OBJECTIVE:To optimize the extraction technology of Compound epimedium chewable tablets. METHODS:Using the extraction rate of icariin,the content of crude polysaccharide and yield of extractum as index,the effects of water amount,ex-traction time and extraction times on extraction effect were investigated by orthogonal test. The extraction technology was optimized and validation test was conducted. RESULTS:The optimized extraction technology was as follows as 6-fold water,extracting 3 times,2 h each time. The validation test showed that the average extraction rate of icariin was(83.80±0.02)%,the average con-tent of crude polysaccharide was (29.28 ± 0.55) mg/g,and the average yield of extractum was (28.47 ± 0.29)%(RSD≤0.55%, n=3). CONCLUSIONS:The optimized extraction technology is stable,and can be used for the extraction of Compound epimedi-um chewable tablets.

Objective:To evaluate the growth inhibition activity of the crude extract of Cyperus aromaticus (C. aromaticus) cultured cells against the 3rd instar larvae of Aedes aegypti (Linn.) and Aedes albopictus Skuse (Ae. albopictus) under laboratory conditions, and determine the sublethal effects (EI50) of the crude extract of C. aromaticus cultured cells on some biological and morphological parameters of both Aedes mosquito species during two generations as well.
Methods:The cell suspension cultures of C. aromaticus were activated from five callus lines (P4, Pa, Z1, Z6 and Ml) derived from the root explants of in vitro plantlets. The cultured cells were extracted in chloroform and used as plant material for the present study. For detection of juvenile hormone III, the crude extracts were analyzed by HPLC. Then the crude extracts of the three C. aromaticus cultured cell lines which contained varied amounts of juvenile hormone III [high level (P4 cell line), medium level (Z1 cell line) and low level (Ml cell line)] were tested against Aedes mosquito species. Laboratory evaluation was performed against late third instar larvae of the Vector Control Research Unit strains of Ae. aegypti and Ae. albopictus using the standard WHO method. The effects of EI50 of the C. aromaticus cultured P4 cells on fecundity, fertility, growth period, sex ratio, adult size and longevity of Aedes mosquitoes were assessed.
Results:Bioassay tests presented the remarkable growth inhibition activity of the crude extracts of C. aromaticus cultured cells against the two Aedes mosquitoes. Between the two mosquito species, Ae. albopictus was more susceptible to the crude extracts with lower EI50 values. EI50 of the crude extract of C. aromaticus cultured cells (P4) increased the sterility indices in the parental generation females in both Aedes mosquito species. A significant delay in the pupal formation and adult emergence were observed in the parental generation of the both mosquito species. The sex ratio of the adult population either parental or F1 generation of the Aedes mosquito species was not significantly affected by the EI50 dosage of the crude extract of C. aromaticus cultured P4 cells. A significant decrease in the wing length of the treated adult (female and male) of Aedes aegypti as well as the treated female of Ae. albopictus were observed. Longevity of the adult female of the parental generation of both Aedes mosquitoes as well as females of F1 generation of Ae. albopictus were significantly decreased.
Conclusions: The present study revealed the potential of the crude extract of C. aromaticus cultured cells in controlling vector mosquito populations in the effort to reduce the transmission of vector borne diseases.

Aged ; Barium Sulfate ; adverse effects ; Colorectal Neoplasms ; diagnosis ; physiopathology ; Extravasation of Diagnostic and Therapeutic Materials ; complications ; Female ; Humans ; Male ; Peritonitis ; etiology ; physiopathology ; Retrospective Studies

Introduction: The life of an adolescent in a school hostel is well-managed with respect to daily food intake and physical activity. These adolescents are likely to be physically active and are assumed to consume nutritious food. However, little is known about malnutrition and factors related to it. Thus, this study determined the association between malnutrition (thinness & overweight) and socio-demographic characteristics of these adolescents living in day-school hostels. Methods: Data from Program Cara Hidup Sihat (Healthy Lifestyle Program), comprising a total of 4189 13-year-old school-going adolescents were used. A multi-stage stratified cluster sampling method was applied. Information on socio-demographic characteristics was collected using self-administered questionnaires. Body weights and heights were measured. Body mass index (BMI)-for-age (z-score), or BAZ, was determined using the World Health Organization's (WHO) Growth Reference. Results: The prevalence of overweight (23.3%, 95% CI: 22.1, 24.7) was about six times higher than thinness (4.3%, 95% CI: 3.7, 5.0). Males had higher prevalence of thinness (5.6%, 95% CI: 4.6, 6.9) compared to females (3.4%, 95% CI: 3.7, 4.2). A higher prevalence of overweight was observed in the central zone than in the other five zones. Complex samples logistic regression showed that adolescents from the central zone and those with monthly parental incomes a RM 5000 were 2.5 times (adjusted odds ratio [OR]=2.5, 95% confidence interval [CI]: 1.6, 3.9) and 2.0 times (adjusted OR=2.0, 95% CI: 1.3, 2.9), respectively, more likely to be at risk of overweight compared to adolescents from the other five zones and with parents whose monthly incomes were less than RM 5000. Conversely, male adolescents were 1.7 times more likely to be at risk of thinness (adjusted OR=1.7, 95% CI: 1.2, 2.3) compared to female adolescents. Conclusion: The dual forms of malnutrition co-existed, with over-nutrition being more prevalent than under-nutrition. Future healthy body weight intervention programs should consider sex, monthly parental incomes and geographic zones of adolescents living in day-school hostels.

Testing of hypothesis was affected by statistical analysis set division which was an important data management work before data base lock-in. Objective division of statistical analysis set under blinding was the guarantee of scientific trial conclusion. All the subjects having accepted at least once trial treatment after randomization should be concluded in safety set. Full analysis set should be close to the intention-to-treat as far as possible. Per protocol set division was the most difficult to control in blinded examination because of more subjectivity than the other two. The objectivity of statistical analysis set division must be guaranteed by the accurate raw data, the comprehensive data check and the scientific discussion, all of which were the strict requirement of data management. Proper division of statistical analysis set objectively and scientifically is an important approach to improve the data management quality.
Clinical Trials as Topic ; standards ; Databases, Factual ; Research Design ; standards ; Statistics as Topic

Missing data is a common but unavoidable issue in clinical trials. It not only lowers the trial power, but brings the bias to the trial results. Therefore, on one hand, the missing data handling methods are employed in data analysis. On the other hand, it is vital to prevent the missing data in the trials. Prevention of missing data should take the first place. From the perspective of data, firstly, some measures should be taken at the stages of protocol design, data collection and data check to enhance the patients' compliance and reduce the unnecessary missing data. Secondly, the causes of confirmed missing data in the trials should be notified and recorded in detail, which are very important to determine the mechanism of missing data and choose the suitable missing data handling methods, e.g., last observation carried forward (LOCF); multiple imputation (MI); mixed-effect model repeated measure (MMRM), etc.
Clinical Trials as Topic ; Data Collection ; methods ; standards ; Humans ; Models, Theoretical ; Research Design

INTRODUCTIONHIV-associated neurocognitive disorders (HAND) comprise a wide spectrum of cognitive, motor, and mood abnormalities prevalent in people living with HIV and AIDS (PLWHAs). This field of HIV medicine has gained renewed prominence in recent years with evidence contending that anti-retroviral agents with increased central nervous system (CNS) penetration may improve neurocognitive outcomes in those affected. This review aims at evaluating the available evidence and postulating further study direction in Singapore.

MATERIALS AND METHODSA PubMed search was carried out for original articles and systematic reviews on the subject of HIV-associated neurocognitive disorders, and the results reviewed by the authors.

RESULTSThere is a growing body of evidence that HAND is not uncommon, and the advent of highly active anti-retroviral therapy has increased its prevalence by improving the prognosis of HIV infection, and hence increasing the likelihood of diagnosing of this neurocognitive condition. Screening and diagnosing HAND is important, and requires clinical suspicion as well as validated test batteries for optimal accuracy. The authors recommend strategies for detection in the local context involving stepwise targeted screening. Anti-retroviral agents with good CNS penetration and activity, as well as adjunctive neuro-rehabilitative interventions, may improve the impairments experienced by affected individuals.

CONCLUSIONIncreased awareness of HAND, with earlier diagnosis and targeted, multi-disciplinary management of this challenging condition, may lead to better all-round outcomes for people living with HIV and AIDS in Singapore.

AIDS Dementia Complex ; Anti-HIV Agents ; therapeutic use ; Anti-Retroviral Agents ; therapeutic use ; Antiretroviral Therapy, Highly Active ; HIV Infections ; drug therapy ; Humans ; Neurocognitive Disorders ; Prevalence

Administration, Cutaneous ; Administration, Topical ; Betamethasone Valerate ; therapeutic use ; China ; Clobetasol ; therapeutic use ; Cohort Studies ; Diabetes Mellitus ; epidemiology ; Ethnic Groups ; statistics & numerical data ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Hyperlipidemias ; epidemiology ; India ; Lichen Planus ; drug therapy ; epidemiology ; Malaysia ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; Triamcinolone ; therapeutic use

Objective: Electroconvulsive therapy (ECT) is the most efficacious treatment for many major mental illnesses but is limited by cognitive side effects. However, research on the pattern and severity of ECT-related cognitive side effects is inconsistent. Furthermore, little is known about the cognitive effects of ECT in Asian populations. A systematic review was conducted to examine objective cognitive performance following ECT in the Asian context. Methods: This review systematically identified studies assessing ECT-related cognitive effects in PubMED, PsychINFO, The Cochrane Library, Journal of ECT and major databases in Asian countries. The search included publications from peer-reviewed journals of languages other than English. Results: A total of 6,322 studies were identified; 823 were assessed for eligibility, of which 16 studies met the search criteria and were included in this review. Majority used high dose Bitemporal ECT for Depression and/or Schizophrenia. Cognitive impairment, which could occur immediate to the first ECT session, was reported in only 9 out of the 16 studies. However, deficits were observed to resolve as early as 3 weeks after the initiation of ECT. The remaining studies reported no impairment or even improvement after ECT. Conclusion There is no consistent evidence that suggests ECT causes cognitive deficits in patients, despite the widespread use of high dose Bitemporal ECT. This review suggests that Asian patients, presenting with a different psychiatric profile, may respond to high-dose Bitemporal ECT differently from Western samples.

INTRODUCTIONSarcosinaemia is a rare metabolic disorder which has not been reported in Asia.

CLINICAL PICTUREThe urine samples of 2 patients were screened as a routine metabolic screening offered for patients with mental retardation in our hospital. We used gas chromatography-mass spectrometry (GC-MS) which is capable of detecting abnormal pattern in amino acids and organic acids. Plasma sarcosine level was further quantified by GC-MS. The same methods were used in the investigations of asymptomatic family members. Urine examination by GC-MS revealed excessive amount of sarcosine in urine (normally undetectable) and their plasma sarcosine levels were raised. The 2 differential diagnoses of presence of sarcosine in urine--glutaric aciduria type II and folate deficiency--were ruled out by the absence of abnormal organic acids in the initial urine screen and by normal serum folate level respectively. Screening of the 2 families identified excessive sarcosine in urine in 2 siblings, one from each family. However, these 2 siblings of indexed patients thus identified have no neurological or developmental problem.

CONCLUSIONOur finding was consistent with the notion that sarcosinaemia is a benign condition picked up coincidentally during screening for mental retardation.

Amino Acid Metabolism, Inborn Errors ; complications ; diagnosis ; Child ; Child, Preschool ; China ; ethnology ; Family Health ; Female ; Gas Chromatography-Mass Spectrometry ; Hong Kong ; Humans ; India ; ethnology ; Intellectual Disability ; complications ; Sarcosine ; blood ; urine ; Sarcosine Dehydrogenase ; deficiency