Browse publications by year: 2010

Fulltext Beneficial lipid-lowering effects of pink guava puree in high fat diet induced-obese rats

Norazmir MN, Ayub MY

Malays J Nutr, 2010 Apr;16(1):171-85.
PMID: 22691864 MyJurnal

A study was carried out to determine the anti-obesity effects of pink guava (Psidium guajava) puree in high fat diet (HFD) induced-obese rats. Thirty male Sprague-Dawley rats were divided into 5 groups: control negative (CN), fed normal rat pellet; control positive (CP), low, medium and high dosage group (LDG, MDG, HDG) were fed HFD, respectively. CN and CP groups were given distilled water; meanwhile treated groups were given the aqueous puree dissolved in distilled water administered orally for six weeks. The results obtained showed that pink guava puree significantly decreased the body weight and systolic blood pressure of HFD induced-obese rats as compared to control. Blood glucose values for treated groups (4.3-4.9 mmol/L) were significantly lower as compared to CN and CP (5.7 and 5.8 mmol/L) respectively. HDG showed a significant reduction in 34.47% total cholesterol (TC) levels followed by MDG (23.30%) and LDG (22.33%). Triglycerides (TG) levels for all treated groups especially HDG (43.59%) showed significant difference as compared to control. High density lipoprotein-cholesterol (HDL-C) levels showed an increase in the treated group as compared to control. Low density lipoprotein-cholesterol (LDL-C) levels significantly decreased in HDG (69.70%), MDG (39.40%) and LDG (37.12%) as compared to control. Kidney function tests showed significant changes in urea concentrations in treated groups as compared to control. Liver function tests showed significant differences in globulin, A:G ratio, alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and CK-Nac in treated groups as compared to control. Specific enzyme activities of glutathione peroxidase (GPx) was significantly higher in LDG (2787.50±266.36 U/L), MDG (2819.50±262.04 U/L) and HDG (2897.33±674.97 U/L) respectively, as compared to CN (2184.50±816.59 U/L) and CP (2610.17±61.63 U/L). Significant differences were also seen in superoxidase dismutase (SOD) activities in treated groups as compared to control. In conclusion, this study found that pink guava puree had anti-obesity properties and high enzyme activities.
Fulltext Effect of selenium supplementation on spermatogenic cells of goats

Ganabadi S, Halimatun Y, Amelia Choong KL, Nor Jawahir A, Mohammed Hilmi A

Malays J Nutr, 2010 Apr;16(1):187-93.
PMID: 22691865 MyJurnal

Selenium is an essential trace mineral that is required for many physiological functions in animals and the potential relevance of selenium to the reproductive system of livestock has been considered by many researchers. The objective of this study was to examine the effect of selenium supplementation on the spermatogenic cells of goat. Eight young male crossbred (Katjang x Boer) goats, aged between 9 to 11 months, were used in this study. The control group (CON; n = 4) was fed with a diet consisting of 60% Guinea grass and 40% concentrates while the treatment group (Se-SUP; n = 4) was fed with the same diet as the goats in the control group but with supplementation of 0.6mg selenium (sodium selenite powder) per goat daily for 100 days and were slaughtered on the 101st day. There were no significant differences (p>0.05) in the mean number of spermatogonium, spermatocytes, spermatozoa and the total number of spermatogenic cells between the CON and Se-SUP goat respectively. However, there was a significant increase (p< 0.05) of spermatid in Se-SUP goats. The mean percentage of spermatids was significantly increased (p< 0.05) while spermatozoa was significantly decreased (p< 0.05) in Se-SUP goats. In conclusion, selenium supplementation increased the percentages of spermatids and decreased the percentages of spermatozoa in the seminiferous tubules in goats.
Pediatric Flexible Bronchoscopy in Singapore: A 10-year Experience

Woodhull S, Goh Eng Neo A, Tang Poh Lin J, Chay OM

J Bronchology Interv Pulmonol, 2010 Apr;17(2):136-41.
PMID: 23168729 DOI: 10.1097/LBR.0b013e3181dc993a

To determine the results of children who underwent flexible bronchoscopy and bronchoalveolar lavage (BAL) in the Respiratory Medicine Service of Kandang Kerbau Women's and Children's Hospital from 1996 to 2005.

MeSH terms: Bronchoalveolar Lavage Fluid; Bronchoscopy; Child; Female; Hospitals, Pediatric; Humans; Pulmonary Medicine; Bronchoalveolar Lavage
Parent's knowledge and management of their children's ailments in Malaysia

Dawood OT, Ibrahim MI, Palaian S

Pharm Pract (Granada), 2010 Apr;8(2):96-102.
PMID: 25132876

Minor ailments like sore throat, fever, cough and diarrhea can be relieved with over-the-counter (OTC) medications such as paracetamol or other traditional remedies, without seeking for consultation from general practitioners. Parents usually take the responsibility to come up with some kind of treatment for their children.
OBJECTIVE: (1) to evaluate the parents' medical knowledge about OTC medicines which are usually used by the parents to treat their children and (2) to evaluate the parents' management in dealing with their children's ailments, and (3) to evaluate the association between medical knowledge and the management of children's ailments related to medicine use among the parents.
METHODS: A cross-sectional survey was conducted to measure the parents' knowledge about their children's ailments. Subjects were selected and information was obtained in September 2008. Non-probability convenient sampling method was used. Parents were recruited from the general public to answer the questionnaires.
RESULTS: 197 parents filled in the questionnaires. From the total respondents, 48.2% of them were male. This study showed that most respondents have medium knowledge (6.11 SD=3.6) and a moderate management (4.39 SD=2.7). The results showed that there is a significant difference between the knowledge and the management level of ailments (P=0.033). Regarding the education level of the parents and the socioeconomic status, the p-value showed there was a significant difference between parents' knowledge and their education level (P=0.012).
CONCLUSION: This study showed that parents have inadequate knowledge and some misconception about how to go about treating their children when they are unwell. It is hoped that by identifying weak areas in parents' management to their children's ailments, better planned educational and behavioral modification efforts can be made to elevate the knowledge level among the parents when they medically treat their children.
Willingness to pay for a pharmacist's dispensing service: a cross-sectional pilot study in the state of Penang, Malaysia

Shafie AA, Hassali MA

Pharm Pract (Granada), 2010 Apr;8(2):116-21.
PMID: 25132879

The aim of this pilot study was to assess the value of the dispensing service of pharmacists from the general public's perspective using the contingent valuation technique in the State of Penang, Malaysia.
Scarf-Related Hangman's Fracture: A Case Report

Chiu CK, Yin-Wei Chan C, Saw LB, Kwan MK

Eur J Trauma Emerg Surg, 2010 Apr;36(2):180-2.
PMID: 26815695 DOI: 10.1007/s00068-009-8212-3

BACKGROUND: Injury to the cervical spine due to a scarfassociated accident has not been reported in the literature. We present a case of a hangman's fracture in a 43-year-old woman that resulted from a scarfrelated injury as a consequence of a motor vehicle accident.
PURPOSE: To identify the mechanism of a scarf-related injury causing Hangman's fracture.
CASE REPORT: A 43-year-old woman was involved in a motor vehicle accident. She was wearing a scarf, which is a common clothing accessory for women in Malaysia. The scarf was violently torn off her head during the injury, causing a type I hangman's fracture. A halo vest for a total period of 3 months was applied.
CONCLUSION: A scarf-related injury can cause an injury that resembles judicial hanging, leading to a traumatic spondylolisthesis of the axis. Careful evaluation of the cervical spine radiographs is crucial as occult fracture of the axis can be missed.
Bile salt deconjugation and cholesterol removal from media by Lactobacillus strains used as probiotics in chickens

Ramasamy K, Abdullah N, Wong MC, Karuthan C, Ho YW

J Sci Food Agric, 2010 Jan 15;90(1):65-9.
PMID: 20355013 DOI: 10.1002/jsfa.3780

Bile salt deconjugation by Lactobacillus strains is often closely linked to bile tolerance and survival of the strains in the gut and lowering of cholesterol in the host. The present study investigated the deconjugation of bile salts and removal of cholesterol by 12 Lactobacillus strains in vitro. The 12 strains were previously isolated from the gastrointestinal tract of chickens.

MeSH terms: Animals; Anticholesteremic Agents/pharmacology; Chickens; Cholesterol/chemistry*; Culture Media; Glycocholic Acid/chemistry*; Hydrolysis; Taurocholic Acid/chemistry*; Probiotics/pharmacology*; Gastrointestinal Tract/microbiology*; In Vitro Techniques
Effect of pre-germination time of brown rice on serum cholesterol levels of hypercholesterolaemic rats

Roohinejad S, Omidizadeh A, Mirhosseini H, Saari N, Mustafa S, Yusof RM, et al.

J Sci Food Agric, 2010 Jan 30;90(2):245-51.
PMID: 20355038 DOI: 10.1002/jsfa.3803

Brown rice is unpolished rice with immeasurable benefits for human health. Brown rice (BR) and pre-germinated brown rice (PGBR) are known to contain various functional compounds such as gamma-oryzanol, dietary fibre and gamma-aminobutyric acid (GABA). In the present study, the experimental diets containing BR and PGBR (24, 48 h pre-germination) were used to investigate the influence of pre-germination time of brown rice on blood cholesterol in Sprague-Dawley male rats.

MeSH terms: Animals; Cholesterol/blood*; Dietary Fats/administration & dosage; Dietary Fiber/metabolism; Food Handling; gamma-Aminobutyric Acid/metabolism; Hypercholesterolemia/diet therapy*; Lipids/blood; Cholesterol, LDL/blood; Male; Phenylpropionates/metabolism; Oryza/growth & development; Oryza/chemistry*; Rats, Sprague-Dawley; Germination*; Rats; Functional Food*
Effect of prebiotics on viability and growth characteristics of probiotics in soymilk

Yeo SK, Liong MT

J Sci Food Agric, 2010 Jan 30;90(2):267-75.
PMID: 20355041 DOI: 10.1002/jsfa.3808

Soy products have attracted much attention lately as carriers for probiotics. This study was aimed at enhancing the growth of probiotics in soymilk via supplementation with prebiotics.

MeSH terms: alpha-Galactosidase/metabolism; Bifidobacterium/growth & development*; Bifidobacterium/metabolism; Carbohydrates; Food Microbiology*; Hydrolysis; Lactobacillus/growth & development*; Lactobacillus/metabolism; Mannitol; Polysaccharides/metabolism*; Stem Cells; Lactic Acid/metabolism; Dietary Supplements; Probiotics*; Soy Milk*; Microbial Viability; Prebiotics*
Effect of malting conditions and quality characteristics of malt and roasted malt extract from 'acha' grains (Digitaria exilis Stapf)

Lasekan O, Salva JT, Abbas K

J Sci Food Agric, 2010 Apr 15;90(5):850-60.
PMID: 20355122 DOI: 10.1002/jsfa.3895

Considering the importance of malting and roasting on the quality of 'acha' beverages, a study was conducted to find optimum conditions for malting and the production of a high-quality roasted extract that could be used for an 'acha' beverage.

MeSH terms: Beverages/analysis*; Color; Cooking/methods*; Dietary Carbohydrates/analysis; Dietary Proteins/analysis; Food Handling/methods*; Hot Temperature; Humans; Nephelometry and Turbidimetry; Plant Extracts/analysis*; Quality Control; Seeds/chemistry*; Smell; Taste; Time Factors; Water/analysis; Models, Statistical; Germination; Digitaria/chemistry*
Relationship between textural properties and sensory qualities of cookies made from medium- and long-chain triacylglycerol-enriched margarines

Arifin N, Peng KS, Long K, Ping TC, Affandi Yusoff MS, Nor Aini I, et al.

J Sci Food Agric, 2010 Apr 30;90(6):943-8.
PMID: 20355133 DOI: 10.1002/jsfa.3886

This study aims to investigate the textural properties and sensory qualities of cookies made from medium- and long-chain triacylglycerol (MLCT)-enriched margarines. Margarine with formulations of MLCT:palm olein:palm stearin, 60:30:10 and 70:20:10, were selected to produce cookies. The textural properties of cookies were determined using a texture analyser. Quantitative descriptive analysis (QDA) and acceptance test were carried out to describe the attributes and to evaluate the degree of liking of cookies, respectively.

MeSH terms: Cooking; Fats/analysis; Food*; Food Preferences; Food Technology*; Hot Temperature; Humans; Margarine*; Plant Oils; Stearates; Taste*; Triglycerides*; Oleic Acid; Principal Component Analysis
cis-Clerodane-type furanoditerpenoids from Tinospora crispa

Choudhary MI, Ismail M, Shaari K, Abbaskhan A, Sattar SA, Lajis NH, et al.

J Nat Prod, 2010 Apr 23;73(4):541-7.
PMID: 20356064 DOI: 10.1021/np900551u

Phytochemical and cytotoxicity investigations on organic solvent extracts of the aerial parts of Tinospora crispa have led to the isolation of 15 cis-clerodane-type furanoditerpenoids. Of these, nine compounds (1-9) were found to be new. Spectroscopic assignments of a previously reported compound, borapetoside A (13), were revised on the basis of HMQC and HMBC correlations. No discernible activity was observed when compounds 10-13 were subjected to evaluation in cytotoxicity assays against human prostate cancer (PC-3) and the normal mouse fibroblast (3T3) cell lines.

MeSH terms: Animals; Drug Screening Assays, Antitumor; Humans; Malaysia; Male; Plants, Medicinal/chemistry*; Prostatic Neoplasms; Stereoisomerism; Molecular Structure; 3T3 Cells; Nuclear Magnetic Resonance, Biomolecular; Tinospora/chemistry*; Diterpenes, Clerodane/isolation & purification*; Diterpenes, Clerodane/pharmacology; Diterpenes, Clerodane/chemistry; Mice
Fulltext Variations of the origin and branches of the external carotid artery in a human cadaver

Thwin SS, Soe MM, Myint M, Than M, Lwin S

Singapore Med J, 2010 Feb;51(2):e40-2.
PMID: 20358142

We report a unique variation in the origin and branches of both the left and right external carotid artery (ECA) found during the dissection of a human cadaver. Knowledge of the possible anatomical variations of the ECA is especially important in facio-maxillary and neck surgeries. Surgeons need to be aware of the possibility of encountering such variations, as they may lead to difficulties in differentiating between the external and internal carotid arteries, and in identifying the branches and origins. This knowledge is also important for radiologists in the image interpretation of the face and neck regions.

MeSH terms: Cadaver; Carotid Artery, External/abnormalities*; Carotid Artery, External/anatomy & histology*; Humans; Neck/anatomy & histology; Neck/blood supply; Carotid Artery, Common/abnormalities; Carotid Artery, Common/anatomy & histology
Fulltext The man with the boggy head: cranial melioidosis

Kuan YC, How SH, Ng TH, Fauzi AR

Singapore Med J, 2010 Feb;51(2):e43-5.
PMID: 20358143

Melioidosis is known to cause abscesses in various organs, including the cranium, though less commonly. We present a patient with scalp abscess and subdural empyema that was visible on computed tomography of the brain. The neurosurgical drainage grew Burkholderia pseudomallei. Despite our best effort to treat the patient using parenteral antibiotics and surgical drainage, the patient did not survive.

MeSH terms: Anti-Bacterial Agents/therapeutic use; Humans; Male; Melioidosis/drug therapy; Melioidosis/radiography*; Middle Aged; Empyema, Subdural/drug therapy; Empyema, Subdural/microbiology*; Empyema, Subdural/radiography*; Burkholderia pseudomallei/isolation & purification; Fatal Outcome
Fulltext Writing a technical note

Ng KH, Peh WC

Singapore Med J, 2010 Feb;51(2):101-3; quiz 104.
PMID: 20358146

A technical note is a short article giving a brief description of a specific development, technique or procedure, or it may describe a modification of an existing technique, procedure or device applicable to medicine. The technique, procedure or device described should have practical value and should contribute to clinical diagnosis or management. It could also present a software tool, or an experimental or computational method. Technical notes are variously referred to as technical innovations or technical developments. The main criteria for publication will be the novelty of concepts involved, the validity of the technique and its potential for clinical applications.

MeSH terms: Humans; Writing/standards; Editorial Policies*
Fulltext The prevalence of obesity among clinical students in a Malaysian medical school

Boo NY, Chia GJ, Wong LC, Chew RM, Chong W, Loo RC

Singapore Med J, 2010 Feb;51(2):126-32.
PMID: 20358151

INTRODUCTION: This study aimed to determine the prevalence of obesity among medical students and its relationship with their dietary intake and physical activities.
METHODS:This observational study was carried out on 240 medical students during the clinical phase of their medical course in a private medical school. Their body weight and height were measured, and a standardised questionnaire was used to collect information on their physical activities and dietary intake.
RESULTS: The median body weight of the participants was 59.0 kg (interquartile range: 51.3-66.8), the mean body height was 166.1 cm (standard deviation [SD] 8.5 cm), and the mean body mass index (BMI) was 21.8 kg/m2 (SD 3.4 kg/m2). Based on the World Health Organization BMI cut-offs for the Asian population, 30.1 percent (n is equal to 72) of the students were overweight or obese, with a BMI that was equal to or greater than 23.0 kg/m2. Logistic regression analysis showed that, after controlling for various potential confounders, the only significant risk factors associated with overweight/obesity among these students were: male gender (adjusted odds ratio [OR] 2.1; 95 percent confidence intervals [CI] of 1.1 and 4.1; p is equal to 0.03), Malay ethnic group (adjusted OR 2.4; 95 percent CI 1.0 and 5.7; p is equal to 0.04), Indian ethnic group (adjusted OR 3.6; 95 percent CI 1.5 and 8.9; p is equal to 0.005), and the number of soft drinks consumed per week (adjusted OR 1.3; 95 percent CI 1.0 and 1.5; p is equal to 0.02). Skipping breakfast, the frequency of physical exercise per week, the number of hours of sleep per day, and eating noodles or roti canai (a type of Malaysian pancake) for breakfast were not significant risk factors.
CONCLUSION: Obesity remains a common problem among medical students in their clinical years.

MeSH terms: Clinical Clerkship/statistics & numerical data; Female; Food Habits; Humans; Malaysia; Malaysia/epidemiology; Male; Obesity/epidemiology*; Sex Factors; Students, Medical/statistics & numerical data*; Body Mass Index; Prevalence; Odds Ratio
Fulltext Inhaled nitric oxide and intravenous magnesium sulphate for the treatment of persistent pulmonary hypertension of the newborn

Boo NY, Rohana J, Yong SC, Bilkis AZ, Yong-Junina F

Singapore Med J, 2010 Feb;51(2):144-50.
PMID: 20358154

The aim of this study was to compare the response and survival rates of term infants with persistent pulmonary hypertension of the newborn (PPHN) on high frequency oscillatory ventilation (HFOV) treated with either inhaled nitric oxide (iNO) or intravenous magnesium sulphate (MgSO4).

MeSH terms: Administration, Inhalation; Female; High-Frequency Ventilation; Humans; Infant, Newborn; Infusions, Intravenous; Magnesium Sulfate/administration & dosage*; Male; Nitric Oxide/administration & dosage*; Persistent Fetal Circulation Syndrome/therapy*; Respiratory Therapy*; Vasodilator Agents/administration & dosage*; Survival Analysis; Intention to Treat Analysis
Fulltext Dual blockade of the renin-angiotensin-aldosterone system is safe and effective in reducing albuminuria in Asian type 2 diabetic patients with nephropathy

Tan F, Mukherjee JJ, Lee KO, Lim P, Liew CF

Singapore Med J, 2010 Feb;51(2):151-6.
PMID: 20358155

INTRODUCTION: Blockade of the renin-angiotensin-aldosterone system (RAAS) by either the angiotensin converting enzyme inhibitor (ACE-I) or the angiotensin II receptor blocker (ARB) has been shown to reduce albuminuria and delay the progression of diabetic nephropathy. This study evaluated the effect of dual blockade of the RAAS by adding an ACEI or an ARB to the administration of either drug alone on albuminuria in Asian type 2 diabetic patients with nephropathy.
METHODS: 34 patients were randomly assigned to receive either enalapril 20 mg or losartan 100 mg once daily for eight weeks. Following this, all patients received a combination of enalapril 10 mg and losartan 50 mg daily for eight weeks, followed by enalapril 20 mg and losartan 100 mg daily for another eight weeks. The blood pressure and 24-hour urinary albumin excretion (UAE) were monitored.
RESULTS: Following monotherapy with enalapril, there was a mean and standard error (SE) reduction in the UAE and mean arterial pressure (MAP) of 9.8 (SE 6.8) percent (p-value is 0.061) and 5.3 (SE 2.2) mmHg (p-value is 0.026), respectively; the reduction in UAE and MAP following monotherapy with losartan was by 10.9 (SE 14.1) percent (p-value is 0.053) and 4.5 (SE 1.9) mmHg (p-value is 0.034), respectively. Combination therapy with enalapril and losartan further reduced the UAE (11.2 [SE 8.7] percent, p-value is 0.009] despite there being no significant change in the MAP (-1.2 [SE 1.47] mmHg, p-value is 0.42). The adverse effects included dry cough (seven [19.4 percent] patients, resulting in the withdrawal of medication in two patients), and transient hyperkalaemia (two [six percent] patients).
CONCLUSION: Dual blockade of the RAAS is safe and effective in reducing albuminuria in Asian type 2 diabetic patients with nephropathy.

MeSH terms: Aged; Albuminuria/drug therapy*; Angiotensin-Converting Enzyme Inhibitors/therapeutic use*; Diabetes Mellitus, Type 2/complications*; Diabetic Nephropathies/drug therapy*; Drug Therapy, Combination; Enalapril/therapeutic use*; Female; Humans; Male; Middle Aged; Losartan/therapeutic use*; Asian Continental Ancestry Group; Angiotensin II Type 1 Receptor Blockers/therapeutic use
Fulltext Type 2 diabetes mellitus patients with poor glycaemic control have lower quality of life scores as measured by the Short Form-36

Kamarul Imran M, Ismail AA, Naing L, Wan Mohamad WB

Singapore Med J, 2010 Feb;51(2):157-62.
PMID: 20358156

INTRODUCTION: This study aimed to compare the quality of life based on the Short Form-36 (SF-36) between two different groups of type 2 diabetes mellitus patients with glycaemic control: those with a glycosylated haemoglobin (HbA1c) level at or below 7.5 percent and those above 7.5 percent.
METHODS: In this cross-sectional study, a generic SF-36 questionnaire was self-administered to patients with type 2 diabetes mellitus. Based on the HbA1c level, the mean SF-36 scale scores were compared. The analysis of covariance was used to obtain the adjusted mean scores of the SF-36 scales while controlling for age and duration of type 2 diabetes mellitus.
RESULTS: 150 patients with type 2 diabetes mellitus were analysed. There were 63 (42 percent) women and 87 (58 percent) men, and their mean HbA1c level was 8.9 percent (SD 2.4 percent). When comparing the two groups of patients with different HbA1c levels, the adjusted means of four scales: physical health functioning, general health, social functioning and mental health, differed significantly between the two. The SF-36 scale scores in type 2 diabetes mellitus patients were also lower than those of the SF-36 norms for the Malaysian population.
CONCLUSION: Type 2 diabetes mellitus patients with poor glycaemic control had lower mean SF-36 scores in physical functioning, general health, social functioning and mental health, and the SF-36 scores in these patients were also lower than the SF-36 norms of the Malaysian population.

MeSH terms: Adolescent; Adult; Blood Glucose/metabolism*; Cross-Sectional Studies; Diabetes Mellitus, Type 2/blood*; Female; Hemoglobin A, Glycosylated/metabolism*; Humans; Male; Quality of Life*; Young Adult
Fulltext Ministry of health clinical practice guidelines: cancer screening

Lee HP, Chew CT, Consigliere DT, Heng D, Huang DT, Khoo J, et al.

Singapore Med J, 2010 Feb;51(2):170-3; quiz 174-5.
PMID: 20358158

The Ministry of Health publishes national clinical practice guidelines to provide doctors and patients in Singapore with evidence-based guidance on managing important medical conditions. This article reproduces the introduction and executive summary (with key recommendations from the guidelines) from the Ministry of Health clinical practice guidelines on cancer screening, for the information of readers of the Singapore Medical Journal. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website (http://www.moh.gov. sg/mohcorp/publications.aspx?id=24018). The recommendations should be used with reference to the full text of the guidelines. Following this article are multiple choice questions based on the full text of the guidelines.

MeSH terms: Female; Health Policy*; Humans; Male; Singapore; Practice Guidelines as Topic*; Early Detection of Cancer/standards*

External Links