MATERIALS AND METHODS: The investigated cell lines include primary colon epithelial (PCE) cells and human colorectal cancer cells; the studied bacterial strains are Staphylococcus aureus, Proteus vulgaris, Bacillus subtilis, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using the agar well-diffusion method, various doses (5, 10, and 20 mg/mL) of plant extracts (ethanol and petroleum ether) were evaluated against each kind of bacterial strain. The minimal inhibitory doses were found using the two-fold serial dilution approach, with a range of 0.156-5 mg/mL.
RESULTS: Comparing extracts of S. trifasciata leaves to tetracycline (0.05 mg/mL), a common antibiotic, revealed a wide range of antibacterial activity. P. vulgaris and S. aureus were the most sensitive bacterial strains to ethanol and petroleum ether extracts, respectively. The MTT test was employed to ascertain the viable cell count of PCE cells and HCT-116. When various ethanol extract concentrations (7.8, 15.63, 31.25, 62.5, 125, 250, 500, and 1000 μg/mL) were tested against the cell lines, HCT-116's IC50, values were lower as compared to PCE. The IC50 values for HCT-116 and PCE cells ranged from 10.0 to 14.07 μg/mL and 92.9-216.9 μg/mL, respectively.
CONCLUSIONS: Ethanolic extract of S. trifasciata showed promising antibacterial and anticancer properties.
INTRODUCTION: Osteoporosis management poses a substantial healthcare challenge, necessitating effective strategies and Clinical Practice Guidelines (CPG) adherence.
METHODS: The study employed a self-administered online questionnaire via Google Forms. Orthopedic clinicians from all study sites were invited to participate via messaging platforms. A total of 135 participants completed the questionnaire and the data was proceeded to statistical analyses.
RESULTS: The study identified significant barriers, including inadequate knowledge of current osteoporosis guidelines and medications (p = 0.014), limited choice of anti-osteoporosis medication (p
PURPOSE: To assess the feasibility of a Fracture Liaison Service in Malaysia and to benchmark our service against the International Osteoporosis Foundation Best Practice Framework.
METHODS: This feasibility study was conducted at a tertiary hospital in Malaysia from March 2021 to March 2022. Patients aged ≥ 50 years admitted with fragility fractures were recruited. Excluded were those with poor prognosis or transferred out from the hospital during admission. Patients were screened, assessed, and followed up at months 4 and 12 post-fracture presentations. Data was collected using Microsoft Excel and the REDCap database. The feasibility of the Fracture Liaison Service was evaluated using the typology of feasibility.
RESULTS: A total of 140 patients (female (93/140, 66.4%), median age 77 (IQR 72, 83), hip fractures (100/140, 65.8%)) were recruited into the Fracture Liaison Service. The recruitment rate was (140/215, 65.1%), as some patients were "missed" due to the COVID-19 pandemic. The completion rate was high (101/114, 88.6%). Among those indicated for antiosteoporosis medication, 82/100 (82%) were initiated on treatment. Various "Best Practice Standards," such as patient evaluation (140/140, 100%), fall prevention (130/140, 92.9%), and medication review standards (15/15, 100%) were high. Complicated referral pathways, inexperienced staff, lack of resources, and communication issues were some of the barriers identified while implementing the Fracture Liaison Service. Challenges were overcome by modifying the service workflow and coordinating with different departments.
CONCLUSION: The Fracture Liaison Service was found to be feasible in Malaysia. It demonstrated promise in improving bone health management; however, several changes were needed to adapt the service to suit our environment.
PURPOSE: Osteoporosis and osteopenia are highly prevalent among older patients scheduled for elective arthroplasties and spinal surgeries. This position paper aims to establish, promote, and standardise effective Bone Health Optimization (BHO) strategies for such patients within orthopaedic practices in Malaysia. It emphasises the need for bone health assessments to be undertaken at the pre-operative, intra-operative, and post-operative stages, with tailored management strategies to meet individual patient needs.
METHODOLOGY: A comprehensive literature review was conducted, focusing on articles published from 2019 to 2024. Twelve broad themes were defined including definitions and importance of BHO, epidemiological data, assessment techniques, risk stratification, management strategies, and outcome metrics.
RESULTS: Elective surgeries on patients with poor bone health are associated with adverse outcomes, such as periprosthetic fractures, aseptic loosening of implants, and complications after spinal surgeries. This position paper advocates for routine bone health assessments and monitoring during the pre-operative, intra-operative, and post-operative phases. It provides summaries of imaging modalities, risk assessment tools, and techniques for each phase. By adapting the successful "5IQ" approach from secondary fracture prevention, we propose 5IQ-based Clinical Standards for BHO, including 18 Key Performance Indicators. A Malaysian BHO Registry is proposed to benchmark care in real-time and support a national quality improvement programme. Practical resources, such as a BHO algorithm and key practice points, are included.
CONCLUSION: This position paper proposes a paradigm shift in the management of bone health for patients undergoing elective orthopaedic surgery in Malaysia, aiming to improve surgical outcomes and patient care through standardised BHO strategies.
OBJECTIVES: This study aimed to describe ICU nurses' knowledge about SBS and the need of an instrument to detect the signs and symptoms of SBS.
METHODS: A cross-sectional study was conducted with a sample of 100 ICU nurses, recruited through simple random sampling from the Critical Care Indonesia Nurse Association. The study focused on nurses' knowledge of SBS and the need for an instrument to detect it. Research instruments included basic respondent characteristics, nurses' knowledge, and the need for an SBS detection tool. Data were analyzed using descriptive statistics.
RESULTS: The majority of respondents exhibited a good level of knowledge (66%), yet many answered questions incorrectly regarding SBS etiology, symptoms, and effects. This was exemplified by incorrect responses attributing noise and chemicals as causes of SBS, overlooking fatigue as a symptom, and inaccurately assessing the physical effects of SBS. Notably, nurses demonstrated strong knowledge regarding SBS prevention (71%) and treatment (94%). Respondents unanimously supported the necessity of an instrument capable of detecting SBS among ICU nurses (71%), with an electronic instrument being the preferred option over other forms.
CONCLUSION: ICU nurses possess a good level of knowledge about SBS. It is recommended to develop and investigate an electronic-based instrument for detecting SBS. Additionally, implementing an e-learning educational program could further enhance the knowledge and management of SBS among healthcare professionals.