Medication adherence is very important for the effective treatment or control of various health problems, including chronic disease like diabetes mellitus (DM). However, medication non-adherence among diabetic patients on follow-up treatment is still a global health problem. This study aimed to identify factors associated with medication adherence and to determine methods on how it could be improved. A cross-sectional study was conducted on medication adherence among Malays, Iban and Melanau ethnic groups in Kota Samarahan and Sarikei, Sarawak using the Health Belief Model framework. Interviews with questionnaires, which were tested for its validity and reliability using the Cronbach’s Alpha, were conducted to collect data on the respondent’s socio-demographic and economic characteristics, and health beliefs of 442 respondents. Data was analyzed using SPSS version 17.0 for frequency distribution, measures of central tendencies, significance testing and logistic regression. The medication adherence rates were low in terms of all the treatment indicators such as amount of medication (31.7%), frequency (38.9%), duration (26%), and follow-up treatment (24.2%). The respondent’s socio-economic and economic characteristics have statistically significant association with medication adherence. The respondents adhered towards medication because they believed in its benefits. They also took their medication because they believed in the severity of DM and their susceptibility to its serious complications. The cues to action (medication taking) such as worrying about their socio-economic well-being, effectiveness of medication, and health campaign on diabetic control have influenced medication adherence. However, forgetfulness, distance of clinic, and costs of transport have caused medication non-adherence. The respondent’s health beliefs in the benefits of taking medication, perceived severity and susceptibility to DM and its serious complications have contributed towards medication adherence. Their concerns about the socio-economic well-being, effectiveness of medication, and health campaign on diabetic control were positive cues to medication taking behavior. Therefore, modifying the respondent’s related health beliefs and reinforcing the positive cues to actions are the relevant intervention strategies that could be used in improving medication adherence among diabetic patients.
Diabetes Mellitus ; Medication Adherence ; Malaysia

OBJECTIVEThe main objectives of this study were to qualitatively evaluate the profile of phytochemical constituents present in methanolic extract of Microcos paniculata bark (BME) and fruit (FME), as well as to evaluate their anti-inflammatory, analgesic and antipyretic activities.

METHODSPhytochemical constituents of BME and FME were determined by different qualitative tests such as Molisch's test, Fehling's test, alkaloid test, frothing test, FeCl3 test, alkali test, Salkowski's test and Baljet test. The anti-inflammatory, analgesic and antipyretic activities of the extracts were evaluated through proteinase-inhibitory assay, xylene-induced ear edema test, cotton pellet-induced granuloma formation in mice, formalin test, acetic acid-induced writhing test, tail immersion test and Brewer's yeast-induced pyrexia in mice.

RESULTSM. paniculata extracts revealed the presence of carbohydrates, alkaloids, saponins, tannins, flavonoids and triterpenoids. All of the extracts showed significant (P<0.05, vs aspirin group) proteinase-inhibitory activity, whereas the highest effect elicited by plant extracts was exhibited by the BME (75.94% proteinase inhibition activity) with a half-maximal inhibitory concentration (IC50) of 61.31 μg/mL. Each extract at the doses of 200 and 400 mg/kg body weight showed significant (P<0.05, vs control) percentage inhibition of ear edema and granuloma formation. These extracts significantly (P<0.05, vs control) reduced the paw licking and abdominal writhing of mice. In addition, BME 400 mg/kg, and FME at 200 and 400 mg/kg showed significant (P<0.05, vs control) analgesic activities at 60 min in the tail immersion test. Again, the significant (P<0.05, vs control) post-treatment antipyretic activities were found by BME 200 and 400 mg/kg and FME 400 mg/kg respectively.

CONCLUSIONStudy results indicate that M. paniculata may provide a source of plant compounds with anti-inflammatory, analgesic and antipyretic activities.

Analgesics ; pharmacology ; Animals ; Anti-Inflammatory Agents ; pharmacology ; Antipyretics ; pharmacology ; Female ; Fruit ; chemistry ; Male ; Mice ; Plant Bark ; chemistry ; Plant Extracts ; pharmacology ; Tiliaceae ; chemistry

In experienced hands, ultrasonic shears had been found to be a useful tool in total thyroidectomy surgery as long as the safety precautions are adhered to closely. It has the advantage of minimising operating time and will eventually reduce the cost of surgery. A randomised controlled trial is thus suggested to further evaluate its efficacy.

Papillary thyroid carcinoma (PTC) associated with familial adenomatous polyposis (FAP) is rare. It is usually associated with the cribriform-morular variant of PTC, with unusual patterns on detailed histology examination. This variant is known to have a good prognosis. Papillary thyroid carcinoma associated with FAP commonly occurs in females in their 30s and rarely in the elderly. We report a case of a 69-year-old female presenting with thyroid swelling and a history of FAP.

Objective: To focus on the analysis of chemical constituents of the Thymus vulgaris L. (locally known as Zaitra or Za'atar; Family: Lamiaceae) which is available in the market of Saudi Arabia. Methods: The Zaitra oil was analyzed by gas chromatography-mass spectrometry. The mass spectra were compared with the standard spectra available in National Institute Standard and Technique library. Results: The results indicated that the Thymus oil is composed of many chemical compounds including a pinene, thymol and caryophyllene which are biologically active and also used in various diseases. Conclusions: It can be concluded that the Thymus vulgaris due to presence of many bioactive compounds can be used as a new potential source of medicine for the treatment of various types of illness.

Targeting the cystine/glutamate exchange transporter, system xc-, is a promising anticancer strategy that induces ferroptosis, which is a distinct form of cell death mediated by iron-dependent lipid peroxidation. The concentration of L-cystine in culture medium is higher than the physiological level. This study was aimed to evaluate the effects of L-cystine concentration on the efficacy of ferroptosis inducers in hepatocellular carcinoma cells. This study showed that treatment with sulfasalazine or erastin, a system xc- inhibitor, decreased the viability of Huh6 and Huh7 cells in a dose-dependent manner, and the degree of growth inhibition was greater in medium containing a physiological L-cystine concentration of 83 μM than in commercial medium with a concentration of 200 μM L-cystine. However, RSL3, a glutathione peroxidase 4 inhibitor, decreased cell viability to a similar extent in media containing both L-cystine concentrations. Sulfasalazine and erastin significantly increased the percentages of propidium iodide-positive cells in media with 83 μM L-cystine, but not in media with 200 μM L-cystine. Sulfasalazine- or erastin-induced accumulation of lipid peroxidation as monitored by C11-BODIPY probe was higher in media with 83 μM L-cystine than in media with 200 μM L-cystine. In contrast, the changes in the percentages of propidium iodide-positive cells and lipid peroxidation by RSL3 were similar in both media. These results showed that sulfasalazine and erastin, but not RSL3, were efficacious under conditions of physiological L-cystine concentration, suggesting that medium conditions would be crucial for the design of a bioassay for system xc- inhibitors.

A survey was conducted to investigate the level of consumption of ‘ulam’ in Selangor State among 252 adults (> 17years) (male 28.6%, female 71.4%) of major ethnics (Malays-51.6%; Chinese-30.5%; Indians-17.5%) with the mean age of 42.7 ± 13.9 years. Consumption data were collected using 24 hours duplicate samples together with questionnaire on perceptions of ‘ulam.’ Results showed that ‘ulam’ was preferred by majority of the subjects (82.1%), especially amongst Malays (92.3%). A total of 52% of the subjects consumed partially or boiled ‘ulam.’ Factors that affect their preferences on ‘ulam’ were the perception of therapeutic effects of the ‘ulam’ towards health, its good taste and unique aroma. The most consumed ‘ulam’ were cucumber (Cucumis sativus) (60.6%) ‘kacang botol’ (Psophocarpus tetragonolobus) (33%), Indian pennywort (Hydrocotyle asiatica) (31.5%), lettuce (Lactuca sativa) (27.6%), ‘petai’ (Parkia speciosa) (29%) and ‘ulam raja’ (Cosmos caudatus) (21.9%). The most preferred partially or boiled ‘ulam’ were tapioca shoot (Manihot esculenta) (31.5%), ocra (Hibiscus esculentus) (12.5%) and ‘jantung pisang’ (Musa sapientum) (20.1%). There was no significant difference (P > 0.05) amongst the three different ethnic groups on the consumption of ‘ulam’ and the median for total intake per day was within the range of 30-39 g/day. Ulam is a potential source for increasing vegetable consumption to meet recommendation by World Health Organization (WHO), which is 400 g per day.

Introduction: Posttraumatic growth (PTG) is a positive psychological change in life that occurs as a result of struggle with highly challenging life crises. There is a growing need to explore posttraumatic growth (PTG) in cancer patients, as higher PTG may enhance well-being of patients. Objectives: The aim of this study was to translate the Posttraumatic Growth Inventory-Short Form (PTGISF) into the Malay language and evaluate its psychometric properties for assessing Malaysian cancer patients in future studies. Methods: Two parallels forward and backward translations of the PTGI-SF into the Malay language were conducted. The test was administered to 195 cancer patients. Reliability was evaluated by testing internal consistency (Cronbach’s α) and calculating the test-retest intra-class correlation coefficient, and validity was examined by determining face, convergent, and discriminant validities and using confirmatory factor analysis (CFA). Results: The Malay version of the PTGI-SF and its five domains demonstrated good internal consistencies and acceptable test-retest reliability. All 10 items of this version were highly correlated with their own domains and thus exhibited convergent validity. Discriminant validity was achieved, as all domains of the Malay PTGI-SF was not highly correlated with the domains of the Source of Social Support Scale. CFA resulted in a bestfitting 5-factor model. Conclusion: The Malay version of the PTGI-SF is a suitable tool for measuring PTG in Malaysian cancer patients.

Objective: It is important to investigate the association between spousal support and psychology of cancer patients, thus a validated instrument to measure the degree of perceived spousal support is required. We translated and evaluated the psychometric properties of the Sources of Social Support Scale-Malay version (SSSS-Malay) among Malaysian cancer patients. Methods: In this study, the SSSS-Malay and Hope Scale-Malay [used to compare with the SSSS-Malay to assess discriminant validity] were administered to 195 Malaysian cancer patients during baseline assessment. The SSSS-Malay was re-administered 2 months after the baseline assessment during follow-up. Results: The SSSS-Malay total score (Cronbach’s α = 0.70, intraclass correlation coefficient (ICC) = 0.72) and its domains (Cronbach’s α ranging from 0.70 to 0.83, intraclass correlation coefficient ranging from 0.6 to 0.76) exhibited good internal consistencies and good test-retest reliability. The SSSS-Malay also demonstrated good convergent and discriminant validities. However, confirmatory factor analysis of the SSSSMalay showed that it was best fit into a 3-factor model instead of the 4-factor model of the original English version. Conclusion: The SSSS-Malay demonstrated good psychometric properties for use in Malaysian cancer patients.

Paediatric subdural empyema is frequently seen in developing Asean countries secondary to rinosinusogenic origins. A cross-sectional analysis on the surgical treatment of intracranial subdural empyema in Hospital Kuala Lumpur (HKL), a major referral center, was done in 2004. A total number of 44 children who fulfilled the inclusion criteria were included into this study. The methods of first surgery, volume of empyema on contrasted CT brain, improvement of neurological status, re-surgery, mortality and morbidity, as well as the demographic data such as age, gender, sex, duration of illness, clinical presentation, probable origin of empyema, cultures and follow-up were studied. Chi-square test was performed to determine the association between surgical methods and the survival of the patients, neurological improvement, clearance of empyema on CT brain, re-surgery and long morbidity among the survivors. If the 20% or more of the cells were having expected frequency less than five, then Fisher’s Exact test was applied. The level of significance was set at 0.05. SPSS version 12.0 was used for data entry and data analysis. There were 44 patients who were less than 18 years. Their mean age was 5.90 ± 6.01 years. There were 30 males (68.2%) and 14 females (31.8%) involved in the study. Malays were majority with 28 (63.6%) followed by Indian 8 (18.2%), Chinese 5 (11.4%) and others 3 (6.8%). The variables which were under interest were gender, race, headache, vomiting, seizures, sign of meningism, cranial nerve palsy, thickness site of abscess, first surgical treatment, improvement in neurological deficit, clearance of CT and whether re-surgery was necessary. All variables were found not to be associated with Henk W Mauser Score for PISDE grading. Comparison between this urban study and a rural setting study by the same corresponding author in the same period on subdural empyema was done. Common parameters were compared and it was found out that seizures were more prevalent in urban study where the patients are more than one year old (p=0.005). Mortality was much higher in urban study than the rural one (p=0.040). The larger proportion of urban group had volume of abscess less than or equal to 50 ml (p=< 0.001).