The aim of our study was to see the efficacy of petroleum ether extract of Cissus quadrangularis (CQ) on development of osteopenia in ovariectomy induced Wistar rats.
Measurements of (222)Rn activity concentration were carried out in 39 samples collected from the domestic and drinking water sources used in the island and mainland of Penang, northern peninsular, Malaysia. The measured activity concentrations ranged from 7.49 to 26.25 Bq l(-1), 0.49 to 9.72 Bq l(-1) and 0.58 to 2.54 Bq l(-1) in the raw, treated and bottled water samples collected, respectively. This indicated relatively high radon concentrations compared with that from other parts of the world, which still falls below the WHO recommended treatment level of 100 Bq l(-1). From this data, the age-dependent associated committed effective doses due to the ingestion of (222)Rn as a consequence of direct consumption of drinking water were calculated. The committed effective doses from (222)Rn resulting from 1 y's consumption of these water were estimated to range from 0.003 to 0.048, 0.001 to 0.018 and 0.002 to 0.023 mSv y(-1), for age groups 0-1, 2-16 and >16 y, respectively.
Many chronic diseases are associated with increased oxidative stress caused by an imbalance between free-radical production and the antioxidant level. Antioxidants, which are abundant in natural honey, are free-radical scavengers that either reduce the formation of or neutralize free radicals. The composition and source of honey greatly dictates its biochemical properties. We performed a comparative analysis of the total phenolic content and antioxidant potential of common commercially available honeys along with Malaysian tualang honey. In vitro biochemical analysis of the phenolic content by the Folin-Ciocalteau method revealed a significantly elevated phenolic content (83.96 ± 4.53 mg gallic acid equivalents per 100 g) in tualang honey. In addition, the antioxidant capacity (53.06 ± 0.41 mg ascorbic acid equivalents per gram) of tualang honey was greater, as assessed by the phosphomolybdenum method, 2,2-diphenyl-1-picryl-hydrazyl assay, and ferric reducing/antioxidant power assay. Peroxynitrite and superoxide radical scavenging activity was determined by spectrophotometric analysis in different honey types. Our data suggest that the elevated free-radical scavenging and antioxidant activity observed in tualang honey is due to the increased level of phenolic compounds. In addition to its antibacterial, anticarcinogenic, and anti-inflammatory properties, our study highlights the favorable antioxidant properties of tualang honey, which may be important to human nutrition and health.
It has been demonstrated that probiotic supplementation has positive effects in several murine models of disease through influences on host immune responses. This study examined the effect of Lactobacillus casei strain Shirota (L. casei Shirota) on the blood glucose, C-reactive protein (CRP), Interleukin-6 (IL-6), Interleukin-4 (IL-4), and body weight among STZ-induced diabetic rats. Diabetes mellitus was induced by streptozotocin (STZ, 50 mg/kg BW) in male Sprague-Dawley rats. Streptozotocin caused a significant increase in the blood glucose levels, CRP, and IL-6. L. casei Shirota supplementation lowered the CRP and IL-6 levels but had no significant effect on the blood glucose levels, body weight, or IL-4. Inflammation was determined histologically. The presence of the innate immune cells was not detectable in the liver of L. casei Shirota-treated hyperglycemic rats. The probiotic L. casei Shirota significantly lowered blood levels of pro-inflammatory cytokines (IL-6, CRP) and neutrophils in diabetic rats, showing a lower risk of diabetes mellitus and its complications.
Computed tomography (CT) is widely used in assessing clinically stable patients with blunt abdominal trauma. In these patients, liver is one of the commonest organs being injured and CT can accurately identify and assess the extent of the injury. The CT features of blunt liver trauma include laceration, subcapsular or parenchymal haematomas, active haemorrhage and vascular injuries. Widespread use of CT has notably influenced the management of blunt liver injury from routine surgical to nonsurgical management. We present pictorial illustrations of various liver injuries depicted on CT in patients with blunt trauma.
Electroencephalogram (EEG) serves as an extremely valuable tool for clinicians and researchers to study the activity of the brain in a non-invasive manner. It has long been used for the diagnosis of various central nervous system disorders like seizures, epilepsy, and brain damage and for categorizing sleep stages in patients. The artifacts caused by various factors such as Electrooculogram (EOG), eye blink, and Electromyogram (EMG) in EEG signal increases the difficulty in analyzing them. Discrete wavelet transform has been applied in this research for removing noise from the EEG signal. The effectiveness of the noise removal is quantitatively measured using Root Mean Square (RMS) Difference. This paper reports on the effectiveness of wavelet transform applied to the EEG signal as a means of removing noise to retrieve important information related to both healthy and epileptic patients. Wavelet-based noise removal on the EEG signal of both healthy and epileptic subjects was performed using four discrete wavelet functions. With the appropriate choice of the wavelet function (WF), it is possible to remove noise effectively to analyze EEG significantly. Result of this study shows that WF Daubechies 8 (db8) provides the best noise removal from the raw EEG signal of healthy patients, while WF orthogonal Meyer does the same for epileptic patients. This algorithm is intended for FPGA implementation of portable biomedical equipments to detect different brain state in different circumstances.
Diplopodia is a rare congenital disorder that has not been extensively discussed in textbooks, and case reports appear to be the main source of information. Although the exact cause of diplopodia remains unknown, the presence of extra digits as well as metatarsals and tarsals allows it to be differentiated from pedal polydactyly. Syndactyly refers to the congenital fusion of the digits. Concomitant bilateral syndactyly and diplopodia is extremely unusual, and in this report we describe a case of right diplopodia and left polydactyly combined with bilateral manual syndactyly in a 15-year-old girl who was ultimately treated with through-the-knee amputation. Radiological examination of the right leg revealed tibial hypoplasia and the right foot displayed 8 digits with corresponding metatarsals and tarsals, whereas the left leg revealed 2 extra digits on the medial aspect of the foot with corresponding metatarsal and tarsal bones. Anatomical dissection of the right foot revealed that it was divided into halves consisting of 8 toes with corresponding metatarsals and tarsals, as well as tibial hypoplasia and absence of the great toe. Diplopodia associated with tibial hypoplasia and syndactyly can be treated surgically, and the present case report details the clinical, radiological, and anatomical elements of this rare deformity.
Nasopharyngeal carcinoma (NPC) is a type of neoplasm that is highly prevalent in East Asia and Africa with Epstein-Barr virus (EBV), genetic, and dietary factors implicated as possible aetiologic factors. Previous studies suggested the association of certain cytokines with the invasion and metastatic properties of NPC. The present study examined the roles of EBV latent membrane protein-1 (LMP1), interleukin-6 (IL-6), interleukin-10 (IL-10), transforming growth factor-beta 1 (TGF-β1) and laminin in the regulation of matrix-metalloproteinases (MMPs) and vascular endothelial growth factor (VEGF) in NPC. The effects of these factors on bmi-1, an oncogene, and ngx6, a tumour suppressor gene, were also investigated.
Emergence of extensively drug resistant tuberculosis (XDR-TB) has been reported by more than 55 countries. XDR-TB is considered as untreatable and highly fatal disease. In developing countries like India, number of cases of multi-drug resistant tuberculosis (MDR-TB) and XDR-TB are increasing. Emergence of resistance to Isoniazid and Rifampicin, the two most effective and well tolerated agents, coupled with resistance to second line agents pose limited treatment options for XDR-TB. The present minireview provides information about the seriousness of XDR-TB and the drugs available for its treatment. Although considered a fatal disorder, judicious use of combination of drugs, retaining their antimycobacterial activity, can improve the clinical outcome of XDR-TB. Only such an approach can provide some hope for the patients of XDR-TB.
The protease activity of different isolates of dermatophytes representing different ecological groups namely geophilic, zoopahilic and anthropophilic, in their vegetative and sporulation growth phases were compared. Unlike their geophilic and zoophilic counterparts, all the isolates of anthropophilic dermatophytes viz. Trichophyton rubrum, T. mentagrophytes, T. tonsurans, T. violaceum and Epidermophyton floccosum recorded reduced protease activity during artificially induced sporulation phase in comparison to their vegetative growth phase. Even among the anthropophilic group, a classical moderation of protease activity was recorded in Trichyphyton rubrum which also correlates to its clinical manifestation. This enzyme moderation could also be an evolutionary adaptation of the anthropization of these species.
This study uses computer simulations to study the impact of a motorcycle with the conventional w-beam guardrail. A three-dimensional computer simulation of a scaled hybrid III 50th-percentile male dummy mounted on a motorcycle and colliding with a w-beam guardrail is carried out. A multi-body model of the motorcycle and finite element model of the guardrail are developed using commercially available software. The simulation model is validated with a physical crash test conducted with same initial impact configurations. Impacts at speeds of 32, 48, and 60 km/h at an impact angle at 45 degrees are considered. The predicted forces and accelerations are compared with the biomechanical limits for each body part and the risk of injury to the rider are evaluated. Speed was found to have a significant influence on the level of injury to the head, neck, chest, and femur. A significant reduction of the severity of injuries was found when the impact speed was reduced from 60 to 32km/h. The accelerations experienced by the head and chest are found to be higher than safe levels for impact speeds of 48 and 60 km/h. The biomechanical limit for the right femur is exceeded at all three considered impact speeds. Neck injuries are also a concern, with the predicted tension values and neck bending extent being higher than the biomechanical limit for the 60 km/h impact speed. In light of these results, it is suggested that the design of guardrails should be reviewed with a focus on the safety of motorcyclists.
Rituximab is a B-cell-depleting monoclonal anti-CD20 antibody. It is widely used in haematology and rheumatology. However, usage of rituximab in immunosupressed patient has been associated with various opportunistic infections. The authors reported a case of refractory rheumatoid arthritis treated with rituximab, which later presented with non-resolving pneumonia with pulmonary nodule. Percutaneous computer tomogram guided lung biopsy was arranged to confirm the suspicion of tuberculosis, but did not yield conclusive results. Later, she presented left-chest abscess and underwent incision and drainage. The pus culture and sensitivity confirmed pulmonary nocardiosis with chest wall dissemination. She was treated with 2-week course of trimethoprim sulfamethoxazole and responded. The authors also reviewed published cases of nocardiosis post-rituximab.
The objectives of this study were to initiate a pharmacist-coordinated program to improve the adverse drug reaction (ADR) reporting on complementary and alternative medicines (CAM) in a tertiary care hospital and to evaluate the pattern of the reported ADRs.
BACKGROUND AND AIMS: Many patients who presented to Universiti Kebangsaan Malaysia Medical Centre (UKMMC) with signs and symptoms of urolithiasis had mild hydronephrosis with non visualization of calculus on ultrasound examination. These patients underwent an intravenous urogram (IVU) in order to determine the presence of urolithiasis and most of them had normal IVU. The main aim of this study was to determine the predictive value of urinalysis in this group of patients in determining the need for IVU examinations.
MATERIALS AND METHODS: Retrospectively the ultrasound, urinalysis and intravenous urography reports of 53 patients were reviewed and evaluated.
RESULTS: The positive predictive and negative predictive value of urinalysis was found to be 68% and 96.4%, respectively. CONCLUSIONS; The results indicate that the urinalysis was an excellent negative predictor for IVU. In view of high radiation dose, risk of contrast reaction and contrast induced nephropathy of IVU, we suggest that it should not be performed in patient with non visualization of calculus mild hydronephrosis when the urinalysis is negative for blood.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
AIM: This pilot study aimed to explore the perceptions of general medical practitioners (GPs) towards the professional training and roles of community pharmacists.
METHODS: A self-administered questionnaire was distributed to all private clinics (n=160) run by GPs in a northern state of Malaysia. The instrument contained questions to evaluate the practitioners' level of agreement using a 5-point Likert-type scale.
RESULTS: Of 160 GPs, 80 returned the questionnaire (response rate 50%). The respondents agreed that: GPs should consider the community pharmacists' recommendations whenever there is/are any problem(s) with the prescriptions given by them (46.3%); community pharmacists are the best healthcare professionals to educate patients about safe and appropriate use of medications (52.5%); the pharmacy profession had undergone a major metamorphosis from a product-oriented profession to a more patient-centred and outcome-oriented one (61.3%); if dispensing separation is implemented, they will work closely with the community pharmacists in monitoring patients' pharmacotherapeutic outcomes (77.5%).
CONCLUSION: The current findings suggest that GPs would support an extension of the role of the community pharmacists in number of activities of patient care activities such as medication counselling. Thus, suggesting potential collaborative care between GPs and community pharmacists towards patient care and the needs to develop and incorporate topics on inter-professional relationship in the current medical and pharmaceutical education curriculums.
KEYWORDS: Community pharmacists; general practitioners; perceptions; roles; training
Cystic spinal or ancient schwannoma is a rare form of intradural tumour especially in the conus medullaris region. Due to its indolent behavior and benign course, the diagnosis of schwannoma is always a challenge and the imaging findings can be misleading. Our patient presented with chronic mild sciatica pain without any other neurological symptom. MRI of the spine showed intradural tumour located at the conus medullaris region with nerves compression and was reported as ependymoma. L3-L5 laminectomy and total excision of tumour was performed without any neurological complication. We concluded that ancient schwannoma of the conus medullaris is a rare benign tumour that can present with minimal non-specific neurological symptom that lead to misdiagnosis. Radical tumour excision is safe with an excellent outcome.
Efficacy of Morinda citrifolia L. leaf (MLE) and fruit extracts (MFE) in inhibiting lipoprotein lipase (LPL) was determined in vitro. The result of the study showed that the highest inhibition on the LPL activity was exhibited by MLE (66%+/- 2.1%), which is significantly higher than that demonstrated by MFE (54.5%+/- 2.5%), green tea extract (GTE) (54.5%+/- 2.6%), and catechin (43.6%+/- 6.1%). Percent of LPL inhibition increase with concentration of the extracts. Quantitative analysis of the extracts revealed the presence of high levels of (+)-catechin at 63.5 +/- 17 and 53.7 +/- 5.7 mg/g in MLE and MFE, respectively, although not as high as that found in GTE (530.6 +/- 42 mg/g). Appreciable amount of epicatechin was found in all extracts tested, while rutin was only found in MLE and MFE. The study suggested that both leaf and fruit of M. citrifolia may be used as antiobesity agents in body weight management.
A 13 year old boy presented with a huge mass on his right arm of 6 months duration. Histopathological examination revealed sheets of malignant small round blue cells with immunopositivity for LCA, CD43, CD45Ro, CD30, EMA, ALK-1 and CD99, and negativity for CD20, TdT, myogenin, myoD1, NSE, bcl-6, bcl-2 and CD10. Fluorescent In-Situ Hybridization (FISH) testing excluded the diagnosis of Ewing's sarcoma/PNET. Pathologists need to be aware of the diagnosis of a small cell variant of ALCL, as well as of the fact that CD99 expression commonly occurs in cases of ALK-positive ALCL, in order to distinguish this entity from Ewing's sarcoma/PNET.