NATURAL PRODUCTS TARGETING NITRIC OXIDE AS A THERAPEUTIC STRATEGY FOR TREATMENT OF HYPERTENSION: A REVIEW Hypertension remains a significant global health challenge, necessitating the exploration of novel therapeutic strategies. Nitric oxide (NO) signaling plays a pivotal role in blood pressure regulation, making it an attractive target for hypertension management. Natural products have garnered considerable attention for their potential to modulate NO signaling pathways and mitigate hypertension. This review provides a comprehensive overview of natural products targeting NO as a therapeutic strategy for hypertension treatment. We systematically examine the mechanisms by which natural compounds enhance NO bioavailability, promote vasodilation, and exert antihypertensive effects. Key natural products are evaluated for their efficacy in preclinical studies. Furthermore, we discuss the challenges and limitations associated with translating preclinical findings to clinical practice. Overall, this review highlights the promising role of natural products in modulating NO signaling pathways and offers insights into their potential as adjunctive therapies for hypertension management. Further research is warranted to elucidate the optimal dosing regimens, long-term effects, and potential drug interactions of natural compounds in diverse patient populations.

Background: Mutations in glucocerebrosidase (GBA) have been associated with the risk of developing Parkinson’s disease (PD) in different ethnic populations. The prevalence of GBA mutations among Malay PD patients is unknown. Thus, the aim of this study was to determine the frequency of GBA mutations among Malay PD patients, focusing on early (EOPD) and late-onset (LOPD) patients. Methods:EOPD (n = 50) and LOPD (n = 50) patients along with 50 ethnically and age-matched control wererecruited. The GBA exons of these patients were sequenced using the Ion Torrent PGMTM System. Results: Five heterozygous mutations exclusive to EOPD patients were identified; c.-203A>G,p.S146L, p.R159Q, p.L483P and p.L483R+c.-145G>A. In LOPD patients, c.543C>T(p.(F181=)), c.28-10C>A and p.R202Q were identified in which this p.R202Q was also present in a control subject. In addition, c.259C>A(p.(R87=)) and c.-145G>A were identified in two control subjects. In summary, we observed GBA mutations in 8% and 6% of Malay PD cases and control subject, respectively. The prevalence of GBA mutations was higher in EOPD (10%) than LOPD (6%). However, these differences were not statistically significant; [PD vs. controls: OR = 1.36, 95%CI 0.35-5.38, p = 0.752] and [EOPD vs. LOPD: OR = 1.74, 95%CI 0.39-7.71, p = 0.715]. Conclusion: We identified five exclusive heterozygous GBA mutations in EOPD patients which might predict the increase susceptibility of Malays to develop PD at young age. These findings could add knowledge into the existing evidences linking genetic alterations in GBA and PD.

Locked knee is an orthopaedic condition requiring urgent treatment. Although the condition can be diagnosed via history, physical examination and imaging studies, the cause of the mechanical obstruction may only be apparent during arthroscopic examination of the knee joint. It is known that imaging plays a role in evaluating the integrity of intra-articular structures, however in some atypical cases, imaging cannot identify the definitive cause of locked knee. Here we report on two cases of locked knee, due to uncommon conditions which were unobservable via normal imaging studies.

Nursemaid’s elbow is a radial head subluxation caused by axial traction on the extended arm while the forearm is pronated, allowing for slippage of the radial head. A 2-year-old boy presented with pain, swelling and reduced range of movement of the right elbow for 4 days. The mother noted that the child was moving the right upper limb less often and there was tenderness over the right elbow. X-ray of the right elbow showed subluxation of the elbow joint with no obvious fracture. A trial of conservative management was decided upon and the patient was placed on a right elbow backslab with the right forearm in a supine position. On follow-up, there was no swelling, tenderness or neurological deficit noted. A repeate x-ray revealed normal findings.

Heel pain is a common presentation at a primary care setting. The majority of these cases are benign and self limiting in nature. Common differential diagnoses include plantar fasciitis and peroneal muscle sprains. However, certain conditions—if undetected early—may cause significant morbidity to the patient. A high index of suspicion and early referral for further investigations are needed to prevent long-term morbidities.