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  1. Leh HE, Mohd Sopian M, Abu Bakar MH, Lee LK
    Ann Med, 2021 12;53(1):1059-1065.
    PMID: 34180336 DOI: 10.1080/07853890.2021.1943515
    BACKGROUND: The use of lycopene as a complementary medicine for Type II diabetes mellitus (T2DM) is limited and controversial. This study evaluated the effect of lycopene intake on the changes of glycaemic status and antioxidant capacity among the T2DM patients.

    PATIENTS AND METHODS: This case-control study involved the participation of 87 patients and 122 healthy individuals. Lycopene intake was assessed by using a food frequency questionnaire. The peripheral antioxidant capacity among the T2DM patients was evaluated. Glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) were measured as indications of glycaemic status.

    RESULTS: Peripheral antioxidant capacity was significantly lower in the T2DM group. Direct positive correlations were found between the lycopene intake and peripheral antioxidant level among the T2DM patients. Contrarily, HbA1c and FPG levels decreased significantly with the higher lycopene intake.

    CONCLUSIONS: T2DM patients with a higher lycopene intake showed a greater peripheral antioxidant capacity and better glycaemic control. Lycopene may act to ameliorate oxidative stress and improve the pathophysiology of T2DM.

  2. Nisa FY, Rahman MA, Hossen MA, Khan MF, Khan MAN, Majid M, et al.
    Ann Med, 2021 Dec;53(1):1476-1501.
    PMID: 34433343 DOI: 10.1080/07853890.2021.1966088
    Alzheimer's disease (AD) is the most conspicuous chronic neurodegenerative syndrome, which has become a significant challenge for the global healthcare system. Multiple studies have corroborated a clear association of neurotoxicants with AD pathogenicity, such as Amyloid beta (Aβ) proteins and neurofibrillary tangles (NFTs), signalling pathway modifications, cellular stress, cognitive dysfunctions, neuronal apoptosis, neuroinflammation, epigenetic modification, and so on. This review, therefore, aimed to address several essential mechanisms and signalling cascades, including Wnt (wingless and int.) signalling pathway, autophagy, mammalian target of rapamycin (mTOR), protein kinase C (PKC) signalling cascades, cellular redox status, energy metabolism, glutamatergic neurotransmissions, immune cell stimulations (e.g. microglia, astrocytes) as well as an amyloid precursor protein (APP), presenilin-1 (PSEN1), presenilin-2 (PSEN2) and other AD-related gene expressions that have been pretentious and modulated by the various neurotoxicants. This review concluded that neurotoxicants play a momentous role in developing AD through modulating various signalling cascades. Nevertheless, comprehension of this risk agent-induced neurotoxicity is far too little. More in-depth epidemiological and systematic investigations are needed to understand the potential mechanisms better to address these neurotoxicants and improve approaches to their risk exposure that aid in AD pathogenesis.Key messagesInevitable cascade mechanisms of how Alzheimer's Disease-related (AD-related) gene expressions are modulated by neurotoxicants have been discussed.Involvement of the neurotoxicants-induced pathways caused an extended risk of AD is explicited.Integration of cell culture, animals and population-based analysis on the clinical severity of AD is addressed.
  3. Md Pisar M, Chee BJ, Long I, Osman A
    Ann Med, 2023 Dec;55(1):2224970.
    PMID: 37318144 DOI: 10.1080/07853890.2023.2224970
    BACKGROUND AND AIM: Centella asiatica (L.) Urb. (Apiaceae) is a renowned medicinal plant being used in the Ayurvedic system for its pharmacological effects on the central nervous system such as rejuvenating, sedative, anxiolytic and memory-enhancing properties. The present study was designed to investigate the effect of Centella asiatica (CA) extract on inflammatory responses induced by lipopolysaccharide (LPS) and resulting changes in cognitive behavior.

    MATERIALS AND METHODS: Adult male Sprague-Dawley rats were divided into 4 groups as control, LPS, CA and LPS + CA. The treatments with LPS (5 mg/kg) were intraperitoneally (i.p) injected on day 4 and CA ethanol extract (200 mg/kg) were given orally for 14 days. Morris Water Maze (MWM) test was performed to assess spatial learning and memory performance. Acute oral toxicity of the extract at the highest dose of 5000 mg/kg was also conducted.

    RESULTS: Single administration of LPS was able to significantly elicit learning and memory impairment (p 

  4. Asaga Mac P, Tadele M, Airiohuodion PE, Nisansala T, Zubair S, Aigohbahi J, et al.
    Ann Med, 2023 Dec;55(1):652-662.
    PMID: 37074313 DOI: 10.1080/07853890.2023.2175903
    INTRODUCTION: Mosquito-borne infections are of global health concern because of their rapid spread and upsurge, which creates a risk for coinfections. DENV and ZIKV are transmitted by Aedes aegypti and A. albopictus and are prevalent in Nigeria and neighbouring countries. However, their seroprevalence, burden, hidden endemicity and possible cocirculation are poorly understood in Nigeria.

    METHODS: We conducted a cross-sectional study of 871 participants from three regions of Nigeria. All serum samples were analysed using malaria RDT and the immunoblot molecular diagnostic assay recomLine Tropical Fever for the presence of arboviral antibody serological marker IgG (Mikrogen Diagnostik, Neuried, Germany) with DENV and ZIKV Nonstructural protein 1 (NS 1), DENV and ZIKV Equad (variant of the envelope protein with designated mutations to increase specificity), according to the manufacturer's instructions.

    RESULTS: The overall IgG antibody seropositivity against DENV-flavivirus was 44.7% (389/871); 95% CI (41.41-47.99), while ZIKV-flavivirus was 19.2% (167/871); 95% CI (0.16-0.21), and DENV-ZIKV-flavivirus cocirculation antibody seropositivity was 6.2%5 (54/871); 95% CI (0.6-0.7) in the three study regions of Nigeria. The study cohort presented similar clinical signs and symptoms of flaviviruses (DENV and ZIKV) in all three study regions.

    CONCLUSION: This study highlighted an unexpectedly high antibody seropositivity, burden, hidden endemicity, and regional spread of mono- and co-circulating flaviviruses (DENV and ZIKV) in Nigeria.Key messagesDengue flavivirus sero-cross-reactivity drives antibody-dependent enhancement of ZIKV infection.Both viruses share common hosts (humans) and vectors (primarily Aedes aegypti), and are thus influenced by similar biological, ecological, and economic factors, resulting in epidemiological synergy.Additionally, the actual burden in epidemic and interepidemic periods is grossly or chronically unknown and underreported. Despite this trend and the potential public health threat, there are no reliable data, and little is known about these arboviral co-circulation infections.

  5. Arafat HM, Omar J, Shafii N, Naser IA, Al Laham NA, Muhamad R, et al.
    Ann Med, 2023 Dec;55(1):2198256.
    PMID: 37078247 DOI: 10.1080/07853890.2023.2198256
    BACKGROUND: Among the world, the most frequently discovered and fatal cancer in women is breast cancer (BC). From the perspective of public health, estimating the BC risk linked to dairy intake may aid in comprehensive management. In epidemiological research data on the association between eating dairy foods and the risk of BC are conflicting. Therefore, we sought to assess the link between dairy food consumption and the development of BC.

    MAIN TEXT: To summarize and quantify the most recent findings on consuming milk or other dairy foods and the development of BC, we performed a systematic literature review. We checked through several databases for relevant publications published in English up to January 2022. Of the 82 articles identified, only 18 met the inclusion criteria and were analyzed. Nine Prospective, seven Retrospective and two Cross-Sectional studies were finally identified.

    CONCLUSIONS: Overall, dairy consumption was inversely associated with the risk of developing breast cancer. Future studies will help elucidate the role of dairy products in human health, and their use within a balanced diet should be considered.KEY MESSAGESThe effect of different types of dairy products, and possible dose-response relationships on BC risk remains unknown.Estimating BC risk associated with dairy consumption may help to take the decision-making of physicians and public health policy in developing preventive strategies to reduce its occurrence.This systematic review was conducted to assess dairy consumption and BC risk.Overall, inverse associations were found when looking at dairy consumption and BC risk.

  6. Loh GOK, Wong EYL, Goh CZ, Tan YTF, Lee YL, Pang LH, et al.
    Ann Med, 2023;55(2):2270502.
    PMID: 37857359 DOI: 10.1080/07853890.2023.2270502
    The study aimed to develop a sensitive and high-throughput liquid chromatography coupled with tandem mass spectrometry method to quantify concentrations of tramadol and paracetamol simultaneously in human plasma. Sample preparation involved single-step protein precipitation using methanol and two deuterated internal standards, tramadol D6 and paracetamol D4. Agilent Poroshell 120 EC-C18 (100 × 2.1 mm, 2.1 µm) analytical column was employed to achieve chromatographic separation. Detection was in positive ion multiple reaction monitoring mode. A tailing factor (Tf) of <1.2, separation factor (K prime) of >1.5 from the column dead time and signal-to-noise (S/N) ratio >10, were obtained for analytes and internal standards. The standard curve was linear over the concentration range of 2.5-500.00 ng/mL for tramadol and 0.025-20.00 μg/mL for paracetamol. A small injection volume of 1 µL, low flow rate of 440 µL/min and short analysis time of 3.5 min reduced the solvent consumption, analysis cost and system contamination. The results of method validation parameters fulfilled the acceptance criteria of bioanalytical guidelines. The method was successfully applied to a bioequivalence study of fixed-dose combination products of tramadol and paracetamol in Malaysian healthy subjects.
  7. Ng WH, Abu Zaid Z, Mohd Yusof BN, Amin Nordin S, Lim PY
    Ann Med, 2023;55(2):2303399.
    PMID: 38242100 DOI: 10.1080/07853890.2024.2303399
    BACKGROUND: Obesity, particularly excessive body fat, is an established risk factor and substantial prognostic determinant in breast cancer. Recent studies suggested that diet-related inflammation plays a key role in obesity. This study aimed to determine the association between energy-adjusted dietary inflammatory index (E-DII) and body composition, particularly body fat percentage, among patients with newly diagnosed breast cancer.

    MATERIALS AND METHODS: This cross-sectional study was conducted on 124 breast cancer outpatients within the first year of diagnosis and yet to commence oncological treatment. Body composition parameters [body weight, body mass index (BMI), body fat percentage, fat mass over fat-free mass ratio (FM/FFM), muscle mass, and visceral fat] were obtained using a bioelectrical impedance analyzer. Body fat percentage was categorized into two groups which were normal (<35%) and high (≥35%). The E-DII was calculated from the validated 165-items Food Frequency Questionnaire (FFQ) and categorized into three groups or tertiles. Multiple logistic regression analysis was used to determine the association between the E-DII and body fat percentage.

    RESULTS: Mean body weight, body fat percentage, FM/FFM, and visceral fat increased as E-DII increased from the lowest tertile (T1) to the most pro-inflammatory tertile (T3) (p for trend <0.05). E-DII was positively associated with body fat percentage (OR 2.952; 95% CI 1.154-7.556; p = 0.024) and remained significant after adjustment for cancer stage, age, physical activity, ethnicity, smoking history, and presence of comorbidities. Compared to T1, participants in T3 had a significantly lower consumption of fiber, vitamin A, beta-carotene, vitamin C, iron, thiamine, riboflavin, niacin, vitamin B6, folic acid, zinc, magnesium, and selenium, but a higher intake of total fat, saturated fat, and monounsaturated fatty acids.

    CONCLUSIONS: A higher E-DII was associated with increased body fat percentage, suggesting the potential of advocating anti-inflammatory diet to combat obesity among newly diagnosed breast cancer patients.

  8. Veerabathiran R, P A, Bk I, D R, Rs AH
    Ann Med, 2023;55(2):2302520.
    PMID: 38198642 DOI: 10.1080/07853890.2024.2302520
    Background: Type 2 diabetes mellitus (T2DM) is a multifaceted disease appropriate to elevated blood glucose levels resulting from decreased insulin and beta-cell activity. Using a case-control methodology, researchers have examined the relationship between polymorphisms in LEPR and T2DM in a population from south India.Materials and Methods: We conducted a genetic analysis of 311 participants, and results were accomplished using a case-control study, a meta-analysis of previous studies on LEPR was conducted, and type 2 diabetes genotype distribution across various geographical regions Malaysians, Chinese Han, Kuwait, Iran, Mongolia, and Han Chinese, Greece, Saudi, India (North India, Punjabi), (South India, Tamilnadu). The study involved 254 prospective investigations, and nine association studies were preferred according to preset criteria. Studies were assessed for quality using the Hardy-Weinberg equilibrium (HWE) and the Newcastle-Ottawa Scale (NOS). An analysis of the genetic models was conducted to determine their relationship, statistical analysis was utilized to calculate odds ratios (ORs) and matching 95% confidence intervals (CIs).Results: The LEPR-rs1137101 polymorphism in the case-control study was associated with a significant increase in the risk of type 2 diabetes. A meta-analysis revealed a connection between LEPR gene polymorphism (rs1137101) and type 2 diabetes risk. Investigators might gain a more profound thought on the significance of the identified genetic variation and its impact on the chance of developing type 2 diabetes by verifying and strengthening previously reported findings. The model of fixed effects was chosen due to the low heterogeneity, and significant associations were observed in the allelic (OR = 0.79, 95% CI [0.70-0.87]), homozygote (OR = 0.58, 95% CI [0.46-0.72]), dominant (OR = 0.66, 95% CI [0.56-0.79]), and recessive (OR = 0.83, 95% CI [0.71-0.96]) genetic models. A Begg's funnel plot and Egger's test indicated no publication bias. These findings suggest that the rs1137101 variant in the LEPR gene has been linked to a higher risk of T2DM.Conclusions: A larger sample size, however, is required for further research, and consideration of potential confounding factors is needed to validate these associations. Understanding the implications of LEPR gene polymorphisms in T2DM susceptibility may contribute to personalized treatment strategies for patients with T2DM.
  9. Mohamad Bakro R, Farrukh MJ, Rajagopal MS, Kristina SA, Ramatillah DL, Ming LC, et al.
    Ann Med, 2023;55(2):2281655.
    PMID: 38010360 DOI: 10.1080/07853890.2023.2281655
    BACKGROUND: Menstruation is a natural phenomenon considered an important indicator of women's health, reflecting their endocrine function. Women in low middle income countries face substantial menstrual hygiene management challenges. Data on the knowledge of dysmenorrhea and health-related practices among Malaysian women are scarce. The present study aimed to investigate the prevalence of dysmenorrhea among Malaysian women in Kuala Lumpur and its association with socio-demographic factors, knowledge level, and general practices.

    METHOD: A cross-sectional study was carried out among Malaysian women in Kuala Lumpur. A total of 362 unmarried women, nulliparous and aged between 18 and 25 years old, were included in this study. Participants were conveniently recruited through online platforms as well as face to face using a self-administered questionnaire with five sections consisting of demographics, menstrual characteristics, Working ability, Location, Intensity, Days of pain, Dysmenorrhea (WaLIDD) score for diagnosing and assessing the severity of dysmenorrhea as well as an evaluation of respondents' general knowledge and practices towards dysmenorrhea. The collected data were analysed using the SPSS tool, a descriptive statistic was used to report demographic characteristics. Inferential statistics was used to report the differentiation, association, and correlations of the variables.

    RESULTS: The prevalence of primary dysmenorrhea was 73.2%. It was found that the majority of the respondents had poor knowledge (60%) and poor practices (61.88%) of dysmenorrhea. The most common preventive practices among the respondents were using dietary supplements, and herbs, taking a rest and exercising. The findings also indicated that dysmenorrhea among the respondents was significantly associated with family history of dysmenorrhea (p = 0.002), monthly income (p = 0.001), and knowledge level (p = 0.001).

    CONCLUSION: Dysmenorrhea has a high prevalence among women in Malaysia in Kula Lumpur driven by low knowledge and lack of evidence-based practices among these women. Thus, it is critical for Government and healthcare authorities to promote education related to women health among Malaysian women.

  10. Khattak M, Rehman AU, Muqaddas T, Hussain R, Rasool MF, Saleem Z, et al.
    Ann Med, 2024 Dec;56(1):2313683.
    PMID: 38346381 DOI: 10.1080/07853890.2024.2313683
    BACKGROUND: The Directly Observed Treatment-Short Course (DOTS) Programme was implemented by WHO and includes a combination of four anti-tuberculosis (TB) drugs (isoniazid, pyrazinamide, ethambutol and rifampicin) for a period of six months to eradicate the TB infection completely. Diabetes mellitus (DM) is recognized as one of a strong contributor of TB according to World Health Organization (WHO). The presence of diabetes mellitus type 2 (DM type 2) makes TB treatment complicated. Thus, the objective of the current meta-analysis was to identify and quantify the impact of type 2 DM on treatment outcomes of TB patients treated under the DOTS Programme.

    METHODS: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Through a systematic review of relevant literature, we focused on studies investigating treatment outcomes including extended treatment duration and recurrence for individuals with both TB and DM undergoing DOTS therapy. The extracted information included study designs, sample sizes, patient characteristics and reported treatment results.

    RESULTS: In 44 studies from different parts of the world, the pooled HR for the impact of DM on extended treatment duration and reoccurrence were HR 0.72, 95% CI 0.56-0.83, p 

  11. Goh KW, Ming LC, Al-Worafi YM, Tan CS, Hermansyah A, Rehman IU, et al.
    Ann Med, 2024 Dec;56(1):2271942.
    PMID: 38346353 DOI: 10.1080/07853890.2023.2271942
    AIM: The use of tobacco is responsible for many preventable diseases and deaths worldwide. Digital interventions have greatly improved patient health and clinical care and have proven to be effective for quitting smoking in the general population due to their flexibility and potential for personalization. However, there is limited evidence on the effectiveness of digital interventions for smoking cessation in Asian countries.

    METHODS: Three major databases - Web of Science (WOS), Scopus, and PubMed - for relevant studies published between 1 January 2010 and 12 February 2023 were searched for studies evaluating the effectiveness of digital intervention for smoking cessation in Asian countries.

    RESULTS: A total of 25 studies of varying designs were eligible for this study collectively involving a total of n = 22,005 participants from 9 countries. Among different digital tools for smoking cessation, the highest abstinence rate (70%) was reported with cognitive behavioural theory (CBT)-based smoking cessation intervention via Facebook followed by smartphone app (60%), WhatsApp (59.9%), and Pharmacist counselling with Quit US smartphone app (58.4%). However, WhatsApp was preferred over Facebook intervention due to lower rates of relapse. WeChat was responsible for 15.6% and 41.8% 7-day point prevalence abstinence. For telephone/text messaging abstinence rate ranged from 8-44.3% and quit rates from 6.3% to 16.8%. Whereas, no significant impact of media/multimedia messages and web-based learning on smoking cessation was observed in this study.

    CONCLUSION: Based on the study findings the use of digital tools can be considered an alternative and cost-effective smoking cessation intervention as compared to traditional smoking cessation interventions.

  12. Foong CC, Bashir Ghouse NL, Lye AJ, Pallath V, Hong WH, Vadivelu J
    Ann Med, 2022 Dec;54(1):195-210.
    PMID: 35019800 DOI: 10.1080/07853890.2021.1967440
    BACKGROUND: Poor academic performance and failure can cause undesired effects for students, schools, and society. Understanding why some students fail while their peers succeed is important to enhance student performance. Therefore, this study explores the differences in the learning process between high- and low-achieving pre-clinical medical students from a theory of action perspective.

    METHODS: This study employed a qualitative instrumental case study design intended to compare two groups of students-high-achieving students (n = 14) and low-achieving students (n = 5), enrolled in pre-clinical medical studies at the Universiti Malaya, Malaysia. Data were collected through reflective journals and semi-structured interviews. Regarding journaling, participants were required to recall their learning experiences of the previous academic year. Two analysts coded the data and then compared the codes of high- and low-achieving students. The third analyst reviewed the codes. Themes were identified iteratively, working towards comparing the learning processes of high- and low-achieving students.

    RESULTS: Data analysis revealed four themes-motivation and expectation, study methods, self-management, and flexibility of mindset. First, high-achieving students were more motivated and had higher academic expectations than low-achieving students. Second, high-achieving students adopted study planning and deep learning approaches, whereas low-achieving students adopted superficial learning approaches. Third, in contrast to low-achieving students, high-achieving students exhibited better time management and studied consistently. Finally, high-achieving students proactively sought external support and made changes to overcome challenges. In contrast, low-achieving students were less resilient and tended to avoid challenges.

    CONCLUSION: Based on the theory of action, high-achieving students utilize positive governing variables, whereas low-achieving students are driven by negative governing variables. Hence, governing variable-based remediation is needed to help low-achieving students interrogate the motives behind their actions and realign positive governing variables, actions, and intended outcomes.Key MessagesThis study found four themes describing the differences between high- and low-achieving pre-clinical medical students: motivation and expectation, study methods, self-management, and flexibility of mindset.Based on the theory of action approach, high-achieving pre-clinical medical students are fundamentally different from their low-achieving peers in terms of their governing variables, with the positive governing variables likely to have guided them to act in a manner beneficial to and facilitating desirable academic performance.Governing variable-based remediation may help students interrogate the motives of their actions.

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