Browse publications by year: 2025

  1. Ting ASY, Gan PT
    Mycologia, 2025;117(1):9-18.
    PMID: 39485902 DOI: 10.1080/00275514.2024.2401321
    The endolichenic Fusarium solani (EF5), known to show induced metabolite production when exposed to red and green lights, was selected for characterization of their putative light-regulated bioactive compounds. To achieve this, fractionation was first performed for crude extracts from cultures of F. solani (EF5) incubated in green, red, white-fluorescent light and dark conditions. The extract yielded 12 (dark condition) to 15 (exposed to green, red, and white-fluorescent lights) fractions, and each of the fractions was tested for antimicrobial activities. The fraction (fraction 5) that showed the most promising antimicrobial activity was then subjected to high-performance liquid chromatography (HPLC) and liquid chromatography-mass spectrometry (LC-MS) to identify the bioactive compounds. Results revealed detection of two new metabolites from endolichenic F. solani, putatively identified as 8-deoxyjavanicin and fusolanone A, which are known to have antimicrobial properties. This study revealed that red and green lights trigger the production of 8-deoxyjavanicin and fusolanone A, which likely contributed to the antimicrobial properties demonstrated by endolichenic F. solani.
    MeSH terms: Chromatography, High Pressure Liquid; Chromatography, Liquid; Light*; Microbial Sensitivity Tests; Mass Spectrometry
  2. Ng JH, See MH, Haridah A, Lai LL, Wong LP
    Telemed J E Health, 2025 Jan 08.
    PMID: 39772892 DOI: 10.1089/tmj.2024.0466
    Background: Telemedicine has emerged as a promising solution to address the challenges of providing continuous care to breast cancer patients, particularly in remote areas. This study aims to assess the acceptability of using telemedicine for breast cancer follow-up. Methods: A cross-sectional study utilizing a self-administered survey was conducted from January to March 2024 among 450 breast cancer patients at the Universiti Malaya Medical Center, Malaysia. Partial least-squares structural equation modeling was used to identify factors such as demographics, patients' characteristics, experience with telemedicine, attitudes, and concern of telemedicine use influencing willingness to use telemedicine for breast cancer follow-up. Results: Of the total 450 complete responses received, nearly half (49.3%) reported being somewhat likely to seek telemedicine for breast cancer follow-up, while only 11.1% reported being very likely. Comfort with telemedicine emerged as the strongest predictor of willingness to use it (β = 0.757, p < 0.001). A higher level of concern significantly negatively impacted willingness (β = -0.138, p < 0.001). However, attitudes toward telemedicine (β = 0.059, p = 0.144) were not significantly associated with its use. Among demographic factors, only age (β = 0.074, p = 0.018) was significantly positively associated with the willingness to use telemedicine, while education levels were found to have a significant inverse association (β = -0.076, p = 0.034). Conclusions: Improving comfort with telemedicine and addressing various concerns about its use for breast cancer follow-up through educational programs and support services are essential. Tailoring communication and support for different age groups and education levels can also enhance acceptance and utilization.
  3. Mohamad Radzuan MIS, Karuppannan M
    Curr Drug Saf, 2025 Jan 03.
    PMID: 39773068 DOI: 10.2174/0115748863334598241203073907
    BACKGROUND: The COVID-19 pandemic has called for the rapid development and use of antiviral drugs to effectively control the disease. Nirmatrelvir/Ritonavir (Paxlovid), Molnupiravir, and Remdesivir have been pivotal in therapeutic approaches, although they raise concerns regarding adverse drug reactions (ADRs).

    OBJECTIVE: This study aimed to thoroughly assess the ADRs associated with these drugs by utilizing the Adverse Event Reporting System (FAERS) database of the Food and Drug Administration (FDA).

    METHODS: ADR reports for Paxlovid, Molnupiravir, and Remdesivir throughout the period of January 2022 to May 2023 were extracted and classified according to the severity, type of reaction, and demographic variables. Reporting Odds Ratios (RORs) with 95% confidence intervals were calculated to evaluate the relationship between antiviral medications and various ADRs.

    RESULTS: The study established notable correlations between Paxlovid and the recurrence of the disease (40.08%) and dysgeusia (16.29%). Molnupiravir was linked to gastrointestinal (16.73%) and skin reactions (9.47%), while Remdesivir had impairments in the liver (25.21%) and kidneys (13.34%). ADRs were more commonly observed in female patients treated with Paxlovid (57.95%) and Molnupiravir (49.40%), whereas Remdesivir ADRs were mostly reported in males (58.56%). Paxlovid and Remdesivir ADRs were frequently reported in adults between the ages of 18 and 64 (46.01% and 45.01%), while Molnupiravir ADRs were more common in older individuals aged 65 to 85 (40.38%).

    CONCLUSION: This thorough assessment emphasizes the importance of careful surveillance and control of ADRs linked to COVID-19 antiviral therapies. It is essential to customize treatments by considering specific patient histories, particularly for pre-existing diseases.

  4. Shahrudin MS, Nik-Nasir NM, Mohamed-Yassin MS
    BMC Prim Care, 2025 Jan 07;26(1):4.
    PMID: 39773193 DOI: 10.1186/s12875-024-02697-7
    BACKGROUND: In Malaysia, the recent COVID-19 pandemic had increased the workload of all health professionals, especially primary care doctors (PCDs). Hence, this study aimed to determine the level of work-related stress and factors associated with higher levels of work-related stress among PCDs in Malaysia during this pandemic.

    METHODS: A cross-sectional study was conducted online using Google Forms™. Sociodemographic as well as work and workplace data were collected. The Job Demand Inventory, Physicians' Lack of Professional Autonomy, and Health Professions Stress Inventory questionnaires were used to assess the job demand score, job autonomy score, and the level of work-related stress, respectively. Multiple linear regression was performed to determine the significant factors associated with higher work-related stress.

    RESULTS: A total of 301 PCDs participated in this study with the majority being female (76.1%), Malay (67.8%), married (73.1%), medical officers (68.8%), and worked in urban (70.4%) and public primary care clinics (83%). The mean (SD) score for work-related stress was 62.8 (18.4), (score range 0-120). PCDs who had any degree of worry about being alienated by friends and relatives because of close contact with COVID-19 patients had higher work-related stress levels compared to PCDs who did not have any worry [rarely (b = 10.23, 95% CI:5.57, 14.89), sometimes (b = 10.41, 95% CI:5.68, 15.13), often (b = 10.12, 95% CI:4.16, 16.08), and always (b = 14.65, 95% CI:7.43, 21.89)]. The other significant factor was higher job demand scores (b = 1.13, 95% CI:0.91, 1.35). In contrast, PCDs who always received support from supervisors at their workplace were found to have lower work-related stress levels compared to those who did not receive any support (b=-5.65, 95% CI:-10.38, -0.93).

    CONCLUSIONS: The level of work-related stress among Malaysian PCDs during the COVID-19 pandemic was higher compared to American PCDs and Malaysian physicians before the pandemic but lower compared to Australian emergency physicians during the pandemic. Urgent measures to address the above-mentioned associated factors should be implemented as another pandemic may be just around the corner.

    MeSH terms: Adult; Cross-Sectional Studies; Female; Humans; Malaysia/epidemiology; Male; Middle Aged; Surveys and Questionnaires; Workload/psychology; Professional Autonomy; Workplace/psychology; Pandemics
  5. Nasreldein A, Asyraf W, Nguyen TN, Martins S, Lioutas VA, Elbassiouny A, et al.
    Int J Stroke, 2025 Feb 03.
    PMID: 39773209 DOI: 10.1177/17474930251314395
    BACKGROUND: Mechanical thrombectomy (MT) is the standard of care for eligible acute ischemic stroke (AIS) patients with large vessel occlusion (LVO) since 2015.

    AIM: Our aim was to determine the key challenges for MT implementation and access worldwide.

    METHODS: We conducted an international online survey consisting of 37 questions, distributed through the World Stroke Organization network and as invited by co-authors between December 2022 and March 2023. The survey included a preamble outlining its purpose, questions on respondent demographics, imaging availability, MT service availability, MT selection criteria, barriers to MT, and training status in each country.

    RESULTS: We received 526 responses from 89 countries distributed across 7 continents. One hundred and sixteen (22.1%) respondents did not have available MT service, 43 (8.2%) had available MT only during working hours, 362 (68.8%) had 24/7 MT availability. Regarding neuroimaging protocols, 13.5% used non-contrast computed tomography (NCCT) only, 40.1% used NCCT/CT angiography, 37.5% used NCCT/CT angiography/CT perfusion), 0.4% used magnetic resonance imaging (MRI) only, and 7.8% used MRI/MR angiography. The most common reasons for not receiving MT were cost, late presentation, and lack of availability of qualified neurointerventional services within reasonable distance. There were 59.1% of respondents who reported having a well-structured MT training program. Lack of qualified trainers, financial support, support from higher authorities, and lack of collaboration between departments were the most common obstacles against developing a training program.

    CONCLUSION: Our study highlights significant variations in MT availability, accessibility, patient selection criteria, and MT service training programs worldwide. Financial costs and a shortage of trained neurointerventionalists were the main challenges in low- and middle-income countries.

  6. Mohd Iqbal HA, Zanudin A, Mohd Nordin NA
    BMJ Open, 2025 Jan 07;15(1):e075912.
    PMID: 39773787 DOI: 10.1136/bmjopen-2023-075912
    INTRODUCTION: Emulating the vast inclusion of advanced technology in everyday practice, the medical world is no exception to its implementation, in particular, virtual reality (VR). Initially, its introduction as a therapy was accompanied by high aspirations and expectations for its growth and potential. Motivation is said to be the most associated benefit; although it is imperative to note that there exists a paucity of research that specifically quantifies its tangible impact on cerebral palsy (CP). There has yet to be a systematic review of the instruments used to precisely measure motivation and examine its association with the benefits of VR for children with cerebral palsy.

    METHODS AND ANALYSIS: This review will evaluate comparative studies that used VR therapy as part of interventions for children with CP. Qualitative studies, single-case studies, systematic reviews, literature reviews and guideline audits will be excluded. This review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-P) guidelines. The methodological protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO). The following electronic databases will be used to access related studies published between January 2012 and December 2023: MEDLINE (via EBSCOhost), Web of Science, Scopus, PubMed and Cochrane. The Peer Review of Electronic Search Strategies checklist will be employed to develop database search strategies.

    ETHICS AND DISSEMINATION: This review does not require ethical approval as it uses secondary data. The findings will be published in a scientific journal. We intend to contribute to the expansion of knowledge concerning the motivational implications of VR on children with CP.

    PROSPERO REGISTRATION NUMBER: International Prospective Register of Systematic Reviews (identification number CRD42023401079).

    MeSH terms: Child; Humans; Motivation*; Research Design; Physical Therapy Modalities
  7. Prathiksha D, Rajeshkumar S, Lingaraj J, Pradeep M
    Med J Malaysia, 2025 Jan;80(Suppl 1):1-6.
    PMID: 39773934
    INTRODUCTION: Silver nanoparticles (AgNPs) are effective against almost all kinds of pathogenic organisms. The green synthesis of AgNPs utilizing extracts from medicinal plants is being researched to examine the therapeutic advantages of AgNPs because the chemical production of AgNPs is more toxic. In this study, the stem extract of Ocimum Gratissimum (OG) also known as Karunthulasi or wild basil for green synthesis of AgNPs and evaluating their antiinflammatory and antimicrobial effects.

    MATERIALS AND METHODS: The produced nanoparticles were characterized using UV-visible spectroscopy. The Bovine Serum Assay (BSA) and Egg Albumin (EA) assays were used to assess the anti-inflammatory effects. The protein denaturation of AgNPs was calculated and compared to a standard to determine the anti-inflammatory activity of green synthesized AgNPs. Using varying concentrations of OGmediated AgNPs in Mueller Hinton Agar (MHA), the antimicrobial effects of OG have been investigated against E. coli, S. aureus, and Pseudomonas sp. Additionally, by measuring optical density, the time-kill curve analysis for E. Coli and S. Aureus has been examined from one hour for up to five hours.

    RESULTS: The green synthesized AgNPs were developed successfully using a plant Ocimum gratissimum. The synthesized AgNPs exhibited a maximum absorption peak at 440 nm and SEM analysis revealed that the synthesized AgNPs were spherical and oval. The result findings of the anti-inflammatory activity reveal that AgNPs have great potential when compared to the standard. At the concentration of 50 μg/mL, AgNPs exhibit 76% in BSA assay and 74% in EA assay, where the standard shows 80% inhibition. The antimicrobial activity showed a zone of inhibition around 19mm for E. coli and a 20mm zone of inhibition for S. aureus and Pseudomonas sp., which shows the efficacy of AgNPs. The time-kill assay shows that the optical density of E. coli and S. aureus was reduced to 0.1 after 5 hours of incubation, which shows the potential of green synthesized AgNPs.

    CONCLUSION: OG-mediated AgNPs have both antiinflammatory and antimicrobial effects. Anti-inflammatory effects are better when compared to standard drugs. Antimicrobial effects are better for Gram-negative bacteria.

    MeSH terms: Anti-Infective Agents/chemical synthesis; Anti-Infective Agents/pharmacology; Anti-Infective Agents/chemistry; Escherichia coli/drug effects; Microbial Sensitivity Tests; Pseudomonas/drug effects; Staphylococcus aureus/drug effects
  8. Akash R, Panimalar AV, Puri SK, Divya N
    Med J Malaysia, 2025 Jan;80(Suppl 1):7-9.
    PMID: 39773935
    Tamoxifen, an oral medication that blocks estrogen activity, is frequently prescribed for the treatment of advanced breast cancer and as an additional therapy following surgical removal of early stage disease. A 45-year-old female with a history of breast carcinoma treated with tamoxifen presented with sudden onset bilateral visual impairment for 4 days. On ocular examination, the patient exhibited optic disc edema with hyperemia and bilateral anterior pathway defects in visual evoked potentials. Magnetic resonance imaging revealed a thickened right optic nerve sheath with patchy enhancement of the left optic nerve sheath. The patient was diagnosed with bilateral optic neuritis and treated with intravenous methylprednisolone, which resulted in significant improvement in visual acuity and resolution of optic disc edema. This case underscores the importance of vigilant ophthalmological monitoring in patients undergoing tamoxifen therapy to facilitate the early detection and management of ocular complications.
    MeSH terms: Breast Neoplasms/drug therapy; Female; Humans; Magnetic Resonance Imaging; Methylprednisolone; Middle Aged; Antineoplastic Agents, Hormonal/adverse effects
  9. Geetha RV, Shwetha K, Annika R, Rajeshkumar S, Pradeep M, Jayasree A
    Med J Malaysia, 2025 Jan;80(Suppl 1):10-16.
    PMID: 39773936
    INTRODUCTION: Zinc oxide nanoparticles (ZnO NPs) exhibit a wide range of biomedical applications majorly used as antiinflammatory, anti-cancer, anti-diabetic, and anti-microbial activity and other biomedical applications because they show less toxicity and are very compatible. Zinc metal is an inorganic and essential element in the human body at the trace level. ZnO NPs are also GRAS substances (Generally Recognized As Safe). This study's main objective is synthesizing zinc oxide nanoparticles using red tea & clove mediated herbal formulation and screening for its antimicrobial, and anti-diabetic properties.

    MATERIALS AND METHODS: Red tea and clove-mediated ZnO NPs were synthesized using the green synthesis method. The anti-microbial activity was tested against oral pathogens using the agar well diffusion method, while the anti-diabetic activity was estimated using the alpha-amylase inhibitory assay method by using red tea and clovemediated ZnO NPs.

    RESULTS: ZnO NPs were successfully synthesized using red tea and clove-formulated extract. The synthesized ZnO NPs using Aspalathus linearis (red tea) and Syzygium aromaticum (clove) mediated ZnO NPs were characterized using UV visible spectrophotometry and SEM (Scanning Electron Microscope) analysis. The green synthesized ZnO NPs show promising anti-microbial activity by exhibiting a 12 mm zone of inhibition against S. aureus, 11 mm in E. faecalis, 9 mm in S. mutans, and 11 mm in C. albicans. In anti-diabetic activity, the green synthesized ZnO NPs showed a maximum inhibition percentage of up to 80% at the maximum concentration of 50 µg/mL.

    CONCLUSION: Green synthesized ZnO NPs using red tea and clove showed maximum efficacy in anti-microbial properties which can lead to huge potential use as antibacterial agents. Simultaneously, anti-diabetic activity showed an excellent inhibition percentage which can be a potent therapeutic agent in the field of nanomedicine in diabetes management.

    MeSH terms: Anti-Infective Agents/pharmacology; Anti-Infective Agents/chemistry; Humans; Microbial Sensitivity Tests; Plant Extracts/pharmacology; Plant Extracts/chemistry; Nanoparticles/chemistry; Metal Nanoparticles/chemistry
  10. Akash R, Reddy CS, Nithya R, Sankar Kumar T
    Med J Malaysia, 2025 Jan;80(Suppl 1):17-19.
    PMID: 39773937
    Ocular toxoplasmosis is the leading cause of infectious retinochoroiditis in both adults and children. It is caused by the obligate intracellular parasite, Toxoplasma gondii. It is a common cause of posterior uveitis and focal retinitis, typically seen in immunocompetent individuals as a primary infection or in immunocompromised individuals as reactivation of latent infection. Here, we report a rare case of a 29-year-old immunocompetent female presenting with gradual, painless diminution of vision in the left eye associated with headache for over one month. She had a history of hypertension but no other significant medical history. On ocular examination anterior segment was unremarkable and fundus examination of left eye showed "Headlight in fog appearance" suggestive of vitritis. Serological evaluation revealed positive for Toxoplasma IgG antibodies. The patient was treated with cotrimoxazole, oral prednisolone, and topical steroids for 4-6 weeks. Following treatment, her visual acuity improved to 6/6 in left eye. This case highlights the importance of considering ocular toxoplasmosis in the differential diagnosis of unilateral vitritis, even in immunocompetent patients.
    MeSH terms: Adult; Female; Humans; Immunocompetence
  11. Shanmuga SS, Mariraj I, Rajeshkumar S, Dhanyaa M, Pradeep M
    Med J Malaysia, 2025 Jan;80(Suppl 1):20-25.
    PMID: 39773938
    INTRODUCTION: The biomedical potential of silver nanoparticles (Ag NPs) synthesized with Zingiber officinale and Ocimum gratissimum herbal formulation was investigated in this study. The study aims to reveal their applications in various biomedical fields. The study evaluates the antioxidant, thrombolytic, and antimicrobial potential of Zingiber officinale and Ocimum gratissimum herbal formulation-mediated Ag NPs.

    MATERIALS AND METHODS: Biogenically synthesized silver nanoparticles (Ag NPs) from an herbal formulation containing Zingiber officinale and Ocimum gratissimum were tested at various concentrations using the DPPH (2,2- diphenyl-1-picrylhydrazyl) assay. The absorbance was measured at 517 nm to quantify DPPH free radicals. With Ag NP concentrations, the H2O2 test exhibited increased activity. This work evaluated the antibacterial activity of Ag NPs mediated by Zingiber officinale and Ocimum gratissimum against Staphylococcus aureus, Streptococcus mutans, Candida albicans, and Enterococcus faecalis.

    RESULTS: The utilization of herbal formulations from Z. officinale and O. gratissimum to synthesize Ag NPs revealed considerable therapeutic effectiveness. At a concentration of 50 μl, the maximal inhibition was 76%, which is comparable in effectiveness to that of standard ascorbic acid. Significant blood clot dissolution was observed during thrombolytic testing at a concentration of 100μg/ml, indicating promising prospects for the treatment of thrombotic disorders. Nanoparticles dose-dependently inhibited E. faecalis, C. albicans, S. aureus, and S. mutans in antibacterial testing. These results show the potential of the nanoparticles as supplementary or alternative treatments to conventional antibiotics, particularly in light of the increasing prevalence of antibiotic resistance.

    CONCLUSION: The further investigation of nanoparticles into their mechanisms and efficacy in therapeutic applications, positioning Zingiber officinale and Ocimum gratissimum formulation-mediated Ag NPs as viable candidates in developing antioxidant, thrombolytic, and antimicrobial treatments.

    MeSH terms: Anti-Bacterial Agents/pharmacology; Microbial Sensitivity Tests; Plant Extracts/pharmacology; Metal Nanoparticles*
  12. Taarika G, Panimalar AV, Puri SK, Divya N
    Med J Malaysia, 2025 Jan;80(Suppl 1):26-28.
    PMID: 39773939
    Visual loss following secondary retinitis pigmentosa (RP) is a rare complication of cytotoxic chemotherapy. Few cases of docetaxel- and/or platinum-induced retinal toxicity have been reported. Routine ocular examination of patients undergoing chemotherapy is required for early recognition and intervention of ocular toxicity. A 72- year-old female undergoing docetaxel and carboplatin combination chemotherapy for the past 3 months presented with complaints of defective vision in both eyes for 2 months. Fundus examination revealed a waxy pale disc in both eyes, arteriolar attenuation, and peripheral bony spicules, suggesting secondary retinitis pigmentosa. Optical Coherence Tomography (OCT) of the macula revealed macular dystrophy. The Humphrey Visual Field (HVF) showed field defects. Despite the reduction in chemotherapy dosage, no improvement was observed during the threeweek follow-up period.
    MeSH terms: Aged; Antineoplastic Agents/adverse effects; Antineoplastic Combined Chemotherapy Protocols/adverse effects; Female; Humans; Taxoids/adverse effects
  13. Giriprasad M, Mariraj I, Rajeshkumar S, Pradeep M, Santhoshkumar J
    Med J Malaysia, 2025 Jan;80(Suppl 1):29-36.
    PMID: 39773940
    INTRODUCTION: Selenium nanoparticles (SeNPs) have drawn a lot of interest among researchers because of their distinct impact on antioxidant activity, anti-inflammatory tests, antibacterial activity, and in the treatment of various diseases. A. linearis has shown great findings in biomedical applications because of its physio-chemical compounds such as Aspalathin, orientin, and isoorientin. The increasing demand for eco-friendly and sustainable nanomaterial synthesis has led to the development of green methods utilizing natural resources. The study's main objective is to synthesize green SeNPs using Aspalathus linearis and then test them for cytotoxic, anti-inflammatory, and anti-diabetic properties.

    MATERIALS AND METHODS: A UV-visible spectrophotometer and SEM were used to characterize the green synthesized SeNPs. The anti-inflammatory and anti-diabetic activities of green synthesized SeNPs were measured using the alphaamylase inhibitory & beta-glucosidase enzyme inhibition assay and the egg albumin, bovine serum albumin, and membrane stabilization assays. A test for the mortality of brine shrimp was used to determine the cytotoxic impact of SeNPs.

    RESULTS: A. linearis powder was used for the green synthesis of selenium nanoparticles, which exhibited the highest peak at 440 nm when analyzed using a UV-visible spectrophotometer. The In vitro anti-inflammatory effect of synthesized SeNPs was maximally inhibited by 44-83% in the bovine serum albumin assay 54-79% in the egg albumin assay, and 54-86% in the membrane stabilization assay compared with standard. The inhibition percentage of antidiabetic activity was found to be 50-86% in the alphaamylase assay and 49-85% in the beta-glucosidase assay when compared to standards at various concentrations. Furthermore, the cytotoxicity impact shows that 70% of brine shrimp were alive at the maximum fixation of 80 µg/mL.

    CONCLUSION: The SeNPs showed concentration-dependent anti-inflammatory and anti-diabetic action, and the green synthesized SeNPs demonstrated an excellent antiinflammatory and anti-diabetic agent. The brine shrimp lethality assay confirmed the SeNPs' biocompatible nature even at high concentrations with less toxicity. Hence the study may enhance SeNPs in developing inflammation drugs and can also be utilized in diabetes management.

    MeSH terms: Animals; Plant Extracts/pharmacology; In Vitro Techniques
  14. Kaur H, Narayanan L, Yachendra VSG, Bhaskaran B
    Med J Malaysia, 2025 Jan;80(Suppl 1):37-43.
    PMID: 39773941
    INTRODUCTION: Pregnancy induces physiological changes, including alterations in cardiovascular dynamics, predisposing pregnant women to supine hypotension syndrome (SHS) during lower-segment cesarean section (LSCS) under spinal anesthesia. Various methods, including manual displacement of the uterus and use of wedges or cushions, have been proposed to prevent SHS, but their effectiveness remains variable. This study aimed to compare the efficacy of a novel 3D-printed uterine displacement device with that of a traditional wedge in preventing SHS during LSCS after spinal anesthesia.

    METHODOLOGY: This prospective, randomized, controlled trial enrolled pregnant females undergoing LSCS after spinal anesthesia. The participants were randomized into two groups: a novel 3D device group and a traditional wedge group. Primary outcome measures included the incidence of SHS, while secondary outcomes included maternal hemodynamic parameters, fetal outcomes, feasibility, ease of use, and the safety profile of the devices.

    RESULTS: Baseline characteristics were well balanced between the two groups. Although some differences in maternal hemodynamic parameters were noted, the incidence of SHS was significantly lower in the novel 3D device group than that in the traditional wedge group. Fetal outcomes did not differ significantly between the groups. The novel 3D device demonstrated high compatibility with various patient anatomies and was easy to integrate into routine practice. The adverse event profiles were similar between the groups.

    CONCLUSION: This study highlights the potential of a novel 3D-printed uterine displacement device for preventing SHS during LSCS, thereby improving maternal and fetal outcomes. Future research should further validate these findings and explore the long-term implications of the maternal and neonatal outcomes.

    MeSH terms: Adult; Cesarean Section*; Female; Humans; Hypotension/etiology; Hypotension/prevention & control; Hypotension, Orthostatic/etiology; Hypotension, Orthostatic/prevention & control; Pregnancy; Prospective Studies; Uterus; Supine Position; Printing, Three-Dimensional*
  15. Dathan P, Nallaswamy D, Rajeshkumar S, Joseph S, Shahin I, Tharani M
    Med J Malaysia, 2025 Jan;80(Suppl 1):44-51.
    PMID: 39773942
    INTRODUCTION: Pomegranate peel is considered a reservoir of biologically active compounds, the presence of which provides anti-inflammatory and antioxidant properties to peel extracts. Calcium sulfate is considered an ideal boneaugmenting material, and in the present study, pomegranate peel extract-mediated calcium sulfate nano particles (PPE CaSo4 NPs) were synthesized and their anti-inflammatory and antioxidant properties were evaluated. This study aimed to evaluate the biological effects of PPE CaSo4 NPs, with a focus on their anti-inflammatory and antioxidant properties. The objectives were to green - synthesize PPE CaSo4 NPs, analyze their optical characteristics using UV-visible spectra analysis, and subsequently evaluate their antioxidant and anti-inflammatory activities.

    MATERIALS AND METHODS: UV-visible spectra analysis was employed to investigate the optical characteristics and surface morphology, such as the size and shape of PPE CaSo4 NPs synthesized at different time intervals, which were characterized using a Scanning Electron Microscope. Anti-inflammatory activity was evaluated using bovine serum albumin denaturation assay (BSA), and egg albumin denaturation assay (EA) was compared with diclofenac sodium as a standard. Antioxidant activity was measured using 2,2 Diphenyl -1- Picryl hydraxylhydrate assay (DPPH), hydrogen peroxide radical scavenging assay (H2O2), and Ferric Reducing Antioxidant power assay (FRAP). Comparison made with ascorbic acid as the standard.

    RESULTS: Anti-inflammatory activity was observed at all concentrations of PPE CaSo4 NPs, and there was no significant difference between the test material and the standard p>0.05. A significant difference was found for the antioxidant activity between PPE CaSo4 NPs and the standard in concentrations of 10 μl, for DPPH, 10 μl and 20 μl for H2O2 (p<0.05) between the concentrations of 30, 40, and 50, and there was no significant difference between the test material and the standard in all three tests conducted.

    CONCLUSION: The study concluded that the PPE CaSo4 NPs have Anti-inflammatory and Antioxidant activities and are concentration-dependent.

    MeSH terms: In Vitro Techniques
  16. Joseph S, Nallaswamy D, Rajeshkumar S, Dathan PC, Rasheed N, Tharani M, et al.
    Med J Malaysia, 2025 Jan;80(Suppl 1):52-58.
    PMID: 39773943
    INTRODUCTION: Green tea is a medicinal beverage extracted from the plant Camellia sinensis. Antioxidants that exist naturally can be extracted as pure compounds from their parent materials for nutraceutical and medicinal applications. The present study aims to assess the antioxidant activity of Zinc oxide-titanium dioxide nano-composites (ZnO-TiO2 NCs) containing green tea extract.

    MATERIALS AND METHODS: The antioxidant activity was tested by Hydrogen Peroxide [H2O2] assay, Fluorescence recovery after photo-bleaching [FRAP] assay and 2, 2-diphenyl-1- picrylhydrazyl[DPPH] assay. All tests have shown very good results for the ZnO-TiO2 NCs.

    RESULTS: In this study, we present a straightforward, ecofriendly alternative for producing non-toxic zinc oxide and titanium oxide nano-composite material. This study could make a valuable contribution and create new opportunities in the market such as biological and pharmaceutical applications.

    CONCLUSION: The in vitro tests concluded that the novel nanocomposite containing ZnO-TiO2 and green tea extract has good anti-oxidant properties and it is non-toxic to the biological systems.

    MeSH terms: In Vitro Techniques
  17. Shyam Sudhakar S
    Med J Malaysia, 2025 Jan;80(Suppl 1):59-64.
    PMID: 39773944
    INTRODUCTION: Vertigo and dizziness are symptoms of various underlying conditions, ranging from benign to severe, affecting up to 40% of adults. Understanding the etiological factors and demographic characteristics associated with these symptoms is crucial for improving diagnostic accuracy and management. This study aims to identify the etiological factors contributing to vertigo and dizziness in a clinical setting and assess the effectiveness of treatment strategies.

    MATERIALS AND METHODS: Retrospective cohort study conducted at Department of ENT and Head & Neck Surgery, Saveetha Medical College Hospital, Thandalam, Chennai, Tamil Nadu, India from September 2022 to March 2024. We included patients presenting with vertigo or dizziness, excluding those with non-vestibular dizziness or incomplete medical records. We analysed demographic data, medical history, and clinical findings from patient records. Data analysis was performed. Continuous variables were compared using independent sample t-tests and categorical variables using chi-square tests.

    RESULTS: The study included 268 patients, predominantly females (57.8%) and individuals aged 40-50 years (29.9%). Benign Paroxysmal Positional Vertigo (BPPV) was the most common etiological factor (41.0%), followed by orthostatic dysregulation (17.2%) and vestibular peripheral dysfunction (VPD) (16.0%). Clinical presentations and outcomes varied with the underlying etiology. Overall, 91.0% of the patients showed improvement following treatment, with 7.1% achieving full recovery.

    CONCLUSION: This study highlights the complexity of vertigo and dizziness, which are influenced by various factors and demographics. This emphasizes the importance of tailored management strategies and a patient-centered, multidisciplinary approach, emphasizing customized treatments to improve patient outcomes.

    MeSH terms: Adolescent; Adult; Aged; Female; Humans; India/epidemiology; Male; Middle Aged; Retrospective Studies; Young Adult; Benign Paroxysmal Positional Vertigo/etiology; Benign Paroxysmal Positional Vertigo/therapy
  18. Navin U, Varshini C, Lal DV, Vaanmathi AS
    Med J Malaysia, 2025 Jan;80(Suppl 1):65-68.
    PMID: 39773945
    INTRODUCTION: Neonatal circulatory shock poses a significant challenge in intensive care settings and necessitates early recognition and intervention to prevent adverse outcomes. The perfusion index (PI), derived from pulse oximetry signals, is a potential adjunct tool for assessing peripheral perfusion and predicting shock in neonates. This prospective observational study aimed to evaluate the correlation between PI and circulatory shock in neonates with the goal of establishing PI as an objective parameter for early shock identification.

    MATERIALS AND METHODS: Study was conducted in the neonatal intensive care unit (NICU) of Saveetha Medical College Hospital, India, in 2023, between January and June. This study enrolled 100 neonates who underwent hemodynamic monitoring over 48-72 hours. Hemodynamic parameters including heart rate, blood pressure, and PI were systematically recorded. Statistical and Receiver operating characteristic curve analyses were used to assess the relationship between PI and shock.

    RESULTS: Neonates experiencing shock exhibited significantly lower PI values than those without (P < 0.05). ROC curve analysis identified a PI threshold of 0.7 for predicting shock, demonstrating a high sensitivity (92.5%) and specificity (94.78%). Additionally, a significant association was observed between PI and serum lactate level (p < 0.05), underscoring the utility of PI as a predictor of shock severity.

    CONCLUSION: The study suggests that a PI < 0.7 may serve as an indicator of circulatory shock in neonates, offers good sensitivity and specificity. The PI, along with clinical parameters and serum lactate levels, is a valuable tool for early shock identification in neonatal intensive care. Further research, including multicenter studies, are warranted to validate these findings.

    MeSH terms: Female; Hemodynamics/physiology; Humans; India; Infant, Newborn; Intensive Care Units, Neonatal; Male; Oximetry; Prospective Studies; ROC Curve
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