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  1. Lua PL, Salihah N, Mazlan N
    Complement Ther Med, 2015 Jun;23(3):396-404.
    PMID: 26051575 DOI: 10.1016/j.ctim.2015.03.009
    OBJECTIVE: To assess the efficacy of inhaled ginger aromatherapy on nausea, vomiting and health-related quality of life (HRQoL) in chemotherapy breast cancer patients.

    DESIGN: Single-blind, controlled, randomized cross-over study. Patients received 5-day aromatherapy treatment using either ginger essential oil or fragrance-matched artificial placebo (ginger fragrance oil) which was instilled in a necklace in an order dictated by the treatment group sequence.

    SETTING: Two oncology clinics in the East Coast of Peninsular Malaysia.

    MAIN OUTCOME MEASURES: VAS nausea score, frequency of vomiting and HRQoL profile (EORTC QLQ-C30 scores).

    RESULTS: Sixty female patients completed the study (age=47.3±9.26 years; Malay=98.3%; on highly emetogenic chemotherapy=86.7%). The VAS nausea score was significantly lower after ginger essential oil inhalation compared to placebo during acute phase (P=0.040) but not sustained for overall treatment effect (treatment effect: F=1.82, P=0.183; time effect: F=43.98, P<0.001; treatment×time effect: F=2.04; P=0.102). Similarly, there was no significant effect of aromatherapy on vomiting [F(1, 58)=0.29, P=0.594]. However, a statistically significant change from baseline for global health status (P<0.001) was detected after ginger essential oil inhalation. A clinically relevant 10 points improvement on role functioning (P=0.002) and appetite loss (P<0.001) were also documented while patients were on ginger essential oil.

    CONCLUSION: At present time, the evidence derived from this study is not sufficiently convincing that inhaled ginger aromatherapy is an effective complementary therapy for CINV. The findings for HRQoL were however encouraging with significant improvement in several domains.

  2. He Y, Abdul Wahab NET, Muhamad H
    Heliyon, 2024 Jan 15;10(1):e23715.
    PMID: 38192755 DOI: 10.1016/j.heliyon.2023.e23715
    BACKGROUND: China's societal and cultural significance placed on female fertility and the changing roles of women can lead to fertility anxiety in both married and unmarried women. This anxiety is shaped by factors such as social media use, intergroup emotions, fertility risk perceptions, and national policies. This study examines the interplay of these factors in understanding fertility anxiety among Chinese women.

    METHODS: This study surveyed 607 young Chinese women using the Fertility Anxiety Scale developed by Zhang and Zhao. Mplus software was used for latent class analysis of respondents' fertility anxiety. A three-step approach with multinomial logistic regression was used to explore factors influencing fertility anxiety among married and unmarried women.

    RESULTS: The latent class analysis supported a two-category model: "high fertility anxiety" (65.70 % married, 53.70 % unmarried) and "low fertility anxiety" (34.30 % married, 46.30 % unmarried). Multinomial logistic regression showed that increased social media usage intensity and perception of health-family risks correlated with higher fertility anxiety in both married and unmarried women. Among unmarried women, intergroup emotions and perceptions of occupational-economic risks also influenced fertility anxiety. Attention to national policies did not significantly impact fertility anxiety among young women.

    CONCLUSION: This study sheds light on the complex interplay of societal and individual factors in shaping fertility anxiety among young Chinese women. It underscores the enduring cultural significance placed on female fertility and the evolving roles of women in modern China. Regardless of their marital status, both married and unmarried women experience fertility anxiety, highlighting the pervasiveness of this concern.

  3. Farizan NH, Sutan R, Mani KK
    Iran J Public Health, 2020 Oct;49(10):1921-1930.
    PMID: 33346223 DOI: 10.18502/ijph.v49i10.4695
    Background: We aimed to assess the effectiveness of the health educational booklet intervention in improving parents/guardian's knowledge on prevention of child drowning and, the perception of drowning risk and water safety practice.

    Methods: A quasi-experimental study was conducted in year 2017 in Selangor, Malaysia among 719 parents/guardians of primary school children. The parent/guardians were randomly assigned as the intervention groups and were given a health educational Be-SAFE booklet on drowning prevention and water safety. The pretest was conducted before the intervention and posttest was done one month of intervention. The data collection tool was using a validated questionnaire on knowledge, attitude and practice for drowning prevention and water safety.

    Results: There were 719 respondents (response rate of 89.9%) participated at baseline and 53.7% at end line (after the intervention). Significant differences found in knowledge, attitudes and practice on drowning prevention and water safety for the intervention and control groups after the intervention (P<0.001). There was a significant difference in mean scores for knowledge and attitude before and after the intervention, whereas no significant findings noted for practices (P<0.001).

    Conclusion: Be SAFE booklet contributed to the increase in parents/guardian's knowledge and attitudes towards drowning prevention and water safety to prevent the risk of child drowning.

  4. Munirah MP, Norhayati MN, Noraini M
    Int J Environ Res Public Health, 2022 Sep 16;19(18).
    PMID: 36141931 DOI: 10.3390/ijerph191811658
    Insomnia is a common complaint affecting human performance in daily life activities. This study aimed to analyze the effects of Crocus sativus on insomnia. Methods: PRISMA guidelines were used according to the PICOS model. A systematic search of PubMed/Medline and the Cochrane Library was undertaken for literature until December 2021. A random effects model was used with I2 statistic to assess heterogeneity and a GRADE assessment was used to assess the quality of the outcomes. Eight articles were included, involving 431 participants. Crocus sativus reduced insomnia severity (SMD: 0.53; 95%CI: -0.05 to 1.11; I2 statistic = 59%; p = 0.08) and increased sleep quality (SMD 0.89, 95% CI 0.10 to 1.68; I2 statistic = 90%; p = 0.03; 6 studies, 308 participants, very low-quality evidence) and duration (SMD: 0.57; 95%CI: 0.21 to 0.93; I2 statistic = 40%; p = 0.002; 5 studies; 220 participants, moderate-quality evidence) compared with the placebos. Although there is limited evidence of a very low- to moderate-quality, Crocus sativus may benefit people with insomnia. This non-pharmacological intervention may reduce the chance of adults with insomnia taking sedative-hypnotic medication, thus reducing dependency and withdrawal symptoms.
  5. Hassan NA, Hashim Z, Hashim JH
    Asia Pac J Public Health, 2016 Mar;28(2 Suppl):38S-48S.
    PMID: 26141092 DOI: 10.1177/1010539515592951
    This review discusses how climate undergo changes and the effect of climate change on air quality as well as public health. It also covers the inter relationship between climate and air quality. The air quality discussed here are in relation to the 5 criteria pollutants; ozone (O3), carbon dioxide (CO2), nitrogen dioxide (NO2), sulfur dioxide (SO2), and particulate matter (PM). Urban air pollution is the main concern due to higher anthropogenic activities in urban areas. The implications on health are also discussed. Mitigating measures are presented with the final conclusion.
  6. Lee CY, Yusof HM, Zakaria NS
    Malays J Med Sci, 2019 Sep;26(5):122-131.
    PMID: 31728124 MyJurnal DOI: 10.21315/mjms2019.26.5.11
    Background: Body-image perception is one of the determinants in weight management, especially among adolescents. This study aimed to assess weight-control knowledge, attitude and behaviours along with body-image perceptions among Chinese high school students in order to compare the weight-control behaviours with those perceptions.

    Methods: A cross-sectional study was conducted among 277 Chinese students in Form 1 and Form 2 in Pulau Pinang, Malaysia using convenience sampling. The following outcomes were evaluated: weight-control knowledge, attitude and behaviours (weight-related knowledge and attitude questionnaire; weight control strategies scale) and body-image perceptions (figure rating scale).

    Results: Both genders were found to have high weight-control knowledge, with female adolescents scoring significantly higher than male adolescents (P = 0.010). However, only half of the adolescents (50.9%) perceived that obesity is bad for health. Although only 44.4% of adolescents were dissatisfied with their current weight status, 62.8% intended to change their present weight status. Male adolescents significantly engaged more in physical activity (PA) (P = 0.035) and self-monitoring (SM) (P = 0.014) compared to their female counterparts. Furthermore, male adolescents chose their current body size as their ideal body image, but female adolescents preferred a slimmer ideal figure. The percentage of male and female adolescents who desired a smaller body figure was 39.6% and 54.5%, respectively. Lastly, there was no significant difference between weight-control behaviours and adolescents' body-image perceptions.

    Conclusion: Female Chinese adolescents had higher weight-control knowledge and preferred a slimmer body size, yet males were more likely to engage in PA and SM behaviours. Essentially, imprecise attitude towards obesity among half of the Chinese high school students is of particular concern.
  7. Wong YP, Masir N, Sharifah NA
    Malays J Med Sci, 2015 Jan-Feb;22(1):84-8.
    PMID: 25892955 MyJurnal
    Pilomatricomas can be confidently diagnosed cytologically due to their characteristic cytomorphological features. However, these lesions are rarely encountered by cytopathologists and thus pose a diagnostic dilemma to even experienced individuals, especially when the lesions are focally sampled. We describe two cases of histologically confirmed pilomatricoma. The first case is of a 13-year-old boy with posterior cervical 'lymphadenopathy', and the second one is of a 12-year-old girl with a lower cheek swelling. Both aspirates comprised predominantly atypical basal-like cells, with prominent nucleoli. 'Ghost cells' were readily identified by cell block in case two, but cell block in case one yielded no diagnostic material. In case two, pilomatricoma was accurately diagnosed pre-operatively. A cytological suspicion of a neoplastic process was raised in case one. Despite being diagnostically challenging, pilomatricoma can be diagnosed with careful observation of two unique cytological features of the lesions: (1) pathognomonic 'ghost cells' and (2) irregular, saw-toothed, loosely cohesive basaloid cells, with prominent nucleoli. The role of thorough sampling of the lesion, with multiple passes of various sites, cannot be overemphasized.
  8. Baharuddin A, Musa MN, Salleh SS
    Malays J Med Sci, 2016 Jan;23(1):1-3.
    PMID: 27540319 MyJurnal
    Muslim relies on the structure or guideline of shari'ah or the maqasid al-shariah, which consist of five essential values, namely preservation/protection of faith, life, intellect, property, and dignity/lineage - to guide them in discovering guiding principles for new concerns such as posed by neuroscience. Like in the case of brain imaging technology, there is in need for proper explanation within Islamic and among the Muslim scientists/scholars on how Islamic beliefs, values, and practices might cumulatively provide 'different' meanings to the practice and application of this technology, or whether it is in line with the shari'ah - in the context of preservation of health and protection of disease. This paper highlights the Islamic mechanism for neuroethics as basis for a holistic ethical framework of neuroscience to cope with its new, modern, and emerging technologies in the globalised world, and how Muslim should response to such changes.
  9. Aljarousha M, Badarudin NE, Che Azemin MZ
    Malays J Med Sci, 2016 May;23(3):72-7.
    PMID: 27418872 MyJurnal
    INTRODUCTION: Diabetes may affect the human body's systems and organs, including the eye. Diabetic retinopathy is the 5th leading cause of blindness globally. Diabetic subjects demonstrated dry eye symptoms that were also supported by the low values of the clinical tests.
    PURPOSE: This study aimed to compare the dry eye symptoms and signs between diabetics and non-diabetics and tear functions between diabetic subjects with and without dry eye.
    METHODS: This retrospective study was based on the observation of 643 medical files. Using a convenience sampling method, 88 subjects were found to report diabetes mellitus. The information extracted from the files included: date of first examination, age at first visit, gender, past ocular history, systemic disease, symptoms of dry eye disease and details of clinical diagnostic signs. Non-contact lens wearers were excluded. A group of 88, age and gender matched, control subjects were included for this comparison study.
    RESULTS: The percentage of dry eye symptoms was higher in diabetic subjects (15.9%) compared with non-diabetic subjects (13.6%; p<0.001). The percentage of dry eye symptoms was also higher in diabetics with dry eye (63%) than in diabetics without dry eye (36.9%; p<0.001). Tear break up time was significantly different between diabetics and non-diabetics (p<0.001) and between diabetics with and without dry eye (p=0.046). The corneal staining was significantly different between diabetic subjects with and without dry eye (p=0.028).
    CONCLUSION: Dry eye symptoms were significantly associated with diabetics. Tear break up time was significantly shorter in diabetics with dry eye compared to diabetics without dry eye.
    KEYWORDS: Diabetes mellitus; cornea; dry eye syndromes; signs and symptoms; tears
    Study site: Klinik Kesihatan Jalan Hospital, Kuantan, Malaysia
  10. Abdullah DC, Ibrahim NS, Ibrahim MI
    Malays J Med Sci, 2004 Jul;11(2):52-8.
    PMID: 22973127 MyJurnal
    The main aim of this study was to determine the medication errors among geriatrics at the outpatient pharmacy in a teaching hospital in Kelantan and the strategies to minimize the prevalence. A retrospective study was conducted that involved screening of prescription for a one-month period (March 2001). Only 15.35% (1601 prescription) of a total 10,429 prescriptions were for geriatrics. The prescriptions that were found to have medication errors was 403. Therefore, the prevalence of medication errors per day was approximately 20 cases. Generally, the errors between both genders were found to be comparable and to be the highest for Malays and at the age of 60-64 years old. Administrative errors was recorded to be the highest which included patient's particulars and validity of the prescriptions (70.22%) and drugs that available in HUSM (16.13%). Whereas the total of prescribing errors were low. Under prescribing errors were pharmaceutical error (0.99%) and clinical error (8.68%). Sixteen cases or 3.98% had more than 1 error. The highest prevalence went to geriatrics who received more than nine drugs (32.16%), geriatrics with more than 3 clinical diagnosis (10.06%), geriatrics who visited specialist clinics (37.52%) and treated by the specialists (31.07%). The estimated cost for the 403 medication errors in March was RM9,327 or RM301 per day that included the cost of drugs and humanistic cost. The projected cost of medication errors per year was RM 111,924. In conclusion, it is very clear that the role of pharmacist is very great in preventing and minimizing the medication errors beside the needs of correct prescription writing and other strategies by all of the heath care components.
  11. Mostapha G, Aziz NAA, Ali MF
    PLOS Glob Public Health, 2024;4(12):e0002759.
    PMID: 39630654 DOI: 10.1371/journal.pgph.0002759
    Primary-care long-term stroke care service offers comprehensive management at the community level. A clinical audit was carried out to assess the services of this clinic as compared to the established standardized criteria for longer-term stroke care.A retrospective audit was performed to evaluate the adherence to service parameters based on eleven criteria adapted from the Canadian Post-Stroke Checklist. The following clinical parameters were audited using the Malaysian CPG on Cardiovascular Disease 2017 and Malaysian CPG on Ischemic Stroke 2020: systolic blood pressure (SBP), diastolic blood pressure (DBP), low-density lipoprotein cholesterol (LDL-C), HbA1c, and weight, and smoking status. 113 registered patients from the 2022 clinic census were audited using paired Student's t-test and McNemar's test.Overall, only 2 out of 11 criteria for service parameters did not meet the standard: inquiring about patient fatigue (43.4%) and access to community resources (26.5%). The attainment of the target for BP and HbA1c meets the standards set for this audit. Patients experienced reduced SBP, DBP, LDL-C, and HbA1c levels, and a statistically significant reduction was observed in DBP (4.15 mmHg, p<0.05) and LDL-C (0.30 mmol/L, p<0.05). A notable reduction in the percentage of smokers (p<0.05) was also seen.Post-stroke patients at a specific-service clinic within the primary care setting benefited from clinicians' high adherence to clinical guidelines, observed from improved clinical parameters. These may serve as an impetus for clinicians to include long-term stroke service as a specialized service within primary care specialties.
  12. Abdullah NRA, Akbar RZA
    J ASEAN Fed Endocr Soc, 2017;32(1):50-53.
    PMID: 33442085 DOI: 10.15605/jafes.032.01.09
    Autoimmune thyroiditis in the course of other autoimmune diseases such as systemic lupus erythematosus (SLE) is common because these disorders are attributed to the production of autoantibodies against various autoantigens. Beyond this association, autoimmune thyroiditis can occur before, during or after the development of SLE. In this report, we describe a female who presented with facial puffiness, lethargy and progressive abdominal distension. She was diagnosed with autoimmune thyroiditis followed by the diagnosis of SLE complicated by a massive ascites, a rare form of lupus peritonitis, which is sterile ascites that results from severe serositis. Her presentation was complex and posed a diagnostic challenge and dilemma to the physicians involved in her care.
  13. Idris NA, Dian NL
    Asia Pac J Clin Nutr, 2005;14(4):396-401.
    PMID: 16326647
    Inter-esterification is one of the processes used to modify the physico-chemical characteristics of oils and fats. Inter-esterification is an acyl-rearrangement reaction on the glycerol molecule. On the other hand, hydrogenation involves addition of hydrogen to the double bonds of unsaturated fatty acids. Due to health implications of trans fatty acids, which are formed during hydrogenation, the industry needs to find alternatives to hydrogenated fats. This paper discusses some applications of inter-esterified fats, with particular reference to inter-esterified palm products, as alternatives to hydrogenation. Some physico-chemical properties of inter-esterified fats used in shortenings are discussed. With inter-esterification, more palm stearin can be incorporated in vanaspati. For confectionary fats and infant formulations, enzymatic inter-esterification has been employed.
  14. Awaluddin SM, Lim KK, Shawaluddin NS
    JBI Evid Synth, 2024 Nov 01;22(11):2342-2349.
    PMID: 39092602 DOI: 10.11124/JBIES-23-00454
    OBJECTIVE: This systematic review aims to determine the global pooled prevalence of overweight and obesity among health care workers in the 6 World Health Organization regions.

    INTRODUCTION: The escalating prevalence of overweight and obesity among health care workers significantly affects both individual health and the quality of health care services. Understanding this global prevalence is crucial to be able to implement informed interventions and policies, and for the overall optimization of health care delivery.

    INCLUSION CRITERIA: Observational studies with prevalence data for overweight and obesity among health care workers in both private and public health care facilities will be considered for inclusion. Transparent documentation of anthropometric measurements and adherence to established overweight and obesity criteria by the WHO, Asia Pacific standards, or Asian criteria are required to be eligible for inclusion. The review will focus on observational study designs, including cross-sectional, survey, case-control, and cohort studies.

    METHODS: PubMed, Scopus, and Web of Science Core Collection will be searched for records with predefined keywords, including MeSH terms. Records found through hand-searching and reference lists will be added. Two researchers will independently screen studies, resolving any discrepancies with a third researcher. Standardized critical appraisal and data extraction forms will be used. If suitable, pooled prevalence for overweight and obesity based on the 6 WHO regions will be calculated using the DerSimonian-Laird random-effects model. Statistical analysis will be performed and publication bias will be assessed through funnel plot analysis using either Egger, Begg, or Harbord test.

    REVIEW REGISTRATION: PROSPERO CRD42023452330.

  15. Ismail NA, Hashim HA, Ahmad Yusof H
    Games Health J, 2022 Feb;11(1):1-17.
    PMID: 34851732 DOI: 10.1089/g4h.2021.0104
    Recently, exergames have been widely applied as exercise platforms among older adults. However, studies on the influence of exergames on older adults' physical activity remain scarce. The review article highlights the potential benefit of exergames as a physical activity tool for older adults. The literature search followed the PRISMA guidelines on databases PubMed (Public/Publisher MEDLINE), CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane, and Scopus. The literature included studies that evaluated the influence of exergames on older adults' physical activity. Articles were excluded if the mixed intervention was used, emphasizing specific limbs, improving specific tasks, or not mentioning intervention. The review article identified 25 studies that reported on 855 older adults 55 years of age and older. In addition, the common exergaming technology platforms examined were Microsoft Kinect™, Nintendo® Wii™, cybercycling, and interactive video dance games. Meanwhile, 11 studies used a pretest/post-test design and randomized controlled trial design in 14 studies. The review found that exergames significantly impacted the older adults' physical activity level as participants experienced improved balance and cognitive function, and enjoyed playing exergame, thus prolonging their game engagement. Although research on exergames is still new, current evidence showed a significant potential benefit of exergames as a physical activity tool for older adults. To overcome the limitation on various parameters that showed different effects and outcomes of exergames, the study recommends implementing randomized controlled trials with long-term observation using a mixed-method approach. Moreover, a multidisciplinary method involving exercise and neuromotor control experts could determine potential mechanisms of action that benefited from the exercises.
  16. Salleh NS, Abdullah KL, Chow HY
    J Pediatr (Rio J), 2025;101(2):133-149.
    PMID: 39510130 DOI: 10.1016/j.jped.2024.07.012
    OBJECTIVE: There is a pressing need for public health practitioners to understand cultural values influencing parents on the uptake of human papillomavirus (HPV) vaccination for their daughters, which is presenting a growing challenge to close the immunization gap worldwide. Parental decisions were predominantly shaped by cultural norms and values. This systematic review encompasses parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters.

    METHOD: This systematic review was registered on PROSPERO CRD42020211324. Eligible articles were selected from CINAHL, PsycINFO, EMBASE, PubMed and Science Direct. Original qualitative studies exploring parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters under the age of 18, published in the English language with no restriction dates were reviewed. Two authors independently screened abstracts, conducted the fill-text review, extracted information using a standardized form, and assessed study quality. A third author is needed to resolve the disagreements if necessary.

    RESULTS: Of the 1552 citations, 22 were included, with information on 639 parents. Five themes emerged from the data: sexuality-related concerns; upbringing and moral values; obligation to protect; external influences; and vaccine-related concerns.

    CONCLUSION: This systematic review is beneficial to identify and understand the culturally related facilitators and barriers to HPV vaccination among young women for the development of strategies to optimize HPV vaccine coverage among this population group by the policymakers.

  17. Asih DR, Alam MZ, Alam Z, Salleh MN, Salleh N, Salihu A
    J Oleo Sci, 2014;63(8):779-85.
    PMID: 25017863
    A pilot-scale production of lipase using palm oil mill effluent (POME) as a fermentation basal medium was carried out, and parameters for immobilization of the produced lipase were optimized. Lipase production in a 300-L bioreactor was performed using two proposed strategies, constant power per volume (P/V) and constant tip speed. Moreover, lipase immobilization on different materials was also investigated. Lipase production was performed using liquid-state bioconversion of POME as the medium and Candida cylindracea as the inoculum. The fermentation medium was composed of 1% total suspended solids (TSS) of POME, 0.5% (w/v) peptone, 0.7% (v/v) Tween-80, and 2.2% inoculum. The medium composition was decided on the basis of the medium optimization results of a previous study. The fermentation was carried out for 48 h at 30°C and pH 6. The maximum lipase production was 5.72U/mL and 21.34 U/mL, obtained from the scale-up strategies of constant tip speed and P/V, respectively. Four accessible support materials were screened for their potential use in immobilization. The most suitable support material was found to be activated carbon, with a maximum immobilization of 94%.
  18. Huat LB, Mitra AK, Jamil NI, Dam PC, Mohamed HJ, Muda WA
    J Glob Infect Dis, 2012 Jan;4(1):10-4.
    PMID: 22529621 DOI: 10.4103/0974-777X.93753
    Soil-transmitted intestinal helminth infection is prevalent in rural communities of Malaysia. Risk factors contributing to helminth infections are largely unknown in the country.
  19. Shahar S, Adznam SN, Lee LK, Yusof NA, Salleh M, Mohamed Sakian NI
    Public Health Nurs, 2013 Mar;30(2):140-9.
    PMID: 23452108 DOI: 10.1111/j.1525-1446.2012.01051.x
    This study aimed to determine the effectiveness of a nutrition education intervention package in improving anthropometric, clinical and biochemical indicators of rural older Malays with metabolic syndrome (MS).
  20. Suparji NS, Chan G, Sapili H, Arshad NM, In LL, Awang K, et al.
    PLoS One, 2016;11(3):e0151472.
    PMID: 26974436 DOI: 10.1371/journal.pone.0151472
    Geranylated 4-phenylcoumarins, DMDP-1 & -2 isolated from Mesua elegans were investigated for anticancer potential against human prostate cancer cells. Treatment with DMDP-1 & -2 resulted in cell death in a time and dose dependent manner in an MTT assay on all cancer cell lines tested with the exception of lung adenocarcinoma cells. DMDP-1 showed highest cytotoxic efficacy in PC-3 cells while DMDP-2 was most potent in DU 145 cells. Flow cytometry indicated that both coumarins were successful to induce programmed cell death after 24 h treatment. Elucidation on the mode-of-action via protein arrays and western blotting demonstrated death induced without any significant expressions of caspases, Bcl-2 family proteins and cleaved PARP, thus suggesting the involvement of caspase-independent pathways. In identifying autophagy, analysis of GFP-LC3 showed increased punctate in PC-3 cells pre-treated with CQ and treated with DMDP-1. In these cells decreased expression of autophagosome protein, p62 and cathepsin B further confirmed autophagy. In contrary, the DU 145 cells pre-treated with CQ and treated with DMDP-2 has reduced GFP-LC3 punctate although the number of cells with obvious GFP-LC3 puncta was significantly increased in the inhibitor-treated cells. The increase level of p62 suggested leakage of cathepsin B into the cytosol to trigger potential downstream death mediators. This correlated with increased expression of cathepsin B and reduced expression after treatment with its inhibitor, CA074. Also auto-degradation of calpain-2 upon treatment with DMDP-1 &-2 and its inhibitor alone, calpeptin compared with the combination treatment, further confirmed involvement of calpain-2 in PC-3 and DU 145 cells. Treatment with DMDP-1 & -2 also showed up-regulation of total and phosphorylated p53 levels in a time dependent manner. Hence, DMDP-1 & -2 showed ability to activate multiple death pathways involving autophagy, lysosomal and endoplasmic reticulum death proteins which could potentially be manipulated to develop anti-cancer therapy in apoptosis resistant cells.
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