Displaying publications 341 - 360 of 1053 in total

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  1. Ahmad S, Jerampang P, Tohid H, Ali MF, Jamil TR, Kong CHC
    Nagoya J Med Sci, 2020 Nov;82(4):613-621.
    PMID: 33311792 DOI: 10.18999/nagjms.82.4.613
    Type 2 diabetes mellitus (T2DM) may be independently associated with testosterone deficiency syndrome (TDS). Both conditions are linked with reduced quality of life and cardiovascular comorbidities. The magnitude of TDS among T2DM men and its predictors has still not been well established in Malaysia. This study aimed to determine the prevalence of TDS and its predictors among men with T2DM attending a government health clinic in Kuching, Sarawak. TDS severity and level of serum total testosterone were also explored. A cross-sectional study was conducted involving 360 respondents. Aging Males Symptoms Scale (AMS) score > 26 and serum total testosterone ≤ 12 nmol/L were used to diagnose TDS. The prevalence of TDS in current study was 19.7%. Multivariate analysis showed that determinants for TDS included age (Adjusted OR 1.061: 95% CI 1.020; 1.103), Iban ethnicity (Adjusted OR 2.469: 95% CI 1.154; 5.283) and a waist circumference equal or greater than 90 cm (Adjusted OR 3.655: 95% CI 1.472; 9.081). However, there was no significant association between TDS and the level of serum total testosterone (p = 0.581). We concluded that the prevalence of TDS in this study was relatively low. The severity of this condition may not be influenced by testosterone level. Physicians might consider a diagnosis of TDS if elder diabetic men with abdominal obesity present to primary care clinics with clinical features of hypogonadism. Health care providers also might consider lowering their threshold to screen for TDS among Iban men with T2DM.
  2. Tan ET, Materne CM, Silcock RG, D'Arcy BR, Al Jassim R, Fletcher MT
    J Agric Food Chem, 2016 Aug 31;64(34):6613-21.
    PMID: 27509381 DOI: 10.1021/acs.jafc.6b02437
    Livestock industries have maintained a keen interest in pasture legumes because of the high protein content and nutritive value. Leguminous Indigofera plant species have been considered as having high feeding values to be utilized as pasture, but the occurrence of the toxic constituent indospicine in some species has restricted this utility. Indospicine has caused both primary and secondary hepatotoxicosis and also reproductive losses, but has only previously been determined in a small number of Indigofera species. This paper validates a high-throughput ultraperformance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method to determine the indospicine content of various Indigofera species found in Australian pasture. Twelve species of Indigofera together with Indigastrum parviflorum plants were collected and analyzed. Of the 84 samples analyzed, *I. spicata (the asterisk indicates a naturalized species) contained the highest indospicine level (1003 ± 328 mg/kg DM, n = 4) followed by I. linnaei (755 ± 490 mg/kg DM, n = 51). Indospicine was not detected in 9 of the remaining 11 species and at only low levels (<10 mg/kg DM) in 2 of 8 I. colutea specimens and in 1 of 5 I. linifolia specimens. Indospicine concentrations were below quantitation levels for other Indigofera spp. (I. adesmiifolia, I. georgei, I. hirsuta, I. leucotricha, *I. oblongifolia, I. australis, and I. trita) and Indigastrum parviflorum. One of the more significant findings to emerge from this study is that the indospicine content of I. linnaei is highly variable (from 159 to 2128 mg/kg DM, n = 51) and differs across both regions and seasons. Its first regrowth after spring rain has a higher (p < 0.01) indospicine content than growth following more substantial summer rain. The species collected include the predominant Indigofera in Australia pasture, and of these, only *I. spicata and I. linnaei contain high enough levels of indospicine to pose a potential toxic threat to grazing herbivores.
  3. Razali A, Fullerton CJ, Turci F, Hallett JE, Jack RL, Royall CP
    Soft Matter, 2017 May 03;13(17):3230-3239.
    PMID: 28401216 DOI: 10.1039/c6sm02221a
    We consider the sedimentation of a colloidal gel under confinement in the direction of gravity. The confinement allows us to compare directly experiments and computer simulations, for the same system size in the vertical direction. The confinement also leads to qualitatively different behaviour compared to bulk systems: in large systems gelation suppresses sedimentation, but for small systems sedimentation is enhanced relative to non-gelling suspensions, although the rate of sedimentation is reduced when the strength of the attraction between the colloids is strong. We map interaction parameters between a model experimental system (observed in real space) and computer simulations. Remarkably, we find that when simulating the system using Brownian dynamics in which hydrodynamic interactions between the particles are neglected, we find that sedimentation occurs on the same timescale as the experiments. An analysis of local structure in the simulations showed similar behaviour to gelation in the absence of gravity.
  4. Tan GH, Shah SA, Ali NM, Goh EH, Singam P, Ho CCK, et al.
    Investig Clin Urol, 2017 05;58(3):186-191.
    PMID: 28480344 DOI: 10.4111/icu.2017.58.3.186
    PURPOSE: This study aimed to determine the urethral stricture (US) rate and identify clinical and surgical risk factors associated with US occurrence after transurethral resection of the prostate using the bipolar Gyrus PlasmaKinetic Tissue Management System (PK-TURP).

    MATERIALS AND METHODS: This was an age-matched case-control study of US occurrence after PK-TURP. Retrospective data were collected from the hospital records of patients who had a minimum of 36 months of follow-up information. Among the data collected for analysis were prostate-specific antigen level, estimated prostate weight, the amount of prostate resected, operative time, history of urinary tract infection, previous transurethral resection of the prostate, and whether the PK-TURP was combined with other endourological procedures. The resection rate was calculated from the collected data. Univariate and multivariate analyses were performed to identify clinical and surgical risk factors related to US formation.

    RESULTS: A total of 373 patients underwent PK-TURP between 2003 and 2009. There were 13 cases of US (3.5%), and most of them (10 of 13, 76.9%) presented within 24 months of surgery. Most of the US cases (11 of 13, 84.6%) occurred at the bulbar urethra. Multivariable logistic regression analyses identified slow resection rate as the only risk factor significantly associated with US occurrence.

    CONCLUSIONS: The US rate of 3.5% after PK-TURP in this study is comparable to contemporary series. A slow resection rate seems to be related to US occurrence. This should be confirmed by further studies; meanwhile, we must be mindful of this possibility when operating with the PK-TURP system.

  5. Peach J, Czajka A, Hazell G, Hill C, Mohamed A, Pegg JC, et al.
    Langmuir, 2017 03 14;33(10):2655-2663.
    PMID: 28215094 DOI: 10.1021/acs.langmuir.7b00324
    For equivalent micellar volume fraction (ϕ), systems containing anisotropic micelles are generally more viscous than those comprising spherical micelles. Many surfactants used in water-in-CO2 (w/c) microemulsions are fluorinated analogues of sodium bis(2-ethylhexyl) sulfosuccinate (AOT): here it is proposed that mixtures of CO2-philic surfactants with hydrotropes and cosurfactants may generate elongated micelles in w/c systems at high-pressures (e.g., 100-400 bar). A range of novel w/c microemulsions, stabilized by new custom-synthesized CO2-phillic, partially fluorinated surfactants, were formulated with hydrotropes and cosurfactant. The effects of water content (w = [water]/[surfactant]), surfactant structure, and hydrotrope tail length were all investigated. Dispersed water domains were probed using high pressure small-angle neutron scattering (HP-SANS), which provided evidence for elongated reversed micelles in supercritical CO2. These new micelles have significantly lower fluorination levels than previously reported (6-29 wt % cf. 14-52 wt %), and furthermore, they support higher water dispersion levels than other related systems (w = 15 cf. w = 5). The intrinsic viscosities of these w/c microemulsions were estimated based on micelle aspect ratio; from this value a relative viscosity value can be estimated through combination with the micellar volume fraction (ϕ). Combining these new results with those for all other reported systems, it has been possible to "map" predicted viscosity increases in CO2 arising from elongated reversed micelles, as a function of surfactant fluorination and micellar aspect ratio.
  6. Lim TSC, Thong KM, Zakaria NFB, Thevandran K, Shah AM
    CEN Case Rep, 2016 May;5(1):70-73.
    PMID: 28509168 DOI: 10.1007/s13730-015-0194-x
    Calciphylaxis on the background of immune thrombocytopenic purpura (ITP) has never been described. The pathogenesis of calciphylaxis is complex and not fully understood as yet. ITP has a complex pathogenesis that leads to bleeding or thrombotic events. Although ITP is treatable and reversible, calciphylaxis on the other hand, responds poorly to treatment and carries high mortality and morbidity. We present a case of a 56-year-old lady with end-stage renal disease with ITP, who complained of 1-month history of painful necrotic patches over the thighs. Due to delayed diagnosis, the patient deteriorated and passed away despite aggressive multidisciplinary approach. This case highlights the importance of early recognition of the increased thrombotic risk in an end-stage renal failure patient with poor phosphate control and ITP.
  7. Sharif Nia H, Pahlevan Sharif S, Lehto RH, Boyle C, Yaghoobzadeh A, Kaveh O, et al.
    Jpn J Clin Oncol, 2017 Aug 01;47(8):713-719.
    PMID: 28505271 DOI: 10.1093/jjco/hyx065
    Objective: The surfacing of thoughts and depressive affect associated with the prospect of death are prevalent among patients with advanced cancer. Because death cognitions and associated negative affect occur along an adaptive-less adaptive continuum, it is essential that valid and reliable instruments are available to measure death depression. The present study aimed to determine the psychometric properties of the Death Depression Scale among Iranian patients with advanced cancer.

    Methods: About 497 cancer patients completed a Persian version of the 21-item Death Depression Scale-Revised. The face, content and construct validity of the scale were ascertained. Reliability was also assessed using internal consistency, construct reliability and intra-class correlation coefficient (ICC).

    Results: Construct validity determined one factor with an eigenvalue greater than 1. The model had a good fit (χ2 (179, N = 248) = 520.345, P < 0.001; χ2/df = 2.907, CFI = 0.916, TLI = 0.902, IFI = 0.917, SRMR = 0.049 and RMSEA = 0.088 (90% confidence interval = 0.079-0.097)) with all factors loadings greater than 0.5 and statistically significant. The internal consistency, construct reliability and ICC were greater than 0.70. Convergent validity of the scale was demonstrated.

    Conclusions: Findings revealed that the Persian version of the Death Depression Scale-Revised is valid and reliable, and may be used to assess and evaluate death depression in Iranian patients with advanced cancer.

  8. Velapasamy S, Dawson CW, Young LS, Paterson IC, Yap LF
    Cancers (Basel), 2018 Jul 27;10(8).
    PMID: 30060514 DOI: 10.3390/cancers10080247
    The transforming growth factor-β (TGF-β) signalling pathway plays a critical role in carcinogenesis. It has a biphasic action by initially suppressing tumorigenesis but promoting tumour progression in the later stages of disease. Consequently, the functional outcome of TGF-β signalling is strongly context-dependent and is influenced by various factors including cell, tissue and cancer type. Disruption of this pathway can be caused by various means, including genetic and environmental factors. A number of human viruses have been shown to modulate TGF-β signalling during tumorigenesis. In this review, we describe how this pathway is perturbed in Epstein-Barr virus (EBV)-associated cancers and how EBV interferes with TGF-β signal transduction. The role of TGF-β in regulating the EBV life cycle in tumour cells is also discussed.
  9. Kohli S, Wui Vun AL, Daryl Philip C, Muhammad Aadil C, Ramalingam M
    Int J Dent, 2018;2018:7127209.
    PMID: 30034470 DOI: 10.1155/2018/7127209
    Purpose: Falls occur commonly in geriatric populations and undesirably influence their life, morbidity, and mortality. The aim of this study was to analyze the association between the number of teeth present among the elderly population and covariates in relation to the risk of falls.

    Materials and Methods: This study was conducted at various old age homes in the Klang Valley region of Malaysia involving the geriatric population aged 60 years and above. A detailed questionnaire consisting of sociodemographic data including sex, age, household income, and dental variables such as the number of teeth and chewing difficulty was obtained. The Tinetti test (TT) was used to evaluate the patients' ability to walk, to maintain postural balance, and to determine their risk of falling. The short version of the Geriatric Depression Scale was used to assess depression among the participants, and the Barthel Scale was used to analyze the subject's ability to perform the activities of daily living (ADL).

    Results: Statistically significant association was observed in relation to the number of teeth present and risk of falls (p < 0.05). Subjects who had 19 teeth or less in total had moderate to highest risk of falls (p=0.001) in comparison with subjects who had 20 teeth or more. Those aged 70 years and above showed the highest risk of falls (p=0.001) in comparison with the subjects aged between 60 and 69 years. Subjects with depression (p=0.03) and presence of illness related to fall showed statistically significant difference (p=0.001) in comparison with those who did not suffer from the same. Compromised ADL (p=0.001) (which included ability to perform several tasks like indoor mobility, climbing stairs, toilet use, and feeding) and low monthly income (p=0.03) was also observed among subjects who had higher risk of falls.

    Conclusion: According to the results achieved, there was a high statistically significant association observed between the number of teeth present, age, depression, ADL, and presence of illness in relation to the risk of falling among the geriatric population. Henceforth, oral rehabilitation of elderly patients with less number of teeth may reduce their risk of falls.

  10. Ling I, Kumari H, Mirzamani M, Sobolev AN, Garvey CJ, Atwood JL, et al.
    Chem Commun (Camb), 2018 Sep 25;54(77):10824-10827.
    PMID: 30140821 DOI: 10.1039/c8cc05650a
    We report on the assembly of three-fold axially compressed icosahedral arrays of the bowl shaped p-sulfonatocalix[4]arene molecules in the solid-state, intricately bound to dipicolinate and yttrium(iii) ions, with the compression reflected in Hirshfeld surface analyses. Solution studies show dissolution of the icosahedra intact, but with a geometrical rearrangement to regular icosahedra.
  11. Marinda PA, Genschick S, Khayeka-Wandabwa C, Kiwanuka-Lubinda R, Thilsted SH
    PLoS One, 2018;13(9):e0204009.
    PMID: 30248126 DOI: 10.1371/journal.pone.0204009
    BACKGROUND: This study examines socio-economic determinants of food consumption patterns amongst women of reproductive age and children aged 6-59 months from urban poor settlements of Lusaka and their implications for nutritional status. Particular emphasis was placed on the role of fish in their diets and nutritional status.

    METHODS: A cross-sectional survey design was applied, in which 714 mother-child dyads, with children aged 6-59 months were enrolled. A three-stage randomized cluster sampling approach was applied.

    RESULTS: The mean dietary diversity score among children aged 6-23 and 24-59 months was 2.98 (±1.27) and 3.478 (±1.07), respectively. In children aged 6-23 months, there was a significant difference in their nutritional status, based on fish consumption (χ2 = 10.979, df = 2, p = 0.004). Children from poorer households consumed mostly small fish (Kapenta). The quantity of fish consumed by children was significantly associated with stunting in both age groups, odds ratio = 0.947 (95% CI: 0.896, 1.000) for children aged 6-23 months and odds ratio = 1.038 (95% CI: 1.006, 1.072) for children aged 24-59 months old. Other significant risk factors for stunting in children aged 6-23 months were the child's age, mother's body mass index, access to treated water and child morbidity. Child's age, mother's educational level and wealth status were determinants of dietary diversity in children aged 6-59 months as shown by the Poisson regression.

    CONCLUSION: Nutritional status of children aged 6-23 months is associated with fish consumption, with children consuming fish less likely to be stunted. Small fish (Kapenta) is an animal-source food that is particularly important in the diet of children in urban poor households in Zambia and contributes to better nutritional outcomes. As all small fish stem from capture fisheries, sustainable one health environmental integration, monitoring and management strategies are desirable.

  12. Md Zoqratt MZH, Eng WWH, Thai BT, Austin CM, Gan HM
    PeerJ, 2018;6:e5826.
    PMID: 30397546 DOI: 10.7717/peerj.5826
    Aquaculture production of the Pacific white shrimp is the largest in the world for crustacean species. Crucial to the sustainable global production of this important seafood species is a fundamental understanding of the shrimp gut microbiota and its relationship to the microbial ecology of shrimp pond. This is especially true, given the recently recognized role of beneficial microbes in promoting shrimp nutrient intake and in conferring resistance against pathogens. Unfortunately, aquaculture-related microbiome studies are scarce in Southeast Asia countries despite the severe impact of early mortality syndrome outbreaks on shrimp production in the region. In this study, we employed the 16S rRNA amplicon (V3-V4 region) sequencing and amplicon sequence variants (ASV) method to investigate the microbial diversity of shrimp guts and pond water samples collected from aquaculture farms located in Malaysia and Vietnam. Substantial differences in the pond microbiota were observed between countries with the presence and absence of several taxa extending to the family level. Microbial diversity of the shrimp gut was found to be generally lower than that of the pond environments with a few ubiquitous genera representing a majority of the shrimp gut microbial diversity such as Vibrio and Photobacterium, indicating host-specific selection of microbial species. Given the high sequence conservation of the 16S rRNA gene, we assessed its veracity at distinguishing Vibrio species based on nucleotide alignment against type strain reference sequences and demonstrated the utility of ASV approach in uncovering a wider diversity of Vibrio species compared to the conventional OTU clustering approach.
  13. Bunmark W, Jinatongthai P, Vathesatogkit P, Thakkinstian A, Reid CM, Wongcharoen W, et al.
    Front Pharmacol, 2018;9:1322.
    PMID: 30510510 DOI: 10.3389/fphar.2018.01322
    Background: Patients undergoing percutaneous coronary intervention (PCI) who require anticoagulant therapy are at increased risk of bleeding. The optimal regimen for these patients is uncertain. This study aimed to compare safety and efficacy of antithrombotic regimens used in patients undergoing PCI with concomitant anticoagulant therapy. Methods: A systematic review and network meta-analysis was performed among studies comparing antithrombotic regimens for anticoagulated patients undergoing PCI. The primary outcome of interest was major bleeding. The secondary outcomes were coronary events. The reference intervention was classic triple therapy (aspirin plus clopidogrel plus VKA). Cluster rank incorporating risk (major bleeding) and benefit (all-cause death) was performed to identify the most appropriate regimen(s). Results: There were 3 RCTs (6 interventions) and 29 non-RCTs (8 interventions) that met the inclusion criteria with 22,179 patients. Network meta-analysis of RCTs indicated that dual therapy (DT), either with vitamin K antagonist (VKA) or direct anticoagulant (DOAC) plus an antiplatelet, significantly reduced the risk of major bleeding compared to triple therapy (TT) [pooled RR of 0.51 (0.30-0.87) and 0.68 (0.49-0.94), respectively]. In addition, VKA-DT significantly reduced the risk of all-cause death compared to TT [pooled RR of 0.40 (0.17-0.93)]. Results from network meta-analysis of non-RCT paralleled that of RCTs. No significant differences of coronary events were found. Conclusions: In conclusion, for anticoagulated patients undergoing PCI, dual therapy, either with warfarin or DOAC plus an antiplatelet, should be considered due to its optimal balance on efficacy and safety.
  14. Saucier JR, Milensky CM, Caraballo-Ortiz MA, Ragai R, Dahlan NF, Edwards DP
    Zootaxa, 2019 Oct 17;4686(4):zootaxa.4686.4.1.
    PMID: 31719467 DOI: 10.11646/zootaxa.4686.4.1
    The enigmatic 'Spectacled Flowerpecker'-a probable new bird species from the island of Borneo-was first sighted in the Danum Valley of Sabah, Malaysia in 2009. However, the absence of a holotype specimen has prevented its formal scientific description. Since then only a handful of reports from widely disparate localities across the island have emerged, all from lowland sites and often in close association with fruiting mistletoe. Here, we report the long-awaited capture of a specimen of this putative new species and confirm its morphological and molecular distinctiveness as a novel species in the genus Dicaeum.
  15. Gough N, Brkan L, Subramaniam P, Chiuccariello L, De Petrillo A, Mulsant BH, et al.
    PLoS One, 2020;15(2):e0223029.
    PMID: 32092069 DOI: 10.1371/journal.pone.0223029
    With technological advancements and an aging population, there is growing interest in delivering interventions at home. Transcranial Direct Current Stimulation (tDCS) and Cognitive Remediation (CR) as well as Cognitive Training (CT) have been widely studied, but mainly in laboratories or hospitals. Thus, the objectives of this review are to examine feasibility and the interventions components to support the domiciliary administration of tDCS and CR. We performed a systematic search of electronic databases, websites and reference lists of included articles from the first date available until October 31, 2018. Articles included had to meet the following criteria: original work published in English using human subjects, majority of tDCS or CR intervention administered remotely. A total of 39 studies were identified (16 tDCS, 23 CR/CT, 5 using both tDCS & CT). Four studies were single case studies and two were multiple case studies. The remaining 33 studies had a range of 9-135 participants. Five tDCS and nine CR/CT studies were double blind randomized controlled trials. Most studies focused on schizophrenia (8/39) and multiple sclerosis (8/39). Literature examined suggests the feasibility of delivering tDCS or CR/CT remotely with the support of information and communication technologies.
  16. da Silva WR, Swami V, Nogueira Neves A, Marôco J, Ochner CN, Alvares Duarte Bonini Campos J
    Percept Mot Skills, 2019 Jun;126(3):462-476.
    PMID: 30922204 DOI: 10.1177/0031512519839537
    The Body Shape Questionnaire (BSQ) is a widely used measure of body shape concerns that was originally designed for use with women but has more recently been used with boys and men. The latter use may be problematic, given that no previous study has demonstrated sex invariance for BSQ scores. To determine the extent to which BSQ scores are sex invariant, we asked Portuguese-speaking women ( n = 1,613) and men ( n = 871) to complete the full BSQ (34 items). Confirmatory factor analysis indicated that a hypothesized 32-item model of BSQ scores and shorter versions had acceptable fit indices in women and men, separately. However, multigroup confirmatory factor analysis showed that these BSQ model scores had configural but not metric, scalar, or strict sex invariance. Differential item analysis indicated significant item-functioning differences on 19 of the 32 retained BSQ items. Thus, BSQ scores are not sex invariant, making problematic the results of previous studies that have compared latent BSQ scores across sex.
  17. Sghaireen MG, Alam MK, Patil SR, Rahman SA, Alhabib S, Lynch CD, et al.
    J Int Med Res, 2020 Mar;48(3):300060520912138.
    PMID: 32228352 DOI: 10.1177/0300060520912138
  18. Ayensu J, Larbie C, Annan RA, Lutterodt H, Edusei A, Loh SP, et al.
    J Nutr Metab, 2020;2020:8061365.
    PMID: 32322416 DOI: 10.1155/2020/8061365
    Edible insects have emerged as an inexpensive alternative source of protein for reducing the burden of malnutrition worldwide. However, there is a dearth of evidence on its efficacy, and thus, the aim of this study was to investigate the effect of edible insect consumption on the nutritional status of female Wistar albino rats. The study assessed the subchronic effect of palm weevil larvae (PWL) and orange-fleshed sweet potato- (OFSP-) enriched biscuits (fortified biscuits (FB), plain biscuits (PB), biscuits fortified with PWL (PWB), and biscuits fortified with OFSP only (SPB)) as a model to predict the potential of PWL to improve the nutritional status of pregnant women in Ghana. Twenty-five female Wistar albino rats were randomly assigned to five experimental groups to receive one of the five feed supplements for 28 days. After which, the effects of treatment on haematological and biochemical parameters including lipid profile were assessed. No significant differences were observed with haematological (Hb) parameters. However, total cholesterol levels of the FB, PB, PWB, and SPB were significantly higher than in the N group. Apart from elevated total cholesterol concentrations, biscuits fortified with PWL had no adverse effects and can be a nutritious snack for maintaining acceptable HB levels.
  19. Ahmed SI, Farooqui M, Syed Sulaiman SA, Hassali MA, Lee CKC
    J Patient Exp, 2019 Mar;6(1):33-40.
    PMID: 31236449 DOI: 10.1177/2374373518770805
    Background: It is widely accepted that for HIV-positive persons on highly active antiretroviral treatment, high levels of adherence to treatment regimens are essential for promoting viral suppression and preventing drug resistance.

    Objectives: This qualitative study examines factors affecting the adherence to HIV/AIDS treatment among patients with HIV/AIDS at a local hospital in Malaysia.

    Methods: The data from purposefully selected patients were collected by in-depth interviews using a pretested interview guide. Saturation was reached at the 13th interview. All interviews were audio-taped and transcribed verbatim for analysis using thematic content analysis.

    Results: Fear and stigma of perceived negative image of HIV diagnosis, lack of disease understating, poor support from the community, and perceived severity or the treatment side effects were among the reasons of nonadherence. Appropriate education and motivation from the doctors and reduction in pill burden were suggested to improve adherence.

    Conclusion: Educational interventions, self-management, and peer and community supports were among the factors suggested to improve adherence. This necessitates uncovering efficient ways to boost doctor-patient communication and recognizing the role of support group for the social and psychological well-being of the patients.

  20. Abdul Rashid AM, Abd Ghani F, Inche Mat LN, Lim CTS
    BMC Complement Med Ther, 2020 Jun 02;20(1):163.
    PMID: 32487242 DOI: 10.1186/s12906-020-02971-y
    BACKGROUND: Herbal medication is widely used in our region as a mode of alternative medicine. Its contents and combinations are often modified to suit the needs of different populations. These products are said to boost the immune system and may serve as a protective measure against many diseases including Systemic Lupus Erythematosus (SLE). Some even lay claims to be able to cure SLE. Although they are not without side effects, these medications are still preferred due to their widespread availability and affordability, compared to modern medications. However, to date, there have been no reported cases in which these traditional medications can trigger a lupus-like reaction, moreover one involving the kidneys.

    CASE PRESENTATION: We report a patient who developed overt lupus nephritis after consuming a course of herbal supplement. Her renal status did not improve upon cessation of the offending drug, and she required immunosuppressive therapy. After one cycle of IV cyclophosphamide, we managed to get the patient into remission - she is now on tapering doses of steroids.

    CONCLUSION: We wish to highlight the possibility of consumption of herbal medication and the emergence of drug-induced lupus nephritis. A thorough anamnesis and high index of suspicion of drug-induced lupus nephritis is warranted when a patient on supplements presents with urinary abnormalities.

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