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  1. Samsudin MA, Manokaran T, Ali MS, Jamaluddin AAA, Sashideran DP, Ting HP, et al.
    Malays J Med Sci, 2024 Dec;31(6):217-256.
    PMID: 39830106 DOI: 10.21315/mjms2024.31.6.17
    Localisation in neurology is an important step in determining the location of a neurological lesion based on history taking and clinical examination before confirmation with imaging. Lesions can vary from the cortical to the subcortical, brainstem, and spinal cord levels, in which every presentation and finding from the patient can provide a rough idea of where the pathology is located. A differential diagnosis can later be made according to the duration of the symptoms and the cumulative signs and symptoms presented. This is considered the most important step in managing neurological patients to ensure that no stone is left unturned in making an accurate diagnosis.
  2. Faisal DR, Noveyani AE, Purwatiningsih Y, Lestyoningrum SD, Putro WG, Mikrajab MA, et al.
    Malays J Med Sci, 2024 Dec;31(6):112-125.
    PMID: 39830107 DOI: 10.21315/mjms2024.31.6.9
    Southeast Asia (SEA) countries are characterised by a high burden of tuberculosis (TB). This research seeks to compile evidence of the prevalence and risk factors associated with TB among children in SEA countries. The searching of articles was conducted for four databases (PubMed, Scopus, Embase, and the Web of Science) published between 2013 and 2023 in the English language. The quality of articles was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Tool for Assessment of Risk Bias for Cross-Sectional studies. This research was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. Eight studies were included in the systematic review. The prevalence of paediatric TB in SEA countries varies between 1.50% and 38.10%. Risk factors associated with the occurrence of TB in children include the nutritional status, the Bacillus Calmette-Guérin (BCG) vaccine status, close contact with TB patients, parental smoking behaviour, unhealthy living conditions, and socioeconomic determinants. The continued high prevalence of TB in several SEA countries, particularly among children, remains a significant public health concern. The various risk factors summarised can serve as a basis for implementing interventions aimed at reducing cases and preventing the transmission of TB among children.
  3. Teo PF, Koh EBY, Chong SC
    Malays J Med Sci, 2024 Dec;31(6):178-193.
    PMID: 39830103 DOI: 10.21315/mjms2024.31.6.14
    BACKGROUND: A considerable number of schizophrenia patients still require long-term hospital care despite psychiatric deinstitutionalisation, especially in developing nations. Prolonged hospitalisation is associated with greater impairment in psychosocial functioning. This study aimed to determine the level of psychosocial functioning and its predictors among long-stay schizophrenia patients in a Malaysian mental institution.

    METHODS: This cross-sectional study included 138 patients selected through universal sampling. Data on socio-demographics, illness characteristics such as psychopathology and illness severity [measured using the Brief Psychiatric Rating Scale (BPRS)], and cognitive function [assessed using the Montreal Cognitive Assessment (MoCA)] were collected. The Personal and Social Performance (PSP) scale was used to evaluate psychosocial functioning. Pearson correlation coefficients and multiple linear regression analyses were applied to identify the correlates and predictors of psychosocial functioning.

    RESULTS: This study found that 47.8% and 16.7% of the patients had moderate and severe cognitive impairments, respectively. The mean PSP score was 69.68 (standard deviation (SD) = 15.48). Female gender, previous unemployment and more severe cognitive impairments were significantly associated with poorer psychosocial functioning. Meanwhile, negative symptoms and age of onset were negatively correlated with psychosocial functioning. By contrast, the duration of illness was positively correlated with psychosocial functioning. The regression model indicated that being female (β = -7.32, p < 0.001), previously unemployed (β = -3.67, p < 0.047), having negative symptoms (β = -4.18, p < 0.001), experiencing a longer illness duration (β = -0.60, p = 0.004), and the presence of severe cognitive impairment (β = -9.80, p < 0.001) significantly predicted poorer psychosocial functioning.

    CONCLUSION: Long-stay schizophrenia patients experience substantial difficulties in psychosocial functioning. Factors such as gender, last employment status, negative symptoms, illness duration, and cognitive function affect psychosocial functioning.

  4. Wali MH, Naif HM, Abdul Rahim NA, Yunus MA
    Malays J Med Sci, 2024 Dec;31(6):133-147.
    PMID: 39830110 DOI: 10.21315/mjms2024.31.6.11
    BACKGROUND: Respiratory syncytial virus (RSV) is a common aetiological agent that causes respiratory infections, especially among infants. Identifying circulating RSV genotypes is an essential strategy for understanding the spread of the virus in a certain area. Sequencing the variable regions of the attachment glycoprotein (G) gene of RSV is a quick and direct approach for identifying the genotypes.

    METHODS: This study was aimed to sequence the G gene region of RSV isolated from patients admitted to hospitals in Baghdad, Iraq, during the autumn of 2022 and winter of 2023. To achieve this goal, 150 patients with lower respiratory symptoms were screened for RSV infections. RSV-positive samples were detected and confirmed using the reverse transcription-quantitative polymerase chain reaction (RT-qPCR) approach, which involved the use of specific TaqMan primer sets targeting RSV subgroups. Then, a G gene region that included hypervariable region 2 (HVR2) was amplified and sequenced using the Sanger sequencing method. Furthermore, molecular and phylogenetic analyses were performed on the G gene region to determine the variability profile of the tested specimens.

    RESULTS: There were 41 (26.6%) RSV-positive cases. Of these, the RSV-B subgroup was the most prevalent (82.90%), while the RSV-A subgroup incidence rate was 17.07%. The phylogenetic analysis showed that the RSV-B isolates were related to the BA genotype and shared nucleotide sequence similarities with isolates from India, Australia and the UK. The RSV-A isolates belonged to the ON genotype and had some degree of similarities with isolates from Italy, Tunisia, and France.

    CONCLUSION: Seasonal tracking of the RSV isolates would facilitate a better understanding of virus evolution, viral pathogenesis, and genetic diversity.

  5. Selvam K, Najib MA, Khalid MF, Harun A, Aziah I
    Malays J Med Sci, 2024 Dec;31(6):34-56.
    PMID: 39830111 DOI: 10.21315/mjms2024.31.6.4
    Melioidosis is a life-threatening infectious disease caused by the bacterium Burkholderia pseudomallei. Although culture is the gold standard for diagnosing melioidosis, it is time-consuming and delays timely treatment. Non-culture-based diagnostic techniques are interesting alternatives for the rapid detection of melioidosis. This systematic review provides an overview of the performance of antibody-detection tests for melioidosis. A thorough literature search was conducted in two databases to identify relevant studies published until 31 December 2023. Among the 453 studies identified, 29 were included for further analysis. Various antibody-detection methods have been developed, primarily enzyme-linked immunosorbent assays (ELISAs). Recombinant outer membrane protein A-(OmpA)-specific immunoglobulin G (IgG), immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin D (IgD) exhibited the highest accuracy, with a sensitivity of 95.0% and a specificity of 98.0% in ELISA. Furthermore, immunochromatographic testing has emerged as a promising rapid diagnostic test (RDT), with haemolysin co-regulated protein 1 (Hcp1) demonstrating significant accuracy, a sensitivity of 88.3%, and a specificity of 91.6%. Additionally, IgG against Burkholderia invasion protein D (BipD) showed excellent accuracy, with a sensitivity of 100.0% and a specificity of 100.0% in surface plasmon resonance assay. Combining multiple antigens or employing different detection techniques can enhance the accuracy of melioidosis diagnosis.
  6. Wulandari RD, Latifah L, Laksono AD, Nugraheni WP, Suryati T, Rachmawati T, et al.
    Malays J Med Sci, 2024 Dec;31(6):205-216.
    PMID: 39830104 DOI: 10.21315/mjms2024.31.6.16
    BACKGROUND: The Indonesian government policy regarding obtaining universal coverage through National Health Insurance (NHI) is expected to increase public access to health service facilities, including in disadvantaged areas. This study analysed the role of NHI in hospital utilisation in underprivileged areas of Indonesia.

    METHODS: Data from the 2023 National Socioeconomic Survey were used in this cross-sectional study that included 130,331 participants. Hospital utilisation was the dependent variable and NHI membership was the independent variable. Residence, age, sex, marital status, education, occupation, and wealth status were control factors. A multinomial logistic regression was employed in the final stage for data evaluation.

    RESULTS: In 2023, the hospital utilisation rate in Indonesia's disadvantaged regions was 1.5% and the percentage of NHI members was 74.5%. People with an NHI membership were 3.01 times more likely to utilise the hospital than those without [95% confidence interval (CI) 2.58-3.50]. Seven control variables related to hospital utilisation were identified, namely, residence type, age, sex, marital status, education level, employment status, and wealth status.

    CONCLUSION: This study concluded that NHI membership influenced hospital utilisation in disadvantaged areas of Indonesia. Individuals with NHI membership were three times more likely to visit hospitals.

  7. Kardani AK, Fitri LE, Samsu N, Subandiyah K
    Malays J Med Sci, 2024 Dec;31(6):57-64.
    PMID: 39830109 DOI: 10.21315/mjms2024.31.6.5
    Nephrotic syndrome is the most common glomerular disease in children. While the exact pathogenesis of nephrotic syndrome is not fully understood, recent research has shed light on some of the underlying mechanisms involved in it. Improvement by B cell depletion therapy using antiCD20 in nephrotic syndrome has led to a paradigm shift from immunoinflammatory disease influenced by T cell dysregulation to B cell involvement in the pathogenesis of nephrotic syndrome. The expression of the B cell activating factor (BAFF), an essential cytokine for the maturation and differentiation of B lymphocytes, in the podocytes of paediatric patients with nephrotic syndrome is known to be associated with worse renal outcomes. The pro-inflammatory cytokines and pathogenic antibodies produced by B cells allegedly cause podocyte injury leading to proteinuria due to effacement of foot processes. Considering the role of the BAFF in B cell proliferation and antibody production, BAFF signalling is a potential target for development as targeted therapy in nephrotic syndrome. Nevertheless, there is limited research regarding the role of BAFF in nephrotic syndrome, and the exact mechanism of BAFF involvement in the pathogenesis of nephrotic syndrome is still unknown. This review discusses the role of the BAFF in the pathogenesis of nephrotic syndrome and highlights the gap of knowledge for future research.
  8. Chaidoutis EA, Chatzimpirou O, Migdanis I, Migdanis A, Papadakis A, Lazaris AC, et al.
    Malays J Med Sci, 2024 Dec;31(6):21-33.
    PMID: 39830105 DOI: 10.21315/mjms2024.31.6.3
    Food safety is a key priority for public health. However, consumer demand for cheese products may expose the population to the risk of mycotoxicosis and cancer, among others. Acute mycotoxicosis and cancer are examples of linked disorders. Among the most frequent toxic agents that enter the human body through food consumption are mycotoxins. This review study highlights the significance of the impact of the most important mycotoxins on public health through the consumption of cheese products. Despite being a poor substrate for mycotoxin development, cheese products have been found to contain harmful toxins. Aflatoxin M1 (AFM1) and ochratoxin A (OTA) are the main mycotoxins in cheese products, and they are very harmful to human health. Adherence to legislative limits and the implementation of appropriate control measures by food business operators (FBOs) are considered necessary to protect consumers' health.
  9. Ismail SNQ, Abdullah JM
    Malays J Med Sci, 2024 Dec;31(6):1-5.
    PMID: 39830102 DOI: 10.21315/mjms2024.31.6.1
    This editorial reviews the Malaysian Journal of Medical Sciences' performance over 2023-2024, highlighting key achievements and challenges. It aims to provide a detailed analysis of the journal's processes and identify areas for improvement.
  10. Amaran A, Draman N, Idris NS, Harith S
    Malays J Med Sci, 2024 Dec;31(6):194-204.
    PMID: 39830097 DOI: 10.21315/mjms2024.31.6.15
    BACKGROUND: Older people are more susceptible to malnutrition. Malnutrition is defined as imbalances and deficiencies of nutrients that result in diminished function. However, malnutrition identification through nutrition screening is not routinely performed at Malaysian health clinics or hospitals. Our study aimed to determine the proportion of older people at high risk of malnutrition and its associated factors.

    METHODS: This was a cross-sectional study conducted among older persons aged ≥ 60 years, and the exclusion criteria were older persons with known cases of dementia or the inability to stand and have hand problems that limit the ability to hold the dynamometer. Sociodemographic data and anthropometry assessment were conducted. Malnutrition risk screening tool-hospital, modified Barthel Index and the Elderly Cognitive Assessment Questionnaire were used in this study. The data were analysed using descriptive statistics and multiple logistic regression.

    RESULTS: A total of 200 older persons participated in the study, and the proportion of the high risk of malnutrition was 27 (13.5%). Poor handgrip strength odd ratio (OR) = 3.56, 95% confidence interval (CI) = 1.41, 8.98; p = 0.007) and living arrangements (OR = 4.6, 95% CI = 1.31, 16.1; p = 0.017) were significantly associated with a high risk of malnutrition in older persons.

    CONCLUSIONS: The proportion of older persons at high risk of malnutrition was low (13.5%). Poor handgrip strength and living arrangements are significant factors associated with a high risk of malnutrition among older persons. Nutrition screening can help identify the cause and other factors of malnutrition. The role of healthcare personnel should be emphasised in nutrition screening, as they are commonly the first point of contact for patients seeking medical advice.

  11. Mohamed Shukri NRI, Hassan SK, Md Noor SS, Ab Hamid SA, Nik Mohamad NA, Wan Muhd Shukeri WF, et al.
    Malays J Med Sci, 2024 Dec;31(6):160-177.
    PMID: 39830098 DOI: 10.21315/mjms2024.31.6.13
    BACKGROUND: Hospital-acquired bloodstream infections (BSI) are associated with high morbidity and mortality rates. This study was conducted to describe the outcomes and the prognosis of hospital-acquired BSI in the Critical Care Unit, Hospital Pakar Universiti Sains Malaysia (HPUSM), as well as to identify associated factors of treatment failure and mortality at 28 days.

    METHODS: This prospective cohort study was conducted in the Critical Care Unit of HPUSM from September 2019 to March 2021. Eligible participants included patients with a positive blood culture recorded after 48 hours of admission to hospital.

    RESULTS: There was a total of 250 patients, whose positive blood cultures were isolated. The main isolated organisms were Klebsiella pneumonia (23.6%), Pseudomonas spp. (19.2%), Escherichia coli (12.8%) and Acinetobacter sp. (9.2%). The mortality of hospital-acquired BSI was 27.6%. Multiple logistic regression analysis revealed that age [adjusted odds ratio (OR) = 1.06; 95% confidence interval (CI): 1.03, 1.09; p < 0.001], cases with extended-spectrum beta-lactamases (ESBL) (adjusted OR = 5.57; 95% CI: 2.04, 15.21; p = 0.001), with multidrug-resistant (MDR) organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p < 0.001) and those with a sequential organ failure assessment (SOFA) score > 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015) had statistically significant associations with treatment failure. Factors significantly associated with 28-day mortality included age (adjusted OR: 1.06: 95% CI; 1.03, 1.09; p < 0.001), MDR organisms (adjusted OR = 14.70; 95% CI: 3.97, 54.48; p < 0.001) and SOFA score > 11 (adjusted OR = 4.16; 95% CI: 1.31, 13.19; p = 0.015).

    CONCLUSION: The elderly, ESBL, MDR organisms and high SOFA scores were associated with treatment failure and 28-day mortality in hospital-acquired BSI.

  12. Abrar SS, Hairon SM, Yaacob NM, Ismail MP, Isa SAM
    Malays J Med Sci, 2024 Dec;31(6):103-111.
    PMID: 39830100 DOI: 10.21315/mjms2024.31.6.8
    Cervical cancer poses a significant challenge to global health, particularly in low- and middle-income countries. Tracking the survival rates of cancer patients through data gathered by population-based cancer registries constitutes a crucial aspect of cancer management. In recent years, attention within bibliometric studies has been directed towards examining the correlation between inflammation and radiotherapy in cervical cancer. However, to date, there is no published literature investigating research trends in cervical cancer survival through bibliometric analysis. Thus, this study was undertaken to identify and analyse global research patterns and hotpots in this area. A systematic search was performed within the Web of Science Core Collection (WoSCC) database, employing the following search parameters: TITLE - (((survival) OR (survival rate) OR (survival analysis) OR (survival probability)) AND ((cervical cancer) OR (cervical carcinoma))). A comprehensive analysis of research trends was conducted utilising various tools on the WoSCC website and VOSviewer. A total of 840 papers pertaining to cervical cancer and survival were identified from 45 distinct departments or subjects. Notably, the People's Republic of China and the USA collectively accounted for half of all publications from 2000 to 2023. An extensive cohort comprising 4,759 authors affiliated with 1,454 institutions across 82 countries contributed to the progression of this research domain. Despite a substantial increase in research on cervical cancer survival over the last decade, it is essential to encourage and conduct research, particularly in high-risk regions, especially in countries classified as low- or middle-income.
  13. Koo TH, Leong XB, Zakaria AD
    Malays J Med Sci, 2024 Dec;31(6):65-76.
    PMID: 39830099 DOI: 10.21315/mjms2024.31.6.6
    Immunonutrition, which involves the targeted use of specific nutrients to enhance immune function and mitigate inflammation, has recently become a mainstay for both medical and surgical benefits. This review explores the evolution, mechanisms, and clinical applications of immunonutrition, with a focus on essential nutrients, such as omega-3 fatty acids, glutamine, arginine, and vitamins. These immunonutrients modulate immune responses, reduce pro-inflammatory cytokines, and support tissue repair. Clinical evidence indicates that immunonutrition reduces postoperative complications, shortens the duration of hospitalisation, and lowers the rate of infection, mainly in high-risk surgical patients and those with cancer or chronic diseases. In this regard, nutrients such as glutamine and omega-3 fatty acids have improved the nutritional status and recovery of cancer patients, while omega-3 fatty acids and antioxidant vitamins have exerted an anti-inflammatory effect, improving heart health in patients with cardiovascular disease. Immunonutrition has bright prospects in the management of infectious diseases, where certain nutrients, including vitamin D and zinc, aid in fighting immune defences and reducing the severity of infection. Future studies should investigate the molecular mechanisms underlying immunonutrition and its role in personalised nutrition. This could revolutionise dietary interventions based on genetic and proteomic profiling.
  14. Yusof ANM, Razali HYH
    Malays J Med Sci, 2024 Dec;31(6):126-132.
    PMID: 39830101 DOI: 10.21315/mjms2024.31.6.10
    When a medical error occurs, the instinct to blame healthcare professionals may seems like a way to ensure they learn from their mistakes. However, in today's healthcare landscape, the blame culture, coupled with the fear of litigation, proves detrimental to improving patient care. This culture fosters a reluctance among healthcare professionals to openly disclose mistakes, depriving them of valuable learning opportunities. These professionals, often referred to as second victims, deserve as much attention and support as the patients who are affected by the errors. Given that medical errors are inevitable, it becomes imperative to effectively manage the aftermath to ensure all parties involved are adequately supported and shielded from adverse consequences. This article delves into the ethical complexities of medical errors, advocating for a shift from a blame-centric culture to one that prioritises support for second victims. The aim of this article is to underscore the crucial importance of addressing medical errors within the healthcare sector by fostering an environment that promotes learning and growth post-error.
  15. Ashari LS, Abd Rashid AA, Mohd Razif S, Yeong Yeh L, Jan Mohamed HJ
    Malays J Med Sci, 2023 Jun;30(3):8-31.
    PMID: 37425391 DOI: 10.21315/mjms2023.30.3.2
    This review aimed to map current evidence on the association between dietary factors and colorectal cancer (CRC) risk in Asia. This review was conducted based on Arksey and O'Malley methodological framework. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) flow diagram was used to record the review process. For the purpose of searching for articles, three electronic databases namely PubMed, EBSCOHost and ScienceDirect were employed. The inclusion criteria for articles selection were articles with association analysis between diet and CRC risk among Asians, had adults as participants, articles were written in English, open-accessed and published between years 2009 and 2021. Thus, 35 out of 369 screened articles were eventually included in this review which covered 28 case-control studies, six prospective cohort studies and one randomised clinical trial. Foods such as meats, alcohol and westernised diet have been shown to be associated with increase of CRC risk while fruits, vegetables and traditional meals decreased the risk of CRC. Only a few interventional and dietary patterns studies were identified. Specific single foods and nutrients and dietary patterns have been found to increase the risk but also protected the Asian population against CRC. The findings of this review will guide health professionals, researchers and policy makers to conduct a suitable study design and topic for future research.
  16. Abas AH, Daud A, Mohd Hairon S, Shafei MN
    Malays J Med Sci, 2023 Jun;30(3):32-41.
    PMID: 37425379 DOI: 10.21315/mjms2023.30.3.3
    Data on the prevalence and risk factors of low back pain (LBP) in Malaysia remain unclear as they are currently limited to specific settings and occupational groups. Therefore, this study aims to determine the prevalence and risk factors of low back pain in Malaysia. In this scoping review, we had systematically searched PubMed, Scopus, ScienceDirect and Google Scholar from January 2016 to April 2020. In addition, we had included cross-sectional studies on LBP in Malaysia. Studies without data on the prevalence and risk factors were excluded. The settings, population, design, sample size, evaluation methods, prevalence and risk factors of the studies were summarised. The literature search identified 435 potentially eligible studies; of these, 21 had met the inclusion criteria. The prevalence of LBP in Malaysia among various types of the population had ranged from 12.4% to 84.6%. Among the various types of occupation, the prevalence of LBP was the highest among nurses (67.9%), followed by drivers (65.7%). In addition, age, gender, body mass index (BMI), lifting heavy objects, working posture, lifestyle, working hours and mental health were identified as the risk factors of LBP in Malaysia. The current evidence suggests that LBP is a serious health problem among several occupational groups in Malaysia. Therefore, it is crucial to implement the correct interventions for the prevention of LBP among these groups.
  17. Najib MA, Izani NJN, Amilah WAWWN, Faez AM, Shafizol Z
    Malays J Med Sci, 2020 Feb;27(1):22-36.
    PMID: 32158342 MyJurnal DOI: 10.21315/mjms2020.27.1.3
    This review aimed to provide a comprehensive overview of ruminant and human fascioliasis in Malaysia and to identify research gaps in knowledge of the prevalence of fascioliasis in Malaysia and risk factors for the disease using available evidence-based data. We conducted a scoping review based on the framework of Arksey and O'Malley. The preferred reporting items for systematic reviews and meta-analyses were used to guide the review process. The citation search was performed between May and September 2018. Using specific keywords, literature published between 1998 to September 2018 was retrieved from electronic databases. Six articles related to fascioliasis in Malaysia were included in the final review from 1,932 screened articles and reports. Five studies focused on ruminants, including cattle, buffaloes, sheep and goats in the states of Terengganu and Perak. The most frequent ruminant fascioliasis outbreaks involved cattle and goats, with a prevalence of 82%-95% and these outbreaks occurred in Terengganu. Only one study examined the risk of fascioliasis in cattle. In the study, the age and sex of the cattle were important risk-related parameters. The search returned only one documented report of a suspected case of human fascioliasis with an atypical clinical presentation. At present, human fascioliasis in Malaysia remains under-reported and its prevalence remains unknown. The data summarised in this review based on existing evidence identifies research gaps on fascioliasis in ruminants and humans.
  18. Abidin NZ, Ooi CH, Nosaka K, Rathakrishnan V, Chan SY, Karim NKA
    Malays J Med Sci, 2024 Dec;31(6):77-102.
    PMID: 39830113 DOI: 10.21315/mjms2024.31.6.7
    Delayed onset muscle soreness (DOMS) and impaired muscle recovery significantly affect athletes and recreational exercisers, influencing their performance and training consistency. Resveratrol, a natural polyphenol known for its anti-inflammatory and antioxidant properties, is thought to mitigate these effects, yet its effectiveness remains to be fully verified. This systematic review evaluates the impact of RES supplementation on muscle recovery in adults by examining its influence on DOMS, oxidative stress, and inflammation, along with its interactions with other supplements. Three electronic databases and one registry were searched in October 2023. A total of 10 studies met the inclusion criteria, encompassing a combined participant count of 238 (N=238). The review encompassed diverse participant populations, exercise types, and resveratrol dosages. The findings indicated that resveratrol potentially reduces markers of muscle damage, such as creatine kinase and lactate dehydrogenase, and alleviates DOMS symptoms to varying degrees. However, results varied based on exercise intensity, participant demographics, timing of supplementations and dosages. Synergistic interaction studies suggested that resveratrol, in combination with other compounds, could be more effective in exerting its effects. Despite promising findings, the research was limited by diverse study designs and the absence of long-term impact assessments. Further studies should standardise methods and explore resveratrol's long-term safety and effectiveness. Nevertheless, these results underscore resveratrol's potential as a beneficial supplement in exercise and sports medicine, meriting additional detailed exploration to refine its use.
  19. Sanip Z, Rasool AHG, Pahimi N, Bokti NA, Yusof Z, Mohamed MS, et al.
    Malays J Med Sci, 2024 Dec;31(6):148-159.
    PMID: 39830114 DOI: 10.21315/mjms2024.31.6.12
    BACKGROUND: Non-obstructive coronary artery disease (NOCAD) is a condition in stable patients that experience angina despite not having significant coronary obstructive lesion. Knowledge on the role of certain biomarkers in patients with NOCAD is still limited. This study aimed to evaluate the roles of inflammation and adhesion molecules in the development of NOCAD. The correlations between the peripheral and coronary levels of the inflammatory biomarkers and adhesion molecules were also investigated.

    METHODS: In this cross-sectional study, symptomatic angina patients scheduled for coronary angiograms were recruited and separated into obstructive coronary artery disease (OCAD) and NOCAD groups based on those angiograms. Peripheral and coronary blood samples were taken to measure inflammation biomarkers [high sensitivity C-reactive protein (hsCRP) and growth differentiation factor 15 (GDF-15)], and adhesion molecules [vascular cell adhesion molecule-1 (VCAM-1)]. Subjects without angina symptoms were recruited for the control group.

    RESULTS: The hsCRP, GDF-15, and VCAM-1 levels were higher in the OCAD and NOCAD groups than in the control group. VCAM-1 levels successfully predicted the incidence of NOCAD [p = 0.010, area under the curve (AUC) = 0.716]. All biomarkers' levels in the peripheral and coronary blood were correlated in OCAD and NOCAD patients (p < 0.001).

    CONCLUSION: Elevated levels of the hsCRP, GDF-15, and VCAM-1 were found with NOCAD, despite the absent of significant coronary obstruction. VCAM-1 successfully predicted NOCAD and may thus serve as an early NOCAD biomarker. Significant correlations of hsCRP, GDF-15, and VCAM-1 level in peripheral and coronary blood indicate that the peripheral levels of these biomarkers reflect the levels and changes that occur at the coronary level.

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