Identification of the stages of smoking cessation among smokers is essential to improve the rate of smoking cessation. The aims of this study were to determine the prevalence and factors associated with stages of smoking cessation across the demographic distribution of adult smokers in Malaysia. Data were derived from a population-based study among Malaysian adults aged 18 years and above. Face-to-face interviews were carried out by trained staff using a validated questionnaire to obtain data related to smoking from 4,288 selected respondents. Of 4,288, 438 respondents are current smokers. Multivariable logistic regression analysis was used to determine factors associated with stage of smoking cessation. Approximately 60% (n=269/438) of the current smokers were in the pre-contemplation stage and 40% (n=169/438) were in the contemplation and preparation stages of smoking cessation. The proportion of pre-contemplators was higher among smokers with higher levels of nicotine addiction (71.3%), lower education attainment (71.4%), and those who were single/widowed/divorced (66.9%). Multivariable analysis showed that males, and those who reported low to high level of nicotine addiction were more likely to be in the pre-contemplation stage whilst those in the older age groups were more likely to be in the advanced stage of smoking cessation. The study revealed that the majority of current smokers in Malaysia had no intention to quit smoking within 6 months. Specific interventions targeting males, young adults and smokers with low to high nicotine addiction should be introduced to ensure the smokers proceed to the advanced stage of smoking cessation.

BACKGROUNDToll like receptor (TLR) 9 has been shown to play a crucial role in the pathogenesis of systemic lupus erythematosus (SLE) in animal models. Its pathogenic role in human SLE, however, was poorly elucidated. This study was performed to investigate the role of TLR9 involved in the aberrant signaling pathway and its correlation with disease activity in SLE.

METHODSmRNA level of TLR9 and interferon (IFN) regulatory factor 5 (IRF5) in peripheral blood mononuclear cells (PBMCs) were determined by real-time polymerase chain reaction (PCR). IFN-a expression was measured in the serum of the SLE patients by enzyme-linked immunosorbent assay (ELISA).

RESULTSTLR9 expression was significantly higher in SLE patients than that in health controls (P = 0.011). SLE patients with positive anti-dsDNA antibody had significantly higher expression of TLR9 than that with negative anti-dsDNA antibody (P = 0.001). TLR9 expression was positively correlated with fever (P = 0.017), alopecia (P = 0.046), safety of estrogens in lupus erythematosus national assessment SLE disease activity index (SELENA-SLEDAI) score (r(s) = 0.385, P = 0.003), and the level of IRF5 (r(s) = 0.35, P = 0.027) and IFN-a (r(s) = 0.627, P = 0.001) in SLE patients.

CONCLUSIONTLR9 is associated with SLE disease activity and might be involved in the IFN-a pathway of SLE.

Adolescent ; Adult ; Antibodies, Antinuclear ; blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Interferon Regulatory Factors ; metabolism ; Interferon-alpha ; blood ; Leukocytes, Mononuclear ; metabolism ; Lupus Erythematosus, Systemic ; blood ; genetics ; metabolism ; Male ; Middle Aged ; Real-Time Polymerase Chain Reaction ; Toll-Like Receptor 9 ; genetics ; metabolism ; Young Adult

INTRODUCTION: To describe the maternal and fetal outcomes in systemic lupus erythematosus (SLE) pregnancies followed-up in a single tertiary referral centre. METHODS: We performed a retrospective cohort study of 75 SLE pregnancies who were followed up in Singapore General Hospital over a 16-year period from 2000 to 2016. Adverse fetal and maternal outcomes including preterm delivery, miscarriages, fetal growth restriction, congenital heart block, neonatal lupus, pre-eclampsia and SLE flares were obtained from the medical records. RESULTS: The mean age at conception was 32 years old (SD 3.8). The mean SLE disease duration was 5.9 years (SD 5.2). The majority (88%) had quiescent SLE disease activity at baseline. Most pregnancies resulted in a live birth (74.7%). The mean gestational age at birth was 37.4 weeks (SD 3.4). Adverse fetal outcomes occurred in 53.3%. Preterm delivery (33.9%), miscarriages (20%) and fetal growth restriction (17.3%) were the most frequent adverse fetal outcomes. There was 1 neonatal death and SLE flares occurred in a third (33%). In the subgroup of SLE pregnancies with antiphospholipid syndrome, there were higher SLE flare rates (40%) and adverse fetal outcomes occurred in 8 pregnancies (80%). There were no predictive factors identified for all adverse fetal and maternal outcomes. In the subgroup analysis of preterm delivery, anti-Ro (SS-A) antibody positivity and hydroxychloroquine treatment were associated with a lower risk of preterm delivery. CONCLUSION Although the majority had quiescent SLE disease activity at baseline, SLE pregnancies were associated with high rates of adverse fetal and maternal outcomes.

Background: Gliomas, characterized by their invasive persistence and tendency to affect critical brain regions, pose a challenge in surgical resection due to the risk of neurological deficits. This study focuses on a personalized approach to achieving an optimal onco-functional balance in glioma resections, emphasizing maximal tumor removal while preserving the quality of life. Methods: A retrospective analysis of 57 awake surgical resections of gliomas at the NationalUniversity Hospital, Singapore, was conducted. The inclusion criteria were based on diagnosis, functional boundaries determined by direct electrical stimulation, preoperative Karnofsky Performance Status score, and absence of multifocal disease on MRI. The treatment approach included comprehensive neuropsychological evaluation, determination of suitability for awake surgery, and standard asleepawake-asleep anesthesia protocol. Tumor resection techniques and postoperative care were systematically followed. Results: The study included 53 patients (55.5% male, average age 39 years), predominantlyright-handed. Over half reported seizures as their chief complaint. Tumors were mostly low-grade gliomas. Positive mapping of the primary motor cortex was conducted in all cases, with awake surgery completed in 77.2% of cases. New neurological deficits were observed in 26.3% of patients at 1 month after operation; most showed significant improvement at 6 months. Conclusion The standardized treatment paradigm effectively achieved an optimal onco-functional balance in glioma patients. While some patients experienced neurological deficits postoperatively, the majority recovered to their preoperative baseline within 3 months. The approach prioritizes patient empowerment and customized utilization of functional mapping techniques, considering the challenge of preserving diverse languages in a multilingual patient population.

Introduction: Expansion of smoke-free areas in public domains is suspected to displace smoking into the home. However, the scarcity of such information in Malaysia warrants an investigation to determine SHS exposure at home among adults in Malaysia. Methods: This study studied 4,250 and 21,445 adults who participated in the 2011 Global Adult Tobacco Survey-Malaysia (GATS-M) and, the National Health and Morbidity Survey (NHMS) 2015, respectively. Multivariable logistic regression modelling was used to compare the odds of SHS exposure at home among adults in 2011 (GATS-M) to odds of SHS exposure at home among adults in 2015 (NHMS 2015). Results: Approximately one third of respondents were exposed to SHS at home in 2011 (38.4%) and 2015 (37.9%). MLR analysis revealed the odds of SHS exposure at home was not significantly different from 2011 [AOR 1.14, 95 % CI (0.99-1.31). 2015 exposure to SHS as reference]. This study also indicates no significant displacement of smoking into the home by socio-demographic and smoking status between 2011 and 2015. Conclusion: The findings suggest that smoking has not been displaced into the home in the past four years although the number of smoke-free public areas have increased. More public smoke free areas should be established.

Introduction: Adolescents are the future generation, and their support for smoke-free policies might create momentum for future stringent smoke-free initiatives. This study aimed to determine the levels and factors associated with support for smoking in public areas among Malaysian school-going adolescents aged 10-19 years Methods: The data were derived from the Tobacco and E-cigarettes among adolescents in Malaysia (TECMA), which employed the cross-sectional study design and multistage sampling to select the representative samples of school-going adolescents. Data was obtained through self-administered of pre-validated questionnaire. Descriptive study, cross-tabulation and multivariable analysis were used for analysis Conclusion The level of support for smoke-free initiative in public areas was high among youths in Malaysia, and this might offer promising prospects to expand the non-smoking areas to more public areas in the future.

Our previous study demonstrated that methanolic extract of Chrysanthemum zawadskii Herbich var. latilobum Kitamura (Compositae) has the potential to induce detoxifying enzymes such as NAD(P)H:(quinone acceptor) oxidoreductase 1 (EC 1.6.99.2) (NQO1, QR) and glutathione S-transferase (GST). In this study we further fractionated methanolic extract of Chrysanthemum zawadskii and investigated the detoxifying enzyme-inducing potential of each fraction. The fraction (CZ-6) shown the highest QR-inducing activity was found to contain (+)-(3S,4S,5R,8S)-(E)-8-acetoxy-4-hydroxy-3-isovaleroyloxy-2-(hexa-2,4-diynyliden)-1,6-dioxaspiro [4,5] decane and increased QR enzyme activity in a dose-dependent manner. Furthermore, CZ-6 fraction caused a dose-dependent enhancement of luciferase activity in HepG2-C8 cells generated by stably transfecting antioxidant response element-luciferase gene construct, suggesting that it induces antioxidant/detoxifying enzymes through antioxidant response element (ARE)-mediated transcriptional activation of the relevant genes. Although CZ-6 fraction failed to induce hepatic QR in mice over the control, it restored QR activity suppressed by CCl4 treatment to the control level. Hepatic injury induced by CCl4 was also slightly protected by pretreatment with CZ-6. In conclusion, although CZ-6 fractionated from methanolic extract of Chrysanthemum zawadskii did not cause a significant QR induction in mice organs such as liver, kidney, and stomach, it showed protective effect from liver damage caused by CCl4.
Alkanes ; Animals ; Antioxidant Response Elements ; Carbon ; Carbon Tetrachloride ; Chrysanthemum ; Glutathione Transferase ; Kidney ; Liver ; Luciferases ; Methanol ; Mice ; NAD(P)H Dehydrogenase (Quinone) ; Stomach ; Transcriptional Activation

Abstract Introduction: Total restriction on smoking in the home is an effective tool to reduce Second-hand smoke (SHS) exposure in private dwellings. The aim of this study is to determine the prevalence of total smoking restrictions in Malaysian homes and factors associated with its adoption. Methods: We analyzed data from a cross-sectional, household study – the Global Adult Tobacco Survey 2011, which involved a representative sample of Malaysian adults. Factors associated with the adoption of a totally smoke free home policy was determined by multivariable logistic regression. Results: Out of the 4250 respondents studied, 40.9% (95% CI 38.1-43.8) adopted a total smoking restriction within their homes. Adoption of total smoke-free home policy was significantly higher among Chinese and Indians, those without smokers in the house, non-smokers and government employees. The likelihood of adopting the total smoking restriction at home was lower among current smokers, of Malay ethnicity, low education attainment, having at least one house member who smoked, residing in rural areas, single or widow/widower/divorcee, those working in the private sector or self-employed. Conclusions: Less than half of Malaysian households implemented a total smoking restriction in their residence. Targeted activities to encourage the adoption of voluntary smoke-free rules among groups least likely to implement 100% smoking restrictions in the home are urgently needed with participation of all stakeholders to ensure its success.

Introduction: Multitude studies have shown perception is an integral factor associated with smoking, However, no such tool was available in Malay language. In this study, we established a Bahasa Malaysia version of PTSQ (BM-PTSQ) and tested the validity and reliability among secondary school adolescents. Methods: The English version of PTSQ originally consists of 12 items. It was translated into Bahasa Malaysia and back-translated again into English to check for consistency. After face validity (face-to-face query) was determined among 20 secondary school adolescents, only 10 items were included in the survey. Construct validity was established from 407 school adolescents through random selection in the same locality. More than 60% of the respondents were female, a majority (67.3%) were schooling in rural areas. Then, the reliability of the questionnaire was determined with Cronbach's alpha. Results: EFA has grouped PTSQ into two components, they are associated with either knowledge or attitude towards smoking. The variance and Cronbach's alpha for the first and second component were 38.24% and 0.861 (7 items) and 21.62% and 0.661 (3 items) respectively. Conclusion The PTSQ showed good validity and reliability for measurement of perception in smoking among school adolescents in Malaysia, thus this is a viable measurement tool. More importantly this study shows an urgent need to improve the smoking education among adolescents in Malaysia.

Aims: The gut microbiota is referred to as an ‘extra organ’ and is critical in assisting the host in terms of nutrition and immunity. Environmental stressors could alter the gut microbial community and cause gut inflammation. This study aimed to investigate and compare the gut microbiota community between healthy and diseased Tor tambroides. Methodology and results: In this study, such gut microbial alterations were explored using NGS-based 16S rDNA targeted sequencing on the Malaysian mahseer (T. tambroides). Three healthy adult and three diseased adult Malaysian mahseers (showing signs of exophthalmia, coelomic distension and petechial haemorrhage) were obtained from LTT Aquaculture Sdn Bhd. Our results revealed significant differences in microbial diversity, composition and function between both populations of T. tambroides. Alpha diversity analysis depicts lower diversity of gut microbiota composition in diseased T. tambroides as compared to the healthy group. In particular, Enterobacteriaceae, Aeromonas, Bacteroides, Vibrio and Pseudomonas were found within gut microbiota of the diseased fishes. In addition, cellulosedegrading bacteria and protease-producing bacteria were identified from the gut of T. tambroides. Conclusion, significance and impact of study Thus, our findings emphasized on the association between the alteration in gut microbiota composition and infectious abdominal dropsy (IAD) in T. tambroides. This finding is important to provide basic information for further diagnosis, prevention and treatment of intestinal diseases in fish.
Gastrointestinal Microbiome ; Cyprinidae