MATERIALS AND METHODS: Seventy-five participants underwent MRE as an initial investigation or follow-up for inflammatory bowel disease. A systematic sampling method was used to divide the participants into three different groups: group 1 received 6.7% mannitol concentration, group 2 received 3.3% mannitol concentration and group 3 received pineapple juice as an oral contrast agent during their MRE examination. The degree of bowel distension on MRE images was assessed by a radiologist by measuring the bowel diameter from inner wall to inner wall at specified levels, while qualitative analysis was evaluated based on the presence of artefacts. All patients were asked to score their acceptance of the oral contrast and were asked about side effects such as diarrhoea, abdominal discomfort and vomiting.
RESULTS: All patients were able to completely ingest 1.5L of oral contrast. The mean diameter of bowel distension was 2.1cm in patients who received 6.7% mannitol concentration, 2.0cm in patients who received 3.3% mannitol concentration and 1.6 cm in patients who received pineapple juice. Twothirds of patients who received 6.7% mannitol and 3.3% mannitol solutions had good-quality MRE images, but 68% of patients who received pineapple juice had poor-quality MRE images. Twenty-four patients (96%) who received pineapple juice rated it as slightly acceptable and acceptable but only 12 patients (48%) who received 6.7% mannitol solution rated it as slightly acceptable and acceptable. Eighty-eight percent of patients who received 6.7% mannitol solution experienced at least one form of side effect as compared to 44% of patients who received 3.3% mannitol solution and 18% of patients who received pineapple juice.
CONCLUSION: Optimum small bowel distension and good image quality can be achieved using 3.3% mannitol concentration as an oral contrast agent. Increase in mannitol concentration does not result in significant improvement of small bowel distension or image quality but is instead related to poorer patient acceptance and increased side effects. Pineapple juice is more palatable than mannitol and produces satisfactory small bowel distension. However, the small bowel distension is less uniform when using pineapple juice with a considerable presence of artefacts. Mannitol, 3.3% concentration, is therefore recommended as an endoluminal contrast agent for bowel in MRE.
OBJECTIVE: Evaluate the metabolite variations and antioxidant activity among M. calabura leaves subjected to different drying methods and extracted with different ethanol ratios using proton nuclear magnetic resonance (1 H-NMR)-based metabolomics. Methodology The antioxidant activity of M. calabura leaves dried with three different drying methods and extracted with three different ethanol ratios was determined by using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and nitric oxide (NO) scavenging assays. The metabolites variation among the extracts and correlation with antioxidant activity were analysed by 1 H-NMR-based metabolomics.
RESULTS: Muntingia calabura leaves extracted with 50% and 100% ethanol from air-drying and freeze-drying methods had the highest total phenolic content and the lowest IC50 value for the DPPH scavenging activity. Meanwhile, oven-dried leaves extracted with 100% ethanol had the lowest IC50 value for the NO scavenging activity. A total of 43 metabolites, including sugars, organic acids, amino acids, phytosterols, phenolics and terpene glycoside were tentatively identified. A noticeable discrimination was observed in the different ethanol ratios by the principal component analysis. The partial least-squares analysis suggested that 32 compounds out of 43 compounds identified were the contributors to the bioactivities.
CONCLUSION: The results established set the preliminary steps towards developing this plant into a high value product for phytomedicinal preparations.