Screening For Colorectal Cancer – Time to Act
The International Medical Journal Malaysia.2017;16(1):1-.
The International Medical Journal Malaysia
2002 (v1, n1) to Present ISSN: 1671-8925
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The International Medical Journal Malaysia.2017;16(1):11-20.
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.
Ethnobotanical Survey of Plants Commonly used for Diabetes in Tarlac of Central Luzon Philippines
The International Medical Journal Malaysia.2017;16(1):21-28.
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.
The International Medical Journal Malaysia.2017;16(1):29-36.
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.
The International Medical Journal Malaysia.2017;16(1):37-44.
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.
Validating a Lower Urine Output Criteria in Predicting Death in Critically Ill Patients
The International Medical Journal Malaysia.2017;16(1):45-52.
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.
Psychiatric Morbidities among Attenders of an Islamic Spiritual Healing Centre in Malaysia
The International Medical Journal Malaysia.2017;16(1):75-82.
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.
Anti-atherosclerotic Effects of Eurycoma Longifolia (Tongkat Ali) in Rats Fed on High-fat Diet
The International Medical Journal Malaysia.2017;16(1):83-90.
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.
The International Medical Journal Malaysia.2017;16(1):91-98.
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.
The International Medical Journal Malaysia.2017;16(1):99-106.
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.
Country
Malaysia
Publisher
International Islamic University Malaysia (IIUM)
ElectronicLinks
https://journals.iium.edu.my/kom/index.php/imjmEditor-in-chief
Prof. Dr. Naseer Amjad
nasser@iium.edu.my
Abbreviation
IMJM
Vernacular Journal Title
IIUM Medical Journal Malaysia
ISSN
1823-4631
EISSN
Year Approved
Current Indexing Status
Currently Indexed
Start Year
2002
Description
IIUM Medical Journal Malaysia (IMJM) formerly known as the International Medical Journal Malaysia (IMJM) is the official journal of the Kulliyyah (Faculty) of Medicine, International Islamic University Malaysia. It serves primarily as a forum for education and intellectual discourse for health professionals namely in clinical medicine but covers diverse issues relating to medical ethics, professionalism as well as medical developments and research in basic medical sciences. It also serves the unique purpose of highlighting issues and research pertaining to the Muslim world. Contributions to the IMJM reflect its international and multidisciplinary readership and include current thinking across a range of specialties, ethnicities and societies.
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