Introduction: Hepatitis C virus (HCV) genotyping is very important for the clinical management of HCVinfected patients. The aim of this study was to determine the genotypes of HCV-infected patients and to identify their risk factors and comorbidities. Materials and Methods: This was an observational, cross sectional study in which forty (40) HCV-infected patients attending Gastroenterology Clinic, Hospital Tengku Ampuan Afzan (HTAA) Kuantan Pahang were recruited for the study, from January to July 2014. Nucleotide sequence analysis of the 5’UTR and NS5B region were performed to identify the viral genotypes. Results: Of the 40 samples, 31 (77.5%) isolates were successfully classified into their genotypes and subtypes; 3a (57.5%), 1a (12.5%), 3b (2.5%) and 1b (2.5%). No genotype 2, 4, 5 and 6 were found in this study. However, there was one mixed-genotype (3a/1a) HCV infection. Risk factors and co-morbidities found in this study include IVDUs, haemodialysis, blood transfusion, surgery and co-infection with HIV. Conclusion: Genotype 3 followed by genotype 1 were the common HCV genotypes found in this study population. Furthermore, the highest risk factors and co-morbidities were IVDUs and co-infection with HIV.

Introduction: Plants have been used for the treatment of diabetes in Philippine system of medicine and in other countries. They provide clues for the development of new and better oral drugs for diabetes due to the fact that prevalence of diabetes is on a steady upsurge worldwide and identified as one of the leading causes of mortality in Philippines. Methods: An ethnobotanical survey was carried out in Tarlac of Central Luzon Philippines to evaluate the relative efficacy of the plants used to treat diabetes. A total number of 450 respondents medically diagnosed of having diabetes were interviewed using a previously prepared questionnaire. Fidelity levels (FLs) and use values (UVs) were calculated to identify and verify most preferred plant species used in study areas. Results: A total of 25 plant species are utilized by the respondents to treat diabetes. Medicinal plants commonly utilized are Momordica charantia Linn., Moringa oleifera Lam, Annona muricata Linn., Psidium guajava Linn., Lagerstroemia speciosa (L.) Pers., Hibiscus esculentis Linn., Amomum zingiber Linn., Myrtus cumini Linn., Garcinia mangostana Linn., and Aloe vera Linn. Decoction process is used to prepare the leaves of the medicinal plants for medical consumption in the form of tea. Conclusion: This study confirms the use of different plant species to treat diabetes. It further affirms that most people with diabetes in the study areas rely on traditional medicine for their primary health care needs.

Background: Pneumococcal pneumonia is the commonest type of bacterial pneumonia worldwide. In Malaysia, the reported incidence of pneumococcal pneumonia is low. This may be due to poor sensitivity of conventional methods. The use of BinaxNOW, a urinary antigen test for Streptococcus pneumoniae can aid in the diagnosis of pneumococcal pneumonia. Objective: To determine the detection rate of pneumococcal pneumonia using BinaxNOW kit and to compare this with the conventional culture method for blood and sputum. Methods: This was a prospective cohort study involving patients 18 year-old and above admitted for community-acquired pneumonia (CAP) or health-care associated pneumonia (HCAP) to UKMMC between December 2011 and June 2012. BinaxNOW test, serology for Mycoplasma, Legionella and Chlamydia and cultures from blood/sputum/other respiratory tract samples and other routine investigations were performed. Results: A total of 102 patients were recruited; 89 (87.3%) with CAP, 13 (12.7%) with HCAP. 57 (55.9%) had pneumonia of unknown aetiology, 11 patients (10.8%) had positive blood cultures, 8 patients (7.8%) had a positive urine BinaxNOW test and 6 patients (5.9%) had positive sputum cultures. Streptococcus pneumoniae was the commonest isolate accounting for 9 cases (8.8%) followed by Klebsiella pneumoniae in 7 cases (6.9%). 8 out of 9 patients with positive urine BinaxNOW test had negative cultures for Streptococcus pneumoniae. One patient grew Streptococcus pneumoniae from the tracheal aspirate however the urine BinaxNOW test was negative. Conclusion: The use of urine BinaxNOW kit in UKMMC increased the detection rate of pneumococcal pneumonia in hospitalized patients.

Background: Teachers play an important role in reducing adolescent health problems. However, the involvement of teachers in adolescent health is not well understood. This current study was conducted to address this. Methods: A cross-sectional study was conducted among teachers of randomly selected arts, commerce and science colleges in Sangli, (Maharashtra) India. The data was collected by cluster random sampling. The study period was from November 2014 to April 2015. The study tool was self-administered questionnaire. Due ethical considerations, consents were taken. Analysis was done using Microsoft Excel 2003 and IBM SPSS version 22. Results: Out of 319 study participants; 246 (77.1%) participants had good awareness regarding adolescent health problems, 254 (79.6%) participants had good attitude towards reproductive health. Forty-three (13.5%), 22 (6.9%) and 15 (4.7%) participants had good practices regarding behavioural problems, psychological problems and substance abuse respectively. Practices about behavioural problems and substance abuse were associated with adolescent health training. In bi-variate analysis, age was a significant predictor for all the three practices. Conclusion: Most teachers had good attitude and awareness; but poor knowledge and practices regarding adolescent issues. All teachers should undergo training regarding adolescent health; with periodic refresher courses or lectures. Anonymous feedback from students should be sought to keep vigilance over efforts of the teachers.

Introduction: Urine output provides a rapid estimate for kidney function, and its use has been incorporated in the diagnosis of acute kidney injury. However, not many studies had validated its use compared to the plasma creatinine. It has been showed that the ideal urine output threshold for prediction of death or the need for dialysis was 0.3 ml/kg/h. We aim to assess this threshold in our local ICU population. Methods: This was a secondary analysis of an observational study done in critically ill patients. Hourly urine output data was collected, and a moving average of 6-hourly urine output was calculated over the first 48 hours of ICU admission. AKIuo was defined if urine output ≤ 0.5 ml/kg/h, and UO0.3 was defined as urine output ≤ 0.3 ml/kg/h. Results: 143 patients were recruited into the study, of these, 87 (61%) had AKIuo, and 52 (36%) had UO0.3. The AUC of AKIuo in predicting death was 0.62 (0.51 to 0.72), and UO0.3 was 0.66 (0.55 to 0.77). There was lower survival in patients with AKIuo and UO0.3 compared to those without (p=0.01, and 0.001, respectively). However, only UO0.3 but not AKIuo independently predicted death (HR 2.44 (1.15 to 5.18). Conclusions: A threshold of 6 hourly urine output of 0.3 ml/kg/h but not 0.5 ml/kg/h independently predictive of death. This support previous finding of a lower threshold of urine output criteria for optimal prediction.

Introduction: Traditional medicine which includes Islamic faith healing centre is still an important place to seek treatment whether for psychiatric reasons or others. This study aims to determine the prevalence of psychiatric illness among attenders of an Islamic spiritual healing centre and to understand patients’ illness attribution and their religiosity. Methods: A cross-sectional study was done with a systematic random sampling to obtain the prevalence of psychiatric illness which was diagnosed using Malay version of Mini International Neuropsychiatric Interview (M.I.N.I). Religiosity was measured using Hatta Islamic Religiosity Scale 1996 (HIRS96) and illness perception using Brief Illness Perception Questionnaire (BIPQ). Results: The prevalence of psychiatric illness among the attenders was 53.5%. Depressive disorder were more prevalent (41.5%) followed by anxiety disorder (28.3%), bipolar disorder (16.8%) and psychotic disorders (5.9%). More than half (58.8%) of attenders attributed their illness to supernatural causes but there were no significant difference between those with psychiatric illness and those without in terms of their attribution to supernatural causes, p=0.197.Generally, the patients had a higher religiosity score. Conclusion : This high prevalence shows a need for collaboration with the spiritual healing practitioners to improve delivery of treatment to patient and this would be a more holistic approach.

Atherosclerosis in cardiovascular disease (CVD) is a growing health problem, especially in developing countries. Hyperlipidemia is known as a dominant risk factor for the development of atherosclerosis. This study was designed to investigate the effects of Eurycoma Longifolia (EL) also known as Malaysian Ginseng/ Tongkat Ali on the testosterone level, biochemical changes of lipid profile and intima media thickness (IMT) in rats fed on high-fat diet. Twenty young, adult male Sprague-Dawley (SD) rats were housed for 12 weeks. After one week of acclimatization, they were randomly divided into four groups of 5 animals each and treated for 12 weeks as follow: Group ND was given only normal diet, group NDEL was given normal diet and EL extracts (15mg/kg) dissolved in distilled water, group HFD was given only high fat diet and group HFDEL was given high fat diet and EL extracts (15mg/kg). Rats which were treated with EL (NDEL and HFDEL) showed a significant increase (p<0.05) in the testosterone levels. There was a significant decrease (p<0.05) in triglyceride (TG) in HFDEL group compered to HFD group. The histological sections of aortas revealed a significant decrease (p<0.05) in IMT in HFDEL as compared with HFD group. No histological changes were observed in NDEL group compared with ND group and there was no significant difference in IMT values between NDEL and ND. These findings suggest that EL is a promising protective agent against atherosclerosis induced by high-fat diet.

Introduction: Diabetes mellitus has become a serious warning to mankind health all over the world. The management goal of diabetes is to keep blood glucose levels as close as possible to healthy individuals. Medications used to treat diabetes are usually associated with complications and may cause different side effects. Many traditional anti-diabetic plants have become popular in the management of diabetes mellitus. Flaxseed has been used as traditional medicine for centuries. Objective: This study aimed to evaluate the hepatoprotective effects of flaxseed extract in streptozotocin (STZ)-induced diabetic rats. Methods: Diabetes mellitus was induced in Sprague-Dawley rats using a single injection of streptozotocin (60 mg/kg i.p.). The rats were divided into five groups of 8 rats each. Group NC, normal control rats; Group NF, normal rats treated with flaxseed extract (400 mg/kg); Group DC, diabetic control rats; Group DG, diabetic rats treated with glibenclamide (0.6 mg/kg); Group DF, diabetic rats treated with flaxseed extract (400 mg/kg); for 4 weeks. Results: There were significant increase in relative liver weight, blood glucose levels in DC group comparing to NC group (p<0.05). The disturbance of these parameters was ameliorated in DF and DG groups. Histological observation revealed congestion of central veins, degeneration of hepatocytes, and reduced glycogen granules in DC group. These pathological changes were ameliorated in the flaxseed extract and glibenclamide treated rats. Conclusion: Flaxseed extract may represent a candidate alternative treatment to control diabetes mellitus and its related hepatopathy.

Background: Exposure to cyclophosphamide (CPA) for cancer treatment results in over-production of reactive oxygen species and oxidative stress thus affecting the DNA in male germ cell inducing sperm defects. Our goal is to assess the potential effects of Nigella sativa extract (NSE) and thymoquinone (TQ) on sperm and embryo quality following fertlization of sperm produced from germ cells which have been exposed to the damaging alkylating effects of CPA. Methods: Thirty six male ICR mice were divided into six groups; (I) Vehicle-treated control (normal saline), (II) CPA-only, (III) TQ-only, (IV) NSE-only, (V) CPA followed by TQ and (VI) CPA followed by NSE. Treatment with 200mg/kg CPA and 10mg/kg of both NSE and TQ were given by intraperitoneal injection. Animals were sacrificed at 33 days by cervical dislocation and sperm from caudal epidydymis were taken for analysis and in vitro fertilization (IVF) with eggs from untreated female. Fertilization rates and embryo development were monitored for 5 days. The result were analysed by using SPSS 16.Results: TQ and NSE supplementation to CPA-exposed male mice have no significant effect (p>0.05) on the total number of sperm if compared to CPA-only exposed mice. NSE and TQ supplementation have been shown to have significant effect (p<0.05) on the percentage of motile sperm as well as the number of abnormal sperm. Four types of abnormalities of the sperm were found which includes folded sperm, amorphous, banana-like and the head lacking of the usual hook. Finally, the embryo quality shows a significant improvement by the supplementation of TQ and NSE to CPA-exposed male mice (p<0.05). Conclusion: Overall, both NSE and TQ have indicated chemopreventive potential against the cytotoxicity of cyclophosphamide on the reproductive capacity and fertility.