Evaluation of Anti-Hyperlipidaemic Activity of a Mixture of Zinger officinale, Allium sativum, Citrus Lemon, Honey, and Malus domestica Vinegar (ZACAH) Extracts in Rats Fed with High Cholesterol Diet

@#Introduction: The incidence and complications of hyperlipidemia associated co-morbidities and mortalities are grossly increasing globally. Intervention with natural products preparation has been identified as an alternative for the management of hyperlipidaemia and its related cardiovascular complications. This study investigated the anti-hyperlipidaemic activities of a mixture of Zinger officinale, Allium sativum, Citrus lemon, honey, and Malus domestica vinegar (ZACAH) extracts in in Sprague Dawley (SD) rats fed with high cholesterol diet. Methods: Thirty-six male SD rats were randomly distributed into 6 groups, including normal chow diet-fed (NC), high cholesterol diet (HCD), HCD+ Simvastatin (standard drug) while the remaining three groups were fed with HCD + ZACAH extracts at different doses (1, 3 and 5mg/kg body weight) for 18 weeks. Simvastatin at 10 mg/kg of bodyweight was used as control. High-performance liquid chromatography (HPLC) was used to determine phenolic compounds present in ZACAH extracts, elastase inhibitory assay was determined using spectrometric with a substrate (N-Succ-(Ala)3-pnitroanilide (SANA) while 2,2-diphenyl-1-picrylhydrazyl (DPPH) was performed based by the method described by Blois, 1958. Results: In vitro; ZACAH extracts had oxygen radical absorbance capacity (ORAC) value of 2000 µmol TE/100 mL, total phenolic content (TPC) of 7537 ± 54.5%, DPPH free radical scavenging activity of 27.34 ± 2.71%, elastase inhibitory assay of 29.29 ± 1.65% and lipoxygenase inhibitory assay of 98.58 ± 1.42%. In vivo, ZACAH extracts showed decreased bodyweight, adipose tissue, improved lipid profiles and hepatic biochemical enzymes. Conclusion: These results suggested that ZACAH extracts supplementation improved hyperlipidaemia in SD rats and might be a promising adjuvant for the treatment of hyperlipidaemia.

Sleep quality and body weight status of Malaysian university students

@#Introduction: Inadequate sleep duration is a modifiable behaviour linked with body weight, yet limited is known on the role of sleep quality with body weight status among university students. The study aimed to determine sleep quality and its association with body weight status among university students. Methods: A crosssectional study was conducted among 240 university students (24.6% males, 75.4% females) with a mean age of 21.22±1.24 years. Subjects were recruited from four faculties of University Putra Malaysia (UPM). Information on socio-demographic, sleep quality and anthropometric measurements were collected. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, whereby a summation score from seven components yielded a global score on sleep quality, with higher scores indicating poor sleep quality. Results: Majority of subjects were Malay (79.2%) with a mean body mass index of 22.6kg/m2. A majority (61.3%) had normal body weight, with the prevalences of underweight (UW), overweight (OW), and obesity (OB) at 12.9%, 19.6% and 6.3%, respectively. The mean global PSQI score was 5.76±2.64, with half of the respondents (50.4%) experiencing poor sleep quality. OW-OB experienced poorer sleep quality (6.53±2.79, p=0.004) and longer sleep latency (1.34±0.10, p=0.008) relative to UW-NW. OB subjects had substantially more frequent sleep disturbances compared to non-OB subjects (1.53±0.64, p=0.012). Conclusion: Findings suggest that OW-OB students at university are at a greater risk of having reduced sleep quality with longer sleep latency and frequent sleep disturbances. There is a need for a wellness initiative to reduce the incidence of obesity while fostering healthier sleeping habits among university students.

Platelet Aggregation Pattern on Light Transmission Aggregometry Among Malaysian Healthy Individuals

@#Introduction: Platelet aggregation test using light transmission aggregometry (LTA) is considered as the gold standard for evaluation of platelet function. Variations of platelet aggregation had been reported in apparently healthy individuals whereby a normal cut–off value established locally is highly recommended. This study aims to determine the platelet aggregation pattern and the preliminary findings on reference values for multiple agonists–induced platelet aggregation among Malaysian healthy individuals in a single centre. Method: A total number of 63 informed consented healthy individuals consisted of Malay, Chinese and Indian were recruited among staff and blood donors at National Blood Centre, Kuala Lumpur. Platelet aggregation was measured using LTA against adenosine diphosphate 10 µM (ADP10), collagen 0.19 mg/mL (COL), ristocetin 1.5 mg/mL (RIS), arachidonic acid 1 mM (AA) and epinephrine 10 µM (EPI). Results were expressed as percent final aggregation (%FA). Reference values were calculated from mean±2SD. Results: Age, gender and ethnic groups had no significant effect on platelet aggregation. A variability of platelet aggregation response to EPI was observed among the healthy individuals. Ten of 33 respondents (30%) had impaired aggregation with <20% FA in response to EPI. The local population showed a slightly higher aggregation pattern in response to COL, RIS, AA and EPI (excluding non-responders) compared to manufacturer’s reference values. Conclusion: This study has provided a glimpse of the aggregation pattern of the local nationality showing considerable differences in the reference values from manufacturer’s; thus highlighting the need of establishing local reference values.

Secondary polycythaemia in a Malay girl with homozygous Hb Tak

Hb Tak is one of more than 200 high affinity haemoglobin variants reported worldwide. It resultsfrom the insertion of two nucleotides (AC) at the termination codon, between codon 146 and codon147 of the beta-globin gene [Beta 147 (+AC)]. Polycythaemia is the main clinical feature althoughaffected carriers are usually asymptomatic and do not require intervention. Several case studies inthis region have reported the co-inheritance of Hb Tak with Hb E, delta beta and beta thalassaemiawith one case of homozygous Hb Tak in a Thai boy. In this case report, a cluster of haemoglobinTak was found in a family of Malay ethnic origin. Cascade family screening was conducted whileinvestigating a 4-year old girl who presented with symptomatic polycythaemia. She had 2 previousHb analysis done, at 7-month and 2-year-old with the diagnosis of possible Hb Q Thailand andHomozygous Hb D, respectively. Both diagnosis did not fit her clinical presentations. She was plethoric,had reduced exercise tolerance as well as cardiomyopathy. Her parents were consanguineouslymarried and later diagnosed as asymptomatic carriers of Hb Tak. Consequently, re-analysis of thegirl’s blood sample revealed a homozygous state of Hb Tak. In conclusion, high oxygen affinityhaemoglobin like Hb Tak should be considered in the investigation of polycythaemic patients withabnormal Hb analyses. In this case, DNA analysis was crucial in determining the correct diagnosis.

Thrombosis At Unusual Sites in Reproductive Age Group-A Case Series

Thrombosis is one of the causes of morbidity and mortality in women of reproductive age group. Thrombosis at unusual sites may pose diagnostic and management dilemma for health care personnel. Teamwork and good communication provide the best modalities for maximum benefits to patients. Here with, we presented case a series of thrombosis at unusual sites seen and managed in our clinic. A 35 year-old Malay lady presented with left hemiparesis while she was on oestrogen based combined contraception pills (C-OCP). Imaging studies showed extensive venous thrombosis with bilateral acute cortical infarct. Thrombophilia screening of antiphospholipid syndrome were negative. She was put on anticoagulant and stopped 2 years after the incident. A 40 year-old Malay lady presented with abdominal discomfort, lethargy and massive splenomegaly. Bone marrow and trephine examination revealed primary myelofibrosis with positive JAK2617F. Imaging study showed chronic portal vein thrombosis with portal vein hypertension, complicated by gastro-oesophageal varices. She was put on hydroxyurea and later started on ruxolitinib with banding done over her gastro-oesophageal varices. A 26 year-old Malay lady presented with serositis, mouth ulcer and anaemia symptoms. Laboratory studies were positive for systemic lupus erythematosus and negative for antiphospholipid study. Imaging study showed long segment thrombosis of right internal jugular vein with surrounding subcutaneous oedema. She is currently stable on anticoagulants and steroid. Teamwork and holistic approach is practiced in the investigation and management to provide maximum benefits for patients.

Candida isolates from pregnant women and their antifungal susceptibility in a Malaysian tertiary-care hospital

Objective: Pregnant women are susceptible to vaginal colonization and infection by yeast. The purpose of the study was to determine the prevalence of Candida spp in high vaginal swabs of pregnant women and their antifungal susceptibility. Methods: High vaginal swab samples received from Serdang Hospital, Selangor, Malaysia during 2011 initially had microscopic examination, Gram-staining and fungal culture. These were finally confirmed by growth in chromogenic medium [CHROMagarCandida; Difco BBL, USA] and commercial biochemical identification kit [API 20C AUX; bioMérieux, Lyon, France]. Antifungal susceptibility was performed by E-test method. Results: Out of 1163 specimens 200 [17.2%] candida spp were confirmed from high vaginal swabs of pregnant women. Candida albicans [83.5%] is the most common species detected followed by Candida glabrata [16%] and Candida famata [0.05%]. All C.albicans and C.famata isolates were susceptible to fluconazole while C.glabrata isolates were dose dependent susceptibility. First and second trimester, and diabetes were considered significant factors in patients for the vaginal candidiasis [p < 0.001]. Conclusions: In pregnant women, C. albicans was the frequently isolated yeast from high vaginal swabs. Routine screening and treatment are important of pregnant women regardless of symptoms

Qualitative Flow Cytometric Analysis of Malaysian Myelodysplastic Syndromes (MDS) Patients

Myelodysplastic syndromes (MDS) are a group of haematological malignancies categorized by ineffective hematopoiesis that result in dysplasia. Although morphological diagnosis is a traditional and standard technique that is used for the diagnosis of MDS, the heterogeneous blood and bone marrow characteristics of MDS patients can potentially obscure the right diagnosis. Thus, we have utilized flow cytometric immunophenotyping as a supportive mechanism to obtain a more accurate and faster method for detection of abnormal markers in MDS. Flow cytometry was used for analyzing bone marrow samples from newly diagnosed MDS patients to investigate the abnormal antigen expression patterns in granulocytic, monocytic, erythroid, lymphoid lineages and myeloid precursors. The results were compared with those obtained from cases that had Idiopathic Thrombocytopenic Purpura (ITP) as a control. The most common abnormality found in the granulocytic lineage was the decrease of CD10. Low expressions of CD13 were the most frequent abnormality in the monocytic lineage. The erythroid lineage was found to have low expression of CD235A+/CD71+, reduce of CD71and decreased CD235a. In conclusion, this method is useful for confirming cases in which it is difficult to make a diagnosis by morphology.