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Genipin-Crosslinked Gelatin Scaffold in Tissue Engineering: A Systematic Review

MUHAMMAD MIOR AMIRUL A1 ; MOHD HEIKAL MY ; MH BUSRA F

Medicine and Health.2019;14(2):1-16.

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.

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Various Ways of Continuous Intraocular Pressure Monitoring in Glaucoma Patients: A Narrative Review

RAMAKRISHNAN G ; CHE HAMZAH J ; SHARANJEET-KAUR S

Medicine and Health.2019;14(2):17-29.

Glaukoma adalah sejenis penyakit neurodegeneratif yang berlaku akibat ketidakseimbangan dalam peredaran cecair akues yang disebabkan oleh resistan pada sistem pengaliran keluar cecair tersebut. Ini meningkatkan tekanan intraokular (TIO) yang menyebabkan kerosakan pada saraf optik dan seterusnya mengakibatkan kebutaan yang kekal. Oleh kerana TIO adalah satu faktor risiko glaukoma yang boleh dikawal, ciri-ciri dan variasi tekanan sepanjang 24 jam perlu dikenalpasti sebelum rawatan dimulakan. Pemantauan TIO adalah satu aspek yang terpenting dan kritikal dalam pengurusan glaukoma. Pelbagai tindakan kawalan melalui penggunaan teknologi yang berbeza telah dan sedang dilakukan untuk pemantauan TIO yang kerap dan berterusan selama 24 jam untuk menentukan kewujudan TIO yang tinggi (peak) dan fluktuasi tekanan. Artikel ini bertujuan untuk meninjau pendekatan inovatif yang terkini serta untuk mengulas kepentingan dan kelemahan setiap teknik bagi memperolehi profil TIO selama 24 jam.

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Honey on Brain Health: Benefit or Forfeit?

ARSHAD NA ; NELLYSHA NAMELA MAK ; TEOH SL ; YAHAYA MF

Medicine and Health.2019;14(2):30-40.

Kemerosotan kesihatan otak merupakan suatu wabak di seluruh dunia. Penyakit Alzheimer dan demensia lain adalah antara penyakit yang tertinggi kos untuk dirawat, dengan perbelanjaan penjagaan langsung melebihi mereka yang menghidap kanser dan penyakit jantung. Pengambilan terlalu banyak dan terlalu kerap produk makanan terproses telah menyumbang kepada peningkatan kemerosotan kesihatan pada usia yang muda. Madu telah diketahui di seluruh dunia sejak sekian lama merupakan salah satu produk asli dan semulajadi untuk digunapakai sebagai makanan kesihatan terutamanya disebabkan oleh kandungan antioksidan dan fenoliknya. Beberapa dekad kebelakangan ini, banyak kajian telah dilakukan untuk memahami proses biologi gangguan kerosakan terhadap sel otak dan cara untuk menghentikan atau melambatkan proses berkenaan menggunakan produk semulajadi. Madu telah menunjukkan potensi besar yang mampu mengurangkan atau melambatkan gangguan kemerosotan saraf ini. Berdasarkan kajian terbaru penggunakan madu dan kesannya ke atas anatomi dan fisiologi otak, menunjukkan bahawa madu mempunyai potensi untuk menghentikan atau merawat gangguan kemerosotan kesihatan otak.

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STAT6 is a Useful Immunohistochemical Adjunct for the Diagnosis of Solitary Fibrous Tumour

AMIZATUL AINI S ; NUR MAYA SABRINA TL ; MUHAMAD FAKHRI MS ; NORAINI MD ; REENA RAHAYU MZ

Medicine and Health.2019;14(2):41-49.

Solitary fibrous tumour (SFT) adalah neoplasma fibrotik, juga dikenali sebagai hemangiopericytoma. STAT6 merupakan protein yang berfungsi sebagai transduser isyarat dan penggerak transkripsi keluarga STAT6 dalam fungsi imun dan pertumbuhan sel awal. Perubahan onkogen STAT6 memainkan peranan penting sebagai pemacu tertentu untuk genetik SFT melalui gen gabungan NAB2-STAT6. Tujuan kajian ini adalah untuk membandingkan dan menilai ekspresi STAT6 di antara SFT dan tumor yang menyerupai SFT. Kami menilai sebanyak 30 kes blok tisu parafin yang sebelum ini didiagnosis SFT (n=14) dan tumor yang menyerupai SFT (n=16) selama tempoh 15 tahun. Empat belas kes SFT (100%) menunjukkan ekspresi nuklear STAT6. Semua jenis tumor yang lain adalah negative untuk STAT6 kecuali satu kes liposarcoma dediferensiasi satu tumor stromal gastrointestinal dan satu lipoma yang menunjukkan pewarnaan sitoplasma yang tidak spesifik dan lemah. Ekspresi nuklear STAT6 adalah berguna dan boleh dipercayai sebagai penanda adjunksi SFT apabila diagnosis tidak boleh dibuat melalui kaedah konvensional.

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Characteristics and Factors Associated with Adverse Cutaneous Drug Reactions Caused by Traditional, Complementary and Conventional Medicine in Malaysia

NOR HAZLIN T ; LEELAVATHI M ; ZUHRA H ; ADAWIYAH J ; DAWN AA

Medicine and Health.2019;14(2):50-59.

Traditional and Complimentary Medicines (TCMs) can potentially cause Adverse Cutaneous Drug Reactions (ACDRs). The aim of this study was to describe the characteristics of ACDRs due to TCMs and compare with those due to conventional medicine. This was a retrospective study with 134 cases being diagnosed with ACDR at the Dermatology Clinic of a tertiary hospital in Kuala Lumpur. Most (82.1%) ACDRs were caused by conventional drugs, while 17.9% were due to TCMs. Majority (70-75%) of the ACDRs were of mild to moderate severity. The most common ACDR to TCM was Exfoliative Dermatitis (ED) and Acute Generalized Exanthematous Pustulosis (AGEP) (both 16.7%) while maculopapular rash was the most common reaction for conventional medications (25.5%). The onset of adverse reaction to TCM was about 4 weeks (60.2%) while reactions due to conventional medication was earlier (1 to 6 days, 65.4%; p<0.05). The odds of developing delayed ACDR was 14 times more with TCM compared to conventional medicine (p<0.05). This study showed that ED and AGEP were the most common ACDR manifestations of TCM while macuplopapular rash was the most common manifestation of conventional medications. However, most of these reactions were of mild to moderate severity. ACDR due to TCM may manifest long after the initiation of these products and hence its use should be routinely inquired when patients present with skin problems. All suspected cases of ADRs to TCM should be reported to the Malaysian Adverse Drug Reactions Advisory Committee (MADRAC) for continuous pharmacovigilance of these products.

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Bacteraemia in Haematopoietic Stem Cell Transplant Recipients in a Single Tertiary Referral Centre

NURUL IMAN P ; RAMLIZA R ; WAN FARIZA WJ ; SHAMSUL AZHAR S ; NOR AZIMAH I ; FADILAH SAW

Medicine and Health.2019;14(2):60-76.

Bacteraemia is a common and one of the serious complications in haematopoietic stem cell transplantation (HSCT). To date, there are no published data on antibiotic resistance and clinical outcome among HSCT recipients in Malaysia. The aims of the present study was to analyse the prevalence, antibiotic resistance and clinical outcome of bacteraemia in HSCT recipients within 100 days following transplantation. We retrospectively analysed the prevalence, antibiotic resistance pattern and mortality rate of early bacteraemia among HSCT recipients in a single centre over a 5-year period (2013-2017). Thirty patients of 85 HSCT recipients developed bacteraemia with 40 positive cultures resulting in prevalence of 47% (40/85). Gram negative bacteria (GNB) accounted for 60.5% of total isolates. Enterobacteriaceae and Coagulase negative Staphylococcus (CoNS) were the commonest pathogens isolated. GNB showed a high resistance rate to ciprofloxacin. Only 30% of recipients responded to first line empirical antibiotics for febrile neutropenia (FN). The mortality rate was 13.3% (4/30), of which 50% was attributed to multi-drug resistance (MDR) Acinetobacter and 25% to extended spectrum beta-lactamase (ESBL) Enterobacteriaceae. Bacteraemia is a frequent and life-threatening early complication among HSCT recipients with MDR GNB being the commonest cause of mortality. The high rate of resistance to ciprofloxacin and failure of the first line empirical antibiotics to treat FN calls for a thorough evaluation of the current antibiotic prophylaxis and empirical treatment protocols. These findings have important clinical implications regarding the use and selection of both prophylactic and empiric antibiotic regimens to treat FN.

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Analytical Evaluation of Cardiac Poct: Humasis Hubi-Quanpro Troponin I

MUNIRAH M ; MOHD NAZRUL AA ; NORSHEILA M ; DIAN NASRIANA N ; HANITA O

Medicine and Health.2019;14(2):77-86.

Point-of-care testing (POCT) of cardiac troponin device is aimed for improvement in turn round time (TAT) and assist in acute management care of acute coronary syndrome (ACS). The present study was conducted to assess the analytical performance and correlation of HUBI-QUANPro troponin I with an existing laboratory instrument of high-sensitivity troponin I, Abbott Architect. The factors that were studied, included precision study by using manufacturer quality control (QC) material (2 levels) and correlation study of sample differences (whole blood, plasma and serum) and methodology (immunochromatographic assay and chemiluminescent immunoassay). A total of 30 QC was used for precision study and 42 sample serum and EDTA for the correlation study. An acceptable total imprecision of 10.9% and 6.7% were seen at level of 0.91 ng/mL and 2.66 ng/mL, respectively. Regression analysis of sample differences (plasma vs whole blood) in HUBI-QUANPro showed slope of 0.935, r=0.991 (p=<0.001). Correlation of HUBI-QUANPro and Abbott Architect (whole blood, plasma vs serum) both demonstrated regression slope of 0.205, r=0.963 (whole blood) and slope of 0.192, r=0.954 (plasma), p=<0.001, respectively. HUBI-QUANPro troponin I POCT device is a sensitive, fast, precise and has a good comparable analytical performance with reference laboratory instrument for cardiac troponin I measurement. It is able to serve as a good POCT device in cardiac-related acute care management.

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The Relationship between Depression and Anxiety and Heart Failure Patients’ Adherence to Self-Care Recommendations

JAAFAR MH ; VILLIERS-TUTHILL A ; MCGEE H ; MORGAN K

Medicine and Health.2019;14(2):87-96.

Heart failure is a physically debilitating and psychologically distressing chronic condition. Although depressive disorder is a strong predictor of short-term deterioration of heart failure symptoms and mortality, only few studies have focused on habit and daily routines. The present study aimed to investigate the relationship between depression and anxiety and heart failure patients’ self-care behaviour. Interviews were completed with 161 patients at hospital outpatient clinics in Belfast and Dublin. Depression and anxiety were assessed using the Hospital Anxiety and Depression Scale (HADS). Self-care behaviour was assessed using the European Heart Failure Self-Care Behaviour Scale (EHFSCBS). ‘Probable’ clinical depression was indicated in 18%, and ‘probable’ caseness of anxiety disorder in 16% of patients. Self-care behaviour adherence varied considerably across behaviours and was higher for taking medication as prescribed (93.1%), and taking it easy if breathless (75.1%) and lower for daily self-weighing (13.6%), regular exercise (33.6%) and limiting fluid intake (38.5%). No significant relationship was found between overall reported self-care adherence and anxiety or depression. However, significant association with depression were found for five of the 12 self-care items, and also with anxiety for two of these. Our results demonstrated that mental well-being in patients with heart failure plays a significant role in the patients’ ability to adhere to self-care regimens.

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Factors Associated with Successful Fasting among Type 2 Diabetic Mellitus Patients during Ramadan: A Retrospective Recall Study

LEOW SN ; TONG SF

Medicine and Health.2019;14(2):97-108.

Among diabetic patients, fasting is associated with increased risk of ketoacidosis, hypoglycaemia and dehydration. Previous randomised controlled trials and prospective studies have shown that intensive pre-Ramadan education on fasting is able to help patients fast successfully during Ramadan. At the same time, observational studies show that many diabetic patients are still able to fast successfully throughout Ramadan despite deficiencies in knowledge about fasting practices. We conducted a retrospective recall study in Klinik Kesihatan Jalan Perak, Penang to determine the factors associated with successful fasting. Patients were selected using convenience sampling. Successful fasting was defined as a patient fasted as intended, and not having to break-fast due to hypo/ hyperglycaemia symptoms or hospitalization due to diabetic complications. Multiple logistic regression was used to determine independent factors associated with successful fasting. 113 patients were enrolled. 70.9% (n=80) of patients were able to fast successfully. Knowing the name of their diabetic medications were significantly associated with successful fasting (AOR=8.56, 95%CI: 2.04;35.8, p=0.003). Knowledge and fasting practices were not associated with successful fasting. We may identify patients who might not fast successfully by evaluating their understanding of their diabetic medications. They can then be targeted for further pre-Ramadan counselling. Nonetheless, an intensive pre-Ramadan counselling is still optimal if resources are available.

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Medical Students’ Perceptions on the Adequacy and Effectiveness of Pharmacology Teaching during Preclinical Years

NORAZLINA M ; SITI MARIAM B ; MOHAMAD-SHARIF MA ; NORAIN MM ; MUHAMMAD-ADAM AC ; HAZLINDA M ; DARISHINI G

Medicine and Health.2019;14(2):109-120.

Pharmacology teaching during preclinical years is important for medical students to make rational choices in choosing suitable treatment for patients in future. Therefore, the present study determined the adequacy and effectiveness of pharmacology teaching in the undergraduate medical program at the Universiti Kebangsaan Malaysia Medical Center (UKMMC). Suggestions for improvement of the curriculum were also identified. An online questionnaire on the perceptions of pharmacology teaching methodology was distributed to a total of 459 medical students in 4th and 5th year at UKMMC. The questionnaire covered demographics, perceptions about pharmacology teaching, the ideal teaching learning methodology for learning pharmacology, pharmacology topics which are useful for future clinical practice, the pharmacology topic which was most interesting and recommendations for improvement. The response rate was 46.4% and majority of the participants were females (65.7%). Most of the students agreed that interactive learning was more helpful than didactic lectures (88.0%). Seventy percent of the students reported that pharmacology lectures in the preclinical years were helpful during the clinical years. Percentage of students who agreed that pharmacology teaching in their preclinical was adequate for their clinical practice was 47.0%. There was no association between demographic variables (gender, race, year of study and medical family background) and interest in pharmacology (p>0.05). In conclusion, the pharmacology teaching during preclinical years was perceived to be effective and useful for students’ clinical practice. More pharmacology teaching sessions in clinical years was suggested which may improve adequacy of pharmacology teaching.

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