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Fulltext Retrospective study of predictors for foot ulceration among diabetic patients attending Kuala Langat Health Centre from 1999 to 2008

Faridah K, Azmi MT

Malaysian Journal of Community Health, 2009;15(2):43-59.
MyJurnal

Background : Foot ulcers and its complications are an important cause of morbidity and mortality in diabetes. The aim of this retrospective study is to determine the ulcer-free survival in diabetic foot and its relevant predictors in a cohort of diabetic patients in the primary health care setting.
Methods : Data of newly diagnosed diabetics (n=1121) who received treatment in five health centers in the district of Kuala Langat, Selangor between 1st January 1999 until the 30th June 2008 were studied. Information was gathered by reviewing patient’s medical records. All patients were followed until 31st December 2008. The duration of ulcer-free survival was measured from the date of being diagnosed as diabetic until the development of the ulcer.
Results : The total incidence of diabetic foot ulcer was 9.9% (n=111), with an average annual incidence of 1%. The total incidence of amputation was 1.2%. Mean age of being diagnosed having diabetic was 52+10.7 year old and mean age of being diagnosed having diabetic foot ulcer was 54.68+10.16 year old. The mean for overall ulcer-free survival was 99 months (95%CI:96-102). Male gender (LR=6.56; p=0.01), smokers (LR=3.94; p=0.04), low body mass index (LR=4.45; p=0.03), impaired renal function (LR=5.17; p=0.02) and long duration between follow-up (LR=25.10; p

Matched MeSH terms: Ulcer; Foot Ulcer
Cimetidine for chronic duodenal ulceration: short term clinical trial

Chelvam P, Zhmad Z

Med J Malaysia, 1979 Mar;33(3):274-6.
PMID: 392272
Matched MeSH terms: Duodenal Ulcer/drug therapy*
Clinical trials of intravenous tetracycline in traumatic and orthopaedic cases from the orthopaedic unit, General Hospital, Kuala Lumpur

Ismail AM

Med J Malaysia, 1963 Sep;18:59-63.
PMID: 14064300
Matched MeSH terms: Ulcer*
Fulltext Antiulcer properties of Kelulut honey against Ethanol-induced gastric ulcer

Latifah Saiful Yazan, Nurul Amira Zainal, Muhamad Firdaus Shyfiq Muhamad Zali, Gopalsamy, Banulata, Ling, Voon Fui, Aminah Suhaila Haron, et al.

Pertanika Journal of Science & Technology, 2018;26(1):121-132.
MyJurnal

Ulcers in the gastrointestinal tract refer to any appreciable depth of break in the mucosa lining that may involve submucosa. Common types of ulcer include peptic, gastric and duodenal ulcer, which may lead to chronic inflammation. Ulcers may be caused by excessive alcohol intake or prolonged use of non-steroidal anti-inflammatory drugs (NSAID), in addition to several other factors. Conventional medication such as Omeprazole (proton pump inhibitor) and Ranitidine (H2 blockers) for management of ulcers may cause severe side effects such as myelosupression and abnormal heart rhythm. This has driven researchers to explore the potential of natural products for management of ulcers with reduced side effects. Kelulut honey (KH) is a type of honey that is produced by stingless bees from the Trigona species. It is believed to have a lot of medicinal properties such as being antimicrobial, antioxidant and antidiabetic. Yet, no scientific study has been carried out on its antiulcer properties. This study was carried out to determine the antiulcer properties of KH. Eighteen male Sprague dawley rats (5 to 6 weeks old, weighing between 200 and 300 g) were divided into three groups (n=6). The groups were 1) normal control group (without ulcer, without KH), 2) positive control group (with ulcer, without KH) and 3) treatment group (with ulcer, treated with KH). The treatment, KH (1183 mg/kg), was given twice daily for 30 consecutive days by oral administration. On Day 31, the rats were induced with absolute ethanol (5 mL/kg) via oral administration after being fasted for 24 h and were sacrificed 15 min after the induction. The stomach was collected for macroscopic and histopathological evaluation. Pretreatment with KH significantly reduced (p

Matched MeSH terms: Duodenal Ulcer; Ulcer
Fulltext Atypical contact lens related corneal ulcer caused by pasteurella multocida

Fatin Hanisah, F., Umi Kalthum, M. N., Rona Asnida, N., Jemaima, C. H.

Journal of Surgical Academia, 2018;8(1):43-46.
MyJurnal

A 55-year-old healthy lady with history of regular contact lens (CL) use presented with 10 days history of
progressive left eye blurring of vision, redness and pain. There was good CL hygiene practiced with no history of
swimming, trauma or contact with domestic pets. Left eye vision was hand movement and right eye was 1/60,
pinhole 6/18. On the left eye, there was a central, oval-shaped corneal infiltrate with an overlying large epithelial
defect and stromal oedema, with significant anterior chamber cells and fibrin. B-mode ultrasound showed no vitritis.
Intensive topical benzylpenicillin 10000iu/ml and topical gentamycin 1.4% hourly, homatropine 2% three times
daily, oral doxycycline and oral ascorbic acid were started. The gram stain results showed gram positive cocci
growth. Her ulcer improved with the treatment and preservative-free dexamethasone 0.1% once daily was
commenced to reduce inflammation and scarring. Interestingly, culture was reported as Pasteurella maltocida, a
gram negative bacilli sensitive to penicillin, and so treatment was continued until the ulcer completely healed. She
had central corneal scarring with best corrected vision of 6/24 in the left eye but was not keen on further surgery to
improve her vision. Although it has not been previously reported, Pasteurella multocida can cause CL related
corneal ulcer with severe anterior chamber inflammation. This diagnosis should be considered even if there is trivial
contact or no history of exposure to domestic animals.

Matched MeSH terms: Corneal Ulcer; Ulcer
Fulltext The global burden of decubitus ulcers from 1990 to 2019

Zhang X, Zhu N, Li Z, Xie X, Liu T, Ouyang G

Sci Rep, 2021 11 05;11(1):21750.
PMID: 34741095 DOI: 10.1038/s41598-021-01188-4

There are no studies assessing the epidemiology and burden of decubitus ulcers at global, regional, and national levels. We aim to report this issue from 1990 to 2019 by extracting data from the Global Burden of Disease Study (GBD) 2019 and stratifying it by age, gender, and socio-demographic index (SDI). Globally, the number of prevalent cases of decubitus ulcers in 2019 is 0.85 (95% UI 0.78 to 0.94) million. The age-standardized rates of prevalence, incidence, and years lived with disability (YLDs) in 2019 are 11.3 (95% UI 10.2 to 12.5), 41.8 (37.8 to 46.2), and 1.7 (1.2 to 2.2) per 100,000 population, and compared with 1990, it has decreased by 10.6% (95% UI 8.7% to 12.3%), 10.2% (8.2 to 11.9%), and 10.4% (8.1 to 12.5%), respectively. In addition, the global prevalence rate of decubitus ulcers increases with age, peaking at the > 95 age group among men and women. At the regional and national levels, we observe a positive correlation between age-standardized YLDs and SDI. Malaysia, Saudi Arabia, and Thailand experienced the most significant increases in age-standardized prevalence rates at the national level. Finally, we concluded that the age-standardized prevalence, incidence, and YLDs rates of decubitus ulcer declined from 1990 to 2019, with significant regional differences. In order to monitor the dynamic changes of decubitus ulcers burden, it is recommended to improve the quality of decubitus ulcer health data in all regions and countries.

Matched MeSH terms: Pressure Ulcer/epidemiology*
3,4-Dimethoxybenzohydrazide derivatives as antiulcer: Molecular modeling and density functional studies

Taha M, Ismail NH, Zaki HM, Wadood A, Anouar EH, Imran S, et al.

Bioorg Chem, 2017 12;75:235-241.
PMID: 29031169 DOI: 10.1016/j.bioorg.2017.10.004

3,4-Dimethoxybenzohydrazide derivatives (1-25) have been synthesized and evaluated for their urease inhibitory potential. Among the series, compounds 2, 3, 4 and 5 with IC50 values 12.61 ± 0.07, 18.24 ± 0.14, 19.22 ± 0.21, and 8.40 ± 0.05 µM, respectively, showed excellent urease inhibitory potentials when compared with standard thiourea (IC50 value 21.40 ± 0.21 µM). Compounds 1, 6, 8, 18, 19 and 20 also showed good to moderate inhibition, while the remaining compounds were found to be completely inactive. The structures of compounds 6 and 25 were confirmed through X-ray crystallography while the structures of remaining compounds were confirmed through ESI-MS and 1H NMR. Molecular docking studies were performed understand the binding interactions with enzyme active site. The synthesized compounds were evaluated for cytotoxicity and found to be nontoxic.

Matched MeSH terms: Anti-Ulcer Agents/chemistry*
Fulltext Chromobacterium violaceum septicaemia in Malaysia

Sagin DD, Tan PT, Dolkadir J

Singapore Med J, 1994 Aug;35(4):426.
PMID: 7899912
Matched MeSH terms: Skin Ulcer/microbiology
Plasma pepsinogen levels in three races of Malaysia

Alhady SM, Buttery JE

Med J Aust, 1970 Jan 31;1(5):218-9.
PMID: 4908222
Matched MeSH terms: Peptic Ulcer/diagnosis*
Fulltext Helicobacter pylori vacA as marker for gastric cancer and gastroduodenal diseases: one but not the only factor

Abadi AT, Lee YY

J Clin Microbiol, 2014 Dec;52(12):4451.
PMID: 25399000 DOI: 10.1128/JCM.02640-14
Matched MeSH terms: Duodenal Ulcer/microbiology*
Fulltext Blended learning for reinforcing dental pharmacology in the clinical years: A qualitative analysis

Eachempati P, Kiran Kumar KS, Sumanth KN

Indian J Pharmacol, 2016 Oct;48(Suppl 1):S25-S28.
PMID: 28031603 DOI: 10.4103/0253-7613.193315

OBJECTIVES: Blended learning has become the method of choice in educational institutions because of its systematic integration of traditional classroom teaching and online components. This study aims to analyze student's reflection regarding blended learning in dental pharmacology.
SUBJECTS AND METHODS: A cross-sectional study was conducted in Faculty of Dentistry, Melaka-Manipal Medical College among 3(rd) and 4(th) year BDS students. A total of 145 dental students, who consented, participate in the study. Students were divided into 14 groups. Nine online sessions followed by nine face-to-face discussions were held. Each session addressed topics related to oral lesions and orofacial pain with pharmacological applications. After each week, students were asked to reflect on blended learning. On completion of 9 weeks, reflections were collected and analyzed.
STATISTICAL ANALYSIS: Qualitative analysis was done using thematic analysis model suggested by Braun and Clarke.
RESULTS: The four main themes were identified, namely, merits of blended learning, skill in writing prescription for oral diseases, dosages of drugs, and identification of strengths and weakness. In general, the participants had a positive feedback regarding blended learning. Students felt more confident in drug selection and prescription writing. They could recollect the doses better after the online and face-to-face sessions. Most interestingly, the students reflected that they are able to identify their strength and weakness after the blended learning sessions.
CONCLUSIONS: Blended learning module was successfully implemented for reinforcing dental pharmacology. The results obtained in this study enable us to plan future comparative studies to know the effectiveness of blended learning in dental pharmacology.

Matched MeSH terms: Oral Ulcer/drug therapy
Fulltext Mechanisms of Gastroprotective Effects of Ethanolic Leaf Extract of Jasminum sambac against HCl/Ethanol-Induced Gastric Mucosal Injury in Rats

Alrashdi AS, Salama SM, Alkiyumi SS, Abdulla MA, Hadi AH, Abdelwahab SI, et al.

Evid Based Complement Alternat Med, 2012;2012:786426.
PMID: 22550543 DOI: 10.1155/2012/786426

Jasminum sambac is used in folk medicine as the treatment of many diseases. The aim of the present investigation is to evaluate the gastroprotective effects of ethanolic extracts of J. sambac leaves against acidified ethanol-induced gastric ulcers in rats. Seven groups of rats were orally pre-treated with carboxymethylcellulose (CMC) as normal group, CMC as ulcer group, 20 mg/kg of omeprazole as positive group, 62.5, 125, 250, and 500 mg/kg of extract as the experimental groups, respectively. An hour later, CMC was given orally to normal group and acidified ethanol solution was given orally to the ulcer control, positive control, and the experimental groups. The rats were sacrificed after an hour later. Acidity of gastric content, the gastric wall mucus, ulcer areas, and histology and immunohistochemistry of the gastric wall were assessed. Gastric homogenates were determined for prostaglandin E(2) (PGE(2)), superoxide dismutase (SOD), andmalondialdehyde (MDA) content. Ulcer group exhibited significantly severe mucosal injury as compared with omeprazole or extract which shows significant protection towards gastric mucosal injury the plant promotes ulcer protection as it shows significant reduction of ulcer area grossly, and histology showed marked reduction of edema and leucocytes infiltration of submucosal layer compared with ulcer group. Immunohistochemistry showed overexpression of Hsp70 protein and downexpression of Bax protein in rats pretreated with extract. Significant increased in the pH, mucus of gastric content and high levels of PGE(2), SOD and reduced amount of MDA was observed.

Matched MeSH terms: Stomach Ulcer; Ulcer
Fulltext Essential Oils Derived from Momordica charantia Seeds Exhibited Antiulcer Activity against Hydrogen Chloride/Ethanol and Indomethacin

Abu Bakar N', Hakim Abdullah MN, Lim V, Yong YK

Evid Based Complement Alternat Med, 2021;2021:5525584.
PMID: 33976701 DOI: 10.1155/2021/5525584

Momordica charantia (MC) is popular for its medicinal uses especially for treating diabetic-related complications. However, the antiulcer activity of essential oil derived from the seeds has not been systematically studied. This study aims to evaluate the gastroprotective activities of essential oil derived from the seed of MC induced by hydrochloride acid/ethanol (HCl/EtOH) and indomethacin and pylorus-ligation model. Gastric ulceration was induced by oral administration of HCl/EtOH solution or indomethacin on day 7 after animals have been pretreated with testing compounds. The first group received just distilled water and the second group received ranitidine (100 mg/kg). Groups 3, 4, and 5 received 10, 50, and 100 mg/kg of essential oil based on their body weight (10 mL/kg), respectively. Macroscopically, pretreatment of essential oil extracted from MC significantly decreased ulceration induced by HCl/EtOH and indomethacin in vivo. Microscopically, essential oil also significantly suppressed the formation of edema, epithelial disruption, and mucosa erosions. Moreover, essential oil significantly elevated the pH without decreasing the total acidity of the gastric juice and was able to increase the amount of adherent mucus compared to control. Current results provide scientific basis to the ethno-pharmacological usage of the MC in preventing ulcer formation induced by HCl/EtOH and indomethacin.

Matched MeSH terms: Stomach Ulcer; Ulcer
Fulltext Gastroprotective Effects of Lion's Mane Mushroom Hericium erinaceus (Bull.:Fr.) Pers. (Aphyllophoromycetideae) Extract against Ethanol-Induced Ulcer in Rats

Wong JY, Abdulla MA, Raman J, Phan CW, Kuppusamy UR, Golbabapour S, et al.

Evid Based Complement Alternat Med, 2013;2013:492976.
PMID: 24302966 DOI: 10.1155/2013/492976

Hericium erinaceus is a famous tonic in oriental medicine. The gastroprotective effects of aqueous extract of H. erinaceus against ethanol-induced ulcers in Sprague Dawley rats were investigated. The possible involvements of lipid peroxidation, superoxide dismutase, and catalase were also investigated. Acute toxicity study was performed. The effects of aqueous extract of H. erinaceus on the ulcer areas, ulcer inhibition, gastric wall mucus, gross and histological gastric lesions, antioxidant levels, and malondialdehyde (MDA) contents were evaluated in ethanol-induced ulcer in vivo. In acute toxicity study, a high dose of 5 g/kg did not manifest any toxicological signs in rats. The extract promoted ulcer protection as ascertained by a significant reduction of the ulcer area. Furthermore, it exhibited a significant protection activity against gastric mucosal injury by preventing the depletion of antioxidant enzymes. The level of MDA was also limited in rat stomach tissues when compared with the ulcer control group. Immunohistochemistry showed upregulation of HSP70 protein and downregulation of BAX protein in rats pretreated with the extract. The aqueous extract of H. erinaceus protected gastric mucosa in our in vivo model. It is speculated that the bioactive compounds present in the extract may play a major role in gastroprotective activity.

Matched MeSH terms: Anti-Ulcer Agents; Ulcer
Fulltext Gastroprotective Activity of Polygonum chinense Aqueous Leaf Extract on Ethanol-Induced Hemorrhagic Mucosal Lesions in Rats

Ismail IF, Golbabapour S, Hassandarvish P, Hajrezaie M, Abdul Majid N, Kadir FA, et al.

Evid Based Complement Alternat Med, 2012;2012:404012.
PMID: 23365597 DOI: 10.1155/2012/404012

Polygonum chinense is a Malaysian ethnic plant with various healing effects. This study was to determine preventive effect of aqueous leaf extract of P. chinense against ethanol-induced gastric mucosal injury in rats. Sprague Dawley rats were divided into seven groups. The normal and ulcer control groups were orally administered with distilled water. The reference group was orally administered with 20 mg/kg omeprazole. The experimental groups received the extracts 62.5, 125, 250, and 500 mg/kg, accordingly. After sixty minutes, distilled water and absolute ethanol were given (5 mL/kg) to the normal control and the others, respectively. In addition to histology, immunohistochemical and periodic acid schiff (PAS) stains, levels of lipid peroxidation, malondialdehyde (MDA), antioxidant enzymes, and superoxide dismutase (SOD) were measured. The ulcer group exhibited severe mucosal damages. The experimental groups significantly reduced gastric lesions and MDA levels and increased SOD level. Immunohistochemistry of the experimental groups showed upregulation and downregulation of Hsp70 and Bax proteins, respectively. PAS staining in these groups exhibited intense staining as compared to the ulcer group. Acute toxicity study revealed the nontoxic nature of the extract. Our data provide first evidence that P. chinense extract could significantly prevent gastric ulcer.

Matched MeSH terms: Stomach Ulcer; Ulcer
Experience with gastroscopy in the diagnosis of stomach cancer in Malaysia

Paramarajah S

Southeast Asian J Trop Med Public Health, 1985 Dec;16(4):609-12.
PMID: 3835705

Two hundred and eight patients underwent oesophago-gastro-duodenoscopy within the first year of its introduction at a peripheral general hospital in Malaysia. There were 7 cases of gastric cancer, proved histologically, as compared to 38 cases of benign gastric ulcer. The frequencies of the common symptoms and signs in the two conditions are compared. Of the 3 main ethnic groups, Malays, Chinese and Indians, the incidence of gastric ulcer was highest among the Chinese, next the Indians; however, the number of gastric cancers were too few for analysis of its racial incidence.

Matched MeSH terms: Stomach Ulcer/diagnosis
Oral histoplasmosis presenting as oral ulcer in a non-HIV patient

Rahman MT, Bakar NH, Philip R, Shamsudin AR

Southeast Asian J Trop Med Public Health, 2004 Jun;35(2):388-90.
PMID: 15691142

A 40-year-old man presented with chronic mouth ulcer for the last six months. Histopathological examination of the biopsy from the lesion confirmed a diagnosis of histoplasmosis. Although histoplasmosis commonly manifests in immunocompromized patients, like HIV, the present case was negative for HIV. Histoplasmosis is endemic in certain parts of the world and it is comparatively rare in the South Asian region, particularly Malaysia. Thirty-seven cases of histoplasmosis were reported from Malaysia (Ng and Siar, 1996), between July 1967 and October 1997. Despite the apparent rarity of the disease, clinicians and pathologists should be aware of the possibility of histoplasmosis when cases of oral ulcer are encountered.

Matched MeSH terms: Oral Ulcer*
Fulltext In vivo antioxidant and antiulcer activity of Parkia speciosa ethanolic leaf extract against ethanol-induced gastric ulcer in rats

Al Batran R, Al-Bayaty F, Jamil Al-Obaidi MM, Abdualkader AM, Hadi HA, Ali HM, et al.

PLoS One, 2013;8(5):e64751.
PMID: 23724090 DOI: 10.1371/journal.pone.0064751

BACKGROUND: The current study was carried out to examine the gastroprotective effects of Parkia speciosa against ethanol-induced gastric mucosa injury in rats.
METHODOLOGY/PRINCIPAL FINDINGS: Sprague Dawley rats were separated into 7 groups. Groups 1-2 were orally challenged with carboxymethylcellulose (CMC); group 3 received 20 mg/kg omeprazole and groups 4-7 received 50, 100, 200 and 400 mg/kg of ethanolic leaf extract, respectively. After 1 h, CMC or absolute ethanol was given orally to groups 2-7. The rats were sacrificed after 1 h. Then, the injuries to the gastric mucosa were estimated through assessment of the gastric wall mucus, the gross appearance of ulcer areas, histology, immunohistochemistry and enzymatic assays. Group 2 exhibited significant mucosal injuries, with reduced gastric wall mucus and severe damage to the gastric mucosa, whereas reductions in mucosal injury were observed for groups 4-7. Groups 3-7 demonstrated a reversal in the decrease in Periodic acid-Schiff (PAS) staining induced by ethanol. No symptoms of toxicity or death were observed during the acute toxicity tests.
CONCLUSION: Treatment with the extract led to the upregulation of heat-shock protein 70 (HSP70) and the downregulation of the pro-apoptotic protein BAX. Significant increases in the levels of the antioxidant defense enzymes glutathione (GSH) and superoxide dismutase (SOD) in the gastric mucosal homogenate were observed, whereas that of a lipid peroxidation marker (MDA) was significantly decreased. Significance was defined as p<0.05 compared to the ulcer control group (Group 2).

Matched MeSH terms: Anti-Ulcer Agents/adverse effects; Anti-Ulcer Agents/pharmacology; Anti-Ulcer Agents/therapeutic use*; Stomach Ulcer/drug therapy*; Stomach Ulcer/enzymology; Stomach Ulcer/pathology
Fulltext Helicobacter pylori Virulence Factors Exploiting Gastric Colonization and its Pathogenicity

Ansari S, Yamaoka Y

Toxins (Basel), 2019 Nov 19;11(11).
PMID: 31752394 DOI: 10.3390/toxins11110677

Helicobacter pylori colonizes the gastric epithelial cells of at least half of the world's population, and it is the strongest risk factor for developing gastric complications like chronic gastritis, ulcer diseases, and gastric cancer. To successfully colonize and establish a persistent infection, the bacteria must overcome harsh gastric conditions. H. pylori has a well-developed mechanism by which it can survive in a very acidic niche. Despite bacterial factors, gastric environmental factors and host genetic constituents together play a co-operative role for gastric pathogenicity. The virulence factors include bacterial colonization factors BabA, SabA, OipA, and HopQ, and the virulence factors necessary for gastric pathogenicity include the effector proteins like CagA, VacA, HtrA, and the outer membrane vesicles. Bacterial factors are considered more important. Here, we summarize the recent information to better understand several bacterial virulence factors and their role in the pathogenic mechanism.

Matched MeSH terms: Peptic Ulcer/microbiology
Histamine dosage for maximal gastric secretion in Asians - a reappraisal

Ti TK

Ann Acad Med Singap, 1981 Apr;10(2):198-200.
PMID: 7332283

Paired augmented histamine tests using 40 microgram 60 microgram histamine acid phosphate (HAP) per kg body weight were conducted on each of 57 Asian subjects. The mean peak acid output (PAO) for the total series to the two different doses of HAP was 22.3 mEq/hr and 23.3 mEq/hr respectively and the difference was not statistically significant according to the paired t test. There were similarly no significant difference in PAO to the two doses of HAP in the following groups of subjects: 26 Chinese, 17 Indians, 14 Malays; 24 subjects with duodenal ulcer, 16 controls; 28 subjects with body weight below 50 kg, 19 between 50-60 kg and 10 exceeding 60 kg. These findings differ from earlier reports that for maximal gastric secretion Asians required a higher dosage of histamine compared with Caucasian subjects.

Matched MeSH terms: Duodenal Ulcer/metabolism

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