Thalassemia is identified as a prevalent disease in Malaysia, known to be one of the developing countries. Fourteen patients with confirmed cases of thalassemia were recruited from the Hematology Laboratory. The molecular genotypes of these patients were tested using the multiplex-ARMS and GAP-PCR methods. The samples were repeatedly investigated using the Devyser Thalassemia kit (Devyser, Sweden), a targeted NGS panel targeting the coding regions of hemoglobin genes, namely the HBA1, HBA2, and HBB genes, which were used in this study. There were many different genetic variants found in 14 unrelated cases. Out of all fourteen cases, NGS was able to determine an additional -50 G>A (HBB:c.-100G>A) that were not identified by the multiplex-ARMS method, including HBA2 mutations, namely CD 79 (HBA2:c.239C>G). Other than that, CD 142 (HBA2:c.427T>C) and another non-deletional alpha thalassemia and alpha triplication were also not picked up by the GAP-PCR methods. We illustrated a broad, targeted NGS-based test that proposes benefits rather than using traditional screening or basic molecular methods. The results of this study should be heeded, as this is the first report on the practicality of targeted NGS concerning the biological and phenotypic features of thalassemia, especially in a developing population. Discovering rare pathogenic thalassemia variants and additional secondary modifiers may facilitate precise diagnosis and better disease prevention.

Development of resistance to imatinib mesylate (IM) in chronic myeloid leukemia (CML) patients is mediated by different mechanisms that can be classified as BCR-ABL dependent or BCR-ABL independent pathways. BCR-ABL dependent mechanisms are most frequently associated with point mutations in tyrosine kinase domain (TKD) of BCR-ABL1 and also with BCR-ABL gene amplification. Many different types and frequencies of mutations have been reported in different studies, probably due to the different composition of study cohorts. Since no reports are available from Malaysia, this study was undertaken to investigate the frequency and pattern of BCR-ABL kinase domain mutations using dHPLC followed by sequencing, and also status of BCR-ABL gene amplification using fluorescence in situ hybridization (FISH) on 40 IM resistant Malaysian CML patients. Mutations were detected in 13 patients (32.5%). Five different types of mutations (T315I, E255K, Y253H, M351T, V289F) were identified in these patients. In the remaining 27 IM resistant CML patients, we investigated the contribution made by BCR-ABL gene amplification, but none of these patients showed amplification. It is presumed that the mechanisms of resistance in these 27 patients might be due to BCR-ABL independent pathways. Different mutations confer different levels of resistance and, therefore, detection and characterization of TKD mutations is highly important in order to guide therapy in CML patients.

Coronavirus disease 2019 (COVID-19) is a global pandemic. Clinical studies have shown that there was an association between COVID-19 and cardiovascular disease. The virus can directly induce myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism. In Malaysia, students will come back to University soon. The screening techniques framework is required to reduce the pandemic Covid-19 transmission among the students. In this manuscript, we present a new screening technique framework which is consists of temperature and heart rate measurements, movement tracking and risk assessment. Students will be given a questionnaire to stratify their risk into high, medium, and low risk. The temperature will be measured by using an infrared thermometer. The heart rate will be monitored only in those in high and lowrisk categories by using a smart bracelet. The students’ movement will be tracked by using a Wi-Fi based location technique. To avoid any privacy concerns, the location data will be extracted only if the student shared the location with the confirmed COVID-19 case. Lastly, the risk assessment is required in reporting if the infection occurs among students.

Development of resistance to imatinib mesylate (IM) in chronic myeloid leukemia (CML) patients has emerged as a significant clinical problem. The observation that increased epigenetic silencing of potential tumor suppressor genes correlates with disease progression in some CML patients treated with IM suggests a relationship between epigenetic silencing and resistance development. We hypothesize that promoter hypermethylation of HOXA4 could be an epigenetic mechanism mediating IM resistance in CML patients. Thus a study was undertaken to investigate the promoter hypermethylation status of HOXA4 in CML patients on IM treatment and to determine its role in mediating resistance to IM. Genomic DNA was extracted from peripheral blood samples of 95 CML patients (38 good responders and 57 resistant) and 12 normal controls. All samples were bisulfite treated and analysed by methylation-specific high-resolution melt analysis. Compared to the good responders, the HOXA4 hypermethylation level was significantly higher (P = 0.002) in IM-resistant CML patients. On comparing the risk, HOXA4 hypermethylation was associated with a higher risk for IM resistance (OR 4.658; 95% CI, 1.673-12.971; P = 0.003). Thus, it is reasonable to suggest that promoter hypermethylation of HOXA4 gene could be an epigenetic mechanism mediating IM resistance in CML patients.

Database era has been appear during Prophet Muhammad S.A.W. We are using the same concept but only deployed in the medical environment with security features which is related to aqli and naqli. The development of a system not only covered the ability of the system to be functioned and execute very well but a good and efficient system must be able to communicate with the users and become a user friendly system. This research is about developing Hospital Patient Information System developed for Hematology Ward and Hemato-oncology Laboratory at the Hospital UniversitiSains Malaysia (HUSM) based on the aqli and naqli. It lacks of security in term of data integrity of the system. It will be enhanced in its security features which will be implemented with the data integrity feature and also password encryption to overcome the problems. As a result, an automated calculation of blood series and graph production as for data analysis will be implemented in this system.An approach of agile method is the chosen process to be used in realizing this research. This system will come out with the ability of protection in data integrity, password encryption and automatic calculation in order to reduce the fraud and human errors.

Information on the Leukemia patients is very crucial by keep track medical history and to know the current status of the patient's. This paper explains on development of Hematology Information System (HIS) in Hospital Universiti Sains Malaysia (HUSM). HIS is the web application, which is the enhancement of the standalone application system that used previously. The previous system lack of the implementation of security framework and triple 'A' elements which are authentication, authorization and accounting. Therefore, the objective of this project is to ensure the security features are implemented and the information safely kept in the server. We are using agile methodology to develop the HIS which the involvement from the user at the beginning until end of the project. The user involvement at the beginning user requirement until implemented. As stated above, HIS is web application that used JSP technology. It can only be access within the HUSM only by using the local Internet Protocol (IP). HIS ease medical doctor and nurse to manage the Leukemia patients. For the security purpose HIS provided password to login, three different user access levels and activity log that recorded from each user that entered the system