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  1. Effects of Different Electrode Configurations on the Narrow Band Level-Specific CE-Chirp and Tone-Burst Auditory Brainstem Response at Multiple Intensity Levels and Frequencies in Subjects With Normal Hearing
    Dzulkarnain AAA, Abdullah SA, Ruzai MAM, Ibrahim SHMN, Anuar NFA, Rahim 'EA
    Am J Audiol, 2018 Sep 12;27(3):294-305.
    PMID: 30054628 DOI: 10.1044/2018_AJA-17-0087
    Purpose: The purpose of this study was to investigate the influence of 2 different electrode montages (ipsilateral and vertical) on the auditory brainstem response (ABR) findings elicited from narrow band (NB) level-specific (LS) CE-Chirp and tone-burst in subjects with normal hearing at several intensity levels and frequency combinations.

    Method: Quasi-experimental and repeated-measures study designs were used in this study. Twenty-six adults with normal hearing (17 females, 9 males) participated. ABRs were acquired from the study participants at 3 intensity levels (80, 60, and 40 dB nHL), 3 frequencies (500, 1000, and 2000 Hz), 2 electrode montages (ipsilateral and vertical), and 2 stimuli (NB LS CE-Chirp and tone-burst) using 2 stopping criteria (fixed averages at 4,000 sweeps and F test at multiple points = 3.1).

    Results: Wave V amplitudes were only 19%-26% larger for the vertical recordings than the ipsilateral recordings in both the ABRs obtained from the NB LS CE-Chirp and tone-burst stimuli. The mean differences in the F test at multiple points values and the residual noise levels between the ABRs obtained from the vertical and ipsilateral montages were statistically not significant. In addition, the ABR elicited from the NB LS CE-Chirp was significantly larger (up to 69%) than those from the tone-burst, except at the lower intensity level.

    Conclusion: Both the ipsilateral and vertical montages can be used to record ABR to the NB LS CE-Chirp because of the small enhancement in the wave V amplitude provided by the vertical montage.

  2. Fulltext Outcomes of STEMI patients with chronic kidney disease treated with percutaneous coronary intervention: the Malaysian National Cardiovascular Disease Database - Percutaneous Coronary Intervention (NCVD-PCI) registry data from 2007 to 2014
    Ismail MD, Jalalonmuhali M, Azhari Z, Mariapun J, Lee ZV, Zainal Abidin I, et al.
    BMC Cardiovasc Disord, 2018 09 24;18(1):184.
    PMID: 30249197 DOI: 10.1186/s12872-018-0919-9
    BACKGROUND: Patients with renal impairment often left out from most major clinical trials assessing the optimal treatment for ST-elevation myocardial infarction (STEMI). Large body of evidence from various cardiovascular registries reflecting more 'real-world' experience might contribute to the knowledge on how best to treat this special cohort. We aim to analyze the outcomes of Malaysian STEMI patients with renal impairment treated with coronary angioplasty.

    METHODS: Utilizing the Malaysian National Cardiovascular Disease Database-Percutaneous Coronary Intervention (NCVD-PCI) registry data from 2007 to 2014, STEMI patients treated with percutaneous coronary intervention (PCI) were stratified into presence (GFR 

  3. Phomopsidione nanoparticles coated contact lenses reduce microbial keratitis causing pathogens
    Bin Sahadan MY, Tong WY, Tan WN, Leong CR, Bin Misri MN, Chan M, et al.
    Exp Eye Res, 2019 01;178:10-14.
    PMID: 30243569 DOI: 10.1016/j.exer.2018.09.011
    Microbial keratitis is the infection caused by pathogenic microorganisms that commonly occurs among the contact lens users. Various antimicrobial compounds were coated on contact lenses to kill keratitis causing microorganisms, however these compounds caused several adverse side effects. Hence, the aim of this study is to develop a silicone hydrogel contact lens coated with phomopsidione nanoparticle that inhibit keratitis causing clinical isolates. Phomopsidione nanoparticles were synthesized using polyvinyl alcohol as encapsulant. The nanoparticles showed an average size of 77.45 nm, with neutral surface charge. Two drug release patterns were observed in the drug release profile, which are the initial slow release phase with extended drug release (release rate 46.65 μg/h), and the burst release phase observed on Day 2 (release rate 2224.49 μg/h). This well-regulated drug delivery system enables the control of drug release to meet the therapeutic requirements. On agar diffusion assay, 3 out of 5 test microorganisms were inhibited by phomopsidione nanoparticle coated contact lenses, including two Gram negative bacteria. Besides, all test microorganisms showed at least 99% of growth reduction, with the treatment of the contact lens model. The drug loaded onto the nanoparticles is sufficient to prevent the bacterial growth. In conclusion, this study provides an effective alternative to combat keratitis-causing microorganisms among contact wearers.
  4. Two-way switch: Maximizing productivity of tilted panel in membrane bioreactor
    Eliseus A, Bilad MR, Nordin NAHM, Khan AL, Putra ZA, Wirzal MDH, et al.
    J Environ Manage, 2018 Dec 15;228:529-537.
    PMID: 30273771 DOI: 10.1016/j.jenvman.2018.09.029
    Membrane fouling is a major challenge in membrane bioreactors (MBRs) and its effective handling is the key to improve their competitiveness. Tilting panel system offers significant improvements for fouling control but is strictly limited to one-sided panel. In this study, we assess a two-way switch tilting panel system that enables two-sided membranes and project its implications on performance and energy footprint. Results show that tilting a panel improves permeance by up to 20% to reach a plateau flux thanks to better contacts between air bubbles and the membrane surface to scour-off the foulant. A plateau permeance could be achieved at aeration rate of as low as 0.90 l min-1, a condition untenable by vertical panel even at twice of the aeration rate. Switching at short periods (<5min) can maintain the hydraulic performance as in no-switch (static system), enables application of a two-sided switching panel. A comparison of vertical panel under 1.80 l min-1 aeration rate with a switching panel at a half of the rate, switched at 1 min period shows ≈10% higher permeance of the later. Since periodic switching consumes a very low energy (0.55% of the total of 0.276 kWh m-3), with reduction of aeration by 50%, the switching tilted panel offers 41% more energy efficient than a referenced full-scale MBR (0.390 kWh m-3). Overall results are very compelling and highly attractive for significant improvements of MBR technologies.
  5. Fulltext Arsenic Resistance and Biosorption by Isolated Rhizobacteria from the Roots of Ludwigia octovalvis
    Titah HS, Abdullah SRS, Idris M, Anuar N, Basri H, Mukhlisin M, et al.
    Int J Microbiol, 2018;2018:3101498.
    PMID: 30723505 DOI: 10.1155/2018/3101498
    Certain rhizobacteria can be applied to remove arsenic in the environment through bioremediation or phytoremediation. This study determines the minimum inhibitory concentration (MIC) of arsenic on identified rhizobacteria that were isolated from the roots of Ludwigia octovalvis (Jacq.) Raven. The arsenic biosorption capability of the was also analyzed. Among the 10 isolated rhizobacteria, five were Gram-positive (Arthrobacter globiformis, Bacillus megaterium, Bacillus cereus, Bacillus pumilus, and Staphylococcus lentus), and five were Gram-negative (Enterobacter asburiae, Sphingomonas paucimobilis, Pantoea spp., Rhizobium rhizogenes, and Rhizobium radiobacter). R. radiobacter showed the highest MIC of >1,500 mg/L of arsenic. All the rhizobacteria were capable of absorbing arsenic, and S. paucimobilis showed the highest arsenic biosorption capability (146.4 ± 23.4 mg/g dry cell weight). Kinetic rate analysis showed that B. cereus followed the pore diffusion model (R2 = 0.86), E. asburiae followed the pseudo-first-order kinetic model (R2 = 0.99), and R. rhizogenes followed the pseudo-second-order kinetic model (R2 = 0.93). The identified rhizobacteria differ in their mechanism of arsenic biosorption, arsenic biosorption capability, and kinetic models in arsenic biosorption.
  6. Synthesis, X-ray crystal and monoamine oxidase inhibitory activity of 4,6-dihydrobenzo[c]pyrano[2,3-e][1,2]thiazine 5,5-dioxides: In vitro studies and docking analysis
    Ahmad S, Jalil S, Zaib S, Aslam S, Ahmad M, Rasul A, et al.
    Eur J Pharm Sci, 2019 Apr 01;131:9-22.
    PMID: 30735822 DOI: 10.1016/j.ejps.2019.02.007
    We report the synthesis and biological evaluation of two new series of 2-amino-6-benzyl-4-phenyl-4,6-dihydrobenzo[c]pyrano[2,3-e][1,2]thiazine-3‑carbonitrile 5,5-dioxides and 2-amino-6-methyl-4-phenyl-4,6-dihydrobenzo[c]pyrano[2,3-e][1,2]thiazine-3‑carbonitrile 5,5-dioxides. The synthetic methodology involves a multistep reaction starting with methyl anthranilate which was coupled with methane sulfonyl chloride. The product of the reaction was subjected to N-benzylation and N-methylation reactions followed by ring closure with sodium hydride resulting in the formation of respective 2,1-benzothiazine 2,2-dioxides. These 2,1-benzothiazine precursors were subjected to multicomponent reaction with malononitrile and substituted benzaldehydes for the synthesis of two new series of pyranobenzothiazines (6a-r and 7a-r). The synthesized compounds were screened as selective inhibitors of monoamine oxidase A and monoamine oxidase B. The in vitro results suggested that compound 6d and 7q are the selective inhibitors of monoamine oxidase A, however, the selective and potent inhibitors of monoamine oxidase B included compounds 6h and 7r. Moreover, some dual inhibitors were noticed like 7l having more inhibitory activity towards both the isozymes. Moreover, the binding modes of the selective and potent inhibitors of monoamine oxidase A and B were investigated by molecular docking analysis. The results suggested that the synthetic derivatives may be potential towards the monoamine oxidase isozymes.
  7. Fulltext Toxicological studies of Orthosiphon stamineus (Misai Kucing) standardized ethanol extract in combination with gemcitabine in athymic nude mice model
    Yehya AHS, Asif M, Kaur G, Hassan LEA, Al-Suede FSR, Abdul Majid AMS, et al.
    J Adv Res, 2019 Jan;15:59-68.
    PMID: 30581613 DOI: 10.1016/j.jare.2018.05.006
    Pancreatic cancer has the highest mortality rate among cancers due to its aggressive biology and lack of effective treatment. Gemcitabine, the first line anticancer drug has reduced efficacy due to acquired resistance. The current study evaluates the toxicological effects of Orthosiphon stamineus (O.s) and its marker compound (rosmarinic acid) in combination with gemcitabine. O.s (200 or 400 mg/kg/day) and rosmarinic acid (32 mg/kg/day) were administered orally and gemcitabine (10 mg/kg/3 days) intraperitoneally either alone or in combination treatment for fourteen days. Parameters including blood serum biochemistry, hematology, myeloid-erythroid ratio, incident of lethality, and histopathological analysis of liver, kidney, and spleen tissues were studied. Neither, individual drugs/extract nor chemo-herbal combinations at tested doses induced any toxicity and damage to organs in nude mice when compared to control group. Toxicological data obtained from this study will help to select the best doses of chemo-herbal combination for future pancreatic xenograft tumor studies.
  8. In silico and BSA binding study of some new biological analogs of 1,2,4-triazolependant with azinane through microwave and conventional synthesis
    Virk NA, Rehman A, Abbasi MA, Siddiqui SZ, Ashraf A, Lateef M, et al.
    Pak J Pharm Sci, 2018 Nov;31(6 (Supplementary):2645-2654.
    PMID: 30587474
    Microwave and conventional techniques were employed to synthesize a novel array of compounds 7a-g with 1,2,4-triazole and piperidine rings having great biological importance. The microwave assisted method has a better operational scope with respect to time and yield comparative to the conventional method. 1H-NMR, 13C-NMR and IR techniques were employed to justify the structure of synthesized compounds. The antioxidant, butyrylcholinesterase inhibition and urease inhibition potential of every synthesized compound was evaluated. Every member of the synthesized series was found potent against mentioned activities. Compound 7g was the most active anti-urease agent having IC50 (μM) value 16.5±0.09 even better than the thiourea with an IC50(μM) value of 24.3±0.24. The better urease inhibition potential of 7g was also elaborated and explained by docking and bovine serum albumin (BSA) binding studies.
  9. Fulltext Factors associated with the severity of hypertension among Malaysian adults
    Mahadir Naidu B, Mohd Yusoff MF, Abdullah S, Musa KI, Yaacob NM, Mohamad MS, et al.
    PLoS One, 2019;14(1):e0207472.
    PMID: 30605462 DOI: 10.1371/journal.pone.0207472
    High blood pressure is a worldwide problem and major global health burden. Whether alone or combined with other metabolic diseases, high blood pressure increases the risk of cardiovascular disease. This study is a secondary data analysis from the National Health and Morbidity Survey 2015, a population-based study that was conducted nationwide in Malaysia using a multi-stage stratified cluster sampling design. A total of 15,738 adults ≥18-years-old were recruited into the study, which reports the prevalence of hypertension stages among adults in Malaysia using the JNC7 criteria and determinants of its severity. The overall prevalence of raised blood pressure was 66.8%, with 45.8% having prehypertension, 15.1% having Stage 1 hypertension, and 5.9% having Stage 2 hypertension. In the multivariate analysis, a higher likelihood of having prehypertension was observed among respondents with advancing age, males (OR = 2.74, 95% CI: 2.41-3.12), Malay ethnicity (OR = 1.21, 95% CI: 1.02-1.44), lower socioeconomic status, and excessive weight. The factors associated with clinical hypertension (Stages 1 and 2) were older age, rural residency (Stage 1 OR = 1.22, Stage 2 OR = 1.28), Malay ethnicity (Stage 2 OR = 1.64), diabetes (Stage 2 OR = 1.47), hypercholesterolemia (Stage 1 OR = 1.34, Stage 2 OR = 1.82), being overweight (Stage 1 OR = 2.86, Stage 2 OR = 3.44), obesity (Stage 1 OR = 9.01, Stage 2 OR = 13.72), and lower socioeconomic status. Almost 70% of Malaysian adults are at a risk of elevated blood pressure. The highest prevalence was in the prehypertension group, which clearly predicts a future incurable burden of the disease. Public health awareness, campaigns through mass and social media, and intervention in the work place should be a priority to control this epidemic.
  10. Synthesis of novel quinoline-based thiadiazole, evaluation of their antileishmanial potential and molecular docking studies
    Almandil NB, Taha M, Rahim F, Wadood A, Imran S, Alqahtani MA, et al.
    Bioorg Chem, 2019 04;85:109-116.
    PMID: 30605884 DOI: 10.1016/j.bioorg.2018.12.025
    New series of quinoline-based thiadiazole analogs (1-20) were synthesized, characterized by EI-MS, 1H NMR and 13C NMR. All synthesized compounds were subjected to their antileishmanial potential. Sixteen analogs 1-10, 12, 13, 16, 17, 18 and 19 with IC50 values in the range of 0.04 ± 0.01 to 5.60 ± 0.21 µM showed tremendously potent inhibition as compared to the standard pentamidine with IC50 value 7.02 ± 0.09 µM. Analogs 11, 14, 15 and 20 with IC50 8.20 ± 0.35, 9.20 ± 0.40, 7.20 ± 0.20 and 9.60 ± 0.40 µM respectively showed good inhibition when compared with the standard. Structure-activity relationships have been also established for all compounds. Molecular docking studies were performed to determine the binding interaction of the compounds with the active site target.
  11. Fulltext Opportunities and challenges associated with fecal progesterone metabolite analysis
    Peter ID, Haron AW, Jesse FFA, Ajat M, Han MHW, Fitri WN, et al.
    Vet World, 2018 Nov;11(10):1466-1472.
    PMID: 30532503 DOI: 10.14202/vetworld.2018.1466-1472
    Conventionally, plasma or milk progesterone evaluations are used to determine the reproductive status of female animals. Collection of such samples is often associated with difficulties of animal handling and restraint. Measurable quantities of progesterone metabolites are found in feces of animals. Their concentrations are known to be well correlated to plasma progesterone levels and are, therefore, used as non-invasive samples for assessing reproductive function in a wide range of animal species. Although the analysis of fecal progesterone metabolites has been widely accepted in many laboratories, several factors are known to affect the results from this valuable analytical technique. Some of these factors include storage/transportation media for fecal samples, type of solvent that is used for extraction of progesterone metabolites from feces, and the type and sensitivity of an assaying technique employed. Although fecal progesterone metabolites analysis is associated with some difficulties, it can effectively be used to monitor reproductive function in a wide range of animal species. This review aims to highlight the usefulness of fecal progesterone metabolite analysis as a non-invasive technique in monitoring reproductive function in animals. The article mainly focuses on the many opportunities and challenges associated with this analytical technique.
  12. Risk of concentrations of major air pollutants on the prevalence of cardiovascular and respiratory diseases in urbanized area of Kuala Lumpur, Malaysia
    Tajudin MABA, Khan MF, Mahiyuddin WRW, Hod R, Latif MT, Hamid AH, et al.
    Ecotoxicol Environ Saf, 2019 Apr 30;171:290-300.
    PMID: 30612017 DOI: 10.1016/j.ecoenv.2018.12.057
    Rapid urbanisation in Malaysian cities poses risks to the health of residents. This study aims to estimate the relative risk (RR) of major air pollutants on cardiovascular and respiratory hospitalisations in Kuala Lumpur. Daily hospitalisations due to cardiovascular and respiratory diseases from 2010 to 2014 were obtained from the Hospital Canselor Tuanku Muhriz (HCTM). The trace gases, PM10 and weather variables were obtained from the Department of Environment (DOE) Malaysia in consistent with the hospitalisation data. The RR was estimated using a Generalised Additive Model (GAM) based on Poisson regression. A "lag" concept was used where the analysis was segregated into risks of immediate exposure (lag 0) until exposure after 5 days (lag 5). The results showed that the gases could pose significant risks towards cardiovascular and respiratory hospitalisations. However, the RR value of PM10 was not significant in this study. Immediate effects on cardiovascular hospitalisations were observed for NO2 and O3 but no immediate effect was found on respiratory hospitalisations. Delayed effects on cardiovascular and respiratory hospitalisations were found with SO2 and NO2. The highest RR value was observed at lag 4 for respiratory admissions with SO2 (RR = 1.123, 95% CI = 1.045-1.207), followed by NO2 at lag 5 for cardiovascular admissions (RR = 1.025, 95% CI = 1.005-1.046). For the multi-pollutant model, NO2 at lag 5 showed the highest risks towards cardiovascular hospitalisations after controlling for O3 8 h mean lag 1 (RR = 1.026, 95% CI = 1.006-1.047), while SO2 at lag 4 showed highest risks towards respiratory hospitalisations after controlling for NO2 lag 3 (RR = 1.132, 95% CI = 1.053-1.216). This study indicated that exposure to trace gases in Kuala Lumpur could lead to both immediate and delayed effects on cardiovascular and respiratory hospitalisations.
  13. Fulltext Angiogenic potential of extracellular matrix of human amniotic membrane
    Hashim SNM, Yusof MFH, Zahari W, Noordin KBAA, Kannan TP, Hamid SSA, et al.
    Tissue Eng Regen Med, 2016 Jun;13(3):211-217.
    PMID: 30603401 DOI: 10.1007/s13770-016-9057-6
    Combination between tissue engineering and other fields has brought an innovation in the area of regenerative medicine which ultimate aims are to repair, improve, and produce a good tissue construct. The availability of many types of scaffold, both synthetically and naturally have developed into many outstanding end products that have achieved the general objective in tissue engineering. Interestingly, most of this scaffold emulates extracellular matrix (ECM) characteristics. Therefore, ECM component sparks an interest to be explored and manipulated. The ECM featured in human amniotic membrane (HAM) provides a suitable niche for the cells to adhere, grow, proliferate, migrate and differentiate, and could possibly contribute to the production of angiogenic micro-environment indirectly. Previously, HAM scaffold has been widely used to accelerate wound healing, treat bone related and ocular diseases, and involved in cardiovascular repair. Also, it has been used in the angiogenicity study, but with a different technical approach. In addition, both side of HAM could be used in cellularised and decellularised conditions depending on the objectives of a particular research. Therefore, it is of paramount importance to investigate the behavior of ECM components especially on the stromal side of HAM and further explore the angiogenic potential exhibited by this scaffold.
  14. Fulltext Microwave Hydrothermal Carbonization of Rice Straw: Optimization of Process Parameters and Upgrading of Chemical, Fuel, Structural and Thermal Properties
    Nizamuddin S, Qureshi SS, Baloch HA, Siddiqui MTH, Takkalkar P, Mubarak NM, et al.
    Materials (Basel), 2019 Jan 28;12(3).
    PMID: 30696042 DOI: 10.3390/ma12030403
    The process parameters of microwave-induced hydrothermal carbonization (MIHTC) play an important role on the hydrothermal chars (hydrochar) yield. The effect of reaction temperature, reaction time, particle size and biomass to water ratio was optimized for hydrochar yield by modeling using the central composite design (CCD). Further, the rice straw and hydrochar at optimum conditions have been characterized for energy, chemical, structural and thermal properties. The optimum condition for hydrochar synthesis was found to be at a 180 °C reaction temperature, a 20 min reaction time, a 1:15 weight per volume (w/v) biomass to water ratio and a 3 mm particle size, yielding 57.9% of hydrochar. The higher heating value (HHV), carbon content and fixed carbon values increased from 12.3 MJ/kg, 37.19% and 14.37% for rice straw to 17.6 MJ/kg, 48.8% and 35.4% for hydrochar. The porosity, crystallinity and thermal stability of the hydrochar were improved remarkably compared to rice straw after MIHTC. Two characteristic peaks from XRD were observed at 2θ of 15° and 26°, whereas DTG peaks were observed at 50⁻150 °C and 300⁻350 °C for both the materials. Based on the results, it can be suggested that the hydrochar could be potentially used for adsorption, carbon sequestration, energy and agriculture applications.
  15. Comparative secondary metabolites profiling and biological activities of aerial, stem and root parts of Salvadora oleoides decne (Salvadoraceae)
    Saleem H, Ahmad I, Zengin G, Mahomoodally FM, Rehman Khan KU, Ahsan HM, et al.
    Nat Prod Res, 2020 Dec;34(23):3373-3377.
    PMID: 30678488 DOI: 10.1080/14786419.2018.1564299
    In this study, different parts (aerial, stem and root) of Salvadora oleoides Decne were investigated in order to explore their phytochemical composition and biological potential. The bioactive contents were evaluated by conventional spectrophotometric methods. Additionally, the secondary metabolite compounds were identified by UHPLC-MS analysis. Biological potential was evaluated by determining antioxidant (DPPH, FRAP, and Phosphomolybdenum) and enzyme inhibitory (butrylcholinesterase and lipoxygenase) effects. Higher total bioactive contents were found in methanolic extracts which tend to correlate with higher radical scavenging and reducing potential of these extracts. LC/MS spectrum revealed the presence of 16 different secondary metabolites belonging to terpene, glucoside and sesquiterpenoid dervivatives. Glucocleomin and emotin A were the main compounds present in all three parts. The strongest butrylcholinesterase and lipoxygenase inhibitory activity was observed for root and stem DCM extracts. Demonstrated biological potential of S. oleoides plant can trace a new road map for developing newly designed bioactive pharmaceuticals.
  16. Synthesis and structure-activity relationship of elastase inhibiting novel ethylated thiazole-triazole acetamide hybrids: Mechanistic insights through kinetics and computational contemplations
    Butt ARS, Abbasi MA, Aziz-Ur-Rehman, Siddiqui SZ, Hassan M, Raza H, et al.
    Bioorg Chem, 2019 05;86:197-209.
    PMID: 30711702 DOI: 10.1016/j.bioorg.2019.01.040
    Keeping in mind the pharmacological importance of 2-aminothiazole and 1,2,4-triazole heterocyclic moieties, a series of novel ethylated bi-heterocyclic acetamide hybrids, 9a-p, was synthesized in a multi-step protocol. The structures of newly synthesized compounds were characterized by 1H NMR, 13C NMR, IR and EI-MS spectral studies. The inhibitory effects of these bi-heterocyclic acetamides (9a-n) were evaluated against elastase and all these molecules were identified as potent inhibitors relative to the standard used. The Kinetics mechanism was analyzed by Lineweaver-Burk plots which revealed that, 9h, inhibited elastase competitively by forming an enzyme-inhibitor complex. The inhibition constants Ki calculated from Dixon plots for this compound was 0.9 µM. The computational study was articulate with the experimental results and these ligands unveiled good binding energy values (kcal/mol). So, these molecules can be considered as promising medicinal scaffolds for the treatment of skin melanoma, wrinkle formation, uneven pigmentation, and solar elastosis.
  17. The comparison between propofol and dexmedetomidine infusion on perioperative anxiety during regional anesthesia
    Lim YP, Yahya N, Izaham A, Kamaruzaman E, Zainuddin MZ, Wan Mat WR, et al.
    Turk J Med Sci, 2018 Dec 12;48(6):1219-1227.
    PMID: 30541250 DOI: 10.3906/sag-1802-126
    Background/aim: Regional anesthesia for surgery is associated with increased anxiety for patients. This study aimed to compare the
    effect of propofol and dexmedetomidine infusion on perioperative anxiety during regional anesthesia.

    Materials and methods: Eighty-four patients were randomly divided into two groups receiving either study drug infusion. Anxiety
    score, level of sedation using the Bispectral Index and Observer’s Assessment of Alertness and Sedation, hemodynamic stability, and
    overall patient’s feedback on anxiolysis were assessed.

    Results: Both groups showed a significant drop in mean anxiety score at 10 and 30 min after starting surgery. Difference in median
    anxiety scores showed a significant reduction in anxiety score at the end of the surgery in the dexmedetomidine group compared to the
    propofol group. Dexmedetomidine and propofol showed a significant drop in mean arterial pressure in the first 30 min and first 10 min
    respectively. Both drugs demonstrated a significant drop in heart rate in the first 20 min from baseline after starting the drug infusion.
    Patients in the dexmedetomidine group (76.20%) expressed statistically excellent feedback on anxiolysis compared to patients in the
    propofol group (45.20%).

    Conclusion: Dexmedetomidine infusion was found to significantly reduce anxiety levels at the end of surgery compared to propofol
    during regional anesthesia.

  18. The anti-inflammatory and anti-nociceptive effects of Korean black ginseng
    Lee YY, Saba E, Irfan M, Kim M, Chan JY, Jeon BS, et al.
    Phytomedicine, 2019 Feb 15;54:169-181.
    PMID: 30668366 DOI: 10.1016/j.phymed.2018.09.186
    BACKGROUND: Different processing conditions alter the ginseng bioactive compounds, promoting or reducing its anti-inflammatory effects. We compared black ginseng (BG) - that have been steamed 5 times - with red ginseng (RG).

    HYPOTHESIS/ PURPOSE: To compare the anti-inflammatory activities and the anti-nociceptive properties of RG and BG.

    METHODS: Nitric Oxide (NO) and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazoliumbromide (MTT) assay, quantitative Reverse Transcriptase-Polymerase Chain Reaction (qRT-PCR), western blot, xylene-induced ear edema, carrageenan-induced paw edema RESULTS: The ginsenoside contents were confirmed using high-performance liquid chromatography (HPLC) and has been altered through increased processing. The highest concentration of these extracts inhibited NO production to near-basal levels in lipopolysaccharide (LPS)-stimulated RAW 264.7 without exhibiting cytotoxicity. Pro-inflammatory cytokine expression at the mRNA level was investigated using qRT-PCR. Comparatively, BG exhibited better inhibition of pro-inflammatory mediators, iNOS and COX-2 and pro-inflammatory cytokines, IL-1β, IL-6 and TNF-α. Protein expression was determined using western blot analysis and BG exhibited stronger inhibition. Xylene-induced ear edema model in mice and carrageenan-induced paw edema in rats were carried out and tested with the effects of ginseng as well as dexamethasone and indomethacin - commonly used drugs. BG is a more potent anti-inflammatory agent, possesses anti-nociceptive properties, and has a strong potency comparable to the NSAIDs.

    CONCLUSION: BG has more potent anti-inflammatory and anti-nociceptive effects due to the change in ginsenoside component with increased processing.

  19. Fulltext The 4717C > G polymorphism in periplakin modulates sensitivity to EGFR inhibitors
    Lee HM, Kelly GM, Zainal NS, Yee PS, Fadlullah MZH, Lee BKB, et al.
    Sci Rep, 2019 02 20;9(1):2357.
    PMID: 30787334 DOI: 10.1038/s41598-019-38742-0
    The use of EGFR inhibitors on oral squamous cell carcinoma (OSCC) as monotherapy yielded modest clinical outcomes and therefore would benefit from biomarkers that could predict which patient subsets are likely to respond. Here, we determined the efficacy of erlotinib in OSCC cell lines, and by comparing sensitive and resistant lines to identify potential biomarkers. We focused on the 4717C > G polymorphism in periplakin (PPL) where the CC genotype was associated with erlotinib resistance. To validate this, erlotinib-resistant cell lines harbouring CC genotype were engineered to overexpress the GG genotype and vice versa. Isogenic cell lines were then studied for their response to erlotinib treatment. We demonstrated that overexpression of the GG genotype in erlotinib-resistant lines sensitized them to erlotinib and inhibition of AKT phosphorylation. Similarly, the expression of the CC genotype conferred resistance to erlotinib with a concomitant increase in AKT phosphorylation. We also demonstrated that cell lines with the CC genotype generally are more resistant to other EGFR inhibitors than those with the GG genotype. Overall, we showed that a specific polymorphism in the PPL gene could confer resistance to erlotinib and other EGFR inhibitors and further work to evaluate these as biomarkers of response is warranted.
  20. Fulltext Efficacy and Safety of Whey Protein Supplements on Vital Sign and Physical Performance Among Athletes: A Network Meta-Analysis
    Lam FC, Bukhsh A, Rehman H, Waqas MK, Shahid N, Khaliel AM, et al.
    Front Pharmacol, 2019;10:317.
    PMID: 31068804 DOI: 10.3389/fphar.2019.00317
    Introduction: Athletes train physically to reach beyond their potential maximum aerobic threshold. Whey protein supplements (WPS) are often used in conjunction with physiotherapy and psychotherapy to regain better vital sign and physical performances. This review aimed to explore the clinical evidence on the efficacy and safety of WPS in sports performance and recovery among athletes. Methodology: A comprehensive literature search was performed to identify relevant randomized control trials (RCTs) that investigated the efficacy and safety of WPS on the vital sign and physical performance among athletes. The Cochrane Risk of Bias (ROB) Assessment tools were used to assess the quality of the studies. Meta-analysis was conducted using the frequentist model with STATA version 14.2®. Results: A total of 333,257 research articles were identified out of which 20 RCTs were included for qualitative synthesis and network meta-analysis with 351 participants. Among the studies, 7 had low ROB and 3 RCTs had high ROB. Of these 20 trials, 16 trials were randomized clinical trials which compared whey protein supplements (WPS) with various comparators i.e., L-alanine, bovine colostrum, carbohydrate, casein, leucine, maltodextrin, rice, protein + caffeine were compared with placebo. Analysis from the pairwise meta-analysis revealed that for respiratory exchange ratio (RER) WPS was found to be significantly improving compared to maltodextrin (WMD = 0.012; 95%CI = 0.001, 0.023). Similarity to RPE (Rate Perceived Exertion), slight difference between WPS and the comparators, however, when the estimation was favorable to the comparators, there was moderate-high heterogeneity. For VO2max, high heterogeneity appeared when WPS compared to maltodextrin with the I2 = 97.8% (WMD = 4.064; 95% CI = -4.230, 12.359), meanwhile bovine colostrum (WMD = -2.658; 95%CI = -6.180, 0.865) only comparator that was better than WPS. According to the estimated effect of the supplements on physical performance outcome results, maximum power (8 studies, 185 athletes), highest ranked was bovine colostrum (SUCRA = 70.7%) and the lowest ranked was placebo (SUCRA = 17.9%), yet all insignificant. Then again, on average power (nine studies, 187 athletes), WPS was the highest ranked (SUCRA = 75.4 %) about -112.00 watt (-187.91, -36.08) and most of the estimations were significant. Body mass was reported in 10 studies (171 athletes), carbohydrate may be at the highest ranked (SUCRA = 66.9%) but it is insignificant. Thought the second highest ranked was WPS (SUCRA = 64.7%) and it is significant (WMD = -6.89 kg; CI = -8.24, -5.54). Conclusion: The findings of this review support the efficacy and safety of WPS as an ergogenic aid on athletes' sports performance and recovery. The overall quality of clinical evidence was found to be valid and reliable from the comprehensive search strategy and ROB assessment.
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