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Fulltext Management of extensive surgical wounds of the extremity after tumour resections using two simultaneous composite flaps: two case reports

Faisal, A., Ahmad, S.H., Zulmi, W.

Journal of Surgical Academia, 2011;1(1):42-45.
MyJurnal

Tumour surgery for locally extensive malignant neoplasms of the extremity will sometimes result in extensive composite soft tissue defect. Local flaps are usually inadequate to cover these large defects. More than one tissue flap might be required to cover any exposed neurovascular structures, bone or prosthesis. We present two cases where two composite flaps were simultaneously used to cover extensive surgical defects after ablative tumour resections in the extremity. These resulted in uncomplicated wound healing and limb salvage.
Fulltext Locked-in syndrome following a king cobra (Ophiophagus hannah) envenomation

Ahmad Khaldun, I., Mohd Fyzal, B., Soo, C. I., Yeap, B. T., Mohamed Faisal, A. H.

Medicine & Health, 2017;12(2):357-362.
MyJurnal

The incidence of envenoming from king cobra, Ophiophagus hannah in human is relatively rare. Its venom acts on the postsynaptic region of the neuromuscular junction causing descending flaccid paralysis. Locked-in syndrome is a clinical state of inability to provide motor response in a conscious patient. Many reported cases of locked-in syndrome following neurotoxic snake-bite mimics brain death. We report a case of a middle aged man who presented with progressive neurological deficit following a king cobra bite over his right arm. He had local and systemic neurotoxic envenoming. His condition deteriorated, and was intubated and ventilated in the emergency department. He received a total of 33 vials of the Ophiophagus hannah monospecific antivenom and subsequently recovered well with no neurological deficit. Retrospectively, he was able to recall the events and while he was lying paralysed and intubated under minimal sedation in the intensive care unit. He described it as a terrifying and painful experience. This case highlights the rare presentation of locked-in syndrome following a systemic envenoming from a king cobra bite. It is important to differentiate neurotoxic snake envenoming lock-in syndrome from brain dead. Patients are unable to respond to physical pain and require adequate analgesia. A patient suffering this highly distressing experience may require psychological support.
Keywords: emergency, envenoming, neurotoxicity, snakebite
Ways to overcome non-draining indwelling pleural catheter in malignant pleural effusion

Faisal AH, Ng BH

Med J Malaysia, 2019 12;74(6):555-557.
PMID: 31929490

The indwelling pleural catheter (IPC) is a 16-Fr-multifenestrated catheter. It has become an accepted practice in the management of malignant pleural effusion, especially in patients with non-expandable lung. However, IPC blockage or not draining is common. A 53-year-old female with malignant pleural effusion presented to us with blocked IPC and symptomatic pleural loculation one month after IPC insertion. After failing saline flushing and low-pressure wall suction, intrapleural alteplase was instituted through the IPC with a favourable outcome, and she continued to drain daily thereafter. The present case highlights the safety of intrapleural alteplase via IPC in the non-expandable lung.
Fulltext Purple urine bag syndrome: Case report from a nursing home resident with a false alarm of urosepsis

Mohamed Faisal AH, Shathiskumar G, Nurul Izah A

Med J Malaysia, 2015 Aug;70(4):265-6.
PMID: 26358028 MyJurnal

Purple urine bag syndrome (PUBS), as the name implies produces purplish discoloration of the urine. It is commonly observed among elderly women with constipation, and individuals with long term catheter in the setting of urinary tract infection (UTI). From the literature research, there were no publications on PUBS in Malaysia; however we believe that it is underreported. We present a unique case of this rare condition occurring in a 68-year-old man, a nursing home resident on long term urinary catheter. The urine cleared after hydration, antibiotic therapy and replacement of the catheter.
CT-MRI Dual Information Registration for the Diagnosis of Liver Cancer: A Pilot Study Using Point-based Registration

Rahimi A, Khalil A, Faisal A, Lai KW

Curr Med Imaging, 2021;18(1):61-66.
PMID: 34433403 DOI: 10.2174/1573405617666210825155659

BACKGROUND: Early diagnosis of liver cancer may increase life expectancy. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) play a vital role in diagnosing liver cancer. Together, both modalities offer significant individual and specific diagnosis data to physicians; however, they lack the integration of both types of information. To address this concern, a registration process has to be utilized for the purpose, as multimodal details are crucial in providing the physician with complete information.
OBJECTIVE: The aim was to present a model of CT-MRI registration used to diagnose liver cancer, specifically for improving the quality of the liver images and provide all the required information for earlier detection of the tumors. This method should concurrently address the issues of imaging procedures for liver cancer to fasten the detection of the tumor from both modalities.
METHODS: In this work, a registration scheme for fusing the CT and MRI liver images is studied. A feature point-based method with normalized cross-correlation has been utilized to aid in the diagnosis of liver cancer and provide multimodal information to physicians. Data on ten patients from an online database were obtained. For each dataset, three planar views from both modalities were interpolated and registered using feature point-based methods. The registration of algorithms was carried out by MATLAB (vR2019b, Mathworks, Natick, USA) on an Intel (R) Core (TM) i5-5200U CPU @ 2.20 GHz computer. The accuracy of the registered image is being validated qualitatively and quantitatively.
RESULTS: The results show that an accurate registration is obtained with minimal distance errors by which CT and MRI were accurately registered based on the validation of the experts. The RMSE ranges from 0.02 to 1.01 for translation, which is equivalent in magnitude to approximately 0 to 5 pixels for CT and registered image resolution.
CONCLUSION: The CT-MRI registration scheme can provide complementary information on liver cancer to physicians, thus improving the diagnosis and treatment planning process.
Electro-navigational bronchoscopy for bilateral peripheral lung lesions: A case report

Faisal AH, Sopian AW, Tidi H

Med J Malaysia, 2017 08;72(4):241-243.
PMID: 28889136 MyJurnal

Electromagnetic navigational bronchoscopy (ENB), one of the methods of navigational bronchoscopy is an advanced diagnostic tool allowing tissue sampling at the lung peripheries which were previously accessible only by computed tomography (CT) guidance or video-assisted thoracoscopic surgery (VATS). We report a 53-year-old man who presented with a cough and dyspnea with constitutional symptoms for one month. CT thorax revealed multiple bilateral peripheral lung nodules and there were no endobronchial lesions on flexible bronchoscopy. ENB was performed using a loan machine from Veran navigational technology. Biopsy successfully revealed small cell carcinoma of the lung thus preventing him from undergoing a more invasive diagnostic procedure. This case highlights the utility of ENB in the evaluation of peripheral lung nodules that were inaccessible by conventional bronchoscopy. This is one of the first few successful applications of Veran ENB in Asia.
Fulltext Elevated mitochondrial genome variation after 50 generations of radiation exposure in a wild rodent

Baker RJ, Dickins B, Wickliffe JK, Khan FAA, Gaschak S, Makova KD, et al.

Evol Appl, 2017 09;10(8):784-791.
PMID: 29151870 DOI: 10.1111/eva.12475

Currently, the effects of chronic, continuous low dose environmental irradiation on the mitochondrial genome of resident small mammals are unknown. Using the bank vole (Myodes glareolus) as a model system, we tested the hypothesis that approximately 50 generations of exposure to the Chernobyl environment has significantly altered genetic diversity of the mitochondrial genome. Using deep sequencing, we compared mitochondrial genomes from 131 individuals from reference sites with radioactive contamination comparable to that present in northern Ukraine before the 26 April 1986 meltdown, to populations where substantial fallout was deposited following the nuclear accident. Population genetic variables revealed significant differences among populations from contaminated and uncontaminated localities. Therefore, we rejected the null hypothesis of no significant genetic effect from 50 generations of exposure to the environment created by the Chernobyl meltdown. Samples from contaminated localities exhibited significantly higher numbers of haplotypes and polymorphic loci, elevated genetic diversity, and a significantly higher average number of substitutions per site across mitochondrial gene regions. Observed genetic variation was dominated by synonymous mutations, which may indicate a history of purify selection against nonsynonymous or insertion/deletion mutations. These significant differences were not attributable to sample size artifacts. The observed increase in mitochondrial genomic diversity in voles from radioactive sites is consistent with the possibility that chronic, continuous irradiation resulting from the Chernobyl disaster has produced an accelerated mutation rate in this species over the last 25 years. Our results, being the first to demonstrate this phenomenon in a wild mammalian species, are important for understanding genetic consequences of exposure to low-dose radiation sources.
Fulltext Prediction of the Influential Factors on Eating Behaviors: A Hybrid Model of Structural Equation Modelling-Artificial Neural Networks

Kheirollahpour MM, Danaee MM, Merican AFAF, Shariff AAAA

ScientificWorldJournal, 2020;2020:4194293.
PMID: 32508538 DOI: 10.1155/2020/4194293

The importance of eating behavior risk factors in the primary prevention of obesity has been established. Researchers mostly use the linear model to determine associations among these risk factors. However, in reality, the presence of nonlinearity among these factors causes a bias in the prediction models. The aim of this study was to explore the potential of a hybrid model to predict the eating behaviors. The hybrid model of structural equation modelling (SEM) and artificial neural networks (ANN) was applied to evaluate the prediction model. The SEM analysis was used to check the relationship of the emotional eating scale (EES), body shape concern (BSC), and body appreciation scale (BAS) and their effect on different categories of eating behavior patterns (EBP). In the second step, the input and output required for ANN analysis were obtained from SEM analysis and were applied in the neural network model. 340 university students participated in this study. The hybrid model (SEM-ANN) was conducted using multilayer perceptron (MLP) with feed-forward network topology. Moreover, Levenberg-Marquardt, which is a supervised learning model, was applied as a learning method for MLP training. The tangent/sigmoid function was used for the input layer, while the linear function was applied for the output layer. The coefficient of determination (R2) and mean square error (MSE) were calculated. Using the hybrid model, the optimal network happened at MLP 3-17-8. It was proved that the hybrid model was superior to SEM methods because the R2 of the model was increased by 27%, while the MSE was decreased by 9.6%. Moreover, it was found that BSC, BAS, and EES significantly affected healthy and unhealthy eating behavior patterns. Thus, a hybrid approach could be suggested as a significant methodological contribution from a machine learning standpoint, and it can be implemented as software to predict models with the highest accuracy.
Fulltext Double trouble: COVID-19 vaccine misinformation amidst conflict in Ukraine

Zoaib Habib T, Ennab F, Matiashova L, Nawaz FA, Volkova A, Trill V, et al.

Ann Med Surg (Lond), 2022 Aug;80:104127.
PMID: 35845861 DOI: 10.1016/j.amsu.2022.104127
Computer assisted diagnostic system in tumor radiography

Faisal A, Parveen S, Badsha S, Sarwar H, Reza AW

J Med Syst, 2013 Jun;37(3):9938.
PMID: 23504472 DOI: 10.1007/s10916-013-9938-3

An improved and efficient method is presented in this paper to achieve a better trade-off between noise removal and edge preservation, thereby detecting the tumor region of MRI brain images automatically. Compass operator has been used in the fourth order Partial Differential Equation (PDE) based denoising technique to preserve the anatomically significant information at the edges. A new morphological technique is also introduced for stripping skull region from the brain images, which consequently leading to the process of detecting tumor accurately. Finally, automatic seeded region growing segmentation based on an improved single seed point selection algorithm is applied to detect the tumor. The method is tested on publicly available MRI brain images and it gives an average PSNR (Peak Signal to Noise Ratio) of 36.49. The obtained results also show detection accuracy of 99.46%, which is a significant improvement than that of the existing results.
Fulltext Recurrent spontaneous pneumothorax during pregnancy managed conservatively: a case report

Mohamed Faisal AH, Hazwani A, Soo CI, Andrea Ban YL

Med J Malaysia, 2016 04;71(2):93-5.
PMID: 27326955 MyJurnal

A 36-year-old lady presented with four episodes of right sided pneumothorax during pregnancy requiring multiple chest drain insertion. It was complicated with persistent air leak despite low pressure high volume suction applied to the chest drainage. She delivered safely through spontaneous vaginal delivery with chest drainage. Further imaging by high resolution computed tomography (HRCT) scan of thorax done revealed bilateral scattered pulmonary cysts and sub pleural bullae and was later followed up with respiratory unit. She had no further episodes of pneumothorax postpartum. This case highlights the vital importance of prompt recognition and management of pneumothorax in pregnancy as the patient involved is at higher risk for acute respiratory failure leading to maternal and/or foetal mortality. It is essential for early involvement of obstetric team and to expedite the delivery for a better perinatal and maternal outcome.
Intra-pleural Instillation of Autologous Blood - Fine-tuning Techniques for Better Success Rate: Two Case Reports

Ng BH, Tan JK, Andrea Ban YL, Faisal AH

Med J Malaysia, 2020 03;75(2):181-183.
PMID: 32281606

In the past, many case series have reported the effectiveness of autologous blood patch pleurodesis (ABPP) in recurrent secondary spontaneous pneumothorax (SSP), particularly in those who were unfit for surgery. We describe two cases of persistent air leak in pneumoconiosis and pulmonary fibrosis with bronchiectasis, whereby the techniques employed had improved the success rate of ABPP. The determining factors that lead to the success of ABPP were determined by the volume of autologous blood instilled, Trendelenburg position post instillation, and early chest physiotherapy with mobilisation by application of pneumostat.
Doctors' Interactions with Pharmaceutical Sales Representatives: Modelling Doctors Prescription Behaviour

Faisal A, Ahmad MS, Thurasamy R, Ahmed R

Community Ment Health J, 2020 Apr;56(3):456-463.
PMID: 31728716 DOI: 10.1007/s10597-019-00501-w

Using theory of planned behaviour, this study seeks to examine the effect of health practitioner's interaction with pharmaceutical sales representatives on their prescription behaviour. Data was collected from 248 health practitioners working in the city of Attock and from five Tehsils of Attock District through questionnaires with a net response rate of 82%. The hypothesis was tested by PLS Path Modelling. The major findings of the study were that physicians' interactions with pharmaceutical sales representatives in terms of market knowledge, product knowledge, corporate reputation and tangible rewards affect the prescription behaviour of physicians directly as well as through the mediating effect of the attitudinal component. The findings of the study would be helpful for the pharmaceutical industry as well as for drug regulatory authorities and health policy makers towards unethical practices in the medical field. Study provided practical implications for policy makers and health practitioners. Moreover, future directions for research were also provided.
Comparing fixed and auto adjusting continuous positive airway pressure (CPAP) amongst symptomatic Obstructive Sleep Apnoea patients - A randomised controlled trial

Gan WL, Ban AYL, Mohamed Faisal AH

Med J Malaysia, 2021 09;76(5):611-616.
PMID: 34508364

INTRODUCTION: Continuous Positive Airway Pressure (CPAP) is required for obstructive sleep apnoea (OSA). Thisstudy compares the efficacy between Fixed Pressure CPAP (Fixed CPAP) and Auto-adjusting Pressure (APAP) based on Apnoea Hypopnoea Index (AHI), Epworth Sleepiness Score (ESS) among patients with symptomatic OSA and to ascertain their CPAP preference.
METHODS: This is a prospective, randomised, crossover, single-blinded study conducted from February 2018 to February 2019 among adult subjects attending respiratory clinic Universiti Kebangsaan Malaysia Medical Centre (UKMMC).
RESULTS: Forty-six subjects were recruited with 27 males (58.7%). The mean age was 54 (+11) year old. The baseline median Body Mass Index (BMI) was 34.2 kg/m2 (Interquartile Range IQR: 30.8 kg/m2 -41.7 kg/m2); baseline median AHI 28.8 /hour (IQR 21.2/hour-54.0/hour); andbaseline median ESS 15 (IQR 13-16). After intervention, the median AHI was 5.0 / hour (IQR 4.2/hour-6.0/hour) at fixed CPAP arm; APAP arm was 5.5/ hour (IQR 4.2/hour-6.3/hour); p<0.01. The median ESS at fixed CPAP arm was 2 (IQR 0-3); APAP arm was 2 (IQR 1-3); p < 0.01. Those who preferred APAP were 22 subjects (47.8%) and had median optimal CPAP pressure 13.0 cmH2O (IQR 12.0 cmH2O -13.5 cmH2O); 24 subjects (52.2%) who preferred Fixed CPAP had median optimal CPAP pressure 8.0 cmH2O (IQR 6.3 cmH2O -8.7 cmH2O); p<0.01. Median baseline BMI was 37.6 kg/m2 (IQR 30.8 kg/m2 -43.0 kg/m2) for those who preferred APAP and 32.3 kg/m2 (IQR 30.8 kg/m2 - 38.4 kg/m2) for subjects preferred Fixed CPAP; p=0.03.
DISCUSSION: Fixed CPAP maybe considered as first line therapy for symptomatic moderate and severe OSA with titrated optimal CPAP pressure less than 8 cmH2O and BMI less than 32.3 kg/m2; based on subjects' preference. Baseline AHI and average daily CPAP usage was not statisticallysignificant in affecting patient preference between fixed and auto adjusting CPAP. This is the first study of its kind conducted in Malaysia.
Fulltext Multimodality registration of two-dimensional echocardiography and cardiac CT for mitral valve diagnosis and surgical planning

Khalil A, Faisal A, Ng SC, Liew YM, Lai KW

J Med Imaging (Bellingham), 2017 Jul;4(3):037001.
PMID: 28840172 DOI: 10.1117/1.JMI.4.3.037001

A registration method to fuse two-dimensional (2-D) echocardiography images with cardiac computed tomography (CT) volume is presented. The method consists of two major procedures: temporal and spatial registrations. In temporal registration, the echocardiography frames at similar cardiac phases as the CT volume were interpolated based on electrocardiogram signal information, and the noise of the echocardiography image was reduced using the speckle reducing anisotropic diffusion technique. For spatial registration, an intensity-based normalized mutual information method was applied with a pattern search optimization algorithm to produce an interpolated cardiac CT image. The proposed registration framework does not require optical tracking information. Dice coefficient and Hausdorff distance for the left atrium assessments were [Formula: see text] and [Formula: see text], respectively; for left ventricle, they were [Formula: see text] and [Formula: see text], respectively. There was no significant difference in the mitral valve annulus diameter measurement between the manually and automatically registered CT images. The transformation parameters showed small deviations ([Formula: see text] deviation in translation and [Formula: see text] for rotation) between manual and automatic registrations. The proposed method aids the physician in diagnosing mitral valve disease as well as provides surgical guidance during the treatment procedure.
2D to 3D fusion of echocardiography and cardiac CT for TAVR and TAVI image guidance

Khalil A, Faisal A, Lai KW, Ng SC, Liew YM

Med Biol Eng Comput, 2017 Aug;55(8):1317-1326.
PMID: 27830464 DOI: 10.1007/s11517-016-1594-6

This study proposed a registration framework to fuse 2D echocardiography images of the aortic valve with preoperative cardiac CT volume. The registration facilitates the fusion of CT and echocardiography to aid the diagnosis of aortic valve diseases and provide surgical guidance during transcatheter aortic valve replacement and implantation. The image registration framework consists of two major steps: temporal synchronization and spatial registration. Temporal synchronization allows time stamping of echocardiography time series data to identify frames that are at similar cardiac phase as the CT volume. Spatial registration is an intensity-based normalized mutual information method applied with pattern search optimization algorithm to produce an interpolated cardiac CT image that matches the echocardiography image. Our proposed registration method has been applied on the short-axis "Mercedes Benz" sign view of the aortic valve and long-axis parasternal view of echocardiography images from ten patients. The accuracy of our fully automated registration method was 0.81 ± 0.08 and 1.30 ± 0.13 mm in terms of Dice coefficient and Hausdorff distance for short-axis aortic valve view registration, whereas for long-axis parasternal view registration it was 0.79 ± 0.02 and 1.19 ± 0.11 mm, respectively. This accuracy is comparable to gold standard manual registration by expert. There was no significant difference in aortic annulus diameter measurement between the automatically and manually registered CT images. Without the use of optical tracking, we have shown the applicability of this technique for effective fusion of echocardiography with preoperative CT volume to potentially facilitate catheter-based surgery.
Knee cartilage segmentation and thickness computation from ultrasound images

Faisal A, Ng SC, Goh SL, Lai KW

Med Biol Eng Comput, 2018 Apr;56(4):657-669.
PMID: 28849317 DOI: 10.1007/s11517-017-1710-2

Quantitative thickness computation of knee cartilage in ultrasound images requires segmentation of a monotonous hypoechoic band between the soft tissue-cartilage interface and the cartilage-bone interface. Speckle noise and intensity bias captured in the ultrasound images often complicates the segmentation task. This paper presents knee cartilage segmentation using locally statistical level set method (LSLSM) and thickness computation using normal distance. Comparison on several level set methods in the attempt of segmenting the knee cartilage shows that LSLSM yields a more satisfactory result. When LSLSM was applied to 80 datasets, the qualitative segmentation assessment indicates a substantial agreement with Cohen's κ coefficient of 0.73. The quantitative validation metrics of Dice similarity coefficient and Hausdorff distance have average values of 0.91 ± 0.01 and 6.21 ± 0.59 pixels, respectively. These satisfactory segmentation results are making the true thickness between two interfaces of the cartilage possible to be computed based on the segmented images. The measured cartilage thickness ranged from 1.35 to 2.42 mm with an average value of 1.97 ± 0.11 mm, reflecting the robustness of the segmentation algorithm to various cartilage thickness. These results indicate a potential application of the methods described for assessment of cartilage degeneration where changes in the cartilage thickness can be quantified over time by comparing the true thickness at a certain time interval.
Fulltext How to face COVID-19: proposed treatments based on remdesivir and hydroxychloroquine in the presence of zinc sulfate. Docking/DFT/POM structural analysis

Ben Hadda T, Berredjem M, Almalki FA, Rastija V, Jamalis J, Emran TB, et al.

J Biomol Struct Dyn, 2022;40(19):9429-9442.
PMID: 34033727 DOI: 10.1080/07391102.2021.1930161

Remdesivir and hydroxychloroquine derivatives form two important classes of heterocyclic compounds. They are known for their anti-malarial biological activity. This research aims to analyze the physicochemical properties of remdesivir and hydroxychloroquine compounds by the computational approach. DFT, docking, and POM analyses also identify antiviral pharmacophore sites of both compounds. The antiviral activity of hydroxychloroquine compound's in the presence of zinc sulfate and azithromycin is evaluated through its capacity to coordinate transition metals (M = Cu, Ni, Zn, Co, Ru, Pt). The obtained bioinformatic results showed the potent antiviral/antibacterial activity of the prepared mixture (Hydroxychloroquine/Azithromycin/Zinc sulfate) for all the opportunistic Gram-positive, Gram-negative in the presence of coronavirus compared with the complexes Polypyridine-Ruthenium-di-aquo. The postulated zinc(II) complex of hydroxychloroquine derivatives are indeed an effective antibacterial and antiviral agent against coronavirus and should be extended to other pathogens. The combination of a pharmacophore site with a redox [Metal(OH2)2] moiety is of crucial role to fight against viruses and bacteria strains. [Formula: see text]Communicated by Ramaswamy H. Sarma.
Fulltext Recent Progress in Synthesis, POM Analyses and SAR of Coumarin-Hybrids as Potential Anti-HIV Agents-A Mini Review

Suleiman M, Almalki FA, Ben Hadda T, Kawsar SMA, Chander S, Murugesan S, et al.

Pharmaceuticals (Basel), 2023 Oct 31;16(11).
PMID: 38004404 DOI: 10.3390/ph16111538

The human immunodeficiency virus (HIV) is the primary cause of acquired immune deficiency syndrome (AIDS), one of the deadliest pandemic diseases. Various mechanisms and procedures have been pursued to synthesise several anti-HIV agents, but due to the severe side effects and multidrug resistance spawning from the treatment of HIV/AIDS using highly active retroviral therapy (HAART), it has become imperative to design and synthesise novel anti-HIV agents. Literature has shown that natural sources, particularly the plant kingdom, can release important metabolites that have several biological, mechanistic and structural representations similar to chemically synthesised compounds. Certainly, compounds from natural and ethnomedicinal sources have proven to be effective in the management of HIV/AIDS with low toxicity, fewer side effects and affordability. From plants, fungi and bacteria, coumarin can be obtained, which is a secondary metabolite and is well known for its actions in different stages of the HIV replication cycle: protease, integrase and reverse transcriptase (RT) inhibition, cell membrane fusion and viral host attachment. These, among other reasons, are why coumarin moieties will be the basis of a good building block for the development of potent anti-HIV agents. This review aims to outline the synthetic pathways, structure-activity relationship (SAR) and POM analyses of coumarin hybrids with anti-HIV activity, detailing articles published between 2000 and 2023.
Phytosterols as a natural anticancer agent: Current status and future perspective

Shahzad N, Khan W, Md S, Ali A, Saluja SS, Sharma S, et al.

Biomed Pharmacother, 2017 Apr;88:786-794.
PMID: 28157655 DOI: 10.1016/j.biopha.2017.01.068

Phytosterols are naturally occurring compounds in plants, structurally similar to cholesterol. The human diet is quite abundant in sitosterol and campesterol. Phytosterols are known to have various bioactive properties including reducing intestinal cholesterol absorption which alleviates blood LDL-cholesterol and cardiovascular problems. It is indicated that phytosterol rich diets may reduce cancer risk by 20%. Phytosterols may also affect host systems, enabling antitumor responses by improving immune response recognition of cancer, affecting the hormone dependent endocrine tumor growth, and by sterol biosynthesis modulation. Moreover, phytosterols have also exhibited properties that directly inhibit tumor growth, including reduced cell cycle progression, apoptosis induction, and tumor metastasis inhibition. The objective of this review is to summarize the current knowledge on occurrences, chemistry, pharmacokinetics and potential anticancer properties of phytosterols in vitro and in vivo. In conclusion, anticancer effects of phytosterols have strongly been suggested and support their dietary inclusion to prevent and treat cancers.

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