Purpose: To evaluate corneal cell morphology in patients with keratoconus using an in vivo slit scanning confocal microscope. Methods: A cross-sectional study was conducted to evaluate the corneal cell morphology of 47 keratoconus patients and 32 healthy eyes without any ocular disease. New keratoconus patients with different disease severities and without any other ocular co-morbidity were recruited from the ophthalmology department of a public hospital in Malaysia from June 2013 to May 2014. Corneal cell morphology was evaluated using an in vivo slit-scanning confocal microscope. Qualitative and quantitative data were analysed using a grading scale and the Nidek Advanced Visual Information System software, respectively. Results: The corneal cell morphology of patients with keratoconus was significantly different from that of healthy eyes except in endothelial cell density (P = 0.072). In the keratoconus group, increased level of stromal haze, alterations such as the elongation of keratocyte nuclei and clustering of cells at the anterior stroma, and dark bands in the posterior stroma were observed with increased severity of the disease. The mean anterior and posterior stromal keratocyte densities and cell areas among the different stages of keratoconus were significantly different (P < 0.001 and P = 0.044, respectively). However, the changes observed in the endothelium were not significantly different (P > 0.05) among the three stages of keratoconus. Conclusion: Confocal microscopy observation showed significant changes in corneal cell morphology in keratoconic cornea from normal healthy cornea. Analysis also showed significant changes in different severities of keratoconus. Understanding the corneal cell morphology changes in keratoconus may help in the long-term monitoring and management of keratoconus.

The accumulation of tear film proteins as well as microbes colonization onto worn contact lenses can be eliminated conventionally by mechanical rubbing during the cleaning process. Lens2® functions in rotation manner to loosen the deposits on the contact lens and has antimicrobial coating to keep lenses away from contamination. The objective of this study was to determine the efficiency of Lens2® to remove deposited protein and reduce microbial contamination compared to conventional method. Twenty-eight subjects each wore a pair of contact lens FDA Group 1 (Polymacon, SoftLens®38, Bausch & Lomb) for one month and cleaned them using multipurpose solution (COMPLETE® MoisturePLUSTM, Advanced Medical Optics) separately using two different methods. The right lens was cleaned conventionally while the left lens were cleaned using the Lens2®. The control group of thirteen subjects each wore a pair of contact lens for the same period and cleaned both conventionally. These lenses and its cases were then analyzed for protein deposition using Bichinchoninic Acid Assay (BCA) Kit (Sigma, USA) in 96-well plate. Microbial contamination was determined by culturing the samples on nutrient agar for bacteria and fungi and non-nutrient agar for amoeba isolation. The mean of total protein on control lenses (17.014 ± 13.246 μg/mL) was not significantly different from those on the Lens2® (21.623 ± 19.127 μg/mL). There were also low growth numbers of amoeba in each group of samples. Interestingly, there were no growths of amoeba from all Lens2® samples collected. There was also low growth numbers of bacteria in each sample group whereby Lens2® had the lowest growth of bacteria. No growth of fungi was obtained from all samples. The automatic lens cleaner, Lens2® was found to be as efficient as the conventional cleaning method. However, the Lens2® has additional advantage because of its antimicrobial material and need shorter time in the cleaning process as well as easy and effective.

Objective: The occurrence of food contaminants such as aflatoxin in the foodstuffs has been reported widely. Unfortunately, only a few know about the impact of aflatoxin to human health and this phenomenon let us to question the extent of public’s knowledge on fungal and aflatoxin contamination in the diets. Thus, this study aimed to investigate determinants of adults’ knowledge on fungal and aflatoxin contamination in the diets based on two factors namely socio-demographic and socio-economic factors. Method: A questionnaire was self-administered to 160 respondents from a faculty in Universiti Putra Malaysia. Results: Most of respondents had low level of knowledge in regard to fungal and aflatoxin contamination. Besides, the total score of knowledge on fungal and aflatoxin contamination was significantly and positively correlated (r=0.340, P<0.0001). The multivariate analysis indicated that personal income (below US $487) was the only predictor of respondent’s knowledge (β=-0.288, P<0.001) [Odds ratio (OR)=4.996]. Nonetheless, being male and single, divorced or widowed had significant OR of 2.040 and 0.313 respectively as predictors of low level of knowledge. Conclusions: Income inequalities may have impact to the respondents in acquiring knowledge on fungal and aflatoxin contamination in the diets. Additionally, an extensive survey on aflatoxin should be warranted in order to assess the public awareness and knowledge about this food contaminant.

Aims: The white rot fungus Pycnoporus cinnabarinus MUCL 39533 is able to reduce vanillic acid to vanillin. Reduction of vanillic acid to vanillin catalysed by the key enzyme aryl-aldehyde dehydrogenase has been reported. Here we report the isolation and cloning of aryl-aldehyde dehydrogenase from P. cinnabarinus strain MUCL 39533. Methodology and results: An aryl-aldehyde dehydrogenase gene (PcALDH) was isolated from P. cinnabarinus by producing a partial cDNA sequence fragment of an aryl-aldehyde dehydrogenase gene through PCR. Degenerate PCR primers were designed based on codons corresponding to conserved amino acid regions of aryl-aldehyde dehydrogenases of several fungi and bacteria. The full-length PcALDH cDNA was obtained through ReverseTranscription-Polymerase Chain Reaction (RT-PCR) and Rapid Amplification cDNA Ends (RACE) PCR. PcALDH cDNA comprises an open reading frame of 1,506 bp that encodes a protein of 501 amino acids. The PcALDH predicted protein showed the highest amino acid sequence identity (84%) to ALDH from Trametes versicolor. In silico analysis of PcALDH indicated that it belongs to the ALDH super-family and Class 3 ALDH. Conclusion, significance and impact study: PcALDH cDNA was successfully isolated and characterized. Important motifs identified from the highly conserved PcALDH protein indicated that it belongs to the aldehyde dehydrogenase superfamily. The cDNA clone will be used in expression studies to confirm the catalytic function of the enzyme.
Vanillic Acid ; Flavoring Agents

Background: This study aims to examine various solvent extracts of Cyphomandra betacea (tamarillo) also known as the tree tomato, for their bioactive constituents and antioxidant activity. The study also aims to examine its effect on cancer cell death using two types of cancer cell lines (liver and breast cancer cell). Methods: The first part of the study evaluates the nutritional composition of tamarillo. Then, phytochemical profiling using GC-MS analysis in ethanolic tamarillo extract was conducted. Different fractions of n-butanol, ethyl acetate and aqueous fractions were obtained from the ethanolic extract of tamarillo. Then, the fractions were subjected to the quantification of total phenol (TPC) and flavonoid contents (TFC), free radical scavenging activity (SA) and also antioxidant activity (AOX) assayed by beta-carotene bleaching (BCB) assay. Finally, the capability of the ethanolic extract of tamarillo and different fractions were evaluated for their anticancer properties. Results: Findings from this study revealed that the nutritional composition (ash, protein, carbohydrate and total dietary fiber), and mineral levels (calcium, magnesium, potassium and iron) of tamarillo were moderate. The crude ethanol extract of tamarillo contained the highest phenolic and total flavonoid content. FT-IR analysis revealed the presence of alkanes, carboxylic acid, phenol, alkanes, carboxylic acids, aromatics and nitro compounds. Twelve bioactive constituents in tamarillo have been identified through GC-MS analysis. Cytotoxic activity suggests the potential of ethanolic extracts of tamarillo having a chemopreventive effect on breast and liver cancer cells. Conclusion: This study reveals that tamarillo has substantial antioxidant activity as well as anticancer properties.

The aim of the present study was to evaluate visual functions and retinal morphology of Polypoidal Choroidal Vasculopathy (PCV) patients seen in an AMD referral centre of Malaysia and to further explore association between visual functions and optical coherence tomography (OCT) parameters in PCV eyes. In this single centre, cross sectional study, best corrected distance visual acuity (DVA), near vision acuity (NVA), reading speed (RS), and contrast sensitivity (CS) were measured in naïve PCV eyes. Selective parameters such as integrity of external limiting membrane (ELM), inner segment and outer segment junction (IS-OS), retinal pigment epithelium and Bruch’s membrane (RPE-BM) complex, average retinal thickness (ART) and volume (ARV), central retinal thickness (CT), centre maximum (CTmax) and centre minimum (CTmin) thickness were assessed using spectral-domain OCT. Forty-three new PCV eyes of 42 patients were evaluated. Mean (±SD) DVA, NVA, CS, RS were 0.83 ± 0.35 logMAR, 0.77 ± 0.3 logMAR, 0.69 ±.26 log CS and 59.56 ±14 words per minutes respectively. ART and CT showed good correlation with DVA (r=0.571& 0.546) and CS (r= 0.576 & 0.586). ARV and CTmax showed good correlation with CS (r=0.516 &, 0.513). The mean DVA, NVA and CS between three ELM and IS-OS status were significantly different (p=.002 & .000; p=.012 & .029; p=.005 & .001). In conclusion, present study reports visual functions and OCT characteristics of PCV patients in an AMD referral centre of Malaysia. Many of the quantitative and qualitative OCT parameters showed good association with the visual functions in eyes with PCV.
polypoidal choroidal vasculopathy ; visual functions ; ocular coherence tomography

Objective: Cataract is the leading cause of blindness inMalaysia. There is an alarming backlog of cataractextraction surgery as the majority believes they did notrequire surgery. This study aimed to explore the barriersat the primary care level to cataract surgery from theperspective of patients with severe cataract blindness.Methods: Eleven participants were involved in thisqualitative research which utilised the interpretativephenomenological analysis approach more renowned inhealth psychology research. All interviews conducted attheir home. The interviews were recorded, typedverbatim, and the transcripts were analysed using NVivosoftware version 8.0.Results: The main barriers identified at the primary carelevel were 1) nondisclosure of their visual problemsoriginated from their belated needs for better sight,delayed awareness of their visual status and socialstigma and 2) patient-provider-related issues namelymiscommunication and delayed referral. The first maintheme explains their belief for not requiring surgery. Thishas led to their delayed awareness and impededdisclosure of their visual problems to family members orprimary care providers. The second main theme reflectsthe provider-patient-related issues which retardedcataract detection and referral process required for earliercataract extraction surgery.Conclusion: Thus, the appropriate approach targeting thesespecific barriers at primary care level will be able to detect,motivate and assist patients for early uptake of cataractextraction surgery to improve their vision and prevent severeblindness.

Background: There is a lack of information on the practice of family planning among Muslim women in New York City in the United States of America (USA) [hereinafter known as “Muslim women residing in the United States” (MWRIU)], Tehran in the Islamic Republic of Iran (IRI) and Kuala Lumpur, Malaysia. The limited figures on this issue are either outdated or mere estimates. The importance of sexual and reproductive health of Muslim women is expected to have massive effects on the social and economic progress of developing countries like the IRI and Malaysia. It is also expected to have imperative impacts on the attempts to empower the MWRIU community and enhance their health status to meet the national standards. Objective: The study objective is to explore and compare the practice of family planning, namely on contraceptive use and abortion among Muslim women in 3 major cities of different countries. Methodology: A survey of 379, 377 and 380 respondents from New York City, Tehran and Kuala Lumpur respectively was conducted in 2013 using self-administered questionnaires. Results: There were significant differences in contraceptive and abortion practices across these countries (P<0.01). While a significant 86.6% of Iranian and 66.2% of the MWRIU used contraception, only 22.9% of the Malaysian women did so. For abortion, 13.6% of the MWRIU and 6.3% of the Malaysian respondents had abortion at least once; while only 22% of Iranians revealed their abortion history, totaling 32.1% of them who had abortion. Financial problems and having an unsupportive husband were among the major factors hindering their practice of healthy family planning. Conclusion: Educational campaigns should be promoted to increase the awareness on the permissibility of family planning in Islam, as well as on sexual and reproductive rights.
Family Planning Services

Background: Mutations in glucocerebrosidase (GBA) have been associated with the risk of developing Parkinson’s disease (PD) in different ethnic populations. The prevalence of GBA mutations among Malay PD patients is unknown. Thus, the aim of this study was to determine the frequency of GBA mutations among Malay PD patients, focusing on early (EOPD) and late-onset (LOPD) patients. Methods:EOPD (n = 50) and LOPD (n = 50) patients along with 50 ethnically and age-matched control wererecruited. The GBA exons of these patients were sequenced using the Ion Torrent PGMTM System. Results: Five heterozygous mutations exclusive to EOPD patients were identified; c.-203A>G,p.S146L, p.R159Q, p.L483P and p.L483R+c.-145G>A. In LOPD patients, c.543C>T(p.(F181=)), c.28-10C>A and p.R202Q were identified in which this p.R202Q was also present in a control subject. In addition, c.259C>A(p.(R87=)) and c.-145G>A were identified in two control subjects. In summary, we observed GBA mutations in 8% and 6% of Malay PD cases and control subject, respectively. The prevalence of GBA mutations was higher in EOPD (10%) than LOPD (6%). However, these differences were not statistically significant; [PD vs. controls: OR = 1.36, 95%CI 0.35-5.38, p = 0.752] and [EOPD vs. LOPD: OR = 1.74, 95%CI 0.39-7.71, p = 0.715]. Conclusion: We identified five exclusive heterozygous GBA mutations in EOPD patients which might predict the increase susceptibility of Malays to develop PD at young age. These findings could add knowledge into the existing evidences linking genetic alterations in GBA and PD.

Necrotising fasciitis is a life-threatening infection of the soft tissue which can be caused by different microorganisms, but infection caused by Aeromonas spp. or Vibrio spp. is frequently associated with higher mortality rate. Necrotising fasciitis progresses rapidly and often need aggressive surgical intervention. We present a rare case of necrotising fasciitis cause by Aeromonas sobria which mortality was successfully prevented by swift diagnosis and aggressive surgery.