Introduction: Proteomic profiling is essential in understanding the pathophysiological process of multifactorial diseases such as acute myocardial infarction (AMI). Despite the increasing incidence of AMI in young adults, proteomic-based study focusing on young AMI remains limited. This study aimed to examine the plasma proteomic profiles of young adults with AMI compared to control subjects. We also hope to identify disease-specific protein biomarkers that contribute to the development of AMI in the young. Methods: Pooled plasma protein from 10 AMI patients aged 18 to 45 years and 10 age, gender and race - matched volunteers were separated using two-dimensional electrophoresis (2-DE). The spots proteins were analysed using the PD Quest analysis software. The spots proteins that were found to have been expressed differently between the two groups were identified by Matrix Assisted Laser Desorption/Ionization Time of Flight (MALDI-TOF) Mass Spectrometry. Results: There were three differently expressed proteins namely Apolipoprotein AI (Apo AI), Apolipoprotein AIV (Apo AIV) and Haptoglobin (p < 0.05). The expressions of these proteins were found to be increased in young patients with AMI compared to control subjects. Conclusion: The up regulation of Apo AI, Apo AIV and Haptoglobin in AMI patients indicate their important roles in the development of atherosclerotic disease. Thus, Apo AI, Apo AIV and Haptoglobin are potential disease biomarkers for young AMI.

Background: and Purpose Abnormal excitability of the central nervous system, both spinal and supraspinal, has previously been described as a pathophysiological plastic mechanism for chronic pain syndromes. Primary fibromyalgia (FM) as one extreme of this spectrum of diseases. This case-control study aimed to determine the changes in the spinal excitability by investigating the Hoffman reflex (H-reflex) in patients with FM. Methods: Thirty-eight patients with FM and 30 healthy controls participated in this case-control study. We measured the H-reflex bilaterally in the upper limbs (flexor carpi radialis) and the lower limbs (gastrocnemius and soleus). Moreover, pain-related variables were measured, including pain severity (using a visual analogue scale), pain duration, Widespread Pain Index, and the score on the Symptom Severity Scale. Various psychiatric comorbidities and qualityof-life parameters were measured for each patient, including scores on the Hamilton Depression Rating Scale, Taylor’s Manifest Anxiety Scale, and the Revised Fibromyalgia Impact Questionnaire. Results: A significant increase in the ratio of the maximum baseline-to-peak amplitudes of H and M waves (Hmax/Mmax) but not in the H-wave minimum latency was found in patients with FM compared with healthy controls. There were no significant correlations between this ratio in both muscles and the various pain-related measures, psychiatric comorbidity, and quality of life in patients with FM. Patients with FM suffered more depression and anxiety than did the controls. Conclusions We found increased spinal excitability in patients with FM, which was not confined to the site of maximum pain. This information may help in the diagnosis of FM and supports the hypothesis of central sensitization.

Acanthamoeba is a free-living protozoa which causes serious ocular problem. Acanthamoeba keratitis is becoming more prevalent amongst contact lens wearers and it can cause loss of vision and blindness if not treated properly. The objective of this research is to determine the effectiveness of gentamicin against six Acanthamoeba spp. isolates, of which three were clinical isolates (HS 6, HKL 95, HTH 73) and three environmental isolates (SMAL 7, SMAL 8, TTT 9). Cyst suspension from the chosen isolates were exposed to gentamicin. After 48 hours of incubation at temperature of 30°C and 37ºC, each mixture was filtered and filtration membrane was put onto non-nutrient agar laid with Escherichia coli. The agar plates were incubated for three days at 30oC and 37oC and the plates were examined daily until day 14 to look for the presence of Acanthamoeba trophozoites under inverted microscope. The presence of trophozoites indicated the ineffectiveness of gentamicin. Gentamicin was found to be effective against Acanthamoeba cysts from all the test strains at both incubation temperatures. The minimum cysticidal concentration (MCC) mean value of gentamicin was 0.193 mg/mL at 30oC and 0.229 mg/mL at 37oC. So, we concluded that gentamicin has cysticidal potential towards Acanthamoeba.

Background: The high prevalence and impacts of orofacial pain (OFP) have caused major sufferings to individuals and society. The purpose of the study was to investigate the problems and impacts of OFP among a group of Malaysian aborigines. The objectives were to determine (i) the prevalence, aetiology, duration, severity, types and persistence of OFP during the past 3 months preceding the study; (ii) its associated impact on daily performance; and (iii) the measures taken for pain relief. Methods: This is a cross sectional study carried out in Kuala Lipis, Pahang involving 6 villages of Orang Asli Bateq and Semai. Study sample was chosen using convenient sampling including adults aged 16 years and above. Participants were invited for an interview using structured questionnaire followed by clinical examination. Data analysis was carried out using SPSS ver12. Results: Response rate was low at 20% (n = 140). Over one-quarter (26.4%) of the sample experienced OFP in the previous 3 months. Toothache was found to be the main aetiology (83.3%) followed by gingival pain (18.9%), temporomandibular joint (10.8%) and facial pain (8.1%). Mean duration of pain was 9.8 days for toothache, 162.4 days for gingival pain, 7.3 days for TMJ and 5.7 days for facial pain. Of those who had OFP, over half rated the pain as moderate (37.8%) and severe (29.7%) and most of the pain was ‘intermittent’ in nature (81.1%). Over half (62.2%) admitted the pain had disappeared during the interview. In terms of pain relief, 56.8% of the sample used traditional medicine. The pain had impacted on the chewing ability (70.3%, p=0.01), ability to sleep at night (73.0%, p<0.001), levels of anxiety (70.3%), ability to perform daily chores (33.3%) and social life (35.1%) of the Orang Asli sample. Conclusion: This study suggests the prevalence of OFP was high among the Orang Asli sample, which imposed considerable physical and psychological impacts on daily life.

Introduction: Acanthamoeba is an ubiquitous free-living protozoa which causes serious ocular problems. Acanthamoeba keratitis is becoming more prevalent amongst contact lens wearers. The disease can cause loss of vision and blindness if not treated properly. The objective of this research is to study the sensitivity of six Acanthamoeba spp. isolates, of which three were from the clinical isolates (HKL 95, HTH 40 and HS 6) and the remaining three from environmental isolates (TTT 9, TL 3 and SMAL 8) to antimicrobial agents. Methods: The antimicrobial agents chosen for this purpose were polyhexamethylene biguanide and chlorhexidine. Cyst suspensions from the chosen isolates were exposed to PHMB and chlorhexidine respectively. After 48 hours incubation time at 30°c,each mixture was filtered and filtration membrane was put onto non-nutrient agar laid with Escherichia coli. The agar plates were incubated for three days at 30°c and examined daily until day 14 to detect the presence of Acanthamoeba trophozoites under the inverted microscope. The presence of thropozoites indicated the ineffectiveness of the antimicrobial agents. Results: Both of the antimicrobial agents tested were found to be effective against Acanthamoeba cysts from all the test starins. Polyhexamethylene biguanide gave minimum cysticidal concentration (MCC) mean value of 2.848mg/mL while chlorhexidine showed MCC mean value at a concentration of 3.988mg/mL. Conclusion: It can be concluded that the Acanthamoeba were sensitive to polyhexamethylene biguanide and chlorhexidine.

One hundred and sixty eight rats were trapped from the National Service Training Centres (NSTC) in Kelantan and Terengganu from October 2008 to May 2009. Microscopic agglutination test (MAT) was performed to detect the presence of agglutinating antibodies to Leptospira among the rats caught. All the MAT positive rats were identified as Rattus tiomanicus. In Kelantan, 17.3 % (14/81) of the rats had leptospiral antibodies to serovars Icterohaemorrhagiae (12.3%), Canicola (2.5%), Ballum (1.2%), and Pyrogenes (1.2%). In Terengganu, 18.4% (16/87) of the rats had antibodies to serovars Icterohaemorrhagiae (15%), Canicola (1.1%), Pyrogenes (1.1%) and Hebdomadis (1.1%). This study indicated that Leptospira serovars were prevalent in the rat population in the study areas and could be a source of infection to humans. Therefore, control of the rat population in all NSTC is critical to prevent outbreaks of leptospirosis amongst the NSTC trainees.

Increased susceptibility of diabetics to melioidosis, a disease caused by the Burkholderia pseudomallei bacterium is believed to be attributed to dysfunction of the innate immune system. However, the underlying mechanism of the innate susceptibility is not well-understood. Glycogen synthase kinase-3β (GSK3β) plays an important role in the innate inflammatory response caused by bacterial pathogens. The present study was conducted to investigate the effects of GSK3β inhibition by LiCl on levels of pro- and anti-inflammatory cytokines; and the activity of transcription factor NF-κB in B. pseudomallei-infected peripheral blood mononuclear cells (PBMC) derived from diabetic-induced and normal Sprague Dawley rats. In addition, the effects of LiCl on intracellular bacterial counts were also investigated. Infection of PBMC from diabetic and normal rats with B. pseudomallei resulted in elevated levels of cytokines (TNF-α, IL-12 and IL-10) and phosphorylation of NF-κB in both cell types. Intracellular bacterial counts decreased with time in both cell types during infection. However bacterial clearance was less prominent in diabetic PBMC. Burkholderia pseudomallei infection also caused inactivation (Ser9 phosphorylation) of GSK3β in normal PBMC, an effect absent in infected diabetic PBMC. Inhibition of GSK3β by LiCl lowered the levels of pro-inflammatory cytokines (TNF-α and IL-12) in both normal and diabetic PBMC. Similarly, phosphorylated NF- κB (pNF-κB) levels in both cell types were decreased with LiCl treatment. Also, LiCl was able to significantly decrease the intracellular bacterial count in normal as well as diabetic PBMC. Interestingly, the levels of anti-inflammatory cytokine IL-10 in both normal and diabetic PBMC were further elevated with GSK3β inhibition. More importantly, GSK3β in infected diabetic PBMC was inactivated as in their non-diabetic counterparts upon LiCl treatment. Taken together, our results suggest that inhibition of dysregulated GSK3β in diabetic PBMC resulted in the inactivation of NF-κB and modulation of inflammatory cytokine levels. This is evidence that dysregulation of GSK3β is a contributing factor in the molecular basis of innate dysfunction and susceptibility of diabetic host to melioidosis infection.

AIMTo assess the changes in semen parameters in men with spinal cord injury (SCI) and the possible causes of these changes.

METHODSThe study included 45 subjects with SCI. Semen retrieval was done by masturbation (2), vigorous prostatic massage (n = 13), penile vibratory stimulation (n = 13) or electroejaculation (n = 17).

RESULTSThe semen of men with SCI showed normal volume (2.3 +/- 1.9 mL) and sperm count (85.0 X 10(6) +/- 83.8 X 10(6)/mL) with decreased motility (11.6% +/- 0.1%), vitality (18.5% +/- 5.2%) and normal forms (17.5% +/- 3.4%), and pus cells has been increased (6.0 X 10(6) +/- 8.2 X 10(6)/mL). Total (13.4 +/- 9.9 vs. 7.1 +/- 6.8) and progressive (4.4 +/- 3.9 vs.2.2 +/- 2.1) motility were significantly higher in subjects with lower scrotal temperatures. There was no statistical significant difference between electroejaculation and penile vibratory stimulation groups as regards any of the semen parameters. Subjects'age, infrequent ejaculation, injury duration and hormonal profile showed no significant effect on semen parameters.

CONCLUSIONThe defining characteristics of the seminogram in men with SCI are normal volume and count with decreased sperm motility, vitality and normal forms, and the increased number of pus cells. The most acceptable cause of the deterioration of semen is elevated scrotal temperature.

Disease Progression ; Ejaculation ; Hormones ; blood ; Humans ; Male ; Massage ; Masturbation ; Movement ; Prostate ; physiopathology ; Semen ; physiology ; Sperm Count ; Sperm Motility ; Spinal Cord Injuries ; physiopathology ; rehabilitation ; Vibration

Background: In Malaysia, training to enter dentalnursing profession is only open to women. Ironically,there are no such gender restrictions on training forany other health related professions in Malaysia.Aim: Therefore this study aims to assess theperceptions of Malaysian Senior Dental Officers(SDOs) towards the employability of male workers inthe dental nursing profession and to compare findingsfrom male and female SDOs. Methods: This crosssectional study was carried out on all SDOs inMinistry of Health, Malaysia, using a self-administeredquestionnaire. Descriptive statistics and a chi squaretest were used to address the study objectives. Results:Of the 112 participants, 78 SDOs returned thequestionnaire, yielding a response rate of 70%. Themajority of SDOs had positive perceptions of theemployment of male dental nurses. It was indicated thatgender is an important indicator for workforcedevelopment, and that the employment of both maleand female dental nurses would enhance productivity.Almost 70% of SDOs perceived that the productivityof oral health service would be enhanced by havingmale and female dental nurses but 84.6% disagreedthat male dental nurses would be more productive thanfemale. Two thirds of SDOs disagreed that male dentalnurses would increase satisfaction among malepatients. About 64% of male SDOs disagreed thatdental nursing profession is associated with femaletraits. There was no significant difference betweenperceptions by male and female SDOs for anystatements. Conclusion: The majority of MalaysianSDOs have positive perceptions towards theemployability of male dental nurses, and perceiveddental nursing as a suitable profession for bothgenders. Training for the dental nursing professionshould therefore be made available for men.

Introduction: Cervical cancer ranks as the second most frequent cancer among women inMalaysia. Although a cervical screening program has been introduced since 1960s and isprovided free of charge in all government health facilities, the coverage and adherence rate torecommendation among Malaysian women remains low.Objectives: To determine the proportion of non-adherence to Pap smear screening guidelines andits associated factors among women attending a health clinic in Malaysia.Method: A cross sectional study involving 316 women aged 20 to 65 years who had undergonea Pap smear. Universal sampling method was applied to select participants among womenwho attended the selected health clinic from January 2013 to May 2013. A self-administeredquestionnaire was used to obtain the socio-demographic characteristics, socio-health data andperceptions about cervical cancer and Pap smear screening. The data was analysed using descriptivestatistics and multiple logistic regression.Result: The proportion of non-adherence to Pap smear screening was 90.5%. Age, marital status,duration of marriage, education level, employment, household income and number of children were notsignificantly associated with non-adherence. Perceived severity, perceived susceptibility, perceived benefit,perceived barrier and cues to action did not show significant association with non-adherence to Papsmear screening.Conclusion: Non-adherence to Pap smear screening was high among Malaysian women. Measuresshould be taken to increase Pap smear screening coverage in our country. Other factors beyondHealth Belief Model that influence Pap smear screening practice among Malaysian women shouldbe explored.