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.

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.

Madam S, who diagnosed to have stage IV lung adenocarcinoma with exon 21 L858R point mutation (T3N2M1a) was admitted for massive pericardial effusion in April 2016. She was ECOG 4 on admission. Her ECOG improved to 1 after pericardial tapping and initiation of free sample erlotinib 100 mg daily. Repeated CT thorax post treatment showed the disease was partial responded. Due to financial constraints, she had never bought any EGFR-TKI. She was given a free sample of erlotinib intermittently for total of 12 months followed by intermittent afatinib supply for 2 years. Due to this limited supply, she took half doses of afatinib by cutting a 40 mg tablet once every few days to sustain the continuation of cancer treatment. No major side effects were observed and she remained ECOG 0 with good weight gain. Up to her last clinic visit in September 2021, her PFS was more than 5 years. Intermittent doses of EGFR-TKI may prolong PFS in patients with advanced EGFRm+ NSCLC who has limited treatment options.

Introduction: Childhood anxiety is one of the common mental health problems in children. Untreated childhood anxiety will lead to a higher risk of developing mental health problems in adulthood. Thus, this study aimed to investigate the relationship between parental emotional styles and family values to anxiety level among primary school children. Methods: A cross-sectional study was conducted in a selected primary school in Kelantan, Malaysia. A set of questionnaires consisted of the Revised Child Anxiety and Depression Scale–Parents’ Report (RCADS-P 25), the Parental Emotional Style Questionnaire (PESQ), and the Asian Family Characteristics Scale (AFCS) was used for assessing anxiety, parental emotional styles, and family values, respectively. Data were collected via an online survey using Google Form, and were analysed using Multiple Linear Regression (MLR) to determine the factors associated with childhood anxiety. The significance value was set at p < 0.05. Results: A total of 150 parents of primary school children from the selected school was involved in this study. The majority of respondents were females (82.0%), married (94.7%), hold a degree (66.7%), and were working in the government sector (60.0%). Most of the respondents’ child were twelve years old (20.7%) and males (62%). Based on the MLR, emotional dismissing parental style (p = 0.025) and family values (p = 0.016) were significantly associated with anxiety in these children. Conclusion: Emotional dismissing parental style and family values were significant predictors of anxiety in primary school children. Future intervention research on childhood anxiety is needed.