Browse publications by year: 2018

  1. Wan Dali WPE, Jan Mohamed HJ, Yusoff H
    Iran J Public Health, 2018 Aug;47(8):1098-1107.
    PMID: 30186781
    Background: The study examined the baseline findings of a controlled intervention study comprising anthropometric measurements, nutrient intakes, and physical activity among overweight or obese children in Kota Bharu, Kelantan, Malaysia.

    Methods: The study was completed in 2016 and the baseline data were gathered from four groups in a school-based randomized community trial among Year Five students from primary schools in Kota Bharu, Kelantan, Malaysia. Participants completed anthropometry assessment, three-day dietary record, and Physical Activity Questionnaire for Older Children (PAQ-C).

    Results: The prevalence of obesity was higher among the boys (52.5%). Mean energy intake was significantly higher among boys as compared to the girls (P=0.003). Twenty-five percent of the participants had exceeded the recommended nutrient intakes (RNI) of energy recommended. The calcium, thiamine, riboflavin, and niacin were also significantly higher among boys as compared to the girls (P<0.05). Boys also exhibited a significantly higher score on performance of physical activity (mean=2.68; SD=0.60) as compared to the girls (mean=2.38; SD=0.51) however it is still in the category of moderately active. Approximately 14.4% of children had a very low physical activity level.

    Conclusion: Overweight and obese boys had higher energy and fat intakes but were more physically active as compared to the girls. These findings might be useful in planning appropriate intervention strategies to be designed and delivered especially for this cohort.

    MeSH terms: Anthropometry; Energy Intake; Child; Female; Humans; Malaysia; Male; Niacin; Nutritional Requirements; Obesity; Surveys and Questionnaires; Riboflavin; Students; Thiamine; Cohort Studies; Exercise; Diet Records; Prevalence; Overweight
  2. Jaafar H, Razi NA, Azzeri A, Isahak M, Dahlui M
    Environ Sci Pollut Res Int, 2018 Oct;25(30):30009-30020.
    PMID: 30187406 DOI: 10.1007/s11356-018-3049-0
    Economic losses due to health-related implications of air pollution were huge and incurred significant burdens towards healthcare providers. The objective of this study is to systematically review published literature on the financial implications of air pollution on health in Asia. Four databases: PubMed, Scopus, NHS Economic Evaluation Database (NHS EED), and Web of Science (WoS) were used to identify all the relevant articles. It was limited to all articles that had been published in the respected databases from January 2007 until March 2017. Twenty-four articles were included in this review. Five of the 24 studies (20.8%) reported financial implications of air pollution-related disease through value of statistical life (VOSL) which ranged from USD180 million to USD2.2 billion, six (25%) studies used cost of illness (COI) to evaluate air pollution-related morbidity and found that the cost ranged from USD5.4 million to USD9.1 billion. Another six studies (25%) used a combination of VOSL and COI for both mortality and morbidity valuation and found that the financial implications ranging from USD253 million to USD2.9 billion. Thirteen (54.2%) studies reported healthcare cost associated with both hospital admission and outpatient visit, five (20.1%) on hospital admission only, and one (4.2%) on outpatient visit only. Economic impacts of air pollution can be huge with significant deterioration of health among the Asians.
    MeSH terms: Air Pollutants/analysis; Air Pollutants/economics; Air Pollution/analysis; Air Pollution/economics*; Asia; Cost-Benefit Analysis; Health/economics*; Humans; Cost of Illness
  3. Kiyasudeen K, Ibrahim MH, Muhammad SA, Ismail SA, Gonawan FN, Zuknik MH
    Environ Sci Pollut Res Int, 2018 Nov;25(31):31062-31070.
    PMID: 30187407 DOI: 10.1007/s11356-018-3074-z
    Earthworms are commonly referred as environmental engineers and their guts are often compared with chemical reactors. However, modeling experiments to substantiate it are lacking. The aim of this study was to use established reactor models, particularly PFR, on the gut of the vermicomposting earthworm Eudrilus eugeniae to understand more on its digestion. To achieve the objective, a mathematical model based on first-order kinetics was framed and used to determine the pattern of digestion rates of nutrient indicators, namely total carbon (%), total nitrogen (%), C/N ratio, 13C (‰), and 15N (‰) at five intersections (pre-intestine, foregut, midgut A, midgut B, and hindgut) along the gut of E. eugeniae. The experimental results revealed that the concentrations of TC, TN, 13C, and 15N decreased during gut transit, whereas C/N ratio increased. The first-order model demonstrated that all the nutrients exhibit a linear pattern of digestion during gut transit, which supports the PFR model. On this basis, the present study concludes that the gut of E. eugeniae functions as PFR.
    MeSH terms: Animals; Carbon/metabolism; Kinetics; Models, Biological*; Nitrogen/metabolism; Oligochaeta/metabolism*; Gastrointestinal Tract/metabolism*
  4. Wong YP, Tan GC, Kumar R
    Neuropathology, 2018 Dec;38(6):619-623.
    PMID: 30187570 DOI: 10.1111/neup.12511
    Xanthomatous changes can be observed in various conditions including primary xanthomatosis that is linked to an underlying hypercholesterolemia and more commonly associated with secondary xanthomatous degenerative processes in neoplasm and chronic inflammation. Meningioma with extensive xanthomatous change is exceedingly rare. The presence of cholesterol clefts within this peculiar meningioma subtype has not been described. Herein, we report an unusual case of xanthomatous meningioma in an 83-year-old normolipidemic woman, who presented to us with worsening lower limb weakness and global aphasia. There was increasing evidence to suggest that the presence of xanthomatous changes in long-standing meningioma is merely a sequela of cellular degeneration rather than true metaplastic change as previously hypothesized. Hence, the diagnosis of "xanthomatous meningioma" in the metaplastic category should be revisited and considered as a distinct histological subtype. The possible histogenesis of such intriguing phenomenon is discussed with a review of the literature.
    MeSH terms: Aged, 80 and over; Female; Humans; Meningeal Neoplasms/pathology*; Meningioma/pathology*; Metaplasia; Xanthomatosis/pathology*
  5. Lu MC, Li TY, Hsieh YC, Hsieh PC, Chu YL
    Environ Toxicol, 2018 Dec;33(12):1229-1236.
    PMID: 30188005 DOI: 10.1002/tox.22629
    Clinacanthus nutans has been used as herbal medicine with antidiabetic, blood pressure lowering, and diuretic properties in Singapore, Thailand, and Malaysia. The in vitro cellular study showed the chloroform extract possessed significant cytotoxicity against leukemia K562 and lymphoma Raji cells. The clinical study reported that administration of plant could treat or prevent relapse in 12 cancer patients. However, detailed mechanism of the anticancer effects and chemical profiles are not thoroughly studied. The chemical study did show that the acetone extract (MHA) exerted the highest antiproliferative effect on human leukemia MOLT-4 cells and lymphoma SUP-T1 cells in dose-dependent cytotoxicity. We found that the use of MHA increased apoptosis by 4.28%-43.65% and caused disruption of mitochondrial membrane potential (MMP) by 11.79%-26.93%, increased reactive oxygen species (ROS) by 19.54% and increased calcium ion by 233.83%, as demonstrated by annexin-V/PI, JC-1, H2 DCFDA, and Flou-3 staining assays, respectively. MHA-induced ER stress was confirmed by increase expression of CHOP and IRE-1α with western blotting assay. In conclusion, we identified good bioactivity in Clinacanthus nutans and recognize its potential effect on cancer therapy, but further research is needed to determine the use of the plant.
    MeSH terms: Antineoplastic Agents, Phytogenic/pharmacology; Antineoplastic Agents, Phytogenic/chemistry; Humans; Lymphoma/metabolism; Lymphoma/pathology*; Phytotherapy; Plant Extracts/pharmacology*; Plant Extracts/chemistry*; Apoptosis/drug effects*; Reactive Oxygen Species/metabolism; Acanthaceae/chemistry*; Cell Line, Tumor; Membrane Potential, Mitochondrial/drug effects
  6. Lee WH, Loo CY, Ghadiri M, Leong CR, Young PM, Traini D
    Adv Drug Deliv Rev, 2018 08;133:107-130.
    PMID: 30189271 DOI: 10.1016/j.addr.2018.08.012
    Lung cancer is a highly invasive and prevalent disease with ineffective first-line treatment and remains the leading cause of cancer death in men and women. Despite the improvements in diagnosis and therapy, the prognosis and outcome of lung cancer patients is still poor. This could be associated with the lack of effective first-line oncology drugs, formation of resistant tumors and non-optimal administration route. Therefore, the repurposing of existing drugs currently used for different indications and the introduction of a different method of drug administration could be investigated as an alternative to improve lung cancer therapy. This review describes the rationale and development of repositioning of drugs for lung cancer treatment with emphasis on inhalation. The review includes the current progress of repurposing non-cancer drugs, as well as current chemotherapeutics for lung malignancies via inhalation. Several potential non-cancer drugs such as statins, itraconazole and clarithromycin, that have demonstrated preclinical anti-cancer activity, are also presented. Furthermore, the potential challenges and limitations that might hamper the clinical translation of repurposed oncology drugs are described.
    MeSH terms: Administration, Inhalation; Antineoplastic Agents/administration & dosage*; Antineoplastic Agents/therapeutic use*; Humans; Lung Neoplasms/drug therapy*; Clarithromycin/administration & dosage; Clarithromycin/therapeutic use*; Itraconazole/administration & dosage; Itraconazole/therapeutic use*; Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use*; Drug Repositioning*
  7. Butt FI, Muhammad N, Hamid A, Moniruzzaman M, Sharif F
    Int J Biol Macromol, 2018 Dec;120(Pt A):1294-1305.
    PMID: 30189278 DOI: 10.1016/j.ijbiomac.2018.09.002
    PHAs (polyhydroxyalkanoates) have emerged as biodegradable plastics more strongly in the 20th century. A wide range of bacterial species along with fungi, plants, oilseed crops and carbon sources have been used extensively to synthesize PHA on large scales. Alteration of PHA monomers in their structures and composition has led to the development of biodegradable and biocompatible polymers with highly specific mechanical properties. This leads to the incorporation of PHA in numerous biomedical applications within the previous decade. PHAs have been fabricated in various forms to perform tissue engineering to repair liver, bone, cartilage, heart tissues, cardiovascular tissues, bone marrow, and to act as drug delivery system and nerve conduits. A large number of animal trials have been carried out to assess the biomedical properties of PHA monomers, which also confirms the high compatibility of PHA family for this field. This review summarizes the synthesis of PHA from different sources, and biosynthetic pathways and biomedical applications of biosynthesized polyhydroxyalkanoates.
    MeSH terms: Bacteria/genetics; Bacteria/chemistry; Humans; Plants/genetics; Plants/chemistry; Drug Delivery Systems; Tissue Engineering*; Biosynthetic Pathways/genetics*; Polyhydroxyalkanoates/biosynthesis; Polyhydroxyalkanoates/therapeutic use; Polyhydroxyalkanoates/chemistry*; Biodegradable Plastics/chemical synthesis; Biodegradable Plastics/therapeutic use; Biodegradable Plastics/chemistry*
  8. Zarzour RHA, Alshawsh MA, Asif M, Al-Mansoub MA, Mohamed Z, Ahmad M, et al.
    Nutrients, 2018 Aug 09;10(8).
    PMID: 30096951 DOI: 10.3390/nu10081057
    The growth of adipose tissues is considered angiogenesis-dependent during non-alcoholic fatty liver disease (NAFLD). We have recently reported that our standardized 50% methanolic extract (ME) of Phyllanthus niruri (50% ME of P. niruri) has alleviated NAFLD in Sprague⁻Dawley rats. This study aimed to assess the molecular mechanisms of action, and to further evaluate the antiangiogenic effect of this extract. NAFLD was induced by eight weeks of high-fat diet, and treatment was applied for four weeks. Antiangiogenic activity was assessed by aortic ring assay and by in vitro tests. Our findings demonstrated that the therapeutic effects of 50% ME among NAFLD rats, were associated with a significant increase in serum adiponectin, reduction in the serum levels of RBP4, vaspin, progranulin, TNF-α, IL-6, and significant downregulation of the hepatic gene expression of PPARγ, SLC10A2, and Collα1. Concomitantly, 50% ME of P. niruri has exhibited a potent antiangiogenic activity on ring assay, cell migration, vascular endothelial growth factor (VEGF), and tube formation, without any cytotoxic effect. Together, our findings revealed that the protective effects of P. niruri against NAFLD might be attributed to its antiangiogenic effect, as well as to the regulation of adipocytokines and reducing the expression of adipogenic genes.
    MeSH terms: Animals; Cell Line; Disease Models, Animal; Gene Expression Regulation; Humans; Liver/drug effects*; Liver/metabolism; Liver/pathology; Male; Plant Extracts/isolation & purification; Plant Extracts/pharmacology*; Signal Transduction/drug effects; Rats, Sprague-Dawley; Neovascularization, Physiologic/drug effects*; Angiogenesis Inhibitors/isolation & purification; Angiogenesis Inhibitors/pharmacology*; Angiogenic Proteins/genetics; Angiogenic Proteins/metabolism*; Adipokines/genetics; Adipokines/metabolism*; Non-alcoholic Fatty Liver Disease/metabolism; Non-alcoholic Fatty Liver Disease/pathology; Non-alcoholic Fatty Liver Disease/physiopathology; Non-alcoholic Fatty Liver Disease/prevention & control*
  9. Mat Baki M, Clarke P, Birchall MA
    J Laryngol Otol, 2018 Sep;132(9):846-851.
    PMID: 30180919 DOI: 10.1017/S0022215118000476
    OBJECTIVE: This prospective case series aimed to present the outcomes of immediate selective laryngeal reinnervation.

    METHODS: Two middle-aged women with vagal paraganglioma undergoing an excision operation underwent immediate selective laryngeal reinnervation using the phrenic nerve and ansa cervicalis as the donor nerve. Multidimensional outcome measures were employed pre-operatively, and at 1, 6 and 12 months post-operatively.

    RESULTS: The voice handicap index-10 score improved from 23 (patient 1) and 18 (patient 2) at 1 month post-operation, to 5 (patient 1) and 1 (patient 2) at 12 months. The Eating Assessment Tool 10 score improved from 20 (patient 1) and 24 (patient 2) at 1 month post-operation, to 3 (patient 1) and 1 (patient 2) at 12 months. There was slight vocal fold abduction observed in patient one and no obvious abduction in patient two.

    CONCLUSION: Selective reinnervation is safe to perform following vagal paraganglioma excision conducted on the same side. Voice and swallowing improvements were demonstrated, but no significant vocal fold abduction was achieved.

    MeSH terms: Adult; Cervical Plexus/surgery; Cranial Nerve Neoplasms/surgery*; Deglutition Disorders/complications; Female; Humans; Laryngeal Nerves/pathology; Laryngeal Nerves/surgery*; Larynx/pathology; Middle Aged; Nerve Regeneration/physiology; Paraganglioma/surgery*; Phonation/physiology; Phrenic Nerve/transplantation*; Prospective Studies; Vocal Cord Paralysis/etiology; Vocal Cord Paralysis/surgery; Vocal Cords/physiopathology; Voice/physiology; Outcome Assessment (Health Care); Vagus Nerve Diseases/pathology; Dysphonia/complications
  10. Solarin SA, Al-Mulali U, Ozturk I
    Environ Sci Pollut Res Int, 2018 Nov;25(31):30949-30961.
    PMID: 30182312 DOI: 10.1007/s11356-018-3060-5
    We investigate the role of military expenditure on emission in USA during the period 1960-2015. To achieve the objectives of this study, two measures of military expenditure are utilised, while several timeseries models are constructed with the gross domestic product (GDP) per capita, population, energy consumption per capita, non-renewable energy consumption per capita, renewable energy consumption per capita, urbanisation, trade openness and financial development serving as additional determinants of air pollution. We also use ecological indicator as an alternative measure of pollution. Moreover, different timeseries methods are utilised including a likelihood-based approach with two structural breaks. The output of this research concluded that all the variables are cointegrated. It is found that military expenditure has mixed impact on CO2 emissions. Real GDP per capita, energy consumption per capita, non-renewable energy consumption per capita, population and urbanisation increase CO2 emissions per capita in the long-run, while renewable energy consumption, financial development and trade openness reduce it. There is also evidence for the mixed role of military expenditure, when ecological footprint is utilised as the environmental degradation index. From the output of this research, few policy recommendations are offered for the examined country.
    MeSH terms: Air Pollutants/analysis; Air Pollution/analysis*; Carbon Dioxide/analysis; Humans; Military Personnel*; United States; Urbanization; Likelihood Functions; Gross Domestic Product; Renewable Energy
  11. Loo CH, Tan WC, Tang JJ, Khor YH, Manikam MT, Low DE, et al.
    Int J Dermatol, 2018 Dec;57(12):1454-1463.
    PMID: 30182482 DOI: 10.1111/ijd.14210
    BACKGROUND: Hidradenitis suppurativa (HS) is a chronic, recurrent, inflammatory disorder of follicular occlusion, resulting in abscesses with tunnel formation and severe scarring. Our objectives were to identify the clinical patterns and the prevalence of metabolic syndrome (MetS) among our HS patients and to determine the role of ultrasonography in the clinical assessment of HS.

    METHODS: This was a cross-sectional study carried out from September 2016 to August 2017 at three tertiary hospitals in Northern Peninsular Malaysia.

    RESULTS: A total of 62 patients were recruited, 83.9% of whom were male. The mean age was 29.2 with the median age of onset at 18 years old. The median duration of delay in diagnosis was 3 years. A quarter of them had positive family history. Nearly three-quarters were overweight and obese. About 12/62 (19.4%) had MetS, and it was comparable to healthy controls (15/62, 24.2%). HS patients had a significant higher risk of low-high-density lipoprotein (HDL) and obesity. Based on Hurley staging, 15/62 (24.2%) were in stage I, 38/62 (61.3%) and 9/62 (14.5%) in stages II and III, respectively. However, sonographic scoring showed 50% had severe stage of disease, and 56.9% of the patients had subclinical lesions. There was only a fair agreement between ultrasonography and Hurley staging of disease severity (k = 0.25; P = 0.004).

    CONCLUSION: There was a male preponderance among HS patients in Northern Peninsular Malaysia with early age of onset and more severe disease. Only one-fifth had MetS, but they had significantly higher risks of obesity and low HDL. Ultrasonography examination was useful to detect subclinical lesions and providing a better understanding on disease severity.

    MeSH terms: Adolescent; Adult; Cross-Sectional Studies; Female; Humans; Lipoproteins, HDL/blood; Malaysia/epidemiology; Male; Middle Aged; Obesity/epidemiology*; Phenotype; Severity of Illness Index; Sex Factors; Ultrasonography; Comorbidity; Prevalence; Hidradenitis Suppurativa/blood; Hidradenitis Suppurativa/epidemiology*; Age of Onset; Metabolic Syndrome X/epidemiology*; Young Adult
  12. Lim PK, Ng SC, Lovell NH, Yu YP, Tan MP, McCombie D, et al.
    Physiol Meas, 2018 10 11;39(10):105005.
    PMID: 30183675 DOI: 10.1088/1361-6579/aadf1e
    OBJECTIVE: The photoplethysmography (PPG) signal, commonly used in the healthcare settings, is easily affected by movement artefact leading to errors in the extracted heart rate and SpO2 estimates. This study aims to develop an online artefact detection system based on adaptive (dynamic) template matching, suitable for continuous PPG monitoring during daily living activities or in the intensive care units (ICUs).

    APPROACH: Several master templates are initially generated by applying principal component analysis to data obtained from the PhysioNet MIMIC II database. The master template is then updated with each incoming clean PPG pulse. The correlation coefficient is used to classify the PPG pulse into either good or bad quality categories. The performance of our algorithm was evaluated using data obtained from two different sources: (i) our own data collected from 19 healthy subjects using the wearable Sotera Visi Mobile system (Sotera Wireless Inc.) as they performed various movement types; and (ii) ICU data provided by the PhysioNet MIMIC II database. The developed algorithm was evaluated against a manually annotated 'gold standard' (GS).

    MAIN RESULTS: Our algorithm achieved an overall accuracy of 91.5%  ±  2.9%, with a sensitivity of 94.1%  ±  2.7% and a specificity of 89.7%  ±  5.1%, when tested on our own data. When applying the algorithm to data from the PhysioNet MIMIC II database, it achieved an accuracy of 98.0%, with a sensitivity and specificity of 99.0% and 96.1%, respectively.

    SIGNIFICANCE: The proposed method is simple and robust against individual variations in the PPG characteristics, thus making it suitable for a diverse range of datasets. Integration of the proposed artefact detection technique into remote monitoring devices could enhance reliability of the PPG-derived physiological parameters.

    MeSH terms: Adolescent; Adult; Algorithms*; Female; Humans; Male; Middle Aged; Motion; Movement; Signal Processing, Computer-Assisted; Artifacts; Photoplethysmography/methods*; Principal Component Analysis; Young Adult
  13. Bakar AA, Adamson EAS, Juliana LH, Nor Mohd SA, Wei-Jen C, Man A, et al.
    PLoS One, 2018;13(9):e0202945.
    PMID: 30183729 DOI: 10.1371/journal.pone.0202945
    Management of wild fisheries resources requires accurate knowledge on which species are being routinely exploited, but it can be hard to identify fishes to species level, especially in speciose fish groups where colour patterns vary with age. Snappers of the genus Lutjanus represent one such group, where fishes can be hard to identify and as a result fisheries statistics fail to capture species-level taxonomic information. This study employs traditional morphological and DNA barcoding approaches to identify adult and juvenile Lutjanus species harvested in Malaysian waters. Our results reveal a suite of species that differs markedly from those that have previously been considered important in the Malaysian wild-capture fishery and show that official fisheries statistics do not relate to exploitation at the species level. Furthermore, DNA barcoding uncovered two divergent groups of bigeye snapper ('Lutjanus lutjanus') distributed on either side of the Malay Peninsula, displaying a biogeographical pattern similar to distributions observed for many co-occurring reef-distributed fish groups. One of these bigeye snapper groups almost certainly represents an unrecognized species in need of taxonomic description. The study demonstrates the utility of DNA barcoding in uncovering overlooked diversity and for assessing species catch composition in a complicated but economically important taxonomic group.
    MeSH terms: Animals; Industry; Malaysia; Oceans and Seas; Perciformes/classification*; Perciformes/genetics*; Perciformes/growth & development; Species Specificity; Seafood; Biodiversity; Coral Reefs; DNA Barcoding, Taxonomic; Animal Distribution
  14. Sajali N, Wong SC, Hanapi UK, Abu Bakar Jamaluddin S, Tasrip NA, Mohd Desa MN
    J Food Sci, 2018 Oct;83(10):2409-2414.
    PMID: 30184265 DOI: 10.1111/1750-3841.14338
    High-quality DNA extracts are imperative for downstream applications in molecular identification. Most processed food products undergo heat treatments causing DNA degradation, which hampers application of DNA-based techniques for food authentication. Moreover, the presence of inhibitors in processed food products is also problematic, as inhibitors can impede the process of obtaining high qualities and quantities of DNA. Various approaches in DNA extraction and factors in structure and texture of various food matrices affecting DNA extraction are explained in this review.
    MeSH terms: Cooking; DNA/genetics; DNA/isolation & purification*; DNA/chemistry; Food Analysis*; Food Contamination/analysis*; Food Handling
  15. Suwanwela NC, Chen CLH, Lee CF, Young SH, Tay SS, Umapathi T, et al.
    Cerebrovasc Dis, 2018;46(1-2):82-88.
    PMID: 30184553 DOI: 10.1159/000492625
    BACKGROUND AND PURPOSE: MLC601 has been shown in preclinical studies to enhance neurorestorative mechanisms after stroke. The aim of this post hoc analysis was to assess whether combining MLC601 and rehabilitation has an effect on improving functional outcomes after stroke.

    METHODS: Data from the CHInese Medicine NeuroAiD Efficacy on Stroke (CHIMES) and CHIMES-Extension (CHIMES-E) studies were analyzed. CHIMES-E was a 24-month follow-up study of subjects included in CHIMES, a multi-centre, double-blind placebo-controlled trial which randomized subjects with acute ischemic stroke, to either MLC601 or placebo for 3 months in addition to standard stroke treatment and rehabilitation. Subjects were stratified according to whether they received or did not receive persistent rehabilitation up to month (M)3 (non- randomized allocation) and by treatment group. The modified Rankin Scale (mRS) and Barthel Index were assessed at month (M) 3, M6, M12, M18, and M24.

    RESULTS: Of 880 subjects in CHIMES-E, data on rehabilitation at M3 were available in 807 (91.7%, mean age 61.8 ± 11.3 years, 36% female). After adjusting for prognostic factors of poor outcome (age, sex, pre-stroke mRS, baseline National Institute of Health Stroke Scale, and stroke onset-to-study-treatment time), subjects who received persistent rehabilitation showed consistently higher treatment effect in favor of MLC601 for all time points on mRS 0-1 dichotomy analysis (ORs 1.85 at M3, 2.18 at M6, 2.42 at M12, 1.94 at M18, 1.87 at M24), mRS ordinal analysis (ORs 1.37 at M3, 1.40 at M6, 1.53 at M12, 1.50 at M18, 1.38 at M24), and BI ≥95 dichotomy analysis (ORs 1.39 at M3, 1.95 at M6, 1.56 at M12, 1.56 at M18, 1.46 at M24) compared to those who did not receive persistent rehabilitation.

    CONCLUSIONS: More subjects on MLC601 improved to functional independence compared to placebo among subjects receiving persistent rehabilitation up to M3. The larger treatment effect of MLC601 was sustained over 2 years which supports the hypothesis that MLC601 combined with rehabilitation might have beneficial and sustained effects on neuro-repair processes after stroke. There is a need for more data on the effect of combining rehabilitation programs with stroke recovery treatments.

    MeSH terms: Aged; Asia; Combined Modality Therapy; Disability Evaluation; Drugs, Chinese Herbal/adverse effects; Drugs, Chinese Herbal/therapeutic use*; Female; Humans; Male; Middle Aged; Time Factors; Multicenter Studies as Topic; Randomized Controlled Trials as Topic; Treatment Outcome; Neuroprotective Agents/adverse effects; Neuroprotective Agents/therapeutic use*; Recovery of Function; Stroke/diagnosis; Stroke/physiopathology; Stroke/therapy*; Independent Living; Stroke Rehabilitation/adverse effects; Stroke Rehabilitation/methods*
  16. Gupta G, Singhvi G, Chellappan DK, Sharma S, Mishra A, Dahiya R, et al.
    Panminerva Med, 2018 Sep;60(3):109-116.
    PMID: 30176701 DOI: 10.23736/S0031-0808.18.03462-6
    Glioblastoma, also known as glioblastoma multiforme, is the most common and worldwide-spread cancer that begins within the brain. Glioblastomas represent 15% of brain tumors. The most common length of survival following diagnosis is 12 to 14 months with less than 3% to 5% of people surviving longer than five years. Without treatment, survival is typically 3 months. Among all receptors, special attention has been focused on the role of peroxisome proliferator-activated receptors (PPARs) in glioblastoma. PPARs are ligand-activated intracellular transcription factors. The PPAR subfamily consists of three subtypes encoded by distinct genes named PPARα, PPARβ/δ, and PPARγ. PPARγ is the most extensively studied subtype of PPAR. There has been interesting preliminary evidence suggesting that diabetic patients receiving PPARγ agonists, a group of anti-diabetics, thiazolidinedione drugs, have an increased median survival for glioblastoma. In this paper, the recent progresses in understanding the potential mechanism of PPARγ in glioblastoma are summarized.
    MeSH terms: Animals; Brain Neoplasms/metabolism; Brain Neoplasms/therapy*; Glioblastoma/metabolism; Glioblastoma/therapy*; Glucose/chemistry; Humans; Insulin/metabolism; Ligands; Lipids/chemistry; Transcription Factors/metabolism; Protein Isoforms; Thiazolidinediones/pharmacology; PPAR gamma/metabolism*; PPAR gamma/chemistry; PPAR gamma/agonists*; Mice
  17. Dua K, Madan JR, Chellappan DK, Gupta G
    Panminerva Med, 2018 09;60(3):135-136.
    PMID: 30176702 DOI: 10.23736/S0031-0808.18.03442-0
    MeSH terms: Animals; Curcumin/chemistry; Gold/chemistry; Humans; Inflammation; Mice, Inbred BALB C; Respiration Disorders/drug therapy*; Solubility; Drug Delivery Systems*; Reactive Oxygen Species/chemistry; Nanotechnology*; Mice; Metal Nanoparticles/chemistry
  18. Dua K, Gupta G, Awasthi R, Chellappan DK
    Panminerva Med, 2018 09;60(3):136-137.
    PMID: 30176703 DOI: 10.23736/S0031-0808.18.03446-8
    MeSH terms: Animals; Anti-Infective Agents/administration & dosage*; Bacteriophages; Bifidobacterium; Drug Carriers; Gastrointestinal Diseases/microbiology; Humans; Immunotherapy; Intensive Care Units; Drug Delivery Systems*; Plant Preparations/pharmacology; Nanotechnology; Mice; Microbiota/drug effects*
  19. Jamil NA, Yew MH, Noor Hafizah Y, Gray SR, Poh BK, Macdonald HM
    Public Health Nutr, 2018 Dec;21(17):3118-3124.
    PMID: 30176950 DOI: 10.1017/S1368980018002057
    OBJECTIVE: To compare the contributions of UVB exposure and diet to total vitamin D among Asians living in Kuala Lumpur (KL) and Aberdeen (AB).

    DESIGN: Longitudinal study.

    SETTING: UVB exposure (using polysulfone film badges) and skin colour and dietary vitamin D intake (by web-based questionnaire) were measured at each season in AB and during south-west (SWM) and north-east monsoons (NEM) in KL.

    SUBJECTS: One hundred and fifteen Asians in KL and eighty-five Asians in AB aged 20-50 years.

    RESULTS: Median summer UVB exposure of Asians in AB (0·25 SED/d) was higher than UVB exposure for the KL participants (SWM=0·20 SED/d, P=0·02; NEM= 0·14 SED/d, P<0·01). UVB exposure was the major source of vitamin D in KL year-round (60%) but only during summer in AB (59%). Median dietary vitamin D intake was higher in AB (3·50 µg/d (140 IU/d)), year-round, than in KL (SWM=2·05 µg/d (82 IU/d); NEM=1·83 µg/d (73 IU/d), P<0·01). Median total vitamin D (UVB plus diet) was higher in AB only during summer (8·45 µg/d (338 IU/d)) compared with KL (SWM=6·03 µg/d (241 IU/d), P=0·04; NEM=5·35 µg/d (214 IU/d), P<0·01), with a comparable intake across the full year (AB=5·75 µg/d (230 IU/d); KL=6·15 µg/d (246 IU/d), P=0·78).

    CONCLUSIONS: UVB exposure among Asians in their home country is low. For Asians residing at the northerly latitude of Scotland, acquiring vitamin D needs from UVB exposure alone (except in summer) may be challenging due to low ambient UVB in AB (available only from April to October).

    MeSH terms: Adult; Climate*; Diet*; Female; Humans; Longitudinal Studies; Malaysia; Male; Middle Aged; Nutritional Status; Surveys and Questionnaires; Rain; Scotland; Seasons*; Skin Pigmentation; Sunlight*; Vitamins/administration & dosage; Vitamins/biosynthesis; Asian Continental Ancestry Group*; Young Adult
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