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Nor Hayati Othman

Universiti Sains Malaysia, Pathology Department, Faculty Member

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Senior Professor [VK5], Department of Pathology, Universiti Sains Malaysia; Senior Consultant Surgical Pathologist, Hospital Universiti Sains Malaysia, Kelantan, Malaysia; Lecturer (joint appointment), Department of Medical Education; President, International Academy of Pathology [Malaysian Division]; Member, USM Research Ethics Committee; MQA/MMC accrediting panel for Medical programs in Malaysia; ISO15189 accreditating panel for Anatomic Pathology laboratories in Malaysia; Elected Member; Malaysian Medical Council
Address: President, International Academy of Pathology [Malaysia Division]
Department of Pathology,
School of Medical Sciences,
Universiti Sains Malaysia,
16150 Kubang Kerian, Kelantan, MALAYSIA
Tel:+609 7676948 (office);

email: hayatikb@usm.my

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Papers by Nor Hayati Othman

Prevalence and type distribution of human papillomavirus (HPV) in Malaysian women with and without cervical cancer: an updated estimate

Bioscience Reports, Mar 29, 2018

Information on the prevalence and type distribution of human papillomavirus (HPV) among Malaysian... more Information on the prevalence and type distribution of human papillomavirus (HPV) among Malaysian women is currently limited. The present study therefore aimed to provide an updated estimate on the prevalence and type distribution of HPV among Malaysian women with and without cervical cancer. Total DNA was isolated from the cervical cell specimens of 185 histopathologically confirmed cervical cancer patients and 209 cancer-free healthy females who were tested negative in a recent Pap test. Viral-specific DNA was subsequently amplified with biotinylated primers and hybridized to HPV type-specific probes via a proprietary "flow-through hybridization" process for determination of HPV genotype. It was demonstrated that 83.2% of the cervical cancer patients and none (0.0%) of the cancer-free females were positive for HPV infection. Among HPV-positive subjects, 14 different viral genotypes were observed, namely HPV16,

Pattern of Histopathological Alterations in N-methyl-N-Nitrosourea (MNU) Induced Breast Cancer in Female Sprague Dawley (SD) Rats Treated with Crude Honey

Pertanika Journal of Science and Technology, 2020

Natural products are becoming primary investigative molecules creating hope for finding new power... more Natural products are becoming primary investigative molecules creating hope for finding new powerful classes of anticancer agents for breast cancer. One of the most remarkable of these is honey. To explore the mechanism of action of any anticancer agent the initial step is to analyse its effect in the histopathological tissue section. This study was designed to describe the histopathology of N-methyl- N-nitrosourea (MNU) induced breast cancer in Sprague Dawley rat (SD rats) treated with crude honey. Female rats were distributed into 4 groups: Group0 (normal), Group1 (MNU control), Group2 and 3: Tualang and Manuka honey-treated, respectively. Rats were sacrificed and histopathology of both non-treated and treated tumours was done. Lower histological grade, infrequent combination histologic pattern (p<0.001), prominent cytoplasmic vacuolization (p<0.001), aggregates of atypical macrophages (p<0.001) and lesser necrosis (p= 0.005) were major outcomes in treated cancers. This d...

Management of Operable Breast Cancers When Patient Refuses Surgery

Electronic Journal of General Medicine, 2010

Surgery is the crucial modality of management in the multidisciplinary care of breast cancer. Wit... more Surgery is the crucial modality of management in the multidisciplinary care of breast cancer. Without surgery the outcome of treatment is complicated and sub-optimal. The oncologists face dilemma when patient refuse for surgery or not operable due to patients medical condition. Here we describe two post-menopausal women with operable breast cancers those refused surgery. We managed these patients with induction chemotherapy, radical radiotherapy and hormonal therapy. Their serial radiological evaluation revealed complete disappearance of primary breast tumor and axillary lymph nodes at the end of 88 and 69 months post treatment with good cosmesis. Conservative management may be an option among post-menopausal women with operable breast cancers those refuse surgery. The controversial management of above cases has been discussed with review of literature.

Poorly differentiated thyroid carcinoma: A hospital-based clinicopathological study and review of literature

Indian journal of pathology & microbiology

Poorly differentiated thyroid carcinoma (PDTC) is a rare aggressive malignancy of thyroid follicu... more Poorly differentiated thyroid carcinoma (PDTC) is a rare aggressive malignancy of thyroid follicular cells and has unique features in morphology and behavior. This study was aimed to describe the experience of a tertiary medical center with PDTC within a 10-year period. This is a descriptive retrospective study of eight cases of PDTC among 418 various thyroid carcinomas. All cases of PDTC were retrieved along with the clinicopathological information. Only eight cases (1.9%) of PDTC were diagnosed among 418 thyroid carcinomas. Mean age was 48.12 with 3:5 (male:female) and tumor size ranged 3-12 cm. PDTC were diagnosed coexisting with one or more other pathologies; nodular hyperplasia (four cases), papillary carcinoma (one case), follicular carcinoma (three cases), and Hashimoto thyroiditis (two cases); with ≥60% PDTC component. Six cases associated with high-grade features died within 3 years after diagnosis. Mean age in this study was younger including a 20-year-old girl. Younger ag...

Curcumin: the spicy modulator of breast carcinogenesis

Journal of Experimental & Clinical Cancer Research, 2017

Worldwide breast cancer is the most common cancer in women. For many years clinicians and the res... more Worldwide breast cancer is the most common cancer in women. For many years clinicians and the researchers are examining and exploring various therapeutic modalities for breast cancer. Yet the disease has remained unconquered and the quest for cure is still going on. Present-day strategy of breast cancer therapy and prevention is either combination of a number of drugs or a drug that modulates multiple targets. In this regard natural products are now becoming significant options. Curcumin exemplifies a promising natural anticancer agent for this purpose. This review primarily underscores the modulatory effect of curcumin on the cancer hallmarks. The focus is its anticancer effect in the complex pathways of breast carcinogenesis. Curcumin modulates breast carcinogenesis through its effect on cell cycle and proliferation, apoptosis, senescence, cancer spread and angiogenesis. Largely the NFkB, PI3K/Akt/mTOR, MAPK and JAK/STAT are the key signaling pathways involved. The review also highlights the curcumin mediated modulation of tumor microenvironment, cancer immunity, breast cancer stem cells and cancer related miRNAs. Using curcumin as a therapeutic and preventive agent in breast cancer is perplexed by its diverse biological activity, much of which remains inexplicable. The information reviewed here should point toward potential scope of future curcumin research in breast cancer.

Oral Administration of Tualang and Manuka Honeys Modulates Breast Cancer Progression in Sprague-Dawley Rats Model

Evidence-Based Complementary and Alternative Medicine, 2017

Breast cancer has been recognized as the leading cause of death in women worldwide. Research has ... more Breast cancer has been recognized as the leading cause of death in women worldwide. Research has shown the importance of complementary and alternative therapies in cancer. In this study, we investigated the antitumoural therapeutic effects of Malaysian Tualang honey (TH) and Australian/New Zealand Manuka honey (MH) against breast cancer in rats. Thirty syngeneic virgin female Sprague-Dawley (SD) rats were induced by the carcinogen 1-methyl-1-nitrosourea (MNU) 80 mg/kg. The treatment started when first palpable tumour reached 10–12 mm in size by dividing rats into following groups: Group 0 (negative control); Group 1 (positive control); and Groups 2 and 3 which received 1.0 g/kg body weight/day of TH and MH, respectively, for 120 days. The data demonstrate that cancer masses in TH and MH treated groups showed a lower median tumour size, weight, and multiplicity compared with the nontreated positive control (p<0.05). Treatment also showed a dramatic slower growth rate (up to 70.82%...

FAS c.-671A>G polymorphism and cervical cancer risk: a case–control study and meta-analysis

Cancer Genetics, 2017

This study aimed to investigate the association between FAS c.-671A&amp;amp;amp;amp;amp;amp;a... more This study aimed to investigate the association between FAS c.-671A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;G polymorphism and cervical cancer risk in a case-control setting, followed by a meta-analysis of the published literatures. The case-control study involved genotyping of the polymorphism in 185 histopathologically confirmed cervical cancer patients and 209 cancer-free female controls utilizing PCR-RFLP technique, followed by logistic regression analyses. Meta-analysis was then conducted under homozygous, heterozygous, dominant, recessive and allele contrast models to combine data from 12 studies which consisted of 2798 cases and 3039 controls. Our case-control analysis revealed a significant association of the variant allele (G) and the homozygous variant genotype (GG) of the FAS polymorphism with an increased risk of cervical cancer. Subgroup analysis by ethnicity further confirmed the risk association in Malays (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), but not among non-Malays (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). However, results of meta-analysis suggested a lack of association between the polymorphism and cervical cancer risk in all the five genetic models analyzed. In conclusion, while the FAS c.-671A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;G polymorphism may serve as a biomarker for cervical cancer risk prediction among the Malays, there is a limited usability of the polymorphism as a cervical cancer risk biomarker in other populations.

Dyspnea on swallowing: a case of thyroid lymphoma

Bangladesh Journal of Medical Science, 2017

Thyroid Hodgkin's lymphoma is infrequent occurrence that has four to one female preponderance. Mo... more Thyroid Hodgkin's lymphoma is infrequent occurrence that has four to one female preponderance. Most thyroid lymphomas are of B-cells lineage. In this case we present a primary Hodgkin's lymphoma in 45-year-old male patient who presented with gradual onset of upper airway obstructive symptoms. CT shows enlarged thyroid lobes with multiple nodal involvement and right internal jugular vein thrombosis. He was stridorous and was started on intravenous steroid. Right hemithyroidectomy was performed to alleviate the impinged airway as well as serving biopsy purpose. The histology confirmed diffuse B-cell non-Hodgkin's lymphoma. He responded well to treatment.

Inhibitory Effects of Tualang Honey on Experimental Breast Cancer in Rats: A Preliminary Study

Asian Pacific Journal of Cancer Prevention, 2013

The study was conducted to determine the effect of Malaysian jungle Tualang Honey (TH) on develop... more The study was conducted to determine the effect of Malaysian jungle Tualang Honey (TH) on development of breast cancer induced by the carcinogen 7,12-dimethylbenz(α)anthracene (DMBA) in rats. Forty nulliparous female Sprague-Dawley rats were given 80 mg/kg DMBA then randomly divided into four groups: Group 1 served as a Control while Groups 2, 3 and 4 received 0.2, 1.0 or 2.0 g/kg bodyweight/day of TH, respectively, for 150 days. Results showed that breast cancers in the TH-treated groups had slower size increment and smaller mean tumor size (≤2cm 3) compared to Controls (≤8cm 3). The number of cancers developing in TH-treated groups was also significantly fewer (P<0.05). Histological grading showed majority of TH-treated group cancers to be of grade 1 and 2 compared to grade 3 in controls. There was an increasing trend of apoptotic index (AI) seen in TH-treated groups with increasing dosage of Tualang Honey, however, the mean AI values of all TH-treated groups were not significantly different from the Control value (p>0.05). In conclusion, Tualang Honey exerted positive modulation effects on DMBA-induced breast cancers in rats in this preliminary study.

Inhibitory effects of Malaysian tualang honey and Australian/New Zealand Manuka honey in modulating experimental breast cancers induced by n-methyl-n-nitrosourea (mnu): A comparative study

Pathology, 2016

Background: The major problem with cervical cancer screening in countries which have no organized... more Background: The major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the participation of women to screen for cervical cancer. Aims: To determine the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus cytological diagnoses made on samples collected by physicians (Physician sampling) Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician scraping using Cervex brush. They women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from the two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study. Thin Prep smears by physicians were better in terms of volume and variety of the cells seen. There is significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). The Thin Prep smears by self-sampling method were better in detecting microorganisms. Conclusion: This study shows that samples taken by women themselves (self-sampling) and physicians sampling had good cytology agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.

Semi-automated pseudo colour features extraction technique for cervical cancer's pap smear images

International Journal of Knowledge-based and Intelligent Engineering Systems, 2011

Image analysis is one of the common applications in the medical field especially in cytology, whe... more Image analysis is one of the common applications in the medical field especially in cytology, where the microscopic examination of cells and tissues is involved. Visual interpretation of microscopic images is tedious and in many cases is errorprone. Therefore a number of attempts have been carried out using the computer vision system to supplement the human visual inspection and to automate some of these tedious visual screening tasks. This study, in effect, proposes a semi-automated method of identifying features for Pap smear cytology images; i.e. semi-automated Pseudo-Colour Feature Extraction (PCFE) technique by integrating a clustering algorithm with the manual PCFE algorithm. The technique is used to segment the cervical cell images to provide the clearly seen nucleus and cytoplasm regions and then to extract the four features of cervical cells namely the size of nucleus and cytoplasm of cervical cells, as well as their gray level. A correlation test is applied between the data extracted using the proposed algorithm and data extracted manually by cytotechnologists. The technique operates well on cervical cells images with correlation values approaching 1.0, which indicates a strong positive correlation. The analysis also favours the AFKM clustering algorithm as the best clustering algorithm to be used with the PCFE by possessing the strongest relationship in terms of the correlation value. Furthermore, this study proves that the proposed algorithm is suitable and capable to be used to detect and extract features of cervical cells even for the overlapping cervical cells' images.

Synchronous mucoepidermoid carcinoma of the right upper eyelid and right parotid gland in a young patient

Malaysian Journal of Medicine and Health Sciences

Mucoepidermoid carcinoma is a relatively common neoplasm that affects the major and minor salivar... more Mucoepidermoid carcinoma is a relatively common neoplasm that affects the major and minor salivary glands comprising 10-30% of primary carcinomas. [1] They may involve the skin through direct extension, metastases, and rarely, as a primary focus (adenosquamous carcinoma). [1] Our patient presented with extensive tumor of the upper eyelid, which later was confirmed as mucoepidermoid carcinoma with areas of squamous cell carcinoma transformation. It was difficult to determine the origin of the tumor; possibilities include upper eyelid epithelium, accessory lacrimal gland, sweat gland or other skin appendages. THE CASE A 26 years old lady, with a history of burn on the face during childhood, first presented with a small ulcerative nodule like lesion at the right upper eyelid for few weeks duration. The lesion was progressively increasing in size and associated with pain and foul discharge with contact bleeding. An excisional biopsy was performed by a general practitioner, and was then referred to our center for further management. Examination at the time of presentation showed a 10 x 7cm fungating mass over the right periorbital region. The surface was ulcerated and partly covered with exudates and foul-smelling discharge. The conjunctiva was injected with central corneal opacity. She was also noted to have a right parotid swelling which is hard in consistency. There was involvement of the overlying skin which also displaced the ear lobe. There was no palpable cervical lymphadenopathy. Computed tomography scan of the head and neck demonstrated an irregular heterogenously enhancing soft tissue lesion involving the orbit. Medially, the mass extended to the right side of the nasal bridge, associated with soft tissue thickening extending to the frontal sinus area. The right parotid gland was enlarged measuring 4.0 x 2.0 x 4.5 cm with central necrosis. The deep lobe of the parotid gland was normal. Magnetic resonance imaging revealed right frontal bone involvement with frontal lobe dura enhancement. These clinical and radiological assessments indicate a malignancy which was further confirmed by the biopsy result which showed squamous cell carcinoma of right upper eyelid with intraorbital extension. Resection of right upper eyelid tumour with right total orbital exenteration, right total parotidectomy with excision of upper branch of facial nerve were performed together with removal of right orbital rim and coagulation of tumour attached to dura. Reconstruction was done by using free myocutaneous latissimus dorsi flap. Full histopathology report of the right periorbital specimen confirmed the diagnosis of extensive mucoepidermoid carcinoma with areas of transformation into squamous cell carcinoma. The right parotid showed a high grade mucoepidermoid carcinoma. The patient had an uneventful post-operative recovery. The patient was referred to oncology department for further palliative radiotherapy.

Preference of treatment facilities among Malaysian Hajj pilgrims for acute respiratory symptoms

Saudi medical journal, 2009

A cross-sectional study was conducted among 2000 Malaysian Hajj pilgrims from 23 December 2007 to... more

Unilateral exophthalmos caused by an extramedullary plasmacytoma: a case report

The Malaysian journal of medical sciences : MJMS, 2003

Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the liter... more Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the literature consist of some case reports. Solitary plasmacytoma presenting with exophthalmos are rare. We report a case of intracranial solitary plasmacytoma in an elderly lady with involvement of the right orbitocranial region presenting with severe exophthalmos. The tumour was debulked and radiotherapy was given.

Correlation of Nuclear Morphometry and AgNOR Score with Radiation Response in Squamous Cell Cancers of the Head and Neck: A Preliminary Study

The Malaysian journal of medical sciences : MJMS, 2010

Prediction of radiation response before the completion of the radiotherapy schedule is challengin... more Prediction of radiation response before the completion of the radiotherapy schedule is challenging. Information about radiation response could help oncologist to choose the appropriate combination and sequence of therapies in the multidisciplinary management of cancer. The study involved 26 patients with squamous cell cancers of the head and neck region who received radiotherapy to a dose of 30 Gy in 10 fractions over a 2-week period as part of a split-course technique. Fine-needle aspiration cytology was performed on day 1 and day 5 of the schedule. The silver staining of the nuclear organiser region (AgNOR) and nuclear morphometric study were done on both days. The median age of the patients was 44 years old. The primary tumours were distributed in the nasopharynx (n = 11), larynx and hypopharynx (n = 5), metastatic node (n = 4), and miscellaneous tumours were found in the head and neck sub sites (n = 6). The mean initial AgNOR score was 3.0, range 1.2-7.0. The median of nuclear a...

The association between pre-morbid conditions and respiratory tract manifestations amongst Malaysian Hajj pilgrims

Tropical biomedicine, 2010

In a very closed and overcrowding environment, influenza transmission during Hajj season is almos... more In a very closed and overcrowding environment, influenza transmission during Hajj season is almost inevitable. The aim of this study was to determine the association between pre-morbid conditions and influenza-like illness (ILI) amongst Hajj pilgrims. A cross-sectional study was conducted amongst Malaysian Hajj pilgrims in year 2007. Survey forms were distributed at Madinatul-Hujjaj, Jeddah and Tabung Haji Clinic, Medina, Saudi Arabia where pilgrims stay on transit before returning to Malaysia. Allergic rhinitis was significantly associated with sore throat (p=0.047), longer duration of cough (p=0.017) and runny nose (p=0.016). Pilgrims who suffered from chronic obstructive pulmonary diseases (COPD) had significant association with longer duration of cough (p=0.041) and those with diabetes mellitus had significant association with longer duration of sore throat (p=0.048). Underlying asthma was significantly associated with severe influenza like illness requiring admission to hospita...

Is Kelantan joining the global cancer epidemic?--experience from hospital Universiti Sains Malaysia; 1987-2007

Asian Pacific journal of cancer prevention : APJCP

To determine the trend of cancer cases in one major hospital in Kelantan over a 20 year period fr... more To determine the trend of cancer cases in one major hospital in Kelantan over a 20 year period from 1987 to 2007 and to speculate the change in trend due to the socio-economic and other health status in the state. All data on clinically diagnosed cancer cases in Hospital Universiti Sains Malaysia [HUSM] were retrieved from the hospital medical records. The cancers were classified according to ICD10 and scrutinized to avoid duplicate or more entries. The increment in cancer incidence was calculated based on total numbers of cancer cases per each 5-6 year period. A total of 12,228 solid cancers were diagnosed during the period. There is an increment of 20.1% for 1991-1996 from 1987-1990 period, 67.4% for 1997-2001 from 1991-1996 period and 305.9% for 2002-2007 from the 1997-2001 period. The rise was steep in the last 5-6 years. After excluding referred cases from states outside Kelantan, the increments were 20.1%, 67.4% and 143.6% for the consecutive 5-6 year periods. The predominant ...

$Research paper thumbnail of Pilot Study on Continuous Hyperfractionated Accelerated Radiotherapy(CHART) and High Dose Rate Brachytherapy in Locally Advanced Cervical Cancer$

Pilot Study on Continuous Hyperfractionated Accelerated Radiotherapy(CHART) and High Dose Rate Brachytherapy in Locally Advanced Cervical Cancer

Journal of Cancer Science & Therapy, 2011

Background: Fractionated external beam radiotherapy followed by intracavitary brachytherapy is th... more Background: Fractionated external beam radiotherapy followed by intracavitary brachytherapy is the mainstay of treatment in cervical cancer. Due to long radiotherapy course, patients in developing countries default effective radiotherapy. Treatment break or discontinuance leads to treatment failure. Continuous hyperfractionated accelerated radiotherapy (CHART) is an altered fractionation scheme used to reduce overall treatment time, overcome tumor repopulation thus could be an option in cervical carcinoma. Methods: Twenty-five histopathological documented locally advanced cervical carcinoma (FIGO stage IB2-IVA) were treated with 42Gy/30fractions external radiotherapy over 10-day period at an inter-fraction interval of 6 hours using CHART technique. Following CHART, patients were subjected to high dose rate brachytherapy to a dose schedule of 9Gyx2 at weekly interval. The response to above radiotherapy protocol and morbidity pattern was evaluated. Results: All patients completed planned CHART external radiotherapy. The median follow-up was 32-months with a pelvic control rate of 68% and 24-month overall survival was 72%. The most common acute toxicity in CHART technique was fatigue (64%) and diarrhea (52%), the late effects being rectal bleeding (2-cases), subcutaneous fibrosis (1-case), spinal pain (1-case). Conclusion: CHART technique is an effective and well tolerated technique in locally advanced cervical cancer at a cost of manageable fatigue and diarrhea. Further investigation involving large number of patients is warranted to evaluate this technique.

Effect of Influenza Vaccination on Acute Respiratory Symptoms in Malaysian Hajj Pilgrims

Journal of Immigrant and Minority Health, 2014

Respiratory illness were a major problem and caused high hospital admission during hajj seasons. ... more Respiratory illness were a major problem and caused high hospital admission during hajj seasons. One of the contributing cause to this illness is infection. Various measures had been implemented to reduce respiratory infections. The aim on the study is to determine the effect of influenza vaccination against acute respiratory illness among Malaysian Hajj pilgrims. This is an observational cohort study. Influenza vaccination was given to pilgrims at least 2 weeks prior to departure. The occurrence of symptoms for respiratory illness such as cough, fever, sore throat and runny nose was monitored daily for 6 weeks during pilgrimage using a health diary. A total of 65 vaccinated hajj pilgrims and 41 controls were analyzed. There was no significant difference in pattern of occurrence of symptoms of respiratory illness by duration of pilgrimage as well as the number of symptoms between both groups. Hajj pilgrims have frequent respiratory symptoms. We were unable to document benefit from influenza vaccination, but our study was limited by a small sample size and lack of laboratory testing for influenza.

The Benefit of Tualang Honey in Reducing Acute Respiratory Symptons Among Malaysian Hajj Pilgrims: A Preliminary Study

Journal of ApiProduct and ApiMedical Science, 2011

Acute respiratory symptoms such as cough, rhinitis, sore throat and fever are one of the main hea... more Acute respiratory symptoms such as cough, rhinitis, sore throat and fever are one of the main health problems encountered by pilgrims performing Hajj in Mekah. The possible causes include overcrowding and low immune status as a result of stress. Honey is reputed to contain multiple chemical compounds that are capable of enhancing the immune system and has antibacterial, antiviral and antifungal properties. We determined the effectiveness of Malaysian multi floral wild honey "Madu Lebah Tualang-Agromas" in reducing acute respiratory symptoms amongst Hajj pilgrims. A non-randomized control trial was conducted among Hajj pilgrims during the 2007 Hajj season. The intervention group was given two kilograms of honey and they were requested to consume 20 g of the honey twice daily throughout the 42 day Hajj journey (from Malaysia to Mekah and back), and to record any respiratory symptoms in the Health Diary provided. The number of symptoms was scored as 1, 2, 3 and 4 where each acute respiratory symptom contributed one point to the score. The outcomes were compared with the control group who were not given honey. Both intervention and control groups received an influenza vaccination. Outcomes were measured in terms of respiratory symptoms and evaluated statistically using repeated measures ANOVA by SPSS software. Results showed that the group which received honey generally scored a lower number of symptoms. They also had a significantly lower percentage of symptoms of sore throat and rhinitis during the third week of the journey. No significant differences were noted in the symptoms of cough and fever. The difference of mean symptom-score was maximum on the third week of the journey; however it was not statistically significant between the two groups. In conclusion honey "Madu Lebah Tualang-Agromas" was shown to reduce the respiratory symptom score of Malaysian Hajj pilgrims. It is significantly effective in reducing sore throat and rhinitis on the mid journey. Honey could be used as one of the prophylactic measures in reducing acute respiratory symptoms among Hajj pilgrims.

Prevalence and type distribution of human papillomavirus (HPV) in Malaysian women with and without cervical cancer: an updated estimate

Bioscience Reports, Mar 29, 2018

Information on the prevalence and type distribution of human papillomavirus (HPV) among Malaysian... more Information on the prevalence and type distribution of human papillomavirus (HPV) among Malaysian women is currently limited. The present study therefore aimed to provide an updated estimate on the prevalence and type distribution of HPV among Malaysian women with and without cervical cancer. Total DNA was isolated from the cervical cell specimens of 185 histopathologically confirmed cervical cancer patients and 209 cancer-free healthy females who were tested negative in a recent Pap test. Viral-specific DNA was subsequently amplified with biotinylated primers and hybridized to HPV type-specific probes via a proprietary "flow-through hybridization" process for determination of HPV genotype. It was demonstrated that 83.2% of the cervical cancer patients and none (0.0%) of the cancer-free females were positive for HPV infection. Among HPV-positive subjects, 14 different viral genotypes were observed, namely HPV16,

Pattern of Histopathological Alterations in N-methyl-N-Nitrosourea (MNU) Induced Breast Cancer in Female Sprague Dawley (SD) Rats Treated with Crude Honey

Pertanika Journal of Science and Technology, 2020

Natural products are becoming primary investigative molecules creating hope for finding new power... more Natural products are becoming primary investigative molecules creating hope for finding new powerful classes of anticancer agents for breast cancer. One of the most remarkable of these is honey. To explore the mechanism of action of any anticancer agent the initial step is to analyse its effect in the histopathological tissue section. This study was designed to describe the histopathology of N-methyl- N-nitrosourea (MNU) induced breast cancer in Sprague Dawley rat (SD rats) treated with crude honey. Female rats were distributed into 4 groups: Group0 (normal), Group1 (MNU control), Group2 and 3: Tualang and Manuka honey-treated, respectively. Rats were sacrificed and histopathology of both non-treated and treated tumours was done. Lower histological grade, infrequent combination histologic pattern (p<0.001), prominent cytoplasmic vacuolization (p<0.001), aggregates of atypical macrophages (p<0.001) and lesser necrosis (p= 0.005) were major outcomes in treated cancers. This d...

Management of Operable Breast Cancers When Patient Refuses Surgery

Electronic Journal of General Medicine, 2010

Surgery is the crucial modality of management in the multidisciplinary care of breast cancer. Wit... more Surgery is the crucial modality of management in the multidisciplinary care of breast cancer. Without surgery the outcome of treatment is complicated and sub-optimal. The oncologists face dilemma when patient refuse for surgery or not operable due to patients medical condition. Here we describe two post-menopausal women with operable breast cancers those refused surgery. We managed these patients with induction chemotherapy, radical radiotherapy and hormonal therapy. Their serial radiological evaluation revealed complete disappearance of primary breast tumor and axillary lymph nodes at the end of 88 and 69 months post treatment with good cosmesis. Conservative management may be an option among post-menopausal women with operable breast cancers those refuse surgery. The controversial management of above cases has been discussed with review of literature.

Poorly differentiated thyroid carcinoma: A hospital-based clinicopathological study and review of literature

Indian journal of pathology & microbiology

Poorly differentiated thyroid carcinoma (PDTC) is a rare aggressive malignancy of thyroid follicu... more Poorly differentiated thyroid carcinoma (PDTC) is a rare aggressive malignancy of thyroid follicular cells and has unique features in morphology and behavior. This study was aimed to describe the experience of a tertiary medical center with PDTC within a 10-year period. This is a descriptive retrospective study of eight cases of PDTC among 418 various thyroid carcinomas. All cases of PDTC were retrieved along with the clinicopathological information. Only eight cases (1.9%) of PDTC were diagnosed among 418 thyroid carcinomas. Mean age was 48.12 with 3:5 (male:female) and tumor size ranged 3-12 cm. PDTC were diagnosed coexisting with one or more other pathologies; nodular hyperplasia (four cases), papillary carcinoma (one case), follicular carcinoma (three cases), and Hashimoto thyroiditis (two cases); with ≥60% PDTC component. Six cases associated with high-grade features died within 3 years after diagnosis. Mean age in this study was younger including a 20-year-old girl. Younger ag...

Curcumin: the spicy modulator of breast carcinogenesis

Journal of Experimental & Clinical Cancer Research, 2017

Worldwide breast cancer is the most common cancer in women. For many years clinicians and the res... more Worldwide breast cancer is the most common cancer in women. For many years clinicians and the researchers are examining and exploring various therapeutic modalities for breast cancer. Yet the disease has remained unconquered and the quest for cure is still going on. Present-day strategy of breast cancer therapy and prevention is either combination of a number of drugs or a drug that modulates multiple targets. In this regard natural products are now becoming significant options. Curcumin exemplifies a promising natural anticancer agent for this purpose. This review primarily underscores the modulatory effect of curcumin on the cancer hallmarks. The focus is its anticancer effect in the complex pathways of breast carcinogenesis. Curcumin modulates breast carcinogenesis through its effect on cell cycle and proliferation, apoptosis, senescence, cancer spread and angiogenesis. Largely the NFkB, PI3K/Akt/mTOR, MAPK and JAK/STAT are the key signaling pathways involved. The review also highlights the curcumin mediated modulation of tumor microenvironment, cancer immunity, breast cancer stem cells and cancer related miRNAs. Using curcumin as a therapeutic and preventive agent in breast cancer is perplexed by its diverse biological activity, much of which remains inexplicable. The information reviewed here should point toward potential scope of future curcumin research in breast cancer.

Oral Administration of Tualang and Manuka Honeys Modulates Breast Cancer Progression in Sprague-Dawley Rats Model

Evidence-Based Complementary and Alternative Medicine, 2017

Breast cancer has been recognized as the leading cause of death in women worldwide. Research has ... more Breast cancer has been recognized as the leading cause of death in women worldwide. Research has shown the importance of complementary and alternative therapies in cancer. In this study, we investigated the antitumoural therapeutic effects of Malaysian Tualang honey (TH) and Australian/New Zealand Manuka honey (MH) against breast cancer in rats. Thirty syngeneic virgin female Sprague-Dawley (SD) rats were induced by the carcinogen 1-methyl-1-nitrosourea (MNU) 80 mg/kg. The treatment started when first palpable tumour reached 10–12 mm in size by dividing rats into following groups: Group 0 (negative control); Group 1 (positive control); and Groups 2 and 3 which received 1.0 g/kg body weight/day of TH and MH, respectively, for 120 days. The data demonstrate that cancer masses in TH and MH treated groups showed a lower median tumour size, weight, and multiplicity compared with the nontreated positive control (p<0.05). Treatment also showed a dramatic slower growth rate (up to 70.82%...

FAS c.-671A>G polymorphism and cervical cancer risk: a case–control study and meta-analysis

Cancer Genetics, 2017

This study aimed to investigate the association between FAS c.-671A&amp;amp;amp;amp;amp;amp;a... more This study aimed to investigate the association between FAS c.-671A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;G polymorphism and cervical cancer risk in a case-control setting, followed by a meta-analysis of the published literatures. The case-control study involved genotyping of the polymorphism in 185 histopathologically confirmed cervical cancer patients and 209 cancer-free female controls utilizing PCR-RFLP technique, followed by logistic regression analyses. Meta-analysis was then conducted under homozygous, heterozygous, dominant, recessive and allele contrast models to combine data from 12 studies which consisted of 2798 cases and 3039 controls. Our case-control analysis revealed a significant association of the variant allele (G) and the homozygous variant genotype (GG) of the FAS polymorphism with an increased risk of cervical cancer. Subgroup analysis by ethnicity further confirmed the risk association in Malays (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), but not among non-Malays (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.05). However, results of meta-analysis suggested a lack of association between the polymorphism and cervical cancer risk in all the five genetic models analyzed. In conclusion, while the FAS c.-671A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;G polymorphism may serve as a biomarker for cervical cancer risk prediction among the Malays, there is a limited usability of the polymorphism as a cervical cancer risk biomarker in other populations.

Dyspnea on swallowing: a case of thyroid lymphoma

Bangladesh Journal of Medical Science, 2017

Thyroid Hodgkin's lymphoma is infrequent occurrence that has four to one female preponderance. Mo... more Thyroid Hodgkin's lymphoma is infrequent occurrence that has four to one female preponderance. Most thyroid lymphomas are of B-cells lineage. In this case we present a primary Hodgkin's lymphoma in 45-year-old male patient who presented with gradual onset of upper airway obstructive symptoms. CT shows enlarged thyroid lobes with multiple nodal involvement and right internal jugular vein thrombosis. He was stridorous and was started on intravenous steroid. Right hemithyroidectomy was performed to alleviate the impinged airway as well as serving biopsy purpose. The histology confirmed diffuse B-cell non-Hodgkin's lymphoma. He responded well to treatment.

Inhibitory Effects of Tualang Honey on Experimental Breast Cancer in Rats: A Preliminary Study

Asian Pacific Journal of Cancer Prevention, 2013

The study was conducted to determine the effect of Malaysian jungle Tualang Honey (TH) on develop... more The study was conducted to determine the effect of Malaysian jungle Tualang Honey (TH) on development of breast cancer induced by the carcinogen 7,12-dimethylbenz(α)anthracene (DMBA) in rats. Forty nulliparous female Sprague-Dawley rats were given 80 mg/kg DMBA then randomly divided into four groups: Group 1 served as a Control while Groups 2, 3 and 4 received 0.2, 1.0 or 2.0 g/kg bodyweight/day of TH, respectively, for 150 days. Results showed that breast cancers in the TH-treated groups had slower size increment and smaller mean tumor size (≤2cm 3) compared to Controls (≤8cm 3). The number of cancers developing in TH-treated groups was also significantly fewer (P<0.05). Histological grading showed majority of TH-treated group cancers to be of grade 1 and 2 compared to grade 3 in controls. There was an increasing trend of apoptotic index (AI) seen in TH-treated groups with increasing dosage of Tualang Honey, however, the mean AI values of all TH-treated groups were not significantly different from the Control value (p>0.05). In conclusion, Tualang Honey exerted positive modulation effects on DMBA-induced breast cancers in rats in this preliminary study.

Inhibitory effects of Malaysian tualang honey and Australian/New Zealand Manuka honey in modulating experimental breast cancers induced by n-methyl-n-nitrosourea (mnu): A comparative study

Pathology, 2016

Background: The major problem with cervical cancer screening in countries which have no organized... more Background: The major problem with cervical cancer screening in countries which have no organized national screening program for cervical cancer is sub-optimal participation. Implementation of self-sampling method may increase the participation of women to screen for cervical cancer. Aims: To determine the agreement of cytological diagnoses made on samples collected by women themselves (self-sampling) versus cytological diagnoses made on samples collected by physicians (Physician sampling) Methods: We invited women volunteers to undergo two procedures; cervical self-sampling using the Evalyn brush and physician scraping using Cervex brush. They women were shown a video presentation on how to take their own cervical samples before the procedure. The samples taken by physicians were taken as per routine testing (Gold Standard). All samples were subjected to Thin Prep monolayer smears. The diagnoses made were according to the Bethesda classification. The results from the two sampling methods were analysed and compared. Results: A total of 367 women were recruited into the study. Thin Prep smears by physicians were better in terms of volume and variety of the cells seen. There is significant good agreement of the cytological diagnoses made on the samples from the two sampling methods with the Kappa value of 0.568 (p=0.040). The Thin Prep smears by self-sampling method were better in detecting microorganisms. Conclusion: This study shows that samples taken by women themselves (self-sampling) and physicians sampling had good cytology agreement. Self-sampling could be the method of choice in countries in which the coverage of women attending clinics for screening for cervical cancer is poor.

Semi-automated pseudo colour features extraction technique for cervical cancer's pap smear images

International Journal of Knowledge-based and Intelligent Engineering Systems, 2011

Image analysis is one of the common applications in the medical field especially in cytology, whe... more Image analysis is one of the common applications in the medical field especially in cytology, where the microscopic examination of cells and tissues is involved. Visual interpretation of microscopic images is tedious and in many cases is errorprone. Therefore a number of attempts have been carried out using the computer vision system to supplement the human visual inspection and to automate some of these tedious visual screening tasks. This study, in effect, proposes a semi-automated method of identifying features for Pap smear cytology images; i.e. semi-automated Pseudo-Colour Feature Extraction (PCFE) technique by integrating a clustering algorithm with the manual PCFE algorithm. The technique is used to segment the cervical cell images to provide the clearly seen nucleus and cytoplasm regions and then to extract the four features of cervical cells namely the size of nucleus and cytoplasm of cervical cells, as well as their gray level. A correlation test is applied between the data extracted using the proposed algorithm and data extracted manually by cytotechnologists. The technique operates well on cervical cells images with correlation values approaching 1.0, which indicates a strong positive correlation. The analysis also favours the AFKM clustering algorithm as the best clustering algorithm to be used with the PCFE by possessing the strongest relationship in terms of the correlation value. Furthermore, this study proves that the proposed algorithm is suitable and capable to be used to detect and extract features of cervical cells even for the overlapping cervical cells' images.

Synchronous mucoepidermoid carcinoma of the right upper eyelid and right parotid gland in a young patient

Malaysian Journal of Medicine and Health Sciences

Mucoepidermoid carcinoma is a relatively common neoplasm that affects the major and minor salivar... more Mucoepidermoid carcinoma is a relatively common neoplasm that affects the major and minor salivary glands comprising 10-30% of primary carcinomas. [1] They may involve the skin through direct extension, metastases, and rarely, as a primary focus (adenosquamous carcinoma). [1] Our patient presented with extensive tumor of the upper eyelid, which later was confirmed as mucoepidermoid carcinoma with areas of squamous cell carcinoma transformation. It was difficult to determine the origin of the tumor; possibilities include upper eyelid epithelium, accessory lacrimal gland, sweat gland or other skin appendages. THE CASE A 26 years old lady, with a history of burn on the face during childhood, first presented with a small ulcerative nodule like lesion at the right upper eyelid for few weeks duration. The lesion was progressively increasing in size and associated with pain and foul discharge with contact bleeding. An excisional biopsy was performed by a general practitioner, and was then referred to our center for further management. Examination at the time of presentation showed a 10 x 7cm fungating mass over the right periorbital region. The surface was ulcerated and partly covered with exudates and foul-smelling discharge. The conjunctiva was injected with central corneal opacity. She was also noted to have a right parotid swelling which is hard in consistency. There was involvement of the overlying skin which also displaced the ear lobe. There was no palpable cervical lymphadenopathy. Computed tomography scan of the head and neck demonstrated an irregular heterogenously enhancing soft tissue lesion involving the orbit. Medially, the mass extended to the right side of the nasal bridge, associated with soft tissue thickening extending to the frontal sinus area. The right parotid gland was enlarged measuring 4.0 x 2.0 x 4.5 cm with central necrosis. The deep lobe of the parotid gland was normal. Magnetic resonance imaging revealed right frontal bone involvement with frontal lobe dura enhancement. These clinical and radiological assessments indicate a malignancy which was further confirmed by the biopsy result which showed squamous cell carcinoma of right upper eyelid with intraorbital extension. Resection of right upper eyelid tumour with right total orbital exenteration, right total parotidectomy with excision of upper branch of facial nerve were performed together with removal of right orbital rim and coagulation of tumour attached to dura. Reconstruction was done by using free myocutaneous latissimus dorsi flap. Full histopathology report of the right periorbital specimen confirmed the diagnosis of extensive mucoepidermoid carcinoma with areas of transformation into squamous cell carcinoma. The right parotid showed a high grade mucoepidermoid carcinoma. The patient had an uneventful post-operative recovery. The patient was referred to oncology department for further palliative radiotherapy.

Preference of treatment facilities among Malaysian Hajj pilgrims for acute respiratory symptoms

Saudi medical journal, 2009

A cross-sectional study was conducted among 2000 Malaysian Hajj pilgrims from 23 December 2007 to... more

Unilateral exophthalmos caused by an extramedullary plasmacytoma: a case report

The Malaysian journal of medical sciences : MJMS, 2003

Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the liter... more Solitary plasmacytoma of the head and neck is a rare disease entity. Its description in the literature consist of some case reports. Solitary plasmacytoma presenting with exophthalmos are rare. We report a case of intracranial solitary plasmacytoma in an elderly lady with involvement of the right orbitocranial region presenting with severe exophthalmos. The tumour was debulked and radiotherapy was given.

Correlation of Nuclear Morphometry and AgNOR Score with Radiation Response in Squamous Cell Cancers of the Head and Neck: A Preliminary Study

The Malaysian journal of medical sciences : MJMS, 2010

Prediction of radiation response before the completion of the radiotherapy schedule is challengin... more Prediction of radiation response before the completion of the radiotherapy schedule is challenging. Information about radiation response could help oncologist to choose the appropriate combination and sequence of therapies in the multidisciplinary management of cancer. The study involved 26 patients with squamous cell cancers of the head and neck region who received radiotherapy to a dose of 30 Gy in 10 fractions over a 2-week period as part of a split-course technique. Fine-needle aspiration cytology was performed on day 1 and day 5 of the schedule. The silver staining of the nuclear organiser region (AgNOR) and nuclear morphometric study were done on both days. The median age of the patients was 44 years old. The primary tumours were distributed in the nasopharynx (n = 11), larynx and hypopharynx (n = 5), metastatic node (n = 4), and miscellaneous tumours were found in the head and neck sub sites (n = 6). The mean initial AgNOR score was 3.0, range 1.2-7.0. The median of nuclear a...

The association between pre-morbid conditions and respiratory tract manifestations amongst Malaysian Hajj pilgrims

Tropical biomedicine, 2010

In a very closed and overcrowding environment, influenza transmission during Hajj season is almos... more In a very closed and overcrowding environment, influenza transmission during Hajj season is almost inevitable. The aim of this study was to determine the association between pre-morbid conditions and influenza-like illness (ILI) amongst Hajj pilgrims. A cross-sectional study was conducted amongst Malaysian Hajj pilgrims in year 2007. Survey forms were distributed at Madinatul-Hujjaj, Jeddah and Tabung Haji Clinic, Medina, Saudi Arabia where pilgrims stay on transit before returning to Malaysia. Allergic rhinitis was significantly associated with sore throat (p=0.047), longer duration of cough (p=0.017) and runny nose (p=0.016). Pilgrims who suffered from chronic obstructive pulmonary diseases (COPD) had significant association with longer duration of cough (p=0.041) and those with diabetes mellitus had significant association with longer duration of sore throat (p=0.048). Underlying asthma was significantly associated with severe influenza like illness requiring admission to hospita...

Is Kelantan joining the global cancer epidemic?--experience from hospital Universiti Sains Malaysia; 1987-2007

Asian Pacific journal of cancer prevention : APJCP

To determine the trend of cancer cases in one major hospital in Kelantan over a 20 year period fr... more To determine the trend of cancer cases in one major hospital in Kelantan over a 20 year period from 1987 to 2007 and to speculate the change in trend due to the socio-economic and other health status in the state. All data on clinically diagnosed cancer cases in Hospital Universiti Sains Malaysia [HUSM] were retrieved from the hospital medical records. The cancers were classified according to ICD10 and scrutinized to avoid duplicate or more entries. The increment in cancer incidence was calculated based on total numbers of cancer cases per each 5-6 year period. A total of 12,228 solid cancers were diagnosed during the period. There is an increment of 20.1% for 1991-1996 from 1987-1990 period, 67.4% for 1997-2001 from 1991-1996 period and 305.9% for 2002-2007 from the 1997-2001 period. The rise was steep in the last 5-6 years. After excluding referred cases from states outside Kelantan, the increments were 20.1%, 67.4% and 143.6% for the consecutive 5-6 year periods. The predominant ...

$Research paper thumbnail of Pilot Study on Continuous Hyperfractionated Accelerated Radiotherapy(CHART) and High Dose Rate Brachytherapy in Locally Advanced Cervical Cancer$

Pilot Study on Continuous Hyperfractionated Accelerated Radiotherapy(CHART) and High Dose Rate Brachytherapy in Locally Advanced Cervical Cancer

Journal of Cancer Science & Therapy, 2011

Background: Fractionated external beam radiotherapy followed by intracavitary brachytherapy is th... more Background: Fractionated external beam radiotherapy followed by intracavitary brachytherapy is the mainstay of treatment in cervical cancer. Due to long radiotherapy course, patients in developing countries default effective radiotherapy. Treatment break or discontinuance leads to treatment failure. Continuous hyperfractionated accelerated radiotherapy (CHART) is an altered fractionation scheme used to reduce overall treatment time, overcome tumor repopulation thus could be an option in cervical carcinoma. Methods: Twenty-five histopathological documented locally advanced cervical carcinoma (FIGO stage IB2-IVA) were treated with 42Gy/30fractions external radiotherapy over 10-day period at an inter-fraction interval of 6 hours using CHART technique. Following CHART, patients were subjected to high dose rate brachytherapy to a dose schedule of 9Gyx2 at weekly interval. The response to above radiotherapy protocol and morbidity pattern was evaluated. Results: All patients completed planned CHART external radiotherapy. The median follow-up was 32-months with a pelvic control rate of 68% and 24-month overall survival was 72%. The most common acute toxicity in CHART technique was fatigue (64%) and diarrhea (52%), the late effects being rectal bleeding (2-cases), subcutaneous fibrosis (1-case), spinal pain (1-case). Conclusion: CHART technique is an effective and well tolerated technique in locally advanced cervical cancer at a cost of manageable fatigue and diarrhea. Further investigation involving large number of patients is warranted to evaluate this technique.

Effect of Influenza Vaccination on Acute Respiratory Symptoms in Malaysian Hajj Pilgrims

Journal of Immigrant and Minority Health, 2014

Respiratory illness were a major problem and caused high hospital admission during hajj seasons. ... more Respiratory illness were a major problem and caused high hospital admission during hajj seasons. One of the contributing cause to this illness is infection. Various measures had been implemented to reduce respiratory infections. The aim on the study is to determine the effect of influenza vaccination against acute respiratory illness among Malaysian Hajj pilgrims. This is an observational cohort study. Influenza vaccination was given to pilgrims at least 2 weeks prior to departure. The occurrence of symptoms for respiratory illness such as cough, fever, sore throat and runny nose was monitored daily for 6 weeks during pilgrimage using a health diary. A total of 65 vaccinated hajj pilgrims and 41 controls were analyzed. There was no significant difference in pattern of occurrence of symptoms of respiratory illness by duration of pilgrimage as well as the number of symptoms between both groups. Hajj pilgrims have frequent respiratory symptoms. We were unable to document benefit from influenza vaccination, but our study was limited by a small sample size and lack of laboratory testing for influenza.

The Benefit of Tualang Honey in Reducing Acute Respiratory Symptons Among Malaysian Hajj Pilgrims: A Preliminary Study

Journal of ApiProduct and ApiMedical Science, 2011

Acute respiratory symptoms such as cough, rhinitis, sore throat and fever are one of the main hea... more Acute respiratory symptoms such as cough, rhinitis, sore throat and fever are one of the main health problems encountered by pilgrims performing Hajj in Mekah. The possible causes include overcrowding and low immune status as a result of stress. Honey is reputed to contain multiple chemical compounds that are capable of enhancing the immune system and has antibacterial, antiviral and antifungal properties. We determined the effectiveness of Malaysian multi floral wild honey "Madu Lebah Tualang-Agromas" in reducing acute respiratory symptoms amongst Hajj pilgrims. A non-randomized control trial was conducted among Hajj pilgrims during the 2007 Hajj season. The intervention group was given two kilograms of honey and they were requested to consume 20 g of the honey twice daily throughout the 42 day Hajj journey (from Malaysia to Mekah and back), and to record any respiratory symptoms in the Health Diary provided. The number of symptoms was scored as 1, 2, 3 and 4 where each acute respiratory symptom contributed one point to the score. The outcomes were compared with the control group who were not given honey. Both intervention and control groups received an influenza vaccination. Outcomes were measured in terms of respiratory symptoms and evaluated statistically using repeated measures ANOVA by SPSS software. Results showed that the group which received honey generally scored a lower number of symptoms. They also had a significantly lower percentage of symptoms of sore throat and rhinitis during the third week of the journey. No significant differences were noted in the symptoms of cough and fever. The difference of mean symptom-score was maximum on the third week of the journey; however it was not statistically significant between the two groups. In conclusion honey "Madu Lebah Tualang-Agromas" was shown to reduce the respiratory symptom score of Malaysian Hajj pilgrims. It is significantly effective in reducing sore throat and rhinitis on the mid journey. Honey could be used as one of the prophylactic measures in reducing acute respiratory symptoms among Hajj pilgrims.

A chapter in a book called “Honey in Traditional an Modern Medicine” edited by Laid Boukraa; Honey in Tradional and Modern Medicine

Garden of Wisdom Beauty and Love – a thrilling voyage through poetry and imagination of 3 medical professors

Public-private collaboration in research and development in Malaysia