Awareness, knowledge and attitudes towards epilepsy among rural populations in East Coast Peninsular Malaysia: A preliminary exploration

AbstractThis study was carried out to gauge the preliminary insight regarding epilepsy among the rural society. The purposes of this study were: (1) to determine general level of awareness, knowledge and attitudes (AKA) towards epilepsy among rural communities, (2) to compare the AKA level based on socio-demographic characteristics and (3) to investigate rural cohort's perception of the best epilepsy treatment, preference for epilepsy information delivery and preference for mode of transportation to seek medical treatment. This prospective, cross sectional study included a sample of 615 rural residents enrolled via cluster sampling in East Coast region of Peninsular Malaysia (mean age=41.6±18.02, female=56.6%, married=65.5%, Malay=94.0%, monthly income≤RM 500=56.9%). The Total AKA level was generally low (2.66±0.7). Gender-wise no significant difference was shown regarding AKA level (p>0.05). However, respondents with higher education significantly possessed better attitudes and higher Total AKA level compared to those with lower education level (p<0.001). Employed respondents reported significantly more favourable attitudes than unemployed respondents (p=0.011). Additionally, higher income rural cohorts possessed both significantly better attitudes and better AKA. These rural communities perceived modern medicine as the best epilepsy treatment (56.60%), preferred to obtain direct epilepsy-related information from health personnel (60.4%) and chose to use their own car to seek medical treatment in hospital (76.30%). The outcomes of this preliminary study signified the need to devise a dedicated epilepsy education program for implementation among rural residents. Increased AKA level in the society could enhance the people's acceptance, reduce stigmatisation and improve health-related quality of life (HRQoL) for epilepsy patients and their family

The Spetzler-Martin grading system and management of patients with intracranial Arteriovenous malformation in a tertiary referral hospital

Introduction: An arteriovenous malformation (AVM) is an abnormal collection of blood vessels in which arterial blood flows directly into the draining vein without the normal interposed capillaries. The Spetzler-Martin grading system has been widely accepted worldwide to estimate the pretreatment risks and predict the outcome of patients with intracranial AVM. In Malaysia, we still do not have the baseline data of this grading system. Methods: A total of 33 patients from a tertiary referral hospital diagnosed with intracranial AVM based on neuroimaging findings over a 4-year period were studied. Medical records were traced and neuroimaging findings were analysed. The AVMs were graded according to the Spetzler-Martin grading system and Fisher’s exact test was used to assess statistical difference between the grades of the AVM and management plan for the patients. Results: Four patients were graded as Grade 1, 9 patients as Grade II, 10 patients as Grade III, 6 patients as Grade IV and 4 patients as Grade V. Ten patients were treated conservatively; six patients underwent surgery and embolisation respectively. Four patients underwent radiosurgery and a combination of embolisation while surgery and radiosurgery were given to 5 patients and 2 patients respectively. Statistically significant difference (p=0.016) was found between the Spetzler-Martin grading system and the management of intracranial AVMs. Conclusion: The management decision was not made based on the grading of the AVMs. It is recommended that all AVM patients be routinely graded according to this system prior to treatment. Keywords: Intracranial arteriovenous malformation

The effects of MDMA on brain: An in vivo study in rats

Background and objective : 3, 4-Methylenedioxymethamphetamine (MDMA) is a powerful central nervous system stimulant that acts by increasing the activity of several neurotransmitter systems. This study aimed to investigate the effect of different doses of MDMA on the level of serotonin in the brain measured from the cerebrospinal fluid (CSF) and their effects on the neurons. Materials and methods : Twenty-six adult male rats were divided into 4 groups. The control group (n=7) received intraperitoneal (IP) injections of 1 mL/gm normal saline twice daily for one week. The MDMA treated groups (n= 6/7) were further subdivided into 3 groups, each receiving 5, 10 or 15mg/kg MDMA intraperitoneal (IP) injections twice daily for one week ; respectively. 24 hours after the last injection of the rats, the CSF was collected. The brains were dissected and processed for paraffin sections and stained by cresyl etch violet stain. Histology, morphometry and statistical analysis were done. Results : The administration of different doses of MDMA significantly increased the level of serotonin in comparison with the control group. The morphometry study indicated that the number of intact neurons in the hippocampus significantly decreased following the administration of different doses of MDMA comparing to the control group. The results also indicated that there was a strong negative correlation between the serotonin levels and the number of intact neurons. Conclusion : MDMA administration even at a low dose had degenerative effects on the neurons in the hippocampus as evidenced by morphometric study, and the intake should be avoided

Development of biodegradable sustained-release damnacanthal nanocapsules for potential application in in-vitro breast cancer studies

The “noni” species of Morinda citrifolia L., is using in traditional medicine in the tropical country for over 2000 years. Noni fruit has come from the Morinda citrifolia tree which is called Rubiaceae, and it is from the coffee family. It is a perennial herb whose ripe fruit has a robust butyric acid smell and flavor. Recently scientists have proven that this fruit has antioxidant and antibiotic properties in vitro. An anthraquinone, damnacanthal, is one of the constituents of Morinda citrifolia. It has been demonstrated to have anti-cancer properties. Damnacanthal has low water solubility and low bioavailability. Formulating of damnacanthal into the biodegradable nanocapsule drug delivery system may increase its bioavailability. Various formulations of damnacanthal would be developed to enable the selection of a dosage form that could offer the provision of the anti-cancer bioactive substance with suitable sustained- or controlled release properties. The efficiency of extraction of damnacanthal will be compared using both conventional and traditional method. Both the damnacanthal and an anthraquinone active compounds extracted from noni roots, are currently being studied in the context of anti-cancer study. Soon, the medical values, bioactivities and nutritional of this fruit can be assessed, especially its anti-cancer activity, this fruit extract could play an outstanding economic role in Malaysia and other tropical countries

Controlled release of lysozyme from double-walled poly(Lactide-Co-Glycolide) (PLGA) microspheres

Double-walled microspheres based on poly(lactide-co-glycolide) (PLGA) are potential delivery systems for reducing a very high initial burst release of encapsulated protein and peptide drugs. In this study, double-walled microspheres made of glucose core, hydroxyl-terminated poly(lactide-co-glycolide) (Glu-PLGA), and carboxyl-terminated PLGA were fabricated using a modified water-in-oil-in-oil-in-water (w1/o/o/w2) emulsion solvent evaporation technique for the controlled release of a model protein, lysozyme. Microspheres size, morphology, encapsulation efficiency, lysozyme in vitro release profiles, bioactivity, and structural integrity, were evaluated. Scanning electron microscopy (SEM) images revealed that double-walled microspheres comprising of Glu-PLGA and PLGA with a mass ratio of 1:1 have a spherical shape and smooth surfaces. A statistically significant increase in the encapsulation efficiency (82.52 ± 3.28%) was achieved when 1% (w/v) polyvinyl alcohol (PVA) and 2.5% (w/v) trehalose were incorporated in the internal and external aqueous phase, respectively, during emulsification. Double-walled microspheres prepared together with excipients (PVA and trehalose) showed a better control release of lysozyme. The released lysozyme was fully bioactive, and its structural integrity was slightly affected during microspheres fabrication and in vitro release studies. Therefore, double-walled microspheres made of Glu-PLGA and PLGA together with excipients (PVA and trehalose) provide a controlled and sustained release for lysozyme

Dynamic renal scintigraphy: technetium99m (Tc99m) diethylenetriaminepentaacetic Acid (DTPA), breast cancer center of International Islamic University Malaysia (IIUM) experience

Technetium99m Diethylenetriaminepenta acetic acid (DTPA) has been used in renal imaging over the last few decades. It is one of excellence radiotracer for evaluation of the renal parenchymal function. Breast cancer center designed a prospective study to evaluate the ability of Tc99m DTPA scintigraphy to detect renal parenchymal functions in adult patient with Endocytosis. The purpose of this paper is to provide a better understanding of the use of Tc99m DTPA as a tool in dynamic renal imaging and highlight Breast cancer center, IIUM experience using Tc99m DTPA for the assessment of renal parenchymal function. Retrospective analysis of 73 patients from March 2015 to December 2016 using Tc99m DTPA renal scintigraphy is presented in this study. The clinical profile and scintigraphy findings of all the patients were analyzed. Dynamic renal scintigraphy is superior in measuring kidney function (GFR, ERPF), compared to investigations based on the serum creatinine value. Number of uses in of 99mTc-DTPA indicated that this radio radiopharmaceuticals quality control is very crucial in preparation and need to ensure it efficiency and safety when administered to patients. Tc99m DTPA remains a very useful tool to assess renal parenchymal function and specific renal pathology. CTc99m DTPA scintigraphy diagnostic methods can improve the sensitivity and specificity to establish renal parenchymal function. During the follow-up the renal parenchymal functions, improved in all cases. In IIUM breast cancer center present here and experience of radionuclide studies in the evaluation of renal parenchymal function at the Nuclear Medical Centre

The first Malay database toward the ethnic-specific target molecular variation

BACKGROUND:The Malaysian Node of the Human Variome Project (MyHVP) is one of the eighteen official Human Variome Project (HVP) country-specific nodes. Since its inception in 9(th) October 2010, MyHVP has attracted the significant number of Malaysian clinicians and researchers to participate and contribute their data to this project. MyHVP also act as the center of coordination for genotypic and phenotypic variation studies of the Malaysian population. A specialized database was developed to store and manage the data based on genetic variations which also associated with health and disease of Malaysian ethnic groups. This ethnic-specific database is called the Malaysian Node of the Human Variome Project database (MyHVPDb). FINDINGS:Currently, MyHVPDb provides only information about the genetic variations and mutations found in the Malays. In the near future, it will expand for the other Malaysian ethnics as well. The data sets are specified based on diseases or genetic mutation types which have three main subcategories: Single Nucleotide Polymorphism (SNP), Copy Number Variation (CNV) followed by the mutations which code for the common diseases among Malaysians. MyHVPDb has been open to the local researchers, academicians and students through the registration at the portal of MyHVP ( http://hvpmalaysia.kk.usm.my/mhgvc/index.php?id=register ). CONCLUSIONS:This database would be useful for clinicians and researchers who are interested in doing a study on genomics population and genetic diseases in order to obtain up-to-date and accurate information regarding the population-specific variations and also useful for those in countries with similar ethnic background

Familial hypercholesterolaemia in children and adolescents from 48 countries: a cross-sectional study

Background: Approximately 450 000 children are born with familial hypercholesterolaemia worldwide every year, yet only 2·1% of adults with familial hypercholesterolaemia were diagnosed before age 18 years via current diagnostic approaches, which are derived from observations in adults. We aimed to characterise children and adolescents with heterozygous familial hypercholesterolaemia (HeFH) and understand current approaches to the identification and management of familial hypercholesterolaemia to inform future public health strategies. Methods: For this cross-sectional study, we assessed children and adolescents younger than 18 years with a clinical or genetic diagnosis of HeFH at the time of entry into the Familial Hypercholesterolaemia Studies Collaboration (FHSC) registry between Oct 1, 2015, and Jan 31, 2021. Data in the registry were collected from 55 regional or national registries in 48 countries. Diagnoses relying on self-reported history of familial hypercholesterolaemia and suspected secondary hypercholesterolaemia were excluded from the registry; people with untreated LDL cholesterol (LDL-C) of at least 13·0 mmol/L were excluded from this study. Data were assessed overall and by WHO region, World Bank country income status, age, diagnostic criteria, and index-case status. The main outcome of this study was to assess current identification and management of children and adolescents with familial hypercholesterolaemia. Findings: Of 63 093 individuals in the FHSC registry, 11 848 (18·8%) were children or adolescents younger than 18 years with HeFH and were included in this study; 5756 (50·2%) of 11 476 included individuals were female and 5720 (49·8%) were male. Sex data were missing for 372 (3·1%) of 11 848 individuals. Median age at registry entry was 9·6 years (IQR 5·8-13·2). 10 099 (89·9%) of 11 235 included individuals had a final genetically confirmed diagnosis of familial hypercholesterolaemia and 1136 (10·1%) had a clinical diagnosis. Genetically confirmed diagnosis data or clinical diagnosis data were missing for 613 (5·2%) of 11 848 individuals. Genetic diagnosis was more common in children and adolescents from high-income countries (9427 [92·4%] of 10 202) than in children and adolescents from non-high-income countries (199 [48·0%] of 415). 3414 (31·6%) of 10 804 children or adolescents were index cases. Familial-hypercholesterolaemia-related physical signs, cardiovascular risk factors, and cardiovascular disease were uncommon, but were more common in non-high-income countries. 7557 (72·4%) of 10 428 included children or adolescents were not taking lipid-lowering medication (LLM) and had a median LDL-C of 5·00 mmol/L (IQR 4·05-6·08). Compared with genetic diagnosis, the use of unadapted clinical criteria intended for use in adults and reliant on more extreme phenotypes could result in 50-75% of children and adolescents with familial hypercholesterolaemia not being identified. Interpretation: Clinical characteristics observed in adults with familial hypercholesterolaemia are uncommon in children and adolescents with familial hypercholesterolaemia, hence detection in this age group relies on measurement of LDL-C and genetic confirmation. Where genetic testing is unavailable, increased availability and use of LDL-C measurements in the first few years of life could help reduce the current gap between prevalence and detection, enabling increased use of combination LLM to reach recommended LDL-C targets early in life

PKM Pendampingan Pembelajaran Furudhul Ainiyah melalui Media Pembelajaran di Madrasah Tsanawiyah (MTs) Negeri 1 Probolinggo

Lembaga Pendidikan tingkat MTs, memerlukan stategi tersendiri dalam proses pembelajaran yang diberikan kepada siswa. Hal ini disebabkan kondisi psikologis siswa adalah masa transisi dari anak-anak menjadi dewasa, pada masa transisi ini guru dituntut untuk lebih kreatif dalam melaksanaan belajara mengajar. Kegiatan pengabdian kepada masyarakat ini ingin memberikan pendampingan dalam pembelajaran Furudhul Ainiyah di MTs Negeri I Probolinggo dengan harapan pembelajaran  Furudhul Ainiyah bisa diterima dengan baik dan dipraktikan dalam kehidupan sehari-hari siswa. Hasil dari pengabdian kepada masyarakat ini antara lain 1). Para peserta didik sudah bisa berwudhu dengan benar. 2).  Para peserta didik sudah bisa melakukan gerakan- gerakan sholat dengan benar menurut ilmu fiqh. 3).  Para peserta didik lebih rapi dalam menata sof saat akan melakukan sholat berjamaah. 4). Para peserta didik mampu membaca al-qur`an secara benar menurut ilmu tajwid 5).Para peserta didik lebih semangat dalam mengerjakan shalat yang lima waktu. 6). Sopan dan santun para peserta didik kepada para tenaga pendidik sudah semakin bagu