Two new naphthoquinones designated as 3alpha-hydroxy-2-(2-hydroxypropan-2-yI)-9alpha-methoxy-2,3,3alpha,9alpha-tetra-hydronaphtho[2,3-b]furan-4,9-dione (callicarpa-quinone A, 1) and 5-hydroxy-2-(2-hydroxypropan-2-yl)naphtho[2,3-b]furan-4,9-dione (callicarpaquinone B, 2) were isolated from the chloroform fraction of Callicarpa maingayi. Three other known compounds, identified as avicequinone-C (3), wodeshiol (4) and paulownin (5), were reported for the first time from this species. The structure elucidation of compounds was established by comprehensive 1D and 2D NMR spectroscopic analyses as well as EIMS, UV and IR spectral data. Compounds 1 and 2 were tested in vitro for their cytotoxic activity against human breast cancer MCF-7cells. Compound 2 exhibited strong cytotoxic activity with an IC50 value of 1.9 +/- 0.2 microM, while 1 showed moderate activity with an IC50 value of 25.0 +/- 4.3 microM.
The composition of the essential oils of Murraya koenigii (L.) Spreng, cultivated at six locations in Peninsula Malaysia and Borneo are presented. The oils were obtained from fresh leaves by hydrodistillation and analyzed by gas chromatography-mass spectrometry (GC-MS); 61 compounds were identified, of which eleven were present in all the specimens analyzed. The two major volatile metabolites were identified as beta-caryophyllene (16.6-26.6%) and alpha-humulene (15.2-26.7%) along with nine minor compounds identified as beta-elemene (0.3-1.3%), aromadendrene (0.5-1.5%), beta-selinene (3.8-6.5%), spathulenol (0.6-2.7%), caryophyllene oxide (0.7-3.6%), viridiflorol (1.5-5.5%), 2-naphthalenemethanol (0.7-4.8%), trivertal (0.1-1.0%) and juniper camphor (2.6-8.3%). The results suggest that beta-caryophyllene and alpha-humulene could be used as chemotaxonomical markers for Malaysian M. koenigii, hence these specimens could be of the same stock and different from the ones in India, Thailand and China.
This was a retrospective cohort study undertaken to assess the rate and pattern of dental caries development in 6-year-old school children followed-up for a period of 5 years, and to identify baseline risk factors that were associated with 5 years caries experience in Malaysian children.
OBJECTIVE: The aim of this study was to determine risk factors and prevalence of diabetic neuropathy (DN) among type II diabetic patients in Malaysian hospital setting.
SUBJECTS AND METHODS: a observational prospective longitudinal follow up study design was selected, total no of respondents were 1077 type 2 diabetes mellitus outpatients recruited via attended the diabetes clinics at Hospital Universiti Sains Malaysia (HUSM) in Kelantan. The diagnosis of neuropathy was confirmed by nerve conduction studies. Logistic regression analysis was used to assess the independent variables that affect the development of neuropathy.
RESULTS: The prevalence of nephropathy is 54.3%. Longitudinal logistic regression identified four predictive variables on the development and progression of diabetic neuropathy that are: duration of diabetes, retinopathy, HbA1c at second visit, and creatinine clearance third visit.
CONCLUSION: Findings of this study show high prevalence of diabetic neuropathy. HbA1c and creatinine clearance are two modifiable risk factors for the development of diabetic neuropathy.
Study site: Diabetes clinics, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
MeSH terms: Adult; Age Factors; Aged; Alcohol Drinking/epidemiology*; Diabetes Mellitus, Type 2/blood; Diabetes Mellitus, Type 2/epidemiology*; Diabetes Mellitus, Type 2/physiopathology; Diabetic Neuropathies/blood; Diabetic Neuropathies/epidemiology*; Diabetic Neuropathies/physiopathology; Diabetic Retinopathy/blood; Diabetic Retinopathy/epidemiology*; Diabetic Retinopathy/physiopathology; Female; Follow-Up Studies; Hemoglobin A, Glycosylated/metabolism*; Hospitals, University; Humans; Longitudinal Studies; Malaysia/epidemiology; Male; Middle Aged; Outpatient Clinics, Hospital; Predictive Value of Tests; Prospective Studies; Risk Factors; Smoking/epidemiology*; Cohort Studies; Body Mass Index; Prevalence; Logistic Models
INTRODUCTION: Like many countries Malaysia is facing an increase in the number of people with type 2 diabetes mellitus diabetes (T2DM) and modifiable lifestyle factors such as sedentary behaviour are important drivers of this increase. The level of physical activity is low among elderly Malay people. In Malaysia, strategies to promote physical activity in elderly Malay people with T2DM are not well documented in the research literature. This paper discusses an intervention to increase physical activity in elderly Malay people with T2DM. The aim of our study was to evaluate the effectiveness of personalised feedback alone and in combination with peer support in promoting and maintaining physical activity in comparison with usual care.
METHODS AND ANALYSIS: A three-arm randomised controlled trial will be conducted among sedentary Malay adults aged 60 years and above with T2DM attending an urban primary healthcare clinic in Malaysia. The participants will be randomised into three groups for a 12-week intervention with a follow-up at 24 and 36 weeks to assess adherence. The primary outcome of this study is pedometer-determined physical activity. Glycaemic and blood pressure control, body composition, cardiorespiratory fitness, balance, lipid profile, health-related quality of life, psychological well-being, social support and self-efficacy for exercise are the secondary measures. Linear mixed models will be used to determine the effect of the intervention over time and between groups. ETHICAL AND DISSEMINATION: The Monash University Human Research Ethics Committee and the Malaysian Ministry of Health's Medical Research Ethics Committee approved this protocol. The findings of this study will be presented at international conferences and published in peer-reviewed journals.
TRIAL REGISTRATION: This study protocol has been registered with the Malaysian National Medical Research Registry and with the Current Controlled Trial Ltd (http://www.controlled-trials.com/ISRCTN71447000/).
MeSH terms: Adult; Aged; Blood Glucose; Blood Pressure; Body Composition; Diabetes Mellitus, Type 2; Follow-Up Studies; Humans; Life Style; Lipids; Malaysia; Primary Health Care; Quality of Life; Registries; Social Support; Universities; Exercise; Self Efficacy; Ethics Committees, Research; Biomedical Research; Actigraphy; Sedentary Lifestyle; Cardiorespiratory Fitness
Autoimmune hepatitis is an inflammatory condition of the liver that can lead to significant morbidity and mortality. Corticosteroids with or without azathioprine have been shown to improve outcome and are the current standard of care in autoimmune hepatitis patients. However, long-term use of corticosteroids and use of azathioprine could be associated with significant adverse effects that prevent their continued use at optimal dosages or may even require complete cessation. We present a patient with autoimmune liver cirrhosis who was intolerant of corticosteroid and azathioprine, who was successfully treated with cyclosporine. To our knowledge, cyclosporine use has not been reported previously in autoimmune cirrhosis, although it has been used in autoimmune hepatitis patients with reported success and good tolerability. We conclude that cyclosporine seems to be an effective alternative to azathioprine as a steroid-sparing agent in both non-cirrhotic and cirrhotic autoimmune hepatitis.
Cancer is a disease wherein abnormal cells divide without control and are able to attack other tissues. Most of the patients and their families face some degree of depression, anxiety, and fear when cancer becomes a part of their lives. They feel helpless and eager to find ways on how to get rid of it. The study focuses on anxiety among breast cancer patients. It aims at investigating cancer, its symptoms, and effects the disease has on the anxiety level of patients.
Wound bed preparation has been performed for over two decades, and the concept is well accepted. The 'TIME' acronym, consisting of tissue debridement, infection or inflammation, moisture balance and edge effect, has assisted clinicians systematically in wound assessment and management. While the focus has usually been concentrated around the wound, the evolving concept of wound bed preparation promotes the treatment of the patient as a whole. This article discusses wound bed preparation and its clinical management components along with the principles of advanced wound care management at the present time. Management of tissue necrosis can be tailored according to the wound and local expertise. It ranges from simple to modern techniques like wet to dry dressing, enzymatic, biological and surgical debridement. Restoration of the bacterial balance is also an important element in managing chronic wounds that are critically colonized. Achieving a balance moist wound will hasten healing and correct biochemical imbalance by removing the excessive enzymes and growth factors. This can be achieved will multitude of dressing materials. The negative pressure wound therapy being one of the great breakthroughs. The progress and understanding on scientific basis of the wound bed preparation over the last two decades are discussed further in this article in the clinical perspectives.
Simulation in medical education is progressing in leaps and bounds. The need for simulation in medical education and training is increasing because of a) overall increase in the number of medical students vis-à-vis the availability of patients; b) increasing awareness among patients of their rights and consequent increase in litigations and c) tremendous improvement in simulation technology which makes simulation more and more realistic. Simulation in wound care can be divided into use of simulation in wound modelling (to test the effect of projectiles on the body) and simulation for training in wound management. Though this science is still in its infancy, more and more researchers are now devising both low-technology and high-technology (virtual reality) simulators in this field. It is believed that simulator training will eventually translate into better wound care in real patients, though this will be the subject of further research.
Researchers have identified several of the cellular events associated with wound healing. Platelets, neutrophils, macrophages, and fibroblasts primarily contribute to the process. They release cytokines including interleukins (ILs) and TNF-α, and growth factors, of which platelet-derived growth factor (PDGF) is perhaps the most important. The cytokines and growth factors manipulate the inflammatory phase of healing. Cytokines are chemotactic for white cells and fibroblasts, while the growth factors initiate fibroblast and keratinocyte proliferation. Inflammation is followed by the proliferation of fibroblasts, which lay down the extracellular matrix. Simultaneously, various white cells and other connective tissue cells release both the matrix metalloproteinases (MMPs) and the tissue inhibitors of these metalloproteinases (TIMPs). MMPs remove damaged structural proteins such as collagen, while the fibroblasts lay down fresh extracellular matrix proteins. Fluid collected from acute, healing wounds contains growth factors, and stimulates fibroblast proliferation, but fluid collected from chronic, nonhealing wounds does not. Fibroblasts from chronic wounds do not respond to chronic wound fluid, probably because the fibroblasts of these wounds have lost the receptors that respond to cytokines and growth factors. Nonhealing wounds contain high levels of IL1, IL6, and MMPs, and an abnormally high MMP/TIMP ratio. Clinical examination of wounds inconsistently predicts which wounds will heal when procedures like secondary closure are planned. Surgeons therefore hope that these chemicals can be used as biomarkers of wounds which have impaired ability to heal. There is also evidence that the application of growth factors like PDGF will help the healing of chronic, nonhealing wounds.
Wound care is constantly evolving with the advances in medicine. Search for the ideal dressing material still continues as wound care professionals are faced with several challenges. Due to the emergence of multi-resistant organisms and a decrease in newer antibiotics, wound care professionals have revisited the ancient healing methods by using traditional and alternative medicine in wound management. People's perception towards traditional medicine has also changed and is very encouraging. The concept of moist wound healing has been well accepted and traditional medicine has also incorporated this method to fasten the healing process. Several studies using herbal and traditional medicine from different continents have been documented in wound care management. Honey has been used extensively in wound care practice with excellent results. Recent scientific evidences and clinical trials conducted using traditional and alternative medicine in wound therapy holds good promise in the future.
Recurrence following failure of chemotherapy limits the application of high doses of anticancer drugs currently used for eliminating cancerous cells. It has been identified that ATP-binding cassette (ABC) multidrug transporters are associated with chemoresistance, which is a major obstacle in cancer therapy. The present study aimed to investigate the association of pretherapeutic multidrug resistance-associated protein 2 (MRP2) expression with response to chemotherapy in stage II/III colorectal cancer (CRC). Protein expression was determined by immunohistochemical analysis of 50 archival samples from patients who had not received preoperative chemotherapy and radiotherapy. All patients were treated with 5-fluorouracil/leucovorin (FL) plus oxaliplatin (FOLFOX-4) regimen for 6 months following curative resection. During the 12 months of follow-up, local and distant recurrences were observed in 15 (30%) cases, of which 5 occurred at the time of chemotherapy. MRP2 expression was observed in 24 (48%) and 7 (14%) cases in the tumor tissues and matched normal tissues, respectively. A significant difference was observed between the positive expression frequency in the tumor tissues compared to the surrounding normal mucosa (P=0.003). The incidence of recurrence and metastasis for patients in the MRP2-positive group was lower than that in the MRP2-negative group (P>0.05); however, all 5 cases who demonstrated recurrence during their treatment were MRP2-positive (P=0.022). MRP2 expression was not correlated with the clinicopathological markers in this group of patients. Kaplan-Meier analysis revealed that MRP2 expression was not associated with a shorter disease-free survival or overall survival of patients (P>0.05). The results of this study indicated that MRP2 is overexpressed in the course of CRC development and progression. However, expression of MRP2 was not associated with recurrence of patients treated with FL and oxaliplatin in the population studied.
INTRODUCTION: The majority of our knowledge regarding disease-related mechanisms of uncontrolled citrullination and anti-citrullinated protein antibody development in rheumatoid arthritis (RA) was investigated in Caucasian populations. However, peptidylarginine deiminase (PADI) type 4 gene polymorphisms are associated with RA in East Asian populations and weak or no association was found in Caucasian populations. This study explores the association between the PADI4 polymorphisms and RA risk in a multiethnic population residing in South East Asia with the goal of elucidating generalizability of association in non-Caucasian populations.
METHODS: A total of 320 SNPs from the PADI locus (including PADI1, PADI2, PADI3, PADI4 and PADI6 genes) were genotyped in 1,238 RA cases and 1,571 control subjects from the Malaysian Epidemiological Investigation of Rheumatoid Arthritis (MyEIRA) case-control study. Additionally, we conducted meta-analysis of our data together with the previously published studies of RA from East Asian populations.
RESULTS: The overall odds ratio (ORoverall) for the PADI4 (rs2240340) allelic model was 1.11 (95% confidence interval (CI) = 1.00 to 1.23, P = 0.04) and for the genotypic model was 1.20 (95% CI = 1.01 to 1.44, P = 0.04). Haplotype analysis for four selected PADI4 SNPs revealed a significant association of one with susceptibility (P = 0.001) and of another with a protective effect (P = 0.02). The RA susceptibility was further confirmed when combined meta-analysis was performed using these data together with data from five previously published studies from Asia comprising 5,192 RA cases and 4,317 control subjects (ORoverall = 1.23 (95% CI = 1.16 to 1.31, Pheterogeneity = 0.08) and 1.31 (95% CI = 1.20 to 1.44, Pheterogeneity = 0.32) in allele and genotype-based models, respectively). In addition, we also detected a novel association of PADI2 genetic variant rs1005753 with RA (ORoverall = 0.87 (95% CI = 0.77 to 0.99)).
CONCLUSION: Our study demonstrates an association between PADI4 and RA in the multiethnic population from South East Asia and suggests additional association with a PADI2 gene. The study thus provides further support for the notion that polymorphisms in genes for enzymes responsible for citrullination contribute to RA development in multiple populations of Asian descent.
This study describes the properties of colloidal gold nanoparticles (AuNPs) with sizes of 20, 30 and 40 nm, which were synthesized using citrate reduction or seeding-growth methods. Likewise, the conjugation of these AuNPs to mouse anti-human IgG(4) (MαHIgG(4)) was evaluated for an immunochromatographic (ICG) strip test to detect brugian filariasis. The morphology of the AuNPs was studied based on the degree of ellipticity (G) of the transmission electron microscopy images. The AuNPs produced using the seeding-growth method showed lower ellipticity (G ≤ 1.11) as compared with the AuNPs synthesized using the citrate reduction method (G ≤ 1.18). Zetasizer analysis showed that the AuNPs that were synthesized using the seeding-growth method were almost monodispersed with a lower polydispersity index (PDI; PDI≤0.079), as compared with the AuNPs synthesized using the citrate reduction method (PDI≤0.177). UV-visible spectroscopic analysis showed a red-shift of the absorbance spectra after the reaction with MαHIgG(4), which indicated that the AuNPs were successfully conjugated. The optimum concentration of the BmR1 recombinant antigen that was immobilized on the surface of the ICG strip on the test line was 1.0 mg ml(-1). When used with the ICG test strip assay and brugian filariasis serum samples, the conjugated AuNPs-MαHIgG(4) synthesized using the seeding-growth method had faster detection times, as compared with the AuNPs synthesized using the citrate reduction method. The 30 nm AuNPs-MαHIgG(4), with an optical density of 4 from the seeding-growth method, demonstrated the best performance for labelling ICG strips because it displayed the best sensitivity and the highest specificity when tested with serum samples from brugian filariasis patients and controls.
Magnetic iron oxide nanoparticles were prepared using a sonochemical method under atmospheric conditions at a Fe²⁺ to Fe³⁺ molar ratio of 1:2. The iron oxide nanoparticles were subsequently coated with chitosan and gallic acid to produce a core-shell structure.
Steady two dimensional MHD laminar free convective boundary layer flows of an electrically conducting Newtonian nanofluid over a solid stationary vertical plate in a quiescent fluid taking into account the Newtonian heating boundary condition is investigated numerically. A magnetic field can be used to control the motion of an electrically conducting fluid in micro/nano scale systems used for transportation of fluid. The transport equations along with the boundary conditions are first converted into dimensionless form and then using linear group of transformations, the similarity governing equations are developed. The transformed equations are solved numerically using the Runge-Kutta-Fehlberg fourth-fifth order method with shooting technique. The effects of different controlling parameters, namely, Lewis number, Prandtl number, buoyancy ratio, thermophoresis, Brownian motion, magnetic field and Newtonian heating on the flow and heat transfer are investigated. The numerical results for the dimensionless axial velocity, temperature and nanoparticle volume fraction as well as the reduced Nusselt and Sherwood number have been presented graphically and discussed. It is found that the rate of heat and mass transfer increase as Newtonian heating parameter increases. The dimensionless velocity and temperature distributions increase with the increase of Newtonian heating parameter. The results of the reduced heat transfer rate is compared for convective heating boundary condition and found an excellent agreement.
MeSH terms: Algorithms; Electric Conductivity; Hot Temperature; Models, Theoretical*; Rheology*; Nanotechnology
While associations between trace elements and heavy metals with prostate cancer are still debatable, they have been considered as risk factors for prostate cancer. Thus, this study aimed to detect any links between selected minerals and heavy metals including Se, Zn, Cu, Mn and Fe with prostate cancer. A case control study was carried out among 100 subjects (case n=50, control n=50), matched for age and ethnicity. Trace elements and heavy metals level in hair and nail samples were determined by ICP-MS. Mean selenium levels in hair and nail of the cases were significantly lower as compared to controls. A similar trend was noted for zinc in both hair and nail samples, whereas the mean level of copper was significantly higher in cases than controls. Similar elevation was noted for iron and manganese (p<0.05 for all parameters). Low levels of selenium and zinc and high levels of copper, iron and manganese appear to be associated with the risk of prostate cancer. Further studies to elucidate the causal mechanisms and appropriate chemopreventive measures are needed.