Introduction: The persistently increasing number of dengue cases costs a significant amount of health financial ex-penditure by the government. Communities throughout the country should be equipped with adequate knowledge and have a good practice in the avenue of reducing dengue infection incidence. This study aims to describe the knowledge and practice levels on dengue fever and their associated factors among adults in a rural village in Negeri Sembilan. Methods: This cross-sectional study was conducted in a village of Tampin District using a pretested struc-tured questionnaire. Face-to-face interview was conducted among participants whose houses were randomly select-ed. The questionnaire consisted of sections identifying the socio-demographic factors and assessing their knowledge and practice on dengue fever. Knowledge that was assessed includes the sign and symptoms of dengue fever, knowl-edge on the vector, preventive measures and legislation related to it while practice includes their routine action in preventing dengue fever. Results: A total of 221 respondents responded to the questionnaire. The prevalence of re-spondents ever had dengue fever was 10.4% (n=23). Out of 100, the mean (s.d.) knowledge and practice score was 77.2(13.1) and 75.8(16.7) respectively. Good knowledge and practice on dengue fever was found among 52.0% and 47.5% of the respondents respectively. Good knowledge was associated with being middle aged (p=0.001), married (p=0.010) and having higher household income (p= 0.037). There was a significant but weak positive correlation between knowledge and practice of dengue fever (r=0.237, p
Introduction: Group A streptococcus (GAS) is responsible for high morbidity and mortality globally. Hence, the need to develop sensitive, reliable and cost- effective method of detection is crucial. In this study, we developed a visual detection method for the common virulence gene, streptococcal pyrogenic exotoxin B (speB) involved in invasive GAS diseases using loop-mediated isothermal amplification (LAMP) with fluorescent detection dye (calcein). Meth-ods: The LAMP reaction was optimized at 63°C for 35 minutes using five sets of primer designed with LAMP primer V5 software. When the dye was added prior to amplification, samples with speB DNA developed a characteristic green color after the reaction, but no color reactions were observed in samples with DNAs of non-GAS isolates. De-tection of speB by LAMP assay was done among 43 clinical isolates of blood, pus, wound, tissue and throat samples and ATCCs for controls. Our findings were further reconfirmed by subjecting the LAMP products to 0.5% gel electro-phoresis. Results: The detection limit of this LAMP assay for speB was 10-7 ng/μl of genomic DNA per reaction, which was 10,000-fold more sensitive than conventional PCR 10-3 ng/μl. All 100 % samples were positive for speB gene by LAMP, and 93% by conventional PCR method. Conclusion: LAMP assay could offer remarkably high sensitivity, specificity, repeatability, reliability, affordability, and visibility; it is appropriate for rapid detection of speB in Group A streptococci (GAS) as a point of care testing.
Vocabulary is essential in mastering any languages. However, learning vocabulary is tedious as it requires students to memorize numerous words and perform a lot of exercises. Thus, it is essential to provide fun learning activities for learning vocabulary in order to promote students’ engagement in the learning process. Since the Arabic language is learnt in various levels of learning institutions such as schools and universities, a card game has a great potential to be utilized as a learning tool to enhance the learning of Arabic language vocabulary. This paper investigated perceptions of students on using a card game named as Ahsulu! in learning the Arabic language vocabulary at the intermediate level of Arabic language proficiency. This study involved students of Degree in Biology and Degree in Chemistry at Universiti Teknologi MARA Negeri Sembilan, Kuala Pilah Campus, Malaysia, who were selected based on purposive sampling. The data gathered by using an online survey and were analyzed descriptively by using Social Science Statistical Package (SPSS) Version 23. The findings suggest that using Ahsulu! as a learning tool could promote fun learning, ensure learning to take place and increase communication.
MeSH terms: Communication; Humans; Language; Learning; Malaysia; Surveys and Questionnaires; Schools; Social Sciences; Students; Universities; Vocabulary; Problem-Based Learning
The aim of this research is to apply the variance and conditional value at risk (CVaR) as risk measures in portfolio selection problem. Consequently, we are motivated to compare the behavior of two different type of risk measures (variance and CVaR) when the expected returns of a portfolio vary from a low return to a higher return. To obtain an optimum portfolio of the assets, we minimize the risks using mean variance and mean CVaR models. Dataset with stocks for FBMKLCI is used to generate our scenario returns. Both models and dataset are coded and implemented in AMPL software. We compared the performance of both optimized portfolios constructed from the models in term of risk measure and realized returns. The optimal portfolios are evaluated across three different target returns that represent the low risk low returns, medium risk medium returns and high risk high returns portfolios. Numerical results show that the composition of portfolios for mean variance are generally more diversified compared to mean CVaR portfolios. The in sample results show that the seven optimal mean CVaR0:05 portfolios have lower CVaR0:05 values as compared to their optimal mean variance counterparts. Consequently, the standard deviation for mean variance optimal portfolios are lower than the standard deviation of its mean CVaR0:05 counterparts. For the out of sample analysis, we can conclude that mean variance portfolio only minimizes standard deviation at low target return. While, mean CVaR portfolios are favorable in minimizing risks at high target return.
MeSH terms: Data Collection; Motivation; Risk; Software
Choral Speaking is known for its’ numerous benefits in the enhancement of the English Language in the ESL context. However, it has been found that both – learners and teachers alike, perceive Choral Speaking to be arduous. Hence, when performances and competitions are organised, there is a dual resistance and anxiety from the learners and teachers. This study looked at perceptions and challenges on Choral Speaking, of learners from a public university, and that of teachers from secondary schools in Malaysia. Methodology comprised qualitative and quantitative methods, where questionnaires and interviews were administered to the participants. Hence, data comprised responses from these two instruments. The findings showed that though the majority of the learners and teachers perceive Choral Speaking as beneficial, the challenges identified, caused reluctance in participation. This paper provides recommendations to address these issues.
Learning accounting for non accounting major students is constantly considered challengin g. Therefore, the objective of the study is to identify the relationship between the learning style adopted by non accounting students in learning accounting course and the impact on their course performance. The Kolb’s learning style survey model that was re designed by Honey and Mumford in 1986 was adopted to recognise the learning style preferred by students. The students’ academic performance in accounting course was obtained from their scores in major assessment methods including assignment, test, quiz, an d final examination result, which represented their final grade. Further, this paper identified other factors affecting students’ academic performance. The result indicated that students who adopted the Pragmatist and Theorist learning styles were more exc ellent in their academic performance in accounting course, while those who adopted the Activist learning style were poorer in their academic result. Accordingly, accounting course does not only involve number, data, and calculation but requires fact fin din g and applying critical thinking, areas in which the Activist learning style lacks. Other factors found that educators who conducted the lecture were recognised as important contributors towards the students’ achievement in accounting course. Neverthele ss, students with a higher level of anxiety performed better academically as compared to those with low anxiety. In conclusion, to succeed in accounting course, students should not rely merely on one style in the learning process.
In Islamic transaction, the disputations between two or more parties could affect the roles and responsibilities. Furthermore, when the court received a case from disputed parties, there will be a perception among each of parties of win-lose situation, whereby one party embellished with satisfaction, while the other party will beat in suffering, so the impact is the relationship between two parties are become farther. Therefore, alternative dispute resolution (ADR) in Islamic Finance is suggested in by many Muslim economist and legal experts as a substitute to any further legal activities. This is because it will satisfy many of litigants and it provides a complementary substitute to litigation. The study about ADR in Islamic finance has been done by previous literature. By the way, the implementation of ADR in Islamic financial institutions still needs to be elaborated. Therefore, this paper aims to discuss about updated issues and challenges of implementations of ADR in Islamic finance. This paper found that the ADR in Islamic finance need a model to make the ADR more flexible and eligible with different kinds of conflicts.
MeSH terms: Islam; Personal Satisfaction; Religion and Medicine; Social Behavior; Social Problems; Dissent and Disputes
Introduction: Acalypha indica is commonly referred to as “pokok kucing galak”. It is an herbaceous species that grow along the earth’s equator line, including the wet, temperate and tropical regions. Domestic cats experience the effect of this plant by reacting very favorably to the root. The first compilation of the ethnopharmacology and phytochemistry of the Acalypha plants was published. This genus is the fourth largest genus of the Euphorbiaceae family, with about 500 species. However, the review only represents about one third of the species from the Acalypha genus. Methods: Hence, this study is performed to obtain updates on the biochemistry of this plant, via literature search. Results: From the articles, almost every part of the plant, including the leaves, stems and roots, are used as traditional remedies. Local people consume the plant for therapeutic purposes such as anthelminthic, anti-ulcer, anti-bacteria, anti-microbial and wound healing. In homeopathy practice, it is used for asthma and bronchitis. Nevertheless,
there is still a potential risk of using A. indica. It was reported that this traditional medicine could induce Intravascular haemolysis in patients with a glucose-6-phosphate-dehydrogenase (G6PD) deficiency. Clinical evaluations of Acalypha extract could be utilized to justify the ethnomedicinal claims and for the safety of its therapeutic applications. Meanwhile, there is an increase in the phytochemical and chromatographic experiments of A. indica that could introduce the extract’s role in pharmaceutical, nutraceutical, zoology and veterinary fields. It contains secondary metabolites, including dihydroactinidiolide; a terpenoid, alkaloids, flavonoids and steroids, for example, brassicasterol. Conclusion: The finding of this review concludes that Acalypha is a natural source, worth to be further investigated. It is hoped that new biologically active constituents could be discovered, since only few Acalypha species were comprehensively studied.
ABSTRACTS FOR INTERNATIONAL HEALTH AND MEDICAL SCIENCES CONFERENCE 2019 (IHMSC 2019)
Held at Taylor’s University Lakeside Campus, Subang Jaya, Selangor, Malaysia, 8-9th March, 2019
Introduction: Unsafe blood products cause transfusion-transmissible infections among blood receivers. The knowledge and perception of blood donors is important as it is associated with their donation behaviour and hence the safety of blood products. There was no previous study that assessed the knowledge and perception on blood safety issues among blood donors to date. The objective of this study was to assess the knowledge and perception of blood
donors on blood safety issues.
Methods: This was a pilot study conducted to pilot test the self-developed questionnaire by the researchers. The questionnaire was available in the Malay language. One-hundred-thirty donors at the National Blood Centre were recruited to complete the self-administered questionnaire. Health sciences professionals, medical students and non-Malaysians were excluded in this study.
Results: A total of 130 donors comprising of 70 males (53.8%) and 60 females (46.2%) responded. The mean age of the respondents is 32.48±8.86 years. Most of the respondents were Malay (55.4%), single (49.2%), working in private sector (46.9%) and regular donor (68.5%). More than half of the respondents did not know that dengue, Zika and mad-cow disease can be contracted through blood transfusion. Ten percent of the respondents answered that bisexual people are eligible to donate blood. 40.7% of the donors agreed to check their HIV status through blood donation. Majority of the donors (60.7%) agreed that the donors’ blood is safe if the screening test is negative. Whereas, 33.9% of the donors disagreed that they shall be responsible if their blood causes infection.
Conclusion: Several knowledge gaps and inappropriate perception among the respondents were identified and these might affect the safety of the blood products. Targeted measures should be taken to rectify donors’ knowledge and perception in order to minimise inappropriate blood donor behaviours and reduce unsafe blood products.
MeSH terms: Zika Virus Infection; Adult; Blood Donors; Blood Transfusion; Dengue; Female; Humans; Malaysia; Male; Pilot Projects; Surveys and Questionnaires; HIV Infections; Young Adult; Blood Safety
Introduction: Inflammation is one of the major cause of cardiovascular disease, obesity, cancer and stroke. Many dietary compounds containing kernel oil or coconut oil with anti-inflammatory effect can delay the onset of these chronic diseases however the underlying mechanism is unclear. Methods: This study compares the effects of 5% virgin palm kernel oil (VPKO), virgin coconut oil (VCO) and refined, bleached, deodorized olive oil (RBDOO) on selected immune markers in healthy sprague dawley (SD) rats (n=16 per treatment) across 8 weeks. Sera were obtained for four major immunological analyses including cluster of differentiation 4 (CD 4), cluster of differentiation 8 (CD 8), interleukin 6 (IL 6), and c reactive protein (CRP). Results were expressed in mean ± standard error of the mean (mean±SE). Results: Eight weeks fat feeding had no significant difference in weight gain across treatments. Interestingly, we observe significant different on the concentration of CD 4 (p=0.001) with the lowest CD 4 level in rats fed with VPKO 3.87±0.65 ng/ml. The concentration of CD 8 in rats fed with VPKO 8.19±0.25 (p=0.001) ng/ml was comparable to VCO fed rats but was found lower than the control group, RBDOO fed rats. Lower T cell count (CD 4 or CD 8) indicates suppression in inflammation. IL-6 and CRP concentration in rat fed with VPKO 10.89±0.22 pg/ml and 118.39±7.13 ng/ml were slightly higher than that of VCO fed rats but were lower than RBDOO fed rats. Conclusion: We postulate that VPKO could be a potential supplement as an alternative to VCO for relieving inflammation and enhancing body immune system.
Introduction: Crude herbs can be defined as raw plants materials (e.g. leaves, flowers, roots, etc.) which are not being/minimally processed or dried. Globally, particularly in Malaysia, the use of crude herbs has been increasing. The reasons were as an ailment of diseases underlying conditions and for general wellbeing. In this study, our aim was to investigate factors influences crude herbs use among older patients with chronic diseases. Methods: A cross-sectional survey was conducted using purposive sampling among patients attended government health clinic
at Klinik Kesihatan Kampar, Perak. Self-designed questionnaires were used to collect data and data was analysed using SPSS software (ver. 23). Results: A total of 441 participants were enrolled in this study, the response rate was 71.35%. Demographic characteristics of patients who consume crude herbs were; female (57.25%), Malays (45.06%), age between 50-59 years old (31.96%), secondary education level (49.1%), and earned income less than RM3000 (93.27%). Female gender was found associated with the use of crude herbs (p < 0.05). Other socio-demographic characteristics, such as age, race, education level, and salary range found not associated with crude herbs (p > 0.05). The common reasons given by patients to use crude herbs were; family influence, effectiveness in reducing sugar, and accessible and cheaper compared to commercialised herbal drugs. The prevalence of crude herbs use,
particularly among ageing patients is alarming. The physicians need to take into account on crude herbs used when prescribing medications. The use of crude herbs can be beneficial but yet can be detrimental if it is consumed while on prescribed medications. Conclusion: The findings of this study indicate that the survey area needs to broaden to other parts of Malaysia, particularly rural is warranted.
Introduction: The use of crude herbs for well-being as well as curation and prevention of ailments is evident globally, including Malaysia. To understand the effectiveness and reliability, the presence of phytochemical compounds as the factor influencing the use of crude herbs shall be determined. This study was conducted to screen the presence of phytochemical compounds in the local crude herbs consumed by patients with chronic diseases. This is part of
a larger study, where a cross-sectional study was conducted and reported elsewhere. Methods: In total, 15 types of crude herbs were reported by the patients with chronic diseases attending government health clinic at Kampar, Perak. The herbs were extracted using hot and standard cold methods respectively. Results: All the 15 crude herbs’ hot and cold extracts revealed the presence of eight phytochemical compounds, namely, phenols, quinones, tannins, terpenoids, saponins, flavonoids, glycosides, and alkaloids at varying intensity. Saponins, alkaloids, and glycosides were present in all the crude herbs extracts. However, terpenoids, tannins, and phenols were absent in Orthosiphon stamineus, Clinacanthus nutans, and Pandanus amaryllifolius extracts respectively. However, the cold extracts exhibited a higher intensity of phytochemicals compared to hot extracts. The present study confirms the presence of
phytochemicals in the local crude herbs consumed by patients with chronic diseases. The screened phytochemicals are bioactive compounds that possess medicinal properties that may trigger the patients to treat their diseases’ underlying conditions. However, the use of prescribed medicine, particularly among aging patients must be taken into account while consuming crude herbs. Conclusion: The findings of this study indicate that structured-evidence based crude herbs use interventions for patients with chronic diseases is warranted.
Introduction: Systemic inflammation is the major clinical problem which is constellation of communicable and non-communicable infection equipped with acute to chronic inflammation. It may lead to unfavourable conditions for instance, systemic inflammatory syndrome, burns and sepsis. Systemic inflammation might rotate the steering towards vital clinical maladies including cardiomyopathy, neuroinflammation, hepatitis, liver and kidney diseases and even diabetes. In order to elucidate the molecular insights in these clinical implications, there is an intensive need
to design rodent model of systemic inflammation having close association with systemic inflammatory conditions in humans. Methods: Presently, lipopolysaccharide (LPS) induced systemic inflammatory rodent model is widely established, reproducible and acceptable among scientists. In this model animals are treated with intraperitoneal injection of LPS ranging from 1-10 mg/kg which leads to instant release of proinflammatory cytokines to provide robust model of systemic inflammation in order to elucidate pathological conditions and their in-depth mechanism to uncover the new anti-inflammatory therapeutic targets. Conclusion: Robust model would open new window to explore anti-inflammatory activities of phytochemicals, small molecules and drug candidates along with crosstalk of different signaling pathways at molecular level.
Introduction: The geriatric population in Malaysia is expanding rapidly due to increased life expectancies. The vulnerability of this population to the adverse effects of medications due to multiple comorbidities and polypharmacy predisposes them to potentially inappropriate medications (PIMSs). The Beers Criteria is a recognized tool for assessing PIMs, but the level of awareness regarding these criteria among community pharmacists is currently unknown.
This study aimed to assess the awareness and knowledge of Beers Criteria and its extent of application in practice among community pharmacists in the Klang Valley, Malaysia. Methods: A cross-sectional study was conducted among 218 community pharmacists in the Klang Valley using a validated, self-administered questionnaire. Knowledge on PIMs was assessed using a ten-question clinical vignette based on Beers Criteria. Descriptive and inferential statistics were used to analyze the data. Results: Respondents had a significant proportion of their customer base who were elderly. Only 28% of respondents were aware of Beers Criteria, and of this group only 41% were aware of the latest update. The mean score for the clinical vignette was 5.42 ± 1.98. Awareness of Beers Criteria and years of experience in practice were associated with higher knowledge scores (p < 0.05). Good geriatric practices were reported by respondents with the exception of regular usage of Beers Criteria (16.5% agreement) and regularly asking
elderly-looking customers their age (43.6% agreement). Most respondents (74.3%) utilized other clinical resources and were confident in providing care to elderly customers. Conclusion: Awareness of Beers Criteria remains low among community pharmacists. However, pharmacists utilized other resources and demonstrated good geriatric practices. While this shows the adequacy of current practice, efforts to increase awareness of geriatric-specific tools such as Beers Criteria may address specific knowledge gaps and improve the level of care involving the elderly.
MeSH terms: Potentially Inappropriate Medication List; Aged; Cross-Sectional Studies; Humans; Life Expectancy; Malaysia; Pharmacists; Surveys and Questionnaires; Comorbidity; Polypharmacy; Drug-Related Side Effects and Adverse Reactions
Introduction: Reduction or complete absence of α-globin chain production may result α-thalassemia. Alpha thalassemia carrier may have normal haemoglobin level and thus will be eligible as blood donor. Few complications may happen in which the carrier who donated the blood might be at risk of hypoxia and their blood components might not suitable for transfusion. Thus, it is important to screen for α-thalassemia to prevent any complications happen
after donation. The objective of this study is to investigate the interaction of red blood cell indices and α-globin genotypes among eligible blood donors in a private university, Universiti Tunku Abdul Rahman (UTAR), Malaysia. Methods: A total of 270 eligible blood donors were recruited for this study. Red cell indices were analysed using Horiba hematology analyser and α-globin genotyping was performed for seven alpha deletions, six alpha point mutations
and two alpha triplications. Results: Our study showed high prevalence of α-thalassemia carriers among the eligible blood donors (7.7%, 21/270), with all of them showed normal Hb level (>12 gm/dl). Five genotypes were detected consisting of 249 αα/αα (92.2%), 9 -α3.7/αα (3.3%), 9 --SEA/αα (3.3%), 2 -α4.2/αα (0.7%) and 1 ααCS/αα (0.4%). All α-globin genotypes showed normal Hb level with no significant difference between genotypes (p=0.167). Different
α-globin genotypes showed significant difference in RBC, MCV, MCH, MCHC, RDW and Hct/Hb ratio at the p
Introduction: Filipino β°-deletion is predominant among the β-thalassaemia patients in the indigenous population of Sabah, Malaysia particularly among the Kadazandusun. Individuals who co-inherit with α- and β-thalassaemia will demonstrate milder clinical symptoms with modified complete blood count (CBC) and Hb subtype parameters. HBS1L-MYB variants act as one of the key regulator of haematopoiesis and erythropoiesis and display strong association
with variation of HbF levels. Therefore, this study aims to evaluate the association between genetic variants in HBS1L-MYB with Hb subtypes level among Filipino β°-deletion carriers co-inherited with -α3.7 deletion. Methods: Filipino β°-deletion and -α3.7 deletion were identified using gap-polymerase chain reaction (PCR). A total of 34 subjects found with coinheritance of Filipino β°-deletion and -α3.7 deletion were subjected for HBS1L-MYB intergenic polymorphisms (HMIP) analysis. Hb subtypes level were quantified using BioRad Variant II Hb analyser. Genotyping of HBS1L-MYB variants rs9399137 and rs11759553 was done using own designed tetra primer ARMS-PCR. Results: The minor allele frequencies (MAF) of the two HMIP is found more than 0.05 (rs11759553, MAF=0.18 and rs9399137, MAF=0.15), indicating the significance of these variants among the study subjects. Significant difference was found between HbF level and HBS1L-MYB variant rs11759553 with p-value less than 0.05 (p=0.001). Subjects with homozygous genotype for rs11759553 (T/T) was found with higher HbF, followed by heterozygous (A/T) and wild type (A/A). rs11759553 and rs9399137 was found did not influence the level of HbA and HbA2. HMIP of rs11759553 and rs9399137 are found significant among Filipino β°-deletion carriers co-inherited with -α3.7deletion with its high minor allelic frequency and high HbF level. Strong association with HbF level was demonstrated when
coinheritance of rs11759553. Conclusion: This study demonstrates that there are significant associations between certain genetic variants in HBS1L-MYB with Hb subtypes level among Filipino β°-deletion carriers co-inherited with -α3.7 deletion.
MeSH terms: Blood Cell Count; Erythropoiesis; Gene Frequency; Genotype; Heterozygote; Homozygote; Humans; Malaysia; Polymerase Chain Reaction; beta-Thalassemia; Population Groups
Introduction: Diabetic foot ulcer (DFU) is the most distressing complication of diabetes mellitus and often associated with risk of non-traumatic lower extremity amputations. Available formulations and wound dressings for DFU treatment are unfortunately less effective both on controlling and healing DFU. Issues commonly found are associated with providing an optimum environment which facilitates healing process; moist environment, effective oxygen exchange, preventing infection, controlling exudate and also patients compliance. The challenge is therefore to develop a novel drug delivery which address this unmet medical need for better wound treatment of chronic and slow healing DFU. This study aimed to develop a biomaterial based nanofibrous wound dressing formulation containing deferoxamine (DFO), which reported as a potential therapeutic approach to improve wound healing. Deferoxamine regulates the expression and increase stability of hypoxia-inducible factor-1α (HIF-1 α), growthfactor that crucial in wound repair, and thus increase neovascularization. Preparation and characterization of chosen polymers; chitosan/ alginate/polyvinyl alcohol (PVA) for nanofiber formulation will be carried out. Such biodegradable polymer nanofiber is a great benefit for drug delivery owing to its high surface area to volume ratio and high porosity which creates ideal environment to aid in wound healing. Methods: Nanofibers loaded DFO will be fabricated by electrospinning
method that utilizes electrostatic force to produce fine fibers from the polymeric solution. Results: Various polymers concentrations and ratios are investigated to obtain the desired fibers characteristics. The selected optimized DFO nanofibers will be studied for its efficacy in wound healing through in-vivo animal studies. Conclusion: The proposed formulation would be an ideal low cost novel wound dressing with improved healing potential for efficient treatment
of diabetic foot ulcer.
Introduction: Type 2 diabetes is increasing at an alarming rate worldwide. One of the leading factors to this condition is obesity. Low glycemic index (GI) and glycemic load (GL) diets have been proposed as lifestyle changes to address obesity, however, there is a lack of consensus on the optimal approach for weight loss, glycemic control and improving insulin sensitivity. In addition, the outcome of these diets are equivocal, with some studies suggesting beneficial outcomes and others suggesting otherwise. Furthermore, discrepant study designs have led to divergent conclusions. In order to provide a comprehensive overview of the low GI and low GL diets, a systematic review of literature on relevant observational studies and randomised control trials was performed on these databases:- The Cochrane Library, Medline, PubMed, Embase, Cinahl and Web of Science. Methods: The review was conducted based on the methodological standards for the conduct and reporting of Cochrane intervention reviews, Version 1.07, November 2018. Population, Intervention, Comparison and Outcomes (PICO) tool was used as the organising framework to define key elements of the review question. Results: Pertinent outcome variables include body weight, insulin resistance, HbA1c, fasting serum glucose, BMI, waist-to-hip ratio, triglyceride, HDL and LDL cholesterol. Our current understanding of these diets has been complicated by the reports that were based on different study designs and study populations. This review defines the issues, gaps in the research, study design, and evidence that is needed to inform practice, policy making and future research. There is also a dearth of information on the effect of low GI and GL diets on the Asian populations, specifically on improving insulin resistance. High carbohydrate diets are a mainstay of Asian societies. Conclusion: As cases of obesity and type 2 diabetes surge, there is an urgent need for research on low GI and GL dietary modifications among the Asian populations.
MeSH terms: Glycemic Load; Blood Glucose; Body Weight; Diabetes Mellitus, Type 2; Diet; Fasting; Humans; Insulin Resistance; Cholesterol, LDL; Obesity; Weight Loss; Body Mass Index; Consensus; Glycemic Index; Waist-Hip Ratio
Introduction: Second generation functionalized nanocrystal is the advancement of nanocrystal technology with great potential to accommodate BCS (Biopharmaceutical Classification System) class II drugs to meet their formulation and drug delivery challenges. Gliclazide is a BCS class II drug used in the treatment of type 2 diabetes, shows poor water solubility and low rate of dissolution, leads to poor and variable oral bioavailability. The second generation poly(D,L-lactide-co-glycolide) (PLGA) Hydroxypropyl methylcellulose (HPMC) based functionalized nanocrystals of gliclazide were prepared by a combination method of emulsion diffusion-high pressure homogenization-solvent evaporation. Methods: Gliclazide second generation nanocrystals were fabricated with taguchi orthogonal experimental design in combination of step up and top down nanoformulation strategies using drug-polymer (PLGA) ratio at 1:0.5, 1:0.75, 1:1 with HPMC(0.5, 0.75, 1% w/v) as stabilizer. The formulated gliclazide PLGA-HPMC nanocrystals were investigated on particle size, polydispersity index, zeta potential, solubility study, drug entrapment efficiency, in vitro drug release, and surface morphology and compatibility studies. The gliclazide PLGA nanocrystals formulation was prepared with Drug : PLGA at 1: 1 ratio with concentrations 0.75% w/v HPMC at 5 homogenization cycles with 1000bar produce optimized gliclazide nanocrystals. Results: The optimized MSGNC8 formulation
showed particle size of 239.9 nm, entrapment efficiency 98.62%, and drug release of 43.75%, 82.12% and 98.08% at 3hrs, 24hrs, and 48hrs compared to pure gliclazide % drug release of 28.73%, 67.51% and 78.41% at 3hrs, 24hrs, 48hrs respectively. The solubility study of optimized formulation shows eight folds increased in saturation solubility compared to pure drug. Scanning electron microscopy (SEM) analysis of the gliclazide nanocrystals revealed that
gliclazide retained its crystal morphology in polymeric nanocrystals. Further, fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) studies on gliclazide PLGA-HPMC nanocrystals emphasize drug and excipient compatibility in development of gliclazide nanocrystals. Conclusion: The potential outcomes of research findings emphasize that the developed gliclazide second-generation nanocrystals, which resulted in increase in drug solubility and rate of dissolution with delayed modified release, can be explored in delivery of gliclazide for type 2 diabetes management.
MeSH terms: Biological Availability; Calorimetry, Differential Scanning; Diabetes Mellitus, Type 2; Excipients; Gliclazide; Microscopy, Electron, Scanning; Particle Size; Polymers; Research Design; Solubility; Drug Delivery Systems; Spectroscopy, Fourier Transform Infrared; Hypromellose Derivatives; Drug Liberation
Introduction: Diabetes mellitus (DM) is one of the top diseases that lead public health concern in Malaysia. It was believed to rise in number up to 4.5 million on cases by year 2020 based on the current figure. Momordica charantia Linn (MC), a climber belonging to family Cucurbitaceae, is well known in treating diabetic-related conditions. In earlier studies related to the hypoglycemic properties of MC mainly utilized the crude extract, which contain a mixture of bioactives (charantins, insulin-like peptides and alkaloids). Till now, there is no conclusive result on the major bioactives that play role in the hypoglycemic effect of MC and research regarding the charantin purification was not well established. Hence, the objectives of this study were to purify the charantin from MC and to characterize the purified charantin before further subjected to in vivo hypoglycemic study. Methods: The crude was first extracted from MC using ethanol as solvent via Soxhlet extraction following by a series of purification steps via washing, centrifugation, and C-18 cartridges. Results: The HPLC analysis showed that the charantin of purified extract after passing out from the cartridge exuded at 12.50 min with a concentration of 500 ppm, which is relatively 20 times higher than the crude extract (25 ppm). The structural properties of purified charantin were studied using FTIR and it showed strong peaks of carboxylic acids (2884 nm), alcohols (1023 nm) and diethyl ether (1114 nm) as compared
with the standard. The compound was reconfirmed in LC-MS analysis. The result displayed mass spectrum in positive mode indicates the presence of similar compound in the purified extract and standard charantin, as presented by ion m/z = 300. Conclusion: The charantin was successfully purified from MC and can act as a potent plant-based hypoglycemic agent for diabetes.
MeSH terms: Ethanol; Carboxylic Acids; Chromatography, High Pressure Liquid; Chromatography, Liquid; Diabetes Mellitus; Ether; Hypoglycemic Agents; Insulin; Malaysia; Public Health; Spectroscopy, Fourier Transform Infrared; Cucurbitaceae; Momordica charantia; Tandem Mass Spectrometry; Insulin, Regular, Human