Balance and motor skills are essential prerequisites for physical development of a child. The aims of this study were to measure anthropometrics, postural balance and motor skills; and examine their correlation among healthy preschool children. Forty nine healthy preschool children aged between 3 to 4 years old participated from PERMATA preschool organization. Pediatric Balance Scale and Peabody Development Motor Scale-2nd Edition (PDMS-2) were administered to measure balance skills for both fine and gross motor skills respectively. Mann-Whitney U test demonstrated that there was no significant difference in balance (p=0.72) and motor skill (p=0.33) between boys and girls. Spearman correlation coefficient demonstrated that there was significant correlation between balance skills with height (r=0.45, p=0.001) and body mass index(r=0.47, p=0.001). No significant correlation was found between balance skills and motor skills (r=0.11, p=0.44). The present study suggests that balance skills in healthy preschool children aged 3-4 years old are correlated with their physical growth such as height and weight but not motor skills.
Adherence to antiretroviral therapy (ART) prevents disease progression, and the emergence of resistant mutations. It also reduces morbidity, and the necessity for more frequent, complicated regimens which are also relatively more expensive. Minimum adherence levels of 95% are required for treatment success. Poor adherence to treatment remains a stumbling block to the success of treatment programs. This generates major concerns about possible resistance of the human immunodeficiency virus (HIV) to the currently available ARVs. This paper aims to describe baseline results from a cohort of 242 Malaysian patients receiving ART within the context of an intervention aimed to improve adherence and treatment outcomes among patients initiating ART. A single-blinded Randomized Controlled Clinical Trial was conducted between January and December, 2014 in Hospital Sungai Buloh. Data on socio-demographic factors, clinical symptoms and adherence behavior of respondents was collected using modified, pre-validated Adult AIDS Clinical Trials Group (AACTG) adherence questionnaires. Baseline CD4 count, viral load, weight, full blood count, blood pressure, Liver function and renal profile tests were also conducted and recorded. Data was analyzed using SPSS version 22 and R software. Patients consisted of 215 (89%) males and 27 (11%) females. 117 (48%) were Malays, 98 (40%) were Chinese, 22 (9%) were Indians while 5 (2%) were of other ethnic minorities. The mean age for the intervention group was 32.1 ± 8.7 years while the mean age for the control group was 34.7 ± 9.5 years. Mean baseline adherence was 80.1 ± 19.6 and 85.1 ± 15.8 for the intervention and control groups respectively. Overall mean baseline CD4 count of patients was 222.97 ± 143.7 cells/mm³ while overall mean viral load was 255237.85 ± 470618.9. Patients had a mean weight of 61.55 ± 11.0 kg and 61.47 ± 12.3 kg in the intervention and control groups, respectively. Males account for about 90% of those initiating ART in the HIV clinic, at a relatively low CD4 count, high viral load and sub-optimal medication adherence levels at baseline.
Mesenchymal stem cells (MSCs) hold a great therapeutic potential for regenerative
medicine and tissue engineering due to inherent immunomodulatory and reparative properties. Hence,
it necessitates a readily available supplyof MSCs to meet the clinical demands adequately. Although,
a human placenta can produce MSCs, the in vitro culture-mediated cellular senescence often affect the
quality of cell product. Thus, the current study has explored the feasibility of basic fibroblast growth
factor (bFGF) to enhance the growth of placenta-derived MSCs (PLC-MSCs). Methods:The basic
fibroblast growth factor (bFGF) was supplemented to optimise the growth of MSCs. The effects of
bFGF on morphology, growth kinetics and cytokine secretion of PLC-MSCs were assessed. Results:
The bFGF supplementation increased the proliferation of PLC-MSCs in a dose-dependent manner and
40 ng/ml showed a high trophism effect on PLC-MSC’s growth. In the presence of bFGF, PLC-MSCs
acquired a small and well-defined morphology that reflect an active proliferative status. BFGF has
induced PLC-MSCs to achieve a shorter doubling time (45 hrs) as compared to the non-supplemented
PLC-MSCs culture (81 hrs). Furthermore, bFGF impelled PLC-MSCs into cell cycle machinery where
a substantial fraction of cells was driven to S and G2/M phases. Amongst, 36 screened cytokines, bFGF
had only altered the secretion of IL-8, IL-6, TNFR1, MMP3 and VEGF. Conclusion:The present study
showed that bFGF supplementation promotes the growth of PLC-MSCs without significantly deviating
from the standard criteria of MSCs. Thus, bFGF could be considered as a potential mitogen to facilitate
the large-scale production of PLC-MSCs.
Introduction: Cholera is an infection caused by the bacterium Vibriocholerae that causes severe watery diarrhoea, which can lead to dehydration. Beet-roothas been shown to induce favourable outcomes and holds promise as an economic, practical natural dietary intervention in cholera. Methods: Systematic search of peer-reviewed literature on beet-root ORS and carrot ORS use for acute diarrhoea in below 6-year-old. We identified 3 studies for abstraction. Results: A study had compared a commercial carrot/rice-based ORS A (Na 52 mmol/L) and two glucose-based ORS B (Na 55 mmol/L) and C (Na 90 mmol/L). Fluid intake, faecal and urine output and absorption of fluid was measured in 161 infants and children (3-48 months old) during the first 48 hours after admission. The number of stools (p < 0.01) and the mean faecal output (p < 0.05) per kg body weight were significantly lower in group A. Children in group A also had significantly (p < 0.01) greater fluid absorption (mean 464 ml/kg) than in groups C (312 ml/kg) and B (140 ml/kg). Conclusions: While there are some promising results, this analysis indicates that the need for further investi- gation into approaches to increasing beet-root ORS and carrot ORS use.
Introduction: Crisis communication is an important skill for healthcare professionals, especially during disaster peri- od including the current 2019-nCoV pandemic. Nevertheless, the skill of crisis communication is not commonly an integral part of Malaysian nursing diploma and degree course. Methods: A half days session on how to communicate in the context of crisis was incorporated into an experiential learning workshop to 25 existing and newly recruited nurses together with 7 other healthcare professionals. The topics of nature of disaster, disease outbreak, preparation for disaster, principles and responsibility of crisis communication, preparing statement for press conference, and corporate communication were covered through brief lecture, round table discussion and tabletop simulations. Real time example of 2019-nCoV crisis communication was used to illustrate the skills required in the situation. Results: All participants confirmed that this was the first exposure to hands-on training on crisis communication and enlightening although majority of them were uncertain that they are capable to perform it during the crisis despite the ongoing 2019-nCoV issue in view of their the position that they are holding. Most nursing curriculums focus on clinical theory and clinical skill competency acquisition without addressing the need of learning how to commu- nicate beyond clinical setting in the situation of disaster and panic, which is mostly learned at job. The limitation included the practice in tabletop simulations might not be immediately translatable into real life practice. Conclu- sion: Regular reinforcement through more workshops and incorporation into disaster may potentially be a solution to improve the competency of healthcare professionals in crisis communication. Further assessment on the practice of the participants in performing crisis communication is needed to ensure the competency level has been achieved and to evaluate the efficiency of the workshop delivery method.
Introduction: Public transit is a sustainable transport mode that can improve the health and well-being of urban population. Following the development of mass rapid transits (MRT) in Greater Kuala Lumpur, this study aims to em- pirically test the behavioral framework behind the intention to use rail transport among private motor vehicle users. Methods: Data was obtained through a cross sectional travel survey (N=509) conducted on the catchment popula- tion of an upcoming MRT line in Greater Kuala Lumpur. The factors in the hypothesized framework were service quality, environmental health concerns, attitude and the intention to use. The data was modeled using the Maximum Likelihood (ML) estimation in structural equations. Results: The validated model indicated that service quality and environmental health concerns significantly affected respondents' intention to use rail transport, mediated by attitude. Reliability, convenience and comfort were the most valued service qualities, while environmental concerns were more valued than health concerns. There were significant moderation by age, income, and having children below 18 years old on the framework. Higher age groups valued more on service quality, while attitude had larger determin- ing effects on the higher income groups. Besides, the lower direct effect of service quality on attitude among higher income groups implied possibility of other affective factors for the subgroup. Conclusion: This study demonstrated the importance of service quality, attitude, and environmental health concerns in encouraging rail transport usage among private motor vehicle users. Certain subpopulations may be targeted for promotion strategies to improve rail transport use in the city.
Beta (β)- thalassaemia is a public health problem in Malaysia. The carrier rate is estimated to be 4.5% by micro-mapping studies particularly among Malays who comprise 53.5% of the population in Malaysia. The common diagnostic method in Malaysia for mutation detection is by amplification refractory mutation system (ARMS). It allows single mutation detection in each reaction but is labour intensive and time consuming when many mutations need to be identified. The purpose of this study was to develop a diagnostic tool for effective mutation detection of beta thalassaemia in Malay patients and compare its efficacy with ARMS-PCR, the current method in use. Methods: Reverse dot blot hybridization (RDBH) technique was incorporated in the development of two strip assays [RDBH-Strip M(6) and RDBH-Strip C(6)] to identify common beta thalassaemia mutations in the Malays. The panels of selected mutations were based on the mutation frequencies in Malaysia reported in previous studies. RDBH-Strip M(6) was applied as step 1 and RDBH-Strip C(6) was applied as step 2 for unidentified mutations. The strips were validated with the gold standard method, ARMS- PCR. Results: One hundred and thirty seven Malay patients with 274 alleles were studied. In Step 1 mutation detection, 238 alleles (86.9%) were identified in 119 of patients by RDBH-Strip M(6). Step 2 resulted in a further detection of 20 alleles in another 10 patients by RDBH-Strip C(6). The combination of both strips resulted in the identification of 258 alleles in 129 (94.6%) of 137 Malay patients. The strip assays were 100% sensitive and specific when compared with ARMS-PCR method. Conclusion: Two strip assays utilising the RDBH technique were developed to identify common β-thalassaemia mutations in Malays. The RDBH Strip M(6) identified 86.9% of the mutations and the RDBH-Strip C (6) detected further 7.3% alleles. This two step strategy was found to be rapid and cost effective for the direct diagnosis of β-thalassaemia mutations in the Malays. The remaining unidentified mutations would require DNA sequencing. It can serve as a specific molecular diagnostic tool for effective diagnosis of
β-thalassaemia mutations in this ethnic group.
Introduction: This study reported the concentration of bacterial and fungal bioaerosol at an animal house and hospi- tal laboratories with the aim to compare the concentration levels at library and administrative offices. The bioaerosol levels between mid-shift (afternoon) were also compared to the concentration measured during pre-shift (morning). Methods: The NIOSH 0800 method utilising microbiological air sampler collecting airborne bacterial and fungal samples via impaction technique on Nutrient agar (NA) and Sabouraud Dextrouse agar (SDA) as culture medium, respectively. Sampling was done twice daily; before (pre-shift) and during working (mid-shift) hour. Results: The highest bacteria and fungi concentration was recorded at the animal house with median concentration of 2477 CFU/ m3 (IQR=121-2477) and 791 CFU/m3 (IQR = 379-2081), respectively. Higher-risked workplaces such as animal house and hospital laboratories have significantly higher bioaerosol concentrations compared to control workplaces such as library and administrative offices (p
Despite increasing interest in in nutraceuticals and their potential health benefits, not much is known about bioavailability of most of these nutraceutical compounds. Although they are considered dietary supplements and are subjected to a limited form of regulation, there is, however, a need to improve the efficacy and safety of these nutraceuticals. Additional research which defines the pharmacology, stability and bioavailability of these products is expected to gain strength and may offer a better understanding of their applicability in the prevention of disease conditions. This article reviews some aspects of nutraceutical bioavailability with examples from our work on the absorption studies of minerals from spirulina (Arthrospira plantensis) and gamma-oryzanol from rice bran (Oryza sativa) extract which employed human colon carcinoma (Caco-2) cell line and in vivo bioassays using animal models. Bioavailability of iron from spirulina was compared with its common source FeS04. Using the in vitro digestion protocol in combination with Caco-2 cell culture system, spirulina showed a high iron bioavailability compared to FeS04. The presence of other dietary factors (calcium, ascorbic acid, zinc, tannin and caffeine) was found to be not as significant as ferrous sulphate in affecting the iron uptake from spirulina. In vivo study showed that the efficacy of iron repletion in anaemic rats was enhanced in groups fed either commercial or cultured spirulina with improved haematological parameters of iron status. Further work on the behaviour and distribution of radiolabelled iron from spirulina has shown that iron-59 retained in the GIT of mice was lower in spirulina group compared to FeS04. Bioavailability study of gamme oryzanol was similarly conducted using Caco-2 cell as in vitro system and rabbit as in vivo model with the application of different formulations of gamma oryzanol in comparison with the natural form. Both systems showed that gamma oryzanol in its natural oil was poorly absorbed. However, when converted to other formulations, gamma oryzanol bioavailability was greatly increased by as much as 200 and 33 times more from the emulsion and microspheres respectively. These findings suggest that the efficacy of nutraceuticals in particular plant derived products which contain many phytochemicals should be assessed in terms of not only their potential health benefits such as antioxidant action but also their bioavailability in order to provide a more wholesome picture of their potential.
Introduction: Statins have several pleiotropic effects including its primary effect of lipid lowering that is important to prevent cardiovascular disease (CVD). Subjects often have heterogeneous responses to statin. This study aims to determine the biochemical effects of statins on lipid parameters among newly diagnosed dyslipidaemia subjects.
Methods: This was a prospective observational study involving 118 newly diagnosed adults with dyslipidaemia from three government health clinics in Selangor, Malaysia. Biochemical analyses including fasting lipid profile [triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)] and apolipoproteins (apoA1, apoB) were taken at baseline and follow-up after a month on statin.
Results: Majority of subjects (61.9%) were prescribed with lovastatin, with the rest on simvastatin. At baseline, the median values for all lipid profile parameters (TC, LDL-C, HDL-C) and non-conventional lipid parameters (LDL-C:HDL-C ratio, non-HDL-C, TC:HDL-C ratio, apoB:apoA1 ratio) were deranged except for TG and apoA1. On follow up, all parameters showed median values within the reference range except for HDL-C, non-HDL-C and TC:HDL-C ratio. There was significant difference in the effect of statins on lipid parameters including predictors of cardiovascular risk, simvastatin having better effects.
Conclusions: Different statins have varying effects on lipid parameters. Simvastatin showed significantly better effects compared to lovastatin. Non-HDL value should be included in the standard lipid profile report given its ease of use and implementation as it’s both a marker of coronary artery disease (CAD) risk stratification as well as an established determinant of goal attainment during therapy.
Introduction: One of the most common aetiology of opportunistic fungal infections in humans is Candida species. The virulence of Candida species is due to repertoire of factors, specifically, the ability to form biofilms. Medical devices such as intravenous catheters, prosthetic heart valves and surgical interventions provide pathogenic microorganisms with a surface to adhere to form biofilm. Fungi present as biofilms are often resistant to antifungal treatment because these biofilms offer a protective barrier that prohibits the drugs to get to the active site of the fungi. The objective of this study is to investigate the biofilm architecture of Candida rugosa (C.rugosa) at different developmental phases and to identify Sessile Minimum Inhibition Concentrations (SMICs) of amphotericin B, caspofungin, fluconazole, and voriconazole for the biofilm of C. rugosa. Methods: Confocal scanning laser microscopy (CSLM) and scanning electron microscopy (SEM) were used to visualize C. rugosa biofilms at different developmental phases. The antifungal susceptibility test was performed using serial doubling dilution. The growth kinetics of Candida biofilms was quantified using XTT reduction assay and crystal violet assay. Results: From the antifungal susceptibility test, the biofilms had SMIC of >16μg/mL for amphotericin B, 6µg/mL for caspofungin, >64μg/mL for fluconazole and >16μg/ mL for voriconazole. From the SEM micrographs, C. rugosa biofilm have a structure composed of an adherent yeast cells and blastopores with hyphal elements. There were significant alterations in the morphology after exposure to antifungal agents. The quantitative measurement of the matrix thickness of embedded yeast cells were obtained from CLSM micrographs. Conclusion: In conclusion, the ability of C. rugosa to form biofilms may attribute to one of the virulence factors that causes reduced susceptibility to antifungal agents.
Introduction: A study on biological monitoring of lead on children was conducted when unleaded gasoline was widely used in 1998. The objectives were to monitor lead exposure using blood lead, urine d-aminolevulinic acid (d-ALA) and urine lead concentrations as biological indicators and to determine the relationship between these variables.
Methodology: Two hundred and sixty-nine school children, 169 from an urban school of Kuala Lumpur and 100 from an industrial school in southern Malaysia were selected for the study. These were Malay children in the age range of 61/2 to 81/2 years old. Blood and urine lead concentrations were analyzed using the Graphite Furnace Atomic Absorption Spectrophotometer. Urine d-ALA was measured with Spectrophotometer UV/VIS.
Results: The mean blood lead concentrations of the urban children (3.56 mg/dl) and the industrial children (3.75 mg/dl) were not significantly different (p=0.451). The urine d-ALA (urban=9.606; industrial=6.965 mg/g creatinine) and urine lead (urban=2.625; industrial=4.548 mg/g creatinine) of the urban children were significantly higher than the industrial children (p=0.014: p 10 mg/dl. About 78% of the urban children and 76% of the industrial children have urine d-ALA in a normal range (<0.6 mg/100ml) while 22% of the urban children and 24% of the industrial children were in the acceptable range (0.6 - 2.0 mg/100ml). All the children had normal urine lead concentrations (<8 mg/100ml).
Conclusion: These children were not highly exposed to lead as indicated by their blood lead, urine d-ALA and urine lead concentrations which were below the allowable standard in both study areas . This may be due to the total ban on leaded gasoline in the country since 1998 and as a result, the environmental lead exposure in these areas was quite low.
Keywords: Children's lead exposure, blood lead, urine lead, urine d-ALA
Introduction: The increasing prevalence of depression has been a major public health concern. Being a marginalized population put the inmates at risk of depression. The main objective of this study was to identify the determinants of depression among the inmates according to the biopsychosocial model. Methods: A cross sectional study involv- ing 460 male inmates was conducted at a medium security prison in Seremban. Only Malaysian adult prisoners who have been convicted and had spent a minimum of three months in the prison were eligible for the study. They were selected using the probability proportional to size using stratified random sampling. Data was collected using validated and pre-tested questionnaire by face-to-face interviews, with depression was measured using the Center for Epidemiologic Studies Depression (CES-D) Scale. The data were analyzed using IBM SPSS version 22 with a p-value less than 0.05 was considered statistically significant. Results: The results showed prevalence of depression were 40.70% (95% CI: 36.21-45.19) with its development being predicted by presence of communicable disease (AOR=2.145, 95% CI: 1.123-4.095), history of childhood abuse (AOR=1.762, 95% CI: 1.045-2.972), sentences of more than 5 years (AOR=3.801, 95% CI: 1.529-9.450), being non-Muslims (AOR=2.261, 95% CI: 1.461-3.497) and perceived stress (AOR=4.007, 95% CI= 2.610-6.151). Conclusions: This study revealed an alarmingly high preva- lence of depression among the male inmates, with stress being the strongest risk factor. Reintegration of the prisoners into the community should be considered as part of the rehabilitation program to ensure continuation of psychiatric care and reduce relapsing.
Introduction: Childhood obesity becomes a global epidemic with the majority are living in developing countries. Obese children are at risk of becoming obese adults with non-communicable diseases, which may further lead to huge economic burden for the affected countries. The study objectives were to determine the biosocial background contributing overweight and obesity among preschoolers in Putrajaya (2017) - sociodemographic, pre-and perinatal factors, feeding and weaning practices. Methods: Cross-sectional study was performed using cluster random sampling among 897 preschoolers, whose anthropometric body weights and heights were measured. The calculated BMI was used to determine their obese status based on WHO Growth Standards 2006 and Reference 2007. Their mothers were distributed with self-administered, validated, and pre-tested questionnaires regarding their children’s first two-years-of-life experience. Chi Square test was used for bivariate categorical analysis, Independent T-test and Mann Whitney U test for continuous data analysis. Multivariate binary logistic regression was executed to determine predictors of child obesity. Results: The prevalence of obese children was 7.4%, which can be predicted by the increase in child’s age (Adjusted Odd Ratio: 2.619; 95%CI: 1.435 – 4.780), mothers with higher level of education (AOR: 3.896; 95%CI: 1.127 – 13.470), and higher maternal BMI (AOR: 1.132; 95%CI: 1.057 – 1.213). Conclusion: Three predictors of child obesity can be derived from sociodemographic and pre-and perinatal factors. Further application on these predictors in more targeted interventions and policies need to be considered to reduce the prevalence of obesity and related non-communicable diseases in the country.
Introduction: Chemical pesticide is commonly used among vegetable family farmers in Sabah. There is no system to monitor adverse health effects. This study is to determine the blood cholinesterase activity and associated factors among vegetable family farmers. Methods: A cross sectional study has involved 163 farmers aged 18-60 years old. Validated questionnaire was used to assess the associated factors. Lovibond AF267 Cholinesterase Kit was used to determine the blood cholinesterase activity. Chi square test was used to determine the association between blood cholinesterase activity and socio demographic factors and work practices. Results: Approximately 23.3% of study sample had low blood cholinesterase activity. There were significant associations between low blood cholinesterase activity with older age group (p
Introduction: The Ministry of Health Malaysia over the last 20 years has initiated healthy lifestyle campaign to curb obesity but the issue has remained an escalating problem affecting Malaysians. Obesity among students in higher institute is a concern. Undergraduate student nurses as role-model advocating health, being overweight can be a problem. This study is to identify BMI status and determine associated lifestyle factors among undergraduate nurses in UMS. Methods: The study deployed a cross-sectional descriptive survey using a questionnaire to empirically asses BMI status and associated dietary and exercise practice among student nurses. Ethical clearance for the study was ob- tained from UMS`s REC and as well as respondents` consent. A total of 100(N) nursing students were selected through stratified sampling by year of study (year 1, n=35; year 2 n=35; and year 3 n=30). Random sampling for each year of study was done using full name list generated using Microsoft excel. The study tool consists of a validated instrument which captured the respondent’s demographics, BMI index, Healthy Eating Practice Index, and Exercise Practice Inventory. Results: Among the 100 student nurses in this study, 28 students had BMI index of more than 24.9 (either being overweight, obesity Type I or Type II). Students from finalYear 3are significantly overweight(p=0.03) compared to Year 1 or Year 2 students. Comparing respondents with optimum BMI and non-optimum BMI, students who are overweight had significantly poorer Healthy Eating Practice scores and poorer Exercise practice scores. Conclusion: Findings from this study imply that 1 in 4 nursing students are overweight mostly related to poor lifestyle habits. These findings raise the rhetoric and implication of overweight nurses as health care role -models and this paper will discuss some suggestions to address the issue.
Introduction: Prevention of osteoporotic fracture requires identification of individuals at high risk. Bone mineral
density(BMD) is commonly used to estimate fracture probability despite inadequate predictive discrimination ability.
Sphingosine-1-phosphate(S1P), a new marker of bone metabolism and bone turnover markers(BTM) such as procollagen-type-1 amino-terminal propeptide(P1NP) and C-terminal telopeptide of type I collagen(CTX) may complement
current assessment. The study determined P1NP, CTX and S1P levels and their correlation with BMD, 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone(PTH) in selected subjects. Method: A cross-sectional study involving
Malaysian Chinese men and women aged 50-90 years old from Puchong and Kajang, Selangor. Each subject had
BMD determined by dual-energy x-ray absorptiometry and blood samples taken for 25(OH)D, PTH, P1NP, CTX and
S1P. Results: A total of 131 subjects [45(34.4%) males and 86(65.6%) post-menopausal women] with median age
of 65(IQR=17) were recruited. P1NP and CTX were significantly higher in post-menopausal women (P1NP=61.71
ng/ml, CTX=0.489 ng/ml) compared to men (P1NP=46.94 ng/ml, CTX=0.381 ng/ml). P1NP and CTX differed significantly according to BMD categories with values highest in osteoporosis. S1P between men (2.12±0.75 µmol/L) and
post-menopausal women (1.96±0.68 µmol/L) did not differ significantly and did not differ according to BMD categories. S1P did not correlate with BMD, P1NP, CTX and 25(OH)D. P1NP and CTX negatively correlated with BMD
at all measured sites but not 25(OH)D. Conclusion: CTX and P1NP, but not S1P negatively correlated with BMD.
CTX and P1NP were highest in those with osteoporosis. In this group of Malaysian Chinese subjects, CTX and P1NP
rather than S1P reflects bone health.
Mitragyna speciosa (Korth.) or kratom is a native medicinal plant of Southeast Asia. Commonly used by hard labours in harsh working environment, the ingestion of brewed kratom decoction is reported to produce dose-dependent stimulant and opioid-like effects. Kratom is also regularly consumed as a pain killer and as traditional cure for common maladies such as fever and cough. However, it remains unknown whether regular consumption of kratom decoction is associated with brain abnormalities in regular users in traditional settings. Methods: A total of 14 subjects (7 regular kratom users and 7 non-kratom users) voluntarily participated in this cross-sectional study. Face-to-face interviews were conducted with kratom users to determine history of kratom use and later these respondents underwent brain magnetic resonance imaging (MRI). Results: There were no significant differences (p>0.05) in the intracranial volume (ICV), cortical volumes (frontal, parietal, temporal, occipital, or cingulate lobe), or subcortical volumes (striatum, hippocampus, or amygdala), as well as in the diffusion tensor imaging (DTI) metrics, fractional anisotropy (FA) and mean diffusivity (MD) between kratom users and the controls. Conclusion: This preliminary study showed long-term consumption of kratom decoction is not significantly associated with altered brain structures in regular kratom users in traditional settings. However, further study is needed to establish more data for kratom use and its effects.
Introduction: Intracranial brain tumour like meningiomas and glioblastomas are most prevalent tumour. The metas- tasis to the brain is one of the major issues in the tumours of the central nervous system. The diagnosis of metastatic and primary brain tumour is incomprehensible with standard magnetic resonance imaging (MRI). The magnetic res- onance spectroscopy (MRS) is basically performed in standard clinical setting for diagnosing and tracking the brain tumour. Method: It is a retrospective study containing 53 patients with MRS. The patients with metastatic tumour (n=10), glioblastomas (n=8) and meningiomas (n=20) are included in the study. Single voxel technique is applied in the tumour core to determine the metabolites. The tumour N-acetyl aspartate (NAA), Choline (Cho), Creatine (Cr), Lactate, Alanine and lipids were analysed. The ratios of NAA/Cr, Cho/NAA and Cho/Cr were recorded and com- pared between the three tumours. The metabolites were detected between short echo time (TE) to long echo time (TE) during MRS. Results: There is a sharp fall of NAA peak in metastatic tumour. The resonance of creatine, lactate and alanine is higher in glioblastomas. A high lipid mean value of 3.13(0.17) is seen in metastatic tumour. The ROC curve shows a low NAA/Cr specificity of 46.7%, high sensitivity of 83.3% in Cho/NAA and Cho/Cr ratio. Conclusion: The metabolic profiles of metastatic brain tumour, glioblastomas and meningioma illustrate a divergence in their description that will assist in planning therapeutic and surgical intervention of these tumours.
Phyllodes tumour (PT) of the breast is firstly described in literature as early as 1838. This article reports the youngest recorded case of giant complicated PT and the role of toilet mastectomy as a salvage surgery. A 19-year-old lady presented with a gigantic lump of the left breast for 6 months which was rapidly growing (20 x 20 cm) and complicated with a foul-smelling blackish discoloration of the breast skin and tissues. Toilet mastectomy was performed as a result. The specimen weighed 4.0 kg with histopathological report of the tumor being borderline phyllodes. Herein, we describe a case of PT, who presented with breast necrosis and we discuss its medico-social aspect of it.