Introduction: Medicinal herbs Acorus calamus, Curcuma longa, Zingiber officinale, and Piper betle have been traditionally used for treating stomach-related conditions such as irregular bowel movement, bloating, and gastric ulcers. The present study aimed to explore current status, research trends, and future directions of these herbs as functional herbal teas in prevention and treatment of gastritis. Methods: A total of 80 articles from Scopus database were retrieved and reviewed. Research trends were quantitatively analysed using VOSviewer software, focusing on the keywords, authors, countries, journals, and documents. A narrative review was integrated to provide comprehensive insights into the study. Results: Analysis revealed China and India as driving forces of this specific area of research, with the Journal of Ethnopharmacology emerging as a prominent source for publications in this field. “Curcumin”, “ginger”, and “Helicobacter pylori” were the main keywords of the study. Several gastroprotective mechanisms, including stimulation of mucosal proliferation, regulation of gastric acid production, reduction of inflammation in the gastric mucosa, protection of the gastric mucosa from oxidative damage, and inhibition of the growth of H. pylori, were associated with these herbs. Active compounds, such as α-asarone, curcumin, gingerol, and piperbetol, were found to be responsible for these effects. Conclusion: This study highlights various gastroprotective properties of A. calamus, C. longa, Z. officinale, and P. betle, providing researchers with a deeper understanding of the subject matter and opening new avenues for potential development into a functional herbal tea formulation known as “Lega Tea” (Relief Tea).

Introduction: Pituitary apoplexy is a rare, life-threatening condition resulting from hemorrhage or infarction of the pituitary gland, most commonly in patients with pre-existing pituitary tumors. It typically presents with a sudden headache, visual disturbance, ophthalmoplegia, and altered mental status. An uncommon but serious complication is ischemic stroke in the middle cerebral artery (MCA) territory, particularly in the absence of direct internal carotid artery (ICA) compression. Case: We report a case of a 36-year-old male who presented with headache, visual impairment, and fever. Initial computed tomography (CT) brain imaging demonstrated a heterogeneous sellar lesion with peripheral calcification measuring 2.4 × 3.2 × 2.7 cm, suggestive of a pituitary mass with possible apoplexy, without evidence of acute cerebral infarction. The patient subsequently developed dysarthria, hemianopia, and reduced consciousness, prompting repeat neuroimaging. Follow-up CT revealed a large hypodense area in the right fronto-parieto-temporal region consistent with ischemic infarction. Magnetic resonance imaging confirmed an acute infarct in the right MCA territory without hemorrhagic transformation. A sellar-suprasellar mass measuring 2.3 × 2.8 × 3.8 cm was identified, consistent with a pituitary macroadenoma with intratumoral hemorrhage compressing the optic chiasm, but without direct right ICA compression. Time-of-flight mineralocorticoid receptor antagonists demonstrated attenuated flow in the right ICA (C2–C7), suggesting intracranial ICA thrombosis and reduced perfusion in the right MCA and its branches. Laboratory evaluation revealed hyperthyroidism and hypocortisolism, with no evidence of coagulopathy. The patient was treated with corticosteroid replacement and carbimazole and referred for neurosurgical management. Conclusion This case highlights a rare association between pituitary apoplexy and MCA stroke, possibly mediated by vasospasm, inflammation, or hypercoagulability. More research is needed to understand this connection and improve treatment strategies.
Middle Cerebral Artery ; Pituitary Apoplexy ; Infarction

Pengurusan Sisa Penjagaan Kesihatan Pesakit di Rumah oleh Penjaga bagi Pesakit yang Menghidap Penyakit Tidak Berjangkit: Ulasan Naratif Pengenalan Pengurusan sisa penjagaan kesihatan adalah penting dalam menjaga alam sekitar dan kesihatan awam. Dalam konteks penjagaan pesakit penyakit tidak berjangkit (NCD) di rumah, penghasilan sisa berbahaya seperti benda tajam dan bahan berjangkit menuntut pengurusan yang berkesan bagi mengurangkan risiko pencemaran dan jangkitan. Ulasan naratif ini bertujuan untuk mengenalpasti jenis sisa yang dijana, amalan pelupusan dan kekangan yang dihadapi semasa pengurusan sisa penjagaan di rumah. Metodologi Kajian ini menggunakan pendekatan ulasan naratif dengan meneliti artikel jurnal, laporan kes, dan panduan berkaitan pengurusan sisa penjagaan kesihatan di rumah bagi pesakit NCD dalam tempoh 10 tahun. Carian artikel dilakukan dalam pangkalan data seperti PubMed, Scopus dan WOS. Hasil Tujuh artikel telah memenuhi kriteria inklusi melalui carian literatur yang dijalankan. Penemuan menunjukkan sisa yang dihasilkan terdiri daripada benda tajam, bahan berjangkit, dan sisa farmaseutikal. Walau bagaimanapun, terdapat kekurangan dalam amalan pengasingan dan pelupusan sisa yang sesuai oleh penjaga. Sebahagian besar penjaga membuang sisa klinikal bercampur dengan sisa domestik biasa, yang meningkatkan risiko kesihatan.KesimpulanPerbezaan amalan pengurusan sisa penjagaan pesakit di rumah adalah berdasarkan tahap ekonomi sesebuah negara. Kekurangan pengetahuan, garis panduan khusus serta pemantauan bagi pengurusan sisa penjagaan di rumah menyebabkan penjaga menghadapi cabaran dalampelupusan yang selamat. Di samping itu, ketiadaan infrastruktur yang mencukupi turut memburukkan keadaan bagi negara berpendapatan rendah atau sederhana. Latihan dan kesedaran kepada penjaga serta dasar yang komprehensif diperlukan untuk memastikan pengurusan sisa penjagaan kesihatan yang lebih selamat dan efektif. Hal ini penting bagi mengurangkan risiko jangkitan dan perlindungan alam sekitar.

This report presents a case of cervical tuberculous spondylitis (Pott disease) in a 45-year-old woman and discusses the effectiveness of endoscopic anterior cervical corpectomy and fusion (E-ACCF) in managing spinal cord compression symptoms caused by Pott disease. A 45-year-old female patient with a fracture of the fifth cervical vertebra due to Pott disease presented with progressing tetraparesis, paresthesia below the C3 level, and incontinence during the past month. The patient underwent E-ACCF with a titanium mesh, followed by an antituberculosis therapy regimen. One month post surgery the patient showed significant improvement. She regained the ability to walk and exhibited a substantial range of motion in the shoulder and neck joints. Endoscopic procedures such as E-ACCF are effective in managing cervical tuberculous spondylitis with spinal cord compression symptoms, resulting in excellent outcomes with minimal damage to adjacent structures.

Aims: The aim of this study was to identify an isolate B, an exopolysaccharide (EPS)-producing lactic acid bacteria and determine the fermentation time effect on EPS production. Methodology and results: Isolate B, an EPS producer, was isolated from peanut milk containing commercial sugar, which was fermented spontaneously for 24 h. Isolate B was identified biochemically using API 50 CH and molecularly based on 16S rDNA. The effect of fermentation time on EPS production by isolate B with variations of the fermentation time were 12, 24, 36, 48 and 60 h. Isolate B was able to produce EPS qualitatively by producing mucoid colonies on solid media containing sucrose. The identification revealed that this isolate was Weissella confusa both biochemically using API 50 CH and molecularly based on 16S rDNA sequence homology-based method. The fermentation time significantly affected EPS production (P<0.05). Isolate B (W. confusa) produced the highest EPS (10.41 g/L) at 36 h with a cell viability of 6.5 × 108 CFU/mL. Furthermore, the FTIR results of EPS showed absorption bands characteristic of carbohydrates, including O-H, C-H, C=O, C-O-C and α-1,6 glycosidic groups. The EPS in this study was most likely a dextran type. Conclusion, significance and impact of study The yield of EPS production was influenced by fermentation time. Results suggest that W. confusa isolated from peanut milk had a good ability for EPS production. Therefore, it can be considered further to apply this strain for the production of EPS. However, further research is required.

Aims: This study aims to determine the antibacterial potential and identify the bioactive compounds of Hypoxylon monticulosum isolated from marine macroalgae Ulva lactuca. Methodology and results : Ulva lactuca was collected from the Desaru coast, Johor, Malaysia and three endophytes were isolated following surface sterilisation. One fungal isolate was further characterised by the morphology of white, yellowish colonies and fibrous with a waxy structure indicative of a member from the genus Hypoxylon. Molecular identification through internal transcribed spacer (ITS) sequence analysis matches the reference sequence with more than ≥98% homology to Hypoxylon monticulosum AS26-D8. Minimum inhibition concentration (MIC) of the fungal ethyl acetate (EA) extract was determined against five human pathogenic bacteria. Wide spectrum antibacterial activity was noted; with MIC against Escherichia coli was 1.25 ± 0 mg/mL, Bacillus subtilis and Enterobacter faecalis both at 5.00 ± 0 mg/mL, and finally, both Staphylococcus aureus and Klebsiella pneumoniae were 10.00 ± 0 mg/mL, respectively. Bioassay-guided fractionation was performed using solvents of increasing polarities, producing three fractions and analysis by liquid chromatography-mass spectrometry (LC/MS) identified 128 compounds. From these, nine compounds were identified as having biological activities. Dihydrocordoin, D-pantothenoyl-L-cysteine, caffeine and Tumonoic A acid were among the compounds identified as having antibacterial properties. Conclusion, significance and impact of study Hypoxylon monticulosum from marine source has antibacterial potential owing to the compounds previously reported to display antibacterial and other biological properties. The compounds differ from those previously reported in H. monticulosum from terrestrial sources.

CHARACTERISTICS OF SMEAR-POSITIVE PULMONARY TUBERCULOSIS WITH NORMAL CHEST RADIOGRAPHIC FINDINGS DURING A TUBERCULOSIS OUTBREAK IN NORTHEAST MALAYSIA: A CROSS-SECTIONAL STUDY Introduction: Tuberculosis (TB) remains a highly prevalent disease in Malaysia. Early identification using cost-effective methods such as chest radiography can reduce the health burden of a TB epidemic. However, normal chest radiographic findings are common. This study aimed to evaluate the characteristics of smear-positive pulmonary TB with normal chest radiographic findings during an outbreak. Methods: A cross-sectional study was conducted by reviewing the medical records of 56 pulmonary TB cases registered at Kodiang Health Clinic from April to October 2022. Smear-negative and extrapulmonary TB cases were excluded. Relevant information was extracted from the medical records and recorded in a case report form for data management and analysis. Results: Approximately 60.7% of the cases had symptoms lasting >2 weeks, and 89.3% showed abnormal findings upon clinical examination. Additionally, 73.2% had sputum acid-fast bacilli counts of ≥1+, and the sputum Mycobacterium tuberculosis culture and sensitivity test findings were positive in 82.1% of the cases. The proportion of smear-positive pulmonary TB with normal chest radiographic findings was 42.9%. The factors associated with smear-positive pulmonary TB with normal chest radiographic findings included being under 18 years old (P=0.021), being a student (P=0.010), being single (P=0.012) and being asymptomatic (P=0.04). Conclusion: Normal chest radiographic findings may lead to a misdiagnosis of smear-positive pulmonary TB, especially during an outbreak. Therefore, active case detection among close contacts with risk factors for normal radiographic findings should consider additional supportive tests.

Purpose: We investigated research barriers among Jordanian medical postgraduates to understand the current context of the local health research landscape and improve scholarly output. Methods: Using a validated questionnaire, Jordanian interns, residents, specialists, and consultants were examined for their perceived attitudes and barriers towards research. Participants were conveniently sampled from public, university, military, and private institutions. Differences in responses were examined using the Student t-test and analysis of variance. Binary logistic regression was utilized to examine predictors of being able to publish. Results: A total of 1,141 Jordanian medical postgraduates were recruited, of which 61.3% were junior postgraduates (i.e., interns and residents in their first 2 years of residency) while 38.7% were senior postgraduates (i.e., senior residents, specialists, and consultants). Around 76.0% of participants had no peer-reviewed publications. Of those with least one publication (n=273), only 31.1% had first authorships. Participants portrayed dominantly positive attitudes towards the importance of research. There were no significant differences between junior and senior postgraduates for overall attitudes (p=0.486) and knowledge barriers scores (p=0.0261). Conversely, senior postgraduates demonstrated higher mean organizational barriers (p<0.001). Seniority (odds ratio [OR], 5.268; 95% confidence interval [CI], 3.341–8.307), age (OR, 1.087; 95% CI, 1.019–1.159), academic standing (OR, 1.730; 95% CI, 1.103–2.715), and confidence (OR, 1.086; 95% CI, 1.009–1.169) were positive predictors of publication in peer reviewed journals. Conclusion The Jordanian medical research landscape is riddled with all forms of different barriers. The reworking of current and integration of new research training programs are of utmost importance.

Background: Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer. Methods: A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCOm2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening. Results: A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening. Conclusion Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.