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Fulltext Transverse myelopathy following intrathecal administration of chemotherapy

Teh HS, Fadilah SA, Leong CF

Singapore Med J, 2007 Feb;48(2):e46-9.
PMID: 17304378

Transverse myelopathy is one of the rare complications following administration of intrathecal chemotherapy. We report two cases of transverse myelopathy following administration of intrathecal methotrexate and cytarabine arabinoside. One patient was a 17-year-old Malay man who had lymphoblastic lymphoma in the leukaemic phase, while the other patient was a 40-year-old Malay man with relapsed Hodgkin's lymphoma. Both cases demonstrated variability in onset of symptoms, clinical progression and final outcome from the complication.
Fulltext Clinical Characteristics and Treatment Outcome of Gastrointestinal Non-Hodgkin's Lymphoma

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.
Primary plasma cell leukemia presented as progressive paraplegia: a case report

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.
Autoimmune thrombocytopenia and neutropenia after autologous peripheral blood stem cell transplantation

Wahid FS, Cheong SK, Sivagengei K

Acta Haematol., 2002;107(4):237-8.
PMID: 12053154
Stomatocytic elliptocytosis and 'neutrophil drumsticks' as a marker of stem cell engraftment

S-Abdul-Wahid F, Soon-Keng C

Br J Haematol, 2002 Mar;116(4):731.
PMID: 11886374
Fulltext Antiproliferative Activities of Acetone Extract From Canarium Odontophyllum (Dabai) Stem Bark Against Human Colorectal Cancer Cells

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.
Fulltext A study on knowledge, attitude and practice of family planning among doctors and nurses in Petaling District

Nor Fadilah Othman, Hamidah Amin Abd. Latip, Fazlina Yusoff, Haslinda Hassan, Ziti Akthar Supian

Malaysian Journal of Medicine and Health Sciences, 2019;15(104):82-82.
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
Adhesion ability and cytotoxic evaluation of lactobacillus strains isolated from malaysian fermented fish (pekasam) on ht-29 and ccd-18co intestinal cells

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.
Fulltext The invisible evil twin of an adrenal adenoma

Aimi Fadilah M, Fatimah MS, Nor Aisyah Z, Nur’Aini EW, Nazimah AM, Effat O, et al.

Journal of Clinical and Health Sciences, 2019;4(1):58-63.
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.
Fulltext Structured periodic rehabilitation intervention sessions to stroke patients. a longitudinal review

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
Fulltext Abdominal obesity increased breast cancer risk

Rabeta Mohd Salleh, Suzana Shahar, Fatimah Arshad, Ahmad Rohi Ghazali, Normah Haron, Nor Fadilah Rajab

Jurnal Sains Kesihatan Malaysia, 2007;5(2):17-28.
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.
Fulltext An overview of mercury emission sources and application of activated carbon for mercury removal from flue gas

Hidayu Abdul Rani, Nor Fadilah Mohamad, Sherif Abdulbari Ali, Matali, Sharmeela, Sharifah Aishah Sheikh Abdul kadir

Scientific Research Journal, 2013;10(1):0-0.
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.
Fulltext The association between physical fitness with successful ageing and risk of cognitive impairment among Malaysian older adults

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.
Fulltext Mechanism identification of ficus deltoidea aqueous extract in rat uterine contractions

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.
Fulltext The relationship between mood states and cognitive functions among older adults with mildcognitive impairment

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.
Total nucleated cell count and cd34+ cell is reduced in preeclampsia and gestational diabetes mellitus pregnancies: viable affix criteria for cord blood banking

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.
Fulltext Identification and characterization of the Lactic Acid Bacteria isolated from Malaysian fermented fish (Pekasam)

Ida Muryany, M,Y., Ghazali, A.R., Hing, H.L., Nor Fadilah, R., Ina Salwany, M,Y.

International Food Research Journal, 2017;24(2):868-875.
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.
Fulltext Effects of electromagnetic field (EMF) on histological changes and norepinephrine levels in the brains of adult male rats

Yap, Hui Cin, Asmah Hamid, Farah Wahida Ibrahim, Nor Fadilah Rajab, Yanti Rosli

Jurnal Sains Kesihatan Malaysia, 2016;14(1):55-61.
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
Exploration of the main active metabolites from Tinospora crispa (L.) Hook. f. & Thomson stem as insulin sensitizer in L6.C11 skeletal muscle cell by integrating in vitro, metabolomics, and molecular docking

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.
Respiratory drugs prescribed off-label among children in the outpatient clinics of a hospital in Malaysia

Mohamad NF, Mhd Ali A, Mohamed Shah N

Int J Clin Pharm, 2015 Feb;37(1):127-32.
PMID: 25488318 DOI: 10.1007/s11096-014-0049-0

BACKGROUND: Prescribing medicines in an unlicensed and off-label manner for children is a widespread practice around the world.
OBJECTIVES: To determine the extent and predictors of off-label respiratory drug prescriptions for children in the outpatient clinics of a hospital in Malaysia.
SETTING: Outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre, a tertiary teaching hospital in Malaysia.
METHODS: The pharmacy-based computer system and medical records of the patients were utilized to collect data from 220 pediatric patients who were prescribed at least one respiratory drug from July 2011 to December 2011.
MAIN OUTCOME MEASURE: Characteristics of the off-label respiratory drug prescriptions were measured.
RESULTS: A total of 134 children (60.9 %) received at least one respiratory drug prescribed in an off-label manner. The most common reasons for the off-label prescribing of drugs were off-label use by indication (31.5 %), followed by higher than the recommended dose (24.9 %) and lower than the recommended frequency (17.1 %). Diphenhydramine was the most common respiratory drug prescribed off-label. The number of medications prescribed was the only significant predictor of off-label prescription of respiratory drugs. Pediatric patients receiving 4-6 medications were 7.8 times more likely to receive at least one off-label respiratory drug compared to pediatric patients that received 1-3 medications (OR 7.8, 95 % CI 1.74-37.44).
CONCLUSION: There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population.

Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)

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