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Background: Astrocytic gliomas are the most common primary brain tumors that developed from glial origin. The angiogenic cell population from brain tumor enhances the recruitment of circulating cancer stem cells homing towards tumor site.Objectives: This study aimed to investigate the tumor angiogenic cell population that stained with CD133+ and VEGFA+ markers and its association with circulating cancer stem cell (CD133+/VEGFR2-) population in the peripheral blood mononuclear cells (PBMCs) of astrocytic glioma patients.Methods: A total of 22 astrocytic glioma patients from Hospital Universiti Sains Malaysia who consented to the study were included. Tumors (n=22) were sliced and stained with CD133+ and VEGFA+ angiogenic markers and counter stained with DAPI. The circulating cancer stem cells (CD133+/VEGFR2-) in PBMCs (n=22) were quantified using FACS based on the expression of CD133 and VEGFR2 markers. The paired t-test and Pearson correlation were used for the data analysis.Results: The percentage of angiogenic cell population was significantly higher in brain tumor compared to adjacent normal brain tissue (1.25 ± 0.96% vs. 0.74 ± 0.68%; paired t-test=2.855; df=21, p = 0.009). Positive correlation was found between the angiogenic cells of brain tumor tissue and adjacent normal brain tissue (Pearson correlation, r = 0.53, p = 0.011). Significant positive correlation was found between angiogenic cells in glioma tumor and cancer stem cells in peripheral circulating systems of astrocytic glioma patients (Pearson correlation, r = 0.42, p = 0.049).Conclusion: Angiogenic cells in the brain tumor resident promote the recruitment of circulating cancer stem cells homing to the tumor site and induce the proliferation and growth of the tumor in astrocytic glioma patients.

OBJECTIVE To investigate association between major depressive disorder (MDD) and quality of life in patients with neurological disorder. METHODS This cross-sectional study was carried out at a Malaysian hospital between April 2016 and December 2016 using convenience sampling. Patients aged ≥18 years with intracranial tumour or other brain disorders were invited to participate. Quality of life was assessed using the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire version 3.0; diagnosis of MDD was made using Mini International Neuropsychiatric Interview. RESULTS Of 122 patients approached, 100 (66 women and 34 men) were included (response rate, 93.5%), with a mean age of 45.3 years. The prevalence of MDD in patients with neurological disorder was 30%. Compared with non-depressed patients, patients with MDD had poorer global health status / quality of life (p = 0.003), and reduced physical (p = 0.003), role (p = 0.021), emotional (p < 0.001), cognitive (p = 0.004), and social (p = 0.007) functioning, as well as more symptoms of fatigue (p = 0.004), pain (p < 0.001), dyspnoea (p = 0.033), insomnia (p < 0.001), appetite loss (p = 0.002), constipation (p = 0.034), diarrhoea (p = 0.021), and financial difficulties (p = 0.039). CONCLUSION Patients with MDD had reduced quality of life. Fatigue, pain, dyspnoea, insomnia, appetite loss, constipation, diarrhoea, and financial difficulties were prevalent among patients with MDD.

In South Africa, traditional healers treat a wide range of health-related problems and culture-bound syndromes considered non-responsive to Western medicine. Given the widespread use of traditional medicine in treating common mental disorders, especially among low-income groups, it is important to explore the self-identification, training, and practices of traditional healers. We also explored traditional healers’ perceptions of collaboration with Western health care institutions (hospitals, clinics). IsiXhosa traditional healers ( n = 50, female = 40, mean age = 52.7 years, SD = 14.7 years) were interviewed using both a structured and a semi-structured interview schedule, including the Patient Health Questionnaire-9. Data were analysed using SPSS version 24 and Statistica. Interview notes were typed soon after each interview and thematically analysed. Participants described similar experiences regarding the three steps of becoming a traditional healer and treating clients with mental illness using herbs (90%), candles (82%), and prayer (78%). Self-identification as a spiritualist or sangoma, and type of church attended (African Initiated vs. Mainline Christian) were both significantly associated with traditional healers’ mode of diagnosis and/or treatment. Participants were open about collaborating with Western health care institutions around treating mental health issues. However, this was hampered by mistrust, as evidenced in the reluctance of a few participants to share detailed information about treatment methods.

Background: This paper investigates the quality of life of brain pathology patients in relation to their socio-demographic profiles and clinical factors. Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100 patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning, Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea, Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study. Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared to patients who were more than 40 years old. Male patients faced more financial difficulties compared with female patients. Patients who were married had increased insomnia compared to the single patients. Employed patients had better physical functioning and less financial difficulties compared with patients who were unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher. Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had better physical functioning. Meningioma patients had more symptoms of insomnia compared with other patients. All the findings were with p value less than 0.05. Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients. Keywords: Brain pathology, quality of life, socioeconomic factors

Objective: Brain and nervous system cancer incidence was one of the ten most common cancers in Malaysia. The study intends to model the structural relationship of MDD, anxiety disorders, other psychiatric disorders, quality of life, coping styles and their associated factors among neurological disorder (brain tumour / brain disorder) patients. Methods: The EORTC-Quality of Life, Brief COPE, Single Item Social Support, MINI International Neuropsychiatric Interview and Patient Health Questionnaires were utilised in the study. Results: The multivariate normality kurtosis was 6.174 with c.r = 2.440 obtained in this SEM model. Chi-square normalized by degrees of freedom, (χ̰2 /df) =1.086, p= 0.353. The RMSEA was 0.03, TLI = 0.988 and CFI =0.999 were obtained in the study. All 8 paths out of 10 paths were significant with p-values less than 0.05 (two-tailed) with R2 values ranging from 0.48 to 0.55 which indicates that the variance explained ranged from 48% for emotional functioning to 55% for severity of depression. The severity of MDD has positive relationship with insomnia and panic disorder lifetime and negative relationship with self distraction coping styles. Meanwhile emotional functioning had negative relationship with fatigue, venting and panic disorder lifetime and positive relationship with global health status. The emotional functioning also was correlated negatively with the severity of MDD (p < 0.005). Conclusion: Therefore based on the path analysis, the main contributing factors of MDD severity were emotional functioning, insomnia, self distraction coping and panic disorder lifetime. The emotional functioning of the patients were influenced by the fatigue, global health status, venting coping styles and panic disorder lifetime and this increased the severity of MDD among the patients. Therefore the role of quality of life and coping styles on depression and anxiety should not be neglected. The clinician, health psychologist, psychiatrist, and counselor in this country need to implement better treatments for the effected patients.

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Astrocytic gliomas are highly aggressive and lethal brain tumours that depend on angiogenesis for growth. The endothelial progenitor cell (EPCs) and von Willebrand factor (vWF) involved in the formation of new blood vessels in astrocytic glioma. Objectives: This study aimed to investigate the association between circulating and tissue resident EPCs with vWF in astrocytic glioma patients. Methods: Blood specimen and brain tissue biopsy were collected from a total of 22 astrocytic glioma patients admitted to Hospital Universiti Sains Malaysia. Circulating EPCs (blood) and tissue resident EPCs (tissue biopsy) were characterized using EPC-specific markers, CD133 and VEGFR2 and quantified using fluorescenceactivated cell sorting analysis and immunofluorescence microscopy, respectively. The plasma vWF was measured by using commercialized Elisa kit (Cusabio Biotech Co.,Ltd). Results: The mean percentage of circulating EPCs was (0.01 ± 0.01%), brain tumor tissue EPCs (0.48 ± 0.38%) and adjacent normal brain tissue EPCs (0.18 ± 0.23%). The mean plasma vWF was 9.23 ± 7.57%. Positive correlation was found between brain tumor EPCs and plasma vWF (Spearman’s rho r = 0.45, p = 0.035). However no correlation was found between adjacent normal brain EPCs and plasma vWF. About 14 patients had (mild vWF level of> 5%), 8 patients had (moderate vWF level of 1-5%) and no patients had (severe vWF level of < 1%). The mean percentage of patients with mild vWF level was 12.48 ± 7.77% and moderate vWF level was 3.53 ±1.32%. There was a significant correlation between circulating EPCs and patients with mild vWF level(Spearman’s rho r = 0.63, p = 0.015). Conclusion: This study demonstrated that EPCs have significant positive association with vWF suggesting the homing of plasma vWF at the tumor site. Article DOI: https://dx.doi.org/10.20319/lijhls.2015.11.4859 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

Brain tumour diagnosis affects the lives of many patients, and the burden can be overwhelming for patients with psychiatric disorders. The study intends to investigate on inter-relationships between quality of life, coping styles, social support, clinical factors and demographic impact on depression and anxiety among Malaysian neurological disorder (brain tumour / brain disorder) patients. Participants were assessed with numbers of measures: socio-demographic, Medical Information, EORTC-Quality of Life,Brief COPE, Single Item Social Support, MINI International Neuropsychiatric Interview and Patient Health Questionnaires.Results: In the structural equation modeling of neurological disorder patients(brain tumour / brain disorder), all 8 paths were significant with p-values less than 0.05 (two-tailed) with R2 values ranging from 0.48 to 0.55 which indicates that the variance explained ranged from 48% for emotional functioning to 55% for severity of depression. The insomnia and panic disoder lifetime have positive relationship with severity of MDD. The self distraction coping styles has negative relationship with severity of MDD (p=0.005). The fatigue (p0.001), venting (p=0.015) and panic disorder lifetime (p = 0.010) were found to have a negative relationship with emotional functioning score while global health status has positive relationship with emotional functionig (p 0.001). Emotional functioning was found to have significant negative relationship with severity of MDD (p=0.03). Conclusion: Therefore based on SEM analysis, the main contributing factors of severity of MDD among the brain tumour / brain disorder patients were fatigue, insomnia, venting coping styles and panic disoder lifetime.

This review aims at showing the importance of assessing stress in Community Health Agents and the correlation of this stress with their activity, given that the situations they face in the different risk areas and the direct contact with the community are considered highly stressing factors. It is known that the presence of stressed agents in a team leads to discontent, reduced productivity and low-quality health assistance for the community. Special attention should thus be paid to professionals with an inclination to react intensely to stress factors, not only in benefit of the Family Health team but also of the assisted community. Estudo de revisão que buscou justificar a importância de se avaliar o estresse dos Agentes Comunitários de Saúde e a correlação deles com a atividade ocupacional, uma vez que as situações vivenciadas pelos mesmos, nas diferentes áreas de risco, bem como o contato direto com a comunidade, representam agentes estressantes de relevante magnitude. Sabe-se que a presença de trabalhadores estressados na equipe resulta em insatisfação, diminuição da produtividade e má assistência de saúde à comunidade. Portanto, especial atenção deve ser dada aos profissionais propensos a reações mais intensas aos agentes geradores de estresse, o que resulta em benefícios tanto para a equipe de Saúde da Família quanto para a comunidade assistida.

Estudo de revisão que buscou justificar a importância de se avaliar o estresse dos Agentes Comunitários de Saúde e a correlação deles com a atividade ocupacional, uma vez que as situações vivenciadas pelos mesmos, nas diferentes áreas de risco, bem como o contato direto com a comunidade, representam agentes estressantes de relevante magnitude. Sabe-se que a presença de trabalhadores estressados na equipe resulta em insatisfação, diminuição da produtividade e má assistência de saúde à comunidade. Portanto, especial atenção deve ser dada aos profissionais propensos a reações mais intensas aos agentes geradores de estresse, o que resulta em benefícios tanto para a equipe de Saúde da Família quanto para a comunidade assistida.

Introduction: Astrocytic gliomas are the most common and lethal intracranial brain tumours and rely on angiogenesis for the tumour development. Endothelial progenitor cells (EPCs) contribute to the angiogenesis of glioma tumour. Objectives: The study aimed to investigate the matured circulating endothelial cells population in the peripheral blood mononuclear cells (PBMCs) and its associations with tissue resident angiogenic cells in astrocytic glioma patients. Methods: A total of 22 astrocytic glioma patients were recruited from Hospital Universiti Sains Malaysia. Tumour were sliced and stained with CD133+ and VEGFA+ for angiogenic cells (n=22). The circulating (CD133-/VEGFR2+) matured endothelial cells in PBMCs (n=22) were quantified using FACS. The paired t-test and Pearson correlation test were used for the data analysis. Results: The angiogenic cells in brain tumour tissue were significantly higher compared to adjacent normal brain tissue (median 1.07±0.96% vs. median 0.69±0.68%; Wilcoxon signed rank test Z=-3.100; p=0.002). Positive correlation was found between the angiogenic cells of brain tumour tissue and adjacent normal brain tissue (Spearman’s rho correlation test, r=0.56; p=0.007). Significant positive correlation was found between matured endothelial cells in peripheral circulating systems and angiogenic cells in tumour of astrocytic glioma patients (Pearson correlation test, r=0.60, p=0.003).Conclusion:The findings of the study give support to the possible roles of EPCs in astrocytic glioma patients. Thus targeting tissue resident angiogenic cells and matured circulating endothelial cells by antiangiogenic treatment might be useful to prevent the tumour growth.