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  1. Fulltext Saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia: a randomized controlled trial
    Marimuthu D, Han KM, Mohamad MSF, Azman M
    Clin Oral Investig, 2021 May;25(5):3105-3115.
    PMID: 33175253 DOI: 10.1007/s00784-020-03634-5
    OBJECTIVES: Xerostomia is a prevalent sequelae among nasopharyngeal cancer (NPC) survivors; yet, effective treatment protocols have been elusive. This study was a prospective randomized clinical trial to compare the effects of saliva substitute mouthwash in nasopharyngeal cancer survivors with xerostomia, between two treatment arms, conducted in a tertiary center.

    MATERIALS AND METHODS: This study measured the effects within 4 weeks in relation to summated xerostomia inventory (SXI) and unstimulated whole saliva (UWS). Patients randomized into the interventional arm were prescribed an immunologically active saliva substitute (IASS), while patients in the control arm were prescribed a non-immunologically active mouthwash as placebo.

    RESULTS: The study population consisted of 94 patients. There was a significant difference in SXI difference (p < 0.0001) and UWS difference (p < 0.0001) between control and interventional arms. No harmful side effects associated with the use of either mouthwash encountered throughout the study duration.

    CONCLUSION: IASS mouthwash significantly reduces subjective xerostomia scores measured using SXI and improves objective measurement of salivary flow using UWS among nasopharyngeal cancer survivors with xerostomia.

    CLINICAL RELEVANCE: IASS is significantly more effective in improving subjective and objective xerostomia measurements compared to non-immunologically active mouthwash. Additionally, this treatment is very safe, with superior side effect profiles.

    TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04491435.

  2. Fulltext Is Heart Rate a Confounding Factor for Photoplethysmography Markers? A Systematic Review
    Md Lazin Md Lazim MR, Aminuddin A, Chellappan K, Ugusman A, Hamid AA, Wan Ahmad WAN, et al.
    Int J Environ Res Public Health, 2020 04 10;17(7).
    PMID: 32290168 DOI: 10.3390/ijerph17072591
    Finger photoplethysmography (PPG) waveform is blood volume change of finger microcirculation that reflects vascular function. Reflection index (RI), stiffness index (SI) and second derivative of photoplethysmogram (SDPPG) are derived from PPG waveforms proposed as cardiovascular disease (CVD) markers. Heart rate (HR) is a known factor that affects vascular function. Individual resting HR variation may affect RI, SI and SDPPG. This review aims to identify studies about the relationship between HR with RI, SI and SDPPG among humans. A literature search was conducted in Medline via the Ebscohost and Scopus databases to find relevant articles published within 11 years. The main inclusion criteria were articles in the English language that discuss the relationship between HR with RI, SI and SDPPG using PPG among humans. The search found 1960 relevant articles but only six articles that met the inclusion criteria. SI and RI showed an association with HR. SDPPG (SDPPG-b/SDPPG-a ratio, SDPPG-d/SDPPG-a ratio, aging index (AGI) and revised aging index (RAGI)) also had an association with HR. Only RI had a considerable association with HR, the association between SI and HR was non-considerable and the association between HR and SDPPG was inconclusive. Further interventional studies should be conducted to investigate this issue, as a variation in resting HR may challenge the validity of PPG-based CVD markers.
  3. Prognostic value of pulse wave velocity for cardiovascular disease risk stratification in diabetic patients: A systematic review and meta-analysis
    Cheong SS, Samah N, Che Roos NA, Ugusman A, Mohamad MSF, Beh BC, et al.
    J Diabetes Complications, 2024 Dec;38(12):108894.
    PMID: 39531755 DOI: 10.1016/j.jdiacomp.2024.108894
    AIM: Arterial stiffness, a significant cardiovascular risk marker, is particularly important in patients with diabetes mellitus (DM). Pulse wave velocity (PWV), a non-invasive measure of arterial stiffness, has emerged as an independent predictor of cardiovascular morbidity and mortality. However, its precise prognostic value in DM patients for cardiovascular risk stratification remains unclear. To address this, a systematic review was conducted.

    METHOD: A thorough search of Ovid and Scopus databases was performed for cohort studies on PWV measurements for cardiovascular risk stratification in DM patients. Nine studies were included, examining the relationship between PWV and cardiovascular events or composite endpoints in DM patients asymptomatic of cardiovascular diseases (CVD).

    RESULTS: The review revealed that optimal PWV cutoffs to predict composite cardiovascular events ranged from 10 to 12.16 m/s (aortic PWV) and 14 to 16.72 m/s (brachial-ankle PWV). In addition, meta-analysis yielded a HR of 1.15 (95 % CI 1.07-1.24, p 

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