Background: Obesity and overweight are strong independent risk factors for chronic kidney disease (CKD). Using serum creatinine-based estimated glomerular filtration rate (eGFR) equations in these subjects may be inaccurate. On the other hand, cystatin C–based eGFR equations may overestimate CKD prevalence as recent findings suggest an association of cystatin C with obesity. The objective of this study was to assess the accuracy of a cystatin C–based eGFR equation compared to two creatinine –based eGFR equations in overweight and obese subjects. Methods: This was a prospective cross-sectional study which recruited healthy volunteers aged 18-55 years with a body mass index (BMI) ≥ 23kg/m² (Asia Pacific Guidelines). Their renal profiles, serum cystatin C and 99m technetium diethylene triamine pentacetic acid (⁹⁹mTc-DTPA) scans were performed on the same day. The correlations and accuracy of the creatinine-based and cystatin C-based eGFR equations with the ⁹⁹mTc-DTPA GFR were determined. Results: One hundred and one subjects with a median age of 30.0 (27.0-43.5) years and mean BMI of 28.7 ± 4.5 kg/m2 were recruited. The cystatin C-based eGFR equation showed the best correlation with the ⁹⁹mTc-DTPA GFR (r=0.526, p=0.001) and was more accurate in measuring abnormal GFR compared to the creatinine-based eGFR equations. Conclusion: Our study showed that the cystatin C-based eGFR equation was more accurate, sensitive and specific in overweight and obese subjects compared to the creatininebased eGFR equations.

Breast cancer is the most common cancer among Malaysian women. This study aimed to determine the reproductive for premenopausal breast cancer risk in Kuala Lumpur, Malaysia. A case-control study was conducted in 216 histopathologically confirmed cases of premenopausal breast cancer and 216 community-based controls that were matched by age within a 5-year period and ethnicity. The results of this study showed that premenopausal breast cancer risks were strongly related to parity, number of live births and family history of breast cancer. Premenopausal women with these known reproductive and family history risk factors should take extra measures to undergo appropriate screening method for early detection of breast cancer

(T2DM) among the younger age groups is a growing concernworldwide. Thus, assessing the perception of risk andknowledge among those at risk may provide an opportunityfor early intervention, delay or even prevent the onset. Objective: The aim of this study was to determine theperceived risk of developing T2DM and its knowledgeamong the offspring of diabetic patients.Methods: A cross sectional study using a self-administeredquestionnaire was conducted among university studentswhose parents had type 2 diabetes to determine theirperceived risk and knowledge on T2DM. Results: A total of 336 university students participated inthis study and 56.5% of them correctly identified themselvesat risk of developing T2DM. About half of them (52.7%) hadhigher knowledge of T2DM. Male students appeared to havebetter risk perception (p=0.024) compared to females whilethose with mothers affected by T2DM appear to have higherknowledge regarding diabetes (p=0.007). Most of theirinformation regarding T2DM was obtained from the internet(87.5%) and other family members (77.9%).Conclusion: The students whose mothers had T2DM appearto have better knowledge and information regarding T2DMand this was mostly obtained from the internet and familymembers. Awareness regarding diabetes and healthylifestyles advice through primary patients may be beneficialfor their offspring.

Bacteria of the genus Bartonella have been known as emerging zoonotic pathogens for several human diseases including cat scratch disease, Carrion’s disease and trench fever. Numerous species of small mammals have been reported to play a role as a suitable reservoir to many pathogenic Bartonella. These infections are thought to be transmitted through blood-feeding arthropod vectors such as ticks, fleas and lice. The purpose of this study is to detect the presence of Bartonella species from tick samples collected from small mammals in mangrove forests of Peninsular Malaysia. Herein, 38 individual ticks and their small mammals host were evaluated for the presence of Bartonella DNA by conventional PCR targeting the 16S rRNA intergenic spacer region (ITS) and partial sequencing of 460 bp from this locususing Bartonella genus-specific primers. Two tick individuals from Dermacentor auratus and Haemaphysalis hystricis collected from Rattus tiomanicus (host), were PCR-positive for Bartonella DNA amplification. No Bartonella amplification was possible in other tick species (Amblyomma sp.). Phylogenetic analysis of ITS fragments demonstrated that the sequences from ticks were closely related to Bartonella phoceensis, a species that has been reported from black rats (Rattus rattus) in Australia. This is the first report of a Bartonella bacteria detected in ticks from small mammals in Malaysia. Further research should be warranted to investigate the transmission of Bartonella and the potential impact of this zoonotic pathogen in animals and humans as this mangrove ecosystem is significant for local economy and tourism

Antibiotics which once a boon in medicine and saved millions of lives are now facing an ever-growing menace of antibacterial resistance, which desperately needs new antibacterial drugs which are innovative in chemistry and mode of action. For many years, the world has turned to natural plants with antibacterial properties to combat antibiotic resistance. On that basis, we aimed to identify plants with antibacterial and antibiotic potentiating properties. Seventeen different extracts of 3 plants namely Burkillanthus malaccensis, Diospyros hasseltii and Cleisthanthus bracteosus were tested against multi-drug resistant Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Methicillinresistant Staphylococcus aureus (MRSA) and methicillin-susceptible Staphylococcus aureus (MSSA). Antibacterial activity of hexane, methanol and chloroform extracts of bark, seed, fruit, flesh and leaves from these plants were tested using, disk diffusion assay, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) assays. Antibiotic potentiating capabilities were tested using time-kill assay. B. malaccensis fruit chloroform extract showed the biggest zone of inhibition against MRSA (13.00±0.0 mm) but C. bracteosus bark methanol extract showed the biggest inhibition zone against MSSA (15.33±0.6 mm). Interestingly, bark methanol extract of C. bracteosus was active against MRSA (8.7±0.6 mm), MSSA (7.7±0.6 mm) (Gram-positive) and A. baumannii (7.7±0.6 mm) (Gram-negative). Overall, the leaf methanol and bark methanol extract of C. bracteosus warrants further investigation such as compound isolation and mechanism of action for validating its therapeutic use as antibiotic potentiator importantly against MRSA and A. baumannii.