Browse publications by year: 2023

  1. Yusof AKM, Halil NM, Jaffar N, Sabian IS, Looi ZL
    Malays J Med Sci, 2023 Oct;30(5):116-128.
    PMID: 37928782 DOI: 10.21315/mjms2023.30.5.10
    BACKGROUND: Uncontrolled hypertension can cause cardiovascular disease and is an important public health issue. Single-pill combination (SPC) therapies possess combined blood pressure (BP)-lowering effect and may improve compliance to treatment. This study assessed the effectiveness of valsartan (Val)-based SPC therapies in achieving BP control in hypertensive patients.

    METHODS: This was a retrospective study. Data were extracted from the hybrid medical records of patients from the Institut Jantung Negara (IJN), Malaysia. Adults with established diagnosis of hypertension and on prescription of Val-based SPC therapies as part of routine medical care from 1 January 2013 to 31 December 2018, with ≥ 1 year of follow-up were included. Primary endpoint was proportion of patients achieving therapeutic BP control (BP < 140/90 mmHg). Secondary outcomes included change from baseline (CFB) in systolic BP (SBP) and diastolic BP (DBP), and subgroup analysis was based on baseline SBP categories and presence of diabetes.

    RESULTS: Study included 409 hypertensive patients. The mean (standard deviation [SD]) age of the population was 65.1 (10.6) years old, with male predominance (61.6%). Proportion of patients achieving target BP between baseline and follow-up were 57.0% (P < 0.001). Mean CFB in SBP and DBP were recorded as 19.52 mmHg and 7.47 mmHg, respectively. Over half of the patients achieved the target BP in all subgroups categorised by SBP at baseline, except the subgroup of SBP 160 mmHg-179 mmHg. SPC therapies were continued in 97.3% of patients at 1-year follow-up.

    CONCLUSION: Patients using Val-based SPC therapies had significant reduction in BP with good tolerability, with 57% of patients achieving target BP over a prolonged 1-year follow-up period. Uptake of SPC therapy is warranted to improve patient care and outcomes in hypertension.

  2. Lim XY, Wong JKC, Idris Z, Ghani ARI, Abdul Halim S, Abdullah JM
    Malays J Med Sci, 2023 Oct;30(5):206-220.
    PMID: 37928783 DOI: 10.21315/mjms2023.30.5.17
    An accurate and reliable neurological examination is pivotal in diagnosing patients with neurological and neurosurgical conditions. Despite the advancement of neuroscientific knowledge and the ever-progressing technologies and modalities that are being adopted to help achieve the challenge of accurate diagnosis, the neurologic examination is still crucial in both ambulatory and emergency settings. It provides the physician a tool to recognise neurologic involvement in certain disease states, and thereby allow proper work-up and treatment for patients. A basic neurologic examination can be performed rapidly with practice. Manual muscle testing of the lower limbs was carried out in accordance with a bedside clinical examination involving a clinical personnel examiner and a patient. This testing was performed in a rostro-caudal manner, starting from the hip and progressing to the toes. The neurological exam can be intimidating to perform for a lot of physicians. Deficiencies in accurate muscle testing have always presented a challenge for medical students and clinicians. By referring to the examination methods mentioned in our text and with the help of related video, it is our aim to improve the quality of neurological examination among medical personnel so that diseases may be recognised and managed earlier in their course.
  3. Raees F, Harun A, Ahmed A, Deris ZZ
    Malays J Med Sci, 2023 Oct;30(5):7-22.
    PMID: 37928784 DOI: 10.21315/mjms2023.30.5.2
    Bacteriophages were discovered in early 20th century. However, the interest in bacteriophage research was reduced with the discovery of antibiotics. With the increasing number of infections due to multidrug-resistant (MDR) organisms, the potential usefulness of bacteriophages as therapeutic agents has been re-evaluated. In this review, we found that more than 30 lytic bacteriophages that infect Acinetobacter species have been characterised. These are mainly members of Caudovirales, with genome sizes ranging from 31 kb to 234 kb and G+C contents ranging from 33.5% to 45.5%. The host range can be as low as < 10% of all tested Acinetobacter strains. Fourteen published murine trials indicated positive outcomes in bacteriophage-treated groups. Only two case reports were pertaining to the use of bacteriophages in the treatment of Acinetobacter infections in humans; in both cases, the infections were resolved with bacteriophage therapy. The use of bacteriophages has been associated with reduced Acinetobacter burden in the environment, as shown in two studies. The major limitation of bacteriophage therapy is its highly selective host strain. In conclusion, the potential usefulness of bacteriophage therapy for the treatment of MDR Acinetobacter species has been documented only in limited studies and more research is needed prior to its extensive use in clinical practice.
  4. Awang Ahmad N, Lai SK, Suboh R, Hussin H
    Malays J Med Sci, 2023 Oct;30(5):81-90.
    PMID: 37928785 DOI: 10.21315/mjms2023.30.5.7
    BACKGROUND: Mast cells influence tumour growth, neo-angiogenesis and the propensity for metastasis by contributing to innate and adaptive immune responses in the tumour microenvironment. The number of mast cells has increased in various malignant tumours and their abundance has been associated with either a favourable or unfavourable prognosis. This study investigated the significant difference in stromal mast cell density among multiple prognostic factor groups in invasive breast carcinoma.

    METHODS: CD117 (c-KIT) antibodies were used to stain 160 formalin-fixed and paraffin-embedded invasive breast carcinoma tissues to demonstrate the presence of mast cells. Then the labelled mast cells were counted in 10 fields at 400× magnification and the mean value was used to represent the mast cell density.

    RESULTS: The demographic distribution revealed that most patients were 40 years old or older (92.5%) and of Malay ethnicity (66.3%). With regard to prognostic factors, the most prevalent subtype was invasive carcinoma of no special type (80.6%), followed by tumour grade 3 (41.3%), T2 tumour size (63.1%), N0 lymph node stage (51.3%), presence of lymphovascular invasion (59.4%), positive oestrogen (64.4%) and progesterone receptors (53.1%), and negative human epidermal growth factor receptor 2 (HER2) expression (75.0%). However, there was no significant difference in stromal mast cell density among the different demographic and prognostic factor groups in invasive breast carcinoma.

    CONCLUSION: The findings from this study suggest that stromal mast cells do not play a significant role in preventing or promoting tumour growth in invasive breast carcinoma.

  5. Pramestutie HR, Kristina SA, Lazuardi L, Widayanti AW
    Malays J Med Sci, 2023 Oct;30(5):52-69.
    PMID: 37928786 DOI: 10.21315/mjms2023.30.5.5
    The simulated patient method has been widely used to assess community pharmacy practice in the management of childhood diarrhoea. In such a process, a community pharmacist is required to explore a patient's history, choose the right medication and provide drug-related information. The aim of this review was to evaluate the aforementioned practice. A comprehensive literature search was carried out over Sage Journal, PubMed, ScienceDirect and Google Scholar, and the analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Eligible articles were those published from 2011 to 2021 and original studies that used the simulated patient method to examine the pharmaceutical services provided by pharmacists in relation to childhood diarrhoea. The eight studies that satisfied the eligibility criteria were reviewed. These investigations were undertaken in Brazil, Nigeria, Turkey, Ethiopia and Pakistan. Five of the studies focused on history taking with regard to the characteristics of diarrhoea and revealed that the evaluated pharmacists asked about patient histories. In terms of therapy, three studies indicated that the evaluated pharmacists recommended the administration of oral rehydration salts. Pharmacies should improve their history-taking process, provide drug-related information and recommend therapies to increase the knowledge of simulated patients about diarrhoea treatment in children.
  6. Irani M, Aradmehr M, Ghorbani M, Baghani R
    Malays J Med Sci, 2023 Oct;30(5):70-80.
    PMID: 37928787 DOI: 10.21315/mjms2023.30.5.6
    This study examined the effects of exposure to electromagnetic fields (EMF) on pregnancy and the risk of miscarriage. We performed a systematic search for relevant studies published to August 2021 in the medical databases of PubMed, CINAHL, Scopus, Web of Science, Google Scholar and Cochrane Library. The following key terms were used: 'electromagnetic field,' 'mobile phones,' 'mobile phone base stations,' 'watching TV,' 'using Internet,' 'miscarriage,' 'abortions,' 'spontaneous abortion,' 'early abortion' and 'late abortion'. All case-control and cohort studies that investigated the effect of EMF exposure on the risk of miscarriage were included without any restriction of language or time. Statistical analyses were done using Comprehensive Meta-Analysis software (version 2.0). A random-effects model was performed to calculate the overall effect size. A primary search revealed a total of 982 relevant studies; six articles (N = 3,187 participants) met the inclusion criteria for the meta-analysis. The results of the random-effects meta-analysis indicated that EMF exposure had a significant effect on miscarriage: rate ratio (RR) = 1.699; 95% confidence interval (CI): 1.121, 2.363 (P < 0.001); and heterogeneity (I2) = 84.55% (P < 0.001). The findings showed that pregnant woman who were exposed to high levels of EMF had an increased risk of miscarriage.
  7. Ab Razak A, Rahman NA, Zulkifly MFM, Sapiai NA, Phoa PKA, Mohamed Mustafar MF, et al.
    Malays J Med Sci, 2023 Oct;30(5):1-6.
    PMID: 37928788 DOI: 10.21315/mjms2023.30.5.1
    Improving healthcare and living conditions has led to an increase in life expectancies and challenges of population aging in Malaysia. The Advanced Memory and Cognitive Service builds on integrated healthcare among multidisciplinary specialists to provide holistic and patient-centred healthcare. The service treats older adults experiencing neurocognitive impairment as well as young individuals with complex neurocognitive disorders and thoroughly screens asymptomatic individuals at high risk of developing neurocognitive disorders. This early intervention strategy is a preventive effort in the hope of reducing disease burden and improving quality of life to prepare Malaysia for the forthcoming population aging.
  8. Abidin NZ
    Malays J Med Sci, 2023 Oct;30(5):91-105.
    PMID: 37928789 DOI: 10.21315/mjms2023.30.5.8
    BACKGROUND: The cumulative health impact of sarcopenia when it overlaps with obesity and osteoporosis is poorly understood. This cross-sectional study compared the muscle, bone and fat indices between stages of sarcopenia and determined the association of sarcopenia stages with adiposity and bone density in Malaysian postmenopausal women.

    METHODS: One hundred and thirty-six postmenopausal Malaysian women from Semenyih and Kuala Lumpur, Malaysia participated in the study. Muscle mass and body fat percentages (BFP) were assessed using a bioelectrical impedance analyser. Bone density was assessed using quantitative calcaneal ultrasonography. Handgrip strength (HGS) was assessed using a handgrip dynamometer. Gait speed was assessed using the 6-m walk test. The sarcopenia stage was classified into pre-sarcopenia, sarcopenia and severe sarcopenia.

    RESULTS: The overall prevalence of participants with various stages of 'sarcopenia' was 29.4%. The rates of low bone density were 13.7%, 12.5%, 17.4% and 85.7% in the non-sarcopenic, pre-sarcopenic, sarcopenic and severe sarcopenic groups, respectively (P < 0.000). Age, adiposity, muscle mass, gait speed and bone density differed significantly between the reference (non-sarcopenic) and 'severe sarcopenic' groups. The 'sarcopenic' and 'severe sarcopenic' groups had common impairments whereby no significant differences were found in HGS and gait speed between them.

    CONCLUSION: The results showed significant correlations between sarcopenia stages and age, body weight, adiposity and bone density. Individuals with 'sarcopenia' had the same level of HGS and gait speed as those with severe forms of the disorder, implying that individuals with sarcopenia and severe sarcopenia were at the same level in terms of strength and endurance.

  9. Nallaluthan V, Tan GY, Murni MF, Saleh U, Abdul Halim S, Idris Z, et al.
    Malays J Med Sci, 2023 Oct;30(5):221-235.
    PMID: 37928790 DOI: 10.21315/mjms2023.30.5.18
    Neurological status is essential and often challenging for neurosurgical residents and also for neurosurgeons to determine surgical management. Pain as a component of the Glasgow Coma Scale (GCS) can be used as a tool in patients, especially an unconscious or comatose patient. In order to elicit this adequate noxious stimulus, a certain amount of pressure-pain threshold is required upon performing either as the central or peripheral technique. The scientific explanation behind each technique is required and needs to be well understood to aid the localisation of the defect in the neurological system. This paper will briefly review the aid of pain as a neurological guide in GCS status assessment.
  10. Othman MF, Zakaria AD, Yahya MM, Md Hashim MN, Wan Mokhter WM, Wan Zain WZ, et al.
    Malays J Med Sci, 2023 Oct;30(5):106-115.
    PMID: 37928791 DOI: 10.21315/mjms2023.30.5.9
    BACKGROUND: Polyethylene glycol (PEG) solution is widely used as a colonoscopic bowel cleaning agent, although some patients are intolerant due to the need for ingesting large solution volumes and unpleasant taste. A low-volume solution may enhance patient tolerability and compliance in bowel preparation. Accordingly, this study compared the effectiveness of two difference PEG volumes for bowel preparation before colonoscopy in terms of bowel cleanliness, completeness of colonoscopy, patient tolerability and colonoscopy duration.

    METHODS: Using a prospective randomised controlled single-blinded study design, 164 patients scheduled for colonoscopy were allocated to two groups (n = 82 patients in each) to receive either the conventional PEG volume (3 L, control group) or the low volume (2 L, intervention group). The Boston Bowel Preparation Scale (BBPS), a validated scale for assessing bowel cleanliness during colonoscopy, was used to score bowel cleanliness in three colon segments. Secondarily, colonoscopy completeness, tolerability to drinking PEG and the duration of colonoscopy were compared between the groups.

    RESULTS: There were no statistically significant differences between the two intervention groups in terms of bowel cleanliness (P = 0.119), colonoscopy completion (P = 0.535), tolerability (P = 0.190) or the amount of sedation/analgesia required (midazolam, P = 0.162; pethidine, P = 0.708). Only the duration of colonoscopy differed between the two groups (longer duration in the control group, P = 0.039).

    CONCLUSION: Low-volume (2 L) PEG is as effective as the standard 3 L solution in bowel cleaning before colonoscopy; however, the superiority of either solution could not be established.

  11. Mohd Azmi NA, Muhammad J, Mohd Yusoff SS, Nik Hussin NR
    Malays J Med Sci, 2023 Oct;30(5):144-154.
    PMID: 37928792 DOI: 10.21315/mjms2023.30.5.12
    BACKGROUND: Breast cancer is among the most common cancers in Malaysia and around the world. Early detection is essential to improve outcomes, increase survival and reduce the death rate. Breast cancer screening via mammography is one of the proven effective methods. Health staff plays an important role to increase awareness and promote mammogram screening in the community. This study aims to determine the prevalence of mammogram screening and its associated factors among the female staff at Health Campus, Universiti Sains Malaysia.

    METHODS: A cross-sectional study was conducted among the female staff aged 50 years old and above in Health Campus, Universiti Sains Malaysia. The data were collected using a self-administered questionnaire and the Viarad online system. The questionnaires include sociodemographic information, medical factors, knowledge regarding breast cancer and health beliefs about breast cancer. The Viarad online system was used to trace data of mammogram findings for those who underwent mammogram screening.

    RESULTS: Among 260 participants, the prevalence of mammogram screening uptake was only 51.9%. By using statistical analysis simple logistic regression and multiple logistic regression, we found that the most significant associated factors were age, clinical breast examination (CBE), level of knowledge and physician recommendation. The mammogram screening showed that most of the breast cancer findings in Breast Imaging Reporting and Data System (BI-RADS) category 2 were at a rate of approximately 35.6%.

    CONCLUSION: This study showed the prevalence of mammogram screening uptake among the female staff was 51.9% although the service is free, readily available and accessible. The older age group, CBE, physician recommendation and knowledge about breast cancer were the main associated factors for mammogram screening uptake in the female staff in this hospital. An education programme aimed at improving the knowledge and role of a physician in promoting mammogram screening among staff should be established.

  12. Chokphukiao P, Poncumhak P, Intaruk R, Thaweewannakij T, Somboonporn C, Amatachaya S
    Malays J Med Sci, 2023 Oct;30(5):129-143.
    PMID: 37928794 DOI: 10.21315/mjms2023.30.5.11
    BACKGROUND: Older adults frequently experience body composition changes-decreased lean body mass (LBM) and bone mineral content (BMC), along with increased body fat mass (FM)-which affect their health and independence. However, the need for standard complex and costly imaging modalities could delay the detection of these changes and retard treatment effectiveness. Thus, this study explored the ability of practical measures, including simple muscle strength tests and demographic data, to determine the body composition of older adults.

    METHODS: Participants (n = 111, with an average age of 77 years old) were cross-sectionally assessed for the outcomes of the study, including upper limb loading during a seated push-up test (ULL-SPUT), hand grip (HG) strength test and body composition.

    RESULTS: The ULL-SPUT significantly correlated with body composition (r or rs, = 0.370-0.781; P < 0.05), particularly for female participants and was higher than that found for the HG strength test (rs = 0.340-0.614; P < 0.05). The ULL-SPUT and HG strength test, along with gender and body mass index (BMI), could accurately determine the LBM and BMC of the participants up to 82%.

    CONCLUSION: The ULL-SPUT along with gender and BMI can be used as a practical strategy to detect the LBM and BMC of older adults in various settings. Such a strategy would facilitate timely managements (i.e. standard confirmation or appropriate interventions) in various settings.

  13. Ahmad Hamdan AF, Abu Bakar A
    Malays J Med Sci, 2023 Oct;30(5):169-180.
    PMID: 37928795 DOI: 10.21315/mjms2023.30.5.14
    INTRODUCTION: A no-show appointment occurs when a patient does not attend a previously booked appointment. This situation can cause other problems, such as discontinuity of patient treatments as well as a waste of both human and financial resources. One of the latest approaches to address this issue is predicting no-shows using machine learning techniques. This study aims to propose a predictive analytical approach for developing a patient no-show appointment model in Hospital Kuala Lumpur (HKL) using machine learning algorithms.

    METHODS: This study uses outpatient data from the HKL's Patient Management System (SPP) throughout 2019. The final data set has 246,943 appointment records with 13 attributes used for both descriptive and predictive analyses. The predictive analysis was carried out using seven machine learning algorithms, namely, logistic regression (LR), decision tree (DT), k-near neighbours (k-NN), Naïve Bayes (NB), random forest (RF), gradient boosting (GB) and multilayer perceptron (MLP).

    RESULTS: The descriptive analysis showed that the no-show rate was 28%, and attributes such as the month of the appointment and the gender of the patient seem to influence the possibility of a patient not showing up. Evaluation of the predictive model found that the GB model had the highest accuracy of 78%, F1 score of 0.76 and area under the curve (AUC) value of 0.65.

    CONCLUSION: The predictive model could be used to formulate intervention steps to reduce no-shows, improving patient care quality.

  14. Mohamad Yazid MN, Nik Husain NR, Daud A, Osman Y, Mustapa N, Abdul Hadi A
    Malays J Med Sci, 2023 Oct;30(5):192-205.
    PMID: 37928796 DOI: 10.21315/mjms2023.30.5.16
    BACKGROUND: Workplace violence prevention initiatives are undeniably lacking in healthcare facilities. The aim of this study was to validate a newly developed questionnaire and assess employers' perceptions and practices towards workplace violence prevention at healthcare facilities.

    METHODS: A cross-sectional study was conducted from October 2021 to November 2021 by recruiting 333 employers at healthcare facilities in Kelantan, Malaysia. The original draft of the Malay version of the questionnaire comprised 62 items constructed under two domains (perception and practice). A confirmatory factor analysis was conducted to evaluate construct validity and internal consistency using R software.

    RESULTS: The final model for the perception and practice domain of the questionnaire consisted of 13 factors and 56 items. The factor loadings for all items were above 0.6. The fit indices used for confirmatory factor analysis in the final model were as follows: χ2 = 2092.6 (P < 0.001), standardised root mean squared residual (SRMR) = 0.053, root mean square error of approximation (RMSEA) = 0.042, comparative fit index (CFI) = 0.928 and Tucker Lewis index (TLI) = 0.920. The construct reliability for all factors was reliable, with Raykov's rho coefficients above 0.70.

    CONCLUSION: The newly developed questionnaire demonstrated excellent psychometric properties and adequate validity and reliability, confirming that this instrument is reliable and valuable for evaluating employers' perceptions and practices towards workplace violence prevention at healthcare facilities.

  15. Zamri NFI, Mohd Shafri MA, Zamli Z, Mamat S
    Malays J Med Sci, 2023 Oct;30(5):23-39.
    PMID: 37928797 DOI: 10.21315/mjms2023.30.5.3
    BACKGROUND: Malay medical manuscripts have deciphered the medicinal value of Piper betle (sirih) enormously. In this review, an effort was made to explore the medicinal use of P. betle and correlate this information with the scientific evidence.

    METHODS: The information regarding the use of P. betle was retrieved from the books consisting of a Malay medical manuscript with an identification number MSS 2219 from the National Library of Malaysia. PubMed, ScienceDirect and Scopus databases were used to collect information regarding the scientific evidence for the medicinal use of P. betle. This review was written following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The keywords used for searching the articles included P. betle, antimicrobial, analgaesic, haepatic and gastric.

    RESULTS: MSS 2219 showed that P. betle has varied medicinal uses and based on that, it can be grouped into six categories. P. betle application method was different in different conditions. In terms of the literature search, 226 articles were found, 75 articles were extracted for detailed analysis and only 23 met the inclusion criteria. The information was related to the chemical assays, in vivo and in vitro studies.

    CONCLUSION: In summary, P. betle has the potential to treat medical conditions in various types of categories as recorded in the Malay medical manuscripts and also based on scientific publications. For clinical purposes, more information is required, such as the specific mechanism involved, the best extraction method and the best dosage for treatment.

  16. Tan YQ, Loh CK, Makpol S
    Malays J Med Sci, 2023 Oct;30(5):40-51.
    PMID: 37928798 DOI: 10.21315/mjms2023.30.5.4
    L-asparaginase is effective as part of the first line childhood acute lymphoblastic leukaemia (ALL) treatment regimen but suffers the risk of antibody production causing immune-mediated sequelae. This article aimed to describe the clinical implication of L-asparaginase hypersensitivity and review the types of antibodies and genetic polymorphisms contributing to it. Clinical or subclinical L-asparaginase hypersensitivity may lead to suboptimum therapeutic effect and jeopardise the clinical outcome in ALL children. Anti-asparaginase antibodies immunoglobulin (Ig)G, IgM and IgE were identified in the L-asparaginase hypersensitivities. Enzyme-linked immunosorbent assay (ELISA) is commonly used to quantify the IgG and IgM levels. The role of IgE in mediating L-asparaginase hypersensitivity is contradictory. Moreover, the presence of antibodies may not necessarily correlate inversely with the L-asparaginase efficacies in some studies. Patients with specific genetic variants have been shown to be more susceptible to clinical hypersensitivity of L-asparaginase. With the advance of technology, gene polymorphisms have been identified among Caucasians using whole-genome or exon sequencing, but the evidence is scanty among Asians. There is lack of pre-clinical study models that could help in understanding the pathophysiological pathway co-relating the gene expression and anti-asparaginase antibody formation. In conclusion, future research studies are required to fill the current gap in understanding the immune mediated reactions towards L-asparaginase upon its administration and its potential impact to the disease outcome.
  17. Ekeuku SO, Chin KY, Qian J, Zhang Y, Qu H, Ahmad F, et al.
    Int J Med Sci, 2023;20(13):1711-1721.
    PMID: 37928881 DOI: 10.7150/ijms.84604
    Background: Menopause is accompanied by increased oxidative stress, partly contributing to weight gain and bone marrow adiposity. Traditional Chinese medication, E'Jiao, has been demonstrated to reduce excessive bone remodelling during oestrogen deprivation, but its effects on body composition and bone marrow adiposity during menopause remain elusive. Objective: To determine the effects of E'Jiao on body composition, bone marrow adiposity and skeletal redox status in ovariectomised (OVX) rats. Methods: Seven groups of three-month-old female Sprague Dawley rats were established (n=6/group): baseline, sham, OVX control, OVX-treated with low, medium or high-dose E'Jiao (0.26, 0.53, 1.06 g/kg, p.o.) or calcium carbonate (1% in tap water, ad libitum). The supplementation was terminated after 8 weeks. Whole-body composition analysis was performed monthly using dual-energy X-ray absorptiometry. Analysis of bone-marrow adipocyte numbers and skeletal antioxidant activities were performed on the femur. Results: Increased total mass, lean mass, and bone marrow adipocyte number were observed in the OVX control versus the sham group. Low-dose E'Jiao supplementation counteracted these changes. Besides, E'Jiao at all doses increased skeletal catalase and superoxide dismutase activities but lowered glutathione levels in the OVX rats. Skeletal malondialdehyde level was not affected by ovariectomy but was lowered with E'Jiao supplementation. However, peroxisome proliferator-activated receptor gamma protein expression was not affected by ovariectomy or any treatment. Conclusion: E'Jiao, especially at the low dose, prevented body composition changes and bone marrow adiposity due to ovariectomy. These changes could be mediated by the antioxidant actions of E'Jiao. It has the potential to be used among postmenopausal women to avoid adiposity.
    MeSH terms: Animals; Antioxidants/pharmacology; Bone Marrow*; Female; Humans; Infant; Obesity; Ovariectomy/adverse effects; Oxidation-Reduction; Bone Density; Rats, Sprague-Dawley; Adiposity*; Rats
  18. Khan MUA, Stojanović GM, Rehman RA, Moradi AR, Rizwan M, Ashammakhi N, et al.
    ACS Omega, 2023 Oct 31;8(43):40024-40035.
    PMID: 37929099 DOI: 10.1021/acsomega.2c06825
    Biopolymer-based bioactive hydrogels are excellent wound dressing materials for wound healing applications. They have excellent properties, including hydrophilicity, tunable mechanical and morphological properties, controllable functionality, biodegradability, and desirable biocompatibility. The bioactive hydrogels were fabricated from bacterial cellulose (BC), gelatin, and graphene oxide (GO). The GO-functionalized-BC (GO-f-BC) was synthesized by a hydrothermal method and chemically crosslinked with bacterial cellulose and gelatin using tetraethyl orthosilicate (TEOS) as a crosslinker. The structural, morphological, and wettability properties were studied using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and a universal testing machine (UTM), respectively. The swelling analysis was conducted in different media, and aqueous medium exhibited maximum hydrogel swelling compared to other media. The Franz diffusion method was used to study curcumin (Cur) release (Max = 69.32%, Min = 49.32%), and Cur release kinetics followed the Hixson-Crowell model. Fibroblast (3T3) cell lines were employed to determine the cell viability and proliferation to bioactive hydrogels. Antibacterial activities of bioactive hydrogels were evaluated against infection-causing bacterial strains. Bioactive hydrogels are hemocompatible due to their less than 0.5% hemolysis against fresh human blood. The results show that bioactive hydrogels can be potential wound dressing materials for wound healing applications.
  19. Marlina A, Misran M
    ACS Omega, 2023 Oct 31;8(43):40494-40507.
    PMID: 37929136 DOI: 10.1021/acsomega.3c05108
    Stearoyl chitosan (SC), derived from the acylation of chitosan, contributes to the efficiency of drug delivery systems because of its structure, which accommodates the drug in a particle. Nonetheless, its role in chemotherapy has been largely unexplored. The present study involves the synthesis of stearoyl chitosan through the reaction of depolymerized chitosan with stearoyl chloride under mild reaction conditions. The resulting compound was subjected to structural analysis utilizing Fourier-transform infrared (FTIR) spectroscopy, 1H NMR, and X-ray diffraction (XRD) spectroscopy. The dispersion of SC molecules in phosphate-buffered saline (PBS) forms SC nanoparticles. The best dispersion of SC in the solution was achieved at a 1:60 chitosan-to-stearoyl chloride weight ratio. Three antimetabolite drugs, methotrexate, pemetrexed, and raltitrexed, were selected to examine the loading efficacy of SC. Pemetrexed had the highest drug-loading value of 36.8% among the three antimetabolites incorporated into SC, along with an encapsulation efficiency of 85.1%. The size of SC loaded with antimetabolites ranged from 225 to 369 nm, and their spherical form was verified via a transmission electron microscope. The in vitro release study showed that SC demonstrated controlled drug release, suggesting that SC nanoparticles have significant promise as a delivery strategy for chemotherapy.
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