APOLIPOPROTEIN E (APOE) GENE POLYMORPHISMS AND THEIR ASSOCIATION WITH CARDIOVASCULAR DISEASE (CVD) IN TYPE 2 DIABETES MELLITUS (T2DM) Apolipoprotein E (ApoE) is well known for its crucial role in lipid metabolism and is associated with an increased risk of cardiovascular disease (CVD) among subjects with type 2 diabetes mellitus (T2DM). Various apolipoprotein gene families have been determined, including APO (A-I), APO (A-II), APO (A-IV), APO (C-1), APO (C-II), APO (C-III), and APOE. A total of 3,597 nucleotides are encoded by the APOE gene, with four exons and three introns, constituting a polypeptide with 299 amino acids. The current study embarks on linking APOE gene polymorphisms with CVD among patients diagnosed with T2DM. This cross-sectional study involved 101 subjects with specific inclusion and exclusion criteria. The participants were separated into two groups, T2DM (n = 59) and T2DM with CVD (n = 42). Comparative analyses of clinical and biochemical characteristics were performed using student’s t-test and Pearson’s chi-square test (x2). Univariate and multivariate analyses were applied to establish the relationship between APOE gene polymorphisms with ischemic heart disease. The ε3/ε3 genotype was the most prevalent among both groups. The ε3/ε3 genotype (AOR= 0.052; 95% CI = 0.003-0.792; p = 0.033), ε3 allele (AOR = 34.83; 95% CI = 1.118-1085.134; p = 0.043), systolic blood pressure (SBP) (AOR = 1.046; 95% CI = 1.002-1.091; p = 0.042), and HbA1c (AOR = 2.286; 95% CI = 1.577-3.314; p < 0.001) were significantly associated with CVD. The ε3/ε3 genotype was also significantly associated with the lipid parameter, low density lipoprotein cholesterol (LDLc) (p = 0.011). Most T2DM patients presented with ε3 allele which may affect lipid profiles and the risk of CVD disease. This highlights the need to establish APOE as a likely predictive gene for CVD disease in T2DM subjects.

SOCIODEMOGRAPHIC PATTERNS OF HYPERTHYROID PATIENTS UNDERGOING RADIOACTIVE IODINE THERAPY IN NORTHERN MALAYSIA: AN OBSERVATIONAL STUDY Introduction: Sociodemographic data of hyperthyroid patients undergoing RAI therapy remains limited. This study aims to assess the sociodemographic profile of hyperthyroid patients referred for RAI therapy in northern Malaysia. Methods: In this study, the participants involved were the hyperthyroid patients referred for RAI therapy at the Department of Nuclear Medicine, Hospital Pulau Pinang, from May 2019 to May 2020. Self-reported sociodemographic and clinical information were documented. Descriptive statistics were applied with continuous variables presented as mean and standard deviation and categorical variables as frequencies and percentages. Results: Among the 123 patients studied, the majority were female, with a mean age of 43.9 years. Most patients were of Malay ethnicity, hailing from Kedah, married, and acquired lower education. They were employed with an average monthly income of RM2303.88. The patients were primarily diagnosed with Graves’ disease without other comorbidities and were in a hyperthyroid state biochemically. A significant portion underwent RAI therapy for the first time, receiving a fixed cumulative dose of 555 MBq. Conclusions Overall, the sociodemographic patterns observed in this cohort align with established trends of thyroid disease related to age, gender, demographics, and etiology. However, the ethnic distribution contradicts previous literature, as Malay ethnicity exhibited the highest percentage of thyroid disorders in this study. Despite medical therapy, many patients had poor thyroid function control at the time of referral, necessitating RAI therapy for definitive management. Further, most patients had lower educational backgrounds, lower incomes, and were employed. Additionally, the presence of common non-communicable diseases in Malaysia was noted among the patients.

Obesity is thought to be a complicated, multifaceted chronic disease that results from the combination of environmental and genotypic variables. Implementing a wide strategy for obesity prevention and management is required given the variety and complexity of factors impacting obesity. Most healthcare practitioners use dietary therapies such calorie-restricted diets, Mediterranean diets, DASH diets, and intermittent fasting to encourage weight loss. Meal replacement products (MRPs) are used as part of a calorie restricted diet which helps to control our food choices and leads to calorie reduction. This article reviews the usage of MRP as a weight loss therapy and summarizes the literature about their effectiveness to reduce weight in patients with obesity. From the literature search, it can be concluded that MRPs contain a precise amount of macronutrients, micronutrients, and fiber to provide a nutritionally balanced meal. MRPs have been extensively studied as a weight loss therapy, and several scientific studies have confirmed their efficacy. The main ways that MRPs aid in weight loss are by reducing appetite and improving diet adherence, which makes it easier for individuals to stick to their diet plan and achieve their weight loss goals. Overall, MRPs should be considered as a viable treatment option for patients who are motivated to lose weight, as they offer a simple, convenient, and effective way to reduce calorie intake, improve diet adherence, and achieve sustainable weight loss. However, it is important to note that MRPs should be used as part of a comprehensive weight loss plan that includes regular physical activity and behavior modification strategies for long-term success.
Obesity

Introduction: ABO blood group can be associated with chronic diseases, for example, cancer and coronary heart disease, however it is not proven in Type 2 Diabetes Mellitus (T2DM). The aim of this study was to identify the association between the ABO blood group and disease control among T2DM patients at Kepala Batas, Penang. Methods: Approximately two mL vials of fresh blood were collected and typed using the tube method from 129 T2DM and 132 non-diabetic (control) patients, who visited the specialist clinic. The sociodemographic characteristics of the T2DM patients was analysed using descriptive analysis. The proportions of A, B, AB, and O blood groups among the diabetic and control patients were compared using the chi-square test. Any association between the ABO blood group and disease control was identified using the bivariate correlation test. Results: No significant association was found between the ABO group and T2DM patients (p = 0.152) when compared with the control group. However, blood group B was the most frequent among T2DM patients (33.3%) compared to blood group O within the control group (36.4%). Negative associations were observed between the ABO blood group and BMI (r = 0.098, p = 0.268), as well as the HbA1C value (r = -0.065, p = 0.464). Conclusion: No association was found between the ABO blood group and the associated risk factors (BMI and HbA1C). However, individuals with blood group B and risk factors, such as older age group, obesity, and high HbA1C value (more than 7.0%), should be monitored.

Dementia is a health concern worldwide, as there is currently no cure for this neurodegenerative disease. Many studies have been conducted to better understand the symptoms and causes of this disease. Dementia can be diagnosed in a person as early as 40 years of age, which has been a source of concern for everyone. Most of the population have a long-held belief that dementia would only affect the elderly. Genetic factors may have the potential to improve the accuracy by which specific causes of dementia can be diagnosed in clinical. A comprehensive review of the literature was conducted to gather credible and up-to-date information regarding this disease from previous studies. This review study will therefore aid in the understanding of different types of dementia, as well as the genetic factors that contribute to dementia.
Dementia

Heart Failure with Preserved Ejection Fraction (HFpEF) is becoming more common as the United States (U.S.A) population ages, along with the present of obesity pandemic. In general, HFpEF is the most common type of heart failure (HF) found in general population, however, the elderly, especially women are mostly suffering from it. It is primarily caused by obesity, hypertension, coronary artery disease, and diabetes. Obesity is frequent in individuals with HFpEF. However, it may constitute a distinct phenotype of HFpEF, with distinct hemodynamic and anatomical problems. Obesity causes a systemic inflammatory response which can lead to cardiac fibrosis and endothelial dysfunction. Because most obese patients are still excluded from HFpEF clinical trials, further research is needed to evaluate the role of pharmacologic and interventional treatments in this expanding group. Thus, this review study will aid in the understanding of HFpEF and its association with obesity.
Heart Failure, Diastolic

Introduction: The association between clinical characteristics and endoscopic profile of acute non-variceal upper gastrointestinal bleeding (NVUGIB) patients with red blood cell (RBC) transfusion has not been well explored in Malaysia. Therefore, a retrospective study was performed using a five-years database to analyse the factors clinically and endoscopically for RBC transfusion. Methods: All adult NVUGIB patients who received RBC transfusion within the study period of 2012-2017 in Putrajaya Hospital were enrolled. There were 180 patients selected by systematic random sampling. Our composed clinical data include demography, risk factor, aetiology, presenting symptoms, Glasgow-Blatchford Score (GBS), endoscopic findings according to Forrest Classification and number unit of RBC transfusion. These data were analysed using Mann-Whitney U-Test, Pearson Correlation and Multiple Linear Regression (MLR). Results: Total 180 patients, the mean age was 63.9 (SD 11.6). Their presenting symptoms were melaena (62.8%), haematemesis (38.3%), and haematochezia (10.6%), with the cause of bleeding was gastric erosion (65.6%), duodenitis/duodenal ulcer (26.1%), and oesophagitis (7.8%). The mean GBS score was 10.7, and the number of RBC transfusion unit was 2.8. The Forrest Classification showed Forrest III (36.1%), Forrest IIc (22.8%), Forrest IIb and Ib (14.4%) respectively. Pearson’s Correlation showed a strong correlation between GBS and unit of RBC transfusion (r = 0.922, p-value <0.001). MLR analysis revealed haematochezia (p = 0.022) and higher GBS (p <0.001) were independent factors associated with a higher number of RBC transfusion unit. Conclusion: Haematochezia and higher GBS score were two predictive factors for a higher RBC transfusion unit in NVUGIB patients.