Introduction: Paediatric asthma, a prevalent chronic disease among children in Malaysia, can have its morbidity reduced through effective education. This study aims to assess the knowledge and perceptions of childhood asthma in the Malaysian general population. Materials and methods: A prospective study was conducted among visitors attending paediatric wards and clinics at the Institute of Paediatric Hospital Kuala Lumpur. Participants, who gave their consent, completed validated questionnaires in written form that evaluated their knowledge of asthma symptoms, triggering factors, medication, prevention, and myth perception. A higher score indicated a deeper understanding of asthma. Results: The study included 200 participants, predominantly female (88%), with a median age of 35.5 years. Among them, 12% were asthmatics, and 36% had a family member with asthma. The primary source of asthma information was electronic media (82%). The average score for knowledge of asthma symptoms, triggering factors, medication prevention and myth was 62.13% (SD 17.6). 62.88% (SD 16.3), 56.7% (SD 16.5), 82% (SD 15.1) and 57.8% (SD 15.4) respectively. Asthma myth perception and source of asthma information from family members were strongly related (p-value of 0.042). Conclusion: The general population exhibits an average understanding of asthma, comparable to findings from previous studies in other countries. This highlights the need for targeted educational interventions to dispel myths and enhance asthma knowledge.

Dengue is a mosquito-transmitted infection endemic in tropical and subtropical locations of the world where nearly half of the world’s population resides. The disease may present as mild febrile illness to severe and can even be fatal if untreated. There are four genetically related but antigenically distinct dengue virus (DENV) serotypes. Immune responses to DENV infection are in general protective but under certain conditions, they can also aggravate the disease. The importance of the cellular immune responses and the antibody responses involving IgG and IgM has been well-studied. In contrast, not much has been described on the potential role of hypersensitivity reactions involving IgE in dengue. Several studies have shown elevated levels of IgE in patients with dengue fever, but its involvement in the immune response against the virus and disease is unknown. Activation of mast cells (MCs) and basophils mediated through dengue-specific IgE could result in the release of mediators affecting dengue virus infection. The present review explores the relationships between the induction of IgE in dengue virus infection, and the potential role of MCs and basophils, exploring both protective and pathogenic aspects, including antibody-dependent enhancement (ADE) of infection in dengue.

Staphylococcus aureus is a common bacterial pathogen known to cause various kinds of infections due to its repertoire of virulence factors. This study aimed to investigate the distribution of 19 types of virulence genes among clinical isolates of methicillin-susceptible S. aureus (MSSA) using the polymerase chain reaction. A total of 109 MSSA isolates, i.e., 63 hospital-associated (HA) and 46 community-associated (CA) were collected from Hospital Sultanah Nur Zahirah, the main tertiary hospital in Terengganu, Malaysia, from July 2016 to June 2017. The most frequent virulence genes detected were hla (78.9%, n=86) and hld (78.0%, n=85) encoding hemolysins, lukED (56.9%, n=62) encoding leukotoxin ED, followed by seb (26.6%, n=29) and sea (24.8%, n=27) encoding enterotoxins. Among 34 (31.2%) isolates carrying six or more virulence genes, only five were multidrug resistant (MDR) while the remaining isolates were susceptible. Significant associations were discovered between the hld gene with CA-MSSA (p=0.016) and the seo gene with HA-MSSA (p=0.023). However, there is no significant association between virulence genes among the different types of infection. The clinical MSSA isolates in Terengganu showed high prevalence and high diversity of virulence gene carriage.

Introduction: The Asthma Knowledge Questionnaire developed by C. Rodriguez Martinez in 2005 was proved to be a valid instrument for asthma knowledge assessment for parents of children with asthma. 17 items were included in the questionnaire including their myths and beliefs, knowledge, and associated aspects. The objective of this study is to analyse the validity and reliability of the Malay version of the questionnaire. Methods: Forward-Backward translation method was used by language experts to obtain the Malay version of the questionnaire. The questionnaire was then given to twenty respondents at the Paediatric Institute Hospital Kuala Lumpur to ensure the clarity and relevance of the questionnaire as a pilot study. Subsequently, 60 respondents who fulfilled the inclusion and exclusion criteria were selected to proceed with the reliability test of the Malay version questionnaire. The results were analysed with SPSS version 26.0. The reliability and internal consistency were confirmed by intra-class correlation and Cronbach’s alpha coefficient. Results: There were 60 respondents to the questionnaire consisting of parents and caretaker who has child with asthma at the Institute of Paediatric Hospital Kuala Lumpur. The mean age of respondents was 34 ± 7.5year old. 91.7% of the respondents were female. The overall Cronbach’s alpha coefficient of the questionnaire was 0.84. Conclusion: The Malay version of the Asthma Knowledge Questionnaire has a good degree of validity, reliability and is culturally acceptable equivalent to the original version.

Healthcare providers are responsible for performing medical check-ups, analyse and interpret patient's laboratory results. It is common for an initially asymptomatic patient to receive abnormal results including liver enzymes such as alkaline phosphatase (ALP). The concern in these patients is the cut-off value for mildly elevated levels that requires intervention. This paper reports a case of liver malignancy in a 32-year-old man who presented with a mild elevation of ALP level less than five times the upper limit of normal. The patient had no clinical symptoms. Early ultrasound liver assessment showed dilated common bile duct, which led to an urgent CT scan of the liver that revealed supportive features of fibrolamellar carcinoma. The patient was managed successfully with early partial hepatectomy that has saved him from morbidity and mortality of liver malignancy. Indeed, liver malignancy can be detected early in a health clinic from a further assessment of trivial elevation of ALP.

Introduction: The World Health Organisation (WHO) has estimated that 80% of people with osteoarthritis (OA) have movement limitations while 25% of them cannot perform their major daily activities, thus resulting in a decline of their nutritional status and quality of life (QOL). Therefore, this study aimed to compare the nutritional status and healthrelated quality of life (HRQOL) of OA patients between gender and age group. Material and methods: A cross-sectional study was conducted on 131 OA patients in Rehabilitation Health Organisation, Terengganu. Socio-demographic, clinical, lifestyle histories, 24-hour dietary intake and HRQOL were assessed using a structured questionnaire. Results: Knee and/or hip OA patients recruited consisted of 19.1% of men and 80.9 % of women collectively with a mean age of 61.81 (9.28) years ranging from 38 to 83 years. The percentages of underweight, normal, overweight, and obese patients were 1.5%, 12.2%, 36.7%, and 49.6%, respectively. Further assessment of HRQOL showed that the highest mean score was obtained by the social functioning (SF) domain of 41.25 (27.16), while the mental domain scored the least mean score of 21.15 (20.92). In terms of gender breakdown, the males had significantly greater weight and height but lower body fat (BF) compared to their female counterparts, as well as a significantly higher energy, carbohydrate and protein intake. According to the age group, patients aged < 60 years had significantly greater weight, height, and BF than those aged ≥ 60 years. Conclusion: This study is an important baseline reference for proper OA management and prevention by providing crucial nutritional status and HRQOL information.

Background: Astrocytic gliomas are the most common primary brain tumors that developed from glial origin. The angiogenic cell population from brain tumor enhances the recruitment of circulating cancer stem cells homing towards tumor site. Objectives: This study aimed to investigate the tumor angiogenic cell population that stained with CD133+ and VEGFA+ markers and its association with circulating cancer stem cell (CD133+/VEGFR2-) population in the peripheral blood mononuclear cells (PBMCs) of astrocytic glioma patients.Methods: A total of 22 astrocytic glioma patients from Hospital Universiti Sains Malaysia who consented to the study were included. Tumors (n=22) were sliced and stained with CD133+ and VEGFA+ angiogenic markers and counter stained with DAPI. The circulating cancer stem cells (CD133+/VEGFR2-) in PBMCs (n=22) were quantified using FACS based on the expression of CD133 and VEGFR2 markers. The paired t-test and Pearson correlation were used for the data analysis.Results: The percentage of angiogenic cell population was significantly higher in brain tumor compared to adjacent normal brain tissue (1.25 ± 0.96% vs. 0.74 ± 0.68%; paired t-test=2.855; df=21, p = 0.009). Positive correlation was found between the angiogenic cells of brain tumor tissue and adjacent normal brain tissue (Pearson correlation, r = 0.53, p = 0.011). Significant positive correlation was found between angiogenic cells in glioma tumor and cancer stem cells in peripheral circulating systems of astrocytic glioma patients (Pearson correlation, r = 0.42, p = 0.049).Conclusion: Angiogenic cells in the brain tumor resident promote the recruitment of circulating cancer stem cells homing to the tumor site and induce the proliferation and growth of the tumor in astrocytic glioma patients.

The purpose of this study was to assess the association of bottle feeding and oral hygiene practices with the severity of caries among 3 to 5-year-old children with Early Childhood Caries (ECC). This cross-sectional study was carried out on pediatric dental patients with ECC attending a public university hospital. The parents or guardians were interviewed for the bottle-feeding pattern and oral hygiene practices followed by a clinical dental examination of their children with ECC. Data analysis was done using Chi squared test. Out of 32 children, 69% had severe early childhood caries with mean dft of 8.88. In this study, 87.5% of the subjects had a history of bottle feeding, with 53.1% still being bottle fed at the time of study. Current bottle-feeding habit was found to be statistically significant with the severity of caries (p=0.021). Majority (69 %) of the children were introduced to tooth brushing only after 1 year of age. About 40% of the children consumed either pre-chewed rice and/or shared spoons or feeding utensils with their parents or siblings but there was no significant association with the severity of caries (p=1.00). Because of its association with ECC, prolonged bottle feeding is significantly associated with the severity of caries in our study population. Besides, vertical and horizontal transmission of bacteria was also a risk factor for ECC, but it did not show any significant association with severity of ECC.

Objective: This study examined the influence of visual art therapy techniques in reducing anxiety levelamong 4 to 6 years old paediatric dental patients.Methods: Eleven subjects were selected among 4 to 6 years old paediatric dental patients. The initialreaction towards dental procedure/treatment was evaluated using Frankl Behavior Rating Scale. Theanxiety level was assessed by using Malay-Modified Child Dental Anxiety Scale (MCDASf) to measurea child situational anxiety of pre- and post-treatment. Visual art making activities included free drawing,clay moulding and collage technique. The participant reaction to dental treatment was assessed by usingFrankl Behavioural Rating Scale for two subsequent independent visits in two weeks interval. Medianand Ordinal Test ranked the variables score of behavioural reaction towards dental treatment and anxietylevel.Results: Play-doh (PD) subjects could accept dental procedures more if compared to free drawing (FD)and storytelling by collage (ST) subjects, which has lower post treatment-median scores in Visit 1 andVisit 2, FD and ST subjects need more time to show positive attitude towards dental treatment.Conclusion: These findings suggest dental anxiety level of children aged 4 to 6 years old reduced afterthe art therapy and play-doh(clay-moulding technique) is the art making activity of choice among 4 to 6years old paediatric dental patients.

OBJECTIVETo demonstrate a noninvasive large mammalian genetic sampling method using blood meal obtained from a tabanid fly.

METHODSBlood meal was recovered from the abdomen of an engorged tabanid fly (Haematopota sp.) which was captured immediately after biting a Sumatran rhino in captivity. The blood was applied on to a Whatman FTA(®) blood card. Subsequent laboratory work was conducted to extract, amplify and sequence the DNA from the sample. Validation was done by sampling the hair follicles and blood samples from the rhinoceros and subjecting it to the same laboratory process.

RESULTSBLAST search and constructed phylogenetic trees confirmed the blood meal samples were indeed from the rhino.

CONCLUSIONSThis method could be used in the field application to noninvasively collect genetic samples. Collection of tabanids and other haematophagous arthropods (e.g. mosquitoes and ticks) and other blood-sucking parasites (e.g. leeches and worms) could also provide information on vector-borne diseases.

Animals ; Diet ; veterinary ; Diptera ; genetics ; physiology ; Endangered Species ; Female ; Food Chain ; Indonesia ; Insect Bites and Stings ; blood ; veterinary ; Molecular Sequence Data ; Perissodactyla ; Phylogeny ; Polymerase Chain Reaction ; veterinary ; Sequence Analysis, DNA ; veterinary