This thesis represents an effort by the author to overcome the dearth of Islamic discourses in Medical imaging, a sub-specialisation within the bigger field of Medicine. Driven by the concepts of Islamisation of Knowledge (IOK), integration of Islamic input in the professions, as well as his professional obligation as an academician in an Islamic university, the author posits himself to contribute towards the realisation of the above concepts and enriching the Islamic based literature. Efforts were made done to ascertain the state of affairs of the presence of Islamic perspectives in Medical imaging literature. The results showed a major void in Islamic perspectives in the literature. The term “perspective” and “perspectives” used in this thesis are seen within the definition of perspective; “a particular way of considering something”. The plural form does not suggest that Islam has differing opinions or views when confronted with a particular issue but represents the various sources and types of references. The essence of these individual perspectives remains embedded in Tauhidic (Oneness of Allah) principles and objectives. The thesis proposes a methodology in integrating Islamic perspectives into the theoretical domains within a typical Medical imaging curriculum. Existing knowledge from the predominantly secular environment that has dominated Medical imaging since its inception is not discriminately discarded unless those that is not in line with what Islam champions. Harmonisation and individual tailoring of the Islamic perspectives with the human sciences remain the core approaches in the integration process. The integration also identifies the teaching, learning and assessment considerations. The superficiality in the coverage over the wide dimensions in the discipline is seen within the context of future avenues for in-depth discourses to be made. Typically, the involvement of Muslim practitioners at all levels; the academicians, the practitioners, the leadership, the administration and the professional fraternity are required for promoting, internalising and sustaining Islamic perspectives in the discipline.

The increasing number of healthcare services facilities to accommodate the needs of population growth especially in developing countries including Malaysia has increased the prevalence of sharps injury among the healthcare workers (HCWs). The role of HCWs to ensure the safety standards and practices are implemented is crucial due to the high risk of becoming infected with HBV, HCV, and HIV at 30%, 1.8%, and 0.3%, respectively. However, preliminary study has revealed that until currently, there is no national guidelines on how to handle sharps to avoid injury during various procedures in Healthcare Establishment (HCEs). Therefore, a study was conducted to develop a sharps safety module by considering various factors to ensure that the module is systematic and comprehensive for the basis of national guidelines. The study was conducted through a qualitative study by exploring the current practices and technical methods in managing sharps at selected HCEs in Malaysia, a quantitative study by measuring the prevalence of knowledge, attitude, and practices on sharps management among HCWs in HCEs in Malaysia and an Analytical Hierarchy Process (AHP) method as a multi-criteria decision-making tool to help HCEs stakeholders in making the right decisions. The qualitative study revealed two main themes: organisational factor and employee factors. Seven codes that influenced the cause of sharps injury in these two themes were cost, policy and guideline, training, technology, safety, reporting issues and handling. The quantitative study results revealed that even though most of the participants had a good knowledge level, the attitude, and practices of the participants toward sharps management were only at moderate and poor attitude, and moderate to fair level of practices. All factors identified in qualitative and quantitative study were then included as the criteria in AHP. A three- tier hierarchy structure was established for this study. The first tier stated that the goal of the AHP was to select the best safety module to reduce the risk of sharps. The second tier included the criteria that made up of the six factors: policy, and training, reporting issue, safety, technology, and handling. Finally, the third tier included three alternatives, namely Module A: Basic Integrated Sharps Management Safety Module; Module B: Intermediate Integrated Sharps Management Safety Module and Module; and Module C: Advanced Integrated Sharps Management Safety Module. Once the hierarchy was established, pairwise comparisons were made to formulate the final weights for each criterion and the selection of the alternative. AHP recommended Module C (Integrated Safety Sharps Management Module), with the overall priority at 42.3% as the best safety module to reduce the risk of sharps injury among HCWs in HCEs. Based on the Module C and elements identified in earlier phase of the study, a model of sharps safety management module was established, in conclusion, this study findings provide a comprehensive framework of model for sharps safety management module as the basis for national guidelines on sharps management to ensure the safety of HCWs in HCEs in Malaysia. Keywords: Healthcare workers, Malaysia, NSI, Sharps management

Degenerative joint disease has no known cure. Although this medical condition affects mostly the ageing population, joint injuries at a young age may accelerate the degeneration process. The existing pharmacological and surgical treatments alleviate symptomatic pain and help patients to remain active. Unfortunately, there is no single treatment that is able to address the root cause of the disease thoroughly. As an alternative, tissue engineering and regenerative medicine (TERM) method offer numerous options to treat joint diseases. There are growing demands for tissue-engineered medical products (TEMPs) worldwide, including Malaysia. However, based on a scoping review, scientific development and clinical translation activities for TEMPs are not progressing as they should be. These multitude limitations perhaps stemmed from many challenges in TERM practices ranging from scientific and technical issues, economic recession, social perplexities, as well as ethical and legal issues. This study aims to formulate an ethical and legal framework to facilitate both scientific and social progress of articular cartilage tissue engineering (ACTE) research in Malaysian context. A survey on the worldwide trend of ACTE research was conducted using a systematic search and through content analysis in formulating the framework. This ethical and legal framework is addressed from the Islamic perspective. A framework, with the benefits being weighed up against possible risks and harmful effects, should be the basis of the practices of ACTE research. Since both ethics and scientific knowledge play a role to determine the permissibility of ACTE research, this study uses both scientific as well as ethical and legal literature, so the two disciplines are bridged. It is so because the concerns made by the bioethicists in this matter are worthy. While scientific endeavours done by the researchers to improve the scientific knowledge in ACTE is also worthy, these two concerns are thus complementary, not contradictory to each other. Although the monitoring by responsible bodies such as governments, legislators, and scientific organisations is essential, it equally is the responsibility of a competent TERM professional to be morally aware when confronted with issues related to ACTE research. More intellectual and engaging deliberation on ACTE research should enter the domain of ongoing moral, ethical and legal education. The end goal of this effort is towards establishing a holistic healthcare management model for patients in the future.

Cardiovascular diseases are major contributor to morbidity and mortality worldwide. Atherosclerosis is a leading cause to cardiovascular diseases in addition to its pathogenic association with non-alcoholic fatty liver disease (NAFLD). Protection against atherosclerosis and NAFLD constitutes a global aim. Modern trend has emerged to reintroduce natural products such as honey for management of these metabolic epidemics because of the less side effects perhaps. In the present study, Trihoney was investigated for its anti-atherosclerotic and hepatoprotective effects in diet induced hypercholesterolemic rabbits model. Forty-eight male New Zealand white rabbits were randomly assigned to one of 6 groups. First group was fed only commercial rabbit diet, second group was fed commercial rabbit diet with 0.6g of Trihoney/kg/day, third group was fed 1% cholesterol diet, fourth and fifth groups were fed 1% cholesterol diet with 0.3 and 0.6 g of Trihoney/kg/day while the last group was fed 1% cholesterol diet plus 2mg of atorvastatin/kg/day. Experiment continues for 12 weeks duration. Blood samples were withdrawn before and after the experimental period. Aorta and liver were harvested and processed for homogenate and histopathological studies. In the first phase, Trihoney was investigated for its lipid lowering and anti-inflammatory effects through analysis of serum lipids [total cholesterol (TC), low-density lipoprotein (LDL-c), high-density lipoprotein (HDL-c), triglycerides (TG) and TC/HDL risk ratio] and by assay of serum pro-atherogenic inflammatory cytokines [interleukin-1β (IL-1β), interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α)]. The results showed that Trihoney had significant lipid lowering and marked anti-inflammatory effects. In the second phase, Trihoney was assessed for antioxidant function by analysing serum and aorta homogenate for superoxide dismutase (SOD), glutathione peroxidase (GPx) and malondialdehyde (MDA), in addition to analysing serum for oxidised-LDL (Ox-LDL). Results showed that Trihoney exerted significant antioxidant effects systemically as well as locally in the aorta. In the third phase, Trihoney was investigated of its effects on the atherosclerotic plaques, inflammatory adhesion molecules such as intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and on homocysteine. Results showed that Trihoney had significant anti-inflammatory and vascular protective functions. In the fourth phase, Trihoney was examined for hepatoprotective function against NAFLD through histopathological study and via assay of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), total bilirubin (T. Bil.), alkaline phosphatase (ALP), fasting glucose, fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR). In addition to antioxidant assay of liver homogenate for SOD, GPx and MDA. Results showed that under status of sustained hypercholesterolemia, Trihoney was able to normalise hepatic function in NAFLD induced hypercholesterolemia, Trihoney showed no effect on fasting glucose, insulin and HOMA-IR, Trihoney exhibited significant antioxidant effect against hepatic oxidative stress and it was protective against progression of NAFLD to non-alcoholic steatohepatitis (NASH). Accordingly, Trihoney has a potential protective role against atherosclerosis and NAFLD through hypocholesterolemic, antioxidant and anti-inflammatory functions. Further studies may be needed to explore possible molecular mechanisms underlying those health beneficial properties of Trihoney.

Hystrix brachyura bezoar (PB) has been traditionally used as an alternative medicine to treat cancer. However the anticancer effect of PB is yet to be explored. Therefore this study aims to evaluate PB anticancer potential using metabolomics approach and molecular docking. Four different PBs namely PB-A, PB-B, PB-C and PB-D were procured and used in this study to evaluate the anticancer effect. All PBs were treated with water through ultrasonication-assisted extraction technique to obtain aqueous extracts. The melanoma cells (A375) were chosen for the evaluation of further anticancer effects. A375 cells were subjected to cell proliferation, colony formation, apoptosis, cell cycle arrest, cell migration, cell invasion assays followed by molecular pathways using real time polymerase chain reaction (qPCR) and in vivo antiangiogenesis using zebrafish (Danio rerio) larvae. Additionally, all four PBs were also evaluated for their toxicity effect using zebrafish embryos. The anticancer compounds of PB were putatively identified using liquid chromatography–mass spectrometry (LC-MS) and liquid chromatography–mass spectrometry (LC-MS) based metabolomics approaches. All the compounds identified were then docked to BCL-2, cyclin B/CDK1 complex, VEGF and NM23 crystal structures to predict the ligand-protein interaction. Lastly, the study also developed a validated regression model using Fourier transform infra-red (FT-IR) spectroscopy to predict the anticancer activity of new PB extract to ensure its quality as an effective anticancer agent. All PB extracts exhibited significant cytotoxicity on A375 cells. Further analysis revealed that PB-A, PB-C and PB-D had a good inhibitory effect on cell proliferation, colony formation, cell cycle, cell migration, cell invasion, angiogenesis and apoptosis inducer. PB-A, PB-C and PB-D revealed apoptosis through intrinsic pathway, arresting the cell cycle at G2/M phase by downregulating cyclin B and CDK1. PB-A, PB-C and PB-D at molecular level were showed to suppress NM23, E-cadherin, MMP2 and MMP9. The toxicity assessment showed the morphological developmental defects caused by all four PB extracts such as deformed brain section, contorted backbone with deformities in somites and notochord, deformities in soft tissues (yolk sac, pericardial edema and swim bladder). Additionally, the PB extracts were showed to affect the cardiovascular systems via presence of heart edema, downregulating the heart rate and blood flow. The LC50 values at 96 hpf were <100 µg/mL. Chemical profiling analyses of PB extracts through GC-MS and LC-MS based metabolomics approached identified 4-androsten-4-ol-3,17-dione, acetate cholest-7-en-3-ol, gallic acid, isolongifolol, mangiferin and propafenone as the active principles. The docking results predicted the interaction of the active principles with BCL-2, cyclin B/CDK1 complex, VEGF and NM23 majorly via hydrophobic interaction with protein residues. The docking results showed good binding affinity to the crystal structures of BCL-2, cyclin B/CDK1 complex, VEGF and NM23 for 4-androsten-4-ol-3,17-dione, cholest-7-en-3beta-ol,4,4-dimethyl-, acetate and mangiferin, suggesting the roles of these compounds as the potential anticancer agents. Moreover, the study has also generated a validated statistical model to predict the anticancer activity of new PB extracts. Conclusively, the study has revealed the anticancer activity of Hystrix brachyura bezoar, active principles, in vitro mechanism of action and in vivo toxicity effect using zebrafish model for the first time. Results of this study further support the traditional claims for the use of Hystrix brachyura bezoar as an anticancer agent in Malaysia.

The consumption of fruits has been correlated with better health and prevention of several diseases. Phytochemicals such as phenolic compounds and vitamins in fruits are believed to act as antioxidants that could reduce oxidative damage to biomolecules by modulating reactive free radicals. Since Malaysia is rich in a wide variety of tropical fruits, we should examine them in producing healthy and tasty juices. A new fruit juice named Mixed Fruit Juice (MFJ) was formulated from a combination of three tropical fruits (soursop, mango and kasturi lime).There is no information regarding the antioxidant activity, antioxidant compounds, safety parameters and bioavailability of the bioactive compounds in this product. Therefore, this study focuses on the measurement of antioxidant activity by using the common chemical methods (TPC, FRAP, DPPH) followed by the identification and quantification of phenolic acids by GC-MS. The safety and in vivo antioxidant effects of MFJ were done in normal and aged rats. Human intervention study was established in order to determine the bioavailability of the phenolic compounds in MFJ. Results show that MFJ contained 23.50±1.57 mg GAE/100g (TPC) and 18.77±0.46 mg TE/100g (FRAP) and DPPH value at 83.66±0.84%. The 28-day sub-chronic toxicological test showed no systemic toxicity attributable to the MFJ administration in normal rats. There was no significant effect in the haematological profiles and both liver and kidney function tests when compared to control rats. Furthermore, MFJ was able to modulate the antioxidant enzymes such as SOD, GPx and CAT in the blood and tissues (liver and brain) of aged rats. Aged condition reduces all the antioxidant enzymes in blood and tissues. The supplementation of MFJ in aged rats had increased the TAS, GPx and SOD values in the blood by 14%, 30% and 104%, respectively. In the liver, the CAT and SOD also increased by 33% and 22%, respectively. In addition, substantial increment was observed in the activity of enzymes in the brains of aged rats. GPx was found to increase by 75% in aged rats after receiving MFJ. Moreover, SOD had increased more than 100% in aged rats after receiving MFJ. In the bioavailability study, phenolic acids (p-coumaric acid, ferulic acid and caffeic acid) were found in conjugated form (plasma and urine) and mainly further metabolized to hippuric acid that was excreted in the urine after one hour of MFJ ingestion. Hippuric acid, the main metabolite in urine was found to increase by 25% compared to baseline. In addition, ferulic acid which is known as an antioxidant compound was also recovered in the urine at 16% in one hour. Thus, it is suggested that the absorption of phenolic acids may occur in the small intestine. In conclusion, this current study shows that MFJ was able to exert the antioxidant effects due to the content of phenolic acids which was proven bioavailable in humans.

Treating articular cartilage defect remains a major orthopaedic predicament. Being a simple structure that is avascular and aneural, articular cartilage has little ability to repair itself when damaged. Cartilage tissue engineering provides an alternative technique for restoring and regenerating damaged cartilage tissues. This study attempts to (1) evaluate and compare the growth of bone marrow mesenchymal stem cells (BMSCs) aspirated from rabbits’ iliac crest and femur in two different culture media; α-Minimum Essential Medium (α-MEM) and a mixture of 1:1 Ham’s F12 Nutrient Mixture (F12) and Dulbecco’s Modified Eagle Medium (DMEM) or FD, (2) to evaluate the in vitro and in vivo cartilaginous tissue formation using BMSCs-seeded poly(lactic-co-glycolic acid) PLGA/Fibrin scaffolds and (3) to explore the bioethical issues within the Islamic perspective in relation to tissue engineering and regenerative medicine (TERM). Growth kinetic assessments were performed on monolayer-cultured BMSCs harvested from two locations and cultured in two different media. Constructs fabricated from BMSCs seeded onto PLGA/Fibrin were cultured for three weeks and thereafter were implanted in rabbit model. The in vitro cartilaginous engineered constructs were evaluated by gross inspection, cell proliferation assay, gene expression, sulphated glycosaminoglycan (sGAG) production and histology at week 1, 2 and 3 while the in vivo construct were harvested at week 6 and week 12 post-implantation. It was observed that BMSCs harvested from the iliac crest region and cultured in FD significantly promoted BMSCs growth. The in vitro study showed that after 3 weeks of culture, the PLGA/Fibrin construct exhibited significantly higher cell viability, higher sGAG content and better histo-architecture and cartilaginous extracellular matrix (ECM) compound in concert with the positive glycosaminoglycan accumulation when compared to the PLGA only construct. Post implantation, the osteochondral defects treated with PLGA/Fibrin/BMSCs constructs showed better repair, more cartilaginous extracellular matrix, higher sGAG content, superior compressive strength and greater expression of chondrogenic marker genes than PLGA/BMSCs group. COL2A1 which is the specific cartilage marker, ACAN, COL9A1 and SOX9 genes were expressed both in the in vitro and in vivo. This study suggested that PLGA/Fibrin when seeded with pluripotent BMSCs that underwent optimum manipulation may serve as a prospective construct to be developed as functional tissue engineered cartilage. This study may also act as a platform to spark the initiative in integrating Islamic bioethics in providing “middle of the road” approach moderating between science and religion. Debates on TERM must comprise on religious and ethical view considering there are still many grey areas that requires Islamic input. Based from the Islamic perspective, scientific researches in TERM are permitted, as long as it is not a threat to human being and applied within the permissible limits described by the Shari’ah.

Glaucoma is an ocular disease that results progressive damage of the retinal nerve fibre layer which result to irreversible visual deterioration. Glaucoma impact on the brain is not conclusive. Even the magnetic resonance spectroscopy (MRS) findings in the visual pathway areas shown incoherent findings. This study aimed to investigate and measure the concentration of metabolites in the lateral geniculate nucleus (LGN) and visual cortex (VC) of subjects with glaucoma using MRS. The MRS measurement using a single-voxel spectroscopy (SVS) was performed using 1.5 Tesla MRI, on healthy young adults, healthy older adults, mild glaucoma, and severe glaucoma. A standardised volume of interest of 13mm x 13mm x 13mm was placed in the region of LGN and VC. Five metabolites were extracted and quantified from raw spectra using the AMARES (Advanced Method for Accurate, Robust, and Efficient Spectral Fitting) method within the Java-based magnetic resonance user interface (jMRUI). The quantification process yields amplitudes in arbitrary units of N-acetyl aspartate (NAA), glutamate-glutamine (Glx), creatine (Cr), choline (Cho), and Myo-Inositol (mI). Two consecutive scans were performed on each LGN and VC from both brain hemispheres of young healthy adults. The repeatability of MRS measurement in the LGN and VC were analysed. The LGN and VC of young healthy subjects and healthy elderly subjects were scanned. The metabolites were compared between groups. The metabolites in the LGN of healthy elderly subjects, participants with mild glaucoma and severe glaucoma were compared. The metabolites in the VC of healthy elderly subjects, participants with mild glaucoma and severe glaucoma were compared. The metabolites concentration in the LGN and VC showed no significant differences between consecutive scan (p>0.05). Analysis showed good agreement and small variability between the consecutive MRS measurements (bias in LGN: -0.46 to 1.17; bias in VC: -0.61 to -0.22). Healthy older adults have lower levels of NAA and higher levels of Glx, Cr, and Cho in the LGN compared to healthy young adults (p<0.05). In the VC, healthy older adults have higher levels of Cr, Cho and mI compared to healthy young adults (p<0.05). Severe glaucoma group has higher level of NAA (65.03±14.66; Tukey HSD, p=0.03) and lower level of Cho (14.09±5.07; Games-Howell, p=0.016) in the LGN compared to healthy group. Glx (604.93±93.55; Games-Howell, p=0.031) level in the VC was lower in severe glaucoma compared to healthy group while Cho/Cr (0.030±0.06; Tukey HSD, p=0.031) level in the VC was lower in severe glaucoma group compared to mild glaucoma group. The single voxel MRS using 1.5 Tesla MRI is repeatable in determining metabolites concentration in the LGN and VC. Age affects the NAA, Glx, Cr and Cho concentrations in the LGN, and Cr, Cho and mI concentrations in the VC. Metabolites analysis should consider aging into factor. Glaucoma may cause shift in the NAA and Cho concentration amplitudes and ratio in the LGN. Glaucoma may cause shift in the Glx and Cho/Cr concentration amplitudes and ratio in the VC. Further research in this area may help elucidate the underlying mechanisms of glaucoma and potentially aid in the development of novel diagnostic or therapeutic approaches.

Memorising the holy Quran has been the motivation for most Muslims due to the advantages that it offers, in this life and the hereafter. The robust process of memorising the holy Quran is expected to cause changes in the brain regions which is associated with the memory encoding, storage, and retrieval capacity. The main areas in the brain that are involved with memory encoding, storage, and retrieval capacity are the amygdala, hippocampus, cerebellum, and prefrontal cortex. At the moment, the analysis of neuroplasticity is limited to be analysed in binary image because gray-scale analysis requires the usage of more robust image processing techniques. Therefore, this study aims to investigate and characterise the complexity of textual memorisation brain structures using fractal analysis between huffaz and non-huffaz by means of global box-counting analysis, global FFD analysis, and VOI-based analysis. The study recruited 47 participants (mean±SD age, 22.55±1.472 years) from students of IIUM Kuantan Campus. Huffaz group had their 18 months of memorisation training at Darul Quran, Kuala Kubu Bharu, Selangor. The brain MRI images were acquired before being pre-processed using Voxel-Based Morphometry (VBM) toolboxes with MATLAB as platform. Processed images were then thresholded with three thresholding techniques to find the best thresholding method; Otsu, midpoint and hysteresis. Otsu method was proven to be the best thresholding technique (mean±SD, 2.3801±0.953) with a significant difference (p<0.01) tested with ANOVA. Global box-counting and FFD analysis were conducted on the brain MRI images concurrently with VBM to find out the possible brain regions with neuroplasticity. Both analyses found no significant statistical difference between brains of huffaz and non-huffaz (p>0.05), with VBM analysis also could not find any activated voxel brain regions. VOI-based analysis found nine significant areas (p<0.05); two for box-counting analysis (angular gyrus and medial temporal gyrus), six for FFD analysis (BA20, BA30, anterior cingulate, fusiform gyrus, inferior temporal gyrus and frontal lobe), and only a single area (BA33) have shown significant volume differences between huffaz and non-huffaz using VOI-based analysis. BA20 is part of the temporal cortex in the brain, BA30 is located at isthmus of the cingulate gyrus, while BA33 is located at the anterior cingulate gyrus of the brain cortex. All these Brodmann areas involve heavily in memory encoding, memory storage, and retrieval capacity of humans. The results have highlighted the sensitivity of VOI-based analysis because of its local analysis, as compared to the global analysis by box-counting and FFD. These findings have shown that brain neuroplasticity was managed to be detected using VOI-based analysis, and that neuroplasticity due to memorisation process occurred by involving multiple brain areas and regions, and not solely on a single area or a region. To conclude, the application of ability of fractal analysis has been proven to detect structural changes occurrence in brains of huffaz as compared to non-huffaz.

Polyamine biosynthesis, which is tightly regulated in normal cells to maintain homeostasis, is frequently dysregulated in carcinoma cells, resulting in uncontrolled proliferation, evasion of apoptosis, and enhanced cancer cell survival. As part of the World Health Organization’s (WHO) initiative to eliminate cervical cancer as a public health concern by 2030, chemoprevention strategies offer a promising approach to target vulnerable populations and reduce cancer incidence. This study aims to investigate and elucidate the mechanistic and therapeutic potential of selected Malaysian herbs as chemopreventive agents targeting the polyamine pathway in human cervical cancer, SiHa cells. Aqueous extracts of 11 selected Malaysian herbs were prepared via maceration at 60 °C with a cosolvent and subsequently lyophilised at −80°C. An initial screening of the herbs –including S. aromaticum, E. scaber, H. rosa sinensis, C. caudatus, C. ternatea, C. verum, C. zedoaria, F. deltoideia, S. crispus, C. tamala, and M. fragrans –was conducted to assess cytotoxicity against SiHa cells. Phytochemical profiling was performed using Gas Chromatography-Mass Spectrometry (GC-MS) and Liquid Chromatography-Mass Spectrometry (LC-MS). The antiproliferative effects were evaluated using MTT and TBE assays, while protein levels were measured using Lowry’s assay. Key genes involved in polyamine metabolism—ODC, SSAT, OAZ1, and SMOX—were analysed via quantitative PCR (qPCR). Cell death mechanisms were investigated through cell cycle analysis, annexin V assay, and caspase 3, 8, and 9 activity assays. Following cytotoxicity screening, S. aromaticum and E. scaber were selected for their highest cytotoxicity, with lowest IC50 values of 177.6 and 88.8 μg/ml at 48 hours, respectively. Both extracts significantly inhibited cell growth and reduced intracellular protein content (p < 0.05). Low endogenous polyamine levels were detected in S. aromaticum (0.585 nmol/mg) and E. scaber (0.192 nmol/mg) extracts. Polyamine biosynthesis was disrupted by the downregulation of ODC (p < 0.05) and pregulation of OAZ1, SSAT, and SMOX (p <0.05), indicating a significant reduction in polyamine production in SiHa cells following treatment. Cell cycle analysis revealed G0/G1 arrest and G2/M accumulation, while annexin V assay indicated increased in late apoptotic cell populations. Caspase assays demonstrated that both extracts increased caspase 3 activity, with E. scaber predominantly activating caspase 8 and S. aromaticum significantly increasing caspase 9 activity. This study demonstrates the in vitro efficacy of S. aromaticum and E. scaber as chemopreventive agents against cervical cancer. The findings support their potential to inhibit cell proliferation, reduce polyamine content, induce apoptosis, and cause cell cycle arrest in SiHa cells, suggesting their promise as apoptosis-mediated therapeutic candidates for cervical cancer prevention and treatment.

Nasopharyngeal carcinoma (NPC) is among the most frequently reported cancer in Malaysia where it is usually diagnosed at late stages. The inconvenient and painful contemporary diagnostic methods for NPC discourage the population at risk from being screened at early stages. Thus, the discovery on non-invasive biomarkers for early detection of NPC is warranted. MicroRNAs (miRNAs), a class of RNAs that have been found to circulate stably in body fluids, are widely studied as potential biomarkers for NPC. While many countries with high NPC prevalence are actively studied extracellular miRNAs as diagnostic biomarker for NPC, such studies in Malaysia were scarce. Thus, this study aimed to identify the circulating and salivary miRNAs as early detection biomarker of the disease by analysing their differential expression. Blood and saliva samples were collected from 37 NPC and 37 control subjects in the states of Pahang and Kelantan, and were subjected to miRNA extraction. miRNA extracts from NPC (n=10) and control (n=11) plasma samples were used to screen the differentially expressed miRNAs using Taqman® Low Density Array card A and B. The significant differentially expressed (p<0.05) miRNAs in plasma of NPC subjects were selected for validation using 36 plasma and 37 saliva samples of NPC and control subjects. The consistent differential expression of miRNAs in plasma, as well as their corresponding miRNAs in saliva, were further analysed to evaluate their diagnostic performance. The selected miRNAs were cross-validated to select the best combination of miRNA model in predicting NPC. ROC curve analysis was used to evaluate the diagnostic performance of miRNA models. The result on circulating miRNA screening showed that eleven miRNAs were significantly differentially expressed (p<0.05) in NPC as compared to control subjects. The validation on eight selected miRNAs revealed that four miRNAs, namely hsa-miR-150, hsa-miR-205, hsa-miR-639 and hsa-miR-889, were consistently differentially expressed in plasma of NPC as compared to control subjects with significant result. The cross-validation showed three similar circulating and salivary miRNAs were selected as the best model in predicting NPC. Additionally, two circulating miRNAs, namely hsa-miR-150 and hsa-miR-205, and one salivary miRNA, namely hsa-miR-144#, were also proposed as miRNA models for diagnostic performance analysis due to their significant expression. The ROC curve analysis demonstrated that the model with two circulating miRNAs, namely hsa-miR-150 and hsa-miR-205, with adjustment for known risk factors of NPC was the best model in predicting NPC (AUC = 0.865) and early stage NPC (AUC = 0.860). Therefore, the present study proposed the two miRNAs, namely hsa-miR-150 and hsa-miR-205, as minimal invasive diagnostic biomarkers for early detection of NPC. The findings from this study is expected to provide more evidences for the gaps in discovery phase of biomarker development pipelines for NPC.

Food insecurity occurs when there is uncertainty of the availability of food or the insufficiency in quantity and quality of food required for a healthy life style, or the need to use socially unacceptable ways to acquire foods. Based on several studies conducted from 2001 to 2014 in Malaysia, 58% to 86% of households were reported as having some kind of food insecurity. However, none of those studies has mentioned the prevalence of food insecurity in the university student population. Therefore, this study had sought to assess the validity and reliability of a cross-culturally adapted English version of the U.S. Adults Food Security Survey Module (AFSSM) in the measurement of food insecurity among university students. A total of n=208 Malay university students aged between 18-25 years old were selected in this cross-sectional study using convenient sampling. The students’ socio-economic status were evaluated using a self-reported questionnaire. The eleven item AFSSM was used to measure food insecurity. Content validity was assessed by an expert panel, and the questionnaire was then tested among 22 students for clarity. Internal consistency was evaluated by Cronbach’s ? and construct validity was assessed through exploratory factor analysis. Criterion validity was assessed by correlating the measure with a number of selected nutrition and inflammatory biomarkers. In all, the prevalence of food insecurity was measured at 56.3% (95% CI: 49.2%-63.1%), with 21.6% (n=45) of students having very low food security. Cronbach’s ? was observed at 0.81. Factor analysis of the AFSSM items revealed two factors: factor 1 (Insufficient food quantity) and factor 2 (Psychological). For criterion validity, only three items were significantly correlated with measured biomarkers. Item Q2 (r=0.15; p=0.044) and Q4 (r=0.18; p=0.018) were positively correlated with serum hs-CRP. On the other hand, item Q5 (-0.15; p=0.046) was found to be negatively correlated with serum folate levels. Only gender was significantly associated with food insecurity where female students were less likely to be food insecure (OR=0.32; 95% CI: 0.11-0.90; p=0.030). As for the conclusion, the cross-culturally adapted and validated English version of the AFSSM showed acceptable levels of reliability, construct validity, and criterion validity to recommend its use in assessing individual food insecurity among Malay university students.

Cancer is a major cause of morbidity and mortality worldwide. In recent biomedical researches, the areas of cancer and infectious diseases have a leading position in utilization of medicinal plants as a source of drug discovery. Malaysia has a diversity and large quantity of underutilized fruits which are rich in phenolic compounds. The objective of study one was projected in vitro to explore natural sources of antioxidant in Artocarpus.altilis (breadfruit) extracts and antioxidant properties. The total phenolic content (TPC) was measured using the Folin-Ciocalteau method and the total flavonoid content (TFC) was determined by using aluminium chloride colorimetric method. Antioxidant properties were determined via the DPPH radical scavenging and β–carotene bleaching (βCB) assays. The various fruits parts Pulp (PU), peel (PE) and whole fruit (WF) were extracted with various solvents such as hexane, dichloromethane (DCM) and methanol. The methanol extracts obtained the highest yields among other solvents (hexane and DCM). The pulp (edible portion) had the highest yield (p<0.01). Methanol extract of pulp part revealed the highest total phenol and flavonoid content value of 781±17.32 mg (GAE)/g and 6213.33±82.24 mg (QE)/g of dry sample, respectively. IC50 values of methanol extract of pulp part in DPPH radical were obtained to be 0.05±0.00 mg/mL as compared to positive control (ascorbic acid) 0.06±0.00 and the antioxidant activity for the β-carotene bleaching assay was 88.34±0.75% of methanol extract of pulp part as compared to the positive control (Trolox) 90.02±0.87%. The objective of study two was to identify and quantify some phenolic compounds in the methanol extracts. By using the ultra high-performance liquid chromatography-tandem mass spectrometry (UHPLC/MSMS) based approach, a total of 9 compounds were detected and characterized on the basis of their chromatographic retention time, UV-vis spectra and mass spectra in the negative-ion mode and data from the literature. The results of the various parts of A. altilis fruit extracts showed promising antioxidant and potential bioactivities due to the high content of phenolic compounds. The purpose of the study three was to evaluate the cytotoxicity effects of methanol fruit extracts on four human cancer (A375, MCF-7, A549, and HT-29) cell lines. The IC50 of the samples were measured using trypan blue exclusion assay (TBEA). The methanol extract of pulp part showed the least inhibition concentration of 15.40±0.91 μg/mL on A375 cells. In the study four, the molecular mechanism of methanol extracts-induced apoptosis and cell cycle arrested in human cancer cells were investigated in a time dependent approach by using flow cytometry. The treated cells were stained with nexin to detect early and late apoptosis and with PI for cell cycle arrest associated with the DNA fragmentation, various cells arrests were occurred at G1/S, S and G2/M phases. Lastly the gene expression analysis by reverse transcription quantitative PCR (qPCR) method was carried out by analysing the expression of gene of interest for quantification of mRNA levels. Results after cells treated with IC50 were revealed by upregulating of anti-apoptotic genes/downregulated of pro-apoptotic BCL-2 gene expressions were triggered the treated cells into CASPASE-3, intrinsic and extrinsic pathways. These findings suggest that the methanol extracts of three parts of A. altilis fruit have potential chemotherapeutic activity against human cancer cell lines mainly the pulp part of the fruit.

Thousands of surgical procedures are performed daily to repair or replace tissue damaged by disease or trauma, with scaffolds playing a critical role in supporting bone regeneration. However, the clinical application of a scaffold remains challenging, particularly in the treatment of periodontal disease, where bone loss and microbial infection significantly impede the healing process. Tissue engineering aims to overcome these limitations by developing biodegradable scaffolds that not only support tissue regrowth but also deliver therapeutic agents to the defect site. These scaffolds act as temporary templates that guide regeneration while simultaneously preventing infection. Recent advances in nano-assisted drug delivery have enabled localised and sustained drug release, thereby reducing systemic side effects and minimising the risk of antibiotic resistance. This study aimed to develop a biodegradable collagen–chitosan scaffold loaded with metronidazole nanoparticles (CCMNP) for periodontal bone regeneration. The scaffold was fabricated by blending chitosan and collagen at a 70:30 ratio, with MNP incorporated at various concentrations (0–40% w/v). Physical crosslinking was achieved using dehydrothermal treatment. Characterisation of the scaffolds was conducted using field emission scanning electron microscopy (FESEM) to assess morphology, pore structure, and pore size. In vitro studies were conducted to assess antibacterial activity, biocompatibility, and cell adhesion. Antibacterial efficacy was tested against Porphyromonas gingivalis and Fusobacterium nucleatum using the disc diffusion method. Biocompatibility was evaluated using the 3-(4,5- dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with human gingival fibroblasts (HGF-1), and cell adhesion was visualised using FESEM. Based on the in vitro results, the scaffold exhibiting the optimal characteristic was selected for in vivo evaluation. The selected scaffold was implanted into critical-size calvarial bone defects in a rat model. Bone regeneration was assessed after a four-week healing period using histological staining and morphometric analysis. The findings revealed that the 30% w/v MNP-loaded scaffold exhibited desirable physical characteristics, including appropriate pore size and controlled biodegradability. It showed a significant inhibitory effect against the tested periodontal pathogens and promoted the proliferation, viability, and adhesion of HGF-1 cells. In vivo analysis demonstrated enhanced new bone formation at the defect site compared to controls, confirming the scaffold’s regenerative potential. In conclusion, the CC scaffold loaded with 30% w/v MNP demonstrated promising results for periodontal bone regeneration. It offers a targeted, dual action approach by combining antimicrobial protection with structural support for tissue healing. This strategy provides an alternative to conventional systemic antibiotic therapies and contributes to the advancement of scaffold-based regenerative techniques in tissue engineering and dental medicine.

Chronic disease patients often express their burden of illness to the dietitians because they need spiritual comfort. However, due to the lack of time, skills, and knowledge in spirituality, it may be challenging for the dietitian to provide spiritual support, but some manage to address the needs. By using a pragmatism philosophical approach and Islamic worldview, this study aimed to examine dietitians’ experience with integrating spirituality during nutrition counselling. The specific objectives were to, 1) synthesis current literature on issues with religion/spirituality in nutrition and dietetic research, 2) identify attitudes of dietitian towards spiritual inquiry and their values on spirituality, 3) explore Islamic spiritual conversation during nutrition counselling, and 4) create a model for integrating Islamic spiritual care in dietetics practice. In general, this study has three components including integrative review, e-survey, and focus group. It started with an integrative review using samples of articles published up to 2018 from selected databases. Then, followed by a concurrent cross-sectional e-survey (quantitative) and focus group (qualitative) between May to December 2019. This concurrent study is known as convergent mixed methods study design. Participants were recruited among the members of Malaysian Dietitians’ Association for the e-survey (N=128) using volunteer sampling through their official Facebook page. Besides, the study interviewed selected Muslim dietitians (N=28) working within the East Coast of Peninsular Malaysia in six focus group discussions using snowball sampling. For the analysis, the integrative review used descriptive and meta-synthesis. The survey adopted descriptive analysis, Pearson’s chi-square test, and factor analysis. Meanwhile, data from the focus group was analysed using thematic content analysis. Cross-analysis of data from the esurvey and focus group had enabled the study to interpret merged integrated data through joint displays approach. As the results, regardless of religious affiliation, more than half of the dietitians reported have ever inquired about patients’ spiritual needs, but only 2% always willingly made the inquiry. Talking about spirituality might promote inner strength and gave meaning to dietitians’ self-spirituality. The study identified several themes that emerged for dietitians’ experiences with Islamic spiritual conversation. The final spiritual care model identified three possible approaches that always willingly made spiritual inquiry, only when the patient asked, and never inquire. This study concludes that 1) spirituality play an important role in dietary selfmanagement of diabetic patients, 2) small proportion of Malaysian dietitian are always willingly making a spiritual inquiry, 3) Islamic spiritual conversation during nutrition counselling are evident among Muslim dietitians, 4) a new model for integrating Islamic spiritual care in dietetics practices may offer immediate response to a patient with spiritual distress. The practical implication of the study demonstrated that spiritual conversations might promote a holistic approach in dietetic patient-centred care practices.

Excessive sugar intake has been widely associated with the increased prevalence of obesity and diabetes due to its potential in instigating positive energy balance. Sugar craving, an issue which has yet been explored in our local community, is also postulated to relate to erratic eating behavior, impulsive food intake and binge eating. The initial part of this research aimed to develop and validate a sugar craving assessment tool suitable for Malaysians. Eventually, the Sugar Craving Assessment Tool for Malaysian (MySCAT) was created that has good internal consistency (? = 0.866) and the score was significantly correlated with sugar intake measured via FFQ Sugar (r = 0.332, p <0.01). As opposed to high energy density and palatability of sugar in foods, the low calorie sweeteners (LCS) has been suggested as alternative to sweeten foods but without markedly excessive calories. Stevia has recently been popular as sugar substitute and it is from plant source, hence deemed more acceptable to be consumed by lay person, relative to artificial sweetener like aspartame. Further, we compared the sweetness perception and acceptance of solid and liquid foods containing either sugar, stevia or aspartame. Healthy adults perceived sugar sweeter than both LCS. The replacement of sugar with LCS was acceptable among the subjects. In the subsequent study using different group of subjects, we investigated the association between sugar craving and sweetness perception as well as eating behavior (restraint, emotional and external traits). Results indicate that female, overweight/obese individuals and restraint eaters possessed higher sweetness perception than their counterparts. The final part of this research aimed to compare the effects of sugar, stevia and aspartame consumption on energy compensation, appetite responses (satiety, fullness and desire to eat sweet) and appetite hormones changes (insulin, leptin and ghrelin). The “preload paradigm” method has been used, whereby 3 types of preloads (sugar, stevia and aspartame) were given prior to test meal served as lunch buffet with ad-libitum intake. We found that following LCS preloads, energy intake during test meal was higher (COMPX 45.6% for stevia and 54.1% for aspartame) but total energy intake (preloads + test meal) was significantly higher with LCS consumption. Sugar preload significantly increased leptin the most compared to LCS after 2 hours. There was no significant relationship recorded between sweeteners and their impact on appetitive responses. Conclusively, we had successfully develop a novel method to measure sugar craving among Malaysian and it is useful in the assessment of the risk of excessive sugar intake. In the effort of reducing energy density of food and sugar content, replacement of sugar with stevia, a natural sweetener, is recommended as it proven to reduce total energy intake while maintaining the normal hormonal changes and do not interfere with appetitive responses.

Given the beneficial roles of adiponectin protein on body metabolism and its profound protective effects against metabolic diseases, a better understanding of the protein’s secretion and regulation is very important. The objectives of this study were to extract, detect and quantify the total adiponectin in trimmed off abdominal adipose tissues from meat sources, namely chicken, beef and lamb, and test it on STZ-induced hyperglycaemic rats. Abdominal adipose tissues were isolated from the aforementioned sources and delipidation of the tissues were performed through chloroform/methanol extractions. Afterwards, the protein concentration was determined by using Protein Assay Bicinchoninate Kit method. This was followed by quantification of the adiponectin using ELISA assay kit. Followed by tests in STZ-induced hyperglycaemic rats on blood glucose and blood lipid, hormone measurement and lastly quantification of PPAR-? mRNA, AMPK mRNA, AdipoR1 mRNA, AdipoR2 mRNA and AdipoQ mRNA in the hepatocytes. The experiment was conducted in triplicates and the results were presented as mean ± SD. The data was statistically analyzed by using SPSS statistical software version IBM 21.0. One-way analysis of variance (ANOVA) was used and the data were considered statistically different at 95% confidence interval. Results indicated that the extraction of 10-gram subcutaneous adipose tissues from chicken, beef and lamb yielded 0.10-gram, 0.15 gram and 0.15 gram of protein, respectively, which were 1 - 1.5 % from the total tissue mass. The protein concentration in the abdominal adipose tissues from chicken, beef and lamb were 1.25 ± 0.05, 1.75 ± 0.05 & 2.53 ± 0.07 mg/ml, respectively. The isolated adiponectin concentration in chicken, beef and lamb was 158 ± 0.05 ng/ml, 24240 ± 0.05 ng/ml and 37 ± 0.08 ng/ml, respectively. Adiponectin concentration in beef abdominal adipose tissues was significantly (p<0.001) higher compared to chicken and lamb. In the animal study, the normal, insulin-treated, PCCA-treated (protein containing chicken adiponectin), PCBA-treated (protein containing beef adiponectin) and PCLA-treated (protein containing lamb adiponectin) hyperglycaemic groups exhibited significantly (p<0.05) reduced blood glucose levels after the treatment period when compared with the NT (control diabetic) group. Similarly, the normal, insulin-treated, PCBA-treated and PCLA-treated diabetic groups exhibited significantly (p<0.05) reduced in blood cholesterol and triglycerides levels after the treatment period when compared to the NT group. Moreover, serum adiponectin concentration was significantly (p<0.05) higher in the normal, insulin-treated, PCBA-treated, PCCA-treated and PCLA-treated diabetic groups as compared to the NT group. Nevertheless, serum insulin concentration was significantly (p<0.05) higher in the normal, insulin-treated and PCBA-treated groups as compared to the NT group. Lastly, AMPK, AdipoR1 and AdipoR2 mRNAs were significantly (p<0.05) upregulated in the normal, insulin-treated, PCBA-treated, PCCA-treated and PCLA-treated diabetic groups as compared to the NT group. However, there was no significant difference among groups for PPAR-? mRNA and AdipoQ mRNA. In conclusion, the present study suggested that the beef protein had the highest amount of adiponectin protein and gave the highest positive effects on STZ-induced hyperglycaemic rats. Thus, adiponectin proteins extracted from these cheaper sources of wasted adipose tissues in meat can be one of the promising target for future novel pharmacological and therapeutic treatments/preventions for insulin resistance and metabolic diseases.

This thesis aimed to investigate the effect of different pterygium morphology on anterior corneal curvature and predicting visual outcome after surgical intervention. A total of 93 primary pterygium participants were selected from patients who visited an ophthalmology clinic. This prospective cohort study involved pre and post-surgical assessment, with a total of 5 data collection sessions (Pre-surgical, 1, 3, 6, 12 months post-surgical. For pre-surgical, pterygium morphologies (redness, thickness, length, corneo-pterygium total area and dry weight were measured objectively. The association between pterygium morphologies (predictive factors) and predictive outcomes (SimK, CIM, SF, TKM, BCVA and CSF) were investigated. All participants underwent similar pterygium surgery procedures performed by a single surgeon. For all post-surgical assessment, identical measurements of topographic and clinical changes were made based on changes in its predictive outcomes. Comparisons in the magnitude changes between different types of pterygium were performed. Our result shows that fibro-connective components of pterygium were found able to provide the highest prediction with 27 – 55% of the predictive outcomes. With regards to types of pterygium, type III (fleshy) was found causing the biggest changes, followed by type II and I. Concisely, we found that single predictive factor is inadequate to either describe or predict changes on anterior corneal curvature and predicting visual outcome. We had demonstrated that utilizing pterygium morphologies, we were able to describe and predict changes in different types of pterygium better. We suggest that different types of pterygium would give rise to different magnitude changes on anterior corneal curvature and predicting visual outcome, thus we need to consider all pterygium morphologies in assessing pterygium.

Eurycoma longifolia is a traditional plant that has long been used for enhancement of male reproductive functions by enhancement of male testosterone levels thus improving the spermatogenesis process. However, effects of E. longifolia on the female reproductive functions are lacking and have yet to be elucidated. The present work was performed to investigate the potential and beneficial effects of E. longifolia standardized extract, TAF 273, on female reproductive functions and abnormalities. The effects of TAF 273 were investigated in normal female rats and estradiol valerate-induced polycystic ovarian condition rats as well as foetal development and teratogenicity conditions in female rats. Effects of TAF 273 on normal female rats were assessed in female Sprague-Dawley rats, aged between 8 to 10 weeks old. Animals were orally treated with 2.5, 5, 10, 25, 50 and 100 mg/kg of TAF 273 over 5 and 14 days. Oestrous cycle and levels of reproductive hormones were then evaluated together with the histomorphological changes in the ovaries. Similar sets of animals were used for induction of polycystic ovarian syndrome (PCOS) by a single subcutaneous dose of 2 mg estradiol valerate per rat. Rats with vaginal cornification at the end of 60 days were taken to be successfully induced. Treatments with Clomiphene citrate and TAF 273 were administered orally daily for 28 days. The hormonal levels were then measured followed by assessment of histomorphology of the ovary. Steroidogenesis-related genes and proteins (CYP11A1, CYP17A1 and CYP19A1) were also examined in histological paraffin sections using HRP-DAB method and quantitative RT-PCR. Evaluation of foetal development and teratogenicity was done by administration of a single subcutaneous injection of 0.15 mg/kg of estradiol valerate to dams on day 12 of gestation and concurrent treatment with TAF 273 (25, 50 and 100 mg/kg) from day 12 to day 19 of gestation. Foetal assessment was conducted following termination of pregnancy at day 21. The administration of TAF 273 extract did not significantly alter the oestrous cycle of the rats during the 5 and 14 days of treatment which was supported by normal levels of the reproductive hormones as well as normal morphology of the ovaries. TAF 273 extract at a dose of 100 mg/kg also possess beneficial effects in improvement of PCO by improving the ovarian morphology as evident by the presence of more abundant healthy follicles as opposed to cystic follicles and the occurrence of corpora lutea as an indication of ovulation. Hormonal imbalances and expressions of steroidogenic genes were also found to be attenuated probably through its action on oestradiol hormones and CYP19A1 gene. A higher potency of abortion and foetus showing abnormalities in external morphology was observed in female dams exposed to estradiol valerate on GD12. The number of live foetuses in dams treated with 100 mg/kg TAF 273 extract increased but with decreased body weight and crown-rump length of the foetuses. Foetuses with malformations in the form of kyphosis, scoliosis and kinky tail were more pronounced in EV group compared to the control and TAF 273-treatment groups. In conclusion, results obtained showed that the E. longifolia standardized extract, TAF 273, has the potential in maintaining normal functions of the female reproductive system and it may have economic value in the management of female disorders and reproductive health.

Attention Deficit Hyperactivity Disorder (ADHD) is characterized by the inability of the brain to focus and to filter irrelevant stimuli, affecting working memory and sensory gating functions. To date, medication is prescribed to control ADHD symptoms, however, the prolonged use of these medications has shown some adverse effects for individuals with ADHD. Alternatively, two non-pharmacological approaches have been proposed to help reduce ADHD symptoms, which are sound therapy interventions and systematic working memory trainings. Despite the potential use of white noise in sound therapy to reduce ADHD symptoms, it has poor melody harmonization, thus preventing children with ADHD features from participating in long training sessions. To address this issue, the present study investigated the possible use of a combination of working memory trainings and sound therapy using various sounds, including white noise, waterfall, and Quranic recitation. The present study aimed to examine the effect of sound-working memory training intervention on sensory gating, working memory, and severity of ADHD symptoms in children with ADHD features in Kuantan, Pahang. The study was conducted in three phases. In Phase 1, the Swanson, Nolan and Pelham Teachers and Parents Rating Scale of ADHD symptoms (SNAP-IV) were cross-culturally translated into Malay (M-SNAP-IV). Additionally, the Sensory Gating Scale (SGS) was also developed. The M-SNAP-IV and the new SGS were psychometrically evaluated among 702 parents and were proven to be culturally suited and valid for use in Phases 2 (participants’ selection process) and 3 (intervention). In Phase 3, 39 children aged 8 – 11 years old with ADHD symptoms participated, and these children were divided randomly into five groups [white noise + working memory training (n=8); waterfall + working memory training (n=8); Al-Fatihah + working memory training (n=8); working memory training alone (no sound stimulus) (n=8)], and one control group (n=7). The training groups received repetitive computerised working memory training for 4 – 5 weeks (10 – 13 sessions), while the control group did not receive any intervention. The Corsi test (untrained working memory test), M-SNAP-IV, and SGS were used as pre- and post-intervention testing. In general, some of the findings showed a significant increase in sensory gating abilities and working memory, and significant decrease of ADHD symptoms in the training groups. Furthermore, it was found that the combination of white noise and working memory training was the best method in improving working memory performance and sensory gating ability, and in reducing ADHD symptoms. The present study also found a significant high-negative correlation between SGS and M-SNAP-IV scores, indicating that the increase of SGS score (the severity of sensory gating deficits reduces) led to the decrease of the M-SNAP-IV score (the reduction of severity of ADHD symptoms). However, some of the findings were negative for SGS and M-SNAP-IV, for example, a significant improvement of M-SNAP-IV’s post-intervention scores was shown in the control group, which was believed to be due to random effect. To conclude, the positive findings from the current study suggested that the sound-working memory training approach has great potential as one of the future alternative psychological and behavioural approaches for ADHD intervention.