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Piper sarmentosum prevents glucocorticoid-induced osteoporotic bone resorption by increasing 11β-hydroxysteroid dehydrogenase type 1 activity

Suhana MR, Farihah HS, Faizah O, Nazrun SA, Norazlina M, Norliza M, et al.

Clin Ter, 2011;162(4):313-8.
PMID: 21912818

Osteoporosis is a proven complication of long-term glucocorticoid therapy. Concern on glucocorticoid induced osteoporosis has increased dramatically in recent years with the widespread use of synthetic glucocorticoids. Glucocorticoid action in bone depends upon the activity of 11βhydroxysteroid dehydrogenase type 1 enzyme (11βHSD1). This enzyme plays an important role in regulating corticosteroids by locally interconverting cortisone into active cortisol. This has been demonstrated in primary cultures of human, mouse or rat osteoblasts. Therefore, inhibition of this enzyme may reduce bone resorption markers. Piper sarmentosum (Ps) is a potent inhibitor of 11βHSD1 in liver and adipose tissue. In this study we determined the effect of Ps on 11βHSD1 activity in bones of glucocorticoid-induced osteoporotic rats.
Fulltext Pharmacological Therapy in Panic Disorder: Current Guidelines and Novel Drugs Discovery for Treatment-resistant Patient

Zulfarina MS, Syarifah-Noratiqah SB, Nazrun SA, Sharif R, Naina-Mohamed I

Clin Psychopharmacol Neurosci, 2019 May 31;17(2):145-154.
PMID: 30905115 DOI: 10.9758/cpn.2019.17.2.145

Panic disorder (PD) being one of the most intensively investigated anxiety disorders is considered a heterogeneous psychiatric disease which has difficulties with early diagnosis. The disorder is recurrent and usually associated with low remission rates and high rates of relapse which may exacerbated social and quality of life, causes unnecessary cost and increased risk for complication and suicide. Current pharmacotherapy for PD are available but these drugs have slow therapeutic onset, several side effects and most patients do not fully respond to these standard pharmacological treatments. Ongoing investigations indicate the need for new and promising agents for the treatment of PD. This article will cover the importance of immediate and proper treatment, the gap in the current management of PD with special emphasis on pharmacotherapy, and evidence regarding the novel anti-panic drugs including the drugs in developments such as metabotropic glutamate (mGlu 2/3) agonist and levetiracetam. Preliminary results suggest the anti-panic properties and the efficacy of duloxetine, reboxetine, mirtazapine, nefazodone, risperidone and inositol as a monotherapy drug. Apart for their effectiveness, the aforementioned compounds were generally well tolerated compared to the standard available pharmacotherapy drugs, indicating their potential therapeutic usefulness for ambivalent and hypervigilance patient. Further strong clinical trials will provide an ample support to these novel compounds as an alternative monotherapy for PD treatment-resistant patient.
Influence of Adolescents' Physical Activity on Bone Mineral Acquisition: A Systematic Review Article

Zulfarina MS, Sharkawi AM, Aqilah-S N ZS, Mokhtar SA, Nazrun SA, Naina-Mohamed I

Iran J Public Health, 2016 Dec;45(12):1545-1557.
PMID: 28053920

BACKGROUND: This study conducted to examine and to provide a systematic literature over the influence of adolescents' physical activity (PA) in maximizing`s peak bone mass (PBM). PBM or the 'bone bank' is an important determinant in achieving healthy bone. PA is one of the bone's lifestyle contributors and high PBM is one of the major strategies for preventing osteoporosis.
METHODS: A computerized literature search using Medline (Ovid) and Scopus were conducted to identify relevant observational studies on the influence of different level of PA on bone acquisition among the healthy adolescent population. All articles included, were limited to original articles and English language.
RESULTS: Nine studies met the inclusion criteria. Reported bone outcomes were of bone mass, bone structure and bone strength. Eight studies showed positive association between adolescents' PA and high bone variables. The influence of PA may differ according to sex, skeletal sites and bone outcomes.
CONCLUSION: This study supported the importance of increase adolescents' regular PA in optimizing PBM thus preventing osteoporosis at later life.
Fulltext Modifiable factors associated with bone health in Malaysian adolescents utilising calcaneus quantitative ultrasound

Zulfarina MS, Sharif R, Syarifah-Noratiqah SB, Sharkawi AM, Aqilah-Sm ZS, Mokhtar SA, et al.

PLoS One, 2018;13(8):e0202321.
PMID: 30106982 DOI: 10.1371/journal.pone.0202321

Maximizing bone mineral accrual to attain an optimal peak bone mass (PBM), particularly during adolescence, appears to be an effective protective strategy in the prevention of osteoporosis. This study aimed to evaluate the influence of physical activity (PA), fat mass (FM), lean mass (LM), body mass index (BMI), calcium, or combination of vitamin D supplement intake, smoking and alcohol drinking status on bone health assessed by calcaneus quantitative ultrasound (QUS) in a healthy adolescent population. The participants comprised of 920 male and female secondary school adolescents aged 15-17 years old. Quantitative ultrasound measurements of the left heel were performed using Lunar Achilles EX II, which included results of broadband ultrasound attenuation (BUA), speed of sound (SOS), and a calculated stiffness index (SI). Multivariable linear regression analyses revealed that-PA was positively associated with all three QUS indices in both genders; BMI was positively associated with SI and SOS in females; LM was positively associated with BUA in both genders; and FM was negatively associated with SI in females. These variables accounted for 32.1%, 21.2% and 29.4% of females' SOS, BUA and SI variances (p<0.001), respectively and 23.6%, 15.4% and 17.2% of males' SOS, BUA and SI variances (p<0.001), respectively. Promoting health benefits from physical activity could influence bone status and consequently improve PBM, which is a potent protective determinant against osteoporosis in adulthood.