Displaying publications 1 - 20 of 109 in total

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  1. Zerumbone alleviates chronic constriction injury-induced allodynia and hyperalgesia through serotonin 5-HT receptors
    Chia JSM, Omar Farouk AA, Mohamad AS, Sulaiman MR, Perimal EK
    Biomed Pharmacother, 2016 Oct;83:1303-1310.
    PMID: 27570173 DOI: 10.1016/j.biopha.2016.08.052
    Zerumbone, a bioactive sesquiterpene isolated from Zingiber zerumbet (Smith), has shown to exert antiallodynic and antihyperalgesic effects in neuropathic pain mice model in our recent study. The mechanism through which zerumbone alleviates neuropathic pain has yet to be elucidated. Thus, this study aimed to determine whether the serotonergic system, part of the descending pain modulation pathway, contributes to the antineuropathic effect of zerumbone. Participation of the serotonergic system in zerumbone-induced antiallodynia and antihyperalgesia was assessed using Dynamic Plantar Aesthesiometer von Frey test and Hargreaves plantar test respectively in chronic-constriction injury mice model. Administration of ρ-chlorophenylalanine (PCPA, 100mg/kg, i.p.) for four consecutive days to deplete serotonin (5-HT) prior to zerumbone administration blocked the antiallodynic and antihyperalgesic effects of zerumbone. Further investigation with 5-HT receptor antagonists methiothepin (5-HT1/6/7 receptor antagonist, 0.1mg/kg), WAY-100635 (5-HT1A receptor antagonist, 1mg/kg), isamoltane (5-HT1B receptor antagonist, 2.5mg/kg), ketanserin (5-HT2A receptor antagonist, 0.3mg/kg) and ondansetron (5-HT3 receptor antagonist, 0.5mg/kg) managed to significantly attenuate antiallodynic and antihyperalgesic effects of zerumbone (10mg/kg). These findings demonstrate that zerumbone alleviates mechanical allodynia and thermal hyperalgesia through the descending serotonergic system via 5-HT receptors 1A, 1B, 2A, 3, 6 and 7 in chronic constriction injury neuropathic pain mice.
    Matched MeSH terms: Constriction
  2. Fulltext Zerumbone Modulates α2A-Adrenergic, TRPV1, and NMDA NR2B Receptors Plasticity in CCI-Induced Neuropathic Pain In Vivo and LPS-Induced SH-SY5Y Neuroblastoma In Vitro Models
    Chia JSM, Izham NAM, Farouk AAO, Sulaiman MR, Mustafa S, Hutchinson MR, et al.
    Front Pharmacol, 2020;11:92.
    PMID: 32194397 DOI: 10.3389/fphar.2020.00092
    Zerumbone has shown great potential in various pathophysiological models of diseases, particularly in neuropathic pain conditions. Further understanding the mechanisms of action is important to develop zerumbone as a potential anti-nociceptive agent. Numerous receptors and pathways function to inhibit and modulate transmission of pain signals. Previously, we demonstrated involvement of the serotonergic system in zerumbone's anti-neuropathic effects. The present study was conducted to determine zerumbone's modulatory potential involving noradrenergic, transient receptor potential vanilloid type 1 (TRPV1) and N-methyl-D-aspartate (NMDA) receptors in chronic constriction injury (CCI)-induced in vitro and lipopolysaccharide (LPS)-induced SH-SY5Y in vitro neuroinflammatory models. von Frey filament and Hargreaves plantar tests were used to assess allodynia and hyperalgesia in the chronic constriction injury-induced neuropathic pain mouse model. Involvement of specific adrenoceptors were investigated using antagonists- prazosin (α1-adrenoceptor antagonist), idazoxan (α2-adrenoceptor antagonist), metoprolol (β1-adrenoceptor antagonist), ICI 118,551 (β2-adrenoceptor antagonist), and SR 59230 A (β3-adrenoceptor antagonist), co-administered with zerumbone (10 mg/kg). Involvement of excitatory receptors; TRPV and NMDA were conducted using antagonists capsazepine (TRPV1 antagonist) and memantine (NMDA antagonist). Western blot was conducted to investigate the effect of zerumbone on the expression of α2A-adrenoceptor, TRPV1 and NMDA NR2B receptors in CCI-induced whole brain samples of mice as well as in LPS-induced SH-SY5Y neuroblastoma cells. Pre-treatment with α1- and α2-adrenoceptor antagonists significantly attenuated both anti-allodynic and anti-hyperalgesic effects of zerumbone. For β-adrenoceptors, only β2-adrenoceptor antagonist significantly reversed the anti-allodynic and anti-hyperalgesic effects of zerumbone. β1-adrenoceptor antagonist only reversed the anti-allodynic effect of zerumbone. The anti-allodynic and anti-hyperalgesic effects of zerumbone were both absent when TRPV1 and NMDA receptors were antagonized in both nociceptive assays. Zerumbone treatment markedly decreased the expression of α2A-adrenoceptor, while an up-regulation was observed of NMDA NR2B receptors. Expression of TRPV1 receptors however did not significantly change. The in vitro study, representing a peripheral model, demonstrated the reduction of both NMDA NR2B and TRPV1 receptors while significantly increasing α2A-adrenoceptor expression in contrast to the brain samples. Our current findings suggest that the α1-, α2-, β1- and β2-adrenoceptors, TRPV1 and NMDA NR2B are essential for the anti-allodynic and antihyperalgesic effects of zerumbone. Alternatively, we demonstrated the plasticity of these receptors through their response to zerumbone's administration.
    Matched MeSH terms: Constriction
  3. Fulltext Zerumbone Alleviates Neuropathic Pain through the Involvement of l-Arginine-Nitric Oxide-cGMP-K⁺ ATP Channel Pathways in Chronic Constriction Injury in Mice Model
    Zulazmi NA, Gopalsamy B, Min JC, Farouk AA, Sulaiman MR, Bharatham BH, et al.
    Molecules, 2017 Mar 30;22(4).
    PMID: 28358309 DOI: 10.3390/molecules22040555
    The present study investigates the involvement of the l-arginine-Nitric Oxide-cGMP-K⁺ ATP pathways responsible for the action of anti-allodynic and antihyperalgesic activities of zerumbone in chronic constriction injury (CCI) induced neuropathic pain in mice. The role of l-arginine-NO-cGMP-K⁺ was assessed by the von Frey and the Randall-Selitto tests. Both allodynia and hyperalgesia assessments were carried out on the 14th day post CCI, 30 min after treatments were given for each respective pathway. Anti-allodynic and antihyperalgesic effects of zerumbone (10 mg/kg, i.p) were significantly reversed by the pre-treatment of l-arginine (10 mg/kg), 1H [1,2,4]Oxadiazole[4,3a]quinoxalin-1-one (ODQ), a soluble guanosyl cyclase blocker (2 mg/kg i.p.) and glibenclamide (ATP-sensitive potassium channel blocker) (10 mg/kg i.p.) (p < 0.05). Taken together, these results indicate that systemic administration of zerumbone produces significant anti-allodynic and antihyperalgesic activities in neuropathic pain in mice possibly due to involvement of the l-arginine-NO-cGMP-PKG-K⁺ ATP channel pathways in CCI model.
    Matched MeSH terms: Constriction
  4. Fulltext White cord syndrome: A devastating complication of spinal decompression surgery
    Vinodh VP, Rajapathy SK, Sellamuthu P, Kandasamy R
    Surg Neurol Int, 2018;9:136.
    PMID: 30090668 DOI: 10.4103/sni.sni_96_18
    Background: Reperfusion injury of the spinal cord or "white cord syndrome" refers to the sudden onset of neurological deterioration after spinal decompressive surgery. Associated magnetic resonance (MR) findings only include focal hyperintensity on T2-weighted images without any other pathological changes.

    Case Description: A patient with cervical stenosis secondary to metastatic tumor in the intradural and extradural compartments presented with lower limb paraparesis. She underwent an uneventful tumor excision accompanied by posterior cervical decompression and fusion. Postoperatively, she was quadriplegic and required ventilator support. The emergent postoperative MR scan revealed focal hyperintensity on the T2-weighted image consistent with spinal cord edema extending into the lower brain stem.

    Conclusion: Very few cases of reperfusion injury of the cervical spinal cord or "white cord syndrome" are described in the literature. Here we present a patient who, following cervical laminectomy and fusion for excision of metastatic tumor, developed quadriplegia. Notably, postoperative MR showed only findings of upper cervical cord and lower brain stem edema consistent with a "white cord syndrome" without other compressive pathology.

    Matched MeSH terms: Constriction, Pathologic
  5. Fulltext Wellen's syndrome: Challenges in diagnosis
    Agarwal A, Vyas S, Kumar R
    Malays Fam Physician, 2015;10(3):35-7.
    PMID: 27570607
    Wellen's syndrome is a pre-infarction stage of coronary artery disease characterised by predefined clinical and electrocardiographic (ECG) criteria of a subgroup of patients with myocardial ischaemia. Early recognition and appropriate intervention of this syndrome carry significant diagnostic and prognostic value. We report this unusual syndrome in an elderly man who presented with recurrent angina and characteristic ECG changes as T-waves inversion in the precordial leads, especially in V2-V6 during pain-free periods and ECG obtained during episodes of pain demonstrating upright T-waves with possible elevated ST segments from V1-V4. Cardiac enzymes were positive and coronary angiography revealed critical stenosis in the proximal left anterior descending artery. It is important to timely identify this condition and intervene appropriately as these patients may develop extensive myocardial infarction that carries a significant morbidity and mortality.
    Matched MeSH terms: Constriction, Pathologic
  6. Virtual Bronchoscopic Navigation Guided Recanalization of Chronic Total Post-Tuberculosis Bronchial Stenosis
    Kho SS, Nasaruddin MZ, Abdul Rahaman JA
    Arch Bronconeumol, 2022 Nov;58(11):768-769.
    PMID: 35606265 DOI: 10.1016/j.arbres.2022.05.003
    Matched MeSH terms: Constriction, Pathologic/etiology; Constriction, Pathologic/surgery
  7. Fulltext Videolaryngoscope-assisted fibreoptic tracheal intubation in a young adolescent with hunter syndrome for posterior cervical fusion
    Zabir, A.F., Frawley, G., Squire, P.
    Journal of Surgical Academia, 2013;3(2):92-96.
    MyJurnal
    We here describe a videolaryngoscope assisted fibreoptic tracheal intubation in a 17-year-old patient with Hunter Syndrome (Mucopolysaccharidosis Type II) and known difficult intubation who required posterior cervical fusion surgery for cervical canal stenosis. The patient had a history of failed nasal and oral fibreoptic intubation. The use of a videolaryngoscope enabled continuous visualization of the tracheal inlet and allowed a straightforward nasal fibreoptic intubation attempt without complications. This report suggests a viable alternative for the management of a known difficult airway in children with mucopolysaccharidosis.
    Matched MeSH terms: Constriction, Pathologic
  8. Velopharyngeal and choanal stenosis after radiotherapy for nasopharyngeal carcinoma
    Hussein J, Tan TS, Chong AW, Narayanan P, Omar R
    Auris Nasus Larynx, 2013 Jun;40(3):323-6.
    PMID: 22652485 DOI: 10.1016/j.anl.2012.05.004
    Choanal stenosis is a well recognized late complication of radiotherapy for nasopharyngeal carcinoma. However velopharyngeal stenosis post radiotherapy for nasopharyngeal carcinoma is rare. We present here a case of bilateral choanal stenosis and velopharyngeal stenosis in a patient treated with radiotherapy for nasopharyngeal carcinoma. A 58-year-old woman presented to our otolaryngology clinic with a one year history of nasal obstruction. She was diagnosed to have nasopharyngeal carcinoma 12 years ago for which she received radiotherapy. Clinical examination revealed bilateral choanal stenosis and velopharyngeal stenosis. Treatment of choanal stenosis and velopharyngeal stenosis is challenging due to high incidence of recurrence and patients frequently require multiple procedures. The patient underwent a transnasal endoscopic excision of velopharyngeal scar tissue and widening of posterior choana using Surgitron®, mitomycin-C applied topically to the surgical wound and bilateral stenting under general anesthesia. The stents were kept for two weeks, and 3 years post operation velopharyngeal aperture and posterior choana remained patent. As illustrated in this case velopharyngeal stenosis can occur after radiotheraphy and should not be overlooked. Combine modality of transnasal endoscopic excision of velopharyngeal scar tissue, widening of choanal stenosis with Surgitron® followed by the application of mitomycin-C and stenting has been shown to be an effective option.
    Study site: ENT clinic, University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Constriction, Pathologic/etiology; Constriction, Pathologic/physiopathology; Constriction, Pathologic/surgery
  9. Fulltext Ureteral stricture formation after ureteroscope treatment of impacted calculi: a prospective study
    Fam XI, Singam P, Ho CC, Sridharan R, Hod R, Bahadzor B, et al.
    Korean J Urol, 2015 Jan;56(1):63-7.
    PMID: 25598938 DOI: 10.4111/kju.2015.56.1.63
    Urinary calculi is a familiar disease. A well-known complication of endourological treatment for impacted ureteral stones is the formation of ureteral strictures, which has been reported to occur in 14.2% to 24% of cases.
    Matched MeSH terms: Constriction, Pathologic/diagnosis*
  10. Unusual presentation of pheochromocytoma with ischemic sigmoid colitis and stenosis
    Tan F, Thai AC, Cheah WK, Mukherjee JJ
    South. Med. J., 2009 Oct;102(10):1068-70.
    PMID: 19738530 DOI: 10.1097/SMJ.0b013e3181b571e6
    A 45-year-old woman with poorly controlled hypertension and diabetes mellitus presented with left iliac fossa pain, constipation alternating with diarrhea, and weight loss. She had been diagnosed with idiopathic cardiomyopathy five years previously. Echocardiogram had shown a left ventricular ejection fraction (LVEF) of 35%; coronary angiogram was normal. Colonoscopy revealed sigmoid colitis with stenosis. Abdominal computed tomography revealed a 5 cm right adrenal tumor. Twenty-four hour urinary free catecholamines and fractionated metanephrine excretion values were elevated, confirming pheochromocytoma. Her colitis resolved after one month of adrenergic blockade. Repeat echocardiogram showed improvement of LVEF to 65%. After laparoscopic right adrenalectomy, the patient's hypertension resolved, and diabetic control improved. Timely management avoided further morbidity and potential mortality in our patient.
    Matched MeSH terms: Constriction, Pathologic/etiology; Constriction, Pathologic/therapy
  11. Unsteady magnetohydrodynamic blood flow through irregular multi-stenosed arteries
    Mustapha N, Amin N, Chakravarty S, Mandal PK
    Comput Biol Med, 2009 Oct;39(10):896-906.
    PMID: 19665698 DOI: 10.1016/j.compbiomed.2009.07.004
    Flow of an electrically conducting fluid characterizing blood through the arteries having irregular shaped multi-stenoses in the environment of a uniform transverse magnetic-field is analysed. The flow is considered to be axisymmetric with an outline of the irregular stenoses obtained from a three-dimensional casting of a mild stenosed artery, so that the physical problem becomes more realistic from the physiological point of view. The marker and cell (MAC) and successive-over-relaxation (SOR) methods are respectively used to solve the governing unsteady magnetohydrodynamic (MHD) equations and pressure-Poisson equation quantitatively and to observe the flow separation. The results obtained show that the flow separates mostly towards the downstream of the multi-stenoses. However, the flow separation region keeps on shrinking with the increasing intensity of the magnetic-field which completely disappears with sufficiently large value of the Hartmann number. The present observations certainly have some clinical implications relating to magnetotherapy which help reducing the complex flow separation zones causing flow disorder leading to the formation and progression of the arterial diseases.
    Matched MeSH terms: Constriction, Pathologic/physiopathology*
  12. Fulltext Undiagnosed bicuspid aortic valve: a silent danger
    Ngow, H.A., Wan Khairina, W.M.N.
    International Medical Journal Malaysia, 2012;11(2):45-48.
    MyJurnal
    The normal aortic valve has three leaflets, which are almost equal in size. A bicuspid aortic valve developed as a result of abnormal aortic cusp formation during early embryogenesis. Complications such as valvular stenosis or incompetence are well known. Delayed in identifying the congenital abnormality or the complications may cause morbidity and mortality. We report two cases of congestive cardiac failure as the results of undiagnosed bicuspid aortic valve with severe aortic incompetence. Both young men in their productive age without cardiac risk factors, were unfortunate to present too late. Although one of them was lucky to survive the ordeal, most late presentation ends up gravely. Aortic valve replacement can be offered if early detection is made. Those with severe disease at diagnosis may require a heart transplant.
    Matched MeSH terms: Constriction, Pathologic
  13. Undiagnosed acute phase endobronchial tuberculosis with progression to irreversible tracheobronchial stenosis
    Abdullah H, Quek CZ
    BMJ Case Rep, 2017 Aug 07;2017.
    PMID: 28784877 DOI: 10.1136/bcr-2017-219877
    Matched MeSH terms: Constriction, Pathologic/microbiology
  14. Fulltext Treatment of multiple-level tracheobronchial stenosis secondary to endobronchial tuberculosis using bronchoscopic balloon dilatation with topical mitomycin-C
    Faisal M, Harun H, Hassan TM, Ban AY, Chotirmall SH, Abdul Rahaman JA
    BMC Pulm Med, 2016;16(1):53.
    PMID: 27080697 DOI: 10.1186/s12890-016-0209-1
    Tracheobronchial stenosis is a known complication of endobronchial tuberculosis. Despite antituberculous and steroid therapy, the development of bronchial stenosis is usually irreversible and requires airway patency to be restored by either bronchoscopic or surgical interventions. We report the use of balloon dilatation and topical mitomycin-C to successful restore airway patency.
    Matched MeSH terms: Constriction, Pathologic
  15. Treatment of chronic total occlusions in native coronary arteries by drug-coated balloons without stenting - A feasibility and safety study
    Köln PJ, Scheller B, Liew HB, Rissanen TT, Ahmad WA, Weser R, et al.
    Int J Cardiol, 2016 Dec 15;225:262-267.
    PMID: 27741486 DOI: 10.1016/j.ijcard.2016.09.105
    Chronic total occlusions remain one of the biggest challenges for interventional cardiologists and the high risk of restenosis and stent thrombosis is still a major problem. Drug-coated balloons showed favorable results for the treatment of in-stent restenosis and other lesion types. The aim of this study was to evaluate the feasibility and outcome of a drug-coated balloon only approach for chronic total occlusion.
    Matched MeSH terms: Constriction, Pathologic
  16. Fulltext Tracheal agenesis: a rare cause of unsuccessful tracheal intubation during resuscitation
    Iszuari M, Mazita A, Tan GC, Hayati AR, Shareena I, Cheah FC
    Med J Malaysia, 2010 Dec;65(4):317-8.
    PMID: 21901957
    Tracheal agenesis is a rare congenital airway anomaly that usually results in a fatal outcome. The diagnosis is usually made through post-mortem examination. In the current literature, there has been no reported long-term survival although a few reports claimed prolongation of life of several hours to days. This condition is commonly associated with premature birth, polyhydramnios and a male predominance. In 90% of the cases, it is associated with multiple cardiovascular, gastrointestinal and genitourinary tract anomalies which are incompatible with life. We report a case of a premature newborn with severe respiratory distress, absent cry and cyanosis soon after birth. Attempts at endotracheal intubation failed as it was no possible to negotiate the tube beyond the vocal cords. Needle cricothyrotomy and attempted tracheostomy also failed to secure the airway. The diagnosis was confirmed at post-mortem examination.
    Matched MeSH terms: Constriction, Pathologic/complications*
  17. Fulltext Total proximal ureter substitution using buccal mucosa
    Fahmy O, Schubert T, Khairul-Asri MG, Stenzl A, Gakis G
    Int J Urol, 2017 04;24(4):320-323.
    PMID: 28208217 DOI: 10.1111/iju.13307
    The surgical treatment of a long proximal ureteral stricture is a challenging situation for reconstructive surgeons. Despite the underlying morbidities, ileal interposition and autotransplantation are the options available to treat complex cases of long segment ureteral stricture. Buccal mucosa has shown excellent results in urethroplasty. However, its use in ureteral reconstruction is infrequent. We report on a 64-year-old female patient with multiple comorbidities and prior abdominal surgeries for Crohn's disease who underwent a successful total substitution of a long segment of the proximal ureter using buccal mucosa. Regular postoperative isotope scans showed improvement in renal function. Based on the pleasant outcome of this case and review of the literature, buccal mucosa might be a viable option with low morbidity in selected cases.
    Matched MeSH terms: Constriction, Pathologic/diagnosis; Constriction, Pathologic/surgery
  18. Fulltext Total pancreatectomy for diffuse pancreatic adenocarcinoma
    Azlanudin, A., Razman, J.
    Journal of Surgical Academia, 2011;1(1):39-41.
    MyJurnal
    A 64-year-old lady presented with a brief history of abdominal pain associated with obstructive jaundice. Endoscopic retrograde cholangiopancreaticography (ERCP) revealed a short segment stricture with contact bleeding and the brush cytology confirmed presence atypical cells. Ca 19.9 levels were markedly elevated. She was planned for a Whipple’s procedure but was instead subjected to a total pancreatectomy based on intraoperative findings of a diffusely hard and nodular pancreas. Histopathological examination confirmed our diagnosis of diffuse pancreatic adenocarcinoma. This rare presentation of a locally contained and fully resectable diffuse pancreatic adenocarcinoma is being discussed.
    Matched MeSH terms: Constriction, Pathologic
  19. Thromboangitis Obliterans involving Bilateral Upper limb Extremities - A Rare Case Report from Malaysia
    Murali U, Ahmad MAA, Najihah F
    J Clin Diagn Res, 2017 Mar;11(3):PD06-PD08.
    PMID: 28511446 DOI: 10.7860/JCDR/2017/23807.9507
    Thromboangitis Obliterans (TAO) or Buerger's disease is a non-atherosclerotic, occlusive, progressive and highly inflammatory disorder of distal arteries seen predominantly affecting the lower limb in smokers. TAO presenting itself in upper limb or bilaterally involving the upper limb is a very rare entity. We report on a rare case of TAO in a 46-year-old gentleman who presented with bilateral upper extremity digital gangrene with 18 pack-years of smoking. Brachial and radial pulses were palpable bilaterally and were of good volume but right ulnar pulse was faintly felt, while on the left side it was not appreciated due to malunion. Further Computed Tomography (CT)- angiography showed occlusion of distal right ulnar artery, stenosis of distal left ulnar artery with bilateral poor opacification of palmar and digital arteries. This case reports on the unusual and rare presentation of TAO in upper extremity involving both limbs. The case is reported for the first time from Malaysia.
    Matched MeSH terms: Constriction, Pathologic
  20. The utility of a 'non-significant' coronary angiogram
    Wang TK, Oh TH, Samaranayake CB, Webster MW, Stewart JT, Watson T, et al.
    Int J Clin Pract, 2015 Dec;69(12):1465-72.
    PMID: 26304046 DOI: 10.1111/ijcp.12723
    Coronary angiography is the gold standard for assessing coronary artery disease (CAD). In many patients with chest pain, no or mild CAD (< 50% stenosis) is found. It is uncertain whether this 'non-significant' result influences management and outcomes. We reviewed characteristics and outcomes in a contemporary cohort of chest pain referrals who had mild or absent CAD on coronary angiography.
    Matched MeSH terms: Constriction, Pathologic
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