Displaying publications 41 - 60 of 235 in total

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  1. Fadilah SA, Vuckovic S, Khalil D, Hart DN
    Stem Cells Dev, 2007 Oct;16(5):849-55.
    PMID: 17999605
    Methods that allow expansion of myeloid dendritic cells (MDCs) from CD34(+) cells are potentially important for boosting anti-leukemic responses after cord blood (CB) hematopoietic stem cell transplantation (HSCT). We showed that the combination of early-acting cytokines FLT3-ligand (FL), stem cell factor (SCF), interleukin (IL)-3, and IL-6 supported the generation of CD11c(+)CD16() CD1a()/c() MDCs from CB CD34(+) cells or CB myeloid precursors. Early-acting cytokine-derived MDCs were maintained within the myeloid CD33(+)CD14()CD15() precursors with a mean of 4 x 10(6) cells generated from 1-4 x 10(4) CB CD34(+) cells or myeloid precursors after 2 weeks. After 8-12 days of culture the MDCs expressed higher levels of HLA-DR antigen but lower levels of CD40 and CD86 antigen, compared to adult blood MDCs. At this stage of differentiation, the early-acting cytokine-derived MDCs had acquired the ability to induce greater allogeneic T cell proliferation than monocytes or granulocytes derived from same culture. Early-acting cytokine-derived MDCs exposed to the cytokine cocktail (CC) comprising IL-1beta, IL-6, tumor necrosis factor (TNF)-alpha, and prostaglandin E (PGE)-2, upregulated the surface co-stimulatory molecules CD40 and CD86 and enhanced allogeneic T cell proliferation, as is characteristic of MDCs maturation. The reliable production of MDCs from CB CD34(+) cells provides a novel way to study their lineage commitment pathway(s) and also a potential means of enriching CB with MDCs to improve prospects for DC immunotherapy following CB HSCT.
  2. Zhao J, Xiang C, Tengku Fadilah TK, Luo H
    J Sports Sci Med, 2024 Jun;23(2):289-304.
    PMID: 38841637 DOI: 10.52082/jssm.2024.289
    Perception is an essential component of children's psychological development, which is foundational to children's ability to understand and adapt to their external environment. Perception is also a crucial tool for understand and navigating one's surroundings, enabling children to identify objects and react appropriately to settings or situations. Substantial evidence indicates that engaging in physical activity is beneficial for the development of children's perceptual abilities, as the two are closely intertwined. Still, more research is necessary to gain a full understanding of the impact of physical activity on children's perception. To further identify and quantify the effects of physical activity on a number of specific perceptions in children. Systematic review and meta-analysis. Searches were performed using five online databases (i.e., PubMed, SPORTDiscus, PsycINFO, Web of Science, and Cochrane Library) for articles published up to and including June 2023 to identify eligible citations. A total of 12 randomized controlled trials, encompassing 1,761 children under the age of 12, were analyzed. Overall, physical activity as an intervention showed a notable effect on the development of children's perceptions. The meta-analysis indicated that participating in physical activity for 30 minutes around, daily, had a greater impact on children's visual perception and executive functioning than on their motor perception, body perception, and global self-worth (SMD = 1.33, 95% CI: 0.75, 1.91, p < 0.001). The effects of physical activity on children's perception performance varied by participant characteristics, with physical activity having better effects on body perception and overall self-worth in children who were obese or overweight. Furthermore, physical activity can also enhance executive function and attention in children with developmental coordination disorders. The effects of physical activity on children's perception performance varied according to the intervention time, with different activity durations resulting in different perception performances. Therefore, parents and educators must prioritize an appropriate length of physical activity time for children to ensure their optimal growth and development. Registration and protocol CRD42023441119.
  3. Hasmoni MH, Wahid FA, Keng CS
    South. Med. J., 2009 Jan;102(1):101-3.
    PMID: 19077786 DOI: 10.1097/SMJ.0b013e31818018c1
    Plasma cell leukemia (PCL) is a rare plasma cell disorder. It is the leukemic variant of multiple myeloma. A 52-year-old man with an atypical presentation of primary plasma cell leukemia is reported. The patient presented with paraparesis which progressively worsened to paraplegia. MRI of the spine showed an extradural mass causing cord compression and multiple bony erosions from soft tissue masses. Peripheral blood film examination and bone marrow aspiration showed numerous plasmablasts. Atypical cells expressed surface and cytoplasmic lambda light chain on immunochemical studies, surface CD45 and CD38. To our knowledge, primary PCL presenting with progressive paraplegia has not been reported in the literature.
  4. Praveen S, Ho CC, Fadilah S, Sagap I
    Med J Malaysia, 2010 Jun;65(2):98-100.
    PMID: 23756789
    Primary gastrointestinal (GIT) lymphoma constitutes only 5 - 10% of all gastrointestinal tumours. The optimal therapy for these lymphomas is poorly defined and still controversial. We present our experience in the treatment and outcome of primary GIT lymphomas in UKM Medical Center, Malaysia. A retrospective review of all patients with primary GIT lymphoma from the year 2002 until 2007 was done. Our series has shown that primary GIT lymphoma is a rare disease as it comprises only 6.5% of all lymphomas treated in this institution. We had a female predominance of this disease with a large majority at an advanced stage of the disease. There was equal distribution involving stomach, small and large intestines. The incidence of primary GIT lymphomas was 6.5% with a female predominance. The majority had advanced diseases (stage III and IV) with equal distribution involving the stomach, small and large intestines. The most common histological variant was diffuse large B cell lymphoma (66%). Most (83%) patients with intestinal lymphoma had surgical resection and adjuvant chemotherapy. All patients with gastric lymphomas had chemotherapy alone. The mortality rate was 22% predominantly in younger patients with aggressive histology subtypes and advanced disease.
  5. Ishak SF, Rajab NF, Basri DF
    Dose Response, 2023;21(2):15593258221098980.
    PMID: 37077718 DOI: 10.1177/15593258221098980
    Colorectal cancer is the most common malignant cancer in developing countries. Canarium odontophyllum, also known as "Dabai" or "Borneo Olive" is among the natural plants that can potentially be used as an anticancer agent. This study aims to determine the antiproliferative activities and cytotoxicity effects of acetone extract from C. odontophyllum stem bark against human colorectal cancer cell lines HCT 116 and HT 29. Acetone extract of C. odontophyllum stem bark exerted a significant cytotoxic effect on HCT 116 and HT 29 cells determined by MTT assay at the concentration of 12.5 μg/mL to 200 μg/mL for 24, 48, and 72 hours treatment. It was found that acetone extract of C. odontophyllum stem bark inhibited proliferation of HCT 116 with an IC50 value of 184.93 ± .0 μg/mL, 61.24 ± .1 μg/mL, 79.98 ± .029 for 24, 48 and 72 hours respectively. The findings also showed that acetone extract of C. odontophyllum stem bark revealed a lower inhibitory effect against HT-29 with an IC50 value of more than 200 μg/mL for 24, 48 and 72 hours. However, acetone extract of C. odontophyllum stem bark at similar concentrations and time points did not show any cytotoxic effect to normal colorectal fibroblast cell CCD18-Co. In conclusion, the acetone extract of C. odontophyllum stem bark exhibited more sensitivity against HCT 116 than HT 29. Its antiproliferative ability towards HCT 116 and HT 29 cells provides insight that this extract may serve as an anticancer agent against colorectal cancer.
  6. Ida Muryany, M,Y., Ghazali, A.R., Hing, H.L., Nor Fadilah, R., Ina Salwany, M,Y.
    MyJurnal
    Recently researchers are interested with the biotherapeutic potential of probiotics in gut disease
    treatment. The bacteria are generally regarded as a safe, have a stability of usage and originate
    from the natural resources. The study aims to identify and characterize the potential probiotic
    Lactic Acid Bacteria (LAB) isolated from Malaysian fermented fish product known as
    Pekasam. Fourty isolates obtained were firstly screened for their antagonism activities against
    the common pathogenic bacteria; Esherichia coli, Staphylococcus aureus and Klebsiella sp.
    Our study revealed only three (labeled as L8, L20 and S1) of the isolates tested showed broad
    antimicrobial effects towards the pathogenic bacteria. All of the isolates were also γ-hemolytic
    and tolerant to various pH (pH 3, 5 and 7.5) and 0.3% (w/v) bile salts. The bacteria isolates
    of strain L8 and L20 were susceptible to seven antibiotics tested except vancomycin and
    tetracycline whereas S1 was resistant to all antibiotics. Phenotypic tests revealed that both
    bacteria isolates of strain L8 and L20 were Bacillus megaterium while S1 was Pediococcus
    pentosaceus whereas 16S rRNA gene sequence analysis showed potential bacteria isolates
    of strain L8 and L20 belonged to the Lactobacillus plantarum (99% similarity) and S1 was
    characterized as Lactobacillus pentosus (100% similarity) respectively. Our present study
    showed that the probiotics of strain L8, L20 and S1 isolated from the fermented fish (Pekasam)
    exhibited the potential probiotic properties to be developed as biotherapeutic agents.
  7. Huijin, Lau, Nor Fadilah Rajab, Arimi Fitri Mat Ludin, Suzana Shahar
    Jurnal Sains Kesihatan Malaysia, 2015;15(22):97-102.
    MyJurnal
    The expansion of ageing population has gained much public attention on the importance of healthy and successful ageing,
    which is absence of major chronic diseases, preserved physiological and cognitive functioning and active engagement
    with life. Previous studies have found there was a significant correlation between physical fitness with cognition. However,
    the relationship between physical fitness with successful and unsuccessful cognitive ageing groups are very limited. This
    study was aimed to identify the significant physical fitness components that contribute in reducing risk of cognitive decline
    represented as different cognitive ageing groups. A total of 300 community-based elderly aged 60 and above from the
    states of Selangor, Perak and Kelantan were recruited using multistage random sampling method in this cross-sectional
    study. Cognitive function of subjects was categorized into three groups, namely Mild Cognitive Impairment (MCI) (n
    = 100), Usual Ageing (UA) (n = 100) and Successful Ageing (SA) (n = 100) based on defined criteria. Senior Fitness
    Tests included 2-minute step, handgrip strength, chair stand, chair sit-and-reach, 8 foot up-and-go and back scratch
    were measured to determine the cardiorespiratory fitness; muscle strength; agility and flexibility of subjects. SA group
    had significantly better performance than non-SA groups in all fitness components, except for chair sit-and-reach. After
    controlling for age, gender, education years and smoking status, handgrip strength and chair stand tests were associated
    with a reduced risk of MCI by 7% [OR: 0.93, 95% C.I: 0.88-0.99, p < 0.05] and 15% [OR: 0.85, 95% C.I: 0.75-0.95, p <
    0.01], respectively. These findings suggest that older adults with higher upper and lower body muscular strength could
    serve as protective factors for cognitive impairment. Further research is warranted to evaluate the mechanism of physical
    and cognitive decline such as Motoric Cognitive Risk Syndrome (MCR) in more detailed for the purpose for promoting
    healthy and successful ageing.
  8. Farah Wahida Ibrahim, Nor Idayu Derased, Umi Romaizatul Amiera Zainudin, Nihayah Mohammad, Nor Fadilah Rajab
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):75-81.
    MyJurnal
    Ficus deltoidea or ‘mas cotek,’ is a uterotonic herb traditionally consumed by women to improve menstrual circulation, assist labour, remove retained placenta and treat postpartum bleeding. The aim of the study was to elucidate the mechanism of F. deltoidea in uterine contraction. Crude extracts from 2 different variants of F. deltoidea were used in the study; F. deltoidea var. Deltoidea (FDD) and F. deltoidea var. Angustifolia (FDA). This study was conducted ex vivo on the strips of isolated rats uterus treated with either FDD or FDA aqueous extract with increasing concentrations ranging from 10 μg/ml until 1280 μg/ml at time intervals of 5 minutes between doses. The frequency and intensity of the uterine contractions were monitored via Powerlab software. Maximum contractions for both extracts were identified, recorded and the uterine strips samples at maximum contraction were selected and homogenized in order determine the role of prostaglandin F2α (PGF2α) in the mechanism of uterine contraction. Other than that, phosphorylated 42/44 (p42/44) of mitogen activated protein kinase (MAPK) expression was also detected via immunoblotting. The results showed that the maximum contraction induced by FDD was at the concentration of 320 μg/ml, whereas for FDA was at 960 μg/ml. Both FDD and FDA increased the intensity of uterine strips contractions and there were notable trend of increased PGF2α expression as well. Further analysis revealed that the uterine contractions involved the MAPK pathway through the phosphorylation of p42/44 protein. In conclusion, Ficus deltoidea of both variants have the ability to stimulate uterine contraction through the mechanism of MAPK pathway.
  9. Suzana Shahar, Huijin Lau, Hanis Mastura Yahya, Nor Fadilah Raj, Normah Che Din
    Jurnal Sains Kesihatan Malaysia, 2018;16(101):239-240.
    MyJurnal
    There is some evidence stated that mood states might influence cognitive functioning, such as episodic memory, working memory and creative problem solving. This study was conducted to evaluate the relationship between mood states and cognitive functioning among older adults with Mild Cognitive Impairment (MCI). This study involved 12 male and 37 female subjects from Klang Valley aged 60 year old and above. MCI was defined based on criteria proposed by Peterson. Cognitive functions of the subjects were accessed using Mini Mental State Examination (MMSE), Rey Auditory Verbal Learning Test (RAVLT), Digit Span, Digit Symbol Substituition Test (DSST) and Visual Reproduction; while mood states including tension, depression, anger, vigour, esteem related affect, fatigue and confusion were accessed using Profile of Mood States (POMS) questionnaire. Total positive subscales score, total negative subscales score and total mood disturbance (TMD) were also calculated. There were significant positive correlations between tension (r = 0.325, p = 0.30), vigour (r = 0.235, p = 0.036), esteem related affect (r = 0.316, p = 0.034) and total positive subscales score (r = 0.307, p = 0.040) with verbal episodic memory as measured using RAVLT fifth trial. In addition, positive correlations were also observed between vigour (r = 0.228, p = 0.035) and total positive subscales score (r = 0.237, p = 0.025) with DSST. After adjusted for confounding factors, subjects who scored higher in esteem related affect (Adjusted OR = 0.390, 95% CI [0.069-0.711], p = 0.019) and tension (Adjusted OR = 0.253, 95% CI [0.075-0.431], p = 0.007) had better verbal episodic memory. Subjects who have higher total positive subscales score were also had faster processing speed (OR = 0.856, 95% CI [0.099-1.614], p = 0.028). However after adjusted for confounding factors, the relationship was not significant (Adjusted OR = 0.383, 95% CI [-0.247-1.013], p = 2.226). Older adults with MCI who had a more positive mood tend to have a better short-term verbal memory and faster processing speed.
  10. Ida Muryany, Ahmad Rohi Ghazali, Nor Fadilah Rajab, Hing HL, Ina-Salwany, Mohd Zamri Saad, et al.
    Sains Malaysiana, 2018;47:2391-2399.
    Bacterial adhesion to host cells is the most important probiotic character. However, the adhesion of probiotic should not
    affect the viability of the host cells. In this study, Lactobacillus plantarum strain L8, Lactobacillus plantarum strain L20
    and Lactobacillus pentosus strain S1 were tested for their cytotoxic effects through MTT assay and their ability to adhere
    and colonize on HT-29 and CCD-18Co intestinal cells as detected microscopically using light microscopy and Scanning
    Electron Microscopy (SEM). No cytotoxicity effects were observed on both intestinal cells following 24 h treatment with
    all Lactobacillus strains. Additionally, all strains demonstrated strong adhesive activity where more than 100 bacteria
    adhered to both intestinal cells although differences in the adhesion scores observed among different strains. The adhesion
    as observed via SEM showed an autoagreggative pattern and adhered as clusters on the surface of both intestinal cells.
    In conclusion, all three Lactobacillus strains are non-cytotoxic to both cells with strong adhesion ability on intestinal
    cells and this study also proved that Malaysian fermented fish are good source of probiotic bacteria.
  11. Mohd Razif Mohd Idris, Fazlina Nordin, Fadilah Abd Wahid S, Zaleha Abdullah Mahdy
    Sains Malaysiana, 2018;47:2491-2499.
    The aim of this study to determine the numbers of CD34+ cells and total nucleated cell (TNC) in umbilical cord blood (UCB)
    collected from pregnant mothers with gestational diabetes mellitus (GDM) and preeclampsia (PE), following statistical
    analysis of both maternal and perinatal factors which affect UCB parameters. Most of studies explored the influence of
    obstetric factors on the number of UCB cell collection and only a few looked at the effects on UCB haematopoietic stem
    cell (UCB-HSC) of common disorders complicating pregnancy. A total of 112 UCB samples (32 PE, 42 GDM and 38 nondiseased) were collected. CD34+ cell and NC count were enumerated using FACS Calibur. The TNC and CD34+ cells were
    significantly reduced in both PE and GDM groups as compared to the control group. The PE group shows significantly
    lower birth weight and higher BP which led to a lower UCB volume and CD34+ count. Gestational age shows significant
    correlation with nucleated cell count (NCC) and TNC. GDM group shows significantly lower systolic BP, NCC and TNC count,
    including low placental weight and birth weight. Conclusively, some obstetrics factors have significant influences to the
    numbers and quality of UCB-HSC in both PE and GDM groups, which could guide in the selection criteria for CB banking.
  12. Nor Fadilah Othman, Hamidah Amin Abd. Latip, Fazlina Yusoff, Haslinda Hassan, Ziti Akthar Supian
    MyJurnal
    Introduction: Family planning practice is important among the high-risk mothers. Thus, the knowledge, attitude and practice of family planning among health care workers are very important in influencing the use of contraception among them. The objective of this study was to determine level of knowledge, attitudes and practices related to contraception among doctors and nurses in Petaling District, Selangor, Malaysia. Methods: A cross-sectional study involving 300 doctors and nurses working in the Maternal and Child Health Unit from six large public health clin-ics in Petaling district was conducted in May 2019. A self-administered questionnaire was used for data collection. Results: A total of 109 doctors and 149 nurses participated in this study. The response rate was 86%. The median duration of service in KKM and working in MCH were 9 years (IQR 6.0) and 3 years (IQR 6.0) respectively. Majority (74%) had attended CME on family planning. The mean score of knowledge was 9.0 (out of 13) (SD 1.899). In terms of attitude, 51.6% would often suggest family planning to relatives or friends. Three common perceived barriers for effective counselling on family planning were too many patients (94.5%), time constraint (91.7%) and inadequate knowledge on contraception (60.4%). Common preferred methods of contraception among users were hormonal method (33.1%), followed by barrier (condom) method (29.5%). Medical officers had better knowledge score as compared to nurses (p
  13. Yap, Hui Cin, Asmah Hamid, Farah Wahida Ibrahim, Nor Fadilah Rajab, Yanti Rosli
    MyJurnal
    The emergence of research about the biological effects of electromagnetic field (EMF) have growing concern among
    researchers. The aim of this study was to investigate the effects on the brain of rats periodically exposed to 0.1 mT EMF.
    Total 24 adult male Sprague Dawley rats were subdivided randomly to 4 groups: 2 control groups (C1 6 hours: 6 h/
    day for 5 days; C2 20 hours: 20 h/day for 5 days) and 2 treatment groups which exposed to 0.1 mT EMF (T1 6 hours:
    6 h/day for 5 days; T2 20 hours: 20 h/day for 5 days). A significant decrease in the pyramidal cell number was higher
    as the exposure duration to EMF was extended (T1, p
  14. Hidayu Abdul Rani, Nor Fadilah Mohamad, Sherif Abdulbari Ali, Matali, Sharmeela, Sharifah Aishah Sheikh Abdul kadir
    MyJurnal
    Mercury emission into the atmosphere is a global concern due to its detrimental effects on human health in general. The two main sources of mercury emission are natural sources and anthropogenic sources. Mercury emission from natural sources include volcanic activity, weathering of rocks, water movement and biological processes which are obviously inevitable. The anthropogenic sources of mercury emission are from coal combustion, cement production and waste incineration. Thus, in order to reduce mercury emission it is appropriate to investigate how mercury is released from the anthropogenic sources and consequently the mercury removal technology that can be implemented in order to reduce mercury emission into the atmosphere. Many alternatives have been developed to reduce mercury emission and the recent application of activated carbon showed high potential in the adsorption of elemental mercury. This paper discusses the ability of activated carbon and variable parameters that influence mercury removal efficiency in flue gas.
  15. Aziz, N.A., Nashrah, H., Fadilah A.Z., Ali, M.F., Zawawi, S., Katijah, A.
    Medicine & Health, 2011;6(2):114-122.
    MyJurnal
    Despite evidence showing that structured rehabilitation after stroke improves functional outcomes, providing seamless rehabilitation from hospital to community has been elusive. The service provided should be able to accommodate variable degree of impairments and needs of the stroke survivors. This study aimed to assess the outcome of a multidisciplinary-based outpatient rehabilitation service for stroke patients living in the community. Patients who were discharged from Universiti Kebangsaan Malaysia Medical Centre after an acute stroke were referred to the Combined Stroke Rehabilitation Clinic (CSRC). Post stroke patients were assigned individually designed programs which were problem based and used task specific activities to achieve desired goals. Patients were reviewed on a regular basis either up to completion of the 2 year program, or are able to be discharged to the community, whichever is earlier. Modified Barthel Index (MBI) and Berg Balance Scores (BBS) were used for monitoring. A total of 68 patients were managed in CSRC for two years since its initiation, with mean age of 62.4 years (SD 12.4) with the mean duration of stroke when first reviewed in CSRC was 11.5 months (SD 11.9). Majority of patients (64.7%) received either two or three types of intervention. Both MBI and BBS demonstrated significant improvement over 12-months period (p value of 0.006 and 0.017 respectively). CSRC proved that structured rehabilitation intervention was beneficial in terms of functional status and improvement in balance to post-stroke patients.
    Study site: Combined Stroke Rehabiltation clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
  16. Rabeta Mohd Salleh, Suzana Shahar, Fatimah Arshad, Ahmad Rohi Ghazali, Normah Haron, Nor Fadilah Rajab
    MyJurnal
    Kajian kes-kawalan ini dijalankan untuk mengkaji hubungan adipositi dan komposisi tubuh terhadap risiko kanser payudara di kalangan 70 orang wanita yang baru didiagnos kanser payudara dan 138 orang kawalan. Parameter antropometri yang merangkumi tinggi, berat, ukuran pinggang dan ukuran pinggul dan aras glukosa darah berpuasa serta tekanan darah diukur di kalangan subjek. Komposisi tubuh ditentukan menggunakan analisis bioimpedans (Maltron 906). Hasil kajian menunjukkan Indeks Jisim Tubuh (?T) kumpulan kes adalah 26.0 ± 4.8 kg/m2 dan 25.3 ± 4.5 kg/m2 bagi kumpulan kawalan (p > 0.05). Seramai 71% subjek dari kumpulan kes dan 40% subjek kumpulan kawalan mengalami obesiti abdominal (ukurlilit pinggang 80 cm) [OR = 3.4 (95% CI =1.7-6.9] (p < 0.05). Wanita pra menopaus berisiko sebanyak empat kali untuk mendapat kanser payudara dengan [Adjusted OR = 4.3 (95% CI = 1.8-10.3)]. Peratus lemak tubuh adalah tinggi di kalangan kes (36.4 ± 4.7%) berbanding kawalan 35.3 ± 4.4% tetapi perbezaan ini adalah tidak signifikan. Jisim Tubuh Tanpa Lemak ?TTL) menunjukkan nilai min 38.8 ± 5.7 kg bagi kawalan dan 38.9 ± 5.5 kg pada kes. Korelasi positif yang lemah ditunjukkan di antara umur dan IJT (r = 0.179, p = 0.010), ukuran pinggang (r = 0.218, p = 0.002), nisbah pinggang-pinggul (NPR) (r = 0.233, p = 0.001) dan peratus lemak tubuh (r = 0.330, p = 0.000). Kesimpulannya, obesiti abdominal meningkatkan risiko kanser payudara, terutama di kalangan wanita pra menopaus. Obesiti jenis ini dan peratus lemak tubuh adalah meningkat dengan pertambahan usia. Adalah penting bagi wanita untuk mengekalkan ukuran pinggang yang sihat melalui gaya hidup sihat bagi mengurangkan risiko kanser payudara.
  17. Aimi Fadilah M, Fatimah MS, Nor Aisyah Z, Nur’Aini EW, Nazimah AM, Effat O, et al.
    MyJurnal
    Primary aldosteronism (PA) causes a persistently elevated blood pressure (BP) due to
    excessive release of the hormone aldosterone from the adrenal glands. Classically, it is called
    Conn’s syndrome and is described as the triad of hypertension and hypokalemia with the
    presence of unilateral adrenal adenoma. It can be cured with surgical resection of the
    aldosterone-secreting adenoma leading to resolution of hypertension, hypokalemia and
    increased cardiovascular risk associated with hyperaldosteronism. We present a case of a man
    with previous ischemic heart disease (IHD) who presented with resistant hypertension.
    Investigations for secondary causes of hypertension revealed an elevated aldosterone level
    and saline suppression test confirmed the diagnosis of PA. Radiological examination revealed
    a left adrenal adenoma and a normal right adrenal gland. However, adrenal venous sampling
    showed lateralization of aldosterone secretion towards the right. He subsequently underwent
    a laparoscopic right adrenalectomy which improved his BP control promptly. This case
    highlights the importance of recognizing the need to investigate for secondary causes of
    hypertension. It also underscores the importance of dynamic tests, which may not be easily
    accessible to most clinicians but should pursue, to allow a definitive diagnosis and effective
    treatment.
  18. Zuhri UM, Yuliana ND, Fadilah F, Erlina L, Purwaningsih EH, Khatib A
    J Ethnopharmacol, 2024 Jan 30;319(Pt 3):117296.
    PMID: 37820996 DOI: 10.1016/j.jep.2023.117296
    ETHNOPHARMACOLOGICAL RELEVANCE: Tinospora crispa (L.) Hook. f. & Thomson stem (TCS) has long been used as folk medicine for the treatment of diabetes mellitus. Previous study revealed that TCS possesses multi-ingredients and multi-targets characteristic potential as insulin sensitizer activity. However, its mechanisms of action and molecular targets are still obscure.

    AIM OF THE STUDY: In the present study, we investigated the effects of TCS against insulin resistance in muscle cells through integrating in vitro experiment and identifying its active biomarker using metabolomics and in molecular docking validation.

    MATERIALS AND METHODS: We used centrifugal partition chromatography (CPC) to isolate 33 fractions from methanolic extract of TCS, and then used UHPLC-Orbitrap-HRMS to identify the detectable metabolites in each fraction. We assessed the insulin sensitization activity of each fraction using enzyme-linked immunosorbent assay (ELISA), and then used confocal immunocytochemistry microscopy to measure the translocation of glucose transporter 4 (GLUT4) to the cell membrane. The identified active metabolites were further simulated for its molecular docking interaction using Autodock Tools.

    RESULTS: The polar fractions of TCS significantly increased insulin sensitivity, as measured by the inhibition of phosphorylated insulin receptor substrate-1 (pIRS1) at serine-312 residue (ser312) also the increasing number of translocated GLUT4 and glycogen content. We identified 58 metabolites of TCS, including glycosides, flavonoids, alkaloids, coumarins, and nucleotides groups. The metabolomics and molecular docking simulations showed the presence of minor metabolites consisting of tinoscorside D, higenamine, and tinoscorside A as the active compounds.

    CONCLUSIONS: Our findings suggest that TCS is a promising new treatment for insulin resistance and the identification of the active metabolites in TCS could lead to the development of new drugs therapies for diabetes that target these pathways.

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