Displaying publications 1 - 20 of 45 in total

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  1. In LL, Arshad NM, Ibrahim H, Azmi MN, Awang K, Nagoor NH
    PMID: 23043547 DOI: 10.1186/1472-6882-12-179
    Oral cancers although preventable, possess a low five-year survival rate which has remained unchanged over the past three decades. In an attempt to find a more safe, affordable and effective treatment option, we describe here the use of 1'S-1'-acetoxychavicol acetate (ACA), a component of Malaysian ginger traditionally used for various medicinal purposes.
  2. Hasima N, Aun LI, Azmi MN, Aziz AN, Thirthagiri E, Ibrahim H, et al.
    Phytomedicine, 2010 Oct;17(12):935-9.
    PMID: 20729047 DOI: 10.1016/j.phymed.2010.03.011
    Medicinal plants containing active natural compounds have been used as an alternative treatment for cancer patients in many parts of the world especially in Asia (Itharat et al. 2004). In this report, we describe the cytotoxic and apoptotic properties of 1'S-1'-acetoxyeugenol acetate (AEA), an analogue of 1'S-1'-acetoxychavicol acetate (ACA), isolated from the Malaysian ethno-medicinal plant Alpinia conchigera Griff (Zingiberaceae) on human breast cancer cells. Data from MTT cell viability assays indicated that AEA induced both time- and dose-dependent cytotoxicity with an IC(50) value of 14.0 μM within 36 h of treatment on MCF-7 cells, but not in HMEC normal control cells. Both annexin V-FITC/PI flow cytometric analysis and DNA fragmentation assays confirmed that AEA induced cell death via apoptosis. AEA was also found to induce cell cycle arrest in MCF-7 cells at the G(0)/G(1) phase with no adverse cell cycle arrest effects on HMEC normal control cells. It was concluded that AEA isolated from the Malaysian tropical ginger represents a potential chemotherapeutic agent against human breast cancer cells with higher cytotoxicity potency than its analogue, ACA.
  3. In LL, Azmi MN, Ibrahim H, Awang K, Nagoor NH
    Anticancer Drugs, 2011 Jun;22(5):424-34.
    PMID: 21346553 DOI: 10.1097/CAD.0b013e328343cbe6
    In this study, the apoptotic mechanism and combinatorial chemotherapeutic effects of the cytotoxic phenylpropanoid compound 1'S-1'-acetoxyeugenol acetate (AEA), extracted from rhizomes of the Malaysian ethnomedicinal plant Alpinia conchigera Griff. (Zingiberaceae), on MCF-7 human breast cancer cells were investigated for the first time. Data from cytotoxic and apoptotic assays such as live and dead and poly-(ADP-ribose) polymerase cleavage assays indicated that AEA was able to induce apoptosis in MCF-7 cells, but not in normal human mammary epithelial cells. A microarray global gene expression analysis of MCF-7 cells, treated with AEA, suggested that the induction of tumor cell death through apoptosis was modulated through dysregulation of the nuclear factor-kappaB (NF-κB) pathway, as shown by the reduced expression of various κB-regulated gene targets. Consequent to this, western blot analysis of proteins corresponding to the NF-κB pathway indicated that AEA inhibited phosphorylation levels of the inhibitor of κB-kinase complex, resulting in the elimination of apoptotic resistance originating from NF-κB activation. This AEA-based apoptotic modulation was elucidated for the first time in this study, and gave rise to the proposal of an NF-κB model termed the 'Switching/Alternating Model.' In addition to this, AEA was also found to synergistically enhance the proapoptotic effects of paclitaxel, when used in combination with MCF-7 cells, presumably by a chemosensitizing role. Therefore, it was concluded that AEA isolated from the Malaysian tropical ginger (A. conchigera) served as a very promising candidate for further in-vivo development in animal models and in subsequent clinical trials involving patients with breast-related malignancies.
  4. Asma A, Azmi MN, Mazita A, Marina MB, Salina H, Norlaila M
    PMID: 22468245 DOI: 10.1007/s12070-011-0132-y
    Neuropathy is frequently a late complication of diabetes mellitus. Auditory neuropathy and microangiopathy of inner ear are the possible causes of hearing loss in diabetics. To study the correlation between glycaemic control and hearing threshold in patients with type 2 diabetes mellitus and to determine the differences of hearing threshold between groups treated with different modality. This single blind randomized controlled study was performed at the Department of Medicine and Department of Otorhinolaryngology, Hospital Universiti Kebangsaan Malaysia (UKM) between 1st May 2003 and 31st September 2004. This study was approved by Research Ethics Committee (code number FF-137). Subjects were randomized into two groups. Group 1 were patients treated with conventional oral hypoglycemic agents. The patients in group 2 were those treated with insulin injection. The subjects were seen 4 weekly for 3 months. Audiometric test were performed in all subjects at each visit. Blood were taken for fasting blood glucose, Hb1Ac, and fructosamine at every visit to determine the glycaemic controls of the subject. They were 11 patients (22 ears) treated with oral hypoglycemic agents and 17 patients treated (34 ears) with subcutaneous insulin. There is no significant difference between mean pure tone threshold before and after treatment at all frequencies in both groups. There is also no significance different in fasting glucose level and fructosamine. However, there is significant difference HbA1c levels between the two groups after treatment (P 
  5. Musa RM, Hassan I, Abdullah MR, Latiff Azmi MN, Abdul Majeed APP, Abu Osman NA
    Front Public Health, 2022;10:835119.
    PMID: 36033746 DOI: 10.3389/fpubh.2022.835119
    The non-complexity of tennis, coupled with its health benefits, renders it appealing and encourages varying competitions at different levels of age, gender, and expertise. However, the rapid increase in the participation rates witnesses a surge in injury occurrences, prompting the need for in-depth analysis to facilitate immediate intervention. We employed a media content analysis technique in which tennis-associated articles published in the last 5 years were examined. A total of 207 news reports were gathered and screened for analysis. Subsequently, 71 articles were excluded from the study due to content duplications or summary updates of existing news articles, while 23 news articles were also excluded from the study due to inappropriateness. Finally, 113 news reports directly related to injury in tennis were coded and analyzed. We examined various types of injuries reported from the screened articles with respect to their status (fresh, recurrent, and recovery) across expertise levels i.e., elite, or amateur. Similarly, the incidence of injury occurrences based on the types of tournaments the players engage in was also investigated. A chi-square analysis was employed to achieve the objectives of the study. Occurrences of tennis-associated injuries are disseminated across expertise levels [ χ ( 18 ) 2 = 16.542; p = 0.555], with knee, hip, elbow, and shoulder injuries being highly prevalent in both elite and amateur players. Nevertheless, it was noted that elite players suffered a staggering 72.60% of injury-related problems, while amateur players sustained 27.40% of injuries. Moreover, the status of injury spreads based on types of tournaments [ χ ( 4 ) 2 = 3.374; p = 0.497], with higher occurrences of fresh and recurrent injuries, while low recovery rates were observed. The findings further demonstrated that injuries are sustained regardless of tournament types [ χ ( 36 ) 2 = 39.393; p = 0.321]. However, most of the injuries occurred at international tournaments (85%). Whereas, only 5.30% of the injuries occurred at national/regional tournaments while 9.70% were unidentified. It could be deduced from the findings of this investigation that elite players are more prone to injuries compared with amateur players. Furthermore, the most common tennis-related injuries affect the lower, trunk, and upper regions of the body, respectively. A large number of the reported tennis injuries are fresh and recurrent, with a few recoveries. The international tennis tournaments are highly attributed to injury occurrences as opposed to the national/regional tournaments. The application of the media-based data mining technique is non-trivial in projecting injury-related problems that could be used to facilitate the development of an injury index peculiar to the tennis sport for prompt intervention.
  6. Murtihapsari M, Salam S, Kurnia D, Darwati D, Kadarusman K, Abdullah FF, et al.
    Nat Prod Res, 2021 Mar;35(6):937-944.
    PMID: 31210054 DOI: 10.1080/14786419.2019.1611815
    A new antimalarial sterol, kaimanol (1), along with a known sterol, saringosterol (2) was isolated from the Indonesian Marine sponge, Xestospongia sp. The chemical structure of the new compound was determined on the basis of spectroscopic evidences and by comparison to those related compounds previously reported. Isolated compounds, 1 and 2 were evaluated for their antiplasmodial effect against Plasmodium falciparum 3D7 strains. Compounds 1 and 2 exhibited antiplasmodial activity with IC50 values of 359 and 0.250 nM, respectively.
  7. Supriatno, Nurlelasari, Herlina T, Harneti D, Maharani R, Hidayat AT, et al.
    Nat Prod Res, 2018 Nov;32(21):2610-2616.
    PMID: 29368952 DOI: 10.1080/14786419.2018.1428600
    A new limonoid, pentandricine (1), along with three known limonoids, ceramicine B (2), 6-de(acetyloxy)-23-oxochisocheton (3), 6-de(acetyloxy)-23-oxo-7-O-deacetylchisocheton (4), have been isolated from the stembark of Chisocheton pentandrus. The chemical structures of the new compound were elucidated on the basis of spectroscopic evidence. All of the compounds were tested for their cytotoxic effects against MCF-7 breast cancer cells. Compounds 1-4 showed weak and no cytotoxicity against MCF-7 breast cancer cells with IC50 values of 369.84, 150.86, 208.93 and 120.09 μM, respectively.
  8. Riyadi SA, Naini AA, Mayanti T, Lesmana R, Azmi MN, Fajriah S, et al.
    J Nat Med, 2024 Mar 22.
    PMID: 38517622 DOI: 10.1007/s11418-024-01794-2
    A total of five new mexicanolides (1-5), namely alliaxylines A-E, together with two known limonoids 6 and 7, were isolated and identified from Dysoxylum alliaceum (Blume) Blume ex. A.Juss. (Meliaceae). The structures of these compounds were elucidated based on extensive spectroscopic analyses, including HR-ESI-MS, UV, IR, 1D, and 2D NMR, as well as theoretical stimulation of NMR shifts with the DP4 + algorithm. Consequently, this study aimed to examine cytotoxic activities of these compounds against MCF-7 and A549 cell lines. The results implied that compound 2 was the most potent against the two tested cells, with IC50 values of 34.95 ± 0.21 and 44.39 ± 1.03 µM.
  9. Phuah NH, In LL, Azmi MN, Ibrahim H, Awang K, Nagoor NH
    Reprod Sci, 2013 May;20(5):567-78.
    PMID: 23012319 DOI: 10.1177/1933719112459220
    The aims of this study were to investigate the combined effects of a natural compound 1'S-1'-acetoxychavicol acetate (ACA) with cisplatin (CDDP) on HPV-positive human cervical carcinoma cell lines (Ca Ski-low cisplatin sensitivity and HeLa-high cisplatin sensitivity), and to identify microRNAs (miRNAs) modulated in response toward ACA and/or CDDP. It was revealed that both ACA and CDDP induced dose- and time-dependent cytotoxicity when used as a stand-alone agent, while synergistic effects were observed when used in combination with a combination index (CI) value of 0.74 ± 0.01 and 0.85 ± 0.01 in Ca Ski and HeLa cells, respectively. A total of 25 miRNAs were found to be significantly differentially expressed in response to ACA and/or CDDP. These include hsa-miR-138, hsa-miR-210, and hsa-miR-744 with predicted gene targets involved in signaling pathways regulating apoptosis and cell cycle progression. In conclusion, ACA acts as a chemosensitizer which synergistically potentiates the cytotoxic effect of CDDP in cervical cancer cells. The altered miRNA expression upon administration of ACA and/or CDDP suggests that miRNAs play an important role in anticancer drug responses, which can be manipulated for therapeutic purposes.
  10. Liew SK, Azmi MN, In L, Awang K, Nagoor NH
    Drug Des Devel Ther, 2017;11:2763-2776.
    PMID: 29075101 DOI: 10.2147/DDDT.S130349
    Nine analogs of 1'S-1'-acetoxychavicol acetate (ACA) were hemi-synthesized and evaluated for their anticancer activities against seven human cancer cell lines. The aim of this study was to investigate the anti-proliferative, apoptotic, and anti-migration effects of these compounds and to explore the plausible underlying mechanisms of action. We found that ACA and all nine analogs were non toxic to human mammary epithelial cells (HMECs) used as normal control cells, and only ACA, 1'-acetoxyeugenol acetate (AEA), and 1'-acetoxy-3,5-dimethoxychavicol acetate (AMCA) inhibited the growth of MDA-MB-231 breast cancer cells with a half-maximal inhibitory concentration (IC50) value of <30.0 μM based on 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay results, and were selected for further investigation. DNA fragmentation assays showed that these three compounds markedly induced apoptosis of MDA-MB-231 cells. Western blot analysis revealed increased expression levels of cleaved PARP, p53, and Bax, while decreased expression levels of Bcl-2 and Bcl-xL were seen after treatment, indicating that apoptosis was induced via the mitochondrial pathway. Moreover, ACA, AEA, and AMCA effectively inhibited the migration of MDA-MB-231 cells. They also downregulated the expression levels of pFAK/FAK and pAkt/Akt via the integrin β1-mediated signaling pathway. Collectively, ACA and its hemi-synthetic analogs, AEA and AMCA are seen as potential anticancer agents following their abilities to suppress growth, induce apoptosis, and inhibit migration of breast cancer cells.
  11. Muhammad MT, Beniddir MA, Phongphane L, Abu Bakar MH, Hussin MH, Awang K, et al.
    Fitoterapia, 2024 Apr;174:105873.
    PMID: 38417682 DOI: 10.1016/j.fitote.2024.105873
    Diabetes mellitus stands as a metabolic ailment marked by heightened blood glucose levels due to inadequate insulin secretion. The primary aims of this investigative inquiry encompassed the isolation of phytochemical components from the bark of Kopsia teoi, followed by the assessment of their α-amylase inhibition. The phytochemical composition of the K. teoi culminated in the discovery of a pair of new indole alkaloids; which are 16-epi-deacetylakuammiline N(4)-methylene chloride (akuammiline) (1), and N(1)-methoxycarbonyl-11-methoxy-12-hydroxy-Δ14-17-kopsinine (aspidofractinine) (2), together with five known compounds i.e. kopsiloscine G (aspidofractinine) (3), akuammidine (sarpagine) (4), leuconolam (aspidosperma) (5), N-methoxycarbonyl-12-methoxy-Δ16, 17-kopsinine (aspidofractinine) (6), and kopsininate (aspidofractinine) (7). All compounds were determined via spectroscopic analyses. The in vitro evaluation against α-amylase showed good inhibitory activities for compounds 5-7 with the inhibitory concentration (IC50) values of 21.7 ± 1.2, 34.1 ± 0.1, and 30.0 ± 0.8 μM, respectively compared with the reference acarbose (IC50 = 34.4 ± 0.1 μM). The molecular docking outputs underscored the binding interactions of compounds 5-7 ranging from -8.1 to -8.8 kcal/mol with the binding sites of α-amylase. Consequently, the outcomes highlighted the anti-hyperglycemic attributes of isolates from K. teoi.
  12. Othman K, Evelyn-Tai LM, Raja-Azmi MN, Julieana M, Liza-Sharmini AT, Tharakan J, et al.
    Int J Surg Case Rep, 2017;30:197-200.
    PMID: 28061417 DOI: 10.1016/j.ijscr.2016.12.010
    Hyphema and orbital apex syndrome occurring concurrently in a patient with herpes zoster ophthalmicus have not been reported previously. We present a case with these unique findings and discuss the pathogenesis of these conditions and their management.
  13. Hariri F, Abdul Rahman ZA, Bahuri NFA, Azmi MN, Abdullah NA, Ganesan D
    J Oral Maxillofac Surg, 2018 03;76(3):646.e1-646.e12.
    PMID: 29268076 DOI: 10.1016/j.joms.2017.11.029
    Crouzon syndrome (CS) is the most common craniosynostosis syndrome and requires a comprehensive management strategy for the optimization of care and functional rehabilitation. This report presents a case series of 6 pediatric patients diagnosed with CS who were treated with distraction osteogenesis (DO) to treat serious functional issues involving severe orbital proptosis, an obstructed nasopharyngeal airway, and increased intracranial pressure (ICP). Three boy and 3 girls were 8 months to 6 years old at the time of the operation. The mean skeletal advancement was 16.1 mm (range, 10 to 27 mm) with a mean follow-up of 31.7 months (range, 13 to 48 months). Reasonable and successful outcomes were achieved in most patients as evidenced by adequate eye protection, absence of signs and symptoms of increased ICP, and tracheostomy tube decannulation except in 1 patient. Complications were difficult fixation of external stabilizing pins in the distraction device (n = 1) and related to surgery (n = 4). Although DO can be considered very technical and can have potentially serious complications, the technique produces favorable functional and clinical outcomes in treating severe CS.
  14. Juanarita J, Azmi MN, Azhany Y, Liza-Sharmini AT
    Asian Pac J Trop Biomed, 2012 Sep;2(9):755-6.
    PMID: 23570008 DOI: 10.1016/S2221-1691(12)60223-8
    A 24 year-old Malay lady presented with high grade fever, myalgia, generalized rashes, severe headache and was positive for dengue serology test. Her lowest platelet count was 45 × 10(9) cells/L. She complained of sudden onset of painlessness, profound loss of vision bilaterally 7 days after the onset of fever. On examination, her right eye best corrected vision was 6/30 and left eye was 6/120. Her anterior segment examination was unremarkable. Funduscopy revealed there were multiple retinal haemorrhages found at posterior pole of both fundi and elevation at fovea area with subretinal fluid. Systemic examination revealed normal findings except for residual petechial rashes. She was managed conservatively. Her vision improved tremendously after 2 months. The retinal hemorrhages and foveal elevation showed sign of resolving. Ocular manifestations following dengue fever is rare. However, bilateral visual loss can occur if both fovea are involved.
  15. Azmi MN, Din MF, Kee CH, Suhaimi M, Ping AK, Ahmad K, et al.
    Int J Mol Sci, 2013;14(12):23369-89.
    PMID: 24287912 DOI: 10.3390/ijms141223369
    Resveratrol, a natural stilbene found in grapes and wines exhibits a wide range of pharmacological properties. Resveratrol is also known as a good chemopreventive agent for inhibiting carcinogenesis processes that target kinases, cyclooxygenases, ribonucleotide reductase and DNA polymerases. A total of 19 analogues with an amide moiety were synthesized and the cytotoxic effects of the analogues on a series of human cancer cell lines are reported. Three compounds 6d, 6i and 6n showed potent cytotoxicity against prostate cancer DU-145 (IC50=16.68 µM), colon cancer HT-29 (IC50=7.51 µM) and breast cancer MCF-7 (IC50=21.24 µM), respectively, which are comparable with vinblastine. The resveratrol analogues were synthesized using the Heck method.
  16. Guan-Fook N, Hayati AA, Raja-Azmi MN, Liza-Sharmini AT, Wan-Hazabbah WH, Zunaina E
    Clin Ophthalmol, 2012;6:487-90.
    PMID: 22536041 DOI: 10.2147/OPTH.S29806
    We report a case of diffuse unilateral subacute neuroretinitis in a young boy with no clinical visualization of nematode. The diagnosis was made based on clinical findings and detection of Toxocara immunoglobulin G by Western blot test. An 11-year-old Malay boy presented with progressive blurring of vision in the left eye for a duration of 1 year. It was associated with intermittent floaters. Visual acuity in the left eye was 6/45 and improved to 6/24 with pinhole. There was positive relative afferent pupillary defect, impaired color vision, and presence of red desaturation in the left eye. There were occasional cells in the anterior chamber with no conjunctiva injection. Posterior segment examination revealed mild-to-moderate vitritis and generalized pigmentary changes of the retina with attenuated vessels. The optic disk was slightly hyperemic with mild edema. There was presence of multiple, focal, gray-white subretinal lesions at the inferior part of the retina. Full blood picture results showed eosinophilia with detection of Toxocara immunoglobulin G by Western blot test. Investigations for other infective causes and connective tissue diseases were negative. The diagnosis of diffuse unilateral subacute neuroretinitis secondary to Toxocara was made based on clinical findings and laboratory results. He was treated with oral albendazole 400 mg daily for 5 days and oral prednisolone 1 mg/kg with tapering doses over 6 weeks. At 1 month follow-up, the inflammation had reduced, and multiple, focal, gray-white subretinal lesions were resolved; however there was no improvement of vision.
  17. Alrajhi AH, Ahmed NM, Halim MM, Altowyan AS, Azmi MN, Almessiere MA
    Materials (Basel), 2023 Jun 21;16(13).
    PMID: 37444824 DOI: 10.3390/ma16134510
    This paper reports the optical properties of zinc oxide nanofilm fabricated by using organic natural products from Salvia officinalis leaves (SOL) extract and discusses the effect of the nanocrystal (NC) structure (nanoyarn and nanomat-like structure) on nanofilm optical properties. The surface-active layer of the nanofilm of ZnO nanoparticles (ZnO NPs) was passivated with natural organic SOL leaves hydrothermally, then accumulated on zinc oxide nanorods (ZnO NRs). The nanofilms were fabricated (with and without PEO) on glass substrate (at 85 °C for 16 h) via chemical solution deposition (CSD). The samples were characterized by UV-vis, PL, FESEM, XRD, and TEM measurements. TEM micrographs confirmed the nucleation of ZnO NPs around 4 nm and the size distribution at 1.2 nm of ZnO QDs as an influence of the quantum confinement effect (QCE). The nanofilms fabricated with SOL surfactant (which works as a capping agent for ZnO NPs) represent distinct optoelectronic properties when compared to bulk ZnO. FESEM images of the nanofilms revealed nanoyarn and nanomat-like structures resembling morphologies. The XRD patterns of the samples exhibited the existence of ZnO nanocrystallites (ZnO NCs) with (100), (002), and (101) growth planes. The nanofilms fabricated represented a distinct optical property through absorption and broad emission, as the optical energy band gap reduced as the nanofilms annealed (at 120 ℃). Based on the obtained results, it was established that phytochemicals extracted from organic natural SOL leaves have a distinct influence on zoic oxide nanofilm fabrication, which may be useful for visible light spectrum trapping. The nanofilms can be used in photovoltaic solar cell applications.
  18. Phuah NH, Azmi MN, Awang K, Nagoor NH
    Mol Cells, 2017 Apr;40(4):291-298.
    PMID: 28401751 DOI: 10.14348/molcells.2017.2285
    MicroRNAs (miRNAs) are short non-coding RNAs that regulate genes posttranscriptionally. Past studies have reported that miR-210 is up-regulated in many cancers including cervical cancer, and plays a pleiotropic role in carcinogenesis. However, its role in regulating response towards anti-cancer agents has not been fully elucidated. We have previously reported that the natural compound 1'S-1'-acetoxychavicol acetate (ACA) is able to induce cytotoxicity in various cancer cells including cervical cancer cells. Hence, this study aims to investigate the mechanistic role of miR-210 in regulating response towards ACA in cervical cancer cells. In the present study, we found that ACA down-regulated miR-210 expression in cervical cancer cells, and suppression of miR-210 expression enhanced sensitivity towards ACA by inhibiting cell proliferation and promoting apoptosis. Western blot analysis showed increased expression of mothers against decapentaplegic homolog 4 (SMAD4), which was predicted as a target of miR-210 by target prediction programs, following treatment with ACA. Luciferase reporter assay confirmed that miR-210 binds to sequences in 3'UTR of SMAD4. Furthermore, decreased in SMAD4 protein expression was observed when miR-210 was overexpressed. Conversely, SMAD4 protein expression increased when miR-210 expression was suppressed. Lastly, we demonstrated that overexpression of SMAD4 augmented the anti-proliferative and apoptosis-inducing effects of ACA. Taken together, our results demonstrated that down-regulation of miR-210 conferred sensitivity towards ACA in cervical cancer cells by targeting SMAD4. These findings suggest that combination of miRNAs and natural compounds could provide new strategies in treating cervical cancer.
  19. Kautsari A, Naini AA, Mayanti T, Nurlelasari, Harneti D, Farabi K, et al.
    J Asian Nat Prod Res, 2024 Mar 21.
    PMID: 38511479 DOI: 10.1080/10286020.2024.2329726
    A new seco-A tirucallane triterpenoid named excelxylin A (1), along with two known seco-A triterpenoids (2-3), were isolated from the n-hexane extract of Dysoxylum excelsum (Spreng.) Blume ex G.Don stem bark. The structure and stereochemistry configuration of compounds 1-3 was established by NMR, IR, and HR-ESI-MS spectroscopic data analyses and comparison of their NMR data with literatures. The compounds exhibited the carbon framework for seco-A ring tirucallane triterpenoid, first reported in the Dysoxylum genus. All compounds were tested for their cytotoxicity against human cervical HeLa cells.
  20. Zailani MH, Azmi MN, Deen KI
    Med J Malaysia, 2010 Mar;65(1):66-7.
    PMID: 21265253 MyJurnal
    Faecal incontinence is a debilitating chronic clinical condition which may affect the patient and care givers. Modality of treatment is based on severity of the symptoms as well as the anatomical defect itself, availability of resources and expertise. We describe a modified technique of dynamic graciloplasty as neoanal sphincter for the treatment severe faecal incontinence who has failed previous over lapping sphincteroplasty. In our modified version, instead of using implanted intramuscular electrodes and subcutaneous neurostimulator to provide continuous stimulation, the patient will undergo an external stimulation on the nerve of transplanted gracilis periodically and concurrent biofeedback therapy. We believe the technique is relatively easy to learn and very cost effective without any electrodes or neurostimulator related complications.
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