Leaves of Thottea dependens have been used as folk medicine in Malaysia for the treatment of several conditions involving pain and inflammation with accompanying pyrexia. However, there is no scientific evidence for its effectiveness to treat fever. Hence, the purpose of this study was to evaluate the anti-pyretic activity of methanol (MeOH) and aqueous (Aq) extracts of T. dependens leaves in albino mice (ICR strain). Methods: Thirty-six albino mice of both sexes, randomized into six groups (n=6) were used. Group I served as the control and received only the vehicle, normal saline. Group II received paracetamol 150 mg/kg body weight (b.w.) orally, groups III and IV received 100 and 200 mg/kg b.w. of the MeOH extract while groups V and VI received 100 and 200 mg/kg b.w. of the Aq extract orally. Pyrexia was induced by a subcutaneous injection of 10 mL/kg b.w. of 15% (w/v) yeast suspended in 0.5% (w/v) methylcellulose solution. LD50 of both extracts were determined according to the method of Organisation for Economic Co-operation and Development guidelines. Phytochemical screening was carried out qualitatively for the presence of different class of biologically active compounds. Results: LD50 values for both extracts were found to be greater than 1000 mg/kg b.w. indicating the wide margin of safety of T. dependens leaves. The MeOH extract at 200 mg/kg b.w. showed statistically significant (P<0.01) dose dependent reduction of brewer’s yeast induced pyrexia in albino mice. Flavonoids, saponins and phenolic compounds were found to be major biologically active phytoconstituents in MeOH extract. Conclusion: The study showed that T. dependens leaves possess significant anti-pyretic activity, thus justifying its ethnomedicinal use in Malaysia to treat fever.

Paraneoplastic syndrome (PNS) is a distant neurological manifestation of an underlying tumour. Humoral hypercalcaemia of malignancy is a form of paraneoplastic syndrome where there is an increased in calcium levels. In this article we report a 48 year old lady, with no known medical illness and presented with symptomatic hypercalcaemia. She presented to our institution complaining of a fungating and ulcerating mass over the right breast, measuring 11 X 15 cm and associated with gradual paraxial body weakness. Further investigations revealed the lesion to be an invasive breast carcinoma with metaplastic features. Computed tomography (CT) scan showed a locally advanced breast carcinoma with right axillary node metastasis, without evidence of distant metastasis. Serum calcium, i-PTH together with SPECT has confirmed the patient to have a humoral hypercalcaemia malignancy with elevated ectopic parathyroid hormone level. Bone scan did not reveal any evidence of metastasis. High volume intake and loop diuretics were employed in the management of hypercalcaemia, which was eventually resolved following mastectomy with axillary clearance of the ipsilateral side. Currently she’s she is under oncologist’s follow up for further management.
Breast Neoplasms

Background/Aims: Colonoscopy for screening is associated with unpleasant experiences for patients, and abdominal compression devices have been developed to minimize these problems. However, there is a paucity of data supporting the therapeutic benefits of this strategy. This study examined the effects of using an abdominal compression device during colonoscopy on the cecal intubation time (CIT), abdominal compression, patient comfort, and postural changes. Methods: We searched PubMed and Scopus (from inception to November 2021) for randomized controlled trials that assessed the effects of an abdominal compression device during colonoscopy on CIT, abdominal compression, patient comfort, and postural change. A random-effects meta-analysis was performed. Weighted mean differences (WMDs) and Mantel-Haenszel odds ratios (ORs) were calculated. Results: Our pooled analysis of seven randomized controlled trials revealed that abdominal compression devices significantly reduced CIT (WMD, –0.76 [–1.49 to –0.03] minutes; p=0.04), abdominal compression (OR, 0.52; 95% confidence interval [CI], 0.28–0.94; p=0.03), and postural changes (OR, 0.46; 95% CI, 0.27–0.78; p=0.004) during colonoscopy. However, our results did not show a significant change in patient comfort (WMD, –0.48; 95% CI, –1.05 to 0.08; p=0.09) when using an abdominal compression device. Conclusions Our findings demonstrate that employing an abdominal compression device may reduce CIT, abdominal compression, and postural change but have no impact on patient comfort.