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A pilot study on the efficacy of nasal rinsing during ablution in reducing acute respiratory tract infection (ARI) among male Hajj pilgrims

Ramli RR, Mohamad I, Ab Wahab MS, Naing NN, Wan Din WS

J Taibah Univ Med Sci, 2018 Aug;13(4):364-369.
PMID: 31435348 DOI: 10.1016/j.jtumed.2018.04.004

Objective: This study aimed to assess the effectiveness of nasal rinsing during ablution in reducing acute respiratory tract infection among male Hajj pilgrims.
Methods: A quasi-experimental trial study was conducted to compare the effectiveness of nasal rinsing between two groups. The intervention group was instructed to perform nasal rinsing during ablution, while the control group was not asked to do nasal rinsing. Both groups were provided progress diaries to record the symptoms of respiratory tract infection, including cough, rhinorrhoea, nasal blockage, fever, and sore throat, as well as thick phlegm, shortness of breath, epistaxis, and changes in sense of smell. The groups were also instructed to record any visits to clinics for their symptoms throughout their stay in Makkah for the Hajj ritual.
Results: The study showed that nasal rinsing significantly reduced the symptoms of cough, rhinorrhoea, and nasal blockage. The intervention group had an increased number of visits to healthcare facilities for treatment, when compared to those of the control group. There were no significant differences in the groups regarding the symptoms of fever and sore throat.
Conclusion: Nasal rinsing can be included as part of intervention methods that include vaccination and the use of a face mask. Nasal rinsing can be easily practiced by the pilgrims, since it is a Sunnah act in ablution, which is an integral element of Muslims' daily life.
Fulltext Effects of honey and its mechanisms of action on the development and progression of cancer

Erejuwa OO, Sulaiman SA, Wahab MS

Molecules, 2014;19(2):2497-522.
PMID: 24566317 DOI: 10.3390/molecules19022497

Honey is a natural product known for its varied biological or pharmacological activities-ranging from anti-inflammatory, antioxidant, antibacterial, antihypertensive to hypoglycemic effects. This review article focuses on the role of honey in modulating the development and progression of tumors or cancers. It reviews available evidence (some of which is very recent) with regards to the antimetastatic, antiproliferative and anticancer effects of honey in various forms of cancer. These effects of honey have been thoroughly investigated in certain cancers such as breast, liver and colorectal cancer cell lines. In contrast, limited but promising data are available for other forms of cancers including prostate, bladder, endometrial, kidney, skin, cervical, oral and bone cancer cells. The article also underscores the various possible mechanisms by which honey may inhibit growth and proliferation of tumors or cancers. These include regulation of cell cycle, activation of mitochondrial pathway, induction of mitochondrial outer membrane permeabilization, induction of apoptosis, modulation of oxidative stress, amelioration of inflammation, modulation of insulin signaling and inhibition of angiogenesis. Honey is highly cytotoxic against tumor or cancer cells while it is non-cytotoxic to normal cells. The data indicate that honey can inhibit carcinogenesis by modulating the molecular processes of initiation, promotion, and progression stages. Thus, it may serve as a potential and promising anticancer agent which warrants further experimental and clinical studies.
Fulltext Oligosaccharides might contribute to the antidiabetic effect of honey: a review of the literature

Erejuwa OO, Sulaiman SA, Wahab MS

Molecules, 2011 Dec 28;17(1):248-66.
PMID: 22205091 DOI: 10.3390/molecules17010248

Evidence shows that honey improves glycemic control in diabetes mellitus. Besides its hypoglycemic effect, studies indicate that honey ameliorates lipid abnormalities in rats and humans with diabetes. The majority of these studies do not examine the mechanisms by which honey ameliorates glycemic and/or lipid derangements. The gut microbiota is now recognized for its ability to increase energy harvest from the diet and alter lipid metabolism of the host. Recently available data implicate a causal role of these gut microbes in the pathophysiology of obesity, insulin resistance, and diabetes mellitus. In this review, we present some of the latest findings linking gut microbiota to pathogenesis of obesity, insulin resistance, and diabetes mellitus. The review also underlines data that demonstrate the beneficial effects of oligosaccharides on various abnormalities commonly associated with these disorders. Based on the similarities of some of these findings with those of honey, together with the evidence that honey contains oligosaccharides, we hypothesize that oligosaccharides present in honey might contribute to the antidiabetic and other health-related beneficial effects of honey. We anticipate that the possibility of oligosaccharides in honey contributing to the antidiabetic and other health-related effects of honey will stimulate a renewed research interest in this field.
Fulltext Fructose might contribute to the hypoglycemic effect of honey

Erejuwa OO, Sulaiman SA, Wahab MS

Molecules, 2012 Feb 15;17(2):1900-15.
PMID: 22337138 DOI: 10.3390/molecules17021900

Honey is a natural substance with many medicinal properties, including antibacterial, hepatoprotective, hypoglycemic, antioxidant and antihypertensive effects. It reduces hyperglycemia in diabetic rats and humans. However, the mechanism(s) of its hypoglycemic effect remain(s) unknown. Honey comprises many constituents, making it difficult to ascertain which component(s) contribute(s) to its hypoglycemic effect. Nevertheless, available evidence indicates that honey consists of predominantly fructose and glucose. The objective of this review is to summarize findings which indicate that fructose exerts a hypoglycemic effect. The data show that glucose and fructose exert a synergistic effect in the gastrointestinal tract and pancreas. This synergistic effect might enhance intestinal fructose absorption and/or stimulate insulin secretion. The results indicate that fructose enhances hepatic glucose uptake and glycogen synthesis and storage via activation of hepatic glucokinase and glycogen synthase, respectively. The data also demonstrate the beneficial effects of fructose on glycemic control, glucose- and appetite-regulating hormones, body weight, food intake, oxidation of carbohydrate and energy expenditure. In view of the similarities of these effects of fructose with those of honey, the evidence may support the role of fructose in honey in mediating the hypoglycemic effect of honey.
Fulltext Honey--a novel antidiabetic agent

Erejuwa OO, Sulaiman SA, Wahab MS

Int J Biol Sci, 2012;8(6):913-34.
PMID: 22811614 DOI: 10.7150/ijbs.3697

Diabetes mellitus remains a burden worldwide in spite of the availability of numerous antidiabetic drugs. Honey is a natural substance produced by bees from nectar. Several evidence-based health benefits have been ascribed to honey in the recent years. In this review article, we highlight findings which demonstrate the beneficial or potential effects of honey in the gastrointestinal tract (GIT), on the gut microbiota, in the liver, in the pancreas and how these effects could improve glycemic control and metabolic derangements. In healthy subjects or patients with impaired glucose tolerance or diabetes mellitus, various studies revealed that honey reduced blood glucose or was more tolerable than most common sugars or sweeteners. Pre-clinical studies provided more convincing evidence in support of honey as a potential antidiabetic agent than clinical studies did. The not-too-impressive clinical data could mainly be attributed to poor study designs or due to the fact that the clinical studies were preliminary. Based on the key constituents of honey, the possible mechanisms of action of antidiabetic effect of honey are proposed. The paper also highlights the potential impacts and future perspectives on the use of honey as an antidiabetic agent. It makes recommendations for further clinical studies on the potential antidiabetic effect of honey. This review provides insight on the potential use of honey, especially as a complementary agent, in the management of diabetes mellitus. Hence, it is very important to have well-designed, randomized controlled clinical trials that investigate the reproducibility (or otherwise) of these experimental data in diabetic human subjects.
Fulltext Nigerian Honey Ameliorates Hyperglycemia and Dyslipidemia in Alloxan-Induced Diabetic Rats

Erejuwa OO, Nwobodo NN, Akpan JL, Okorie UA, Ezeonu CT, Ezeokpo BC, et al.

Nutrients, 2016;8(3).
PMID: 26927161 DOI: 10.3390/nu8030095

Diabetic dyslipidemia contributes to an increased risk of cardiovascular disease. Hence, its treatment is necessary to reduce cardiovascular events. Honey reduces hyperglycemia and dyslipidemia. The reproducibility of these beneficial effects and their generalization to honey samples of other geographical parts of the world remain controversial. Currently, data are limited and findings are inconclusive especially with evidence showing honey increased glycosylated hemoglobin in diabetic patients. It was hypothesized that this deteriorating effect might be due to administered high doses. This study investigated if Nigerian honey could ameliorate hyperglycemia and hyperlipidemia. It also evaluated if high doses of honey could worsen glucose and lipid abnormalities. Honey (1.0, 2.0 or 3.0 g/kg) was administered to diabetic rats for three weeks. Honey (1.0 or 2.0 g/kg) significantly (p < 0.05) increased high density lipoprotein (HDL) cholesterol while it significantly (p < 0.05) reduced hyperglycemia, triglycerides (TGs), very low density lipoprotein (VLDL) cholesterol, non-HDL cholesterol, coronary risk index (CRI) and cardiovascular risk index (CVRI). In contrast, honey (3.0 g/kg) significantly (p < 0.05) reduced TGs and VLDL cholesterol. This study confirms the reproducibility of glucose lowering and hypolipidemic effects of honey using Nigerian honey. However, none of the doses deteriorated hyperglycemia and dyslipidemia.
Hypoglycemic and antioxidant effects of honey supplementation in streptozotocin-induced diabetic rats

Erejuwa OO, Omotayo EO, Gurtu S, Sulaiman SA, Ab Wahab MS, Sirajudeen KN, et al.

Int J Vitam Nutr Res, 2010 Jan;80(1):74-82.
PMID: 20533247 DOI: 10.1024/0300-9831/a000008

Oxidative stress plays a crucial role in the development of diabetic complications. The aims of this study were to investigate whether honey could reduce hyperglycemia and ameliorate oxidative stress in kidneys of streptozotocin-induced diabetic rats.
Effect of Influenza Vaccination on Acute Respiratory Symptoms in Malaysian Hajj Pilgrims

Hasan H, Deris ZZ, Sulaiman SA, Abdul Wahab MS, Naing NN, Ab Rahman Z, et al.

J Immigr Minor Health, 2015 Aug;17(4):1114-9.
PMID: 24946936 DOI: 10.1007/s10903-014-0059-y

Respiratory illness were a major problem and caused high hospital admission during hajj seasons. One of the contributing cause to this illness is infection. Various measures had been implemented to reduce respiratory infections. The aim on the study is to determine the effect of influenza vaccination against acute respiratory illness among Malaysian Hajj pilgrims. This is an observational cohort study. Influenza vaccination was given to pilgrims at least 2 weeks prior to departure. The occurrence of symptoms for respiratory illness such as cough, fever, sore throat and runny nose was monitored daily for 6 weeks during pilgrimage using a health diary. A total of 65 vaccinated hajj pilgrims and 41 controls were analyzed. There was no significant difference in pattern of occurrence of symptoms of respiratory illness by duration of pilgrimage as well as the number of symptoms between both groups. Hajj pilgrims have frequent respiratory symptoms. We were unable to document benefit from influenza vaccination, but our study was limited by a small sample size and lack of laboratory testing for influenza.
Fulltext The prevalence of acute respiratory symptoms and role of protective measures among Malaysian hajj pilgrims

Deris ZZ, Hasan H, Sulaiman SA, Wahab MS, Naing NN, Othman NH

J Travel Med, 2010 Mar-Apr;17(2):82-8.
PMID: 20412173 DOI: 10.1111/j.1708-8305.2009.00384.x

BACKGROUND: Respiratory symptoms including cough, runny nose, sore throat, and fever are the most common clinical manifestations faced by hajj pilgrims in Mecca. The aim of the study was to determine the prevalence of respiratory symptoms among Malaysian hajj pilgrims and the effect of a few protective measures taken by hajj pilgrims to reduce respiratory symptoms.
METHODS: A cross-sectional study was conducted by distributing survey forms to Malaysian hajj pilgrims at transit center before flying back to Malaysia. The recruitment of respondents to the survey was on a voluntary basis.
RESULTS: A total of 387 survey forms were available for analysis. The mean age was 50.4 +/- 11.0 years. The common respiratory symptoms among Malaysian hajj pilgrims were: cough 91.5%, runny nose 79.3%, fever 59.2%, and sore throat 57.1%. The prevalence of hajj pilgrims with triad of cough, subjective fever, and sore throat were 40.1%. The symptoms lasted less than 2 weeks in the majority of cases. Only 3.6% did not suffer from any of these symptoms. Seventy-two percent of hajj pilgrims received influenza vaccination before departure and 72.9% wore facemasks. Influenza vaccination was not associated with any of respiratory symptoms but it was significantly associated with longer duration of sore throat. Wearing masks was significantly associated with sore throat and longer duration of sore throat and fever.
CONCLUSIONS: The prevalence of respiratory symptoms was high among Malaysian hajj pilgrims and the current protective measures seemed inadequate to reduce it. Beside standardization of the term used in hajj studies, more collaborative effort should be taken to reduce respiratory symptoms. The hajj authority should prepare for the challenge of pandemic influenza by providing more healthcare facilities and implementation of more strict measures to reduce the transmission of pandemic influenza strain among hajj pilgrims.
Fulltext The association between pre-morbid conditions and respiratory tract manifestations amongst Malaysian Hajj pilgrims

Deris ZZ, Hasan H, Ab Wahab MS, Sulaiman SA, Naing NN, Othman NH

Trop Biomed, 2010 Aug;27(2):294-300.
PMID: 20962728 MyJurnal

In a very closed and overcrowding environment, influenza transmission during Hajj season is almost inevitable. The aim of this study was to determine the association between pre-morbid conditions and influenza-like illness (ILI) amongst Hajj pilgrims. A cross-sectional study was conducted amongst Malaysian Hajj pilgrims in year 2007. Survey forms were distributed at Madinatul-Hujjaj, Jeddah and Tabung Haji Clinic, Medina, Saudi Arabia where pilgrims stay on transit before returning to Malaysia. Allergic rhinitis was significantly associated with sore throat (p=0.047), longer duration of cough (p=0.017) and runny nose (p=0.016). Pilgrims who suffered from chronic obstructive pulmonary diseases (COPD) had significant association with longer duration of cough (p=0.041) and those with diabetes mellitus had significant association with longer duration of sore throat (p=0.048). Underlying asthma was significantly associated with severe influenza like illness requiring admission to hospital for further treatment of respiratory symptoms (p=0.016). Based on these findings, we suggest those with underlying asthma should be discouraged from participating in the hajj and they should seek early treatment if they develop respiratory symptoms.
Fulltext Preference of treatment facilities among Malaysian Hajj pilgrims for acute respiratory symptoms

Deris ZZ, Hasan H, Sulaiman SA, Wahab MS, Naing NN, Othman NH

Saudi Med J, 2009 Aug;30(8):1103-4.
PMID: 19668898
Fulltext Tolerability and pharmacokinetics of non-fixed and fixed combinations of artesunate and amodiaquine in Malaysian healthy normal volunteers

Navaratnam V, Ramanathan S, Wahab MS, Siew Hua G, Mansor SM, Kiechel JR, et al.

Eur J Clin Pharmacol, 2009 Aug;65(8):809-21.
PMID: 19404632 DOI: 10.1007/s00228-009-0656-1

There is limited pharmacokinetic data available for the combination artesunate + amodiaquine, which is used widely to treat uncomplicated malaria. This study examines the bioavailability and tolerability of a fixed (200 mg artesunate + 540 mg amodiaquine) and loose (200 mg + 612 mg) combination with a 2x2 cross-over design in 24 healthy volunteers.
A Cross-Sectional Study on the Use of, Preference for, and Perceived Reliability of Mass Media for Drug-Related Information Among the General Public in Sarawak

Ting CY, Abd Wahab MS, Lee KS, Tan RT, Ming LC

Ther Innov Regul Sci, 2017 Mar;51(2):212-220.
PMID: 30231729 DOI: 10.1177/2168479016674041

BACKGROUND: Because of the large size of Sarawak and the high proportion of people residing in rural areas in this Malaysian state, disseminating drug-related information there can be challenging. It is, therefore, important to recognize the type of mass media for drug-related information that are salient to the people of Sarawak. This study was aimed at identifying the use of and the preferences for mass media to obtain drug-related information among the public in Sarawak. We also aimed to recognize the media perceived as the most reliable for drug-related information.
METHODS: This was a cross-sectional study using a self-administered questionnaire carried out from September to October 2013. Survey respondents were recruited from 4 divisions in Sarawak: Kuching, Sibu, Miri, and Bintulu.
RESULTS: A total of 433 completed questionnaires were obtained at the end of the study period. All respondents had access to common mass media such as television (89.8%, 389/433), radio (68.6%, 297/433), and the Internet (66.1%, 286/433). Among all respondents, television (71.4%, 309/433) was noted as the most preferred media for drug-related information. Compared with rural respondents, urban respondents were significantly more likely to have access to and prefer the Internet to obtain drug-related information. On the other hand, rural respondents were more likely to have access to and prefer radio for such information compared to their urban counterparts.
CONCLUSIONS: Television can be an important and attractive choice of mass media in a quality use of medicines (QUM) campaign. The Internet can be used to disseminate drug-related information in urban areas, whereas radio can be used in a QUM campaign targeting the rural public.
Fulltext Self-Learning about Herbal and Dietary Supplements: Perspectives Using the Theoretical Domains Framework

Abd Wahab MS, Wan Ismail WNS, Ali AA, Ibrahim N, Othman N, Mohd Nor Hazalin NA, et al.

Int J Environ Res Public Health, 2022 Sep 01;19(17).
PMID: 36078618 DOI: 10.3390/ijerph191710901

Background: Self-learning (SL) is a process in which individuals take the initiative to acquire knowledge with or without the help of others. Knowledge about herbal and dietary supplements (HDS) is important for pharmacists. Unfortunately, there is limited coverage of topics relating to HDS in the pharmacy curricula. The present focus group study applies the Theoretical Domains Framework (TDF) to explore pharmacy students' practices and beliefs regarding SL about HDS (SL-HDS). Methods: Focus group interviews (FGIs) were conducted between April and May 2019 among a sample of undergraduate pharmacy students at a public university (n = 20). Four FGI sessions were conducted, each lasting about 60 to 75 min, and all the sessions were audio-recorded. The interviews were transcribed verbatim and analysed using thematic content analysis. Results: Beliefs about SL-HDS were categorised into 12 domains based on the TDF. Students showed positive attitudes towards SL-HDS and agreed that their involvement in SL-HDS was instrumental in improving their knowledge about various aspects of HDS including indications, adverse effects, and HDS-drug interactions. Various facilitators and barriers influencing students' participation in SL-HDS were uncovered (e.g., access to the internet, time, availability of reference resources). The students demanded to be equipped with critical appraisal skills, as they had limited confidence in assessing literature or information about HDS. Conclusion: This study revealed that the students saw the benefits of SL-HDS. They also perceived that engaging in SL-HDS is compatible with the role of pharmacy students. The findings showed students' readiness and willingness to conduct SL-HDS.
Fulltext Effects of Fabric Counts and Weave Designs on the Properties of Laminated Woven Kenaf/Carbon Fibre Reinforced Epoxy Hybrid Composites

Aisyah HA, Paridah MT, Khalina A, Sapuan SM, Wahab MS, Berkalp OB, et al.

Polymers (Basel), 2018 Nov 28;10(12).
PMID: 30961245 DOI: 10.3390/polym10121320

The effects of different fabric materials namely weave designs (plain and satin) and fabric counts (5 × 5 and 6 × 6) on the properties of laminated woven kenaf/carbon fibre reinforced epoxy hybrid composites were evaluated. The hybrid composites were fabricated from two types of fabric, i.e., woven kenaf that was made from a yarn of 500tex and carbon fibre, by using vacuum infusion technique and epoxy resin as matrix. The panels were tested for tensile, flexural, and impact strengths. The results have revealed that plain fabric is more suitable than satin fabric for obtaining high tensile and impact strengths. Using a fabric count of 5 × 5 has generated composites that are significantly higher in flexural modulus as compared to 6 × 6 which may be attributed to their structure and design. The scanned electron micrographs of the fractured surfaces of the composites demonstrated that plain woven fabric composites had better adhesion properties than satin woven fabric composites, as indicated by the presence of notably lower amount of fibre pull out.
Inappropriate prescribing in hospitalised Australian elderly as determined by the STOPP criteria

Wahab MS, Nyfort-Hansen K, Kowalski SR

Int J Clin Pharm, 2012 Dec;34(6):855-62.
PMID: 22864867 DOI: 10.1007/s11096-012-9681-8

BACKGROUND: The elderly population is increasing worldwide. Due to age-related physiological changes that affect the pharmacokinetics and pharmacodynamics of drugs, the elderly are predisposed to adverse drug reactions. Prescribing of potentially inappropriate medications (PIMs) has been found to be prevalent among the elderly and PIM use has been associated with hospitalisations and mortality.
OBJECTIVES: This study aims to identify the prevalence and nature of pre-admission inappropriate prescribing by using the STOPP (screening tool of older people's prescriptions) criteria amongst a sample of hospitalised elderly inpatients in South Australia.
SETTING: Medical, surgical and rehabilitation wards of a public teaching hospital in Adelaide, South Australia.
MAIN OUTCOME MEASURE: Pre-admission prevalence of PIM.
METHOD: Medication management plans of 100 patients of ≥65 years old were prospectively studied to determine the prevalence of pre-admission PIM use. Sixty-five criteria of STOPP were applied to identify PIMs.
RESULTS: The total number of pre-admission medications screened during the study period was 949; the median number of medicines per patient was nine (range 2-28). Overall the STOPP criteria identified 138 PIMs in 60 % of patients. The most frequently encountered PIM was opiates prescribed in patients with recurrent falls (12.3 %), followed by benzodiazepines in fallers (10.1 %) and proton pump inhibitors when prescribed for peptic ulcer disease for long-term at maximum doses (9.4 %). The number of medications were found to have a positive correlation with pre-admission PIM use (r(s) = 0.49, P < 0.01).
CONCLUSIONS: Pre-admission PIM use is highly prevalent among the studied population. Strategies to reduce PIM use should be undertaken by physicians and pharmacists. The use of the STOPP criteria in clinical practice to reduce prescriptions of inappropriate medications requires further investigation.
Drug-related problems among older people with dementia: A systematic review

Xue Qin QN, Ming LC, Abd Wahab MS, Tan CS, Yuda A, Hermansyah A

Res Social Adm Pharm, 2023 Jun;19(6):873-881.
PMID: 36914513 DOI: 10.1016/j.sapharm.2023.02.015

INTRODUCTION: Dementia is a disorder that causes a decline of cognitive function, and it affects millions of people worldwide. Increased availability of medications used to treat dementia will inevitably increase the likelihood of drug-related problems (DRPs).
OBJECTIVE: This systematic review sought to identify DRPs due to medication misadventures, including adverse drug reactions (ADRs), and use of inappropriate medications, among patients with dementia or cognitive impairments.
METHODS: The included studies were retrieved from the electronic databases PubMed and SCOPUS, and a preprint platform (MedRXiv) which were searched from their inception through August 2022. The English-language publications that reported DRPs among dementia patients were included. The JBI Critical Appraisal Tool for quality assessment was used to evaluate the quality of studies included in the review.
RESULTS: Overall, 746 distinct articles were identified. Fifteen studies met the inclusion criteria and reported the most common DRPs, which comprised medication misadventures (n = 9), such as ADRs, inappropriate prescription use, and potentially inappropriate medication use (n = 6).
CONCLUSION: This systematic review provides evidence that DRPs are prevalent among dementia patients, particularly the older people. It indicates that medication misadventures such as ADRs and inappropriate drug use, as well as potentially inappropriate medications, are the most prevalent DRPs among older people with dementia. Due to the small number of included studies, however, additional studies are required to improve comprehension about the issue.
Fulltext Self-reported side effects of COVID-19 vaccines among the public

Karuppannan M, Ming LC, Abdul Wahab MS, Mohd Noordin Z, Yee S, Hermansyah A

J Pharm Policy Pract, 2024;17(1):2308617.
PMID: 38420042 DOI: 10.1080/20523211.2024.2308617

BACKGROUND: The safety, side effects and efficacy profile of COVID-19 vaccines remain subjects of ongoing concern among the public in Malaysia. The aim of this study was to determine the types of adverse effects following immunisation with COVID-19 vaccines and the differences based on various types of COVID-19 vaccines to raise public awareness and reduce vaccine hesitancy among the public.
METHODS: A total of 901 Malaysian adults (≥18 years) who received various COVID-19 vaccines were selected to participate in our cross-sectional study through an online survey between December 2021 and January 2022.
RESULTS: A total of 814 (90.3%) of the participants reported ≥1 side effect following COVID-19 immunisation. Of these, the predominant symptoms were swelling at the injection site (n = 752, 83.5%), headache (n = 638, 70.8%), pain or soreness at the injection site (n = 628, 69.7%), fatigue or tiredness (n = 544, 60.4%), muscle weakness (n = 529, 58.7%) and diarrhea (n = 451, 50.1%). Recipients of the Pfizer-BioNTech (Comirnaty ®) vaccine reported the highest number of adverse effects (n = 355, 43.6%), followed by mixed COVID-19 vaccines (n = 254, 31.2%), the Oxford-AstraZeneca (ChAdOx1-®[recombinant]) vaccine (n = 113, 13.9%) and the Sinovac (CoronaVac®) vaccine (n = 90, 11.1%). The study showed that individuals who reported significantly more side effects were of elderly age, female gender and high educational level [P value
Fulltext Honey supplementation in spontaneously hypertensive rats elicits antihypertensive effect via amelioration of renal oxidative stress

Erejuwa OO, Sulaiman SA, Ab Wahab MS, Sirajudeen KN, Salleh S, Gurtu S

Oxid Med Cell Longev, 2012;2012:374037.
PMID: 22315654 DOI: 10.1155/2012/374037

Oxidative stress is implicated in the pathogenesis and/or maintenance of elevated blood pressure in hypertension. This study investigated the effect of honey on elevated systolic blood pressure (SBP) in spontaneously hypertensive rats (SHR). It also evaluated the effect of honey on the amelioration of oxidative stress in the kidney of SHR as a possible mechanism of its antihypertensive effect. SHR and Wistar Kyoto (WKY) rats were randomly divided into 2 groups and administered distilled water or honey by oral gavage once daily for 12 weeks. The control SHR had significantly higher SBP and renal malondialdehyde (MDA) levels than did control WKY. The mRNA expression levels of nuclear factor erythroid 2-related factor 2 (Nrf2) and glutathione S-transferase (GST) were significantly downregulated while total antioxidant status (TAS) and activities of GST and catalase (CAT) were higher in the kidney of control SHR. Honey supplementation significantly reduced SBP and MDA levels in SHR. Honey significantly reduced the activities of GST and CAT while it moderately but insignificantly upregulated the Nrf2 mRNA expression level in the kidney of SHR. These results indicate that Nrf2 expression is impaired in the kidney of SHR. Honey supplementation considerably reduces elevated SBP via amelioration of oxidative stress in the kidney of SHR.
Fulltext Comparison of antioxidant effects of honey, glibenclamide, metformin, and their combinations in the kidneys of streptozotocin-induced diabetic rats

Erejuwa OO, Sulaiman SA, Wahab MS, Salam SK, Salleh MS, Gurtu S

Int J Mol Sci, 2011;12(1):829-43.
PMID: 21340016 DOI: 10.3390/ijms12010829

Hyperglycemia-induced increase in oxidative stress is implicated in diabetic complications. This study investigated the effect of metformin and/or glibenclamide in combination with honey on antioxidant enzymes and oxidative stress markers in the kidneys of streptozotocin (60 mg/kg; intraperitoneal)-induced diabetic rats. Diabetic rats were randomized into eight groups of five to seven rats and received distilled water (0.5 mL); honey (1.0 g/kg); metformin (100 mg/kg); metformin (100 mg/kg) and honey (1.0 g/kg); glibenclamide (0.6 mg/kg); glibenclamide (0.6 mg/kg) and honey (1.0 g/kg); metformin (100 mg/kg) and glibenclamide (0.6 mg/kg); or metformin (100 mg/kg), glibenclamide (0.6 mg/kg) and honey (1.0 g/kg) orally once daily for four weeks. Malondialdehyde (MDA) levels, glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities were significantly elevated while catalase (CAT) activity, total antioxidant status (TAS), reduced glutathione (GSH), and GSH:oxidized glutathione (GSSG) ratio was significantly reduced in the diabetic kidneys. CAT, glutathione reductase (GR), TAS, and GSH remained significantly reduced in the diabetic rats treated with metformin and/or glibenclamide. In contrast, metformin or glibenclamide combined with honey significantly increased CAT, GR, TAS, and GSH. These results suggest that combination of honey with metformin or glibenclamide might offer additional antioxidant effect to these drugs. This might reduce oxidative stress-mediated damage in diabetic kidneys.

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