; 3: 52-56. (IF: NA).

230

218 Yang WY, Burrows T, MacDonald-Wicks L, Williams LT, Collins CE, Chee WSS. The Family Diet Study: A cross-sectional study into the associations between diet, food habits and body weight status in Malay families. Journal of Human Nutrition and Dietetics, 2015; doi:

10.1111/jhn.12356. [IMU Internal Grant - IMU 275/2013]. (ISI IF: 2.583; SCI IF: 2.218; HI: 46; Tier: Q1).

231

219 Yap PSX, Kamar AA, Chong CW, Yap IKS, Thong KL, Choo YM, Md Yusof MY, Teh CSJ. Intestinal carriage of multidrug-resistant gram-negative bacteria in preterm-infants during hospitalization in neonatal intensive care unit (NICU). Pathogens and Global Health, 2016; 1-9. doi: 10.1080/20477724.2016.1229884. (ISI IF: 1.486; SCI IF: 1.613; HI: 55; Tier: Q1).

232

220 Yap YJ, Omasanggar R, Koh YL, Yew MY, Lai HT, Ling APK, Chye SM, Ng KY, Koh RY. Neurotoxic effect of salsolinol through oxidative stress induction and Nrf2-Keap1 signalling regulation. Journal of Chemical and Pharmaceutical Research, 2016; 8(5): 30-38. [IMU Undergraduate Grant - BMSc I/01/2012(05)2014]. (SCI IF: 0.195; HI: 21; Tier: Q3).

233

221 Yee MS, Khiew PS, Chiu WS, Tan YF, Kok YY, Leong CO. Green synthesis of graphene-silver nanocomposites and its application as a potent marine antifouling agent. Colloids and Surfaces B: Biointerfaces,

2016; 148: 392-401. (ISI IF 3.902; SCI IF: 4.042; HI 96, Tier: Q1).

234

222 Zaleha MI, Khadijah S, Noriklil Bukhary IB, Khor GL, Zaleha AM, Haslinda H, Noor Sharifatul HY, Hasanain FG. The reliability of Fitzpatrick skin type chart comparing to mexameter (mx 18) in measuring skin color among first trimester pregnant mothers in Petaling District, Malaysia. Malaysian Journal of Public Health Medicine, 2016;

16: 59-65. (SCI IF: 0.216; HI: 3; Tier: Q4).

235

223 Zalilah MS, Khor GL, Sarina S, Chin YS, Barakatun Nisak MY, Chan YM, Lee HS, Maznorila M. Higher dietary energy density is associated with stunting but not overweight and obesity in a sample of urban Malaysian children. Ecology of Food and Nutrition, 2016; DOI:

10.1080/03670244.2016.1181065. (SCI IF: 0.955; HI: 22; Tier: Q2).

236

224 Zanariah H, Sri Wahyu T, Harvinder Kaur GS, Chee WSS. Diabetes care in Malaysia: Problems, new models, and solutions. State-of-the-art Review. Annals of Global Health, 2015; 81(6): 851-862. (ISI IF:

1.417; SCI IF: 1.851; HI: 49; Tier: Q2).

237


24


225 Zulkefli NJ, Mariappan V, Vellasamy KM, Chong CW, Thong KL, Ponnampalavanar S, et al. Molecular evidence of Burkholderia pseudomallei genotypes based on geographical distribution. PeerJ,

2016; 4: e1802. (ISI IF: 2.183; SCI IF: 2.009; HI: 16; Tier: Q1).

238


25

Agarwal R, Agarwal P. Targeting ECM remodeling in disease: Could resveratrol be a potential

candidate? Experimental Biology and Medicine, 2016; 0: 1–10. (ISI IF: 2.542; SCI IF: 2.376;

HI: 122; Tier: Q1).

Targeting ECM remodeling in disease: Could resveratrol be a potential candidate? Agarwal R1, Agarwal P2. 1Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor 47000, Malaysia 2Department of Ophthalmology, School of Medicine, International Medical University, Jalan Rasah, Seremban 70300, Malaysia

Abstract Disturbances of extracellular matrix homeostasis are associated with a number of pathological conditions. The ability of extracellular matrix to provide contextual information and hence control the individual or collective cellular behavior is increasingly being recognized. Hence, newer therapeutic approaches targeting extracellular matrix remodeling are widely investigated. We reviewed the current literature showing the effects of resveratrol on various aspects of extracellular matrix remodeling. This review presents a summary of the effects of resveratrol on extracellular matrix deposition and breakdown. Mechanisms of action of resveratrol in extracellular matrix deposition involving growth factors and their signaling pathways are discussed. Involvement of phosphoinositol-3-kinase/Akt and mitogen-activated protein kinase pathways and role of transcription factors and sirtuins on the effects of resveratrol on extracellular matrix homeostasis are summarized. It is evident from the literature presented in this review that resveratrol has significant effects on both the synthesis and breakdown of extracellular matrix. The major molecular targets of the action of resveratrol are growth factors and their signalling pathways, phosphoinositol-3-kinase/Akt and mitogen-activated protein kinase pathways, transcription factors, and SIRT1. The effects of resveratrol on extracellular matrix and the molecular targets appear to be related to experimental models, experimental environment as well as the doses. Keywords: Resveratrol, TGF-β, extracellular matrix, matrix metalloproteinases.

26

Ahmadi K, Hasan SS. Implementing professionalism by deprofessionalized strategies: A

moral quandary. Currents in Pharmacy Teaching and Learning, 2016; 9(1): 9-11. Doi:

http://dx.doi.org/10.1016/j.cptl.2016.08.032. (SCI IF: 0.478; HI: 7; Tier: Q1).

Implementing professionalism by deprofessionalized strategies: A moral

quandary.

Keivan Ahmadi1, Syed Shahzad Hasan2.

1School of Pharmacy, University of Lincoln, Lincolnshire, United Kingdom 2Department of Pharmacy Practice, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia

Abstract Monetary fine proceedings has been one of the methods of upholding professionalism amongst health care professionals. Professionalism as a concept is multifaceted and fragmented and it has become symbolic to the extent that, unfortunately, some traits of professionalism showcase the whole concept. It seems fair to interpret the symbolic views on the concept of professionalism as means to capitalize on certain aspects of professions such as commercial profitability for the employer and respected status for the profession. Evaluation of professionalism is often implicit and inadequate; and assessing professionalism by relying on abstract and idealized definitions implies that professionalism is a compounded composite of certain set of stable traits. We suggest to refer to the theory of values-based practice so as to achieve collocated views on professionalism among employers and health academics. Instead of capitalizing on certain traits of professionalism to project the whole concept of professionalism, we may need to relook at the traits of professionalism as values. It is extremely crucial to internalize the values of the health profession in the future health professionals, so that the future health professionals imbibe the professionalism through dialog and democratic methods of sharing values during the course of professional development. Keywords: Professionalism, Deprofessionalization, Health care students.

http://dx.doi.org/10.1016/j.cptl.2016.08.032

27

Amarra MSV, Khor GL, Chan P. Intake of added sugar in Malaysia: A review. Asia Pacific Journal of Clinical Nutrition, 2016; 25(2): 227-240. (SCI IF: 1.371; HI: 51; Tier: Q2).

Intake of added sugar in Malaysia: A review. Maria Sofia V Amarra1, Geok Lin Khor2, Pauline Chan MS1. 1Scientific Programs, International Life Sciences Institute Southeast Asia Region (ILSI SEA), Singapore 2School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia

Abstract

The term ‘added sugars’ refers to sugars and syrup added to foods during processing or preparation, and sugars and syrups added at the table. Calls to limit the daily intakes of added sugars and its sources arose from evidence analysed by WHO, the American Heart Association and other organizations. The present review examined the best available evidence regarding levels of added sugar consumption among different age and sex groups in Malaysia and sources of added sugars. Information was extracted from food balance sheets, household expenditure surveys, nutrition surveys and published studies. Varying results emerged, as nationwide information on intake of sugar and foods with added sugar were obtained at different times and used different assessment methods. Data from the 2003 Malaysian Adult Nutrition Survey (MANS) using food frequency questionnaires suggested that on average, Malaysian adults consumed 30 grams of sweetened condensed milk (equivalent to 16 grams sugar) and 21 grams of table sugar per day, which together are below the WHO recommendation of 50 grams sugar for every 2000 kcal/day to reduce risk of chronic disease. Published studies suggested that, for both adults and the elderly, frequently consumed sweetened foods were beverages (tea or coffee) with sweetened condensed milk and added sugar. More accurate data should be obtained by conducting population-wide studies using biomarkers of sugar intake (e.g. 24-hour urinary sucrose and fructose excretion or serum abundance of the stable isotope 13C) to determine intake levels, and multiple 24 hour recalls to identify major food sources of added sugar. Keywords: sugar, intake, added sugars, sources, Malaysia.

28

Arfuzir NNN, Lambuk L, Jafri AJA, Agarwal R, Iezhitsa I, Sidek S, Agarwal P, Bakar NS, Kutty MK, Md Yusof AP, Krasilnikova A, Spasov A, Ozerov A, Mohd Ismail N. Protective effect of magnesium acetyltaurate against endothelin-induced retinal and optic nerve injury. Neuroscience, 2016; 325: 153-164. (ISI IF: 3.231; SCI IF: 3.297; HI: 179; Tier: Q1).

Protective effect of magnesium acetyltaurate against endothelin-induced retinal and optic nerve injury. Arfuzir NNN1, Lambuk L1, Jafri AJA1, Agarwal P1, Iezhitsa I1,2, Sidek S1, Agarwal P3, Bakar NS1, Kutty MK1, Md Yusof AP1, Krasilnikova A1, Spasov A2, Ozerov A2, Mohd Ismail N1. 1Center for Neuroscience Research, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh Campus, Selangor, Malaysia 2Volgograd State Medical University, Research Institute of Pharmacology, Volgograd, Russia 3Faculty of Medicine, International Medical University, IMU Clinical School, Seremban, Malaysia

Abstract

Vascular dysregulation has long been recognized as an important pathophysiological factor underlying the development of glaucomatous neuropathy. Endothelin-1 (ET1) has been shown to be a key player due to its potent vasoconstrictive properties that result in retinal ischemia and oxidative stress leading to retinal ganglion cell (RGC) apoptosis and optic nerve (ON) damage. In this study we investigated the protective effects of magnesium acetyltaurate (MgAT) against retinal cell apoptosis and ON damage. MgAT was administered intravitreally prior to, along with or after administration of ET1. Seven days post-injection, animals were euthanized and retinae were subjected to morphometric analysis, TUNEL and caspase-3 staining. ON sections were stained with toluidine blue and were graded for neurodegenerative effects. Oxidative stress was also estimated in isolated retinae. Pre-treatment with MgAT significantly lowered ET1-induced retinal cell apoptosis as measured by retinal morphometry and TUNEL staining. This group of animals also showed significantly lesser caspase-3 activation and significantly reduced retinal oxidative stress compared to the animals that received intravitreal injection of only ET1. Additionally, the axonal degeneration in ON was markedly reduced in MgAT pretreated animals. The animals that received MgAT co- or post-treatment with ET1 also showed improvement in all parameters; however, the effects were not as significant as observed in MgAT pretreated animals. The current study showed that the intravitreal pre-treatment with MgAT reduces caspase-3 activation and prevents retinal cell apoptosis and axon loss in ON induced by ET1. This protective effect of ET1 was associated with reduced retinal oxidative stress. Keywords: RGC apoptosis, endothelin-1, optic nerve, magnesium acetyltaurate.

29

Assenheimer D, Knox K, Nadarajah VD, Zimitat C. Medical students' epistemological beliefs: Implications for curriculum. Education for Health, 2016; 29(2): 107-112. (SCI IF: 0.366; HI: 22; Tier: Q3).

Medical students' epistemological beliefs: Implications for curriculum. Dwight Assenheimer1, Katherine Knox2, Vishna Devi Nadarajah3, Craig Zimitat1,4. 1School of Medicine, Faculty of Health, University of Tasmania, Hobart 2Department of Psychology, Griffith University, Brisbane, Australia 3International Medical University, Kuala Lumpur, Malaysia 4Centre for Learning and Teaching, Curtin University, Perth, Western Australia.

Abstract Background: Epistemological beliefs have a pervasive influence on learning and practice. Understanding these beliefs and how they develop, could play an important role in medical student training and shape later clinical practice.

Methods: The epistemological beliefs of first‑year medical students from an Australian and

Malaysian university were explored using a domain‑specific instrument.

Results: There were significant differences between the disciplinary epistemological beliefs

of Australian and Malaysian medical students across many items, and two specific factors (Certainty of Knowledge and Justification for Knowing). Discussion: These findings have potential implications for teaching in biomedical disciplines and adaptation of Western curriculum innovations in Eastern educational contexts. Further work is needed to confirm and understand any epistemological differences and subsequent implications for learning and teaching in medicine.

Keywords: Culture, curriculum, epistemology, knowledge beliefs, problem‑based learning.

30

Aung HH, Barua A, Sivakumar A, Khin MM. Application of anatomical knowledge by final year dental students of integrated curriculum: A pilot study. Journal of Medical Science and Clinical Research, 2016; 4(11): 13827-33. [IMU Internal Grant – IMU 309_2014]. (ISI IF: 5.244).

Application of anatomical knowledge by final year dental students of integrated curriculum: A pilot study. Htar Htar Aung1, Ankur Barua2, Anupa Sivakumar3, Khin Ma Ma4. 1Department of Human Biology, School of Medicine, International Medical University Malaysia 2Department of Community Medicine, School of Medicine, International Medical University Malaysia 3Department of Human Biology, School of Medicine, International Medical University Malaysia 4Department of Human Biology, School of Medicine, International Medical University Malaysia

Abstract

The integrated curriculum has been introduced in the Dental faculty of the designated institution since 2008. This study was aimed to evaluate the application of anatomical knowledge of final year undergraduate dental students of integrated curriculum, and to assess the perception of the both dental students and their lecturer on clinical application of anatomy. A cross-sectional study was conducted for 4 weeks among 40 final year undergraduate dental students and 18 lecturers. Students underwent an examination that included 6 Objective Structured Practical Examination (OSPE) and 20 One Best Answer (OBA) questions to test their application knowledge in clinical settings. A semi-structured, self-administrated questionnaire was used to identify their perceptions on the application of anatomical knowledge. The data were analysed by using SPSS 17. The Spearman’s Correlation test reported a significant, strong, positive correlation between the scores of OSPE and OBA. The Mann-Whitney U-test revealed statistically significant associations regarding the perception of both dental students and lecturers in terms of Problem based learning (PBL), practical sessions, Self-directed Learning (SDL), the strong surface anatomy knowledge, the usefulness of cadaver and the confidence in applying the anatomical knowledge. The present curriculum needs more interactive face to face sessions, small group discussions in practical sessions and more SDL in order to provide the strong foundations for undergraduate dental students in clinical anatomy. Keywords: Anatomical knowledge, Application, Undergraduate, Dental student, Integrated

curriculum.

31

Azadeh K, Farid M, Niusha S, Mahidzal D. Dynamic modeling of PEM fuel cell of power electric bicucle system. International Journal of Hydrogen Energy, 2016; 24(22), 9585–9594. (ISI IF: 3.205; SCI IF: 3.311; HI: 146; Tier: Q1).

Dynamic modeling of PEM fuel cell of power electric bicucle system. Azadeh Kheirandish1, Farid Motlagh2, Niusha Shafiabady3, Mahidzal Dahari1. 1Department of Mechanical Engineering, Faculty of Engineering, University Malaya, Kuala Lumpur, 50603, Malaysia 2Department of Biomedical Engineering, Faculty of Engineering, University Malaya, Kuala Lumpur, 50603, Malaysia 3Faculty of Medicine and Health Sciences, International Medical University, 57000, Malaysia

Abstract Fuel cells eliminate pollution caused by burning fossil fuels; hence, a proton exchange membrane fuel cell (PEMFC) is one of the promising technological advances for the future of the transportation industry. The key existing challenges for fuel cell commercialization are performance, design and vehicle efficiency. Since the analytical model expressing fuel cells' characteristics is not accurate in comparison with the real system's performance a robust and dynamic model for fuel cells is of great importance. This study aims to introduce an optimized model for PEMFC using an electric bicycle that consists of a 250 W fuel cell, battery pack, DC/DC convertor, electric motor and electric control unit (ECU). In the first phase of this multifold study, the analytical model of PEMFC's efficiency has been compared with the experimental results obtained from the electric bicycle. The result of this phase showed an overall system efficiency of 35.4% and a maximum fuel cell efficiency of 63%. This confirms that fuel cell performance is least efficient when functioning under maximum output power conditions. In the second phase of this research, the collected data was used for developing linear and nonlinear regression models. The resulting model was compared with an artificial neural network used for the same purpose, and their prediction efficiencies compared. Results show that neural network modelling improves accuracy and provides promising performance for the electric bicycle system. Keywords: Modelling, Proton exchange membrane fuel cell, Regression models, Artificial

neural networks.

32

Aznal SS, Nalliah S, Chng TW. Revisiting cerebral palsy: Pathogenesis and management. Journal of South Asian Federation Obstetrics and Gynecology (SAFOG), 2016; 8(1): 57-65. (SCI IF: 0.0; HI: 3; Tier: Q3).

Revisiting cerebral palsy: Pathogenesis and management. Sharifah Sulaiha Aznal, Sivalingam Nalliah, Tong Wooi Chng. Clinical Campus Seremban, International Medical University, Negeri Sembilan, Malaysia.

Abstract

Brain damage in utero and its consequences in neonates especially cerebral palsy (CP), are socially disturbing and psychologically distressing to both patients and carers. The prevalence of CP has not declined considerably despite several preventive measures in obstetric and neonatal care. Current views on the pathogenesis and causal pathways of CP relate to hypoxic-related ischemic events. A series of cascading events trigger the inflammatory processes resulting in gliosis of the white matter when labor and the delivery processes are reviewed. Though animal studies seem to support these concepts several other causes like perinatal infection and prematurity are also strong contributors to its pathogenesis. Multiple gestation and genetic factors may play a role in the etiology. Current management strategies focus on preventive measures during antenatal and intrapartum care. The use of antenatal steroids, magnesium sulfate infusion for cerebral protection and the extensive use of electronic fetal monitoring during labor have been elaborated as deliberate attempts to minimize the impact of any of the possible contributing cause. As CP is still prevalent in pediatric practice and in our community discussing means to improve prognosis of affected children are relevant. Keywords: Cerebral palsy, Etiology, Management, Pathogenesis.

33

Babar MG. Professionalism 2.0. IeJSME, 2016; 10(1): 1-2. (MyCite IF: 0.038).

Professionalism 2.0. Muneer Gohar Babar. School of Dentistry, International Medical University, MALAYSIA

Abstract

The use of social media tools has become increasingly widespread over the past decade and has caused a paradigm shift in the way people communicate. Because of its simple and easy access, social media platforms have become the major source by which many people participate in and keep informed about news of ongoing developments, discussions and discoveries in the world around them. However, in recent years, the rapid adoption of social media has significantly blurred the boundary between personal and professional life. At a UK university 96% of medical students had Facebook accounts, 52% acknowledged that photos of self on Facebook existed that they considered embarrassing. And 54% reported observations of unprofessional behaviours in colleagues on Facebook.

34

Balakrishnan J, Appalasamy JR, Verma RK. A study on awareness of skin infection among

adults in Petaling district, Malaysia. International Journal of Pharmacy and Pharmaceutical

Sciences, 2016; 8(2): 136-139. (ISI IF: 0.49; SCI IF: 0.486; HI: 24; Tier: Q2).

A study on awareness of skin infection among adults in Petaling district,

Malaysia.

Jayshalene Balakrishnan1, Jamuna Rani Appalasamy1, Rohit Kumar Verma1.

1School of Pharmacy, International Medical University, Malaysia

Abstract Objective: The prevalence of skin infection is on the rise globally and there is a lack of published data pertaining to skin infection in Malaysia. Hence, the aim of this study is to determine the awareness of skin infection among adults and to study the effect of skin infection on quality of life (QoL). Methods: A cross-sectional descriptive study was conducted among adults 18 y and above

in Petaling district, Malaysia. Subjects were interviewed based on a validated questionnaire to elicit information on socio-demographic data, prevalence and level of awareness of skin infection. Whereas the impact of skin infection on quality of life was questioned using a validated questionnaire Dermatology Life Quality Index (DLQI). Data was analyzed using Microsoft Excel and SPSS version 18.0. Results: Out of 384 participants, 230 (60%) of the subjects had a skin infection. Bacterial skin

infection such as acne (54.8%) being most prevalent, followed on by a fungal infection (29.6%), viral infection (11.7%) and parasitic infection (3.9%). It was found that most of the subjects were aware of the risk factors of skin infection. Nevertheless, those with skin infection reported their quality of life was affected mainly due to the physical symptoms of skin infection and treatment of skin infection. A significant association was found between the awareness of risk factor of skin infection and QoL in those with a skin infection with a p-value<0.05. Conclusion: Most of the respondents were found to be aware of skin infection. Nevertheless, respondents reported that their QoL was affected due to physical symptoms and treatment of skin infection. The study also shows that there is association found between level of awareness of skin infection and QoL in subjects with a skin infection. Hence, dermatological community programs should be encouraged to educate the public further. Keywords: Skin infection, Awareness, Quality of life, Dermatology Life Quality Index.

35

Banavar SR, Chippagiri P, Pandurangappa R, Annavajjula S, Rajasheraiah P. Image montaging for creating a virtual pathology slide: An innovative and economical tool to obtain a whole slide image. Analytical Cellular Pathology, 2016; 2016: 1-7. (ISI IF: 0.459; SCI IF:

0.692; HI: 12; Tier: Q3).

Image montaging for creating a virtual pathology slide: An innovative and economical tool to obtain a whole slide image. Spoorthi Ravi Banavar1, Prashanthi Chippagiri2, Rohit Pandurangappa3, Saileela Annavajjula4, and Premalatha Bidadi Rajashekaraiah5. 1Oral Diagnostic and Surgical Science Division, International Medical University, No. 126, Jalan 19/155B, 57000 Bukit Jalil, Kuala Lumpur, Malaysia 2Oral Pathology and Oral Medicine Division, Faculty of Dentistry, MAHSA University, Bandar Saujana Putra, 41200 Jenjarom, Selangor, Malaysia 3Restorative Dentistry Division, International Medical University, No. 126, Jalan 19/155B, 57000 Bukit Jalil, Kuala Lumpur, Malaysia 4MDS, Oral and Maxillofacial Pathology, 12-13-36, Lakshmi Nivas, Tarnaka, Hyderabad 500017, India 5Oral Pathology, JSS Dental College and Hospital, Sri Shivarathreeshwara Nagara, Bannimantap, Mysore 570015, India

Abstract Background: Microscopes are omnipresent throughout the field of biological research. With

microscopes one can see in detail what is going on at the cellular level in tissues. Though it is a ubiquitous tool, the limitation is that with high magnification there is a small field of view. It is often advantageous to see an entire sample at high magnification. Over the years technological advancements in optics have helped to provide solutions to this limitation of microscopes by creating the so-called dedicated “slide scanners” which can provide a “whole slide digital image.” These scanners can provide seamless, large-field-of-view, high resolution image of entire tissue section. The only disadvantage of such complete slide imaging system is its outrageous cost, thereby hindering their practical use by most laboratories, especially in developing and low resource countries. Methods: In a quest for their substitute, we tried commonly used image editing software

Adobe Photoshop along with a basic image capturing device attached to a trinocular microscope to create a digital pathology slide. Results: The seamless image created using Adobe Photoshop maintained its diagnostic quality. Conclusion: With time and effort photomicrographs obtained from a basic camera-

microscope set up can be combined and merged in Adobe Photoshop to create a whole slide digital image of practically usable quality at a negligible cost.

36

Banavar SR, Saileela A. Association of lip prints and palatal rugae with birth month. International Journal of Current Advanced Research, 2016; 5(5): 912-914. (ISI IF: 4.915).

Association of lip prints and palatal rugae with birth month. Spoorti BR1 and Annavajjula Saileela2. 1Oral Diagnostic and Surgical Sciences Division. International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia. 57000 2Private Practitioner Hyderabad-500017

Abstract Context: Establishing a person’s identity can be a very difficult process. Dental records, finger

prints and DNA comparisons are probably the most common techniques used in this context, allowing fast and secure identification processes. However, since they cannot always be used, sometimes it is necessary to apply different and less known techniques. Lip prints and palatal rugae can be considered as a source of comparative material, because of their accuracy in legitimizing an identification process even in extreme circumstances. Aims: To correlate lip prints, palatal rugae with birth month.

Methods and Material: Study comprised of 360 samples. Lip prints were recorded in half of

360 samples and in the other half of the sample palatal rugae were recorded. Both the records were analysed. Statistical analysis used: Chi-square test was applied for statistical analysis.

Results: Statistical tests revealed significant association of few types of lip prints, palatal

rugae with birth month. Conclusions: Significant association of lip prints and palatal rugae with birth month was obtained. Hence, it can be used as an adjunct information. Keywords: Lipprints, Palatal Rugae, Birth Month.

37

Banavar SR, Saileela A. Comparison of cyanoacrylates and Dpx for mounting a histological section. International Journal of Recent Scientific Research, 2016; 7(5): 10971-10975. (ISI IF: 5.971).

Comparison of cyanoacrylates and Dpx for mounting a histological section. Spoorthi Ravi Banavar1 and Annavajjula Saileela2. 1Oral Diagnostic and Surgical Sciences Division, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia, 57000 2Oral Pathologist Private Practioner Hyderabad – 500017

Abstract Context: Histological sections before being examined under microscope, need to be mounted under a cover-slip in order to preserve the sections and most importantly, to obtain a clear image. The substance which serves this purpose is called a mountant or mounting media. In practice, Dibutyl phthalate xylene (DPX) is the widely used mounting media. Although considered ideal, DPX has several drawbacks. This triggered us to explore alternatives for DPX such as Bio adhesive and Fevikwik that can overcome these drawbacks. Aims: To compare Fevikwik and Surgical glue with DPX. Settings and Design: Methods and Material: A total of 24 sections were taken from archival collection of the Department of Oral Pathology and General pathology. All the sections were mounted using Dpx, Fevikwik and Bio adhesive. Comparison was drawn between these three mountants

based on quality index. Statistical analysis used: One way analysis of variance. Results: Quality index of Fevikwik and Surgical glue were significantly equal to that of DPX quality index. ‘p’ value < 0.005 was considered as significant. Conclusions: Hence, Cyanoacrylates (Fevikwik and Surgical glue) can be used as alternatives to DPX. Keywords: Mountant, DPX, Fevikwik, Surgical glue, Cyanoacrylates.

38

Banneheke H, Fernandopulle R, Gunasekara U, Barua A, Fernando N, Wickremasinghe R. Can trichomonas immunochromatographic test increase the validity and reliability of WHO syndromic algorithm for vaginal discharge as a screening tool for trichomoniasis? Annals of Tropical Medicine and Public Health, 2016; 9(1): 43. (SCI IF: 0.185; HI: 5; Tier: Q3).

Can trichomonas immunochromatographic test increase the validity and reliability of WHO syndromic algorithm for vaginal discharge as a screening tool for trichomoniasis? Banneheke H1,2, Fernandopulle R3, Gunasekara U4, Barua A5, Fernando N6, Wickremasinghe R1. 1Departments of Parasitology, University of Sri Jayewardenepura, Nugegoda, Sri Lanka 2Division of Pathology, School of Medicine, Kuala Lumpur, Malaysia 3Departments of Gynaecology and Obstetrics, University of Sri Jayewardenepura, Nugegoda, Sri Lanka 4Ministry of Health, Sri Lanka 5Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia 6Departments of Microbiology, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

Abstract Background: Trichomoniasis is a sexually transmitted parasitic infection. The World Health Organization (WHO) advocated flow charts for curable sexually transmitted infections (STIs) to improve the care. In this study, an attempt was made to evaluate the validity and reliability of WHO syndromic algorithm for vaginal discharge against trichomonas immunochromatographic test (ICT). Trichomonas ICT is a test with high validity, reliability, and feasibility. Objectives: The objective was to evaluate the validity and reliability of “WHO syndromic algorithm for vaginal discharge” against “trichomonas ICT” as a screening tool for trichomonas infection among women of reproductive age in the Western Province, Sri Lanka. Materials and Methods: This cross-sectional study was conducted in sexually transmitted disease clinics, well woman clinics, gynecology clinics, and institutional health clinics in the Western Province, Sri Lanka. We enrolled 100 women in the age group of 15-45 years using the stratified random sampling method. They were interviewed and examined and the specimens were collected to identify trichomoniasis by culture and ICT. Two-stage analyses were done to evaluate the performance of the WHO algorithm against Trichomonas ICT. Results: In a two-stage analysis, the specificity of syndromic algorithm improved from 80.9%

to 94.4% while false positive rate reduced from 19.1% to 5.6%. The net effect of specificity was 98.7% while the false positive rate was 1.3%. Conclusion: The validity and reliability of WHO syndromic algorithm as a diagnostic tool for trichomoniasis can be improved by adding trichomonas ICT. Keywords: Vaginal discharge, validity.

39

Barling PM, Shyam S, Selvathevan MD, Misra S. Anomalous association of salivary amylase

secretion with the postprandial glycaemic response to starch. BMC Nutrition, 2016; 2(1): 50.

DOI: 10.1186/s40795-016-0088-0. [IMU Internal Grant: BMS I02\2014 (07)]. (IF: NA).

Anomalous association of salivary amylase secretion with the postprandial

glycaemic response to starch.

Peter Michael Barling1, Sangeetha Shyam2, Mayure Devi Selvathevan3 and Snigdha Misra2.

1Department of Human Biology, School of Medicine, International Medical University, Kuala Lumpur, Malaysia. 2Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur, Malaysia. 3School of Medicine, International Medical University, Kuala Lumpur, Malaysia.

Abstract Background: This study is an investigation as to whether salivary amylase secretory rates

are correlated with the magnitude of postprandial glycaemic responses to starch ingestion in healthy young Malaysian adults. Methods: Fasting unstimulated and stimulated salivary amylase secretory rates were

measured and ranked for 54 participants. Subjects (n = 5) with amylase activities below the median and subjects (n = 5) with amylase activities above the median were selected for subsequent carbohydrate challenge tests. Following an overnight fast, the postprandial glycaemic responses of these subjects were assessed to 50 g carbohydrate bolus challenges; glucose (n = 2), maltose (n = 1) and starch (n = 1), tested in random order. Blood glucose concentrations were estimated before each carbohydrate challenge and at half-hour intervals thereafter for 2 h. The magnitude of each glycaemic response was estimated from the area under the curve (AUC). Results: High amylase secretors responded to the consumption of a starch bolus with

significantly lower AUCs than low amylase secretors (267 +/− 64 vs. 159 +/− 72 mmol/L*120 min, p = 0.037; mean +/− SD). However, the glycaemic responses to maltose and glucose did not differ significantly between the two groups. These findings confirm that subjects with higher salivary amylase secretory rates have better glycaemic tolerance to a starch challenge than subjects with lower salivary amylase secretory rates. Conclusion: Low amylase secretion should be considered as a potential prognosticator for

impaired glucose tolerance to dietary starch in young Malaysian adults. Keywords: Salivary α-amylase, Glycaemic response, Starch, Glucose, Maltose, Gastric

inhibitory peptide.

40

Beshir SA, Chee KH, Lo YL. Factors associated with abrupt discontinuation of dabigatran therapy in patients with atrial fibrillation in a teaching hospital in Kuala Lumpur, Malaysia. International Journal of Clinical Pharmacy, 2016; 38: 1182-1190. DOI 10.1007/s11096-016-


Factors associated with abrupt discontinuation of dabigatran therapy in patients with atrial fibrillation in a teaching hospital in Kuala Lumpur, Malaysia. Semira Abdi Beshir1, Kok-Han Chee2, Yoke-Lin Lo1,3. 1Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia 2Department of Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia 3School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia

Abstract Background: Oral anticoagulant therapy is indicated for the prevention of stroke or other thromboembolic events. Premature discontinuation of oral anticoagulants may increase the risk of thromboembolism resulting in adverse sequelae. There are sparse data on the prevalence and the predictors of dabigatran discontinuation in Malaysian patients with atrial fibrillation. Objectives: Determine the reasons and identify associated factors for abrupt discontinuation

of dabigatran, assess the switching pattern and the occurrence of thromboembolic events after dabigatran discontinuation. Setting: A university-affiliated tertiary hospital in Kuala Lumpur, Malaysia. Methods: The clinical and demographic data of a cohort who were initiated with dabigatran

between 2010 and 2012 at the University of Malaya Medical Centre were reviewed until the date of death or on 31st December 2013. Those patients who discontinued dabigatran were further followed up until 31st December 2015 to determine the occurrence of any thromboembolic event. Main outcome measure: Permanent discontinuation of dabigatran for more than 8 weeks.

Results 26 (14 %) of a cohort of 192 patients discontinued dabigatran therapy during a median follow-up period of 20 (range 3–45) months. About one-half of the discontinuation occurred within the first 6 months of dabigatran use. The three most cited reasons for discontinuation are bleeding events (19 %), high out-of-pocket drug payment (19 %) and cardioversion (19 %). Heart failure [adjusted odds ratio 3.699 (95 % confidence interval 1.393–9.574)] or chronic kidney disease [adjusted odds ratio 5.211 (95 % confidence interval 1.068–23.475)] were found to be independent risk factors for abrupt dabigatran discontinuation. Patients who discontinued dabigatran received warfarin (38 %), antiplatelet agents (16 %) or no alternative antithrombotic therapy (46 %). Five of the 26 patients who discontinued dabigatran developed an ischaemic stroke within 3–34 months after discontinuation. Conclusion: Abrupt dabigatran discontinuation without an alternative oral anticoagulant increases the risk of thromboembolic events. As adverse drug events and renal impairment contribute substantially to the premature discontinuation of dabigatran, it is important to identify and monitor patients at risk to reduce dabigatran discontinuation rate especially during the first six months of dabigatran therapy. Keywords: Atrial fibrillation, Dabigatran, Discontinuation, Malaysia, DOAC, Stroke prevention.

41

Bhatia S, Kohli S. CBCT usage: An alert to dentistry. Imaging Science in Dentistry, 2016; 46(2):

145–146. (SCI IF: 0.989; HI: 8; Tier: Q2).

Cone-beam computed tomography usage: An alert to the field of dentistry Shekhar Bhatia1, Shivani Kohli2. 1Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia 2Department of Prosthodontics, MAHSA University, Kuala Lumpur, Malaysia

Abstract Cone-beam computed tomography (CBCT) is a relatively novel technique for visualizing an

individual tooth or dentition in relation to the surrounding skeletal tissues and for generating a

three-dimensional image of the area to be studied. Since CBCT is extensively used in dental

and maxillofacial imaging for the treatment planning of dental implants, endodontics,

maxillofacial surgery, and orthodontics, it is imperative for operators and referring practitioner

to comprehend the basic concepts of this imaging modality. Its widespread use and the fact

that it involves greater radiation doses has given rise to numerous concerns regarding the

rationalization and optimization of CBCT exposure, the training of CBCT operators, quality

assurance for CBCT scanners, variations in image quality, differences in radiation doses in

equipment made by different manufacturers, the inappropriate referral of patients for CBCT,

and the need to safeguard staff from radiation exposure.

42

Birnin-Yauri AU, Ibrahim NA, Zainuddin N, Abdan K, Then YY, Chieng BW. Influence of kenaf core fiber incorporation on the mechanical performance and dimensional stability of oil palm fiber reinforced poly(lactic acid) hybrid biocomposites. BioResources, 2016; 11(2): 3332. (ISI

IF: 1.334; SCI IF: 1.329; HI: 36; Tier: Q2).

Influence of kenaf core fiber incorporation on the mechanical performance and dimensional stability of oil palm fiber reinforced poly(lactic acid) hybrid biocomposites. Abubakar Umar Birnin-Yauri1,2, Nor Azowa Ibrahim1,3, Norhazlin Zainuddin1, Khalina Abdan4, Yoon Yee Then1,5, Buong Woei Chieng1,3. 1Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia 2Department of Pure and Applied Chemistry, Kebbi State University of Science and Technology, P.M.B. 1144, Aliero, Kebbi State, Nigeria 3Materials Processing and Technology Laboratory, Institute of Advanced Technology, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia 4Deoartment of Biological and Agricultural Engineering, Faculty of Engineering, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor 5Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur.

Abstract This study demonstrated the reinforcing potential of kenaf core fiber (KCF) to complement and sustain oil palm fiber supply chain in the production of natural fiber-thermoplastic biocomposites. The lignin-rich KCF was incorporated into cellulose-rich oil palm empty fruit bunch fiber (EFBF)- and oil palm mesocarp fiber (OPMF)-poly(lactic acid) (PLA) composites, aimed at achieving synergism. The hybrid biocomposites developed by melt blending and subsequent compression molding were characterized for possible application as an alternative to medium-density fiberboards. The mechanical properties and dimensional stability of both single fiber- and hybrid fiber-PLA biocomposites were evaluated and compared. The test results showed a synergistic improvement as a consequence of fiber hybridization. Also, the findings suggested the best material performance with the incorporation of 5% KCF into 55% EFBF or OPMF and 40% PLA matrix. The OPMF-KCF-PLA hybrid biocomposites gave better results than the EFBF-KCF-PLA hybrid biocomposites. Keywords: Hybrid biocomposite, Oil palm empty fruit bunch fiber, Oil palm mesocarp fiber,

Kenaf core fiber, Poly(lactic acid).

43

Birnin-Yauri AU, Ibrahim NA, Zainuddin N, Abdan K, Then YY, Chieng BW. Enhancement of the mechanical properties and dimensional stability of oil palm empty fruit bunch-kenaf core and oil palm mesocarp-kenaf core hybrid fiber-reinforced poly(lactic acid) biocomposites by borax decahydrate modification of fibers. BioResources, 2016; 11(2): 4865. (ISI IF: 1.334; SCI

IF: 1.329; HI: 36; Tier: Q2).

Enhancement of the mechanical properties and dimensional stability of oil palm empty fruit bunch-kenaf core and oil palm mesocarp-kenaf core hybrid fiber-reinforced poly(lactic acid) biocomposites by borax decahydrate modification of fibers. Abubakar Umar Birnin-Yauri1,2, Nor Azowa Ibrahim1,3, Norhazlin Zainuddin1, Khalina Abdan4, Yoon Yee Then1,5, Buong Woei Chieng1,3. 1Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia 2Department of Pure and Applied Chemistry, Kebbi State University of Science and Technology, P.M.B. 1144, Aliero, Kebbi State, Nigeria 3Materials Processing and Technology Laboratory, Institute of Advanced Technology, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia 4Deoartment of Biological and Agricultural Engineering, Faculty of Engineering, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor 5Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur.

Abstract

The surfaces of kenaf core fiber (KCF), oil palm empty fruit bunch fiber (EFBF), and oil palm mesocarp fiber (OPMF), were chemically modified using 5 wt.% aqueous sodium tetraborate decahydrate (borax) solution to enhance their hybrid fiber interface bonding with a polylactic acid (PLA) matrix. The untreated fibers (KCF, EFBF, and OPMF) and treated fibers (BXKCF, BXEFBF, and BXOPMF), were examined using chemical analysis, Fourier transform infrared (FTIR) spectroscopy, and scanning electron microscopy (SEM). The treatment caused minimal removal of lignin and significant elimination of hemicellulose and waxy substances. The treated and untreated KCF (5%), as a secondary fiber, was randomly mixed, respectively, with treated and untreated EFBF and OPMF (55%), melt-blended with PLA (40%), and subsequently compression-molded to form hybrid fiber-PLA biocomposites. The resulting composite is aimed to exhibit improvements in its mechanical properties and dimensional stability. The optimum results for tensile and flexural properties, as well as water uptake and thickness swelling, were observed for the borax-treated fibers in comparison with the untreated fibers. The BXEFBF-BXKCF-PLA biocomposites exhibited the best results. This work demonstrated that aqueous borax modification of natural fibers could offer a possible option to the most common mercerization method. Keywords: Borax decahydrate, Oil palm empty fruit bunch fiber, Oil palm mesocarp fiber,

Kenaf core fiber, Poly(lactic acid), Hybrid biocomposite.

44

Chan CW, Lai JW, Ooi IH, Er HM, Chye SM, Tan KW, Ng SW, Mohd JM, Ng CH. Structural characterization, ROS-inductive and proteasome inhibitory properties of ternary and binary copper(II) complexes of N2-and N2O2-ligands. Inorganica Chimica Acta, 2016; 450: 202 [eSc

02-02-09-SF0036]. (ISI IF: 1.918; SCI IF: 1.826; HI: 84; Tier: Q2).

Structural characterization, ROS-inductive and proteasome inhibitory properties of ternary and binary copper(II) complexes of N2-and N2O2-ligands. Cheang Wei Chan1,3, Jing Wei Lai1, Ing Hong Ooi1, Hui Meng Er1, Soi Moi Chye2, Kong Wai Tan3, Seik Weng Ng3, Mohd Jamil Maah3, Chew Hee Ng1. 1Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia 2Department of Human Biology, School of Medicine, International Medical University, 57000 Kuala Lumpur, Malaysia 3Chemistry Department, University of Malaya, 50603 Kuala Lumpur, Malaysia

Abstract

The four copper(II) complexes involving ethylenediamine-N,N-diacetic acid (H2edda) and ethylenediamine (en), viz. [Cu(edda)(en)]-H2O 1, [Cu(en)Cl2] 2, [Cu(edda)] 3 and [Cu2(Hedda)2Cl2] 4, were synthesized and characterized by various physical means. The crystal structures of 1 and 4 established them as mononuclear and dichlorido-bridged dicopper(II) complexes respectively. Complexes 1 and 4 showed weak and strong antiferromagnetic Cu. . .Cu interaction. Dynamic light scattering data of 3 suggested it to be a 3-dimensional coordination polymer in aqueous solution, gel and solid forms. The copper(II) species of 1–4 in aqueous solution were analysed by UV–visible and molar conductivity data. The weak hydroxyl radical-inducing property of free copper(II) ions in solution was enhanced by the chelation of both types of ligands. However, chelation of each or both of these ligands reduce the strong proteasome inhibitory property of the copper(II). All complexes inhibited the three proteolytic sites of the 20S proteasome, with the Trypsin-like site been mostly selectively inhibited. Keywords: Copper complexes, Spin-spin interaction, Reactive oxygen species, Proteasome

inhibition, Trypsin-like site selective inhibitor.

45

Chang SK, Alasalvar C, Bolling BW, Shahidi F. Nuts and their co-products: The impact of processing (roasting) on phenolics, bioavailability, and health benefits – A comprehensive review. Journal of Functional Foods, 2016; 26: 88-122. (ISI IF: 3.973; SCI IF: 4.168; HI: 35;

Tier: Q1).

Nuts and their co-products: The impact of processing (roasting) on phenolics, bioavailability, and health benefits – A comprehensive review. Sui Kiat Chang1, Cesarettin Alasalvar2, Bradley W. Bolling3, Fereidoon Shahidi4. 1Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 2TÜBITAK Marmara Research Center, Food Institute, P.O. Box 21, 41470 Gebze-Kocaeli, Turkey 3Department of Food Science, University of Wisconsin-Madison, 1605 Linden Dr., Madison, WI 53706, USA 4Department of Biochemistry, Memorial University of Newfoundland, St. John’s, NL A1B 3X9, Canada

Abstract

Nuts serve as important healthful snacks worldwide. They are highly desirable due to the presence of numerous essential macro- and micronutrients and health-promoting phenolic compounds (polyphenols). Nuts are usually consumed either as raw (natural) or as roasted. In addition, nuts and their co-products have been demonstrated to be rich sources of phenolic compounds that possess various health-beneficial properties. Therefore, inclusion of these phenolic compounds from nut co-products into the human diet is highly recommended as these may provide inexpensive sources of natural antioxidants for use as functional food ingredients and nutraceuticals. Hence, the phenolic compositions and antioxidant activities of nuts (natural and roasted) and their co-products (such as skin, hard shell, hull, and pellet) are discussed in detail. The impact of processing (roasting) on nut phenolics and antioxidant activities are highlighted. The bioavailability and health benefits of the phenolic compounds from nuts, especially their co-products are also discussed. Research findings from the existing literature published within the last 10 years have been compiled and summarised. Keywords: Nut co-products, Roasting, Phenolic compounds, Antioxidant activity,

Bioavailability, Health benefits.

46

Chellappan DK, Candasamy M. Cellulitis – Current management approach through complementary and alternative medicine. Advances in Pharmacoepidemiology and Drug Safety, 2016; 5: 211. doi:10.4172/2167-1052.1000211. (ISI IF: 0.94).

Cellulitis – Current management approach through complementary and

alternative medicine.

Dinesh Kumar Chellappan and Mayuren Candasamy.

International Medical University, Kuala Lumpur, Malaysia

Abstract Letter to The Editor

Cellulitis is an inflammatory condition of sub-cutaneous connective tissue under the skin. Bacteria, most commonly Streptococci and Staphylococci, when they get beneath the skin

tissue through possible cuts or bruises, play a big role in the pathogenesis of this condition [1,2]. Diagnosis is fairly straight forward based on the appearance of the skin. If untreated, cellulitis may be highly dangerous. Managing cellulitis with integrative and complementary medicine involves three areas of focus: Anti-inflammatory and antibacterial approaches; rejuvenating factors; and enhancing immunity. An integrated and multi-faceted treatment approach may be successful in restoring normal health in patients suffering from cellulitis. There are currently no clinical studies done on any complementary and alternative medicines including plant products till date for the treatment of cellulitis. Physicians primarily treat cellulitis with the help of antibiotics that can work effectively against Staphylococcus and Streptococcus

strains. It is recommended that Cellulitis should not be treated with complementary or alternative medicine alone. But this can be treated with a holistic approach combining both Western medicine and alternative therapies. Some of the selected complementary and alternative therapies for the treatment of cellulitis are mentioned below. Ayurvedic therapies have shown to treat cellulitis with their diverse range of synergistic formulations. Hydrastis canadensis (Goldenseal root) together with Ulmus fulva (Slippery elm),

when made into a paste and applied on the affected area twice a day, have shown to be effective in cellulitis. Goldenseal root has been proved to be a potent anti-inflammatory agent, whereas, slippery elm is reported to be an antiseptic agent [3]. Tea tree oil (Melaleuca alternifolia), turmeric paste (Curcuma longa) and honey are other topical preparations of significance which are widely used [4]. There are also reports published on thyme oil claiming its effectiveness in treating cellulitis [5]. Thyme oil is reported to have potent antifungal and antibacterial actions. Homeopathy offers cost-effective treatment options for cellullitis. Two formulations namely, Rhus toxicodendron and Mercurius are effectively used for the treatment

of itchy cellulitis [6]. The primary mechanism of action of these homeopathic remedies is by acting as an antibacterial agent. Cupping therapy is one of the oldest practiced treatment methods for cellulitis. By creating a partial vacuum above the scarified mark, blood is drawn from the cutane to the surface, which enables quicker healing of the infected skin and removal of toxins and microbes [7]. Apart from this, hyperbaric oxygen therapy is gaining much popularity in curing skin related ailments like cellulitis, dermatitis, abrasive wounds and inflammation of the skin [8]. Acupuncture and other traditional Chinese medicine therapies may also help with the treatment of cellulitis. But there are no scientific or clinical studies that have studied on their effectiveness on cellulitis [9].

47

Though physicians prescribe more of antibiotics for the treatment of cellulitis, a holistic approach can be highly effective in the clinical management of cellulitis.

48

Chia YC, Beh HC, Ng CJ, Teng CL, Hanafi NS, Choo WY, Ching SM. Ethnic differences in the prevalence of knee pain amongst adults of a community in a cross-sectional study. BMJ Open, 2016; 6: e011925. Doi: 10.1136/bmjopen-2016-011925. (ISI IF: 2.562; SCI IF: 2.588;

HI: 35; Tier: Q1).

Ethnic differences in the prevalence of knee pain amongst adults of a community in a cross-sectional study. Yook Chin Chia1,2, Hooi Chin Beh1, Chirk Jenn Ng1, Cheong Lieng Teng3, Nik Sherina Hanafi1, Wan Yuen Choo4, Siew Mooi Ching5,6. 1Department of Primary Care Medicine, Faculty of Medicine, University of Malaya Primary Care Research Group (UMPCRG), University of Malaya, Kuala Lumpur, Malaysia 2Sunway Institute for Healthcare Development, Sunway University, Bandar Sunway, Selangor, Malaysia 3International Medical University, Seremban, Negeri Sembilan, Malaysia 4Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre University of Malaya, University of Malaya, Kuala Lumpur, Malaysia 5Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia 6Department of Gerontology, University Putra Malaysia, Serdang, Malaysia

Abstract Objective: To determine the prevalence of knee pain among 3 major ethnic groups in

Malaysia. By identifying high-risk groups, preventive measures can be targeted at these populations. Design and setting: A cross-sectional survey was carried out in rural and urban areas in a

state in Malaysia. Secondary schools were randomly selected and used as sampling units.

Participants: Adults aged ≥ 18 years old were invited to answer a self-administered

questionnaire on pain experienced over the previous 6 months. Out of 9300 questionnaires distributed, 5206 were returned and 150 participants who did not fall into the 3 ethnic groups were excluded, yielding a total of 5056 questionnaires for analysis. 58.2% (n=2926) were women. 50% (n=2512) were Malays, 41.4% (n=2079) were Chinese and 8.6% (n=434) were Indians. Results: 21.1% (n=1069) had knee pain during the previous 6 months. More Indians (31.8%) experienced knee pain compared with Malays (24.3%) and Chinese (15%) ( p<0.001). The odds of Indian women reporting knee pain was twofold higher compared with Malay women. There was a rising trend in the prevalence of knee pain with increasing age ( p<0.001). The association between age and knee pain appeared to be stronger in women than men. 68.1% of Indians used analgesia for knee pain while 75.4% of Malays and 52.1% of Chinese did so ( p<0.001). The most common analgesic used for knee pain across all groups was topical medicated oil (43.7%). Conclusions: The prevalence of knee pain in adults was more common in Indian women and

older women age groups and Chinese men had the lowest prevalence of knee pain. Further studies should investigate the reasons for these differences.

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Chieng BW, Ibrahim NA, Then YY, Loo YY. Mechanical, thermal, and morphology properties of poly(lactic acid) plasticized with poly(ethylene glycol) and epoxidized palm oil hybrid plasticizer. Polymer Engineering and Science, 2016; 56(10): 1169-1174. DOI:

10.1002/pen.24350. (ISI IF: 1.719; SCI IF: 1.557; HI: 86; Tier: Q2).

Mechanical, thermal, and morphology properties of poly(lactic acid) plasticized with poly(ethylene glycol) and epoxidized palm oil hybrid plasticizer. Buong Woei Chieng1,2, Nor Azowa Ibrahim1,2, Yoon Yee Then3, Yuet Ying Loo4. 1Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang, Malaysia 2Materials Processing and Technology Laboratory, Institute of Advanced Technology, Universiti Putra Malaysia, Serdang, Malaysia 3Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia 4Department of Food Science, Faculty of Food Science and Technology, Universiti Putra Malaysia, Serdang, Malaysia

Abstract Poly(lactic acid) (PLA) has received great attention recently due to its good physical and mechanical properties such as high tensile strength and modulus, good processability and biodegradability. In this study, low molecular weight poly(ethylene glycol) (PEG) and epoxidized palm oil (EPO) were used as hybrid plasticizers to improve toughness and ductility of PLA. Using the solubility parameter, a tentative evaluation of the hybrid plasticizer that could act as the most effective plasticizer for PLA has been performed and the obtained results have been corroborated with the materials physical properties. Excellent plasticizing effect was obtained by hybrid plasticizer PEG:EPO with ratio 2:1. Addition of PEG:EPO (2:1) hybrid plasticizer to PLA shows a significant improvement of 12,402%, compared to neat PLA. The improvement in flexibility and decrease in rigidity for the plasticized PLA is well evidenced by lower glass transition temperature (Tg) and tensile modulus values. In relation to the thermal stability, a decrease in thermal properties of the hybrid plasticized PLA was observed due to the volatility of the plasticizers. Scanning electron microscopy (SEM) shows that the hybrid plasticizer was turned PLA’s smooth surface to fibrous structure and rough fracture surface.

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Chin YT, Lim YAL, Chong CW, Teh CSJ, Yap IKS, Lee SC, Tee MZ, Siow VWY, Chua KH. Prevalence and risk factors of intestinal parasitism among two indigenous sub-ethnic groups in Peninsular Malaysia. Infectious Diseases of Poverty, 2016; 5: 1-15. (ISI IF: 2.13; SCI IF:

2.075; HI: 12; Tier: Q1).

Prevalence and risk factors of intestinal parasitism among two indigenous sub-ethnic groups in Peninsular Malaysia. Yuee Teng Chin1, Yvonne Ai Lian Lim2, Chun Wie Chong3, Cindy Shuan Ju Teh4, Ivan Kok Seng Yap3, Soo Ching Lee2, Mian Zi Tee1, Vinnie Wei Yin Siow2 and Kek Heng Chua1. 1Department of Biomedical Science, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia 2Department of Parasitology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia 3Department of Life Sciences, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia 4Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia

Abstract Background: Intestinal parasitic infections (IPIs) among indigenous people have been widely

documented in Malaysia, however, the prevalence of these infections remains high. In the past, most studies have focused on specific species of parasites but polyparasitism has received limited attention. In addition, epidemiology studies on indigenous people tend to consider them as a homogenous group, whereas in reality different sub-ethnic groups have different cultural and living practices. Variations in living habits such as personal hygiene practices may predispose different groups to different parasitic infections. To better understand prevalence and risk factors of intestinal parasitism among different sub-ethnic groups, the present study was conducted among two sub-ethnic groups of indigenous people (Temuan and Mah Meri) residing in Selangor state, Malaysia. Methods: A cross-sectional study that focused on two distinct sub-ethnic groups was carried

out from February to September 2014. Faecal samples were collected from 186 participants and examined using the formalin-ether sedimentation technique. A molecular approach was adopted to conduct a genetic characterisation of the parasites. Additionally, questionnaires were administered to obtain information on the demographics, socioeconomic backgrounds and behavioural risks relating to the participants, as well as information about their environments. Statistical analyses (i.e. binary and multivariate logistic regression analyses) were performed to measure risk factors. Results: For Temuan communities, trichuriasis (64.2 %) was the most common infection

found, preceding hookworm infection (34%), ascariasis (7.5%), giardiasis (14.2%) and amoebiasis (7.5%). As for the Mah Meri communities, trichuriasis (77.5%) prevailed over ascariasis (21.3%), hookworm (15%), giardiasis (7.5%) and amoebiasis (3.8%). Significant differences in proportions of trichuriasis, ascariasis and hookworm infections were observed between the Temuan and Mah Meri sub-ethnic groups. Polyparasitism was more common among the Temuan sub-ethnic group (41.5%) compared to the Mah Meri sub-ethnic group (32.5%), with the majority of participants harbouring two parasites concurrently (Temuan: 33%, Mah Meri: 20%). Trichuris trichiura and Ascaris lumbricoides co-infections were most prevalent (10%) among the Mah Meri communities, while a co-infection of T. trichiura with hookworm (19.8 %) was most common among the Temuan communities. Multivariate analyses showed that being unemployed, having a large family and drinking unboiled water were found to be significantly associated with intestinal parasitism.

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Conclusion: The present study highlights substantial polyparasitism and risk factors for

infections in the Temuan and Mah Meri sub-ethnic groups. The high prevalence of IPIs among these two sub-ethnic groups indicates that parasitic infections are important health issues in these communities. Hence, it is imperative to implement sound intervention strategies such as periodic preventive chemotherapy coupled with health education in order to reduce and eradicate these infections. Keywords: Intestinal parasites, Intestinal parasitism, Indigenous people, Risk factors, Prevalence, Sub-ethnic group, Temuan sub-ethnic group, Mah Meri sub-ethnic group, Peninsular Malaysia.

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Ching S, Ramachandran V, Gew LT, Lim SM, Sulaiman WA, Foo YL, Zakaria ZA, Samsudin NH, Lau PC, Veettil SK, Hoo F. Complementary alternative medicine use among patients with dengue fever in the hospital setting: A cross-sectional study in Malaysia. BMC Complementary and Alternative Medicine, 2016; 16(1): 37. (SCI IF: 2.208; HI: 53; Tier: Q1).

Complementary alternative medicine use among patients with dengue fever in the hospital setting: A cross-sectional study in Malaysia. Siew Mooi Ching1,2, Vasudevan Ramachandran2, Lai Teck Gew3, Sazlyna Mohd Sazlly Lim4, Wan Aliaa Wan Sulaiman4, Yoke Loong Foo4, Zainul Amiruddin Zakaria5, Nurul Huda Samsudin4, Paul Chih Ming Chih Lau4, Sajesh K. Veettil6 and Fankee Hoo4. 1Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia 2Malaysian Research Institute on Ageing, Universiti Putra Malaysia, 43400 Serdang, Malaysia 3Department of Medicine, Hospital Kuala Lumpur, Kuala Lumpur, Malaysia 4Department of Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400 Selangor, Malaysia 5Department of Biomedical Science, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor 43400, Malaysia 6Department of Pharmacy Practice, International Medical University, Kuala Lumpur 57000, Malaysia.

Abstract Background: In Malaysia, the number of reported cases of dengue fever demonstrates an

increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. Methods: This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. Results: The prevalence of CAM use was 85.3 % among patients with dengue fever. The

most popular CAMs were isotonic drinks (85.8 %), crab soup (46.7 %) and papaya leaf extract (22.2 %). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3 %). The main resource of information on CAM use among patients with dengue fever was family (54.8 %). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95 % confidence interval (CI 1.62–20.45) and 3.8 (95 % CI 1.12–12.93) times than secondary level and primary and below respectively. Conclusion: CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education. Keywords: Complementary alternative medicine, Dengue fever, Prevalence, Hospital,

Malaysia.

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Chong HP, Kasi R, Ng KY, Koh RY, Ng CH, Chye SM. para-Phenylenediamine containing hair dye: An overview of mutagenicity, carcinogenicity and toxicity. Journal of Environmental and Analytical Toxicology, 2016; 6: 403. doi: 10.4172/2161-0525.1000403. (ISI IF: 2.72).

para-Phenylenediamine containing hair dye: An overview of mutagenicity, carcinogenicity and toxicity. Chong HP1, Reena K1, Ng KY2, Koh RY1, Ng CH3 and Chye SM1. 1School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia 2School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia 3School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia

Abstract

The great demand for hair dyes can be seen by the proliferation of hair salons. Their ability to impart temporary or permanent colour change to the hair satisfies the desire of consumers for beauty, fashion, and a look-younger image. para-Phenylenediamine (PPD) is found in more than 1000 hair dye formulations and is the most frequently used permanent hair dye component in Europe, North America, and East Asia. In addition, PPD containing permanent hair dyes account for three-quarters of global use and more than one-third of women use in Europe, North America, and East Asia. However, PPD has been banned in Germany, France and Sweden in the early 1900's as a hair dye component and the hazard of PPD on health has been discussed for the past few decades. PPD containing hair dyes have been associated with cancer and mutagenicity, with supportive evidences from both clinical and laboratory studies. Apart from that, PPD has potential toxicity which includes acute toxicity such as allergic contact dermatitis and subacute toxicity. In this article, we provide comprehensive review on the chemical ingredients of hair dyes, roles of PPD in hair dye, metabolic mechanisms of PPD through in vivo and in vitro studies, and mechanism involvement in the health effect of PPD as evidenced from both clinical and laboratory studies. Keywords: para-Phenylenediamine, Hair dye, Mutagenicity, Carcinogenicity, Toxicity.

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Chong MX, Khoo CD, Goh KH, Rahman F, Shoji Y. Effect of age on bite force. Journal of Oral Science, 2016; 58(3): 361-363. (SCI IF: 0.908; HI: 35; Tier: Q2).

Effect of age on bite force. Mei Xin Chong1, Chong Dee Khoo2, Kai Hoe Goh1, Farhana Rahman3, and Yoshinobu Shoji3. 1School of Dentistry, International Medical University, Kuala Lumpur, Malaysia 2Toothworks, Invercargill, New Zealand 3Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, University Technology MARA, Sungai Buloh, Malaysia

Abstract

This study compared bite force in adults older than 60 years with that of young adults. The participants were 20 healthy adults (9 men) older than 60 years (median age, 66 years) and 44 healthy young adults (22 men; age range, 18-25 years; median age, 22 years) at the International Medical University, Malaysia. All participants had at least 20 teeth, and bite force was measured and evaluated using the Dental Prescale system. Average (SD) bite force was 420.5 (242.0) N for the older adults and 541.4 (296.3) N for the young adults. Although mean bite force was higher for the young adults, the difference was not significant. These findings suggest that bite force is unaffected by age in adults with adequate dentition. Keywords: bite force, elderly, aging.

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Chu WL, Phang SM. Marine algae as a potential source for anti-obesity agents. Marine Drugs,

2016; 14(12): 222. (ISI IF: 3.345; SCI IF: 3.373; HI: 56; Tier: Q2).

Marine algae as a potential source for anti-obesity agents. Chu Wan-Loy1 and Phang Siew-Moi2,3. 1School of Postgraduate Studies, International Medical University, Kuala Lumpur 57000, Malaysia 2Institute of Biological Sciences, University of Malaya, Kuala Lumpur 50603, Malaysia 3Institute of Ocean & Earth Sciences (IOES), University of Malaya, Kuala Lumpur 50603, Malaysia

Abstract

Obesity is a major epidemic that poses a worldwide threat to human health, as it is also associated with metabolic syndrome, type 2 diabetes and cardiovascular disease. Therapeutic intervention through weight loss drugs, accompanied by diet and exercise, is one of the options for the treatment and management of obesity. However, the only approved anti-obesity drug currently available in the market is orlistat, a synthetic inhibitor of pancreatic lipase. Other anti-obesity drugs are still being evaluated at different stages of clinical trials, while some have been withdrawn due to their severe adverse effects. Thus, there is a need to look for new anti-obesity agents, especially from biological sources. Marine algae, especially seaweeds are a promising source of anti-obesity agents. Four major bioactive compounds from seaweeds which have the potential as anti-obesity agents are fucoxanthin, alginates, fucoidans and phlorotannins. The anti-obesity effects of such compounds are due to several mechanisms, which include the inhibition of lipid absorption and metabolism (e.g., fucoxanthin and fucoidans), effect on satiety feeling (e.g., alginates), and inhibition of adipocyte differentiation (e.g., fucoxanthin). Further studies, especially testing bioactive compounds in long-term human trials are required before any new anti-obesity drugs based on algal products can be developed. Keywords: obesity, algae, seaweeds, fucoxanthin, alginates, fucoidans, phlorotannins, pancreatic lipase inhibitors.

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Chung FFL, Mai CW, Ng PY, Leong CO. Roles of cytochrome P450 2W1 (CYP2W1) in colorectal cancers. Current Cancer Drug Targets, 2016; 16(1): 71-8. DOI: 10.2174/1568009616888151112095948. (ISI IF: 3.707; SCI IF: 3.752; HI: 73; Tier: Q1).

Roles of cytochrome P450 2W1 (CYP2W1) in colorectal cancers. Fei-Lei Chung Felicia, Wai Mai Chun, Yuen Ng Pei, Leong Chee-Onn. International Medical University, Kuala Lumpur.

Abstract

Cytochrome P450, family 2, subfamily W, polypeptide 1 (CYP2W1) is a newly identified monooxygenase enzyme that is expressed specifically in tumor tissues and during fetal life. Particularly, high expression of CYP2W1 was observed in up to 60% of colorectal cancers and its expression correlated with poor survival. CYP2W1 has been shown to metabolize various endogenous substrates including lysophospholipids and several procarcinogens, such as polycyclic aromatic hydrocarbon. The specific substrate for CYP2W1, however, is currently unknown. Due to its tumor-specific expression and its unique catalytic activities in colorectal cancers, CYP2W1 was deemed as an interesting target in colorectal cancer therapy. This review sought to summarize the current understanding of the CYP2W1 biology and biochemistry, its genetic polymorphisms and cancer risk, and its implication as a tumor-specific diagnostic and therapeutic target. Keywords: CYP2W1, Cancer therapeutics, colorectal cancer, cytochrome P450, prodrug.

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Chung PY. Plant-derived compounds as potential source of novel anti-biofilm agents against Pseudomonas aeruginosa. Current Drug Targets, 2016; 17. (ISI IF: 3.029; SCI IF: 3.14; HI: 77; Tier: Q1).

Plant-derived compounds as potential source of novel anti-biofilm agents against Pseudomonas aeruginosa. Chung PY1, et al. 1Department of Pathology, School of Medicine, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

Abstract Pseudomonas aeruginosa is the most common Gram-negative bacterium associated with

nosocomial and life-threatening chronic infections in cystic fibrosis patients. This pathogen is well-known for its ability to attach to surfaces of indwelling medical devices to form biofilms, which consist of a regular array of extracellular polymers. Tenaciously bound to the surface of devices and inherently resilient to antibiotic treatment, P. aeruginosa poses a serious threat

in clinical medicine and contributes to the persistence of chronic infections. Studies on microbial biofilms in the past decade involved mainly the understanding of environment signals, genetic elements and molecular mechanisms in biofilm formation, tolerance and dispersal. The knowledge obtained from the studies of these mechanisms is crucial in the establishment of strategies to eradicate or to prevent biofilm formation. Currently, biofilm infections are usually treated with combinations of antibiotics and surgical removal, in addition to frequent replacement of the infected device. More recently, specific natural sources have been identified as antibiofilm agents against this pathogen. This review will highlight the recent progress made by plantderived compounds against P. aeruginosa biofilm infections in both in

vitro or in vivo models.

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Chung PY. The emerging problems of Klebsiella pneumoniae infections: Carbapenem resistance and biofilm formation. FEMS Microbiology Letters, 2016; 363, fnw219. (ISI IF: 1.858; SCI IF: 2.817; HI: 118; Tier: Q2).

The emerging problems of Klebsiella pneumoniae infections: Carbapenem resistance and biofilm formation. Chung PY1. 1Department of Pathology, School of Medicine, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia

Abstract Klebsiella pneumoniae is an opportunistic pathogen that commonly causes nosocomial

infections in the urinary tract, respiratory tract, lung, wound sites and blood in individuals with debilitating diseases. Klebsiella pneumoniae is still a cause of severe pneumonia in alcoholics in Africa and Asia, and the predominant primary pathogen of primary liver abscess in Taiwan and Southeast Asia, particularly in Asian and Hispanic patients, and individuals with diabetes mellitus. In the United States and Europe, K. pneumoniae infections are most frequently associated with nosocomial infections. The emergence of antibiotic-resistant strains of K. pneumoniae worldwide has become a cause of concern where extended spectrum β-

lactamases (ESBLs) and carbapenemase-producing strains have been isolated with increasing frequency. The pathogen's ability to form biofilms on inserted devices such as urinary catheter has been proposed as one of the important mechanisms in nosocomially acquired and persistent infections, adding to the increased resistance to currently used antibiotics. In this review, infections caused by K. pneumoniae, antibiotic resistance and formation of biofilm will be discussed. Keywords: Klebsiella pneumoniae, antibiotic resistance, mixed-species biofilm.

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Dujaili JA, Syed Sulaiman SA, Awaisu A, Hassali MA, Blebil AQ, Bredle JM. Comparability of interviewer-administration versus self-administration of the Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB) health-related quality of life questionnaire in pulmonary tuberculosis patients. Pulmonary Therapy, 2016; 2(1): 127-137. (IF: NA).

Comparability of interviewer-administration versus self-administration of the Functional Assessment of Chronic Illness Therapy-Tuberculosis (FACIT-TB) health-related quality of life questionnaire in pulmonary tuberculosis patients. Juman Abdulelah Dujaili1,3, Syed Azhar Syed Sulaiman1, Ahmed Awaisu3, Mohamed Azmi Hassali4, Ali Qais Blebil5, Jason M. Bredle6. 1Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minden Malaysia. 2Department of Pharmacy Practice, International Medical University, Bukit Jalil, Malaysia 3Clinical Pharmacy and Practice Section, College of Pharmacy Qatar University, Doha Qatar 4Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Minde, Malaysia 5Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, UCSI University, Kuala Lumpur, Malaysia 6FACIT.org, Elmhurst, USA

Abstract Objective: To investigate the extent to which two different modes of administration (interview by a trained interviewer versus self-administration) yielded a comparable estimate of health-related quality of life (HRQL) in patients with pulmonary tuberculosis (PTB). Methods: The study was conducted between September 2012 and July 2013, among

consecutive patients treated for PTB at the Thoracic and Respiratory Disease Specialist Centre in Baghdad, Iraq. The mode of administration of the functional assessment of chronic illness therapy-tuberculosis (FACIT-TB), a new TB-specific HRQL instrument, was recorded at baseline in 305 subjects. Results: Although the FACIT-TB questionnaire was designed for self-administration, most patients in our sample (n = 193, 63.3 %) requested some help from an interviewer to fill out the questionnaire. Patients capable of self-administration were younger (38.2 ± 12.9 years vs. 43.6 ± 16.4 years, p = 0.005) and required less time to complete the questionnaire (14.6 ± 3.2 min vs. 17.2 ± 2.6 min, p < 0.001) compared to those who were interviewed by a trained interviewer. No differences in gender were observed between the two groups. HRQL scores across all domains for those who were interviewed were slightly lower than those who answered the questionnaire by self-administration. However, the results did not reach statistical significance (p > 0.05). Conclusions: The study demonstrates that the administration of FACIT-TB instrument using either self-administration or interviewing techniques has resulted in a comparable estimate of HRQL among patients with PTB. The FACIT-TB instrument is able to accommodate the needs of patients with diverse social, educational, and functional skills. Keywords: FACIT-TB, Mode of administration, Quality of life, Questionnaire, Tuberculosis.

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Ebrall PS. Commentary: Is EBM damaging the social conscience of chiropractic? Chiropractic Journal of Australia, 2016; 44(3): 204-213. (SCI IF: 0.222; HI: 3; Tier: Q4).

Commentary: Is EBM damaging the social conscience of chiropractic? Phillip Stuart Ebrall1. 1Senior Education Advisor, Tokyo College of Chiropractic; Adjunct Professor, Faculty of Medicine, International Medical University, Kuala Lumpur; Education Advisor, Stress Management Institute

Abstract Introduction: One expression of the social conscience of chiropractic is the provision by

chiropractic educational institutions of low-cost or free chiropractic care to disadvantaged communities. It is expected that institutions offer to all patients the same full standard of care that is the hallmark of traditional chiropractic. Objective: To explore whether an observed schism occurring within chiropractic education, where a minority of institutions are minimising the major premise of the discipline and replacing it with an emphasis on only the science or literature component of the evidence-based triad, has any potential impact on the quality of care provided particularly within the charitable context. Data Sources and Synthesis: The indexed literature supplemented by informal literature,

news reports, URLs identified by on-line searching, personal communication and key informants. A contextual narrative identifies themes which combine to suggest the healing component of the chiropractic encounter may be compromised. Concern is also expressed that students in those institutions which have removed the major premise of chiropractic from their curriculum may experience compromise in their learning which may negatively impact patient care. Conclusion: The social conscience of chiropractic may be compromised by undue emphasis on science and the relegation of traditional concepts as historical artefacts. Academic chiropractors seem yet to address potential consequences. Keywords: Chiropractic, Medical History, Evidence-Based Practice.

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Edavanputhillath R, Joseph L, Kademane K, Rao SN. Anticonvulsant activity of Nigella sativa, Aegle marmelos and Benincasa hispida in Pentylenetetrazole induced seizure in Swiss albino mice. Asian Journal of Medical Sciences, 2015; 7(3):97-102. (E-ISSN 2091-0576; P-ISSN

2467-9100). (IF: NA).

Anticonvulsant activity of Nigella sativa, Aegle marmelos and Benincasa hispida in Pentylenetetrazole induced seizure in Swiss albino mice. Rejeesh Edavan Puthillath1, Lovelyn Joseph2, Kumaraswamy Kademane3, Sundarshanram Narayan Rao4. 1Assistant Professor, Department of Pharmacology, Government Medical College, Palakkad, Kerala, India 2Associate Professor, Department of Pharmacology, PK Das Institute of Medical Sciences, Vaniyamkulam, Palakkad, India 3Lecturer, Department of Pharmacology, International Medical University, Kuala Lumpur, Malaysia 4Professor and Head, Department of Pharmacology, Yenepoya Medical College, Mangalore, Karnataka, India

Abstract Aims and Objectives: To test anticonvulsant properties of three medicinal plants with

pentylenetetrazole induced seizure test in Swiss albino mice. Materials and Methods: Aqueous extract of Aegle marmelos leaves (AmAE),Ethanolic extract of Nigella sativa seeds (NsEE) and crude extract of Benincasa hispida fruit juice

(BhE)were prepared. Qualitative phytochemical analysis of the test extracts were done with Preliminary chemical reaction tests, and Liquid chromatography–mass spectrometry (LC/MS). Male Swiss albino mice, 3-4 months of age, weighing 25-30g were used in the study. Extracts and vehicle were administered orally 1 hour prior to inducing convulsions with Pentylenetetrazole (PTZ) induced seizure test [60mg/kg/i.p]. Onset of first jerky movement, onset of Straub’s tail, onset of clonic convulsions, onset of tonic flexion, onset of Hind limb tonic extension (HLTE) and reduction in mortality were measured. Animals were treated with extracts at a dose of 900mg/kg orally. The results were compared with control group and test for analysis of variance and significance was done (ANOVA, Dunnett’s test). Results: Aqueous extract of Aegle marmelos leaves and Ethanolic extract of Nigella sativa

seeds possess anticonvulsant property in Pentylenetetrazole (PTZ) induced seizure model, Crude extract of Benincas ahispida fruits did not show statistically significant anticonvulsant

property. Conclusions: Aegle marmelos leaf and Nigella sativa seed possess anticonvulsant properties

in pentylenetetrazole induced seizures, this is in accordance with many other published reports on the same herbs with different animal models and indicates effectiveness in human absence seizure patients. Keywords: Pentylenetetrazole (PTZ) induced seizure test, Anticonvulsant, Aegle marmelos, Nigella sativa, Benincasa hispida, Sodium valproate, Ethosuximide, Swiss albino mice.

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Edib Z, Kumarasamy V, Abdullah N, Rizal AM, Al-Dubai SA. Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia. Health and Quality of Life Outcomes, 2016; 14(1): 1. (ISI IF: 2.212; SCI IF: 2.433; HI: 75; Tier: Q1).

Most prevalent unmet supportive care needs and quality of life of breast cancer patients in a tertiary hospital in Malaysia. Edib Z1, Kumarasamy V1, binti Abdullah N2, Rizal AM3, AlDubai SAR4. 1Department of Community Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, 57000 2Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, 56000 3Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras, Kuala Lumpur, 56000 4Faculty of Medicine, SEGi University, Kota Damansara, Petaling Jaya, Selangor, 47810

Abstract Background: Addressing breast cancer patients' unmet supportive care needs in the early

stage of their survivorship have become a prime concern because of its significant association with poor quality of life (QOL), which in turn increases healthcare utilization and costs. There is no study about unmet supportive care needs of breast cancer patients in Malaysia. This study aims to assess the most prevalent unmet supportive care needs of Malaysian breast cancer patients and the association between QOL and patients' characteristics, and their unmet supportive care needs. Methods: A crosssectional study was conducted at the Surgery and Oncology Clinic between

May 2014 and June 2014 in a tertiary hospital in Malaysia. A total of 117 patients out of 133 breast cancer patients recruited by universal sampling were interviewed using a structured questionnaire consisted of three parts: participants' sociodemographic and disease characteristics, Supportive Care Needs Survey Short Form Questionnaire (SCNSSF34) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQC30). Results: The highest unmet supportive care needs were observed in the psychological

domain (Mean 53.31; SD ± 21.79), followed by physical domain (Mean 38.16; SD ± 27.15). Most prevalent unmet supportive care needs were uncertainty about the future (78.6%), fears about the cancer spreading (76.1%), feelings of sadness (69.2%), feelings about death and dying (68.4%), concerns about those close to the patient (65.0%) and feeling down or depressed (65.0%). Multivariate linear analysis showed that early breast cancer survivors diagnosed at an advanced stage and with greater physical and psychological needs were significantly (p < 0.05) associated with poorer QOL. Conclusion: Most prevalent unmet needs among Malaysian breast cancer patients were

found in the psychological domain. Early breast cancer survivors with late stage diagnosis who had more unmet needs in psychological and physical domains were more likely to have a poor QOL. Keywords: Breast cancer, Quality of life, Supportive care, Unmet needs.

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Erna L, Ling APK, Koh RY, Wong YP, Mohd Lila MA, Hussein S. Plant-based vaccines: Production and challenges. Journal of Botany, 2016: Article ID: 4928637. doi:10.1155/2016/4928637. [ERGS- [ERGS/1/2012/SKK10/IMU/03/4]. (IF: NA).

Plant-based vaccines: Production and challenges. Erna Laere1, Anna Pick Kiong Ling1, Ying Pei Wong1, Rhun Yian Koh1, Mohd Azmi Mohd Lila2, Sobri Hussein3. 1Department of Applied Biomedical Sciences and Biotechnology, School of Health Sciences, International Medical University, 57000 Bukit Jalil, Kuala Lumpur, Malaysia 2Department of Veterinary Pathology and Microbiology, Faculty of Veterinary Medicine, Universiti Putra Malaysia (UPM), 43400 Serdang, Selangor, Malaysia 3Agrotechnology and Bioscience Division, Malaysian Nuclear Agency, Bangi, 43000 Kajang, Selangor, Malaysia

Abstract Plant-based vaccine technologies involve the integration of the desired genes encoding the antigen protein for specific disease into the genome of plant tissues by various methods. Agrobacterium-mediated gene transfer and transformation via genetically modified plant virus are the common methods that have been used to produce effective vaccines. Nevertheless, with the advancement of science and technology, new approaches have been developed to increase the efficiency of former methods such as biolistic, electroporation, agroinfiltration, sonication, and polyethylene glycol treatment. Even though plant-based vaccines provide many benefits to the vaccine industry, there are still challenges that limit the rate of successful production of these third-generation vaccines. Even with all the limitations, continuous efforts are still ongoing in order to produce efficient vaccine for many human and animals related diseases owing to its great potentials. This paper reviews the existing conventional methods as well as the development efforts by researchers in order to improve the production of plant-based vaccines. Several challenges encountered during and after the production process were also discussed.

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Fong BY, Lin Ma, Khor GL, van der Does Y, Rowan A, McJarrow P, Mac Gibbon AKH. Ganglioside composition in beef, chicken, pork, and fish determined using liquid chromatography − High-resolution mass spectrometry. Journal of Agricultural and Food Chemistry, 2016; DOI: 10.1021/acs.jafc.6b02200. [External Grant from Fonterra, IMU R

139/2014]. (ISI IF: 2.857; SCI IF: 2.923; HI: 216; Tier: Q1).

Ganglioside composition in beef, chicken, pork, and fish determined using liquid chromatography − High-resolution mass spectrometry. Bertram Y. Fong1, Lin Ma1, Geok Lin Khor2, Yvonne van der Does1, Angela Rowan1, Paul McJarrow1, and Alastair K. H. MacGibbon1. 1Fonterra Research and Development Centre, Dairy Farm Road, Private Bag 11029, Palmerston North 4442, New Zealand 2School of Health Sciences, International Medical University, No. 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia

Abstract Gangliosides (GA) are found in animal tissues and fluids, such as blood and milk. These sialo-glycosphingolipids have bioactivities in neural development, the gastrointestinal tract, and the immune system. In this study, a high-performance liquid chromatography−mass spectrometry (HPLC−MS) method was validated to characterize and quantitate the GA in beef, chicken, pork, and fish species (turbot, snapper, king salmon, and island mackerel). For the first time, we report the concentration of GM3, the dominant GA in these foods, as ranging from 0.35 to 1.1 mg/100 g and 0.70 to 5.86 mg/100 g of meat and fish, respectively. The minor GAs measured were GD3, GD1a, GD1b, and GT1b. Molecular species distribution revealed that the GA contained long- to very-long-chain acyl fatty acids attached to the ceramide moiety. Fish GA contained only N-acetylneuraminic acid (NeuAc) sialic acid, while beef, chicken, and pork contained GD1a/b species that incorporated both NeuAc and N-glycolylneuraminic acid (NeuGc) and hydroxylated fatty acids. Keywords: glycosphingolipids, fatty acids, sialic acid, mammalian tissue, multiple-reaction

monitoring.

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Fu JY, Tan DMY, Er HM, Chen YS, Nesaretnam K. Tumour-targeted niosome as novel carrier for intravenous administration of tocotrienol. Asian Journal of Pharmaceutical Sciences, 2016; 11(1): 79-80. DOI: http://dx.doi.org/doi: 10.1016/j.ajps.2015.10.062. (SCI IF: 1.89; HI: 11; Tier: Q2).

Tumour-targeted niosome as novel carrier for intravenous administration of tocotrienol. Ju-Yen Fu1, Doryn Meam Yee Tan1,2, Hui Meng Er2, Yu Sui Chen2, Kalanithi Nesaretnam1. 1Malaysian Palm Oil Board, Bandar Baru Bangi, Selangor, 43000, Malaysia 2International Medical University, Bukit Jalil, Kuala Lumpur, 57000, Malaysia

Abstract

Tocotrienol (T3), the unsaturated form of vitamin E has gained global attention due to its potent anticancer effects against a wide range of cancers. Found abundantly in palm oil [1], T3 was reported to exhibit their anti-cancer properties via various pathways including anti-proliferative, anti-angiogenesis, antiinflammatory, apoptosis and improvement of immunological function [2]. However, the lack of tumor specificity and rapid body clearance have restricted the clinical applications of T3 [3]. Nanotechnology offers an alternative approach to novel formulation of tocotrienols as the sub- micron sized niosomes are able to enhance both pharmacokinetic and surface properties of tocotrienol. In this study, transferrin will be investigated as the targeting protein able to recognize the overexpressed transferrin receptors on breast cancer cells. The main objectives of this study are to develop a tumour-targeted nanocarrier-based delivery system for intravenous injection of T3, and evaluate the therapeutic efficacy in human breast cancer cells and murine xenograft tumor models.

Using film hydration method, spherical niosomes with size less than 200 nm were synthesized. The average encapsulation efficiency, drug loading and Tf- conjugation efficiency was 28.0%, 5.8% and 13.1%, respectively. The encapsulation of T3 in niosomes significantly improve the in vitro performance of T3, with at least 2-fold enhancement in cytotoxicity effect and 2.5-fold increment in T3 uptake in human breast cancer cells. In animal model, breast cancer cells were subcutaneously implanted to female BALB/c nude mice. Treatment with tumor-targeted niosomes encapsulated T3 showed reduced tumor volume of 3 times smaller than those injected with free T3. Note worthily, no sign of adverse effect and significant weight loss were observed in all treatment groups. The results were summarized in Fig. 1.

In current work, we demonstrated that the encapsulation of T3 in tumour-targeted niosomes resulted in enhanced cytotoxicity and T3 uptake in human breast cancer cells. Meanwhile, significant lower rate of tumor growth and tumor volume was observed in tumor-bearing mice treated with tumour-targeted niosomes encapsulating T3. This study exploits the therapeutic potential of T3 cancer therapy for the widespread benefits of patients suffering from cancers. Keywords: Tocotrienol; Niosome; Tumour-targeted; Breast cancer.

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George P, Balasingam V, Thurairajasingam S, Ramasamy P, Yusof HM, Yasin MAM, Bahkt ZU. Methadone complications among opioid dependent patients in Malaysia: A case series. Drug and Alcohol Review, 2016; DOI: 10.1111/dar.12456. (ISI IF: 2.405; SCI IF: 2.447; HI: 54;

Tier: Q1).

Methadone complications among opioid dependent patients in Malaysia: A case series. George P1, Vicknasingam B2, Thurairajasingam S3, Ramasamy P4, Mohd Yusof H5, Yasin MA3, Shah ZU1. 1School of Medicine, International Medical University, Kuala Lumpur, Malaysia. 2Centre for Drug Research, Universiti Sains, George Town, Malaysia. 3School of Medicine, Monash University, Subang Jaya, Malaysia. 4Hospital Kuala Pilah, Kuala Pilah, Malaysia. 5Hospital Permai, Johor Bahru, Malaysia.

Abstract Introduction and Aims: Opioid dependence remains the main type of illicit substance used in Malaysia, which has an estimated 187 771 opiate users. There are currently 333 active methadone maintenance treatment centres nationwide. Although methadone has proven to be an effective maintenance therapy, it has clinical concerns which can have an impact on its effectiveness and safety. Design, Methods, and Results: A case series of seven patients from Malaysian private and public hospital settings who had an adverse reaction with methadone is discussed. Discussion and Conclusion: Despite methadone being an effective therapy for opioid

dependence, there is a need for other alternative effective therapies, such as naltrexone, buprenorphine and the co-formulation of buprenorphine-naloxone, to be made available to physicians in both public and private sectors. There is need for individual treatment consideration to avoid adverse effects, drug-drug interactions, overdosing and in the presence of co-morbidities. An emphasis on safe storage of takeaway methadone is also needed. Keywords: adverse effect; interaction; methadone; methadone poisoning; opioid dependence.

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Ghazi HF, Al-abed AAA, Hasan TN, Zaleha MI, Qader MAA, Abdul-Majeed S. Nutrition and breast cancer risk: Review of recent studies. Malaysian Journal of Public Health Medicine, 2016; 16 (1): 75-80. (SCI IF: 0.216; HI: 3; Tier: Q4).

Nutrition and breast cancer risk: Review of recent studies. Hasanain Faisal Ghazi1, Al-abed Ali Ahmed Al-abed2, Tiba Nezar Hasan3, Zaleha Md. Isa3, Mohammed A. Abdal Qader1, Saif Abdul-Majeed4. 1Community Medicine Unit, International Medical School, Management and Science University, Shah Alam, Selangor, Malaysia. 2Department of Community Medicine, Faculty of Medicine, Lincoln University College, Petaling Jaya, Selangor, Malaysia. 3Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre,Kuala Lumpur, Malaysia. 4Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia.

Abstract

The association between nutrition and cancer in general had been a controversial issue between scientists in the last three decades, because some argued that there is a relationship and some nutrients can help in preventing cancer occurrence, although this has not been a consistent finding by other studies. Studies were identified through a systematic review of literature available on PubMed in between 1st January 2010 to 31st December 2013. We included all studies that assessed nutrition or diet with occurrence or mortality of breast cancer. Out of 42 articles, we included 8 articles in our screening and discussion. Among these 8 studies, there were 2 case-controls, 3 cohort and 3 randomized control trials (RCT) studies. Although most studies reported that nutrition isassociated with decreased risk, some reported the contrary, whereas others reported no relation. It was demonstrated a conflict between the included papers in regards of the association between nutrition and breast cancer. These finding needs to be re-evaluated in future studies. Keywords: Nutrition, Breast cancer, Food intake, Diet.

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Hamid Jan b Jan Mohamed, Loy SL, Mohd Nasir Mohd Taib, Norimah A Karim, Tan SY, Appukutty M, Nurliyana Abdul Razak, Thielecke F, Hopkins S, Ong MK, Ning C, Tee ES. Characteristics associated with the consumption of malted drinks among Malaysian primary school children: Findings from the MyBreakfast Study. BMC Public Health, 2015; 15: 1322.


Characteristics associated with the consumption of malted drinks among Malaysian primary school children: Findings from the MyBreakfast Study. Hamid Jan b. Jan Mohamed1, S. L. Loy2, Mohd Nasir Mohd Taib3, Norimah A Karim4, S. Y. Tan5, M. Appukutty6, Nurliyana Abdul Razak3, F. Thielecke7,8, S. Hopkins7, M. K. Ong9, C. Ning9 and E. S. Tee10. 1Nutrition Programme, School of Health Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia. 2KK Research Centre, KK Women’s and Children’s Hospital, Bukit Timah Road, Singapore 229899, Singapore. 3Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor Darul Ehsan, Malaysia. 4School of Healthcare Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, 50300 Kuala Lumpur, Malaysia. 5Department of Nutrition and Dietetics, School of Health Sciences, International Medical University, No.126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia. 6Sports Science Programme, Faculty of Sports Science and Recreation, Universiti Teknologi MARA, 40450 Shah Alam, Selangor Darul Ehsan, Malaysia. 7Cereal Partners Worldwide, Chemin du Viaduc 1. Prilly, Lausanne 1008, Switzerland. 8Nestlé Research Center, Vers chez les Blanc, 1000 Lausanne, Lausanne, Switzerland. 9Nestlé R&D Center, 2655633, 29 Quality Road, 618802 Singapore, Singapore. 10Nutrition Society of Malaysia, c/o Division of Human Nutrition, Institute for Medical Research, Kuala Lumpur, Malaysia.

Abstract Background: The consumption of beverages contributes to diet quality and overall nutrition.

Studies on malted drinks, one of the widely consumed beverage choices among children in Asia, however, have received limited attention. This study aimed to examine the prevalence of malted drink consumption and explored associations of sociodemographic characteristics, nutrient intakes, weight status and physical activity levels with malted drink consumption among primary school children in Malaysia. Methods: Data for this analysis were from the MyBreakfast Study, a national cross-sectional

study conducted from April to October 2013 throughout all regions in Malaysia. A total of 2065 primary school children aged 6 to 12 years were included in the present analysis. Data on two days 24-h dietary recall or record, anthropometry, physical activity and screen time were recorded. Associations between malted drink consumption and related factors were examined using binary logistic regression, adjusting for region, area, gender, ethnicity and household income. Results: Among children aged 6 to 12 years, 73.5 % reported consuming malted drinks for at least once per week. Consumption of malted drinks was significantly associated with region (χ2 = 45.64, p < 0.001), gender (χ2 = 4.41, p = 0.036) and ethnicity (χ2 = 13.74, p = 0.008). Malted drink consumers had similar total energy intake but higher micronutrient intakes compared to non-consumers. High physical activity level (OR = 1.77, 95 % CI = 1.06, 2.99) and lower screen time during weekends (OR = 0.93, 95 % CI = 0.86, 0.99) were independently associated with malted drink consumption among 6 to 9 year-old children, but not among 10

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to 12 year-old children. No association was observed between malted drink consumption and weight status. Conclusions: Malted drink consumption is prevalent among Malaysian primary school

children, particularly higher among boys, indigenous children and those who lived in the East Coast region of Malaysia. Consuming malted drinks is associated with higher micronutrient intakes and higher levels of physical activity, but not with body weight status. Keywords: BMI, Children, Malted drinks, Micronutrients, Physical activity, Screen time.

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Harvinder GS, Chee WSS, Karupaiah T, Sahathevan S, Chinna K, Ahmad G, Bavanandan S, Goh BL. Dialysis malnutrition and malnutrition inflammation scores: Screening tools for prediction of dialysis – related protein-energy wasting in Malaysia. Asia Pacific Journal of Clinical Nutrition, 2016; 25(1): 26-33. (SCI IF: 1.371; HI: 51; Tier: Q2).

Dialysis malnutrition and malnutrition inflammation scores: Screening tools for prediction of dialysis – related protein-energy wasting in Malaysia. Gilcharan Singh Harvinder1, Winnie Chee Siew Swee1, Tilakavati Karupaiah2, Sharmela Sahathevan2, Karuthan Chinna3,Ghazali Ahmad4, Sunita Bavanandan4, Bak Leong Goh5. 1Department of Nutrition & Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia 2Dietetics Program, Faculty of Health Sciences, National University of Malaysia, Kuala Lumpur, Malaysia 3Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 4Nephrology Department of Kuala Lumpur Hospital, Kuala Lumpur, Malaysia 5Nephrology Department of Serdang Hospital, Kuala Lumpur, Malaysia

Abstract Background and Objectives: Malnutrition is highly prevalent in Malaysian dialysis patients

and there is a need for a valid screening tool for early identification and management. This cross-sectional study aims to examine the sensitivity of the Dialysis Malnutrition Score (DMS) and Malnutrition Inflammation Score (MIS) tools in predicting protein-energy wasting (PEW) among Malaysian dialysis patients. Methods and Study Design: A total of 155 haemodialysis (HD) and 90 peritoneal dialysis

(PD) patients were screened for risk of malnutrition using DMS and MIS and comparisons were made with established guidelines by International Society of Renal Nutrition and Metabolism (ISRNM) for PEW.

Results: MIS cut-off score of ≥5 indicated presence of malnutrition in all patients. A total of

59% of HD and 83% of PD patients had PEW by ISRNM criteria. Based on DMS, 73% of HD and 71% of PD patients exhibited moderate malnutrition, whilst using MIS, 88% and 90%, respectively were malnourished. DMS and MIS correlated significantly in HD (r2=0.552, p<0.001) and PD (r2=0.466, p<0.001) patients. DMS and MIS had higher sensitivity values in PD (81% and 82%, respectively) compared to HD (59% and 60%, respectively) patients. Conclusions: The MIS cut-off scores for malnutrition classification were established (score

≥5) for use amongst Malaysian dialysis patients. Both DMS and MIS are valid tools to be

used for nutrition screening of dialysis patients especially those undergoing peritoneal dialysis. The DMS may be a more practical and simpler tool to be utilized in the Malaysian dialysis settings as it does not require laboratory markers. Keywords: protein-energy malnutrition, nutritional assessment, dialysis, Dialysis Malnutrition

Score, Malnutrition Inflammation Score.

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Hasan SS, Thiruchelvam K, Syed Imran Ahmed, Clavarino AM, Mamun AA, Kairuz T. Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes. Asian Journal of Psychiatry, 2016; 23: 56–63. (SCI IF: 1.353; HI: 13; Tier: Q2).

Psychological health and menopause-specific quality of life of Malaysian women with type 2 diabetes. Syed Shahzad Hasan1, Kaeshaelya Thiruchelvam2, Syed Imran Ahmed2, Alexandra M. Clavarino1, Abdullah A. Mamun3, Therese Kairuz4. 1The University of Queensland, 20 Cornwall Street, Woolloongabba, 4102 Queensland, Australia 2International Medical University, Jalan Jalil Perkasa 19, 57000 Bukit Jalil, Kuala Lumpur, Malaysia 3The University of Queensland, Herston Road, Herston, 4006 Queensland, Australia 4James Cook University, Angus Smith Drive, Townsville, 4811 Queensland, Australia

Abstract

Anxiety and depression are more common among females and those experiencing diabetes and menopause. Menopausal symptoms experienced by women can vary tremendously from population to population; therefore, there is a need to investigate these symptoms and associated risk factors in different communities. This study investigated the differences in psychological health and menopause-specific quality of life (MENQOL) between women with and without diabetes type 2 (T2DM) in Malaysia. Women with T2DM (n = 320) were matched by age range to controls without T2DM (n = 320). Data were collected from March 2012 to January 2013. Delusions Symptoms States Inventory (DSSI) instrument was used to identify symptoms of depression and anxiety. Women with diabetes had higher depressive (11.8% versus 8.4%) and anxiety (8.4% versus 6.6%) symptoms compared to women without diabetes. In both groups, the most common menopausal symptom was aches (muscles and joints). Women without diabetes had significantly higher scores for the sexual domain compared to women with diabetes (4.20 versus 3.21, p = 0.001). The odds that a postmenopausal woman with diabetes was depressed or anxious on the DSSI scale increased significantly when the MENQOL score on the physical, vasomotor, and psychosocial domains increased by one unit. Both diabetes and psychological problems have negative impact on MENQOL. Our findings support the view of screening postmenopausal women with diabetes for depressive and anxiety, to improve overall quality of life. Keywords: Diabetes, Type 2, Depression, Anxiety, Women.

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Ho SE, Ting JAJ, Lee LC, Wong PF. Information needs in relation to physical activity among angina patients before percutaneous coronary intervention (PCI) at a private hospital in Penang, Malaysia. Journal of Krishna Institute of Medicine Sciences University (JKIMSU),

2016; 5(4): 18-23. ISSN 2231-4261. (IF: NA).

Information needs in relation to physical activity among angina patients before percutaneous coronary intervention (PCI) at a private hospital in Penang, Malaysia. Ho Siew Eng1, Jessica Ting Ai Jin1, Lee Li Ching2, Wong Pak Fong1. 1Nursing Division, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia, 2Cardiologist, Private Hospital, Penang, Malaysia

Abstract Background: Episodes experienced by angina patients are potentially frightening and life

threatening. Angina patients lack awareness regarding Percutaneous Coronary Intervention (PCI) as a prognostic benefit. Aim and Objectives: To identify the information needs in relation to physical activity among

angina patients before PCI at a private hospital in Penang, Malaysia. Material and Methods: A cross-sectional study was conducted from April to July 2016; 150

respondents who fulfilled the inclusion criteria were recruited. A 16-item questionnaire related to physical limitations was adapted and modified from Seattle Angina Questionnaire (SAQ). Results: The findings reported that majority of respondents (103; 69%) possessed more than

one co-morbidity, while 47 respondents (31%) single co-morbidity. Those with secondary level education showed (M=15.98, SD±6.14) while tertiary level education reported (M=16.61, SD±6.11), with no significant difference (t= -0.623, p= 0.534) between respondents' education level and physical activity. In terms of occupation, employed (M=15.58, SD±6.42) and unemployed (M=17.31, SD±5.52) also reported significant difference with (t= -1.70, p= 0.04). There was likewise a significant difference between respondents with single co-morbidity (M=18.09, SD±6.88) and multiple co-morbidity (M=15.46, SD±5.58) with (t= 2.475, p= 0.01). However, there was no significant difference between respondents with previous admission and physical activity (t= 0.868, p=0.387), as well as respondents' age group with physical activity (t=-0.675, p= 0.501). Conclusion: In conclusion, respondents' information needs regarding PCI are significantly associated with occupation and co-morbidity towards physical activity before PCI. Age, educational level and previous admission did not have any effect on respondents' physical activity before PCI. Keywords: Information Needs, Angina, Patient, Physical Activity, Percutaneous Coronary Intervention.

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Iezhitsa I, Agarwal R, Saad SD, Zakaria FK, Agarwal P, Krasilnikova A, Rahman TH, Rozali KN, Spasov A, Ozerov A, Alyautdin R, Ismail NM. Mechanism of the anticataract effect of liposomal MgT in galactose-fed rats. Molecular Vision, 2016; 22: 734-47. (ISI IF: 2.11; SCI IF:

2.106; HI: 70; Tier: Q1).

Mechanism of the anticataract effect of liposomal MgT in galactose-fed rats. Igor Iezhitsa1,2,3, Renu Agarwal1,2, Sarah Diyana Bt Saad1, Fatin Kamilah Bt Zakaria1, Puneet Agarwal4, Anna Krasilnikova1,2, Thuhairah Hasrah Abdul Rahman1, Khairul Nizam Bin Rozali1, Alexander Spasov3, Alexander Ozerov3, Renad Alyautdin5, Nafeeza Mohd Ismail1,2. 1Center for Neuroscience Research, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Jalan Hospital, Sungai Buloh, Selangor Darul Ehsan, Selangor, Malaysia 2Universiti Teknologi MARA, RIG “Molecular Pharmacology and Advanced Therapeutics,” Pharmaceutical & Life Sciences (PLS) Communities of Research (CoRe), Shah Alam, Selangor Darul Ehsan, Malaysia 3Volgograd State Medical University, Research Institute of Pharmacology, 1 Pavshikh Bortsov sq., Volgograd, Russian Federation 4International Medical University, IMU Clinical School, Department of Ophthalmology, Jalan Rasah, Seremban, Malaysia 5Scientific Centre for Expertise of Medical Application Products, Ministry of Health, Russian Federation.

Abstract Purpose: Increased lenticular oxidative stress and altered calcium/magnesium (Ca/Mg) homeostasis underlie cataractogenesis. We developed a liposomal formulation of magnesium taurate (MgT) and studied its effects on Ca/Mg homeostasis and lenticular oxidative and nitrosative stress in galactose-fed rats. Methods: The galactose-fed rats were topically treated with liposomal MgT (LMgT), liposomal

taurine (LTau), or corresponding vehicles twice daily for 28 days with weekly anterior segment imaging. At the end of the experimental period, the lenses were removed and subjected to analysis for oxidative and nitrosative stress, Ca and Mg levels, ATP content, Ca2+-ATPase, Na+,K+-ATPase, and calpain II activities. Results: The LTau and LMgT groups showed significantly lower opacity index values at all

time points compared to the corresponding vehicle groups (p<0.001). However, the opacity index in the LMgT group was lower than that in the LTau group (p<0.05). Significantly reduced oxidative and nitrosative stress was observed in the LTau and LMgT groups. The lens Ca/Mg ratio in LMgT group was decreased by 1.15 times compared to that in the LVh group. Calpain II activity in the LMgT group was decreased by 13% compared to the LVh group. The ATP level and Na+,K+-ATPase and Ca2+-ATPase activities were significantly increased in the LMgT group compared to the LVh group (p<0.05). Conclusions: Topical liposomal MgT delays cataractogenesis in galactose-fed rats by maintaining the lens mineral homeostasis and reducing lenticular oxidative and nitrosative stress.

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Ingle PV, Patil SD, Sharma SA, Patil PH, Surana SJ. A prospective study on adverse drug reactions from pegylated interferon alfa-2a and alfa-2b in combination with ribavirin in hepatitis B and C. Journal of Pharmaceutical Research and Clinical Practice, 2016; 6(1): 1-6. (ISI IF:

3.8).

A prospective study on adverse drug reactions from pegylated interferon alfa-2a and alfa-2b in combination with ribavirin in hepatitis B and C. P. V. Ingle1, S. D. Patil2, S. A. Sharma3, P. H. Patil3, S. J. Surana3. 1International Medical University, School of Pharmacy, Department of Pharmacy Practice, Kuala Lumpur, Malaysia. 2H. R. Patel Institute of Pharmaceutical Education & Research, Department of Pharmacology, Shirpur-425405, Dhule, Maharashtra, India. 3R. C. Patel Institute of Pharmaceutical Education & Research, Shirpur-425405, Dhule, Maharashtra, India.

Abstract Background: The recommended treatment for patients infected with hepatitis B or C infection is pegylated interferon (peg interferon) and ribavirin for 24 or 48 weeks. Two pegylated formulations was studied in the present study for the treatment of hepatitis C: PEG-IFN-α 2a, with a molecular weight of 40 kDa, and PEG-IFN-α 2b, with a molecular weight of 12 kDa. Objective: To investigate the adverse drug reactions from pegylated interferon Alfa- 2a and

pegylated interferon Alfa- 2b in combination with ribavirin in patients infected with the hepatitis B virus and hepatitis C virus. Materials and Methods: A Prospective, observational, pharmacoviglance study was

conducted in the gastroenterology and hepatology department of an Indian hospital. A total of 42 patients were treated for hepatitis B and hepatitis C infection. During the 1-year period of hepatitis B and hepatitis C therapy visits, all the patients were interviewed for all the adverse drug reactions and their use of drugs. Results: The constitutional, gastrointestinal and hematological ADRs were more frequent as

compared to psychiatric, dermatological and adverse drug reactions related to the respiratory tract. The adverse drug reactions were not assessed as serious for withdrawing the medication, dosage reductions were not required for any patient and seemed less frequent than that required in clinical trials. Compared with the results of clinical trials, lower frequencies of ADR’s were detected. Conclusion: Treatment with pegylated interferon in combination with ribavirin is the mainstay

of the therapy with less frequent adverse drug reactions and high response rate in Indian patients. Keywords: Hepatitis B, hepatitis C, pegylated interferon alfa 2a, pegylated interferon alfa 2b, ribavirin.

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Ingle PV, Samsudin SZ, Chan PQ, Ng MK, Heng LX, Yap SC, Chai AS, Wong AS. Development and novel therapeutics in hepatocellular carcinoma: A review. Therapeutics and Clinical Risk Management, 2016; 12: 445-455. (ISI IF: 1.903; SCI IF: 2.286; HI: 31; Tier: Q1).

Development and novel therapeutics in hepatocellular carcinoma: A review. Pravinkumar Vishwanath Ingle, Sarah Zakiah Samsudin, Pei Qi Chan, Mei Kei Ng, Li Xuan Heng, Siu Ching Yap, Amy Siaw Hui Chai, Audrey San Ying Wong. Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia

Abstract

This review summarizes the epidemiological trend, risk factors, prevention strategies such as vaccination, staging, current novel therapeutics, including the drugs under clinical trials, and future therapeutic trends for hepatocellular carcinoma (HCC). As HCC is the third most common cause of cancer-related death worldwide, its overall incidence remains alarmingly high in the developing world and is steadily rising across most of the developed and developing world. Over the past 15 years, the incidence of HCC has more than doubled and it increases with advancing age. Chronic infection with hepatitis B virus is the leading cause of HCC, closely followed by infection with hepatitis C virus. Other factors contributing to the development of HCC include alcohol abuse, tobacco smoking, and metabolic syndrome (including obesity, diabetes, and fatty liver disease). Treatment options have improved in the past few years, particularly with the approval of several molecular-targeted therapies. The researchers are actively pursuing novel therapeutic targets as well as predictive biomarker for treatment of HCC. Advances are being made in understanding the mechanisms underlying HCC, which in turn could lead to novel therapeutics. Nevertheless, there are many emerging agents still under clinical trials and yet to show promising results. Hence, future therapeutic options may include different combination of novel therapeutic interventions. Keywords: hepatocellular carcinoma, HCC, novel therapeutics, treatment, management,

molecular targeted therapies, clinical drug trial.

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Jafri AJA, Arfuzir NNN, Lambuk L, Iezhitsa I, Agarwal R, Agarwal P, Razali N, Krasilnikova A, Kharitonova M, Demidov V, Serebryansky E, Skalny A, Spasov A, Yusof APM, Ismail NM. Protective effect of magnesium acetyltaurate against NMDA-induced retinal damage involves restoration of minerals and trace elements homeostasis. Journal of Trace Elements in Medicine and Biology, 2016; 39: 147-154. doi: 10.1016/j.jtemb.2016.09.005. (ISI IF: 2.55; SCI

IF: 2.196; HI: 49; Tier: Q3).

Protective effect of magnesium acetyltaurate against NMDA-induced retinal damage involves restoration of minerals and trace elements homeostasis. Azliana Jusnida Ahmad Jafri1, Natasha Najwa Nor Arfuzir1, Lidawani Lambuk1, Igor Iezhitsa1,2, Renu Agarwal1, Puneet Agarwal3, Norhafiza Razali1, Anna Krasilnikova1, Maria Kharitonova2,4, Vasily Demidov5, Evgeny Serebryansky5, Anatoly Skalny5,6,7, Alexander Spasov2, Ahmad Pauzi Md. Yusof1, Nafeeza Mohd Ismail1. 1Center for Neuroscience Research, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh Campus, Selangor, Malaysia 2Volgograd State Medical University, Research Institute of Pharmacology, Volgograd, Russia 3International Medical University, IMU Clinical School, Seremban, Malaysia 4Institute of Pharmacy, Department of Pharmacology and Toxicology, University of Innsbruck, Center for Chemistry and Biomedicine, Innrain 80 − 82/III,A-6020, Innsbruck, Austria 5Russian Society of Trace Elements in Medicine, 46 Zemlyanoy Val str., Moscow, 105064, Russia 6Peoples’ Friendship University of Russia, Moscow, Russia 7All-Russian Research Institute of Medicinal and Aromatic Plants, Moscow, Russia

Abstract Glutamate-mediated excitotoxicity involving N-methyl-d-aspartate (NMDA) receptors has been recognized as a final common outcome in pathological conditions involving death of retinal ganglion cells (RGCs). Overstimulation of NMDA receptors results in influx of calcium (Ca) and sodium (Na) ions and efflux of potassium (K). NMDA receptors are blocked by magnesium (Mg). Such changes due to NMDA overstimulation are also associated with not only the altered levels of minerals but also that of trace elements and redox status. Both the decreased and elevated levels of trace elements such asiron (Fe), zinc (Zn), copper (Cu) affect NMDA receptor excitability and redox status. Manganese (Mn), and selenium (Se) are also part of antioxidant defense mechanisms in retina. Additionally endogenous substances such as taurine also affect NMDA receptor activity and retinal redox status. Therefore, the aim of this study was to evaluate the effect of Mg acetyltaurate (MgAT) on the retinal mineral and trace element concentration, oxidative stress, retinal morphology and retinal cell apoptosis in rats after-NMDA exposure. One group of Sprague Dawley rats received intravitreal injection of vehicle while 4 other groups similarly received NMDA (160 nmol L−1). Among the NMDA injected groups, 3 groups also received MgAT (320 nmol L−1) as pre-treatment, co-treatment or post-treatment. Seven days after intravitreal injection, rats were sacrificed, eyes were enucleated and retinae were isolated for estimation of mineral (Ca, Na, K, Mg) and trace element (Mn, Cu, Fe, Se, Zn) concentration using Inductively Coupled Plasma (DRC ICP-MS) techniques (NexION 300D), retinal oxidative stress using Elisa, retinal morphology using H&E staining and retinal cell apoptosis using terminal deoxynucleotidyltransferase dUTP nick-end labeling (TUNEL). Intravitreal NMDA injection resulted in increased concentration of Ca (4.6 times, p < 0.0001), Mg (1.5 times, p < 0.01), Na (3 times, p < 0.0001) and K (2.3times, p < 0.0001) compared to vehicle injected group. This was accompanied with significant increase of Ca/Mg and Na/K ratios, 3 and 1.27 times respectively, compared to control group. The trace elements such as Cu, Fe and Zn also showed a significant increase amounting to 3.3 (p < 0.001), 2.3(p < 0.0001) and 3 (p < 0.0001) times respectively compared to control group. Se was increased by 60% (p < 0.005). Pre-treatment with MgAT abolished effect of NMDA on minerals and trace elements more effectively than co- and post-treatment. Similar

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observations were made for retinal oxidative stress, retinal morphology and retinal cell apoptosis. In conclusion, current study demonstrated the protective effect of MgAT against NMDA-induced oxidative stress and retinal cell apoptosis. This effect of MgAT was associated with restoration of retinal concentrations of minerals and trace elements. Further studies are warranted to explore the precise molecular targets of MgAT. Nevertheless, MgAT seems a potential candidate in the management of diseases involving NMDA-induced excitotoxicity. Keywords: N-methyl-d-aspartate (NMDA), Excitotoxicity, Retina, Ganglion cell layer (GCL), Magnesium acetyltaurate (MgAT), Minerals, Calcium (Ca), Magnesium (Mg), Potassium (K), Sodium (Na), Trace elements, Iron (Fe), Zinc (Zn), Copper (Cu), Manganese (Mn), Selenium (Se), Inductively coupled plasma-mass spectrometry (ICP-MS).

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Janvier A, Lantos J, Aschner J, Barrington K, Batton B, Batton D, Berg SF, Carter B, Campbell D, Cohn F, Lyerly AD, Ellsbury D, Fanaroff A, Fanaroff J, Fanaroff K, Gravel S, Haward M, Kutzsche S, Marlow N, Montello M, Maitre N, Morris JT, Paulsen OG, Prentice T, Spitzer AR. Stronger and more vulnerable: A balanced view of the impacts of the NICU experience on parents. Pediatrics, 2016; doi: 10.1542/peds.2016-0655. (ISI IF: 3.890; SCI IF: 5.179; HI: 263;

Tier: Q1).

Stronger and more vulnerable: A balanced view of the impacts of the NICU experience on parents. Annie Janvier1, John Lantos2, Judy Aschner3, Keith Barrington1, Beau Batton4, Daniel Batton4, Siri Fuglem Berg5, Brian Carter2, Deborah Campbell3, Felicia Cohn6, Anne Drapkin Lyerly7, Dan Ellsbury8, Avroy Fanaroff9, Jonathan Fanaroff9, Kristy Fanaroff9, Sophie Gravel1, Marlyse Haward10, Stefan Kutzsche11, Neil Marlow12, Martha Montello13, Nathalie Maitre14, Joshua T. Morris15, Odd G. Paulsen16, Trisha Prentice17, Alan R. Spitzer8. 1Department of Pediatrics, Hôpital Saint-Justine, Montréal, Quebec, Canada 2Children’s Mercy Hospital, Kansas City, Missouri 3Albert Einstein College of Medicine, The Children’s Hospital at Montefiore, New York, New York 4Department of Pediatrics, Southern Illinois University School of Medicine, Springfield, Illinois 5Municipality of Gjovik, and Innlandet Hospital Trust, Hamar, Norway 6Bioethics, Kaiser Permanente, Oakland, California 7Center for Bioethics and Department of Social Medicine, University of North Carolina, Chapel Hill, North Carolina 8Pediatrix Medical Group, Mednax, Inc, Sunrise, Florida 9Division of Neonatology 10Department of Pediatrics, Case Western Reserve University, Rainbow Babies and Children’s Hospital, Cleveland, Ohio 11International Medical University, Kuala Lumpur, Malaysia 12UCL EGA Institute for Women’s Health, University College London, London, United Kingdom 13Center for Bioethics, Harvard Medical School, Boston, Massachusetts 14Department of Pediatrics, Center for Perinatal Research, Nationwide Children’s Hospital and Ohio State University, Columbus, Ohio 15Pediatrics, Miller Children’s and Women’s Hospital Long Beach, Long Beach, California 16Department of Anesthesiology, Innlandet Hospital Trust, Hamar, Norway 17Pediatrics, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia

Abstract For parents, the experience of having an infant in the NICU is often psychologically traumatic. No parent can be fully prepared for the extreme stress and range of emotions of caring for a critically ill newborn. As health care providers familiar with the NICU, we thought that we understood the impact of the NICU on parents. But we were not prepared to see the children in our own families as NICU patients. Here are some of the lessons our NICU experience has taught us. We offer these lessons in the hope of helping health professionals consider a balanced view of the NICU’s impact on families.

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Jayaraman J, Roberts GJ. Demirjian's method is unsuitable for dental age estimation. Forensic Science, Medicine, and Pathology, 2016; 12(4): 532-533. DOI: 10.1007/s12024-016-9811-z. (ISI IF: 1.896; SCI IF: 1.209; HI: 20; Tier: Q2).

Demirjian's method is unsuitable for dental age estimation. Jayakumar Jayaraman1, Graham Roberts2. 1School of Dentistry, International Medical University, 57000 Bukit Jalil, Kuala Lumpur, Malaysia 2Department of Orthodontics, King’s College London Dental Institute, 22/F Guys Tower, London SE1 9RT, UK

Abstract

We read the article titled ‘‘Is Demirjian’s original method really useful for age estimation in a forensic context?’’ published in your journal [1]. We find that the study is well conducted but the title of this study is misleading. From the title it looked like the study had tested the Demirjian’s method on different population groups or that the authors had undertaken a review of the literature on the existing studies on Demirjian’s method, but the aim of the study was to assess the reliability of Demirjian’s method on a sample of Portuguese children. This is not reflected in the title. This study concluded that the method overestimated the age of both Portuguese boys and girls. While this study adds important information to the existing literature on the application of Demirjian’s method, the findings in this study are not a new; an earlier study on the Portuguese population also reported overestimation of age in both genders [2]. The use of Demirjian’s method has been questioned over several years as published studies in different population groups have consistently reported overestimation of age. The appropriate way to assess population differences is by applying Demirjian’s method on different population groups with stringent data collection and analysis taking into account of several factors in age estimation including number, age, and gender of the samples included in the analysis. Another approach is to conduct a systematic review of the literature on the studies that used Demirjian’s method. Both of these procedures have already been carried out. A study by Liversidge found group differences in the estimated age when using the Demirjian method on subject data from Europe, Middle East, Africa, India, China, and South America. The study concluded that Demirjian’s dental maturity method is inappropriate to assess population differences in dental maturity [3]. The first systematic review and meta-analysis on the studies that utilized Demirjian’s method was published by the DARLInG team in early 2013. We identified 34 studies from 22 countries that satisfied the inclusion criteria and found that Demirjian’s method on average overestimated the age by 6 months, sometimes up to 3 years [4]. Following this, another systematic review was published in the same year, which also reported a similar outcome. We later found that their review had several errors including the selection of articles and misinterpretation of data that had been subsequently published as comments to the article [5]. The use of Demirjian’s method for dental age estimation has always been problematic and several investigators have had difficulty in interpreting their data. The overestimation of age is just the beginning of the issues associated with this method. The most important area is that the statistical approach utilized to derive maturity scores is not understood. It is clear that the method is not designed to estimate dental age, which Demirjian and co-workers clearly mention in their original paper. They also warned about the existence of population differences in dental maturity [6]. Despite these warnings, the use of the method continues in different populations; the most recent was on a Tunisian population published in early 2016 [7]. There are several factors that determine the accuracy of the estimated age. While it has been shown physiological maturity differs with age, gender, and ethnicity, the additional influences of secular trend, socio-economic status, and nutritional changes are yet to be fully explored. We agree with the authors that the Demirjian’s dental maturity data cannot be used to estimate age and this practice should be totally abandoned.

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We have contacted Prof. Arto Demirjian and Prof. Harvey Goldstein, authors of the original study, to gain insight into the statistical approach used in their study to be able to conduct a detailed analysis of the Demirjian method and the reason why it is no longer suitable. This will be published as a separate paper.

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Jayaraman J, Wong HM, King NM, Roberts GJ. Development of a Reference Data Set (RDS) for dental age estimation (DAE) and testing of this with a separate Validation Set (VS) in a southern Chinese population. Journal of Forensic and Legal Medicine, 2016; 43: 26-33. (ISI

IF: 0.870; SCI IF: 1.003; HI: 31; Tier: Q1).

Development of a Reference Data Set (RDS) for dental age estimation (DAE) and testing of this with a separate Validation Set (VS) in a southern Chinese population. Jayakumar Jayaraman1, Hai Ming Wong2, Nigel M. King3, Graham J. Roberts4. 1Department of Pediatric Dentistry, School of Dentistry, International Medical University, Kuala Lumpur 57000, Malaysia 2Paediatric Dentistry & Orthodontics, Faculty of Dentistry, University of Hong Kong, Hong Kong 3Department of Paediatric Dentistry, School of Dentistry, University of Western Australia, Perth, WA 6009, Australia 4Department of Orthodontics, Floor 22, Tower Wing, St Thomas Street, King's College Dental Institute, London SE1 9RT, United Kingdom

Abstract Background: Many countries have recently experienced a rapid increase in the demand for

forensic age estimates of unaccompanied minors. Hong Kong is a major tourist and business center where there has been an increase in the number of people intercepted with false travel documents. An accurate estimation of age is only possible when a dataset for age estimation that has been derived from the corresponding ethnic population. Thus, the aim of this study was to develop and validate a Reference Data Set (RDS) for dental age estimation for southern Chinese. Materials and methods: A total of 2306 subjects were selected from the patient archives of a large dental hospital and the chronological age for each subject was recorded. This age was assigned to each specific stage of dental development for each tooth to create a RDS. To validate this RDS, a further 484 subjects were randomly chosen from the patient archives and their dental age was assessed based on the scores from the RDS. Dental age was estimated using meta-analysis command corresponding to random effects statistical model. Chronological age (CA) and Dental Age (DA) were compared using the paired t-test. Results: The overall difference between the chronological and dental age (CA-DA) was 0.05

years (2.6 weeks) for males and 0.03 years (1.6 weeks) for females. The paired t-test indicated that there was no statistically significant difference between the chronological and dental age (p > 0.05). Conclusion: The validated southern Chinese reference dataset based on dental maturation accurately estimated the chronological age. Keywords: Dental maturity, Dental age, Age estimation, Southern Chinese, Reference Data Set.

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Kadam A, Patil SK, Patil S, Tumkur A. Pharmaceutical waste management - An Overview. Indian Journal of Pharmacy Practice, 2016; 9(1): 2-8. (IF: NA).

Pharmaceutical waste management - An Overview. Atul Kadam1, Shitalkumar Patil1, Sachin Patil1, Anil Tumkur2. 1Department of Pharmaceutics, Ashokrao Mane College of Pharmacy, Peth Vadgaon, Kolhapur, INDIA. 2Department of Pharmacy Practice, International Medical University, Kuala Lumpur, MALAYSIA.

Abstract Introduction: Medication disposal is an alarming issue today and gaining more and more

awareness from the healthcare professionals as well as consumers. Pharmacists have the potential to be on the forefront of this movement as a healthcare professionals and pharmacists are in an admirable position to educate patients about safe drug disposal. Proper patient counselling on safe medication disposal can make a significant difference to public health and the environment. The knowledge on method of disposal of unused medicines is equally important as that of consumption of medicines. Objective: This article aims to provide a background, the importance and significance of proper medication disposal, describe the correct methods to dispose of unwanted and expired medications. Method: The information about methods of proper disposal as well as consequence of

improper disposal was collected by extensive literature survey of all available resources. Conclusion: Till date, researchers have acknowledged many human and veterinary pharmaceutical compounds at serious concentrations in drinking water resources and they are a major contributor to environmental pollution. Emphasis is also given on pharmacist role in proper disposal of unwanted and expired medicine makes a significant impact on the environment as well as it prevents accident, poisoning and intentional violence. So it will lead to the welfare of society and trudge towards goal of 2020 health for all. Keywords: Pharmaceutical Waste Management, Medication disposal, Patient education,

Pollution.

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Kademane K, Karikalan B. Micronucleus – Applications in non-communicable diseases. International Journal of Innovative and Applied Research, 2016; 4(4): 32-7. (ISI IF: 2.845).

Micronucleus – Applications in non-communicable diseases. Dr. Kumaraswamy Kademane1 and Dr. Barani Karikalan2. 1Department of Pathology, International Medical University, Malaysia. 2Department of Pathology, Mahsa University, Malaysia.

Abstract

Micronuclei (MN) are directly related to genetic damage caused by various reasons and involved in pathogenesis of many diseases. MN assay can be utilized in many settings like to evaluate association of a risk factor, to understand pathological mechanism, to estimate susceptibility of the disease occurrence, to estimate prognosis of the disease, to predict the occurrence of complications related to the disease, to test newer treatment options and to compare different treatment modalities for the disease. With the said knowledge, diseases can be managed more effectively. This review gives a brief idea on how MN levels can be used in the management of various non-communicable diseases like diabetes, cardiovascular diseases, neurological diseases, chronic obstructive pulmonary diseases, chronic kidney diseases and immunological diseases. Keywords: Micronucleus, non-communicable diseases, genetic damage.

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Kannan MM. Knowledge, attitude, and practice of people toward epilepsy in a South Indian village. Journal of Neurosciences in Rural Practice, 2016; 7(3): 339–340. (SCI IF: 0.761; HI: 10; Tier: Q3).

Knowledge, attitude, and practice of people toward epilepsy in a South Indian village. Mari Kannan Maharajan. Department of Pharmacy Practice, School of Pharmacy, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.

Abstract

Epilepsy, a common central nervous system disorder, affects people of all ages worldwide. Epilepsy related stigma and discrimination by the society make patients susceptible to psychopathology[1] and affect their quality of life. The social discrimination and disease related stigma are often more difficult to overcome than the seizures themselves.[2] In addition to this, drug related complications of epilepsy also increase the disease burden. To improve the self efficacy of the epileptic patients, they should be educated about their condition which consequently may improve their perceived stigma and anxiety related to epilepsy.[3] The association between knowledge of epilepsy and depressive is a well-known concept. In this regard, the finding of the present study is important to emphasize the demand for knowledge of epilepsy to manage disease associated stigma. The outcome of this research may be useful to formulate tailor made educational programs for the rural population. The lower level of knowledge in the rural population is alarming and indicating the need of awareness campaigns to change the perception of rural population about epilepsy. Health education projects oriented toward the management of epilepsy should be focused. Considering the size of the population of this study, it may be prudent to conduct further research on the knowledge, attitude, and practice of the rural population on epilepsy management in a broader spectrum. Such an analysis would help identify the significance of the differences in knowledge of the population and helped to design a better educational program. It would also help identify what information can be best placed to maximize their knowledge. The cross-sectional study design did not establish whether greater knowledge about epilepsy acts to improve depression in the study population. Although the purpose of the questionnaire permits quantitative evaluation, some open-ended questions would have permitted the respondents to mention some free comment and the data might have led to some qualitative insight into the responses.[4] Special consideration should be taken in generalizing the study findings to the general population because the sample cohort was recruited non-randomly and mostly from one particular place. The future works on this theme may include focusing group discussions to further explore the perceptions and attitudes of the study population. It may give the study population the opportunity to express themselves. The public misunderstandings of epilepsy may be partially because it is unlikely to be an everyday topic of daily conversation or media coverage among non-medical personnel, especially in the rural setup. Overall, this study sheds some light on the deficiency in knowledge, attitudes, and misconceptions of rural population about epilepsy which may deserve attention when planning health educational campaigns.

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Kasi R, Ng KY, Koh RY, Gnanajothy P, and Chye SM. para-Phenylenediamine induces apoptosis through activation of reactive oxygen species-mediated mitochondrial pathway, and inhibition of the NF-κB, mTOR, and Wnt pathways in human urothelial cells. Environmental Toxicology, 2016; 32(1): 265-277. DOI: 10.1002/tox.22233. (ISI IF: 2.868; SCI IF: 2.191; HI:

54; Tier: Q2).

para-Phenylenediamine induces apoptosis through activation of reactive oxygen species-mediated mitochondrial pathway, and inhibition of the NF-κB, mTOR, and Wnt pathways in human urothelial cells. Reena K1, Ng KY2, Koh RY1, Gnanajothy P1, Chye SM1. 1Department of Human Biology, School of Medicine, International Medical University, Kuala Lumpur, 57000, Malaysia. 2Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, 47500, Malaysia.

Abstract

para-Phenylenediamine (PPD) has long been used in two-thirds of permanent oxidative hair dye formulations. Epidemiological studies and in vivo studies have shown that hair dye is a suspected carcinogen of bladder cancer. However, the toxicity effects of PPD to human bladder remains elusive. In this study, the effects of PPD and its involvement in the apoptosis pathways in human urothelial cells (UROtsa) was investigated. It was demonstrated that PPD decreased cell viability and increased the number of subG1 hypodiploid cells in UROtsa cells. Cell death due to apoptosis was detected using Annexin V binding assay. Further analysis showed PPD generated reactive oxygen species (ROS), induced mitochondrial dysfunction through the loss of mitochondrial membrane potential and increased caspase-3 level in UROtsa cells. Western blot analysis of PPD-treated UROtsa cells showed down-regulation of phosphorylated proteins from NF-κB, mTOR, and Wnt pathways. In conclusion, PPD induced apoptosis via activation of ROS-mediated mitochondrial pathway, and possibly through inhibition of NF-κB, mTOR, and Wnt pathways. Keywords: NFκB, apoptosis, human urothelial cells, mTOR, paraphenylenediamine.

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Khajotia RR, Sree Raman K. Managing severe COPD: Addressing the challenges with latest trends and treatment options (Part I: Pharmacological Management). Journal of Clinical Respiratory Diseases and Care, 2016; 2(3): 118. doi:10.4172/2472-1247.1000118. (IF: NA).

Managing severe COPD: Addressing the challenges with latest trends and treatment options (Part I: Pharmacological Management). Khajotia RR1 and Sree Raman K2. 1Department of Internal Medicine and Pulmonology, International Medical University, Seremban, Malaysia 2Hospital Tuanku Ja’afar, Seremban, Malaysia

Abstract

Managing severe (GOLD 3 and GOLD 4) COPD requires patience and tenacity, both on the part of the patient and the treating physician. Though not an easy task, a thorough understanding by the discerning physician of the latest diagnostic and treatment options available, prognosis and expected quality of life (which is essentially individualized for each patient), goes a long way in the meaningful management of such patients. Essentially, management of severe COPD involves monitoring the disease process closely, reducing existing risk factors such as smoking and occupational exposure (dusts, irritants, toxic vapours and fumes), managing the patient while he is in a stable or baseline state, preventing and treating complications, and managing acute exacerbations, as and when they occur. Besides medical management, an ongoing programme in pulmonary rehabilitation is also critically important in improving the patient’s effort tolerance and lung functions, thereby reducing symptoms and improving the overall quality of life. Finally, end-of-life decision making and advanced directives are critically important, both to the patient and the treating physician, in the final stages of the disease process.

In this review article we have detailed the various treatment options available for patients with severe COPD, and the clinical challenges commonly encountered during the course of management. Keywords: Severe COPD, Chronic bronchitis, Emphysema, Long-term oxygen therapy, Non-

invasive ventilation (NIV), Invasive mechanical ventilation, Pulmonary rehabilitation.

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Khajotia RR. A middle-aged man with right-sided chest pain, hemoptysis and weight loss. Journal of Clinical Respiratory Diseases and Care, 2016; 2(2): i002. doi:10.4172/2472- 1247.1000i002. (IF: NA).

A middle-aged man with right-sided chest pain, hemoptysis and weight loss. Khajotia RR. Internal Medicine and Pulmonology, International Medical University, Seremban, Malaysia

Abstract

A 50-year-old man, chronic smoker, smoking 20 cigarettes per day for the last 30 years, presents to the pulmonary out-patient department with complaints of right-sided chest pain accompanied by tenderness over the right chest wall and occasional hemoptysis, since the past 4 months. The chest pain disturbs his sleep and he now requires increasing doses of pain killers in order to combat the pain. He has lost 20 kgs weight over the last 4 months. On examination, the right hemithorax is significantly tender on palpation, and moves less with respiration as compared to the left side. A swelling is noticed in the right supraclavicular region which is hard, non-tender and fixed to the underlying structures. The trachea is shifted to the left side. There is a dull note on percussion over the right 1st to 5th intercostal spaces, while the left side is normal. On auscultation, air entry is diminished over the right hemithorax with bronchial breath sounds in the right 4th and 5th intercostal spaces. Normal vesicular breath sounds are heard over the left hemithorax.

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Khanum R, Qureshi MJ, Mohandas K. Antibiofilm potential of meropenem-loaded poly(ɛ-caprolactone) nanoparticles against Klebsiella pneumoniae. International Journal of Pharmaceutical and Clinical Research, 2016; 8(9): 1343-1350. [IMU Internal Grant for MSc

candidature - IMU 241/2011]. (ISI IF: 1.668; SCI IF: 0.165; HI: 4; Tier: Q4).

Antibiofilm potential of meropenem-loaded poly(ɛ-caprolactone) nanoparticles against Klebsiella pneumoniae. Khanum R1, Qureshi M J2, Mohandas K3. 1School of Postgraduate Studies, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia. 2Faculty of Pharmacy, MAHSA University, Jalan SP 2, Bandar Saujana Putra, 42610 Jenjarom, Selangor, Malaysia. 3Department of Microbiology, Faculty of Medicine, MAHSA University College, Jalan Elmu, Off Jalan University, 59100, Kuala Lumpur, Malaysia.

Abstract Colonisation of Klebsiella pneumoniae (K. pneumoniae) biofilms on biotic and abiotic surfaces are difficult to treat with traditional methods, prompting investigations on novel treatment strategies. Drug delivery systems show potential for use in biofilm treatment and poly(ɛ-caprolactone) is a polymer emerging as an effective carrier in drug release technology. This study is aimed to synthesise polymeric nanoparticles incorporating meropenem, for investigation against K. pneumoniae biofilms and as a coating over central venous catheters.

Meropenem-loaded poly(ɛ-caprolactone) (PCL) nanoparticles were prepared using a modified nanoprecipitation method. Their physical properties and drug incorporation activities were characterised. Planktonic cells and biofilms of K. pneumoniae were treated with meropenem

at concentrations corresponding to release profiles of the PCL nanoparticles. Central venous catheter pieces were coated with the nanoparticles and evaluated against K. pneumoniae. Meropenem nanoparticles had negatively charged surfaces and measured 170 - 330 nm. Transmission Electron Microscopy and X-ray diffraction analysis demonstrated spherical and crystalline nanoparticles respectively. The nanoparticles had entrapment efficiencies of 55 - 75% and drug loading percentages of 3 - 4%. In our bioassays, meropenem was released from the PCL nanoparticles at varied concentrations for 7 days. Released meropenem was 100% effective against planktonic cells of K. pneumoniae whilst concentrations higher than

28.6 mg/L were effective against biofilms of the same bacterium. Catheters coated with meropenem-loaded nanoparticles inhibited bacterial growth for 24 hours. As such, we conclude that meropenem-loaded PCL nanoparticles are effective in killing K. pneumoniae

planktonic cells and show antibiofilm potential against the bacterium. Keywords: Meropenem, poly(ɛ-caprolactone) nanoparticles, Klebsiella pneumoniae, biofilms, central venous catheter.

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Kheirandish A, Motlagh F, Shafiabady N, Dahari M. Dynamic modelling of PEM fuel cell of power electric bicycle system. International Journal of Hydrogen Energy, 2016; 41(22): 9227-9718. (ISI IF: 3.205; SCI IF: 3.311; HI: 146; Tier: Q1).

Dynamic modelling of PEM fuel cell of power electric bicycle system. Azadeh Kheirandish1, Farid Motlagh2, Niusha Shafiabady3, Mahidzal Dahari1. 1Department of Mechanical Engineering, Faculty of Engineering, University Malaya, Kuala Lumpur, 50603, Malaysia 2Department of Biomedical Engineering, Faculty of Engineering, University Malaya, Kuala Lumpur, 50603, Malaysia 3Faculty of Medicine and Health Sciences, International Medical University, 57000, Malaysia

Abstract Fuel cells eliminate pollution caused by burning fossil fuels; hence, a proton exchange membrane fuel cell (PEMFC) is one of the promising technological advances for the future of the transportation industry. The key existing challenges for fuel cell commercialization are performance, design and vehicle efficiency. Since the analytical model expressing fuel cells' characteristics is not accurate in comparison with the real system's performance a robust and dynamic model for fuel cells is of great importance. This study aims to introduce an optimized model for PEMFC using an electric bicycle that consists of a 250 W fuel cell, battery pack, DC/DC convertor, electric motor and electric control unit (ECU). In the first phase of this multifold study, the analytical model of PEMFC's efficiency has been compared with the experimental results obtained from the electric bicycle. The result of this phase showed an overall system efficiency of 35.4% and a maximum fuel cell efficiency of 63%. This confirms that fuel cell performance is least efficient when functioning under maximum output power conditions. In the second phase of this research, the collected data was used for developing linear and nonlinear regression models. The resulting model was compared with an artificial neural network used for the same purpose, and their prediction efficiencies compared. Results show that neural network modelling improves accuracy and provides promising performance for the electric bicycle system. Keywords: Modelling, Proton exchange membrane fuel cell, Regression models, Artificial

neural networks.

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Kheirandish A, Shafiabady N, Dahari M, Isa D. Modelling of commercial proton exchange membrane fuel cell using support vector machine. International Journal of Hydrogen Energy, 2016; 41(26): 11351–11358. (ISI IF: 3.205; SCI IF: 3.311; HI: 146; Tier: Q1).

Modelling of commercial proton exchange membrane fuel cell using support vector machine. Azadeh Kheirandish1, Niusha Shafiabady2, Mahidzal Dahari1, Mohammad Saeed Kazemi1, Dino Isa3. 1Department of Mechanical Engineering, Faculty of Engineering, University Malaya, Kuala Lumpur, 50603, Malaysia 2IMU, Malaysia 3Department of Electrical Engineering, University of Nottingham, Malaysia Campus, Malaysia

Abstract

A method for predicting the performance of a proton exchange membrane fuel cell (PEMFC) system of a commercially available electrical bicycle using a support vector machine (SVM) is presented in this paper. The main advantage of the results obtained from this study is facilitating the use of carbon-free fuels instead of carbon-based ones and consequently reducing the energy consumption. Because such cells are nonlinear, multivariable systems that are difficult to model through traditional methods hence SVMs, which are powerful tools for predicting PEMFC performance, are used. Experimental data obtained from a 250 W PEMFC were used to predict parameters to describe the V–I, P–I, and efficiency–power curves, and then, the data was applied to predict overall PEMFC performance. To evaluate the functionality of suggested model, this method has been compared with multilayer perceptron (MLP) artificial neural network model. It has been demonstrated that, the error of SVM model is much smaller than MLP, and the proposed approach has better performance to predict the PEM fuel cell curve for the electrical bicycle. It was shown that the coefficient of determination in the SVM prediction model for power–current curve is approximately 99%, which is 97% for MLP model that makes the proposed black box SVM PEMFC model suitable for monitoring and simulating fuel cell performance in the electrical bicycle that is beneficial for its variety of energy saving applications. Keywords: Prediction, Modelling, PEMFC, Support vector machine, Fuel cells, Energy-saving.

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Kho MT, Chong CW, Lim ESH, Ismail NH, Draper LO, Yam WK, Lim PKC, Mak JW, Yap IKS. Systems biology analyses of the dynamic host response to Toxoplasma gondii infection in a murine model. Parasitology Open, 2016; 2: e9. [IMUR093/2012]. (IF: NA).

Systems biology analyses of the dynamic host response to Toxoplasma gondii infection in a murine model. Ivan K. S. Yap1, Mee Teck Kho2, Chun Wie Chong1, Swee Hua Erin Lim3, Nor Hadiani Ismail4, Patricia Kim Chooi Lim2, Mak Joon Wah2. 1Life Sciences Department, School of Pharmacy, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 2School of Postgraduate Studies and Research, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 3Perdana University, Block B & D Aras 1, MAEPS Building, MARDI Complex, Jalan MAEPS Perdana, 43400 Serdang, Selangor DE, Malaysia 4Atta-ur-Rahman Institute for Natural Products Discovery, Universiti Teknologi MARA, 42300 Bandar Puncak Alam, Selangor DE, Malaysia

Abstract Purpose: Toxoplasmosis, one of the most common parasitic diseases worldwide, is caused by the protozoan Toxoplasma gondii. It is a parasite with no specific host and has more than one obligatory host in its life cycle. T. gondii is prevalent in most part of the world with an

estimated one third of the global human population infected. Thus, it is imperative that the mechanism of infection and the interactions between parasite and mammalian host are elucidated to uncover the mechanisms of pathology ultimately leading to improved disease diagnosis, control and surveillance. Here, we compared the serum cytokines, urine metabolite and faecal bacterial profiles of mice infected with T. gondii using integrated systems biology

approach to assess and unravel the complex interactions between the host and the parasite. T. gondii infection led to up-regulation of serum cytokine levels which correlated with

perturbations in urinary metabolites and faecal bacteria compositions. Methods: Murine model of T. gondii infection was established and the tissue, urine, blood

serum and faecal pellet were harvested for analyses. Infection was assessed by histopathology of brain slices using H & E staining. Subsequent serum, urine and faecal samples were analysed using multiplex, nuclear magnetic resonance spectroscopy and TRFLP respectively. The data generated were analysed using multivariate statistical analysis and the covariation between the cytokines, NMR data and bacteria populations were explored using correlation network analyses and multiple linear regressions modelling techniques. Results: The integrated systems biology approach using correlation network analyses of data from the three matrices showed differences in energy metabolism and gut microbe metabolism, distinctive immunological phenotypes, and shifts in microbial composition between the infected and control animals. Conclusions: The current study showed complex interactions between the host and the

parasites across the three biological compartments. The correlation between host innate immune response, host metabolism and gut microbiome were established. This study proved that T. gondii infection will affect not only host physiological functions but the host gut

microbiome as well. Results from the current study enhance understanding of parasite infection in mammalian system and facilitate biomarkers discovery.

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Khoo EJ. Systemic lupus erythematosus (SLE): Not just a rash. Archives of Disease in Childhood, 2016; DOI: http://dx.doi.org/10.1136/archdischild-2016-311438. (ISI IF: 3.231; SCI IF: 2.645; HI: 118; Tier: Q1).

Systemic lupus erythematosus (SLE): Not just a rash. Erwin Jiayuan Khoo Department of Paediatrics, School of Medicine, International Medical University, Jalan Rasah, 70300 Seremban, Negeri Sembilan DK, Malaysia

Abstract

A previously healthy 11-year-old Chinese girl presented to the accident and emergency department with a 4-month history of persistent rashes over her palms and soles, and a 1-week history of malaise and low-grade fever. Her general practitioner had suggested that the rash could have been caused by hand, foot and mouth disease. On examination, she had non-blanching erythematous macular lesions with few palpable crusted purpura over her palms (figure 1) and soles. Considering her demographic status and unexplained symptoms, a connective tissue disease workup was done. Her serum complement levels were low. Antinuclear antibody was speckled and homogenous with a titre of 640. DsDNA antibodies were quantified >1000 IU/mL. She was treated with oral glucocorticoids. Seven days later, the rash healed with postinflammatory hyperpigmentation. She remains in remission on low-dose glucocorticoids. This case highlights the diverse presentations of systemic lupus erythematosus (SLE). The prevalence of SLE has been increasing in the UK in recent years1 with a median age of onset of juvenile SLE at 12 years.2 The diagnosis is generally guided by the Systemic Lupus International Collaborating Clinics group classification criteria3 to identify salient features. One-fifth of SLE cases will not manifest the minimum criteria when a child is first seen.3 These children should remain under surveillance for additional findings of SLE. Cutaneous vasculitis lesions are usually found on the face, palms and soles that are characterised as petechiae or palpable purpura that may blister. They are induced by the formation of immune complexes and neutrophilic infiltration, which is related to disease activity.

http://dx.doi.org/10.1136/archdischild-2016-311438

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Khor GL, Shyam S, Misra S, Fong B, Chong MHZ, Sulaiman N, et al. Correlation between dietary intake and serum ganglioside concentrations: A cross-sectional study among Malaysian toddlers. BMC Nutrition, 2016; 2: 74. DOI: 10.1186/s40795-016-0113-3. [IMU

external Grant: Project ID No. IMU R 139/2014]. (IF: NA).

Correlation between dietary intake and serum ganglioside concentrations: A cross-sectional study among Malaysian toddlers. Geok Lin Khor1, Sangeetha Shyam1, Snigdha Misra1, Bertram Fong2, Megan Hueh Zan Chong1, Norhasmah Sulaiman3, Yee Lin Lee3, Rebecca Cannan2 and Angela Rowan2. 1Department of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia. 2Fonterra Research and Development Centre, Palmerston North, New Zealand. 3Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia.

Abstract Background: Gangliosides are a group of sialylglycosphingolipids, widely distributed in body tissues, mainly as components of plasma membranes. They play crucial roles in neurodevelopment, gut maturation, and immune system. Dietary gangliosides have been shown to bring about benefits including cognition and immune support for breastfed infants. There is dearth of studies on dietary gangliosides intake or plasma ganglioside levels for toddlers. Given toddlers are still growing rapidly, a good understanding of ganglioside intake during this early childhood period is important for future dietary recommendations. The aim of this study was to provide information on dietary ganglioside intake in Malaysian toddlers and correlations with serum ganglioside levels. Methods: Toddlers who fulfilled the inclusion criteria were recruited from the Federal Territory of Putrajaya and neighboring urban suburbs. Background characteristics and food intake using food frequency questionnaire were collected for the entire sample (n = 153). As for ganglioside correlation determination, a 2 day weighed food record was conducted on a sub-group who provided blood (n = 74). Ganglioside levels in the food and blood were determined using modern high performance liquid chromatography mass spectrometry method. Results: The average dietary intake of total gangliosides for the Malaysian toddlers (aged 12–24.5 months) was 5.86± 0.56 mg/day. Growing up milks had a wide ganglioside concentration range (0.03 11.4 mg/100 g), and were the major contributor to dietary ganglioside intake (85%). The remaining dietary gangliosides were provided by other dairy products, meat, fish, bakery and biscuits. Serum levels varied from 5.05 μg/mL to 16.15 μg/mL. While no significant correlation was observed between dietary ganglioside intake from growing up milks and serum ganglioside levels in the toddlers, there was a significant but weak correlation between dietary ganglioside intake from dairy products (r = 0.241; p = 0.038) and meat (r = 0.294; p = 0.010) with serum ganglioside levels Conclusions: Gangliosides are a component of the Malaysian toddlers’ diet (5.68 ± 0.56 mg/day), and were measured in their plasma at levels ranging from 5.05 to 16.15 μg/mL. Growing up milk contributed to 85% of the total dietary gangliosides intake, with remaining contributions from chicken meat and fish. More studies should be undertaken on the contributions of dietary gangliosides, including breast milk, in bringing about health benefits to young children.

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Khor GL, Tan SY, Tan KL, Chan PS, Amarra MSV. Compliance with WHO IYCF indicators and dietary intake adequacy in a sample of Malaysian subjects aged 6-23 months. Nutrients, 2016; 8: 778. (ISI IF: 3.759; SCI IF: 3.952; HI: 38; Tier: Q1).

Compliance with WHO IYCF indicators and dietary intake adequacy in a sample of Malaysian subjects aged 6-23 months. Geok Lin Khor1, Sue Yee Tan1, Kok Leong Tan1, Pauline S. Chan2 and Maria Sofia V. Amarra2. 1Department of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia 2International Life Sciences Institute South East Asia Region, Singapore 238959, Singapore

Abstract Background: The 2010 World Health Organisation (WHO) Infant and Young Child Feeding

(IYCF) indicators are useful for monitoring feeding practices. Methods: A total sample of 300 subjects aged 6 to 23 months was recruited from urban

suburbs of Kuala Lumpur and Putrajaya. Compliance with each IYCF indicator was computed according to WHO recommendations. Dietary intake based on two-day weighed food records was obtained from a sub-group (N = 119) of the total sample. The mean adequacy ratio (MAR) value was computed as an overall measure of dietary intake adequacy. Contributions of core IYCF indicators to MAR were determined by multinomial logistic regression. Results: Generally, the subjects showed high compliance for (i) timely introduction of

complementary foods at 6 to 8 months (97.9%); (ii) minimum meal frequency among non-breastfed children aged 6 to 23 months (95.2%); (iii) consumption of iron-rich foods at 6 to 23 months (92.3%); and minimum dietary diversity (78.0%). While relatively high proportions achieved the recommended intake levels for protein (87.4%) and iron (71.4%), lower proportions attained the recommendations for calcium (56.3%) and energy (56.3%). The intake of micronutrients was generally poor. The minimum dietary diversity had the greatest contribution to MAR (95% CI: 3.09, 39.87) (p = 0.000) among the core IYCF indicators. Conclusion: Malaysian urban infants and toddlers showed moderate to high compliance with

WHO IYCF indicators. The robustness of the analytical approach in this study in quantifying contributions of IYCF indicators to MAR should be further investigated. Keywords: infant and young child feeding, dietary adequacy, core complementary feeding

indicators, micronutrients, dietary diversity.

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Kingston R, Kannan MM. Framework for action to implement interprofessional education and collaborative practice in pharmacy and allied health sciences programs in India. Indian Journal of Pharmaceutical Education and Research, 2016; 50(2): 238-245. (ISI IF: 0.219; SCI IF: 0.226;

HI: 13; Tier: Q3).

Framework for action to implement interprofessional education and collaborative practice in pharmacy and allied health sciences programs in India. Kingston Rajiah1 and Marikannan Maharajan1. 1Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, MALAYSIA.

Abstract Background: Interprofessional education is a step towards providing higher quality patient

care by producing collaborative and practice-ready health care professionals who appreciate each other’s roles in the health care settings. The objectives, learning outcomes and action plans to implement IPL in various phases is discussed in this paper. Methods: A literature review was done to write a concept paper to produce a framework for

action to implement interprofessional education and collaborative practice in Pharmacy and allied health sciences programs in India. Results: The key information need as per this concept paper is; effective collaboration and

communication skills are needed to make the healthcare team members such as doctors, pharmacists, nurses, and other allied health graduates to work both autonomously and collaboratively in complex and challenging clinical environments. Conclusion: The need for evidenced-based collaborative care that utilizes the expertise of various disciplines has been acknowledged worldwide. Therefore, it is important to create the opportunity for the various health professional students to understand interprofessional education and appreciate the roles played by different professionals. Interprofessional education provides a better understanding of the health care system and ultimately improves the quality of patient care. Keywords: Inter-professional education, Indian health care programs, Collaborative practice,

Inter-professional learning, Pharmacy.

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Kingston R, Mari Kannan M, Sarah ZBS, Choo Lin T, Tan AYP, Wong ASY. Ebola: Emergency preparedness and perceived response of Malaysian healthcare providers: Perceptions of preparedness. American Journal of Infection Control, 2016; 44: 1720-1722. DOI:

http://dx.doi.org/10.1016/j.ajic.2016.05.019. (ISI IF: 1.995; SCI IF: 2.046; HI: 81; Tier: Q1).

Ebola: Emergency preparedness and perceived response of Malaysian healthcare providers: Perceptions of preparedness. Kingston Rajiah1, Mari Kannan Maharajan1, Sarah Zakiah Binti Samsudin2, Choo Lin Tan2, Adeline Tan Yen Pei2, Audrey Wong San Ying2. 1Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia 2Department of Pharmacy, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia

Abstract

We studied the emergency preparedness and perceived response for Ebola virus disease among various health care providers in Malaysia using a self-report questionnaire. Most of the health care providers felt that they were able to respond to Ebola virus disease and were aware of the level of preparedness needed during emergency. Keywords: Ebola, preparedness, response, Malaysia, health care providers.

http://dx.doi.org/10.1016/j.ajic.2016.05.019

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Koh KC, Pak JW. Immune reconstitution inflammatory syndrome in a HIV-infected patient with disseminated tuberculosis. Malaysian Family Physician, 2016; 11(1): 31-34. (SCI IF: 0.13; HI: 7; Tier: Q3).

Immune reconstitution inflammatory syndrome in a HIV-infected patient with disseminated tuberculosis. Koh KC1, Pak JW2. 1Department of Medicine, International Medical University, Jalan Rasah, 70400 Seremban, Negeri Sembilan, Malaysia. 2Hospital Raja Permaisuri Bainun, Jalan Hospital, 30990 Ipoh, Perak, Malaysia.

Abstract

Immune reconstitution inflammatory syndrome (IRIS) is the paradoxical worsening of pre-existing infectious processes after commencement of anti-retroviral therapy (ART) in HIV-infected patients. Its manifestations are dependent on the underlying opportunistic infections. We report a case of an HIV-infected patient with disseminated tuberculosis, who responded to anti-tuberculosis therapy but suffered from paradoxical worsening after commencement of ART. Keywords: Immune reconstitution, inflammatory syndrome, HIV, tuberculosis, antiretroviral therapy.

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Kohli S, Bhatia S. The need for dental digital photography education. Australian Dental Journal,

2016; 61(1): 125. (ISI IF: 1.272; SCI IF: 1.417; HI: 46; Tier: Q2).

The need for dental digital photography education. Shivani Kohli1, Shekhar Bhatia2. 1Department of Prosthodontics, MAHSA University, Kuala Lumpur, Malaysia 2Division of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia

Abstract

I write in regard to Louise Brown’s article ‘Inadequate record keeping by dental practitioners’.1 I wholeheartedly agree that newer technologies such as digital intraoral and extraoral photography and audio recording of patient interactions may offer a solution to record keeping problems. Clinicians with decades of experience or a student of dental history can look back at advances in dentistry and affirm that the dental profession has experienced an enormous amount of technological expansion. One is the advent of dental digital photography. Photographs have always been emblematic of memories and with the initiation of digital photography, it has become much easier to bring images together in a more inclusive and qualitative approach. Scientific upgradation in the field of digital photography has revolutionized the perception of photography as an influential means of expression and communication. Moreover, it offers a variety of perception, analysis and execution. Photography and dentistry go hand in hand for the disclosure of concealed and unnoticed defects in teeth and other parts of the cavity.

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Krishanappa SKK, Prashanti E, Sumanth KN, Naresh S, Moe S, Aggarwal H, Mathew RJ. Interventions for treating oro-antral communications and fistula due to dental procedures. Cochrane Database of Systematic Reviews, 2016; Issue 5, Art No.: CD011784. DOI:

10.1002/14651858. CD011784.pub2. (ISI IF: 6.103; SCI IF: 4.662; HI: 133; Tier: Q1).

Interventions for treating oro-antral communications and fistula due to dental procedures. Salian Kiran Kumar Krishanappa1, Eachempati Prashanti1, Kumbargere N Sumanth2, Shetty Naresh3, Soe Moe4, Himanshi Aggarwal5, Rebecca J Mathew6. 1Faculty of Dentistry, MelakaManipal Medical College, Department of Prosthodontics, Melaka, Malaysia 2Faculty of Dentistry, MelakaManipal Medical College, Department of Oral Medicine & Oral Radiology, Melaka, Malaysia 3International Medical University IMU, School of Dentistry Oral & Maxillofacial Surgery, Bukit Jalil, Kuala Lumpur, Malaysia 4Faculty of Medicine, Department of Community Medicine, Melaka, Melaka, Malaysia 5King George's Medical University, Department of Prosthodontics, Lucknow, Uttar Pradesh, India 6Christian Medical College, South Asian Cochrane Network & Center, Prof. BV Moses Center for Evidence Informed Health Care and Health Policy, Vellore, Tamil Nadu, India

Abstract Background: An oro-antral communication is an unnatural opening between the oral cavity

and maxillary sinus. When it fails to close spontaneously, it remains patent and is epithelialized to develop into an oro-antral fistula. Various surgical and non-surgical techniques have been used for treating the condition. Surgical procedures include flaps, grafts and other techniques like re-implantation of third molars. Non-surgical techniques include allogenic materials and xenografts. Objectives: To assess the effectiveness and safety of various interventions for the treatment

of oro-antral communications and fistulae due to dental procedures. Search Methods: We searched the Cochrane Oral Health Group's Trials Register (whole

database, to 3 July 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2015, Issue 6), MEDLINE via OVID (1946 to 3 July 2015), EMBASE via OVID (1980 to 3 July 2015), US National Institutes of Health Trials Registry (http://clinicaltrials.gov) (whole database, to 3 July 2015) and the World Health Organization (WHO) International Clinical Trials Registry Platform (http://www.who.int/ictrp/en/) (whole database, to 3 July 2015). We also searched the reference lists of included and excluded trials for any randomised controlled trials (RCTs). Selection Criteria: We included RCTs evaluating any intervention for treating oro-antral communications or oro-antral fistulae due to dental procedures. We excluded quasi-RCTs and cross-over trials. We excluded studies on participants who had oro-antral communications, fistulae or both related to Caldwell-Luc procedure or surgical excision of tumours. Data Collection and Analysis: Two review authors independently selected trials. Two review

authors assessed trial risk of bias and extracted data independently. We estimated risk ratios (RR) for dichotomous data, with 95% confidence intervals (CI). We assessed the overall quality of the evidence using the GRADE approach. Main Results: We included only one study in this review, which compared two surgical interventions: pedicled buccal fat pad flap and buccal flap for the treatment of oro-antral communications. The study involved 20 participants. The risk of bias was unclear. The

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relevant outcome reported in this trial was successful (complete) closure of oro-antral communication.The quality of the evidence for the primary outcome was very low. The study did not find evidence of a difference between interventions for the successful (complete) closure of an oro-antral communication (RR 1.00, 95% Cl 0.83 to 1.20) one month after the surgery. All oro-antral communications in both groups were successfully closed so there were no adverse effects due to treatment failure.We did not find trials evaluating any other intervention for treating oro-antral communications or fistulae due to dental procedures. Author’s Conclusions: We found very low quality evidence from a single small study that compared pedicled buccal fat pad and buccal flap. The evidence was insufficient to judge whether there is a difference in the effectiveness of these interventions as all oro-antral communications in the study were successfully closed by one month after surgery. Large, well-conducted RCTs investigating different interventions for the treatment of oro-antral communications and fistulae caused by dental procedures are needed to inform clinical practice.

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Krishnappa P, Eu JL, Ibtisam BM, Mahadevan DT, Meenakshi A, Kandasami P. A histomorphological and immunohistochemical study of gastrointestinal stromal tumors in Hospital Tuanku Ja’afar Seremban, Malaysia. Asia Pacific Journal of Cancer Prevention, 2016;

17(6): 2795-2799. (ISI IF: 2.514; SCI IF: 2.241; HI: 47; Tier: Q2).

A histomorphological and immunohistochemical study of gastrointestinal stromal tumors in Hospital Tuanku Ja’afar Seremban, Malaysia. Purushotham Kkrishnappa1, Eu Jhin Loh2, Ibtisam Binti Mohamad3, Mahadevan Deva Tata4, Meenakshi Akhilesh2, Kandasami Palayan4. 1Pathology, Medicine, International Medical University, Bukit Jalil 2Pathology, Medicine, International Medical University , Kuala Lumpur 3Department of Pathology, Hospital Tuanku Ja’afar, Seremban, Malaysia 4Department of Surgery, Hospital Tuanku Ja’afar, Seremban, Malaysia

Abstract Purpose: To study histomorphological and immunohistochemical patterns of gastro-intestinal stromal tumours (GISTs) in Malaysia. Materials and Methods: A total of 29 GIST cases from Hospital Tuanku Ja’afar, Seremban, were studied retrospectively over a period of 10 years from January 2002 to December 2011. Patient demographic data like age, sex and etnicity were collected. Tumour characteristics like site, maximum dimension and specimen type were analysed. Evaluation was according to established criteria into very low, low, intermediate and high-risk categories. Immunohistochemical characteristics were also analysed. Results: The mean age of patients was 59.7 years. Males (59%) were found to be more commonly affected than females (41%). The Chinese (45%) were commonly affected than Malays (41%), and Indians (10%). The most common symptom was pain in the abdomen (13.8%). More than half of the cases were seen in stomach (53%). The tumour size ranged from 1.5 cm to 17 cm with a mean of 6.94cm. Microscopic findings revealed that the spindle cell type was the most common (76%). It was observed that the majority of the cases (48%) were categorised in the intermediate risk group. Immunohistochemical staining showed positivity for CD117 (78.6%), CD34 (71.4%), vimentin (86.2%), S-100 (27.6%), SMA (35.7%), PKC THETA (46.4%) and PDGRFA (67.9%). Keywords: Gastrointestinal stromal tumor, immunohistochemistry, risk categories, spindle

cell, CD 117.

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Kugan V, Mahadevan DT, Kandasami P. Comparison of features and outcomes of perforated peptic ulcer between Malaysians and foreigners. Medical Journal of Malaysia, 2016; 71(1): 12-6. (SCI IF: 0.528; HI: 24; Tier: Q3).

Comparison of features and outcomes of perforated peptic ulcer between Malaysians and foreigners. Kugan Vijian1, Mahadevan Deva Tata1, Kandasami Palayan2. 1Department of Surgery, Tuanku Ja’afar Hospital, Seremban, Negeri Sembilan 2International Medical University, Seremban, Negeri Sembilan

Abstract Background: Perforated peptic ulcers (PPU) present as serious surgical emergencies that

carry high mortality and morbidity. Foreigners with PPU are also managed in our hospital setting. Their inclusion significantly alters the trend and pattern of PPU seen in Malaysia. Aim: To compare per-operative and post-operative features and outcomes of perforated

peptic ulcers between Malaysians and foreigners. Material and Methods: This was an analytical cross-sectional study. All patients who

underwent repair of perforated peptic ulcer disease during a 6-year period were included. 50 consecutive patients’ records with perforated peptic ulcer were analysed. Data were collected from operation theatre database and hospital medical records. Chi square and t test were performed using SPSS statistical software. Results: Total of 50 patients, of which 30 were Malaysians and 20 were foreigners. The mean

age of Malaysian patients was 58.3 ± 15.2 years whereas the mean age for foreign patients was 30.3 ± 6.7 years, with foreign patients being significantly younger than local patients. Foreigners had significantly smaller ulcers with only 5% of them having ulcers more than 1cm while 36.7% of Malaysian patients had ulcers more than 1cm. Post-operative complications are significantly higher in Malaysian patients (p<0.05) with 40% of Malaysian patients and 10% of foreign patients developing post-operative complications. Conclusion: Foreign patients are younger with significantly smaller perforated ulcers and

better post-operative outcomes. Keywords: Peptic ulcer, Perforated, Foreigners, Malaysia.

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Kumanan T, Guruparan M, Mohideen MR. Non-adherence of antihypertensive therapy: A serious public health issue in Sri Lanka. Journal of the Ceylon College of Physicians, 2016; 47: 50-51. (IF: NA).

Non-adherence of antihypertensive therapy: A serious public health issue in Sri Lanka. Kumanan T1, Guruparan M2, Mohideen M R3. 1Department of Medicine, Faculty of Medicine, University of Jaffna, Sri Lanka. 2Cardiology Unit, Teaching Hospital, Jaffna, Sri Lanka. 3Department of Internal Medicine, International Medical University, BatuPahat, Johor, Malaysia.

Abstract

Hypertension is the commonest risk factor for the most of the common causes of death in Sri Lanka; coronary heart disease, stroke, heart and renal failure. Nearly one-fifth to one-third of adult Sri Lankans have blood pressure levels that are above normal and the prevalence is comparable to those in the developed countries. The problem of hypertension is further compounded by the underuse of effective and generallywell tolerated antihypertensive medications. A large study carried out in the Gampaha district showed that 31.8% of patients had undetected hypertension and of the diagnosed hypertensives 19.5% were not on any medications. Only about 32.1% had optimal blood pressure control. Among hypertensive patients attending cardiology unit of National Hospital Colombo uncontrolled hypertension was present in 41.1% of the patients and 19.1% of them had resistant hypertension. The data available from the recent yet unpublished studies indicate that sub-optimal blood pressure control is a serious public health issue in Sri Lanka. It has been shown that 50% of individuals discontinue antihypertensive drugs within 6 to 12 months of their initiation. A multicenter observational study of blood pressure control among clinic attendees done in Colombo, Galle and Kandy showed that only 22% achieved a blood pressure target of less than 140/90 mmHg.

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Kwa SK, Zainab AM, Tan KN. Delay and misdiagnosis in adult myasthenia gravis: A case report. IeJSME, 2016; 10(3): 37-39. (MyCite IF: 0.038).

Delay and misdiagnosis in adult myasthenia gravis: A case report. Siew Kim Kwa, Zainab Abdul Majeed, Kah Nian Tan. International Medical University Clinical Campus, Seremban, Negeri Sembilan, MALAYSIA

Abstract

Myasthenia gravis (MG) is a rare autoimmune disorder characterised by fluctuating and variable combination of muscle weakness and fatigue. Most cases are due to T-cell mediated autoantibodies against post-synaptic acetylcholine receptors (AChR-Ab), thus preventing acetylcholine from binding and signalling skeletal muscle to contract. The annual incidence is 7-23 new cases per million. It can occur at any age but with two peaks; an earlyonset (20-40 years) female-predominant and a late-onset (60-80 years) male-predominant peak. MG is classified into ocular and generalised (80%). More than half the patients initially present with ptosis and diplopia but half will progress to generalised disease with involvement of bulbar, limb and respiratory weakness. Those presenting as generalised MG can also develop eye signs later. It is important to recognise MG early because it is highly treatable. Untreated disease leads to permanent weakness. Treatment reduces mortality from lifethreatening myasthenic crisis. Misdiagnosis leads to potentially harmful interventions and inappropriate management. Diagnosis in late-onset MG is easily missed because of overlapping symptoms with other diseases common in the elderly. We report a case of delay and misdiagnosis in an elderly patient with co-morbidities. Keywords: Myasthenia gravis, misdiagnosis, delay diagnosis, late-onset, elderly.

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Lai JW, Chan CW, Ng CH, Ooi IH, Tan KW, Maah MJ, Ng SW. Hydrated and anhydrous forms of copper (II) complex of 3-methylpicolinic acid, and spectroscopic studies of their ROS-inducing and proteasome inhibition. Journal of Molecular Structure, 2016; 1106: 234-41. (ISI

IF: 1.78; SCI IF: 1.716; HI: 75; Tier: Q3).

Hydrated and anhydrous forms of copper (II) complex of 3-methylpicolinic acid, and spectroscopic studies of their ROS-inducing and proteasome inhibition. Jing Wei Lai1, Cheang Wei Chan1,2, Chew Hee Ng1, Ing Hong Ooi1, Kong Wai Tan2, Mohd Jamil Maah2, Seik Weng Ng2. 1Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia 2Chemistry Department, University of Malaya, 50603 Kuala Lumpur, Malaysia

Abstract

The hydrated and anhydrous forms of the copper(II) complex of 3-methylpicolinic acid, monomeric [Cu(3Me-pic)2(H2O)].H2O 1 and polymeric [Cu(3Me-pic)2]n 2, were synthesized and characterized by FTIR, UV-visible spectroscopy, conductivity measurement, magnetic susceptibility determination, electron paramagnetic resonance (EPR) and light scattering. Crystal structure analysis of 2 shows that it has a doubly-bridged polymeric structure, involving diagonally stacked Cu(3Me-pic)2 units which are linked via carbonyl oxygen atoms of the 3Me-pic moieties. Analysis of EPR spectra at 133 K and 293 K suggests isotropic intermolecular spin interaction only in 2. Complex 2 dissolved in DMF and DMSO solvents to yield nano-size particles. Solution studies show aqueous solutions of 1 and 2 contain the same neutral Cu(3Me-pic)2 species, which generates less hydroxyl radicals from the reaction with hydrogen peroxide than their precursor CuCl2. The Cu(3Me-pic)2 species exhibit more selective inhibition of the b2 site of the 20S proteasome, among the three proteolytic sites. Keywords: 3-methylpyridine-2-carboxylic acid, Polymeric copper(II), Chelate effect, Hydroxyl radicals, 20S proteolytic sites.

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Lakshman AR, Kanneppady SK, Castelino RL. Evaginated odontome with dens invaginatus in maxillary lateral incisor – A rare presentation. Saudi Journal of Medicine, 2016; 1(1): 16-20. (IF: NA).

Evaginated odontome with dens invaginatus in maxillary lateral incisor – A rare presentation. Dr. Anusha Rangare Lakshman1, Dr. Chaithra Kalkur2, Dr. Renita lorina Castelino3, Dr. Sham Kishor Kanneppady4. 1Reader and Head of the Department, Department of Oral Medicine and Radiology, Century International Institute of Dental Science and Research Centre, Poinachi, Kasaragod – 671541 Kerala, India 2Assistant Professor, Department of Oral Medicine and Radiology, Century International Institute of Dental Science and Research Centre, Poinachi, Kasaragod - 671541 Kerala, India 3Assistant Professor, Department of Oral Medicine and Radiology, A.B Shetty Memorial Institute of Dental Sciences, NITTE university, Mangalore 4School of Dentistry, International Medical university, Kuala Lumpur, Malaysia

Abstract

The talon cusp, or dens evaginatus of anterior teeth, is a relatively rare dental developmental anomaly characterized by the presence of an accessory cusp-like structure projecting from the cingulum area or cementoenamel junction. This cusp resembles an eagle's talon hence named after it. It usually contains normal enamel, dentin and sometimes extending into the pulp. Dens invaginatus results from an infolding of the outer surface of a tooth. It is the embryological anomaly that results in invagination of an amelodental structure within the pulp. We are hereby highlighting a rare and unusual case of talons cusp and dens invaginatus occurring concurrently on maxillary lateral incisor. Keywords: Talon cusp, dens evaginatus, dens invaginatus, maxillary incisors.

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Lam KY, Ling APK, Koh RY, Wong YP, Say YH. A review on medicinal properties of orientin. Advances in Pharmacological Sciences, 2016; Volume: 2016, Article ID: 4104595. DOI: dx.doi.org/10.1155/2016/4104595. [FRGS/1/2013/SKK07/IMU/03/3] (IF: NA).

A review on medicinal properties of orientin. Kit Ying Lam1, Anna Pick Kiong Ling2, Rhun Yian Koh2, Ying Pei Wong2, and Yee How Say3. 1School of Postgraduate Studies and Research, International Medical University, 57000 Kuala Lumpur, Malaysia 2Division of Biomedical Science and Biotechnology, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia 3Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Perak Campus, 31900 Kampar, Perak, Malaysia

Abstract Medicinal plants continue to play an important role in modern medications and healthcare as consumers generally believe that most of them cause fewer or milder adverse effects than the conventional modern medicines. In order to use the plants as a source of medicinal agents, the bioactive compounds are usually extracted from plants. Therefore, the extraction of bioactive compounds from medicinal plants is a crucial step in producing plant-derived drugs. One of the bioactive compounds isolable from medicinal plants, orientin, is often used in various bioactivity studies due to its extensive beneficial properties. The extraction of orientin in different medicinal plants and its medicinal properties, which include antioxidant, antiaging, antiviral, antibacterial, antiinflammation, vasodilatation and cardioprotective, radiation protective, neuroprotective, antidepressant-like, antiadipogenesis, and antinociceptive effects, are discussed in detail in this review.

108

Lambuk L, Jafri AJ, Arfuzir NN, Iezhitsa I, Agarwal R, Rozali KN, Agarwal P, Bakar NS, Kutty MK, Yusof AP, Krasilnikova A, Spasov A, Ozerov A, Ismail NM. Neuroprotective effect of magnesium acetyltaurate against NMDA-induced excitotoxicity in rat retina. Neurotoxicity Research, 2016; 31(1): 31-45. (ISI IF: 3.14; SCI IF: 3.057; HI: 52; Tier: Q1).

Neuroprotective effect of magnesium acetyltaurate against NMDA-induced excitotoxicity in rat retina. Lidawani Lambuk1, Azliana Jusnida Ahmad Jafri1, Natasha Najwa Nor Arfuzir1, Igor Iezhitsa1,2, Renu Agarwal1, Khairul Nizam Bin Rozali1, Puneet Agarwal3, Nor Salmah Bakar1, Methil Kannan Kutty1, Ahmad Pauzi Md. Yusof1, Anna Krasilnikova1, Alexander Spasov2, Alexander Ozerov2, Nafeeza Mohd Ismail1. 1Center for Neuroscience Research, Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh Campus, Sungai Buloh 47000, Selangor Darul Ehsan, Malaysia 2Research Institute of Pharmacology, Volgograd State Medical University, 1, Pavshikh Bortsov sq., Volgograd, Russian Federation 400131 3Department of Ophthalmology, IMU Clinical School, International Medical University, Jalan Rasah, Seremban, Malaysia

Abstract Glutamate excitotoxicity plays a major role in the loss of retinal ganglion cells (RGCs) in glaucoma. The toxic effects of glutamate on RGCs are mediated by the overstimulation of N-methyl-D-aspartate (NMDA) receptors. Accordingly, NMDA receptor antagonists have been suggested to inhibit excitotoxicity in RGCs and delay the progression and visual loss in glaucoma patients. The purpose of the present study was to examine the potential neuroprotective effect of Mg acetyltaurate (MgAT) on RGC death induced by NMDA. MgAT was proposed mainly due to the combination of magnesium (Mg) and taurine which may provide neuroprotection by dual mechanisms of action, i.e., inhibition of NMDA receptors and antioxidant effects. Rats were divided into 5 groups and were given intravitreal injections. Group 1 (PBS group) was injected with vehicle; group 2 (NMDA group) was injected with NMDA while groups 3 (pre-), 4 (co-), and 5 (post-) treatments were injected with MgAT, 24 h before, in combination or 24 h after NMDA injection respectively. NMDA and MgAT were injected in PBS at doses 160 and 320 nmol, respectively. Seven days after intravitreal injection, the histological changes in the retina were evaluated using hematoxylin & eosin (H&E) staining. Optic nerves were dissected and stained in Toluidine blue for grading on morphological neurodegenerative changes. The extent of apoptosis in retinal tissue was assessed by TUNEL assay and caspase-3 immunohistochemistry staining. The estimation of neurotrophic factor, oxidative stress, pro/anti-apoptotic factors and caspase-3 activity in retina was done using enzyme-linked immunosorbent assay (ELISA) technique. The retinal morphometry showed reduced thickness of ganglion cell layer (GCL) and reduction in the number of retinal cells in GCL in NMDA group compared to the MgAT-treated groups. TUNEL and caspase-3 staining showed increased number of apoptotic cells in inner retina. The results were further corroborated by the estimation of neurotrophic factor, oxidative stress, pro/anti-apoptotic factors, and caspase-3 activity in retina. In conclusion, current study revealed that intravitreal MgAT prevents retinal and optic nerve damage induced by NMDA. Overall, our data demonstrated that the pretreatment with MgAT was more effective than co- and posttreatment. This protective effect of MgAT against NMDA-induced retinal cell apoptosis could be attributed to the reduction of retinal oxidative stress and activation of BDNF-related neuroprotective mechanisms. Keywords: Glaucoma, RGC apoptosis, NMDA, Excitotoxicity, Magnesium acetyltaurate,

Neuroprotection.

109

Lee CL, Chee WSS. Translation of evidence to clinical practice for use of meal replacements in weight loss and obesity – Lessons learned from research studies. Journal of Nutrition and Food Science, 2016; 6: 541. doi: 10.4172/2155-9600.1000541. [IMU Internal Grant]. (ISI IF:

1.22).

Translation of evidence to clinical practice for use of meal replacements in weight loss and obesity – Lessons learned from research studies. Ching Li Lee and Winnie SS Chee. Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur, Malaysia.

Abstract

Meal replacements have been shown to be effective in assisting weight loss in many clinical trials; however, adherence is a major determinant of the reported success. Characterizing how meal replacements were used for weight loss in clinical studies can assist healthcare providers to replicate efficacy and improve adherence to achieve successful weight loss. This narrative review characterizes the treatment conditions that support meal replacements use for weight loss from 45 clinical trials. From these studies, the key treatment conditions that support the successful use of meal replacements include contact with healthcare providers; structured education and counseling sessions; and close monitoring of progress. Weekly contacts with healthcare providers that included a physician with dietitian/nutritionist team for at least three months were needed in the initial phase of using meal replacements. Education and counseling sessions should be conducted at individual and group level to provide structured diet plans which included healthy eating, exercise plan and incorporation of cognitive/psychological motivation components. Frequent monitoring of progress included weekly to monthly weight monitoring, the use of food and exercise records, and self-monitoring of blood glucose in subjects with diabetes. In conclusion, similar with other lifestyle interventions, intensive follow ups and monitoring are required to ensure the success of using meal replacements for weight loss in everyday clinical practice. Keywords: Weight loss, Meal replacements, Clinical practice, Treatment conditions.

110

Lee CY, Ooi IH. Preparation of temozolomide-loaded nanoparticles for glioblastoma multiforme targeting-ideal versus reality. Pharmaceuticals, 2016; 9(3): 54. [published online]. Doi: 10.3390/ph9030054. (SCI IF: 4.504; HI: 26; Tier: Q1).

Preparation of temozolomide-loaded nanoparticles for glioblastoma multiforme targeting-ideal versus reality. Chooi Yeng Lee1, and Ing Hong Ooi2. 1School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia 2Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia

Abstract

Temozolomide (TMZ) is one of the most effective chemotherapeutic agents for glioblastoma multiforme, but the required high administration dose is accompanied by side effects. To overcome this problem and to further improve TMZ’s efficacy, targeted delivery of TMZ by using polymeric nanoparticles has been explored. We synthesised the PLGA-PEG-FOL copolymer and attempted encapsulation of TMZ into PLGA-PEG-FOL nanoparticles using the emulsion solvent evaporation method and the nanoprecipitation method. Conjugation of PEG and FOL to PLGA has been reported to be able to increase the delivery of TMZ to the brain as well as targeting the glioma cells. However, despite making numerous modifications to these methods, the loading of TMZ in the nanoparticles only ranged between 0.2% and 2%, and the nanoparticles were between 400 nm and 600 nm in size after freeze-drying. We proceed with determining the release profile of TMZ in phosphate buffered saline (PBS). Our initial data indicated that TMZ was slowly released from the nanoparticles. The metabolite of TMZ rather than the parent compound was detected in PBS. Our study suggests that while PLGA-PEG-FOL can be used as a polymeric or encapsulation material for central delivery of TMZ, a practical and cost effective formulation method is still far from reach. Keywords: glioblastoma, polymeric nanoparticles, sustained release, targeted delivery,

temozolomide.

111

Lee KTW, Tan JK, Lam AKY, Gan SY. MicroRNAs serving as potential biomarkers and therapeutic targets in nasopharyngeal carcinoma: A critical review. Critical Reviews in Oncology/Hematology, 2016; 103: 1–9. (ISI IF: 5.039; SCI IF: 5.127; HI: 98; Tier: Q1).

MicroRNAs serving as potential biomarkers and therapeutic targets in nasopharyngeal carcinoma: A critical review. Katherine Ting-Wei Lee1,2, Juan-King Tan3, Alfred King-yin Lam1, Sook-Yee Gan4. 1Cancer Molecular Pathology, School of Medicine, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia 2School of Postgraduate Studies and Research, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 3School of Medicine, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 4School of Pharmacy, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia

Abstract

Despite significant medical advancement, nasopharyngeal carcinoma (NPC) remains one of the most difficult cancers to detect and treat where it continues to prevail especially among the Asian population. miRNAs could act as tumour suppressor genes or oncogenes in NPC. They play important roles in the pathogenesis of NPC by regulating specific target genes which are involved in various cellular processes and pathways. In particular, studies on miRNAs related to the Epstein Barr virus (EBV)-encoded latent membrane protein one (LMP1) and EBVmiRNA- BART miRNA confirmed the link between EBV and NPC. Both miRNA and its target genes could potentially be exploited for prognostic and therapeutic strategies.They are also important in predicting the sensitivity of NPC to radiotherapy and chemotherapy. The detection of stable circulating miRNAs in plasma of NPC patients has raised the potential of miRNAs as novel diagnostic markers. To conclude, understanding the roles of miRNA in NPC will identify ways to improve the management of patients with NPC. Keywords: MicroRNA, Nasopharyngeal carcinoma, Cancer, Epstein-Barr virus, BART-miRNAs, Biomarkers, Therapeutic, Prognostic.

112

Lee SW, Lai NM, Chaiyakunapruk N, Chong DW. Adverse effects of herbal or dietary supplements in G6PD deficiency: A systematic review. British Journal of Clinical Pharmacology, 2016; 83(1): 172-179. doi: 10.1111/bcp.12976. (ISI IF: 3.83; SCI IF: 3.934; HI:

110; Tier: Q1).

Adverse effects of herbal or dietary supplements in G6PD deficiency: A systematic review. Shaun Wen Huey Lee1, Nai Ming Lai2, Nathorn Chaiyakunapruk1,3,4,5 and David Weng Kwai Chong6. 1School of Pharmacy, Monash University Malaysia, Malaysia 2School of Medicine, Taylor's University, Malaysia 3Center of Pharmaceutical Outcomes Research (CPOR), Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand 4School of Pharmacy, University of Wisconsin, Madison, USA 5School of Population Health, University of Queensland, Brisbane, Australia 6School of Pharmacy, International Medical University, Malaysia

Abstract Aim: Glucose6phosphate dehydrogenase (G6PD) deficiency is a common genetic disorder,

affecting nearly 400 million individuals worldwide. Whilst it is known that a number of drugs, foods and chemicals can trigger haemolysis in G6PD deficient individuals, the association between herbal and dietary supplements and haemolysis is less clear. The objective of this study was to evaluate the association between herbal or dietary supplements and adverse events in G6PD deficient individuals. Methods: We searched fourteen electronic databases from their inception until November

2015 for articles describing the use of herbal or dietary supplements in G6PD deficient individuals. Additional publications were identified from manually searching textbooks, conference abstracts and the grey literature. All study designs were included as long as they contained clinical information. These findings gathered were summarised narratively. Results: Thirty two publications met inclusion criteria. These reported on ten herbal and

dietary supplements. Overall evidence linking haemolysis to a herbal/dietary supplement was only found for henna. No evidence of harms were observed for vitamin C, vitamin E, vitamin K, Gingko biloba and αlipioc acid. Conclusions: The review showed that there was insufficient evidence to contravene the use

of most herbal or dietary products at therapeutic doses in G6PD deficient subjects.

Keywords: Systematic review, glucose6phosphate dehydrogenase, herbal medicine, safety.

113

Lee WZ, Chang SK, Khoo HE, Sia CM, Yim HS. Influence of different extraction conditions on antioxidant properties of soursop peel. ACTA Scientiarum Polonorum Technologia Alimentaria, 2016; 15(4): 419-428. (SCI IF: 0.9; HI: 10; Tier: Q2).

Influence of different extraction conditions on antioxidant properties of soursop peel. Wei Zin Lee1, Sui Kiat Chang2, Hock Eng Khoo3, Chiaw Mei Sia1, Hip Seng Yim1. 1Department of Food Science and Nutrition, UCSI University 1 Jalan Menara Gading, UCSI Heights, 56000 Kuala Lumpur, Malaysia 2Department of Nutrition and Dietetics, School of Health Sciences, International Medical University 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 3Department of Nutrition and Dietetics, Universiti Putra Malaysia 43400 UPM Serdang, Selangor, Malaysia.

Abstract Background: Soursop is a healthy fruit. Peels form about 20% of the soursop fruit and are

usually discarded as waste product. With a view to utilizing soursop peel as a source of valuable compounds, this study aimed to investigate the influence of different extraction conditions on total phenolic content (TPC) and antioxidant capacity (AC) of soursop (Annona muricata L.) peel. Material and methods: Different ethanol concentrations (20-100%, v/v), extraction

temperatures (25-60°C), and extraction time (1-5 h) were tested. Extracts were prepared on

the basis of the best optimal extraction conditions (20% ethanol, 40ºC the extraction temperature, and 4 h of extraction time), an optimal TPC and AC was determined for the soursop peel using DPPH, ABTS, FRAP and β-carotene bleaching (BCB) assays. The different extraction conditions tested at best optimum conditions have significantly affected the TPC and AC of the soursop peel. Results: Soursop peel extract extracted in the best optimal extraction conditions had

moderate levels of TPC (52.2 µg GAE/ml), and FRAP value (58.9 µg TE/ml extract). The extract demonstrated high BCB inhibitory activity (80.08%). The EC50 values of the extract were high, 1179.96 and 145.12 µg/ml, as assessed using DPPH and ABTS assays, respectively. The TPC was positively and highly correlated with the AC of soursop peel assessed by ABTS, FRAP, and BCB assay, but it was moderately correlated with DPPH radical scavenging activity. A moderate correlation of TPC with DPPH suggested that polyphenols in the extracts were partially responsible for the AC. Conclusions: By-products of soursop such as its peel could be an inexpensive source of good natural antioxidants with nutraceutical potential in the functional food industry. Keywords: antioxidant capacity, Annona muricata, extraction parameters, soursop peel, total phenolic content, waste products.

114

Leng CH, Lim SY, Siew WF. Are nurses ready for evidence-based practice? A descriptive

study of information literacy competency among clinical practicing registered nurses in a

private hospital in Malaysia. IeJSME, 2016; 10(1): 10-16. (MyCite IF: 0.038).

Are nurses ready for evidence-based practice? A descriptive study of information literacy competency among clinical practicing registered nurses in a private hospital in Malaysia. Chun Hoe Leng, Suk Yin Lim, Wei Fern Siew. Division of Nursing, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA

Abstract Background: Nurses are the highest numbered healthcare professionals who work in a

knowledge-driven environment, where accurate and updated information is needed when delivering care to clients. Information literacy has therefore become one of the criteria in determining nurses’ readiness for evidence-based practice in recent years. In the actual day-to-day care practice, are nurses ready for this? Objective: To determine the information literacy competency in readiness for evidence-based

practice among clinical practicing registered nurses in a private hospital in Penang, Malaysia. Methods: This cross sectional descriptive study was conducted in the selected private

hospital. Universal sampling method was used. At the time of study, there were 443 registered nurses who met the eligibility criteria of this study. The registered nurses were asked to complete a self-reporting questionnaire about information literacy for evidence-based practice. Results: The response rate was 86.2%, with a total of 382 returned questionnaires. Less than half of the participants (47%) stated that they frequently sourced information to support nursing practice. Poor research experiences among these participants were identified where 56% of the registered nurses never identified researchable problems, 59% have not evaluated a research report and 54% have never utilised research into practice. Registered nurses frequently sought information sources from colleagues or peers (65%) rather than from printed resources, where only 43% and 33% respectively make use of CINAHL and MEDLINE bibliography databases as the electronic resources for their practice. Conclusions: Results demonstrated that information literacy among registered nurses from

this hospital was lacking. Organisation efforts are needed to create awareness of information for evidence-based practice as well as to encourage more research activities and the search of bibliography database among its registered nurses. Keywords: evidence-based practice, information literacy, information literacy competency,

information search, registered nurses.

115

Leong XY, Thanikachalam PV, Pandey M, Ramamurthy S. A systematic review of the protective role of swertiamarin in cardiac and metabolic diseases. Biomedicine and Pharmacotherapy, 2016; 84: 1051-1060. (ISI IF: 2.326; SCI IF: 2.447; HI: 67; Tier: Q2).

A systematic review of the protective role of swertiamarin in cardiac and metabolic diseases. Xin Yu Leong1, Punniyakoti Veeraveedu Thanikachalam1, Manisha Pandey, Srinivasan Ramamurthy. 1School of Pharmacy, International Medical University, Bukit Jalil- 57000, Malaysia.

Abstract Background: Swertiamarin, is a secoiridoid glycoside found in genera of Enicostemma Species (Enicostemma littorale and Enicostemma axillare) belonging to the family of

gentianaceae, which has been reported to cure many diseases such as diabetes, hypertension, atherosclerosis, arthritis, malaria and abdominal ulcers. However, to the best of our knowledge, till date systematic studies to understand the molecular basis of cardiac and metabolic disease preventing properties of swertiamarin has not been reported. Aim of the review: The present review aims to compile an up-to-date information on the

progress made in the protective role of swertiamarin in cardiac and metabolic diseases with the objective of providing a guide for future research on this bioactive molecule. Materials and methods: Information on the swertiamarin was collected from major scientific

databases (Pubmed, Springer, google scholar, and Web of Science) for publication between 1974-2016. In this review, the protective role of swertiamarin on cardiac and metabolic diseases was discussed. Results: Swertiamarin reported to exhibit a wide range of biological activities such as anti-atherosclerotic, antidiabetic, anti-inflammatory and antioxidant effects. These activities were mainly due to its effect on various signaling pathways associated with cardiac remodeling events such as inhibition of NF-kB expression, LDL oxidation, apoptosis, inflammatory and lipid peroxidation markers and stimulation of antioxidant enzymes. Conclusion: Sweriamarin exhibit a wide range of biological activities. This review presents evidence supporting the point of view that swertiamarin should be considered a potential therapeutic agent against cardiac and metabolic diseases, giving rise to novel applications in their prevention and treatment. Keywords: Swertiamarin, Enicostemma littorale, Cardiac disease, Antidiabetic, Antioxidant,

Anti-inflammatory.

116

Liew KL, Jee JM, Yap IKS, Yong PVC. In vitro analysis of metabolites secreted during infection of lung epithelial cells by Cryptococcus neoformans. PLoS ONE, 2016; 11: e0153356. (SCI IF: 3.027; HI: 181; Tier: Q1).

In vitro analysis of metabolites secreted during infection of lung epithelial cells by Cryptococcus neoformans.

Kah Leong Liew1, Jap Meng Jee1, Ivan Yap2, Phelim Voon Chen Yong1.

1School of Biosciences, Taylor’s University, Subang Jaya, Selangor Darul Ehsan, Malaysia 2Department of Life Sciences, International Medical University, Kuala Lumpur, Malaysia

Abstract Cryptococcus neoformans is an encapsulated basidiomycetous yeast commonly associated with pigeon droppings and soil. The opportunistic pathogen infects humans through the respiratory system and the metabolic implications of C. neoformans infection have yet to be

explored. Studying the metabolic profile associated with the infection could lead to the identification of important metabolites associated with pulmonary infection. Therefore, the aim of the study was to simulate cryptococcal infection at the primary site of infection, the lungs, and to identify the metabolic profile and important metabolites associated with the infection at low and high multiplicity of infections (MOI). The culture supernatant of lung epithelial cells infected with C. neoformans at MOI of 10 and 100 over a period of 18 hours were analysed

using gas chromatography mass spectrometry. The metabolic profiles obtained were further analysed using multivariate analysis and the pathway analysis tool, MetaboAnalyst 2.0. Based on the results from the multivariate analyses, ten metabolites were selected as the discriminatory metabolites that were important in both the infection conditions. The pathways affected during early C. neoformans infection of lung epithelial cells were mainly the central

carbon metabolism and biosynthesis of amino acids. Infection at a higher MOI led to a perturbance in the β-alanine metabolism and an increase in the secretion of pantothenic acid into the growth media. Pantothenic acid production during yeast infection has not been documented and the β-alanine metabolism as well as the pantothenate and CoA biosynthesis pathways may represent underlying metabolic pathways associated with disease progression. Our study suggested that β-alanine metabolism and the pantothenate and CoA biosynthesis pathways might be the important pathways associated with cryptococcal infection.

117

Lim CK, Subramaniam H, Gan SY, Loo SM, Loo JR, Jong VYM, Soo HC, Leong CO, Mai CW, Chee CF. In vitro cytotoxic activity of chemical constituents from Malaysia Calophyllum species. Medicinal Chemistry Research, 2016; 25: 1686–1694. DOI: 10.1007/s00044-016-

1606-y. [BMS I01/2015 (01)] (ISI IF: 1.436; SCI IF: 1.466; HI: 27; Tier: Q1).

In vitro cytotoxic activity of chemical constituents from Malaysia Calophyllum species. Chan Kiang Lim1, Subramaniam Hemaroopini1, Shu Ying Gan1, Siew Mian Loo1, Jo Ring Low1, Vivien Yi Mian Jong2, Hsien Chuen Soo3, Chee Onn Leong4, Chun Wai Mai5, Chin Fei Chee5. 1Faculty of Science, Universiti Tunku Abdul Rahman, Jalan Universiti, Bandar Barat, Kampar, Perak, Malaysia 2Centre for Applied Sciences, Faculty of Applied Sciences, Universiti Teknologi MARA, Jalan Meranek, Kota Samarahan, Sarawak, Malaysia 3School of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia 4Department of Life Sciences, School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia 5Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia

Abstract

Cancer is a leading cause of death worldwide. In our continuing search for new anticancer agents, four Malaysian Calophyllum species, namely C. castaneum, C. teysmannii, C. canum, and C. sclerophyllum, had been phytochemically studied to give compounds 1–12. All the isolated compounds were evaluated for their antiproliferative activity against nasopharyngeal (SUNE1, TW01, CNE1, HK1) and breast (HCC38, MDA-MB-231, MDA-MB-468, SKBR3) cancer cell lines via methyl thiazolyl tetrazolium cell viability assay. Among the tested compounds, isodispar B (1) showed a promising dose-dependent and a broad spectrum of cytotoxic effects on all the tested cancer cell lines; in particular, potent inhibitory activities were observed on nasopharyngeal cancer cell lines (SUNE1, TW01, CNE1, HK1), with IC50 values ranging from 3.8 to 11.5 μM. In comparison with 5-fluorouracil as positive control, compound 1 was found to exhibit at least sixfold much higher activity than the standard drug used against the nasopharyngeal cell lines. Compound 1 was later found to induce apoptotic cell death in nasopharyngeal cancer cells, as evidenced by ‘Cell Death Detection’ ELISAPLUS kit, and exhibited good cancer-specific cytotoxicity when tested with noncancerous NP460 cells. Meanwhile, compounds 2–12 displayed moderate to weak activities against the tested cancer cell lines. The findings have highlighted the therapeutic potential of compound 1 against nasopharyngeal cancer. Keywords: Calophyllum, Antiproliferative activity, Apoptosis, Chromanone acids, Phenylcoumarins.

118

Lim KG, Cheah WK. A review of metabolic syndrome research in Malaysia. Medical Journal of Malaysia, 2016; 71(s1): 20-26. (SCI IF: 0.528; HI: 24; Tier: Q3).

A review of metabolic syndrome research in Malaysia. Lim Kean Ghee1, Cheah Wee Kooi2. 1International Medical University Clinical School, Seremban 2Department of Medicine, Taiping Hospital, Taiping

Abstract

Seventy-three articles related to metabolic syndrome were found in a search through databases dedicated to indexing all literature with original data involving the Malaysian population between years 2000 and 2015. Metabolic syndrome affects 25 to 40% of adult population of Malaysia with the risk increasing with age. Obese children are also at risk. Indian ethnicity has the highest rates, followed by Malay and chinese. It was found that socioeconomics determinants such as living in urban areas, unemployment, lower income, lower education level and shift workers had higher prevalence of metabolic syndrome. Metabolic syndrome is associated with other medical conditions like cardiovascular diseases, psychiatric disorders, erectile dysfunction, polycystic ovarian syndrome and colorectal cancer. Several biomarkers have been determined to be relevant to our local population but their usage in clinical setting needs further research. Literature into effectiveness of management of metabolic syndrome in Malaysia is lacking and the results were only modest. there are several diagnostic criteria available for metabolic syndrome internationally and their individual significant to our local population is not clear. It also makes it difficult to compare results between studies using different criteria. Finally, we could not identify any local study to look at the health economic burden of metabolic syndrome locally. Keywords: metabolic syndrome, risk factors, Malaysia, prevalence, biomarkers, obesity.

119

Lim KG. A review of adult obesity research in Malaysia. Medical Journal of Malaysia, 2016;

71(s1): 1-19. (SCI IF: 0.528; HI: 24; Tier: Q3).

A review of adult obesity research in Malaysia. Lim Kean Ghee. International Medical University Clinical School, Seremban.

Abstract

A literature search of articles as detailed in the paper Bibliography of clinical research in Malaysia: methods and brief results, using the MESH terms Obesity; Obesity, Abdominal; and Overweight; covering the years 2000 till 2015 was undertaken and 265 articles were identified. Serial population studies showed that the prevalence of obesity increased rapidly in Malaysia in the last decade of the twentieth century. This follows the rising availability of food per capita which had been begun two to three decades previously. Almost every birth cohort, even up to those in their seventh decade increased in prevalence of overweight and obesity between 1996 and 2006. However, the rise in prevalence in obesity appears to have plateaued after the first decade of the twentieth century. Women are more obese than men and Malays and Indians are more obese than Chinese. The Orang Asli (Aborigines) are the least obese ethnic group in Malaysia but that may change with socioeconomic development. Neither living in rural areas nor having low income protects against obesity. On the contrary, a tertiary education and an income over RM4,000/month is associated with less obesity. Malaysians are generally not physically active enough, in the modes of transportation they use and how they use their leisure time. Other criteria and measures of obesity have been investigated, such as the relevance of abdominal obesity, and the Asian criteria or Body Mass Index (BMI) cut-offs value of 23.0 kg/m2 for overweight and 27.0 kg/m2 for obesity, with the view that the risk of diabetes and other chronic diseases start to increase at lower values in Asians compared to Europeans. Nevertheless the standard World Health Organization (WHO) guidelines for obesity are still most widely used and hence is the best common reference. Guidelines for the management of obesity have been published and projects to combat obesity are being run. However, more effort needs to be invested. Studies on intervention programmes showed that weight loss is not easy to achieve nor maintain. Laboratory research worldwide has uncovered several genetic and biochemical markers associated with obesity. Similar studies in Malaysia have found some biomarkers with an association to obesity in the local population but none of great significance. Keywords: overweight, obesity, Malaysia, abdominal obesity, physical activity, food intake,

hypertension, diabetes, metabolic syndrome, psychiatric conditions, breast cancer, colorectal cancer.

120

Lim PKC, Babar MG. Service learning in health professions education for the 21st century. IeJSME, 2016; 10(2): 1-2. (MyCite IF: 0.038).

Service learning in health professions education for the 21st century. Patricia Kim Chooi Lim1, Muneer Gohar Babar2. 1School of Medicine, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA 2School of Dentistry, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA

Abstract

Service learning has moved from a recommendation to an accreditation standard in the health professions. Service learning is an important educational tool to develop students’ knowledge and skills to make them useful citizens. Community development was considered to be the main goal of service-learning in the seventies.1 In the nineties the trend in service-learning moved from the academic and non-academic role of service-learning to volunteerism.2 In the new millennium the trend in service-learning has shifted again from mere volunteerism to a more comprehensive approach, that is, learning and development of the learner in the community setting.3,4 So what does service learning add to the student’s and faculty’s experiences and why should we be concerned with an additional level of academic complexity?

121

Lim SG, Muhamad Asyraf Bin Muhtar. Factors influencing nursing students’ decision to choose nursing. IeJSME, 2016; 10(2): 3-10. [IMU Internal Grant - BN101/2010(PR-13)2013]. (MyCite IF: 0.038).

Factors influencing nursing students’ decision to choose nursing. Swee Geok Lim, Muhamad Asyraf Bin Muhtar. Nursing Division, School of Health Sciences, International Medical University, Kuala Lumpur, 126 Jln Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA

Abstract Background: Nurses are the “front line” staff in most health systems and their contribution is

recognised as essential in meeting development goals and delivering safe and effective care (ICN, 2007). Nurses are in high demand not only in developed countries but also in developing countries like Malaysia. However, more than 70% of Malaysian hospitals currently do not have adequate nursing staff. At least 174,000 nurses need to be trained by 2020 to meet WHO’s nurse-to-patient ratio of 1:200. The purpose of this study is to identify the main factors that influence the nursing students’ decision to choose nursing as their career. Method: A descriptive study guided by Self Determination Theory was used for this study. A

29- item questionnaire adapted from McCabe, Nowak and Mullen (2005) was distributed to all students in a nursing college (n=117). Results: The five main reasons for choosing nursing as a career were “ability to help others”,

“training was provided on the job”, “ability to work closely with people”, “parental advice”, and “accommodation was provided while training”. The top three main domains that influenced the nursing students’ decision to choose nursing as their career include “travel opportunities of nursing”, “intrinsic attraction of nursing” and “immediacy of support on entry to nursing”. A total of 19 (0.2%) will not choose nursing if given a chance. The main reasons were “want to take another course”, “no time to spend with family” and “nursing is a stressful job”. Conclusion: The findings of this study provided valuable information regarding motivating factors which attract the current generation to join nursing. It is of concern that items representing nurses’ image were not rated highly. Keywords: career, extrinsic factors, intrinsic factors, nursing, student nurse.

122

Lim SG, Yam SW. The level of knowledge and competency in the use of the Morse Fall Scale as an assessment tool in the prevention of patient falls. IeJSME, 2016; 10(3): 14-23. (MyCite IF: 0.038).

The level of knowledge and competency in the use of the Morse Fall Scale as an assessment tool in the prevention of patient falls. Swee Geok Lim, Siew Woan Yam. Nursing Division, School of Health Sciences, International Medical University, Kuala Lumpur, MALAYSIA.

Abstract Introduction: Patient falls has been identified as one of the major issues in today’s health care despite efforts taken in preventing such incidents from happening (Cox et al., 2014).

Patient falls can be prevented by using fall risk assessment tools such as Morse Fall Scale. Morse Fall Scale was implemented in the year 2014 in a private hospital in Malaysia but the patient fall rate did not decrease. Objective: The research objective is to determine the nurses’ level of knowledge and

competency in the use of the Morse Fall Scale as an assessment tool in the prevention of patient falls. Method: A quantitative, descriptive, cross-sectional research design was conducted with 100

registered nurses from a private hospital in Selangor, Malaysia. Universal sampling technique was used to recruit the nurses. Results: The registered nurses had a moderate level of knowledge (M = 7.72; SD = 1.72) and

competency (scoring Morse Fall Scale, M = 4.75; SD = 1.26; planning intervention, M = 13.19; SD = 1.89) in using the Morse Fall Scale. Conclusion: It is recommended that a review of the training programme on the use of the

Morse Fall Scale be implemented in a more structured manner. Keywords: Assessment tool, competency, patient falls, knowledge, Morse Fall scale.

123

Ling APK, Chin JM, Koh RY, Wong YP. Investigating prostaglandin E2 and intracellular oxidative stress levels in lipopolysaccharide-stimulated RAW 264.7 macrophages upon treatment with Strobilanthes crispus. International Journal of Medical, Health, Biomedical, Bioengineering and Pharmaceutical Engineering, 2016; 10(5): 209-214. [IMU grant - BMSc

I01/2010(01)2012]. (IF: NA).

Investigating prostaglandin E2 and intracellular oxidative stress levels in lipopolysaccharide-stimulated RAW 264.7 macrophages upon treatment with Strobilanthes crispus. Anna Pick Kiong Ling, Jia May Chin, Rhun Yian Koh, Ying Pei Wong. Division of Human Biology, School of Health Sciences, International Medical University, Kuala Lumpur, MALAYSIA.

Abstract Background: Uncontrolled inflammation may cause serious inflammatory diseases if left

untreated. Non-steroidal anti-inflammatory drug (NSAIDs) is commonly used to inhibit pro-inflammatory enzymes, thus, reduce inflammation. However, long term administration of NSAIDs leads to various complications. Medicinal plants are getting more attention as it is believed to be more compatible with human body. One of them is a flavonoid-containing medicinal plants, Strobilanthes crispus which has been traditionally claimed to possess anti-inflammatory and antioxidant activities. Nevertheless, its anti-inflammatory activities are yet to be scientifically documented. Objectives: This study aimed to examine the anti-inflammatory activity of S. crispus by

investigating its effects on intracellular oxidative stress and prostaglandin E2 (PGE2) levels. Materials and Methods: In this study, the Maximum Non-toxic Dose (MNTD) of methanol extract of both leaves and stems of S. crispus was first determined using 3-(4,5-dimethylthiazolyl-2)-2,5-diphenytetrazolium Bromide (MTT) assay. The effects of S. crispus

extracts at MNTD and half MNTD (½MNTD) on intracellular ROS as well as PGE2 levels in 1.0 μg/mL LPS-stimulated RAW 264.7 macrophages were then be measured using DCFH-DA and a competitive enzyme immunoassay kit, respectively. Results: The MNTD of leaf extract was determined as 700μg/mL while for stem was as low

as 1.4μg/mL. When LPS-stimulated RAW 264.7 macrophages were subjected to the MNTD of S. crispus leaf extract, both intracellular ROS and PGE2 levels were significantly reduced.

In contrast, stem extract at both MNTD and ½MNTD did not significantly reduce the PGE2 level, but significantly increased the intracellular ROS level. Conclusion: The methanol leaf extract of S. crispus may possess anti-inflammatory properties as it is able to significantly reduce the intracellular ROS and PGE2 levels of LPS-stimulated cells. Nevertheless, further studies such as investigating the interleukin, nitric oxide and cytokine tumor necrosis factor-α (TNFα) levels has to be conducted to further confirm the anti-inflammatory properties of S. crispus. Keywords: Anti-inflammatory, natural products, prostaglandin E2, reactive oxygen species.

124

Low CY, Cheang QJ, Lim PH. Perceptions and evaluation regarding clinical teaching among nursing students in a selected nursing college in Selangor. IeJSME, 2016; 10(2): 21-29. (MyCite IF: 0.038).

Perceptions and evaluation regarding clinical teaching among nursing students in a selected nursing college in Selangor. Chia Yen Low1, Qing Jun Cheang1, Pek Hong Lim2. 1Bachelor of Nursing Honours Degree student, International Medical University, Kuala Lumpur, MALAYSIA 2School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA

Abstract Background: Clinical teaching is an important and essential teaching tool in the clinical area.

Clinical teaching and learning is essential for the development and progression of experiential nursing knowledge. Objectives: This research study aims to identify the perceptions and evaluations regarding

clinical teaching among Year 2 and Year 3 nursing students, and also to find out if there are any differences in the perceptions and evaluations of the nursing students in regards to clinical teaching. Methods: The formula for calculating the sample size was adopted from Morris (2005). The

sample size obtained from the calculation with the confidence interval of 95%, was 132 participants. The participants were taken from a universal population of 142 diploma nursing students: 50 Year 2 nursing students and 92 Year 3 nursing students from the International Medical College in Selangor. The research instrument used was the Bedside Teaching Evaluation questionnaire that was adapted with approval by the writer from the University of Witwatersrand Department of Surgery (2008). A pilot study was conducted on 20 participants of Year 1 to Year 3 nursing students from the Assunta College of Nursing, with a Cronbach’s alpha reliability index of 0.89. Results: The data collected were analysed using descriptive statistics to find out the

participant’s perceptions and evaluations regards clinical teaching; and also to compare the perceptions and evaluations between the two groups of nursing students from Years 2 and 3. The study findings showed that 46% (n=142) of the respondents had a good feedback on all the five (5) items under the perceptions of clinical teaching whereas 42% (n=142) of the respondents had a moderate view on all the five (5) items in the perceptions of clinical teaching sessions. With regards to the evaluation of clinical teaching sessions, 50% of the respondents had a moderate feedback on all the three (3) items in this section. Conclusion: Most of the participants perceived and evaluated the clinical teaching as an important teaching-learning strategy in enhancing clinical learning. Keywords: Perceptions, Evaluation, Nursing student, Clinical teaching, Nurses.

125

Low ML, Chan CW, Ng PY, Ooi IH, Mohd Jamil M, Chye SM, Ng SW, Tan KW, Ng CH. Ternary and binary copper(II) complexes: Synthesis, characterization, ROS-inducive, proteasome inhibitory and anticancer properties. Journal of Coordination Chemistry, 2016; 1-19. DOI: http://dx.doi.org/10.1080/00958972.2016.1260711. (SCI IF: 1.79; HI: 39; Tier: Q2).

Ternary and binary copper(II) complexes: Synthesis, characterization, ROS-inducive, proteasome inhibitory and anticancer properties. May Lee Low, Cheang Wei Chan, Pei Ying Ng, Ing Hong Ooi, Mohd Jamil Maah, Soi Moi Chye, Kong Wai Tan, Seik Weng Ng, Chew Hee Ng.

Abstract

Three ternary copper(II) complexes, [Cu(phen)(L-phe)Cl]·2H2O, [Cu(phen)(L-leu)Cl]·4½H2O, and [Cu(phen)(L-tyr)Cl]·3H2O, and four binary copper(II) complexes, [Cu(phen)Cl2], Cu(L-phe)2·½H2O, Cu(L-leu)2·½H2O, and Cu(L-tyr)2·H2O (where phen = 110-phenanthroline, L-phe = L-phenylalanine, L-tyr = L-tyrosine, L-leu = L-leucine and Cl- = chloride), were synthesized and characterized by elemental analysis, spectroscopic techniques (FTIR, UV–visible, fluorescence spectroscopy), magnetic susceptibility, molar conductivity, and lipophilicity measurement. X-ray diffraction determination of a single crystal of [Cu(phen)(L-tyr)Cl] showed two independent molecules in the asymmetric unit, each with the same distorted square pyramidal geometry about copper(II). p-Nitrosodimethylaniline assay revealed that the three ternary complexes were better inducers of reactive oxygen species over time than binary complexes, CuCl2, and free ligands. All the copper(II) complexes in this series inhibited the three proteolytic activities in the order Trypsin-like > Caspase-like > Chymotrypsin-like. In terms of anticancer properties, the copper(II)-phen complexes had GI50 values of less than 4 μM against MCF-7, HepG2, CNE1 and A549 cancer cell lines, more potent than cisplatin.

http://dx.doi.org/10.1080/00958972.2016.1260711

126

Maharajan MK, Ranjan A, Chu JF, Foo WL, Chai ZX, Lau EY, Ye HM, Theam XJ, Lok YL. Zika virus infection: Current concerns and perspectives. Clinical Reviews in Allergy and Immunology, 2016; published online. Doi: 10.1007/s12016-016-8554-7. (ISI IF: 5.313; SCI IF:

4.556; HI: 53; Tier: Q2).

Zika virus infection: Current concerns and perspectives. Mari Kannan Maharajan1, Aruna Ranjan1, Jian Feng Chu1, Wei Lim Foo1, Zhi Xin Chai1, Eileen Yin Yien Lau1, Heuy Mien Ye1, Xi Jin Theam1, Yen Ling Lok1. 1Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia

Abstract The Zika virus outbreaks highlight the growing importance need for a reliable, specific and rapid diagnostic device to detect Zika virus, as it is often recognized as a mild disease without being identified. Many Zika virus infection cases have been misdiagnosed or underreported because of the non-specific clinical presentation. The aim of this review was to provide a critical and comprehensive overview of the published peer-reviewed evidence related to clinical presentations, various diagnostic methods and modes of transmission of Zika virus infection, as well as potential therapeutic targets to combat microcephaly. Zika virus is mainly transmitted through bites from Aedes aegypti mosquito. It can also be transmitted through

blood, perinatally and sexually. Pregnant women are advised to postpone or avoid travelling to areas where active Zika virus transmission is reported, as this infection is directly linked to foetal microcephaly. Due to the high prevalence of Guillain-Barre syndrome and microcephaly in the endemic area, it is vital to confirm the diagnosis of Zika virus. Zika virus infection had been declared as a public health emergency and of international concern by the World Health Organisation. Governments and agencies should play an important role in terms of investing time and resources to fundamentally understand this infection so that a vaccine can be developed besides raising awareness. Keywords: Zika virus, Diagnosis, Cytokines, Transmission, Management.

127

Mai CW, Yap IKS, Kho MT, Nor Hadiani Ismail, Yusoff K, Shaari K, Chin SY, Lim ESH. Mechanisms underlying the anti-inflammatory effects of Clinacanthus nutans Lindau extracts: Inhibition of cytokine production and toll-like receptor-4 activation. Frontiers in Pharmacology,

2016; (in press). DOI: http://dx.doi.org/10.3389/fphar.2016.00007. (ISI IF: 4.418; SCI IF: 4.215; HI: 32; Tier: Q1).

Mechanisms underlying the anti-inflammatory effects of Clinacanthus nutans Lindau extracts: Inhibition of cytokine production and toll-like receptor-4 activation. Mai CW1, Yap KS2, Kho MT3, Ismail NH4, Yusoff K5, Shaari K6, Chin SY1, Lim ES7. 1Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University Bukit Jalil, Malaysia. 2Department of Life Sciences, School of Pharmacy, International Medical University Bukit Jalil, Malaysia. 3School of Postgraduate Studies and Research, International Medical University Bukit Jalil, Malaysia. 4Atta-ur-Rahman Institute for Natural Products Discovery, Universiti Teknologi MARA Shah Alam, Malaysia. 5Institute of Bioscience, Universiti Putra Malaysia Serdang, Malaysia; Department of Microbiology, Faculty of Biotechnology and Biomolecular Sciences, Universiti Putra MalaysiaSerdang, Malaysia. 6Institute of Bioscience, Universiti Putra Malaysia Serdang, Malaysia. 7Perdana University-Royal College of Surgeons Ireland, Perdana University Serdang, Malaysia.

Abstract Clinacanthus nutans has had a long history of use in folk medicine in Malaysia and Southeast

Asia; mostly in the relief of inflammatory conditions. In this study, we investigated the effects of different extracts of C. nutans upon lipopolysaccharide (LPS) induced inflammation in order to identify its mechanism of action. Extracts of leaves and stem bark of C. nutans were

prepared using polar and non-polar solvents to produce four extracts, namely polar leaf extract (LP), non-polar leaf extract (LN), polar stem extract (SP), and non-polar stem extracts (SN). The extracts were standardized by determining its total phenolic and total flavonoid contents. Its anti-inflammatory effects were assessed on LPS induced nitrite release in RAW264.7 macrophages and Toll-like receptor (TLR-4) activation in TLR-4 transfected human embryonic kidney cells (HEK-Blue(TM)-hTLR4 cells). The levels of inflammatory cytokines (TNF-α, IFN-γ, IL-1β, IL-6, IL-12p40, and IL-17) in treated RAW264.7 macrophages were quantified to verify its anti-inflammatory effects. Western blotting was used to investigate the effect of the most potent extract (LP) on TLR-4 related inflammatory proteins (p65, p38, ERK, JNK, IRF3) in RAW264.7 macrophages. All four extracts produced a significant, concentration-dependent reduction in LPS-stimulated nitric oxide, LPS-induced TLR-4 activation in HEK-Blue(TM)-hTLR4 cells and LPS-stimulated cytokines production in RAW264.7 macrophages. The most potent extract, LP, also inhibited all LPS-induced TLR-4 inflammatory proteins. These results provide a basis for understanding the mechanisms underlying the previously demonstrated anti-inflammatory activity of C. nutans extracts. Keywords: Clinacanthus nutans, Toll-like receptor 4, anti-inflammatory agents, macrophages.

total flavonoid content.

http://dx.doi.org/10.3389/fphar.2016.00007

128

Mak JW. Research integrity. IeJSME, 2016; 10(3): 1-3. (MyCite IF: 0.038).

Research integrity. Joon Wah Mak. International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA

Abstract

Good practices in research, including data interpretation, communications of findings, and the translation of results to applications, are desired outcomes expected by funding agencies, the scientific community and the public. However, there are concerns that violations of expected good practices can occur at any point during the process, including at formulation of the research project, conduct of research, and also in the publication of research findings.

Research integrity has been defined as responsible, honest, ethical, professional conduct and management of research. Research integrity must begin from project proposal, during its conduct, and continue even after project completion, including the publication, and translation of findings for application. Any deviation of expected behaviour related to these activities will trigger attention and scrutiny to determine if serious violations have occurred regarding expected integrity and responsibility of those involved in the research process.

Arising from concerns of violations on responsible research, the European Science Foundation (ESF) and the US Office of Research Integrity (ORI), Department of Health and Human Services, convened the First World Conference on Research Integrity in Lisbon, Portugal, on 16 – 19 September 2007, and issued its Report on strategies fostering responsible research and harmonising policies on research misconduct.1 It encouraged all countries to formulate best research practice guidelines and also procedures for responding to research misconduct. It further recommended that the ESF and ORI should lead in developing a Global Clearing House for Research Integrity, providing information on each nation’s policies on research conduct/misconduct, training programmes on responsible research, and related activities and organisational contacts.1

The Singapore Statement on Research Integrity which was developed at the Second World Congress on Research Integrity, 21 – 24 July 2010 serves as a global guide for responsible conduct of research.2 It sets out the principles of honesty, accountability, professional courtesy and fairness, as well as good stewardship in research activities. A list of 14 responsibilities relating to the above principles for research integrity was officially formulated.

The Montreal Statement developed at the Third World Conference on Research Integrity, 5 – 8 May 2013, in Montreal, added guidelines to research responsibility in relation to cross-boundary research collaboration.3

129

Mani SD, Vengadasamy R, Hamdan IS. Chado in Murakami’s Sputnik Sweetheart: Asymmetry, boundaries and chanced meetings. Forum for World Literature Studies, 2016; 8(1): 161-176. (IF: NA).

Chado in Murakami’s Sputnik Sweetheart: Asymmetry, boundaries and chanced meetings. Sheba D.Mani1, Ravichandran Vengadasamy2, Shahizah Ismail Hamdan3. 1Department of Language, Communication and Culture, International Medical University (IMU) 2National University of Malaysia 3School of Language and Linguistics Studies (SOLLS), National University of Malaysia.

Abstract

The Japanese tea ceremony, also known as chado, embodies the values of impermanence, imperfection and incompleteness. These values are translated into the practices of the tea ceremony in a regulated manner, through the concepts of sukiya, roji and ichigo ichie. Sukiya which represents asymmetric characteristics is seen in the structure of the tea house and utensils, roji is expressed through boundaries for the purpose of signifying differences or creating intimacy and, ichigo ichie encapsulates the entirety of the experience as a single chance in a single meeting to receive a lesson about life. This article aims to show how the Japanese worldview, interpreted through the principles of the tea ceremony is appropriated in Haruki Murakami's novel Sputnik Sweetheart (2002). Through a symbolic encounter with the tea ceremony, the concepts of sukiya, roji and ichigo ichie are employed to analyse the characters in Sputnik Sweetheart. These concepts are appropriated to character study by examining their idiosyncrasies, relationships and the unique experiences they encounter. By this way, the novel transfers the Japanese tea ceremony and its underlying worldview to literature.

130

Mansuri S, Kesharwani P, Jain K, Tekade RK, Jain NK. Mucoadhesion: A promising approach in drug delivery system. Reactive and Functional Polymers, 2016; 100: 151-72. (ISI IF: 2.725; SCI IF: 2.774; HI: 72; Tier: Q1).

Mucoadhesion: A promising approach in drug delivery system. Shakir Mansuri1, Prashant Kesharwani1,2, Keerti Jain1,3, Rakesh K. Tekade4, N.K. Jain1,5. 1Department of Pharmaceutical Sciences, Dr. H. S. Gour Central University, Sagar, MP 470003, India 2Department of Pharmaceutical Sciences, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI 48201, USA 3Department of Pharmaceutics, National Institute of Pharmaceutical Education and Research, Raebareli, UP 229010, India 4Department of Pharmaceutical Technology, School of Pharmacy, The International Medical University Jalan Jalil Perkasa 19, Kuala Lumpur 57000, Malaysia 5School of Pharmaceutical Sciences, Rajiv Gandhi Technical University, Bhopal, MP 462036, India

Abstract

Mucoadhesion, the state in which two materials, amongst which one is biological in nature, adhere to each other for extended periods of time with the help of interfacial forces, provides an attractive strategy to overcome the hurdles of conventional drug delivery systems including first pass metabolism, and localized delivery of biomolecules including proteins, peptides and oligonucleotides. Mucoadhesion provides great opportunities for the delivery of a variety of compounds via different routes of administration viz. ocular, nasal, vaginal and buccal. In addition mucoadhesion also makes it possible to obtain prolonged, local or systemic drug action. In this review we discussed about potential applications of mucoadhesion and mucoadhesive polymers in drug delivery along with the mechanism of mucoadhesion and the methods for evaluation of mucoadhesive drug delivery systems. Keywords: Mucoadhesion, Bioadhesion, Polymer, Lectins, Drug delivery, Routes of drug administration.

131

Matin MM, Nath AR, Attiyah AS, Bhuiyan MMH, Kadir F, Hamid SBA, Alhadi AA, Ali E, Yehya WA. Synthesis, PASS-predication and in vitro antimicrobial activity of benzyl 4-O-benzoyl-L-rhamnopyranoside derivatives. International Journal of Molecular Sciences, 2016; 17: 1412;

doi: 10.3390/ijms17091412. (ISI IF: 3.257; SCI IF: 3.419; HI: 64; Tier: Q1).

Synthesis, PASS-predication and in vitro antimicrobial activity of benzyl 4-O-benzoyl-L-rhamnopyranoside derivatives. Mohammed Mahbubul Matin1, Amit R. Nath2, Omar Saad3, Mohammad M. H. Bhuiyan1, Farkaad A. Kadir4, Sharifah Bee Abd Hamid2, Abeer A. Alhadi5, Md. Eaqub Ali2 and Wageeh A. Yehye2. 1Organic Research Laboratory, Department of Chemistry, University of Chittagong, Chittagong 4331, Bangladesh 2Nanotechnology & Catalysis Research Centre (NANOCAT), University of Malaya, Block 3A, Institute of Postgraduate Studies Building, Kuala Lumpur 50603, Malaysia 3Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia 4Division of Human Biology, School of Medicine, International Medical University, Kuala Lumpur 57000, Malaysia 5Department of Chemistry, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia

Abstract Benzyl -L-rhamnopyranoside 4, obtained by both conventional and microwave assisted glycosidation techniques, was subjected to 2,3-O-isopropylidene protection to yield compound 5 which on benzoylation and subsequent deprotection of isopropylidene group gave the desired 4-O-benzoylrhamnopyranoside 7 in reasonable yield. Di-O-acetyl derivative of benzoate 7 was prepared to get newer rhamnopyranoside. The structure activity relationship (SAR) of the designed compounds was performed along with the prediction of activity spectra for substances (PASS) training set. Experimental studies based on antimicrobial activities verified the predictions obtained by the PASS software. Protected rhamnopyranosides 5 and 6 exhibited slight distortion from regular 1C4 conformation, probably due to the fusion of pyranose and isopropylidene ring. Synthesized rhamnopyranosides 4–8 were employed as test chemicals for in vitro antimicrobial evaluation against eight human pathogenic bacteria and two fungi. Antimicrobial and SAR study showed that the rhamnopyranosides were prone against fungal organisms as compared to that of the bacterial pathogens. Interestingly, PASS prediction of the rhamnopyranoside derivatives 4–8 were 0.49 < Pa < 0.60 (where Pa is probability ‘to be active’) as antibacterial and 0.65 < Pa < 0.73 as antifungal activities, which showed significant agreement with experimental data, suggesting rhamnopyranoside derivatives 4–8 were more active against pathogenic fungi as compared to human pathogenic bacteria thus, there is a more than 50% chance that the rhamnopyranoside derivative structures 4–8 have not been reported with antimicrobial activity, making it a possible valuable lead compound. Keywords: L-rhamnose, benzyl -L-rhamnopyranoside, benzoylation, prediction of activity spectra for substances (PASS), structure activity relationship, antimicrobial agents.

132

Meesala R, Ahmad Saifuddin MA, Mohd Nizam M, Sharif MM. Iodine-catalyzed one-pot decarboxylative aromatization of tetrahydro-β-carbolines. Tetrahedron, 2016; 72(52): 8537–8541. DOI: http://dx.doi.org/10.1016/j.tet.2016.10.069. (ISI IF: 2.645; SCI IF: 2.704; HI: 189; Tier: Q1).

Iodine-catalyzed one-pot decarboxylative aromatization of tetrahydro-β-carbolines. Ramu Meesala1, Ahmad Saifuddin Mohamad Arshad2, Mohd Nizam Mordi2, Sharif Mahsufi Mansor2. 1Department of Pharmaceutical Chemistry, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil 57000, Kuala Lumpur, Malaysia 2Centre for Drug Research, Universiti Sains Malaysia, Minden 11800, USM, Penang, Malaysia

Abstract

A synthetic strategy was developed for the preparation of b-carbolines by one-pot decarboxylation and aromatization of tetrahydro-β-carboline-3-carboxylic acids by employing 10 mol% of iodine in presence of oxidant aqueous H2O2. The method was also successfully extended for the aromatization of tetrahydro-β-carboline-3-methyl esters. The utility of the method was demonstrated in the synthesis of bcarboline alkaloids norharmane, harmane and eudistomin N. Keywords: β-Carboline, Decarboxylative aromatization, Iodine, Hydrogen peroxide,

Tetrahydro-β-carboline.

http://dx.doi.org/10.1016/j.tet.2016.10.069

133

Menon V, Mohideen R. Assessing clinical reasoning skills of final year medical students using the script concordance test. IeJSME, 2016; 10(1): 36-40. (MyCite IF: 0.038).

Assessing clinical reasoning skills of final year medical students using the script concordance test. Velayudhan Menon, Rifdy Mohideen. Department of Internal Medicine, International Medical University, MALAYSIA.

Abstract Background: Clinical reasoning is the name given to the cognitive processes by which doctors evaluate and analyse information from patients. It is a skill developed by experiential learning and is difficult to assess objectively. The script concordance test, an assessment tool introduced into the health sciences about 15 years ago, is a way of assessing clinical reasoning ability in an objective manner and allows comparisons of the decisions made by medical students and experts in situations of uncertainty. Methods: Twenty-six final year medical students from the International Medical University,

Kuala Lumpur, were tested on their decision making skills regarding a young febrile patient. The students evaluated different pieces of information in five different scenarios and made decisions on a five-point Likert scale in the standard format of the script concordance test. Their decisions were compared to the decisions of a panel of experienced clinicians in Internal Medicine. Results: The script concordance test scores for the different scenarios were calculated with

higher scores being indicative of greater concordance between the reasoning of students and doctors. The students showed poor concordance with doctors in evaluating clinical information. Overall, only 20 percent of the choices made by students were the same as the choices made by the majority of doctors. Conclusion: Medical students vary in their ability to interpret the significance of clinical information. Using the script concordance test, this preliminary study looked at the ability of final year medical students to interpret information about a patient with a febrile illness. The results showed poor concordance between students and doctors in the way they interpreted clinical information. The script concordance test has the potential to be a tool for teaching and assessing clinical reasoning. Keywords: Assessment in medical education, clinical reasoning, script concordance test.

134

Molugulu N, Tumkur A, Nilugal KC. Study of premenstrual syndrome among future healthcare professionals in Masterskill Global College. International Journal of Pharmacy and Pharmaceutical Sciences, 2016; 8(2): 66-71. ISSN- 0975-1491. (ISI IF: 0.49; SCI IF: 0.486;

HI: 24; Tier: Q2).

Study of premenstrual syndrome among future healthcare professionals in Masterskill Global College. Nagashekhara Molugulu1, Anil Tumkur1, Kiran C Nilugal2. 1International Medical University, Kuala Lumpur, Malaysia 2Asia Metropolitian University, Kuala Lumpur, Malaysia

Abstract Objective: Premenstrual syndrome (PMS) is the name given to a collection of physical, psychological and behavioral symptoms that experienced by women during their late luteal phase of each menstrual cycle. This study was undertaken at Masterskill Global College to determine the prevalence of PMS, common premenstrual syndrome symptoms, and coping methods. It also highlights the impairment of life, social and emotional well beings. Methods: This is a cross-sectional descriptive study using the retrospective method,

analyzing the incidence of PMS based on (ACOG) criteria. Results: The outcome of the study showed that 37% out of 300 samples diagnosed with PMS;

22% mild PMS. 9% moderate PMS and 5.3% severe PMS. 7% of the sample was diagnosed with Premenstrual Dysphoric Disorder (PMDD). The study finding suggested association of PMS severity with younger age group (P value<0.05), stressful lifestyles (P value<0.05), academic stress (P value<0.05) and sleeping problem (P value<0.05). Conclusion: The study outcome showed PMS prevalence in Masterskill Global College and

action shall be taken to provide as an educational guideline to increase their awareness and provide a better coping method to alleviate the symptoms of PMS. Keywords: Premenstrual Dysphoric Disorder, ACOG Criteria, Late Luteal Phase, Premenstrual Symptoms.

135

Motlagh F, Ibrahim F, Menke JM, Rashid R, Seghatoleslam T, Habil H. Neuroelectrophysiological approaches in heroin addiction research: A review of literatures. Journal of Neuroscience Research, 2016; 94(4): 297-309. doi: 10.1002/jnr.23703. (ISI IF:

2.689; SCI IF: 2.606; HI: 132; Tier: Q3).

Neuroelectrophysiological approaches in heroin addiction research: A review of literatures. Motlagh F1,2,3, Ibrahim F1,2, Menke JM4, Rashid R3, Seghatoleslam T3, Habil H3. 1Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. 2Centre for Innovation in Medical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur, Malaysia. 3Centre of Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia. 4Department of Psychology, School of Medicine, International Medical University, Kuala Lumpur, Malaysia.

Abstract Neuroelectrophysiological properties have been used in human heroin addiction studies. These studies vary in their approach, experimental conditions, paradigms, and outcomes. However, it is essential to integrate previous findings and experimental methods for a better demonstration of current issues and challenges in designing such studies. This Review examines methodologies and experimental conditions of neuroelectrophysiological research among heroin addicts during withdrawal, abstinence, and methadone maintenance treatment and presents the findings. The results show decrements in attentional processing and dysfunctions in brain response inhibition as well as brain activity abnormalities induced by chronic heroin abuse. Chronic heroin addiction causes increased β and α2 power activity, latency of P300 and P600, and diminished P300 and P600 amplitude. Findings confirm that electroencephalography (EEG) band power and coherence are associated with craving indices and heroin abuse history. First symptoms of withdrawal can be seen in high-frequency EEG bands, and the severity of these symptoms is associated with brain functional connectivity. EEG spectral changes and event related potential (ERP) properties have been shown to be associated with abstinence length and tend to normalize within 36 months of abstinence. From the conflicting criteria and confounding effects in neuroelectrophysiological studies, the authors suggest a comprehensive longitudinal study with a multimethod approach for monitoring EEG and ERP attributes of heroin addicts from early stages of withdrawal until longterm abstinence to control the confounding effects, such as nicotine abuse and other comorbid and premorbid conditions. Keywords: EEG, ERP, brain signals, cognitive dysfunction, methadone, opioids.

136

Munjan JH, Vijayan SE, Chellamuthu L, Ho SE. Perception of adult patient towards the importance of prevention of coronary artery disease in a private hospital in Malaysia. The Malaysian Journal of Nursing, 2016; 7(4): 49-55. (IF: NA).

Perception of adult patient towards the importance of prevention of coronary artery disease in a private hospital in Malaysia. Leela Chellamuthu, Ho Siew Eng, Joel Hoashea Munjan, Susanna Emmanuel Vijayan. Division of Nursing, Internaĕonal Medical University, Bukit Jalil, Kuala Lumpur, Malaysia

Abstract Aim: This study aims to determine the perception of adult patients towards the importance of

prevention of coronary artery diseases (CAD) in order to raise awareness on the risk of CAD. Method: 80 adults between 18 - 40 years old were enrolled in the out-patient department at a

private hospital. The awareness and perception of the importance of preventing CAD were assessed using a questionnaire. Result: The level of perception on the importance of prevention of CAD was quite good. 75%

of the subjects (n = 60) recorded good level of perception meaning they are aware of the importance of prevention of CAD. 22.5% of the subjects (n = 18) recorded a satisfactory level of perception while only 2.5% of the subjects (n = 2) recorded a poor level of perception towards the importance of prevention of CAD. Majority of the subjects had good perception on importance of a balanced diet, exercise and active lifestyle. Conclusion: In conclusion it can be said that although people are aware of the risk posed by

CAD, recommendations such as proper health teachings and guide lines are still required to ensure that the community is able to understand the risk and take preventive measure in order to reduce the risk of obtaining the risk of heart disease. Keywords: Coronary artery disease, perception of Coronary Heart Disease, prevention of

coronary heart disease.

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Murthy CRV, Molugulu N, Chyn LT, Samuel VP, Kademane K, Gubbiyappa KS, Pushpa BS. Ethical, social and legal intricacies on facial transplant. Anthropologist, 2016; 25(1,2): 117-121. (SCI IF: 0.222; HI: 9; Tier: Q2).

Ethical, social and legal intricacies on facial transplant. C. R. Vasudeva Murthy1, Molugulu Nagashekhara2, Lim Tzer Chyn3, Vijaya Paul Samuel1, Kumaraswamy Kademane1, Kumar Shiva Gubbiyappa2 and B. S. Pushpa4. 1School of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia 2School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia 3Biomedical Student, International Medical University, Bukit Jalil, Kuala Lumpur 57000, Malaysia 4Graduate Research Assistant, University Kebangsaan Malaysia

Abstract Facial tissue has become a clinical reality and is gaining popularity as the preferred surgical option for patients with devastating facial deformities due to disease, trauma or congenital malformation. Conventional facial reconstruction method can be lengthy, laborious, inflicting unbearable pain and may require prolonged hospitalization. On the contrary, restoration of aesthetics and functionality by facial tissue allotransplant is superior and has minimized all of those undesirable affects mentioned above. Nevertheless, these surgical options are associated with complex social, ethical and legal aspects. The primary objective of this review is to provide a glimpse of the history of facial transplantation and discuss the critical issues related to facial transplant. Keywords: Change of Identity, Dilemma, Reconstructive Surgery.

138

Nagendrababu V, Gutmann JL. Factors associated with postobturation pain following single-visit nonsurgical root canal treatment: A systematic review. Quintessence International, 2016; doi: 10.3290/j.qi.a36894. (ISI IF: 1.04; SCI IF: 0.788; HI: 58; Tier: Q2).

Factors associated with postobturation pain following single-visit nonsurgical root canal treatment: A systematic review. Nagendrababu V, Gutmann JL.

Abstract Objective: Reducing the pain after root canal therapy is a key aspect in endodontic practice.

The present systematic review aimed to identify the factors that influence postobturation pain (POP) in patients receiving single-visit nonsurgical root canal treatment. Data Sources: A literature search was performed manually and in Pubmed (Medline)

database to identify relevant articles. A data extraction form was constructed and data were collected from the identified articles. Results: In total, 24 articles were identified for the systematic review, and factors associated

with POP were tabulated. Conclusion: Specific preoperative factors (old age, sex, molar teeth, mandibular teeth,

presence of preoperative pain, and absence of periapical radiolucency) and procedures (administration of prophylactic drug, bupivicaine anesthetic agent, radiograph or apex locator working length determination methods, instrumentation, irrigating system, laser, cold lateral compaction obturation technique, reducing the occlusion, and postoperative drugs) were associated with POP.

139

Naik SV, Rajeshwari K, Kohli S, Zohabhasan S, Bhatia S. Ozone - A biological therapy in dentistry - Reality or myth????? Open Dentistry Journal, 2016; 10: 196–206. (SCI IF: 0.952; HI: 9; Tier: Q3).

Ozone - A biological therapy in dentistry - Reality or myth????? Saraswathi V. Naik1, Rajeshwari K2, Shivani Kohli3, Sayyad Zohabhasan4 and Shekhar Bhatia5. 1Department of Pedodontics and Preventive Dentistry, Bapuji Dental College and Hospital, Davangere, India 2Department of Prosthodontics, KLE Institute of Dental Sciences, Bangalore, India 3Department of Prosthodontics, Faculty of Dentistry, MAHSA University, Kaula lumpur, Malaysia 4Department of Oral Medicine and Radiology, Vyedhi Institue of Dental Sciences and Research, Bangalore, India 5International Medical University, Kuala Lumpur, Malaysia

Abstract The usage of ozone in dentistry has been proposed because of its antimicrobial, disinfectant, biocompatibility and healing properties. In the last decade a number of therapeutic protocols with ozone have been developed to address common dental infections associated with periodontal disease, RCT and caries. Despite these advantages, therapeutic ozone’s application in dentistry is limited because of its possible side effects. Hence, dental practitioners need to know the proper usage of ozone therapy that can provide better patient care and considerably cut down the time and cost of the treatment. Keywords: Antimicrobial, dental applications, Ozone therapy, RCT and caries.

140

Naing C, Aung K, Lai PK, Mak JW. Association between telomere length and the risk of colorectal cancer: A meta-analysis of observational studies. BMC Cancer, 2016; 17(24):1-7. (ISI IF: 3.265; SCI IF: 3.412; HI: 84; Tier: Q1).

Association between telomere length and the risk of colorectal cancer: A meta-analysis of observational studies. Cho Naing1, Kyan Aung2, Pei Kuan Lai1 and Joon Wah Mak1. 1School of Postgraduate Studies, International Medical University (IMU), Kuala Lumpur 57000, Malaysia. 2School of Medicine, International Medical University (IMU), Kuala Lumpur, Malaysia.

Abstract Background: Human chromosomes are capped and stabilized by telomeres. Telomere length

regulates a ‘cellular mitotic clock’ that defines the number of cell divisions and hence, cellular life span. This study aimed to synthesize the evidence on the association between peripheral blood leucocytes (PBL) telomere length and the risk of colorectal cancer (CRC). Methods: We searched relevant studies in electronic databases. When two or more observational studies reported the same outcome measures, we performed pooled analysis. All the analyses were performed on PBL using PCR. The odds ratio (OR) and its 95% confidence interval (CI) were used to assess the strength of association. Results: Seven studies (with 8 datasets) were included in this meta-analysis; 3 prospective

studies, 3 retrospective studies and 1 study with a separate prospective and retrospective designs. The pooled analysis of 4 prospective studies (summary OR 1.01, 95% CI: 0.77–1.34, I2:30%) and 4 retrospective studies (summary OR 1.65, 95% CI: 0.96–2.83, I2:96%) showed no relationship between PBL telomere length and the CRC risk. A subgroup analysis of 2 prospective studies exclusively on females also showed no association between PBL telomere length and the CRC risk (summary OR, 1.17, 95% CI:0.72–1.91, I2:57%). Conclusion: The current analysis is insufficient to provide evidence on the relationship between PBL telomere length and the risk of CRC. Findings suggest that there may be a complex relationship between PBL telomere length and the CRC risk or discrepancy between genetics, age of patients and clinical studies. Future well powered, large prospective studies on the relationship between telomere length and the risk of CRC, and the investigations of the biologic mechanisms are recommended. Keywords: Telomere, Colorectal cancer, Association, Meta-analysis.

141

Naing C, Sandhu NK, Wai VN. The effect of malaria and HIV co-infection on anemia: A meta-analysis. Medicine, 2016; 95(14). (ISI IF: 2.133; SCI IF: 1.614; HI: 111; Tier: Q1).

The effect of malaria and HIV co-infection on anemia: A meta-analysis. Cho Naing1, Nisha Kaur Sandhu1, Victor Nyunt Wai2. 1School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia. 2School of Medicine, International Medical University, Kuala Lumpur, Malaysia.

Abstract

Malaria and human immunodeficiency virus (HIV) infections are globally important public health concerns. The objectives of this study were (i) to determine the prevalence of malaria and HIV coinfections in people living in endemic countries, and (ii) to assess the effect of co-infection on anemia.

Studies were searched on electronic databases including PubMed, Embase, Medline, Google Scholar, and African Journals Online. Observational studies, assessing the prevalence of co-infection and reporting its association with anemia, were included. The methodological quality of included studies was assessed using a tool called the risk of bias assessment for non-randomized studies. Heterogeneity among studies was investigated with the I-square test. Pooled prevalence of the coinfection and its 95% confidence interval (CI) were estimated using the random-effect model, reflected on heterogeneity among studies. Summary odds ratio (OR), summary standardized mean difference (SMD), and their corresponding 95% CIs were estimated, as appropriate. Subgroup analysis and meta-regression were performed for robustness of results. Publication bias was assessed by visualization of a funnel plot.

Twenty-three studies were included in the present study. Overall, the pooled prevalence of co-infection was 19% (95% CI: 15–23%, I2: 98.1%), showing 26% (95% CI: 20–32%, I2: 98.7%) in adults, 12% (95% CI: 7–17%, I2: 95.0) in pregnant women, and 9% (95% CI: 6–11%, I2: 68.6%) in children. Anemia was comparable between the monoinfected and co-infected adults (summary OR: 1.49, 95% CI: 0.93–2.37) and increased by 49% in co-infected pregnant women (summary OR: 1.49, 95% CI: 1.14–1.94). The mean hemoglobin concentration was significantly lower in the co-infected group than the monoinfected group (summary SMD: -0.47, 95% CI: -0.61 to -0.33). The results of meta-regression on the prevalence of co-infection using the publication year and total population as covariates showed the I2 value remained high implying a de facto random distribution of heterogeneity. An asymmetrical funnel plot indicated the presence of publication bias. Due to heterogeneity of the studies in this review, the results have to be interpreted with caution.

The findings of this study suggest that the prevalence of malaria and HIV co-infection, particularly in pregnant women, requires special attention from healthcare personnel. Better understanding of the coinfection is crucial for designing treatment strategies. Future well-powered, prospective designs assessing the interaction between malaria and HIV are recommended.

142

Naing C, Whittaker M, Aung K, Racloz V. Anabolic steroids for treating pressure ulcers. Cochrane Database of Systematic Reviews, 2016; Issue 11. Art. No.: CD011375. DOI: 10.1002/14651858.CD011375. (ISI IF: 6.103; SCI IF: 4.662; HI: 133; Tier: Q1).

Anabolic steroids for treating pressure ulcers. Cho Naing1,2, Maxine A Whittaker1, Kyan Aung3, Vanessa Racloz1. 1ACITH/ School of Population Health, University of Queensland, Brisbane, Australia. 2School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia. 3School of Medical Science, International Medical University, Kuala Lumpur, Malaysia.

Abstract This is the protocol for a review and there is no abstract. The objectives are as follows: To determine the effects of anabolic steroids on the healing of pressure ulcers of any grade, in any care setting; to establish whether anabolic steroids are an effective treatment; whether there is an optimal anabolic steroid, treatment duration and dosage; and which anabolic steroid has fewest side effects.

143

Naing C, Yeoh PN, Wai VN, Win NN, Lai PK, Aung K. Hypertension in Malaysia: An Analysis of Trends from the National Surveys 1996 to 2011. Medicine, 2015; 95(2): e2417. (ISI IF: 2.133; SCI IF: 1.614; HI: 111; Tier: Q1).

Hypertension in Malaysia: An Analysis of Trends from the National Surveys 1996 to 2011. Cho Naing, Peng Nam Yeoh, Victor Nyunt Wai, Ni Ni Win, Lai Pei Kuan, Kyan Aung. International Medical University, Kuala Lumpur, Malaysia.

Abstract

This study aimed to determine trends in prevalence, awareness, and control of hypertension in Malaysia and to assess the relationship between socioeconomic determinants and prevalence of hypertension in Malaysia.

The distribution of hypertension in Malaysia was assessed based on available data in 3 National Health and Morbidity Surveys (NHMSs) and 1 large scale non-NHMS during the period of 1996 to 2011. Summary statistics was used to characterize the included surveys. Differences in prevalence, awareness, and control of hypertension between any 2 surveys were expressed as ratios. To assess the independent associations between the predictors and the outcome variables, regression analyses were employed with prevalence of hypertension as an outcome variable.

Overall, there was a rising trend in the prevalence of hypertension in adults ≥30 years: 32.9% (30%–35.8%) in 1996, 42.6% (37.5%–43.5%) in 2006, and 43.5% (40.4%–46.6%) in 2011. There were significant increase of 32% from 1996 to 2011 (P<0.001) and of 29% from 1996 to 2006 (P<0.05), but only a small change of 1% from 2006 to 2011 (P=0.6). For population ≥18 years, only a 1% increase in prevalence of hypertension occurred from the 2006 NHMS (32.2%) to the 2011 NHMS (32.7%) (P=0.25). A relative increase of 13% occurred in those with primary education (P<0.001) and a 15% increase was seen in those with secondary education (P<0.001). The rate of increase in the prevalence of hypertension in the population with income level RM3000–3999 was the highest (18%) during this period. In general, the older age group had higher prevalence of hypertension in the 2006 and 2011 NHMSs. The prevalence peaked at 74.1% among population aged 65 to 69 years in the 2011 NHMS. Both the proportion of awareness and the control of hypertension in Malaysia improved from 1996 to 2006. A change in the control of hypertension was 13% higher in women than in men.

The findings suggest that the magnitude of hypertension in Malaysia needs additional attention. Strengthening the screening for hypertension in primary health-care settings in the high-risk groups and frequent health promotion to the community to enhance individual awareness and commitment to healthy living would be of immense value.

144

Nalliah S, Sim ML, Thuraisingham C. Ethics of termination of pregnancy in myasthenia gravis: A case report and critical discussion. International Journal of Person Centered Medicine, 2016; 6(2): 119-125. DOI: http://dx.doi.org/10.5750/ijpcm.v6i2.516 (IF: NA).

Ethics of termination of pregnancy in myasthenia gravis: A case report and critical discussion. Sivalingam Nalliah, Sim Miao Ling, Chandramani Thuraisingham. Clinical Campus Seremban, International Medical University, Seremban.

Abstract Introduction: Myasthenia gravis (MG), an autoimmune disorder characterised by muscle

weakness caused by impairment of the acetylcholine receptors at the neuromuscular junction as a result of autoantibodies acting against the ACh receptors, is twice as common in women, occurring in the second and third decades. Successful pregnancy outcomes are possible with patient compliance to medication and care by a multidisciplinary team. Objective: The article demonstrates the ethical dilemma doctors face when dealing with

termination of pregnancy in myasthenia gravis in pregnancy. Discussion: During pregnancy, MG exacerbates in one third of patients during the first trimester, and tends to improve during the second and third trimesters, with most women achieving normal delivery. The authors put up a case where decision for termination of pregnancy (TOP) could have been avoided through application of an ethical decision making framework. The patient could have decided otherwise if a clear alternative line of management had been offered. Fully informed consent is essential preserving was not given and patient autonomy in such complex decisions. The emotive effects on the patient that biomedical imaging like showing a normal and active foetus through ultrasonography also needs to be considered. Analysis: A possible ethical framework using some of the principles of ethical decision-making, under the headings of i). Clear justification according to the norms and values of the individual, law and society for the intervention ii). Patient autonomy iii). Incongruence between parents in the abortion decision iv). The foetus as a person v). Directive counselling vi). Principle-based ethics, and, vii). Case-based ethics and case-based reasoning could be applied when confronted with the issue of termination of pregnancy in MG. While principle-based ethics is a useful starting point, care-based ethics also has a place in decisions on TOP. Keywords: Myasthenia gravis, ethics, decision making, termination of pregnancy.

http://dx.doi.org/10.5750/ijpcm.v6i2.516

145

Narayanan SS, Cheang A. The influence of perceived social support and self-efficacy on resilience among first year Malaysian students. Kajian Malaysia, 2016; 34(2): 1-23. [IMU Internal Grant - BPS I-01/2012(01)2014]. (SCI IF: 0.357; HI: 3; Tier: Q2).

The influence of perceived social support and self-efficacy on resilience among first year Malaysian students. Shreas Suresh Narayanan and Alexius Cheang Weng Onn. Division of Psychology (& Behavioural Sciences), International Medical University, Kuala Lumpur, MALAYSIA

Abstract

This study sought to determine whether perceived social support and self-efficacy were significant predictors of resilience among students when the effects of other variables such as stress, age, gender, and cumulative grade point average (CGPA) were controlled for. The effect of the interaction between perceived social support and self-efficacy on resilience was also tested. The study sample consisted of 377 first year local undergraduate students from a public university in Malaysia. Multiple regression was used to analyse the data. The results indicated that both perceived social support and self-efficacy were significant predictors of resilience as higher scores on perceived social support and on self-efficacy scales predicted higher resilience. The interaction effect between these variables was also positive and significant. Further analysis using ordered probit model revealed that when a student scored higher on levels of perceived social support as well as on self-efficacy, it lowered the probability of the student being in the low resilience category and increased the probability of being in the moderately resilient and highly resilient categories. The interaction effect remained significant across all categories of resilience. Keywords: ordered probit, perceived social support, resilience, self-efficacy, university

students.

146

Nazarbahjat N, Kadir FA, Zanariah A, Mahmood AA, Ng SW, Azhar A, Yehye WA. Antioxidant and gastroprotective activities of new2-(ethylsulfanyl)-N'-(substitutedphenyl)methylidene]benzohydrazide against ethane-induced acute gastric mucosal injury in rats. PLoS ONE, 2016; 11(6): e0156022. [University of Malaya Research

Grant UMRG (RG149-11AFR); University of Malaya Research Grant UMRG (RPO43A-15HTM) and Postgraduate graduate research grant (PG033-2012B)]. (SCI IF: 3.027; HI: 181; Tier: Q1).

Antioxidant and gastroprotective activities of new2-(ethylsulfanyl)-N'-(substitutedphenyl)methylidene]benzohydrazide against ethane-induced acute gastric mucosal injury in rats. Nafal Nazarbahjat1, Farkaad A. Kadir2, Azhar Ariffin1, Mahmood A. Abdulla3, Zanariah Abdullah1,

Wageeh A. Yehye4. 1Department of Chemistry, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia 2Division of Human Biology, Faculty of Medicine, International Medical University, Kuala Lumpur, Malaysia 3Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia 4Nanotechnology & Catalysis Research Centre (NANOCAT), University of Malaya, Block 3A, Institute of Postgraduate Studies Building, Kuala Lumpur, Malaysia

Abstract

A series of new 2-(ethylthio)benzohydrazone derivatives (1-6) were prepared and characterised by IR, 1H NMR, and 13C NMR spectroscopy and mass spectrometry. The newly prepared compounds were screened for their in vitro antioxidant activities using free radical scavenging 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) assays. Among them, most powerful antioxidant, compound 1 has been selected in order to illustrate anti-ulcer effect on ethanol-induced gastric mucosal lesions in rats. Four groups of Sprague Dawley rats were respectively treated with 10%Tween 20 as ulcer control group, 20 mg/kg omeprazole as reference group, 50 mg/kg and 100 mg/kg compound 1 as experimental animals. Macroscopically, ulcer control group showed extensive hemorrhagic lesions of gastric mucosa compared with omeprazole or compound 1. Rats pre-treated with compound 1 showed increased in gastric pH and gastric mucus. Histologically, ulcer control group showed severe damage to gastric mucosa with edema and leucocytes infiltration of submucosal layer. In immunohistochemical analysis, rats which were pre-treated with compound 1 showed up-regulation of HSP70 and down-regulation of Bax proteins. In conclusion, the gastroprotective effect of compound 1 may be due to its antioxidant activity, and/or due to up-regulation of HSP70 and down-regulation of Bax protein in stained tissue section.

147

Ng CH, Chan CW, Lai JW, Ooi IH, Chong KV, Maah MJ, Seng HL. Enantiomeric pair of copper(II) polypyridyl-alanine complexes: Effect of chirality on their interaction with biomolecules. Journal of Inorganic Biochemistry, 2016; 160: 1-11. [eSc 02-02-09-SF0036].


Enantiomeric pair of copper(II) polypyridyl-alanine complexes: Effect of chirality on their interaction with biomolecules. Chew Hee Ng1, Cheang Wei Chan1,3, Jing Wei Lai1, Ing Hong Ooi1, Kok Vei Chong2, Mohd Jamil Maah3, Hoi Ling Seng4. 1Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 2Faculty of Science, Universiti Tunku Abdul Rahman, 31900 Kampar, Perak, Malaysia 3Department of Chemistry, University of Malaya, 50603 Kuala Lumpur, Malaysia 4Department of Biological Sciences, Sunway University, 47500 Bandar Sunway, Malaysia

Abstract

Like chiral organic drugs, the chemical and biological properties of metal complexes can be dependent on chirality. Two pairs of [Cu(phen)(ala)(H2O)]X·xH2O (phen = 1.10-phenanthroline: X = NO3−; ala: L-alanine (L-ala), 1 and D-alanine (D-ala) 2; and (X = Cl−; ala: L-ala, 3 and D-ala, 4) complex salts (x = number of lattice water molecules) have been synthesized and characterized. The crystal structure of 3 has been determined. The same pair of enantiomeric species, viz. [Cu(phen)(L-ala)(H2O)]+ and [Cu(phen)(D-ala)(H2O)]+, have been identified to be present in the aqueous solutions of both 1 and 3, and in those of both 2 and 4 respectively. Both 3 and 4 bind more strongly to ds(AT)6 than ds(CG)6. There is no or insignificant effect of the chirality of 3 and 4 on the production of hydroxyl radicals, binding to deoxyribonucleic acid from calf thymus (CT-DNA), ds(CG)6, G-quadruplex and 17-base pair duplex, and inhibition of both topoisomerase I and proteasome. Among the three proteasomeproteolytic sites, the trypsin-like site is inhibitedmost strongly by these complexes. However, the chirality of 3 and 4 does affect the number of restriction enzymes inhibited, and their binding constants towards ds(AT)6 and serum albumin. Keywords: Ternary copper(II) complexes, Chirality, Deoxyribonucleic acid, Restriction

enzyme, Topoisomerase I, Proteasome.

148

Ng CH, Wang WS, Win YF, Neo KE, Ganguly R, Er HM, Ooi IH. Rac-aqua(4-methyl-oxazolidine-4-carboxylato)(nitrato)(1,10-phenanthroline)-copper(II), the aldol condensation product of formaldehyde with the D- and L-(alaninato)aqua(1,10-phenanthroline)copper(II) nitrate. Transition Metal Chemistry, 2016; 41: 563–571. DOI: 10.1007/s11243-016-0053-4.

[eSc02-02-09-SF0036] (ISI IF: 1.465; SCI IF: 1.54; HI: 45; Tier: Q2).

Rac-aqua(4-methyl-oxazolidine-4-carboxylato)(nitrato)(1,10-henanthroline)copper(II), the aldol condensation product of formaldehyde with the D- and L-(alaninato)aqua(1,10-phenanthroline)copper(II) nitrate. Chew Hee Ng1, Wai San Wang2, Yip Foo Win2, Kian-Eang Neo2, Rakesh Ganguly3, Hui Meng Er1, Ing Hong Ooi1. 1Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, 57000 Bukit Jalil, Kuala Lumpur, Malaysia 2Faculty of Science, Universiti Tunku Abdul Rahman, 31900 Kampar, Perak, Malaysia 3Division of Chemistry and Biological Chemistry, Nanyang Technological University, Singapore 637371, Singapore

Abstract

The D- and L-enantiomers of the ternary complex [Cu(phen)(ala)(H2O)]NO3 [phen = 1,10-phenanthroline; ala = alanine; L-enantiomer (1a); D-enantiomer (1b)] both undergo an aldol-type condensation with formaldehyde under mild acidic conditions to yield racemic rac-[Cu(phen)(4MeOCA)(H2O)(NO3)] (2) (4MeOCA = 4-methyl-oxazolidine-4-carboxylate). The precursors and the products were characterized by circular dichroism, FTIR,UV–Vis, fluorescence spectroscopy, molar conductivity and electrospray ionization mass spectrometry. The racemic nature of the product was established by X-ray crystallography. In the crystal structure, the copper atom has a tetragonally elongated octahedral geometry in which the water and an oxygen atom of a nitrate group are mutually trans. A possible mechanism for the racemization of the ligand is proposed.

149

Ng CJ, Teng CL, Abdullah A, Wong CH, Hanafi NS, Phoa SSY, Tong WT. The status of family medicine training programs in the Asia Pacific. Family Medicine, 2016; 48(3): 194-202. (SCI IF: 0.843; HI: 54; Tier: Q2).

The status of family medicine training programs in the Asia Pacific. Jenn Ng C, Lieng Teng C, Abdullah A, Hoong Wong C, Sherina Hanafi N, Su Yin Phoa S, Tong WT. Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia.

Abstract

The family medicine training programs in the Asia Pacific (AP) are evolving. To date, there is a lack of comprehensive and systematic documentation on the status of family medicine training in the AP. This study aims to determine the status of family medicine training at both the undergraduate and postgraduate levels in medical schools (universities or colleges) in the AP. In 2014, the authors conducted a cross-sectional online survey to assess the undergraduate and postgraduate family medicine programs in academic family medicine departments from AP countries. A 37-item online survey questionnaire was sent to key informants from academic institutions with established family medicine departments/units. Only one response from each family medicine department/unit was included in the analysis.The medical school and country response rates were 31.31% and 64.1%, respectively. The majority of the medical schools (94.7%, n=71/75) reported having a department/unit for family medicine. Family medicine is recognized as a specialist degree by the governments of 20/25 countries studied. Family medicine is included in the undergraduate program of 92% (n=69/75) of all the participating medical schools. Only slightly more than half (53.3%) (n=40/75) reported conducting a postgraduate clinical program. Less than one third (26.7%) (n=20/75) of the medical schools conducted postgraduate research programs.Undergraduate training remains the focus of most family medicine departments/units in the AP. Nevertheless, the number of postgraduate programs is increasing. A more rigorous and long-term documentation of family medicine training in the AP is warranted.

150

Ng TKW, Yu TJ, Low YO, Loo ZWY, Gan CL. Dietary fibre and total fluid intakes are inversely associated with risk of constipation in Malaysian adolescents, adults and the elderly. IeJSME, 2016; 10(1): 17-23. (MyCite IF: 0.038).

Dietary fibre and total fluid intakes are inversely associated with risk of constipation in Malaysian adolescents, adults and the elderly. Tony Kock Wai Ng1, Yu Tang Jia2, Yip Onn Low2, Loo Zheng Wei Yeoh2, Cai Li Gan2. 1Nutrition and Dietetics Department, School of Health Sciences, International Medical University (IMU), Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA 2ND1/09 Student Cohort, Bachelor of Science (Honours) Nutrition and Dietetics Programme, IMU, Kuala Lumpur, MALAYSIA

Abstract Introduction: Dietary fibre (DF) and fluid intakes have been reported elsewhere to reduce the

risk of constipation. The association of these dietary components on Agachand’s Constipation Score (CS) was investigated in the present study. Methods: A total of 202 Malaysian participants comprising 50 adolescents (aged 12.4 ± 5.3

yrs), 50 adults (aged 46.3 ± 11.3 yrs), 52 women of child-bearing age (aged 29.1 ± 9.3 yrs) and 50 elderly persons (aged 70.0 ± 7.4 yrs) were recruited by convenience sampling from five venues - two communities in Cheras, one community in Klang, the IMU campus, Bukit Jalil and a private secondary school in Klang. All participants were interviewed with a previously-evaluated food frequency questionnaire (FFQ) and an Agachand’s Constipation Score (CS) Questionnaire. Results: Mean daily DF intakes were low across all age groups with means ranging from 10.0

– 15.6g. The percentage of subjects with daily DF intakes below the “deficient” cut-off of 20g was alarmingly high; 80% in adolescents, 45% in adults, 85% in women of child-bearing age

and 70% in the elderly. About one-fifth or 20% of subjects in all age groups had CS values ≥15 which indicated a problem of constipation. Mean daily total fluid consumption (TFC) ranged from 2128 – 5490 ml in the four categories of subjects. Overall, both daily DF intakes and TFC were negatively associated with CS values. This inverse association was significant for DF vs CS scores in adolescents (r = -0.500, p = 0.001), adults (r = -0.351, p = 0.013), the elderly (r = -0.392, p = 0.005) and all subjects combined (r = -0.366, p=0.001). For TFC vs CS scores, the inverse association was only significant for the elderly (r = -0.312, p = 0.027) and all subjects combined (r = -0.245, p = 0.001). Conclusion: The results of this study support the role of dietary fibre intake and TFC in reducing the risk of constipation, as well as reinforcing previous data for low DF intakes among the Malaysian population. Keywords: Dietary fibre, fluid consumption, constipation score.

151

Norazida AR, Teng CL, Sheamini S. Antibiotic prescribing in public and private practice: A cross-sectional study in primary care clinics in Malaysia. BMC Infectious Diseases, 2016; 16(1): 208,016-1530-2. (ISI IF: 1.366; SCI IF: 2.842; HI: 66; Tier: Q1).

Antibiotic prescribing in public and private practice: A cross-sectional study in primary care clinics in Malaysia. Norazida Ab Rahman1, Cheong Lieng Teng2 and Sheamini Sivasampu1. 1Healthcare Statistics Unit, Clinical Research Centre, 3rd Floor MMA Building, 124 Pahang Road, 53000 Kuala Lumpur, Malaysia. 2Department of Family Medicine, International Medical University, Seremban, Malaysia.

Abstract Background: Antibiotic overuse is driving the emergence of antibiotic resistance worldwide.

Good data on prescribing behaviours of healthcare providers are needed to support antimicrobial stewardship initiatives. This study examined the differences in antibiotic prescribing rates of public and private primary care clinics in Malaysia. Methods: We used data from the National Medical Care Survey (NMCS), a nationwide cluster sample of Malaysian public and private primary care clinics in 2014. NMCS contained demographic, diagnoses and prescribing from 129 public clinics and 416 private clinics. We identified all encounters who were prescribed antibiotic and analyse the prescribing rate, types of antibiotics, and diagnoses that resulted in antibiotic. Results: Five thousand eight hundred ten encounters were prescribed antibiotics; antibiotic

prescribing rate was 21.1 % (public clinics 6.8 %, private clinics 30.8 %). Antibiotic prescribing was higher in private clinics where they contributed almost 87 % of antibiotics prescribed in primary care. Upper respiratory tract infection (URTI) was the most frequent diagnosis in patients receiving antibiotic therapy and accounted for 49.2 % of prescriptions. Of the patients diagnosed with URTI, 46.2 % received antibiotic treatment (public 16.8 %, private 57.7 %). Penicillins, cephalosporins and macrolides were the most commonly prescribed antibiotics and accounted for 30.7, 23.6 and 16.0 % of all antibiotics, respectively. More recently available broad-spectrum antibiotics such as azithromycin and quinolones were more frequently prescribed in private clinics. Conclusions: Antibiotic prescribing rates are high in both public and private primary care settings in Malaysia, especially in the latter. This study provides evidence of excessive and inappropriate antibiotic prescribing for self-limiting conditions. These data highlights the needs for more concerted interventions targeting both prescribers and public. Improvement strategies should focus on reducing inappropriate prescribing. Keywords: Anti-bacterial agents, Antibiotic stewardship, Drug prescriptions, Primary healthcare, Private practice, Public health practice.

152

Noriklil Bukhary IB, Zaleha Md Isa, Shamsuddin K, Khor GL, Zaleha AM, Haslinda H, Noor Sharifatul HY. Risk factors for antenatal hypovitaminosis D in an urban district in Malaysia. BMC Pregnancy and Childbirth, 2016; 16: 156. DOI: 10.1186/s12884-016-0939-3. (ISI IF: 2.18;

SCI IF: 2.46; HI: 45; Tier: Q1).

Risk factors for antenatal hypovitaminosis D in an urban district in Malaysia. Noriklil Bukhary Ismail Bukhary1,2, Zaleha Md Isa1, Khadijah Shamsuddin1, Khor Geok Lin3, Zaleha Abdullah Mahdy4, Haslinda Hassan2 and Noor Sharifatul Hana Yeop1. 1Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. 2Petaling District Health Office, Wisma SAHOCA, No 1, Jalan SS 6/3A Kelana Jaya, 47301 Petaling Jaya, Selangor, Malaysia. 3School of Health Sciences, Faculty of Medicine and Health, International Medical University, Bukit Jalil 57000, Kuala Lumpur, Malaysia. 4Faculty of Medicine, Department of Obstetrics and Gynecology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.

Abstract Background: Pregnant women form one of the high risk groups facing hypovitaminosis D. Low level of vitamin D will affect directly or indirectly both mother and fetus. Screening vitamin D in the first trimester of pregnancy is important to determine the necessary preventive action. Therefore, this study was aimed to determine the prevalence of hypovitaminosis D and its risk factors among pregnant women in the first trimester. Methods: A cross sectional study was carried out among first trimester pregnant women

during their first antenatal visit. Samples were taken from different ethnicities in an urban district in Malaysia. A total of 396 respondents (99 % response rate) aged 18–40 years completed self–administered and guided questionnaire (characteristics and risk factors), validated semi-quantitative food frequency questionnaire for vitamin D in Malaysia (FFQ vitamin D/My), anthropometric measures (weight and height), blood test for serum 25(OH)D, skin measurement using Mexameter (MX 18) and Fitzpatrick Skin Type Chart Measurement (FSTCM). Data were analyzed to determine the association between risk factors and hypovitaminosis D. Results: The prevalence of hypovitaminosis D (serum 25(OH)D < 50 nmol/L) was 90.4 %

(358). The mean age of respondents was 28.06 ± 4.09 years old. The independent predictors of hypovitaminosis D were Malay ethnicity (OR 33.68; 95 % CI: 12.81, 88.56), Indian ethnicity (OR 16.86; 95 % CI: 3.78,75.20), secondary education (OR 12.12; 95 % CI: 2.71, 54.16) and tertiary education (OR 14.38; 95 % Cl: 3.31, 62.45). Conclusion: Awareness should be raised among Malay and Indian pregnant women with

secondary and tertiary education who consumed vitamin D (especially milk) poorly in order to prevent adverse health outcomes. Further studies need to be conducted among health care workers to determine their level of knowledge related to vitamin D, as they are front liner in detecting the hypovitaminosis D. Keywords: Prevalence, Pregnant women, Hypovitaminosis D, Risk factors, Ethnic, Skin type,

Malaysia.

153

Okuda K, Fu HY, Matsuzaki T, Araki R, Tsuchida S, Thanikachalam PV, et al. Targeted therapy for acute autoimmune myocarditis with nano-sized liposomal FK506 in rats. PLoS One, 2016; 11(8): e0160944. (SCI IF: 3.027; HI: 181; Tier: Q1).

Targeted therapy for acute autoimmune myocarditis with nano-sized liposomal FK506 in rats. Keiji Okuda1, Hai Ying Fu1, Takashi Matsuzaki1, Ryo Araki1, Shota Tsuchida1, Punniyakoti V. Thanikachalam2, Tatsuya Fukuta3, Tomohiro Asai3, Masaki Yamato1, Shoji Sanada1, Hiroshi Asanuma4, Yoshihiro Asano1, Masanori Asakura5, Haruo Hanawa6, Hiroyuki Hao7, Naoto Oku3, Seiji Takashima8, Masafumi Kitakaze5, Yasushi Sakata1, Tetsuo Minamino9. 1Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan 2Department of Pharmaceutical Chemistry, International Medical University, Kuala Lumpur, Malaysia 3Department of Medical Biochemistry, University of Shizuoka Graduate School of Pharmaceutical Sciences, Shizuoka, Japan 4Department of Internal Medicine, Meiji University of Integrative Medicine, Nantan, Kyoto, Japan 5Clinical Research and Development, National Cerebral and Cardiovascular Center Research Institute, Suita, Osaka, Japan 6Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan 7Department of Pathology, Nihon University School of Medicine, Tokyo, Japan 8Department of Medical Biochemistry, Osaka University Graduate School of Medicine, Suita, Osaka, Japan 9Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University, Miki, Kagawa, Japan

Abstract

Immunosuppressive agents are used for the treatment of immune-mediated myocarditis; however, the need to develop a more effective therapeutic approach remains. Nano-sized liposomes may accumulate in and selectively deliver drugs to an inflammatory lesion with enhanced vascular permeability. The aims of this study were to investigate the distribution of liposomal FK506, an immunosuppressive drug encapsulated within liposomes, and the Drug’s effects on cardiac function in a rat experimental autoimmune myocarditis (EAM) model. We prepared polyethylene glycol-modified liposomal FK506 (mean diameter: 109.5 ± 4.4 nm). We induced EAM by immunization with porcine myosin and assessed the tissue distribution of the nano-sized beads and liposomal FK506 in this model. After liposomal or free FK506 was administered on days 14 and 17 after immunization, the cytokine expression in the rat hearts along with the histological findings and hemodynamic parameters were determined on day 21. Ex vivo fluorescent imaging revealed that intravenously administered fluorescent-labeled nano-sized beads had accumulated in myocarditic but not normal hearts on day 14 after immunization and thereafter. Compared to the administration of free FK506, FK506 levels were increased in both the plasma and hearts of EAM rats when liposomal FK506 was administered. The administration of liposomal FK506 markedly suppressed the expression of cytokines, such as interferon-γ and tumor necrosis factor-α, and reduced inflammation and fibrosis in the myocardium on day 21 compared to free FK506. The administration of liposomal FK506 also markedly ameliorated cardiac dysfunction on day 21 compared to free FK506. Nano-sized liposomes may be a promising drug delivery system for targeting myocarditic hearts with cardioprotective agents.

154

Ong LC, Chung FF, Tan YF, Leong CO. Toxicity of single-walled carbon nanotubes. Archives of Toxicology, 2016; 90(1): 103-118. (ISI IF: 6.637; SCI IF: 5.711; HI: 76; Tier: Q1).

Toxicity of single-walled carbon nanotubes.

Li‑Chu Ong1,2, Felicia Fei‑Lei Chung1, Yuen‑Fen Tan1,2, Chee‑Onn Leong1,3.

1Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 2School of Postgraduate Studies, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 3School of Pharmacy, International Medical University, 126 Jalan 19/155B, Bukit Jalil, 57000 Kuala Lumpur, Malaysia

Abstract

Carbon nanotubes (CNTs) are an important class of nanomaterials, which have numerous novel properties that make them useful in technology and industry. Generally, there are two types of CNTs: single-walled nanotubes (SWNTs) and multi-walled nanotubes. SWNTs, in particular, possess unique electrical, mechanical, and thermal properties, allowing for a wide range of applications in various fields, including the electronic, computer, aerospace, and biomedical industries. However, the use of SWNTs has come under scrutiny, not only due to their peculiar nanotoxicological profile, but also due to the forecasted increase in SWNT production in the near future. As such, the risk of human exposure is likely to be increased substantially. Yet, our understanding of the toxicological risk of SWNTs in human biology remains limited. This review seeks to examine representative data on the nanotoxicity of SWNTs by first considering how SWNTs are absorbed, distributed, accumulated and excreted in a biological system, and how SWNTs induce organ-specific toxicity in the body. The contradictory findings of numerous studies with regards to the potential hazards of SWNT exposure are discussed in this review. The possible mechanisms and molecular pathways associated with SWNT nanotoxicity in target organs and specific cell types are presented. We hope that this review will stimulate further research into the fundamental aspects of CNTs, especially the biological interactions which arise due to the unique intrinsic characteristics of CNTs. Keywords: Carbon nanotube, Nanotoxicity, Single-walled, Nanomaterials, Toxicology.

155

Onunkwor OF, Al-Dubai SAR, George PP, Arokiasamy J, Hemetram Yadav H, Barua A, Shuaibu HO. A cross-sectional study on quality of life among the elderly in non-governmental organizations’ elderly homes in Kuala Lumpur. Health and Quality of Life Outcomes, 2016; 14:

6. DOI 10.1186/s12955-016-0408-8. (ISI IF: 2.212; SCI IF: 2.433; HI: 75; Tier: Q1).

A cross-sectional study on quality of life among the elderly in non-governmental organizations’ elderly homes in Kuala Lumpur. Obinna Francis Onunkwor1, Sami Abdo Radman Al-Dubai2, Philip Parikial George1, John Arokiasamy1, Hemetram Yadav1, Ankur Barua1 and Hassana Ojonuba Shuaibu1. 1Department of Community Medicine, International Medical University (IMU), Kuala Lumpur, Malaysia. 2Faculty of Medicine, SEGi University, Kota Damansara, Selangor, Malaysia.

Abstract Background: There is a rapid increase in the population of the elderly globally, and Malaysia

is anticipated to become an ageing nation in 2030. Maintaining health, social participation, reducing institutionalization, and improving quality of life of the elderly are public health challenges of the 21st century. Quality of life among elderly in Elderly Homes in Malaysia is under researched. This study aims to determine the quality of life and its associated factors among the Elderly in Elderly Homes in Kuala Lumpur. Methods: This was a cross-sectional study among 203 residents aged 60 years or more in eight randomly selected Elderly Homes in Kuala Lumpur in September 2014. Stratified simple random sampling was used to select participants. Study instruments included World Health Organization Quality of Life Questionnaire-Brief Version (WHOQOL-BREF), Multidimensional Scale for Perceived Social Support, and a questionnaire for Socio-demographic variables. Data collection was by face to face interview. Univariate and Multivariate analysis were used to determine associations, and P-value <0.05 was considered statistically significant. Results: The mean (Standard deviation) for the physical domain was 14.3 (±2.7), 13.7 (±2.5)

for the psychological domain, 10.8 (±3.4) for the social domain, and 13.0 (±2.5) for the environment domain. Factors significantly associated with quality of life included age, gender, level of education, economic status, outdoor leisure activity, physical activity, duration of residence, type of accommodation, co-morbidities, and social support. Conclusion: This study confirms that multiple factors are associated with quality of life among elderly in elderly homes. Social support, chronic co-morbidities, gender and outdoor leisure activity were significantly associated with all the domains of quality of life. Among the four domains of quality of life, the physical domain had the highest score while the social domain had the lowest score. This emphasizes the need for more social support-related interventions in these homes. Keywords: Elderly, Non-governmental Organization, Elderly Homes, Quality of Life, Kuala

Lumpur.

156

Ooi JW, Tan J, Pau A. Kindergarten teachers’ perceived role in pre-school children’s dental care – A qualitative study. International Journal of Dentistry and Oral Health, 2015; 2(2). (IF: NA).

Kindergarten teachers’ perceived role in pre-school children’s dental care – A qualitative study. JW Ooi1, J Tan1 and Allan Pau2. 1Ministry of Health, Malaysia 2School of Dentistry, International Medical University, Malaysia

Abstract Objectives: This paper reports on kindergarten teachers’ perceptions of their role in children’s

dental care, and their gaps in knowledge and skills in a sample of fee-paying kindergartens in a developing country. Design: Qualitative face to face depth interviews.

Setting: Fee paying kindergartens in an inner city of a developing country.

Method: Qualitative face-to-face in-depth interviews up to 60 minutes were undertaken with

a purposive sample of 16 teachers, stratified by kindergarten size and fees structure. Salient comments were extracted from verbatim transcripts and sorted into a thematic framework. Results: Some teachers reported elaborate toothbrushing activities while others felt oral hygiene was the parents’ or the dentist’s responsibility. Varying degrees of strictness in sugar intake regimes were reported. There was no awareness of dietary guidelines although most agreed with a balanced diet. Lack of dental first aid knowledge was widespread, and some reported harmful measures to stop bleeding caused by a dental injury. Kindergarten teachers’ perception of their role was shaded by their sensitivity to the parents’ and dentists’ responsibility, as well as their lack of confidence in dental care, including dental first aid. Conclusion: Collaboration between teachers, parents and dentists is recommended in

promoting dental care in kindergartens. Keywords: Kindergartens, Oral health promotion, Oral health education, Pre-school children,

Qualitative research.

157

Palanisamy S, Mari Kannan M, Kingston R, Wei TT, Loon TW, Yee LC. Evaluation of patient safety culture among Malaysian retail pharmacists: Results of a self-reported survey. Patient Preference and Adherence, 2016; 10: 1317-1325. (ISI IF: 1.718; SCI IF: 1.884; HI: 22; Tier:

Q1).

Evaluation of patient safety culture among Malaysian retail pharmacists: Results of a self-reported survey. Palanisamy Sivanandy1, Mari Kannan Maharajan1, Kingston Rajiah1, Tan Tyng Wei2, Tan Wee Loon2, Lim Chong Yee2. 1Department of Pharmacy Practice, School of Pharmacy, International Medical University, Wilayah Persekutuan Kuala Lumpur, Malaysia 2School of Pharmacy, International Medical University, Wilayah Persekutuan Kuala Lumpur, Malaysia

Abstract Background: Patient safety is a major public health issue, and the knowledge, skills, and experience of health professionals are very much essential for improving patient safety. Patient safety and medication error are very much associated. Pharmacists play a significant role in patient safety. The function of pharmacists in the medication use process is very different from medical and nursing colleagues. Medication dispensing accuracy is a vital element to ensure the safety and quality of medication use. Objective: To evaluate the attitude and perception of the pharmacist toward patient safety in retail pharmacies setup in Malaysia. Methods: A Pharmacy Survey on Patient Safety Culture questionnaire was used to assess patient safety culture, developed by the Agency for Healthcare Research and Quality, and the convenience sampling method was adopted. Results: The overall positive response rate ranged from 31.20% to 87.43%, and the average positive response rate was found to be 67%. Among all the eleven domains pertaining to patient safety culture, the scores of “staff training and skills” were less. Communication openness, and patient counseling are common, but not practiced regularly in the Malaysian retail pharmacy setup compared with those in USA. The overall perception of patient safety of an acceptable level in the current retail pharmacy setup. Conclusion: The study revealed that staff training, skills, communication in patient counseling,

and communication across shifts and about mistakes are less in current retail pharmacy setup. The overall perception of patient safety should be improved by educating the pharmacists about the significance and essential of patient safety. Keywords: patient counseling, medication errors, communication openness, perceptions, attitudes.

158

Palanisamy S, Rasna J. Case report on diabetic amyotrophy. Indian Journal of Pharmacy Practice, 2016; 9(3): 204-205. (IF: NA).

Case report on diabetic amyotrophy. Palanisamy Sivanandy1, Rasna James2. 1Department of Pharmacy Practice, International Medical University, Kuala Lumpur, MALAYSIA. 2Deparment of Clinical Pharmacy, Kovai Medical Center and Hospital, Coimbatore, INDIA.

Abstract Diabetic amyotrophy is a rare complication associated with early-stage diabetes. The main symptoms are muscle weakness and pain, usually in the hips and thighs, leading to difficulty in standing and walking. It usually occurs in patients over 60 years of age and hence its morbidity is increased. However, diabetic amyotrophy (DA) is one complication which seems always to respond to better glycaemic control and if this can be achieved the prognosis is good. Here we report a case on non-insulin-dependent diabetes mellitus, who developed diabetic amyotrophy. Keywords: Diabetes, Insulin, Amyotrophy, Neuropathy, Muscles.

159

Palanisamy S, Tan TW, Tan WL, Lim CY. Evaluation of retail pharmacists’ perception on patient safety. Asian Journal of Pharmaceutical Sciences, 2016; 11(1): 142–143. (SCI IF: 1.89; HI: 11; Tier: Q2).

Evaluation of retail pharmacists’ perception on patient safety. Sivanandy Palanisamy, Tan Tyng Wei, TanWee Loon, Lim Chong Yee. Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia

Abstract

Patient safety has become a focus of clinical care and research in recent years. However, the potential for medical care to cause harm has been appreciated throughout the history of medicine [1]. The safety culture of an organization is the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine the commitment to, and the style and proficiency of, an organization’s health and safety management. It is important for healthcare organizations to establish a safety culture to ensure that patients are not inadvertently harmed by errors in the care that was supposed to heal them [2]. Main objectives of the cross-sectional study were to explore the attitude and perception of retail pharmacists in patient safety, to identify the strength and areas for patient safety improvement and to examine the current practice in patient safety in Malaysian retail pharmacy setup. Malaysian registered pharmacists, working in the retail pharmacies in the study site and willing to participate in this survey, were included.Those who are not willing to participate and did not meet the inclusion criteria for the survey were excluded from the study. The study was carried out in Selangor, Malaysia. This Pharmacy Survey on Patient Safety emphasizes patient and medication safety and quality assurance issues. The survey includes 36 items measuring 11 composites. In addition to the composites, the pharmacy survey includes three items about the frequency of documenting different types of mistakes, three items about respondent background characteristics, an overall rating question, and a section for open-ended comments. The survey has a total of 43 items [3]. It is a validated questionnaire used in many countries for assessing the patient safety in pharmacies. A total of 227 participants were included in the study, and 200 responded to the questionnaire survey and the response rate was found to be 88.1%. It includes 63 (31.5%) Senior and 137 (68.5%) Junior Pharmacists; 48 (24%) male and 152 (76%) female pharmacists. Seventy two percent of pharmacists have more than 1 year of experience in retail pharmacy area and they are working more than 40 hours per week.We received more positive responses for the questionnaire; more than 92 percent of participants said their pharmacy is well organized, and staff were treating each other with respects. Eighty-three percent said staff were working together as an effective team and clearly understand their roles and responsibilities. In overall, 92 percent of the pharmacists said their organization is good in maintaining patient safety and achieved the patient safety grade. Keywords: Retail pharmacists, Patient safety, Perception, Malaysia, Survey.

160

Pan Y, Hsu CJ, Koh RY, Ong CE, Chieng JY. In vitro study of modulatory effects of Strobilanthes crispus extracts on human cDNA-expressed cytochrome P450 2A6 (CYP2A6) and CYP3A4. The All Results Journals, 2016; 7: 1-12. (IF: NA).

In vitro study of modulatory effects of Strobilanthes crispus extracts on human cDNA-expressed cytochrome P450 2A6 (CYP2A6) and CYP3A4. Pan Yan1, Hsu Chia Jie2, Koh Rhun Yian2, Ong Chin Eng3, and Chieng Jin Yu4. 1Department of Biomedical Science, The University of Nottingham Malaysia Campus, Jalan Broga, 43500 Semenyih, Selangor Darul Ehsan, Malaysia 2School of Medical Sciences, International Medical University, 126, Jalan 19/155B, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 3Jeffrey Cheah School of Pharmacy and Health Sciences, Monash University Sunway Campus, Jalan Lagoon Selatan, 46150 Bandar Sunway, Selangor Darul Ehsan, Malaysia 4Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor Darul Ehasan, Malaysia

Abstract Aim: Cytochrome P450 2A6 (CYP2A6) and CYP3A4 play important roles in biotransformation of endogenous substances as well as xenobiotics. Strobilanthes crispus (L.) Blume (S. crispus)

has been found to have anticancer activities and it has been suggested that this is due to inhibition of enzymes involved in metabolic activation of procarcinogens. The purpose of this study was to look into the potential inhibitory effects of various extracts (aqueous, hexane, chloroform, ethyl acetate, and methanol) of S. crispus from leaf and stem on human cDNA-

expressed CYP2A6 and CYP3A4 activities. Methods: The activity of CYP2A6 was examined via a fluorescence-based 7-hydroxylase

coumarin assay. Meanwhile, a high performance liquid chromatography (HPLC)-based testosterone 6β-hydroxylase assay was performed to assess CYP3A4 activity. Results: It was shown that none of the extracts from either leaf or stem potently inhibited CYP2A6 or CYP3A4 activities, with 50% inhibitory concentration (IC50) values above

100μg/ml. Conclusion: S. crispus is unlikely to display anti-cancer properties through the modulation of

CYP2A6 or CYP3A4 activities, but other mechanisms might be involved and merit further investigation. In addition, potential drug-herb interaction occurring between CYP2A6/CYP3A4 substrates and S. crispus preparations would probably be limited in effect, but this requires further investigations via in vivo animal as well as clinical studies. Keywords: CYP2A6, CYP3A4, drug-herb interaction, procarcinogen-activation, Strobilanthes crispus.

161

Patil PG, Hazarey VK, Chaudhari R, Nimbalkar-Patil S. A randomized control trial measuring the effectiveness of a mouth exercising device for mucosal burning in oral submucous fibrosis. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2016; 122(6): 713-718. (ISI

IF: 1.262; SCI IF: 1.386; HI: 88; Tier: Q1).

A randomized control trial measuring the effectiveness of a mouth exercising device for mucosal burning in oral submucous fibrosis. Pravinkumar G. Patil1, Vinay Hazarey2, Rekha Chaudhari3, Smita Nimbalkar-Patil4. 1Senior Lecturer, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. 2Professor, Department of Oral Pathology, Government Dental College and Hospital, Nagpur, India. 3Lecturer, Department of Oral Pathology, Government Dental College and Hospital, Nagpur, India. 4Lecturer, Department of Orthodontics, Faculty of Dentistry, MAHSA University, Kuala Lumpur, Malaysia.

Abstract Objectives: To evaluate effect of ice-cream stick exercise regimen with or without a mouth-exercising device (MED) on mucosal burning sensation in oral submucous fibrosis. Study Design: In total, 282 patients with oral submucous fibrosis were treated with topical corticosteroid and oral antioxidant and the ice-cream stick exercise regimen. Patients in subgroups A1, A2, and A3 were additionally given a new MED. Patients in subgroups A1 and B1 patients with interincisal distance (IID) of 20 to 35 mm were managed without any additional therapy; patients in subgroups A2 and B2 with IID of 20 to 35 mm were additionally managed with intralesional injections; and those in subgroups A3 and B3 with IID less than 20 mm were managed surgically. Subjective evaluation of decrease in the oral mucosal burning was measured on a visual analogue scale (VAS). Analysis of variance and Tukey’s multiple post hoc analysis were carried out to present the results. Results: Patients using the MED, that is, subgroups A1, A2, and A3, showed reduction in burning sensation in the range of 64.8% to 71.1% and 27.8% to 30.9%, whereas in subgroups B1, B2, and B3, reduction in burning sensation ranged from 64.7% to 69.9% and from 29.3% to 38.6% after 6 months. The wo-way analysis of variance indicated statistically significant results in changes in initial VAS scores to 6-monthly VAS scores between MED users and non-MED users. Conclusions: The MED helps to enhance the rate of reduction of mucosal burning sensation, in addition to the conventional ice-cream stick regimen, as an adjunct to local and surgical treatment.

162

Patil PG, Hazarey VK, Chaudhari R, Nimbalkar-Patil S. Clinical efficacy of a mouth-exercising device adjunct to local ointment intra-lesional injections and surgical treatment for oral submucous fibrosis: A randomized controlled trial. Asian Pacific Journal of Cancer Prevention,

2016; 17(3): 1255-9. (ISI IF: 2.514; SCI IF: 2.241; HI: 47; Tier: Q2).

Clinical efficacy of a mouth-exercising device adjunct to local ointment intra-lesional injections and surgical treatment for oral submucous fibrosis: A randomized controlled trial. Pravinkumar Patil1, Vinay Hazarey2, Rekha Chaudhari2, Smita Nimbalkar-Patil3. 1Division of Clinical Dentistry, School of Dentistry, International Medical University 2Department of Oral Pathology, Government Dental College and Hospital, Nagpur, India 3Department of Orthodontics, Faculty of Dentistry, MAHSA University, Kuala Lumpur, Malaysia.

Abstract Background: Oral physiotherapy or mouth exercise is considered to be an adjunct but

mandatory treatment modality for oral submucous fibrosis (OSMF). This study planned to evaluate the clinical efficacy of a newly designed mouth exercising device (MED) in OSMF patients receiving local ointment, intra-lesional drugs and surgical treatment. Materials and Methods: A total of 231 OSMF patients were selected and treated with basic

regime including topical corticosteroids, oral antioxidants and the icecream-stick exercise regime and allotted randomly to two equal groups A and B. Group-A patients were additionally given MED. Subgroups A1 and B1 patients with an inter-incisal distance (IID) 20-35mm were not given any additional therapy; subgroup A2 and B2 patients (IID 20-35mm) were treated additionally with intra-lesional injections. Subgroups A3 and B3 with IID<20mm were managed surgically. IID was measured at baseline and at 6 months recall. The change in IID measurements was calculated and statistically analyzed using 2-way ANOVA and Tukeys multiple post hoc analysis. Results: Average improvement in IID after six months of recall visits was observed to be 8.4

mm in subgroup-A1 (n-53) compared to 5.5 mm in B1(n-50) (p<0.01). The IID improvement in subgroup-A2 was found to be 9.3mm (n-46) compared to 5.1 mm in B2 (n-48) (p<0.01). In the surgery group, mouth opening improvement was observed to be 9.6 mm in subgroup A3 (n-18) compared to 4.8 mm for B3 (n-16) (p<0.01). Conclusions: Use of the MED appears to be effective for increasing oral opening in OMSF

patients in conjunction with local, injection and/or surgical treatment. Keywords: Medical devices, oral precancer, oral submucous fibrosis, oral physiotherapy.

163

Patil PG, Nimbalkar-Patil S. Implant retained obturator for an edentulous patient with a hemimaxillectomy defect complicated with microstomia. Case Reports in Dentistry, 2016; Article ID 461851: 1-6. doi: 10.1155/2016/4618510. (IF: NA).

Implant retained obturator for an edentulous patient with a hemimaxillectomy defect complicated with microstomia. Pravinkumar G. Patil1 and Smita Nimbalkar-Patil2. 1Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia 2Department of Orthodontics, Faculty of Dentistry, MAHSA University, Kuala Lumpur, Malaysia

Abstract Patient: A 68-year-old man was operated on for squamous cell carcinoma (T3N3M0) of the

maxilla creating the hemimaxillary surgical defect on right side. The remaining arch was completely edentulous. There was remarkable limitation in the oral opening with reduced perimeter of the oral cavity due to radiation and surgical scar contracture.This article describes prosthetic rehabilitation by modifying the design of the obturator and achieving the retention with dental implant. Discussion: Severe limitation in the oral opening may occur in clinical situations following the

postsurgical management of oral and maxillofacial defects. The prosthetic rehabilitation of the surgical defect in such patients becomes a challenging task due to limited access to the oral cavity. This challenge becomes even more difficult if the patient is edentulous and there are no teeth to gain the retention, stability, and support. Conclusion: In severe microstomia prosthesis insertion and removal can be achieved with

modification of the maximum width of the prosthesis. Dental implant retention is useful treatment option in edentulous patients with maxillary surgical defect provided that sufficient bone volume and accessibility are there for implant placement.

164

Patil PG, Nimbalkar-Patil S. Lost wax bolus technique to process closed hollow obturator with uniform wall thickness using single flasking procedure. Journal of Indian Prosthodontic Society, 2016; DOI: 10.4103/0972 4052.176538. [Epub ahead of print]. (IF: NA).

Lost wax bolus technique to process closed hollow obturator with uniform wall thickness using single flasking procedure.

Pravinkumar G. Patil1, Smita Nimbalkar‑Patil2.

1Division of Clinical Dentistry, School of Dentistry, International Medical University 2Department of Orthodontics, Faculty of Dentistry, MAHSA University, Kuala Lumpur, Malaysia

Abstract Introduction: Maxillary obturator prosthesis is more frequent treatment modality than surgical

reconstruction for maxillectomy in patients suffering from oral cancer. The obturators often become heavy and hence are hollowed out in the defect portion to reduce its weight as a standard practice. Materials and Methods: The processing technique described the incorporation of the

preshaped “wax-bolus” during packing procedure of the Obturtor prosthesis and eliminated later by melting it once the curing procedure is completed. Results: This article is a single step procedure resulting into the closed-hollow obturator as single unit with uniform wall thickness around the hollow space ensuring the least possible weight of the hollow obturator. Conclusion: This processing technique achieves predictable internal dimension of the hollow

space providing uniform wall thickness of the obturator. Keywords: Hollow obturator, maxillectomy, obturator processing technique, oral cancer,

retention of prosthesis.

165

Patil PG, Seow LL, Tagore M. Single versus two dental implant retained mandibular overdenture: Study protocol for a randomized controlled trial. Dental Implants and Dentures, 2016; 1: 104. Doi: 10.4172/did.1000104. [ITI Foundation, Switzerland Grant - IMU R 148_2014]. (IF: NA).

Single versus two dental implant retained mandibular overdenture: Study protocol for a randomized controlled trial. Patil PG, Seow LL and Tagore M. International Medical University, Kuala Lumpur, Malaysia.

Abstract Background: The consensus is that the standard treatment of choice for the edentulous

mandible should be a two implant retained mandibular overdenture. Some clinicians have tried single median implant to retain the mandibular overdenture, however, there is lack of scientific information with single implant retained mandibular overdenture. Therefore the purpose of the current randomized clinical trial is to test the hypothesis that a single median implant in edentulous mandible will result in a clinical outcome comparable to two implants. Methods/design: This prospective randomized controlled clinical trial is in preparation to

commence. The final patient with 1 year follow up will complete the trial in 2017. In total, 66 edentulous patients between 45 and 85 years of age with mandibular complete dentures will be treated with either single median implant (experimental group, N=33) or two implants (control group, N=33). The existing complete dentures will immediately be supported by the implants using locator attachment/s. The patients will be followed up at intervals of 1 month and 12 months after implant loading. The primary outcome measures are implant success rate, masticatory performance and patient satisfaction level and. The secondary outcome measures encompass effect on oral health related quality of life and clinical, technical and subjective variables. Discussion: This clinical trial will give information on the ability of single median implant to retain a complete mandibular denture when immediately loaded. If viable, this treatment option is advantageous in regards to simpler procedure, reduced treatment cost and reduced risk of surgical morbidity. Keywords: Implant supported overdenture, Implant therapy, Mandibular complete denture,

Single midline implant.

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Patil PG, Tay K. Modified technique to retrofit the crown on fractured core. Journal of Interdisciplinary Dentistry, 2016; 6: 50-3. (IF: NA).

Modified technique to retrofit the crown on fractured core. Pravinkumar G Patil1, Kangjie Tay2. 1Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia 2Klinic Pergigian Kamunting Taiping, Ministry of Health (MOH), Malaysia

Abstract

Post and core followed by crown is a common treatment option to restore the form, function, and esthetics of an endodontically treated tooth. Although uncommon, it is possible that patients may present with fractured core during the crown cementation appointment due to various reasons, including trauma and composite debonding. Depending on the extent and severity of the fracture, retrofitting the crown on a fractured core can be a preferred option. This technique describes the fabrication of vacuum-formed thermoplastic template adapted on an elastomeric putty index obtained from the inner aspect of the crown to build back the composite resin core in original shape. This technique is simple to perform, and the additional time and cost of preparing new crown can be avoided. Clinical Relevance to Interdisciplinary Dentistry

This technique demonstrated the preparation of a vacuum-formed thermoplastic template adapted to the polyvinyl siloxane putty index obtained from the inner aspect of the crown. The technique facilitated chairside repair of the fractured core, thus the additional time and cost of preparing a new crown can be avoided. The effect of the temperature onto the flexible putty during the adaptation of the thermoforming sheet needs to be carefully evaluated. Keywords: Fixed dental prosthesis, indirect restorations, post and core, retrofitting.

167

Patil PG, Ueda T, Sakurai K. Influence of early clinical exposure for undergraduate students on self-perception of different aspects of geriatric dental care: Pilot study between two colleges from Japan and India. Journal of Indian Prosthodontic Society, 2016; 16: 288-93. (IF: NA).

Influence of early clinical exposure for undergraduate students on self-perception of different aspects of geriatric dental care: Pilot study between two colleges from Japan and India. Patil PG1, Ueda T2, Sakurai K2. 1Division of Clinical Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. 2Department of Removable Prosthodontics and Gerodontology, Tokyo Dental College, Tokyo, Japan.

Abstract Objective: The objective of this study is to identify the influence of early clinical exposure for undergraduate students on self-perception of different aspects of geriatric dental care. Materials and Methods: colleges from Japan and India, namely, Tokyo Dental College (TDC), Tokyo, and Government Dental College (GDC), Nagpur, respectively. The GDC students exposed to patients in a 3(rd) year and TDC in the 5(th) year of course. Survey of 74 undergraduate students GDC and 95 of TDC was conducted. The questionnaire was developed based on to the 50 points undergraduate curriculum by European College of Gerodontology. The questionnaire categorized into four parts; Part I (15 questions) on aging and medicine, Part II (15 questions) on communication skills, Part III (15 questions) on diagnosis/treatment, and Part IV (5 questions) on need of more training in Gerodontology. Their own-perception on self-knowledge and competency was scored on 4 level scale as 3, 2, 1, and 0 for response yes, rather yes, rather no, and no, respectively. Average scores were calculated and presented. Results: The differences of the opinions as per students' perception level were found to be

slightly more affirmative in GDC students (1.9 for the 4(th) year and 2 for the 5(th) year) than TDC students (1.1 for 5(th) grade and 1.5 for 6(th) grade). Both clinical and didactic hours should be increased in curriculum according to the TDC (89%) and GDC (79%) students. Separate gerodontology subject is suggested from TDC (76%) to GDC (81%) students. Conclusion: Average scores about own-perception of knowledge and competency about

aging, medicine, and communication skills were almost same in both GDC and TDC students. With early clinical exposure, GDC students appear have better self-perception regarding the different aspects of the geriatric dental care including subject knowledge, communications, diagnosis, and treatment planning than TDC students with late clinical exposure. Keywords: Aging, dental education, geriatric dental care, gerodontology.

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Patil PG. Editorial: Postsurgical rehabilitation of oral cancer patients and vital role of a prosthodontist. International Journal of Prosthodontics and Restorative Dentistry, 2016; 6(1): V. (IF: NA).

Editorial: Postsurgical rehabilitation of oral cancer patients and vital role of a prosthodontist. Pravinkumar G. Patil School of Dentistry, International Medical University (IMU).

Abstract Oral cancer may affect up to 2,75,000 new patients per year worldwide. 1 Frequently, the presence of oral cancer necessitates the surgical removal of all or parts of the maxilla, leaving the patient with a defect that compromises the integrity and functions of the oral cavity. 2 Many of these will be disfigured by the destruction of tissues within the face and the head area. Large orofacial defects result from cancer treatment consequences in serious functional as well as cosmetic deformities. Acceptable cosmetic results usually can be obtained with a facial prosthesis. 3 The rehabilitation phase for more compromised conditions, such as edentulous alveolar ridge, radiation therapy and tongue cancer, soft palate or mandible requires special care. Although techniques for reconstructive surgery and prosthodontic rehabilitation have advanced, more than 50% of head and neck cancer patients who have undergone reconstruction still report impaired mastica-tory function. 4 I think this is unfortunate, though it was mentioned way back in 1978 by Olson and Shedd, 4 the scenario has not been changed much so far in recent years. Still so many oral cancer patients are surgically made cancer free but become oral handicap due to lack of careful surgical or prosthetic rehabilitation procedures. Community based surveys identifying the prevalence of these issues are highly recommended. The immediate postoperative restoration of esthetics, deglutition, and speech shortens recovery time in the hospital and expedites the patient's return to the community as a functioning member. Immediate obturators support soft tissues after surgery and minimize scar contracture and disfigurement, providing a positive effect on the patient's psychology. 2 Depending upon the healing stages of the wound, patients are advised to modulate the consistency of the food. An immediate surgical obturator is placed during surgery and the patients are advised to take only liquid diet. A delayed/interim surgical obturator is placed 6 to 10 days after surgery and the patients are advised to take liquid and semisolid diet. A definitive obturator is placed 3 to 4 months after surgery and the patients are advised to take conventional semisolid and solid food. 2 Midfacial defects may affect speech, mastication, quality of life, psychology, and social behavior. Large defects that result from cancer treatment are rarely rehabilitated by surgical reconstruction alone, they usually require a facial prosthesis to restore the function and appearance. 5 In addition, an intraoral prosthesis, such as an obturator is often needed to restore speech and deglutition. Recent advancements in maxillofacial reconstructive surgery and osseointegrated dental implants provide a treatment modality that may adequately rehabilitate patients with oral cancer so that they can return to a healthy and productive life. Maxillofacial prosthodontics can play a vital role in restoring the normal appearance and functions of such patients. The maxillofacial prosthodontist, as a member of the surgical team, is able to aid in the recovery of the oral cancer patients by careful presurgical planning of prosthetic rehabilitation. Presurgical records in the form of oral impressions, photographs and facial measurements are important parameters that can simplify the nature of complex rehabilitation procedures. This paper highlights the scope and the vital role of the maxillofacial prosthodontist in the team of doctors treating oral cancer patients including pathologist, maxillofacial surgeon, oncology surgeon, radiologist and nutritionist, etc. And thus oral cancer patient, even if he/she becomes cancer free, may become oral handicap due to lack of postsurgical rehabilitation.

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Patil PG. Editorial: Trismus and mouth exercise. International Journal of Prosthodontics and Restorative Dentistry, 2016; 6(2): IV. (IF: NA).

Editorial: Trismus and mouth exercise. Pravinkumar G. Patil School of Dentistry, International Medical University (IMU).

Abstract

Trismus or Lockjaw refers to reduced opening of the jaws caused by spasm of the muscles of mastication, or may generally refer to all causes of limited mouth opening.1 It is a common problem with a variety of causes and may interfere with eating, speech, oral hygiene, and could alter facial appearance. The severity ranges from the simple and nonprogressive to those that are potentially life-threatening.1 There is an increased risk of aspiration. Temporary trismus is much more common than permanent trismus and may be distressing and painful, and limit or prevent medical examination or treatments requiring access to the oral cavity.

Mouth exercising is the well-established method to improve mouth opening and also to prevent postsurgical relapse.2,3 A majority of the appliances are tooth-borne, where opening force can be applied with the help of the devices or stents placed between the maxillary and mandibular arches or teeth. Previous literature described many mouth-opening devices.4-8 All these mouth-opening devices for this purpose are fixed to the teeth to keep the dental arches apart.5,6 Partially or totally edentulous arches, decayed teeth, or periodontitis do not allow the use of such devices and often patients suffering from severe trismus present with these conditions. In such situations, a nontooth-borne mouth-opening devices are helpful. One such device (nontooth-borne) was described with which the force for mouth opening was applied to two intraoral screws placed in the vestibules of the maxillary and mandibular bones.7 Patient noncompliance prevents surgical intervention for placement of the screws and limits the use of such devices. Cox and Zoellner5 used sequential addition of the tongue depressors between upper and lower arches as oral physiotherapy and tested the hypothesis that physiotherapy alone can modify tissue remodeling in oral submucous fibrosis (OSMF) to increase oral opening. A new mouth exercising device (MED) has been designed which is nontooth-borne, handy, and easy to use by the patients by Patil and Patil.8 The MED causes local squeezing and stretching of the mucosa. This leads to increase the blood circulation in the area and thus decreasing the fibrosis and increasing the elasticity of mucosa and ultimately resulting into increase in mouth opening. The MED can also be used in patients with poor dental conditions and can allow rehabilitation to start immediately after trismus release. Patil et al9 studied clinical efficacy of the MED for 6 months for oral submucous and concluded that use of the MED appears to be effective for increasing oral opening in OSMF patients in conjunction with local, injection, and/or surgical treatment.

However, the clinical efficacy of such devices in postradiation trismus and the trismus occurring due to other reasons is still unclear. There is a vast scope of research in this area where many of such devices are still not being evaluated for their long-term efficacy in different clinical situations of trismus.

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Patro G, Bhattamisra S, Mohanty B, Sahoo H. In vitro and in vivo antioxidant evaluation and estimation of total phenolic, flavonoidal content of Mimosa pudica L. Pharmacognosy Research, 2016; 8(1): 22-28. (SCI IF: 1.34; HI: 15; Tier: Q2).

In vitro and in vivo antioxidant evaluation and estimation of total phenolic, flavonoidal content of Mimosa pudica L. Patro G1, Bhattamisra SK2, Mohanty BK3, Sahoo HB4. 1School of Pharmaceutical Education and Research, Berhampur University, Bhanja, Bihar, Berhampur, Odisha, India. 2Department of Pharmacology, Roland Institute of Pharmaceutical Sciences, Berhampur, Odisha, India; Department of Life Sciences, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia. 3Department of Botany and Biotechnology, Khallikote Autonomous College, Berhampur, Odisha, India. 4Department of Pharmacology and Experimental Biology, Vedica College of Pharmacy, RKDF University, Bhopal, Madhya Pradesh, India.

Abstract Objective: Mimosa pudica Linn. (Mimosaceae) is traditionally used as a folk medicine to treat various ailments including convulsions, alopecia, diarrhea, dysentery, insomnia, tumor, wound healing, snake bite, etc., Here, the study was aimed to evaluate the antioxidant potential of M. pudica leaves extract against 2, 2diphenyl1picrylhydrazyl (DPPH) (in vitro) and its modulatory

effect on rat brain enzymes. Materials and Methods: Total phenolic, flavonoid contents, and in vitro antioxidant potential against DPPH radical were evaluated from various extracts of M. pudica leaves. In addition, ethyl acetate extract of Mimosa pudica leaves (EAMP) in doses of 100, 200, and 400

mg/kg/day were administered orally for 7 consecutive days to albino rats and evaluated for the oxidative stress markers as thiobarbituric acid reactive substances (TBARS), superoxide dismutase (SOD), catalase (CAT), and glutathione (GSH) from rat brain homogenate. Results: The ethyl acetate extract showed the highest total phenolic content and total flavonoid content among other extracts of M. pudica leaves. The percentage inhibition and IC50 value of all the extracts were followed dose-dependency and found significant (P < 0.01) as compared to standard (ascorbic acid). The oxidative stress markers as SOD, CAT, and GSH were increased significantly (P < 0.01) at 200 and 400 mg/kg of EAMP treated animals and decreased significantly the TBARS level at 400 mg/kg of EAMP as compared to control group. Conclusions: These results revealed that the ethyl acetate extract of M. pudica exhibits both in vitro antioxidant activity against DPPH and in vivo antioxidant activity by modulating brain enzymes in the rat. This could be further correlated with its potential to neuroprotective activity due to the presence of flavonoids and phenolic contents in the extract. Summary: Total phenolic, flavonoid contents and in-vitro antioxidant potential were evaluated various extracts of M. pudica leaves. Again, in-vivo antioxidant evaluation from brain homogenate on oxidative stress markers as TBARS, SOD, CAT and GSH from rat was investigated. Our findings revealed that M. pudica possesses both in-vitro and in-vivo

antioxidant activity due to presence of phenolics and flavonoids. Keywords: 2; 2diphenyl1picrylhydrazyl, Brain homogenate, Flavonoids, Mimosa pudica,

Oxidative stress.

171

Pau A, Chen YS, Lee VK, Sow CF, De Alwis R. What does the multiple mini interview have to offer over the panel interview? Medical Education Online, 2016; 21: 29874. (ISI IF: 1.039; SCI IF: 1.022; HI: 11; Tier: Q2).

What does the multiple mini interview have to offer over the panel interview? Allan Pau1, Yu Sui Chen2, Verna Kar Mun Lee3, Chew Fei Sow4 and Ranjit De Alwis5. 1Division of Community and Child Oral Health, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia 2Division of Human Biology, School of Medicine, International Medical University, Kuala Lumpur, Malaysia 3Department of Family Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia 4Clinical Skills and Simulation Centre, School of Medicine, International Medical University, Kuala Lumpur, Malaysia 5Department of Community Medicine, School of Medicine, International Medical University, Kuala Lumpur, Malaysia

Abstract Introduction: This paper compares the panel interview (PI) performance with the multiple

mini interview (MMI) performance and indication of behavioural concerns of a sample of medical school applicants. The acceptability of the MMI was also assessed. Materials and methods: All applicants shortlisted for a PI were invited to an MMI. Applicants

attended a 30-min PI with two faculty interviewers followed by an MMI consisting of ten 8-min stations. Applicants were assessed on their performance at each MMI station by one faculty. The interviewer also indicated if they perceived the applicant to be a concern. Finally, applicants completed an acceptability questionnaire. Results: From the analysis of 133 (75.1%) completed MMI scoresheets, the MMI scores

correlated statistically significantly with the PI scores (r=0.438, p=0.001). Both were not statistically associated with sex, age, race, or pre-university academic ability to any significance. Applicants assessed as a concern at two or more stations performed statistically significantly less well at the MMI when compared with those who were assessed as a concern at one station or none at all. However, there was no association with PI performance. Acceptability scores were generally high, and comparison of mean scores for each of the acceptability questionnaire items did not show statistically significant differences between sex and race categories. Conclusions: Although PI and MMI performances are correlated, the MMI may have the

added advantage of more objectively generating multiple impressions of the applicant’s interpersonal skill, thoughtfulness, and general demeanour. Results of the present study indicated that the MMI is acceptable in amulticultural context. Keywords: multiple mini interview, panel interview, students selection, students admission.

172

Pau A, Mutalik VS. Experiential learning in community oral health promotion: A qualitative evaluation of the experiential aspects. Pedagogy in Health Promotion, 2016; 1-7. DOI: 10.1177/2373379916655356. (IF: NA).

Experiential learning in community oral health promotion: A qualitative evaluation of the experiential aspects. Allan Pau1, and Vimi Sunil Mutalik2. 1International Medical University, Kuala Lumpur, Malaysia 2The Ohio State University, Columbus, OH, USA

Abstract

Experiential learning is not merely a set of tools and techniques to provide experiences for knowledge and skills acquisition but also learning that embraces certain principles that must be present at some time during learning. These principles are (a) a mixture of content and process, (b) an absence of excessive judgment, (c) engagement in purposeful endeavors, (d) encouraging the big-picture perspective, (e) the role of reflection, (f) emotional investment, (g) reexamination of values, (h) meaningful relationships, and (i) learning outside one’s perceived comfort zones. We implemented and evaluated a learning initiative in which 30 dental students participated in oral health promotion activities in a residential care home for older adults. Qualitative feedback provided by 24 students suggested that the initiative provided a mixture of content and processes for knowledge application, gave “the opportunity to develop creative interventions and make decisions”; allowed students to “solve problems and share knowledge”; helped them “see the reality more . . . and reach out to the community”; led them to reflect on their effectiveness, “not sure what we have done are sufficient to actually help”; motivated them to “take some time off to understand their troubles” and not just doing what they thought was required; inspired them to examine their values around “feeling of social connectedness . . . and a desire to give back”; and provided opportunities to learn outside their comfort zones, “step out of campus and encounter all the different people” and demonstrated that the experiential aspects of experiential learning can and should be evaluated. Keywords: experiential learning, oral health promotion, qualitative research, service learning.

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Pearce DA, Alekhina IA, Terauds A, Wilmotte A, Quesada A, Edwards A, Dommergue A, Sattler B, Adams BJ, Magalhães C, Chu WL, et al. Aerobiology over Antarctica – A new initiative for atmospheric ecology. Frontiers in Microbiology, 2016; 7: 16.

Doi:10.3389/fmicb.2016.00016. (ISI IF: 4.165; SCI IF: 4.093; HI: 41; Tier: Q1).

Aerobiology over Antarctica – A new initiative for atmospheric ecology. David A. Pearce1,2, Irina A. Alekhina3, Aleks Terauds4, Annick Wilmotte5, Antonio Quesada6, Arwyn Edwards7, Aurelien Dommergue8, Birgit Sattler9, Byron J. Adams10, Catarina Magalhães11, Wan-Loy Chu12, Maggie C. Y. Lau13, Craig Cary14, David J. Smith15, Diana H. Wall16, Gabriela Eguren17, Gwynneth Matcher18, James A. Bradley19, Jean-Pierre de Vera20, Josef Elster21,22, Kevin A. Hughes2, Lewis Cuthbertson23, Liane G. Benning24, Nina Gunde-Cimerman25, Peter Convey2, Soon Gyu Hong26, Steve B. Pointing27, Vivian H. Pellizari28 and Warwick F. Vincent29. 1Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK 2British Antarctic Survey, Cambridge, UK 3Arctic and Antarctic Research Institute, Saint Petersburg, Russia 4Australian Antarctic Division, Kingston, TAS, Australia 5University of Liege, Liège, Belgium 6Universidad Autónoma de Madrid, Madrid, Spain 7Aberystwyth University, Aberystwyth, UK 8Université Grenoble Alpes, Grenoble, France 9University of Innsbruck, Innsbruck, Austria 10Brigham Young University, Provo, UT, USA 11Interdisciplinary Centre of Marine and Environmental Research, University of Porto, Porto, Portugal 12International Medical University, Kuala Lumpur, Malaysia 13Department of Geosciences, Princeton University, Princeton, NJ, USA 14University of Waikato, Hamilton, New Zealand 15NASA Ames Research Center, Moffett Field, CA, USA 16Colorado State University, Fort Collins, CO, USA 17Universidad de la República, Montevideo, Uruguay 18Rhodes University, Grahamstown, South Africa 19University of Bristol, Bristol, UK 20German Aerospace Center, Cologne, Germany 21University of South Bohemia, České Budějovice, Czech Republic 22Institute of Botany of the Academy of Science of the Czech Republic, Třeboň, Czech Republic 23Northumbria University, Newcastle-upon-Tyne, UK 24Helmholtz Centre Potsdam GFZ, German Research Centre for Geosciences, Potsdam, Germany 25University of Ljubljana, Ljubljana, Slovenia 26Korea Polar Research Institute, Incheon, South Korea 27Auckland University of Technology, Auckland, New Zealand 28Universidade de Sao Paulo, Sao Paulo, Brazil 29Laval University, Québec, QC, Canada

Abstract

The role of aerial dispersal in shaping patterns of biodiversity remains poorly understood, mainly due to a lack of coordinated efforts in gathering data at appropriate temporal and spatial scales. It has been long known that the rate of dispersal to an ecosystem can significantly influence ecosystem dynamics, and that aerial transport has been identified as an important source of biological input to remote locations. With the considerable effort devoted in recent decades to understanding atmospheric circulation in the south-polar region, a unique opportunity has emerged to investigate the atmospheric ecology of Antarctica, from regional to continental scales. This concept note identifies key questions in Antarctic microbial biogeography and the need for standardized sampling and analysis protocols to address such questions. A consortium of polar aerobiologists is established to bring together researchers

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with a common interest in the airborne dispersion of microbes and other propagules in the Antarctic, with opportunities for comparative studies in the Arctic. Keywords: aerobiology, Antarctica, metadata, biodiversity, biogeography.

175

Pooke TG, Rozi M, Yap PS, Suraini binti MS, Sharifah Roohi SWA, Harwant S. The effectiveness of seated combined extension-compression and transverse load traction in increasing cervical lordosis - challenging the underlying framework. IeJSME, 2016; 10(3): 24-

33. (MyCite IF: 0.038).

The effectiveness of seated combined extension-compression and transverse load traction in increasing cervical lordosis - challenging the underlying framework. Tamara Gien Pooke1, Rozi Mahmud2, Poh Sin Yap3, Suraini binti Mohamad Saini2, Sharifah Roohi Syed Waseem Ahmad4, Harwant Singh5. 1Department of Chiropractic, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, MALAYSIA 2Imaging Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, MALAYSIA 3Institute of Research, Development and Innovation, International Medical University, 126 Jalan Jalil Perkasa19, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA 4Orthopaedics Department, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, MALAYSIA 5Pantai Medical Centre, 59100 Kuala Lumpur, MALAYSIA

Abstract Introduction: The goal of this study was to assess the effectiveness of seated combined

extension-compression and transverse load (ECTL) traction as a new method for increasing a reduced lordosis of less than 30 degrees in a Malaysian population between the ages of 18 and 60 years. Possible changes in disc height were measured in accordance with the underlying theoretical framework, that suggests the anterior cervical structures would elongate due to creep over the fulcrum of the traction device. Method: This was a single centre, randomised, blinded controlled clinical trial with parallel

groups, used to test the superiority of the seated combined ECTL traction together with physiotherapy exercises when compared with the same physiotherapy exercises used as a control. Fifty randomly allocated subjects who completed the forty treatments over the fourteen weeks were analysed using non-parametric tests for changes in outcomes. Results: There were no significant changes in outcomes for disc height changes seen in this study. The findings of a greater overall increase in posterior disc height changes compared with anterior disc height changes were in contrast with the proposed underlying theoretical framework for this type of ECTL traction. The greater height changes occurring in the control group were also unexpected. Conclusion: The findings in this study of the contrasting changes in disc height of greater

posterior than anterior height changes, question the underlying theoretical framework as postulated for this type of traction. Keywords: extension compression and transverse load traction, cervical lordosis, disc height.

176

Pulikkotil SJ, Toh CG, Mohandas K, Leong KVG. Effect of photodynamic therapy on Aggregatibacter actinomycetemcomitans in periodontitis patients. A randomized split mouth clinical trial. Australian Dental Journal, 2016; 61(4): 440-445. doi: 10.1111/adj.12409. [IMU

Internal Funding, IMU126/12]. (ISI IF: 1.272; SCI IF: 1.417; HI: 46; Tier: Q2).

Effect of photodynamic therapy on Aggregatibacter actinomycetemcomitans in periodontitis patients. A randomized split mouth clinical trial. Pulikkotil SJ1, Toh CG1, Mohandas K2, Leong KV3. 1School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. 2Department of Microbiology, Faculty of Medicine, Malaysian Allied Health Science University (MAHSA), Kuala Lumpur, Malaysia. 3International Medical University, Kuala Lumpur, Malaysia.

Abstract Aim: A randomized split-mouth controlled clinical trial was conducted to evaluate the efficacy of photodynamic therapy (PDT) in reducing Aggregatibacter actinomycetemcomitans (Aa) in

periodontitis patients. Materials and Methods: Twenty patients with periodontitis were recruited for the trial. Following random allocation of either quadrants of the selected jaw to test or control treatment, conventional nonsurgical periodontal therapy (NSPT) was performed. In addition, the test side received adjunct photodynamic therapy. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BoP%) and plaque scores (PS%) were recorded at phase 0 (baseline), phase 1 (immediately after NSPT), phase 2 (7 days following NSPT), phase 3 (1 month following NSPT) and phase 4 (3 months following NSPT). Subgingival plaque samples for quantification of Aa by realtime polymerase chain reaction (rt PCR) was done at phase 0, 1, 2, 4. Results: There was a significant clinical improvement at Phase 3 and 4 compared to baseline while BoP reduced significantly only in test group at phase 4. However no difference in the quantification of Aa was detected between the groups. Conclusion: Within limits of the study PDT adjunct to scaling and root planing (SRP) does not lead to quantitative reduction of Aggregatibacter actinomycetemcomitans (Aa) in

periodontitis patients.

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Qian YS, Ramamurthy S, Candasamy M, Shadab M, Meka VS. Production, characterization and evaluation of kaempferol nanosuspension for improving oral bioavailability. Current Pharmaceutical Biotechnology, 2016; 17(6): 549-55. (ISI IF: 1.802; SCI IF: 1.896; HI: 59; Tier:

Q1). Production, characterization and evaluation of kaempferol nanosuspension for improving oral bioavailability. Qian YS, Ramamurthy S, Candasamy M, Shadab M, Meka VS1. 1Department of Pharmaceutical Technology, School of Pharmacy, International Medical University, Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.

Abstract Context: Kaempferol has a large particle size and poor water solubility, leading to poor oral

bioavailability. The present work aimed to develop a kaempferol nanosuspension (KNS) to improve pharmacokinetics and absolute bioavailability. Methods: A nanosuspension was prepared using high pressure homogenization (HPH)

techniques. The physico-chemical properties of the kaempferol nanosuspension (KNS) were characterized using photon correlation spectroscopy (PCS), transmission electron microscope (TEM), Fourier transform infrared spectroscopy (FTIR) and x-ray diffractometry (XRD). A reverse-phase high performance liquid chromatography (RP-HPLC) method for the analysis of the drug in rat plasma was developed and validated as per ICH guidelines. In vivo pharmacokinetic parameters of oral pure kaempferol solution, oral kaempferol nanosuspension and intravenous pure kaempferol were assessed in rats. Results and Discussion: The kaempferol nanosuspension had a greatly reduced particle

size (426.3 ± 5.8 nm), compared to that of pure kaempferol (1737 ± 129 nm). The nanosuspension was stable under refrigerated conditions. No changes in physico-chemical characteristics were observed. In comparison to pure kaempferol, kaempferol nanosuspension exhibited a significantly (P<0.05) increased in Cmax and AUC(0-∞) following oral administration and a significant improvement in absolute bioavailability (38.17%) compared with 13.03% for pure kaempferol. Conclusion: These results demonstrate enhanced oral bioavailability of kaempferol when

formulated as a nanosuspension.

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Qidwai A, Khan S, Md S, Fazil M, Baboota S, Narang JK, Ali J. Nanostructured lipid carrier in photodynamic therapy for the treatment of basal cell carcinoma. Drug Delivery, 2016; 23(4): 1476-85. (ISI IF: 4.843; SCI IF: 1.944; HI: 40; Tier: Q1).

Nanostructured lipid carrier in photodynamic therapy for the treatment of basal cell carcinoma. Qidwai A1, Khan S1, Md S2, Fazil M1, Baboota S1, Narang JK1,3, Ali J1. 1Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, New Delhi, India 2Department of Pharmaceutical Technology, School of Pharmacy, International Medical University (IMU), Kuala Lumpur, Malaysia 3Department of Pharmaceutics, Khalsa College of Pharmacy, Amritsar, India.

Abstract

Topical photodynamic therapy (PDT) is a promising alternative for malignant skin diseases such as basal-cell carcinoma (BCC), due to its simplicity, enhanced patient compliance, and localization of the residual photosensitivity to the site of application. However, insufficient photosensitizer penetration into the skin is the major issue of concern with topical PDT. Therefore, the aim of the present study was to enable penetration of photosensitizer to the different strata of the skin using a lipid nanocarrier system. We have attempted to develop a nanostructured lipid carrier (NLC) for the topical delivery of second-generation photosensitizer, 5-amino levulinic acid (5-ALA), whose hydrophilicity and charge characteristic limit its percutaneous absorption. The microemulsion technique was used for preparing 5-ALA-loaded NLC. The mean particle size, polydispersity index, and entrapment efficiency of the optimized NLC of 5-ALA were found to be 185.2 ± 1.20, 0.156 ± 0.02, and 76.8 ± 2.58%, respectively. The results of in vitro release and in vitro skin permeation studies showed controlled drug release and enhanced penetration into the skin, respectively. Confocal laser scanning microscopy and cell line studies respectively demonstrated that encapsulation of 5-ALA in NLC enhanced its ability to reach deeper skin layers and consequently, increased cytotoxicity. Keywords: Basal cell carcinoma, nanostructured lipid carrier, photosensitizer, pseudoternary

diagrams, topical photodynamic therapy.

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Rajasingam R, Sagineedu SR, Tan YH, Nalaiya J, Pichika MR. Stress degradation studies and development of a validated RP-HPLC method for determination of tiagabine in presence of its degradation products. International Journal of Pharmacy and Pharmaceutical Sciences,

2016; 8: 230-236; [IMU Project id: MAPC|1/2014(02)]. (ISI IF: 0.49; SCI IF: 0.486; HI: 24; Tier: Q2).

Stress degradation studies and development of a validated RP-HPLC method for determination of tiagabine in presence of its degradation products. Rajakumari Rajasingam1, Sreenivasa Rao Sagineedu1, Yee Hon Tan1, Jeyashanthini Nalaiya2, Mallikarjuna Rao Pichika1. 1Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University (IMU), 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia 2Innovax Sdn. Bhd., Jalan Saudagar U1/16, Seksyen U1, HICOM Glenmarie Industrial Park, 40150 Shah Alam, Selangor Darul Ehsan, Malaysia

Abstract Objective: To develop a simple and rapid isocratic reversed-phase high-performance liquid

chromatography (RP-HPLC) method and validate as per ICH and USP guidelines for analysis of tiagabine in the presence of its degradation products. Methods: The chromatographic separation was achieved on a Vision HT C18column (150 mm

× 4.6 mm, 5 μm) with mobile phase comprising of 11.5 mM of sodium dihydrogen phosphate (adjusted to pH 2.0 with orthophosphoric acid): acetonitrile (50:50,v/v) at a flow rate of 1.0 ml/min and the UV detection wavelength set at 254 nm. Stress degradation studies were performed as stated in ICH guidelines on tiagabine bulk drug using acid, base, oxidation, heat and light. Results: Tiagabine was found to degrade under acidic, photolytic, oxidative and thermal

conditions, but stable under basic hydrolysis condition. The developed method was found to be linear in the concentration range of 50-150 μg/ml (r 2= 0.9983) and the percentage recovery for the accuracy was 98.86%-99.35%. The LOD and LOQ obtained were 31.93 μg/ml and 96.76 μg/ml, respectively while the %RSD for precision, robustness, and stability studies were less than 2%. The degradation products formed from the stress study were well separated from tiagabine and hence the method could be regarded as stability indicating. Conclusion: A simple and rapid RP-HPLC method was developed and validated for analysis of tiagabine in the presence of its degradation products and thus, the proposed method can be used in the analysis of tiagabine bulk drug and pharmaceutical formulation in quality control laboratories. Keywords: Tiagabine, RP-HPLC, Stress degradation studies, Validation.

180

Rajiah K, Maharajan MK, Khoo SP, Chellappan DK, Alwis RD, Chui HC, Tan LL, Tan YN, Lau SY. Suitability of the RIPLS and IEPS for discriminating attitude differences towards interprofessional education among students of healthcare profession. Education Research International, 2016; Vol. 2016, Article ID: 5946154. doi: 10.1155/2016/5946154. [BP-I-01/12

(30) /2015]. (IF: NA).

Suitability of the RIPLS and IEPS for discriminating attitude differences towards interprofessional education among students of healthcare profession. Kingston Rajiah1, Mari Kannan Maharajan1, Suan Phaik Khoo2, Dinesh Kumar Chellappan3, Ranjit De Alwis4, Hui Cing Chui1, Lui Lee Tan1, Yee Ning Tan1, and Shin Yee Lau1. 1Department of Pharmacy Practice, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia 2Department of Oral Sciences, School of Dentistry, International Medical University, 57000 Kuala Lumpur, Malaysia 3Department of Life Sciences, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia 4Department of Community Medicine, School of Medicine, International Medical University, 57000 Kuala Lumpur, Malaysia

Abstract Background: Interprofessional education provides students of healthcare programme an

opportunity to collaborate with students from other disciplines and help them to get a training prior to entering the healthcare workforce. This study may help to select a suitable tool to discriminate attitude differences of healthcare professional students towards interprofessional education. Methods: A study, which was cross-sectional, was conducted at a private university in

Malaysia to explore the two scales (RIPLS and IEPS) and their psychometric properties. Study participants comprised students from four different professions with at least one exposure or no previous exposure to IPE. Results: Both the scales (RIPLS and IEPS) have their own ability to detect differences in students’ attitude towards IPE in their own way. However, the IEPS scale was able to detect differences within the gender, professions (both junior and senior students), and prior exposure to IPE. Conclusions: This study revealed that though both scales can be used to follow the impact

of IPE in curricula, IEPS scale is more suitable than RIPLS to discriminate attitude differences among healthcare students. Educators may develop various strategies to observe students’ behaviours and perceptions qualitatively and conduct longitudinal study to assess the outcomes of including IPE in curricula.

181

Rajiah K, Maharajan MK, Nair S. Pharmacy students’ knowledge and perceptions about adverse drug reactions reporting and pharmacovigilance. Saudi Pharmaceutical Journal, 2016; 24(5): 600-604. (ISI IF: 2.233; SCI IF: 2.45; HI: 20; Tier: Q2).

Pharmacy students’ knowledge and perceptions about adverse drug reactions reporting and pharmacovigilance. Kingston Rajiah1, Mari Kannan Maharajan, Shashina Nair. 1Department of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, Malaysia

Abstract

Pharmacy students’ knowledge about adverse drug reaction reporting can impact their attitude towards patient care and issues on patient safety. The aim of this study was to investigate the knowledge and perception of pharmacy students about adverse drug reaction reporting and pharmacovigilance and to study their willingness to report. A cross-sectional study using a validated questionnaire was conducted among the university students. The demographic details of the respondents were studied. The number of female respondents was comparatively higher than the male respondents. There were no significant differences by gender regarding the knowledge on adverse drug reaction reporting and pharmacovigilance except with the knowledge of post-marketing surveillance for which male students appeared to be more knowledgeable than female students. The results showed that the pharmacy students had sufficient knowledge and there are significant differences in perception among the students on adverse drug reaction reporting. Keywords: Pharmacy students, Malaysia, Pharmacovigilance.

182

Ramamurthy S, Er HM, Nadarajah VD, Pook PCK. Study on the impact of open and closed book formative examinations on pharmacy students’ performance, perception, and learning approach. Currents in Pharmacy Teaching and Learning, 2016; 8: 364-374. (ISI IF: 0.391; SCI

IF: 0.478; HI: 7; Tier: Q1).

Study on the impact of open and closed book formative examinations on pharmacy students’ performance, perception, and learning approach. Srinivasan Ramamurthy1, Hui Meng Er1, Vishna Devi Nadarajah2, Peter C.K. Pook1. 1School of Pharmacy, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 2School of Medicine, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia

Abstract Objectives: To study the impact of open and closed book formative examinations on

pharmacy students’ learning approach and also to assess their performance and perception about open book (OB) and closed book (CB) systems of examination. Methods: A crossover study was conducted among Year 1 and Year 2 pharmacy students. Students were invited to participate voluntarily for one OB and one CB online formative test in a chemistry module in each year. Evaluation of their learning approach and perception of the OB and CB systems of examination was conducted using Deep Information Processing (DIP) questionnaire and Student Perception questionnaire respectively. The mean performance scores of OB and CB examinations were compared. Results: Analysis of DIP scores showed that there was no significant difference (p > 0.05) in the learning approach adopted for the two different examination systems. However, the mean score obtained in the OB examination was significantly higher (p < 0.01) than those obtained

in the CB examination. Preference was given by a majority of students for the OB examination, possibly because it was associated with lower anxiety levels, less requirement of memorization, and more problem solving. Conclusion: There is no difference in deep learning approach of students, whether the format is of the OB or CB type examinations. However, the performance of students was significantly better in OB examination than CB. Hence, using OB examination along with CB examination will be useful for student learning and help them adapt to growing and changing knowledge in pharmacy education and practice. Keywords: Open book examination, Closed book examination, Pharmacy students, Learning

approach, Deep information processing.

183

Ravindranath S, Abrew WKD, Nadarajah VD. Student’s perception of mind mapping in problem-based learning. Journal of Contemporary Medical Education, 2016; 4(2): 60-66. doi:10.5455/jcme.20160620013341. (IF: NA).

Student’s perception of mind mapping in problem-based learning. Sneha Ravindranath1, Warnakula Kusum de Abrew2, Vishna Devi Nadarajah3. 1Dentistry, International Medical University, Kuala Lumpur, Malaysia. 2School of Medicine, International Medical University, Kuala Lumpur, Malaysia. 3Teaching and Learning, International Medical University, Kuala Lumpur, Malaysia.

Abstract Background: Problem based learning enables active learning but an inherent disadvantage is that the knowledge is perceived to be unorganized. The use of concept maps and flow charts has been suggested to enhance reflection in PBL. The objective of the study was to determine if the PBL experience can be enhanced using a mind map for summary writing. Methods: Semester 2 medical students were briefed on the process of mind mapping for

summarizing the PBL group discussion. Students who consented to participate in the study completed a pre-intervention questionnaire on the perception of PBL process. Each student constructed a mind map at the end of every PBL session for three consecutive triggers. The students completed a post-intervention questionnaire on the perception of PBL process at the end of the module. Data analysis of the pre and post-intervention questionnaires was carried out using Independent t-test. Results: Students perception of the PBL learning process continued to be positive after the intervention of summary writing with mind map and there was a difference in the ranking of the PBL learning processes with summarizing and structuring concepts at the top after mind mapping. Students comments indicated that the mind mapping exercise was useful although it was time consuming. Conclusions: Mind mapping can help in summarizing the PBL discussion however, not all

students may find that it enhances the PBL learning process. The findings of this study support the use of mind maps only as an optional tool for summarizing PBL discussion and may be used to complement the learning process in PBL based on students’ learning needs. Keywords: Mind Maps, Summary Writing, Problem Based Learning, Student’s Perception.

184

Ravindranath S, Andiesta NS, ZA Hasan, Chong JA, Pau A. Patterns of dental trauma in children presenting in hospital based dental clinics: A review. Dental Health: Current Research, 2016; 2: 1. (IF: NA).

Patterns of dental trauma in children presenting in hospital based dental clinics: A review. Sneha Ravindranath, Niekla Survia Andiesta, Zeinab Abbas Hasan, Jun Ai Chong and Allan Pau. School of Dentistry, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia

Abstract

Dental trauma is a common dental emergency worldwide and understanding the patterns of its presentation is useful to plan prevention and management. Purpose: The aim of this paper is to review the literature on dental trauma in children

presenting to hospital dental clinics. Methodology: Three different databases were searched and a total of 139 titles were

identified of which 16 met the selection criteria. Data were extracted into a table and the pattern of presentation, common causes and types of dental trauma were researched. Results: Dental trauma represented 0.8% to 4.8% of all dental attendances and 13.0% to

51.0% of all dental emergency attendances in hospital dental clinics. Falls was the most common cause and the maxillary permanent incisors were commonly affected. Conclusion: The patterns of presentation of dental trauma in children show similarity

worldwide. However, more prospective studies and uniformity in reporting will enable meaningful interpretation of data to devise preventive strategies. Keywords: Children, Dental trauma, Hospital dental clinics.

185

Razali N, Agarwal R, Agarwal P, Tripathy M, Kapitonova MY, Kutty MK, Smirnov A, Khalid Z, Ismail NM. Topical trans-resveratrol ameliorates steroid-induced anterior and posterior segment changes in rats. Experimental Eye Research, 2016; 143: 9-16. (ISI IF: 2.998; SCI IF:

2.994; HI: 97; Tier: Q1).

Topical trans-resveratrol ameliorates steroid-induced anterior and posterior segment changes in rats. Norhafiza Razali1, Renu Agarwal1, Puneet Agarwal2, Minaketan Tripathy3, Marina Y. Kapitonova1, Methil K. Kutty1, Alexey Smirnov4, Zalizah Khalid1, Nafeeza M. Ismail1. 1Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia 2School of Medicine, International Medical University, IMU Clinical School, Department of Ophthalmology, Jalan Rasah, Seremban, Malaysia 3Universiti Teknologi MARA, Faculty of Pharmacy, Dept. of Pharmaceutics, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia 4Pathological Anatomy Department, Volgograd State Medical University, 1, Pavshikh Bortsov Square, Volgograd, 400131, Russia

Abstract Steroid-induced hypertension and glaucoma is associated with increased extracellular meshwork (ECM) deposition in trabecular meshwork (TM). Previous studies have shown that single drop application of trans-resveratrol lowers IOP in steroid-induced ocular hypertensive (SIOH) rats. This IOP lowering is attributed to activation of adenosine A1 receptors, which may lead to increased matrix metalloproteinase (MMP)-2 activity. This study evaluated the effect of repeated topical application of trans-resveratrol for 21 days in SIOH animals on IOP, changes in MMP-2 level in aqueous humor, trabecular meshwork and retinal morphology and retinal redox status.We observed that treatment with trans-resveratrol results in significant and sustained IOP reduction in SIOH rats. This IOP reduction is associated with significantly higher aqueous humor total MMP-2 level; significantly reduced TM thickness and increased number of TM cells. Treatment with trans-resveratrol also significantly increased ganglion cell layer (GCL) thickness, the linear cell density in the GCL and inner retina thickness; and significantly reduced retinal oxidative stress compared to the SIOH vehicle-treated group. In conclusion, repeated dose topical application of trans-resveratrol produces sustained IOP lowering effect, which is associated with increased level of aqueous humor MMP-2, normalization of TM and retinal morphology and restoration of retinal redox status. Keywords: Glaucoma, Intraocular pressure, Resveratrol, Retina, Steroid-induced, Trabecular

meshwork.

186

Sahani M, Sulaiman NS, Tan BS, Yahya NA, Anual ZF, Wan Mahiyuddin MW, Khan MF, Muttalib KA. Mercury in dental amalgam: Are our health care workers at risk? Journal of the Air and Waste Management Association, 2016; 66(11): 1077-1083.

DOI:10.1080/10962247.2016.1188866. (SCI IF: 1.858; HI: 78; Tier: Q2).

Mercury in dental amalgam: Are our health care workers at risk? Sahani M1, Sulaiman NS2, Tan BS3, Yahya NA1, Anual ZF1, Mahiyuddin WR2, Khan MF4, Muttalib KA5. 1Faculty of Health Sciences , Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz , Kuala Lumpur , Malaysia. 2Institute for Medical Research , Jalan Pahang , Kuala Lumpur , Malaysia. 3School of Dentistry, Institute of Research , Development and Innovation, International Medical University , Kuala Lumpur , Malaysia. 4Centre for Tropical Climate Change System (IKLIM), Institute of Climate Change , Universiti Kebangsaan Malaysia , Bangi , Selangor , Malaysia. 5Oral Health Division , Ministry of Health , Putrajaya , Malaysia.

Abstract

Dental amalgam in fillings exposes workers to mercury. The exposure to mercury was investigated among 1871 dental health care workers. The aim of the study was to evaluate the risk of mercury exposure among dental compared to nondental health care workers and to determine other risk factors for mercury exposure. Respondents answered questionnaires to obtain demographic, personal, professional, and workplace information and were examined for their own amalgam fillings. Chronic mercury exposure was assessed through urinary mercury levels. In total, 1409 dental and 462 nondental health care workers participated in the study. Median urine mercury levels for dental and nondental health care workers were 2.75 μg/L (interquartile range [IQR] = 3.0175) and 2.66 μg/L (IQR = 3.04) respectively. For mercury exposure, there were no significant risk factor found among the workers involved within the dental care. The Mann-Whitney test showed that urine mercury levels were significantly different between respondents who eat seafood more than 5 times per week compared to those who eat it less frequently or not at all (p = 0.003). The urinary mercury levels indicated significant difference between dental workers in their practice using squeeze cloths (Mann-Whitney test, p = 0.03). Multiple logistic regression showed that only the usage of cosmetic products that might contain mercury was found to be significantly associated with the urinary mercury levels (odds ratio [OR] = 15.237; CI: 3.612-64.276). Therefore, mean urinary mercury levels of health care workers were low. Exposure to dental amalgam is not associated with high mercury exposure. However, usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury. Implications: Exposure to the high levels of mercury from dental amalgam can lead to serious health effects among the dental health care workers. Nationwide chronic mercury exposure among dental personnel was assessed through urinary mercury levels. Findings suggest low urinary mercury levels of these health care workers. Exposure to dental amalgam is not associated with high mercury exposure. However, the usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury.

187

Sahoo HB, Sagar K, Kumar A, Bhaiji A, Bhattamisra SK. Antidiarrhoeal investigation of Apium leptophyllum (Pers.) by modulation of Na+K+ATPase, nitrous oxide and intestinal transit in rats. Biomedical Journal, 2016; 39: 376-381. (ISI IF: 1.062).

Antidiarrhoeal investigation of Apium leptophyllum (Pers.) by modulation of Na+K+ATPase, nitrous oxide and intestinal transit in rats. Himanshu Bhusan Sahoo1, Rakesh Sagar2, Anjan Kumar3, Amrita Bhaiji3, Subrat Kumar Bhattamishra4. 1Department of Pharmacology and Experimental Biology, Vedica College of Pharmacy, RKDF University, India 2Department of Pharmacognosy and Phytochemistry, Sri Satya Sai Institute of Pharmaceutical Sciences, RKDF University, India 3Department of Pharmaceutical Chemistry, Roland Institute of Pharmaceutical Sciences, India 4Department of Life Sciences, School of Pharmacy, International Medical University, Malaysia.

Abstract Background: Apium leptophyllum (Pers.) is an annual herb with traditional appreciation for

various pharmacological properties; however, the scientific information on this herb is insufficient. The aim of the present investigation was undertaken to evaluate flavonoidal fraction of A. leptophyllum fruit (FFALF) against diarrhoea on albino rats.

Methods: The antidiarrhoeal study was conducted by castor oil induce diarrhoea,

prostaglandin E2 (PGE2) induced enteropooling and intestinal transit by charcoal meal test. The rats were divided into five groups (six/group). Group I served as control and received orally 2% acacia suspension; Group II served as standard and received orally loperamide (3 mg/kg) or atropine sulphate (5 mg/kg); Group III, IV and V served as test groups and received the FFALF at doses of 5, 10 and 20 mg/kg orally, respectively. Results: In castor oil-induced diarrhoeal model, the FFALF significantly (p < 0.001) reduced

the frequency of diarrhoea, defecation and weight of faeces as well as increased the sodium-potassium ATPase (Na+K+ATPase) activity and decreased nitric oxide (NO) content in the small intestine. In prostaglandin induced enteropooling model, it significantly (p < 0.01) and dose dependently slowed the intestinal fluid accumulation by decreasing the masses and volumes of intestinal fluid where as in charcoal meal test, it decreased charcoal meal transit in gastrointestinal tract as compared with control. Conclusions: The study reveals that the FFALF possess anti-diarrhoeal properties mediated

through inhibition of hyper secretion and gastrointestinal motility which support the traditional use of the plant.

Keywords: Apium leptophyllum, Castor oil, Enteropooling, Intestinal transit, Na+K+ATPase.

188

Selvaretnam A, Sahu PS, Sahu M, Ambu S. A review of concurrent infections of malaria and dengue in Asia. Asian Pacific Journal of Tropical Biomedicine, 2016; 6(7): 633-638. Doi: http://dx.doi.org/10.1016/j.apjtb.2016.05.008 (ISI IF: 1.203; SCI IF: 1.339; HI: 28; Tier: Q2).

A review of concurrent infections of malaria and dengue in Asia. Aruchana A/P Selvaretnam1, Priyadarshi Soumyaranjan Sahu2, Madhusmita Sahu3, Stephen Ambu2. 1Division of Biomedical Sciences and Biotechnology, School of Health Sciences, International Medical University, 57000 Kuala Lumpur, Malaysia 2Division of Pathology, School of Medicine, International Medical University, 57000 Kuala Lumpur, Malaysia 3Centre for Public Health Informatics, Asian Institute of Public Health, Bhubaneswar, Orissa 751002, India

Abstract Concurrent infections of malaria and dengue are when both of these mosquito-borne diseases occur simultaneously in an individual. In this review, reported cases with these co-infections in Asia are discussed. The focus is on the overlapping clinical presentations and the difficulties encountered in differential diagnosis. Also, cases reported in some special conditions, viz., pregnancy, foetal infections, and co-infections with one or more other infectious agents are highlighted. Due to similar clinical presentations of malaria and dengue, these co-infections may give rise to an incorrect diagnosis. Moreover, the treatment regimens for these co-infections are not the same as those for mono-infections. Hence, a delay in implementing the appropriate treatment regimen for these concurrent infections due to poor diagnosis can be fatal. The present review is intended to increase awareness about the clinical significance and the importance of these co-infections among clinicians, public health workers and health authorities in the Asian region. Though malaria-dengue concurrent infections are seldom reported from the Asian region, it is probably increasing particularly in the countries known to be endemic for both of the above diseases. A compulsory reporting of the incidences of malaria-dengue concurrent infections is recommended. Keywords: Concurrent infection, Co-infection, Malaria, Dengue, Asia.

http://dx.doi.org/10.1016/j.apjtb.2016.05.008

189

Shafiabady N, Lee LH, Rajkumar R, Kallimani VP, Akram NA, Isa D. Using unsupervised clustering approach to train the Support Vector Machine for text classification. Neurocomputing, 2016; 211: 4-10. doi: 10.1016/j.neucom.2015.10.137. (ISI IF: 2.392; SCI IF:

3.048; HI: 84; Tier: Q1).

Using unsupervised clustering approach to train the Support Vector Machine for text classification. Niusha Shafiabady1, L.H. Lee2, R. Rajkumar3, V.P. Kallimani4, Nik Ahmad Akram3, Dino Isa3. 1IMU, Malayisa, 2Universiti Tunku Abdul Rahman, Malaysia 3University of Nottingham, Malaysia Campus 4Universiti Teknologi Petronas, Malaysia

Abstract

The use of learning algorithms for text classification assumes the availability of a large amount of documents which have been organized and labeled correctly by human experts for use in the training phase. Unless the text documents in question have been in existence for some time, using an expert system is inevitable because manual organizing and labeling of thousands of groups of text documents can be a very labor intensive and intellectually challenging activity. Also, in some new domains, the knowledge to organize and label different classes might not be unavailable. Therefore unsupervised learning schemes for automatically clustering data in the training phase are needed. Furthermore, even when knowledge exists, variation is high when the subject under classification depends on personal opinions and is open to different interpretations. This paper describes a methodology which uses Self Organizing Maps (SOM) and alternatively does the automatic clustering by using the Correlation Coefficient (CorrCoef). Consequently the clusters are used as the labels to train the Support Vector Machine (SVM). Experiments and results are presented based on applying the methodology to some standard text datasets in order to verify the accuracy of the proposed scheme. We will also present results which are used to evaluate the effect that dimensionality reduction and changes in the clustering schemes have on the accuracy of the SVM. Results show that the proposed combination has better accuracy compared to training the learning machine using the expert knowledge. Keywords: Unsupervised learning, Classification, Support Vector Machines.

190

Sharmaa AK, Thanikachalamb PV, Rajputa SK. Albiglutide: Is a better hope against diabetes mellitus? Biomedicine and Pharmacotherapy, 2016; 77: 120–128. (ISI IF: 2.326; SCI IF: 2.447; HI: 67; Tier: Q2).

Albiglutide: Is a better hope against diabetes mellitus? Arun K. Sharmaa1, Punniyakoti V. Thanikachalam2, Satyendra K. Rajput1. 1Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh 201303, India 2School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia

Abstract

Type-2 diabetes mellitus (T2DM) is the chronic metabolic disorder which provokes several pitfall signalling. Though, a series of anti-diabetic drugs are available in the market but T2DM is still a huge burden on the developed and developing countries. Numerous studies and survey predict the associated baleful circumstances in near future due to incessant increase in this insidious disorder. The novelty of recent explored anti-diabetic drugs including glitazone, glitazaar and gliflozines seems to be vanished due to their associated toxic side effects. Brown and Dryburgh (1970) isolated an intestinal amino acid known as gastric inhibitory peptide (GIP) which had insulinotropic activity. Subsequently in 1985, another incretin glucagon likes peptide 1 (GLP-1) having potent insulinotropic properties was discovered by Schmidt and his co-workers. On the basis of results’ obtained by Phase III Harmony program FDA approved (14 April, 2014) new GLP-1 agonist ‘Albiglutide (ALB)’, in addition to exiting components Exenatide (Eli Lilly, 2005) and Liraglutide (Novo Nordisk, 2010). ALB stimulates the release of protein kinase A (PKA) via different mechanisms which ultimately leads to increase in intracellular Ca2+ levels. This increased intracellular Ca2+ releases insulin vesicle from b-cells. In-addition, ALB being resistant to degradation by dipeptidyl peptidase-4 (DPP-4) and has longer half life. DPP-4 can significantly degrade the level of GLP-1 agonist by hydrolysis. In spite of potent anti-hypergycemic activity, ALB has pleiotropic action of improving cardiovascular physiology. In light of these viewpoints we reveal the individual pharmacological profile of ALB and the critical analyse about its future perspective in present review. Keywords: Albiglutide, GLP-1R analogue, GIP, Dipeptidyl peptidase-4, Diabetes mellitus.

191

Sheon CP, Nallamolu S, Heng PW. A study on the plasticization of sustained release coatings for their ability to withstand the damaging effects of compaction on coated pellets. Asian Journal of Pharmaceutical Sciences, 2016; 11(1): 209-210. (SCI IF: 1.89; HI: 11; Tier: Q2).

A study on the plasticization of sustained release coatings for their ability to withstand the damaging effects of compaction on coated pellets. Chan Pui Sheon1, Sivaram Nallamolu1, Paul Wan Sia Heng2. 1Department of Pharmaceutical Technology, International Medical University, 57000 Malaysia 2Department of Pharmacy, National University of Singapore, 117543 Singapore

Abstract

Pharmaceutical solid dosage forms are commonly coated to modify the release of drugs. Due to the disadvantages of coated single-unit dosage forms, such as occurrences of dose dumping and local irritation, coated multi-particulates are preferred. Coated multi-particulates can eventually be filled into capsules or compressed into tablets. The latter is more desirable as unit production costs of tablets are considerably lower and machinery is more easily available. However, compression forces can result in structural changes to the coat, affecting its function. Hence, it is important to understand the factors affecting coat damage during compression [1–3].

The objective of this project is to examine how plasticization of coatings mitigate the level of pellet coat damage in tableted multi-unit pellet system (MUPS). The method involves coating of sustained release coats of different levels of plasticizer triethyl citrate (TEC) by film casting method.The compacts were made with the coated pellets. The casted films were studied for their mechanical properties and the coated pellets for their dissolution study. The model drug chlorpheniramine maleate was loaded onto sugar coated pellets of 500–600 μm in size using HPMC, povidone and de-ionized water. The drug loaded pellets were film coated with aqueous ethyl cellulose dispersion with varying levels of TEC using precision coating unit. The coated pellets were formulated with lactose, crospovidone and magnesium stearate into compact masses, by using 15 mm flat face punches with a compression force of 10 kN. These compacted tablets of MUPS were studied for invitro tests like hardness, disintegration and

dissolution rate. The surface morphology of the pellets was assessed by using SEM and the results were statistically analyzed by ANOVA.

The results of hardness, disintegration and dissolution were shown in Fig. 1. When the amount of TEC increased, the tablet hardness decreased which comparably produced soft and easily breakable tablets. The disintegration test shows increase in disintegration time with increased TEC concentration. A significant sustain action was observed in 2% weight gain, rather than 10% weight gain pellets. This was found to be the same in all the varying concentrations of TEC (10%, 20% and 30%) signifying that there was coat damage in 10% weight gain pellets. It can be concluded that the coated pellets could be compressed into tablets without mechanical damage to the coating membrane when additives of 2% weight gain at 10% TEC was used. Keywords: MUPS, Tableting, Plasticizer (TEC), Pellets.

192

Sheriff D, Sheriff SO. Reflective thinking is a part of introspection for a physician. European Journal of Pharmaceutical and Medical Research, 2016; 3(5): 217-219. (ISI IF: 3.628).

Reflective thinking is a part of introspection for a physician. Prof. Dr. Dhastagir Sheriff1 and S. Omer Sheriff2. 1Faculty of Medicine, Benghazi University, Benghazi, Libya. 2Faculty of Dentistry, International Medical University, Kuala Lumpur, Malaysia

Abstract

Reflective thinking and practice have become the norms of medical practice. One of the common problems health workers and practitioners encounter is to deal with patients infected with HIV infection. The fear and social stigma still haunt many in field of Medicine. If a patient who has not disclosed his HIV infection when subjected to a surgical procedure, the surgeon comes into contact with the blood spilled on to his face. That spilling of blood from a HIV infected patient makes him reflect and evaluate the day‟s proceedings of his practice and the precautions he needs to take to avoid such contacts with a blood infected with HIV. Keywords: Reflective thinking, practice, Human immunodeficiency virus (HIV), AIDS.

193

Siew WF, Loh CSN. Participation of nurses in Continuing Professional Development (CPD) in a private hospital in Melaka, Malaysia. IeJSME, 2016; 10(3): 4-13. (MyCite IF: 0.038).

Participation of nurses in Continuing Professional Development (CPD) in a private hospital in Melaka, Malaysia. Wei Fern Siew, Cindy Sze Nee Loh. Division of Nursing, School of Health Sciences, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, MALAYSIA.

Abstract Background: Continuing professional development (CPD) is a primary strategy for nurses to

keep abreast with the rapid changes in the health care practices of current times. Evidence has shown that nurses lack the initiative to take up the additional CPD offered by their organisation and have to be persuaded to do so once they have achieved the minimum 25 points of CPD mandated by Malaysia Professional Regulatory Board of Nursing (MNB). Objective: To determine the extent to which nurses from a private hospital in Melaka will participate in CPD and the challenges affecting them from participating in CPD upon achieving the mandatory CPD points specified by MNB. Methods: This is a cross-sectional descriptive survey. A sample of 188 registered nurses (RNs) from a private hospital in Melaka was recruited via purposive sampling technique to complete a self-reporting questionnaire. The instrument which was adapted and used with permission was pilot-tested for reliability and validated by content experts to ensure its suitability for this local study. Results: The survey showed that 82.4% of the registered nurses (RNs) had attained additional CPD points apart from the minimum 25 CPD points stipulated by MNB. The findings on RNs reading journals or engaged in distance learning programmes were not encouraging as the percentages were only 31.4% and the latter, 9%. In-service talks, grand round discussions and online sources of continual nursing education that do not require the RNs to be away from their work duties were the most frequent type of CPD activities participated by the RNs as compared to conferences, workshops, distance learning programmes or post basic courses. The top 3 challenges that affect RNs’ participation in CPD were time constraint (90.4%), work commitments (85.6%) and difficulty in getting nominated (53.7%) to attend the CPD activities of their choice. Conclusions: The results of this study highlighted the respondents’ views to the management

on the importance to align the approach of sponsoring CPD courses according to the nurses’ needs in order to meet their context of practice. The management also ought to take into consideration the identified challenges encountered by the nurses to participate in CPD upon achieving their mandatory CPD points specified by MNB. Keywords: Continuing professional education, nursing practice, professional development,

registered nurses.

194

Sikarwar AS, Runai FAR, Parolia A, Barua A. A comparative study on an anaerobic oral microbiota among autistic and non-autistic children. British Microbiology Research Journal, 2016; 15(6): 1-7. (IF: NA).

A comparative study on an anaerobic oral microbiota among autistic and non-autistic children. Archana Singh Sikarwar1, Fransazellea Anak Robert Runai2, Abhishek Parolia3 and Ankur Barua4. 1Faculty of Medicine and Health Sciences, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia. 2School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia. 3Faculty of School of Dentistry, International Medical University, Kuala Lumpur, Malaysia. 4Faculty of School of Medicine, International Medical University, Kuala Lumpur, Malaysia.

Abstract Aim: An evidence suggests that microbiota plays an important role in health and diseases.

Studies also suggested that microbiota may be different in children with an autism spectrum disorder (ASD) than typically developing children. The aim of the study was to examine the oral bacterial strain/s commonly found in children with autism. Study Design: Forty-three (43) children with ASD and forty-three (43) non-autistic children

from the same age group were recruited from one of the autistic society in Malaysia from three centres in Klang Valley, Malaysia. Results: Total eighty- six oral samples were tested using biochemical tests from autistic and nonautistic individuals. Eleven different bacterial species were identified. Actinomyces naeslundii was found in eight autistic samples whereas Prevotella intermedia and Porphyromonas gingivalis were not detected in any of the samples.

Conclusion: The study found that Actinomyces naeslundii was significantly present in autistic group. Keywords: Actinomyces naeslundii, Prevotella intermedia, Porphyromonas gingivalis, oral microbiota, autism.

195

Singh RB, Lee JY, Fedacko J, Niaz MA, Takahashi T, Elkilany GEN, Hristova K, Mohideen MR, Hisham MA. Epigenetic inheritance of hypertension. World Heart Journal, 2016; 8(1): 79-88. (SCI IF: 0.78; HI: 9; Tier: Q3).

Epigenetic inheritance of hypertension. RB Singh1, Jong Y Lee2, Jan Fedacko3, MA Niaz1, Toru Takahashi4, Galal E Nagib Elkilany5, Krasimira Hristova6, MR Mohideen7, and Hisham Mohd Aboul Enein8. 1Halberg Hospital and Research Institute, Moradabad, India 2Department of Medicine, University of Minnesota School of Medicine, Minneapolis, USA 3Department of Medicine, PJ Safaric University, Kosice, Slovakia 4Graduate School of Human Environmental Science, Fukuoka, Japan 5Gulf Medical University Hospital, UAE 6National Heart Hospital, Sofia, Bulgaria 7International Medical University, Kuala Lumpur Malaysia 8Benha University Vice President, Cairo, Egypt

Abstract

Blood pressure (BP) is influenced by multifactorial risk factors in a combination of genetics and environments. Evidence supports that the cardiovascular diseases (CVD) is initiated during in utero processes. Maternal nutritional environments may play a role in determining fetal growth, BP and subsequent pathophysiology. Studies proposed ill fitted perinatal environments negatively affect healthy fetal growth and developments. Many CVD risk factors, such as nutrition, smoking, pollution, stress, high BP and abnormal BP variability (BPV), have been associated with the modification of epigenetic influences. To modify factors affecting BP and the CVD, investigations are continued exploring mechanisms and the BP regulation, especially in essential hypertension.

Some genetic and epigenetic studies have been carried out in the perinatal regulation and fetal development that affect offspring’s morbidity and mortality in later life. As examples, hypertensive-prone spontaneously hypertensive rat strains showed significantly lowered BPs in normotensive uterine and/or nursing environments, while a perinatal low protein diet affected adult offspring’s kidney functions significantly, not to mention sodium sensitivity in gastrointestinal-renal ion transport in BP regulation.

A major effect in epigenetics would include DNA methylation, translational histone and noncoding RNA modifications that epigenetic modifications have major functional changes. Although similar to genetic features of DNA heritability, epigenetic mechanisms may differ with potential reversibility by environmental and nutritional factors, which make them potentially crucial for their role in complex and multifactorial diseases. Mechanisms associated with variability and epigenetics are still largely unknown. However, ambulatory BP monitoring (ABPM) as a tool to monitor BP and BPV to detect subtle changes during the subclinical stage to prevent further progress and ultimately make treatment plans before the clinical symptoms appear. Thus, various increased BP and abnormal BPV modifications should be priority tasks in the CVD prevention during the preclinical stages. Understanding the mechanisms and pathology of epigenome that underlie BPV may assist in the better management of hypertensive problems for a predictable reduction of CVD and chronic kidney disease (CKD). Early detection and early intervention in the preclinical stage can save lives and assets.

196

Singh S, Rajendran R, Kuroda K, Isogai E, Krstic-Demonacos M, Demonacos C. Oxidative stress and breast cancer biomarkers: The case of the cytochrome P450 2E1. Journal of Cancer Metastasis and Treatment, 2016; Volume 2016; 2: 269. (IF: NA).

Oxidative stress and breast cancer biomarkers: The case of the cytochrome P450 2E1. Subir Singh1, Ramkumar Rajendran2, Kengo Kuroda3, Emiko Isogai3, Marija Krstic-Demonacos4, Constantinos Demonacos1. 1Manchester Pharmacy School, University of Manchester, Manchester M13 9PT, UK. 2School of Pharmacy, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia. 3Laboratory of Animal Microbiology, Tohoku University Graduate School of Agricultural Science, Sendai, Miyagi, 981-8555, Japan. 4School of Environment and Life Sciences, University of Salford, Peel Building, Salford, M5 4WT, UK.

Abstract Aim: The aim of the study is to investigate the impact of the cytochrome P450 2E1, which is

the most efficient CYP450 family member in generating reactive oxygen species (ROS), on cellular energy metabolism of breast cancer cells and therefore the effects of CYP2E1 on breast carcinogenesis. Methods: The estrogen receptor positive MCF-7 and the triple negative MDA-MB-231 breast

cancer cells were used as experimental system to estimate ROS generation in these cells overexpressing CYP2E1 and treated with the glycolytic inhibitors 3-bromopyruvate or 2-deoxyglucose in the presence or absence of the CYP2E1 inhibitor chlormethiazole. Adenosine triphosphate (ATP) assay was used to measure ATP production and lactate assay to quantify the efflux of lactic acid in breast cancer cells treated with the CYP2E1 inhibitor chlormethiazole, the mitochondrial membrane potential and cell viability assays were employed to assess the pathway of cellular energy production and cellular death respectively after treatment of MCF-7 and MDA-MB-231 with the CYP2E1 activator acetaminophen or the CYP2E1 inhibitor chlormethiazole. Results: The results indicated increased ROS generation in breast cancer cells

overexpressing CYP2E1. ROS generation was differentially regulated in breast cancer cells upon treatment with the CYP2E1 inhibitor chlormethiazole. Chlormethiazole treated MCF-7 cells exhibited reduced lactate efflux implying that CYP2E1 directly or indirectly regulates the glycolytic rate in these cells. Furthermore the mitochondrial membrane potential of both MCF-7 and MDA-MB-231 cells was differentially affected by the CYP2E1 activator acetaminophen versus the CYP2E1 inhibitor chlormethiazole providing additional support for the involvement of CYP2E1 in energy metabolic pathways in breast cancer. Conclusion: Results presented in this study provide evidence to suggest that CYP2E1

regulates cellular energy metabolism of breast cancer cells in a manner dependent on cell type and potentially on the clinical staging of the disease therefore CYP2E1 is a possible breast cancer biomarker. Keywords: Reactive oxygen species, cytochrome P450 2E1, glycolysis, breast cancer.

197

Sivanandy P, Shim HS, Ong YC, Rajasekar D, Gan SW, Hii HC, Ng CE, Khoo XW, Yeap WL. Current trends in the management of Ebola virus disease - An updated systematic review. Asian Pacific Journal of Tropical Disease, 2016; 6(8): 589-595. (SCI IF: 0.982; HI: 17; Tier:

Q3).

Current trends in the management of Ebola virus disease - An updated systematic review. Palanisamy Sivanandy1, Shim Hui Sin2, Ong Yee Ching2, Dayalini Rajasekar2, Gan Sau Woon2, Hii Hieng Chiew2, Charisse Ng Ee-Yenn2, Khoo Xin Wei2, Yeap Wei Leng2. 1Department of Pharmacy Practice, International Medical University, Kuala Lumpur, Malaysia 2School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia

Abstract

The Ebola virus created a ripple of fear when its number of cases rose rapidly and drastically in recent years. Ebola infection is transmitted in humans when contact closely with blood, organs or other body fluids of infected animals or secretions. It is often mortal as it affects vascular system of the body, results in organ failure and serious internal bleeding. Hence, this review was aimed to summarize various essential aspects of Ebola virus disease and its management. A systematic review was carried out by collecting various literatures, published research articles, notes and other published date related to Ebola virus disease. Standard supporting care in a hospital setting such as replenishment of fluid and electrolytes, ventilation support, pain control and nutritional support is initiated to the patients to manage the symptoms and prevent any complications of Ebola disease since there are no Food and Drug Administration-approved medications available. In terms of pharmacological drug therapy, favipiravir has been shown to be efficacious and safe in treating the Ebola virus disease. Nevertheless, there are some preventive measures as well to decrease the risk of getting the disease. Further, the review suggests the efficient control and prevention of Ebola epidemic require adequate political support from the government as well as the establishment of a robust public health infrastructure and medical reserve. Strengthening of contact tracing and quarantine policies are also important for the prevention of Ebola virus disease. There should be a well-designed disease surveillance system when a suspected case is reported. Given the elevated case-fatality rate and the absence of effective treatment, it is sensible to evade research ethics and develop the promising future of experimental vaccines. The collection of clinical and epidemiological information of Ebola should be vigorous and systematic in the endemic affected areas. Keywords: Ebola, Haemorrhagic fever, Infection, Transmission, Bleeding, Virus.

198

Sumathy A, Palanisamy S, Arathi KN, Aswathi UP, Hamna Fathima K. Docking analysis of potent inhibitors of topoisomerase IV as potential antimicrobial agents. Asian Journal of Pharmaceutical and Health Sciences, 2016; 6(2): 1467-1471. (IF: NA).

Docking analysis of potent inhibitors of topoisomerase IV as potential antimicrobial agents. Sumathy A.1, Palanisamy S.2, Arathi K.N.3, Aswathi U.P.3, Hamna Fathima K.3. 1Department of Pharmaceutical Chemistry, Prime College of Pharmacy, Palakkad, India 2Department of Pharmacy Practice, International Medical University, Malaysia. 3Department of Pharmaceutical Chemistry, Grace College of Pharmacy, Palakkad, India.

Abstract

According to data of the World Health Organization, Tuberculosis (TB) caused by Mycobacterium tuberculosis, is considered to be the most chronic communicable disease in

the world especially in Asia and Africa. This situation was made worse by the emergence of multi drug resistant TB (MDR-TB) and is the leading cause of death in HIV-infected adults in developing countries, thus an urgent need exists for the development of new antimycobacterial agents with a unique mechanism of action. Mycobacterium tuberculosis 3LPS, an essential enzyme to pass one double strand of DNA to another there by changing the linking number of DNA is an attractive target for novel anti-tubercolosis agents. A series of Isatin, Thiazole with various acetophenones were computationally designed and energy minimized. The molecular properties were investigated for drug like properties by calculating Lipinski's zero violations of the rule of 5 which indicates good bioavailability. The positive bioactivity score of the derivative were also in agreement with their probability of drug likeness. These compounds were docked using Topoisomerase IV using Argus lab docking software which showed good binding energy for the enzyme, when compared with the binding energies of standard drug isoniazid -5.83kcal/mol.) Among all the designed ligands, the ligand SA and SN showed more binding energy 15values (-8.05 and -8.37Kcal/mol). In future we planned to synthesize these ligand and to screen for their anti TB activity. Keywords: Molinspiration, Drug likeness, Argus lab, Tuberculosis, Topoisomerase IV.

199

Sumathy A, Palanisamy S, Arathi KN, Karthik D, Srinivasan M. Microwave assisted synthesis and evaluation of some thiazole analogues as antitubercular agent. Asian Pacific Journal of Pharmacy and Phytochemistry, 2016; 1(01): 2-10. (IF: NA).

Microwave assisted synthesis and evaluation of some thiazole analogues as antitubercular agent. A. Sumathy1, S. Palanisamy2, K.N. Arathi3, D. Karthik3 and M. Srinivasan4. 1Department of Pharmaceutical Chemistry, Prime College of Pharmacy, Palakkad 2Department of Pharmacy Practice, International Medical University, Malaysia 3Department of Pharmacology, Grace College of Pharmacy, Palakkad 4Department of Pharmaceutical Chemistry, Madurai Medical College, Madurai.

Abstract

Thiazoles and their derivatives have long been used as precursors for the synthesis of biologically active molecules because of the wide spectrum of activity shown by the thiazole moiety. Numerous thiazole compounds substituted with a different group of various positions have been prepared, despite this importance of 2-aminothiazoles have not been previously reviewed. In recent years, several new methods for the preparation of 2-aminothiazole derivatives and reactions have been reported, including waste free techniques. Various substituted phenyl thiazoles were synthesized by the reaction of substituted acetophenone and thiourea in the presence of iodine, where cyclization takes place and these thiazoles were further treated with isatin, those gave respective Schiff bases. The newly synthesized compounds were characterized by IR spectral studies and screened for antitubercular activity against Mycobacterium tuberculosis whereas antimicrobial activity was performed against B.subtilis, E.coli, and C.albicans. The findings of the present investigation highlights, the synthesized thiazoles possessing good anti-tubercular, anti-microbial activities due to the incorporation of secondary amines with the substituted thiazoles. Keywords: Isatin, Substituted acetophenones, Antitubercular activity, Antimicrobial activity.

200

Sumera A, Inn LC, Barua A. An update on new vaccines for tuberculosis. Journal of Asian Scientific Research, 2016; 6(3): 41. (IF: NA).

An update on new vaccines for tuberculosis. Afshan Sumera1, Leong Chia Inn2, Ankur Barua3. 1Lecturer, Pathology Department, School of Medicine, International Medical University, Kuala Lumpur Malaysia 2Student Bachelor of Science (Honours) Biomedical Science Programme, International Medical University, Kuala Lumpur Malaysia 3Senior Lecturer, Community Medicine Department, School of Medicine, International Medical University, Kuala Lumpur Malaysia

Abstract

Tuberculosis (TB) is one of the most common and deadly communicable diseases in the world, infecting approximately one-third of the total human race. The number of drug-resistant TB cases are increasing. The spectrum of resistance varies from single to multidrug and from multidrug to total drug resistance varieties. Human Immunodeficiency Virus (HIV) infection is also responsible for the recent re-emergence of tuberculosis infection worldwide. When drugs are becoming ineffective against Mycobacterium tuberculosis, there is a need to focus more

on preventive strategies. Though Bacillus Calmette–Guérin (BCG) vaccine is efficient in preventing miliary and meningeal tuberculosis in children, it is not effective against pulmonary tuberculosis. For prevention of pulmonary tuberculosis, development of new vaccines is the need of time. Several new vaccines are under clinical trials either to replace old BCG or act as a booster for the current BCG vaccine. New vaccines include live Mycobacterial vaccines, its subunit, live vector-based vaccines and killed whole or fragmented vaccines. This review recaps the status of development of pre-clinical tuberculosis vaccines. Keywords: Vaccine, Mycobacterium tuberculosis, Tuberculosis, Trials, Anti TB vaccines,

BCG vaccine.

201

Supramaniam Y, Chong CW, Silvaraj S, Tan IK-P. Effect of short term variation in temperature and water content on the bacterial community in a tropical soil. Applied Soil Ecology, 2016; 10: 279-289. [IMUR121-2013]. (ISI IF: 2.67; SCI IF: 2.716; HI: 83; Tier: Q1).

Effect of short term variation in temperature and water content on the bacterial community in a tropical soil. Yasoga Supramaniam1,2, Chun-Wie Chong3, Santha Silvaraj1, Irene Kit-Ping Tan1,2. 1Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur, Malaysia 2National Antarctic Research Centre, University of Malaya, Kuala Lumpur, Malaysia 3Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia

Abstract The community dynamics of environmental bacteria is dependent on micro-climatic factors such as temperature and water potentials. A shift in any one of these factors can have a major impact on the richness and composition of the microbes in the soil. However, microbial responses towards these climate stressors are poorly characterised. Here, we undertook a microcosm study to assess the effect of temperature and water content on the bacterial community structure in a tropical soil over a four week period. The microcosms were incubated at three different temperatures (25 °C, 30 °C, and 35 °C) and maintained under two different water levels (2 and 5 mL). Using a combination of molecular assessment tools and numerical inference, we showed that short-term variation in both temperature and water content induced significant changes to the soil bacterial community composition. The greatest difference in community structure between treatments was observed in the Week 2 microcosms, but in the Week 4 microcosms, the community structure between treatments became more similar. Compared to temperature, water content exerted a greater effect on the bacterial diversity. Firmicutes was the most abundant phylum in all the analysed samples, and its relative abundance increased with elevation in temperature and water content. Out of six functional genes analysed, the nitrogen fixation gene (nifH) and denitrification gene (nosZ) showed significant correlations to the bacterial community structures. Keywords: Tropical, Soil bacterial community, Functional gene, T-RFLP, NGS.

202

Suresh A, Mathan R, Nagendrababu V, Deivanayagam K, Yarramreddy S, Kalaiselvam R. Evaluation of the antibacterial efficacy of Azadirachta indica, Commiphora myrrha, Glycyrrhiza glabra against Enterococcus faecalis using real time PCR. Open Dentistry Journal, 2016;

11(10): 160-5. doi: 10.2174/1874210601610010160. (SCI IF: 0.952; HI: 9; Tier: Q3).

Evaluation of the antibacterial efficacy of Azadirachta indica, Commiphora myrrha, Glycyrrhiza glabra against Enterococcus faecalis using real time PCR. Suresh Anand1, Mathan Rajan2, Nagendrababu Venkateshbabu3, Deivanayagam Kandaswamy2, Yarramreddy Shravya2 and Kalaiselvam Rajeswari2. 1Department of Conservative Dentistry and Endodontics, Penang International Dental College, Jalan Bagan Laur,12000, Butterworth, Penang, Malaysia 2Department of Conservative Dentistry and Endodontics, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, 600 116, India 3Department of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.

Abstract Aim: To compare the antibacterial efficacy of Azadirachta indica (Neem), Commiphora myrrha (Myrrh), Glycyrrhiza glabra (Liquorice) with 2% Chlorhexidine (CHX) against E. faecalis by

using Real Time PCR. Materials and Methods: A total of fifty teeth specimens (n=50) were inoculated with E. faecalis for 21 days. Specimens were divided into five groups (Group 1: Myrrh, Group 2: Neem, Group 3: Liquorice, Group 4: 2% CHX and Group 5: Saline (negative control)). The intracanal medicaments were packed inside the tooth. After 5 days, the remaining microbial load was determined by using real time PCR. Results: Threshold cycle (Ct) values of Myrrh extract, Neem extract, Liquorice Extract, 2%

CHX and saline were found to be 30.94, 23.85, 21.38, 30.93 and 17.8 respectively. Conclusion: Myrrh extract showed inhibition of E.faecalis equal to that of 2% CHX followed

by Neem, Liquorice and Saline. Keywords: Commiphora myrrha, Neem, Liquorice, 2% CHX, Dentinal tubules, intracanal

medicament, realtime polymerase chain reaction.

203

Syed IA, Sulaiman SA, Hassali MA, Syed SH, Shan LH, Lee CK. Factors associated with poor CD4 and viral load outcomes in patients with HIV/AIDS. Journal of Medical Virology, 2016; 88(5): 790-797. (ISI IF: 1.998; SCI IF: 2.022; HI: 98; Tier: Q2).

Factors associated with poor CD4 and viral load outcomes in patients with HIV/AIDS. Syed IA1,2, Sulaiman SA1, Hassali MA1, Syed SH3, Shan LH2, Lee CK4. 1School of Pharmaceutical Sciences, Universiti SainsMalaysia (USM), Malaysia. 2School of Pharmacy, International Medical University, Malaysia. 3School of Pharmacy, University of Queensland, Australia. 4Department of Medicine, Hospital Sungai Buloh, Selangor, Malaysia.

Abstract Suboptimal viral suppression and CD4 response to antiretroviral treatment (HAART) is known to cause poor outcomes with the increase cost of treatment. We aimed to assess factors associated with such control among HIV/AIDS patients in Malaysia. Four hundred and six HIV/AIDS patients, using Antiretroviral Therapy (ART) for at least the past three months, treated as outpatients at medication therapy adherence clinics (MTAC) were recruited. CD4 cell counts, viral load readings along with co-variants such as socio-demographic factors, adverse drug reactions, comorbidities, and medication record were obtained. Statistical Package for Social Sciences (SPSS(®)) version 18 and STATA IC(®) version 12 were used for data analysis. CD4 counts were found highest among those within the age category 41-50 years (390.43 ± 272.28), female (402.64 ± 276.14), other ethnicities (400.20 ± 278.04), and participants with no formal education (414.87 ± 290.90). Patients experiencing adverse effects had a 2.28 (95%CI:1.25-4.18) fold greater risk of poor CD4 control, while patients with comorbidities had 2.46 (95%CI:1.02-5.91) fold greater risk of mild viral suppression. Adverse drug reactions, co-morbidities were found to be significantly associated with poor immunological and virological outcomes in HIV/AIDS patients. However, a comprehensive evaluation is needed to better understand other confounders.

Keywords: CD4 outcomes, HIV & AIDS, anti-retroviral therapy, factors associated, viral

suppression.

204

Tan BH, Ong CE. The use of natural remedies to treat osteoarthritis. TANG [HUMANITAS MEDICINE], 2016; 6(1): e1. DOI: http://dx.doi.org/10.5667/tang.2015.0023. (IF: NA).

The use of natural remedies to treat osteoarthritis. Boon Hooi Tan1, Chin Eng Ong2. 1Division of Human Biology, School of Medicine, International Medical University 2School of Pharmacy, Monash University Malaysia

Abstract

Osteoarthritis (OA) is the leading medical condition for which patients use alternative treatments including the natural remedies. The aim of this review is to describe the dietary supplements and herbal remedies most commonly used in patients with osteoarthritis with an emphasis on the efficacy and safety of these natural remedies. Glucosamine and chondroitin sulfate, two of the molecular building blocks found in articular cartilage, are the most commonly used remedies in OA treatment. Most clinical researches suggest that glucosamine and chondroitin show efficacy in reducing or improving symptoms and their ability to arrest progression of the disease or regenerate damaged cartilage. Patented formulations of both remedies are recommended by several therapeutic guidelines for use as first line background OA treatment. Reliable evidence that the combination is more effective than either agent alone is however still lacking. Several other herbs or remedies are promoted for treating osteoarthritis such as S-adenosylmethionine, methylsulfonylmethane, Harpagophytum procumbens (devil's claw), Curcuma longa (turmeric), Zingiber officinale (ginger), and

capsaicin but there is no reliable evidence on long-term efficacy or safety. The clinical usefulness of these remedies is therefore rather limited currently. Keywords: osteoarthritis, natural remedies, glucosamine, chondroitin, herbs.

http://dx.doi.org/10.5667/tang.2015.0023

205

Tan SY, Wong MM, Tiew ALW, Choo YW, Lim SH, Ooi IH, Modamio P, Fernández C, Mariño EL, Segarra I. Sunitinib DDI with paracetamol, diclofenac, mefenamic acid and ibuprofen shows sex-divergent effects on the tissue uptake and distribution pattern of sunitinib in mice. Cancer Chemotherapy and Pharmacology, 2016; 1-10. Doi: 10.1007/s00280-016-3120-9.

[IMU Internal grant BPharm Sem 7– IMU_2010] (ISI IF: 2.824; SCI IF: 2.965; HI: 86; Tier: Q1).

Sunitinib DDI with paracetamol, diclofenac, mefenamic acid and ibuprofen shows sex-divergent effects on the tissue uptake and distribution pattern of sunitinib in mice. Siok Yean Tan1, Mei Mei Wong1, Angela Lu Wun Tiew1, Yai Wen Choo1, Suat Hun Lim1, Ing Hong Ooi2, Pilar Modamio3, Cecilia Fernández3, Eduardo L. Mariño3, Ignacio Segarra1,4,5. 1Department of Pharmaceutical Technology, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia 2Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia 3Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain 4Clinical Pharmacy and Pharmacotherapy Unit, Department of Pharmacy and Pharmaceutical Technology, Faculty of Pharmacy, University of Barcelona, Barcelona, Spain 5University of Barcelona, Avn Joan XXIII s/n, 08028 Barcelona, Spain

Abstract Purpose: Pharmacokinetic interaction of sunitinib with diclofenac, paracetamol, mefenamic

acid and ibuprofen was evaluated due to their P450 mediated metabolism and OATP1B1, OATP1B3, ABCB1, ABCG2 transporters overlapping features. Methods: Male and female mice were administered 6 sunitinib doses (60 mg/kg) PO every

12 h and 30 min before the last dose were administered vehicle (control groups), 250 mg/kg paracetamol, 30 mg/kg diclofenac, 50 mg/kg mefenamic acid or 30 mg/kg ibuprofen (study groups), euthanized 6 h post last administration and sunitinib plasma, liver, kidney, brain concentrations analyzed. Results: Ibuprofen halved sunitinib plasma concentration in female mice (p < 0.01) and

showed 59 % lower concentration than male mice (p < 0.05). Diclofenac and paracetamol female mice showed 45 and 25 % higher plasma concentrations than male mice which were 27 % lower in mefenamic acid female mice. Paracetamol increased 2.2 (p < 0.05) liver and 1.4-fold (p < 0.05) kidney sunitinib concentrations in male mice that were lower in female mice (p < 0.01, p < 0.001, respectively). Ibuprofen increased 2.9-fold (p < 0.01) liver concentration in male mice that were higher than in female mice (p < 0.001). Female control mice had 35 % higher sunitinib brain concentration than male mice but the concentration decreased 37, 33, 10 and 57 % in the diclofenac, paracetamol, mefenamic acid and ibuprofen (p < 0.001), respectively. Tissue–plasma concentrations correlations were nonsignificant in control, paracetamol, mefenamic acid and ibuprofen groups but was significant in the diclofenac group in male mice (liver, brain) and female mice (liver, kidney). Conclusions: These results portray gender-based sunitinib pharmacokinetic differences and NSAIDs selective effects on male or female mice, with potential clinical translatability. Keywords: Sunitinib, Paracetamol, Diclofenac, Ibuprofen, Mefenamic acid, Sex-divergent

pharmacokinetics.

206

Tan WZ, Krishnappa P. Gene polymorphism in cervical cancer. International Journal of Current Medical and Pharmaceutical Research Sciences, 2015; 1(11): 189-192. ISSN: 2395-6429. (ISI IF: 0.543).

Gene polymorphism in cervical cancer. Tan Wu Zhen, Purushotham Krishnappa. Department of Pathology, International Medical University, Malaysia.

Abstract

Cervical cancer is among the common lesions reported in gynecology clinics. It is been well established that infection of high risk human papilloma virus (HPV) plays a significant role in pathogenesis of cervical cancer. However, by itself HPV infection may not solely cause the cancer but should be compounded by many other environmental and genetic factors. It has been estaliblished that gene polymorphism contributes significantly insusceptibility to cancer development. However the concepts of gene polymorphisms and their association with cancers particularly the cervical cancers are not well understood. This review is aimed at gathering updated information about cervical cancer and its association with gene polymorphism. Keywords: Gene Polymorphism, Cervical cancer, Infection, Human Papilloma virus.

207

Tan YJ, Lee CS, Er HM, Lim WH, Wong SF. In-vitro evaluation of griseofulvin loaded lipid nanoparticles for topical delivery. Journal of Drug Delivery Science and Technology, 2016; 31: 1-10. (ISI IF: 0.620; SCI IF: 0.749; HI: 31; Tier: Q2).

In-vitro evaluation of griseofulvin loaded lipid nanoparticles for topical delivery. Yann Jean Tan1, Choy Sin Lee2, Hui Meng Er2, Wen Huei Lim3, Shew Fung Wong4. 1School of Postgraduate Studies and Research, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 2Department of Pharmaceutical Chemistry, School of Pharmacy, International Medical University, No. 126, Jalan Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 3Advanced Oleochemical Technology Division, Malaysian Palm Oil Board, Bandar Baru Bangi, Selangor, Malaysia 4Department of Pathology, School of Medicine, International Medical University, No. 126, Jalan Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

Abstract

In this work, the potential of targeting griseofulvin (GF) into the skin by topical application was evaluated by in-vitro studies. Griseofulvin loaded lipid nanoparticles (GF-LN) were prepared using high pressure homogenization method without any penetration enhancer or solubilizing solvent. The formulations were freeze dried to increase stability of the lipid nanoparticles (LN). The optimum formulation showed a mean particle size of 179.8 nm with polydispersity index of 0.306 and zeta potential of -27.9 mV and the loading of griseofulvin was 0.77%. Morphology and the degree of crystallinity of the LN were investigated using transmission electron microscope (TEM) and differential scanning calorimetry (DSC). In-vitro cytotoxicity studies showed the LN has better safety profile in human keratinocyte cells (HaCaT) with four-folds reduction in cytotoxicity (IC50 30 ± 2.37 mg/mL). In the in-vitro antifungal susceptibility tests, the GF-LN demonstrated comparable antifungal activity against Trichophyton rubrum (MIC 0.5 mg/mL) and Trichophyton mentagrophytes (MIC 0.25 mg/mL). In-vitro skin penetration

and retention studies were carried out on porcine skin. The GF-LN demonstrated sufficient skin permeation with penetration flux of 0.067 ± 0.003 mg/cm2/hr. The retention of griseofulvin was found four-folds higher in the epidermis (14.9 ± 0.483 mg/cm2) on comparison to the dermis. Keywords: Lipid nanoparticles, Griseofulvin, Topical, In-vitro.

208

Tan ZZ, Hossain MZ, Ahsan MS, Chew YC, Win SS, Khoo SP. Microvessel density in different grades of squamous cell carcinoma and its relationship with keratin pearl. Sains Malaysiana, 2016; 45(2): 201–205. (ISI IF: 0.35; SCI IF: 0.474; HI: 15; Tier: Q2).

Microvessel density in different grades of squamous cell carcinoma and its relationship with keratin pearl. Zeng Zhou Tan1, Mohammad Zakir Hossain2, Md Shahidul Ahsan1, Yew Choy Chew3, Swe Swe Win4, Suan Phaik Khoo1. 1School of Dentistry, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Wilayah Persekutuan Malaysia 2Department of Oral Biology & Biomedical Sciences, Faculty of Dentistry, University of Malaya 50603 Kuala Lumpur, Wilayah Persekutuan Malaysia 3School of Science, Monash University, 47500 Bandar Sunway, Selangor Darul Ehsan, Malaysia 4University of Dental Medicine, Thingangyun 11071, Yangon, Yangon Division, Myanmar.

Abstract

Angiogenesis has an important role in the invasion, metastasis and growth of tumors. Increased microvessel density (MVD) has been described in oral squamous cell carcinoma (OSCC) compared to oral dysplasia and normal oral tissue. A morphometric study was designed to evaluate the MVD and to evaluate the presence of any association between MVD and keratin pearl in the three histopathological grades of OSCC (as defined in Bryne’s grad ing system). Forty-five samples of OSCC were graded into well differentiated (WDSCC), moderately differentiated (MDSCC) and poorly-differentiated (PDSCC) oral squamous cell carcinoma. Morphometric analysis showed that MVD was significantly lower in WDSCC compared to MDSCC (p<0.001) and PDSCC (p<0.001). The density in MDSCC was significant lower than PDSCC. The keratin pearl count was significantly higher in WDSCC compared to MDSCC (p<0.001) and PDSCC (p<0.001). Between MDSCC and PDSCC, the keratin pearl count was significantly higher for MDSCC (p=0.001). Pearson correlation test showed a significant negative correlation between keratin pearl and MVD (r=-0.805, p<0.001). The findings suggested that vascularity in OSCC is associated with its cellular differentiation and also associated with keratin pearl formation. Keywords: Keratin pearl, microvessel density (MVD), oral squamous cell carcinoma (OSCC), tumour grading.

209

Tang WB, Sikarwar AS. Diagnostics: Conventional versus modern methods. Journal of Advances in Medical and Pharmaceutical Sciences, 2016; 8(4): 1-7. (IF: NA).

Diagnostics: Conventional versus modern methods. Tang Wai Bunn and Archana Singh Sikarwar. Faculty of Medicine and Health Sciences, International Medical University, Kuala Lumpur, Malaysia.

Abstract

There are many research have been done on the development of rapid and effective diagnostic methods. New modern diagnostic test is widely accepted because of the quick and effective test results, with in a short time duration which will help physicians to correctly diagnose the disease for treatment purposes, however cost of the test will increase because of specific equipment, expensive reagents and qualified staff to run the test. Some pathology labs still uses traditional methods because of cost effectiveness. The objective of an article is to compare conventional and modern diagnostic test to understand the demand of the community for the successful acceptance of modern diagnostic methods. Most considerable factors to decide suitable diagnostic methods are commonly cost effectiveness, specificity, sensitivity as well as the availability of qualified staffs. Currently, nucleic acid manipulation and testing are common test used in the scientific community. Promising approach involves advances in nanotechnology field that provide new directions to simplify assay procedures to make it user-friendly and enhance the detection sensitivity of the assay. Keywords: Diagnostic methods, conventional methods, modern methods.

210

Tang WM, Abdul Rahman Idris. Leaving intention and exit destinations among the Malaysian private hospital nurses. IeJSME, 2016; 10(1): 24-35. (MyCite IF: 0.038).

Leaving intention and exit destinations among the Malaysian private hospital nurses. Wai Mun Tang, Abdul Rahman Idris.

Abstract Background: Many nurses are leaving for various destinations and leaving intention was found to be the immediate precursor for actual turnover, but studies examining the different forms of leaving intention (unit, hospital, country, and profession) and exit destinations are scarce. Objectives: To determine the different forms of nurses’ leaving intention (i.e., leaving the unit,

hospital, country, and profession), exit destinations and associations of demographic variables on the different forms of leaving intention and exit destinations. Methods: The study design was a cross-sectional survey. Private hospital nurses in the

Peninsular Malaysia were the study population and a total of 942 (73% response rate) nurses participated in the study. A self-reported questionnaire was used for data collection. Results: The results revealed that intention of leaving the organisation (M = 2.81, SD = 1.33) was the highest and followed by intention of leaving the unit (M = 2.54, SD = 1.31). In terms of exit destinations, advancing nursing qualification (M = 2.95, SD = 1.31) and practising nursing in another country (M = 2.55, SD = 1.31) were the most preferred exit destinations

among the nurses. Conclusions: Nursing managers play a significant role in retaining nurses within the units and

organisations. The findings on nurses’ exit destinations are crucial because they serve as the direction for nurses’ retention strategies which include professional development opportunities through training, education and staff mobility. Keywords: leaving, intention, exit, destinations, nurses.

211

Teng CL, Lim WY, Chua CZ, et al. Does a single cup of caffeinated drink significantly increase blood pressure in young adults? A randomised controlled trial. Australian Family Physician, 2016; 45(1): 65-8. (ISI IF: 0.714; SCI IF: 0.719; HI: 31; Tier: Q2).

Does a single cup of caffeinated drink significantly increase blood pressure in young adults? A randomised controlled trial. Cheong Lieng Teng, Wee Yang Lim, Chen Zhi Chua, Richard Soon Kiat Teo, Kenny Tze Hoe Lin, Jie Cong Yeo. Department of Family Medicine, International Medical University, Clinical School, Jalan Rasah, Negeri Sembilan, Malaysia.

Abstract Background: Previous studies have shown that the blood pressure elevating effect of acute

caffeine consumption was variable because of the heterogeneity of study participants, dosage of caffeine and study designs. Objective/s: This research aimed to examine the effect of a single cup of coffee on the blood

pressure of young adults. Methods: Normotensive adults were randomised to receive either a cup of caffeinated drink

(intervention group) or a cup of decaffeinated drink (control group). The main outcome measure was mean change in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between intervention and control groups. Results: Enrolled participants (n = 104) were randomly assigned to the intervention group (n = 53) or the control group (n = 51). The mean differences in SBP and DBP of the two groups were +2.77 mmHg (P = 0.05) and +2.11 mmHg (P = 0.64), respectively. Therefore, the rise in both SBP and DBP after caffeine consumption was not statistically significant. Discussion: Our study confirmed that drinking a single cup of coffee (containing 80 mg of

caffeine) does not have a significant impact on the blood pressure of healthy normotensive young adults one hour after the drink.

212

Thiruchelvam K, Hasan SS, Wong PS, Kairuz T. Residential aged care medication review to improve the quality of medication use: A systematic review. Journal of the American Medical Directors Association (JAMDA), 2016; DOI: http://dx.doi.org/10.1016/j.jamda.2016.10.004.

[IMU Internal Grant- IMU349/2016]. (ISI IF: 6.616; SCI IF: 6.623; HI: 55; Tier: Q1).

Residential aged care medication review to improve the quality of medication use: A systematic review. Kaeshaelya Thiruchelvam1, Syed Shahzad Hasan1, Pei Se Wong1, Therese Kairuz2. 1School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia 2College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia

Abstract Background: Aging is often associated with various underlying comorbidities that warrant the

use of multiple medications. Various interventions, including medication reviews, to optimize pharmacotherapy in older people residing in aged care facilities have been described and evaluated. Previous systematic reviews support the positive impact of various medication-related interventions but are not conclusive because of several factors. Objectives: The current study aimed to assess the impact of medication reviews in aged care

facilities, with additional focus on the types of medication reviews, using randomized controlled trials (RCTs) and observational studies. Methods: A systematic searching of English articles that examined the medication reviews

conducted in aged care facilities was performed using the following databases: PubMed, CINAHL, IPA, TRiP, and the Cochrane Library, with the last update in December 2015. Extraction of articles and quality assessment of included articles were performed independently by 2 authors. Data on interventions and outcomes were extracted from the included studies. The SIGN checklist for observational studies and the Cochrane Collaboration’s tool for assessing risk of bias in RCTs were applied. Outcomes assessed were related to medications, reviews, and adverse events. Results: Because of the heterogeneity of the measurements, it was deemed inappropriate to conduct a meta-analysis and thus a narrative approach was employed. Twenty-two studies (10 observational studies and 12 controlled trials) were included from 1141 evaluated references. Of the 12 trials, 8 studies reported findings of pharmacist-led medication reviews and 4 reported findings of multidisciplinary team-based reviews. The medication reviews performed in the included trials were prescription reviews (n = 8) and clinical medication reviews (n = 4). In the case of the observational studies, the majority of the studies (8/12 studies) reported findings of pharmacist-led medication reviews, and only 2 studies reported findings of multidisciplinary team-based reviews. Similarly, 6 studies employed prescription reviews, whereas 4 studies employed clinical medication reviews. The majority of the recommendations put forward by the pharmacist or a multidisciplinary team were accepted by physicians. The number of prescribed medications, inappropriate medications, and adverse outcomes (eg, number of deaths, frequency of hospitalizations) were reduced in the intervention group. Conclusion: Medication reviews conducted by pharmacists, either working independently or

with other health care professionals, appear to improve the quality of medication use in aged care settings. However, robust conclusions cannot be drawn because of significant heterogeneity in measurements and potential risk for biases. Keywords: Aged care, medication review, medication use, quality, residential.

http://dx.doi.org/10.1016/j.jamda.2016.10.004

213

Thuraisingham C, Sinniah D. Stiff hands and feet, facial deformities. Journal of Family Practice,

2016; 65(2): 121-124. (SCI IF: 0.473; HI: 81; Tier: Q3).

Stiff hands and feet, facial deformities. Thuraisingham Chandramani, Sinniah Davendralingam. Clinical Campus Seremban, International Medical University, Seremban.

Abstract

The article presents a case study of 47years old women who is suffering from the autoimmune disease systemic sclerosis (SSC) with symptoms such as stiff hands and feet, facial deformities. Topics discussed include diagnosis of the disease through serologic testing, Capillary microscopy and chest xray; absence of proper cure for the disease and usage of immunosuppressive agents for betterment of life of the patient.

214

Tiong JJL, Loo J, Mai CW. Global antimicrobial stewardship: A closer look at the formidable implementation challenges. Frontiers in Microbiology, 2016; 7: 1860. Accepted for publication. doi: 10.3389/fmicb.2016.01860. (ISI IF: 4.165; SCI IF: 4.093; HI: 41; Tier: Q1).

Global antimicrobial stewardship: A closer look at the formidable implementation challenges. John J. L. Tiong1, Jason S. E. Loo1 and Chun-Wai Mai2. 1School of Pharmacy, Taylor’s University, Subang Jaya, Malaysia 2School of Pharmacy, International Medical University, Bukit Jalil, Malaysia

Abstract

Antimicrobial stewardship (AMS) has been touted as one of the key strategies required in tackling worldwide escalation of antibiotic resistance. Although AMS has optimized antibiotic usage and reduced the incidence of resistance development in some regions, its full global potential has been curtailed by various AMS-impeding factors. This article seeks to highlight in a detailed perspective, the key challenges that hamper global AMS endeavors, some of which include the paucity of effective implementation strategies that cater for the challenging settings of developing nations, the slow response of governments, uncoordinated AMS activities as well as implementation fragmentation across different sectors and countries. The authors of this article call upon all stakeholders to pay attention to these seemingly obvious but often under-addressed problems. If left unresolved, this may render all current and future AMS initiatives pointless. Keywords: antimicrobial stewardship, antibiotic resistance, implementation challenges,

global framework, action plans, health crisis.

215

Tiong JJL, Mai CW, Gan PW, Mak VSL, Johnson J. Separation of prescribing and dispensing in Malaysia: The history, necessities and challenges. International Journal of Pharmacy Practice, 2016; 24(4): 302-5. (SCI IF: 1.009; HI: 28; Tier: Q1).

Separation of prescribing and dispensing in Malaysia: The history, necessities and challenges. John Jeh Lung Tiong1, Chun Wai Mai2, Pou Wee Gan2, James Johnson3 and Vivienne Sook Li Mak4. 1School of Pharmacy, Taylor’s University, Subang Jaya, Selangor, Malaysia 2School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia 3Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK 4School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia

Abstract

This article serves as an update to the work by Shafie et al. (2012) which previously reviewed the benefits of policies separating prescribing and dispensing in various countries to advocate its implementation in Malaysia. This article seeks to strengthen the argument by highlighting not only the weaknesses of the Malaysian health care system from the historical, professional and economic viewpoints but also the shortcomings of both medical and pharmacy professions in the absence of separation of dispensing. It also provides a detailed insight into the ongoing initiatives taken to consolidate the role of pharmacists in the health care system in the advent of separation of dispensing. Under the two tier system in Malaysia at present, the separation of prescribing and dispensing is implemented only in government hospitals. The absence of this separation in the private practices has led to possible profit-oriented medical and pharmacy practices which hinder safe and cost-effective delivery of health services. The call for separation of dispensing has gained traction over the years despite various hurdles ranging from the formidable resistance from the medical fraternity to the public’s scepticism towards the new policy. With historical testament and present evidence pointing towards the merits of a system in which doctors prescribe and pharmacists dispense, the implementation of this health care model is justified. Keywords: dispensing separation, health care reform, medicine, pharmacy.

216

Tiong KH, Tan BS, Choo HL, Chung FFL, Hii LW, Tan SH, Khor NTW, Wong SF, See SJ, Tan YF, Rozita R, Cheong SK, Leong CO. Fibroblast growth factor receptor 4 (FGFR4) and fibroblast growth factor 19 (FGF19) autocrine enhance breast cancer cells survival. Oncotarget, 2016; 7(36): 57633-57650. doi: 10.18632/oncotarget.9328. (ISI IF: 6.359; SCI IF:

4.886; HI: 46; Tier: Q1).

Fibroblast growth factor receptor 4 (FGFR4) and fibroblast growth factor 19 (FGF19) autocrine enhance breast cancer cells survival. Kai Hung Tiong1,2,3, Boon Shing Tan1,4, Heng Lungh Choo1,5, Felicia Fei-Lei Chung5, Ling-Wei Hii1,5, Si Hoey Tan1,5, Nelson Tze Woei Khor6, Shew Fung Wong7, Sze-Jia See5, Yuen-Fen Tan1,5, Rozita Rosli8, Soon-Keng Cheong9, Chee-Onn Leong5,10. 1School of Postgraduate Studies, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia 2Oral Cancer Research and Co-ordinating Center (OCRCC), Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia 3Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia 4Institute of Biological Chemistry, Academia Sinica, Taipei, Taiwan 5Center for Cancer and Stem Cell Research, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia 6School of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand 7School of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia 8UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, UPM Serdang, Selangor, Malaysia 9Faculty of Medicine and Health Sciences, University Tunku Abdul Rahman, Bandar Sungai Long, Selangor, Malaysia 10School of Pharmacy, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia

Abstract Basal-like breast cancer is an aggressive tumor subtype with poor prognosis. The discovery of underlying mechanisms mediating tumor cell survival, and the development of novel agents to target these pathways, is a priority for patients with basal-like breast cancer. From a functional screen to identify key drivers of basal-like breast cancer cell growth, we identified fibroblast growth factor receptor 4 (FGFR4) as a potential mediator of cell survival. We found that FGFR4 mediates cancer cell survival predominantly via activation of PI3K/AKT. Importantly, a subset of basal-like breast cancer cells also secrete fibroblast growth factor 19 (FGF19), a canonical ligand specific for FGFR4. siRNA-mediated silencing of FGF19 or neutralization of extracellular FGF19 by anti-FGF19 antibody (1A6) decreases AKT phosphorylation, suppresses cancer cell growth and enhances doxorubicin sensitivity only in the FGFR4+/FGF19+ breast cancer cells. Consistently, FGFR4/FGF19 co-expression was also observed in 82 out of 287 (28.6%) primary breast tumors, and their expression is strongly associated with AKT phosphorylation, Ki-67 staining, higher tumor stage and basal-like phenotype. In summary, our results demonstrated the presence of an FGFR4/FGF19 autocrine signaling that mediates the survival of a subset of basal-like breast cancer cells and suggest that inactivation of this autocrine loop may potentially serve as a novel therapeutic intervention for future treatment of breast cancers.

Keywords: fibroblast growth factor, breast cancer, RNAi screen, FGFR4, FGF19.

217

Tumkur A, Yee CTW, Yee ELC, Sheng FS, Ern TS. Usage of angiotensin converting enzyme receptor blockers in diabetic hypertensive patients. Manipal Journal of Pharmaceutical Sciences, 2016; 2(1): 3-10. (IF: NA).

Usage of angiotensin converting enzyme receptor blockers in diabetic hypertensive patients. Anil Tumkur, Christie Tang Wen Yee, Edrea Lim Ciin Yee, Foo Siang Sheng, Tay Shun Ern. Department of Pharmacy Practice, International Medical University, No. 126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur 57000, Malaysia

Abstract

Diabetes and Hypertension are diseases that can be debilitating and life-threatening if not well-controlled respectively and the risk of complication further increases when both diseases co-exist in a patient. They can lead to various cardiovascular complications such as heart failure, coronary artery disease, myocardial infarction and stroke as well as nephropathy and neuropathy. According to CPG guideline Malaysia, there are two groups of drugs which are strongly recommended for treatment of diabetic hypertension, namely angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs). Through this review, we hope to compare superiority of ACEI and ARB usage in diabetic patients with hypertension. The criteria for eligible studies were as follows: (i) RCT comparing the efficacy of ACEI or ARB with various classes of antihypertensive agents, ACEI versus ARB, different ARBs and combination use of ACEI and ARB in hypertensive patients with diabetes and (ii) primary outcome data was available including P-values and hazard ratios comparing the active and control treatment with corresponding confidence interval (CI). Following this search, 53 articles were selected. Both ACEI and ARB are beneficial in lowering blood pressure and are preferred hypertension medications for patients with hypertension comorbid with diabetes. They also help in preventing progression of diabetic nephropathy from microalbuminuria to macroalbuminuria. Keywords: Angiotensin Converting Enzyme inhibitors, Angiotensin Receptor Blockers, Diabetes Mellitus, Hypertension.

218

Tye KY, Gan SY, Lim ESH, Tan SE, Chen CA, Phang SM. Comparison of visual observation and emission intensity of resazurin for antimicrobial properties of hexane, dichloromethane, methanol and water extracts from a brown alga, Turbinaria ornata. Cogent Biology, 2016; 2:

1225877. [BP1–01/11(14)2014]. (IF: NA).

Comparison of visual observation and emission intensity of resazurin for antimicrobial properties of hexane, dichloromethane, methanol and water extracts from a brown alga, Turbinaria ornata. Kar-Yee Tye1, Sook-Yee Gan1, Swee-Hua Erin Lim2, Sou-Eei Tan1, Chen-Ai Chen1 and Siew-Moi Phang3. 1School of Pharmacy, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil 57000, Kuala Lumpur, Malaysia. 2Perdana University-Royal College of Surgeons in Ireland (PU-RCSI), Jalan MAEPS Perdana, Perdana University, Block B & D Aras 1, MAEPS Building, MARDI Complex, Serdang 43400, Selangor DE, Malaysia. 3Institute of Ocean and Earth Sciences and Institute of Biological Sciences, University of Malaya, Kuala Lumpur, Malaysia.

Abstract

Marine natural products have been increasingly found to be a promising source of drug candidates for fighting human diseases. The present study was carried out to assess the antimicrobial properties of a brown alga, Turbinaria ornata. Hexane, dichloromethane,

methanol, and water extracts were tested against 23 micro-organisms including Gram-positive and negative bacteria, yeasts, and fungi. The disk diffusion method was employed followed by modified resazurin microtitre assay (REMA). The results obtained from modified REMA using both methods of colorimetric and fluorometric were compared. The best antimicrobial activity was recorded in dichloromethane extract for disk diffusion. Further, modified REMA showed inhibition in Bacillus cereus, Bacillus subtilis, Staphylococcus aureus ATCC 25923, S. aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus, Enterococcus faecalis, Pseudomonas aeruginosa ATCC 27853, Candida parapsilosis ATCC 22019, Candida guilliermondii ATCC 6260, and Saccharomyces cerevisiae. Both methods of modified REMA were substantially in agreement with each other based on Cohen’s kappa statistical analysis (κ value = 0.712; p < 0.0005). Our findings suggested that T. ornata dichloromethane extract

has the potential to be used as a source of antimicrobial compounds. Keywords: antibacterial, antifungal, antimicrobial, seaweed, Turbinaria ornata.

219

Vasiwala R, Burud I. Malignant melanoma of the ear canal presenting as wart. IeJSME, 2016;

10(1): 47-48. (MyCite IF: 0.038).

Malignant melanoma of the ear canal presenting as wart. Rafiqahmed Vasiwala, Ismail Burud. IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, MALAYSIA

Abstract

Malignant melanoma is a rare malignancy of the external auditory canal. The vast majority of them occur in the areas of the body that are exposed to the sun. Early histological examination may possibly favor better prognosis. We report a case of a 38-year-old female who presented with a small mass in right ear canal, earache and minimum discharge since 4 months. Initially scraping was done in the ENT clinic. Subsequently she had a wide excision done by the end aural approach at a different hospital. A year later the patient presented with a swelling involving the ear canal which extended to the helix and supratemporal region with the histology report as malignant melanoma. A literature review of the disease, radiological findings, immunohistochemical features and treatment options are discussed. Keywords: ear canal, malignant melanoma, wart.

220

Veeraveedu PT, Sari FR, et al. Vesnarinone attenuates myocardial inflammation and fibrosis in acute experimental autoimmune myocarditis. The Journal of Biomedical Research, 2016; 30(Suppl 1): 17. (IF: NA).

Vesnarinone attenuates myocardial inflammation and fibrosis in acute experimental autoimmune myocarditis. Punniyakoti T Veeraveedu1,2, Flori R. Sari1, Meilei Harima1, Koichi Hasegawa3, Akira Nagabukuro3, Kenichi Watanabe1. 1Department of Clinical Pharmacology, Niigata University of Pharmacy and Applied Life Sciences, 265-1 Higashijima, Niigata City 956-8603, Japan 2Department of Pharmaceutical Chemistry, International Medical University, No 126 Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia 3Institute of Biomedical Innovation, Otsuka Pharmaceutical Co., Ltd, 463-10 Kagasuno Kawauchi-cho, Tokushima 771-0192, Japan

Abstract Objective: Inflammation and fibrotic process are involved in the pathogenesis of experimental autoimmune myocarditis (EAM). Vesnarinone is known to limit inflammation and fibrosis; however whether vesnarinone confers benefit on EAM is largely unknown. Methods: We investigated the role of vesnarinone treatment in rats with EAM elicited by

porcine cardiac myosin. Fourteen-days after immunization, the surviving rats were randomized to receive either vehicle or vesnerinone as a component of diet for 14 days. Age matched Lewis rats were used as normal control. Myocardial functional parameters were assessed on day 28 by hemodynamic and echocardiographic study; followed by cardiac fibrosis, infiltration of inflammatory cell and mast cell were studied by histological staining. Results: On the day 28 of EAM, cardiac dysfunction was observed in the vehicle-treated EAM

rats when compared to control group. In addition, infiltration of inflammatory cells, cardiac fibrosis and mast cell density were significantly increased in the vehicle-treated EAM rats than those in control rats. Fourteen days treatment with vesnarinone improved myocardial functional parameters and significantly decreased cardiac fibrosis, infiltration of inflammatory cells and mast cell density. Conclusion: Our results suggest that, vesnarinone contributes beneficial effect against EAM

by limiting inflammation, decreasing myocardial fibrosis and improving cardiac function.

221

Veettil SK, Lim KG, Chaiyakunapruk N, Ching SM, Muhammad Radzi AH. Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country. Asian Journal of Surgery, 2016; DOI: http://dx.doi.org/10.1016/j.asjsur.2016.07.005 (ISI IF: 0.912; SCI IF: 0.809; HI: 24; Tier: Q2).

Colorectal cancer in Malaysia: Its burden and implications for a multiethnic country. Sajesh K. Veettil1, Kean Ghee Lim2, Nathorn Chaiyakunapruk3,4,5,6, Siew Mooi Ching7, Muhammad Radzi Abu Hassan8,9. 1School of Pharmacy/School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia 2Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, Negeri Sembilan, Malaysia 3School of Pharmacy, Monash University, Bandar Sunway, Selangor, Malaysia 4Centre of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand 5School of Population Health, University of Queensland, Brisbane, Australia 6School of Pharmacy, University of WisconsindMadison, Madison, WI, USA 7Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang, Malaysia 8Gastroenterology Service, Ministry of Health, Malaysia 9Department of Internal Medicine, Hospital Sultanah Bahiyah, Kedah, Malaysia

Abstract Background: This study aims to provide an analytical overview of the changing burden of

colorectal cancer and highlight the implementable control measures that can help reduce the future burden of colorectal cancer in Malaysia. Methods: We performed a MEDLINE search via OVID with the Medical Subject Headings (MeSH) terms “Colorectal Neoplasms”[Mesh] and “Malaysia”[Mesh], and PubMed with the key words “colorectal cancer” and “Malaysia” from 1990 to 2015 for studies reporting any clinical, societal, and economical findings associated with colorectal cancer in Malaysia. Incidence and mortality data were retrieved from population-based cancer registries/databases. Results: In Malaysia, colorectal cancer is the second most common cancer in males and the

third most common cancer in females. The economic burden of colorectal cancer is substantial and is likely to increase over time in Malaysia owing to the current trend in colorectal cancer incidence. In Malaysia, most patients with colorectal cancer have been diagnosed at a late stage, with the 5-year relative survival by stage being lower than that in developed Asian countries. Public awareness of the rising incidence of colorectal cancer and the participation rates for colorectal cancer screening are low. Conclusion: The efficiency of different screening approaches must be assessed, and an organized national screening program should be developed in a phased manner. It is essential to maintain a balanced investment in awareness programs targeting general population and primary care providers, focused on increasing the knowledge on symptoms and risk factors of colorectal cancer, awareness on benefits of screening, and promotion of healthy life styles to prevent this important disease. Keywords: burden, cancer prevention, colorectal neoplasms, Malaysia, review, screening.

http://dx.doi.org/10.1016/j.asjsur.2016.07.005

222

Veettil SK, Saokaew S, Lim KG, Ching SM, Phisalprapa P, Chaiyakunapruk N. Comparative effectiveness of chemopreventive interventions for colorectal cancer: Protocol for a systematic review and network meta-analysis of randomised controlled trials. Journal of Gastrointestinal Oncology, 2016; 7(4): 595–602. (IF: NA).

Comparative effectiveness of chemopreventive interventions for colorectal cancer: Protocol for a systematic review and network meta-analysis of randomised controlled trials. Sajesh K. Veettil1, Surasak Saokaew2,3,4, Kean Ghee Lim5, Siew Mooi Ching6,7, Pochamana Phisalprapa8, Nathorn Chaiyakunapruk2,4,9,10. 1School of Pharmacy/School of Postgraduate Studies, International Medical University, Kuala Lumpur 57000, Malaysia 2School of Pharmacy, Monash University, Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia 3Center of Health Outcomes Research and Therapeutic Safety (Cohorts), School of Pharmaceutical Sciences, University of Phayao Muang, Phayao 56000, Thailand 4Centre of Pharmaceutical Outcomes Research, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand 5Clinical School, Department of Surgery, International Medical University, Jalan Rasah, Seremban, 70300, Negeri Sembilan, Malaysia 6Department of Family Medicine, Faculty of Medicine and Health Sciences, University Putra Malaysia, Serdang 43400, Malaysia 7Malaysian Research Institute on Ageing, Universiti Putra Malaysia, Serdang, Malaysia 8Division of Ambulatory Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 9School of Population Health, University of Queensland, Brisbane, Australia 10School of Pharmacy, University of Wisconsin-Madison, Madison, WI, USA

Abstract Background: Colorectal cancer (CRC) is the third most common cancer worldwide and is

associated with substantial socioeconomic burden. Despite considerable research, including numerous randomised controlled trials (RCTs) and systematic reviews assessed the effect of various chemopreventive interventions for CRC, there remains uncertainty regarding the comparative effectiveness of these agents. No network meta-analytic study has been published to evaluate the efficacies of these agents for CRC. Therefore, the aim of this study is to summarise the direct and indirect evidence for these interventions to prevent CRC in average-high risk individuals, and to rank these agents for practical consideration. Methods: We will acquire eligible studies through a systematic search of MEDLINE, EMBASE,

the Cochrane Central Registry of Controlled Trials, CINAHL plus, IPA and clinicaltrials.gov website. The Cochrane Risk of Bias Tool will be used to assess the quality of included studies. The primary outcomes are the incidence of CRC, the incidence/recurrence of any adenoma or change in polyp burden (number or size). Quantitative synthesis or meta-analysis will be considered. We will also construct a network meta-analysis (NMA) to improve precision of the comparisons among chemo-preventive interventions by combining direct and indirect evidence. The probability of each treatment being the best and/or safest, the number-neededto-treat [NNT; 95% credible interval (CrIs)], and the number-needed-to-harm (NNH; 95% CrIs) will be calculated to provide measures of treatment efficacy. The GRADE approach will be used to rate the quality of evidence of estimates derived from NMA. Results: This protocol has been registered (registration number: CRD42015025849) with the PROSPERO (International Prospective Register of Systematic Reviews). The procedures of

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this systematic review and NMA will be conducted in accordance with the PRISMA-compliant guideline. The results of this systematic review and NMA will be submitted to a peer-reviewed journal for publication. Conclusions: To the best of our knowledge, this study will be the first NMA to identify the

comparative effectiveness of interventions for the prevention of CRC. The results of our study will update evidence for chemoprevention of CRC, identify key areas for future research, and provide a framework for conducting large systematic reviews involving indirect comparisons. Keywords: Protocol, colorectal neoplasms, chemoprevention, systematic review, network

meta-analysis (NMA), randomised controlled trials (RCTs).

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Venkateshbabu N, Anand S, Abarajithan M, Sheriff SO, Jacob PS, Sonia N. Natural therapeutic options in endodontics – A review. Open Dentistry Journal, 2016; 11(10): 214-26. doi: 10.2174/1874210601610010214. (SCI IF: 0.952; HI: 9; Tier: Q3).

Natural therapeutic options in endodontics – A review. Nagendrababu Venkateshbabu1, Suresh Anand2, Mohan Abarajithan3, Sultan O. Sheriff1, Pulikkotil S. Jacob1 and Nath Sonia4. 1Department of Restorative Dentistry, International Medical University, Kuala lumpur, Malaysia 2Department of Conservative Dentistry and Endodontics, Penang International Dental College, Penang, Malaysia 3Smile Bright Root Canal Academy, Madurai, India 4Department of Periodontology, Vananchal Dental College, Garhwa, India

Abstract Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer. Keywords: Endodontics, Herbs, Intracanal medicament, Irrigants.

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Venkateswaran SP, Nathan LE, Mutalik VS, Shamsuddin NH. Argyrophilic nuclear organizer region and p73 expression in head and neck squamous cell carcinomas: Teammates or adversaries? Journal of Oral and Maxillofacial Pathology, 2016; 20: 427-35. [IMU Internal

Grant – BMS I 1/2014(5)]. (SCI IF: 0.752; HI: 10; Tier: Q3).

Argyrophilic nuclear organizer region and p73 expression in head and neck squamous cell carcinomas: Teammates or adversaries? Venkateswaran SP1, Nathan LE2, Mutalik VS3, Shamsuddin NH4. 1Department of Pathology, International Medical University, Kuala Lumpur, Malaysia. 2Department of Medical Sciences, University of Queensland, Brisbane, Australia. 3Department of Oral and Maxillofacial Pathology and Radiology, The Ohio State University, Columbus, Ohio, United States of America. 4Department of Pathology, Hospital Tuanku Ja'afar, Seremban, Negeri Sembilan, Malaysia.

Abstract Context: Head and neck squamous cell carcinoma (HNSCC) consists of squamous cell carcinomas (SCCs) arising in the upper aerodigestive tract and accounts for 5% of cancers worldwide. In Malaysia, cancers of the nasopharynx, larynx, tongue and oral cavity are among the top twenty most common cancers in men. Argyrophilic nuclear organizer regions (AgNORs) are increased from normal mucosa to premalignant lesions to malignant lesions and have been associated with tumor grade and prognosis of patients. Although p73 is not mutated in human cancers, high levels of p73 expression have been associated with tumor differentiation status and patient prognosis. Aims: To investigate the correlation between AgNORs and p73 immunoexpression. Settings and Design: Fifty-two formalin-fixed, paraffin-embedded HNSCC cases and ten

controls were collected from the Hospital. Subjects and Methods: Tissue blocks were sectioned, dewaxed and rehydrated before silver

nitrate staining to determine the AgNOR count and immunohistochemical staining to determine the p73 expression. Adopting the scoring system used by Chen et al. for p73

staining, the proportion of positively stained cells in the whole epithelial layer was determined. Staining was considered positive if >10% of epithelial cells were stained. Statistical Analysis Used: Spearman's correlation coefficient was calculated using SPSS 18 software to determine the relationship between the p73 score against tumor differentiation, mean AgNOR counts and tumor grade and between the mean AgNOR count and p73 score. Results: Positive results were found in the immunoexpression of p73. Positive results were seen with the staining of AgNOR; however, in comparison with the entire sample size, a significant correlation between mean AgNOR count and p73 immunohistochemical expression was not obtained. Conclusions: AgNOR count showed a linear and decreasing trend as the p73 score

increases. This correlation was statistically insignificant. Keywords: Argyrophilic nuclear organizer regions, head and neck squamous cell carcinoma,

p73 protein.

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Wickramatilake CM, Mohideen MR, Pathirana C. High-sensitivity C-reactive protein in Sri Lankan males with coronary artery disease. Bangladesh Journal of Medical Science, 2016; 15(1): 44-50. (SCI IF: 0.096; HI: 4; Tier: Q3).

High-sensitivity C-reactive protein in Sri Lankan males with coronary artery disease. Wickramatilake CM1, Mohideen MR2, Pathirana C3. 1Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka. 2International Medical University, IMU Clinical School 6 Jalan Indah, Taman Sri Kenangan 8300, Batu Pahat, Johor, Malaysia. 3Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.

Abstract Objectives: Evidence suggests that inflammation and dyslipideamia play a key role in the

pathogenesis of coronary artery disease (CAD). High sensitivity C-reactive protein (hs-CRP) is a sensitive marker of inflammation. We attempted to evaluate the contribution of dyslipidaemia and inflammation in CAD. Materials and methods: Three hundred and nine males (103 with myocardial infarction - MI, 103 with established CAD, 103 healthy controls) were studied. The serum hs-CRP, lipids and plasma glucose were determined. Results: Baseline mean hs-CRP levels in patients with established CAD and MI were significantly higher compared to controls (3.4 ± 1.62 VS. 1.70 ± 0.60 mg/L, p = 0.001) (3.7 ± 0.65 VS. 1.70 ± 0.60 mg/L, p = 0.001). A significant negative correlation observed between hs-CRP and HDL-Ch (r = -0.359, p = 0.001).

Conclusion: Inflammation (which was reflected by elevated hs-CRP) and dyslipidamia were

associated with coronary artery disease. Keywords: Coronary artery disease, dyslipidaemia, high- sensitivity-C-reactive protein.

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Wong CH, Shah ZUBS, Teng CL, Lin TQ, Zainab AM, Chan CW. A systematic review of anxiety prevalence in adults within primary care and community settings in Malaysia. Asian Journal of Psychiatry, 2016; 24: 110-117. (SCI IF: 1.353; HI: 13; Tier: Q2).

A systematic review of anxiety prevalence in adults within primary care and community settings in Malaysia. Chin Hoong Wong1, Zia U Bakt Sultan Shah1, Cheong Lieng Teng1, Tzi Quen Lin3, Zainab Abdul Majeed2, Chun Wai Chan1. 1Department of Family Medicine, International Medical University, IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia 2Department of Psychiatry, International Medical University, IMU Clinical School, Jalan Rasah, 70300 Seremban, Negeri Sembilan, Malaysia 3IMU Healthcare, International Medical University, No. 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

Abstract Background: Anxiety disorders are common mental health disorders with significant impact on the individual as well as burden on the country as a whole. Methods: A systematic review of databases, reference lists, internet sources, and input from

content experts revealed 42 studies that documented the prevalence of anxiety symptoms or disorders. 12 of these studies specifically evaluated anxiety disorders. Results: 4 studies looked at the prevalence of anxiety disorders in the general population, whilst the remainder focused on selected population groups: university students (4 studies); substance abuse (3 studies); and victims of abuse (1 study). Studies in the general population showed that the prevalence of generalised anxiety disorder was 0.4–5.6%, mixed anxiety and depression were 3–5%, panic without agoraphobia 0.4%, phobia unspecified 0.5–1%, and anxiety not-otherwise-specified 0.3–6.5%. We found significant variability in anxiety disorders in the studies in selected population groups. The variability could also have been affected by methodological factors within each study. Conclusion: This study provides a broad overview of the prevalence of anxiety disorders in

Malaysia. More research is required to develop diagnostic instruments that are validated for local use and comparable with international standards. Reliable prevalence estimates are lacking within certain groups, e.g. those in rural, indigenous, migrant population groups and those exposed to natural disasters. Keywords: Anxiety, Prevalence, Malaysia.

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Wong CH, Tan TR, Heng HY, Ramesh T, Ting PW, Lee WS, Teng CL, Sivalingam N, Tan KK. Parental preferences with regards to disclosure following adverse events occurring in relation to medication use or diagnosis in the care of their children - Perspectives from Malaysia. Medical Journal of Malaysia, 2016; 71(4): 186-92. [IMU Internal Grant]. (SCI IF: 0.528; HI: 24;

Tier: Q3).

Parental preferences with regards to disclosure following adverse events occurring in relation to medication use or diagnosis in the care of their children - Perspectives from Malaysia. Chin Hoong Wong1, Tock Rei Tan2, Hian Yue Heng2, Thangatorai Ramesh2, Pey Woei Ting2, Wei Shien Lee2, Cheong Lieng Teng1, Nalliah Sivalingam3, Kah Kee Tan4. 1Department of Family Medicine, International Medical University, Malaysia 2IMU Clinical School, International Medical University, Seremban, Malaysia 3Department of Obstetrics and Gynaecology, International Medical University, Malaysia 4Department of Paediatrics, Tuanku Jaafar Hospital, Seremban, Malaysia.

Abstract Introduction: Open disclosure is poorly understood in Malaysia but is an ethical and

professional responsibility. The objectives of this study were to determine: (1) the perception of parents regarding the severity of medical error in relation to medication use or diagnosis; (2) the preference of parents for information following the medical error and its relation to severity; and (3) the preference of parents with regards to disciplinary action, reporting, and legal action. Methods: We translated and contextualised a questionnaire developed from a previous study. The questionnaire consisted of four case vignettes that described the following: medication error with a lifelong complication; diagnostic error with a lifelong complication; diagnostic error without lifelong effect; and medication error without lifelong effect. Each case vignette was followed by a series of questions examining the subject’s perception on the above areas. We also determined the content validity of the questionnaire. We invited parents of Malaysian children admitted to the paediatric wards of Tuanku Jaafar Hospital to participate in the study. Results: One hundred and twenty-three parents participated in the study. The majority of

parents wanted to be told regarding the event. As the severity of the case vignettes increased, the desire for information, remedial action, acknowledgement of responsibility, compensation, punishment, legal action, and reporting to a higher agency also increased. The findings did not have strong evidence of a relationship with subject’s demographics. Conclusion: This study gives insights into previously unexplored perspectives and preferences of parents in Malaysia regarding open disclosure. It also highlights the opportunity for more research in this area with potentially broad applications. Keywords: Parents, medical error, diagnosis, children, disclosure.

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Wong YC, Mohan M, Pau A. Dental students' compliance with antibiotic prescribing guidelines

for dental infections in children. Journal of Indian Society of Pedodontics and Preventive

Dentistry, 2016; 34(4): 348-53. (ISI IF: 0.22; SCI IF: 0.472; HI: 19; Tier: Q3).

Dental students' compliance with antibiotic prescribing guidelines for dental infections in children. Yee Chen Wong, Mandakini Mohan, Allan Pau. School of Dentistry, International Medical University, Kuala Lumpur, Malaysia.

Abstract Context: To investigate the antibiotic prescribing training received by dental students, clinical

experience in treating child patients, awareness of antibiotic prescribing guidelines, preparedness in antibiotic prescribing, and compliance with antibiotic prescribing guidelines for the management of dental infections in children.

Methods: This was a cross-sectional study involving final year dentals students from

Malaysian and Asian dental schools. A self-administered questionnaire consisting of five

clinical case scenarios was e‑mailed to all final year students at selected dental schools.

Students’ responses were compared for each clinical case scenario with the prescribing guidelines of the American Academy of Pediatric Dentistry and the American Dental Association. Compliance in each scenario was tested for association with their preparedness in antibiotic prescribing, previous training on antibiotic prescribing and awareness of antibiotic

prescribing guidelines using Chi‑square test. Data collected were analyzed using SPSS

statistics version 20. Results: A total of 108 completed responses were received. About 74 (69%) students were

from Malaysian dental schools. The compliance rate with prescribing guidelines ranged from 15.7% to 43.5%. Those attending Malaysian dental schools (47.3%) and those who had treated child patient more often (46.3%) were more likely (P < 0.05) to be aware of the

guidelines. Those who had received antibiotic prescribing training (21.3%) were more likely to think they were well prepared in antibiotic prescribing (P < 0.05). Conclusions: Final year dental students had low awareness and compliance with antibiotic

prescribing guidelines. Further research is needed to investigate how compliance with the guidelines may be enhanced. Keywords: Antibiotic prescribing, dental education, dental students.

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Wong YP, Jeya Seela AR, Ling APK, Koh RY. Anti-inflammatory effect of Strobilanthes crispus methanolic extract on Lipopolysaccharide-stimulated RAW 264.7 macrophages. Journal of Medical and Biological Sciences, 2016; 3: 52-56. (IF: NA).

Anti-inflammatory effect of Strobilanthes crispus methanolic extract on Lipopolysaccharide-stimulated RAW 264.7 macrophages. Ying Pei Wong1, Jeya Seela A/P Anandha Rao1, Rhun Yian Koh1, Anna Pick Kiong Ling1. 1Department of Applied Biomedical Science and Biotechnology, School of Health Sciences, International Medical University, Bukit Jalil, 57000 Kuala Lumpur, Malaysia.

Abstract Background: Inflammation is rapid response by body to deal with injuries, foreign particles

and damaged cells. An unattended inflammation could lead to complication in cerebrovascular, cardiovascular system, joint and intestines. However, currently available conventional drugs exhibited adverse effects on many organ systems besides treating inflammation. Strobilanthes crispus, a native plant is believed to have anti-inflammatory property as it has been used in

folk medicine to treat various diseases. Nevertheless, no scientific studies have been conducted to prove this traditional claim. Hence, this study focused on investigating the anti-inflammatory property of S. crispus on lipopolysaccharide (LPS)-stimulated RAW 264.7

macrophages experimental model. Methods: The maximum non-toxic dose (MNTD) of S. crispus methanol extracts and optimum LPS concentration were determined prior to determination of anti-inflammatory effect of S. crispus. MNTD of S. crispus was determined using MTT assay and the optimum LPS was determined based on the production of nitric oxide (NO) using Griess reaction. Finally, the anti-inflammatory effect of S. crispus was determined by examining the NO and cytokines

levels, namely interleukin-6 (IL-6) and interleukin-10 (IL-10) using Procarta immunoassay kit. Results: The MNTD for S. crispus leaves and stem extracts was 160 μg/mL and 1.5 μg/mL,

respectively. The optimum LPS needed to induce maximum inflammation was 1 μg/mL. Upon pre-treatment with half MNTD (1/2MNTD) of leaf extract, the production of NO was significantly reduced while MNTD of stem extract resulted in an increase in IL-10 level. On the other hand, no significant reduction of IL-6 production was seen upon treatment except for indomethacin, which acted as the positive control drug. Conclusions: The present results showed that S. crispus could possess anti-inflammatory

properties on lipopolysaccharide-stimulated RAW 264.7 macrophages through suppression of NO production and increase in IL-10 level.

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Yang WY, Burrows T, MacDonald-Wicks L, Williams LT, Collins CE, Chee WSS. The Family Diet Study: A cross-sectional study into the associations between diet, food habits and body weight status in Malay families. Journal of Human Nutrition and Dietetics, 2015; doi:

10.1111/jhn.12356. [IMU Internal Grant - IMU 275/2013]. (ISI IF: 2.583; SCI IF: 2.218; HI: 46; Tier: Q1).

The Family Diet Study: A cross-sectional study into the associations between diet, food habits and body weight status in Malay families. Yang WY1,2, Burrows T1, MacDonald-Wicks L1, Williams LT1,3, Collins CE1, Chee WS2. 1School of Health Sciences, Faculty of Health and Medicine, Priority Research Centre in Physical Activity and Nutrition, The University of Newcastle, Callaghan, NSW, Australia. 2Department of Nutrition and Dietetics, School of Health Sciences, Faculty of Medicine and Health, International Medical University, Kuala Lumpur, Malaysia. 3Menzies Health Institute of Queensland, Griffith University, Gold Coast, QLD, Australia.

Abstract Background: Childhood obesity is becoming more common as Malaysia experiences rapid

nutrition transition. Current evidence related to parental influences on child dietary intake and body weight status is limited. The present study aimed to report, among Malay families, the prevalence of energy mis-reporting and dietary relationships within family dyads. Methods: The cross-sectional Family Diet Study (n = 236) was conducted at five primary

schools in central of Peninsular Malaysia. Each family consisted of a Malay child, aged 8-12 years, and their main caregiver(s). Information on socio-demographics, dietary intake and anthropometry were collected. Correlations and regression analyses were used to assess dietary relationships within family dyads. Results: Approximately 29.6% of the children and 75.0% parents were categorised as being

overweight or obese. Intakes of nutrients and food groups were below the national recommended targets for majority of children and adults. A large proportion of energy intake mis-reporters were identified: mothers (55.5%), fathers (40.2%) and children (40.2%). Children's body mass index (BMI) was positively associated with parental BMI (fathers, r = 0.37; mothers, r = 0.34; P < 0.01). For dietary intakes, moderate-to-strong (0.35-0.72) and weak-to-moderate (0.16-0.35) correlations were found between mother-father and child-parent dyads, respectively. Multiple regression revealed that maternal percentage energy from fat (β = 0.09, P < 0.01) explained 81% of the variation in children's fat intake. Conclusions: Clear parental dietary relationships, especially child-mother dyads, were found.

Despite a significant proportion of families with members who were overweight or obese, the majority reported dietary intakes below recommended levels, distorted by energy mis-reporting. The findings of the present study can inform interventions targeting parent-child relationships to improve family dietary patterns in Malaysia. Keywords: body weight, child, developing country, diet, family, nutrition, parent.

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Yap PSX, Kamar AA, Chong CW, Yap IKS, Thong KL, Choo YM, Md Yusof MY, Teh CSJ. Intestinal carriage of multidrug-resistant gram-negative bacteria in preterm-infants during hospitalization in neonatal intensive care unit (NICU). Pathogens and Global Health, 2016; 1-

9. doi: 10.1080/20477724.2016.1229884. (ISI IF: 1.486; SCI IF: 1.613; HI: 55; Tier: Q1).

Intestinal carriage of multidrug-resistant gram-negative bacteria in preterm-infants during hospitalization in neonatal intensive care unit (NICU). Yap PSX1, Ahmad Kamar A2, Chong CW3, Yap IK3, Thong KL4, Choo YM2, Md Yusof MY1, Teh CS1. 1Department of Medical Microbiology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. 2Department of Paediatrics, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. 3Department of Life Sciences, School of Pharmacy, International Medical University, 57000 Kuala Lumpur, Malaysia. 4Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603 Kuala Lumpur, Malaysia.

Abstract The prevalence and antibiotic susceptibility of intestinal carriage of Gram-negative bacteria among preterm infants admitted to the neonatal intensive care unit (NICU) in a tertiary teaching hospital in Malaysia were determined. A total of 34 stool specimens were obtained from preterm infants upon admission and once weekly up to two weeks during hospitalization. The presumptive colonies of Escherichia coli and Klebsiella pneumoniae were selected for

identification, antibiotic susceptibility testing, and subtyping by using pulsed-field gel electrophoresis (PFGE). Out of 76 Gram-negative isolates, highest resistance was detected for amoxicillin/clavulanate (30.8%, n = 16), ceftriaxone (42.3%, n = 22), ceftazidime (28.8%, n = 15), cefoxitin (28.8%, n = 15), aztreonam (36.5%, n = 19), and polymyxin B (23.1%, n = 12). Three colistin resistant K. pneumoniae have also been detected based on E-test analysis. Thirty-nine isolates of K. pneumoniae and 20 isolates of E. coli were resistant to

more than three antimicrobial classes and were categorized as multidrug resistant (MDR). PFGE analysis revealed a higher diversity in pulsotypes for K. pneumoniae (18 pulsotypes) in comparison to E. coli (four pulsotypes). In addition, a total of fifteen pulsotypes was observed from 39 MDR K. pneumoniae. The risk factors for antibiotic resistance were assessed using

random forest analysis. Gender was found to be the most important predictor for colistin resistant while length, OFC, and delivery mode were showing greater predictive power in the polymyxin B resistance. This study revealed worrying prevalence rates of intestinal carriage of multidrug-resistant K. pneumoniae and E. coli of hospitalized preterm infants in Malaysia,

particularly high resistance to polymyxins. Keywords: Gram-negative enteric, Meconium, Multidrug resistant, PFGE, Preterm infants.

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Yap YJ, Omasanggar R, Koh YL, Yew MY, Lai HT, Ling APK, Chye SM, Ng KY, Koh RY. Neurotoxic effect of salsolinol through oxidative stress induction and Nrf2-Keap1 signalling regulation. Journal of Chemical and Pharmaceutical Research, 2016; 8(5): 30-38. [IMU

Undergraduate Grant - BMSc I/01/2012(05)2014]. (SCI IF: 0.195; HI: 21; Tier: Q3).

Neurotoxic effect of salsolinol through oxidative stress induction and Nrf2-Keap1 signalling regulation.

Yiing Jye Yap1, Raevathi Omasanggar1, Yuan Lin Koh1, Mei Yeng Yew2, Hien Tet Lai2, Anna Pick Kiong Ling1, Soi Moi Chye1, Khuen Yen Ng2 and Rhun Yian Koh1. 1International Medical University, No. 126, JalanJalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 2Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor 47500, Malaysia

Abstract

Parkinson’s disease (PD) is commonly characterized by motor movement deterioration and cognitive impairment. A dopamine-derived endogenous neurotoxin, namely salsolinol was found contributing to pathogenesis of the disease. However, the precise molecular mechanisms of the neurotoxin remain unexplored. Hence, this study aims to evaluate the effect of salsolinol on SH-SY5Y neuronal cells, focusing on oxidative stress-associated apoptotic cell death. Salsolinol was added to SH-SY5Y cells for determination of cell proliferation and viability using cell growth curve and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays respectively. Cell cycle analysis was performed to measure cell cycle phase distribution while presence of apoptotic cell death was confirmed with Hoechst stain. Additionally, 2’,7’-dichlorofluorescein diacetate assay was carried out to investigate generation of reactive oxygen species (ROS) and enzyme-linked immunosorbent assay was performed to determine the expression of superoxide dismutase (SOD), NF-E2 related factor 2 (Nrf2) and kelch-like ECH-associated protein 1 (Keap1) proteins. Results reveal that SH-SY5Y cells, when treated with salsolinol (0-100 μM) for 24, 48 and 72 hours elicited neurotoxicity. The reduction and inhibition of cell growth and induction of apoptosis were coincided with enhanced ROS production and increased SOD, Nrf2 and Keap1 proteins expression. Thus, it is suggested that salsolinol can induce oxidative stress-associated apoptotic cell death via SOD, Nrf2 and Keap1 activation. Keywords: Parkinson’s disease, Salsolinol, Apoptosis, Oxidative stress, Nrf2-Keap1 pathway.

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Yee MS, Khiew PS, Chiu WS, Tan YF, Kok YY, Leong CO. Green synthesis of graphene-silver nanocomposites and its application as a potent marine antifouling agent. Colloids and Surfaces B: Biointerfaces, 2016; 148: 392-401. (ISI IF: 3.902; SCI IF: 4.042; HI: 96; Tier: Q1).

Green synthesis of graphene-silver nanocomposites and its application as a potent marine antifouling agent. Maxine Swee-Li Yee1, Poi-Sim Khiew1, Wee Siong Chiu2, Yuen Fen Tan3, Yih-Yih Kok4, Chee-Onn Leong5. 1Centre of Nanotechnology and Advanced Materials, Faculty of Engineering, University of Nottingham Malaysia Campus, Jalan Broga, 43500 Semenyih,Selangor, Malaysia 2Low Dimensional Materials Research Center, Department of Physics, Faculty of Science, University Malaya, 50603 Kuala Lumpur, Malaysia 3School of Postgraduate Studies, International Medical University, 126 Jalan 19/155B, Bukit Jalil 57000 Kuala Lumpur, Malaysia 4School of Health Sciences, International Medical University, 126, Jalan Jalil Perkasa 19, Bukit Jalil, 57000 Kuala Lumpur, Malaysia 5School of Pharmacy, International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil 57000 Kuala Lumpur, Malaysia.

Abstract Fouling of marine surfaces has been a perpetual problem ever since the days of the early sailors. The tenacious attachment of seaweed and invertebrates to man-made surfaces, notably on ship hulls, has incurred undesirable economic losses. Graphene receives great attention in the materials world for its unique combination of physical and chemical properties. Herein, we present a novel 2-step synthesis method of graphene-silver nanocomposites which bypasses the formation of graphene oxide (GO), and produces silver nanoparticles supported on graphene sheets through a mild hydrothermal reduction process. The graphene-Ag (GAg) nanocomposite combines the antimicrobial property of silver nanoparticles and the unique structure of graphene as a support material, with potent marine antifouling properties.The GAg nanocomposite was composed of micron-scaled graphene flakes with clusters of silver nanoparticles. The silver nanoparticles were estimated to be between 72 and 86 nm (SEM observations) while the crystallite size of the silver nanoparticles (AgNPs) was estimated between 1 and 5 nm. The nanocomposite also exhibited the SERS effect. GAg was able to inhibit Halomonas pacifica, a model biofilm-causing microbe, from forming biofilms with as little as 1.3 wt.% loading of Ag. All GAg samples displayed significant biofilm inhibition property, with the sample recording the highest Ag loading (4.9 wt.% Ag) associated with a biofilm inhibition of 99.6%. Moreover, GAg displayed antiproliferative effects on marine microalgae, Dunaliella tertiolecta and Isochrysis sp. and inhibited the growth of the organisms by more

than 80% after 96 h. The marine antifouling properties of GAg were a synergy of the biocidal AgNPs anchored on the stable yet flexible graphene sheets, providing maximum active contact surface areas to the target organisms. Keywords: Graphene nanocomposite, Silver nanoparticles, Marine antifouling, Biofilm inhibitor, Halomonas pacificaa.

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Zaleha MI, Khadijah S, Noriklil Bukhary IB, Khor GL, Zaleha AM, Haslinda H, Noor Sharifatul HY, Hasanain FG. The reliability of Fitzpatrick skin type chart comparing to mexameter (mx 18) in measuring skin color among first trimester pregnant mothers in Petaling District, Malaysia. Malaysian Journal of Public Health Medicine, 2016; 16: 59-65. (SCI IF: 0.216; HI: 3;

Tier: Q4).

The reliability of Fitzpatrick skin type chart comparing to mexameter (mx 18) in measuring skin color among first trimester pregnant mothers in Petaling District, Malaysia. Zaleha Md Isa1, Khadijah Shamsuddin1, Noriklil Bukhary Ismail Bukhari1,2, Khor Geok Lin3, Zaleha Abdullah Mahdy4, Haslinda Hassan2, Noor Sharifatul Hana Yeop1, Hasanain Faisal Ghazi5. 1Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Malaysia. 2Petaling District Health Office, Ministry of Health, Malaysia. 3School of Health Sciences, International Medical University, Malaysia. 4Department of Obstetrics and Gynecology, Universiti Kebangsaan Malaysia Medical Centre, Malaysia. 5Community Medicine Unit, International Medical School, Management and Science University, Selangor, Malaysia

Abstract

Malaysia comprises of multiple ethnic groups, each with a different skin color. The skin color type is related with risk factor of skin cancer and vitamin D deficiency. Thus, the device commonly used for skin color measurement are Fitzpatrick Skin Type Chart Measurement (FSTCM) and Mexameter (Mx 18). The objective of this study was to test the reliability of FSTCM in comparison to MX 18 in measuring skin color. A cross sectional study among first trimester pregnant mothers was performed at their first antenatal visit. The samples were taken from subjects from different ethnic backgrounds with different skin color who were currently living in one of the urban districts in Malaysia. A total of 396 (98%) respondents, aged 18-40 years old had completed the skin test using both MX 18 and FSTCM measurement. The mean age of respondents was 28.07 ± 4.09 years old. The skin type for Malays ranged from skin type I to skin type VI, Chinese ranged between skin type I to IV, meanwhile for Indians the skin type ranged from IV to VI. The Kappa value was 0.731 (p<0.001) for inter-researcher agreement for FSTCM measurement. Thus, the agreement was substantial as they agreed on 80% of the subjects. Meanwhile, for Mx 18, the intra-class correlation (ICC) for inter-researcher with average measure was 0.985 (95%CI-0.982-0.988). The intra-class correlation (ICC) between different time points was 0.99, estimating the reliability of Mx 18. Spearman correlation coefficient between FSTCM and Mx 18 was 0.88 (p<0.001). As a conclusion, the predominant skin color type for Malays is skin type III, while for Chinese is skin type II. The Indians skin are mostly in type V-VI. The ethnicity will not determine the skin type color as the skin types are overlapping between the ethnics. Hence, FSTCM which is a reliable and cheap device can be used for skin color screening purposes. Nevertheless, Mx 18 is an appropriate device to be used for diagnostic and cosmetic purposes. Keywords: Pregnant Mothers, Fitzpatrick Scale, Mexameter (Mx 18), Reliability, Malaysia.

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Zalilah MS, Khor GL, Sarina S, Chin YS, Barakatun Nisak MY, Chan YM, Lee HS, Maznorila M. Higher dietary energy density is associated with stunting but not overweight and obesity in a sample of urban Malaysian children. Ecology of Food and Nutrition, 2016; DOI:

10.1080/03670244.2016.1181065. (SCI IF: 0.955; HI: 22; Tier: Q2).

Higher dietary energy density is associated with stunting but not overweight and obesity in a sample of urban Malaysian children. Zalilah Mohd Shariff1, Khor Geok Lin2, Sarina Sariman3, Chin Yit Siew1, Barakatun Nisak Mohd Yusof1, Chan Yoke Mun1, Huang Soo Lee1 & Maznorila Mohamad2. 1Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia 2Dietetics with Nutrition Programme, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia 3Department of Healthcare Professional, Faculty of Health and Life Sciences, Management and Science University, Shah Alam, Selangor, Malaysia.

Abstract Although diets with high energy density are associated with increased risk of overweight and obesity, it is not known whether such diets are associated with undernutrition. This study assessed the relationship between dietary energy density (ED) and nutritional status of 745 urban 1- to 10-year-old children. Dietary intakes were obtained using food recall and record for two days. Dietary energy density was based on food and caloric beverages. Higher dietary ED was associated with lower intakes of carbohydrate, sugar, vitamins C and D, and calcium but higher fat, fiber, iron, and folate intakes. While intakes of fruits and milk/dairy products decreased, meat, fish, and legume intakes increased with higher dietary ED. Stunting, but not other growth problems, was associated with higher dietary ED. Future studies should confirm the cause-and-effect relationship between higher dietary ED and stunting. Keywords: Energy and nutrients, energy density, food groups, overweight and obesity,

stunting.

237

Zanariah H, Sri Wahyu T, Harvinder Kaur GS, Chee WSS. Diabetes care in Malaysia: Problems, new models, and solutions. State-of-the-art Review. Annals of Global Health, 2015; 81(6): 851-862. (ISI IF: 1.417; SCI IF: 1.851; HI: 49; Tier: Q2).

Diabetes care in Malaysia: Problems, new models, and solutions. State-of-the-art Review. Zanariah Hussein1, Sri Wahyu Taher2, Harvinder Kaur Gilcharan Singh3, Winnie Chee Siew Swee3. 1Putrajaya, Kedah; 2Alor Setar, Kedah; 3Bukit Jalil, Kuala Lumpur, Malaysia

Abstract Background: Diabetes is a major public health concern in Malaysia, and the prevalence of

type 2vdiabetes (T2D) has escalated to 20.8% in adults above the age of 30, affecting 2.8 million individuals. Thevburden ofmanaging diabetes falls on primary and tertiary health care providers operating in various settings. Objectives: This review focuses on the current status of diabetes in Malaysia, including epidemiology, complications, lifestyle, and pharmacologic treatments, as well as the use of technologies in its management and the adoption of the World Health Organization chronic care model in primary care clinics. Methods: A narrative review based on local available health care data, publications, and

observations from clinic experience. Findings: The prevalence of diabetes varies among the major ethnic groups in Malaysia, with

Asian Indians having the highest prevalence of T2D, followed by Malays and Chinese. The increase prevalence of overweight and obesity has accompanied the rise in T2D. Multidisciplinary care is available in tertiary and primary care settings with integration of pharmacotherapy, diet, and lifestyle changes. Poor dietary adherence, high consumption of carbohydrates, and sedentary lifestyle are prevalent in patients with T2D. The latest medication options are available with increasing use of intensive insulin regimens, insulin pumps, and continuous glucose monitoring systems for managing glycemic control. A stepwise approach is proposed to expand the chronic care model into an Innovative Care for Chronic Conditions framework to facilitate implementation and realize better outcomes in primary care settings. Conclusions: A comprehensive strategy and approach has been established by the Malaysian government to improve prevention, treatment, and control of diabetes as an urgent response to this growing chronic disease. Keywords: chronic care model, diabetes, Malaysia, multidisciplinary, programs, state-of-art,

treatment.

238

Zulkefli NJ, Mariappan V, Vellasamy KM, Chong CW, Thong KL, Ponnampalavanar S, et al. Molecular evidence of Burkholderia pseudomallei genotypes based on geographical distribution. PeerJ, 2016; 4: e1802. (ISI IF: 2.183; SCI IF: 2.009; HI: 16; Tier: Q1).

Molecular evidence of Burkholderia pseudomallei genotypes based on geographical distribution. Noorfatin Jihan Zulkefli1, Vanitha Mariappan1, Kumutha Malar Vellasamy1, Chun Wie Chong2, Kwai Lin Thong3, Sasheela Ponnampalavanar4, Jamuna Vadivelu1 and Cindy Shuan Ju Teh1. 1Department of Medical Microbiology, Universiti Malaya, Kuala Lumpur, Malaysia 2Department of Life Sciences, School of Pharmacy, International Medical University, Kuala Lumpur, Malaysia 3Institute of Biological Sciences, Universiti Malaya, Kuala Lumpur, Malaysia 4Department of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Abstract Background: Central intermediary metabolism (CIM) in bacteria is defined as a set of

metabolic biochemical reactions within a cell, which is essential for the cell to survive in response to environmental perturbations. The genes associated with CIM are commonly found in both pathogenic and non-pathogenic strains. As these genes are involved in vital metabolic processes of bacteria, we explored the efficiency of the genes in genotypic characterization of Burkholderia pseudomallei isolates, compared with the established pulsed-field gel

electrophoresis (PFGE) and multilocus sequence typing (MLST) schemes. Methods: Nine previously sequenced B. pseudomallei isolates from Malaysia were

characterized by PFGE, MLST and CIM genes. The isolates were later compared to the other 39 B. pseudomallei strains, retrieved from GenBank using both MLST and sequence analysis

of CIM genes. UniFrac and hierachical clustering analyses were performed using the results generated by both MLST and sequence analysis of CIM genes. Results: Genetic relatedness of nine Malaysian B. pseudomallei isolates and the other 39 strains was investigated. The nine Malaysian isolates were subtyped into six PFGE profiles, four MLST profiles and five sequence types based on CIM genes alignment. All methods demonstrated the clonality of OB and CB as well as CMS and THE. However, PFGE showed less than 70% similarity between a pair of morphology variants, OS and OB. In contrast, OS was identical to the soil isolate, MARAN. To have a better understanding of the genetic diversity of B. pseudomallei worldwide, we further aligned the sequences of genes used in MLST and genes associated with CIM for the nine Malaysian isolates and 39 B. pseudomallei strains from NCBI database. Overall, based on the CIM genes, the strains were subtyped into 33 profiles where majority of the strains from Asian countries were clustered together. On the other hand, MLST resolved the isolates into 31 profiles which formed three clusters. Hierarchical clustering using UniFrac distance suggested that the isolates from Australia were genetically distinct from the Asian isolates. Nevertheless, statistical significant differences were detected between isolates from Malaysia, Thailand and Australia. Discussion: Overall, PFGE showed higher discriminative power in clustering the nine Malaysian B. pseudomallei isolates and indicated its suitability for localized epidemiological

study. Compared to MLST, CIM genes showed higher resolution in distinguishing those non-related strains and better clustering of strains from different geographical regions. A closer genetic relatedness of Malaysian isolates with all Asian strains in comparison to Australian strains was observed. This finding was supported by UniFrac analysis which resulted in geographical segregation between Australia and the Asian countries.

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Keywords: Burkholderia pseudomallei, MLST, Central intermediary metabolism, Genetic

variants, Geographical distribution.

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