METHODS/DESIGN: This open-labelled, randomised controlled trial (RCT) will randomly allocate patients into intervention and control groups. Ambulated Malaysian aged over 18 years and scheduled for elective surgery for (suspected) GC, will be included in this study. The intervention group will be given whey-protein-infused carbohydrate-loading drinks on the evening before their operation and 3 h before their operation as well as started on early oral feeding 4 h post-operatively. The control group will be fasted overnight pre-operation and only allowed plain water, and return to a normal diet is allowed when bowel sounds return post-operatively. The primary outcomes of study are length of post-operative hospital stay, length of clear-fluid tolerance, solid-food tolerance and bowel function. Additional outcome measures are changes in nutritional status, biochemical profile and functional status. Data will be analysed on an intention-to-treat basis.
TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03667755. Retrospectively registered on 12 September 2018; Protocol version: version 3 dated 27 September 2017.
METHOD: A cross-sectional study was conducted among 205 normal hearing adult participants with an age range between 25 and 54 years old. Hearing analysis with extended high-frequency pure-tone audiometry (PTA) and high-frequency DPOAE was carried out for all eligible participants. High-frequency presbycusis was considered to be present when the impairment of more than 25 dB occurs at higher than 8 kHz frequencies on both ears.
RESULTS: Prevalence of high-frequency presbycusis using extended PTA was 31.7 (95% CI: 25.3, 38.1) and using high-frequency DPOAE was 57.4 (95% CI: 50.7, 64.4). The sensitivity and specificity of high-frequency DPOAE in detecting high-frequency presbycusis were 72.3 and 49.3% respectively with positive predictive value of 39.8% and negative predictive value of 79.3%. The association between age and high-frequency presbycusis was significant based on high-frequency DPOAE (p = 0.029).
CONCLUSIONS: The prevalence of high-frequency hearing loss is higher with increasing in age. High-frequency DPOAE may be used as a screening tool followed by confirmation using extended PTA. The early detection of presbycusis is important so that measures can be taken to prevent more severe problems developing.
AIM OF THE STUDY: To assess the in vitro mutagenicity and in vivo genotoxicity of aqueous extract of V. officinalis leaves using a modified Ames test and rat bone marrow micronucleus assay according to OECD guidelines.
MATERIALS AND METHODS: In vitro Ames test was carried out using different strains of Salmonella (TA97a, TA98, TA100, and TA1535) and Escherichia coli WP2 uvrA (pKM101) in the presence or absence of metabolic activation (S9 mixture). For micronucleus experiment, male and female Sprague-Dawley rats (n = 6/group) were received a single oral daily dose of 500, 1000, and 2000 mg/kg of V. officinalis extract for three days. Negative and positive control rats were received distilled water or a single intraperitoneal injection of 50 mg/kg of cyclophosphamide, respectively. Following dissection, femurs were collected and bone marrow cells were stained with May-Grünwald-Giemsa solution for micronucleus assessment.
RESULTS: Ames test results demonstrated that 5, 2.5, 1.25 and 0.625 mg/ml of V. officinalis extract induced a significant mutagenic effect against TA100 and TA98 strains (with and without metabolic activation). Findings of the animal study showed there were no significant increase in the micronucleated polychromatic erythrocytes (MNPE) and no significant alterations in the polychromatic erythrocytes (PCE) to normochromatic erythrocytes (NCE) ratio of treated rats as compared with their negative control. Meanwhile, significantly increased in the MNPEs was seen in the cyclophosphamide-treated group only.
CONCLUSION: Aqueous extract of V. officinalis has mutagenic effect against TA98 and TA100 strains as demonstrated by Ames test, however, there is no in vivo clastogenic and myelotoxic effect on bone marrow micronucleus of rats indicating that the benefits of using V. officinalis in traditional practice should outweigh risks.