Background: Some argue that Malaysia’s extremely low organ donation rate is attributed to religion, specifically Islam. Testing this argument, this study asked Malaysian Muslims their views regarding various issues on organ donation and examined whether their decisions to donate organs are framed by religious beliefs. Materials and Methods: This study investigated the perspectives of Malaysian Muslims between October and December 2013 in Kuala Lumpur. Self-administered questionnaires were distributed to 900 people, with 829 responses collected (92% response rate). Respondents’ verbal consent was taken before proceeding with the survey. Results: The survey found that more than half of respondents felt that organ donation is permitted in Islam and that it is a communal responsibility. However, the same proportions were unsure on the issues of rewards for organs or on whether Islam permits the procuring of organs from brain dead patients. Conclusions: Malaysian Muslims are not against organ donation; however, encouraging organ donation requires the state to address public concerns on Islam’s views on this sensitive issue through effective policy tools to help address these gaps in Malaysian Muslims’ understanding of organ donation. The organ donation rate could improve by using Islamic scholars as ambassadors for an organ donation drive to convey the message of Malaysia’s urgent need for organ donation.
Tissue and Organ Procurement

OBJECTIVETrauma is the leading cause of mortality and morbidity among young age groups in Saudi Arabia and developed countries. This study aimed to evaluate the fall of platelet count in children with traumatic brain injury (TBI) as a potential predictor for clinical severity and outcome.

METHODSTotally 74 patients with TBI were admitted to the Pediatric Intensive Care Unit (PICU) of our hospital from the beginning of January 2008 to the end of March 2010 (27 months). Baseline enrolling criteria were age less than or equal to 12 years, admission within 4 hours after trauma event, and abbreviated injury scale (AIS) less than 3 for extracranial injuries. Injury severity was classified as mild, moderate and severe according to their Glasgow Coma Scale (GCS) scores. Clinical outcomes at discharge were defined as poor (death, severe neurological morbidity) and favorable (moderate disability and good recovery). Platelet count was taken 2-3 times on the first day after admission and thereafter once daily. The percentage fall of platelet count (PFP) was calculated and taken as an index of change. PFP was considered zero if the platelet count was higher than the initial value.

RESULTSPFP was significantly higher in patients with poor outcomes (mean 56.0%+/-3.8%, median 55.5%) compared to those with favorable outcomes (mean 25.3%+/-3.2%, median 20.5%, P less than 0.01). PFP was also closely related to the severity of TBI, GCS score, clinical outcome and length of stay for survivors (P less than 0.01 for each). The frequency of thrombocytopenia was significantly higher in poor outcome patients than in favorable outcome patients (P less than 0.05). The validity of thrombocytopenia as a risk factor to predict poor outcome after TBI was: specificity, 77.4%; odd ratio (OR), 3.1; relative risk (RR), 2.15. Receiver operating characteristic (ROC) curve and Youden index showed that the optimum cutoff point of PFP was at 51.5%.

CONCLUSIONPFP is increased with the severity of TBI and it can be taken as a significant independent predicting factor for its outcome as well.

A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.

Minor amputation was performed as a salvage procedure because most of the patients were not able to ambulate and become dependent following major amputation. Minor amputation is defined as amputation at the level of ankle joint and below while major amputation is defines by amputation above the ankle joint. The aim of this study was to compare the quality of life among diabetes patients following major and minor amputations.

Long-distance running has gathered some momentum among health-conscious participants. However, some studies have revealed association between long-distance running and development of acute kidney injury. Although the impact usually lasts only for a few days after the event, some participants have been admitted for severe acute kidney injury, the minority of which require dialysis treatment. The mechanisms underlying the injury may include dehydration, development of rhabdomyolysis, heat stroke and concomitant use of NSAIDS. Unfortunately, there is no long-term follow-up study to determine the long-term effect on kidney function. Acute hyponatremia may develop in a significant proportion of long-distance runners. Majority of them were asymptomatic but a few fatal cases which were supposedly due to cerebral oedema have been reported. Excessive intake of hypotonic drinks, excessive sweating and secretion of non-osmotic antidiuretic hormone have been postulated to be the causes of hyponatremia. This mini review will discuss the pathophysiology of the development of acute kidney injury and hyponatremia. It will also discuss the prevention and treatment of both conditions

Introduction: Donors per million population and transplantations per million population are standardized, widely used indicators to assess and compare countries’ performance in organ donation and transplantation. This study aims to investigate these two particular metrics of organ donation and transplantation performance, and to introduce a new index, namely, ‘transplantations per patients on the waiting list’. Methods: Secondary analyses of data on 23 countries in 2016 were used to construct the transplantations per patients on the waiting list indicator for kidney, liver, pancreas, heart, and lung transplantation, as well as for the transplantation of any of the five aforementioned organs. Results: According to the transplantations per patients on the waiting list, the best-performing countries in terms of organ donation and transplantation are Belarus for kidney transplantation, Finland for liver and pancreas transplantation, Australia for heart transplantation, and France for lung transplantation. Considering all five organs together, Sweden, Australia, Finland, Austria, and Poland were the top five best-performing countries, followed by Spain in the sixth position. Conclusion: The deceased transplantations per patients on the waiting list can be an alternative indicator to assess performance, along with the widely-used donors and transplantations per million population, but still has its limitations in certain scenarios.

Objective: To profile the secondary metabolites and to evaluate the antidiabetic potential of hydroethanolic leaf extracts of Conocarpus lancifolius. Methods: The various hydroethanolic extracts of Conocarpus lancifolius leaf were prepared by ultrasonication assisted freeze-drying. Total phenolic contents, flavonoid contents, antioxidant activity, α-glucosidase and α-amylase inhibitions of leaf extracts were determined. The metabolite profiling was accomplished by UHPLC-Q-TOF-MS/MS analysis. The antidiabetic assessment of the most potent extract was carried out by measuring the hypoglycemic and hypolipidemic effect in the high fat diet-fed diabetic albino mice. The blood glucose level, haemoglobin, total cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) were determined. Results: The 60% ethanolic extract exhibited the highest phenolic and flavonoid contents of (349.39 ± 2.13) mg GAE/g dry extract and (116.95 ± 2.34) mg RE/g dry extracts, respectively, and the highest DPPH scavenging activity with an IC50 value of (32.87 ± 1.11) μg/mL. The IC50 values for α-glucosidase and α-amylase inhibitions were (38.64 ± 0.93) μg/mL and (44.80 ± 1.57) μg/mL, respectively. UHPLC-Q-TOF-MS/MS analysis confirmed the presence of gallic acid, ellagic acid, corilagin, kaempherol-3-O-rutinoside, caffeic acid derivative, isorhamnetin and galloyl derivatives in the 60% ethanolic extract. Plant extract at a dose of 450 mg/kg body weight reduced blood glucose level, total cholesterol, LDL and HDL, and increased haemoglobin in alloxan-induced diabetic mice, Conclusions: Conocarpus lancifolius leaves are proved as a good source of biologically functional metabolites and possess antidiabetic activity which may be further explored to treat diabetes.

Introduction: School students are young adolescents who are in a period of acquiring good oral hygiene habits that are practised as they grow up. This study aimed to determine the association between oral health knowledge, attitude and practices (KAP) of the adolescents and their dental plaque maturity status. Methods: A cross-sectional study was conducted among 174 school students aged 13 to 14 years in Kota Bharu, Kelantan. The oral health knowledge, attitude and practices were assessed by self-administered questionnaires, while the dental plaque maturity status was assessed using GC Tri Plaque ID gel TM (TPID). The data were analysed using IBM SPSS version 24.0. Results: The mean (SD) for knowledge and attitude score of the students were 4.69 (1.44) and 3.63 (0.63), respectively. The mean (SD) dental plaque maturity score (DPMS) of the students was 1.02 (0.55). Students who had answered correctly on sugar and practised tooth brushing twice daily had significantly lower mean DPMS as compared to those who had answered incorrectly and practised tooth brushing less than twice daily (p<0.05). Conclusion: Adolescents participated in this study had moderate oral health knowledge and good oral health attitude. Correct knowledge regarding sugar and toothbrushing routines of at least twice a day significantly associated with the dental plaque maturity status.

Introduction: The study aims to determine the correlation of the Hearing Handicap Inventory for Elderly Screening (HHIE-S) questionnaire with the pure tone audiometry (PTA) in the Malaysian older adult population. Methods: This cross-sectional study took a random sample of adults ≥60 years in a tertiary hospital. A total of 202 participants completed both the HHIE-S questionnaire and the PTA test. The total HHIE-S score and the PTA result were explored for the correlation using a Kruskal–Wallis and the validity using the receiver operating characteristic curve. Results: A Kruskal–Wallis analysis indicated a significant correlation for the level of hearing impairment (r =.704, p < 0.001) between the HHIE-S score and the PTA result. Comparison between HHIE-S score of 8 and the PTA >25db results gave sensitivity: 87.9%, specificity: 78.4%, positive predictive value: 80.3%, and negative predictive value: 86.6%. Conclusion: This study suggests that the HHIE-S questionnaire is a good and valid screening instrument for hearing impairment detection in the Malaysian older adult population.

Aims: LysM containing-protein is widely distributed in all domains of life and this kind of protein is essential for various biological activities in living organisms. Rv1288, a LysM containing-protein with esterase, was found in Mycobacterium tuberculosis. Biophysical studies revealed that the protein is responsible for modulating lipid metabolism that enables pathogens to survive under extreme conditions and decrease the permeability of the pathogen’s cell wall to drug therapeutic agents. However, recognition and interaction between the protein, lipid and carbohydrate moieties at the molecular level remains largely unknown and must be investigated. Therefore, a production of recombinant protein Rv1288 should be performed to aid the study. Methodology and results: In this study, we cloned the full-length cDNA of Rv1288 from M. tuberculosis strain H37Rv and expressed it in pET-24d- Escherichia coli BL21(DE3) cells. Affinity and size exclusion chromatography methods purified the protein, and its preliminary oligomerisation state was determined based on a calculated apparent molecular weight of the protein. Rv1288 was expressed as a soluble protein at 20 °C, induced with 1 mM of isopropyl β-D-1-thiogalactopyranoside (IPTG). The calculated apparent molecular weight suggested that the Rv1288 protein formed a hexamer in solution. Conclusion, significance and impact of study All the methods involved in this study to produce the recombinant Rv1288-pET24d and its soluble protein in E. coli cells have been described. Hence, it can be implemented for future studies.