Objective: Osteoarthritis (OA), particularly knee OA, affects 24% of adults and is a significant cause of disability. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used but have many adverse effects. Antioxidant and anti-iflammatory properties of Curcuma longa might decrease pain thus improving joint function. Methods: This systematic review and meta-analysis evaluated randomized controlled trials (RCTs) on Curcuma longa efficacy for knee OA. We reported mean differences (MD) with 95% confidence interval (CI) for continuous outcomes and evaluated Visual Analog Scale (VAS) for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) total score over 4 to 6 weeks for treatment effects. Results: Ten RCTs with 786 patients were included. Curcuma longa significantly improved VAS for pain than placebo (MD:18.25, 95% CI: 7.79 to 28.72, p=0.0006). It was not inferior to NSAIDs in WOMAC total score improvement (MD: –11.99, 95% CI: –39.21 to 15.23, p=0.39). Both dosages (<1,000 and ≥1,000 mg/day) of Curcuma longa demonstrated similar improvement in VAS for pain compared to placebo (MD: 27.02, 95% CI: 1.45 to 52.60, p=0.04; MD: 21.48, 95% CI: 1.78 to 41.18, p=0.03). Conclusion Curcuma longa benefits knee OA pain and function, being more effective than placebo and comparable to NSAIDs.Despite positive results, limitation and heterogeneity of the studies necessitates further research to explore optimal dosages and administration methods of Curcuma longa as therapeutic option for knee OA.

Objective: Osteoarthritis (OA), particularly knee OA, affects 24% of adults and is a significant cause of disability. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used but have many adverse effects. Antioxidant and anti-iflammatory properties of Curcuma longa might decrease pain thus improving joint function. Methods: This systematic review and meta-analysis evaluated randomized controlled trials (RCTs) on Curcuma longa efficacy for knee OA. We reported mean differences (MD) with 95% confidence interval (CI) for continuous outcomes and evaluated Visual Analog Scale (VAS) for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) total score over 4 to 6 weeks for treatment effects. Results: Ten RCTs with 786 patients were included. Curcuma longa significantly improved VAS for pain than placebo (MD:18.25, 95% CI: 7.79 to 28.72, p=0.0006). It was not inferior to NSAIDs in WOMAC total score improvement (MD: –11.99, 95% CI: –39.21 to 15.23, p=0.39). Both dosages (<1,000 and ≥1,000 mg/day) of Curcuma longa demonstrated similar improvement in VAS for pain compared to placebo (MD: 27.02, 95% CI: 1.45 to 52.60, p=0.04; MD: 21.48, 95% CI: 1.78 to 41.18, p=0.03). Conclusion Curcuma longa benefits knee OA pain and function, being more effective than placebo and comparable to NSAIDs.Despite positive results, limitation and heterogeneity of the studies necessitates further research to explore optimal dosages and administration methods of Curcuma longa as therapeutic option for knee OA.

Objective: Osteoarthritis (OA), particularly knee OA, affects 24% of adults and is a significant cause of disability. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used but have many adverse effects. Antioxidant and anti-iflammatory properties of Curcuma longa might decrease pain thus improving joint function. Methods: This systematic review and meta-analysis evaluated randomized controlled trials (RCTs) on Curcuma longa efficacy for knee OA. We reported mean differences (MD) with 95% confidence interval (CI) for continuous outcomes and evaluated Visual Analog Scale (VAS) for pain and the Western Ontario and McMaster Universities Arthritis Index (WOMAC) total score over 4 to 6 weeks for treatment effects. Results: Ten RCTs with 786 patients were included. Curcuma longa significantly improved VAS for pain than placebo (MD:18.25, 95% CI: 7.79 to 28.72, p=0.0006). It was not inferior to NSAIDs in WOMAC total score improvement (MD: –11.99, 95% CI: –39.21 to 15.23, p=0.39). Both dosages (<1,000 and ≥1,000 mg/day) of Curcuma longa demonstrated similar improvement in VAS for pain compared to placebo (MD: 27.02, 95% CI: 1.45 to 52.60, p=0.04; MD: 21.48, 95% CI: 1.78 to 41.18, p=0.03). Conclusion Curcuma longa benefits knee OA pain and function, being more effective than placebo and comparable to NSAIDs.Despite positive results, limitation and heterogeneity of the studies necessitates further research to explore optimal dosages and administration methods of Curcuma longa as therapeutic option for knee OA.

A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.

Aim: We designed this study to compare the presence of depressive symptoms pre and 6 months post-MI and to identify the association of various biological and non-biological risk factors with the development of depressive symptoms post-MI. Objective: Coronary artery disease and depressive illness are the largest contributors to global mortality and disability. These disorders frequently occur together and have major health implications. We conducted this study to determine the frequency of increased depressive symptoms following Myocardial Infarction (MI) and analyze associated baseline risk factors. Study Design: Descriptive case series. Place and duration of study: Tertiary care cardiology hospital from Sept 2019 to Jan 2021. Patients and Methods: Patients presenting with a recent episode of myocardial infarction at the out-patient department of cardiology were recruited for this study. Demographic variables and baseline health status were recorded. Hospital Anxiety and Depression Scale (HADS) was applied in two instances, at first contact for depressive symptoms pre-MI and at the second instance 6 months post-MI. An increase in HADS score of 4 or more points after 6 months of MI was considered significant. Association of age, gender, smoking status, employment status, previous MI episode, depression and history of stressful life event with an increase in depression was analyzed. Results: The sample consisted of 140 patients, 88 males and 52 females. The mean age was 51.22 years (SD= ± 12.35). 60.7% (n=85) of patients had an increase in depressive symptoms scores as measured by HADS. Younger age (30 to 50 years), being a smoker and having a previous history of myocardial infarction were associated with a significant increase in depressive symptoms. Conclusion 60.7% of patients have increased depressive symptoms after myocardial infarction. Patients should be regularly screened for emerging depressive symptoms and special attention should be paid to younger patients, smokers and those who have a previous history of coronary artery disease.

A 35-year-old female presented with episodes of frequent dizziness, ear fullness, and right ear tinnitus for 12 months. Head imaging revealed a right glomus tympanicum tumor. She underwent pre-operative endovascular embolization of the glomus tympanicum tumor with surgical, cyanoacrylate-based glue. Immediately after the procedure, she developed drowsiness and severe pain in the right temporal region. Further investigations revealed a right cerebellar stroke in the posterior inferior cerebellar artery territory. She was treated with intravenous heparin, followed by one year of oral anticoagulation. With rehabilitation, she significantly recovered from her post embolization stroke. However, the tumor was resected at another institution. Ten years later, follow-up imaging indicated a gradual increase in the size of the glomus jugulare tumor compressing the nearby critical vascular structures. She subsequently received radiation therapy to treat the residual tumor. Currently, she has no neurological deficit, but her mild dizziness, right ear tinnitus, and hearing impairment persist.

Introduction: Malaysia has been considered an industrialized country and there is a demand for manpower in low-skilled jobs which usually filled by migrant workers. Therefore, this study focused to identify the level of alcohol consumption and its associated factors among Nepali migrant workers in Shah Alam, Selangor. Methods: A cross-sectional study using a convenient sampling method was conducted among 233 Nepali migrant workers in Shah Alam, Selangor using a selfadministered questionnaire. A validated questionnaire (The Alcohol Use Disorder Identification Test) by WHO was used in the study. Results: The results showed that 60.09% of Nepali workers consumed alcohol with most of them are in low (31.43%) and medium (29.28%) risk level for alcohol consumption. The empirical findings revealed a significant association between income, education level, and peer pressure with alcohol consumption (p value <0.001 respectively). However, the study found no association between age, marital status, years of working, and body mass index with alcohol consumption (p value= 0.44, 0.19, 0.42, 0.40 respectively). Conclusion In conclusion, most Nepali migrant workers consumed alcohol but in low and medium risk severity. The results highlighted socio-demographic factors such as income and education as well as peer pressure among the important factors affecting alcohol consumption. Thus, it is important to address this issue by creating awareness by conducting health talk and campaign. This can give a clear idea to migrant workers on the health effect of alcohol consumption. More education and promotion are needed to address the health effect of excessive alcohol consumption and work productivity among migrant workers in their own language.

Sperm-specific phospholipase C zeta (PLCζ) initiates intracellular calcium (Ca

Background/Aims: More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB). Methods: A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB. Results: Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%). Conclusion The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.