Screening for thalassaemia among group of students of a higher institution – our experience

Introduction: Thalassaemia is an inherited blood disorder and is a significant public health alarm in Malaysia with many not knowing they are carriers of this haemoglobin disorders. Materials and methods: This study conducted a one off collection of blood samples from 72 Malays students of International Islamic University Malaysia (IIUM) in Kuantan. Blood samples were subjected to conventional haemoglobin analyses that include full blood count and picture, HPLC, Haemoglobin electrophoresis and H-inclusion test. All samples were also genotyped for alpha thalassaemia–1 of Southeast Asia (a-Thal1SEA). Result: There were 17(23.6%) students who were diagnosed as thalassaemia carriers. Out of this, four (5.5 %) and six (8.3 %) students were presumptive β-thalassaemia trait and Haemoglobin-E trait as determined by the HPLC assay respectively. Nine (12.5%) students were genotyped a-Thal1SEA among whom two were also β-thalassaemia carriers. All thalassaemia cases had MCH of < 27pg. Nonetheless, two out of six Haemoglobin-E trait and three out of nine a-Thal1SEA carrier had MCV value of >80fL. Two out of four (50%) presumptive β -thalassaemia trait and one out of six (17%) students of presumptive Haemoglobin-E trait had family history of thalassaemia respectively. Conclusion: The high occurrence of the three common types of thalassaemia carrier (β, Hb-E and a-Thal1SEA thalassaemia) in our small group of subjects could be due to better participation of students who had family history of thalassaemia. The study reaffirmed the importance of molecular study for detection of alpha-thalassaemia and the use of MCH value of <27pg rather than MCV value of < 80fL for prediction of thalassaemia. KEYWORDS: Thalassaemia, screening, diagnosis, genetic carriers

Nigella sativa oil extracts improves dyslipidaemia in high fat diet (HFD) animal model

Introduction: Nigella sativa has been reported to have anti-inflammatory and antioxidative properties. We aimed to investigate the effects of Nigella sativa oil extract on the high fat diet (HFD) fed animal model. Methods: Thirty male Sprague-Dawley rats were used. Four groups (n=7) were fed with high fat diet (HFD) rat pellet orally for 10 weeks. The rats with HFD groups were subsequently randomly divided again into 4 groups. One group was continued with HFD while the other 3 groups were continued with the HFD in addition to Nigella sativa oil extract treatment at three different concentrations (0.5, 1 and 1.5 ml/kg/day) for another 4 weeks. Blood biochemical analysis and histological assessment of liver were subsequently performed. Results: Animals fed with HFD had increased aspartate aminotransferase (AST), alkaline phosphatase (ALP), albumin, cholesterol/HDL ratio, triglyceride (TG) levels, but decreased globulin, albumin/globulin ratio and high density lipoprotein (HDL) levels. Meanwhile, HFD animals treated with Nigella sativa oil extract showed a significant increase in the globulin and HDL levels, but reduced ALP, albumin, cholesterol/HDL ratio and TG levels. Nigella sativa oil extract at the higher doses displayed much better effect. Histologically the liver in all groups exhibited micro vesicular steatosis. Conclusions: Nigella sativa oil extracts improve the dyslipidaemia in animal models with HFD. KEYWORDS: Nigella sativa, high fat diet, dyslipidaemi

Preliminary analyses on detection of SYT-SSX fusion-transcripts in Synovial Sarcoma

Introduction: Synovial Sarcoma is a rare cancer and account for 5-10% of adult soft tissue sarcomas. The tumour exhibits unspecified histogenesis composed primarily of spindle cells with variable epithelial components. Despite establishment of some immunohistochemistry staining, making a definitive diagnosis of synovial sarcoma remains a challenging task. This is due to the histo-morphology and immunophenotypes similarities of this tumour to other types of soft tissue sarcoma. Objective: The current study aims to apply a molecular method for detection of SYT-SSX fusion transcript, a common molecular defect (>90% of the cases) in Synovial Sarcoma irrespective of the histologic subtypes. Method: Paraffin-embedded fixed-tissue (PEFT) blocks of 3 confirmed and 15 possible cases of Synovial Sarcoma were retrieved from Department of Pathology, Tengku Ampuan-Afzan Hospital, Kuantan and subjected to RNA purification using the standard spin column protocol. A one step direct RT-PCR was performed using SYT-SSX and PBGD primer sets for detection of SYT-SSX fusion gene and the reference gene PBGD respectively. Results: Our preliminary molecular analyses showed positive SYT-SSX fusion transcript in all 3 confirmed cases and 5 possible cases of synovial sarcoma. Further analysis is still on going for the remaining samples. Conclusion: Molecular detection of SYT-SSX fusion-transcript is useful in establishing the diagnosis of Synovial Sarcoma

Integration of Islamic values in undergraduate nursing program: An expository analysis

Nursing is a caring profession which has sympathy, compassion, and helping others inherently which is known as soft skills in current modern day. Those skills are the foundation of Islamic values for a Muslim graduate nurse who should pose. Hence, this study aimed to address the importance of integrating Islamic values in the undergraduate nursing program. This paper provides an account that is intended as an expository analysis method for the integration of Islamic values in the undergraduate nursing program. Paying attention not only to the material world of human but also his or her soul and spirituality dimension. Thus, the subject area to investigate the effect of the integration on Islamic values or soft skills in the undergraduate nursing program is extremely recommended for future study

Pyrosequencing-based quantitative identification of p16 methylation in diffuse large b-cell lymphoma at two centres in the east coast of malaysia

Introduction: Methylation of promoter region of p16 leading to gene silencing has been implicated in a wide range of malignancies including lymphomas. In diffuse large B cell lymphoma (DLBCL) particularly, a varying percentage of epigenetic inactivation of p16 promoter region was observed ranging from 16 - 54%. However, quantitative analysis of p16 promoter methylation in DLBCL has not been extensively studied in Malaysia. Objective: This study aims to quantitatively analyse p16 methylation in DLBCL samples using pyrosequencing technique. Methods: Genomic DNA was extracted from 16 formalin-fixed paraffin-embedded lymphoma tissue blocks from patients diagnosed with DLBCL. Samples were retrieved from Hospital Tengku Ampuan Afzan, Pahang and Hospital Universiti Sains Malaysia, Kelantan. Primers were designed to amplify bisulfite-treated DNA targeting p16 promoter region. Methylation status of 7 CpG sites was determined by pyrosequencing. Results: All the 16 samples studied showed promoter methylation of p16. The range of mean methylation percentage was between 18 to 81%. Conclusion: The present study has successfully measured the level of methylation of p16 in all 7 CpG sites despite the limitation in sample size. Since p16 methylation is a common event in our series of DLBCL cases, it is worth including a larger sample size in future studies to increase the chance of finding a significant correlation with clinical parameters

p16 tumor suppressor gene methylation in diffuse large B cell lymphoma: a study of 88 cases at two hospitals in the East Coast of Malaysia

Introduction: p16 gene plays an important role in the normal cell cycle regulation. Methylation of p16 has been reported to be one of the epigenetic events contributing to the pathogenesis of diffuse large B-cell lymphoma (DLBCL) which occurring at varying frequency. DLBCL is an aggressive and high-grade malignancy which accounts for approximately 30% of all non-Hodgkin lymphoma cases. However, little is known regarding the epigenetic alterations of p16 gene in DLBCL cases in Malaysia. Therefore, the objective of this study was to examine the status of p16 methylation in DLBCL. Methods: A total of 88 formalin-fixed paraffin-embedded DLBCL tissues retrieved from two hospitals located in the east coast of Malaysia, namely Hospital Tengku Ampuan Afzan (HTAA) Pahang and Hospital Universiti Sains Malaysia (HUSM) Kelantan, were chosen for this study. DNA specimens were isolated and subsequently subjected to bisulfite treatment prior to methylation specific-PCR. Two pairs of primers were used to amplify methylated and unmethylated regions of p16 gene. The PCR products were then separated using agarose gel electrophoresis and visualised under UV illumination. SPSS version 12.0 was utilised to perform all statistical analysis. Result: p16 methylation was detected in 65 of 88 (74%) samples. There was a significant association between p16 methylation status and patients aged >50 years old (p=0.04). Conclusion: Our study demonstrated that methylation of p16 tumor suppressor gene in our DLBCL cases is common and significantly increased among patients aged 50 years and above. Aging is known to be an important risk factor in the development of cancers and we speculate that this might be due to the increased transformation of malignant cells in aging cell population. However, this has yet to be confirmed with further research and correlate the findings with clinicopathological parameters

Soft skills elements in structured clinical skill assessment: a qualitative study

Recognition of the importance of soft skills in the current healthcare setting has gained increasing momentum due to the high demand from society and employers

Self-assessment questionnaire development for soft skills competency and core value evaluations

Soft skills play a vital role for providing excellent customer service in the healthcare setting. This study aims to develop and assess the instrument validity and reliability before measuring the levels of soft skills competency and core value internalization on staffs at the Sultan Ahmad Shah Medical Centre @International Islamic University Malaysia (SASMEC@IIUM). A self-assessment questionnaire was developed through three phases. The first phase involved reviewing and identifying relevant literatures and existing soft skills assessment instruments through bibliographic searches and expert consultations. A conceptual model was then established based on the selected conceptual frameworks after determining all relevant soft skill domains. The second phase involved generating relevant items, removing duplicate or irrelevant items, and appraising the content validity by three experts. The third phase was data collection, wherein the finalized instrument was distributed to 32 staff of SASMEC@IIUM via google forms. The instrument reliability was investigated through internal consistency reliability or Cronbach’s alpha, with all items, except for the construct ‘gratitude’, achieving acceptable values by exceeding the threshold value of 0.7. Subsequently, two gratitude items were removed from the questionnaire. The current instrument and theoretical framework employed in the self-assessment questionnaire development are valid and reliable for the actual application

Soft skill components in structured nursing clinical skill assessment on assisted procedures: a clinical audit

Background: Assisted procedures in nursing involve scenarios where nurses are tasked with supporting physicians in the execution of medical procedures. Nursing academics play a crucial role in cultivating appropriate attitudes towards nursing students. This study aimed to examine the soft skill elements in objectively structured clinical skill assessment on assisted procedures in the undergraduate nursing programme. Methods: A clinical audit was carried out on the retrospective structured clinical skill assessment exam questions by using the clinical skill assessment index V (CSAI-V) instrument. A total of 3 assisted procedures set of exam questions were collected from 7 higher learning institutions in Malaysia where they offered the undergraduate nursing programme. The data were analysed descriptively. Results: There were 3 assisted procedures out of 237 collected exam documents found and analysed in this study. The assisted procedures were grouped into 7 types to make them more specific. Although there are nine soft skill elements were identified in relation to assisted procedures, including communication, social and responsibility, critical thinking, problem-solving, teamwork, leadership, professional and ethical decision-making, numeracy, and interpersonal skills. However, none of the identified nine soft skill elements were found in the assessment rubrics. Conclusion: Thus, the current assisted procedure checklist needs improvement, especially the soft skills components. Besides, higher-learning nursing institutions should visit and revise the content of their checklist and the related materials if they are concerned about quality graduates

Expression of microrna-101 in formalin-fixed paraffin- embedded samples of nasopharyngeal carcinoma

Nasopharyngeal carcinoma (NPC) is among the five most common malignancies in Malaysia. Most NPC patients are diagnosed at late stages of the disease which complicates the clinical management of the patients. Identification of new reliable biomarker is crucial to improve early diagnosis of NPC and increase the survival rate of patients. Recent study found that microRNAs (miRNAs), particularly miR-101, were involved in the tumorigenesis of head and neck cancer where NPC samples were included in the study. This study was conducted to observe the expression of miR-101 in NPC tumour tissues and compare its consistency with previous study as a step towards finding the new biomarker for NPC. The biopsy samples were obtained from hospitals and verified histologically using hematoxylin and eosin method for tissue classification. Total RNA was extracted from NPC tissues and normal nasopharyngeal epithelium tissues. The expression of miR-101 in NPC was quantified using quantitative polymerase chain reaction (qPCR) method. The differential expression of miR-101 in NPC as compared to normal nasopharyngeal epithelium tissues was analysed using 2-ΔΔCT calculation. The significance of the differential expression was analysed using SPSS software. Five samples have been verified as NPC and three samples were normal nasopharyngeal epithelium. The differential expression calculation found that miR-101 was downregulated in NPC as compared to normal nasopharyngeal epithelium tissues, which consistent with previous study. However, the differential expression was not significant. Therefore, our finding provides a preliminary result towards embarkment of a larger and comprehensive study. © 2019 Malaysian Society for Biochemistry and Molecular Biology. All rights reserved