Prevalence of obesity in Malaysia has been steadily rising over the last two decades. Therefore, the efforts towards curbing this problem is becoming increasingly necessary. The main objective of this cross-sectional study was to evaluate the effectiveness of obesity projects conducted by the NGOs funded by the Malaysian Health Promotion Board (MHPB). In this study, the secondary data from the final reports of 22 obesity projects were analyzed to evaluate its effectiveness. All the information in the final report was transferred into the formative evaluation forms prepared by MHPB. The effectiveness of obesity projects was determined through the level of achievement of health literacy by using 21 indicators validated data extraction tool based on the RE-AIM Model. Projects which achieved 15 to 21 marks are considered to be of high quality, 8 to 14 marks are considered to be of moderate quality and 0 to 7 marks are categorized as low quality. Using the Cohen’s Kappa test to assess the inter-rater reliability towards 21 indicators validated data extraction tool based on the RE-AIM Model, it was found that there was very high level of inter-rater agreement (K = 0.868). From the 22 obesity projects studied, none was considered to be of high quality, 21 projects were found to have a moderate quality and 1 project was found to be of low quality. There was no significant difference on the percentage achievement of health literacy between different duration of project undertaken (p > 0.05). Based on the health screening of 1982 project participants, 333 (16.8%) are overweight and 354 (17.9%) are obese. In conclusion, although majority of the projects were successfully carried out by the NGOs. A follow-up study is needed to monitor lifestyles change which may eventually lead to reduction in the prevalence of obesity in the community where the projects were executed

BACKGROUND: Transforming growth factor-beta1 (TGF-beta1) is known to be a potent growth inhibitor of many cell types, including most epithelial cells. However, the mechanism of TGF-beta1 action on cell growth in lymphomas and leukemia still remains to be elucidated. c-myc is a central regulator of cell proliferation and apoptosis, and telomerase is believed to play an important role in carcinogenesis. The aim of the study was to determine the effects of cell growth, c-myc gene expression and telomerase activity due to TGF-beta1 and examine its mechanism of action in lymphomas and leukemia. METHODS: The cell growths of Jiyoye (Burkitt lymphoma), H9 (T cell lymphoma), and CCRF-CEM (acute lymphocytic leukemia, T cell) cell lines due to TGF-beta1 were measured using the MTT assay. RT-PCR was also performed to monitor the expression of the c-myc gene in these cells with the telomerase activity measured using a TRAP assay. RESULTS: There was significant inhibition of cell growth in TGF-beta1 (5ng/mL) treated Jiyoye cells. When treated with TGF-beta1, the Jiyoye cells exhibited marked decreases in the levels of c-myc RNA and telomerase activity. However, TGF-beta1 treated H9 and CCRF-CEM cells showed no cell growth inhibition or reductions in the levels of c-myc mRNA and telomerase activity. The effect of TGF-beta1 on cell growth was noted to closely correlate with c-myc mRNA expression and telomerase activity. CONCLUSION: These results suggest that TGF-beta1 may inhibit cell growth in Jiyoye cells by a mechanism involving down-regulation of the c-myc gene, which in turn, reduces the telomerase activity.
Apoptosis ; Carcinogenesis ; Cell Line* ; Cell Proliferation ; Down-Regulation ; Epithelial Cells ; Genes, myc ; Leukemia* ; Leukemia, T-Cell ; Lymphoma* ; RNA ; RNA, Messenger* ; Telomerase* ; Transforming Growth Factor beta1

BACKGROUND: Antituberculosis (anti-TB) drug allergy often involves multiple concurrently administered drugs which subsequently need to be reinitiated as no better alternatives exist. OBJECTIVE: To describe the results of tailored sequential desensitization-rechallenge (D-R) for anti-TB drug allergy. METHODS: Consecutive patients who had undergone D-R to anti-TB drugs between 1 September 1997 and 31 January 2012 were recruited. Following resolution of the acute reaction, anti-TB drug was restarted at 1:6,000 to 1:3 of the final daily dose (FDD), with gradual single or multiple step daily dose escalation to the FDD. Subsequent drugs were sequentially added ≥3 days later when the preceding drug was tolerated. Full blood count and liver function tests were monitored prior to addition of each new drug. RESULTS: There were 11 patients of whom 10 were male, predominantly Chinese (8 patients). Regimens comprised at least 3 drugs: isoniazid (INH), rifampicin (RIF), ethambutol (EMB), pyrazinamide (PZA), or streptomycin. All patients had nonimmediate reactions, with cutaneous eruptions, where maculopapular exanthema (MPE) was the most common (8 patients). Drug-induced hypersensitivity syndrome (DIHS) occurred in 6 patients, and Stevens Johnson syndrome (SJS) in 2 patients. D-R to INH was successful in 7/9 patients (77.8%) and to RIF/EMB/PZA/streptomycin in all. Of the 2 patients who failed INH D-R, 1 developed fever and MPE on day 3, the other MPE on day 8. D-R with INH and RIF respectively was successful in 2 patients with SJS. Among DIHS patients, 1 failed D-R with INH (fever and MPE on day 3). There were 23/25 (92%) successful D-R among the 11 patients. All patients completed TB treatment of ≥5 months' duration with no cases of drug-resistant TB. CONCLUSION: Tailored sequential TB drug D-R is successful where no better alternative therapies are available, with careful dose escalation and close monitoring, and after a careful risk-benefit assessment.
Asian Continental Ancestry Group ; Complementary Therapies ; Drug Eruptions ; Drug Hypersensitivity Syndrome ; Drug Hypersensitivity ; Ethambutol ; Exanthema ; Fever ; Humans ; Hypersensitivity ; Isoniazid ; Liver Function Tests ; Male ; Pyrazinamide ; Retrospective Studies ; Rifampin ; Risk Assessment ; Stevens-Johnson Syndrome ; Streptomycin

Cardio-oncology is an emerging multi-disciplinary field, which aims to reduce morbidity and mortality of cancer patients by preventing and managing cancer treatment-related cardiovascular toxicities. With the exponential growth in cancer and cardiovascular diseases in Asia, there is an emerging need for cardio-oncology awareness among physicians and country-specific cardio-oncology initiatives. In this state-of-the-art review, we sought to describe the burden of cancer and cardiovascular disease in Asia, a region with rich cultural and socio-economic diversity. From describing the uniqueness and challenges (such as socio-economic disparity, ethnical and racial diversity, and limited training opportunities) in establishing cardio-oncology in Asia, and outlining ways to overcome any barriers, this article aims to help advance the field of cardio-oncology in Asia.

Adult onset Still’s disease (AOSD) is a sporadic complex autoinflammatory syndrome first described in 1971.1 It is characterised by high spiking fever, polyarthritis, sore throat, lymphadenopathy, hepatosplenomegaly, serositis, and evanescent skin eruptions.1,2 It is associated with life-threatening complications too. Diagnosis of AOSD is laborious as it requires extensive investigations to exclude infections, autoimmune diseases and malignancy. Here we illustrate a young female who exhibited a turbulent presentation of ASOD.

Therapeutic temperature management (TTM) was strongly recommended by the 2015 International Liaison Committee on Resuscitation as a component of post-resuscitation care. It has been known to be effective in improving the survival rate and neurologic functional outcome of patients after cardiac arrest. In an effort to increase local adoption of TTM as a standard of post-resuscitation care, this paper discusses and makes recommendations on the treatment for local providers.