IIUM Medical Journal Malaysia (IMJM)
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Bilateral total knee replacement in severe knee osteoarthritis with large bone defect using autologous bone graft augmentation
Get PDF40 years old malay gentleman with underlying gout presenting with severe pain in both knees for 10 years, analgesic dependant and wheelchair ambulation. Examination of right knee shows fixed flexion at 10 degrees, range of movement 10-100 degree flexion, lateral collateral laxity and varus deformity. Left knee had fixed flexion at 10 degrees, range of movement 5-100 degree and varus deformity. Blood investigation showed uric acid. X-ray of bilateral knee showed severe tricompartmental arthritis with large medial tibial defect. The patient has undergone bilateral knee replacement in 5 months interval started with left knee. Surgical technique is the same for both knees, intraoperative shows a large posteromedial bone defect. We used 5mm metal augmentation on the right knee, but due to limited financial resources, we have to use the bone graft from the osteotomized bone for the augmentation on the left side. The bone augmentation was fixed with cancellous screw. The patient was referred to physiotherapy for range of motion exercises. 1 year post operatively patient able to ambulate without aid. Pain score improved. The patient does not require analgesia. Functional and knee score is excellent. Range of movement, bilateral knee are 0-100 degree. Radiological finding shows no evidence of construct failure in both metal block and bone graft construct. Severe arthritis with bone defect is common due to late presentation. Using autologous bone graft can provide good result as using expensive meta block for reconstruction
Evaluation of the phytochemical content and the use of the essential oil from the leaves of Malaysian Plectranthus amboinicus (lour) spreng as antimalarial in vivo
Get PDFIntroduction: This study was conducted to evaluate the phytochemical contents and antimalarial properties of the essential oils extracted from the leaves of Malaysian Plectranthus amboinicus in mice infected with Plasmodium berghei. Methods: The essential oils were extracted and prepared by using a steam distillation technique and subjected to phytochemical screening by using gas chromatography–mass spectrometry (GC-MS). The antimalarial activity of different extract doses of the essential oil was tested in vivo in ICR (Instritute of Cancer Research) mice infected with Plasmodium berghei (PZZ1/100) during early, established and residual infections. The control groups were treated with distilled water (containing 10% DMSO, the solvent of the test extracts) and 2 standard drugs: chloroquine and Fansidar. Results: In all, 5 compounds made up 88.34% of total oil and the major chemical compounds were carvacrol (85.14%), thymoquinone (1.65%), terpinen-4-ol (0.70%), octenol (0.62%) and thymol (0.23%). Antimalarial assay showed this essential oil as a potential prophylactic agent with the percentage chemosuppression of 45.23%, 18.28%, 45.38% and 58.26%, while treated with 50, 200, 400 and 1000 µL/kg respectively of essential oil. It also showed a potential as a curative agent with percentage of chemosuppression of 54.10%, 47.35%, 56.75% and 65.38% while treated with the above dose of essential oil. Statistically, no reduction of parasitemia was calculated for suppressive test. Conclusions: The extract has prophylactic and curative effects on P.berghei in mice
Awareness of public in Kuantan on the roles and services provided by an audiologist
Get PDFIntroduction: Prevalence of disabling hearing loss among Malaysians is 5%, according to Malaysia’s Health Survey. The need for audiological service is clear. Despite the urgencies in hearing-related health issues, there is not much known about public awareness of the audiologist’s role and services especially in Kuantan. This current study aims to explore this matter. Methods: Self-administered questionnaires consisting 2 sections were distributed randomly in public in Kuantan. Section A comprises of participants’ sociodemographic information (i.e. gender, race, age, occupation, and level of education). Section B consists of Part a: Familiarity with Audiological Services, Part b: Knowledge on Role and Services of Audiologists, and Part c: Source of Information. 56 respondents were involved. Results: 66.07% of subjects (n=37) claimed they knew about the audiologist existence in Malaysia and 33.93% (n=19) claimed otherwise. There is no significant association between sociodemographic information with the awareness on audiologist existence and also the knowledge that respondents were regarding audiologist role and services. There is a significant association between participants' awareness on the audiologist existence in Malaysia with their familiarity with audiologists (p-value = 0.006). There is also a significant association between the responder awareness with their knowledge on audiologist role and services (p-value = 0.006). However, there is no association between respondents’ familiarity with audiologists and their knowledge on audiologist role and services. Conclusions: Public awareness on audiologists role and services in Kuantan is fair
Flooding impact on distribution of pathogenic bacteria in Pahang river
Get PDFIntroduction: Pahang River is one of the important inland aquatic biodiversity resources that provides major economic activities along the river. It is an excellent source of food and habitat for organisms including microorganisms leading to higher bacterial diversity. This analytical study determines the impact of flooding event to the bacterial distribution and pathogenic bacteria in the river. Methods: Sampling was done during pre-monsoon and post monsoon seasons. Water samples were taken at 19 stations along the Pahang River. Bacterial was isolated from the water samples using cultivation method. Subsequently DNA from the isolated bacteria was extracted using conventional method. 16s RNA was used in the study to amplify the bacterial DNA. Following restriction fragment length polymorphism (RFLP), selected bacteria were sent for sequencing to the First Base company. The sequences were then analyzed using blast from NCBI to obtain the bacterial name. Results: Here, we evaluated the colony forming unit (CFU) and the presence of potentially pathogenic bacteria in the river before and after the flood event in 2014. The CFU calculated was lower before the flooding event and Bacillus sp. were found in many of the water samples. After the flooding event pathogenic bacteria such as Klebsiella pneumoniae, Serratia marcescens and Enterobacter cloacae were discovered while the CFU calculated was shown to be higher. Conclusions: The pathogenic bacteria diversity was increased after the flood in 2014 in Pahang River. The river became contaminated with various types of potential human bacterial pathogens which might pose a health risk to the public
The investigation of cytotoxic effects of Cinnamomum zeylanicum on human breast cancer cell line (MCF-7)
Get PDFIntroduction: Cinnamon is one of the oldest herbal medicines that has been traditionally used as flavouring agent, insecticidal, antifungal and also as tooth powder to treat dental problems. Nowadays cinnamon is used in pharmaceutical preparations, perfume production, chemical industry and food industry as seasonings. In this study, the cytotoxicity of the cinnamon extracts towards human breast cancer cell line (MCF-7) was investigated. Methods: Cinnamomum zeylanicum was extracted using Soxhlet extraction method with methanol as the solvent, producing 7.06% of yield extract. The extract was analysed using gas chromatography/ mass spectrometry (GCMS). Results: The result showed that cinnamaldehyde was the major constituent, forming 74.14% of the total constituents. The cytotoxicity of C. zeylanicum extract against MCF-7 was determined through colorimetric MTT assay. It was demonstarted that the IC50 of extracts at 24 hours and 48 hours of incubation period was 48 µg/ml and 140 µg/ml respectively. Conclusions: The cinnamon methanolic extract possess cytotoxic effects on human breast cancer cell lines
Hearing impairment among scuba divers in Kuantan and neighbouring regions
Get PDFIntroduction: Hearing impairment has been listed as one of the health risks associated with scuba diving. Evidence of hearing loss associated with inner ear barotrauma was found in previous studies. This cross-sectional study investigates the relationship between hearing status and years, depth and total hours of diving. Methods: Thirty male divers from Kuantan and neighbouring areas, with age ranging between 22 and 45 years old, were recruited as subjects. Details regarding diving activity were gathered using a set of questionnaires. Assessment of hearing status was done using otoscopic examination, tympanometry, pure tone audiometry (PTA) and distortion-product otoacoustic emission (DPOAE). Results: Fifteen subjects were found to have sensorineural hearing loss at high frequencies. Pearson's correlation showed no significant correlation between pure tone hearing thresholds and years, depth and total hours of diving. Significant negative correlation was found between DPOAE at 6 kHz on the left ear and years of diving (r= -0.378, p= 0.04) and depth of diving (r= -0.404, p= 0.027). Conclusions: These findings indicate that scuba diving activity may affect cochlear function, particularly in the basal region of the cochlea
Quantification of Total Phenolics Content and Their Antioxidant Scavenging Capacity in Selected Herbs Extract
Get PDFIntroduction: G. procumbens, H. sabdariffa and C. nutans contain potential compoundsthat lead to the development of drugs and supplements. The quantification of phenoliccompound was conducted by analyzing the compounds at 3 different fractions (free,insoluble bound and soluble bound). Thus, the objectives of this research were todetermine TPC and antioxidant of the plants in three different extracts. Methods: Threereplicates of the medicinal plants were extracted with 80% methanol and hydrolysis withHCl and NaOH. The TPC was determined by using Folin-Ciocalteau reagent whileantioxidant radical scavenging capacities were analyzed by using the DPPH assay. Results:Results showed that the TPC of the G. procumbens and C. nutans extracts of the insolublebound extract had the highest amount of phenolic compounds (15.19 ± 0.25 mg of GAE/gand 6.09+ 0.45 mg gallic acid equivalent GAE/g DW, respectively) as compared to theother fractions (p<0.05). In contrast, H. sabdariffa had the highest TPC value inboundsoluble phenolic compound (7.63 + 0.28 mg GAE/g DW) than the other fractions (p<0.05).The antioxidant scavenging capacity of the G. procumbens and C. nutans extracts showedthat highest IC50 values in the insoluble bound extract > free > soluble bound extract,whereas the bound soluble of H. sabdariffa showed highest IC50 value > free >boundinsoluble phenolic extracts. Conclusions: Strong correlations were found between TPCwith antioxidant radical scavenging capacity. This finding proved that these three plantscould be a good source of natural antioxidant for food, cosmetic and pharmaceuticalindustry
The effect of particle size, methods and time of extraction on the natural antioxidant content and radical scavenging activity of Phyllanthus niruri
Get PDFIntroduction: Phyllanthus niruri has a high antioxidant capacity due to high phenolic and flavonoid content. This study is to determine and evaluate the effect of particle size, methods and time of extraction on its antioxidant activities. Methods: P. niruri was dried overnight in drier at 40˚C and grounded to different particle sizes. The extraction methods by using a rotary evaporator were soxhlet and maceration.Three types of biochemical assays were conducted: total phenolic content (TPC), total flavonoids content (TFC) and 1,1-Diphenyl-2 picrylhydrazyl (DPPH) radical scavenging activity assay. Result: The best TPC and DPPH value are recorded for the sample of less than 0.7 mm, treated by a soxhlet extraction method at 8 hours extraction time with TPC valued at 4.95 ± 0.803 mg GAE/g of dried extract and IC50 value of 0.403 ± 0.03790 mg/mL respectively. The highest TFC amount is recorded for the sample treated at less than 0.7 mm particle size, by the maceration method of extraction and at 8 hours extraction time with the total flavonoid content of 56.43 ± 0.594 mg QE/g of dried extract. Conclusions: It can be concluded that there are a synergistic effect between TPC and TFC on the quality of the anti-radical property of the sample affecting DPPH activity within the sample
Clinical and Histopathological Relevance of Helicobacter pylori BabA2 Genotype
Get PDFIntroduction: H. pylori BabA is an outer membrane protein that mediates bacterial adherence to the gastric epithelium, triggers several pathways during the course of infection, and thus contributes to the disease development. Considering the variability in the presence of BabA coding gene (babA2) among H. pylori clinical strains, the aim of this study was to assess the relationship between the genotype status of H. pylori babA2 and the severity of clinical and histopathological outcomes. Methods: Gastric mucosal biopsy specimens were collected from 30 CLO test-positive patients, 16 with gastritis and 14 with peptic ulcer disease. Polymerase chain reaction was carried out to detect the presence of H. pylori-specific glmM gene and BabA coding gene (babA2). Histopathological examination was performed to evaluate the severity of H. pylori-associated gastric disease according to the Updated Sydney Classification System. Results: The glmM and babA2 genes were present in 100% and 86.7% of the tested H. pylori strains, respectively. Although higher degrees of inflammatory activity and H. pylori density were noted in babA2-positive biopsy specimens, there was no statistically significant association between babA2 genotype status and the severity of gastric disease. Conclusion: The babA2 genotype status of H. pylori may not be considered as a sole marker for determining the infection outcomes
Quantification of anti-fertility compound-Diosgenin concentration in the fenugreek seeds aqueous extract (FSA)
Get PDFIntroduction: This study aims to build a standardization method for preparation of effective powder from FSA and to quantify diosgenin in FSA. Methodology: One kg of FS were used in this study. Setting: BMS, KOM and KOP, IIUM Kuantan campus. FS were washed with distilled water to exclude any foreign matter, and were then air dried. FS-powder were put in distilled water in a ratio of 1 g of powder in 20 ml of distilled water and were shaken at room temperature for 24 hours. Ten mg of hydrolyzed extract sample was diluted in 10 ml volumetric flask with methanol for 15 minutes. Chromatographic estimation was performed using an equilibrated reverse phase Eclipse XDB-C18 column (particle size 5 µg, 4.6 mm x 150 mm). Results: One gram of FSA extract was hydrolyzed to produce sapogenins and 46.6% was recovered. A calibration curve that was constructed based on five dilutions of diosgenin standard at concentrations of 2, 5, 10, 20, 30 and 50 ppm produced a linear graft (r = 0.999). The concentration of diosgenin in FSA extract as calculated using the regression analysis was found to be 29.66 µg/ml, 13.81 % w/w on dried weight basis. Conclusion: Preparation and standardization of effective powder from FSA are the corner stone of many scientific researches in IIUM and Malaysia. Diosgenin is available in the FSA in adequate concentration. The adequate amount of diosgenin in the FSA will guide us to do further study in the way of preparation of a natural product that can be used in the field of reversible anti-fertility therapy