IIUM Medical Journal Malaysia (IMJM)
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Antidiabetic Effects of Coffee Enriched with Maca and Marine Collagen Peptide (Blackbelt®) in a Type 2 Diabetes Mellitus Rat Model
Full text linkINTRODUCTION: The International Diabetes Federation (IDF) reported 463 million global cases of Type 2 diabetes mellitus (T2DM) in 2019. Lepidium meyenii (maca) and marine collagen peptide (MCP) have individually shown potential in alleviating T2DM symptoms, but their combined effects remain underexplored. This study evaluated the impact of Blackbelt® coffee, enriched with maca and MCP, on fasting blood glucose, insulin levels, and pancreatic and liver histology in a T2DM rat model. MATERIALS AND METHODS: Thirty-six male rats with a high-fat diet and streptozotocin-induced diabetes were treated with metformin, maca, MCP, Maca/MCP® (Blackbelt® formulation), or Blackbelt® coffee for 28 days. Fasting blood glucose (FBG) levels were monitored, and fasting serum insulin, HOMA-IR (insulin resistance), HOMA-B (ß-cell function), and QUICKI (insulin sensitivity) were assessed. Histological analysis of the pancreas and liver was performed using haematoxylin-eosin staining. RESULTS: After 4 weeks, treatments significantly reduced FBG levels compared to control (p<0.05), with Blackbelt® coffee notably increasing insulin production (p<0.05). All groups showed decreased HOMA-IR (p<0.05), and both metformin and Blackbelt® coffee groups had significant HOMA-B score increases (p<0.05). Histological analysis revealed improved pancreatic health in all treated groups, with significant liver histology enhancement in the Blackbelt® coffee group. CONCLUSIONS: Blackbelt® coffee improved FBG levels, insulin resistance, and ß-cell function more effectively than maca or MCP alone, and surpassed metformin in insulin production and hepatoprotective effects. Despite its promising potential for diabetes therapy, further research is needed to understand the synergistic effects of maca and MCP and the contribution of the coffee components
A Rare Complex Pleural Effusion in Post Trauma Patient: A Case Report
Full text linkPleural effusion is common in routine medical practice and can be due to many different underlying diseases including infections, malignancy, connective tissue disease, heart failure and liver failure. However, a complex pleural effusion such as post-traumatic pleural effusion (PTPE) is an uncommon clinical entity. A precise diagnosis of PTPE can be facilitated by the efficient use of computed tomography (CT) and ultrasound. The PTPE may be successfully managed by pigtail drainage and intrapleural fibrinolysis (IPF), highlighting the significance of prompt intervention in attaining favorable results for patients with PTPE.
Hepatoprotective Effects and Testicular Toxicity of Centella asiatica L. Aqueous Extract in Diabetic Rats
Full text linkINTRODUCTION: Centella asiatica has been widely studied as an herbal substitute for treating diabetes mellitus (DM). This study aimed to investigate the effects of C. asiatica on the liver and testes in a rat model of type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Forty adult male Sprague-Dawley rats were induced with diabetes using a single intraperitoneal injection of streptozotocin-nicotinamide (STZ-NA). Three days after induction of diabetes, the rats were treated with either 250 or 500 mg/kg body weight/day of C. asiatica aqueous extract (CAAE) for 48 days. Serum, liver, and testes were collected for analysis. Parameters measured included fasting blood glucose (FBG), body and organ weights, gonadosomatic and hepatosomatic index, testicular steroidogenesis activity (HSD17B3, testosterone levels, sperm count), and liver biochemical markers. Additionally, antioxidant and lipid peroxidation levels, together with sperm count were assessed in the liver and testes respectively. RESULTS: CAAE treatment improved FBG levels and mitigated weight loss in the STZ-NA group. Oxidative stress markers were ameliorated in both organs after CAAE treatment. Liver serum biochemical markers showed improvement, while testicular steroidogenic function declined. Sperm count decreased compared to the STZ-NA group. CONCLUSION: CAAE ameliorates hyperglycaemia and oxidative stress in the liver and testes but may cause testicular dysfunction in DM. In conclusion, the study demonstrated that C. asiatica is able to reverse STZ-NA-induced oxidative stress and hyperglycaemia but exacerbates testicular dysfunction. evaluate our study outcome
Locked Anterior Hip Dislocation with Ipsilateral Greater Trochanteric Fracture and Common Femoral Artery Compression: A Rare Case Report
Full text linkWe report a rare case of post-traumatic anterior hip dislocation with ipsilateral greater trochanteric fracture and compression of the common femoral artery. To our knowledge, this is the first report that highlights a rare pubic anterior dislocation with greater trochanter fracture complicated with a pale, pulseless limb. Additionally, after two unsuccessful closed manipulative reduction (CMR) attempts, an urgent open reduction was performed, which resulted in an immediate recovery of the distal circulation. We emphasize the need for urgent open reduction following failed CMR. A delayed open reduction that was carried out 12 hours after the injury may have contributed to the surgical site infection, avascular necrosis, and heterotopic ossification that developed in our case
Optimizing Antibiotic Dosing: A Prospective Observational Study of Piperacillin/Tazobactam Plasma Levels in Critically Ill Patients with Augmented Renal Clearance
Full text linkINTRODUCTION: Managing antibiotic dosing in critically ill patients presents challenges especially in achieving optimal therapeutic levels. Thus, we conducted a study to evaluate how augmented renal clearance (ARC) affects the attainment of pharmacokinetic/pharmacodynamic (PK/PD) targets in patients receiving piperacillin/ tazobactam (PTZ) via continuous infusion. MATERIALS AND METHODS: A single centred, prospective, observational study was conducted in intensive care unit at Sultan Ahmad Shah Medical Center @IIUM, Kuantan Pahang. A total of 43 adult patients with normal renal function treated as sepsis with standard PTZ doses via continuous infusion were included for the study and their blood were sampled for assessment of drug concentrations and PK/PD target attainment. RESULTS: There was substantial PK variability with 60% diagnosed with ARC and 37.2% of experienced piperacillin underexposure in which patients with ARC had significantly higher rates of underexposure at both distribution and steady-state phases. CONCLUSION: The high prevalence of ARC in these patients impacted the therapeutic PTZ levels and as many patients did not reach desired drug concentrations, there is increased risk of treatment failure without dose adjustment. These findings underscore the importance of individualized dosing strategies, particularly in critically ill patients with ARC, to optimize antibiotic therapy efficacy and mitigate the risk of inadequate treatment.
Job Satisfaction among Medical Officers in a University Hospital: A Qualitative Study
Full text linkINTRODUCTION: Job satisfaction among medical officers (MOs) in university hospitals is crucial for both healthcare delivery and medical education. High job satisfaction is linked to improved productivity and mental well-being, while dissatisfaction can lead to errors, lower patient satisfaction, and higher employee turnover. Although many studies have examined job satisfaction in Malaysian healthcare settings, most have focused on public hospitals. This qualitative study aimed to explore the experiences of MOs actively working in a Malaysian university hospital to gain a better understanding into the factors influencing their job satisfaction. MATERIALS & METHODS: Using a phenomenological approach, 18 MOs were interviewed through semi-structured, in-depth interviews. The interviews were audio-recorded, transcribed verbatim, and analysed using thematic analysis. Guided by Herzberg’s Two-Factor Theory, we explored motivators and dissatisfiers in the MOs' work environment. RESULTS: Four main themes emerged: (1) enjoyment in patient care including aspects of diagnosing, treating, and communicating with patients, (2) personal fulfilment in relations to family time and educational responsibilities, (3) positive work culture comprising of teamwork and hospital facilities, and (4) distress related to hospital systems, salary, and career advancement. CONCLUSION: This study elucidated how different factors contribute to job satisfaction and dissatisfaction among service and postgraduate MOs. These findings underscore the need for targeted strategies by hospital management and policymakers to address these dynamics, in order to sustain a motivated medical workforce in university hospitals
Injury Prevention Program among Athletes in Malaysia: A Systematic Review
Full text linkSport is responsible for the significant occurrence of acute and overuse injuries among athletes. The injuries during sport can result in long-term negative consequences that reduces the performance of sports. The burden of sport-related injuries is substantial, and there is a lack of studies assessing the effectiveness of injury prevention strategies. To date, cumulative information regarding injury prevention strategies is limited in Malaysia. This study aims to identify the characteristics of injury prevention programs among athletes in Malaysia. This research was systematically conducted utilising the electronic databases of Web of Science (WoS), Scopus, ClinicalKey, Cochrane Library, PubMed, SPORTDiscus, and Google Scholar. Two reviewers, MIS and HAY, independently selected articles based on the established inclusion criteria from 1st January 2015 to 31st December 2024. The study followed PRISMA guidelines and was registered with PROSPERO under registration number CRD42024513383.Nine eligible papers were included in the study and scored at least five points on the 11-point checklist of the CASP appraisal tool. Injury prevention programs, including neuromuscular training and sport-specific interventions, enhance strength, flexibility, and balance, reducing injury risk among athletes. It is recommended that injury prevention programs be adopted in every sport, especially during warm-up periods of training sessions. Future research should focus on individualised programs and technology for real-time feedback injury prevention strategies
Antiaging activities of Muntingia calabura Leaf Aqueous Extracts (MCE) on Testicular Histology, Spermatogenic Proliferation, and Testosterone Level of D-Galactose-Induced Mice Model
Full text linkINTRODUCTION: Male aging may disrupt spermatogenesis and induce intratesticular redox imbalance, leading to testicular damage. Muntingia calabura leaf extracts (MCE) have potent antioxidant activity, but in vivo reports in the male reproductive system aging are limited. This research aimed to determine the effects of MCE on testicular histology and testosterone levels in the D-galactose-induced aging mice model. MATERIALS AND METHODS: Plasma and testicular tissue obtained from 20 male Mus musculus strain Balb/C which were divided into 5 groups: normal; aging; aging+ Muntingia calabura leaf aqueous extracts (MCE) 35 mg/kg; aging+MCE 70 mg/kg; and aging+vitamin C 28 mg/kg. Treatments were scheduled orally for 4 weeks; aging condition was induced using oral 500 mg/kg D-galactose for 6 weeks before treatments. Plasma testosterone was determined using ELISA, seminiferous tubules’ diameter, spermatogenesis score, and Leydig cell number were examined with routine staining, and the nuclear expression of Ki-67 was performed via immunohistochemistry. RESULTS: The MCE-treated aging group had higher seminiferous tubules’ diameter, spermatogenesis score, Leydig cells’ number, and percentage of cells expressing Ki-67 compared with the untreated group (p < 0.005), and the optimum dose was 70 mg/kg. However, testosterone levels of the MCE group did not significantly differ from those of others. CONCLUSION: Administration of MCE in D-galactose-induced aged mice improved seminiferous tubule diameter, spermatogenesis score, Leydig cells’ count, and spermatogenic cell proliferation, but not testosterone level
The Practice of Primary Eye Care by Optometrists Worldwide - A Systematic Literature Review
Full text linkPrimary eye care involves detecting and managing conditions that cause preventable blindness, as well as diagnosing and treating eye diseases. Optometrists play a central role in primary eye care, yet their scope of practice and challenges vary globally. This systematic review was conducted to examine the roles, scope and challenges faced by optometrists in their practices. The systematic search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a registered review protocol. An electronic search of PUBMED, PubMed Central (PMC), Scopus, EBSCO, OVID, and Web of Science (WoS) was conducted between February and September 2022. Two reviewers independently screened and extracted eligible studies. Eleven publications met the inclusion criteria; 10 cross-sectional studies and one retrospective study. Extracted data focused on structural aspects of care delivery, including instrumentation, procedures, services, management, referral pathways, and training. The scope of practice varied widely, ranging from refraction to advanced clinical management, including therapeutic interventions. Standards of optometric practice in several settings extended well beyond refraction and dispensing, incorporating disease management and collaborative care. Optometrists are capable of delivering comprehensive primary eye care that extends beyond basic refractive services. Harmonising educational standards and implementing enabling policies can empower optometrists to work to the full extent of their training, thereby improving access to eye care services and reducing strain on general healthcare systems
Effects of Sauropus androgynus Extract on Cognitive Function Improvement and Neuron Enhancement in Trimethyltin Chloride-Induced Rats
Full text linkINTRODUCTION: Trimethyltin chloride is a compound utilized for inducing neurotoxicity.This study is to examine effects of Sauropus androgynus (SA) on cognitive function, Bax expression, neuronal number in the hippocampus and prefrontal cortex of rats induced TMT. MATERIALS AND METHODS: This is experimental study. Its subjects were 25 males of Rattus norvegicus. The subjects were divided into five groups: group K1 (no treatment), group K2 (TMT-induced), and groups of K3, K4, and K5 (TMT-induced with ethanol extract of SA at doses of 75, 150, and 300 mg/kg body weight respectively). The TMT at a dose of 6 mg/kg body weight. Cognitive function was measured by using the Y-maze spontaneous alternation test. Brain tissue was collected for histological preparations by using toluidine blue staining and immunohistochemistry with Bax antibody. Then microscopic observations were performed to count the number of neurons and Bax expression. RESULTS: The percentage of alternation in the SA extract groups (K3, K4, K5) was higher than that in the TMT group (K2). The number of neurons in the CA1 area of the hippocampus, dentate gyrus, and prefrontal cortex in the three groups (K3, K4, and K5) was higher than that in group K2. The expression of Bax in groups of K4 and K5 was lower than that in group K2. CONCLUSION: The SA extract could improve the memory function, inhibit the Bax expression, and increase the number of neurons in the CA1 area of the hippocampus, dentate gyrus, and prefrontal cortex in the rats induced with neurotoxicity using TMT