Low methylation of matrix metalloproteinase 1 (MMP1) is associated with preterm labour in Malaysian mothers

Preterm births comprise 10.6% of livebirths worldwide and account for 35% of deaths among newborn babies. Understanding DNA methylation may offer basic knowledge in the understanding of pathogenesis of preterm labour. The study was undertaken to determine DNA methylation of matrix metalloproteinase 1 (MMP1) promoter in term and preterm labour using methylation-specific polymerase chain reaction (MSP). Thirty maternal venous blood samples (n=15 each) of term and preterm labour was subjected to bisulfite treatment prior to MSP. This result was then validated using DNA sequencing. Evaluation of the sequencing results by CpG islands analysis was performed using the ClustalW and SPSS software. Primers for MMP1 were located between -1226 and -1378 upstream from the transcription start site (TSS) that consisted five CpG islands. Preterm labour group had significantly lower methylated CpG islands with 39 out of total 75 (52%) compared to the term labour that has 49 out of 75 methylated CpG islands (65.33%) (t=0.694, p<0.05). Methylation occurred in 4 out of 5 methylated CpG islands in the MMP1 promoter where it only involved 2 preterm samples (13.33%) and 7 term samples (46.47%). This data suggested there were significant lower percentage of methylated MMP1 in preterm labour. Higher percentage of methylated MMP1 as observed in the term labour, will probably reduce the expression of MMP1, thus maintaining fibrillar collagen strength on the amniotic membrane and subsequently maintain the pregnancy till term. In conclusion, preterm labour has higher percentage of methylated CpG compared with term labour in MMP1 gene

Augmented reality (AR) and virtual reality (VR) applications during Covid-19 pandemic among preclinical medical and dentistry students: a mini-review

The efficacy of online learning in delivering theoretical knowledge with appropriate content to students is imperative, especially in the Covid-19 pandemic era. Substantial interactive teaching materials were developed for higher education. However, some were designed immensely general, especially in fulfilling the syllabus of preclinical medical and dentistry students. Augmented reality (AR) is an interactive three-dimension (3D) experience that uses computers to overlay virtual information in the real world whereas virtual reality (VR) is a computer-generated artificial recreation of a real-life experience or situation. Interestingly, both can be complemented and integrated into online and traditional teaching methods. Implementation of these technologies will increase the learning efficacy in understanding the human body’s anatomical and physiological changes in the normal or pathological state. As AR and VR technologies are continuously evolving, this review provides the preview and current updates on AR and VR applications in medical and dentistry education which may benefit the educators within these specialities

Face mask usage during Covid-19 pandemic: prevalence and factors associated in Malaysian Medical School

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by a newly discovered coronavirus strain. Anxiety, anticipation, and lack of knowledge in the previous experience on severe acute respiratory syndrome (SARS) and influenza A virus subtype H1N1 (H1N1) pandemic have a substantial impact on significant public health behaviours including wearing face mask in public spaces. We investigate the prevalence of face mask usage and its associated factors during COVID19 amongst students and staff of the Faculty of Medicine and Health Sciences (FMHS), Universiti Putra Malaysia (UPM). Using a cross-sectional study, 220 respondents participated in an electronic version of a self-administered questionnaire. Analyses were performed using the Chi-square test, IBM SPSS Statistics 25, with statistical significance at p<0.05. Out of the 220 respondents, 197 (89.5%) reported that they wore face masks all the time. Most of the respondents (90.3%) had a high level of precautionary measures against COVID-19, 89.6% selected the internet as their source of information and 90.9% had a good attitude level towards measures against COVID-19. There were significant associations between hygienic practices (p=0.001), source of information (internet) (p=0.025), and attitude towards COVID-19 (p=0.001) with face mask usage. This study demonstrated a high prevalence (89.5%) of face mask usage during the COVID-19 outbreak

Association between level of knowledge gained, confidence, motivation and flexibility on types of learning for bedside teaching among clinical students in four Malaysian medical schools during Covid-19 pandemic

Introduction: With the arise of the COVID-19 pandemic, higher institutions are forced to change the method of delivery for bedside teaching sessions from face-to-face to online learning. However, online learning was found not effective in delivering practical knowledge and skills to students. Hence, the objective of this study was to determine the association between level of knowledge gained, confidence, motivation and flexibility on types of learning for bedside teaching sessions among clinical students in four Malaysian medical schools during COVID-19 pandemic. Methods: A cross-sectional study involving medical students from Universiti Putra Malaysia (UPM), Universiti Sains Islam Malaysia (USIM), Universiti Islam Antarabangsa (UIA) and Universiti Sains Malaysia (USM) were conducted from 1st March 2021 until 6th June 2021. An online questionnaire was distributed and it consisted of 5 sections which cover sociodemographic information, level of knowledge gained, confidence, motivation, and flexibility from bedside teaching session. The data was analysed by using SPSS software program. Results: There is a significant association between the level of knowledge gained, level of confidence, level of motivation and level of flexibility with the type of learning (online or face-to-face) during bedside teaching sessions. Results revealed that students gained a higher level of knowledge (84.9%), higher level of confidence in physical examination (93.3%), higher motivation (82.2%) and higher flexibility (64.1%) during face-to-face bedside teaching sessions compared to online learning. Conclusion: Most of the medical students in four Malaysian medical schools prefer face-to-face learning compared to online learning for bedside teaching session

Association between the level of knowledge, awareness and attitude on post-COVID-19 syndrome amongst medical students in four Malaysian universities

Introduction: COVID-19 is a respiratory illness that is caused by a coronavirus. Infected people will have a chance to develop post-COVID-19 syndrome. The aim of this study is to identify the association of gender, marital status, age and university on knowledge, awareness and attitude of post-COVID-19 syndrome among medical students in four universities in Malaysia. Methods: A cross-sectional study was conducted from October 2021 to July 2022 at four universities in Malaysia which are Universiti Putra Malaysia (UPM), Universiti Islam Antarabangsa Malaysia (UIAM), Universiti Sains Malaysia (USM) and Universiti Sains Islam Malaysia (USIM). A self-administered questionnaire was administered to 355 respondents consisted of four sections, assessing socio-demographic data and knowledge, awareness and attitudes of post-COVID-19 syndrome. Results: 54.4% of the respondents had high knowledge, 53.8% had high awareness, and 55.21% had a high attitude towards post-COVID-19 syndrome. In this study, there is a significant association between knowledge on post-COVID-19 syndrome and the age among respondents. Knowledge and awareness, knowledge, and attitude as well as awareness and attitude on post-COVID-19 syndrome was also found to have significant association among respondents. Conclusion: The older age of the respondents have good knowledge towards post-COVID-19 syndrome

The level of knowledge, attitude and practice towards covid-19 immunisation among medical students in public medical schools in Malaysia.

COVID-19 is a highly contagious disease that caused a worldwide pandemic in 2020. Medical students are public advocates for COVID 19 vaccination to achieve herd immunity. Our objective is to ascertain the level of knowledge, attitude, and practice toward COVID-19 immunisation among medical students in Malaysia. The online study included four public universities in Peninsular Malaysia: Universiti Putra Malaysia, International Islamic University Malaysia, Universiti Sains Malaysia and Universiti Sains Islam Malaysia. Data collected include sociodemographic characteristics, history of COVID-19 infection, knowledge, attitude and practice towards COVID-19 immunisation. Analytical statistics were analysed with BM Statistical Package for the Social Science (SPSS) v27.0 using Pearson chi- square or Fisher’s exact test (significant if p < 0.05). From the total of 427 respondents, 60.2% had good knowledge whereby clinical students 67.0% have a higher proportion of good knowledge as compared to preclinical students 53.5% (p = 0.004). Respondents in the age group of 21 to 24 years old (p < 0.001) and 25 to 29 years old (p = 0.016), and Indian ethnicity (p = 0.006) were more likely to have good knowledge. Respondents registered in Malaysia’s National COVID-19 vaccination program were considered as having a positive attitude (N = 264, 61.8%). A vaccination rate of 100% was observed. In conclusion, 60.2% of medical students had good knowledge, 61.8% had a positive attitude and 100% were vaccinated in these four public medical schools in Malaysia. Sociodemographic factors (age group and Indian ethnicity) have an association with only good knowledge but none with the level of attitude and practice towards COVID-19 immunisation

Examination of Placenta and Child Saliva Samples Associated with Childhood Allergy Development

Allergic disease has risen to epidemic proportions during recent years. Evidence shows that prenatal events play a critical role in determining disease susceptibility via environmental influences on placental function and fetal programming. We hypothesised that childhood susceptibility to allergy is increased through significant alterations in placental gene expression involved in regulating immune system development. Furthermore, we hypothesised that products of altered placental genes are indirect measures of altered protein concentrations in the saliva of children with allergies. The aim of this PhD thesis was to identify proteins associated with childhood allergy using two sources of biological tissue: placental tissue and child saliva. The long term objectives were to identify proteins that could be measures of allergic risk in placenta and saliva, develop an assay for detection of allergic risk in newborns and target proteins for interventions that prevent allergy onset. Placental tissue and child saliva samples were examined using a proteomic approach involving quantitative label-free comparative mass spectrometry. Data analysis were performed using Mascot database and MaxLFQ software. Placental tissue and saliva from children with no allergy were compared with children with allergic diseases (placenta, n= 16; saliva, n= 18). Using placental samples, 1223 proteins were identified from MaxLFQ analysis. Nineteen proteins were significantly altered in allergic male placentae and 21 proteins were altered in allergic female placentae, relative to non-allergic children. Of these proteins, five candidate placental proteins associated with allergic diseases were validated with Western blot (n=68), which include chloride intracellular channel protein 3, peroxiredoxin-2, haptoglobin and complement C3. Moreover, 14-3-3 protein had very high expression in allergic children and very low expression in the non-allergic group. Using child saliva samples, 177 proteins were identified from MaxLFQ analysis. Of these proteins, six candidate proteins with significant ratio in specific allergic phenotypes were validated with Western blot (n=62). These proteins include salivary 14-3-3, cornulin, involucrin, transferrin, haptoglobin and desmoglein 1. Based on Western blot findings, 14-3-3, cornulin and involucrin proteins were further validated using the Blitz system that uses crude saliva sample for rapid identification and quantitation as a potential non-invasive bedside allergy biomarker screening (n=126). Blitz results demonstrated that these proteins were significantly altered in allergic children with asthmatic mother (high risk of allergy), as compared to non-allergic children with asthmatic mother. Only salivary cornulin was significantly altered in allergic children as compared to non-allergic children regardless of maternal asthma status. Findings revealed that in both placental and saliva samples, 14-3-3 proteins were significantly altered in female allergic children as compared with female non-allergic children. Interestingly, altered expression of some proteins varies in a sex-specific manner, such as observed in haptoglobin and involucrin, and in relation to presence or absence of maternal asthma. In conclusion, our findings indicate that protein expression can be altered in-utero in children who subsequently develop an allergy and altered expression of these proteins is detectable in saliva in early life.Thesis (Ph.D.) -- University of Adelaide, Adelaide Medical School, 201

Childhood allergy disease, early diagnosis, and the potential of salivary protein biomarkers

Allergic disease has risen to epidemic proportions since the last decade and is among the most common noncommunicable, chronic diseases in children and adolescents worldwide. Allergic disease usually occurs in early life; thus, early biomarkers of allergic susceptibility are required for preventive measures to high-risk infants which enable early interventions to decrease allergic severity. However, to date, there is no reliable general or specific allergy phenotype detection method that is easy and noninvasive for children. Most reported allergic phenotype detection methods are invasive, such as the skin prick test (SPT), oral food challenge (OFC), and blood test, and many involve not readily accessible biological samples, such as cord blood (CB), maternal blood, or newborn vernix. Saliva is a biological sample that has great potential as a biomarker measurement as it consists of an abundance of biomarkers, such as genetic material and proteins. It is easily accessible, noninvasive, collected via a painless procedure, and an easy bedside screening for real-time measurement of the ongoing human physiological system. All these advantages emphasise saliva as a very promising diagnostic candidate for the detection and monitoring of disease biomarkers, especially in children. Furthermore, protein biomarkers have the advantages as modifiable influencing factors rather than genetic and epigenetic factors that are mostly nonmodifiable factors for allergic disease susceptibility in childhood. Saliva has great potential to replace serum as a biological fluid biomarker in diagnosing clinical allergy. However, to date, saliva is not considered as an established medically acceptable biomarker. This review considers whether the saliva could be suitable biological samples for early detection of allergic risk. Such tools may be used as justification for targeted interventions in early childhood for disease prevention and assisting in reducing morbidity and mortality caused by childhood allergy

Childhood allergy susceptibility: the role of the immune system development in the in-utero period

Expression of allergic diseases in very early childhood indicates that early life events play a significant role in childhood allergy development. The developmental origins of allergy hypothesis suggest events initiated in the in-utero period derived from the interaction between maternal, placental, and fetal factors may contribute to childhood allergy susceptibility. Environmental impacts on placental function and fetal programming are imperative in defining illness risk during pregnancy. Fetal programming, a process by which an injury delivered during a critical period of development, causes immediate adaptive responses with long-term consequences on an organism’s structure or function. During pregnancy, the maternal immune response is skewed towards Th2-related humoral responses, hence increasing the susceptibility of childhood allergy development. Maternal atopic phenotype markedly increases the probability of her offspring developing an allergic predisposition. Combination of in utero events – which include maternal asthma or infection, and exposures to maternal allergy which changes the placental function – can alter placental cytokine expression and could predispose offspring to an allergic phenotype. All these events may affect embryology and fetal immune system development. Interestingly, the mechanism and role of the in-utero events on the developmental origins of allergy are not clearly understood; this will be addressed in this review

Low methylation of matrix metalloproteinase 1 (MMP1) is associated with preterm labour in Malaysian mothers

Preterm births comprise 10.6% of livebirths worldwide and account for 35% of deaths among newborn babies. Understanding DNA methylation may offer basic knowledge in the understanding of pathogenesis of preterm labour. The study was undertaken to determine DNA methylation of matrix metalloproteinase 1 (MMP1) promoter in term and preterm labour using methylation-specific polymerase chain reaction (MSP). Thirty maternal venous blood samples (n=15 each) of term and preterm labour was subjected to bisulfite treatment prior to MSP. This result was then validated using DNA sequencing. Evaluation of the sequencing results by CpG islands analysis was performed using the ClustalW and SPSS software. Primers for MMP1 were located between -1226 and -1378 upstream from the transcription start site (TSS) that consisted five CpG islands. Preterm labour group had significantly lower methylated CpG islands with 39 out of total 75 (52%) compared to the term labour that has 49 out of 75 methylated CpG islands (65.33%) (t=0.694, p<0.05). Methylation occurred in 4 out of 5 methylated CpG islands in the MMP1 promoter where it only involved 2 preterm samples (13.33%) and 7 term samples (46.47%). This data suggested there were significant lower percentage of methylated MMP1 in preterm labour. Higher percentage of methylated MMP1 as observed in the term labour, will probably reduce the expression of MMP1, thus maintaining fibrillar collagen strength on the amniotic membrane and subsequently maintain the pregnancy till term. In conclusion, preterm labour has higher percentage of methylated CpG compared with term labour in MMP1 gene