IIUM Medical Journal Malaysia (IMJM)
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Antidiabetic Efficacy of Nigella sativa Linn. in Alloxan-induced Diabetic Rabbits
Get PDFIntroduction: Diabetes mellitus (DM) is the most common metabolic disease worldwide. Multiple medications and side effects, the most significant and prevalent themes in diabetes mellitus ultimately determine novel directions and avenues in drug discovery. The present study was conducted to investigate antidiabetic efficacy of extracts of Nigella sativa Linn. seeds (NS). Methods: Alloxan-induced diabetic rabbits (n = 28) were divided into four groups, including diabetic control. Two groups were treated with NS methanol (NSM) and ethanol (NSE) extracts, and one group were given glibenclamide. Serum glucose, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) were measured by kit methods. Results: NS demonstrated hypoglycaemic and hypolipidaemic activities. Although NS treatments decreased blood glucose, TC, TG and LDL-C and increased HDL-C in diabetic groups, it was unable to normalize all the parameters. NS extracts did not regenerate β-cells of islet of the pancreas. Glibenclamide showed significant (P<0.05) decline in hyperglycaemia and hyperlipidaemia as well as prominent renewal of β-cells of islets of Langerhans. Few surviving beta cells of islet of the pancreas were apparent in NSM treated group. Standard drug glibenclamide showed a significant decline in hyperglycaemia and hyperlipidaemia as well as prominent renewal of beta cells. Conclusion: N. sativa L. extracts have curative effects in terms of diabetes-induced disturbances of glucose and lipids. Further investigations are suggested to ascertain the therapeutic role of NS on islet histopathology in diabetes mellitus
Conserved Peptide with Therapeutic Potential to Overcome Nasopharyngeal Carcinoma
Get PDFNasopharyngeal carcinoma (NPC) is a squamous-cell carcinoma that arises in the upper lining epithelium of the nasopharynx. In this study, conserved peptide (Ulin-1) of Epstein-Barr virus constructed by Biomodelling and Biocomputation was tested for its ability to stimulate B cells to produce specific antibodies. Spleen cells were isolated and cultured with anti-CD3 and lipopolysaccharide (LPS), and treated or not treated with Ulin-1. Cell culture was harvested six days after incubation and analyzed by flow cytometry. Here, we demonstrated the ability of Ulin-1 to stimulate B cells to produce specific antibodies. The results of this study illustrate the importance of Ulin-1 engineered by Biomodelling and Biocomputation as both active and passive immunization agents against nasopharyngeal cancer
Turnover Intention among Public Sector Health Workforce: Is Job Satisfaction the Issue?
Get PDFIntroduction: The paper explores turnover intention and job satisfaction among healthcare employees of Ministry of Health (MOH) Malaysia. Methods: A nationwide study was carried out in order to identify dimensions of job satisfaction and turnover intention among public healthcare employees. Data was collected by means of self-administered questionnaire and distributed based on quota sampling. Results: The study shows that public healthcare workforce is generally satisfied with their work (mean 3.45). In addition, medical specialists and assistant medical officers were found to be significantly more satisfied than other job designations. However, intention to resign was high among medical specialists, pharmacists and dentists. A high proportion of medical specialists also had received job offers from the private sector. Conclusion: The findings showed that employee turnover may not necessarily be due to job dissatisfaction, but rather due to demand from the private sector. Findings from the study would assist policy-makers with respect to talent management in public healthcare service
Assessing and Exploring the Competency of Prehospital Emergency Medical Service Personnel in Klang Valley, Malaysia: a Mixed Method Approach
Get PDFIntroduction: The notion of competency in pre-hospital emergency medical service (EMS) personnel is mainly focused on the professional proficiency that he/she has to provide intervention outside of hospital setting. Consequently, the effectiveness of pre-hospital EMS performance very much depends upon the capability of the personnel at the scene and as well during transport to the definitive care center. The aim of this study is to appraise and explore the competency of pre-hospital care staff and provide strategies for improvement. Methods: A mixed method approach combining the qualitative and quantitative study design. Of 134 staffs only 111(82.84%) returned the questionnaire. Nine semi-structured interviews and two focus group discussions were performed. The main informants were nurses/assistant medical officers, nurse/assistant medical officer administrators, and emergency physicians. Results: From the quantitative finding on the competency of staff handling pre-hospital EMS, all had the essential knowledge and skills. However, most of them reported not having good knowledge and skills for invasive procedures (31%-61%), include giving medications (61%-66%). The qualitative information provided insight about the issues and strategies for the personnel in regards to competency. All the relevant qualitative data were merged into 5 categories relating issues and 5 categories to strategies that could affect the competency of the personnel. Conclusion: Pre-hospital EMS systems need to consider that the competency of pre-hospital EMS personnel has to come along with the responsible attitude of the staff itself, the support of medical direction, clear protocol for guiding them whenever needed, and continuous professional-development courses require them to maintain their professional proficiency
Is Assisted Reproductive Technique Shari’aa-compliant? A Case Study at a Fertility Centre in Malaysia
Get PDFIntroduction: To investigate the questions that Muslim patients, embryologists, paramedics, clinical counsellor and doctors may have pertaining to the compliance of Assisted Reproductive Technique (ART) to Shari’aa. Methods: As a preliminary study, an open-ended survey was administered to participants. Participants for the survey comprised of 21 patients, 2 embryologists, 2 doctors, 4 paramedics and 1 counsellor. Results: Data analysis showed that most of the participants posed questions that fall into six classifications which are: Munakahat (Family Law), social Hukm, Fiqh Ibadah, Fiqh Qadha (Islamic Hukm), General Fiqh and Usul Fiqh. Conclusion: It is clear that even though the participants were rather familiar with some of the existing Fatwas pertaining to ART and IVF in Malaysia, there are still remaining doubts which need to be clarified. This indicates that there are challenges faced in seeking and providing ART treatment to Muslim patients. This needs to be addressed perhaps in the form of Shari’aa-compliant guidelines to provide a clear explanation of each process and procedure in fertility treatment
Update on the Management of Diabetes during Ramadan Fast for Healthcare Practitioners
Get PDFFasting during the month of Ramadan is one of the five pillars of Islam, a recurring annual ritual, which is passionately practiced by most Muslims across the world. It is obligatory on every healthy Muslim; however, the Qur’an and Islamic teachings specifically exempt people with acute or chronic illnesses from this duty, especially if it might have harmful consequences. Muslims with diabetes are exempted from fasting, but many of them still fast during Ramadan, for their personal convictions as revealed by EPIDIAR study which showed that 43% of patients with type 1 diabetes and 79% with type 2 diabetes fasted during Ramadan. Muslims constitute about a quarter of the world’s population who are spread all over the globe. It is inevitable that health care issues peculiar to them will be encountered worldwide and health care providers will have to counsel them regarding medications and whether it is safe to undertake the fast. This paper is an update on the management of Ramadan fasting based on current evidence from published literature and expert opinions
Pharmacogenomics Based Practice in Malaysia: The Attitude, Knowledge and Adoption by the Healthcare Professionals
Get PDFIntroduction: Knowledge, attitude as well as adoption of pharmacogenomics in clinical practice among the pharmacists and physicians in Malaysia have not been reported. This cross-sectional study explores various facets of the two professions as related to pharmacogenomics to determine the need and preferred method to improve education among them. This study also aims to identify the current state of pharmacogenomics practice in Malaysia to help identify barrier and solution to reap advantages from pharmacogenomics practices. Methods: A questionnaire consisting of 38 questions in five parts was adopted and validated. It explores the respondents’ characteristics, attitude, knowledge, adoption and education. It was distributed online to 1500 pharmacists and physicians over five months. Results: Pharmacists differed from the physicians in terms of attitude, knowledge, adoption and education. Overall, adoption rate of pharmacogenomics was found to be low but its anticipation for future adoption is high, and benefits were reported by healthcare professionals who have used the test in a clinical setting. Majority of respondents had poor to fair knowledge and nearly half have had no prior formal teaching on pharmacogenomics. Interest in the education is very high, and most of them preferred to learn pharmacogenomics via continuous professional education programs. Conclusion: Pharmacogenomics is a field that promises many benefits, but to reap these benefits require its implementation in clinical setting. Pharmacists and physicians need to be equipped with adequate knowledge and positive attitude towards pharmacogenomics
Diagnostic Dilemma in Metaplastic Chondroid Breast Carcinoma
Get PDFMetaplastic breast cancer is a rare form of primary breast cancer. It contains a mixture of adenocarcinoma with metaplastic elements. It is important to differentiate with primary sarcoma of the breast which carries different treatment strategies and prognosis. A 55-year-old lady previously diagnosed to have a left breast cancer in the year 2000 and carcinoma of the endometrium in 2009, presented with a right breast lump. A trucut biopsy reported as an infiltrating ductal carcinoma with background of chondromyxoid and cartilagenous matrix, most probably metaplastic carcinoma. A wide local excision with sentinel lymph node biopsy was performed, and the final histology was consistent with metaplastic chondroid carcinoma of the breast with no evidence of metastsis. The surgery was followed by adjuvant radiotherapy and currently free from any recurrence. The diagnostic dilemma on this very rare condition is reviewed
Primary Fixation of AO Type-C Fracture of the Distal Radius with Volar Locking Plates. A Cross-Sectional Study of Patient Rated Outcomes at Hospital Tengku Ampuan Afzan
Get PDFIntroduction: This is a cross-sectional study of 37 patients with AO type C (complete intra-articular) fractures of the distal radius, evaluating the functional, anatomical, and patient rated outcomes one year after primary fixation with a volar locking plate. Methods: Functional outcomes were assessed based on the grip strength, and the range of motion of forearm and wrist. Anatomical outcomes were assessed based on the radial inclination, radial height, volar tilt, and articular step or gap. Patient rated outcome was measured with a Disability of arm, shoulder and hand (DASH) questionnaire. Results: One year after surgery, 24 (64%) patients achieved good and excellent anatomical results, and DASH scores were acceptable in 73% of patients. Most of the patients had achieved 80% of their grip strength. The mean DASH score of 12.3 was comparable with other studies. Grip strength, radial inclination and volar tilt had a significant correlation with the DASH score. Conclusion: Volar locking plates can be used to achieve optimal reduction in all three parameters in the treatment of AO type C fractures of the distal radius. Versatile fracture fragment reduction and angular stability enable rehabilitation hence obtaining good functional outcomes
Interleukin 6 and Interleukin 17a Enhance Proliferation and Differentiation of Murine Osteoblast and Human Foetal Osteoblast Cell Lines
Get PDFIntroduction: Cytokines have been gaining great focus due to their role in enhancing osseointegration as well as their potential in bone reconstruction. Osseointegration often faces complications in its compatibility with the implant due to rejection by the recipients own immune system. Therefore, extensive studies are being carried out to enhance osteoblast development to minimize such complication. The aim of this study was to determine the effect of different concentrations of Interleukin 6 (IL-6) and Interleukin 17a (IL-17A) in the proliferation and differentiation of murine and human osteoblasts. Methods: Various concentrations (5, 10, 25 and 50 ng/ml) of rIL-6 and rIL-17A were tested on both murine osteoblast (MC3T3-E1) and human feotal osteoblast (hFOB) cell lines using [3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium] (MTS) and alkaline phosphatise (ALP) assays. MTS was carried out at 24, 48, 72, 96 and 120 hours while ALP assay was done on day 1, 3, 7, 10 and 14. Results: MC3T3-E1 cells showed steadier proliferation and differentiation compared to hFOB. Both cell lines expressed responses in dose-dependent manner. The concentration of 10ng for IL-6 and IL-17A in the case of MC3T3-E1 cell line was found to be the most suitable for further studies. Conclusion: IL-6 and IL-17A enhance proliferation and ALP activity of both MC3T3-E1 and hFOB cell lines