Browse publications by year: 2014

Fulltext Acute gout in hospitalized patients in Sarawak General Hospital

Teh CL, Chew KF, Ling GR

Med J Malaysia, 2014 Jun;69(3):126-8.
PMID: 25326353 MyJurnal

We performed a prospective study of all hospitalized patients with a diagnosis of Gout in Sarawak General hospital from 1st July 2011 to 1st July 2012. There were a total of 126 patients in our study of which 112 (88.9%) were males. The majority of our patients were from the indigenous populations (71.7%). They have a mean age of 60.0 ± 14.2 years. Most of our patients were overweight (68%) with comorbities of hypertension (78.6%), Chronic Kidney Failure (48.4%), Type II diabetes Mellitus (30.2%), dyslipidemia (27.8%) and Ischaemic heart disease (11.9%). Polyarticular gouty arthritis was the main presenting pattern during hospitalization (88.1%). The mean length of stay for our patients was 9.8 ± 6.0 days which was significantly longer than the mean length of stay for other patients without gout (p<0.05). Only 17 patients had gout on admission and the majority developed gout during hospitalizations. Our patients were admitted respectively for medical problems (45.4%), surgical problems (28.6%) and orthopaedic problems (9.2%). Colchicine (73.8%) and steroid (40.5%) were the main stays of treatment for our patients. Our hospitalized gout patients were complicated patients with multiple comorbidities.

MeSH terms: Adult; Gout*; Hospitals, General; Humans; Malaysia; Prospective Studies; Arthritis, Gouty; Arthritis, Gouty*
Fulltext Two-incision three-port laparoscopic cholecystectomy. A feasible and safe technique

Leow VM, Faizah MS, Mohd Sharifudin S, Letchumanan VP, Yang KF, Manisekar KS

Med J Malaysia, 2014 Jun;69(3):129-32.
PMID: 25326354 MyJurnal

OBJECTIVE: Conventional laparoscopic cholecystectomy (LC) involves the use of four ports, but the number of ports has gradually been reduced to one for cosmetic reasons. however, single-incision LC is technically demanding, and there is a substantial learning curve associated with its successful application. The aim of this clinical study was to evaluate the safety and feasibility of a less demanding alternative LC technique with a faster learning curve.

METHODS: This prospective descriptive study was performed from September 2009 to February 2011 at Sultanah Bahiyah hospital in Kedah, Malaysia. A total of 58 patients underwent two-incision threeport laparoscopic cholecystectomy (TILC), which was performed by the senior consultant hepato-pancreato-biliary surgeon and two hepato-pancreato-biliary trainees. Study end points included operative time, postoperative pain, length of hospital stay and early postoperative complications. The follow-up period was 4 weeks.

RESULTS: The overall operative time taken was 44 ± 18 minutes. none of the patients had major complication or incisional hernia postoperatively. All but one of the patients were discharged within 24 h. nonsteroidal anti-inflammatory drugs were the main postoperative analgesic used.

CONCLUSION: TILC is feasible and safe cholecystectomy technique.

MeSH terms: Incisional Hernia; Analgesics; Cholecystectomy; Consultants; Follow-Up Studies; Humans; Length of Stay; Malaysia; Pain, Postoperative; Patient Discharge; Prospective Studies; Cholecystectomy, Laparoscopic; Learning Curve; Operative Time; Surgeons
Fulltext A ten-year retrospective analysis of gastroenteropancreatic neuroendocrine tumors (GEP-NETs) in Malaysia

Gunavathy M, Rohana AG, Norlela S, Nor Azmi K

Med J Malaysia, 2014 Jun;69(3):133-7.
PMID: 25326355 MyJurnal

Gastroenteropancreatic neuroendocrine tumours (GEP- nETs) are rare neoplasms with a complex spectrum of presentation. The study cohort (n=64) included the diagnoses of carcinoid, (n=26, 41%), insulinoma, (n=25, 39%), undetermined (n=10, 16%), VIPoma, glucagonoma and multiple endocrine neoplasia (MEn-1) (n= 3). Almost half of the patients (n=31) had distant metastasis at diagnosis, the commonest being carcinoid tumours. Presenting symptoms were due to either hormonal expressions or mass effects. diagnoses in all patients were made based on positive immunohistochemical staining for chromogranin and synaptophysin. Less than half (n=30) had either serum chromogranin A, urinary 5-hydroxyindole acetic acid (5-hIAA), serum insulin or C-peptide levels performed. Commonest diagnostic imaging modalities were computed tomography (CT) scan (94%) and abdominal ultrasound (15%). Curative or palliative surgery was performed in 58 patients. Systemic therapy included long acting somatostatin analogues (n=14), chemotherapy (n=7) and interferon-α2b (n=1). nine patients died, all of who had metastatic disease at diagnosis. All patients with insulinoma (n=25) were assessed by endocrinologists whilst carcinoid tumours were mainly managed by surgeons (n=16/26). Involvements of oncologists and gastroenterologists were minimal. This study showed that patients with GEP-nETs in Malaysia commonly presented late in the disease with presence of distant metastases. Less than half had adequate hormonal and biochemical examinations performed for diagnostic as well as prognostic purposes, and only a third received systemic therapy. Lack of institutionalbased database, clinical expertise and multi-disciplinary involvement contributed to the inadequate surveillance and management of the disease.

MeSH terms: Acetates; C-Peptide; Carcinoid Tumor; Chromogranins; Vipoma; Glucagonoma; Humans; Hydroxyindoleacetic Acid; Insulinoma; Malaysia; Multiple Endocrine Neoplasia; Palliative Care; Pancreatic Neoplasms; Prognosis; Somatostatin; Staining and Labeling; Tomography; Tomography, X-Ray Computed; Cohort Studies; Synaptophysin; Interferon-alpha; Neuroendocrine Tumors; Chromogranin A; Surgeons; Endocrinologists; Gastroenterologists; Oncologists
Fulltext Emergency stenting of vertical vein in a neonate with obstructed supracardiac total anomalous pulmonary venous drainage

Lim WK, Wong MN, Tan SK

Med J Malaysia, 2014 Jun;69(3):138-9.
PMID: 25326356 MyJurnal

A late preterm newborn baby presented with respiratory distress and increasing cyanosis within 2 hours of birth. Bedside transthroracic echocardiography showed a critically obstructed vertical vein in a supracardiac total anomalous pulmonary venous drainage (TAPVd). Emergency stenting of the vertical vein was successfully performed at 24 hours of life.

MeSH terms: Cyanosis; Drainage; Echocardiography; Humans; Infant; Infant, Newborn; Scimitar Syndrome; Veins
Fulltext A case of prolonged fever and a diagnosis obscured by an opaque sinus

Velayudhan M, Lee CW

Med J Malaysia, 2014 Jun;69(3):140-1.
PMID: 25326357 MyJurnal

Prolonged fever in patients can be a diagnostic challenge. Clinicians generally consider infectious diseases, malignant diseases and collagen vascular diseases as possible causes of pyrexia of unknown origin (PUO). Even after extensive evaluation as many as 15 percent of patients with prolonged fever may remain undiagnosed. This case report describes subacute thyroiditis as a cause of prolonged fever and documents how that diagnosis was finally made after 40 days of fever.

MeSH terms: Collagen; Communicable Diseases; Connective Tissue Diseases; Fever of Unknown Origin; Humans; Thyroiditis, Subacute; Vascular Diseases
Fulltext Surgical treatment of children with raised intra ocular pressures associated with sturge weber syndrome at Hospital Kuala Lumpur, Malaysia

Premadeva CS, Norazah AR, Sunder R, Jamalia R, Joseph A

Med J Malaysia, 2014 Jun;69(3):142-3.
PMID: 25326358 MyJurnal

No abstract available.

MeSH terms: Humans
Fulltext Rare cause of lower limb deep venous thrombosis: a case report

Khang NC, Hanif H, Zainal Ariffin A

Med J Malaysia, 2014 Jun;69(3):144-5.
PMID: 25326359 MyJurnal

deep venous thrombosis (dVT) in lower limbs caused by abdominal aortic aneurysm (AAA) is rare. A combination of anatomical obstruction with surrounding inflammatory tissue and reduced blood flow in venous limb were probably the main reasons for the occurrence of the dVT. we report a case of infra-renal AAA presented as lower limb dVT and symptomatic pulmonary embolism.

MeSH terms: Pulmonary Embolism; Veins; Aortic Aneurysm, Abdominal; Venous Thrombosis; Lower Extremity
Fulltext An unexpected lesion in cerebellopontine angle: hemangiopericytoma

Teoh JW, Goh BS, Shahizon Azura MM, Siti Aishah MA, Nor Hafliza MS

Med J Malaysia, 2014 Jun;69(3):146-7.
PMID: 25326360 MyJurnal

hemangiopericytoma (hPC) is a rare tumor by definition and intracranial hPC makes up to less than one percent of all the intracranial tumors. It is a dural base tumor and its clinical features and radiological findings are similar to meningiomas. however, cerebellopontine angle hemangipericytoma had only been reported twice and would almost always be misdiagnosed. definite diagnosis is important, as the treatment of hPC is different from meningiomas and acoustic neuromas. we report a case of a young female who presented with atypical symptoms of left cerebellopontine angle mass. A literature review of the nature of the disease, radiological findings, immunohistochemical features and treatment options of the tumor are described.

MeSH terms: Brain Neoplasms; Cerebellopontine Angle; Diagnostic Errors; Female; Hemangiopericytoma; Humans; Meningeal Neoplasms; Meningioma; Neuroma, Acoustic
Fulltext Cholinergic deregulation in traumatic brain injury could be a pathophysiology-related biphasic epiphenomenon

Bimpis A, Baillie GS, Zarros A

Med J Malaysia, 2014 Jun;69(3):148.
PMID: 25326361

No abstract available.

MeSH terms: Humans
Zinc carnosine protects against hydrogen peroxide-induced DNA damage in WIL2-NS lymphoblastoid cell line independent of poly (ADP-Ribose) polymerase expression

Ooi TC, Mohammad NH, Sharif R

Biol Trace Elem Res, 2014 Dec;162(1-3):8-17.
PMID: 25326781 DOI: 10.1007/s12011-014-0153-y

The aim of this study is to investigate the ability of zinc carnosine to protect the human lymphoblastoid (WIL2-NS) cell line from hydrogen peroxide-induced DNA damage. Cells were cultured with medium containing zinc carnosine at the concentrations of 0.4, 4, 16 and 32 μM for 9 days prior to treatment with 30 μM of hydrogen peroxide (30 min). Zinc carnosine at the concentration 16 μM was optimal in protecting cells from hydrogen peroxide-induced cytotoxicity and gave the lowest percentage of apoptotic and necrotic cells. Results showed that zinc carnosine was able to induce glutathione production and protect cells from hydrogen peroxide-induced oxidative stress at all concentration and the highest protection was observed at 32-μM zinc carnosine culture. Cytokinesis-block micronucleus cytome assay showed that cells cultured with 4-32 μM of zinc carnosine showed significant reduction in micronuclei formation, nucleoplasmic bridges and nuclear bud frequencies (p

MeSH terms: Carnosine/chemistry*; Cell Line; DNA Damage/drug effects*; Humans; Hydrogen Peroxide/toxicity*; Poly(ADP-ribose) Polymerases; Zinc/pharmacology*; Zinc/chemistry*; Micronucleus Tests
Is synthetic mouthwash the final choice to treat oral malodour?

Jameel RA, Khan SS, Kamaruddin MF, Abd Rahim ZH, Bakri MM, Abdul Razak FB

J Coll Physicians Surg Pak, 2014 Oct;24(10):757-62.
PMID: 25327922 DOI: 10.2014/JCPSP.757762

The aim of the review was to critically appraise the various pros and cons of the synthetic and herbal agents used in mouthwashes against halitosis and facilitate users to choose appropriate mouthwashes according to their need. Oral Malodour (OMO) or halitosis is a global epidemic with social and psychological impact. Use of mouthwash has been adopted worldwide to control halitosis within a past few decades. Alcohol and Chlorhexidine are common agents in synthetic mouthwashes, while Tannins and Eugenol are derived traditional herbal extracts. Each agent signifies some unique properties distinguishing them from others. Herbal ingredients are gaining the attention of the profession due to its mild side effects and competitive results. Herbal mouthwashes can be a safer choice in combating OMO, as an alternate to synthetic mouthwashes.

MeSH terms: Chlorhexidine/therapeutic use*; Eugenol/therapeutic use*; Halitosis/drug therapy*; Humans; Phytotherapy; Mouthwashes/therapeutic use*; Plant Extracts/therapeutic use*; Tannins/therapeutic use*
Fulltext Comprehensive Healthcare module: medical and pharmacy students' shared learning experiences

Tan CE, Jaffar A, Tong SF, Hamzah MS, Mohamad N

Med Educ Online, 2014 Jan;19(1):25605.
PMID: 28440130 DOI: 10.3402/meo.v19.25605

Introduction The Comprehensive Healthcare (CHC) module was developed to introduce pre-clinical medical and pharmacy students to the concept of comprehensive healthcare. This study aims to explore their shared learning experiences within this module. Methodology During this module, medical and pharmacy students conducted visits to patients' homes and to related community-based organisations in small groups. They were required to write a reflective journal on their experiences regarding working with other professions as part of their module assessment. Highly scored reflective journals written by students from the 2011/2012 academic session were selected for analysis. Their shared learning experiences were identified via thematic analysis. We also analysed students' feedback regarding the module. Results Analysis of 25 selected reflective journals revealed several important themes: 'Understanding of impact of illness and its relation to holistic care', 'Awareness of the role of various healthcare professions' and 'Generic or soft skills for inter-professional collaboration'. Although the primary objective of the module was to expose students to comprehensive healthcare, the students learnt skills required for future collaborative practice from their experiences. Discussion The CHC module provided early clinical exposure to community-based health issues and incorporated some elements of inter-professional education. The students learnt about the roles of other healthcare professions and acquired soft skills required for future collaborative practice during this module.

MeSH terms: Awareness; Comprehensive Health Care; Education, Professional; Feedback; Humans; Learning; Students, Medical*; Students, Pharmacy; Problem-Based Learning
Fulltext Sorption isotherms and isosteric heats of sorption of Malaysian paddy

Mousa W, Ghazali FM, Jinap S, Ghazali HM, Radu S

J Food Sci Technol, 2014 Oct;51(10):2656-63.
PMID: 25328208 DOI: 10.1007/s13197-012-0799-4

Understanding the water sorption characteristics of cereal is extremely essential for optimizing the drying process and ensuring storage stability. Water relation of rough rice was studied at 20, 30, 40 and 50 °C over relative humidity (RH.) between 0.113 and 0.976 using the gravimetric technique. The isotherms displayed the general sigmoid, Type II pattern and exhibited the phenomenon of hysteresis where it was more pronounced at lower temperatures. The sorption characteristics were temperature dependence where the sorption capacity of the paddy increased as the temperature was decreased at fixed (RH). Among the models assessed for their ability to fit the sorption data, Oswin equation was the best followed by the third order polynomial, GAB, Smith, Chung-Pfost, and Henderson models. The monolayer moisture content was higher for desorption than adsorption and tend to decrease with the increase in temperature. Given the temperature dependence of the sorption isotherms the isosteric heats of sorption were calculated using Claussius-Clapeyron equation. The net isosteric heats decreased as the moisture content was increased and heats of desorption were greater than that of adsorption.
Fulltext The development and validation of the Satisfaction Questionnaire for Osteoporosis Prevention in Malaysia

Toh LS, Lai PS, Wu DB, Wong KT, Low BY, Tan AT, et al.

Patient Prefer Adherence, 2014;8:1365-81.
PMID: 25328386 DOI: 10.2147/PPA.S65718

Purpose: To develop and validate the English version of the Satisfaction Questionnaire for Osteoporosis Prevention (SQOP) in Malaysia.
Methods: The SQOP was modified from the Osteoporosis Patient Satisfaction Questionnaire and developed based on literature review and patient interviews. Face and content validity were established via an expert panel. The SQOP consists of two sections: clinical services and types of counseling. There were 23 items in total, each with a five-point Likert-type response. Satisfaction score was calculated by converting the total score to a percentage. A higher score indicates higher satisfaction. English speaking, non-osteoporotic, postmenopausal women aged 50 years were included in the study. Participants were randomized to either the control or intervention group. Intervention participants were provided counseling, whereas control participants received none. Participants answered the SQOP at baseline and 2 weeks later.
Results: A total of 140 participants were recruited (control group: n=70; intervention group: n=70). No significant differences were found in any demographic aspects. Exploratory factor analysis extracted seven domains. Cronbach’s α for the domains ranged from 0.531–0.812. All 23 items were highly correlated using Spearman’s correlation coefficient 0.469–0.996 (P<0.05), with no significant change in the control group’s overall test–retest scores, indicating that the
SQOP achieved stable reliability. The intervention group had a higher score than the control group (87.91±5.99 versus 61.87±8.76; P<0.05), indicating that they were more satisfied than control participants. Flesch reading ease was 62.9.
Conclusion: The SQOP was found to be a valid and reliable instrument for assessing patients’ satisfaction towards an osteoporosis screening and prevention service in Malaysia.
Keywords: patient satisfaction, randomized controlled trial, postmenopausal women, screening
Study site: primary care clinic, tertiary hospital, Malaysia

MeSH terms: Adult; Aged; Ambulatory Care Facilities; China/ethnology; Female; Hospitals, University; Humans; India/ethnology; Malaysia; Malaysia/ethnology; Osteoporosis*; Outpatient Clinics, Hospital
Fulltext Relationship between physical performance and cognitive performance measures among community-dwelling older adults

Won H, Singh DK, Din NC, Badrasawi M, Manaf ZA, Tan ST, et al.

Clin Epidemiol, 2014;6:343-50.
PMID: 25328418 DOI: 10.2147/CLEP.S62392

Cognitive impairment is correlated with physical function. However, the results in the literature are inconsistent with cognitive and physical performance measures. Thus, the aim of this study was to determine the association between cognitive performance and physical function among older adults.
Fulltext Purification and characterization of alkaline-thermostable protease enzyme from Pitaya (Hylocereus polyrhizus) waste: a potential low cost of the enzyme

Amid M, Manap MY, Zohdi NK

Biomed Res Int, 2014;2014:259238.
PMID: 25328883 DOI: 10.1155/2014/259238

The thermoalkaline protease enzyme from pitaya (Hylocereus polyrhizus) waste was purified by a factor of 221.2 with 71.3% recovery using ammonium sulphate precipitation, gel filtration, and cation exchange chromatography. Gel filtration chromatography together with sodium dodecyl sulphate gel electrophoresis (SDS-PAGE) revealed that the enzyme is monomeric with a molecular weight of 26.7 kDa. The apparent K m and V max of the protease were 2.8 mg/mL and 31.20 u/min, respectively. The optimum pH and temperature were 8.0 and 70°C. The enzyme was highly active and stable over a wide pH range (from pH 3.0 to pH 11.0 with the optimum activity at pH 8.0). The protease has broad specificity toward azocasein, casein, hemoglobin, and gelatine. Activity of the enzyme was inhibited by Fe(2+) and Zn(2+), while protease activity was increased in the presence of Ca(2+) and Mg(2+) and Cu(2+) by factors of 125%, 110%, and 105%, respectively. The alkaline protease showed extreme stability toward surfactants and oxidizing agent. The purified protease exhibited extreme stability in the presence of organic solvents and inhibitors. In addition, the enzyme was relativity stable toward organic solvents and chelating agents, such as ethylenediaminetetraacetic acid (EDTA). The enzyme, derived from pitaya peel, possesses unique characteristics and could be used in various industrial and biotechnological applications.

MeSH terms: Agriculture; Catalysis; Enzyme Activation; Fruit/chemistry*; Hydrogen-Ion Concentration; Industrial Waste/analysis; Kinetics; Malaysia; Peptide Hydrolases/classification; Peptide Hydrolases/isolation & purification*; Peptide Hydrolases/chemistry*; Plant Extracts/isolation & purification*; Plant Extracts/chemistry*; Temperature; Cactaceae/enzymology*
Fulltext Evaluation of commercially available diagnostic tests for the detection of dengue virus NS1 antigen and anti-dengue virus IgM antibody

Hunsperger EA, Yoksan S, Buchy P, Nguyen VC, Sekaran SD, Enria DA, et al.

PLoS Negl Trop Dis, 2014 Oct;8(10):e3171.
PMID: 25330157 DOI: 10.1371/journal.pntd.0003171

Commercially available diagnostic test kits for detection of dengue virus (DENV) non-structural protein 1 (NS1) and anti-DENV IgM were evaluated for their sensitivity and specificity and other performance characteristics by a diagnostic laboratory network developed by World Health Organization (WHO), the UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) and the Pediatric Dengue Vaccine Initiative (PDVI). Each network laboratory contributed characterized serum specimens for the panels used in the evaluation. Microplate enzyme-linked immunosorbent assay (ELISA) and rapid diagnostic test (RDT formats) were represented by the kits. Each ELISA was evaluated by 2 laboratories and RDTs were evaluated by at least 3 laboratories. The reference tests for IgM anti-DENV were laboratory developed assays produced by the Armed Forces Research Institute for Medical Science (AFRIMS) and the Centers for Disease Control and Prevention (CDC), and the NS1 reference test was reverse transcriptase polymerase chain reaction (RT-PCR). Results were analyzed to determine sensitivity, specificity, inter-laboratory and inter-reader agreement, lot-to-lot variation and ease-of-use. NS1 ELISA sensitivity was 60-75% and specificity 71-80%; NS1 RDT sensitivity was 38-71% and specificity 76-80%; the IgM anti-DENV RDTs sensitivity was 30-96%, with a specificity of 86-92%, and IgM anti-DENV ELISA sensitivity was 96-98% and specificity 78-91%. NS1 tests were generally more sensitive in specimens from the acute phase of dengue and in primary DENV infection, whereas IgM anti-DENV tests were less sensitive in secondary DENV infections. The reproducibility of the NS1 RDTs ranged from 92-99% and the IgM anti-DENV RDTs from 88-94%.

MeSH terms: Antibodies, Viral/blood*; Antigens, Viral/blood*; Dengue Virus/immunology*; Enzyme-Linked Immunosorbent Assay/methods; Humans; Immunoglobulin M/blood*; Malaysia; Reagent Kits, Diagnostic*; Sensitivity and Specificity; Viral Nonstructural Proteins; Viral Nonstructural Proteins/immunology*
Fulltext The effects of a distracting N-back task on recognition memory are reduced by negative emotional intensity

Buratto LG, Pottage CL, Brown C, Morrison CM, Schaefer A

PLoS One, 2014;9(10):e110211.
PMID: 25330251 DOI: 10.1371/journal.pone.0110211

Memory performance is usually impaired when participants have to encode information while performing a concurrent task. Recent studies using recall tasks have found that emotional items are more resistant to such cognitive depletion effects than non-emotional items. However, when recognition tasks are used, the same effect is more elusive as recent recognition studies have obtained contradictory results. In two experiments, we provide evidence that negative emotional content can reliably reduce the effects of cognitive depletion on recognition memory only if stimuli with high levels of emotional intensity are used. In particular, we found that recognition performance for realistic pictures was impaired by a secondary 3-back working memory task during encoding if stimuli were emotionally neutral or had moderate levels of negative emotionality. In contrast, when negative pictures with high levels of emotional intensity were used, the detrimental effects of the secondary task were significantly attenuated.

MeSH terms: Attention/physiology*; Emotions*; Female; Humans; Judgment/physiology; Male; Recognition (Psychology)*; Young Adult
Fulltext Lipoleiomyoma: a rare benign tumour of the uterus

Johari B, Koshy M, Sidek S, Hanafiah M

BMJ Case Rep, 2014 Oct 19;2014.
PMID: 25331147 DOI: 10.1136/bcr-2014-205814
MeSH terms: Aged; Female; Humans; Hysterosalpingography; Leiomyoma/diagnosis*; Lipoma/diagnosis*; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Uterine Neoplasms/diagnosis*; Uterus/pathology; Uterus/ultrasonography
Fulltext Correlation of antiangiogenic, antioxidant and cytotoxic activities of some Sudanese medicinal plants with phenolic and flavonoid contents

Hassan LE, Ahamed MB, Majid AS, Baharetha HM, Muslim NS, Nassar ZD, et al.

BMC Complement Altern Med, 2014 Oct 20;14:406.
PMID: 25331269 DOI: 10.1186/1472-6882-14-406

BACKGROUND: Consumption of medicinal plants to overcome diseases is traditionally belongs to the characteristics of most cultures on this earth. Sudan has been a host and cradle to various ancient civilizations and developed a vast knowledge on traditional medicinal plants. The present study was undertaken to evaluate the antioxidant, antiangiogenic and cytotoxic activities of six Sudanese medicinal plants which have been traditionally used to treat neoplasia. Further the biological activities were correlated with phytochemical contents of the plant extracts.
METHODS: Different parts of the plants were subjected to sequential extraction method. Cytotoxicity of the extracts was determined by dimethylthiazol-2-yl)- 2,5diphenyl tetrazolium bromide (MTT) assay on 2 human cancer (colon and breast) and normal (endothelial and colon fibroblast) cells. Anti-angiogenic potential was tested using ex vivo rat aortic ring assay. DPPH (1,1-diphenyl-2-picrylhydrazyl) assay was conducted to screen the antioxidant capabilities of the extracts. Finally, total phenolic and flavonoid contents were estimated in the extracts using colorimetric assays.
RESULTS: The results indicated that out of 6 plants tested, 4 plants (Nicotiana glauca, Tephrosia apollinea, Combretum hartmannianum and Tamarix nilotica) exhibited remarkable anti-angiogenic activity by inhibiting the sprouting of microvessels more than 60%. However, the most potent antiangiogenic effect was recorded by ethanol extract of T. apollinea (94.62%). In addition, the plants exhibited significant antiproliferative effects against human breast (MCF-7) and colon (HCT 116) cancer cells while being non-cytotoxic to the tested normal cells. The IC50 values determined for C. hartmannianum, N. gluaca and T. apollinea against MCF-7 cells were 8.48, 10.78 and 29.36 μg/ml, respectively. Whereas, the IC50 values estimated for N. gluaca, T. apollinea and C. hartmannianum against HCT 116 cells were 5.4, 20.2 and 27.2 μg/ml, respectively. These results were more or less equal to the standard reference drugs, tamoxifen (IC50 = 6.67 μg/ml) and 5-fluorouracil (IC50 = 3.9 μg/ml) tested against MCF-7 and HCT 116, respectively. Extracts of C. hartmannianum bark and N. glauca leaves demonstrated potent antioxidant effect with IC50s range from 9.4-22.4 and 13.4-30 μg/ml, respectively. Extracts of N. glauca leaves and T apollinea aerial parts demonstrated high amount of flavonoids range from 57.6-88.1 and 10.7-78 mg quercetin equivalent/g, respectively.
CONCLUSIONS: These results are in good agreement with the ethnobotanical uses of the plants (N. glauca, T. apollinea, C. hartmannianum and T. nilotica) to cure the oxidative stress and paraneoplastic symptoms caused by the cancer. These findings endorse further investigations on these plants to determine the active principles and their mode of action.

MeSH terms: Animals; Antioxidants/analysis; Antioxidants/pharmacology*; Aorta/drug effects; Biphenyl Compounds; Flavonoids/analysis; Flavonoids/pharmacology*; Humans; Male; Phenols/analysis; Phenols/pharmacology*; Plant Extracts/analysis; Plant Extracts/pharmacology*; Plants, Medicinal/chemistry*; Sudan; Tobacco/chemistry; Rats, Sprague-Dawley; Oxidative Stress/drug effects; Plant Leaves/chemistry; Angiogenesis Inhibitors/analysis; Angiogenesis Inhibitors/pharmacology*; Combretum/chemistry; Tephrosia/chemistry; Tamaricaceae/chemistry; Cell Line, Tumor; Cell Proliferation/drug effects; Rats

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