Showing papers in "The Malaysian journal of medical sciences in 2013"

The influence of colour on memory performance: a review.

Abstract: Human cognition involves many mental processes that are highly interrelated, such as perception, attention, memory, and thinking. An important and core cognitive process is memory, which is commonly associated with the storing and remembering of environmental information. An interesting issue in memory research is on ways to enhance memory performance, and thus, remembering of information. Can colour result in improved memory abilities? The present paper highlights the relationship between colours, attention, and memory performance. The significance of colour in different settings is presented first, followed by a description on the nature of human memory. The role of attention and emotional arousal on memory performance is discussed next. The review of several studies on colours and memory are meant to explain some empirical works done in the area and related issues that arise from such studies.

Review of the Medicinal Effects of Tualang Honey and a Comparison with Manuka Honey

Abstract: Tualang honey (TH) is a Malaysian multifloral jungle honey. In recent years, there has been a marked increase in the number of studies published in medical databases regarding its potential health benefits. The honey is produced by the rock bee (Apis dorsata), which builds hives on branches of tall Tualang trees located mainly in the north-western region of Peninsular Malaysia. This review collates the results of the various studies of TH that range from research on tissue culture to randomised control clinical trials. Findings thus far show that, TH has antimicrobial, anti-inflammatory, antioxidant, antimutagenic, antitumor, and antidiabetic properties, in addition to wound-healing attributes. Some of its properties are similar to the well-researched Manuka honey (New Zealand and/or Australian monofloral honey). Distinct differences include higher phenolics, flavonoids, and 5-(hydroxymethyl) furfural (HMF). Compared with Manuka honey, TH is also more effective against some gram-negative bacterial strains in burn wounds.

Nursing Students' Perceptions of their Educational Environment Based on DREEM Model in an Iranian University.

Abstract: Background: The learning climate has been found to be significant in determining students’ academic achievement and learning. The purpose of this study was to measure the viewpoints of nursing students toward their learning environment at Rafsanjan University of Medical Sciences (RUMS). Methods: This descriptive, cross-sectional study was performed on 202 nursing students using the Dundee Ready Educational Environment Measure (DREEM). The items, as well as scale scores were compared among nursing students. Also, data was analysed by SPSS19 using t test and ANOVA. Results: The total mean DREEM score was 114.3 (SD 20.6) out of 200 (corresponding to 57.15% of the maximum score), which was considered as more positive than negative. The subscale with the highest mean score was Students’ Perceptions of learning. Mean score of this subscale was 27.3/48 0 (SD 5.9) corresponding to 56.87% of the maximum score. The lowest mean score was for the Academic Self-perceptions 20.31/32 (SD 4.51) (53.44%), The total DREEM score for female students was significantly higher than for males (P = 0.01). The total scores of new entry students were significantly higher than the others (P = 0.01). Conclusion: The school’s educational climate was generally perceived positively by students, but specific areas identified by students as needing improvement. It is essential for managers to make a greater effort to create an appropriate educational environment in order to provide and maintain high quality learning environments for students.

Prediction of vertical jump height from anthropometric factors in male and female martial arts athletes.

Abstract: BACKGROUND: Vertical jump is an index representing leg/kick power. The explosive movement of the kick is the key to scoring in martial arts competitions. It is important to determine factors that influence the vertical jump to help athletes improve their leg power. The objective of the present study is to identify anthropometric factors that influence vertical jump height for male and female martial arts athletes. METHODS: Twenty-nine male and 25 female athletes participated in this study. Participants were Malaysian undergraduate students whose ages ranged from 18 to 24 years old. Their heights were measured using a stadiometer. The subjects were weighted using digital scale. Body mass index was calculated by kg/m(2). Waist-hip ratio was measured from the ratio of waist to hip circumferences. Body fat % was obtained from the sum of four skinfold thickness using Harpenden callipers. The highest vertical jump from a stationary standing position was recorded. The maximum grip was recorded using a dynamometer. For standing back strength, the maximum pull upwards using a handle bar was recorded. Multiple linear regression was used to obtain the relationship between vertical jump height and explanatory variables with gender effect. RESULTS: Body fat % has a significant negative relationship with vertical jump height (P < 0.001). The effect of gender is significant (P < 0.001): on average, males jumped 26% higher than females did. CONCLUSION: Vertical jump height of martial arts athletes can be predicted by body fat %. The vertical jump for male is higher than for their female counterparts. Reducing body fat by proper dietary planning will help to improve leg power.

Isolation of Extended Spectrum β-lactamase (ESBL) Producing Bacteria from Urban Surface Waters in Malaysia.

Abstract: Background: This was a preliminary study to test for the presence of multiple antibiotic-resistant extended spectrum β-lactamase (ESBL) producing bacteria in Malaysian urban surface waters Although the literature review revealed several published papers on clinical ESBL isolates in Malaysia, none were found on ESBL isolates obtained from local surface waters Methods: Isolated bacterial species were tested for resistance to cefotaxime, amoxicillin/clavulanate and aztreonam, and susceptibility to imipenem and meropenem using antibiotic susceptibility testing (AST) by disc diffusion This served as a screening step to detect bacteria that could be potential ESBL species 16S ribose ribonucleic acid (rRNA) polymerase chain reaction (PCR) testing with two clusters of bla (β-lactamase) gene primers was used to test for the bla genes CTX-M (Groups 1, 2, 9), OXA-1, SHV and TEM Results: A total of 19 isolates were found, possessing at least one of the bla genes tested for There was a relatively high occurrence of CTX-M genes (842%) among these, followed by TEM genes (474%) The isolates were identified as Enterobacteriaceae (895%), predominantly Escherichia coli and Klebsiella pneumoniae Conclusion: There appears to be a high occurrence of ESBL-bacteria in local surface waters, among these being opportunistic pathogens The persistence and spread of these species in the environment poses a threat to exposed human populations

Knowledge, Practices and Attitudes Towards Adverse Drug Reaction Reporting by Private Practitioners from Klang Valley in Malaysia

Abstract: Objectives: The study aimed to determine current status of knowledge, practices, and attitudes towards adverse drug reaction (ADR) reporting among private practitioners in Klang region of Malaysia. Methods: A total of 238 private practitioners in Klang valley were distributed a questionnaire consisting of seven questions, two knowledge-related, two practice-related and three attitude-related. Each favourable and unfavourable response was given a score of 1 and 0 respectively. Total score of 70% or more for each domain was considered “satisfactory” whereas less than 70% as “unsatisfactory”. Results: One hundred forty-five participants completed questionnaire. Knowledge assessment showed 83.4% responses stating that ADR reporting helps to identify safe drugs and 91.7% responded that it measures ADR incidence. Regarding practices, 76.6% respondents were willing to report only if confident that reaction is an ADR. Regarding attitudes, 81.9%, 66.9% and 23.5% participants showed complacency, ignorance, and indifference respectively. Unsatisfactory knowledge, practices, and attitudes were observed in 57.2%, 56.6%, and 73.1% respondents respectively. Satisfactory knowledge was significantly higher in respondent with higher qualification with odds ratio of 2.96 with 95% confidence interval of 1.48–5.93. Conclusion: The study showed unsatisfactory level of knowledge, practices, and attitudes towards ADR reporting among high proportion of private practitioners in Klang valley, Malaysia.

Hypoglycaemic and Tissue-Protective Effects of the Aqueous Extract of Persea Americana Seeds on Alloxan-Induced Albino Rats

Abstract: Background: The tissue-protective potential of Persea Americana necessitated a look into the histopathological effects of the plant extract on the pancreas, liver, and kidneys. This study was conceived and designed based on the gaps in the research that has been performed and what is known about the plant. The hypoglycaemic and tissue-protective effects of hot aqueous Persea americana (avocado pear) seed extracts on alloxan-induced albino rats were investigated. Method: Persea americana seeds were extracted using hot water, and different concentrations of the extract were prepared. The effects of different concentrations (20, 30, 40 g/L) of the hot aqueous P. americana seed extract on alloxan-induced Wistar albino rats were compared with those of a reference drug, glibenclamide. The glucose level of the rats was measured daily, and the weight of the animal was monitored on a weekly basis for 21 days. The oral glucose tolerance test (OGTT) was performed at 0, 30, 60, 90 and 120 minutes, and the histopathologies of the liver, kidneys, and pancreas were investigated. Phytochemical analysis of P. americana seed extracts indicated the presence of glycosides, tannins, saponins, carbohydrates, flavonoids, and alkaloids. Result: The results showed that the extract possessed a significant hypoglycaemic (P < 0.05) effect and reversed the histopathological damage that occurred in alloxan-induced diabetic rats, comparable to the effects glibenclamide. The seeds of P. americana also had anti-diabetic and protective effects on some rat tissues such as the pancreas, kidneys, and liver. Conclusion: In conclusion, the present study provides a pharmacological basis for the folkloric use of the hot-water extract of P. americana seeds in the management of diabetes mellitus.

Prevalence of oral mucosal lesions in patients with type 2 diabetes attending hospital universiti sains malaysia.

Abstract: Objectives: Diabetes mellitus is associated with a greater likelihood of developing certain oral mucosal disorders. This study was aimed at assessing the prevalence of oral mucosal lesions (OMLs) in patients with type 2 diabetes (DM2) and to investigate the association of such lesions with metabolic control of the disease.

Four Possible Itching Pathways Related to the TRPV1 Channel, Histamine, PAR-2 and Serotonin.

Abstract: The following four possible pathways for itching sensation have been suggested by recent reports. 1) Histaminergic TRPV1-positive pathway: Although histamine-positive nerve fibers cannot strictly be classified as "itch specific" due to their excitation also by pure algogens (making them itch-selective), the existence of a subpopulation of nociceptors responsible for itching is strongly suggested. Moreover, the TRPV1-expressing neurons have been suggested to be the main sensors and mediators of itching. 2) Histaminergic TRPV1-negative pathway: The scratching behavior caused by itching was not different between capsaicin-pre-treated and vehicle-treated (control) mast cell-rich NC mice. This result suggests the existence of a capsaicin-insensitive (TRPV1-negative) histaminergic pathway. 3) Non-histaminergic PAR-2 pathway: Protease-activated receptor 2 (PAR-2) has been shown to play a role in the itching of atopic dermatitis (AD). The itch evoked by cowhage (a non-histaminergic pruritogen that activates PAR-2) is very similar in characteristics to the itch evoked by conditions such as AD. 4) Non-histaminergic serotonin (5-HT) pathway: 5-HT alone applied to the human skin evokes an itching sensation and has been suggested to be involved in the itching associated with pruritic diseases, such as polycythemia vera and cholestasis.

Socio-demographic and Clinical Profile of Substance Abusers Attending a Regional Drug De-addiction Centre in Chronic Conflict Area: Kashmir, India.

Abstract: Background: The menace of substance abuse is not only a socially unacceptable reality, but in its entirety is a disease and emerging as a major public health challenge. Objective: To study the socio-demographic and clinical profile of patients attending the drug de-addiction centre. Methods: A descriptive study was undertaken in a drug de-addiction centre at the Police Hospital in Srinagar, and all patients (198) who were admitted during this period were interviewed. Results: The mean (SD) age of patients was 26.8 years (SD 7.37), and over half (56%) belonged to the lower-middle social class. Poly-substance abuse was seen in 91.9%; medicinal opioids and cannabis were the most common substances abused. Most common age of initiation was 11–20 years (76.8%), with peer pressure and relief from a negative mood state being the most common reasons given for starting the drug(s). Prevalence of a co-morbid psychiatric disorder was high, on the order of 49.5%. A high rate of volatile substance use was observed among adolescents (54.5%). Conclusion: A pattern of poly-substance abuse was found to be quite common in patients, and use of volatile substances at a very young age emerged as a new trend. The dreadful repercussions of substance abuse justify the urgency to evolve a comprehensive strategy.

Detection of β-globin Gene Mutations Among β-thalassaemia Carriers and Patients in Malaysia: Application of Multiplex Amplification Refractory Mutation System-Polymerase Chain Reaction.

Abstract: Background: β-thalassaemia is one of the most common single-gene disorders worldwide. Each ethnic population has its own common mutations, accounting for the majority of cases, with a small number of mutations for the rarer alleles. Due to the heterogeneity of β-thalassaemia and the multi-ethnicity of Malaysians, molecular diagnostics may be expensive and time consuming. Methods: A simple polymerase chain reaction (PCR) approach involving a multiplex amplification refractory mutation system (MARMS) and one amplification refractory mutation system (ARMS), consisting of 20 β-globin gene mutations, were designed and employed to investigate β-thalassaemia patients and carriers. Results: Out of 169 carriers tested with the MARMS, Cd 41/42 (–TTCT), Cd 26 (A–G) HbE, IVS 1–1 (G–T), and IVS 1–5 (G–C) were the most common mutations, accounting for 78.1%. Among the Malays, Cd 26 (A–G) HbE, Cd 41/42 (–TTCT), IVS 1–1 (G–T), and IVS 1–5 (G–C) were the most common mutations, accounting for 81.4%, whereas Cd 41/42 (–TTCT) and IVS 2–654 (C–T) were most common among the Chinese (79.1%). Conclusion: We propose the use of this cheap, easy to interpret, and simple system for the molecular diagnostics of β-thalassaemia among Malaysians at the Institute for Medical Research (IMR).

Improving active and passive avoidance memories deficits due to permanent cerebral ischemia by pomegranate seed extract in female rats.

Abstract: Background: This study aimed to evaluate the effect of two weeks oral administration of pomegranate seed extract (PGSE) on active and passive avoidance memories after permanent bilateral common carotid arteries occlusion (2CCAO) to induce permanent cerebral ischemia in adult female rats. Methods: Seventy adult female Wistar rats (250 ± 20 g) were used. Animals were divided randomly into seven groups with 10 in each: 1) Sham-operated; 2) Ischemic; 3–6) Ischemic received PGSE (100, 200, 400, and 800 mg/2mL/kg, orally) for 14 days; 7) Ischemic received vehicle. In order to create 2CCAO, carotid arteries were ligatured and then cut bilaterally. Active and passive avoidance task were measured using criterion condition responses (CCRs) in Y-maze and step-through latency (STL) in two-way shuttle box in all female rats. Results: Both active and passive avoidance memories were significantly impaired in rats after cerebral hypoxia-ischemia (CHI) (P < 0.001). PGSE treatment significantly improved passive and active memory impairments with 2CCAO (P < 0.05, P < 0.01, and P < 0.001). No toxicity was observed even with high-dose PGSE consumption (800 mg/kg, for 14 days). Conclusion: PGSE exhibits therapeutic potential for avoidance memories, which is most likely related at least in part to its antioxidative and free radical scavenging actions.

Uterine Arteriovenous Malformation

Abstract: Uterine arteriovenous malformation (AVM) is a rare condition, with fewer than 100 cases reported in the literature. Despite it being rare, it is a potentially life-threatening condition. This case report describes a 33-year-old woman who presented with secondary post-partum hemorrhage. Transabdominal ultrasound (US) of the pelvis showed increased vascularity with multidirectional flow of the uterus and a prominent vessel, located on the left lateral wall. She also had retained product of conception, which complicated the diagnosis. A uterine artery angiogram confirmed an AVM in the fundal region with an early draining vein. Embolisation of the AVM was performed successfully.

“VisionTouch Phone” for the Blind

Abstract: Our objective is to enable the blind to use smartphones with touchscreens to make calls and to send text messages (sms) with ease, speed, and accuracy. We believe that with our proposed platform, which enables the blind to locate the position of the keypads, new games and education, and safety applications will be increasingly developed for the blind. This innovative idea can also be implemented on tablets for the blind, allowing them to use information websites such as Wikipedia and newspaper portals.

Survey on maternal satisfaction in receiving spinal anaesthesia for caesarean section.

Abstract: Background: This study was undertaken to evaluate patient satisfaction after spinal anaesthesia, which is the most frequently administered anaesthesia in obstetric patients. Method: A cross-sectional study of patients who underwent caesarean section under spinal anaesthesia in the operating rooms of Hospital Teluk Intan was conducted. Post-operative survey of patients on the day after surgery was conducted by collecting pre-operative and intra-operative data on a constructed questionnaire. Post-operative data, including satisfaction and understanding the anaesthetist’s explanation regarding anaesthesia, satisfaction in receiving spinal anaesthesia and adverse effects, and willingness to accept or refuse spinal anaesthesia for a similar surgery again, were inquired by trained anaesthesia personnel. Results: A total of 200 pregnant patients, with age ranging from 17 to 45 years, were surveyed: 64.5% Malay, 17% Indian, 14% Chinese and 4.5% others. All (100%) the patients were satisfied with the explanation provided regarding the choices of anaesthesia, but 2% could not concentrate on the explanation because of labour pain. Overall, the average satisfaction with spinal anaesthesia administration was divided into 194 (97%) satisfied patients and 6 (3%) dissatisfied patients. Factors associated with dissatisfaction were inadequate analgesia during surgery and failed spinal anaesthesia. Post-operative complications included spinal headache 5 (2.5%), post-operative nausea and vomiting (PONV) 1 (0.5%), pain at the surgical site 2 (1%) and backache 2 (1%). Furthermore, 177 (88.5%) patients would opt for spinal anaesthesia in future for similar surgery, if required; 16 (8%) would not; and 7 (3.5%) were not sure. The reasons for refusal to receive spinal anaesthesia were as follows: awareness and failed regional anaesthesia. Conclusion: The patients receiving spinal anaesthesia demonstrated a high rate of patient satisfaction. Ensuring the quality of spinal anaesthesia, improving clinical skill of the anaesthesiologists, and prevention of side effects might improve patient satisfaction.

Prevalence of Hepatitis B and C in Donated Blood from the Jazan Region of Saudi Arabia

Abstract: Background: Infections caused by the hepatitis B virus (HBV) and the hepatitis C virus (HCV) are global public health problems. The safety of donated blood can be estimated by monitoring the prevalence of viral markers in the donor population. The present study was carried out in the Jazan region to determine the prevalence of HBV and HCV among Saudi blood donors.

Frequencies of Cytochrome P450 2B6 and 2C8 Allelic Variants in the Mozambican Population.

Abstract: Background: The cytochrome P450 enzymes (CYP) play an important role in the metabolism of many therapeutic agents. The activities of different enzymes exhibit variability in different populations, which causes variations in drug response or toxicity. The CYP2B6 and CYP2C8 enzymes are encoded by polymorphic genes characterised by different single nucleotide polymorphisms (SNPs). Several of these CYP variants are often associated with slow metabolism phenotypes. This study aimed to analyse the frequencies of allelic variants of CYP2B6 and CYP2C8 in the Mozambican population. Methods: Using a polymerase chain reaction and restriction fragment length polymorphism assay (PCR-RFLP), the frequencies of the allelic variants of CYP2B6 (c.64C>T, c.516G>T, c.777C>A, c.785A>G, c.1459C>T) and CYP2C8 (c.805A>T, c.416G>A, c.1196A>G, c.792C>G) were determined in 360 Mozambican blood donors. Results: The frequencies of the allelic variants of the CYP2B6 gene were 0.057, 0.426, 0.0, 0.410, and 0.004. For the CYP2C8 gene, the frequencies of the allelic variants were 0.160, 0.048, 0.0, and 0.005. No significant differences were observed between the gender and geographic distribution of volunteers around the country. Conclusion: The frequencies of the allelic variants of the CYP2B6 and CYP2C8 genes were found to be homogeneously distributed in the Mozambican population and were comparable to other African populations. Further studies are required to explore the impact of these variants on the clinical response (efficacy and toxicity) of drugs, including antimalarials.

Ten-year Investigation of Clinical, Laboratory and Radiologic Manifestations and Complications in Patients with Takayasu's Arteritis in Three University Hospitals.

Abstract: Background: Takayasu arteritis is a condition of unknown aetiology that affects the aorta and its primary branches. The disease has been primarily recognised and described in Asia. The aims of this study were to identify the main clinical, laboratory, and angiographic features of Takayasu arteritis in Iranian patients over a 10 year period from 2000 to 2010. Methods: Data were obtained from angiographic and medical records of patients treated at Shahid-Rajai, Taleghani, and Loghman Hospitals during the above-mentioned time period. The criteria for definitions and findings were those proposed by the American College of Rheumatology. Results: A total of 15 patients were identified. The median age at presentation was 36 years and 73.3% of patients were females. Fever was the most common presentation. According to “modified” National Institute of Health criteria, 44.7% of patients were in the acute phase of disease with systemic symptoms such as fever, weight loss, and elevated C-reactive protein (CRP) levels. Immunological markers such as antinuclear antibodies (ANA) and antineutrophil cytoplasmic antibodies (C-ANCA) were absent. The tuberculin test result was positive in 40% of the patients. Vascular bruit was present in 86.7% and hypertension was detected in 53.3% with 13.3% having associated renal artery stenosis. The angiographic manifestations were classified as; type I, cervicobrachial type (26.6%); type II, thoracoabdominal type (20.0%); type III, peripheral type (6.6%); and type IV, generalised type (46.7%). Coronary arteries were involved in three cases, pulmonary in two and renal in two. Conclusion: Based on our findings, the most common clinical, laboratory and angiographic findings were fever, increased erythrocyte sedimentation rate (ESR) and stenosis, respectively. Because of dangerous consequences of this disease, attention to fever and increased ESR, especially in young women may be helpful for physicians to prevent diagnosis delay.

Nitric oxide, carbonyl protein, lipid peroxidation and correlation between antioxidant vitamins in different categories of pulmonary and extra pulmonary tuberculosis.

Abstract: BACKGROUND: Lipid peroxidation, nitric oxide, carbonyl protein, causing production of reactive oxygen and reactive nitrogen intermediates that lead to oxidative, nitrosative stress. The stress is found to cause deterioration in the cellular function, mutagenesis, and DNA damage. The oxidative stress is correlated with the antioxidant vitamins status. METHODS: Newly diagnosed cultured positive sputum pulmonary category I, II, III (n = 100 each), extra pulmonary category I (n = 35) before and after directly observed short course treatment of six months vitamins, by HPLC. RESULTS: Oxidative parameter levels were significantly increased, and activities of vitamins were found to be significantly decreased in subjects of all categories of pulmonary and extra pulmonary tuberculosis. Positive correlations between nitric oxide, carbonyl protein, and lipid peroxidation were seen among them. Negative correlations between nitric oxide, carbonyl protein, lipid peroxidation with vitamin E, C, A were seen in tuberculosis (two sided P < 0.01). CONCLUSION: Increase oxidative stress and nitrosative stress, leading to protein carbonyl formation in tuberculosis. The increased protein carbonyl, hampers many important functions of proteins. The changes were reversed after six months of antitubercular treatment in patients with good recovery but increase stress was not completely reversed.

Human adipose tissue derived stem cells as a source of smooth muscle cells in the regeneration of muscular layer of urinary bladder wall.

Abstract: Background: Adipose tissue provides an abundant source of multipotent cells, which represent a source of cell-based regeneration strategies for urinary bladder smooth muscle repair Our objective was to confirm that adipose-derived stem cells (ADSCs) can be differentiated into smooth muscle cells Methods: In this study, adipose tissue samples were digested with 0075% collagenase, and the resulting ADSCs were cultured and expanded in vitro ADSCs at passage two were differentiated by incubation in smooth muscle inductive media (SMIM) consisting of MCDB I31 medium, 1% FBS, and 100 U/mL heparin for three and six weeks ADSCs in non-inductive media were used as controls Characterisation was performed by cell morphology and gene and protein expression Result: The differentiated cells became elongated and spindle shaped, and towards the end of six weeks, sporadic cell aggregation appeared that is typical of smooth muscle cell culture Smooth muscle markers (ie alpha smooth muscle actin (ASMA), calponin, and myosin heavy chain (MHC)) were used to study gene expression Expression of these genes was detected by PCR after three and six weeks of differentiation At the protein expression level, ASMA, MHC, and smoothelin were expressed after six weeks of differentiation However, only ASMA and smoothelin were expressed after three weeks of differentiation Conclusion: Adipose tissue provides a possible source of smooth muscle precursor cells that possess the potential capability of smooth muscle differentiation This represents a promising alternative for urinary bladder smooth muscle repair

Diagnostic Accuracy of the Quantitative C-Reactive Protein, Erythrocyte Sedimentation Rate and White Blood Cell Count in Urinary Tract Infections among Infants and Children.

Abstract: Objectives: The aim of this study was to evaluate the diagnostic accuracy of the quantitative C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count in urinary tract infections (UTI) among hospitalised infants and children in Qazvin, Iran.

Exploring the halal status of cardiovascular, endocrine, and respiratory group of medications.

Abstract: Muslim consumers have special needs in medical treatment that differ from non-Muslim consumers. In particular, there is a growing demand among Muslim consumers for Halal medications. This descriptive exploratory study aims to determine the Halal status of selected cardiovascular, endocrine, and respiratory medications stored in an out-patient pharmacy in a Malaysian governmental hospital. Sources of active ingredients and excipients for each product were assessed for Halal status based on available information obtained from product leaflets, the Medical Information Management System (MIMS) website, or manufacturers. Halal status was based on the products’ sources and categorized into Halal, Mushbooh, or Haram. The proportions of Halal, Mushbooh, and Haram products were at 19.1%, 57.1%, and 23.8%, respectively. The percentage of active ingredients for cardiovascular/endocrine products that were assessed as Haram was 5.3%; for respiratory medications, it was only 1.1%. For excipients, 1.7% and 4.8% fall under the category of Haram for cardiovascular/endocrine products and respiratory products, respectively. Ethanol and magnesium stearate were found to be the common substances that were categorized as Haram and Mushbooh.

Factors Associated with the Outcome of Open Tibial Fractures

Abstract: Background: Although open tibial fractures are common in Malaysia, the outcomes for these patients have not been evaluated in the literature. This retrospective study was conducted to examine the factors associated with infection and non-union in open tibial fractures managed at Hospital Tengku Ampuan Afzan (HTAA), Kuantan, in 2009. Methods: From 1 January until 31 December 2009, the Department of Orthopaedics of HTAA managed 58 patients with open tibial fracture who had a minimum of a one year follow-up period. The median age was 24.5 years (range: 4 to 72 years). The open tibial fractures were graded using the Gustilo open fracture classification as follows: 4 grade I, 21 grade II, 24 grade IIIA and 9 grade IIIB. All open fractures were subjected to a standard treatment protocol at HTAA, which includes the use of prophylactic antibiotics, emergency debridement, fracture stabilisation, wound coverage, and bone reconstruction when required. The mean time from injury to the initial debridement was 29.7 hours (range: 13 to 216 hours). Results: Seventeen (29%) cases were complicated by infection, and 10 patients (17%) developed non-union. The grade of the open fracture was significantly associated with infection, and age and the time interval between the injury and the initial wound debridement were significantly associated with non-union. Conclusions: The high rates of infection and non-union, particularly in severe open fractures, indicate that there is a need to improve the management of open tibial fractures treated at HTAA. The time to initial debridement is an important factor that can be readily amended to improve the outcome. Further studies with larger sample sizes are likely needed to replicate and confirm our findings.

Functional magnetic resonance imaging (FMRI) neurofeedback: implementations and applications.

Abstract: Neurofeedback (NFB) allows subjects to learn how to volitionally influence the neuronal activation in the brain by employing real-time neural activity as feedback. NFB has already been performed with electroencephalography (EEG) since the 1970s. Functional MRI (fMRI), offering a higher spatial resolution, has further increased the spatial specificity. In this paper, we briefly outline the general principles behind NFB, the implementation of fMRI-NFB studies, the feasibility of fMRI-NFB, and the application of NFB as a supplementary therapy tool.

Electrodiagnostic evaluation of peripheral nervous system changes in patients with multiple sclerosis.

Abstract: Background: There is supportive evidence that multiple sclerosis (MS) could potentially affect the peripheral nervous system. We assessed peripheral sensory and motor nerve involvement in patients with MS by a nerve conduction velocity test. Methods: We studied 75 patients who had a relapsing-remitting or secondary progressive pattern. We measured amplitude, latency, conduction velocity, Hoffmann reflex (H-Reflex), and F-Waves. Results: The amplitude of the right tibial, right proneal, left tibial, left proneal, and left median motor nerves was less than the mean for the normal population. Right ulnar sensory conduction in the patients showed an amplitude that was less than that of the normal population; there was no significant change in the amplitude of other sensory nerves. Latencies of the right and left median and right proneal motor nerves and left ulnar sensory nerves were statistically less than that of the normal population. Mean motor conduction velocity and F-wave conduction did not differ significantly from the normal population. H-reflex latencies of the right and left lower limbs were significantly more prolonged than those of the normal population. Conclusion: Our results suggest possible peripheral motor nerve abnormalities in MS patients, especially with the amplitude of the motor nerves; however, our results do not demonstrate any significant difference among the nerve conduction velocity parameters of sensory nerves between MS patients and the normal population.

Effects of the Aqueous Extract of Anethum graveolens Leaves on Seizure Induced by Pentylenetetrazole in Mice.

Abstract: Background: In this study, the aqueous extract of Anethum graveolens (dill) leaves was studied for its effects on treating convulsions and epilepsy, by using a pentylenetetrazole (PTZ) kindling model. The evaluated plant has a traditional medical reputation for profound anticonvulsant activities, additionally, dill has been claimed to exhibit anti-inflammatory and analgesic properties. Methods: For the PTZ kindling induction, mice were given a dose of PTZ (37 mg/kg, intraperitoneally) every other day, and seizure stages were precisely recorded. During and after kindling, the effects of the non-toxic doses of the aqueous extracts (100, 250, and 400 mg/kg) on seizure latency in stage 2 (S2L), seizure latency in stage 4 (S4L), and seizure duration in stage 5 (S5D) were measured. Results: The aqueous extract of dill leaves had a noticeable anticonvulsant effect. The 400 mg/kg dose of the extract sample decreased with S5D (P < 0.05), and increased with S2L and S4L significantly (P < 0.05 and P < 0.01, respectively). Conclusion: The obtained data shows that the aqueous extract possesses anticonvulsant activity against seizure induced by PTZ. The presence of anticonvulsant compounds in this medicinal herb suggests further activity and guided fractionation studies in order to introduce this plant as a valuable source of anticonvulsant agents.

Trends in the Antibiotic Resistance Patterns of Enteric Fever Isolates – a Three Year Report from a Tertiary Care Centre

Abstract: Objectives: The incidence of multidrug resistant enteric fever is increasing alarmingly. This study was planned to determine the rate of isolation of Salmonella spp. and to compare the isolates for their epidemiological parameters and antimicrobial susceptibility patterns at our center. Methods: The study was conducted over a span of three years with a total of 8142, 8134, and 8114 blood culture samples processed for the years 2008, 2009, and 2010 respectively. The minimum inhibitory concentration (MIC) for ciprofloxacin and chloramphenicol was determined using an agar dilution method. The MIC for ciprofloxacin was also confirmed by Epsilon-test (E -test) strips. Results: Of the total 302 Salmonella spp. isolated, 257 were Salmonella enterica serotype Typhi (85.1%) and 45 (14.9%) were S. enterica serotype Paratyphi A. The majority of the isolates recovered were from the pediatric age group (54.6%) and males (60.6%). Complete susceptibility was observed to chloramphenicol, cefotaxime, ceftriaxone, and azithromycin over the last two years (2009 and 2010), with an increase in resistance to nalidixic acid (100%) and ciprofloxacin (13.6%). Conclusions: In our study, we found augmentation of resistance to nalidixic acid and fluoroquinolones and complete sensitivity to ceftriaxone along with reemergence of chloramphenicol sensitivity for Salmonella isolates. This report emphasises the necessity of continuous surveillance of antibiograms of enteric fever isolates in an area.

Predicting outcome of trial of voiding without catheter in acute urinary retention with intravesical prostatic protrusion.

Abstract: Background Acute urinary retention (AUR) is one of the most serious complications of benign prostatic hypertrophy. This study was done to predict the outcome of trial of voiding without catheter (TWOC) in patients with AUR with intravesical prostatic protrusion (IPP) detected on transabdominal ultrasound. Other factors such as prostatic volume and patient's age were also assessed. Methods Patients with a first episode of AUR secondary to benign prostatic hypertrophy were assessed with ultrasound following bladder catheterization. The IPP was measured and graded (grade 1 is 5 mm or less, grade 2 is 5-10 mm and grade 3 is more than 10 mm). Success of TWOC was then correlated with the degree of IPP. Results A total of 32 patients with AUR were included in the study. Patients with grade 3 IPP were found to have a significant failure rate compared to grade 1 (P = 0.022) and grade 2 (P = 0.041). Conclusion Intravesical prostatic protrusion is a useful predictor of success of TWOC in patients with AUR. Patients with grade 3 IPP on ultrasound would benefit from TWOC and warrant earlier definitive surgical treatment.

New horizons in platelets flow cytometry.

Abstract: Platelet flow cytometry is an emerging tool in diagnostic and therapeutic hematology. It is eminently suited to study the expression of platelet surface receptors both qualitatively as well as quantitatively. It can serve as a useful marker for the documentation of in vivo platelet activation, and thus, fore-warn the risk of thromboembolism in patients with diabetes mellitus, coronary syndromes, peripheral vascular diseases, and pre-eclampsia. This technique can also be extended to study and compare the effect of various antiplatelet drugs on the level of activation of platelets and to establish any dose-effect relationship of these drugs. Topographical localization of platelet granules and study of platelet-platelet and platelet-leukocyte interaction is also possible by this procedure. All these parameters serve as pointers towards the presence of activated platelets in the circulation with its thromboembolic consequences. This is a simple reliable and cost effective technique which has a wide application in the diagnosis of various inherited and acquired platelet disorders. Study of platelet cluster of differentiation (CD) markers in various inherited disorders i.e. Bernard Soulier's disease, von Willebrand disease, Glanzman's disease, and Grey platelet syndrome may help categories the molecular lesions in these oft under-studied disorders.

Pulmonary Function Studies of Healthy Non-smoking Male University Students of Kolkata, India - Revisited.

Abstract: Background: Pulmonary function tests (PFTs) need to be revisited in light of rapid economic growth and industrial development. Questions have been raised about the validity of existing population-specific norms for predicting PFTs, and therefore, the present study aimed to determine the applicability of existing norms for PFTs in young healthy non-smoking male university students of Kolkata. Methods: PFTs were carried out for 87 non-smoking male university students who were randomly sampled from the University of Calcutta, Kolkata, India. Results: The PFTs data obtained in this study did not show a significant variation with that obtained in a previous study. Significant (P < 0.001) differences in the forced expiratory volume in 1 s (FEV1%) and peak expiratory flow rate (PEFR) between the two studies may be attributed to differences in the age and body height, which exhibited significant correlations with the vital capacity (VC), forced vital capacity (FVC), FEV1, FEV1%, and PEFR. Regression equations have been computed to predict PFTs parameters from age and body height. Conclusion: Pulmonary function in the university students of Kolkata was found to have remained mostly unchanged in the last 24 years. The equations computed in this study are considered preferable owing to their substantially smaller standard error of estimate (SEE) than those proposed in the previous study.