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  1. Hassanein M, Echtay AS, Malek R, Omar M, Shaikh SS, Ekelund M, et al.
    Diabetes Res Clin Pract, 2018 Jan;135:218-226.
    PMID: 29183844 DOI: 10.1016/j.diabres.2017.11.027
    AIMS: To compare the efficacy and safety of insulin degludec/insulin aspart (IDegAsp) and biphasic insulin aspart 30 (BIAsp 30) before, during and after Ramadan in patients with type 2 diabetes mellitus (T2DM) who fasted during Ramadan.

    METHODS: In this multinational, randomised, treat-to-target trial, patients with T2DM who intended to fast and were on basal, pre- or self-mixed insulin ± oral antidiabetic drugs for ≥90 days were randomised (1:1) to IDegAsp twice daily (BID) or BIAsp 30 BID. Treatment period included pre-Ramadan treatment initiation (with insulin titration for 8-20 weeks), Ramadan (4 weeks) and post-Ramadan (4 weeks). Insulin doses were reduced by 30-50% for the pre-dawn meal (suhur) on the first day of Ramadan, and readjusted to the pre-Ramadan levels at the end of Ramadan. Hypoglycaemia was analysed as overall (severe or plasma glucose <3.1 mmol/L [56 mg/dL]), nocturnal (00:01-05:59) or severe (requiring assistance of another person).

    RESULTS: During the treatment period, IDegAsp (n = 131) had significantly lower overall and nocturnal hypoglycaemia rates with similar glycaemic efficacy, versus BIAsp 30 (n = 132). During Ramadan, despite achieving significantly lower pre-iftar (meal at sunset) self-measured plasma glucose (estimated treatment difference: -0.54 mmol/L [-1.02; -0.07]95% CI, p = .0247; post hoc) with similar overall glycaemic efficacy, IDegAsp showed significantly lower overall and nocturnal hypoglycaemia rates versus BIAsp 30.

    CONCLUSIONS: IDegAsp is a suitable therapeutic agent for patients who need insulin for sustained glucose control before, during and after Ramadan fasting, with a significantly lower risk of hypoglycaemia, versus BIAsp 30, an existing premixed insulin analogue.

    Matched MeSH terms: Blood Glucose
  2. Navindra Kumari Palanisamy, Parasakthi Navaratnam, Shamala Devi Sekaran
    MyJurnal
    Introduction: Streptococcus pneumoniae is an important bacterial pathogen, causing respiratory infection. Penicillin resistance in S. pneumoniae is associated with alterations in the penicillin binding proteins, while resistance to macrolides is conferred either by the modification of the ribosomal target site or efflux mechanism. This study aimed to characterize S. pneumoniae and its antibiotic resistance genes using 2 sets of multiplex PCRs. Methods: A quintuplex and triplex PCR was used to characterize the pbp1A, ermB, gyrA, ply, and the mefE genes. Fifty-eight penicillin sensitive strains (PSSP), 36 penicillin intermediate strains (PISP) and 26 penicillin resistance strains (PRSP) were used. Results: Alteration in pbp1A was only observed in PISP and PRSP strains, while PCR amplification of the ermB or mefE was observed only in strains with reduced susceptibility to erythromycin. The assay was found to be sensitive as simulated blood cultures showed the lowest level of detection to be 10cfu. Conclusions: As predicted, the assay was able to differentiate penicillin susceptible from the non-susceptible strains based on the detection of the pbp1A gene, which correlated with the MIC value of the strains.
    Matched MeSH terms: Blood Culture
  3. Ramatillah DL, Syed Sulaiman SA, Khan AH
    J Glob Infect Dis, 2018 6 19;10(2):37-41.
    PMID: 29910562 DOI: 10.4103/jgid.jgid_85_17
    Background: According to the Association of Nephrologist in Indonesia (Pernefri) recommendation, isolation and using special hemodialysis machines are not necessary for hemodialysis (HD) patients who have been infected by hepatitis C virus (HCV), while according to the Ministry of Health Malaysia recommendation, hepatitis C patients should be dialyzed in a separate room or a separate area with a fixed partition and dedicated machines.

    Aim: The aim of this study was to identify the correlation between the recommendation which had been followed by two HD centers in different countries and the impact of that on the hepatitis C infection issue.

    Methods: A cohort prospective and retrospective study was done in this research. The study included HD patients who were followed up for 9 months and who died in the last 5 years. Universal sampling was used to select the patients based on inclusion criteria.

    Results: There was a significant relationship between HCV during the first checkup and HCV during the second checkup during the 9-month follow-up of HD patients in a HD center, Jakarta, Indonesia. The total number of patients who had hepatitis C during the first and second checkups was also different in this HD center.

    Conclusion: Besides providing special HD rooms and machines for HD patients with hepatitis C, minimizing blood transfusion to the patients on HD is also important to reduce the chance for the patients to acquire hepatitis C and to increase the percentage of survival.

    Matched MeSH terms: Blood Transfusion
  4. Lim SY, Zalilah MS, Chin YS, Ramachandran V, Chan YM
    Nutrients, 2018 Jul 17;10(7).
    PMID: 30018240 DOI: 10.3390/nu10070915
    The interaction of dietary and genetic factors may affect the development of bone deterioration. This study investigated whether the effects of dietary acid load (DAL) on bone loss in postmenopausal Chinese women were moderated by the insulin-like growth factor-1 (IGF-1) single nucleotide polymorphism, a known gene that plays a role in the regulation of bone formation and bone remodeling. A total of 217 healthy participants were recruited from the National Council of Senior Citizens Organizations Malaysia. Serum collagen type 1 cross-linked C-telopeptide was used as a surrogate bone marker to assess bone resorption and Agena® MassARRAY genotyping analysis was used to identify the signaling of IGF-1 rs35767. The dietary acid load was measured by potential renal acid load score while physical activity was ascertained using the Global Physical Activity Questionnaire. Hierarchical regression was applied to test the main and interaction effects of DAL and IGF-1 genotypes in bone resorption. The result supported the diet-dependent acid-base balance theory that higher DAL was positively associated with bone resorption (β = 0.152, p = 0.031, F(6,207) = 2.11, sig-F = 0.036, R² = 0.079). However, the results indicated that there was no significant correlation between IGF-1 and bone resorption, or any significant interaction between DAL and IGF-1. In conclusion, there was no moderating effect of IGF-1 on the relationship between DAL and bone resorption.
    Matched MeSH terms: Peptides/blood; Biomarkers/blood; Collagen Type I/blood
  5. Lim CZ, Sonny Teo KS, Tai E
    Cureus, 2018 Apr 30;10(4):e2553.
    PMID: 29974009 DOI: 10.7759/cureus.2553
    Cataract, defined as cloudiness of the lens, is a common adverse effect of first-generation antipsychotic medications. Newer generation antipsychotics, also known as atypical antipsychotics, are less commonly associated with cataract. A 19-year-old girl with underlying schizophrenia on olanzapine for the past two years complained of gradual blurring of vision in both eyes for four months prior to presentation. On examination, the best corrected visual acuity was counting finger in both eyes. The anterior segment examination showed bilateral diffuse cortical cataract precluding fundus examination. Systemic examination was unremarkable. Blood investigations revealed a high random blood sugar, which normalised after she was initiated on oral hypoglycemic medication. After bilateral lens aspiration, her visual acuity was 6/6 bilaterally. Olanzapine may be cataractogenic via its action as a serotonin antagonist, which results in reduced glucose responsiveness of the pancreatic beta-cells. Patients on anti-psychotic medication are at risk of developing diabetes mellitus and cataract compared to the general population. Screening for diabetes mellitus should be part of the follow-up of these patients. Ophthalmological evaluation is warranted in the presence of visual complaints.
    Matched MeSH terms: Blood Glucose
  6. Khoo LW, Audrey Kow SF, Maulidiani M, Lee MT, Tan CP, Shaari K, et al.
    J Pharm Biomed Anal, 2018 Sep 05;158:438-450.
    PMID: 29957507 DOI: 10.1016/j.jpba.2018.06.038
    The present study sought to identify the key biomarkers and pathways involved in the induction of allergic sensitization to ovalbumin and to elucidate the potential anti-anaphylaxis property of Clinacanthus nutans (Burm. f.) Lindau water leaf extract, a Southeast Asia herb in an in vivo ovalbumin-induced active systemic anaphylaxis model evaluated by 1H-NMR metabolomics. The results revealed that carbohydrate metabolism (glucose, myo-inositol, galactarate) and lipid metabolism (glycerol, choline, sn-glycero-3-phosphocholine) are the key requisites for the induction of anaphylaxis reaction. Sensitized rats treated with 2000 mg/kg bw C. nutans extract before ovalbumin challenge showed a positive correlation with the normal group and was negatively related to the induced group. Further 1H-NMR analysis in complement with Kyoto Encyclopedia of Genes and Genomes (KEGG) reveals the protective effect of C. nutans extract against ovalbumin-induced anaphylaxis through the down-regulation of lipid metabolism (choline, sn-glycero-3-phosphocholine), carbohydrate and signal transduction system (glucose, myo-inositol, galactarate) and up-regulation of citrate cycle intermediates (citrate, 2-oxoglutarate, succinate), propanoate metabolism (1,2-propanediol), amino acid metabolism (betaine, N,N-dimethylglycine, methylguanidine, valine) and nucleotide metabolism (malonate, allantoin). In summary, this study reports for the first time, C. nutans water extract is a potential anti-anaphylactic agent and 1H-NMR metabolomics is a great alternative analytical tool to explicate the mechanism of action of anaphylaxis.
    Matched MeSH terms: Anaphylaxis/blood; Carbohydrates/blood; Lipids/blood
  7. Seyed-Reza, A., Norzarina, M.Z., Kimura, L.W.
    MyJurnal
    Introduction: This study was designed to determine the effectiveness of combined group Cognitive-Behavioral Therapy (CBT) in improving diabetes distress and glycemic control among 60 adults with type 2 diabetes.
    Methods: Half the participants were the experimental group (n = 30), and the other half was the control group (n = 30). Group therapy consisted of eight sessions for three months. Measures obtained at pre-test and post-test included the Diabetes Distress Scale (DDS-17) and blood examination to examine the level of HbA1c.
    Result: The results indicated that group CBT had significant effects on the amelioration of diabetes distress and level of HbA1c among the participants of the experimental group.
    Conclusion: The effectiveness of group CBT in the maintenance of good diabetic control in people who are suffering from type 2 diabetes was successfully demonstrated.
    Study site: Pusat Sejahtera (Universiti Sains Malaysia Clinic), Pulau Pinang, Malaysia
    Matched MeSH terms: Blood Glucose
  8. Tan, W.X., Chan, S.M., Khor, K.H.
    Jurnal Veterinar Malaysia, 2015;27(1):16-19.
    MyJurnal
    Old intact male dogs are often predisposed to benign prostatic hyperplasia. Both hypertrophy and hyperplasia of prostate
    gland occur due to hormonal influences. Clinical signs such as haematuria, stranguria and tenesmus are often associated with benign
    prostatic hyperplasia. A seven year-old local breed intact male dog was presented with a primary complaint of haematuria and
    stranguria. Diagnostic work-up conducted inclusive of complete blood count, serum biochemistry, urinalysis, abdominal radiograph,
    cystourethrography and abdominal ultrasonography. The dog was diagnosed with cystic benign prostatic hyperplasia. Prostatic
    omentalisation and castration were performed in this case.
    Matched MeSH terms: Blood Cell Count
  9. Lau MF, Vellasamy S, Chua KH, Sabaratnam V, Kuppusamy UR
    EXCLI J, 2018;17:186-199.
    PMID: 29743857 DOI: 10.17179/excli2018-1011
    Colorectal cancer (CRC) is the third most leading cause of morbidity and mortality throughout the world. 5-fluorouracil (5-FU), which is often administrated to disrupt carcinogenesis, was found to elevate blood glucose level among CRC patients. Thus, this study was conducted to evaluate the influence of rosiglitazone on antiproliferative effect of 5-FU using cellular model. Two human colonic carcinoma cell lines (HCT 116 and HT 29) were cultured in the presence of 5-FU, rosiglitazone or in combination under normal and high glucose concentration. The drug cytotoxicity was evaluated using the MTT assay whereas the assessment of cell cycle was carried out using the flow cytometry technique. Combination index (CI) method was used to determine the drug interaction between rosiglitazone and 5-FU. High glucose diminished the cytotoxic effect of 5-FU but at a high drug dosage, this effect could be overcome. Cell cycle analysis demonstrated that 5-FU and rosiglitazone caused G1-phase arrest and S-phase arrest, respectively. CI values indicated that rosiglitazone exerted synergistic effect on 5-FU regardless of glucose levels. This study is the first to demonstrate the influence of rosiglitazone on cytotoxicity of 5-FU under normal or high glucose level. Rosiglitazone may be a promising drug for enhancing the efficacy of 5-FU in the treatment of CRC associated with hyperglycemia.
    Matched MeSH terms: Blood Glucose
  10. Ng BC, Kleinheyer M, Smith PA, Timms D, Cohn WE, Lim E
    PLoS One, 2018;13(4):e0195975.
    PMID: 29677212 DOI: 10.1371/journal.pone.0195975
    Despite the widespread acceptance of rotary blood pump (RBP) in clinical use over the past decades, the diminished flow pulsatility generated by a fixed speed RBP has been regarded as a potential factor that may lead to adverse events such as vasculature stiffening and hemorrhagic strokes. In this study, we investigate the feasibility of generating physiological pulse pressure in the pulmonary circulation by modulating the speed of a right ventricular assist device (RVAD) in a mock circulation loop. A rectangular pulse profile with predetermined pulse width has been implemented as the pump speed pattern with two different phase shifts (0% and 50%) with respect to the ventricular contraction. In addition, the performance of the speed modulation strategy has been assessed under different cardiovascular states, including variation in ventricular contractility and pulmonary arterial compliance. Our results indicated that the proposed pulse profile with optimised parameters (Apulse = 10000 rpm and ωmin = 3000 rpm) was able to generate pulmonary arterial pulse pressure within the physiological range (9-15 mmHg) while avoiding undesirable pump backflow under both co- and counter-pulsation modes. As compared to co-pulsation, stroke work was reduced by over 44% under counter-pulsation, suggesting that mechanical workload of the right ventricle can be efficiently mitigated through counter-pulsing the pump speed. Furthermore, our results showed that improved ventricular contractility could potentially lead to higher risk of ventricular suction and pump backflow, while stiffening of the pulmonary artery resulted in increased pulse pressure. In conclusion, the proposed speed modulation strategy produces pulsatile hemodynamics, which is more physiologic than continuous blood flow. The findings also provide valuable insight into the interaction between RVAD speed modulation and the pulmonary circulation under various cardiovascular states.
    Matched MeSH terms: Blood Pressure
  11. Hamdy O, Barakatun-Nisak MY
    Endocrinol Metab Clin North Am, 2016 12;45(4):799-817.
    PMID: 27823606 DOI: 10.1016/j.ecl.2016.06.010
    Medical nutrition therapy (MNT) is a key component of diabetes management. The importance of balancing macronutrients, reducing carbohydrate load, lowering glycemic index, and implementing an overall healthy dietary pattern are emerging as better approaches for MNT in diabetes. Recent research points to improved glycemic control, reduction in body weight, and improvement in many cardiovascular risk factors when these approaches are provided by registered dietitians or health care providers. This review article discusses the current evidence about the role of sensible nutrition in diabetes management. Specific eating plans for weight reduction and for patients with type 1 diabetes are also discussed.
    Matched MeSH terms: Blood Glucose
  12. Ahmad MH, Ibrahim MI, Mohamed Z, Ismail N, Abdullah MA, Shueb RH, et al.
    PMID: 30223572 DOI: 10.3390/ijerph15092018
    Objectives: To study Malaysian dengue clinical practice guideline (CPG) warning signs (WS) in predicting severe dengue (SD) and its associated factors among confirmed cases presented to a teaching hospital in north-eastern Malaysia in 2014. Methods: A cross-sectional study was performed in February 2015 using secondary data acquired from the hospital records. There were 2607 confirmed dengue cases presented to Hospital Universiti Sains Malaysia (HUSM) in 2014. Seven hundred patients were selected after proportionate stratified random sampling conducted according to the number of cases in 12 different months in 2014. Data were collected and analysed using SPSS version 22.0. Results: Severe dengue outcomes represented 4.9% of cases. The prevalence of any of WS in SD was 91.2%. The most common WSs prior to SD were persistent vomiting (55.9%), and abdominal pain/tenderness (52.9%). The most sensitive warning sign in detecting SD was abdominal pain (59%). Specificity of individual WS were generally good, especially of clinical fluid accumulation (99%), hepatomegaly (98%) and mucosal bleeding (93%). Factors associated with SD were persistent vomiting (Adjusted odds ratio (aOR)): 2.41), mucosal bleeding (aOR: 4.73) and haematocrit rise with rapid platelet drop (aOR: 2.74). Conclusion: A focus on sensitivity, specificity, predictive values and association of a number of particular WS should be emphasized in order to better predict severe dengue outcomes.
    Matched MeSH terms: Blood Platelets
  13. Chew BS, Ghazali R, Othman H, Ismail NAM, Othman AS, Laim NMST, et al.
    J Obstet Gynaecol Res, 2018 Oct 10.
    PMID: 30306675 DOI: 10.1111/jog.13836
    AIM: The aim of our study was to determine the endocan-1 expression in placenta of hypertensive women, and its association with maternal and fetal outcomes.

    METHODS: This was a cross-sectional study consisted of 21 pregnant women with hypertension and 23 without hypertension. The gestational age ranged from 28 to 39 weeks (hypertensive) and 32 to 40 weeks (normotensive). The paraffin embedded formalin fixed placenta tissue blocks were retrieved from the pathology archives. Endocan immunohistochemistry was performed on tissue sections of full thickness and maternal surface of the placenta. The endocan expression was determined in fetal endothelial cells, maternal endothelial cells, cytotrophoblasts, syncytiotrophoblasts and decidual cells. The differences in endocan expression in placenta between hypertensive and normotensive subjects were evaluated by Pearson chi-square test and t-test were used in the statistical analysis.

    RESULTS: The endocan expression was significantly higher in fetal endothelial cells (P

    Matched MeSH terms: Blood Pressure
  14. Borgquist S, Rosendahl AH, Czene K, Bhoo-Pathy N, Dorkhan M, Hall P, et al.
    Breast Cancer Res, 2018 08 09;20(1):93.
    PMID: 30092829 DOI: 10.1186/s13058-018-1026-7
    BACKGROUND: Long-term insulin exposure has been implicated in breast cancer etiology, but epidemiological evidence remains inconclusive. The aims of this study were to investigate the association of insulin therapy with mammographic density (MD) as an intermediate phenotype for breast cancer and to assess associations with long-term elevated circulating insulin levels using a genetic score comprising 18 insulin-associated variants.

    METHODS: We used data from the KARolinska MAmmography (Karma) project, a Swedish mammography screening cohort. Insulin-treated patients with type 1 (T1D, n = 122) and type 2 (T2D, n = 237) diabetes were identified through linkage with the Prescribed Drug Register and age-matched to 1771 women without diabetes. We assessed associations with treatment duration and insulin glargine use, and we further examined MD differences using non-insulin-treated T2D patients as an active comparator. MD was measured using a fully automated volumetric method, and analyses were adjusted for multiple potential confounders. Associations with the insulin genetic score were assessed in 9437 study participants without diabetes.

    RESULTS: Compared with age-matched women without diabetes, insulin-treated T1D patients had greater percent dense (8.7% vs. 11.4%) and absolute dense volumes (59.7 vs. 64.7 cm3), and a smaller absolute nondense volume (615 vs. 491 cm3). Similar associations were observed for insulin-treated T2D, and estimates were not materially different in analyses comparing insulin-treated T2D patients with T2D patients receiving noninsulin glucose-lowering medication. In both T1D and T2D, the magnitude of the association with the absolute dense volume was highest for long-term insulin therapy (≥ 5 years) and the long-acting insulin analog glargine. No consistent evidence of differential associations by insulin treatment duration or type was found for percent dense and absolute nondense volumes. Genetically predicted insulin levels were positively associated with percent dense and absolute dense volumes, but not with the absolute nondense volume (percentage difference [95% CI] per 1-SD increase in insulin genetic score = 0.8 [0.0; 1.6], 0.9 [0.1; 1.8], and 0.1 [- 0.8; 0.9], respectively).

    CONCLUSIONS: The consistency in direction of association for insulin treatment and the insulin genetic score with the absolute dense volume suggest a causal influence of long-term increased insulin exposure on mammographic dense breast tissue.

    Matched MeSH terms: Diabetes Mellitus, Type 1/blood; Diabetes Mellitus, Type 2/blood; Insulin/blood
  15. Butt M, Ali AM, Bakry MM
    Curr Diabetes Rev, 2019;15(5):402-406.
    PMID: 30156163 DOI: 10.2174/1573399814666180828152754
    BACKGROUND: This study evaluated the association between self-reported adherence with concurrent and subsequent glycemic control amongst type 2 diabetes patients at a tertiary care hospital in Malaysia.

    METHODS: Demographic and clinical variables were assessed at baseline, after three and six months in 73 type 2 diabetes patients. Regression analysis, using SPSS, evaluated the concurrent and longitudinal association of medication adherence and glycemic control. Potential confounders of variables were identified using bi-variate correlation analyses.

    RESULTS: Concurrent Medication adherence and HbA1c association were significant after adjusting for ethnicity (P = 0.005). For longitudinal observation at 3 months, the association was significant after adjusting for ethnicity (P = 0.016); however, it became non-significant when baseline glycemic control was included in the model (P = 0.28).

    CONCLUSION: Easy to administer MALMAS significantly predicted concurrent glycemic control independent of potential confounders. This association persisted in longitudinal observation after 3 months when adjusted for confounders and became non-significant after adjusting for baseline glycemic control.

    Matched MeSH terms: Blood Glucose
  16. Kow FP, Adlina B, Sivasangari S, Punithavathi N, Ng KK, Ang AH, et al.
    Med J Malaysia, 2018 08;73(4):233-238.
    PMID: 30121686 MyJurnal
    INTRODUCTION: As pharmacological treatment of hypertension has become a burden worldwide, the study looked into nonpharmacological ways of reducing blood pressure. The objective was to determine if music guided, slow and deep breathing will reduce the blood pressure among patients with hypertension in eight weeks.

    METHODS: A participant blinded, multi-centre, randomised controlled trial was conducted in which the participants in the intervention group (IG) practiced deep breathing exercise guided by sound cues and those in the control group (CG) listened to the music. The primary end point was reduction in blood pressure at eight weeks.

    RESULTS: 87 patients, 46 males and 41 females with mean age of 61.1 years were recruited and 93.1% of them successfully completed the study. There was significant reduction in systolic and diastolic Blood Pressure from baseline by 8 weeks in both groups. The reduction in Mean systolic blood pressure (SBP) in the control arm was 10.5mmHg compared to 8.3mmHg (p<0.001) in intervention group. Diastolic blood pressure (DBP) reduction in control and intervention groups were 5.2 mmHg (p<0.001) and 5.6 mmHg (p<0.001) respectively. The absolute difference in SBP reduction from baseline in IG & CG was -2.2 (95%CI: -7.8 to 3.5) and DBP was -0.4 (95%CI: -2.9 to 3.6). However, blood pressure reduction between the two groups was not significant.

    CONCLUSIONS: Both listening to music and deep breathing exercise were associated with a clinically significant reduction in SBP and DBP. However, deep breathing exercise did not augment the benefit of music in reducing BP.

    Matched MeSH terms: Blood Pressure
  17. Ng RL
    Med J Malaysia, 2018 10;73(5):328-329.
    PMID: 30350815
    A 5-year-old girl presented with three brief episodes of afebrile seizure within 24 hours. There was no significant past medical history but she had symptoms of acute gastroenteritis for the past 2 days. She was mildly dehydrated with no neurological signs. Serum electrolytes and blood sugar were normal and cerebrospinal fluid examination was negative for meningoencephalitis. Contrast-enhanced CT Brain showed no evidence of intracranial lesion, haemorrhage or meningeal enhancement. Only stool investigation was positive for Rotavirus. The conclusion of Benign Afebrile Convulsion with gastroenteritis (CwG) was established after excluding other serious causes of afebrile seizure in children.
    Matched MeSH terms: Blood Glucose
  18. Khor KZ, Lim V, Moses EJ, Abdul Samad N
    PMID: 30538753 DOI: 10.1155/2018/1071243
    Moringa oleifera, a fast-growing deciduous tree that is widely cultivated in tropical and subtropical regions of the world, is well known for its abundant uses. The tree is a source of food, shelter, and traditional medicine for many people, especially in developing countries. Many studies have been conducted to evaluate the various claims of traditional medicine practitioners that the moringa tree can improve health and treat various diseases. The tree has a high nutritional profile, especially the nutrient rich leaves. Some reports also support the use of parts of the tree to reduce blood sugar and cholesterol levels. These attractive properties have led researchers to look for other novel uses for the moringa tree, especially as a source of anticancer drugs. Researchers have tested extracts from various parts of the moringa tree both in vitro and in vivo on several types of cancers with varying success. This review explores the state of current research on the anticancer properties of M. oleifera.
    Matched MeSH terms: Blood Glucose
  19. Bukhsh A, Tan XY, Chan KG, Lee LH, Goh BH, Khan TM
    Patient Prefer Adherence, 2018;12:2457-2474.
    PMID: 30538430 DOI: 10.2147/PPA.S180256
    Background: Effectiveness of pharmacist-led educational interventions on self-care activities and glycemic control of type 2 diabetes mellitus (T2DM) patients is vague. The purpose of this review is to appraise the effect of pharmacist-led educational interventions on self-care activities and levels of glycated hemoglobin of T2DM patients.

    Methods: Five electronic databases were searched from date of database inception to September 2017. Randomized clinical trials examining the effectiveness of pharmacist-led educational interventions, directed at T2DM patients only, were included for systematic review and meta-analysis. The protocol is available with PROSPERO (CRD42017078854).

    Results: Eleven studies, involving n=1,544 T2DM patients, were included in this systematic review. Meta-analysis demonstrated that pharmacist-led interventions had a significant effect on lowering of the levels of glycated hemoglobin (-0.66; 95% CI [-0.83, -0.50]; I2=58.3%; P=0.008), in comparison to usual care. Self-care activities were assessed by using Summary of Diabetes Self-care Activities tool in eight studies. Overall meta-analysis of self-care activities for included studies demonstrated a significant effect of pharmacist-led interventions on improvement of self-monitoring of blood glucose (1.62; 95% CI [0.92, 2.32]; I2=70.5%; P=0.005), foot care (1.20; 95% CI [0.49, 1.90]; I2=95.0%; P<0.001), and overall diet (1.16; 95% CI [0.38, 1.93]; I2=64.2%; P=0.094).

    Conclusion: The findings of this review demonstrate a significantly positive effect of pharmacist-led educational interventions on HbA1c levels and self-care practices among T2DM patients.
    Matched MeSH terms: Blood Glucose
  20. Farah, N.A., Johar, M.J., Ismail, M.S.
    Medicine & Health, 2018;13(1):251-258.
    MyJurnal
    Damage control resuscitation, characterized by hemostatic resuscitation with blood products, rapid arrest of bleeding and when possible, permissive hypotension with restricted fluid load form a structured approach in managing a polytrauma patient. When complicated with traumatic rhabdomyolysis however, permissive hypotension strategy may cause more harm resulting in subsequent ischaemicreperfusion injury and acute kidney injury. We present a case involving a 20-yearold man who was rolled over by a lorry and sustained an open unstable pelvic fracture with vascular injury and left lower limb ischaemia. Permissive hypotension strategy was pursued for 4 hours prior to bleeding control in OT. This was followed by protracted surgery of 6 hours. Coagulopathy, acute kidney injury and rhabdomyolysis ensued in the post-operative period and patient succumbed to his injury on Day 3 post-trauma. Challenges and pitfalls in managing a complex polytrauma patient and recent evidences on damage control resuscitation is discussed.
    Matched MeSH terms: Blood Coagulation Disorders
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