The pathophysiology of systemic inflammatory response syndrome (SIRS) had been described to involve various strong oxidative reactions affecting the status and progress of the patients. Antioxidant therapy had been suggested in many studies involving SIRS management. The objective of this study was to compare the role of vitamin E Tocotrienol and vitamin E Tocopherol combined with vitamin C as antioxidant therapy in the management of critically ill patients diagnosed with SIRS, admitted to the intensive care unit and high dependency wards of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). It was a single blind randomized clinical trial with a total of 72 patients in which 44.4% Malays, 34.7% Chinese, 19.4% Indians and 1.4% others with 59.7% males and 40.3% females were recruited. Patients in TRI E group received Tocotrienol with Vitamin C while TOCO group received Tocopherol with Vitamin C and a control group did not receive any antioxidant. The clinical parameters (heart rate, respiratory rate, systolic blood pressure) showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention).Whereas, the sepsis (temperature, PCT, CRP and WBC) and oxidative stress (8-OHdG/Creatinine) parameters showed improvements with significant difference at the end of study (post-intervention) as compared to admission (pre-intervention). The TRI E group showed obvious improvement in clinical, sepsis and oxidative stress parameters, as compared to TOCO and control groups. This study showed that Vitamin E Tocotrienol and Vitamin E Tocopherol in combination with Vitamin C demonstrated significant improvement in the clinical and laboratory parameters during the management of SIRS. Therefore, Vitamin E in combination with Vitamin C had therapeutic benefits in the treatment of critically ill patients with SIRS.
Tocotrienols

Gelatin sering digunakan dalam pembuatan kerangka kejuruteraan tisu kerana ia mempunyai ciri-ciri biologi yang baik, termasuk mempercepatkan penyembuhan luka. Genipin, bahan semula jadi yang diperolehi dari tumbuhan Gardenia, terbukti berkesan dalam memperkukuhkan ciri-ciri fizikokimia gelatin. Ulasan sistematik ini melaporkan pengetahuan terkini mengenai pengunaan genipin sebagai agen penyilangan gelatin. Dua pangkalan data elektronik telah digunakan, iaitu Scopus dan MEDLINE melalui Ebscohost. Carian dilakukan untuk penerbitan antara Januari 1999 hingga Disember 2018 menggunakan kata kunci ‘gelatin’ dan ‘genipin’. Makalah berbahasa Inggeris, yang melaporkan kegunaan genipin untuk pembuatan span gelatin telah dipilih. Terdapat 830 makalah dijumpai melalui carian kata kunci di mana 14 makalah telah dipilih dan dibincangkan dalam ulasan sistematik ini. Dapatan kajian termasuk kepekatan, suhu penyilangan, dan cara pembuatan yang optima untuk genipin. Kepekatan genipin yang optima adalah 0.5% dan suhu penyilangan yang optima adalah 25˚C. Keputusan kajian ini menunjukkan jurang pengetahuan dalam pengunaan genipin sebagai agen penyilangan gelatin dan lebih kajian diperlukan untuk mengisi jurang ini. Kajian ini menyediakan tinjauan meluas berkenaan pengetahuan terkini mengenai penggunaan genipin sebagai agen penyilangan gelatin.

Normal tracheal mucociliary clearance is the key to maintaining the health and defense of respiratory airway. Therefore the present of cilia and mucous blanket are important for tracheal epithelium to function effectively. In the present study, we prepared a tissue engineered respiratory epithelium construct (TEREC) made of autologous respiratory epithelium cells, fibroblast and fibrin from sheep owns blood which replaced a created tracheal mucosal defect. Scanning electron microscopy (SEM) showed encouraging result where immature cilia were present on the surface of TEREC. This result indicates that engineered respiratory epithelium was able to function as normal tissue.