Six groups of adult Sprague-Dawley rats were orally administered with a variety of treatments to elucidate their cytoprotective effects. Absolute ethanol combined with HCl was used to induce gastric lesions in rats. Aqueous and ethanol extracts of Chromolaena odorata, a famous folk herb for treating skin wounds were evaluated to determine their protective effect on gastric mucosa. In this study, aqueous extract and ethanol extract of C. odorata were combined with honey. In addition, honey alone and honey combined with cimetidine were also evaluated. Rat stomachs were examined grossly and histologically. Results were expressed as inhibition percentage. The honey and aqueous extract combination showed the highest inhibition percentage (72.67%) followed by honey and ethanol extract (58.92%), honey and cimetidine (56.55%) and the lowest was honey alone (46.74%). However, there were no significant differences between the effects of aqueous and ethanol extracts of C. odorata and honey in promoting cytoprotective effects and this may be due to the small sample size. Nevertheless, these results suggest that C. odorata and honey may be beneficial in treating induced gastric mucosal injury.
Metastases to the breast from non-mammary malignant neoplasm are relatively rare. We report a case of metastatic disease to the breast from a primary lung adenocarcinoma in a young 22-year-old lady. Computed tomography of the thorax confirmed right upper lobe mass with multiple lung nodules and a breast lump. The diagnosis of breast metastasis was confirmed by fine needle aspiration cytology of the breast lump with histopathological findings and immunohistochemical features consistent with lung adenocarcinoma.
Six groups of adult male Sprague Dawley rats, each consisting of six animals were used throughout the experiment. The gastroprotective effects of aqueous plant extract alone, honey alone or honey in combination with ethanolic or aqueous extracts of A. conyzoides and cimetidine were investigated in rats against ethanol-HCl induced gastric ulcer. Efficacy was assessed by determination of ulcer index and inhibition percentage. Oral administration of ethanol-HCl (5 ml kg-1 body weight) to fasted rats produced extensive lesions of gastric mucosa (Group 1). Pre-treatment with honey (2.5 g kg-1 body weight) alone (Group 2), aqueous plant extract alone (10% w/v 5 ml kg-1) (Group 3), or honey in combination with each of alcoholic extract (10% w/w 5 ml kg-1) (Group 4), aqueous extract (10% w/w 5 ml kg-1) (Group 5) or cimetidine (10 mg/ml honey 5 ml kg-1) (Group 6) orally 30 minutes before administration of absolute ethanol-HCl significantly (p < 0.05) protected gastric lesions by 46.74%, 61.50%, 76.68%, 78.39% and 56.55% respectively. Although the mechanism of gastric protection is unknown, honey in combination with each plant extract appears to increase the resistance of gastric mucosal cells to the necrotizing effect of strong irritants in the absolute ethanol-HCl mixture. The results suggest that honey in combination with each plant extract might be beneficial in the treatment of a variety of diseases in which gastric mucosal injury is present.
Six groups of adult male Sprague Dawley rats, each consisting of six animals were used throughout the experiment. The gastroprotective effects of aqueous plant extract alone, honey alone or honey in combination with ethanolic or aqueous extracts of A. conyzoides and cimetidine were investigated in rats against ethanol-HClinduced gastric ulcer. Efficacy was assessed by determination of ulcer index and inhibition percentage. Oral administration of ethanol-HCl (5 ml kg-1 body weight) to fasted rats produced extensive lesions of gastric mucosa (Group 1). Pre-treatment with honey (2.5 g kg-1 body weight) alone (Group 2), aqueous plant extract alone (10% w/v 5 ml kg-1) (Group 3), or honey in combination with each of alcoholic extract (10% w/w 5 ml kg-1) (Group 4), aqueous extract (10% w/w 5 ml kg-1) (Group 5) or cimetidine (10 mg/ml honey 5 ml kg-1) (Group 6) orally 30 minutes before administration of absolute ethanol-HCl significantly (p < 0.05) protected gastric lesions by 46.74%, 61.50%, 76.68%, 78.39% and 56.55% respectively. Although the mechanism of gastric protection is unknown, honey in combination with each plant extract appears to increase the resistance of gastric mucosal cells to the necrotizing effect of strong irritants in the absolute ethanol-HCl mixture. The results suggest that honey in combination with each plant extract might be beneficial in the treatment of a variety of diseases in which gastric mucosal injury is present. KEYWORDS: Honey, A. conyzoides, cimetidine, rats, ulcer
The exclusive breastfeeding rate in Malaysia is very low. However in recent years the awareness of breastfeeding among mothers has increased. A preliminary qualitative research was carried out on these motivated mothers. The objective of this study was to understand the challenges encountered by breastfeeding mothers and to explore the support and motivation received by them. Information from the motivated mothers was obtained from focus group discussion. Some obstacles faced by the mothers were lack of knowledge on breastfeeding and lack of support from health professionals, parents and siblings. Facilities to express breast milk while at work were not readily available. The main motivation to breastfeed came from the mother herself and support from the husband. A holistic approach must be used to help mothers to continue breastfeeding. This includes breastfeeding promotion and education, setting up more Baby Friendly Hospitals, availability of breastfeeding support groups and provision of enough breastfeeding facilities at work and public places.
The family is an important factor that influences an individual’s decision for organ donation. The number of studies addressing the family’s role in organ donation is limited. It is imperative to explore these studies and offer recommendations that may help in addressing organ shortage. 15 studies with more than 2100 participants were selected for a systematic review. The studies were accessed by searching three databases: MEDLINE, Elsevier, and PsycINFO. This systematic review indicates that knowledge about brain death and the circumstances surrounding organ donation and transplantation are the most important factors that affect a family’s decision regarding organ donation. Educational efforts targeting the family should be initiated, which can then guide the family’s decision on organ donation. We suggest that educational efforts be consistent with other factors such as religious beliefs that influence the family’s decision.
Night work and rotating shift work are found to be detrimental to the health of workers. A cross sectional analytical study was conducted among the employees of a public medical centre in Kuala Lumpur. A total of 380 employees participated in the health screening and questionnaire survey. The majority of the respondents were Malays, females, and with mean age of 49 years old. The shift workers persistently had higher but non-significant proportions of being overweight/obesity and unhealthy clinical indicators such as systolic and diastolic blood pressure, fasting blood glucose and lipid profile except waist circumferences and HDL-cholesterol. There were also slightly more shift workers diagnosed with diabetes mellitus, hypertension or coronary heart disease (p>0.05). Although the present study could not provide established evidence for a relationship between shift work and cardiovascular risks, this could serve as a pilot study for future studies in this area.
INTRODUCTION: Although the Feldenkrais method of rehabilitating chronic obstructive pulmonary disease (COPD) patients have been suggested, its use among practitioners is not widespread owing to preference of the more familiar standard program presently available. Several advantageous of the Feldenkrais Method have been suggested which includes improving the efficiency of movement, posture and, breathing. However how this compares to the standard rehabilitation protocol or pulmonary rehabilitation program (PRP) have not been previously demonstrated. The present study was thus conducted to compare the effectiveness of the Feldenkrais Method to the standard PRP using Borg score and 6 minute walked distance (6MWD) as outcome measurement tools.
RESULTS: There were 17 subjects in the Feldenkrais group (FG) and 19 subjects in the pulmonary group (PG), both of which received therapy for 8 weeks and assessed before and after receiving therapy. There were no improvements observed in the Borg score for the FG (after and before; 6.06+ 1.09 vs. 6.00+0.94). However, improvements in the PG group could be seen (after and before; 3.58+ 1.17 vs. 5.84 +1.01). Improvements in the 6MWD was observed in both groups with no significance differences noted (FG vs. PG; 379+129m vs. 374+80m).
CONCLUSION: The Feldenkrais method does not offer any advantage over the present PRP and in fact the latter offers better improvement in terms of the Borg score. However in view of the small study sample, further study would be needed before a final conclusion can be made.
Study site: Respiratory clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Prescribing medication is not without its adverse effects. Complications due to drug therapy are on the rise in Malaysia, especially when antibiotics are used indiscriminately. We reviewed cases admitted to the Acute Medical Ward of University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, over a two-month period from March to April 2009. The authors found that Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) were the most common severe adverse cutaneous reactions due to ingestion or parenteral use of drugs. In this report, is a brief description of the two conditions and ways to manage them. The authors have come to a conclusion that judicious use of medications with adequate patient education is important in order to avoid these adverse effects.
Background: Cataract is the second priority eye disease in the world and this case in Indonesia occupies the third-highest position in Southeast Asia. There are two methods for cataract treatment that can be expensive, small incision method (SICS) and Phacoemulsification method, and it is important to know the cost-effective comparison of those two methods.
Objective: This study aims to conduct Cost-Effectiveness Analysis (CEA) between cataract surgery; Small Incision Cataract Surgery (SICS) and Phacoemulsification, at Undaan Eye Hospital Surabaya.
Materials and Method: A prospective study following up patients from before surgery up to 21 days’ post surgery. A total of 155 cataract patients had undergone surgery; 25 patients and 130 patients had SICS and Phacoemulsification, respectively. Quality-Adjusted Life Years (QALYs) was used as the outcome measure. The assessment of utility using ‘Visual Function 25’ (VF-25) was the quality of life regarding visual function before surgery, 7 days, and 21 days post-surgery.
Result: The average cost of Phacoemulsification technique was Rp 10,821,038 and the average cost of SICS technique was Rp 10,443,544. QALYs at day7 post-surgery of Phacoemulsification and SICS was 9.49 and 8.95, respectively. While QALYs at day21 post- surgery of Phacoemulsification and SICS was 10.37 and 10.15, respectively. ICER values for Phacoemulsification versus SICS at day7 post-surgery was Rp 696,360 (USD 49,74) while at day 21 was Rp 1,723,559 (USD 123,11).
Conclusion: Phacoemulsification and SICS are effective ways to improve the quality of life related to visual function. The incremental cost per QALYs obtained via Phacoemulsification from SICS at D7 and day21 post- surgery were less than Indonesia’s GDP per capita income of USD 3,347, means that Phacoemulsification is more cost effective than SICS technique for cataract surgery.
The conventional use of aminoglycoside antibiotics has several disadvantages including the need for regular pre- and post-dose assaying and the risks of toxicity. Achieving a therapeutic and non-toxic serum concentration may be difficult in many patients especially those with severe sepsis. Correct timing of doses and assays is essential, but this is often difficult to achieve. Many of these difficulties may be remedied by the use of once daily dosing. This dosing schedule appears to be equally effective as the conventional method and i s also less toxic. There are many other advantages including the need for less assays and venepuncture resulting in reduced costs. KEYWORDS: Aminoglycosides, antibiotic therapy, toxicity, therapeutic monitoring
The crux of the current health problem is the alarming increase of dengue cases in the country. Dengue fever is endemic in Southeast Asia with Malaysia seeing dengue cases surge since 2003. The Health Minister of Malaysia has reported that the acute increase in dengue cases is worrying and could hit the country's productivity, tourism industry and economy.(Copied from article).
Renal angiomyolipoma, once considered a rare benign renal tumour, is relatively common these days. They account for 0.3-3.0% of all renal masses. Histologically, it is composed of adipose tissue, smooth muscles and blood vessels. Here, we wish to highlight five cases of renal angiomyolipomas which were presented to the University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia, over a two-year period between June 2005 and June 2007. This study wish to illustrate its varied clinical presentation and the management undertaken for each underlying condition. These cases were presented in the form of spontaneous perirenal haemorrhage, a large asymptomatic renal mass, a small asymptomatic renal mass, a symptomatic renal angiomyolipoma and a case of renal angiomyolipoma mimicking a renal tumour. Each of these cases varied in its clinical presentation; thus, management has become very challenging to clinicians ranging from conservative management to active intervention, be it operatively or non-operatively.
Background: This paper investigates the quality of life of brain pathology patients in relation to their sociodemographic
profiles and clinical factors.
Methods: This is a cross-sectional study done at a tertiary referral hospital in Kuala Lumpur. A total of 100
patients were recruited in the study after excluding 22 patients who did not met the exclusion criteria. The
European Organisation for Research and Treatment of Cancer Quality of Life (EORTC QLQ-C30) self-administered
questionnaire was utilized in the study. The Global health status/QoL, Physical functioning, Role functioning,
Emotional functioning, Cognitive functioning, Social functioning, Fatigue, Nausea and vomiting, Pain, Dyspnoea,
Insomnia, Appetite loss, Constipation, Diarrhoea, and Financial difficulties were assessed in this study.
Results: The most severe impairment in functioning was with lowest score of cognitive functioning (mean
score=61) and the most severe symptom was fatigue (mean score=45). There were significant differences in
quality of life scores in different socio-demographic groupsand types of brain pathology patients. Patients aged
below 40 years old or less had better physical functioning, less symptoms of fatigue and insomnia compared
to patients who were more than 40 years old. Male patients faced more financial difficulties compared with
female patients. Patients who were married had increased insomnia compared to the single patients. Employed
patients had better physical functioning and less financial difficulties compared with patients who were
unemployed. Patients who earned >RM 2500.00 monthly had better physical functioning, less symptoms of pain and less financial difficulties than patients who earned ≤RM 2500.00. Patients with qualifications lower
than SPM tended to face more financial difficulties compared to patients with qualifications of SPM or higher.
Meningioma patients had better social functioning compared with others, whereas Carvenoma patients had
better physical functioning. Meningioma patients had more symptoms of insomnia compared with other
patients. All the findings were with p value less than 0.05.
Conclusion: The quality of life of patients with brain pathology is affected by socio-demographic factors and
clinical diagnoses. Efforts should be made to improve the overall quality of life of these patients.
Background: Astrocytic gliomas are the most common primary brain tumors that developed from glial origin.
The angiogenic cell population from brain tumor enhances the recruitment of circulating cancer stem cells
homing towards tumor site.
Objectives: This study aimed to investigate the tumor angiogenic cell population that stained with CD133+
and VEGFA+ markers and its association with circulating cancer stem cell (CD133+/VEGFR2-) population in the
peripheral blood mononuclear cells (PBMCs) of astrocytic glioma patients.
Methods: A total of 22 astrocytic glioma patients from Hospital Universiti Sains Malaysia who consented to
the study were included. Tumors (n=22) were sliced and stained with CD133+ and VEGFA+ angiogenic markers
and counter stained with DAPI. The circulating cancer stem cells (CD133+/VEGFR2-) in PBMCs (n=22) were
quantified using FACS based on the expression of CD133 and VEGFR2 markers. The paired t-test and Pearson
correlation were used for the data analysis.
Results: The percentage of angiogenic cell population was significantly higher in brain tumor compared to
adjacent normal brain tissue (1.25 ± 0.96% vs. 0.74 ± 0.68%; paired t-test=2.855; df=21, p = 0.009). Positive
correlation was found between the angiogenic cells of brain tumor tissue and adjacent normal brain tissue
(Pearson correlation, r = 0.53, p = 0.011). Significant positive correlation was found between angiogenic cells
in glioma tumor and cancer stem cells in peripheral circulating systems of astrocytic glioma patients (Pearson
correlation, r = 0.42, p = 0.049).
Conclusion: Angiogenic cells in the brain tumor resident promote the recruitment of circulating cancer stem cells
homing to the tumor site and induce the proliferation and growth of the tumor in astrocytic glioma patients.
The aim of this study was to validate the translation of the Overactive Bladder (OAB) Screener (OAB V8) to the Malay language. It was to assess the reliability of the screener in the context of a Malaysian population. The original screener consists of eight symptoms indicative of OAB that has been proven to be highly sensitive and reliable. Translation was done with a modification of the Brislin Method using back translation and a panel of experts as a final review panel. The pilot study had two groups; a symptomatic (n=19 patients) and an asymptomatic group (n=18 patients). All patients performed the test twice at two week intervals once at the clinic and subsequently at home. Test-retest method was used for reliability and Cronbach's alpha for internal consistency. The translated questionnaire demonstrated good internal consistency in both groups of patients for all eight items individually and for the total score. Cronbach's alphas ranged from 0.972 to 0.981 for the symptomatic group and from 0.750 to 0.976 for the asymptomatic group. Testretest correlation for all items was highly significant. Intraclass orrelation (ICC) was high for both the asymptomatic (ICC ranging from 0.600 to 0.953) and the symptomatic group (ranging from 0.944 to 0.989).The Malay OAB V8 showed itself to be suitable for use, reliable in distinguishing symptomatic and asymptomatic patients and a valid instrument.