Whole-Genome Profiles of Malay Colorectal Cancer Patients with Intact MMR Proteins.

Background: This study aimed to identify new genes associated with CRC in patients with normal mismatch repair (MMR) protein expression.

Method: Whole-genome sequencing (WGS) was performed in seven early-age-onset Malay CRC patients. Potential germline genetic variants, including single-nucleotide variations and insertions and deletions (indels), were prioritized using functional and predictive algorithms.

HIF-1-Independent Mechanisms Regulating Metabolic Adaptation in Hypoxic Cancer Cells.

In solid tumours, cancer cells exist within hypoxic microenvironments, and their metabolic adaptation to this hypoxia is driven by HIF-1 transcription factor, which is overexpressed in a broad range of human cancers. HIF inhibitors are under pre-clinical investigation and clinical trials, but there is evidence that hypoxic cancer cells can adapt metabolically to HIF-1 inhibition, which would provide a potential route for drug resistance. Here, we review accumulating evidence of such adaptions in carbohydrate and creatine metabolism and other HIF-1-independent mechanisms that might allow cancers to survive hypoxia despite anti-HIF-1 therapy.

Spontaneous retroperitoneal hematoma: a rare bleeding occurrence in COVID-19.

Emerging evidence suggest that COVID-19 is associated with hypercoagulability, predisposing patients to increase risk of thromboembolism. Anticoagulation is not without its risks of bleeding and decision to initiate anticoagulation should be carefully considered with close monitoring. Spontaneous retroperitoneal hematoma is a rare complication, and there are only a few documented reports implicating anticoagulant or antiplatelet agents as a potential cause.

Modifications to Hepatopancreatobiliary surgical services during COVID-19 partial lockdown in a hospital in northern Malaysia.

Maintaining hepatopancreatobiliary (HPB) services during the initial phase of a pandemic in a state referral hospital for COVID-19 presents a few challenges, especially when a nationwide, government-issued partial lockdown is in enforcement. We describe the adaptations to our practice to maintain the services whilst ensuring safety of patients and staff, by postponing non-urgent clinic cases, grouping our staff to two mutually exclusive teams that work on alternate shifts and selecting HPB operative cases according to the modified Risk Urgency Decision Matrix.

Convalescent plasma as an adjunctive therapy for COVID-19: A single centre experience in Malaysia.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic posed a significant and urgent threat to global health and economy. Currently, there is no effective treatment known to alter the course of COVID-19. Convalescent plasma (CP) has been used previously to treat several types of infections during pandemics.

Reminder through mobile messaging application improves outpatient attendance and medication adherence among patients with depression: An open-label randomised controlled trial.

Introduction: Non-attendance and medication adherence are longstanding concerns in psychiatric outpatient settings. This study aimed to determine effectiveness of reminders using mobile messaging applications (messaging apps) in improving outpatient attendance and medication adherence among patients with depression.

Methods: This was a parallel, open-label randomised controlled trial with participants recruited from psychiatric outpatient services of a teaching hospital in Kuala Lumpur and a secondary hospital in Melaka.

Congenital colorectal tubular duplication in an infant: A tale of radiological diagnostic challenges.

Enteric duplications (EDs) are rare congenital anomalies that result from defect during embryonic development of the gut. Although EDs can literally occur at any part of the gastrointestinal tract, ileocecal duplication is the commonest type followed by colorectal type. Morphologically, EDs are mostly cystic in nature; tubular duplications are uncommon.

Mortality Rate and Ten Years Survival of Elderly Patients Treated with Total Hip Arthroplasty for Femoral Neck Fractures.

Introduction: Mortality following traumatic femoral neck fractures in the elderly (age >60 years) is influenced by many factors. Addressing some of them may reduce the mortality rate thus improving patient survival and quality of life.

Materials And Methods: This study was a retrospective research using data collected from Hospital Sultanah Bahiyah, Kedah between the years 2008-2018.

Depression and anxiety among patients with psoriasis: A correlation with quality of life and associated factors.

Objectives: Psoriasis is a chronic, immune-mediated illness that primarily affects the skin, nails and joints. This illness may predispose people to mental disorders such as depression and anxiety. This study aims to determine the prevalence of depression and anxiety in patients with psoriasis and their correlation with quality of life and associated factors.

SLC17A3 rs9379800 and Ischemic Stroke Susceptibility at the Northern Region of Malaysia.

Objectives: The relationships of Paired Like Homeodomain 2 (PITX2), Ninjurin 2 (NINJ2), TWIST-Related Protein 1 (TWIST1), Ras Interacting Protein 1 (Rasip1), Solute Carrier Family 17 Member 3 (SLC17A3), Methylmalonyl Co-A Mutase (MUT) and Fer3 Like BHLH Transcription Factor (FERD3L) polymorphisms and gene expression with ischemic stroke have yet to be determined in Malaysia. Hence, this study aimed to explore the associations of single nucleotide polymorphisms (SNPs) and gene expression with ischemic stroke risk among population who resided at the Northern region of Malaysia.

Materials And Methods: Study subjects including 216 ischemic stroke patients and 203 healthy controls were recruited upon obtaining ethical clearance.

Metformin Use in Gestational Diabetes: Awareness, Attitude, and Practice among Healthcare Professionals in Malaysia.

Background: Metformin has been added in the Malaysian clinical practice guideline (CPG) as one of the first-line options in the management of gestational diabetes mellitus (GDM); however, the uptake on this practice among healthcare professionals is unknown.

Objective: The objective of the study is to determine the awareness, attitude, and practice and their predictors on the use of metformin for GDM among healthcare professionals in Malaysia.

Materials And Methods: This was a multicenter, cross-sectional study in three tertiary hospitals in Malaysia.

Effect of Pharmacist-Led Intervention on Progression of Diabetic Complications at Two Tertiary Care Hospitals of Malaysia.

Background And Objective: Diabetes mellitus is a chronic disease which can lead to different complications in patients if not treated properly. An appropriate intervention from health care providers is needed to stop and decrease the progression of diabetic complication in diabetic patients. This study aimed to measure the effect of pharmacist intervention on improvement in sign and symptoms and progression of diabetic complications in diabetic patients.

A Retrospective Hospital-Based Study of HMGCR Expression in HER2 IHC 2+ and 3+ Breast Cancer.

Objective: The role of HMG-CoA reductase (HMGCR) in relation to prognostic and treatment predictive information of HER2 positive breast cancer has been newly explored. In this study, we aimed to determine the expression of HMGCR in HER2 immunohistochemistry (IHC) scores of 2+ and 3+ breast cancer and to correlate with the patients' outcomes.

Methodology: Using a cross-sectional design, invasive breast carcinoma of no special type (NST) and HER2 IHC scores of 2+ and 3+ cases were selected over a 50-month period in Hospital Sultanah Bahiyah (HSB), Alor Setar.

Geriatric Telemedicine: Ensuring continuity of healthcare services to the older patients in Kedah, Malaysia during the COVID-19 pandemic.

Geriatric medicine practice requires a multidimensional and multidisciplinary assessment to provide a holistic overview of the older patients. During the current COVID-19 pandemic time, it becomes more critical to ensure that the elderly patients continue to receive regular geriatric care for their pre-existing chronic illness and at the same time avoid unnecessary exposure to COVID-19 virus. Geriatric telemedicine clinic provides a convenient solution to ensure continuity of care for the older patients.

Recurrent ovarian steroid cell tumour not otherwise specified: A case report.

Steroid cell tumors not otherwise specified are one of the rare virilizing ovarian tumors. Most of the tumors are benign. This case report illustrates the challenge in managing steroid cell tumor not otherwise specified, which starts from determining its malignant potential, surveillance, and adjuvant treatment option.

A Rare Cause of Red Tympanic Membrane: Jugular Bulb Diverticulum.

Significance Statement: Pulsatile tinnitus with erythematous tympanic membrane mass suggests vascular pathologies such as dural arteriovenous fistula, glomus tympanicum, or aberrant carotid artery. Jugular bulb aneurysmatic diverticulum is rare but should be suspected in a case with the presence of aneurysm in other organs. An imaging study is mandatory to confirm the diagnosis.

The Cox model of predicting mortality among melioidosis patients in Northern Malaysia: A retrospective study.

Melioidosis is an infectious disease that is initiated by a bacteria recognized as Burkholderia pseudomallei. Despite the high fatality rate from melioidosis, there is a minimal published study about the disease in Malaysia.This study aimed to identify the prognostic factors of mortality among melioidosis patients in northern Malaysia.

Skull Base Primary Ewing Sarcoma: A Radiological Experience of a Rare Disease in an Atypical Location.

BACKGROUND Ewing sarcoma and primitive neuroectodermal tumor are rare tumors grouped under the spectrum of the Ewing sarcoma family of tumors. These highly malignant tumors involve the bones and commonly occur in children. Ewing sarcoma of the skull bone accounts for only 1% of all Ewing sarcomas, with primary skull base Ewing sarcoma occurring in less than 1% of cases.

Impact of Pharmacist-led Educational Intervention on Predictors of Diabetic Foot at Two Different Hospitals of Malaysia.

Objective: Diabetes mellitus (DM) is a chronic metabolic disorder that can initiate organ damage inside the body if not treated appropriately. Apart from tight glycemic control, a suitable educational intervention is also needed from health-care providers to stop or decrease the progression of organ damage in diabetic patients. This study intended to measure the impact of pharmacist-led educational intervention on improvement in predictors of diabetic foot in two different hospitals in Malaysia.

Clinical and demographic pattern of chronic granulomatous disease (CGD) from a multicenter perspective: Malaysia's experience over 26 years.

Background: A retrospective review of clinical manifestations and demographic pattern of patients diagnosed as chronic granulomatous disease (CGD) from 7 hospitals in Malaysia. An analysis of the available database would establish clinical characteristics, diagnoses and outcome including microbiologic pattern. Studying the demography allows us to document the occurrence of CGD amongst multiethnic groups and its geographical distribution for Malaysia.

Predictive SNPs for β-thalassemia/HbE disease severity.

β-Thalassemia/HbE disease has a wide spectrum of clinical phenotypes ranging from asymptomatic to dependent on regular blood transfusions. Ability to predict disease severity is helpful for clinical management and treatment decision making. A thalassemia severity score has been developed from Mediterranean β-thalassemia patients.

Malaysian clinical practice guidelines for management of diabetic foot: A synopsis for the primary care physician.

Diabetic foot requires careful attention and coordinated management by a dedicated team. Screening, prevention, adequate assessment, and appropriate referral are crucial to prevent complications. Multimodal treatment and rehabilitation are recommended to ensure a better quality of life and reduction of amputation rate in people with diabetic foot.

Medication-related knowledge, administration practice and adherence among caregivers of chronically ill children in Malaysia.

Background: Caregivers' knowledge, practice and adherence in medication administration who care for children with chronic illness requiring long-term pharmacological treatments are factors associating with children medication safety at home. This study aimed to determine the medication-related knowledge, administration practice and adherence among caregivers of chronically ill children in Malaysia. This cross-sectional study was conducted at the paediatric outpatient clinic of a tertiary public hospital.