OBJECTIVE: The present study was undertaken to evaluate the neuropharmacological effect of four herbs commonly identified as source of Shankhpushpi.
MATERIALS AND METHODS: Methanol extracts of all four varieties were tested and evaluated in vitro and in vivo for their neuropharmacological effects. Experiments such as protection against β-amyloid induced neurotoxicity on brain cell line (Neuro 2A), antioxidant potential, AchE (acetylcholinesterase enzyme) inhibition, and 5-LOX (lipoxygenase) enzyme inhibition were conducted for in vitro evaluation. For in vivo evaluation, scopolamine (0.3 mg/kg i.p.) induced memory retrieval using pole climbing apparatus and Morris water maze were performed in rat models.
RESULTS: It was found that protective effects of EA and CD against β-amyloid induced neurotoxicity in Neuro 2A cells were significantly higher than CT and CP. EA proved to be superior than other varieties on the basis of antioxidant activity, AchE inhibitory and LOX inhibitory activities. The preventive activity of EA on scopolamine induced memory retrieval in pole climbing and Morris water maze task in rats was found to be higher than that of CD, CT and CP.
CONCLUSION: EA has remarkable neuropharmacological effect as compared to other three varieties of Shankhpushpi. This effect may be attributed due to the presence of steroids (stigmasterol and betulinic acid), coumarins (scopoletin) and flavonoids (β-carotene and chlorogenic acid). Hence it can be used as a promising lead in development and management of neuronal disorders including Alzheimer's disease.
MATERIALS AND METHODS: We identified differentially expressed mitochondrial proteins in 50 infertile men with varicocele and in 10 fertile controls by secondary liquid chromatography-tandem mass spectroscopy data driven in silico analysis. Identified proteins were validated by Western blot and immunofluorescence. Seminal oxidation-reduction potential was measured.
RESULTS: We identified 22 differentially expressed proteins related to mitochondrial structure (LETM1, EFHC, MIC60, PGAM5, ISOC2 and import TOM22) and function (NDFSU1, UQCRC2 and COX5B, and the core enzymes of carbohydrate and lipid metabolism). Cluster analysis and 3-dimensional principal component analysis revealed a significant difference between the groups. All proteins studied were under expressed in infertile men with varicocele. Liquid chromatography-tandem mass spectroscopy data were corroborated by Western blot and immunofluorescence. Impaired mitochondrial function was associated with decreased expression of the proteins (ATPase1A4, HSPA2, SPA17 and APOA1) responsible for proper sperm function, concomitant with elevated seminal oxidation-reduction potential in the semen of infertile patients with varicocele.
CONCLUSIONS: Impaired mitochondrial structure and function in varicocele may lead to oxidative stress, reduced ATP synthesis and sperm dysfunction. Mitochondrial differentially expressed proteins should be explored for the development of biomarkers as a predictor of infertility in patients with varicocele. Antioxidant therapy targeting sperm mitochondria may help improve the fertility status of these patients.
METHODOLOGY: A cross-sectional comparative study was carried out in the Otorhinolaryngology - HNS Department, Universiti Kebangsaan Malaysia Medical Center (UKMMC). Subjective assessments of nasal symptoms and quality of life (QoL) using SNOT-22 and Visual Analogue Scale (VAS) and objective endoscopic assessment was undertaken using a modified Hadley endoscopic examination.
RESULTS: There was no significant statistical difference in the quality of life between the ECRSwNP and non-ECRSwNP groups as evidenced by the SNOT-22 score and the VAS comparison (p>0.05). However, there was a significant difference in terms of recurrence of disease with the presence of nasal polyps on endoscopic examination. (p = 0.016) CONCLUSION: In conclusion, we found that there is no significant difference in QoL between ECRSwNP and non- ECRSwNP. There is higher frequency of recurrence of nasal polyps amongst ECRSwNP.
METHOD: Forty-six Malay adults (aged 23-74 years) with tinnitus were enrolled. They were instructed to fill in the BEST questionnaire accordingly. After one week, 21 of them were asked to fill in the questionnaire again. The other 25 subjects underwent tinnitus intervention for three months and following this; the BEST was administered to them again.
RESULTS: In the test-retest reliability task, the intraclass correlation values obtained were acceptably high (0.70-0.90). After the intervention, significant differences in the BEST result were found in the mind domain, main domain and composite score (p<0.05) with moderate effect sizes (0.61- 0.70).
CONCLUSION: The test-retest reliability of the BEST was found to be good. It also showed good responsiveness to intervention. The clinical usefulness of the BEST in assessing patients with tinnitus was further supported by the present study.
METHODS: It was a cross-sectional study carried out at Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Malaysia. Records of patients with focal thyroid nodules on ultrasound (US) for which US-guided fine needle aspiration cytology (FNAC) was performed and pathology results were available, from January 2014 to May 2016 were selected for review. Correlation of the U Classification with pathology results was assessed. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, predictive value, negative predictive value and accuracy were calculated in a conservative and non-conservative method. The threshold for statistical performance was set at 0.05. Each sonographic feature was also compared with its pathology results.
RESULTS: A total of 91 patients with 104 nodules were eligible. 12 nodules out of 104 (11.5%) were malignant. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and accuracy were 100%, 91.3%, 11.5, 0.0, 60%, 100% and 92.3%, and 100%, 91.4%, 11.7%, 0.0, 78.6%, 100% and 93.5%, for the non-conservative and conservative method of calculations respectively.
CONCLUSION: The U Classification is reliable in predicting thyroid malignancy. More evidence is nevertheless necessary for widespread adaptation and use.
METHODS: This was a cross-sectional validation study among 159 T2DM patients attending a public primary care clinic in Selangor. The DMOQ English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using Exploratory Factor Analysis, internal consistency and testretest reliability.
RESULTS: The DMOQ domains were conceptually equivalent between English and Malay language. A total of 13 items and two domains were removed during the validation process (three items during the content validation, three items due to poor factor loadings, five items as they loaded onto two domains which were not interpretable, one item as it did not fit conceptually into the factor it loaded onto and one openended question as it did not fit into the retained domains). Therefore, the final DMOQ Malay version consisted of 21- items within five domains. The Cronbach alpha was 0.714 and the intraclass-correlation coefficient was 0.868.
CONCLUSION: The DMOQ Malay version is a valid and reliable tool which is consistent over time. It can be used to examine the perception of T2DM patients towards the risk of their offspring developing diabetes and possibility of intervention in Malay-speaking patients.
OBJECTIVE: To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children.
METHODOLOGY: A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria.
RESULTS: A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia.
CONCLUSION: Our study highlights an urgent need for initiation of preschool vision screening in Malaysia.
OBJECTIVES: To determine the prevalence and predictors of poor sleep quality among secondary school students in Gombak District, Selangor.
METHODS: A cross-sectional study was conducted in Gombak District. The sample size was 1,092 based on two group comparison formula. Students were selected using sampling with probability to proportionate to size. Selfadministered pretested questionnaires were used to collect the data. The data were analysed using the Statistical Package for Social Sciences (SPSS) version 22. Chi-square or Fisher's exact test was performed to determine the association between individual categorical variables and sleep quality. Variables with p-value <0.25 were selected to be subjected into multivariate logistic regression to determine the predictors.
RESULTS: The response rate was 93.0%. The prevalence of poor sleep quality was 24.0% (95% CI = 21.5, 26.6). Based on the analysis of simple logistic regression seven variables that were significantly associated with poor sleep quality were age, gender, marital status of parents, depression, anxiety, stress and academic performance found fit in the model. Multivariate logistic analysis showed that the significant predictors of poor sleep quality were age, marital status of parents, depression, anxiety, stress and academic performance. Factors that were not statistically significant were gender, religion, ethnicity, parent's educational level and family income.
CONCLUSIONS: Prevalence of poor sleep quality among adolescents is high. The predictors of poor sleep quality are age, marital status of parents, depression, anxiety, stress and academic performance.
METHODS: We reviewed retrospectively the performance of pediatric colonoscopies in a training center in Malaysia over 5 years (January 2010-December 2015), benchmarked against five quality indicators: appropriateness of indications, bowel preparations, cecum and ileal examination rates, and complications. The European Society of Gastrointestinal Endoscopy guideline for pediatric endoscopy and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition training guidelines were used as benchmarks.
RESULTS: Median (± SD) age of 121 children [males = 74 (61.2%)] who had 177 colonoscopies was 7.0 (± 4.6) years. On average, 30 colonoscopies were performed each year (range: 19-58). Except for investigations of abdominal pain (21/177, 17%), indications for colonoscopies were appropriate in the remaining 83%. Bowel preparation was good in 87%. One patient (0.6%) with severe Crohn's disease had bowel perforation. Cecum examination and ileal intubation rate was 95% and 68.1%. Ileal intubation rate was significantly higher in diagnosing or assessing inflammatory bowel disease (IBD) than non-IBD (72.9% vs 50.0% P = 0.016). Performance of four trainees was consistent throughout the study period. Average cecum and ileal examination rate among trainees were 97% and 77%.
CONCLUSION: Benchmarking against established guidelines helps units with a low-volume of colonoscopies to identify area for further improvement.