IIUM Medical Journal Malaysia (IMJM)
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Prevalence and intervention of malnutrition risk of Malaysian elderly living in the community: A literature review
Get PDFIntroduction: Malnutrition among the elderly is a concern around the globe, including in Malaysia due to its negative effects to health. The aims of this review are to identify prevalence of malnutrition risk in Malaysian elderly living in the community; and to identify the types of nutrition intervention provided to the elderly following malnutrition risk identification. Methods: Literature searches were undertaken using online databases and a manual search. Main keywords used for literature search strategy were malnutrition, elderly and Malaysia. Inclusion criteria for the literature searches are studies performed in Malaysian community, using either nutrition screening or assessment tool and elderly aged ≥60 years old. Exclusion criteria are studied among hospitalized elderly, conducted in nursing homes, validation and development studies of nutrition screening tool. Results: Four published studies were eligible to be included in the review. The studies showed that prevalence of malnutrition in the Malaysian elderly living in the community is approximately 1.3% - 36.3%. A range of 25.3% to 48.5% elderly was reported to be at malnutrition risk. All of the identified studies were cross-sectional studies; whilst none of the studies provided nutrition intervention to the elderly. Conclusions: Alarming rates of malnutrition risk of Malaysian elderly living in the community has been identified. Appropriate nutrition intervention for malnourished and at risk elderly should be targeted to improve nutritional status and prevent health deterioration. Further evaluation of effectiveness of nutrition intervention following malnutrition risk identification is warranted in future studies
Piper sarmentosum induced apoptosis via mitochondrial pathway in human lung adenocarcinoma cells, A549
Get PDFIntroduction: Lung cancer has been reported as one of the most common types of cancer worldwide. Current cancer treatments like chemotherapy do not result in a complete cure and are known to cause side effects in the patients. Therefore, alternative treatment strategies are being explored, one of which is to investigate the potential of the local herbs in this regard. Piper sarmentosum (daun kaduk) has received much attention due to its anti-cancer properties in A549 cells. In this study, the cell cycle profile and mechanisms of cell death induced by P. sarmentosum were investigated using a flow cytometer. Methods: The cell cycle profile changes were observed using propidium iodide staining while the type of cell death was analyzed using Annexin-V assay. Caspases -3/7,8 and 9 and cytochrome c assays were elucidated using flow cytometry analysis. Results: P.sarmentosum arrested the growth of A549 cells at G0/G1 phase. The Annexin V analysis revealed that P. sarmentosum exhibited significant induction of apoptosis after 24 h exposure. Caspases analysis showed that P. sarmentosum induced apoptosis through mitochondrial pathway, via the activation of caspase 3 and caspase 9. Meanwhile, cytochrome c analysis revealed that P. sarmentosum induced a mitochondrial pathway of cell death through the release of cytochrome c. Conclusions: Based on these preliminary findings, P. sarmentosum has a great potential as a dietary cancer treatment for lung cancer and may perhaps be used for lung cancer pharmacotherapy in the clinical settings in future
Comparison of Ex-Vivo X-Ray changes in different groups of injectable biomaterials (JectOS, MIIG®X3, Osteopaste) in critical size defect of Rabbit Tibia Bone
Get PDFIntroduction: Critical size defect (CSD) is defined as a defect that will not heal without intervention within the lifetime. The gold standard treatment for CSD is bone graft, although with some limitations. Substitute biomaterials were introduced to overcome the limitations. JectOS and MIIG® X3 are commercially available biomaterials in the market. Osteopaste is a local product produced by SIRIM. The objective of this study is to compare the radiological changes between Osteopaste, JectOS and MIIG® X3 in CSD in rabbit tibia bone. Methods: New Zealand White rabbits were divided into four groups: control group (Sham operation, n=3); Osteopaste treatment (n=12); JectOS treatment (n=12) and MIIG® X3 treatment (n=12). CSD was created at the right proximal tibia bone of the rabbits in each of the groups and the defects were filled with the biomaterial as assigned. Four animals from each group were sacrificed at 6 weeks, 12 weeks and 24 weeks respectively. The bones were harvested and x-ray imaging performed using SkyScan 1176 at 90kV, 281µA, resolution 4000x2672 with Aluminium 1.0mm. Results: The radiographic density at the CSD area was more prominent in the JectOS group throughout the 24 weeks. Meanwhile, in the MIIG® X3, full resorption occurred at 24 weeks. The Osteopaste group exhibited radiographic density in between that of JectOS and MIIG® X3. Conclusions: Different types of biomaterial exhibit different radiological changes over the period of bone healing
Effect of Sarang Semut Plant Extract (Myrmecodia Pendens) on wound healing of extracted tooth socket in Sprague Dawley rats
Get PDFIntroduction: Sarang semut (Myrmecodia Pendens) is a well-known traditional medication used by indigenous people of Papua for many diseases such as cancer, rheumatism, and ulcers. However, scientific publication of its curative properties is still lacking. This study was designed to investigate the effect of sarang semut extract on the healing process of tooth socket in Sprague Dawley rats. Methods: Thirty six adult male rats were randomly divided into six groups of six animals each. Group 1 served as a control group (no extraction). While Group 2 and 3 served as a negative control and positive control respectively. Immediately after the extraction of the right lower first molar tooth, the alveolar socket was treated with 1.5% sarang semut paste (SSP) (Group 4), 3% SSP (Group 5) and 5% SSP (Group 6). Two rats from each group were sacrificed at day 4, 7 and 18 consecutively. The extracted tooth socket was sectioned and stained with H&E stains. Soft tissue healing score of ≥ 16 indicates good healing has occurred. Whereas new bone formation of grade 2 and 3 indicates a fair and good percentage of newly deposited bone formation, respectively. Results: Histological analysis showed that soft tissue healing score for 3% SSP groups was highest (mean=19) when compared to all groups at day 18 after tooth extraction. All groups showed a good increase in the amount of bone trabeculae formed with mean grade of 2. Conclusions: This finding suggests that 3% SSP has a promising therapeutic effect on soft tissue intraoral wound healing
Absorbance value in middle-aged and older adult population using wideband tympanometry
Get PDFIntroduction: Wideband tympanometry is a new version of tympanometry available for audiology clinics. The scarcity of information on middle-aged and older adult population leads to study. This study focuses on ear effect, tests re-test reliability, measurement of absorbance according to different age group and comparing current study finding with established normative. Methods: 27 participants (15 men, 12 women, and aged 50-73 years) which comprised of 13 adults with age more than 50 years, 10 adults that aged more than 60 years and 4 adults that aged more than 70 years were assessed using wideband tympanometry. Energy absorbance data were collected at 15 frequencies using a tympanometry developed by Interacoustics. Each side of the ear of the participants was measured three times. Results: An independent t-test and repeated measure ANOVA was done respectively showed that there is no variability observes on ear effect and test re-test reliability. Measurement of absorbance according to age group showed significant difference in middle-aged adults (50 years old group and 60 years old age group, Z= -2.593, p= 0.03) while no significant differences observed between middle-aged and older adults. The mean of absorbance was found to be higher than the other studies at 257 Hz until 1587 Hz and pattern were reverse for frequency 3174 Hz above. Conclusions: This study provides evidence of ear effect, test re-test reliability, and age of measurement of absorbance in middle-aged and older adult population. This finding supports the important establishing age specific norm starting from the middle-aged population
Perforated Incisional Littre’s Hernia: A Rare Content of a Common Hernia
Get PDFAnticipation of complications is of paramount importance for a surgeon. Incisional hernia is a well-known complication for abdominal surgeries. Risk factors such as increasing age, obesity, male gender are well known. Intestinal obstruction, strangulation and perforation are imminent complications of this type of hernia if they become incarcerated. Common contents of a ventral incisional hernia are small bowel, large bowel and omentum. Even though Meckel’s diverticulum is a common gastrointestinal anomaly, it is rarely found to be the content of a hernial sac. A hernia sac containing Meckel’s diverticulum is also known as Littre’s hernia. Only a few cases have been reported in the literature. Thus here we present a case of perforated Meckel’s diverticulum that was entrapped in the ventral incisional hernia
Antidiabetic activity of curry leaves Murraya koenigii on glucose level, kidney and islets of langerhans in streptozotocin induced diabetes in rats
Get PDFIntroduction: This study examined the antihyperglycemic effect of curry leaves, Murraya koenigii “MK” aqueous extract, and to examine its possible protective effects on the Islets of Langerhans and kidneys in streptozotocin (STZ) induced diabetic rats. Methods: Thirty healthy adult male Sprague Dawley rats were randomized into five groups (n=6); normal control, normal treated with “MK” control, diabetic control (non-treated with “MK”), diabetic treated with 200mg/kg MK aqueous leaf extract and diabetic treated with 400mg/kg MK aqueous leaf extract. Blood glucose levels and body weight were monitored. The animals were sacrificed on the 30th day; the kidney and pancreatic tissues were processed for histological studies. Results: The diabetic control group significantly (p<0.001) showed considerable loss of body weight and increase in blood glucose levels and degeneration of the glomeruli and renal convoluted tubules and atrophied islets with disintegration of β-cells. Treatment of diabetic rats with aqueous extract showed significant (p<0.001) improvement in blood glucose levels and body weight gain. The MK extract also caused an improvement in tissue injury induced by STZ injection in the kidney and endocrine pancreas. Conclusions: These findings highlighted the beneficial effects of MK aqueous extract against cellular oxidative damage in STZ-induced diabetic rats
The research methodology for malnutrition risk identification and dietary practices among community living elderly
Get PDFIntroduction: Nutrition screening is an initial procedure to identify malnutrition, whilst subsequent nutrition intervention is warranted for at risk individuals. However, none of nutrition screening studies conducted among Malaysian elderly, accompanied by individualized nutrition intervention. The objective here is to describe the methodology to determine malnutrition risk and nutritional status of elderly in community at baseline and after 3 months of nutrition intervention; and to assess perception of elderly on their dietary practices. Methods: Elderly aged ≥ 60 years will be recruited as participants at several FELDA in Terengganu and Pahang with the calculated sample size of 416. Nutrition screening will be performed to identify malnutrition risk using a validated nutrition screening tool for the elderly in the community; the Mini Nutritional Assessment-Short Form. Dietary intake will be assessed using the diet history method and individualized nutrition intervention will be provided to improve nutritional status. Nutrition screening and assessment will be repeated after three months for malnourished and at risk elderly. An in-depth individual interview will be conducted to assess perception on dietary practices particularly prophetic food intake. Quantitative and qualitative data will be analyzed using IBM SPSS software and NVivo software, respectively. Results: Nutritional status of the elderly is anticipated to improve after 3 months of nutrition intervention and the elderly will perceive that their dietary practices are good. Conclusions: This research is at the forefront to provide individualized nutrition intervention following nutrition screening among Malaysian community elderly. It can potentially prevent further health complications associated with malnutrition through timely malnutrition identification and nutrition intervention
Antibiotic susceptibility study of metal-gentamicin complexes against Pseudomonas aeruginosa biofilms
Get PDFIntroduction: Inherent resistance of biofilm bacteria to conventional antibiotics is alarming because biofilms induce antibiotic resistance to an order of three or more in magnitude greater than those displayed by planktonic bacteria. Pseudomonas aeruginosa is an infectious organism that causes the hallmark of chronic infections including hospital acquired infections that leads to high morbidity and mortality. One of the reasons for the occurrence of resistance is its ability to form biofilms. In this study, the resistance of P. aeruginosa biofilms against a series of metal-antibiotics, an alternative to the conventional antibiotics, was investigated. Methods: A series of metal-antibiotic complexes derived from gentamicin was synthesized to give metal-gentamicin complexes. The metal contents of all the compounds were determined using Atomic Absorption Spectroscopy (AAS). Antibiotic susceptibility testing of the gentamicin-antibiotic complexes against the biofilms was conducted using broth microdilution assay. Results: The results showed that P. aeruginosa is susceptible against all the metal-gentamicin complexes, which include, Ni(II), Fe(II), Cu(II), Zn(II) and Co(II) complexes; all were tested at 0.25 to 1 mmol concentrations. Conclusions: The results show that all metal-gentamicin complexes have higher antimicrobial activity than gentamicin (0.25 to 1 mmol) on its own. Finally, mechanisms of P. aeruginosa biofilms resistance to these metal-antibiotics are also proposed
Success rate of endodontically treated patients attending polyclinic, Kulliyyah of Dentistry, International Islamic University Malaysia
Get PDFIntroduction: The aim of this study is to determine the success rate of the endodontically treated teeth in patients attending the Polyclinic, Kulliyyah of Dentistry IIUM from 2012 to 2015. Methods: A retrospective study involved endodontically treated teeth of patients attending the Polyclinic, Kulliyyah of Dentistry IIUM from 2012 to 2015. Clinical and radiographic data were recorded and classified as successful or failed, and further analyzed by Fisher’s exact test to measure the correlation between the variables by using SPSS software version 16.0. Kappa test was used to measure the overall relationship between clinical and radiographic findings. Results: The overall success rate of the endodontically treated teeth is 85% (n= 51). Correlation between the variables showed no significant (p> 0.05) in the success rate among age groups, between gender, diagnosis and race at the time of treatment, between upper and lower arches, and between anterior and posterior tooth. Correlation between the variable of post-endodontic fixed restorations showed statistically significant in the success rate (p< 0.05). Conclusions: High success rate 85% among patients with no signs and symptoms and with no radiographic changes of post-endodontic fixed restorations. Age, gender and race have no significant relations on the success rate of endodontically treated teeth